bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from The impact of germline alterations in appendiceal adenocarcinoma
Authors: Foote Michael B. , Walch Henry , Kemel Yelena , Vakiani Efsevia , Johannet Paul , Sheehan Margaret , Chatila Walid , Chung Sebastian , NASH Garrett , Maio Anna , Shia Jinru , Mandelker Diana , Berger Michael , Schultz Nikolaus , Diaz Luis A. , Cercek Andrea , Stadler Zsofia K.
Published: June 2023

Abstract
Purpose: Over 10% of assessed patients with appendiceal adenocarcinoma (AC) have a pathogenic (P) or likely pathogenic (LP) germline variant, including genes implicated in heritable gastrointestinal cancer syndromes, such as Lynch Syndrome. We defined the clinical and molecular impact of heritable alterations in AC to evaluate the need for dedicated appendiceal screening and prevention strategies in patients with LP/P germline variants. Experimental Design: We performed an integrated germline and somatic molecular analysis for patients with confirmed AC. Patients underwent paired tumor-normal sequencing for up to 90 hereditary cancer-risk genes and 505 genes for somatic mutation profiling. We defined the co-occurrence of LP/P germline variants and second-hit pathogenic somatic alterations. The associations between germline variants and patient clinicopathologic features were also evaluated. Results: Twenty-five out of 237 patients (10.5%) carried pathogenic or likely pathogenic germline variants in cancer susceptibility genes. Clinicopathologic characteristics and AC-specific survival were similar in patients with or without germline variants. Most (92%, N=23/25) patients with germline variants demonstrated no second-hit somatic alterations, including loss of heterozygosity. Two patients with a germline APC I1307K low-penetrance founder variant exhibited secondary somatic pathogenic alterations in APC. However only one patient tumor exhibited APC-mediated WNT-signaling dysregulation; a plausible consequence of multiple somatic APC mutations with no germline variant contribution. Four patients had germline variants in PMS2 or MSH2 associated with Lynch Syndrome, yet their cancers were microsatellite-stable. Conclusions: Germline variants are likely incidental without a contributory driver role in AC. AC screening in patients with germline variants is not clearly merited.
Data from Type I Interferon Signaling via the EGR2 Transcriptional Regulator Potentiates CAR T cell-intrinsic Dysfunction
Authors: Jung In-Young , Bartoszek Robert L. , Rech Andrew J. , Collins Sierra M. , Ooi Soon-Keat , Williams Erik F. , Hopkins Caitlin R. , Narayan Vivek , Haas Naomi B. , Frey Noelle V. , Hexner Elizabeth O. , Siegel Donald L. , Plesa Gabriela , Porter David L. , Cantu Adrian , Everett John K. , Guedan Sonia , Berger Shelley L. , Bushman Frederic D. , Herbst Friederike , Fraietta Joseph A.
Published: June 2023

Abstract
Chimeric antigen receptor (CAR) T-cell therapy has shown promise in treating hematological cancers, but resistance is common, and efficacy is limited in solid tumors. We found that CAR T-cells autonomously propagate epigenetically-programmed type I interferon signaling through chronic stimulation, which hampers antitumor function. EGR2 transcriptional regulator knockout not only blocks this type I interferon-mediated inhibitory program, but also independently expands early memory CAR T-cells with improved efficacy against liquid and solid tumors. The protective effect of EGR2 deletion in CAR T-cells against chronic antigen-induced exhaustion can be overridden by interferon-β exposure, suggesting that EGR2 ablation suppresses dysfunction by inhibiting type I interferon signaling. Finally, a refined EGR2 gene signature is a biomarker for type I interferon-associated CAR T-cell failure and shorter patient survival. These findings connect prolonged CAR T-cell activation with deleterious immunoinflammatory signaling and point to an EGR2-type I interferon axis as a therapeutically amenable biologic system.
Regulation of PD-L1 Trafficking from Synthesis to Degradation
Authors: Lemma Eyoel Yemanaberhan , Letian Anudari , Altorki Nasser K. , McGraw Timothy E.
Published: June 2023

Programmed death-ligand 1 (PD-L1) is a transmembrane ligand for the programmed cell death protein 1 (PD-1), a receptor that inhibits T-cell activity. The PD-L1/PD-1 immune checkpoint axis has been successfully targeted to enhance antitumor immune responses. Tethering PD-L1 to the membrane spatially restricts its ability to inhibit immune responses, and it provides for the acute and reversible modulation of PD-L1 plasma membrane density by regulation of its trafficking. PD-L1 has functions that are independent of its role as a ligand for PD-1, and control of PD-L1 residence in different intracellular compartments might contribute to the regulation of those activities. Thus, control of PD-L1 trafficking is emerging as a key feature of its biology. Herein, we focus on current understating of PD-L1 trafficking and review current attempts to therapeutically target this process in cancer cells to enhance antitumor immunity.
Targeting the Clear Cell Sarcoma Oncogenic Driver Fusion Gene EWSR1::ATF1 by HDAC Inhibition
Authors: Mae Hirokazu , Outani Hidetatsu , Imura Yoshinori , Chijimatsu Ryota , Inoue Akitomo , Kotani Yuki , Yasuda Naohiro , Nakai Sho , Nakai Takaaki , Takenaka Satoshi , Okada Seiji
Published: June 2023

