bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary cutaneous apocrine carcinoma with RARA::NPEPPS fusion
Authors: Lenskaya Volha , Yang Richard K. , Cho Woo Cheal
Published: March 2024

Gene fusions have emerged as crucial molecular drivers of oncogenesis in a subset of cutaneous adnexal neoplasms, including poroid neoplasms and hidradenomas. We present a unique case of primary cutaneous apocrine carcinoma harboring RARA::NPEPPS fusion, broadening the spectrum of fusion‐associated cutaneous adnexal neoplasms. A 77‐year‐old African American male presented with an ulcerated thigh nodule. Histopathologically, the predominantly dermal‐based adenocarcinoma exhibited papillary, micropapillary, cribriform, and solid growth patterns with central comedonecrosis, set in a fibrotic/desmoplastic stroma. Immunophenotypically, the neoplastic cells were positive for CK7, CK19, GATA3, TRPS1, HER2, CK5/6, calretinin, p63, and DPC4 (no loss), while lacking immunoreactivity for CK20, CDX2, TTF1, napsin‐A, PAX8, arginase‐1, adipophilin, NKX3.1, uroplakin II, and D2‐40. The immunoprofile and clinical and radiographic absence of any internal malignancy, including breast carcinoma, except for multiple lymphadenopathy, supported the diagnosis of primary cutaneous apocrine carcinoma. Next‐generation sequencing unveiled the novel RARA::NPEPPS fusion, concurrent ERBB2 amplification, and multiple somatic mutations involving TP53, CDKN2A, BRCA2, PIK3CA, PIK3R1, and others. The patient developed widespread metastases within a year after the initial diagnosis, indicating the tumor's aggressive behavior. This novel fusion, unprecedented in any human malignancies including primary cutaneous adnexal carcinomas, may suggest a potential new subtype within primary cutaneous adnexal carcinoma.
Quantifying the effects of fragmentation of connectivity networks of deep‐sea vulnerable marine ecosystems
Authors: Wang Shuangqiang , Kenchington Ellen , Murillo F. Javier , Lirette Camille , Wang Zeliang , Koen‐Alonso Mariano , Kenny Andrew , Sacau Mar , Pepin Pierre
Published: March 2024

Aim

Protection of vulnerable marine ecosystems (VMEs) in the high seas has focussed on identifying concentrations of indicator species and prohibiting the operation of bottom‐contact fishing gears where those occur in significant concentrations. Most such species have planktonic larvae and depend on dispersal networks for inter‐generational persistence. Yet, connectivity amongst patches of VME has seldom been considered when spatial management measures are introduced. Here, the relative importance of individual patches for the maintenance of their connectivity networks is evaluated, and a prioritization scheme for management action is proposed. Effective conservation measures should maintain approximately natural network configurations whenever possible.

Location

Grand Bank and Flemish Cap, Northwest Atlantic Ocean.

Methods

3‐D Lagrangian particle tracking was used to model larval dispersal connections between known patches of each of seven groups of benthic invertebrate taxa, previously recognized as indicators of VME. Connectivity networks were constructed and the effects of habitat loss simulated by systematic removal of whole patches, to determine the importance of each patch to connectivity within its respective network.

Results

The various patches differed widely in their contributions to network connectivity. Each taxon group had both some patches that, if removed from the network, would result in a major decline in connectedness but also several which could be lost with negligible consequences for the remainder.

Main Conclusions

While protecting each patch of VME has conservation value, the wide variation in connectedness shows that some patches are much more critical than others to the long‐term persistence of the taxa, providing a foundation for prioritization of conservation actions.
The impact of metformin on weight and metabolic parameters in patients with obesity: A systematic review and meta‐analysis of randomized controlled trials
Authors: Haber Rachelle , Zarzour Fatima , Ghezzawi Malak , Saadeh Natalie , Bacha Dania S. , Al Jebbawi Lama , Chakhtoura Marlene , Mantzoros Christos S.
Published: March 2024

