bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflexible Beliefs
Authors: Kennerley Helen , Padesky Christine A.
Published: December 2023

Chapter 6, “Inflexible Beliefs,” can prove challenging in psychotherapy. Common traps that therapists fall into include trying to proceed despite a poor therapy alliance, difficulties understanding inflexible beliefs that are not articulated in words, disengagement over the course of lengthy therapy, client and therapist hopelessness, and times when client inflexible beliefs trigger therapist inflexible beliefs. Fortunately, there are many specific guided discovery methods designed for working with inflexible beliefs that help avoid these traps. Each of these approaches can include embedded Socratic dialogue to foster a more positive therapy alliance, active client engagement, as well as greater optimism and new pathways for change. Guided discovery methods and related interpersonal processes are described and brought to life with case illustrations. Special attention is given to a prejudice metaphor for understanding the maintenance of inflexible beliefs, alliance-building therapy strategies, how to identify and work with beliefs encoded in imagery or a “felt sense,” use of a continuum to increase core belief flexibility, and strategies for keeping long-term therapy “fresh.”
Impulsive and Compulsive Behaviors
Authors: Kennerley Helen
Published: December 2023

Impulsive and compulsive behaviors can be challenging to successfully manage unless therapists and clients reach a common understanding of the cognitive, emotional, physiological, social, and environmental factors that maintain them. Common traps that therapists fall into include not understanding the personal meanings of behaviors, inadequate risk assessment, underestimating the likelihood of relapse, not appreciating the fluctuating nature of motivation to change, overlooking the world surrounding the client’s change efforts, and failing to consider the negative consequences or dangers of change for the client. Detailed therapist–client interactions illustrate how Socratic dialogue can be effectively employed to manage these traps, identify safer, substitute behaviors, and increase client motivation for change. Good Socratic questions to ask clients are bulleted throughout the chapter to help guide therapist learning and practice.
Supervision and Therapist Beliefs
Authors: Kennerley Helen , Padesky Christine A.
Published: December 2023

Chapter 11, “Supervision and Therapist Beliefs,” addresses the complex tasks faced by supervisors who must simultaneously educate supervisees, support them as they learn, and manage the responsibilities entailed in meeting standards of clinical care for their clients. The authors recommend a written supervision agreement, methods for constructive feedback, and guidance for supervisees on how to prepare for supervision sessions. Uses of Socratic dialogue are illustrated throughout the chapter to demonstrate ways this can boost supervisee learning. Supervisors are encouraged to listen to session recordings and use active guided discovery methods in supervision such as role-play, imagery exercises, and behavioral experiments. Supervisee learning can be maximized by pairing these experiences with Socratic dialogue. Reflective practices for both supervisors and supervisees are also emphasized. Both supervisors and supervisees benefit from processes of self-observations and self-review accompanied with practice using these to inform clinical judgments and decision making. Common supervision traps related to therapist and supervisor assumptions, the social context outside supervision and therapy, and the supervisory relationship are addressed.
Dialogues for Discovery: What Next?
Authors: Padesky Christine A.
Published: December 2023

Chapter 12, “Dialogues for Discovery: What Next?”, recaps some of the main themes of the book regarding the roles discovery plays in psychotherapy. It reviews the common traps addressed in each chapter that can be effectively managed by Socratic dialogue and other methods of guided discovery. In addition, this chapter speculates that the 4-Stage Model of Socratic Dialogue illustrated throughout this text could provide a stimulus for sudden gains in psychotherapy. The importance of actually carrying out the Reader Learning Exercises throughout this book is highlighted. Three Reflective Practice Worksheets are provided to support clinician development of the skills taught in this text. Finally, the author poses a series of research questions that could advance learning about the effective use of guided discovery incorporating Socratic dialogue.
Commodum and the Fear of Exclusion
Authors: Krostenko Brian A.
Published: December 2023

This chapter discusses commodum or ‘emolument,’ part of the ideology of libertas. The bill attached Pompey’s recent Asian gains (LA 1.6, 2.51–55). Before the people Cicero uses the semiotics of space and the proprieties of verbal address to depict a Pompey insulted by a Rullus acting legally under the bill. The tableaux, however unrealistic, symbolize lawful power abused and suggest that the bill will not augment but coopt commoda. The bill also authorized land purchases. Elements of Cicero’s treatment of the measure (LA 2.65–67, 2.71) have no correspondent in the senate speech; the insertions redefine Cicero and commodum. Invoking the language of the marketplace and rituals of colonization, he makes himself the true guardian of the people’s best interests, and he bends commodum toward the shared rights and pleasures of civic life that the urban populace already has.
Two Views of Capua and the ager Campanus
Authors: Krostenko Brian A.
Published: December 2023

This chapter offers readings of the last arguments of the speeches, which treat Rullus’ plan to resettle Capua and the ager Campanus. Both speeches use those places to explore propriety (honestum) and utility (utile), respectively—but in reverse order and differently accented. The popular treatment of the ager Campanus raises issues of insufficiency and exclusion; its treatment of Capua, drawing on the physical space of Rome, converts an argument about propriety into an argument about utility. The senate treatment of the ager Campanus, echoing old poetic forms, converts an argument about utility into an argument about propriety; its treatment of Capua honestum with the shared intellectual and religious culture of the senate. The chapter closes with remarks on late Republican oratorical culture. Inasmuch as Cicero defends his idealistic visions with false polarities and distortions, he paradoxically replicates the very political problems that his idealisms were meant to overcome.
Praktikos
Authors: Young Robin Darling , Kalvesmaki Joel , Stewart Columba , Stang Charles , Dysinger Luke
Published: December 2023

