bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the Counselors and Psychotherapists Perceptions of Therapeutic Errors in the Treatment Room
Authors: Abbaz Yazdian Farnaz , Khodabakhshi-Koolaee Anahita
Published: May 2024

A therapeutic error as a multifactorial phenomenon in psychotherapy and counseling is an action and behavior that is committed by the therapist and leads to treatment failure or client dissatisfaction with the treatment process. Thus, the treatment method deviates from the intended practical and scientific techniques. To this end, the present study aimed to identify the counselor’s perceptions of therapeutic errors in the treatment room. This qualitative study was conducted using conventional content analysis. The data were collected through in-depth and semi-structured interviews with counselors and psychotropics with at least 3 years of experience in psychotherapy and counseling in various fields. They were selected through purposive sampling in 2021 in Tehran. The data were saturated by interviewing 24 counselors and psychotherapists and analyzed by the content analysis approach. The findings showed that therapeutic errors occur for different reasons and in various forms and involve different aspects of the therapist-client interaction. The most important therapeutic errors were intrapersonal and organizational errors including; treatment errors, lack of practicality of the treatment, the therapist’s errors, mistakes committed due to the treatment space, non-compliance with ethical principles and standards, and not informing the clients. The occurrence of these errors and mistakes in the treatment session leads to the abandonment of the session by clients, negative experiences invoked by treatment sessions, and most importantly damage to clients and a range of negative consequences. The findings of this study can have some implications for understanding various forms of treatment errors, preventing errors in treatment sessions, and avoiding harm to clients in treatment sessions.
Trait-based Imitation of CSR: The Moderating Effect of Corporate Image Advertising
Authors: Park Sung-Yun , Yoon Woojin
Published: May 2024

This study investigates the determinants of corporate social responsibility (CSR) in the Korea Composite Stock Price Index (KOSPI) listed firms based on the theoretical arguments of trait-based imitation in uncertainty. This study assumes that an organization’s decision-making occurs under bounded rationality and acquires social legitimacy by past behavior or by imitating other organizations to reduce uncertainty. We used an unbalanced panel data of 6,364 observations from 464 firms from 2000 to 2019 using KIS Value, TS2000, and disclosed business reports to test our research hypotheses. The fixed-effects model results for the unbalanced panel data are as follows:

Firms that had been active in CSR in the past tended to participate more actively in CSR. Also, firms execute CSR more actively if other firms with similar status show a high level of CSR. These results reveal that firms imitate corporate decision-making in their experience or similar-status firms’ activities. In addition, corporate image advertising positively moderates the relationship between the organization’s CSR and those of companies in similar positions.

This study has significance in that it further expanded the scope of theoretical explanation by introducing the theoretical argument that CSR is an act of decision-making in uncertainties and trait-based imitation made under bounded rationality. Furthermore, this study provides an empirical basis for further research on CSR by determining the variables that induce CSR.
Building Critical AI Literacy in the Business Communication Classroom
Authors: DeVasto Danielle , Palmer Zsuzsanna
Published: May 2024

The public release of ChatGPT in 2022 ushered in a new era, affirming the present reality of AI-assisted writing and the critical role business instructors play in preparing students. This study presents the results of a pedagogical experiment. Specifically, it evaluates strategies for integrating and teaching about AI in the business communication classroom, focusing on the impact of generative AI on students’ understanding of business writing principles and how different levels of engagement with AI influence students’ critical AI literacy and attitudes toward AI-assisted writing in the workplace.
Politics of Boundary Consolidation: Income Inequality, Ethnonationalism, and Radical-Right Voting
Authors: Lukk Martin
Published: May 2024

Scholars have linked income inequality to the recent success of radical-right parties and movements. Yet research shows that inequality reduces participation among groups likely to support the radical right and promotes support for redistribution, an issue championed by the radical left. This raises questions about why, if at all, inequality matters for radical-right politics. The author reconciles previous arguments by developing a theory that connects these phenomena through the process of boundary consolidation. He argues that inequality generates status threats that prompt exclusionary shifts in national group boundaries. This promotes ethnonationalism, a restrictive conception of national membership and, ultimately, support for the radical right, whose mobilization relies on ethnonationalist appeals. Analyses of time-series cross-sectional data from 38 countries support this theory, revealing that inequality is associated with greater ethnonationalism, with distinct associations by income and ethnicity, and that ethnonationalism strongly predicts radical-right voting. The author thus demonstrates how long-term structural changes are linked to contemporary radical politics and how arguments setting economic and cultural causes of the radical right in opposition are inadequate.
Book review: Dhananjay Rai, Contested Representation: Dalits, Popular Hindi Cinema, and Public Sphere
Authors: Jyotasana
Published: May 2024

Dhananjay Rai, Contested Representation: Dalits, Popular Hindi Cinema, and Public Sphere (London: Rowman & Littlefield, 2022). 268 pp., ₹9,675 (hardback). ISBN: 978-1-66690-133-7.
Positive Outcomes in Isolated and Syndromic Pierre Robin Sequence Infants Treated with Mandibular Distraction Osteogenesis: A Single Surgeon’s Experience
Authors: Braswell Ann Carol , Wagner Grant P. , Bald Madeline P. , Soto Edgar , Robin Nathaniel H. , Smola Cassi , Myers René P.
Published: May 2024

Background:

Pierre Robin Sequence (PRS) presents in isolation [iPRS] or in conjunction with a genetic syndrome [sPRS] that can subsequently lead to respiratory dysfunction and eventual failure to thrive. Mandibular distraction osteogenesis (MDO) has gained popularity as a way to surgically address the airway obstruction in PRS. sPRS patients routinely have a more challenging clinical course, and there is a paucity of data comparing the effectiveness of MDO as a treatment for sPRS versus iPRS. That said, this study analyzed MDO in both sPRS and iPRS patients within a relatively large single institution cohort.

