bluuebunny/crossref_metadata_2025 huggingface dataset:
Research as care: Positionality and reflexivity in qualitative migration research
Authors: Moralli Melissa
Published: May 2023

This article analyses the implications of qualitative research on migration in terms of reflexivity and positionality. In particular, it presents research as care, revolved around three main critical nodes of reflection: the epistemological importance of emotions, intersectional positionality and the ethics of care. Drawing upon the insights concerning a qualitative research on migration in Italian shrinking areas, the contribution underlines the importance of conceiving research as a process of negotiation. Moreover, it shows how positionality in qualitative migration research is not static but flexible, and is conditioned by different emotionalities emerging during the fieldwork. In this sense, the continuous negotiation that exists between researchers and participants can imply affectivities and kinship that valorises the relationships created during the research.
The moral benefits of coercion: A defense of ideal statism
Authors: Chahboun Naima
Published: May 2023

This paper contributes to recent discussions on ideal anarchism vs. ideal statism. I argue, contra ideal anarchists, that coercive state institutions would be justified even in a society populated by morally perfect individuals. My defense of ideal statism is novel in that it highlights the moral benefits of state coercion. Rather than the practical effects on individual compliance or the distributive outcomes that follow therefrom, coercive state institutions are justified through the moral benefits they provide. The state is morally beneficial because it a) lessens the demands on the will that fall on agents under ideal anarchism, and b) counters the structural domination that follows from differences in natural endowments. By shifting the focus of the debate from feasibility to desirability, the paper exposes the flaws of ideal anarchism and provides new insights into the moral value of the state.
CrackDenseLinkNet: a deep convolutional neural network for semantic segmentation of cracks on concrete surface images
Authors: Manjunatha Preetham , Masri Sami F , Nakano Aiichiro , Wellford Landon Carter
Published: May 2023

Cracks are the defects formed by cyclic loading, fatigue, shrinkage, creep, and so on. In addition, they represent the deterioration of the structures over some time. Therefore, it is essential to detect and classify them according to the condition grade at the early stages to prevent the collapse of structures. Deep learning-based semantic segmentation convolutional neural network (CNN) has millions of learnable parameters. However, depending on the complexity of the CNN, it takes hours to days to train the network fully. In this study, an encoder network DenseNet and modified LinkNet with five upsampling blocks were used as a decoder network. The proposed network is referred to as the “CrackDenseLinkNet” in this work. CrackDenseLinkNet has 19.15 million trainable parameters, although the input image size is 512 × 512 and has a deeper encoder. CrackDenseLinkNet and four other state-of-the-art (SOTA) methods were evaluated on three public and one private datasets. The proposed CNN, CrackDenseLinkNet, outperformed the best SOTA method, CrackSegNet, by 2.2% of F1-score on average across the four datasets. Lastly, a crack profile analysis demonstrated that the CrackDenseLinkNet has lesser variance in relative errors for the crack width, length, and area categories against the ground-truth data. The code and datasets can be downloaded at https://github.com/preethamam/CrackDenseLinkNet-DeepLearning-CrackSegmentation .
Quality of Life Ratings and Proxy Bias in Primary Progressive Aphasia: Two Sides to the Story?
Authors: Ruggero Leanne , Croot Karen , Nickels Lyndsey
Published: May 2023

A valid measure of quality of life is important for clinical goal setting and for evaluating interventions. In the amnestic dementias, proxy-raters (e.g. friends, families, clinicians) typically rate quality of life lower than the self-ratings given by the person with dementia – a proxy bias. This study investigated whether the same proxy bias occurs in Primary Progressive Aphasia (PPA), a language-led dementia.

Quality of life was measured in 18 individuals with PPA using self-ratings, and proxy-ratings by their main communication partner, using the Quality of Life in Alzheimer’s Disease Scale.

There was no strong evidence for proxy bias at a group level, with no consistent pattern across dyads, where proxy- and self-ratings did not show good levels of agreement. We suggest that self-ratings and proxy-ratings of quality of life in PPA are not interchangeable. Higher-powered investigation of the patterns observed here is warranted in future studies.
Neuronal Physiology of Generalized Seizures: The 4 Horsemen of Absence Epilepsy
Authors: Gallagher Martin J.
Published: May 2023

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Video Games as Social Institutions
Authors: Obreja Dragoș M.
Published: May 2023

This article invites social scientists to treat video games as social institutions. Starting with a brief presentation of sociological perspectives from Parsons to Giddens on institutions, this article highlights multiple features that characterize video games as such: historicity, internalization, conflict and change, legitimating ideology, State intervention, and interdependence. Through brief examples from games such as Assassin's Creed Origins, Second Life, Far Cry 5, and Metin2, I argue that understanding video games as social institutions would considerably improve both the perspectives of digital sociology and social theory in general, through: understanding the ubiquitous elements of gamification of our material life, understanding gamer identity at the confluence of other social institutions, such as gender and sexuality, highlighting ideology and the neoliberal agenda, emphasizing gamic agency as a form of institutional control, and redefining time-oriented interactions to explain adaptation and resistance with which the play element has crossed multiple cultures and historical periods.
Numerical analysis of combined heat transfers through concrete hollow bricks in a hot climate of Morocco
Authors: Jamal Bouchaib , El Moutaouakil Lahcen , Boukendil Mohammed , Abdelbaki Abdelhalim , Zrikem Zaki
Published: May 2023