Composed of one hundred kephalaia, “chapters” or “headings” meant for rumination, the Praktikos is prefaced by a letter to a “Brother Anatolios,” interpreting the monastic garment as protective armor against the attacks of demons. After a section of five introductory kephalaia, the Praktikos goes into greater detail in subsequent sections to describe the eight thoughts prompted by demons; the passions; instructions; occurrences during sleep; the approach to apatheia, or passionlessness/calm, the symbols of apatheia; practical concepts; and finally, ten “sayings of holy monks.” The entire Greek text is translated, along with the key Syriac version, and supplemented with cross-references to other ancient literature.
The Diary of Gull Mohammad
Authors: Quraishi Humra
Published: December 2023

This Diary of a young teenaged Kashmiri boy, Gull Mohammad, shows the struggles and challenges he faces, whilst trying to survive in a harsh and heavily surcharged atmosphere. One significant word that kept him going is ‘Sabr’—patience with hope. Gull Mohammad been writing this Diary for just about over a year—from August 2016 till September 2017, to be precise—from (2 August 2016 till 11 September 2017). After he’s shifted from Srinagar to New Delhi, circumstances take him to several other towns and cities. And he describes the people he meets and also the new turns and twists. Destined to be back in Srinagar after a year for a very brief visit he sees the deaths and destruction. His mother and grandparents have died . . . Only his father and twin brother remain alive but in no great shape. Gull Mohammad is devastated and wants to stay back in Srinagar but on his father’s insistence he reaches the safe cum secure ‘Home’ in Kerala’s Calicut . . . It’s here he hears of the death of the Lucknow family he knew and stayed with and was close to . . . Gull Mohammad is over burdened with emotional setbacks and severe shocks.
Shifting from Srinagar
Authors: Quraishi Humra
Published: December 2023

Gull Mohammad starts writing his diary ever since he was taught how to read and write by his father, Ghulam Mohammad, a shawl seller, but like most Kashmiris of his generation, he was well aware of the changing political climate in and around the Valley. Though he enrols the twins—Gull and Gulzar—in an English-medium school in the Valley’s downtown area, with curfews and hartals, the studies get disrupted. As disasters hit the family in more than one way, with Gulzar’s one eye damaged by pellets fired by the security forces, they are left feeling so insecure about Gull’s safety that they decided to shift him to a madrasa situated in New Delhi. There’s an upheaval in the child’s life. But he’s told to look forward to this shift; after all, he would be moving to the capital city—New Delhi.
Another of Those Traumatic Turns!
Authors: Quraishi Humra
Published: December 2023

Till the evening when the local Right-Wing goons, together with the cops, barged in, into this home. Gull Mohammad is dragged to the nearest police station. Thrown into a lock up . . . then shifted to a detention centre. Gull Mohammad kept thinking of his Kashmiri schoolmate Bilal Bukhari who was also kept in police detention for stone throwing. But he hadn’t thrown a thing, yet he made to sit in this detention, with humiliation heaped on him. . . . Until an International Child Rights group who had travelled to Lucknow as part of their study tour notices this boy sitting hunched in solitary cell. Much media focus and with that he is released. Those detention days had made him a near wreck. He had begun to stammer . . . pulling his hair, holding his head, as though preventing his skull from breaking into two.
Monopoly on doubt: Post-mortem examinations in Israel, 1950s–1980s
Authors: Nuriely Benny , Kozma Liat
Published: December 2023

This article examines the durability of high post-mortem examination rates in Israel between the 1950s-1980s. Previous studies overlooked the issue of medical authority and the social history of autopsy, focusing on policy, technological development, and conflict between science and religion. By contrast, our analysis brings together the medical interest in unlimited research of dead bodies and the power relations between doctors and subaltern groups in Israel. Based on the Israeli State Archives, the Hebrew University Archives, and the daily press, we argue that medical biopolitical aspirations and the public shaped the history of postmortem examinations in Israel. High rates were embedded in the medical construction of doubt regarding the cause of death that only physicians could resolve by autopsy. Civilian protests led to a temporary decrease in the 1960s, while political and medical intervention brought about a gradual resurgence in post-mortem rates in the 1980s.
LeishIF4E2 is a cap‐binding protein that plays a role in Leishmania cell cycle progression
Authors: Baron Nofar , Purushotham Rajaram , Pullaiahgari Durgeshwar , Bose Priyanka , Zarivach Raz , Shapira Michal
Published: December 2023

