bluuebunny/crossref_metadata_2025 huggingface dataset:
Immune Surveillance of Acute Myeloid Leukemia Is Mediated by HLA-Presented Antigens on Leukemia Progenitor Cells
Authors: Nelde Annika , Schuster Heiko , Heitmann Jonas S. , Bauer Jens , Maringer Yacine , Zwick Melissa , Volkmer Jens-Peter , Chen James Y. , Stanger Anna M. Paczulla , Lehmann Ariane , Appiah Bismark , Märklin Melanie , Rücker-Braun Elke , Salih Helmut R. , Roerden Malte , Schroeder Sarah M. , Häring Max-Felix , Schlosser Andreas , Schetelig Johannes , Schmitz Marc , Boerries Melanie , Köhler Natalie , Lengerke Claudia , Majeti Ravindra , Weissman Irving L. , Rammensee Hans-Georg , Walz Juliane S.
Published: October 2023

Therapy-resistant leukemia stem and progenitor cells (LSC) are a main cause of acute myeloid leukemia (AML) relapse. LSC-targeting therapies may thus improve outcome of patients with AML. Here we demonstrate that LSCs present HLA-restricted antigens that induce T-cell responses allowing for immune surveillance of AML. Using a mass spectrometry–based immunopeptidomics approach, we characterized the antigenic landscape of patient LSCs and identified AML- and AML/LSC-associated HLA-presented antigens absent from normal tissues comprising nonmutated peptides, cryptic neoepitopes, and neoepitopes of common AML driver mutations of NPM1 and IDH2. Functional relevance of shared AML/LSC antigens is illustrated by presence of their cognizant memory T cells in patients. Antigen-specific T-cell recognition and HLA class II immunopeptidome diversity correlated with clinical outcome. Together, these antigens shared among AML and LSCs represent prime targets for T cell–based therapies with potential of eliminating residual LSCs in patients with AML.

Significance:

The elimination of therapy-resistant leukemia stem and progenitor cells (LSC) remains a major challenge in the treatment of AML. This study identifies and functionally validates LSC-associated HLA class I and HLA class II–presented antigens, paving the way to the development of LSC-directed T cell–based immunotherapeutic approaches for patients with AML.

See related commentary by Ritz, p. 430 .

This article is featured in Selected Articles from This Issue, p. 419
Accuracy of the Depression, Anxiety and Stress Scale (DASS-21) for Screening on Comorbid Internalizing Disorders among Youth in Substance Use Disorder Treatment
Authors: Moska Christina , Goudriaan Anna E. , Blanken Peter , Hendriks Vincent
Published: October 2023

Introduction: Major depression, anxiety disorders, and post-traumatic stress disorder (PTSD) are among the most prevalent comorbid mental disorders in youth addiction treatment. Hence, screening for these internalizing disorders should be part of the standard routine at intake in substance use disorder treatment. We investigated the usefulness of the Depression, Anxiety and Stress Scale (DASS-21) as a screener for this purpose. Methods: A nationally representative sample of 421 treatment-seeking youths aged 16–22 years with a primary cannabis, alcohol, cocaine, or amphetamine use disorder participated in the study. At intake, we administered the DASS-21 and the Mini International Neuropsychiatric Interview (MINI; Sheehan et al., 1998) based on the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), as “gold standard,” as part of a broader baseline assessment of the Youth in transition study [Moska et al. BMC Psychiatry. 2021;21(1):1–11]. Results: At comparable sensitivity (0.80–0.84), based on the optimal cut-off value, specificity was higher for the DASS-21 total score detecting any DSM-5 internalizing disorder (0.62) than for the DASS subscales specifically detecting depression, anxiety, or PTSD (0.44, 0.49, and 0.51, respectively). Receiver operating characteristic curve analyses showed an area under the curve (AUC) value of 0.80 for the DASS total score to detect any internalizing disorder (“good discrimination”), compared with AUC values of 0.70–0.75 of the DASS depression and anxiety subscales to detect DSM-5 depression, anxiety, and PTSD (“fair discrimination”). The optimal DASS total score cut-off value of ≥44 for detecting any internalizing disorder resulted in 0.81 sensitivity, 0.62 specificity, 0.80 positive predictive value, and 0.64 negative predictive value. Conclusion: Given the high prevalence of comorbid internalizing disorders in youth addiction care, the need to address these comorbid disorders in treatment, and the favorable accuracy of the DASS to detect these disorders, we recommend to implement the DASS-21 as routine screener in youth addiction treatment in the Netherlands.
Calcipotriene/Betamethasone Dipropionate Foam as a Potential Safe and Effective Treatment of Nail Psoriasis
Authors: Abbas Alia , Amin Sima , Sanyi Adaugo , Mayo Tiffany , Elewski Boni
Published: October 2023

Background: Nail psoriasis is a common condition that affects quality of life in individuals with psoriasis and psoriatic arthritis. Topical treatments have been shown to be effective in treating nail bed disease but not as effective in treating nail matrix diseases, which often requires intralesional corticosteroids. Objectives: The objective of this open-label study was to evaluate the efficacy of combination calcipotriol/betamethasone dipropionate foam as a treatment for nail psoriasis including nail matrix disease. Method: We report three patients with moderate to severe nail psoriasis with involvement of all ten fingernails who applied study foam nightly for 6 months. Nails were assessed using the NAPSI score evaluating both nail bed and nail matrix disease. Results: NAPSI score improved including nail matrix disease in the majority of nails. No skin irritation or unexpected adverse events occurred. Conclusions: We conclude this foam combination product could be an effective and safe treatment for fingernail psoriasis and may provide better nail matrix penetration as evidenced by improvement in nail matrix score. Further studies are needed for additional evaluation.
Hepatocellular Carcinoma Subtyping and Prognostic Model Construction Based on Chemokine-Related Genes
Authors: Guo Qiusheng , Huang Yangyang , Zhan Xiaoan
Published: October 2023