There are conflicting data on the weight‐reducing potential of metformin (MTF) in nondiabetic patients with obesity. The purpose of this systematic review and meta‐analysis was to evaluate the effect of MTF on weight and cardiometabolic parameters in adults with overweight/obesity with or without nonalcoholic fatty liver disease (NAFLD) (CRD42018085512). We included randomized controlled trials (RCTs) in adults without diabetes mellitus, with mean body mass index (BMI) ≥ 25 kg/m2, with or without NAFLD, comparing MTF to placebo/control, lifestyle modification (LSM) or a US Food and Drug Administration‐approved anti‐obesity drug, reporting on weight or metabolic parameters, and extending over at least 3 months. We conducted a systematic search in MEDLINE, EMBASE, PubMed and the Cochrane Library without time limitation (until March 2022). We screened and selected eligible articles, abstracted relevant data, and assessed the risk of bias. All steps were in duplicate and independently. We conducted a random‐effects model meta‐analysis using Review Manager version 5.3, with prespecified subgroup analyses in case of heterogeneity. We identified 2650 citations and included 49 trials (55 publications). Compared to placebo, MTF was associated with a significant reduction in BMI (mean difference [MD] −0.56 [−0.74, −0.37] kg/m2; p < 0.0001), at doses ranging from 500 to 2550 mg/day, and with a significant percentage change in BMI of −2.53% (−2.90, −2.17) at the dose 1700 mg/day. There was no interaction by baseline BMI, MTF dose or duration, nor presence or absence of NAFLD. There was no significant difference between MTF and LSM. Orlistat was more effective than MTF (at doses of 1000–1700 mg/day) in terms of weight loss, with an MD in BMI of −3.17 (−5.88; −0.47) kg/m2, favouring the former. Compared to placebo/control, MTF improved insulin parameters, while no effect was detected when compared to LSM. A few small trials showed heterogenous effects on liver parameters in patients with NAFLD treated with MTF compared to placebo/control. There was a large variability in the expression of outcome measures and RCTs were of low quality. In conclusion, MTF was associated with a modest weight reduction in obese nondiabetic patients. Further high‐quality and better powered studies are needed to examine the impact of MTF in patients with insulin resistance and NAFLD.
European Academy of Neurology (EAN) guideline on the management of amyotrophic lateral sclerosis in collaboration with European Reference Network for Neuromuscular Diseases (ERNEURO‐NMD)
Authors: Van Damme Philip , Al‐Chalabi Ammar , Andersen Peter M. , Chiò Adriano , Couratier Philippe , De Carvalho Mamede , Hardiman Orla , Kuźma‐Kozakiewicz Magdalena , Ludolph Albert , McDermott Christopher J. , Mora Jesus S. , Petri Susanne , Probyn Katrin , Reviers Evy , Salachas François , Silani Vincenzo , Tysnes Ole‐Bjørn , van den Berg Leonard H. , Villanueva Gemma , Weber Markus
Published: March 2024

Background

This update of the guideline on the management of amyotrophic lateral sclerosis (ALS) was commissioned by the European Academy of Neurology (EAN) and prepared in collaboration with the European Reference Network for Neuromuscular Diseases (ERN EURO‐NMD) and the support of the European Network for the Cure ALS (ENCALS) and the European Organization for Professionals and Patients with ALS (EUpALS).

Methods

Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was used to assess the effectiveness of interventions for ALS. Two systematic reviewers from Cochrane Response supported the guideline panel. The working group identified a total of 26 research questions, performed systematic reviews, assessed the quality of the available evidence, and made specific recommendations. Expert consensus statements were provided where insufficient evidence was available.

Results

A guideline mapping effort revealed only one other ALS guideline that used GRADE methodology (a National Institute for Health and Care Excellence [NICE] guideline). The available evidence was scarce for many research questions. Of the 26 research questions evaluated, the NICE recommendations could be adapted for 8 questions. Other recommendations required updates of existing systematic reviews or de novo reviews. Recommendations were made on currently available disease‐modifying treatments, multidisciplinary care, nutritional and respiratory support, communication aids, psychological support, treatments for common ALS symptoms (e.g., muscle cramps, spasticity, pseudobulbar affect, thick mucus, sialorrhea, pain), and end‐of‐life management.

Conclusions

This update of the guideline using GRADE methodology provides a framework for the management of ALS. The treatment landscape is changing rapidly, and further updates will be prepared when additional evidence becomes available.
Distinct neural signatures of pulvinar in C9orf72 amyotrophic lateral sclerosis mutation carriers and noncarriers
Authors: Nigri Anna , Stanziano Mario , Fedeli Davide , Manera Umberto , Ferraro Stefania , Medina Carrion Jean Paul , Palermo Sara , Lequio Laura , Denegri Federica , Agosta Federica , Spinelli Edoardo Gioele , Filippi Massimo , Grisoli Marina , Valentini Maria Consuelo , De Mattei Filippo , Canosa Antonio , Calvo Andrea , Chiò Adriano , Bruzzone Maria Grazia , Moglia Cristina
Published: March 2024

Background and purpose

Thalamic alterations have been reported as a major feature in presymptomatic and symptomatic patients carrying the C9orf72 mutation across the frontotemporal dementia–amyotrophic lateral sclerosis (ALS) spectrum. Specifically, the pulvinar, a high‐order thalamic nucleus and timekeeper for large‐scale cortical networks, has been hypothesized to be involved in C9orf72‐related neurodegenerative diseases. We investigated whether pulvinar volume can be useful for differential diagnosis in ALS C9orf72 mutation carriers and noncarriers and how underlying functional connectivity changes affect this region.

Methods

We studied 19 ALS C9orf72 mutation carriers (ALSC9+) accurately matched with wild‐type ALS (ALSC9−) and ALS mimic (ALSmimic) patients using structural and resting‐state functional magnetic resonance imaging data. Pulvinar volume was computed using automatic segmentation. Seed‐to‐voxel functional connectivity analyses were performed using seeds from a pulvinar functional parcellation.

Results

Pulvinar structural integrity had high discriminative values for ALSC9+ patients compared to ALSmimic (area under the curve [AUC] = 0.86) and ALSC9− (AUC = 0.77) patients, yielding a volume cutpoint of approximately 0.23%. Compared to ALSmimic, ALSC9− showed increased anterior, inferior, and lateral pulvinar connections with bilateral occipital–temporal–parietal regions, whereas ALSC9+ showed no differences. ALSC9+ patients when compared to ALSC9− patients showed reduced pulvinar–occipital connectivity for anterior and inferior pulvinar seeds.