Leishmania encode six paralogs of the cap‐binding protein eIF4E and five eIF4G candidates, forming unique complexes. Two cap‐binding proteins, LeishIF4E1 and LeishIF4E2, do not bind any identified LeishIF4Gs, thus their roles are intriguing. Here, we combine structural prediction, proteomic analysis, and interaction assays to shed light on LeishIF4E2 function. A nonconserved C‐terminal extension was identified through structure prediction and sequence alignment. m7GTP‐binding assays involving both recombinant and transgenic LeishIF4E2 with and without the C‐terminal extension revealed that this extension functions as a regulatory gate, modulating the cap‐binding activity of LeishIF4E2. The interactomes of the two LeishIF4E2 versions were investigated, highlighting the role of the C‐terminal extension in binding to SLBP2. SLBP2 is known to interact with a stem‐loop structure in the 3′ UTRs of histone mRNAs. Consistent with the predicted inhibitory effect of SLBP2 on histone expression in Xenopus laevis, a hemizygous deletion mutant of LeishIF4E2, exhibited an upregulation of several histones. We therefore propose that LeishIF4E2 is involved in histone expression, possibly through its interaction between SLBP2 and LeishIF4E2, thus affecting cell cycle progression. In addition, cell synchronization showed that LeishIF4E2 expression decreased during the S‐phase, when histones are known to be synthesized. Previous studies in T. brucei also highlighted an association between TbEIF4E2 and SLBP2, and further reported on an interaction between TbIF4E2 and S‐phase‐abundant mRNAs. Our results show that overexpression of LeishIF4E2 correlates with upregulation of cell cycle and chromosome maintenance proteins. Along with its effect on histone expression, we propose that LeishIF4E2 is involved in cell cycle progression.
Fatty acid binding protein 4 (FABP4) induces chondrocyte degeneration via activation of the NF‐κb signaling pathway
Authors: Zhang Chaofan , Lin Yiming , Li Hongyan , Hu Hongxin , Chen Yongfa , Huang Ying , Huang Zida , Fang Xinyu , Zhang Wenming , Lin Yunzhi
Published: December 2023

The pathogenesis of osteoarthritis (OA) is still unclear. Fatty acid binding protein 4 (FABP4), a novel adipokine, has been found to play a role in OA. This study aimed to explore the role of NF‐κB in FABP4‐induced OA. In the in vivo study, four pairs of 12‐week‐old male FABP4 knockout (KO) and wild‐type (WT) mice were included. The activation of NF‐κB was assessed. In parallel, 24 6‐week‐old male C57/Bl6 mice were fed a high‐fat diet (HFD) and randomly allocated to four groups: daily oral gavage with (1) PBS solution; (2) QNZ (NF‐κB‐specific inhibitor, 1 mg/kg/d); (3) BMS309403 (FABP4‐specific inhibitor, 30 mg/kg/d); and (4) BMS309403 (30 mg/kg/d) + QNZ (1 mg/kg/d). The diet and treatment were sustained for 4 months. The knee joints were obtained to assess cartilage degradation, NF‐κB activation, and subchondral bone sclerosis. In the in vitro study, a mouse chondrogenic cell line (ATDC5) was cultured. FABP4 was supplemented to stimulate chondrocytes, and the activation of NF‐κB was investigated. In parallel, QNZ and NF‐κB‐specific siRNA were used to inhibit NF‐κB. In vivo, the FABP4 WT mice had more significant NF‐κB activation than the KO mice. Dual inhibition of FABP4 and NF‐κB alleviated knee OA in mice. FABP4 has no significant effect on the activation of the JNK signaling pathway. In vitro, FABP4 directly activated NF‐κB in chondrocytes. The use of QNZ and NF‐κB‐siRNA significantly alleviated the expression of catabolic markers of chondrocytes induced by FABP4. FABP4 induces chondrocyte degeneration by activating the NF‐κB pathway.
Modern Concepts in Sagittal Curve Measurement
Authors: Pesenti Sébastien , Prost Solene , Solla Federico , Ilharreborde Brice , Ferrero Emmanuelle , Obeid Ibrahim , Riouallon Guillaume , Laouissat Fethi , Charles Yann Philippe , Blondel Benjamin ,   On behalf of the French Society of Spine Surgery (SFCR)
Published: December 2023

Study Design.

Retrospective multicenter study.

Objective.

Our objective was to compare the spline-based measurement of sagittal spinal curvatures to fixed landmarks in a normative population.

Summary of Background Data.

Recent research has stressed the importance of considering sagittal curvature in its entirety using a spline reconstruction. To date, no data supports the superiority of this method in comparison to classic measurement methods.

Patients and Methods.

Full-spine biplanar radiographs of subjects over 20 years old who had normal radiographs were analyzed. Thoracic kyphosis (TK) and lumbar lordosis (LL) were measured following two modalities: either using predefined landmarks (TKT1T12, TKT5T12, and LLL1S1) or spline-based measurement (TKSpline and LLspline).

Results.

A total of 1520 subjects were included (mean 54yo). The mean difference between TKspline and TKT1T12 was 1.4° and between TKspline and TKT5T12 was 11.7° (P<0.001). LLspline was significantly larger than LLL1S1 (55° vs. 54°, P<0.001). LLspline and LLL1S1 were correlated (R=0.950, P<0.001). Pelvic incidence had no influence on the difference between LLspline and LLL1S1 (R=−0.034, P=0.184). Using LLL1S1 measurements, LL was underestimated in 17% of the cases. The comparison of outlier distributions according to age groups (P=0.175), sex (P=0.937), or pelvic incidence groups (P=0.662) found no difference. There were significantly more outliers in Roussouly type 1 compared with other types (56%, P<0.001).

Conclusion.