Clear cell sarcoma (CCS), a rare but extremely aggressive malignancy with no effective therapy, is characterized by the expression of the oncogenic driver fusion gene EWSR1::ATF1. In this study, we performed a high-throughput drug screening, finding that the histone deacetylase inhibitor vorinostat exerted an antiproliferation effect with the reduced expression of EWSR1::ATF1. We expected the reduced expression of EWSR1::ATF1 to be due to the alteration of chromatin accessibility; however, assay for transposase-accessible chromatin using sequencing and a cleavage under targets and release using nuclease assay revealed that chromatin structure was only slightly altered, despite histone deacetylation at the EWSR1::ATF1 promoter region. Alternatively, we found that vorinostat treatment reduced the level of BRD4, a member of the bromodomain and extraterminal motif protein family, at the EWSR1::ATF1 promoter region. Furthermore, the BRD4 inhibitor JQ1 downregulated EWSR1::ATF1 according to Western blotting and qPCR analyses. In addition, motif analysis revealed that vorinostat treatment suppressed the transcriptional factor SOX10, which directly regulates EWSR1::ATF1 expression and is involved in CCS proliferation. Importantly, we demonstrate that a combination therapy of vorinostat and JQ1 synergistically enhances antiproliferation effect and EWSR1::ATF1 suppression. These results highlight a novel fusion gene suppression mechanism achieved using epigenetic modification agents and provide a potential therapeutic target for fusion gene–related tumors.

Significance:

This study reveals the epigenetic and transcriptional suppression mechanism of the fusion oncogene EWSR1::ATF1 in clear cell sarcoma by histone deacetylase inhibitor treatment as well as identifying SOX10 as a transcription factor that regulates EWSR1::ATF1 expression.
Treatment Strategies for Cardiomyopathy in Children: A Scientific Statement From the American Heart Association
Authors: Bogle Carmel , Colan Steven D. , Miyamoto Shelley D. , Choudhry Swati , Baez-Hernandez Nathanya , Brickler Molly M. , Feingold Brian , Lal Ashwin K. , Lee Teresa M. , Canter Charles E. , Lipshultz Steven E. ,   on behalf of the American Heart Association Young Hearts Pediatric Heart Failure and Transplantation Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young (Young Hearts)
Published: June 2023

This scientific statement from the American Heart Association focuses on treatment strategies and modalities for cardiomyopathy (heart muscle disease) in children and serves as a companion scientific statement for the recent statement on the classification and diagnosis of cardiomyopathy in children. We propose that the foundation of treatment of pediatric cardiomyopathies is based on these principles applied as personalized therapy for children with cardiomyopathy: (1) identification of the specific cardiac pathophysiology; (2) determination of the root cause of the cardiomyopathy so that, if applicable, cause-specific treatment can occur (precision medicine); and (3) application of therapies based on the associated clinical milieu of the patient. These clinical milieus include patients at risk for developing cardiomyopathy (cardiomyopathy phenotype negative), asymptomatic patients with cardiomyopathy (phenotype positive), patients with symptomatic cardiomyopathy, and patients with end-stage cardiomyopathy. This scientific statement focuses primarily on the most frequent phenotypes, dilated and hypertrophic, that occur in children. Other less frequent cardiomyopathies, including left ventricular noncompaction, restrictive cardiomyopathy, and arrhythmogenic cardiomyopathy, are discussed in less detail. Suggestions are based on previous clinical and investigational experience, extrapolating therapies for cardiomyopathies in adults to children and noting the problems and challenges that have arisen in this experience. These likely underscore the increasingly apparent differences in pathogenesis and even pathophysiology in childhood cardiomyopathies compared with adult disease. These differences will likely affect the utility of some adult therapy strategies. Therefore, special emphasis has been placed on cause-specific therapies in children for prevention and attenuation of their cardiomyopathy in addition to symptomatic treatments. Current investigational strategies and treatments not in wide clinical practice, including future direction for investigational management strategies, trial designs, and collaborative networks, are also discussed because they have the potential to further refine and improve the health and outcomes of children with cardiomyopathy in the future.
Left Atrial Function Predicts Atrial Arrhythmia Recurrence Following Ablation of Long-Standing Persistent Atrial Fibrillation
Authors: Khan Habib Rehman , Yakupoglu Haci Yakup , Kralj-Hans Ines , Haldar Shouvik , Bahrami Toufan , Clague Jonathan , De Souza Anthony , Hussain Wajid , Jarman Julian , Jones David Gareth , Salukhe Tushar , Markides Vias , Gupta Dhiraj , Khattar Rajdeep , Wong Tom ,   on behalf of the CASA AF Investigators
Published: June 2023

Background:

Left atrial (LA) function following catheter or surgical ablation of de-novo long-standing persistent atrial fibrillation (AF) and its impact on AF recurrence was studied in patients participating in the CASA-AF trial (Catheter Ablation vs. Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation).

Methods:

All patients underwent echocardiography preablation, 3 and 12 months post-ablation. LA structure and function were assessed by 2-dimensional volume and speckle tracking strain measurements of LA reservoir, conduit, and contractile strain. Left ventricular diastolic function was measured using transmitral Doppler filling velocities and myocardial tissue Doppler velocities to derive the e’, E/e’, and E/A ratios. Continuous rhythm monitoring was achieved using an implantable loop recorder.