The aim of this study is to determine the thermal conductance of concrete hollow bricks, which is crucial for assessing the energy efficiency of buildings. The study focuses on three types of concrete hollow bricks that are frequently used to build walls in Morocco. The three modes of heat transfer by convection, conduction and radiation are taken into account. The thermal behavior of the three types was simulated using a computational model created with the finite volume method. The effect of internal surfaces emissivity and solid wall thermal conductivity on overall heat transfer is investigated using practical values of the thermal excitations. Simulation results of the three types were compared and showed that the concrete hollow brick of Type (C) is the best performing configuration. Indeed, it reduces the thermal conductance ( U-value) by 40% compared to hollow brick of Type (B), which will contribute to improve the thermal resistance of the building walls.
Absolute Configuration of Isomeric Mono-Acetyl Tropane Alkaloids Using Chromatography-Assisted Chemical Correlation
Authors: Muñoz Marcelo A. , Cabrera Z. Fabián
Published: May 2023

Objective: To establish the absolute configurations of isomeric 6β-acetyl-3α-tropanol (3) and 3α-acetyl-6β-tropanol (4), constituents of several species of Datura and other genera, using a combination of a simple hemi-synthetic pathway starting from racemic 6β-hydroxytropinone (1) to produce 3α,6β-tropanediol (2), and the use of chiral liquid chromatography coupled with mass and laser optical rotation detectors (LC-MS and LC-OR). Methods: In the case of 3, mono acetylation of the more reactive OH group at C-6 in 2 was achieved under controlled reaction conditions, while more vigorous conditions produced exclusively 3α,6β-diacetyltropane (5). On the other hand, isomer 4 was obtained by partial hydrolysis of the acetyl group at C-6 in 5. Samples of the three compounds were then subjected to chiral LC-MS and LC-OR, which showed chromatograms composed of two peaks of opposite optical rotation. Next, ten consecutive LC injections followed by fraction collection of the column elution, produced a set of micro-scale samples of opposite enantiomeric composition for each mono ester, which were then derivatized by further acetylation to convert the partially enantioenriched samples into their corresponding diacetates. The resulting samples were then evaluated using LC-MS, which allowed the correlation between the enantiomers of 3 and 4 with those of 5. Results: Considering that the absolute configuration of (−)-5 has been assigned previously as (1 S, 3 S, 5 R, 6 S), these chromatographic comparisons established the absolute configurations of monoacetates 3 and 4 as (−)-(1 S, 3 S, 5 R, 6 S)-3 and (+)-(1 R, 3 R, 5 S, 6 R)-3, and (−)-(1 S, 3 S, 5 R, 6 S)-4 and (+)-(1 R, 3 R, 5 S, 6 R)-4, respectively. Conclusion: A methodology based on chiral liquid chromatography allowed the establishment of the absolute configuration of isomeric monoacetates of tropandiol 3 and 4, directly from the racemic mixtures, and without resorting to the isolation of enantiomerically pure samples.
Recurrent Intraventricular Haemorrhage in Cerebral Proliferative Angiopathy – A Case Report and Review of the Literature
Authors: Gerstl Jakob V. E. , Bernstock Joshua D. , Kappel Ari D. , Torio Erickson F. , Du Rose
Published: May 2023

Cerebral proliferative angiopathy (CPA) is an entity distinct from that of classical arteriovenous malformations. As such, few reports have considered the long-term follow-up of patients with hemorrhage in CPA. Accordingly, herein the authors present a case of recurrent hemorrhage in CPA with 32 years of follow-up and in so doing summarize the literature of hemorrhagic cases in CPA. A 19-year-old presented with focal awareness seizures and diagnostic work-up revealed a left hemispheric vascular lesion. The patient presented again with intracranial hemorrhage at ages 28, 43 and 51. Angioarchitectural workup revealed intermingled brain parenchyma between vascular spaces, absence of dominant feeders and a clear nidus consistent with CPA. The size and diffuse nature of the lesion deemed it inoperable. Given our case and review of the literature it is apparent that CPA has a high risk of re-hemorrhage in the rare event that hemorrhage does occur.
Transfer of undertakings and the right of objection from a Portuguese vantage point
Authors: Oliveira Pedro
Published: May 2023

This article seeks to analyse the right of the employee to object to her employment contract being transferred to a new employer (transferee) under the framework of the transfer of undertakings. I will first address the terms, basis, and consequences of the right of objection in accordance with the Portuguese Labour law amendment of 2018. Subsequently, I will show how that right is already being divergently interpreted by the national courts. In conclusion, I will argue that despite the fact that the Portuguese final legal outcome restricted, or sought to restrict, the right of objection to the existence of motives to do so, and regardless of the intense debate in both the doctrine and jurisprudence around it, the social and legal benefits that are inherent to the model will not be outweighed. In fact, the legal enshrinement of the right of objection in Portugal has had a significant impact on the protection of fundamental employment rights.
‘Strengthening cooperation with external partners: Looking for a common response to the phenomenon of foreign terrorist fighters’
Authors: Höhn Christiane
Published: May 2023