Our results suggest that the use of TKT1T12 and LLL1S1 is acceptable to assess spinal sagittal curvatures. However, TKT5T12 is not accurate for the thoracic curve and should be used with caution. LLL1S1 can be used to accurately assess the lumbar curve, except in Roussouly type 1.
Research progress in the off-target effects of Bacille Calmette–Guérin vaccine
Authors: Wu Yanfei , Zhang Xiaoyin , Zhou Li , Lu Jiayu , Zhu Fengcai , Li Jingxin
Published: December 2023

Bacille Calmette–Guérin (BCG) vaccine is designed to provide protection against tuberculosis (TB). However, numerous epidemiological, clinical, and immunological studies have shown that BCG vaccination affects neonatal and infant mortality, which may be related to the reduction of TB-unrelated infections and diseases by BCG vaccine. We aimed to discuss the off-target effects of BCG vaccine on un-TB infections and diseases, as well as the potential mechanism and influencing factors. Literature was retrieved mainly from PubMed using medical subject headings "BCG, variations, and non-specific, heterologous or off-target". Studies have showed that BCG vaccination can prevent various heterologous infections, including respiratory tract infections, leprosy, and malaria, treat viral infections including human papillomavirus and herpes simplex virus infection as immunotherapy, and improve the immune responses as vaccine adjuvant. Besides, BCG vaccine can reduce the recurrence rate of non-muscle-invasive bladder cancer, and may provide protection against autoimmune diseases. These off-target effects of BCG vaccine are thought to be achieved by modulating heterologous lymphocyte responses or inducing trained immunity, which were found to be sex-differentiated and affected by the BCG vaccine strains, sequence or time of vaccination.
Disseminated Infection With a Previously Undescribed Mycoplasma Species From a Cat Bite
Authors: Khan Faisal , Engers Drew , Lieberman Joshua A. , Moudgal Varsha
Published: December 2023

Cat bite wound infections are common, and much is known about their bacteriology, pathogenesis, and management. We report a case of a rare Mycoplasma species from a cat bite causing tenosynovitis and septic arthritis of the hand, as well as distant prosthetic joint infection of the knee. The patient demonstrated poor clinical response to standard and expanded antibiotic regimens. Repeated surgical interventions were necessary until nucleic acid amplification revealed a previously undescribed Mycoplasma species that was effectively treated with the addition of doxycycline.
Exploring the Addition of Simulation-Based Learning Experiences to Prepare Student Physical Therapist Assistants for Inpatient Clinical Experience
Authors: Dunnivan-Mitchell Sharon , Maring Joyce , Curry-Greenwood Kristin
Published: December 2023

Background and Purpose:

In today's fast-paced health care environment, simulation-based learning experiences (SBLEs) are viewed as an optimal approach to provide health professions students an opportunity for safe and deliberate practice in clinical scenarios with an element of risk. Evidence supporting the benefits of SBLEs in preparation for doctor of physical therapy (DPT) students' initial inpatient clinical experience (CE) has recently become available; however, no literature exists describing the use and effect of simulation in training preprofessional physical therapist assistants (PTAs) for higher acuity clinical environments. The authors aimed to describe the perceived value of SBLEs in preparing PTA students for the first inpatient CE, through multiple perspectives: student perception of readiness for the environment, clinical instructor (CI) perception of student preparation, and student performance ratings within the clinical practicum.

Case Description:

Effect of a newly implemented series of SBLEs was explored with a single cohort of PTA students (n = 14) and their associated CIs (n = 8) at one institution. Quantitative and qualitative data were captured through student and CI surveys, focus groups, and the Physical Therapist Assistant Manual for Assessment of Clinical Skills (PTAMACS).

Outcomes:

Student mean scores on a modified Acute Care Confidence Survey were 88.2%, indicating high levels of perceived preparation. This was further supported by themes in the focus group discussions. CIs reported student readiness for the setting, rating students somewhat prepared (occasional cues/<50% assist) or better, on the CI Questionnaire in 85.6% of survey items. CI focus group themes also generally supported student preparation. All students met the PTAMACS required threshold to pass the CE.

Discussion and Conclusion:

Implementation of the SBLE was practicable and well received by a single cohort of PTA students and their CIs; and, students were successful in their inpatient CE following the experiences. PTA student and CI perceptions were consistent with literature on the benefits of SBLE for DPT students. Further research on SBLE and PTA education in larger cohort studies is warranted.
Sexual Violence in Virtual Reality
Authors: Porta Carolyn M. , Frerich Ellen A. , Hoffman Sarah , Bauer Sara , Jain Vedushi M. , Bradley Cynthia
Published: December 2023

Background

One in four Americans report experiencing harassment online via social media and interactive gaming, which includes physical threats, stalking, sexual harassment, and sustained harassment.

Objective

The aim of this study was to gain understanding of the state of the science surrounding young adults and sexual violence/harassment harms in virtual reality (VR) as well as possible uses of VR to heal and intervene.

Methods

A scoping review was conducted in early 2023 using the Ovid Synthesis Clinical Evidence Manager and the MEDLINE database. Forty-seven articles met inclusion criteria.

Results

Our review found a growing body of evidence exploring incidents, effects, possible predictors, and initial strategies to prevent sexual violence in VR and to use the modality to positively intervene. Limited research addresses the effects of harms incurred in VR on (re)traumatization of survivors as well as the development and testing of VR tools used to educate, deliver bystander interventions, transform biases and perceptions via embodiment, and promote healing among survivors.