Methods:

A retrospective review was conducted on all PRS patients who underwent MDO by a single surgeon between 2015 and 2022. The patients were stratified into iPRS or sPRS based on genetic evaluation (N = 50). Primary measures were demographic and situational data; outcome measures included tracheostomy and gastrostomy tube (g-tube) avoidance, Apnea-Hypoxia Index (AHI), and laryngeal view predistraction and at time of distractor removal.

Results:

Prior to distraction, iPRS (N = 32) and sPRS (N = 18) patients showed no significant differences in age (105.1 ± 199.7 days; range 2-1051 days), AHI (17.3 ± 17.1; range 3.6-90), or laryngeal view (65% grade III or IV) ( P > .05). Overall, post-MDO, there was a statistically significant decrease in mean AHI 17.3 to 4.5 ( P < .001). sPRS patients in particular had a significant decrease in average AHI following MDO from 15.2 to 4.5 ( P = .028). Post-MDO both groups had similar improvement of laryngeal view, and avoidance of g-tube ( P < .05).

Conclusions:

MDO was found to be an effective technique to improve airway obstruction in both sPRS and iPRS. Despite the fact that sPRS patients typically have a more challenging clinical course, an equivalent clinical improvement in airway outcomes was seen between sPRS and iPRS patients post-MDO.
Self-reported removal and expulsion of the dapivirine vaginal ring: qualitative reports from female ring users and their male partners in the Ring Study (IPM 027)
Authors: Milford Cecilia , Ramlal Hariska , Mofokeng Rorisang , Rambally Greener Letitia , Nel Annaléne , Smit Jennifer , Malherbe Mariëtte
Published: May 2024

Background/aims

The dapivirine vaginal ring is a self-administered, women-initiated, discreet, long-acting HIV-1 prevention option for women. It was found to be safe and effective in healthy HIV-negative women who adhered to product use instructions, and has been approved for use in women aged 18 and older in some African countries. A qualitative study was conducted to explore participants’ and their male partners’ discussions on accidental/purposeful vaginal ring removals during The Ring Study (IPM 027 clinical trial).

Methods

Data were collected via in-depth interviews and focus group discussions with female trial participants and their male partners, from seven research centres in South Africa and Uganda. Data were thematically analysed using NVivo.

Results

More participants reported purposeful ring removals than accidental expulsions. Various factors influenced purposeful ring removal – including individual (discomfort during use/sex and to clean it), partner (to show them, because of discomfort during sex, to test if partners could feel it, and concerns of harm), organisational (doctor’s request), and socio-cultural (rumours about sickness and infertility). Some described their own ring use removal, others discussed why other participants removed their rings.

Conclusions

Vaginal ring adherence is critical to improve and support product efficacy. Counselling on vaginal anatomy, vaginal ring insertion and importance of adherence is important to minimise vaginal ring removal. Couples counselling is also important to facilitate support and long-term vaginal ring adherence behaviour. Understanding factors influencing vaginal ring adherence is important for tailoring and targeting messages to support correct and consistent vaginal ring use as it is made available to the public.
Morphological features of the acetabulum with coxa profunda in women: a retrospective observational study
Authors: Kato Michitaka , Ando Takanori , Mitamura Shingo
Published: May 2024

Background

The morphology of coxa profunda remains inadequately understood. However, knowledge about the characteristics of the acetabulum in coxa profunda can help to predict pelvic morphology in three dimensions based on radiographic findings, as well as help to diagnose and predict hip pathologies. Therefore, this study aimed to investigate the relationship between the morphological characteristics of the pelvis and coxa profunda.

Methods

We conducted a retrospective analysis including women who had undergone unilateral total hip arthroplasty. Only those with normal hip joint morphology on the opposite side, as evidenced by anteroposterior pelvic radiography showing a distance of ≥ 2 mm between the ilioischial line and acetabular floor, were included. Five parameters related to acetabular anteversion, thickness, and the position of the ilioischial line were measured using axial computed tomography at the central hip joint. The coxa profunda group (n = 39) and control group (n = 34) were compared.

Results

The mean acetabular anteversion angle was 12.5° ± 4° in the control group and 22.3° ± 5.6° in the coxa profunda group. The mean thickness from the acetabular fossa to the medial wall was 7.5 ± 1.7 mm in the control group and 3.9 ± 1.2 mm in the coxa profunda group. Furthermore, the bony region representing the ilioischial line was positioned more posteriorly in the coxa profunda group than it was in the control group.

Conclusion

Our findings suggest that coxa profunda in women is associated with anterior acetabular dysplasia and a thin acetabulum, in contrast to previous interpretations of excessive coverage. This insight suggests a conversion of coxa profunda from a finding of pincer-type femoroacetabular impingement to a finding of acetabular dysplasia, a revelation that also draws attention to cup positioning for total hip arthroplasty.
Women escaping domestic violence to achieve safe housing: an integrative review
Authors: Stulz Virginia , Francis Lyn , Naidu Anshu , O’Reilly Rebecca
Published: May 2024

Background

This integrative review summarises original research that explores women’s experiences of escaping domestic violence to achieve safe housing.