Background: Chemokines not only regulate immune cells but also play significant roles in development and treatment of tumors and patient prognoses. However, these effects have not been fully explained in hepatocellular carcinoma (HCC). Materials and Methods: We conducted a clustering analysis of chemokine-related genes. We then examined the differences in survival rates and analyzed immune levels using single-sample Gene Set Enrichment Analysis (ssGSEA) for each subtype. Based on chemokine-related genes of different subtypes, we built a prognostic model in The Cancer Genome Atlas (TCGA) dataset using the survival package and glmnet package and validated it in the Gene Expression Omnibus (GEO) dataset. We used univariate and multivariate regression analyses to select independent prognostic factors and used R package rms to draw a nomogram reflecting patient survival rates at 1, 3, and 5 years. Results: We identified two chemokine subtypes and, after screening, found that Cluster1 had higher survival rates than Cluster2. In addition, in terms of immune evaluation, stromal evaluation, ESTIMATE evaluation, immune abundance, immune function, and expressions of various immune checkpoints, immune levels of Cluster1 were significantly better than those of Cluster2. The immunophenoscore (IPS) of HCC patients in Cluster1 was significantly higher than that in Cluster2. Furthermore, we established a prognostic model consisting of 9 genes, which correlated with chemokines. Through testing, Riskscore was revealed as an independent prognostic factor, and the model could effectively predict HCC patients’ prognoses in both TCGA and GEO datasets. Conclusion: This study resulted in the development of a novel prognostic model related to chemokine genes, providing new targets and theoretical support for HCC patients.
Effectiveness and Safety of Non-Vitamin K Oral Anticoagulants versus Warfarin in Patients with Atrial Fibrillation and Previous Stroke: A Systematic Review and Meta-Analysis
Authors: Shi Minglei , Liu Lu , Wafa Hatem , Curcin Vasa , Wang Yanzhong
Published: October 2023

Introduction: Current evidence regarding the clinical outcomes of non-vitamin K oral anticoagulants (NOACs) versus warfarin in patients with atrial fibrillation (AF) and previous stroke is inconclusive, especially in patients with previous intracranial haemorrhage (ICrH). We aim to undertake a systematic review and meta-analysis assessing the effectiveness and safety of NOACs versus warfarin in AF patients with a history of stroke. Methods: We searched studies published up to December 10, 2022, on PubMed, Medline, Embase, and Cochrane Central Register of Controlled Trials. Studies on adults with AF and previous ischaemic stroke (IS) or IrCH receiving either NOACs or warfarin and capturing outcome events (thromboembolic events, ICrH, and all-cause mortality) were eligible for inclusion. Results: Six randomized controlled trials (RCTs) (including 19,489 patients with previous IS) and fifteen observational studies (including 132,575 patients with previous IS and 13,068 patients with previous ICrH) were included. RCT data showed that compared with warfarin, NOACs were associated with a significant reduction in thromboembolic events (odds ratio [OR]: 0.85, 95% confidence interval [CI]: 0.75–0.96), ICrH (OR: 0.57, 95% CI: 0.36–0.90), and all-cause mortality (OR: 0.88, 95% CI: 0.80–0.98). In analysing observational studies, similar results were retrieved. Moreover, patients with previous ICrH had a lower OR on thromboembolic events than those with IS (OR: 0.66, 95% CI: 0.46–0.95 vs. OR: 0.80, 95% CI: 0.70–0.93) in the comparison between NOACs and warfarin. Conclusions: Observational data showed that in AF patients with previous stroke, NOACs showed better clinical performance compared to warfarin and the benefits of NOACs were more pronounced in patients with previous IrCH versus those with IS. RCT data also showed NOACs are superior to warfarin. However, current RCTs only included AF patients who survived an IS, and further large RCTs focused on patients with previous ICrH are warranted.
Use of the Gene Expression Test Prosigna® in Premenopausal Patients with HR+, HER2− Early Breast Cancer: Correlation of the Results with the Proliferation Marker Ki-67
Authors: Ziegler Cordula , Sotlar Karl , Hofmann Daniel Maria , Kolben Thomas , Harbeck Nadia , Würstlein Rachel
Published: October 2023