Conclusions

Pulvinar volume could be a differential biomarker closely related to the C9orf72 mutation. A pulvinar–cortical circuit dysfunction might play a critical role in disease progression and development, in both the genetic phenotype and ALS wild‐type patients.
Specific consistency score for rational selection of epilepsy resection surgery candidates
Authors: Tojima Maya , Shimotake Akihiro , Neshige Shuichiro , Okada Tadashi , Kobayashi Katsuya , Usami Kiyohide , Matsuhashi Masao , Honda Masayuki , Takeyama Hirofumi , Hitomi Takefumi , Yoshida Takeshi , Yokoyama Atsushi , Fushimi Yasutaka , Ueno Tsukasa , Yamao Yukihiro , Kikuchi Takayuki , Namiki Takao , Arakawa Yoshiki , Takahashi Ryosuke , Ikeda Akio
Published: March 2024

Objective

Degree of indication for epilepsy surgery is determined by taking multiple factors into account. This study aimed to investigate the usefulness of the Specific Consistency Score (SCS), a proposed score for focal epilepsy to rate the indication for epilepsy focal resection.

Methods

This retrospective cohort study included patients considered for resective epilepsy surgery in Kyoto University Hospital from 2011 to 2022. Plausible epileptic focus was tentatively defined. Cardinal findings were scored based on specificity and consistency with the estimated laterality and lobe. The total points represented SCS. The association between SCS and the following clinical parameters was assessed by univariate and multivariate analysis: (1) probability of undergoing resective epilepsy surgery, (2) good postoperative seizure outcome (Engel I and II or Engel I only), and (3) lobar concordance between the noninvasively estimated focus and intracranial electroencephalographic (EEG) recordings.

Results

A total of 131 patients were evaluated. Univariate analysis revealed higher SCS in the (1) epilepsy surgery group (8.4 [95% confidence interval (CI) = 7.8–8.9] vs. 4.9 [95% CI = 4.3–5.5] points; p < .001), (2) good postoperative seizure outcome group (Engel I and II; 8.7 [95% CI = 8.2–9.3] vs. 6.4 [95% CI = 4.5–8.3] points; p = .008), and (3) patients whose focus defined by intracranial EEG matched the noninvasively estimated focus (8.3 [95% CI = 7.3–9.2] vs. 5.4 [95% CI = 3.5–7.3] points; p = .004). Multivariate analysis revealed areas under the curve of .843, .825, and .881 for Parameters 1, 2, and 3, respectively.

Significance

SCS provides a reliable index of good indication for resective epilepsy surgery and can be easily available in many institutions not necessarily specializing in epilepsy.
Decolonizing and Decoloniality in African Women Theology
Authors: Gunda Masiiwa Ragies
Published: March 2024

Decolonization and decoloniality offer potential gains to African Women Theology (AWT) to address the intersections, continuities, and discontinuities between the pre‐colonial, colonial, and Christian gender ideologies that have disempowered African women. While African women theologians have, at different points, identified the patriarchal forces in these three spheres, an intentional intersectional approach has not always successfully challenged the colonial meta‐narratives of the construction of the African man. Decolonization and decoloniality offer a critical theoretical framework to not only deal with gender meta‐narratives but to deconstruct and dismantle these narratives to develop responses that are appropriate for their communities. These perspectives will also cement AWT as a major player in the renewed calls for decolonization and decoloniality in Africa. This article acknowledges an intersectionality of traditional, colonial, and post‐colonial patriarchies and the persistence of coloniality in the present spaces in which AWT operates, as well as discontinuities in the gender perspectives in these different periods.
Access to justice and strategic climate litigation in the EU: Curing the incurable?
Authors: Krężel Angelika
Published: March 2024

Access to justice in the EU is to be assured via both the CJEU and national courts through direct and indirect action procedures. Following this, the main argument developed throughout this analysis is that the CJEU differentiates the revision standard when interpreting the obligations of EU institutions and those of Member States. It is concluded that this kind of interpretation maintains the limitations to access to justice for individuals in the EU (the ‘incurable’), even when faced with the attempt to overcome this restrictive interpretation in the specific case of strategic climate litigation (‘curing the incurable’). The specific case of strategic climate litigation is used as an example to illustrate the negative consequences of limitations to access to justice for individuals in the EU. In conclusion, it is assessed whether there are any other ‘real cures’ for this deadlocked situation and what the rationale is behind these double standards.
The Children's Justice Clinic: Ensuring high‐quality legal representation for children through clinical legal education
Authors: Hazen Katherine P. , Paxton Michelle , Herzfeld Abigail L. , Brank Eve M.
Published: March 2024