Methods

Integrative review. A robust search strategy was conducted using the following databases: Scopus, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane, Medline and PubMed. All articles were assessed for quality using the Mixed Methods Appraisal Tools (MMAT) scoring. Whittemore and Knafl’s (2005) five stage approach was used to analyse the primary literature related to women’s and stakeholders’ experiences of escaping domestic violence to achieve safe housing.

Results

A total of 41 articles were retrieved and 12 papers were included in this review (six qualitative, one quantitative and five mixed methods) that fulfilled the inclusion criteria. Four overarching themes were identified: ‘Experiences of leaving domestic violence’, ‘Barriers to achieving safe housing’, ‘Facilitators to achieving safe housing’ and ‘The road to recovery’. The ‘Experiences of leaving domestic violence’ theme included two subthemes: ‘the losses’ and ‘ongoing contact with the perpetrator’. The ‘Barriers to achieving safe housing’ theme included three subthemes: ‘financial insecurity’, ‘being judged by others for leaving and service availability’. The ‘Facilitators to achieving safe housing’ theme included two sub-themes: ‘support, partnership, and collaboration between women and service providers’ and ‘feeling respected and heard’. The ‘Road to recovery’ theme included two sub-themes: ‘being a good mother’ and ‘empowerment after leaving domestic violence’.

Conclusions

This review has highlighted the need for service and health care providers to work together and collaborate effectively with the woman experiencing and escaping domestic violence, especially in rural and remote areas. This means giving women access to the most suitable educational resources and services that are appropriate for their unique situation. Tailoring support for women is crucial to enable women to achieve safe housing and to be able to live a safe life with their children, away from the perpetrator of the domestic violence.
The effect of inhaler prescription on the development of lung cancer in COPD: a nationwide population-based study
Authors: Park Ji Eun , Lee Eunyoung , Singh Dave , Kim Eun Kyung , Park Bumhee , Park Joo Hun
Published: May 2024

Background

COPD is associated with the development of lung cancer. A protective effect of inhaled corticosteroids (ICS) on lung cancer is still controversial. Hence, this study investigated the development of lung cancer according to inhaler prescription and comorbidties in COPD.

Methods

A retrospective cohort study was conducted based on the Korean Health Insurance Review and Assessment Service database. The development of lung cancer was investigated from the index date to December 31, 2020. This cohort included COPD patients (≥ 40 years) with new prescription of inhalers. Patients with a previous history of any cancer during screening period or a switch of inhaler after the index date were excluded.

Results

Of the 63,442 eligible patients, 39,588 patients (62.4%) were in the long-acting muscarinic antagonist (LAMA) and long-acting β2-agonist (LABA) group, 22,718 (35.8%) in the ICS/LABA group, and 1,136 (1.8%) in the LABA group. Multivariate analysis showed no significant difference in the development of lung cancer according to inhaler prescription. Multivariate analysis, adjusted for age, sex, and significant factors in the univariate analysis, demonstrated that diffuse interstitial lung disease (DILD) (HR = 2.68; 95%CI = 1.86–3.85), a higher Charlson Comorbidity Index score (HR = 1.05; 95%CI = 1.01–1.08), and two or more hospitalizations during screening period (HR = 1.19; 95%CI = 1.01–1.39), along with older age and male sex, were independently associated with the development of lung cancer.

Conclusion

Our data suggest that the development of lung cancer is not independently associated with inhaler prescription, but with coexisting DILD, a higher Charlson Comorbidity Index score, and frequent hospitalization.
Triglyceride-glucose index is associated with myocardial ischemia and poor prognosis in patients with ischemia and no obstructive coronary artery disease
Authors: Zhang Wen , Liu Lu , Yin Guoqing , Mohammed Abdul-Quddus , Xiang Lanqing , Lv Xian , Shi Tingting , Galip Jassur , Wang Chunyue , Mohammed Ayman A. , Mareai Redhwan M. , Yu Fei , Abdu Fuad A. , Che Wenliang
Published: May 2024

Background

Ischemia and no obstructive coronary artery disease (INOCA) is increasingly recognized and associated with poor outcomes. The triglyceride-glucose (TyG) index is a reliable alternative measure of insulin resistance significantly linked to cardiovascular disease and adverse prognosis. We investigated the association between the TyG index and myocardial ischemia and the prognosis in INOCA patients.

Methods

INOCA patients who underwent both coronary angiography and myocardial perfusion imaging (MPI) were included consecutively. All participants were divided into three groups according to TyG tertiles (T1, T2, and T3). Abnormal MPI for myocardial ischemia in individual coronary territories was defined as summed stress score (SSS) ≥ 4 and summed difference score (SDS) ≥ 2. SSS refers to the sum of all defects in the stress images, and SDS is the difference of the sum of all defects between the rest images and stress images. All patients were followed up for major adverse cardiac events (MACE).