Introduction: In hormone receptor-positive (ER+/PR+) and human epidermal growth factor receptor 2-negative (HER2−) early-stage breast cancer (EBC), gene expression tests such as the Prosigna are increasingly used since classic clinicopathological parameters and the proliferation factor Ki-67 often do not allow a definite therapy decision regarding an adjuvant chemotherapy. While the Prosigna test has been validated for postmenopausal patients, few data are available regarding its use in premenopausal patients. The present study compared the Prosigna test with the Ki-67 index in premenopausal patients. Materials and Methods: Premenopausal patients with HR+ HER2−, pN0-1, G1-2 EBC were retrospectively enrolled (n = 55). The Prosigna assay was performed in formalin-fixed paraffin-embedded tumor samples of surgical resection specimens. Ki-67 was reassessed in original diagnostic core needle biopsy specimens and defined as low, intermediate, or high with the threshold of <10%, 10–24%, ≥25%. Results: According to Ki-67, patients were in the low (LR)-, intermediate (IR)-, and high-risk (HR) groups in 40%, 36%, and 24% of the cases. The Prosigna gene signature assay assessed the risk of recurrence as LR for 45% of the patients, IR for 35%, and HR for 20%. The most frequent intrinsic subtypes were luminal A in 73% and luminal B in 24% of the patients. A moderate correlation was found between Prosigna and Ki-67 scores with a Pearson correlation coefficient of 0.51. In the overall cohort, 47% of the Ki-67-based therapy decision would correspond to those based on the Prosigna score. After exclusion of IR patients, matching of low/low or high/high results was observed in 57% of the cases. Conclusion: According to the present study, there is only limited concordance regarding the risk group stratification between Ki-67 and Prosigna-based risk assessment. The relevance and frequency of premenopausal breast cancer emphasizes the need for further evaluation of gene expression analyses in this setting and the correlation with classic clinicopathological parameters regarding therapy decision-making.
Role of Cardiac Energetics in Aortic Stenosis Disease Progression: Identifying the High-risk Metabolic Phenotype
Authors: Monga Shveta , Valkovič Ladislav , Myerson Saul G. , Neubauer Stefan , Mahmod Masliza , Rider Oliver J.
Published: October 2023

Background:

Severe aortic stenosis (AS) is associated with left ventricular (LV) hypertrophy and cardiac metabolic alterations with evidence of steatosis and impaired myocardial energetics. Despite this common phenotype, there is an unexplained and wide individual heterogeneity in the degree of hypertrophy and progression to myocardial fibrosis and heart failure. We sought to determine whether the cardiac metabolic state may underpin this variability.

Methods:

We recruited 74 asymptomatic participants with AS and 13 healthy volunteers. Cardiac energetics were measured using phosphorus spectroscopy to define the myocardial phosphocreatine to adenosine triphosphate ratio. Myocardial lipid content was determined using proton spectroscopy. Cardiac function was assessed by cardiovascular magnetic resonance cine imaging.

Results:

Phosphocreatine/adenosine triphosphate was reduced early and significantly across the LV wall thickness quartiles (Q2, 1.50 [1.21–1.71] versus Q1, 1.64 [1.53–1.94]) with a progressive decline with increasing disease severity (Q4, 1.48 [1.18–1.70];
P
=0.02). Myocardial triglyceride content levels were overall higher in all the quartiles with a significant increase seen across the AV pressure gradient quartiles (Q2, 1.36 [0.86–1.98] versus Q1, 1.03 [0.81–1.56];
P
=0.034). While all AS groups had evidence of subclinical LV dysfunction with impaired strain parameters, impaired systolic longitudinal strain was related to the degree of energetic impairment (
r
=0.219;
P=
0.03). Phosphocreatine/adenosine triphosphate was not only an independent predictor of LV wall thickness (
r
=−0.20;
P
=0.04) but also strongly associated with myocardial fibrosis (
r
=−0.24;
P
=0.03), suggesting that metabolic changes play a role in disease progression. The metabolic and functional parameters showed comparable results when graded by clinical severity of AS.

Conclusions:

A gradient of myocardial energetic deficit and steatosis exists across the spectrum of hypertrophied AS hearts, and these metabolic changes precede irreversible LV remodeling and subclinical dysfunction. As such, cardiac metabolism may play an important and potentially causal role in disease progression.
ESCRT-III Component CHMP4C Attenuates Cardiac Hypertrophy by Targeting the Endo-Lysosomal Degradation of EGFR
Authors: Liu Ao , Xie Huilin , Tian Fangyan , Bai Peiyuan , Weng Haobo , Liu Yu , Liu Wen , Tang Lu , You Hongmin , Zhou Nianwei , Shu Xianhong
Published: October 2023

BACKGROUND:

Cardiac hypertrophy and subsequent heart failure impose a considerable burden on public health worldwide. Impaired protein degradation, especially endo-lysosome-mediated degradation of membrane proteins, is associated with cardiac hypertrophy progression. CHMP4C (charged multivesicular body protein 4C), a critical constituent of multivesicular bodies, is involved in cellular trafficking and signaling. However, the specific role of CHMP4C in the progression of cardiac hypertrophy remains largely unknown.

METHODS:

Mouse models with CHMP4C knockout or cardiadc-specific overexpression were subjected to transverse aortic constriction surgery for 4 weeks. Cardiac morphology and function were assessed through histological staining and echocardiography. Confocal imaging and coimmunoprecipitation assays were performed to identify the direct target of CHMP4C. An EGFR (epidermal growth factor receptor) inhibitor was administrated to determine whether effects of CHMP4C on cardiac hypertrophy were EGFR dependent.

RESULTS:

CHMP4C was significantly upregulated in both pressure-overloaded mice and spontaneously hypertensive rats. Compared with wild-type mice, CHMP4C deficiency exacerbated transverse aortic constriction–induced cardiac hypertrophy, whereas CHMP4C overexpression in cardiomyocytes attenuated cardiac dysfunction. Mechanistically, the effect of CHMP4C on cardiac hypertrophy relied on the EGFR signaling pathway. Fluorescent staining and coimmunoprecipitation assays confirmed that CHMP4C interacts directly with EGFR and promotes lysosome-mediated degradation of activated EGFR, thus attenuating cardiac hypertrophy. Notably, an EGFR inhibitor canertinib counteracted the exacerbation of cardiac hypertrophy induced by CHMP4C knockdown in vitro and in vivo.