Addressing the challenge of foreign terrorist fighters (FTFs) and their affiliates who travelled to Syria and Iraq to join Da'esh and other terrorist groups has been a priority for the EU and the EU Counter-Terrorism Coordinator since 2013, both within the EU and internationally. This article sets out comprehensive EU cooperation with international partners on foreign terrorist fighters: It covers EU action related to the camps and prisons in North East Syria where FTFs and family members are held, accountability of FTFs and affiliates, cooperation on FTFs with the EU’s neighbourhood: Turkey, Western Balkans and Middle East and North Africa regions, multilateral engagement with the United Nations and other fora as well as addressing Islamist extremist ideology which is contributing to the radicalization process. From a practitioner's perspective, the article provides the EU policy framework and its evolution, as well as examples of capacity building and other initiatives.
Decentring whiteness in engaging Muslim geographies
Authors: Nassar Aya
Published: May 2023

In this commentary, I read Sidaway's ‘Beyond the Decolonial: Critical Muslim Geographies’ as an invitation to engage in alternative cartographies and lateral engagements with what Islam (broadly and complexly conceived) might say to the discipline. In doing so, I build upon Sidaway's invitation to suggest a deeper engagement with the complexity of already existing Islamic geographical traditions and scholarship on Muslim spatialities by pulling out two themes that echo some of those raised in the main article: (1) Islamic traditions of mapping and cartography, and (2) scholarship on Islam and the city. The central aim of my response, however, is to push for different entry points when considering the decolonial possibilities of Muslim geographies rather than an entry point of dismissal from disciplinary geography. Only by decentring the whiteness of the discipline as the starting point, can Islamic traditions of geography be engaged on their own terms, as complex, evolving, contextual, and at times perhaps problematic.
Additional evidence on the phenotype produced by combination of CFTR 1677delTA alleles and their relevance in causing CFTR-related disease
Authors: Tkemaladze Tinatin , Kvaratskhelia Eka , Ghughunishvili Mariam , Rtskhiladze Irakli , Zaalishvili Zurab , Nakaidze Nata , Lentze Michael J , Abzianidze Elene , Skrahina Volha , Rolfs Arndt
Published: May 2023

Cystic fibrosis is the most common, life-threatening, autosomal recessive disease in the Caucasian population. It is caused by mutations in the cystic fibrosis transmembrane conductance regulator gene, which encodes a chloride ion channel expressed on the surface of epithelial cells. There are more than 2000 variants of the cystic fibrosis transmembrane conductance regulator gene reported worldwide. Some of these variants cause classic cystic fibrosis, while others are labeled as variants of unknown significance or variants of varying clinical consequences alleles and associated with atypical disease or cystic fibrosis transmembrane conductance regulator-related disorders. Although these alleles do not directly cause cystic fibrosis, they may predispose compound heterozygous patients to certain clinical phenotypes. Specifically, 1677delTA has been reported as a pathogenic allele in homozygous state or in combination with other cystic fibrosis-causing alleles. However, the L997F allele is considered to be benign or causative of non-classic cystic fibrosis or cystic fibrosis transmembrane conductance regulator-related disorders in combination with other pathogenic alleles. In this case series, we describe three cases with 1677delTA and L997F genotype, and speculate that a co-concurrence of these two alleles in trans does not cause classic cystic fibrosis symptoms; however, because the late-onset of cystic fibrosis is possible in the presence of rare alleles, such as L997F, longer follow-up of these patients and identification of a greater number of adults with 1677delTA/L997F genotype are necessary to make final conclusion about the nature of this genotype.
Artificial Intelligence: First Do the Long Overdue Doable
Authors: Patwardhan Avinash
Published: May 2023

Release of ChatGPT-4, an internet-based computer program that simulates conversation with human users using Artificial Intelligence (AI) on March 14, 2023 set off a flurry of debates regarding the role and impact of AI on human life. Influential leaders and thinkers from diverse fields have chimed in to offer their views, admonitions, and or recommendations. There seems to be a great diversity in viewpoints and visions regarding how AI would affect human destiny—right from confident optimism to stark doomsaying and all in between. However, not much attention is being paid to the insidious long-term effects on human societies, many of them being unintended consequences, that AI has the potential to create over a short period of time. Perhaps the greatest threat of AI is the potential for loss of meaning in life and human-technology-created enfeeblement in a large section of humanity. All the other threats including that of the current AI are mere epiphenomena of this basic threat. In view of the fact that the genie of AI is out of the bottle and that it cannot be put back in, the first order of business for technologists, policy makers, and the governments is to allocate resources and attention to address the problem of meaning in life and mitigation of the sentiment of overwhelming and universal helplessness. Lastly, not to be optimistic about AI while being cautious and pragmatic is not an option.
The Comparison of the Efficiency of the Lecture Method and Flipped Classroom Instruction Method on EFL Students’ Academic Passion and Responsibility
Authors: Liu Feifei , Wang Xiaoli , Izadpanah Siros
Published: May 2023