Results

Among 332 INOCA patients, 113 (34.0%) had abnormal MPI. Patients with higher TyG index had a higher rate of abnormal MPI (25.5% vs. 32.4% vs. 44.1%; p = 0.012). Multivariate logistic analysis showed that a high TyG index was significantly correlated with abnormal MPI in INOCA patients (OR, 1.901; 95% CI, 1.045–3.458; P = 0.035). During the median 35 months of follow-up, 83 (25%) MACE were recorded, and a higher incidence of MACE was observed in the T3 group (T3 vs. T2 vs. T1: 36.9% vs. 21.6% vs. 16.4%, respectively; p = 0.001). In multivariate Cox regression analysis, the T3 group was significantly associated with the risk of MACE compared to the T1 group (HR, 2.338; 95% CI 1.253–4.364, P = 0.008).

Conclusion

This study indicates for the first time that the TyG index is significantly associated with myocardial ischemia and poor prognosis among INOCA patients.
The limitless endophytes: their role as antifungal agents against top priority pathogens
Authors: Moussa Ashaimaa Y.
Published: May 2024

Multi resistant fungi are on the rise, and our arsenal compounds are limited to few choices in the market such as polyenes, pyrimidine analogs, azoles, allylamines, and echinocandins. Although each of these drugs featured a unique mechanism, antifungal resistant strains did emerge and continued to arise against them worldwide. Moreover, the genetic variation between fungi and their host humans is small, which leads to significant challenges in new antifungal drug discovery. Endophytes are still an underexplored source of bioactive secondary metabolites. Many studies were conducted to isolate and screen endophytic pure compounds with efficacy against resistant yeasts and fungi; especially, Candida albicans, C. auris, Cryptococcus neoformans and Aspergillus fumigatus, which encouraged writing this review to critically analyze the chemical nature, potency, and fungal source of the isolated endophytic compounds as well as their novelty features and SAR when possible. Herein, we report a comprehensive list of around 320 assayed antifungal compounds against Candida albicans, C. auris, Cryptococcus neoformans and Aspergillus fumigatus in the period 1980–2024, the majority of which were isolated from fungi of orders Eurotiales and Hypocreales associated with terrestrial plants, probably due to the ease of laboratory cultivation of these strains. 46% of the reviewed compounds were active against C. albicans, 23% against C. neoformans, 29% against A. fumigatus and only 2% against C. auris. Coculturing was proved to be an effective technique to induce cryptic metabolites absent in other axenic cultures or host extract cultures, with Irperide as the most promising compounds MIC value 1 μg/mL. C. auris was susceptible to only persephacin and rubiginosin C. The latter showed potent inhibition against this recalcitrant strain in a non-fungicide way, which unveils the potential of fungal biofilm inhibition. Further development of culturing techniques and activation of silent metabolic pathways would be favorable to inspire the search for novel bioactive antifungals.

Graphic abstract
N6-methyladenosine-modified SENP1, identified by IGF2BP3, is a novel molecular marker in acute myeloid leukemia and aggravates progression by activating AKT signal via de-SUMOylating HDAC2
Authors: Wen Diguang , Xiao Hang , Gao Yueyi , Zeng Hanqing , Deng Jianchuan
Published: May 2024

Background

Elevated evidence suggests that the SENPs family plays an important role in tumor progression. However, the role of SENPs in AML remains unclear.

Methods

We evaluated the expression pattern of SENP1 based on RNA sequencing data obtained from OHSU, TCGA, TARGET, and MILE datasets. Clinical samples were used to verify the expression of SENP1 in the AML cells. Lentiviral vectors shRNA and sgRNA were used to intervene in SENP1 expression in AML cells, and the effects of SENP1 on AML proliferation and anti-apoptosis were detected using in vitro and in vivo models. Chip-qPCR, MERIP-qPCR, CO-IP, RNA pulldown, and dual-luciferase reporter gene assays were used to explore the regulatory mechanisms of SNEP1 in AML.

Results

SENP1 was significantly upregulated in high-risk AML patients and closely related to poor prognosis. The AKT/mTOR signaling pathway is a key downstream pathway that mediates SENP1's regulation of AML proliferation and anti-apoptosis. Mechanistically, the CO-IP assay revealed binding between SENP1 and HDAC2. SUMO and Chip-qPCR assays suggested that SENP1 can desumoylate HDAC2, which enhances EGFR transcription and activates the AKT pathway. In addition, we found that IGF2BP3 expression was upregulated in high-risk AML patients and was positively correlated with SENP1 expression. MERIP-qPCR and RIP-qPCR showed that IGF2BP3 binds SENP1 3-UTR in an m6A manner, enhances SENP1 expression, and promotes AKT pathway conduction.

Conclusions

Our findings reveal a distinct mechanism of SENP1-mediated HDAC2-AKT activation and establish the critical role of the IGF2BP3/SENP1signaling axis in AML development.
Bifidobacterium adolescentis-derived hypaphorine alleviates acetaminophen hepatotoxicity by promoting hepatic Cry1 expression
Authors: Qin Ping , Li Yanru , Su Yangjing , Wang Ze , Wu Rong , Liang Xiaoqi , Zeng Yunong , Guo Peiheng , Yu Zhichao , Huang Xintao , Yang Hong , Zeng Zhenhua , Zhao Xiaoshan , Gong Shenhai , Han Jiaochan , Chen Zhongqing , Xiao Wei , Chen Ali
Published: May 2024