CONCLUSIONS:

CHMP4C represses cardiac hypertrophy by modulating lysosomal degradation of EGFR and is a potential therapeutic candidate for cardiac hypertrophy.
Arterial Stiffness Is Associated With Small Vessel Disease Irrespective of Blood Pressure in Stroke-Free Individuals
Authors: Miyagi Tomo , Ishida Akio , Shinzato Tomoko , Ohya Yusuke
Published: October 2023

BACKGROUND:

Arterial stiffness and hypertension are important risk factors for cerebral small vessel disease (CSVD). Clinically, there are hypertensive patients with low pulse wave velocity (PWV) and nonhypertensive individuals with high PWV. We aimed to determine the effects of arterial stiffness on CSVD in normotensive individuals.

METHODS:

An observational cross-sectional study was conducted in 1894 stroke-free participants who underwent brain magnetic resonance imaging and brachial-ankle pulse wave velocity (baPWV) measurements at a health checkup between 2013 and 2020. CSVD was defined as any of following: white matter hyperintensities, cerebral microbleeds, silent lacunar infarcts, and enlarged perivascular spaces. baPWV was measured using an automatic oscillometric device. Participants were divided into 4 groups according to the following cutoff points: low blood pressure (BP, <120/80 mm Hg) with low baPWV (<14.63 m/s, a cutoff value that predicted CSVD); high BP (≥120/80 mm Hg) with low baPWV; low BP with high baPWV (≥14.63 m/s); and high BP with high baPWV.

RESULTS:

The mean age of the participants was 57±13 years (41% women). The prevalence of CSVD was 718 (38%), which was higher in the low BP with high baPWV (56%) and high BP with high baPWV (55%) groups than in the high BP with low baPWV (24%) and low BP with low baPWV (22%) groups. Compared with the low BP with low baPWV group, the low BP with high baPWV group (odds ratio, 1.63 [95% CI, 1.09–2.43]) and the high BP with high baPWV group (odds ratio, 1.86 [95% CI, 1.39–2.49]) had a significantly higher multivariable-adjusted risk for CSVD.

CONCLUSIONS:

Individuals with a high baPWV had a higher prevalence of CSVD, independent of BP status. Higher arterial stiffness is likely to be a more important risk factor for CSVD than BP status in stroke-free individuals.
Perinatal Azithromycin Provides Limited Neuroprotection in an Ovine Model of Neonatal Hypoxic-Ischemic Encephalopathy
Authors: Mike Jana Krystofova , White Yasmine , Hutchings Rachel S. , Vento Christian , Ha Janica , Manzoor Hadiya , Lee Donald , Losser Courtney , Arellano Kimberly , Vanhatalo Oona , Seifert Elena , Gunewardena Anya , Wen Bo , Wang Lu , Wang Aijun , Goudy Brian D. , Vali Payam , Lakshminrusimha Satyan , Gobburu Jogarao V.S. , Long-Boyle Janel , Wu Yvonne W. , Fineman Jeffrey R. , Ferriero Donna M. , Maltepe Emin
Published: October 2023

BACKGROUND:

Hypoxic-ischemic brain injury/encephalopathy affects about 1.15 million neonates per year, 96% of whom are born in low- and middle-income countries. Therapeutic hypothermia is not effective in this setting, possibly because injury occurs significantly before birth. Here, we studied the pharmacokinetics, safety, and efficacy of perinatal azithromycin administration in near-term lambs following global ischemic injury to support earlier treatment approaches.

METHODS:

Ewes and their lambs of both sexes (n=34, 141–143 days) were randomly assigned to receive azithromycin or placebo before delivery as well as postnatally. Lambs were subjected to severe global hypoxia-ischemia utilizing an acute umbilical cord occlusion model. Outcomes were assessed over a 6-day period.

RESULTS:

While maternal azithromycin exhibited relatively low placental transfer, azithromycin-treated lambs recovered spontaneous circulation faster following the initiation of cardiopulmonary resuscitation and were extubated sooner. Additionally, peri- and postnatal azithromycin administration was well tolerated, demonstrating a 77-hour plasma elimination half-life, as well as significant accumulation in the brain and other tissues. Azithromycin administration resulted in a systemic immunomodulatory effect, demonstrated by reductions in proinflammatory IL-6 (interleukin-6) levels. Treated lambs exhibited a trend toward improved neurodevelopmental outcomes while histological analysis revealed that azithromycin supported white matter preservation and attenuated inflammation in the cingulate and parasagittal cortex.

CONCLUSIONS:

Perinatal azithromycin administration enhances neonatal resuscitation, attenuates neuroinflammation, and supports limited improvement of select histological outcomes in an ovine model of hypoxic-ischemic brain injury/encephalopathy.
Smoking Modifies the Association Between Radon Exposure and Incident Ischemic Stroke: The REGARDS Study
Authors: Zhang Yijia , Yan Qi , Angley Meghan , Lu Liping , Miller Eliza C. , Judd Suzanne E. , Field R. William , Kahe Ka
Published: October 2023

BACKGROUND:

Exposure to radon has been linked to lung cancer and other lung diseases. Although biologically plausible, research of residential radon exposure in relation to stroke risk is scarce.

