bluuebunny/crossref_metadata_2025 huggingface dataset:
INACIA: Integrating Large Language Models in Brazilian Audit Courts: Opportunities and Challenges
Authors: Pereira Jayr , Assumpcao Andre , Trecenti Julio , Airosa Luiz , Lente Caio , Cléto Jhonatan , Dobins Guilherme , Nogueira Rodrigo , Mitchell Luis , Lotufo Roberto
Published: March 2024

This article introduces Instrução Assistida com Inteligência Artificial (INACIA), a groundbreaking system designed to integrate Large Language Models (LLMs) into the operational framework of Brazilian Federal Court of Accounts. The system automates various stages of case analysis, including basic information extraction, admissibility examination,
Periculum in mora
and
Fumus boni iuris
analyses, and recommendations generation. Through a series of experiments, we demonstrate INACIA’s potential in extracting relevant information from case documents, evaluating its legal plausibility, and formulating propositions for judicial decision-making. Utilizing a validation dataset alongside LLMs, our evaluation methodology, to the best of our knowledge, presents a novel approach to assessing system performance, correlating highly with human judgment. These results underscore INACIA’s potential in complex legal task handling while also acknowledging the current limitations. This study discusses possible improvements and the broader implications of applying Artificial Intelligence (AI) in legal contexts, suggesting that INACIA represents a significant step toward integrating AI in legal systems globally, albeit with cautious optimism grounded in the empirical findings.
Eco-Friendly Coffee Waste-Based Carbon Dots Coupled to ZnBi-Layered Double Hydroxide Heterojunction: Enhanced Control of Interfacial Charge Transfer for Highly Efficient Visible-Light Catalytic Activity
Authors: Thanh Huong Nguyen Thi , Nha Khanh Dang Nguyen , Tuong Vy Ngo Thi , Hai Khoa Le , The Anh Nguyen , Bao Tran Dang Vu , Phuong Thuan Tong Pham , Khue Tu Le , Thanh Ha Nguyen , Ngoc Nghia Nguyen , Kim Phuong Nguyen Thi
Published: March 2024

Using a simple, low cost, and excellent efficient approach, carbon dots (CDs) were fabricated via a one-pot hydrothermal process of coffee waste. Amazingly, the combination of 2% CDs with ZnBi2O4 to form a new and excellent heterogeneous photocatalyst enabled the complete decomposition of 2, 4-dichlorophenoxyacetic acid (2, 4-D) into CO2 and H2O. The findings of this study provide a new perspective on the utilization of agricultural waste for creating products of scientific and practical significance. More than 91% of 2, 4-D (initial concentration of 30 mg/L) was completely decomposed and dechlorinated using 1.0 g/L of CDs (2%)-ZnBi2O4 at pH 4.0 after 120 min of exposure to visible light (with k = 0.0178 min−1), and more than 86% of the decomposed 2, 4-D was mineralized into CO2 and H2O. There was no sign of catalyst deactivation after four cycles of reuse, demonstrating the durability and efficiency of CDs (2%)-ZnBi2O4. The significant improvement in the photocatalytic efficiency of CDs (2%)-ZnBi2O4 compared with that of bare CDs or ZnBi2O4 is due to the formation of defects at the interfaces of the heterojunction; therefore, the movement of photogenerated electrons at the interface between the two components is rapid. The mineralization of 2, 4-D by CDs (2%)-ZnBi2O4 upon exposure to visible light is induced mainly by the photogenerated holes, followed by O2•−, and finally OH• radicals.
Psychometric Validation of the Persian Version of Multidimensional Health Locus of Control Scale (MHLC-C) for Menopausal Women
Authors: Khademi Khadijeh , Kaveh Mohammad Hossein , Nazari Mahin , Asadollahi Abdolrahim
Published: March 2024

Background. The Health Locus of Control (HLC) serves as a mediator between an individual’s behaviors and health status, influenced by various cultural, environmental, and situational factors. Its measurement reflects health beliefs and attitudes, ultimately leading to healthy behaviors. Menopause is a significant phenomenon in women’s lives, often resulting in a wide range of symptoms and health issues. Therefore, the perception of HLC plays a crucial role in promoting healthy behaviors and managing menopausal symptoms. This study aimed to assess the validity and reliability of the Persian version of the short form Multidimensional Health Locus of Control Scale (MHLC) in Iranian menopausal women and explore its interrelationships. Methods. A cross-sectional study was conducted with 271 menopausal women from September to November 2023. Psychometric properties such as construct validity (confirmed through confirmatory factor analysis), convergent validity (evaluated using average variance extracted), and internal consistency (assessed by Cronbach’s alpha, composite reliability and rho_A factor) were examined. Discriminant validity was determined using the Fornell–Larcker criterion. Reliability was further established through Cronbach’s alpha and McDonald’s Omega coefficients. The predictive relevance of the model and associations between constructs were analyzed using various statistical measures. Data analysis was conducted using SPSS v.27 and Smart PLS 3.0 software. Limitations of this study include that it was conducted in urban health centers, only women with at least primary education were included, and reliance on self-reported data. Results. The initial stage of construct validity involved the Kolmogorov–Smirnov test, with confirmatory factor analysis demonstrating a good model fit. Significant correlations were found between internal health control and factors related to doctors and other people, indicating that internal health control directly influences these factors in managing menopausal symptoms and health problems. Cronbach’s alpha and McDonald’s Omega coefficients for the 13-item MHLC-C scale were satisfactory (0.81 and 0.72, respectively). Conclusions. The Persian version of the 13-item MHLC-C has been validated as a reliable tool for assessing the health locus of control in Iranian menopausal women. Internal health control was found to significantly impact perceptions related to doctors and other people, highlighting its importance in managing menopausal symptoms effectively.
Risankizumab Efficacy in Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Remission: A Case Report on Rheumatologic and Dermatologic Disease Manifestations with Literature Review
Authors: Ferraioli Mario , Fiannacca Luigi , Greco Elisabetta , Cela Eneida , Fatica Mauro , Bergamini Alberto , Chimenti Maria Sole
Published: March 2024