In recent years, there has been an increasing interest in the efficiency of the lecture and flipped classroom instruction method (FCIM) on EFL students’ academic passion (AP) and responsibility. Although these variables have been studied before, more studies still need to be conducted in this field. The statistical population of this study includes all language students at the University of Tabriz in the academic year 2022–2023. In the current study, 72 of 552 persons were selected using a one-stage cluster sampling method from students in term two and randomly assigned to two groups (36 persons for each group). This research is a quasi-experimental method based on the objectives and method of data collection. Two questionnaires were used in this study: AP and responsibility questionnaire. The content validity index (CVI) and content validity ratio (CVR)methods examined the content validity of the textbook course. The results showed that students’ AP and responsibility in flipped classroom instruction (FCI) are significantly higher than in the lecture method. Thus, by activating learners, they can direct their thoughts and actions in a way that has a more significant impact on their motivation, AP, responsibility, and ultimately on their learning. It can be concluded that FCI is more efficient than the lecture method.
Enabling Patients as Partners on Virtual Teams: A Scoping Review
Authors: Teles Sabrina , Crudo Vanessa , Sangrar Ruheena , Langlois Sylvia
Published: May 2023

Developing partnerships among patients and healthcare providers improves quality of virtual care. Successful patient engagement is influenced by digital literacy. Although adults (35–64) with chronic health challenges may be motivated to use virtual services, they may not have the required skills or orientation to effectively participate on their virtual team. This scoping review aimed to identify resources available to enable adults with chronic health challenges to participate as partners on their virtual teams. Peer-reviewed and grey literature data from 2011 to 2022 were searched. A total of 432 peer-reviewed and 357 grey literature sources were retrieved and screened, and 14 and 84 sources, respectively, met the inclusion criteria. Relevant information from the sources was extracted and analyzed in duplicate and synthesized qualitatively. Key findings include (1) virtual workflow processes/frameworks, (2) ‘webside manner’ guidelines which emphasize “the how” as opposed to “the what” of facilitating team interactions, and (3) virtual patient support personnel. Overall, analyses suggest there are persisting gaps to be addressed in synchronous virtual care resources for adults with chronic health challenges.
Video Didactic Preparation Augments Problem-Based Learning for First Year Medical Students
Authors: Hamilton Kelly L , Kuo Yu-Chun , Horneffer Peter , Stein T Peter , Goldberg Gary S
Published: May 2023

Problem-based learning (PBL) utilizes a self-directed strategy. This process relies on group participation to succeed. Students without a background in biology or medicine can feel overwhelmed by the complexity of the subject matter and unable to participate in the group learning process. We incorporated curated educational videos in the PBL curriculum to help address this situation. First year medical students participated in this study in the form of a typical PBL session. They were then assessed on basic and clinical science knowledge and their learning experience. Student basic science and clinical knowledge were similar between the student groups. However, the students given a list of suggested videos scored higher in their learning experience, perception of feeling prepared, and participating in the group PBL experience than students who were not given the video list. Results from this study indicate that videos can be utilized to enhance the PBL process.
Select liquefaction case histories from the 2001 Nisqually, Washington, earthquake: A digital data set and assessment of model performance
Authors: Rasanen Ryan A , Geyin Mertcan , Maurer Brett W
Published: May 2023

While soil liquefaction is common in earthquakes, the case-history data required to train and test state-of-practice prediction models remains comparatively scarce, owing to the breadth and expense of data that comprise a single case history. The 2001 Nisqually, Washington, earthquake, for example, occurred in a metropolitan region and induced damaging liquefaction in the urban cores of Seattle and Olympia, yet case-history data have not previously been published. Accordingly, this article compiles 24 cone-penetration-test (CPT) case histories from free-field locations. The many methods used to obtain and process the data are detailed herein, as is the structure of the digital data set. The case histories are then analyzed by 18 existing liquefaction response models to determine whether any is better, and to compare model performance in Nisqually against global observations. While differences are measured, both between models and against prior global case histories, these differences are often statistically insignificant considering finite-sample uncertainty. This alludes to the general inappropriateness of championing models based on individual earthquakes or otherwise small data sets, and to the ongoing needs for additional case-history data and more rigorous adherence to best practices in model training and testing.
Chloroplast genome characteristics and phylogeny of the sinodielsia clade (apiaceae: apioideae)
Authors: Weng Long , Jiang Yunhui , Wang Yong , Zhang Xuemei , Zhou Ping , Wu Mei , Li Hongzhe , Sun Hang , Chen Shaotian
Published: May 2023

Background

TheSinodielsiaclade of the subfamily Apioideae (Apiacieae) was established in 2008, and it is composed of 37 species from 17 genera. Its circumscription is still poorly delimited and unstable, and interspecific relationships in the clade lack comprehensive analysis. Chloroplast (cp.) genomes provide valuable and informative data sources for evolutionary biology and have been widely used in studies on plant phylogeny. To infer the phylogenetic history of theSinodielsiaclade, we assembled complete cp. genomes of 39 species and then performed phylogenetic analysis based on these cp. genome sequence data combined with 66 published cp. genomes from 16 genera relative to the Sinodielsia clade.

Results

These 39 newly assembled genomes had a typical quadripartite structure with two inverted repeat regions (IRs: 17,599–31,486 bp) separated by a large single-copy region (LSC: 82,048–94,046 bp) and a small single-copy region (SSC: 16,343–17,917 bp). The phylogenetic analysis showed that 19 species were clustered into theSinodielsiaclade, and they were divided into two subclades. Six mutation hotspot regions were detected from the whole cp. genomes among theSinodielsiaclade, namely,rbcL–accD,ycf4–cemA,petA–psbJ,ycf1–ndhF,ndhF–rpl32 andycf1, and it was found thatndhF–rpl32 andycf1 were highly variable in the 105 sampled cp. genomes.