Juvenile and family law uniquely require interdisciplinary education and experience to balance children's and families' legal rights with their best interests. Clinical legal education provides third‐year law students with advanced and applied experience in a specific area of law to prepare them for legal practice. Recent developments in clinical legal education advance this experience by integrating interdisciplinary experts and reflective practice into clinics. The Children's Justice Clinic is one such clinic that integrates classroom teaching, clinical legal practice, multidisciplinary expert consultation, and reflective practice to train practice‐ready Guardians ad Litem. Evaluation results from the first 5 years of the Children's Justice Clinic demonstrates that the Clinic is making progress toward its goals to provide third‐year law students with the knowledge and skills necessary to be effective Guardians Ad Litem, increase interest in child welfare and juvenile law practice among law students, and increase access to high‐quality legal representation for children. This paper presents the results from the evaluation and shares lessons learned during clinic development and implementation.
Nubecularia‐coralline algal‐serpulid‐microbial bioherms of the Paratethys Sea—Distribution and paleoecological significance (upper Serravallian, upper Sarmatian, Middle Miocene)
Authors: Piller Werner E. , Harzhauser Mathias
Published: March 2024

Nubecularia bioherms represent unique bioconstructions that are restricted to the upper Serravallian of the Paratethys and have been reported since the 19th century. They occur in the Central Paratethys in the late Sarmatian and the Eastern Paratethys in the Bessarabian both regional stages of the respective Paratethyan areas. In this study, several locations in the Vienna and Styrian basins of the Central Paratethys were studied out of which four localities were documented in detail (Wolfsthal, Maustrenk, St. Margarethen—Zollhaus, Vienna—Ruzickagasse) to reconstruct their sedimentary setting, their internal composition, and their indications of environmental parameters. The detailed studies included logging of outcrop sections, petrographic, facies and biotic analyses of polished slabs and thin sections and also cathodoluminescence analyses. These concluded that these bioconstructions are not only composed of the foraminifer Nubecularia but represent a complex mixture and interrelationships of Nubecularia, serpulids and microbial carbonate. Four boundstone types can be differentiated: Nubecularia boundstone, Nubecularia‐coralline algal boundstone, stromatolitic/thrombolitic boundstone and serpulid‐nubeculariid‐microbial boundstone. The first 3 types are characteristic of specific localities; the fourth type occurs in all studied locations and represents the terminal association on top of the three other types. The three basal boundstones are predominantly of columnar growth form irrespective of dominance of Nubecularia, coralline algae or microbial carbonate, and the terminal boundstone is widely irregularly organized. The general depositional environment is characterized by cross‐bedded oolitic grainstones with abundant quartz grains, miliolid foraminifers and mollusks. Intercalated are microbial carbonates mostly stromatolites but also thrombolites. This indicates a general high water energy environment interrupted by more calm periods when the microbial carbonate was built. The 3 basal types of bioconstructions are interpreted to reflect decreasing food supply and/or oxygenation from Nubecularia over Nubecularia‐coralline algal to stromatolitic/thrombolitic boundstone. The serpulid‐nubeculariid‐microbial boundstone reflects an internal succession with a decrease of the same parameters. Water depth is considered very shallow ranging from 0 to a few meters, and salinity was normal marine to hypersaline. The reconstructed paleoenvironment with dominating oolite shoals and seagrass meadows was not restricted to the Central Paratethys but extended over the entire Paratethys and represented the largest oolite facies area of the entire Cenozoic!
Trophic interactions in soil micro‐food webs drive ecosystem multifunctionality along tree species richness
Authors: Shi Xiuzhen , Eisenhauer Nico , Peñuelas Josep , Fu Yanrong , Wang Jianqing , Chen Yuxin , Liu Shengen , He Lulu , Lucas‐Borja Manuel Esteban , Wang Liyan , Huang Zhiqun
Published: March 2024

Rapid biodiversity losses under global climate change threaten forest ecosystem functions. However, our understanding of the patterns and drivers of multiple ecosystem functions across biodiversity gradients remains equivocal. To address this important knowledge gap, we measured simultaneous responses of multiple ecosystem functions (nutrient cycling, soil carbon stocks, organic matter decomposition, plant productivity) to a tree species richness gradient of 1, 4, 8, 16, and 32 species in a young subtropical forest. We found that tree species richness had negligible effects on nutrient cycling, organic matter decomposition, and plant productivity, but soil carbon stocks and ecosystem multifunctionality significantly increased with tree species richness. Linear mixed‐effect models showed that soil organisms, particularly arbuscular mycorrhizal fungi (AMF) and soil nematodes, elicited the greatest relative effects on ecosystem multifunctionality. Structural equation models revealed indirect effects of tree species richness on ecosystem multifunctionality mediated by trophic interactions in soil micro‐food webs. Specifically, we found a significant negative effect of gram‐positive bacteria on soil nematode abundance (a top‐down effect), and a significant positive effect of AMF biomass on soil nematode abundance (a bottom‐up effect). Overall, our study emphasizes the significance of a multitrophic perspective in elucidating biodiversity‐multifunctionality relationships and highlights the conservation of functioning soil micro‐food webs to maintain multiple ecosystem functions.
Treatment of severe hyponatremia with continuous renal replacement therapy: A case and review of corrective strategies
Authors: Der Mesropian Paul J. , Phillips Shawn , Naber Martha , Konduru Sunjeev , Shaikh Gulvahid , Hongalgi Krishnakumar
Published: March 2024