SAPHO syndrome is a complex disease that encompasses both inflammatory arthritis and/or osteitis and dermatologic manifestations. It is considered a rare disease, in fact, no clinical trials have been conducted on its therapy and management. Therefore, therapeutic approach is based on small case studies. Here, we described the case of a 63-year-old woman affected by SAPHO syndrome, treated with the selective IL-23p19 antagonist, Risankizumab, after unsuccessful therapies with Methotrexate, Infliximab, Adalimumab, and an allergic reaction to Secukinumab. At the beginning of therapy, in November 2022, the patient presented with arthritis in both knees associated with palmar pustulosis and guttate psoriasis on the trunk. DAPSA score was 24, PtGA 80 mm, PASI score 11.1, and BSA 40%. Thereafter, Risankizumab was started at the standard dosage of 150 mg. At week 24 patient achieved clinical remission, DAPSA score was 8, PtGA was 30 mm, PASI was 1, and BSA 2.5. Patient maintained clinical remission state at the subsequent week 52 evaluation. At the same time, the patient did not report any adverse effects. Health-related quality of life was also assessed at the same time points aforementioned, showing significant improvement. In conclusion, this case report wants to point out the efficacy and safety of Risankizumab in SAPHO syndrome, reporting a sustained disease remission through a 12 months long follow-up period. We can consider IL-23p19 targeted therapy as a novel treatment option for SAPHO—with a high efficacy potential—especially on patients that have already been treated with other biologics.
Cell Context Is the Third Axis of Synergy for the Combination of ATR Inhibition and Cisplatin in Ewing Sarcoma
Authors: Jess Jennifer , Sorensen Katie M. , Boguslawski Elissa A. , Stout Matthew C. , Madaj Zachary B. , Caiello Benjamin P. , Pomaville Monica , Wilson Elizabeth R. , Kinn-Gurzo Seneca S. , Parker Curtis C. , Veluvolu Sridhar M. , Brysgel Taylor V. , Kaufman Rebecca , Kitchen-Goosen Susan M. , Gedminas Jenna M. , Grohar Patrick J.
Published: March 2024

Purpose:

The importance of cellular context to the synergy of DNA damage response (DDR)-targeted agents is important for tumors with mutations in DDR pathways, but less well-established for tumors driven by oncogenic transcription factors. In this study, we exploit the widespread transcriptional dysregulation of the EWS-FLI1 transcription factor to identify an effective DDR-targeted combination therapy for Ewing sarcoma.

Experimental Design:

We used matrix drug screening to evaluate synergy between a DNA-PK inhibitor (M9831) or an ATR inhibitor (berzosertib) and chemotherapy. The combination of berzosertib and cisplatin was selected for broad synergy, mechanistically evaluated for Ewing sarcoma selectivity, and optimized for in vivo schedule.

Results:

Berzosertib combined with cisplatin demonstrates profound synergy in multiple Ewing sarcoma cell lines at clinically achievable concentrations. The synergy is due to loss of expression of the ATR downstream target CHEK1, loss of cell-cycle check-points, and mitotic catastrophe. Consistent with the goals of the project, EWS-FLI1 drives the expression of CHEK1 and five other ATR pathway members. The loss of CHEK1 expression is not due to transcriptional repression and instead caused by degradation coupled with suppression of protein translation. The profound synergy is realized in vivo with a novel optimized schedule of this combination in subsets of Ewing sarcoma models, leading to durable complete responses in 50% of animals bearing two different Ewing sarcoma xenografts.

Conclusions:

These data exploit EWS-FLI1 driven alterations in cell context to broaden the therapeutic window of berzosertib and cisplatin to establish a promising combination therapy and a novel in vivo schedule.

See related commentary by Ohmura and Grünewald, p. 3358
Supplementary Figure 7 from Autophagy Inhibition–induced Cytosolic DNA Sensing Combined with Differentiation Therapy Induces Irreversible Myeloid Differentiation in Leukemia Cells
Authors: Baba Tomohisa , Tomaru Utano , Hirao Atsushi , Mukaida Naofumi , Johmura Yoshikazu
Published: March 2024

Fig. S7 and its legend
FIGURE 4 from Autophagy Inhibition–induced Cytosolic DNA Sensing Combined with Differentiation Therapy Induces Irreversible Myeloid Differentiation in Leukemia Cells
Authors: Baba Tomohisa , Tomaru Utano , Hirao Atsushi , Mukaida Naofumi , Johmura Yoshikazu
Published: March 2024