Conclusion

Research addressing sexual violence in VR is needed and should build on the existing peripheral science on gaming and social media environments. Forensic nursing is well positioned to advance strategies of health and safety in VR, just as in the physical world. Incorporating forensic nursing avatars in VR and deploying diverse resources targeted for college-age young adults to prevent harms in VR should be explored safely and ethically. Forensic nurses are also positioned to assess for VR-related harms among patients and to work with private and government sectors to influence regulations and policies.
Differentiation of cancer of unknown primary and lymphoma in head and neck metastatic poorly differentiated cancer using 18F-FDG PET/CT tumor metabolic heterogeneity index
Authors: Xu Mingzhen , Gu Bingxin , Zhang Jianping , Xu Xiaoping , Qiao Ying , Hu Silong , Song Shaoli
Published: December 2023

Objective

To explore the value of 18F-FDG PET/CT tumor metabolic heterogeneity index (HI) and establish and validate a nomogram model for distinguishing head and neck cancer of unknown primary (HNCUP) from lymphoma with head and neck metastatic poorly differentiated cancer.

Methods

This retrospective analysis was conducted on 1242 patients with cervical metastatic poorly differentiated cancer. 108 patients, who were clinically and pathologically confirmed as HNCUP or lymphoma, were finally enrolled. Two independent sample t-tests and χ2 test were used to compare the clinical and imaging features. Binary logistic regression was used to screen for independent predictive factors.

Results

Among the 108 patients), 65 patients were diagnosed with HNCUP and 43 were lymphoma. Gender (P = 0.001), SUVmax (P < 0.001), SUVmean (P < 0.001), TLG (P = 0.012), and HI (P < 0.001) had statistical significance in distinguishing HNCUP and lymphoma. Female (OR = 4.546, P = 0.003) and patients with HI ≥ 2.37 (OR = 3.461, P = 0.047) were more likely to be diagnosed as lymphoma.

Conclusion

For patients with cervical metastatic poorly differentiated cancer, gender and HI were independent predictors of pathological type. For such patients, clinical attention should be paid to avoid misdiagnosing lymphoma as HNCUP, which may delay treatment.
Risk and Time to Diagnosis of Lung Cancer in Incidental Pulmonary Nodules
Authors: Hammer Mark M.
Published: December 2023

Purpose:

To determine the risk of lung cancer in incidental pulmonary nodules, as well as the time until cancer growth is detected.

Patients and Methods:

This retrospective study examined patients with incidental nodules detected on chest computed tomography (CT) in 2017. Characteristics of the dominant nodule were automatically extracted from CT reports, and cancer diagnoses were manually verified by a thoracic radiologist. Nodules were categorized per Fleischner Society guideline categories: solid <6 mm, solid 6 to 8 mm, solid >8 mm, subsolid <6 mm, ground glass nodules ≥6 mm, and part-solid nodules ≥6 mm. The time to nodule growth was determined by CT reports.

Results:

A total of 3180 patients (nodules) were included, of which 155 (5%) were diagnosed with lung cancer. By category, 7/1601 (0.4%) solid nodules <6 mm, 11/713 (1.5%) solid nodules 6 to 8 mm, 71/446 (15.9%) solid nodules >8 mm, 1/124 (0.8%) subsolid nodules <6 mm, 29/202 (14.4%) ground glass nodules ≥6 mm, and 36/94 (37.9%) part-solid nodules ≥6 mm were malignant. Of solid lung cancers <6 mm, growth was observed in 1/4 imaged by 1 year and 2/5 by 2 years; of solid lung cancers 6 to 8 mm, growth was observed in 3/10 imaged by 1 year and 6/10 by 2 years.

Conclusion:

Solid nodules <6 mm have a very low risk of malignancy and may not require routine follow-up. However, when malignant, growth is often not observed until 2 or more years later; therefore, stability at 1 to 2 years does not imply benignity.
The Deception of Pancreas Cyst Surveillance
Authors: Lorenzo Amy , Hillel Liza
Published: December 2023

Pancreatic cysts are a growing pandemic around the world. Intrapapillary mucinous neoplasms are the most common type of pancreatic cysts and given their premalignant nature, guidelines recommend surveillance. This case study and discussion addresses the five existing guidelines published to help clinicians manage patients with intraductal papillary mucinous neoplasms and illustrates how, despite guidelines and close surveillance, intraductal papillary mucinous neoplasms can transform into pancreatic adenocarcinoma.
The Patient's Clinical Profile From a Neuro-Ophthalmology Center in Brazil: A Retrospective Study
Authors: Simao Luciano M. , de Almeida Ava Cristina V. , Viana Marcos Tulio S. A. , Vanazzi Marcela A. M. , Andrade Thais N. , Oliveira Ana Flávia A. O. , Hermes Monise Q. , Mendanha Denise B. A.
Published: December 2023

Background:

Neuro-ophthalmology (NO) is a subspeciality of Ophthalmology, which represents more than an intersection of Neurology and Ophthalmology. The present report highlights the increasing importance of the subspeciality in Brazil and provides a unique retrospective study of the patient's clinical profile of a NO reference center.

Methods:

Our study was retrospectively planned aiming to identify all neuro-ophthalmic cases of Instituto de Olhos of the Medical School Faculdade Ciências Médicas de Minas Gerais from August 2013 to March 2022.The first clinical diagnostic impression was selected from a predetermined list of 18 neuro-ophthalmologic conditions. Some NO conditions were eventually reclassified during the follow-up as the final clinical diagnosis impression. The concordance between the first and final clinical impressions was also investigated, as well as the patient's referral source.