Treatment of severely hyponatremic patients with continuous renal replacement therapy (CRRT) presents a unique challenge given the lack of commercial options for hypotonic replacement solutions or dialysate. We report the case of a 55‐year‐old male who presented with profound, symptomatic hyponatremia in the setting of acute kidney injury (AKI). The patient was found to have a serum sodium concentration of 97 mEq/L because of free water retention that occurred during severe AKI from viral gastroenteritis and rhabdomyolysis. Continuous veno‐venous hemofiltration (CVVH) was required for AKI complicated by hyperkalemia, metabolic acidosis, and uremia. To prevent overcorrection of serum sodium, replacement fluids customized to natremic status had to be prepared. Conventional replacement fluid was modified on a daily basis to create hypotonic solutions with successively higher sodium concentrations. Over the course of a week, serum sodium successfully improved in a controlled and safe fashion. This case incorporates and reviews the variety of methods that have been used to safely manage severe hyponatremia with CRRT.
BENEATH MEANING, ORIENTATIONAL NARRATIVES, AND DANTO'S ESSENTIALIST THEORY OF ART: ON NOËL CARROLL'S ELUCIDATIONS AND CONTESTATIONS
Authors: ERKAN EKIN
Published: March 2024

In this review of Noël Carroll's Arthur Danto's Philosophy of Art: Essays, I focus on the issue of Danto's philosophy of art history and Carroll's position that, unlike Danto, we ought to understand Danto's “end of art (history)” thesis as an orientational narrative (that is, a pragmatic‐instrumental narrative with cognitive purchase) rather than as a historical‐scientific narrative. In making this case, I show how Carroll's argument demonstrates that Danto's “end of art (history)” thesis is in tension with Danto's philosophy of history. Furthermore, I engage and respond to the most substantive critiques that Carroll proffers in this text, especially as they concern Danto's philosophy of art history and the related issue of Danto's (art) historically anchored search for a definition of art. In giving special attention to the socio‐historical background conditions (namely, “the artworld” conditions) for an object to be conferred art status, I also show how Carroll's incisive reading offers a critical rejoinder to claims made by recent critics such as Robert B. Pippin and Ivan Gaskell, who have dehistoricized Danto's definition of art, claiming that it allows for any artist to enfranchise any object as an artwork, proper.
Study of online tensile properties for continuous ceramic fibers under high‐temperature loads
Authors: Zhang Chi , Jiang Liquan , Yu Hao , Zhu Kunkun , Xu Weilin , Li Wenbin
Published: March 2024

In this study, a self‐developed online test platform for high‐temperature mechanical properties was utilized to test the tensile properties of three continuous ceramic fibers from room temperature to 1 000°C. It was observed that the tensile strength of all tested continuous ceramic fibers decreased significantly with increasing temperature. Specifically, significant peeling of the surface organic coating from room temperature to 400°C, inherent and newly formed defects exposed from 600°C to 1 000°C contributed to the decrease in tensile strength. More importantly, compared with room temperature, the strength of the silicon carbide fibers and the alumina fibers remained 29.7% and 20.2% respectively when stretched online at 1 000°C, while the quartz fibers dropped to 4.3% dramatically. These findings contribute valuable data for the potential application of ceramic fiber filaments as flexible thermal protection materials.
Facilitating content learning through translanguaging in secondary EMI science classrooms
Authors: He Yuhang , Zhou Xiaozhou (Emily)
Published: March 2024

Despite the rigorous efforts made to promote the use of English as a medium of instruction (EMI), EMI teachers still face linguistic and pedagogical challenges in effectively delivering subject content in English. Previous research has revealed that, faced with such challenges, teachers employ various strategies to make subject knowledge accessible to students, including pedagogical translanguaging. However, there is little empirical evidence of how EMI teachers deploy pedagogical translanguaging to facilitate content learning in secondary science classrooms, particularly in countries or regions where English is not widely used outside schools. Against this backdrop, the current study adopts a qualitative approach to examine the pedagogical translanguaging practices of two EMI science teachers, as well as the factors contributing to their practices at an international secondary school in Shanghai, China. The methods used were video‐assisted classroom observation and semi‐structured interviews. These were subjected to multimodal conversation analysis and thematic analysis, respectively. The findings reveal that teachers’ pedagogical translanguaging practices involve strategically incorporating and orchestrating all multilingual, multimodal, and multisemiotic resources available to facilitate meaning‐making and enhance students’ comprehension of subject knowledge. Meanwhile, personal, social, and contextual factors play an important role in shaping teachers’ pedagogical translanguaging practices. This study showcases pedagogical translanguaging as a strategic means to create space for teaching and learning in EMI contexts, and provides useful insights into potential improvements to EMI pedagogy.
Size and ethnic homogeneity of extended social networks in the Netherlands: Differences between migrant groups and migrant generations
Authors: Jeroense Thijmen , Hofstra Bas , Spierings Niels , Tolsma Jochem
Published: March 2024