Synergistic effect of MRT and FLT3 inhibitor on leukemia cells carrying FLT3-ITD. A, MOLM-14 cells were treated with quizartinib (ChemScene) in the presence or absence of 10 ng/mL FGF2 (ProteinTech) for 48 hours (n = 4). Cell viability was calculated by dividing the values in treated cells with the mean values of the quizartinib-free control. B, Cell proliferation of MOLM-14 cells in drug-free medium after treatment with quizartinib in the presence or absence of FGF2 for 24 hours. Fold change in cell number was calculated by dividing the values at 3d with the values at 0d. Data represent the mean ± SD from three independent experiments. C, Cell proliferation of MOLM-14 cells in drug-free medium after combined treatment with quizartinib and MRT in the presence of FGF2 for 24 hours (n = 4). Fold change in cell number was calculated by dividing the values at each timepoint with the values at 0d. D, Expression of CD11b on MOLM-14 cells after treatment with 5 nmol/L quizartinib and 1 µmol/L MRT in the presence of FGF2 for 24 hours. MFI of cells stained with APC-conjugated anti-CD11b mAb are shown. Data represent the mean ± SD from three independent experiments. E, Cell proliferation of shControl- and shAIM2-transduced MOLM-14 cells in drug-free medium after combined treatment with quizartinib and MRT in the presence of FGF2 for 24 hours (n = 4). Fold change in cell number was calculated by dividing the values at each timepoint with the values at 0d. **, P < 0.01; *, P < 0.05; N.S., no significant difference using two-sided Student t test (A and B), Tukey-Kramer test (D), or Dunnett test (E). d, day.
Preliminary Evidence for the Effects of Gentamicin on Vertical Semicircular Canals
Authors: Khan Salman , Quimby Alexandra E. , Hwa Tiffany P. , Bigelow Douglas C. , Brant Jason , Ruckenstein Michael J.
Published: March 2024

Introduction: Gentamicin is a vestibulotoxic antibiotic often used in patients with Ménière's disease for its vestibular ablative effects. Gentamicin’s effect on the horizontal semicircular canal does not always correlate with the degree of vertigo control achieved by patients; its effect on the vertical semicircular canals remains unknown. We sought to examine the effect of intratympanic gentamicin on vertical semicircular canal function in patients with Ménière's disease using video head impulse testing. Methods: A retrospective case series was carried out at a tertiary academic center. Patients with Ménière's disease who received ≥1 intratympanic gentamicin injection from 2019–2022 and had video head impulse testing performed were included. Outcomes of interest were vertical semicircular canal function following intratympanic gentamicin, correlations between vertical semicircular canal function and horizontal semicircular canal function, and residual symptoms following injection. Results: Ten patients met inclusion criteria. Twenty percent had abnormal V-SCC function prior to any injection and 40% following the first injection. There was an association between abnormal vertical and horizontal semicircular canal function following the first intratympanic gentamicin injection, though the relationship did not reach statistical significance (p = 0.058). While patients with abnormal vertical semicircular canal function following the first injection were less likely to report ongoing vertigo attacks, the relationship was not statistically significant (p = 0.260). Conclusions: Intratympanic gentamicin leads to changes in vertical semicircular canal function in at least a proportion of patients with Ménière's disease. Further study is required to better assess correlations between vertical semicircular canal function and symptom control following intratympanic gentamicin.
Evaluation of optic nerve head microcirculation in open-angle glaucoma patients with unilateral visual field defect
Authors: Lin Pei-Wen , Chiu Li-Wen
Published: March 2024

Introduction: Microcirculation of optic nerve head (ONH) in open-angle glaucoma (OAG) patients with unilateral visual field (VF) loss has yet to be fully investigated, especially the perimetrically unaffected fellow eyes.
Methods: Thirty-eight OAG patients with VF defect in one eye and normal VF in the other eye, and thirty-one healthy participants were analyzed. All participants underwent laser speckle flowgraphy (LSFG), spectral-domain optical coherence tomography (SD-OCT) imaging, and VF test for further analyses. LSFG measurements included mean blur rate in all area of ONH (MA), big vessel area of ONH (MV) and tissue area of ONH (MT). SD-OCT parameters included circumpapillary retinal nerve fiber layer (cpRNFL) thickness and macula thicknesses. The difference of LSFG and SD-OCT indices between glaucoma patients and healthy controls were compared. The diagnostic accuracy was analyzed with the areas under the receiver operating characteristic curves (AROCs).
Results: Global cpRNFL thickness and macular thickness in unaffected eyes of OAG patients were higher than their fellow eyes and lower than healthy eyes. MA and MV in healthy eyes and unaffected eyes were significantly higher than in affected eyes. MT in unaffected eyes of OAG patients was higher than in their fellow affected eyes, but lower than in healthy eyes. The AROCs were highest for cpRNFL (0.925), followed by macular thickness (0.838), and MT (0.834).
Conclusions: ONH microcirculation in perimetrically unaffected fellow eyes was decreased in OAG patients with unilateral VF loss. LSFG can detect changes of ONH in high-risk eyes before detectable VF damage, which may reflect the vascular pathophysiology for glaucoma.
Evaluation of blow fly, Chrysomya megacephala (Calliphoridae: Diptera) as an alternate source of protein in broiler feed
Authors: Sajjad M. , Sajjad A. , Chishti G.A. , Binyameen M. , Abbasi A. , Haq I.U. , Gaafar A.Z. , Hodhod M.S.
Published: March 2024