Conclusion

TheSinodielsiaclade was subdivided into two subclades relevant to geographical distributions, except for cultivated and introduced species. Six mutation hotspot regions, especiallyndhF–rpl32 andycf1, could be used as potential DNA markers in the identification and phylogenetic analyses of theSinodielsiaclade and Apioideae. Our study provided new insights into the phylogeny of theSinodielsiaclade and valuable information on cp. genome evolution in Apioideae.
Shifting levels of peripheral inflammatory profiles as an indicator for comorbid multiple autoimmune diseases and bipolar disorder: a case report
Authors: Shen Yuting , Kong Lingzhuo , Lai Jianbo , Hu Shaohua
Published: May 2023

Autoimmune diseases (AID) cause inflammatory changes in the peripheral blood, which might be a predisposing factor for the development of comorbid bipolar disorder (BD). The levels of peripheral inflammatory indicators and cytokines may also serve as potential biomarkers for predicting BD susceptibility and the efficacy of antipsychotics in patients with AID. Herein, we present the case of a 43-year-old female who has suffered from AID for over 16 years and was recently diagnosed with “bipolar and related disorder due to another medical condition”.
The effect of central lymph node dissection on the prognosis of cN0 papillary thyroid microcarcinoma: a mid-term follow-up study
Authors: Xie Xiaozhang , Deng Jianwei , Zheng Bingxing , Zhong Linkun , Miao Jianhang
Published: May 2023

Background

To investigate the effect of central lymph node dissection on the prognosis of patients with papillary thyroid microcarcinoma (PTMC) without clinical lymph node metastasis (cN0).

Methods

According to the inclusion and exclusion criteria, 462 patients with cN0 PTMC underwent surgery in the Second Department of General Surgery, Zhongshan City People’s Hospital from January 1, 2007, to June 31, 2017. They were divided into two groups: the undissection group (262 cases) and the dissection group (170 cases). A comparison was made between the two groups in terms of postoperative complications, recurrences, metastases, etc., as well aslymph node metastasis risk factors in the central region of cN0 PTMC.

Results

There was no lymphatic leakage or death in all patients after the operation. In the dissection group, 64 cases (37.6%) of central lymph node metastasis were found after the postoperative pathological examination. The undissection group was followed up for (92 ± 28.7) months, and the dissection group was followed up for (86 ± 25.4) months (t=-2.165, P = 0.031). In the two groups, there were no lung metastases, bone metastases, or other distant metastases during the follow-up period. In the undissection group, there were 7 cases, while in the dissection group, there were just 2. Recurrence rates between the two groups did not differ significantly (χ2 = 0.126, P = 0.169); Similarly, disease-free survival curves did not differ significantly (χ2 = 2.565, P = 0.708). Hypoparathyroidism and Hypocalcemia also had no difference between the group. In comparison to the undissection group, the capsular invasion rate (P = 0.026), calcification rate(P < 0.001) incidence of postoperative hoarseness (P = 0.017), and hand and foot numbness rate (P < 0.001) were all considerably greater in the dissection group. Multivariate research revealed that capsular invasion (OR = 9.42, P = 0.002), multifocal (OR = 24.57, P < 0.001), and tumor diameter > 5 mm (OR = 5.46, P = 0.019) were the independent risk factors for central lymph node metastasis in cN0 PTMC.

Conclusions

Thyroidectomy alone is safe for cN0 PTMC, but longer-term follow-up is still required for changes in central lymph nodes. For cN0 PTMC patients with tumor diameter > 5 mm, multifocal, and capsular invasion, central lymph node metastasis is more likely to occur. Comprehensive evaluation and individualized and precise treatment are essential.
The relationship between psychological resilience and professional quality of life among mental health nurses: a cross-sectional study
Authors: Alonazi Ohoud , Alshowkan Amira , Shdaifat Emad
Published: May 2023

Background

Mental health nursing is a demanding and stressful profession that impacts nurses’ professional quality of life. Psychological resilience can be a protective factor. However, the relationship has not been extensively studied. This study aims to examine the relationship between psychological resilience and professional quality of life and identify potential predictors of ProQOL subscales among mental health nurses.

Methods

The study employed a cross-sectional design to collect data from 179 mental health nurses. Data was collected using two standardized questionnaires: the Connor-Davidson resilience scale and the professional quality of life scale. Participants were recruited through convenient sampling during a 3-month period from April to June 2022, and the data were collected using an online survey tool called QuestionPro.

Results

The study found a strong positive correlation between psychological resilience and compassion satisfaction (r = 0.632, P < 0.001). However, there was a negative significant correlation between resilience with burnout (r = -0.470, P < 0.001) and secondary traumatic stress (r = -0.210, P = 0.005). The study also found that higher resilience levels were associated with higher levels of compassion satisfaction and lower levels of secondary traumatic stress. Additionally, higher burnout scores were associated with higher levels of secondary traumatic stress. The study also identified that age and the number of children had weak associations with compassion satisfaction, while workplace was a significant predictor of burnout and secondary traumatic stress.