Results:

Eighty-three patients had echocardiographic data suitable for analysis. Their mean age was 63.6±9.7 years, 73.5% were male, had AF for 22.8±11.6 months, and had a mean LA maximum volume of 48.8±13.8 mL/m
2
. Thirty patients maintained sinus rhythm, and 53 developed AF recurrence. Ablation led to similar reductions in LA volumes at follow-up in both rhythm groups. However, higher LA emptying fraction (36.3±10.6% versus 27.9±9.9%;
P
<0.001), reservoir strain (22.6±8.5% versus 16.7±5.7%;
P
=0.001), and contractile strain (9.2±3.4% versus 5.6±2.5%;
P
<0.001) were noted in the sinus rhythm compared with AF recurrence group following ablation at 3 months. Diastolic function was better in the sinus rhythm compared with the AF recurrence group with an E/A ratio of 1.5±0.5 versus 2.2±1.2 (
P
<0.001) and left ventricular E/e’ ratio of 8.0±2.1 versus 10.3±4.1 (
P
<0.001), respectively. LA contractile strain at 3 months was the only independent predictor of AF recurrence.

Conclusions:

Following ablation for long-standing persistent AF, improvement in LA function was greater in those who maintained sinus rhythm. LA contractile strain at 3 months was the most important determinant of AF recurrence following ablation.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02755688
Life Course Cardiovascular Health: Risk Factors, Outcomes, and Interventions
Authors: Pedamallu Havisha , Zmora Rachel , Perak Amanda M. , Allen Norrina B.
Published: June 2023

Since it was first defined by the American Heart Association in 2010, cardiovascular health (CVH) has been extensively studied across the life course. In this review, we present the current literature examining early life predictors of CVH, the later life outcomes of child CVH, and the relatively few interventions which have specifically addressed how to preserve and promote CVH across populations. We find that research on CVH has demonstrated that prenatal and childhood exposures are consistently associated with CVH trajectories from childhood through adulthood. CVH measured at any point in life is strongly predictive of future cardiovascular disease, dementia, cancer, and mortality as well as a variety of other health outcomes. This speaks to the importance of intervening early to prevent the loss of optimal CVH and the accumulation of cardiovascular risk. Interventions to improve CVH are not common but those that have been published most often address multiple modifiable risk factors among individuals within the community. Relatively few interventions have been focused on improving the construct of CVH in children. Future research is needed that will be both effective, scalable, and sustainable. Technology including digital platforms as well as implementation science will play key roles in achieving this vision. In addition, community engagement at all stages of this research is critical. Lastly, prevention strategies that are tailored to the individual and their context may help us achieve the promise of personalized prevention and help promote ideal CVH in childhood and across the life course.
Gut Microbiota and Microbial Metabolism in Early Risk of Cardiometabolic Disease
Authors: Gabriel Curtis L. , Ferguson Jane F.
Published: June 2023

Cardiometabolic disease comprises cardiovascular and metabolic dysfunction and underlies the leading causes of morbidity and mortality, both within the United States and worldwide. Commensal microbiota are implicated in the development of cardiometabolic disease. Evidence suggests that the microbiome is relatively variable during infancy and early childhood, becoming more fixed in later childhood and adulthood. Effects of microbiota, both during early development, and in later life, may induce changes in host metabolism that modulate risk mechanisms and predispose toward the development of cardiometabolic disease. In this review, we summarize the factors that influence gut microbiome composition and function during early life and explore how changes in microbiota and microbial metabolism influence host metabolism and cardiometabolic risk throughout life. We highlight limitations in current methodology and approaches and outline state-of-the-art advances, which are improving research and building toward refined diagnosis and treatment options in microbiome-targeted therapies.
Physical Activity Over the Lifecourse and Cardiovascular Disease
Authors: Perry Andrew S. , Dooley Erin E. , Master Hiral , Spartano Nicole L. , Brittain Evan L. , Pettee Gabriel Kelley
Published: June 2023

Despite improvements in cardiovascular care in recent decades, cardiovascular disease (CVD) remains a leading cause of death worldwide. At its core, CVD is a largely preventable disease with diligent risk factor management and early detection. As highlighted in the American Heart Association’s
Life’s Essential 8
, physical activity plays a central role in CVD prevention at an individual and population level. Despite pervasive knowledge of the numerous cardiovascular and noncardiovascular health benefits of physical activity, physical activity has steadily decreased over time and unfavorable changes in physical activity occur throughout people’s lives. Here, we use a lifecourse framework to examine the evidence reporting on the association of physical activity with CVD. From in utero to older adults, we review and discuss the evidence detailing how physical activity may prevent incident CVD and mitigate CVD-related morbidity and death across all life stages.
Possessing Enlightenment: Sorcery, Selfhood, and Tragic Responsibility in a Chinese Buddhist Apocryphon
Authors: Buckelew Kevin
Published: June 2023