Poultry industry is one of the fastest growing agri-businesses in the world. However, the usage of expensive soybean meal and fishmeal as poultry feed ingredients is making it less profitable and environmentally unsustainable. Insects are becoming more popular as an alternate protein source in poultry feed because they are more sustainable, cost-efficient and eco-friendly than most of the conventional poultry feed sources. In the present study, we replaced 4%, 8% and 12% soybean meal with blow fly, Chrysomya megacephala (Calliphoridae: Diptera) larvae and evaluated its impact on growth performances, hematological parameters, intestinal morphometry and meat quality of Ross 308 broiler. For comparison, we also evaluated commercially available full fat Hermetia illucens (Stratiomyidae: Diptera) larvae. Three hundred and fifty 1-day-old chicks with initial weight of 40.28 g/chick were randomly divided into seven experimental diets (5 pens per treatment and 10 birds per pen). All the dietary treatments were isocaloric and isonitrogenous, meeting the nutrient requirements of the broilers. The results revealed that the broiler fed on 12% C. megacephala or H. illucens had significantly higher () live weight, average daily weight gain and better feed conversion ratios. The diets containing 12% C. megacephala or H. illucens significantly improved the blood haematology and serum bio-chemistry in the broiler. The gut histological indices of jejunum and ileum such as villus height (Vh), crypt depth (Cd), villus width (Vw), and Vh/Cd ratios also improved by the feeding of 12% C. megacephala and H. illucens diets. The broiler fed on 12% H. illucens diet showed higher L* (lightness) and a* (redness), while those fed on 12% C. megacephala showed higher b* (yellowness) in breast meat (Pectoralis major). Both species performed equally well in growth performance, haematology, serum bio-chemistry, gut histology and meat quality. It was concluded that replacement of soybean meal with 12% C. megacephala or H. illucens larvae improves the growth performance, blood haematology, gut histology and meat color and lightness traits of broiler and thus can be used as an alternate source of protein in broiler feed.
Revision of Meridindia (Hemiptera: Heteroptera: Pentatomidae), an endemic genus, with description of a new species from India
Authors: SALINI S. , GRACY R. G. , SUSHIL S. N.
Published: March 2024

The genus Meridindia Ghauri, 1982 (Hemiptera: Pentatomidae: Pentatominae: Halyini) is redescribed along with the description of Meridindia magnolia sp. nov. from India (Karnataka and Tamil Nadu). Meridindia kaniza Ghauri, 1982 and Meridindia salmana Ghauri, 1982 are redescribed based on type material. Meridindia farhata Ghauri, 1982 is considered junior subjective synonym of M. kaniza. Besides, a key to species of Meridindia is provided and DNA barcode sequences of M. salmana and M. magnolia sp. nov. are obtained and reported.
Assessment of U.S. Urban Surface Temperature Using GOES-16 and GOES-17 Data: Urban Heat Island and Temperature Inequality
Authors: Lee Jangho
Published: March 2024

This study utilizes hourly land surface temperature (LST) data from the Geostationary Operational Environmental Satellite (GOES) to analyze the seasonal and diurnal characteristics of surface urban heat island intensity (SUHII) across 120 largest U.S. cities and their surroundings. Distinct patterns emerge in the classification of seasonal daytime SUHII and nighttime SUHII. Specifically, the enhanced vegetation index (EVI) and albedo (ALB) play pivotal roles in influencing these temperature variations. The diurnal cycle of SUHII further reveals different trends, suggesting that climate conditions, urban and nonurban land covers, and anthropogenic activities during nighttime hours affect SUHII peaks. Exploring intracity LST dynamics, the study reveals a significant correlation between urban intensity (UI) and LST, with LST rising as UI increases. Notably, populations identified as more vulnerable by the social vulnerability index (SVI) are found in high UI regions. This results in discernible LST inequality, where the more vulnerable communities are under higher LST conditions, possibly leading to higher heat exposure. This comprehensive study accentuates the significance of tailoring city-specific climate change mitigation strategies, illuminating LST variations and their intertwined societal implications.
The Crisis of American Democracy in Historical Context
Authors: Lieberman Robert C. , Mettler Suzanne
Published: March 2024

The present is not the only time in American history that American democracy has been at serious risk of backsliding. When we place recent developments in a broader historical and comparative context, we discover that any of four known threats to democracy can weaken it and lead to backsliding. These include political polarization, conflict over who belongs in the political community, high and rising economic inequality, and executive aggrandizement. American democracy has often been fragile, and each past episode of democratic fragility was characterized by some configuration of these four. Now, for the first time in our nation’s history, we face the confluence of all four threats at once. Analyzed through this framework, the January 6, 2021, attack on the U.S. Capitol was not a surprise. Although the attempts to overturn the 2020 election failed, the threats remain with us.
Political Parties and Loser’s Consent in American Politics
Authors: Layman Geoffrey , Lee Frances , Wolbrecht Christina
Published: March 2024

Social science has established that political parties have been indispensable to American democracy and their most active members as keepers of the democratic flame. The aftermath of the 2020 presidential election raised questions about the role of the parties in protecting democracy, particularly the fundamental democratic norm of “loser’s consent.” We argue that recent political developments—close elections, ideological polarization, participatory party nominations, and changes in campaign finance and media—have worked to undermine the parties’ commitment to loser’s consent. We use recent survey data to show that party activists no longer demonstrate greater commitment than do ordinary citizens to democratic norms—especially to loser’s consent. We also examine how parties and voters responded to the post-2020 crisis of democratic legitimacy, finding that both parties prioritized their political interests over democratic health. However, a small number of voters did deviate from normal partisanship and helped to shore up American democracy in the 2022 elections.
In-line monitoring of cryogenic three-point bending test of fiber-reinforced composites using acoustic emission
Authors: Maack Björn
Published: March 2024

