bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of microbiological tests in patients withholding or withdrawing life-sustaining treatment at the end stage of life in 2 Korean hospitals
Authors: Bae Sohyun , Kwon Ki Tae , Hwang Soyoon , Kim Yoonjung , Chang Hyun-Ha , Kim Shin-Woo , Lee Nan Young , Kim Yu Kyoung , Lee Je Chul
Published: September 2023

Objective:

We evaluated the adequacy of microbiological tests in patients withholding or withdrawing life-sustaining treatment (WLST) at the end stage of life.

Setting:

The study was conducted at 2 tertiary-care referral hospitals in Daegu, Republic of Korea.

Design:

Retrospective cross-sectional study.

Methods:

Demographic findings, clinical and epidemiological characteristics, statistics of microbiological tests, and microbial species isolated from patients within 2 weeks before death were collected in 2 tertiary-care referral hospitals from January to December 2018. We also reviewed the antimicrobial treatment that was given within 3 days of microbiological testing in patients on WLST.

Results:

Of the 1,187 hospitalized patients included, 905 patients (76.2%) had WLST. The number of tests per 1,000 patient days was higher after WLST than before WLST (242.0 vs 202.4). Among the category of microbiological tests, blood cultures were performed most frequently, and their numbers per 1,000 patient days before and after WLST were 95.9 and 99.0, respectively. The positive rates of blood culture before and after WLST were 17.2% and 18.0%, respectively. Candida spp. were the most common microbiological species in sputum (17.4%) and urine (48.2%), and Acinetobacter spp. were the most common in blood culture (17.3%). After WLST determination, 70.5% of microbiological tests did not lead to a change in antibiotic use.

Conclusions:

Many unnecessary microbiological tests are being performed in patients with WLST within 2 weeks of death. Microbiological testing should be performed carefully and in accordance with the patient’s treatment goals.
Moving boundaries on what I-O has been, and what I-O can be: The United Nations Sustainable Development Goals as an organizing framework
Authors: Mullins Morrie , Olson-Buchanan Julie
Published: September 2023

Even before the onset of the COVID-19 pandemic, and especially since, I-O psychology has demonstrated its ability to adapt and to make meaningful contributions to how work is accomplished in tumultuous environments. Such contributions reflect the ongoing evolution of the field and an increased awareness of the potential for I-O psychologists to effect meaningful societal change. We believe that I-O psychology must embrace this evolution and, using the United Nations Sustainable Development Goals to help us target our efforts, become a resource and a voice for workers and organizations around the world, and a force for the greater good.
Relationship between urinary potassium excretion, serum potassium levels and cardiac injury in non-dialysis chronic kidney disease: KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD)
Authors: Min Hyang Ki , Sung Su Ah , Jung Ji Yong , Oh Yun Kyu , Lee Kyu Beck , Park Sue K. , Oh Kook-Hwan , Ahn Curie , Lee Sung Woo
Published: September 2023

Although the cardiovascular benefits of an increased urinary potassium excretion have been suggested, little is known about the potential cardiac association of urinary potassium excretion in patients with chronic kidney disease. In addition, whether the cardiac association of urinary potassium excretion was mediated by serum potassium levels has not been studied yet. We reviewed the data of 1633 patients from a large-scale multicentre prospective Korean study (2011–2016). Spot urinary potassium to creatinine ratio was used as a surrogate for urinary potassium excretion. Cardiac injury was defined as a high-sensitivity troponin T ≥ 14 ng/l. OR and 95 % (CI for cardiac injury were calculated using logistic regression analyses. Of 1633 patients, the mean spot urinary potassium to creatinine ratio was 49·5 (sd 22·6) mmol/g Cr and the overall prevalence of cardiac injury was 33·9 %. Although serum potassium levels were not associated with cardiac injury, per 10 mmol/g Cr increase in the spot urinary potassium to creatinine ratio was associated with decreased odds of cardiac injury: OR 0·917 (95 % CI 0·841, 0·998), P = 0·047) in multivariate logistic regression analysis. In mediation analysis, approximately 6·4 % of the relationship between spot urinary potassium to creatinine ratio and cardiac injury was mediated by serum potassium levels, which was not statistically significant (P = 0·368). Higher urinary potassium excretion was associated with lower odds of cardiac injury, which was not mediated by serum potassium levels.
Conditional Freedoms: Non-State Labour in Cuba between Institutional Delegitimisation and Civic Recognition
Authors: Thiemann Louis , González Marrero Claudia
Published: September 2023

During the height of its power over everyday life, between 1968 and 1993, the Cuban Communist Party outlawed virtually all non-state labour and exchange. Since then, however, its continuity in power has increasingly depended on devolution: shifting responsibility for the provision of basic goods and services from failing state enterprises back to the self-employed. The latter now produce the majority of food and basic products; receive most of the national income from tourism, remittances and foreign investment; and generate most new jobs. Nevertheless, they subsist under a subaltern regime of fragile and conditional freedoms. The article adapts James Scott's consideration for the subaltern's ‘hidden transcripts’ and agencies to contemporary Cuba. It analyses the unavoidability of informal and illegal practices for daily subsistence; their naturalisation in society in contrast with their delegitimisation as opportunistic self-enrichment in party-controlled media; and how the self-employed resist such judgements in favour of more conciliatory civic visions.
Mechanistic understanding of individual outcomes: Challenges and alternatives to genetic designs
Authors: Bondarenko Olesya
Published: September 2023