Results:

The sample comprised 903 patients from which 56.4% were female. The mean age was 51.48 ± 20.93 years. Males were more frequent in lower age groups <1 year (n = 3, 100%) and 1–9 years (n = 19/37, 51.4%). An external referral source represented 23.1%, and patients referred after basic ophthalmic consultation and from glaucoma service were 30.3% and 23.2%, respectively. The most encountered first clinical diagnostic impressions were isolated optic atrophy (13.1%), non–neuro-ophthalmic disease (11.7%), optic disc abnormalities (10.4%), ischemic optic neuropathies/retinal vascular occlusions (10.2%), and other visual field defects (9.0%). The kappa concordance coefficient among the first and final clinical diagnostic impressions was 0.53 (95% CI 0.48–0.59), indicating a moderate concordance level. The concordance among the most frequent diagnoses was lower in isolated optic atrophy (33%), other visual field defects (41%), and idiopathic optic neuritis (40%).

Conclusions:

Due to the limited number of epidemiology studies in neuro-ophthalmology, we highlight the importance of a NO service in the public health system in Brazil. It may certainly contribute to better strategy plan assistance among professionals and health care managers. This report should seemingly stimulate other studies regarding the relevant and unique features of this subspeciality, which is undoubtedly increasing its importance among patients, and in the scientific community worldwide.
Wind speed affects the rate and kinetics of stomatal conductance
Authors: Shapira Or , Hochberg Uri , McAdam Scott , Azoulay-Shemer Tamar , Brodersen Craig R. , Holbrook Noel Michelle , Zait Yotam
Published: December 2023

Understanding the relationship between wind speed and gas exchange in plants is a longstanding challenge. Our aim was to investigate the impact of wind speed on maximum rates of gas exchange and the kinetics of stomatal responses. We conducted experiments using an infrared gas analyzer equipped with a controlled leaf fan, enabling precise control of the boundary layer conductance. We first showed that the chamber was adequately mixed even at extremely low fan speeds (down to 200 rpm, equivalent to a wind speed of 0.0005 m s-1) and evaluated the link between fan speed, wind speed, and boundary layer conductance. We observed that higher wind speeds led to increased gas exchange of both water vapor and CO2in Arabidopsis, presumably due to its effect on transpiration and the consequential reduction in epidermal pressure that led to stomatal opening. We documented that stomatal opening in response to light was three times faster at a fan speed of 10000 rpm (wind speed of 2 m s-1) compared with 500 rpm (0.25 m s-1) inVicia faba, while the latter exhibited an opening rate that was similar to those of epidermal peels. The increase of stomatal conductance under high wind was observed in four species under field conditions. Our findings demonstrate the importance of the size of the boundary layer on determining maximum rates of gas exchange and the kinetics of gas exchange responses to environmental changes.
Impact of the population age, testing and vaccination levels on the numbers of COVID-19 cases and deaths per capita and case fatality risks
Authors: Nesteruk Igor
Published: December 2023

The population, governments and researchers show much less interest in the COVID-19 pandemic. However, many questions still need to be answered: why the much less vaccinated African continent has accumulated 15 times less deaths per capita than Europe? or why in 2023 the global value of the case fatality risk is almost twice higher than in 2022 and the UK figure is four times higher than the global one?

The averaged daily numbers of casesDCCand deathDDCper million, case fatality risksDDC/DCCwere calculated for 34 countries and regions with the use of John Hopkins University (JHU) datasets and possible linear and non-linear correlations with the averaged daily numbers of tests per thousandDTC, median age of populationA, and percentages of vaccinationsVCand boostersBCwere investigated. Strong correlations between age andDCCandDDCvalues were revealed. One-year increment in the median age yielded 39.8 increase inDCCvalues and 0.0799 DDC increase in 2022 (in 2023 these figures are 5.8 and 0.0263, respectively). With decreasing of testing levelDTC, the case fatality risk can increase drastically.DCCandDDCvalues increase with increasing the percentages of fully vaccinated people and boosters, which definitely increase for greaterA. After removing the influence of age, no correlations between vaccinations andDCCandDDCvalues were revealed.

The presented analysis demonstrates that age is a pivot factor of visible (registered) part of the COVID-19 pandemic dynamics. Much younger Africa has registered less numbers of cases and death per capita due to many unregistered asymptomatic patients. Of great concern is the fact that COVID-19 mortality in 2023 in the UK is still at least 4 times higher than the global value caused by seasonal flu.
Explaining the counter-intuitive effectiveness of trophectoderm biopsy for PGT-A using computational modelling
Authors: Skinner Benjamin M , Viotti Manuel ,   International Registry of Mosaic Embryo Transfers (IRMET), Griffin Darren K , Ellis Peter JI
Published: December 2023