Acetaminophen (APAP)-induced liver injury (AILI) is a pressing public health concern. Although evidence suggests that Bifidobacterium adolescentis (B. adolescentis) can be used to treat liver disease, it is unclear if it can prevent AILI. In this report, we prove that B. adolescentis significantly attenuated AILI in mice, as demonstrated through biochemical analysis, histopathology, and enzyme-linked immunosorbent assays. Based on untargeted metabolomics and in vitro cultures, we found that B. adolescentis generates microbial metabolite hypaphorine. Functionally, hypaphorine inhibits the inflammatory response and hepatic oxidative stress to alleviate AILI in mice. Transcriptomic analysis indicates that Cry1 expression is increased in APAP-treated mice after hypaphorine treatment. Overexpression of Cry1 by its stabilizer KL001 effectively mitigates liver damage arising from oxidative stress in APAP-treated mice. Using the gene expression omnibus (GEO) database, we verified that Cry1 gene expression was also decreased in patients with APAP-induced acute liver failure. In conclusion, this study demonstrates that B. adolescentis inhibits APAP-induced liver injury by generating hypaphorine, which subsequently upregulates Cry1 to decrease inflammation and oxidative stress.
Neutrophils cultured ex vivo from CD34+ stem cells are immature and genetically tractable
Authors: Naveh Claire A. , Roberts Kiran , Zakrzewski Przemysław , Rice Christopher M. , Ponce-Garcia Fernando M. , Fleming Kathryn , Thompson Megan , Panyapiean Nawamin , Jiang Huan , Diezmann Stephanie , Moura Pedro L. , Toye Ashley M. , Amulic Borko
Published: May 2024

Background

Neutrophils are granulocytes with essential antimicrobial effector functions and short lifespans. During infection or sterile inflammation, emergency granulopoiesis leads to release of immature neutrophils from the bone marrow, serving to boost circulating neutrophil counts. Steady state and emergency granulopoiesis are incompletely understood, partly due to a lack of genetically amenable models of neutrophil development.

Methods

We optimised a method for ex vivo production of human neutrophils from CD34+ haematopoietic progenitors. Using flow cytometry, we phenotypically compared cultured neutrophils with native neutrophils from donors experiencing emergency granulopoiesis, and steady state neutrophils from non-challenged donors. We carry out functional and proteomic characterisation of cultured neutrophils and establish genome editing of progenitors.

Results

We obtain high yields of ex vivo cultured neutrophils, which phenotypically resemble immature neutrophils released into the circulation during emergency granulopoiesis. Cultured neutrophils have similar rates of ROS production and bacterial killing but altered degranulation, cytokine release and antifungal activity compared to mature neutrophils isolated from peripheral blood. These differences are likely due to incomplete synthesis of granule proteins, as demonstrated by proteomic analysis.

Conclusion

Ex vivo cultured neutrophils are genetically tractable via genome editing of precursors and provide a powerful model system for investigating the properties and behaviour of immature neutrophils.
Therapeutic role of interferon-γ in experimental autoimmune encephalomyelitis is mediated through a tolerogenic subset of splenic CD11b+ myeloid cells
Authors: Arellano Gabriel , Acuña Eric , Loda Eileah , Moore Lindsay , Tichauer Juan E. , Castillo Cristian , Vergara Fabian , Burgos Paula I. , Penaloza-MacMaster Pablo , Miller Stephen D. , Naves Rodrigo
Published: May 2024

Cumulative evidence has established that Interferon (IFN)-γ has both pathogenic and protective roles in Multiple Sclerosis and the animal model, Experimental Autoimmune Encephalomyelitis (EAE). However, the underlying mechanisms to the beneficial effects of IFN-γ are not well understood. In this study, we found that IFN-γ exerts therapeutic effects on chronic, relapsing-remitting, and chronic progressive EAE models. The frequency of regulatory T (Treg) cells in spinal cords from chronic EAE mice treated with IFN-γ was significantly increased with no effect on Th1 and Th17 cells. Consistently, depletion of FOXP3-expressing cells blocked the protective effects of IFN-γ, indicating that the therapeutic effect of IFN-γ depends on the presence of Treg cells. However, IFN-γ did not trigger direct in vitro differentiation of Treg cells. In vivo administration of blocking antibodies against either interleukin (IL)-10, transforming growth factor (TGF)-β or program death (PD)-1, revealed that the protective effects of IFN-γ in EAE were also dependent on TGF-β and PD-1, but not on IL-10, suggesting that IFN-γ might have an indirect role on Treg cells acting through antigen-presenting cells. Indeed, IFN-γ treatment increased the frequency of a subset of splenic CD11b+ myeloid cells expressing TGF-β-Latency Associated Peptide (LAP) and program death ligand 1 (PD-L1) in a signal transducer and activator of transcription (STAT)-1-dependent manner. Furthermore, splenic CD11b+ cells from EAE mice preconditioned in vitro with IFN-γ and myelin oligodendrocyte glycoprotein (MOG) peptide exhibited a tolerogenic phenotype with the capability to induce conversion of naïve CD4+ T cells mediated by secretion of TGF-β. Remarkably, adoptive transfer of splenic CD11b+ cells from IFN-γ-treated EAE mice into untreated recipient mice ameliorated clinical symptoms of EAE and limited central nervous system infiltration of mononuclear cells and effector helper T cells. These results reveal a novel cellular and molecular mechanism whereby IFN-γ promotes beneficial effects in EAE by endowing splenic CD11b+ myeloid cells with tolerogenic and therapeutic activities.
Evaluating the process of practice enhancement for exclusive breastfeeding (PEEB): a participatory action research approach for clinical innovation
Authors: Lehane Elaine , Buckley Catherine , Mulcahy Helen , McCarthy Elizabeth , Cogan Liz , O’Connell Rhona , Murphy Margaret , Leahy-Warren Patricia
Published: May 2024

Background

Despite the known benefits of exclusive breastfeeding, global rates remain below recommended targets, with Ireland having one of the lowest rates in the world. This study explores the efficacy of Participatory Action Research (PAR) and Work-Based Learning Groups (WBLGs) to enhance breastfeeding practices within Irish healthcare settings from the perspective of WBLG participants and facilitators.