METHODS:

Study participants were from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) cohort (n=30 239), which consisted of male and female non-Hispanic Black and White adults aged 45 and older. After excluding participants with baseline stroke and transient ischemic attack, and missing information on exposure and outcome of interest, the final sample size was 26 950. The primary outcome was time to the first ischemic stroke through September 30, 2020. County-level radon measures from Lawrence Berkeley National Laboratory were linked to each participant based on their geocoded residential history. We used Cox proportional hazards regression models with a time-dependent exposure to estimate hazard ratios and 95% CIs for the association.

RESULTS:

After controlling for potential confounding factors including demographic, lifestyle, clinical variables, and PM
2.5
, radon exposure was significantly associated with incident ischemic stroke among never-smokers (hazard ratio, 1.39 [95% CI, 1.01–1.90]) but not ever-smokers. The results were generally consistent in the sensitivity analysis when using radon measures from state/Environmental Protection Agency residential radon survey.

CONCLUSIONS:

Findings from this study suggest that the association between residential radon exposure and incidence of ischemic stroke varies by smoking status and may be prominent in never-smokers. Further studies incorporating indoor-radon measures are needed to confirm these findings.
Comparison of New Career Approach Attitudes and Subjective Career Success Perceptions in terms of Demographic Variables
Authors: ÖZTÜRK Uygar , YILDIRIM Elvan
Published: October 2023

This study examines the impact of shifts in the structure of employment and traditional career models on perceptions of boundaryless, protean, and subjective career success among employees of private employment agencies. As private employment agencies represent a relatively new phenomenon in the modern labor market, this research aims to examine these concepts quantitatively. This research investigates the relationship between demographic characteristics and perceptions of boundaryless, protean and subjective career success among employees of private employment agencies.

The sample for this study consisted of 895 employees affiliated with private employment agencies in Istanbul. Research hypotheses were examined using exploratory factor analysis, descriptive statistics, correlation analysis, t-tests, and ANOVA. The results of this study revealed statistically significant differences in perceptions of boundaryless career attitude and subjective career success as a function of gender, age, education, marital status, and income level. However, no statistically significant differences were observed in perceptions of protean career attitudes across any demographic variable. Furthermore, the findings of this study have the potential to inform human resources, recruitment, and career planning practices.
The Politics of Youth Representation at Climate Change Conferences: Who Speaks, Who Is Spoken of, and Who Listens?
Authors: Marquardt Jens , Lövbrand Eva , Buhre Frida
Published: October 2023

In this article, we examine how young climate activists make use of the United Nations (UN) constituency system to give voice to children and youth in global climate governance. Our study is based on a mapping of accredited youth nongovernmental organizations (YOUNGO) as well as fieldwork at two UN Climate Change Conferences, where we conducted interviews, observed events, and analyzed plenary interventions. Informed by constructivist accounts of political representation, the article pays attention to the performative relationship between institutionalized means of youth representation and “the represented.” When analyzing our material, we asked who speaks for youth, how youth are spoken of, and how institutions shape representative speech. Our study identifies three subject positions that offer competing interpretations of who youth are as a political community and what they want. Rather than taking youth’s demands and interests as a starting point for representative politics, the article illustrates how the UN constituency system actively constructs youth and effectively molds young climate activists into professional insiders.
Tomatoes Are Red: The Perception of Achromatic Objects Elicits Retrieval of Associated Color Knowledge
Authors: Takashima Atsuko , Carota Francesca , Schoots Vincent , Redmann Alexandra , Jehee Janneke , Indefrey Peter
Published: October 2023

When preparing to name an object, semantic knowledge about the object and its attributes is activated, including perceptual properties. It is unclear, however, whether semantic attribute activation contributes to lexical access or is a consequence of activating a concept irrespective of whether that concept is to be named or not. In this study, we measured neural responses using fMRI while participants named objects that are typically green or red, presented in black line drawings. Furthermore, participants underwent two other tasks with the same objects, color naming and semantic judgment, to see if the activation pattern we observe during picture naming is (a) similar to that of a task that requires accessing the color attribute and (b) distinct from that of a task that requires accessing the concept but not its name or color. We used representational similarity analysis to detect brain areas that show similar patterns within the same color category, but show different patterns across the two color categories. In all three tasks, activation in the bilateral fusiform gyri (“Human V4”) correlated with a representational model encoding the red–green distinction weighted by the importance of color feature for the different objects. This result suggests that when seeing objects whose color attribute is highly diagnostic, color knowledge about the objects is retrieved irrespective of whether the color or the object itself have to be named.
Intra- and interspecific behavioural ecology within and between Mollienesia males (sailfin molly Poecilia velifera and shortfin molly P. mexicana) in mangroves of the Yucatán peninsula
Authors: Domínguez–Castanedo Omar , Schlupp Ingo
Published: October 2023

Throughout their distribution range, sailfin and shortfin mollies of the genus Poecilia inhabit overlapping habitats; however, little is known about its behavioural coexistence. We first describe the ethogram of Poecilia velifera and P. mexicana in a mangrove of Yucatan. Furthermore, we identify behavioural strategies of each size morphotype/species. We describe reproductive, territorial, and cleaning behaviours in two sympatric species of mollies in their natural context, with emphasis of their behavioural interactions and coexistence. Specifically, here we document (i) specific reproductive strategies in male P. velifera morphotypes (large, intermediate-ornamented and ‘cryptic-intermediate’), suggesting that cryptic-intermediate males have advantages that suggest consequences for their reproductive success; (ii) frequent courtship and sexual behaviours from P. mexicana males directed to P. velifera females, that deserve future attention to determine the possible generation of hybrids; and (iii) increased aggressive behaviour and territoriality of P. mexicana relative to those observed in P. velifera.
Paternalism Is Not Less Wrong in Intimate Relationships
Authors: Bengtson Andreas , Midtgaard Søren Flinch
Published: October 2023