Remotely in-line monitored acoustic emission (AE) of interlaminar shear strength tests in a 3-point bending test of fiber-reinforced polymer composites (FRP) conducted under cryogenic conditions in liquid nitrogen (LN2) were studied. The AE sensors were reversibly mounted at the outer components of the testing machine to thermally decouple them from the cryogenic area and use AE signal transmission through the testing machine structure as a waveguide. The damage mechanisms and effect of the cryogenic temperature were studied at 296 K room temperature (RT) and in LN2 at 77 K, considering machine and process noises. The correlation of machine data with acoustics and the AE hit analysis revealed matrix cracking as the most frequent damage mechanism under both conditions but with different failure mechanisms. At RT and applying higher loads, the most damage suddenly occurred, and the specimen failed. In LN2, the damage occurred continuously from the beginning of testing. The amount of fiber failure increased, and the AE feature ranges enlarged. This study presents a method by AE for remote monitoring the mechanical response of FRP in cryogenic fluids such as liquid hydrogen. The method provides a new approach to support the more efficient development of FRP materials for storage vessel structures and structural health monitoring systems.
Effects of State-Level Individual Mandate on Veterans’ Access to Health Care in the United States
Authors: Oh Dongjin , Lee Keon-Hyung
Published: March 2024

Following the repeal of the federal individual health insurance mandate, five states and D.C. adopted their own state-level individual mandates to counteract the potential negative consequences of the repeal. This study examines the actual changes in veterans’ enrollments in private and Veterans Affairs (VA) insurance following the 2019 repeal. By analyzing data from 65,297 non-elderly veterans aged 18 to 64 in the U.S. between 2019 and 2021, we found that state-level individual mandates have positive effects on veterans’ enrollments in private and VA insurance, but the effects vary depending on individual income levels. The state-level individual mandate successfully serves as a substitute for the federal mandate. The results imply that veterans in states without individual mandate policies are more likely to worry about health insurance premiums and medical bills, limiting access to health care and potentially worsening health outcomes. Thus, the Veterans Health Administration should endeavor to encourage more state governments to adopt individual mandate policies.
A Taxonomy of Subjective Control: Teachers‘ Narrative Accounts of a Teacher Evaluation System
Authors: Pallas Aaron M. , Touloukian Cami
Published: March 2024

Background or Context:

Federal and state reforms have expanded accountability systems for school districts, schools, and teachers. However, there is little evidence that the implementation of new teacher evaluation systems relying on measures of student learning and measures of teaching practice, with differentiated performance categories and rewards and sanctions, have had broad positive influences on teaching practice and student learning.

Purpose, Objective, Research Question, or Focus of Study:

We seek to contribute to an understanding of the modest influence of teacher evaluation systems by focusing on the targets of the policies—teachers—and how they experience the evaluation systems. Drawing on principal-agent theory and control-value theory, each of which suggests that teacher control over their performance evaluations influences their behavioral responses to them, we develop a taxonomy of teachers’ narratives of their subjective control of their evaluations.

Research Design:

We interviewed 141 New York City teachers working in 27 traditional elementary, middle, and high schools in the 2015–16 school year, asking about their experiences with Advance, the New York City annual teacher evaluation system. We developed a thematic analysis system for coding and analyzing the interviews that began with a set of categories reflective of the larger project’s research questions and prior research on performance evaluation in general and teacher evaluation in particular. All told, we coded 4,077 excerpts from the 141 teacher interviews, an average of about 29 excerpts per interview.

Findings:

Seventy-one percent of the teachers in our sample indicated that they had no control over some aspect of their teacher evaluation ratings. Teachers noted three areas in their ratings that they deemed out of their control: other people’s behaviors, notably students, teachers, and the administrators observing and rating their classroom practice; the technology of teacher evaluation, especially the features of observation rubrics and student assessments, and for some teachers, statistical models; and the broader social context of the school, particularly the resources available to support teachers and students and the uncertainties of students’ home lives. A small number of teachers noted their control over their teaching practices and control over their own thoughts and behaviors.

Conclusions or Recommendations:

This study was situated in New York City at a time when many teachers believed the teacher evaluation system was designed to be punitive. Under these circumstances, teachers’ responses to the evaluation system hinge on their trust in school leadership and their perceptions of how much voice they have in the design and implementation of the system. This trust is enhanced when teachers have confidence that principals are able to observe their practice accurately and consistently.
Beyond Linear Effects: Multiple Perspectives of Mother–Adolescent Positive Parenting & Adolescent’s Problem Behavior
Authors: Gniewosz Gabriela , Gniewosz Burkhard
Published: March 2024

Discrepancies among family members’ ratings on aspects of family functioning are challenging both, methodological and interpretational. Family members’ perspectives and their discrepancies are indicators of family functioning, affecting adolescents’ psychological development. Previous research focused on linear effects, ignoring that rather extreme than the small differences in ratings might be associated with higher levels of problem behaviors, indicating a negative development. Based on 947 German mother-adolescent-dyads, this study examined how level and discrepant parenting ratings on parental warmth relate to early adolescents’ problem behaviors (3rd–6th), using LCSMs to assess the level as well as linear and quadratic discrepancy effects. This study showed that before secondary school-transition, high mother-adolescent levels in parental warmth negatively predicted emotional and social problems. After the transition, very high levels of discrepancies positively predicted problem behaviors, when modelled as quadratic effects. The study not only highlights the consideration of multiple perspectives but also the type of modeling.
When Our Best Friend Becomes Our Worst Enemy: The Mitochondrion in Trauma, Surgery, and Critical Illness
Authors: Torp May-Kristin , Stensløkken Kåre-Olav , Vaage Jarle
Published: March 2024