Methods

Employing a PAR approach, interdisciplinary healthcare professionals across maternity, primary, and community care settings (n = 94) participated in monthly WBLGs facilitated by three research and practice experts. These sessions, conducted over nine months (November 2021 – July 2022), focused on critical reflective and experiential learning to identify and understand existing breastfeeding culture and practices. Data were collected through participant feedback, facilitator notes, and reflective exercises, with analysis centered on participant engagement and the effectiveness of WBLGs. This approach facilitated a comprehensive understanding of breastfeeding support challenges and opportunities, leading to the development of actionable themes and strategies for practice improvement.

Results

Data analysis from WBLG participants led to the identification of five key themes: Empowerment, Ethos, Journey, Vision, and Personal Experience. These themes shaped the participants’ meta-narrative, emphasising a journey of knowledge-building and empowerment for breastfeeding women and supporting staff, underlining the importance of teamwork and multidisciplinary approaches. The project team’s evaluation highlighted four additional themes: Building Momentum, Balancing, Space Matters, and Being Present. These themes reflect the dynamics of the PAR process, highlighting the significance of creating a conducive environment for discussion, ensuring diverse engagement, and maintaining energy and focus to foster meaningful practice changes in breastfeeding support.

Conclusion

This study highlights the potential of WBLGs and PAR to enhance the understanding and approach of healthcare professionals towards breastfeeding support. By fostering reflective and collaborative learning environments, the study has contributed to a deeper understanding of the challenges in breastfeeding support and identified key areas for improvement. The methodologies and themes identified hold promise to inform future practice and policy development in maternal and child health.
Presentation and management of delayed bronchopleural fistula after pulmonary lobectomy: a case report
Authors: Jalil Riad Abdel , Dabous Ali , Khamees Almu’atasim , Alzu’bi Ahmad Yasin , Al-Majali Joud
Published: May 2024

Background

Lung cancer is the second most diagnosed cancer and the leading cause of cancer deaths worldwide. Surgical lung resection is the best treatment modality in the early stages of lung cancer as well as in some locally advanced cases. Postoperative air leak is one of the most common complications after pulmonary resection with incidence ranging between 20 and 33%. The majority of air leaks seal, within 5 days after surgery, on their own by conservative management. However, at least 5% of patients still have prolonged air coming out from the residual lung at discharge. This report describes the management of a thin lady with right lung cancer who underwent a right lower lobectomy and then suffered from a delayed air leak 7 weeks after surgery and required extensive thoracic and general surgery collaboration.

Case presentation

A 72-year-old heavy smoker female patient diagnosed with stage I lung cancer underwent right robotic-assisted thoracoscopic surgery converted to thoracotomy because of a fused fissure, right lower lobectomy, and mediastinal lymphadenectomy presented with delayed air leak 49 days after surgery. VATS decortication and mechanical pleurodesis were done 2 weeks after unsuccessful conservative treatment. Still, the lung failed to expand four weeks later so the patient was sent to surgery; she is underweight (BMI of 18) with not many options for a big flap to fill the chest cavity empty space. Accordingly; the decision was to use multiple pedicle flaps; omentum, intercostal muscle, and serratus anterior muscle to cover the bronchopleural fistulas and fill the pleural space in addition to mechanical and chemical pleurodesis. Full expansion of the lung was obtained. The patient was discharged on Post-Operative day 5 without remnant pneumothorax.

Conclusions

Air leaks After lobectomy usually presents directly postoperatively; various management options are available ranging from conservative and minimally invasive to major operative treatment. We presented what we believe was unusual delayed bronchopleural fistula post-lobectomy in a thin lady which demonstrates clearly how a delayed air leak was detected and how collaborative efforts were crucial for delivering high-quality, safe, and patient-centered care till treated and complete recovery.
Knockout mice with pituitary malformations help identify human cases of hypopituitarism
Authors: Martinez-Mayer Julian , Brinkmeier Michelle L. , O’Connell Sean P. , Ukagwu Arnold , Marti Marcelo A. , Miras Mirta , Forclaz Maria V. , Benzrihen Maria G. , Cheung Leonard Y. M. , Camper Sally A. , Ellsworth Buffy S. , Raetzman Lori T. , Pérez-Millán Maria I. , Davis Shannon W.
Published: May 2024

Background

Congenital hypopituitarism (CH) and its associated syndromes, septo-optic dysplasia (SOD) and holoprosencephaly (HPE), are midline defects that cause significant morbidity for affected people. Variants in 67 genes are associated with CH, but a vast majority of CH cases lack a genetic diagnosis. Whole exome and whole genome sequencing of CH patients identifies sequence variants in genes known to cause CH, and in new candidate genes, but many of these are variants of uncertain significance (VUS).