Many believe that paternalism is less wrong in intimate relationships. In this paper, we argue that this view cannot be justified by appeal to (i) beneficence, (ii) shared projects, (iii) vulnerability, (iv) epistemic access, (v) expressivism, or (vi) autonomy as nonalienation. We finally provide an error theory for why many may have believed that paternalism is less wrong in intimate relations.
Norwegian Internationalism and World War ii Exile Diplomacy in Print
Authors: Jakubec Pavol
Published: October 2023

Communication plays a vital role in diplomacy, especially in multilateral settings. Historians of World War ii diplomacy have long neglected the potential of the foreign-language print media originating with the Allied European exiles. Publicity helped the Norwegian government retain two assets of supreme importance to every exile representation – credibility and agency. Norwegian efforts in this realm manifest resourcefulness: several formats have been employed to generate visibility, reciprocity, and reputation, or to transmit positions on the international order in the making. Moreover, content analysis elucidates the transformation of Norwegian internationalism from inter-war liberal propositions towards a more “realist” understanding.
Scandinavian Diplomacy on Human Rights and Economic Inequality at the United Nations in the 1970s
Authors: Søndergaard Rasmus S.
Published: October 2023

In the 1970s, United Nations debates on human rights and economic inequality were deeply shaped by the New International Economic Order (nieo) advocated by the developing countries and the basic needs development strategy championed by the World Bank and the United States. This article uses archives from Sweden, Denmark, and Norway as well as UN records, to examine the contributions Scandinavian diplomats and policymakers made to these debates. It demonstrates that the Scandinavians took a favorable position on both the nieo and basic needs, viewing them as complementary strategies to realize economic and social human rights. This view matched their activist foreign policies centered on UN diplomacy, human rights, and Global South solidarity. Finally, the article argues that the Scandinavian position reflected and was underpinned by a broad conception of human rights that put economic and social rights on an even footing with civil and political rights.
Three Settings for German-Nordic Cultural Diplomacy: Nordic Writers, the Deutsch-Nordische Schriftstellerhaus, and National Socialist Internationalism
Authors: Ørskov Frederik Forrai
Published: October 2023

This article adds to the growing research literature on Fascist trans- and internationalism, not least in regard to the relationships between foreign intellectuals and National Socialist cultural policy. It revolves around three interlinked German cultural relations institutions featuring significant involvement from Nordic writers: the Nordic Society, the German-Nordic Writers’ House, and the European Writers’ Union. Covering a period from 1931 to 1942, the article explores institutional links between these institutions and the versions of Nordic-German cultural diplomacy practiced and developed within their auspices. It argues that National Socialist Germany’s northbound cultural diplomatic efforts contained continuities with pre-1933 practices and conceptions, yet also came with significant inner tensions that ultimately impeded them. Navigating institutional, state, and diplomatic interest, as well as differing visions for cultural relations and cultural internationalist legitimacy abroad proved a difficult balancing act for the German cultural diplomatic actors involved.
Intermediary Bodies in International Politics: Conceptual and Historical Observations on Northern Europe’s Small States in the International System in the 19th and 20th Centuries
Authors: Jonas Michael
Published: October 2023

The article addresses central problems in the field of small state studies. By revisiting Paul W. Schroeder’s often neglected term “intermediary bodies” in the international system, it attempts to provide a broader conceptual alternative to established categories of description and definition such as “smallness” and “weakness.” In Schroeder’s understanding, intermediary bodies affect the international system beyond functioning as mere buffers. Ultimately, intermediaries influence procedures and outcomes substantially and transcend international politics to another level beyond mere (great) power politics. The subsequent remarks explore the utility and viability of the term by practically applying it to two historical examples: the Danish unitary monarchy within the German Confederation and the role of Finland as an intermediary during, before, and beyond the Cold War. Schroeder’s concept is thereby introduced into varying international contexts and bridges the gap between the history of the 19th century international system and the later modern period.
The Diplomat and the Entrepreneur: Olof Aschberg – Converter of Capital, Trader in Trust
Authors: Marklund Carl , Hellenes Andreas Mørkved
Published: October 2023

Swedish financier, philanthropist, and progressive Olof Aschberg played a dynamic, but “forgotten” role in the contacts between international labor, Western finance, and Soviet power across the world wars. We first suggest Aschberg can be studied as a converter of different forms of capital as well as a trader in trust in between the practices of diplomacy and entrepreneurship. We then outline Aschberg’s wide-ranging activities drawing upon existing secondary literature in lieu of a more systematic study of his life. Third, we concentrate on his interwar solidarity work and anti-fascism based in Paris. We analyze, fourth, his cultural diplomacy and publishing activities out of New York in between the Second World War and the early Cold War. Finally, we argue that Aschberg’s multi-positional and variegated vita illustrates the merit of employing entrepreneurship, in its most broad sense, as an analytical category for investigating the art and practice of citizen diplomacy.
4. The Alien, the Artificial, and the Extended
Authors: Matthews Paul
Published: October 2023