This article explores how the Lengyan jing, or Śūrangama Sūtra – an apocryphal Buddhist scripture written in China around 705 CE – remapped Chinese Buddhist understandings of moral responsibility in consequential ways. Although grounded in the orthodox doctrinal premise that all sentient beings innately possess buddha-nature, the Lengyan jing is punctuated by warnings about the danger that even the most earnest seekers of enlightenment might be possessed by demons, embark on evil behavior, and end up fully demonic. Such warnings depart from longstanding norms in Buddhist ethics, according to which responsibility for fault is measured in terms of a person’s intentions. Instead, I argue that the Lengyan jing articulates a moral logic of what Sandra Macpherson calls “tragic responsibility.” This logic informed important but overlooked aspects of the soteriological vision found in key texts from the Chan (Japanese Zen) tradition, which rose to prominence in the centuries following the Lengyan jing’s composition.
Queer Critical Media Literacy and Possibilities for Counterhegemonic Pedagogy
Authors: Woolley Susan W.
Published: June 2023

In this paper, the author considers the analysis of representation and the production of media as two generative pedagogical practices in which queer critical media literacy can give students tools to read and produce society and texts in counterhegemonic ways. Queering critical media literacy generates theoretical and practice-oriented interventions that can focus students’ and teachers’ attention on representation and production, including the reproduction of cisnormativity and ableism as well as their critiques. Engaging with multimodal texts through queer critical media literacy affords students and teachers creative possibilities for reading and producing queer texts, for queering the form of a text, and for queering the genre of “assignment.” Such creative production skills and critical thinking skills serve students for a lifetime while nurturing their processes of identification, representation, and critique – powerful counterhegemonic tools that can be useful in response to anti-queer sociopolitical tensions in public education.
“I Want to Know What People are Saying”: Trans Youth Learning Critical Media Literacies to Negotiate Hate on Social Media
Authors: Shrodes Addie , Coyne Claire , Chen Diane , Macapagal Kathryn , Yuodsnukis Briahna
Published: June 2023

We draw on 37 interviews with a racially diverse group of 21 trans and queer teenagers to consider how they used social media to navigate dominant ideologies amid rapidly accelerating white supremacy, anti-Blackness, xenophobia, anti-transness, and anti-queerness in 2019-2020. The analysis emerges from a humanizing qualitative study of lgbtq+ youth digital life conducted in partnership with an interdisciplinary gender health program that provides holistic services. Employing grounded theory and intersectional theories of queer politics, we expand conceptualizations of queer critical media literacies. We find that youth in the study enacted critical media literacies to 1) anticipate the logics of hate by which they are oppressed; 2) unlearn dominant ideologies that structure privilege; 3) and rehearse responses to intersecting oppression. Understanding the ways youth negotiate dominant ideologies on social media can inform the design of critical media literacy teaching and learning to confront phobic forces in multiple youth-serving contexts.
Creating Relating Stories: Fragmentating the Social Fabric of Heteronormativity through Critical Media Literacies
Authors: Vicars Mark , Tartakover Sarah
Published: June 2023

The problematics of social and academic participation for gender diverse and lgbtqi+ youth in school communities is highlighted by the stigmatising relational dynamics which often become the dominant narrative in educational domains. This paper discusses the creation of a critical literacy/media product which arose from a year 7 level curriculum project in which students were invited to seek solutions to address a problem about which they cared. In 2021 a group of Australian secondary school students undertook an investigation into gender diversity and lgbtqi+ inclusion. In partnership with teachers and pre-service teachers they co-designed an animation on gender identity opening up wider discussion of ‘orientations and dispositions’ and generating critique around issues of social justice, democracy, equality and inclusion in and out of the classroom.
Diagnostic Role of Circulating Endocan Levels in Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis
Authors: Behnoush Amir Hossein , Khalaji Amirmohammad , Amirkhani Nikan , Pezeshki Parmida Sadat
Published: June 2023

Endocan, as an endothelial cell damage marker, plays role in several cardiovascular and non-cardiovascular diseases. This systematic review and meta-analysis evaluates the role of endocan as a potential diagnostic or prognostic biomarker for obstructive sleep apnea (OSA). International databases including PubMed, Embase, Web of Science, and Scopus were searched for relevant studies assessing endocan levels in OSA patients compared with healthy controls or within different severities or comorbidities of OSA. Random-effect meta-analysis was performed in order to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) of serum/plasma endocan in all comparisons. A total of 10 studies were included in our systematic review, among which seven were used in meta-analysis. Meta-analysis showed that endocan levels were significantly higher in patients with OSA compared with healthy controls (SMD 1.29, 95% CI 0.64–1.93, P < .001) and this was not different between serum and plasma subgroups. However, there was no statistical difference between severe and non-severe OSA patients (SMD .64, 95% CI −.22 to 1.50, P = .147). Considerably, higher endocan levels in patients with OSA in comparison with non-OSA individuals might have clinical implications. This association warrants further research due to its potential use as a diagnostic and prognostic biomarker.
Dating Violence Perpetration Among Sexual Minority Youths in the US: Exploring the Effects of Masculinity Ideology
Authors: Lin Kai , Liu Lin
Published: June 2023