Methods

The International Mouse Phenotyping Consortium (IMPC) is an effort to establish gene function by knocking-out all genes in the mouse genome and generating corresponding phenotype data. We used mouse embryonic imaging data generated by the Deciphering Mechanisms of Developmental Disorders (DMDD) project to screen 209 embryonic lethal and sub-viable knockout mouse lines for pituitary malformations.

Results

Of the 209 knockout mouse lines, we identified 51 that have embryonic pituitary malformations. These genes not only represent new candidates for CH, but also reveal new molecular pathways not previously associated with pituitary organogenesis. We used this list of candidate genes to mine whole exome sequencing data of a cohort of patients with CH, and we identified variants in two unrelated cases for two genes,MORC2andSETD5, with CH and other syndromic features.

Conclusions

The screening and analysis of IMPC phenotyping data provide proof-of-principle that recessive lethal mouse mutants generated by the knockout mouse project are an excellent source of candidate genes for congenital hypopituitarism in children.
Actinobacteria diversity associated with marine sediments and a wetland system, Agulhas-South Africa
Authors: Prins Alaric , Dyani Siphosethu S. , Vreulink Jo-Marie , Maldonado Luis A. , Le Roes-Hill Marilize
Published: May 2024

Background

South Africa is known for its great biodiversity. The Agulhas Plain represents one such unique environment where low-gradient topography has resulted in extensive wetland formation. It is fed by two major river systems, bringing in brackish, alkaline water. It has been exposed to major marine transgression and regression events, and harbours great Fynbos diversity as well as a Mediterranean-type climate, thereby creating unique ecosystems. It is therefore surprising that little is known about the bacterial diversity associated with the Agulhas Plain and associated marine ecosystems.

Methods

In this study, we focused on the actinobacterial diversity (Phylum Actinomycetota) associated with an emerging peatland on the Agulhas Plain (SF; Areas 1–3) and a marine site (ANP; Ocean, Rocky, Dry) located 10 km away from SF. A combined metataxanomics and isolation approach was taken to evaluate the actinobacterial diversity of the sampling sites and to determine the effect of environmental physicochemical parameters on these populations. Various genome analyses were performed on an Sva0096 marine bin to gain insight into its ecological role.

Results

Metataxanomics showed that the two sites shared defined major taxa, including Blastococcus, Geodermatophilus, Microbacterium, Mycobacterium, Nocardioides, Streptomyces, and the Sva0996 marine group. Analysis of the biosynthetic potential of an Sva0996 marine bin134 (obtained from GenBank) provided insights into the potential ecological role of this group of bacteria in both the marine and terrestrial environments. Higher actinobacterial diversity (Shannon index > 5) was observed for Areas 2 and 3 (SF), as well as the ANP Dry samples. The actinobacterial population composition was found to be driven by salinity, pH, Mn, and Ca, with certain areas of SF exhibiting similar (and even higher) salinity (SF: 70–100 Ω vs. ANP: 100–160 Ω) and lower pH levels (SF: 6.3-8.0 vs. ANP: 8.6–8.9) to that of the marine environment.

Conclusion

This snapshot study has provided some insights into the actinobacterial diversity of the two sites studied. Analysis of an Sva0096 marine bin134 provided further insights into the potential ability of the Sva0096 marine group to survive in a unique terrestrial environment that is periodically exposed to environmental pressures that mimic the marine environment.
Molecular subtypes of breast cancer identified by dynamically enhanced MRI radiomics: the delayed phase cannot be ignored
Authors: Huang Guoliang , Du Siyao , Gao Si , Guo Liangcun , Zhao Ruimeng , Bian Xiaoqian , Xie Lizhi , Zhang Lina
Published: May 2024

Objectives

To compare the diagnostic performance of intratumoral and peritumoral features from different contrast phases of breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) by building radiomics models for differentiating molecular subtypes of breast cancer.

Methods

This retrospective study included 377 patients with pathologically confirmed breast cancer. Patients were divided into training set (n = 202), validation set (n = 87) and test set (n = 88). The intratumoral volume of interest (VOI) and peritumoral VOI were delineated on primary breast cancers at three different DCE-MRI contrast phases: early, peak, and delayed. Radiomics features were extracted from each phase. After feature standardization, the training set was filtered by variance analysis, correlation analysis, and least absolute shrinkage and selection (LASSO). Using the extracted features, a logistic regression model based on each tumor subtype (Luminal A, Luminal B, HER2-enriched, triple-negative) was established. Ten models based on intratumoral or/plus peritumoral features from three different phases were developed for each differentiation.

Results

Radiomics features extracted from delayed phase DCE-MRI demonstrated dominant diagnostic performance over features from other phases. However, the differences were not statistically significant. In the full fusion model for differentiating different molecular subtypes, the most frequently screened features were those from the delayed phase. According to the Shapley additive explanation (SHAP) method, the most important features were also identified from the delayed phase.

Conclusions

The intratumoral and peritumoral radiomics features from the delayed phase of DCE-MRI can provide additional information for preoperative molecular typing. The delayed phase of DCE-MRI cannot be ignored.

Critical relevance statement

Radiomics features extracted and radiomics models constructed from the delayed phase of DCE-MRI played a crucial role in molecular subtype classification, although no significant difference was observed in the test cohort.

Key Points

The molecular subtype of breast cancer provides a basis for setting treatment strategy and prognosis.

The delayed-phase radiomics model outperformed that of early-/peak-phases, but no differently than other phases or combinations.

Both intra- and peritumoral radiomics features offer valuable insights for molecular typing.