Preimplantation genetic testing for aneuploidy (PGT-A) is one of the most controversial topics in reproductive medicine, with disagreements over the apparently contradictory results of randomised controlled trials, non-selection trials and outcome data analyses. Data from live birth outcomes largely suggest that fully euploid biopsies are associated with positive live birth rates, while fully aneuploid biopsies are not. However, the possible confounding effects of chromosomal mosaicism (when either the whole embryo, the biopsy result (or both) contain an admixture of euploid and aneuploid cells) is frequently cited as a reason why PGT-A should not be performed. Previous computer models have indicated that a mosaic result is a poor indicator of the level of mosaicism of the rest of the embryo, and it is thus unwise to use mosaic PGT-A results when selecting embryos for transfer. Here we developed a computational model,tessera, to create virtual embryos for biopsy, allowing us to vary the number of cells in the simulated embryo and biopsy, the proportion of aneuploid cells and the degree of juxtaposition of those cells. Analysis of approximately 1 million virtual embryos showed that “100% euploid” and “100% aneuploid” biopsy results are relatively accurate predictors of the remainder of the embryo, while mosaic biopsy results are poor predictors of the proportion of euploid and aneuploid cells in the rest of the embryo. Within mosaic embryos, ‘clumping’ of aneuploid cells further reduces the accuracy of biopsies in assaying the true aneuploidy level of any given embryo. Nonetheless - and somewhat counterintuitively - biopsy results can still be used with some confidence to rank embryos within a cohort. Our simulations help resolve the apparent paradox surrounding PGT-A: the biopsy result is poorly predictive of the absolute level of mosaicism of a single embryo, but may be applicable nonetheless in making clinical decisions on which embryos to transfer.
Availability, use and impact of workplace mental health supports during the COVID-19 pandemic in a Canadian cohort of healthcare workers
Authors: Ruzycki Shannon , Adisesh Anil , Burstyn Igor , Durand-Moreau Quentin , Labreche France , Zadunayski Tanis , Cherry Nicola
Published: December 2023

The COVID-19 pandemic focused attention on workplace mental health (MH) supports for healthcare workers (HCWs).

Methods

HCWs in a Canadian cohort reported availability and use of workplace MH supports in October 2020, April 2021 and 2022. At recruitment (April-October 2020) they reported pre-pandemic MH. They completed the Hospital Anxiety and Depression Scale (HADS) at each contact. Availability and use of supports were examined by pandemic phase, workplace, work role and, for use, gender, age, pre-pandemic and current MH. Impact was assessed as MH in 2021/2022 following use in 2020.

Results

Reports of availability, use and HADS scores were obtained from 4400 HCWs working with patients. Access to MH supports increased during the pandemic, with 94% reporting access to some workplace support by 2022. Half the HCWs had at least one clinically significant HADS score during the pandemic. The proportion with high anxiety scores decreased from 29% to 24% as the pandemic progressed: proportions with high depression scores remained close to 10%. Those with a history of pre-pandemic or current mental ill-health formed the majority of HCWs using MH supports. 25% of those with high HADS scores did not use supports, with depressed males least likely to report use. HCWs using an Employment Assistance Program at the 2ndcontact had lower HADS scores at next follow-up but this was not sustained.

Conclusion

HCWs reported increasing availability and use of MH supports as the pandemic progressed but one in four of those with anxiety and, particularly, depression did not seek support.
Computer Simulation and Mathematical Modeling of the Interactions Between Ecological and Sexual Selection to Reveal the Mechanism of Sympatric Speciation
Authors: Lin John , Lin James , Wassall Natalie
Published: December 2023

In modern evolutionary theory, the mechanism of sympatric speciation is still an unsolved mystery. Ecological niche specialization and the subsequent premating reproductive isolation (RI) are the putative initial steps of sympatric speciation, even though the exact mechanism of how the former leads to the latter remains unclear. This study aims to develop a simple, intuitive, and realistic model ecosystem that uses the fewest variables possible but is still comprehensive enough to uncover the fundamental mechanisms of sympatric speciation. Applying the concept of an adaptive fitness landscape, the study used an individual-based computer simulation to investigate how ecological selection and sexual selection may interact to produce sympatric premating RI. Mathematical models were derived to describe the nonlinear adaptive dynamics of the system. A user-friendly computer application was able to solve, numerically, all the trajectories, fixed points, and bifurcation points of the models and display the solutions as phase portraits. The findings reveal that under favorable conditions, fixed points may emerge in the system’s phase portraits to create stable mating-bias-allele polymorphisms and varying degrees of premating RI between niche ecotypes. Solving the nonlinear equations of the mathematical models establishes the precise parametric values required to produce such fixed points. It also specifies the conditions necessary for high-mating-bias mutant alleles to invade and produce, or enhance, premating RI. Restricting migration between niches impedes mutant invasion in parapatric and allopatric populations. Multi-locus mating traits may produce hybrids that prevent speciation. Simulation results of a gonochoric, multi-niche system demonstrate that linkage disequilibrium can emerge spontaneously among ecological, male-trait, and female-preference genotypes to produce premating RI. From these results, a five-stage mechanism of sympatric speciation is formulated: Initially, disruptive ecological selection creates selection pressure for high-mating-bias alleles to invade and rapidly establish premating RI. This then paves the way for the recruitment of late-stage mechanisms, such as adaptive coupling and post-zygotic isolation, to complete the speciation process. Applying nonlinear dynamics theories to model and analyze sympatric speciation has yielded novel findings that support and extend the results of prior studies. These new discoveries may help to overcome the theoretical objections to sympatric speciation and establish it as a prevalent mode of speciation in nature.
Connectivity of marine predators over the Patagonian Shelf during the highly pathogenic avian influenza (HPAI) outbreak
Authors: Riaz Javed , Orben Rachael A. , Gamble Amandine , Tierney Megan , Catry Paulo , Granadeiro José P. , Campioni Letizia , Baylis Alastair M. M.
Published: December 2023