Common for major surgery, multitrauma, sepsis, and critical illness, is a whole-body inflammation. Tissue injury is able to trigger a generalized inflammatory reaction. Cell death causes release of endogenous structures termed damage associated molecular patterns (DAMPs) that initiate a sterile inflammation. Mitochondria are evolutionary endosymbionts originating from bacteria, containing molecular patterns similar to bacteria. These molecular patterns are termed mitochondrial DAMPs (mDAMPs). Mitochondrial debris released into the extracellular space or into the circulation is immunogenic and damaging secondary to activation of the innate immune system. In the circulation, released mDAMPS are either free or exist in extracellular vesicles, being able to act on every organ and cell in the body. However, the role of mDAMPs in trauma and critical care is not fully clarified. There is a complete lack of knowledge how they may be counteracted in patients. Among mDAMPs are mitochondrial DNA, cardiolipin, N-formyl peptides, cytochrome C, adenosine triphosphate, reactive oxygen species, succinate, and mitochondrial transcription factor A. In this overview, we present the different mDAMPs, their function, release, targets, and inflammatory potential. In light of present knowledge, the role of mDAMPs in the pathophysiology of major surgery and trauma as well as sepsis, and critical care is discussed.
Aberrant phenotypes of circulating γδ-T cells may be involved in the onset of systemic lupus erythematosus
Authors: Yuan Shiwen , Wang Cuicui , Zeng Yanting , Li Jiawei , Li Weinian , He Zhixiang , Ye Jinghua , Li Fangfei , Chen Yi , Lin Xiaojun , Xu Yan , Yu Na , Cai Xiaoyan
Published: March 2024

Objective

Human gamma-delta T cells (γδ-T cells) play crucial roles in both innate and adaptive immune responses. However, much less is known about the immune status of γδT cells in systemic lupus erythematosus (SLE) patients. The objective of this study was to explore potential relationships between the frequency of γδ-T-cell subpopulations and disease activity, autoantibody titres and renal involvement in patients with SLE.

Methods

Circulating γδ-T cells and their subsets (Vδ1+ T cells, Vδ2+ T cells and γδ-T-cell subpopulations defined by expression of surface receptors, including NKG2D, NKp30, NKp46 and PD-1), were identified via flow cytometry. Sixty active SLE patients were selected, including 41 new-onset and 19 relapsing cases. One hundred healthy controls (HCs) were enrolled as the control group. Percentages of these cell subsets in SLE patients and HCs and their relationships with disease activity were analysed. Twenty-two of the 41 new-onset SLE patients were assessed before and after treatment. Changes in the frequencies of these cell subsets and their relationships with renal involvement were also analysed.

Results

Compared with that in HCs, the percentage of total γδ-T cells among CD3+ T cells in SLE patients was significantly lower. An imbalance in the proportions of Vδ1+ and Vδ2+ T cells among γδ-T cells was observed. The proportion of Vδ1+ T cells among γδ-T cells was significantly greater in SLE patients than in HCs, while the proportion of Vδ2+ T cells was significantly lower. Expression levels of PD-1, NKG2D, NKp30 and NKp46 in Vδ1+ T cells and Vδ2+ T cells from SLE patients were generally significantly increased, except for expression of NKG2D in Vδ2+ T cells. Moreover, Vδ2+ T cells, Vδ1+ T cells and Vδ1+PD-1+ T cells were associated with disease activity, and an increase in Vδ2+ T-cell frequency and a decrease in PD-1 expression by γδ-T cells might be associated with effective treatment. Interestingly, our results indicated that Vδ2+ T cells and their Vδ2+NKp30+ T-cell subpopulation might be associated with renal involvement in SLE.

Conclusion

A broad range of anomalies in the proportions of γδ-T-cell subsets and γδ-T cells in SLE patients may be involved in the pathogenesis of SLE. There is a strong association between Vδ2+ T cells and their Vδ2+NKp30+ T-cell subpopulation and LN occurrence. Our results indicate that γδ-T cells and their subpopulations might be key players in disease immunopathology and renal involvement in SLE.
Espionage, Counterintelligence, and Naval Observation in the Middle of the Atlantic: A Case Study of US Intelligence in the Canary Islands (1939–1945)
Authors: García Cabrera Marta
Published: March 2024

From 1939 to 1945, the Spanish archipelago of the Canary Islands became an alternative battleground for the intelligence services of the warring powers. US intelligence operated through diplomatic, military, and strategic channels such as consulates, the Office of Naval Intelligence, and the Office of Strategic Services. The archipelago was integrated into the US intelligence network in Spain but was also considered important in relation to operations in North Africa. This article interprets the role played by US intelligence in the Canary Islands as a case study of Allied intelligence operations in the North Atlantic Ocean during the Second World War.
Embracing Inclusivity in Hospice Care: A Case Study in Supporting HIV Patients
Authors: Corpuz Jeff Clyde G.
Published: March 2024