Conclusion

The study emphasizes the importance of resilience, burnout, and secondary traumatic stress in the well-being of healthcare professionals, especially nurses. The findings suggest that assessing nurses’ resilience and professional quality of life can raise psychological resilience awareness and help managers create the necessary working conditions to improve nurses’ professional quality of life.
GRP78/BiP alleviates oxLDL-induced hepatotoxicity in familial hypercholesterolemia caused by missense variants of LDLR in a HepG2 cellular model
Authors: Varghese Divya Saro , Oommen Deepu , John Anne , Ali Bassam R.
Published: May 2023

Background and aims

The accumulation of misfolded proteins, encoded by genetic variants of functional genes leads to Endoplasmic Reticulum (ER) stress, which is a critical consequence in human disorders such as familial hypercholesterolemia, cardiovascular and hepatic diseases. In addition to the identification of ER stress as a contributing factor to pathogenicity, extensive studies on the role of oxidized Low-Density Lipoprotein (oxLDL) and its ill effects in expediting cardiovascular diseases and other metabolic comorbidities are well documented. However, the current understanding of its role in hepatic insults needs to be revised. This study elucidates the molecular mechanisms underlying the progression of oxLDL and ER stress-induced cytotoxicity in HepG2.

Methods

HepG2 cells stably expressing wild-type Low-Density lipoprotein receptor (WT-LDLR) and missense variants of LDLR that are pathogenically associated with familial hypercholesterolemia were used as the in vitro models. The relative mRNA expression and protein profiles of ER stress sensors, inflammatory and apoptotic markers, together with cytotoxic assays and measurement of mitochondrial membrane potential, were carried out in HepG2 cells treated with 100 µg per ml oxLDL for 24 to 48 h. 1-way or 2-way ANOVA was used for statistical analyses of datasets.

Results

ER stress responses are elicited along all three arms of the unfolded protein response (UPR), with adverse cytotoxic and inflammatory responses in oxLDL-treated conditions.

Interestingly, oxLDL-treated ER-stressed HepG2 cells manifested intriguingly low expression of BiP- the master regulator of ER stress, as observed earlier by various researchers in liver biopsies of Non-Alcoholic Steatohepatitis (NASH) patients. This study shows that overexpression of BiP rescues hepatic cells from cytotoxic and inflammatory mechanisms instigated by ER stress in combination with oxLDL, along the ER and mitochondrial membrane and restores cellular homeostasis.

Conclusion

The data provide interesting leads that identify patients with familial hypercholesterolemia conditions and potentially other Endoplasmic Reticulum Associated Degradation (ERAD) diseases as highly susceptible to developing hepatic insults with molecular signatures like those manifested in Non-Alcoholic Fatty Liver Disease (NAFLD) and NASH.

Limitations and future perspectives

Although the use of HepG2 cells as the model is a major caveat of the study, the findings of this research may be used as the pilot study to expand further investigations in primary hepatocytes or iPSC- derived cellular models.
Deep learning for segmentation of the cervical cancer gross tumor volume on magnetic resonance imaging for brachytherapy
Authors: Rodríguez Outeiral Roque , González Patrick J. , Schaake Eva E. , van der Heide Uulke A. , Simões Rita
Published: May 2023

Background

Segmentation of the Gross Tumor Volume (GTV) is a crucial step in the brachytherapy (BT) treatment planning workflow. Currently, radiation oncologists segment the GTV manually, which is time-consuming. The time pressure is particularly critical for BT because during the segmentation process the patient waits immobilized in bed with the applicator in place. Automatic segmentation algorithms can potentially reduce both the clinical workload and the patient burden. Although deep learning based automatic segmentation algorithms have been extensively developed for organs at risk, automatic segmentation of the targets is less common. The aim of this study was to automatically segment the cervical cancer GTV on BT MRI images using a state-of-the-art automatic segmentation framework and assess its performance.

Methods

A cohort of 195 cervical cancer patients treated between August 2012 and December 2021 was retrospectively collected. A total of 524 separate BT fractions were included and the axial T2-weighted (T2w) MRI sequence was used for this project. The 3D nnU-Net was used as the automatic segmentation framework. The automatic segmentations were compared with the manual segmentations used for clinical practice with Sørensen–Dice coefficient (Dice), 95th Hausdorff distance (95th HD) and mean surface distance (MSD). The dosimetric impact was defined as the difference in D98 (ΔD98) and D90 (ΔD90) between the manual segmentations and the automatic segmentations, evaluated using the clinical dose distribution. The performance of the network was also compared separately depending on FIGO stage and on GTV volume.

Results

The network achieved a median Dice of 0.73 (interquartile range (IQR) = 0.50–0.80), median 95th HD of 6.8 mm (IQR = 4.2–12.5 mm) and median MSD of 1.4 mm (IQR = 0.90–2.8 mm). The median ΔD90 and ΔD98 were 0.18 Gy (IQR = -1.38–1.19 Gy) and 0.20 Gy (IQR =-1.10–0.95 Gy) respectively. No significant differences in geometric or dosimetric performance were observed between tumors with different FIGO stages, however significantly improved Dice and dosimetric performance was found for larger tumors.