This study analyzes two waves of survey data from a prospective cohort study of secondary school students in Midwestern United States and shows that masculinity ideology contributes in varying degrees to dating violence perpetration across different gender and sexual orientation groups. Conformity to masculinity ideology not only elevates physical violence among bisexual male and lesbian youths, but also does it to a greater extent than its effect among heterosexual male youths. Gay youths, on the other than hand, report lower levels of physical violence perpetration with higher conformity to masculinity ideology. Conformity to masculinity ideology also precipitates higher levels of sexual violence perpetration among bisexual male and lesbian youths. Several policy implications for dating violence prevention are discussed.
Revalidation of the First Step Act Risk Assessment: A Test of Predictive Strength, Dynamic Validity, and Racial/Ethnic Neutrality
Authors: Labrecque Ryan M. , Hester Rhys , Gwinn Jason
Published: June 2023

The First Step Act mandated the development and implementation a risk and needs assessment system for the Federal Bureau of Prisons (BOP). In response, the Prisoner Assessment Tool Targeting Estimated Risk and Needs (PATTERN) was created to assess the risk of recidivism among each person in BOP custody. This investigation represents the first external validation of PATTERN. Results indicated PATTERN is highly predictive of both general and violent recidivism, individuals are capable of changing risk scores and levels while in custody, and changes in risk levels are associated with meaningful differences in recidivism risk. Although PATTERN was accurate in predicting recidivism across all five racial/ethnic groups examined, it also overpredicted recidivism among some groups and underpredicted recidivism for others.
Post-hypoxic myoclonus; what we know and gaps in knowledge
Authors: Ahmed H Shafeeq
Published: June 2023

Post-hypoxic myoclonus (PHM) is a rare neurological complication having two different variants depending on acute or chronic onset after cardiopulmonary resuscitation following cardiac arrest: myoclonic status epilepticus (MSE) and Lance–Adams syndrome (LAS) respectively. Clinical and simultaneous electro-encephalographic (EEG) and electromyographic (EMG) tracing can distinguish between the two. Anecdotal treatment with benzodiazepines and anaesthetics (in the case of MSE) have been tried. Although limited evidence is available, valproic acid, clonazepam and levetiracetam, either in combination with other drugs or alone, have shown to control epilepsy associated with LAS effectively. Deep brain stimulation is a novel and promising advance in LAS treatment.
Policies on doctors’ declaration of interests in medical organisations: a thematic analysis
Authors: Tzortziou Brown Victoria , McCartney Margaret , Talaga Patrycja , Huxtable Richard , Papanikitas Andrew , David-Barrett Elizabeth
Published: June 2023

Objectives

There has been growing concern about doctors’ conflicts of interests (COIs) but it is unclear what processes and tools exist to enable the consistent declaration and management of such interests. This study mapped existing policies across a variety of organisations and settings to better understand the degree of variation and identify opportunities for improvement.

Design

Thematic analysis.

Setting

We studied the COI policies of 31 UK and international organisations which set or influence professional standards or engage doctors in healthcare commissioning and provision settings.

Participants

31 UK and international organisations.

Main outcome measures

Organisational policy similarities and differences.

Results

Most policies (29/31) referred to the need for individuals to apply judgement when deciding whether an interest is a conflict, with just over half (18/31) advocating a low threshold. Policies differed on the perception of frequency of COI, the timings of declarations, the type of interests that needed to be declared, and how COI and policy breaches should be managed. Just 14/31 policies stated a duty to report concerns in relation to COI. Only 18/31 policies advised COI would be published, while three stated that any disclosures would remain confidential.

Conclusions

The analysis of organisational policies revealed wide variation in what interests should be declared, when and how. This variation suggests that the current system may not be adequate to maintain a high level of professional integrity in all settings and that there is a need for better standardisation that reduces the risk of errors while addressing the needs of doctors, organisations and the public.
Parenting Concerns: Uncovering Barriers and Identifying Ways to Support Pre-teen Flourishing
Authors: Oerther Sarah
Published: June 2023

Parenting capacity and family factors are positively correlated with children’s flourishing. The purpose of this research is to describe parents’ everyday concerns in caring for their children, to uncover barriers to pre-teen flourishing, and to identify ways to support pre-teen flourishing. The research method for this qualitative study was interpretive phenomenology. Semi-structured interviews were conducted with 20 participants in their homes. In this study, participants’ stories revealed barriers to pre-teen flourishing, including shifting expectations around their children’s independence and their children’s exposure to digital environments. Study participants’ stories also revealed that creating new daily routines and participating in traditional activities were the background that supported parents in helping their pre-teen children flourish. Researchers should use these findings as sources of insight to positively impact pre-teen flourishing as they seek contemporary ways to support parents, evaluate pre-teen child outcomes, and create interventions and social policies that aid parents in raising healthy pre-teen children.
Choice of intrapleural fibrinolytic agents in the treatment of adult complicated parapneumonic effusion and empyema: Network meta-analysis
Authors: Yokoyama Yujiro , Kuno Toshiki , Takagi Hisato , Burfeind William
Published: June 2023

Background

The appropriate use of intrapleural fibrinolytic agents in patients with complicated parapneumonic effusion and empyema remains unclear, especially regarding the choice of fibrinolytic agents. We conducted a network meta-analysis comparing outcomes of intrapleural fibrinolytic agents in patients with complicated parapneumonic effusion and empyema.