Extended social networks encompass both weak and strong ties to provide social support and resources. Hence, it is important to study what explains variation in these networks. This paper addresses this and examines the size and ethnic homogeneity of extended social networks, and group differences therein, and it aims to explain these differences based on a preference–opportunities approach through a decomposition analysis. We apply state‐of‐the‐art NSUM methods to measure the extended networks for different ethnic‐majority and minoritized groups, also considering migrant generation differences, in the Netherlands. Results show that group differences in network size reflect first‐generation minority citizens having smaller networks and majority citizens having more ethnically homogeneous networks. More positive out‐group attitudes among the Moroccan– and Turkish–Dutch partly explain why these groups have less homogeneous networks than Dutch majority members. Differences in the ethnic composition of neighbourhoods also contribute to explaining the homogeneity gap between Dutch majority and Turkish‐Dutch.
Between a rock and a hard place: Multisystem resilience and Honduran youth migration intentions
Authors: Rivero Fuentes Maria Estela , Hare Tom , Miller‐Graff Laura
Published: March 2024

More is known about how ‘push factors’ motivate emigration and how immigrants adapt to their new environment than about psychological factors associated with migration intentions for those experiencing adversity in their country of origin. This paper explores the association between multisystem resilience and migration intentions among youth in Honduras. In this context of high economic need and contextual violence, higher levels of resilience are associated with higher levels of migration intentions among those who have a job and thus the ability to navigate or negotiate access to resources – economic, social and psychological – that make it possible to consider migration. Among those who have not been victims of violence and consequently may not have that motivation to migrate, higher levels of resilience are associated with lower migration intentions.
Omicron breakthrough infections after triple‐dose inactivated COVID‐19 vaccination: A comprehensive analysis of antibody and T‐cell responses
Authors: Xiang Tiandan , Quan Xufeng , Jia Hang , Wang Hua , Liang Boyun , Li Sumeng , Wang Xiaoyan , Li Huadong , Feng Xuemei , Fan Lei , Xu Ling , Wang Tong , Xiong Shue , Yang Dongliang , Liu Jia , Zheng Xin
Published: March 2024

This study longitudinally evaluated the immune response in individuals over a year after receiving three doses of an inactivated SARS‐CoV‐2 vaccine, focusing on reactions to Omicron breakthrough infections. From 63 blood samples of 37 subjects, results showed that the third booster enhanced the antibody response against Alpha, Beta, and Delta VOCs but was less effective against Omicron. Although antibody titres decreased post‐vaccination, SARS‐CoV‐2‐specific T‐cell responses, both CD4+ and CD8+, remained stable. Omicron breakthrough infections significantly improved neutralization against various VOCs, including Omicron. However, the boost in antibodies against WT, Alpha, Beta, and Delta variants was more pronounced. Regarding T cells, breakthrough infection predominantly boosted the CD8+ T‐cell response, and the intensity of the spike protein‐specific T‐cell response was roughly comparable between WT and Omicron BA.5.
TREM1/DAP12 based novel multiple chain CAR‐T cells targeting DLL3 show robust anti‐tumour efficacy for small cell lung cancer
Authors: Nie Fengqi , Chen Yuli , Hu Yanming , Huang Peng , Shi Xuefei , Cai Jingsheng , Qiu Mantang , Wang Enxiu , Lu Kaihua , Sun Ming
Published: March 2024

Small cell lung cancer (SCLC), recognized as the most aggressive subtype of lung cancer, presents an extremely poor prognosis. Currently, patients with small cell lung cancer face a significant dearth of effective alternative treatment options once they experience recurrence and progression after first‐line therapy. Despite the promising efficacy of immunotherapy, particularly immune checkpoint inhibitors in non‐small cell lung cancer (NSCLC) and various other tumours, its impact on significantly enhancing the prognosis of SCLC patients remains elusive. DLL3 has emerged as a compelling target for targeted therapy in SCLC due to its high expression on the membranes of SCLC and other neuroendocrine carcinoma cells, with minimal to no expression in normal cells. Our previous work led to the development of a novel multiple chain chimeric antigen receptor (CAR) leveraging the TREM1 receptor and DAP12, which efficiently activated T cells and conferred potent cell cytotoxicity. In this study, we have developed a DLL3‐TREM1/DAP12 CAR‐T (DLL3‐DT CAR‐T) therapy, demonstrating comparable anti‐tumour efficacy against SCLC cells in vitro. In murine xenograft and patient‐derived xenograft models, DLL3‐DT CAR‐T cells exhibited a more robust tumour eradication efficiency than second‐generation DLL3‐BBZ CAR‐T cells. Furthermore, we observed elevated memory phenotypes, induced durable responses, and activation under antigen‐presenting cells in DLL3‐DT CAR‐T cells. Collectively, these findings suggest that DLL3‐DT CAR‐T cells may offer a novel and potentially effective therapeutic strategy for treating DLL3‐expressing SCLC and other solid tumours.
Dynamic competition and market structure for platform‐based products: roles of product quality and indirect network effect
Authors: Dou Guowei , Wei Kun , Ma Lijun , Lin Xudong
Published: March 2024