Graphical Abstract
Disparities in the accuracy of reporting opioid overdoses to 9-1-1 by race and sex of overdose victim, Marion County, Indiana, 2011–2020
Authors: Atkins Danielle N. , del Pozo Brandon , Clark MH , Andraka-Christou Barbara , O’Donnell Daniel , Ray Bradley
Published: May 2024

Objectives

To assess the prevalence of emergency medical incidents wherein naloxone was administered but overdose was not described as the chief complaint during the 9-1-1 call, including differences by overdose victim race/ethnicity and sex.

Methods

We computed the percentage of 9-1-1 calls in Marion County, Indiana, from 2011 to 2020, wherein naloxone was administered but the caller did not describe overdose as the chief complaint. We estimated a logistic regression to examine the associations between reporting of overdose as the chief complaint and race and sex of the overdose victim.

Results

Almost one-fifth of 9-1-1 calls preceding naloxone administration did not describe overdose as the chief complaint. 9-1-1 callers were more likely to describe a non-overdose as the chief complaint when the overdose victim was Black or female.

Conclusion

9-1-1 callers are less likely to use terminology describing overdose when the overdose victim is female or Black, than when the victim is male or White. Inaccurate terminology when calling 9-1-1 could delay naloxone administration, thereby increasing risk of overdose death and hypoxic brain injury. Some 9-1-1 callers may be avoiding overdose terminology to prevent a police response, or due to lack of knowledge about overdose identification, but further research is needed to determine the mechanisms underlying these findings.
FGL1 and FGL2: emerging regulators of liver health and disease
Authors: Chen Jiongming , Wu Lei , Li Yongsheng
Published: May 2024

Liver disease is a complex group of diseases with high morbidity and mortality rates, emerging as a major global health concern. Recent studies have highlighted the involvement of fibrinogen-like proteins, specifically fibrinogen-like protein 1 (FGL1) and fibrinogen-like protein 2 (FGL2), in the regulation of various liver diseases. FGL1 plays a crucial role in promoting hepatocyte growth, regulating lipid metabolism, and influencing the tumor microenvironment (TME), contributing significantly to liver repair, non-alcoholic fatty liver disease (NAFLD), and liver cancer. On the other hand, FGL2 is a multifunctional protein known for its role in modulating prothrombin activity and inducing immune tolerance, impacting viral hepatitis, liver fibrosis, hepatocellular carcinoma (HCC), and liver transplantation. Understanding the functions and mechanisms of fibrinogen-like proteins is essential for the development of effective therapeutic approaches for liver diseases. Additionally, FGL1 has demonstrated potential as a disease biomarker in radiation and drug-induced liver injury as well as HCC, while FGL2 shows promise as a biomarker in viral hepatitis and liver transplantation. The expression levels of these molecules offer exciting prospects for disease assessment. This review provides an overview of the structure and roles of FGL1 and FGL2 in different liver conditions, emphasizing the intricate molecular regulatory processes and advancements in targeted therapies. Furthermore, it explores the potential benefits and challenges of targeting FGL1 and FGL2 for liver disease treatment and the prospects of fibrinogen-like proteins as biomarkers for liver disease, offering insights for future research in this field.
Human post-mortem organotypic brain slice cultures: a tool to study pathomechanisms and test therapies
Authors: Plug Bonnie C. , Revers Ilma M. , Breur Marjolein , González Gema Muñoz , Timmerman Jaap A. , Meijns Niels R.C. , Hamberg Daniek , Wagendorp Jikke , Nutma Erik , Wolf Nicole I. , Luchicchi Antonio , Mansvelder Huibert D. , van Til Niek P. , van der Knaap Marjo S. , Bugiani Marianna
Published: May 2024

Human brain experimental models recapitulating age- and disease-related characteristics are lacking. There is urgent need for human-specific tools that model the complex molecular and cellular interplay between different cell types to assess underlying disease mechanisms and test therapies. Here we present an adapted ex vivo organotypic slice culture method using human post-mortem brain tissue cultured at an air-liquid interface to also study brain white matter. We assessed whether these human post-mortem brain slices recapitulate the in vivo neuropathology and if they are suitable for pathophysiological, experimental and pre-clinical treatment development purposes, specifically regarding leukodystrophies. Human post-mortem brain tissue and cerebrospinal fluid were obtained from control, psychiatric and leukodystrophy donors. Slices were cultured up to six weeks, in culture medium with or without human cerebrospinal fluid. Human post-mortem organotypic brain slice cultures remained viable for at least six weeks ex vivo and maintained tissue structure and diversity of (neural) cell types. Supplementation with cerebrospinal fluid could improve slice recovery. Patient-derived organotypic slice cultures recapitulated and maintained known in vivo neuropathology. The cultures also showed physiologic multicellular responses to lysolecithin-induced demyelination ex vivo, indicating their suitability to study intrinsic repair mechanisms upon injury. The slice cultures were applicable for various experimental studies, as multi-electrode neuronal recordings. Finally, the cultures showed successful cell-type dependent transduction with gene therapy vectors. These human post-mortem organotypic brain slice cultures represent an adapted ex vivo model suitable for multifaceted studies of brain disease mechanisms, boosting translation from human ex vivo to in vivo. This model also allows for assessing potential treatment options, including gene therapy applications. Human post-mortem brain slice cultures are thus a valuable tool in preclinical research to study the pathomechanisms of a wide variety of brain diseases in living human tissue.