Despite the growing prevalence of human immunodeficiency virus (HIV) and acquired immunodefiency syndrome (AIDS) in the Philippines and the psychosocial challenges it engenders, there remains a dearth of research on the intersection of HIV and hospice care. Stigma and discrimination further compound the challenges of providing inclusive hospice care to HIV patients in the country. Drawing upon the results of a recently published article centered on a Veteran assigned male at birth who expressed a desire for gender reassignment while receiving end-of-life care, this paper highlights the importance of sensitivity, understanding, and affirmation in hospice settings for HIV patients in the Philippines.
Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study
Authors: Consolo Letteria , Rusconi Daniele , Colombo Stella , Basile Ilaria , Campa Tiziana , Pezzera Daniele , Benenati Salvatore , Caraceni Augusto , Lusignani Maura
Published: March 2024

Introduction

Electronic patient-reported outcome measures (e-PROMs) offer advantages in palliative cancer care, including rapid completion, improved data quality and direct storage, improving clinical decision-making. The electronic Integrated Palliative Care Outcome Scale (e-IPOS) in this context enables thorough self-assessment by patients, enhancing symptom management and self-reflection of their current situation.

Aim

To evaluate the feasibility of implementing the e-IPOS in home palliative cancer care.

Outcomes

The primary outcomes included the enrollment consent rate, study retention rate, e-IPOS completion rate and response completeness, and the number of clinical assessments and interventions performed during home visits. The secondary outcomes were the number of unscheduled visits and patients’ perceived quality of life.

Design

A two-group quasiexperimental clinical pilot study. The control group received standard palliative care, the intervention group received standard care along with weekly e-IPOS completion during home visits. Both groups were enrolled for 4 weeks.

Setting/participants

Adults with advanced cancer from the home palliative care unit of the Istituto Nazionale dei Tumori of Milan.

Results

Twenty-three patients were enrolled (74.19%), and 20 completed the study (drop-out: 13.04%). 82.5% of the expected e-IPOS responses were received, of which 96.9% were fully complete. In the intervention group, the Wilcoxon test showed an increase in identified needs and documented interventions ( P < .05) and a decrease in unscheduled visits ( P < .05).

Conclusion

It is feasible to recruit people via home palliative care for an e-IPOS implementation study. Future fully powered studies should investigate the feasibility and assess patients’ perceptions of its use to better understand its clinical benefits.
Low-Intensity Statin Plus Ezetimibe Versus Moderate-Intensity Statin for Primary Prevention: A Population-Based Retrospective Cohort Study in Asian Population
Authors: Jung Minji , Lee Beom-Jin , Lee Sukhyang , Shin Jaekyu
Published: March 2024

Background:

While moderate-intensity statin therapy is recommended for primary prevention, statins may not be utilized at a recommended intensity due to dose-dependent adverse events, especially in an Asian population. However, evidence supporting the use of low-intensity statins in primary prevention is limited.

Objective:

We sought to compare clinical outcomes between a low-intensity statin plus ezetimibe and a moderate-intensity statin for primary prevention.

Methods:

This population-based retrospective cohort study used the Korean nationwide claims database (2002-2019). We included adults without atherosclerotic cardiovascular diseases who received moderate-intensity statins or low-intensity statins plus ezetimibe. The primary outcome was a composite of all-cause mortality, myocardial infarction, and ischemic stroke. The safety outcomes were liver and muscle injuries and new-onset diabetes mellitus (DM). We used standardized inverse probability of treatment weighting (sIPTW) and propensity score matching (PSM).

Results:

In the sIPTW model, 1717 and 36 683 patients used a low-intensity statin plus ezetimibe and a moderate-intensity statin, respectively. In the PSM model, each group included 1687 patients. Compared with moderate-intensity statin use, low-intensity statin plus ezetimibe use showed similar risks of the primary outcome (hazard ratio [HR] = 0.92, 95% CI = 0.81-1.12 in sIPTW and HR = 1.16, 95% CI = 0.87-1.56 in PSM model). Low-intensity statin plus ezetimibe use was associated with decreased risks of liver and muscle injuries (subHR [sHR] = 0.84, 95% CI = 0.74-0.96 and sHR = 0.87, 95% CI = 0.77-0.97 in sIPTW; sHR = 0.84, 95% CI = 0.72, 0.96 and sHR = 0.82, 95% CI = 0.72-0.94 in PSM model, respectively). For new-onset DM and hospitalization of liver and muscle injuries, no difference was observed.

Conclusion and Relevance:

Low-intensity statin plus ezetimibe may be an alternative to moderate-intensity statin for primary prevention. Our findings provide evidence on safety and efficacy of statin therapy in Asian population.
Custodians of an ecology of data: Foundational theory and practice for data analysis in a complex world
Authors: Finn R , Brown A
Published: March 2024

Currently, limited guidance is offered to qualitative researchers regarding ways to undertake data analysis that focus on the complex transactions of person and place. We propose that honouring mutuality of person and place requires analysis textured as ‘custodianship’ of the diverse expression of values in research data that constitutes an ‘ecology’. The process of analysis as custodians is the enacted responsibility to learn with data: digging deep within the ecology to reveal flows of diverse values motivating human behaviour. In this article, this inherently more relational approach to data analysis is theorised as an eco-behavioural stance, inspired by the social-ecological model and ecological psychology. Directing increasing sensitivity to the role of the qualitative researcher that considers the multiple emergent processes operating simultaneously across various levels of analysis, we contend, will bring a resultantly richer feast of findings.
Scaphoid Fractures in Adults Aged 50 Years or Older: Epidemiology and Association With Osteopenia and Nonunion
Authors: Mastracci Julia C. , McKnight R. Randall , Ode Gabriella E. , Caraet Brianna , Odum Susan M. , Gantt Erika G.
Published: March 2024

Background:

Scaphoid fractures are less commonly reported in adults older than 50 years. The association between bone density and outcomes following scaphoid fractures has not been explored in this patient population. The second metacarpal cortical percentage (2MCP) has been shown to predict low bone density. The purpose of this study is to describe the epidemiology and radiographic characteristics associated with scaphoid fractures in adults older than 50 years, determine the prevalence of osteopenia defined by 2MCP, and evaluate the characteristics associated with scaphoid nonunion in this population. We hypothesized that osteopenia defined by 2MCP would be common in this patient population and associated with scaphoid nonunion.