Animal movement and population connectivity are key areas of uncertainty in efforts to understand and predict the spread of infectious disease. The emergence of highly pathogenic avian influenza (HPAI) in South America poses a significant threat to globally significant populations of colonial breeding marine predators in the South Atlantic. Yet, there is a poor understanding of which species or migratory pathways may facilitate disease spread. Compiling one of the largest available animal tracking datasets in the South Atlantic, we examine connectivity and inter-population mixing for colonial breeding marine predators tagged at the Falkland Islands. We reveal extensive connectivity for three regionally dominant and gregarious species over the Patagonian Shelf. Black browed albatrosses (BBA), South American fur seals (SAFS) and Magellanic penguins (MAG) used coastal waters along the Atlantic coast of South America (Argentina and Uruguay). These behaviours were recorded at or in close proximity to breeding colonies and haul-out areas with dense aggregations of marine predators. Transit times to and from the Falkland Islands to the continental coast ranged from 0.2 – 70 days, with 84% of animals making this transit within 4 days - a conservative estimate for HPAI infectious period. Our findings show the incursion of HPAI to the Falkland Islands marine predator community is a highly credible threat, which may be facilitated by BBA, SAFS and MAG connectivity with South America. This information is vital in supporting HPAI disease surveillance, risk assessment and marine management efforts across the region.

Significance

The recent emergence of highly pathogenic avian influenza (HPAI) in South America poses a major threat to globally significant marine predator populations in the South Atlantic. There is extensive connectivity over the southern Patagonian Shelf between regionally dominant seal and seabird populations, with potential for large-scale pathogen spread. Despite this connectivity, outbreaks of HPAI are unevenly distributed across the region. Connectivity information is integral for regional disease surveillance, predictive modelling and population viability assessments.
Syncytia Formation Promotes Virus Resistance to Interferon and Neutralizing Antibodies
Authors: Li Tiansheng , Kang Insung , Hu Zhe , Gibbs James , Ye Chengjin , Kosik Ivan , Shi Guoli , Holly Jaroslav , Kosikova Martina , Compton Alex , Martinez-Sobrido Luis , Johnson Reed F. , Xie Hang , Yewdell Jonathan W.
Published: December 2023

SARS-CoV-2, like many viruses, generates syncytia. Using SARS-CoV-2 and S (S) expressing recombinant vesicular stomatitis and influenza A viruses, we show that S-mediated syncytia formation provides resistance to interferons in cultured cells, human small airway-derived air-liquid interface cultures and hACE2 transgenic mice. Amino acid substitutions that modulate fusogenicity in Delta- and Omicron-derived S have parallel effects on viral interferon resistance. Syncytia formation also decreases antibody virus neutralization activity in cultured cells. These findings explain the continued selection of fusogenic variants during SARS-CoV-2 evolution in humans and, more generally, the evolution of fusogenic viruses despite the adverse effects of syncytia formation on viral replication in the absence of innate or adaptive immune pressure.
Phosphene and Motor Transcranial Magnetic Stimulation Thresholds Are Correlated: A Meta-Analytic Investigation
Authors: Phylactou P. , Pham T. , Narskhani N. , Diya N. , Seminowicz D.A. , Schabrun S.M.
Published: December 2023

Transcranial magnetic stimulation (TMS) is commonly delivered at an intensity defined by the resting motor threshold (rMT), which is thought to represent cortical excitability, even if the TMS target area falls outside of the motor cortex. This approach rests on the assumption that cortical excitability, as measured through the motor cortex, represents a ‘global’ measure of excitability. Another common approach to measure cortical excitability relies on the phosphene threshold (PT), measured through the visual cortex of the brain. However, it remains unclear whether either estimate can serve as a singular measure of global cortical excitability. If PT and rMT indeed reflect global cortical excitability, they should be correlated. To test this, we systematically identified previous studies that measured PT and rMT to calculate an overall correlation between the two estimates. Our results, based on 16 effect sizes from eight studies, indicated that PT and rMT are correlated (ρ = .4), and thus one measure could potentially serve as a global cortical excitability measure. Three exploratory meta-analyses revealed that the strength of the correlation is affected by different methodologies, and that PT intensities are higher than rMT. Evidence for a PT-rMT correlation remained robust across all analyses. Further research is necessary for an in-depth understanding of how cortical excitability is reflected through TMS.
Softening in two-component lipid mixtures by spontaneous curvature variance
Authors: Hossein Amirali , Beaven Andrew H. , Sapp Kayla , Sodt Alexander J.
Published: December 2023

The bending modulus of a lipid bilayer quantifies its mechanical resistance to curvature. It is typically understood in terms ofthickness, e.g., thicker bilayers are stiffer. Here, we describe an additional and powerful molecular determinant of stiffness — the variance in the distribution of curvature sensitivity of lipids and lipid conformations. Zwitterionic choline and ethanolamine headgroups of glycero-phospholipids dynamically explore inter- and intra-species interactions, leading to transient clustering. We demonstrate that these clusters couple strongly to negative curvature, exciting undulatory membrane modes and reducing the apparent bending modulus. Three forcefields (Martini 2, Martini 3, and all-atom CHARMM C36) each show the effect to a different extent, with the coarse-grained Martini models showing the most clustering and thus the most softening. The theory is a guide to understanding the stiffness of biological membranes with their complex composition, as well as how choices of forcefield parameterization are translated into mechanical stiffness.