Authors have portrayed alien beings along a spectrum of psychological distance from the barely recognisable to the more relatable. We start here with the famously weird and incomprehensible, such as Lem’s sentient sea in Solaris and the beings in Vandermeer’s Area X. We see that an alien lifeworld can be imagined through a radically different sensory presence and extended language and physical communication skills. And a large number of interesting examples come from the extension of the body, either for AI minds to interact with the world, or for superhuman minds to inhabit entire spacecraft.
7. Conclusion
Authors: Matthews Paul
Published: October 2023

With the exception of the authors cited in the chapters of this book, examples of transparent alien minds are relatively limited, and this suggests that there is huge scope for the expansion of endeavours to create empathy and the experience of contact with other consciousnesses. We have seen that a good inspiration base is our growing (but still limited) knowledge of the life worlds of other species inhabiting our own planet as well as new theories of human consciousness. And if we want to look to more optimistic visions of future-enhanced humanity we could look to new subgenres such as solar punk, where our self-centered focus is expanded to a wider universe.
Estimation of the Eddy Viscosity Profile in the Sea Surface Boundary Layer from Underway ADCP Observations
Authors: Sentchev Alexei , Yaremchuk Max , Bourras Denis , Pairaud Ivane , Fraunié Philippe
Published: October 2023

A method of assessing the mean eddy viscosity profile (EVP) in the sea surface boundary layer (SBL) under variable wind conditions is proposed. Performance of the method is tested using observations by an ADCP-equipped platform in the coastal environment of the northwestern Mediterranean Sea under variable (3–12 m s−1) wind conditions. EVP retrievals are made by a variational method strongly constrained by the Ekman dynamics, with the wind and velocity observations assumed to be uncertain within the prescribed error bars. Results demonstrate a reasonable agreement of the EVPs with KPP shape functions for stronger (8–12 m s−1) wind conditions and appear to be consistent with the classical Pacanowski–Philander parameterization of the viscosity profile based on the Richardson number. For weaker (3–5 m s−1) winds, the EVP retrievals turn out to be less accurate, which is primarily attributed to the decay of the wind-driven turbulence energy in the SBL. Feasibility and prospects of the retrieval technique are discussed in the context of uncertainties in the structure of the background flow and limitations of the microstructure and ADCP profiling.
A Real-Time Automated Machine Learning Algorithm for Predicting Mortality in Trauma Patients: Survey Says it’s Ready for Prime-Time
Authors: Park Caroline , Loza-Avalos Sandra E. , Harvey Jalen , Hirschkorn Carol , Dultz Linda A. , Dumas Ryan P. , Sanders Drew , Chowdhry Vikas , Starr Adam , Cripps Michael
Published: October 2023

Background

Though artificial intelligence (“AI”) has been increasingly applied to patient care, many of these predictive models are retrospective and not readily available for real-time decision-making. This survey-based study aims to evaluate implementation of a new, validated mortality risk calculator (Parkland Trauma Index of Mortality, “PTIM”) embedded in our electronic healthrecord (“EHR”) that calculates hourly predictions of mortality with high sensitivity and specificity.

Methods

This is a prospective, survey-based study performed at a level 1 trauma center. An anonymous survey was sent to surgical providers and regarding PTIM implementation. The PTIM score evaluates 23 variables including Glasgow Coma Score (GCS), vital signs, and laboratory data.

Results

Of the 40 completed surveys, 35 reported using PTIM in decision-making. Prior to reviewing PTIM, providers identified perceived top 3 predictors of mortality, including GCS (22/38, 58%), age (18/35, 47%), and maximum heart rate (17/35, 45%). Most providers reported the PTIM assisted their treatment decisions (27/35, 77%) and timing of operative intervention (23/35, 66%). Many providers agreed that PTIM integrated into rounds and patient assessment (22/36, 61%) and that it improved efficiency in assessing patients’ potential mortality (21/36, 58%).

Conclusions

Artificial intelligence algorithms are mostly retrospective and lag in real-time prediction of mortality. To our knowledge, this is the first real-time, automated algorithm predicting mortality in trauma patients. In this small survey-based study, we found PTIM assists in decision-making, timing of intervention, and improves accuracy in assessing mortality. Next steps include evaluating the short- and long-term impact on patient outcomes.
Comparison of Laser Hemorrhoidoplasty and Milligan-Morgan Hemorrhoidectomy Techniques in the Treatment of Grade 2 and 3 Hemorrhoidal Disease
Authors: Cemil Adas , Ugur Kesici , Salih Genc M. , Merve Karadag , Guray Duman M. , Emine Boluk S.
Published: October 2023

Introduction

The estimated prevalence of hemorrhoidal disease (HD) worldwide ranges from 2.9% to 27.9%. Conservative, medical, non-operative, and surgical therapy approaches are applied in HD treatment. Milligan-Morgan (MM) hemorrhoidectomy which is the most well-known and frequently applied surgical treatment method, and Laser hemorrhoidoplasty (LH) are among the accepted treatment methods in Grade 2-3 HD treatment where medical treatment is insufficient.

Purpose

In this study, the early results of laser hemorrhoidoplasty and Milligan-Morgan hemorrhoidectomy techniques were compared.