Conclusions

The nnU-Net framework achieved state-of-the-art performance in the segmentation of the cervical cancer GTV on BT MRI images. Reasonable median performance was achieved geometrically and dosimetrically but with high variability among patients.
Citrus alkaline extracts improve LPS-induced pulmonary fibrosis via epithelial mesenchymal transition signals
Authors: Junjie Li , Cheng Gu , Kangkang Luo , Yu Li , Zhiyao Yuan , Xudong Wu , Xianmei Zhou , Xiaomin Lu
Published: May 2023

Background

Acute respiratory distress syndrome (ARDS) is a serious life threatening clinical critical illness. ARDS-related pulmonary fibrosis is a common complication of ARDS. The occurrence of early pulmonary fibrosis indicates a higher incidence and mortality of multiple organ failure. LPS-induced ARDS-related pulmonary fibrosis model in mice was established in this study. And we have explored the anti-pulmonary fibrosis effects and molecular mechanisms of the Citrus Alkaline Extracts (CAE) in vivo and in vitro.

Methods

Pulmonary fibrosis mouse model and lung epithelial cell injury model were established in this study. H&E, Masson and Sirius Red staining were used to estimate lung tissue damage. Immunohistochemistry and western blotting were used to analyze proteins expression. Protein-protein interaction was observed by Co-Immunoprecipitation. Systemic impact of CAE on signaling pathway was examined by RNA-seq.

Results

Through H&E, Masson and Sirius Red staining, it was convincingly indicated that therapeutic administration of CAE alleviated lung injury and fibrosis, while pretreated administration of CAE showed weak improvement. In vitro experiments showed that CAE had dual regulation to E-cadherin and N-cadherin, the important indicators of epithelial-mesenchymal transition (EMT). And it was further demonstrated that CAE reversed TGF-β1-induced EMT mainly through Wnt/β-catenin, Stat3/6 and COX2/PGE2 signals. Through RNA-Seq, we discovered important mechanisms by which CAE exerts its therapeutic effect. And network pharmacology analysis demonstrated core potential targets of CAE in EMT.

Conclusion

Thus, this study provides new therapeutic effects of CAE in anti-fibrosis, and offers potential mechanisms for CAE in LPS-induced pulmonary fibrosis.

Graphical Abstract
Healthcare resource utilization of patients with mitochondrial disease in an outpatient hospital setting
Authors: Haque Sameen , Crawley Karen , Shrestha Rupendra , Schofield Deborah , Sue Carolyn M.
Published: May 2023

Background and objectives

Mitochondrial diseases present as multi-system disorders requiring a comprehensive multidisciplinary approach. The data on healthcare resource utilization associated with mitochondrial diseases and the clinical drivers of these costs are limited including for the out-patient setting where the majority of the clinical care for mitochondrial disease patients occurs. We performed a cross-sectional retrospective study of out-patient healthcare resource utilization and costs for patients with a confirmed diagnosis of mitochondrial disease.

Methods

We recruited participants from the Mitochondrial Disease Clinic in Sydney and stratified them into three groups: those with mitochondrial DNA (mtDNA) mutations (Group 1), those with nuclear DNA (nDNA) mutations and the predominant phenotype of chronic progressive external ophthalmoplegia (CPEO) or optic atrophy (Group 2) and those without a confirmed genetic diagnosis but clinical criteria and muscle biopsy findings supportive of a diagnosis of mitochondrial disease (Group 3). Data was collected through retrospective chart review and out-patient costs were calculated using the Medicare Benefits Schedule.

Results

We analyzed the data from 91 participants and found that Group 1 had the greatest average out-patient costs per person per annum ($838.02; SD 809.72). Neurological investigations were the largest driver of outpatient healthcare costs in all groups (average costs per person per annum:—Group 1: $364.11; SD 340.93, Group 2: $247.83; SD 113.86 and Group 3: $239.57; SD 145.69) consistent with the high frequency (94.5%) of neurological symptoms. Gastroenterological and cardiac-related out-patient costs were also major contributors to out-patient healthcare resource utilization in Groups 1 and 3. In Group 2, ophthalmology was the second-most resource intensive specialty ($136.85; SD 173.35). The Group 3 had the greatest average healthcare resource utilization per person over the entire duration of out-patient clinic care ($5815.86; SD 3520.40) most likely due to the lack of a molecular diagnosis and a less customized management approach.

Conclusion

The drivers of healthcare resource utilization are dependent on the phenotype–genotype characteristics. Neurological, cardiac, and gastroenterological costs were the top three drivers in the out-patient clinics unless the patient had nDNA mutations with predominant phenotype of CPEO and/or optic atrophy wherein ophthalmological-related costs were the second most resource intensive driver.
The impact of Hafnia alvei HA4597™ on weight loss and glycaemic control after bariatric surgery — study protocol for a triple-blinded, blocked randomized, 12-month, parallel-group, placebo-controlled clinical trial
Authors: Ismael Shámila , Vaz Carlos , Durão Catarina , Silvestre Marta P. , Calhau Conceição , Teixeira Diana , Marques Cláudia
Published: May 2023

Background

Subjects with obesity exhibit changes in gut microbiota composition and function (i.e. dysbiosis) that contribute to metabolic dysfunction, including appetite impairment. Although bariatric surgery is an effective treatment for obesity with a great impact on weight loss, some subjects show weight regain due to increased energy intake after the surgery. This surgery involves gut microbiota changes that promote appetite control, but it seems insufficient to completely restore the obesity-associated dysbiosis — a possible contributor for weight regain. Thus, modulating gut microbiota with probiotics that could improve appetite regulation as a complementary approach to post-operative diet (i.e. Hafnia alvei HA4597™), may accentuate post-surgery weight loss and insulin sensitivity.