Methods

MEDLINE and EMBASE were searched through April 2022 to identify randomized controlled trials (RCTs) that investigated outcomes in patients with complicated parapneumonic effusion or empyema who were treated with intrapleural fibrinolytic agents. The outcomes of interest were surgical requirements, bleeding, length of hospital stay, and all-cause mortality.

Results

Our analysis included 10 RCTs that enrolled 1085 patients treated with intrapleural tissue plasminogen activator (TPA) ( n = 138), TPA + deoxyribonuclease (DNase) ( n = 52), streptokinase ( n = 311), urokinase ( n = 75), DNase ( n = 51), or placebo ( n = 458). The rates of surgical requirement were significantly lower with TPA and TPA + DNase than with placebo (risk ratio [RR]; 95% confidence interval [CI] = 0.36 [0.14–0.97], p = 0.038, RR [95% CI] = 0.25 [0.08–0.78], p = 0.017, respectively). The risk of bleeding was higher with TPA + DNase than with placebo (RR [95% CI] = 10.91 [1.53–77.99], p = 0.017), as well as TPA and TPA + DNase than with urokinase (RR [95% CI] = 17.90 [1.07–299.44], p = 0.044, RR [95% CI] = 89.3 [2.88–2772.49], p = 0.010, respectively). All-cause mortality was similar among the groups.

Conclusion

TPA and TPA + DNase reduced the rates of surgical requirement compared with placebo. However, TPA + DNase increased the risk of bleeding compared with placebo. Intrapleural agents for complicated parapneumonic effusion and empyema should be selected with an individual risk assessment.
Encountering weak signals: Economic development practitioners’ perceptions of remote work arrangements
Authors: Soroui Sarah Taghvai
Published: June 2023

While alternative work arrangements, such as remote work, have long been part of the work landscape, their growth in recent years signifies a profound transformation in the organization of workplaces. While the pandemic has increased the visibility and diffusion of these practices, the years preceding it saw a significant rise in remote work arrangements. This study examines economic development practitioners’ perceptions of the presence and impact of remote work arrangements. It uses interviews with practitioners and remote-utilizing businesses in Connecticut to explore understandings of remote work trends. Economic development practitioners’ strategies for responding to remote work trends were also analyzed. It draws on the concepts of weak signals and maladaptive learning processes to demonstrate how alternative work arrangements, entrenched professional routines, and institutionalized mental models may hamper the ability of practitioners to detect and understand alternative work trends. Moreover, response strategies reflect traditional economic development orientations and are rationalized to support existing policy approaches. Focusing on the period before the pandemic provides insight into the factors influencing practitioners’ receptivity and responsiveness to emergent developments that have the potential to alter conventional strategies and development trajectories.
The Marquesan Adventure of John Minor Maury
Authors: Wittig Michael Lee
Published: June 2023

John Minor Maury was a young US navy midshipman, who was found on the South Pacific island of Nuku Hiva by the USS Essex, on 25 October 1813. Decades after the incident, a biographical sketch of Maury appeared which purported to illuminate his adventure, in an account provided by his son. For over 130 years thereafter, the tale of John Maury was based on his son's recollection. In 2020, letters written by Maury and others were discovered and studied, revealing a complex and multi-layered enterprise of which he was a part: it is this new information to which this effort is directed, with the wish to provide a complete and verified account of John Maury and the sandalwood enterprise which brought him to the Marquesas.
Modelling and experimental characterization of secondary suspension elements for rail vehicle ride comfort simulation
Authors: La Paglia Ivano , Rapino Luca , Ripamonti Francesco , Corradi Roberto
Published: June 2023

Secondary suspensions play an essential role in the dynamic behaviour of rail vehicles. In particular, they are adopted to reduce the vibrations transmitted to the carbody, thus improving ride comfort. In this paper, an experimental characterization of the viscous damper and coil spring elements composing a vertical secondary suspension is presented. The elements are separately tested with the aim of analysing their dynamic behaviour. Then, modified prototypes are manufactured to reduce the transmitted force. The results of the experimental campaign are later adopted to tune the parameters of the mathematical model of the whole secondary suspension, including the dynamics of both the coil spring and the damper elements. This model allows discussing the effectiveness of the proposed modifications, proving the design of both the components to be fundamental for the improvement of ride comfort.
Environmental Kuznets curve (EKC) hypothesis: A bibliometric review of the last three decades
Authors: Lau Lin-Sea , Yii Kwang-Jing , Ng Cheong-Fatt , Tan Yan-Ling , Yiew Thian-Hee
Published: June 2023

The environmental Kuznets curve (EKC) is a widely tested hypothesis in the environmental economics literature. It explains the dynamics between economic growth and environmental degradation. This study conducts a bibliometric analysis for the past three decades (1994–2021) that contributes to the intellectual structure and knowledge progress of the EKC hypothesis using descriptive analysis and networking analysis. The descriptive analysis comprises publication trends, language, publishers, Web of Science category and research areas, and citation analysis. Meanwhile, networking analysis includes keyword co-occurrence analysis, co-authorship analysis and co-citation analysis. The findings of the descriptive analysis reveal that the number of publications in the EKC hypothesis has gradually increased over the years. The most productive publishers are Elsevier and Springer Nature. Researchers from China and Turkey tend to be the most prolific authors, with the highest number of citations, co-authorships and co-citations. According to the network analysis, the main keywords appearing in the EKC studies are economic growth, CO2 emissions, energy consumption, China, renewable energy and financial development, which is also supported by the most frequently used keyword plus and its clusters. Based on our findings, we have proposed several policy recommendations from the keyword analysis that could foster economic development and improve environmental quality simultaneously. From the emerging trends of EKC, new directions for future research are also proposed.
Decent wage floors in Europe: Does the minimum wage directive get it right?
Authors: Haapanala Henri , Marx Ive , Parolin Zachary
Published: June 2023