Methods:

Patients older than 50 years with an acute, closed scaphoid fracture were identified. Demographic data, radiographic characteristics, and outcome data were collected. The 2MCP was measured using standard hand radiographs.

Results:

A total of 111 patients were identified. Most fractures were nondisplaced and occurred in women via low-energy mechanism. Fifty-six patients (50.5%) had osteopenia defined by a 2MCP less than 60%. Nondisplaced fractures achieved union faster than displaced fractures ( P < .05). Displaced, unstable fractures were statistically associated with nonunion ( P < .001). 2MCP did not correlate with nonunion.

Conclusions:

In adults older than 50 years, scaphoid fractures may represent a fragility fracture cohort given they occur more frequently in female patients via low-energy mechanisms and over half of the cohort had osteopenia defined by a 2MCP less than 60%. Displaced and unstable fractures were statistically more likely to go on to nonunion. Nonunion was not found to be associated with osteopenia.
Efficacy and safety analysis of AcoStream thrombus aspiration device in the treatment of acute superior mesenteric artery embolism
Authors: Xu Qiyang , Wang Yi , Xu Bin , Lang Dehai , Lin Zuodong
Published: March 2024

Objective

Acute superior mesenteric artery embolism is a life-threatening disease caused by the abrupt interruption of mesenteric blood circulation, and the prognosis is very poor. Several studies have confirmed the efficacy and safety of percutaneous mechanical thrombectomy in acute superior mesenteric artery embolism, however, there are currently no literature reports on the latest percutaneous mechanical thrombectomy device—AcoStream™. In the present report, we summarize a series of cases and share our surgical experiences.

Methods

The clinical data of 10 patients (six men and four women, mean age 77.6 ± 7.4 years) with acute superior mesenteric artery embolism treated by AcoStream™ in our center from December 2022 to December 2023 were retrospectively analyzed. Based on the literature, we summarized the diagnosis, therapy, and surgical experience of acute superior mesenteric artery embolism.

Results

Percutaneous mechanical thrombectomy was performed for all the patients. The success rate of surgery reached 100% and no perioperative complications occurred. Abdominal pain was significantly relieved and the abdominal signs gradually disappeared in eight patients, while the other two patients still complained of abdominal pain during hospitalization, and eventually, they underwent resection of necrotic bowel. All the patients’ symptoms were significantly relieved and they were smoothly discharged from the hospital.

Conclusions

As shown in the present study, percutaneous mechanical thrombectomy using AcoStream™ is minimally invasive, safe, and efficient in the initial stage of acute superior mesenteric artery embolism. We believe that percutaneous mechanical thrombectomy can be a promising alternative in selected cases.
Outcomes of treatment of patella fractures in children and adolescents
Authors: Beatty Evan W. , Hupin Mathilde , Kramer Dennis E. , Shore Benjamin J. , Heyworth Benton E.
Published: March 2024

Purpose:

The purpose of this study is to assess clinical and functional outcomes in separate cohorts of operatively and nonoperatively managed pediatric patella fractures.

Methods:

A retrospective review was completed for patients aged 5–19 years treated for a unilateral patella fracture at a single pediatric level-1 trauma center. Patients were excluded for osteochondral fracture associated with patellar dislocation, polytrauma presentation with additional fractures, or <3 months of clinical follow-up. Functional outcomes were assessed via the Pediatric International Knee Documentation Committee form and the Marx Knee Activity Scale.

Results:

A total of 53 patients met inclusion criteria; 30 patients were treated operatively and 23 patients were treated nonoperatively. Patients with patellar sleeve/pole fractures were significantly younger by 5.2 years (p < 0.01) and presented with greater variability in mechanism of injury (p < 0.01). The nonoperative cohort achieved bony healing and returned to sports at a median (interquartile range) of 1.7 (1.2–2.3) months and 2.8 (2.3–3.3) months, respectively, post-injury. The operative group achieved bony healing and returned to sports at 2.8 (2.1–3.5) months and 5.9 (4.0–7.1) months, respectively, following surgery. Median (interquartile range) Pediatric International Knee Documentation Committee and Marx scores were 98 (89–100) and 14 (10–16), respectively, for the nonoperative group, and 92 (84–99) and 13 (12–16), respectively, for the operative group. No significant differences in patient-reported outcomes were observed between fracture patterns or treatment cohorts.

Conclusion:

Pediatric and adolescent patients sustaining patella fractures reported long-term functional outcomes comparable to normative values, across multiple fracture patterns and with appropriate operative and nonoperative treatment. Fractures requiring surgery were expectedly associated with slower healing and return to sport timelines.

Level of evidence:

Therapeutic Level III.