Methods

This is a protocol of a triple-blinded, blocked-randomized, parallel-group, placebo-controlled clinical trial designed to determine the effect of Hafnia alvei HA4597™ supplementation on weight loss and glycaemic control 1 year after bariatric surgery. Patients of Hospital CUF Tejo, Lisbon, that undergo Roux-en-Y gastric bypass are invited to participate in this study. Men and women between 18 and 65 years old, with a BMI ≥ 35 kg/m2 and at least one severe obesity-related comorbidity, or with a BMI ≥ 40 kg/m2, and who are willing to take 2 capsules of Hafnia alvei HA4597™ probiotic supplements (equivalent to 5 × 107 CFU) vs. placebo per day for 90 days are included in this study. Assessments are carried out at baseline, 3, 6, 9, and 12 months after the surgery. Loss of weight in excess and glycated haemoglobin are considered primary outcomes. In addition, changes in other metabolic and inflammatory outcomes, gut microbiota composition and metabolites, as well as gastrointestinal quality of life are also being assessed during the trial.

Discussion

The evidence obtained in this study will provide relevant information regarding the profile of the intestinal microbiota of individuals with severe obesity and the identification of the risk/benefit ratio of the use of Hafnia alvei HA4597™ as an adjunctive treatment in the maintenance of metabolic and weight control one year after the surgical intervention.

Trial registration

ClinicalTrials.gov NCT05170867. Registered on 28 December 2021.
Human umbilical cord mesenchymal stem cell treatment alleviates symptoms in an atopic dermatitis-like mouse model
Authors: Hua Chunting , Liang Qichang , Chen Siji , Zhu Jiang , Tang Yi , Chen Xianzhen , Song Yinjing , van der Veen Stijn , Cheng Hao
Published: May 2023

Background

Atopic dermatitis (AD) is one of the most common immune and inflammatory skin disorders, leading to insufferable itching and skin abnormalities that seriously affect life quality of patients. There are still huge unmet needs for long-term and effective disease control, despite currently available therapies. Evidenced by some preclinical and clinical studies of AD treatment with stem cells, stem cell treatment could significantly and effectively ameliorate AD symptoms.

Objectives

To elucidate underlying mechanisms of how stem cells therapy alleviates AD-like symptoms.

Methods

An AD-like mouse model was constructed and treated with mesenchymal stem cells (MSCs) subcutaneously or subcutaneously combined with intravenously. The differentially expressed genes were sorted out from RNA sequencing results of dorsal skin and blood.

Results

Two injection routes of MSCs could alleviate AD-like symptoms and pathologic changes of the skin and immune organs. RNA sequencing of dorsal skin sections and blood provided gene expression signatures for amelioration of skin defects, inflammatory and immune modulation by MSCs, as well as common AD molecular markers for the skin and blood, which may benefit for clinical diagnosis. IL-1β and its signaling pathway were specifically found to be associated with the development of AD-like dermatitis lesions. MSC treatment effectively inhibited the JAK-STAT pathway and receptors of IL-4, IL-13, IL-17, and IgE.

Conclusions

MSC therapy could regulate abnormal immune and inflammatory status in AD. Mechanistic exploration will contribute to the development of personalized AD treatment based on MSCs.
Multiple sampling schemes and deep learning improve active learning performance in drug-drug interaction information retrieval analysis from the literature
Authors: Xie Weixin , Fan Kunjie , Zhang Shijun , Li Lang
Published: May 2023

Background

Drug-drug interaction (DDI) information retrieval (IR) is an important natural language process (NLP) task from the PubMed literature. For the first time, active learning (AL) is studied in DDI IR analysis. DDI IR analysis from PubMed abstracts faces the challenges of relatively small positive DDI samples among overwhelmingly large negative samples. Random negative sampling and positive sampling are purposely designed to improve the efficiency of AL analysis. The consistency of random negative sampling and positive sampling is shown in the paper.

Results

PubMed abstracts are divided into two pools. Screened pool contains all abstracts that pass the DDI keywords query in PubMed, while unscreened pool includes all the other abstracts. At a prespecified recall rate of 0.95, DDI IR analysis precision is evaluated and compared. In screened pool IR analysis using supporting vector machine (SVM), similarity sampling plus uncertainty sampling improves the precision over uncertainty sampling, from 0.89 to 0.92 respectively. In the unscreened pool IR analysis, the integrated random negative sampling, positive sampling, and similarity sampling improve the precision over uncertainty sampling along, from 0.72 to 0.81 respectively. When we change the SVM to a deep learning method, all sampling schemes consistently improve DDI AL analysis in both screened pool and unscreened pool. Deep learning has significant improvement of precision over SVM, 0.96 vs. 0.92 in screened pool, and 0.90 vs. 0.81 in the unscreened pool, respectively.

Conclusions

By integrating various sampling schemes and deep learning algorithms into AL, the DDI IR analysis from literature is significantly improved. The random negative sampling and positive sampling are highly effective methods in improving AL analysis where the positive and negative samples are extremely imbalanced.