The Directive on Adequate Minimum Wages represents a watershed initiative adding substance to the EU’s social dimension. It contains two ambitious objectives: establishing the minimum level of statutory minimum wages at 60% of the gross median wage, and increasing collective bargaining coverage (CBC) to at least 80% of workers. In this article, we assess how statutory minimum wages and collective bargaining coverage are associated with the likelihood of low pay. Using a time series cross-section of EU-SILC for income years 2004–2019, we identify and assess the absolute and relative size of ‘effective wage floors’ for full-time employees in 30 countries. We specify multilevel, random effects within-between regression models to assess the individual and joint associations of SMW and collective bargaining coverage with wage floors. Our results indicate that SMWs and CBC both have distinct roles in establishing the effective wage floor. First, higher collective bargaining coverage is on average associated with a lower share of workers earning below 60% gross median wages. Second, higher SMWs are strongly associated with higher effective wage floors. Third, both collective bargaining coverage and union density are strongly associated with higher wage floors.
Is it feasible to enhance quality assurance of cervical cancer screening in Latin America? A regional expert consensus
Authors: Rangel Valentina , Fernández-Deaza Ginna Paola , Castillo Juan Sebastián , Murillo Raúl
Published: June 2023

Objectives

Cervical cancer elimination requires high-performance screening tests and high treatment rates, and thus high screening program performance is essential; however, Latin America lacks organized screening and quality assurance (QA) guidelines. We aimed to develop a core set of QA indicators suitable to the region.

Methods

We reviewed QA guidelines from countries/regions with highly organized screening programs and selected 49 indicators for screening intensity, test performance, follow-up, screening outcomes and system capacity. A regional expert consensus using the Delphi method in two rounds was implemented to identify basic indicators actionable within the regional context. The panel was integrated by recognized Latin American scientists and public health experts. They voted for the indicators blinded to each other based on feasibility and relevance. The correlation between both attributes was analyzed.

Results

In the first round 33 indicators reached consensus for feasibility but only 9 for relevance, without full coincidence. In the second round 9 indicators met the criteria for both (2 screening intensity, 1 test performance, 2 follow-up, 3 outcomes, 1 system capacity). A significant positive correlation was observed for test performance and outcomes indicators between the two attributes assessed ( p < 0.05).

Conclusions

Cervical cancer control requires realistic goals supported by proper programs and QA systems. We identified a set of indicators suitable to improve cervical cancer screening performance in Latin America. The assessment by an expert panel with a joint vision from science and public health practice represents a significant progress towards real and feasible QA guidelines for countries in the region.
Exploring action research as a method of creating evidence that is informed by Aboriginal and Torres Strait Islander ways of being, doing and knowing
Authors: Moore Lucas , French Reno
Published: June 2023

Over the past two decades there has been growing acknowledgement of the need to decolonise approaches to evaluation policy, programs and services impacting on the lives of Aboriginal and Torres Strait Islander Peoples. Action research methodologies have been identified as the most appropriate approach ( Evans et al., 2014 ). This article outlines how a community controlled peak body is utilising an action research approach guided by First Nations wisdom and knowledge to drive evaluation. Examination of two action research projects undertaken by Queensland Aboriginal and Torres Strait Islander Child Protection Peak (QATSICPP) demonstrate how action research embodies the principles of self-determination and Indigenous Data Sovereignty in evaluative processes. The article also highlights how evaluative evidence informs new approaches to address the overrepresentation of Aboriginal and Torres Strait Islander children in child protection. Project reflections suggest participants found the action research approach inclusive, participatory, and effective in assisting them to address critical practice and systemic issues. The importance of ensuring evaluative methodologies are meaningful for Aboriginal and Torres Strait Islander people was also highlighted.
A Curious Case of Omental Oxalate Crystals in a Patient With Struma Ovarii: Pointers to an Unusual Clinicopathological Scenario
Authors: Bakshi Neha , Dhawan Shashi , Rao Seema , Arora Anil
Published: June 2023

Percutaneous image-guided biopsies are becoming increasingly common in routine pathology practice, with the greater omentum emerging as a common target. We present herein an account of a middle-aged lady with a complex ovarian mass, omental thickening, and raised serum CA125; clinically suspected to have advanced ovarian malignancy. Fine needle aspiration cytology (FNAC) from the ovarian mass was inconclusive. Omental biopsy revealed only refractile, birefringent crystalline material with surrounding foreign body giant cell reaction; thus surprising the clinical team. Subsequent resection of the ovarian mass showed a teratoma composed exclusively of thyroid tissue, diagnosed as struma ovarii. The omental crystals, interpreted as calcium oxalate crystals, were possibly a consequence of colloid seeding during the ovarian mass FNAC.
Retrospective Phylodynamic and Phylogeographic Analysis of the Human Papillomavirus 16 E6 Gene in the Mediterranean Region
Authors: Souiai Oussama , Sallemi Ameni
Published: June 2023