We consider dynamic competition between two platform‐based products that exhibit two‐sided network effects, such as game consoles and intelligent hardware. Firms compete in terms of pricing and Research & Development investment, which are driven by consumers’ marginal utility of quality, indirect network effects, and the differentiation between consumers’ preference for the products. We find that with a small marginal utility of consumers, the equilibrium investment of one firm increases first and decreases later with its product quality but is not obviously sensitive to the rival's. In contrast, with a large marginal utility, if the quality of the two products is comparable, the equilibrium investment increases substantially. However, if one product pulls ahead, the other firm will stop investing. Besides, we find that when the intrinsic value and the network value coexist, the market becomes more concentrated, even when consumers’ marginal utility is small. The market concentration increases in both the consumers’ marginal utility and the indirect network effect but decreases in the degree of differentiation between consumers’ preference toward the two products. Interestingly, we show that differentiation plays an important role in shaping the market structure only when the network effect is weak. Counterintuitively, we show that the differentiation corrodes firms’ total profits, which demonstrates that less fierce competition resulting from low substitution leads to a lower profit. Additionally, we reveal that dynamic interaction between quality and installed base motivates firms to improve from a low quality, the first‐mover advantage does not ensure market dominance.
Healthy work environment: A systematic review informing a nursing professional practice model in the US Military Health System
Authors: Williams Kathy M. , Campbell Caitlin Marley , House Sherita , Hodson Patricia , Swiger Pauline A. , Orina Judy , Javed Mariyam , Pierce Taylor , Patrician Patrician A.
Published: March 2024

Aim

The aim of the study was to develop recommendations for creating a healthy work environment based on current literature for nurses working within the US Military Health System (MHS). However, our findings would likely benefit other nursing populations and environments as well.

Design

Systematic literature review.

Data Sources

We conducted a systematic literature search for articles published between January 2010 until January 2024 from five databases: PubMed, Joanna Briggs, Embase, CINAHL and Scopus.

Methods

Articles were screened, selected and extracted using Covidence software. Article findings were synthesized to create recommendations for the development, implementation and measurement of healthy work environments.

Results

Ultimately, a total of 110 articles met the criteria for inclusion in this review. The articles informed 13 recommendations for creating a healthy work environment. The recommendations included ensuring teamwork, mentorship, job satisfaction, supportive leadership, nurse recognition and adequate staffing and resources. Additionally, we identified strategies for implementing and measuring these recommendations.

Conclusions

This thorough systematic review created actionable recommendations for the creation of a healthy work environment. Based on available evidence, implementation of these recommendations could improve nursing work environments.

Impact

This study identifies methods for implementing and measuring aspects of a healthy work environment. Nurse leaders or others can implement the recommendations provided here to develop healthy work environments in their hospitals, clinics or other facilities where nurses practice.

Reporting Method

PRISMA 2020 guidelines.

Patient or Public Contribution

No patient or public contribution.
The effects of clinical learning environment and career adaptability on resilience: A mediating analysis based on a survey of nursing interns
Authors: Xu Yutong , Zhang Wanting , Wang Jia , Guo Zihan , Ma Weiguang
Published: March 2024

Background

The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience.

Aims

To evaluate the resilience level of Chinese nursing interns and explore the effects of factors affecting resilience early in their careers, focusing on the mediating roles of career adaptability between clinical learning environment and resilience.

Methods

The cross‐sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor‐Davidson Resilience Scale, the Clinical Learning Environment Scale for Nurse and the Career Adapt‐Abilities Scale. Structural equation modelling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped confidence intervals.

Results

The nursing interns showed a moderately high level of resilience [M (SD) = 70.15 (19.90)]. Gender, scholastic attainment, scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns' resilience. Male interns with good academic performance showed higher levels of resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.62, 0.18, respectively, p < .01). Career adaptability was also positively affected by the clinical learning environment (β = 0.36, p < .01), and mediated the effect of clinical learning environment on resilience (β = 0.22, p < .01).

Conclusion

Clinical learning environment can positively affect the resilience level of nursing interns. Career adaptability can affect resilience directly and also play a mediating role between clinical learning environment and resilience. Thus, promotion of career adaptability and clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for female nursing interns with low academic performance.
On the Ethics of Interacting
Authors: Brownlee Kimberley
Published: March 2024

Ordinary interactions are the primary vehicle through which we show respect, give social pleasure, and grease the wheels of healthy sociality. When we do an interactional wrong to someone, we not only convey disrespect by disregarding their interactional needs, but also cause them social pain and erode healthy social relations. Interactional ethics – the study of the ethics of interacting – concerns both our conduct within our interactions and our broader interactional style. The existing philosophical literature in this area has not yet provided a detailed analysis of the three discrete stages of an ordinary interaction – the initiation stage, the execution stage, and the conclusion stage – or of the specific wrongs beyond disrespect that we can do at each stage. This article develops novel and useful tools to analyse interactional wrongs that both compromise our wellbeing by causing us social pain and threaten healthy sociality. It then distinguishes various patterns of interactional wrongdoing – i.e. interactional vices – that we can manifest as we seek to control with whom we interact and how.
Exploring an effective automated grading model with reliability detection for large‐scale online peer assessment
Authors: Lin Zirou , Yan Hanbing , Zhao Li
Published: March 2024

Background

Peer assessment has played an important role in large‐scale online learning, as it helps promote the effectiveness of learners' online learning. However, with the emergence of numerical grades and textual feedback generated by peers, it is necessary to detect the reliability of the large amount of peer assessment data, and then develop an effective automated grading model to analyse the data and predict learners' learning results.