Material and Methods

A randomized clinical trial. The study included ASA 1-3, total 85 patients aged 18-70 years old with symptomatic Grade 2 and Grade 3 hemorrhoidal disease whose symptoms persisted despite at least one month of medical treatment. Fifty-four patients were allocated to Group L, whereas 31 were allocated to Group M. Age, gender, weight, body mass index, preoperative symptoms, presence of additional disease, use of anticoagulant medication, and length of hospital stay of the patients included in the study were recorded. Rescue analgesic used was recorded. Postoperative VAS score and complications were recorded within 10 days. The total energy numbers applied to all packages were recorded.

Results

The incidence of minor perioperative hemorrhage was significantly lower in Group L compared to Group M ( P = .035). The postoperative 3rd-hour VAS scores were statistically significantly lower in Group L compared to Group ( P < .001). At the 3rd hour postoperatively, the need for rescue analgesia was statistically significantly higher in Group M compared to Group L. On the seventh postoperative day, Group M needed considerably more rescue analgesia compared to Group L ( P < .001, P = 1.00, P = .035, respectively). The cut-off value of 571 J was calculated in Group L.

Conclusion

We believe that it is not an advantageous method compared to MM hemorrhoidectomy, both in terms of patient comfort and cost-effectiveness, since postoperative pain, which is shown as the most important advantage of LH over conventional hemorrhoidectomy methods in the literature, can be relieved with simple NSA-I rescue analgesia in patients undergoing MM. Trial Registration: 03.06.2021/21-63.
Religious-Political Discussion on Instagram and WhatsApp and Perception of Religion among Youths in Delhi
Authors: Fahad Abdul , Mustafa Siti Ezaleila , Luqman Muhammad
Published: October 2023

This research paper examines the impact of social media on the perception of religion among young people in Delhi. The study explores the role of religious feelings and religious-political discourse that occur on social media platforms such as Instagram and WhatsApp, an instant messaging platform. The research uses a qualitative method in which interviews with young people in Delhi played a pivotal role in highlighting major aspects of the study. The findings indicate that social media has a significant impact on young people’s perceptions of religion in Delhi. While social media has provided young people with an opportunity to express their religious beliefs and engage in interfaith dialogue, it has also exposed them to extreme religious views and made it easier for political parties to influence their perception of religion and sometimes dehumanise other coreligionists on the basis of their system of belief and cultural context.
Application of COVIDTracer to Inform Public Health Workforce Planning in Alaska During the COVID-19 Pandemic
Authors: Cueva Katie , Bulkow Lisa , Milton Elaina , Van Wyck Rebecca , Hargrave Sarah , Meyer Jennifer
Published: October 2023

The COVID-19 pandemic has caused social and economic disruption worldwide and spurred numerous mitigation strategies, including state investments in training a large contact tracing and case investigation workforce. A team at the University of Alaska Anchorage evaluated implementation of the COVID-19 contact tracing and case investigation program of the State of Alaska Department of Health and Social Services, Division of Public Health, Section of Public Health Nursing. As part of that evaluation, the team used COVIDTracer, a spreadsheet modeling tool. COVIDTracer generated projections of COVID-19 case counts that informed estimates of workforce needs and case prioritization strategies. Case count projections approximated the reported epidemiologic curve with a median 7% difference in the first month. The accuracy of case count predictions declined after 1 month with a median difference of 80% in the second month. COVIDTracer inputs included previous case counts, the average length of time for telephone calls to cases and outreach to identified contacts, and the average number of contacts per case. As each variable increased, so too did estimated workforce needs. Decreasing the average time from exposure to outreach from 10 to 5 days reduced case counts estimated by COVIDTracer by approximately 93% during a 5-month period. COVIDTracer estimates informed Alaska’s workforce planning and decisions about prioritizing case investigation during the pandemic. Lessons learned included the importance of being able to rapidly scale up and scale down workforce to adjust to a dynamic crisis and the limitations of prediction modeling (eg, that COVIDTracer was accurate for only about 1 month into the future). These findings may be useful for future pandemic preparedness planning and other public health emergency response activities.
Addressing mpox at a Frontline Community Health Center: Lessons for the Next Outbreak
Authors: Allan-Blitz Lao-Tzu , Khan Taimur , Elangovan Kavya , Smith Kevin , Multani Ami , Mayer Kenneth H.
Published: October 2023

The 2022 mpox (formerly monkeypox) outbreak affected predominantly men who have sex with men (MSM), likely through sexual transmission, which resulted in institutions specializing in sexual health being at the frontlines of the mpox outbreak. Fenway Health in Boston serves close to 10 000 MSM annually, which includes more than 2400 MSM who are living with HIV and 3320 MSM with active HIV preexposure prophylaxis (PrEP) prescriptions. We report on the programs implemented and changes to clinical practice at Fenway Health during the mpox outbreak. Fenway Health diagnosed its first case of mpox in June 2022 and treated this patient with tecovirimat. In early July 2022, Fenway Health administered its first dose of the Jynneos vaccine under the Emergency Use Authorization for protection against mpox. As of October 6, 2022, 69 people had tested positive for the mpox virus at Fenway Health. Among the 69 people who tested positive, 43 (62.3%) self-identified as male, with the remaining not reporting a sex or gender identity, and 40 (58.0%) reported their sexual orientation as gay or bisexual. Twenty-five people (36.2%) were treated with tecovirimat. As of October 30, 2022, Fenway Health had administered 6376 doses of the Jynneos vaccine. The programmatic changes involved in rollout and scale-up of vaccination, treatment, and community outreach services at Fenway Health during the 2022 mpox outbreak that we describe here could inform strategies to address subsequent outbreaks.