Human papillomavirus 16 (HPV16) is considered to be strongly correlated with the development of cervical cancer. Among the 8 HPV16 genes, the E6 constitutes a remarkable marker to follow the evolutionary history and spatial phylodynamics of HPV16 in the Mediterranean basin. Thus, this work aims to decipher the major evolutionary events and crosstalks in the Mediterranean basin with a focus on Tunisian strains regarding the E6 oncogene. In this study, we first extracted the available and annotated Mediterranean strains of HPV16 E6 gene sequences (n = 155) from the NCBI nucleotide database. These sequences were aligned, edited, and used for the downstream phylogenetic analyses. Finally, a Bayesian Markov Chain Monte Carlo approach was applied to reconstruct the evolutionary history of HPV16 migration. Our results showed that the HPV circulating in Tunisia derived from a Croatian ancestor around the year 1987. This starting point spreads to most European countries to reach northern Africa through the Moroccan gateway in 2004.
A ‘Humanitarian Disaster’ or a ‘Liberation Struggle’: a comparative analysis of the coverages of The Independent and The New York Times of the 2016 and the 2017 military operations in Aleppo and Al-Raqqa
Authors: Rabea Ali
Published: June 2023

This article explores the coverage by The Independent and The New York Times of the 2016 and the 2017 military operations in Aleppo and Al-Raqqa. It highlights the uneven reporting on the humanitarian crisis in the two cities. The analysis shows that the similarities in the coverage of the two newspapers were greater than the differences. The New York Times and The Independent (to a lesser extent) espoused a pro-US narrative of the Syrian conflict by framing Aleppo as a humanitarian ‘catastrophe’ and Al-Raqqa as a ‘liberation’ struggle. Biases were constructed out of several elements including (1) the dominance of US sources and selective use of UN and NGO sources; (2) the use of visual content quantitatively and qualitatively; (3) the use of graphic and emotive terms; (4) focus on the humanitarian crisis in Aleppo and the military operations in Al-Raqqa.
Avatar and virtual agent-assisted telecare for patients in their homes: A scoping review
Authors: Winkler Anna , Kutschar Patrick , Pitzer Stefan , van der Zee-Neuen Antje , Kerner Susanne , Osterbrink Jürgen , Krutter Simon
Published: June 2023

Introduction

Telecare can be an effective way to deliver healthcare to patients’ homes. Avatar or virtual agent-equipped technologies have the potential to increase user engagement and adherence to telecare. This study aimed to identify telecare interventions assisted by avatars/virtual agents, reflect the concepts of telecare and give an overview on its outcomes.

Methods

A scoping review guided by the PRISMA-ScR checklist was conducted. MEDLINE, CINAHL, PsycINFO and grey literature were searched through 12 July 2022. Studies were included if patients were remotely cared for by healthcare professionals and received telecare interventions assisted by avatars/virtual agents in their homes. Studies underwent quality appraisal, and were synthesized along the dimensions ‘study characteristics’, ‘intervention’ and ‘outcomes’.

Results

Out of 535 records screened, 14 studies were included, reporting the effects of avatar/virtual agent-assisted telecare interventions, tailored to specific patient groups. Telecare interventions mainly focused on teletherapy and telemonitoring. Telecare services were rehabilitative, preventive, palliative, promotive and curative. Modes of communication were asynchronous, synchronous or a mix of both. Tasks of the implemented avatars/virtual agents comprised delivering health interventions, monitoring, assessment, guidance and strengthening agency. Telecare interventions led to improved clinical outcomes and higher adherence. Most studies reported sufficient system usability and high satisfaction among participants.

Conclusions

Telecare interventions were overall target group related and integrated in a service model. This combined with the use of avatars and virtual agents leads to improved adherence to telecare in the home setting. Further studies could account for relatives’ experiences with telecare.
Post-traumatic growth of Afghan adolescents after traumatic loss of father
Authors: Poya Benazir , Esmaeili Maryam , Naghavi Azam
Published: June 2023

Adolescents’ mental health may be influenced either negatively or positively through loss of a parent, especially bereavement due to a traumatic death. This descriptive phenomenological study aimed to investigate Afghan adolescents’ post-traumatic growth after traumatic loss of father. The participants were 14 female and male Afghan adolescents who met the inclusion criteria. Post-traumatic growth was substantiated by virtue of post-traumatic growth questionnaire. Data was collected through a semi-structured interview, and Colaizzi analysis method was used for data analysis. Two main themes were extracted: (a) moving forward with hope and (b) factors associated with enhancement of hope. Findings showed that Afghan traumatized adolescents achieved post-traumatic growth over time. The most important factors in enhancement of hopefulness were social support, psychological, and cognitive factors, as well as spiritual well-being. Our findings suggested that both schools and non-governmental organization in Afghanistan may be benefitted from more accessible opportunities to enhance post-traumatic growth for bereaved adolescents.