Objectives

The present study aimed to propose an automated grading model with reliability detection.

Methods

A total of 109,327 instances of peer assessment from a large‐scale teacher online learning program were tested in the experiments. The reliability detection approach included three steps: recurrent convolutional neural networks (RCNN) was used to detect grade consistency, bidirectional encoder representations from transformers (BERT) was used to detect text originality, and long short‐term memory (LSTM) was used to detect grade‐text consistency. Furthermore, the automated grading was designed with the BERT‐RCNN model.

Results and Conclusions

The effectiveness of the automated grading model with reliability detection was shown. For reliability detection, RCNN performed best in detecting grade consistency with an accuracy rate of 0.889, BERT performed best in detecting text originality with an improvement of 4.47% compared to the benchmark model, and LSTM performed best with an accuracy rate of 0.883. Moreover, the automated grading model with reliability detection achieved good performance, with an accuracy rate of 0.89. Compared to the absence of reliability detection, it increased by 12.1%.

Implications

The results strongly suggest that the automated grading model with reliability detection for large‐scale peer assessment is effective, with the following implications: (1) The introduction of reliability detection is necessary to help filter out low reliability data in peer assessment, thus promoting effective automated grading results. (2) This solution could assist assessors in adjusting the exclusion threshold of peer assessment reliability, providing a controllable automated grading tool to reducing manual workload with high quality. (3) This solution could shift educational institutions from labour‐intensive grading procedures to a more efficient educational assessment pattern, allowing for more investment in supporting instructors and learners to improve the quality of peer feedback.
Prognostic value of cardiac deceleration capacity in patients with atrial fibrillation after catheter ablation: A systematic review and meta‐analysis
Authors: Maimaitijiang Pakezhati , Dai Qi , Lai Zihao , Chen Aiyue , Zheng Lihui
Published: March 2024

Introduction

Cather ablation (CA) is a well‐recognized treatment alternative for atrial fibrillation (AF) patients despite more than 20% ablation‐treated patients suffering from AF recurrence. The underlying mechanism of AF recurrence postablation is probably associated with high cardiac parasympathetic activity, which can be assessed with deceleration capacity (DC) of heart rate. Given that the relationship between DC and AF recurrence is still controversial, this systematic review and meta‐analysis was performed to investigate the characteristics of DC in patients with and without AF recurrence, evaluating the prognostic value of DC in AF patients after CA.

Methods

A literature search was systematically performed in the Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases until October 01, 2023. The observational studies reporting either the pre‐ and postablation DC in both recurrence and non‐recurrence groups or the ratios based on DC for predicting AF recurrence were mainly included. Weighted mean differences (WMD) or odds ratios (OR) based on DC would be calculated with a random‐effect model, if heterogeneity estimated with the I2 index and Q statistic was significant (I2 > 50% or p < .05); otherwise, a fixed‐effect model would be utilized.

Results

A total of eight observational studies involving 914 AF patients treated with radiofrequency or cryoballoon ablation were included in this study. Ablation‐treated patients with AF recurrence had the higher DC postablation in relation to those without recurrence (WMD, 1.00; 95% confidence interval [CI], 0.33–1.67; p < .01), which was present up to 3 months of follow‐up (WMD, 1.54; 95% CI, 1.11–1.96; p < .01), whereas there was no statistical significance in DC before ablation between recurrence and non‐recurrence groups (WMD, 0.34; 95% CI, −0.12 to 0.79; p = .15). The high DC postablation was a risk factor for AF recurrence in ablation‐treated patients (OR, 2.17; 95% CI, 1.44–3.25; p < .01).

Conclusion

The high DC postablation was associated with the risk of AF recurrence, suggesting that DC may act as a prognostic indicator in AF patients treated with CA.
Between blood glucose and mortality in critically ill patients: Retrospective analysis of the MIMIC‐IV database
Authors: Li Yuanyuan , Li Wenqiang , Xu Baocai
Published: March 2024

Aims/Introduction

Mean blood glucose (MBG) level is associated with mortality among critically ill patients. We undertook a cohort study to investigate the relationship between MBG and mortality in critically ill patients.

Materials and Methods

Critically ill patients were enrolled from the Medical Information Mart for Intensive Care IV (MIMIC‐IV) database. MBG was calculated to represent the overall glycemic status during intensive care unit (ICU) hospitalization, and a multivariate logistic regression determined the relationship between MBG and ICU mortality in different subgroups of critically ill patients.

Results

A total of 8,973 patients were included in the study, 1,244 of whom died within 28 days, including 5,402 men and 3,571 women. Multivariate adjusted restricted cubic spline analyses suggested that the relationship between MBG and ICU mortality was a “J” shape. Logistic regression showed 28 day mortality in group 3 (glucose ≥10 mmol/L): the adjusted odds ratio was 2.06 (95% confidence interval 1.65–2.57). The results of subgroup analysis showed that hyperglycemia had a more significant impact on ICU mortality in patients without diabetes, hypoglycemia and liver disease, and the ICU mortality risk of non‐diabetes patients was always higher than that of diabetes patients with the same hyperglycemia level.

Conclusions

Current evidence suggested a J‐shaped relationship between MBG and mortality in critically ill patients.