I argue that advancing “second-generation” or mechanistic causal knowledge of individual outcomes requires a comprehensive research programme that uses a variety of different methods in addition to the ones described in the paper under discussion. I also highlight that environment-focused approaches can be as instrumental in identifying potential phenotypic causes as gene-focused approaches.
Behavior genetics and randomized controlled trials: A misleading analogy
Authors: Kaplan Jonathan Michael , Bird Kevin Andrew
Published: September 2023

Madole & Harden argue that just as the results of randomized controlled trials (RCTs) represent gains in causal knowledge and are useful, despite their limitations, so too are the findings of human behavior genetics. We argue that this analogy is misleading. Unlike RCTs, the results of human behavior genetics research cannot suggest efficacious interventions, nor point toward future research.
All that glisters is not gold: Genetics and social science
Authors: Burt Callie H.
Published: September 2023

In their target article, Madole & Harden offer an account of “what it means for genes to be causes” of social outcomes to bolster their claim that genetics should be incorporated into social science with practical implications. Here I object to several key features of their arguments, their representation of the state of science, and claims about the utility of genetics for social science and society.
Addressing genetic essentialism: Sharpening context in behavior genetics
Authors: Byrne Brian , Olson Richard K.
Published: September 2023

Evidence of a causal role for genes in human behavior underpins genetic essentialism, the scientifically flawed and socially hazardous idea that heritable characteristics are immutable. Behavior geneticists can challenge this idea by designing research that brings the contextual dependence of heritability estimates into sharper focus, and by incorporating a relevant statement into research reports and public outreach.
Drowning in shallow causality
Authors: Shen Hao , Feldman Marcus W.
Published: September 2023

It has been known for decades that inference concerning genetic causes of human behavioral phenotypes cannot be legitimately made from correlations among relatives. We claim that these inferential difficulties cannot be overcome by assigning different names to causes inferred from within-family and population-level genome-wide association studies (GWASs). For educational attainment, for example, unraveling gene–environment interactions requires more than new names for causes.
The social stratification of population as a mechanism of downward causation
Authors: Merchant Emily Klancher
Published: September 2023

This commentary expands on Burt's concept of downward causation to include any association between genomic variants and a given outcome that is forged through social practices rather than biochemical pathways. It proposes the social stratification of population, through which endogamy over a period of generations produces allele frequency differences between socioeconomic strata, as a mechanism of downward causation.
Genomics might not be the solution, but epistemic validity remains a challenge in the social sciences
Authors: Moreau David , Wiebels Kristina
Published: September 2023

We sympathize with many of the points Burt makes in challenging the value of genetics to advance our understanding of social science. Here, we discuss how recent reflections on epistemic validity in the behavioral sciences can further contribute to a reappraisal of the role of sociogenomics to explain and predict human traits, aptitudes, and achievement.
Social scientists would do well to steer clear of polygenic scores
Authors: Curtis David
Published: September 2023

The problems with polygenic scores (PGSs) have been understated. The fact that they are ancestry-specific means that biases related to sociodemographic factors would be impossible to avoid. Additionally, the requirement to obtain DNA would have profound impacts on study design and required resources, as well as likely introducing recruitment bias. PGSs are unhelpful for social science research.
Often wrong, sometimes useful: Including polygenic scores in social science research
Authors: Fletcher Jason
Published: September 2023

This commentary seeks to briefly outline a clear-eyed middle ground between Burt's claims that the inclusion of polygenic scores (PGSs) is essentially useless for social science and proponents' vast overstatements and over-interpretations of these scores. Current practice of including PGSs in social science is often wrong but sometimes useful.
Polygenic scores ignore development and epigenetics, dramatically reducing their value
Authors: Moore David S.
Published: September 2023

Polygenic scores cannot elucidate the mechanisms that produce behavioral phenotypes (including “intelligence”). Therefore, they are unlikely to yield helpful interventions. Moreover, they are poor predictors of individuals' developmental outcomes. Burt's critique is well-supported by the details of molecular biology. Specifically, experiences affect epigenetic factors that influence phenotypes via how the genome functions, a fact that lends support to Burt's conclusions.
Polygenic scores for social science: Clarification, consensus, and controversy
Authors: Burt Callie H.
Published: September 2023

In this response, I focus on clarifying my arguments, highlighting consensus, and addressing competing views about the utility of polygenic scores (PGSs) for social science. I also discuss an assortment of expansions to my arguments and suggest alternative approaches. I conclude by reiterating the need for caution and appropriate scientific skepticism.
Political Experimentation in the Age of Global Revolutions
Authors: González Quintero Nicolás Alejandro
Published: September 2023

This essay reviews six recent books that explore how revolutionary upheavals pushed imperial and republican projects alike to experiment with novel political ideas and mechanisms. These initiatives came in response to calls for representation and equality throughout the Age of Revolution. In doing so, these books reveal the failures and successes of these projects in responding to these demands. The authors of these works show that republican and imperial processes of state-building and legitimacy-building did not have a predetermined outcome—quite the opposite. To constitute themselves as valid political alternatives, revolutionary, imperial, and republican projects had to adapt to different actors’ expectations, contingencies, and growing geopolitical tensions. By exposing those adaptation processes, the six books under review demonstrate that the Age of Revolution was a period of intense political experimentation across the ideological spectrum.
Urbs Giudi: text, translation and topography
Authors: Aitchison Nick
Published: September 2023

This paper re-examines Bede’s reference to urbs Giudi for previously overlooked clues that may help to identify the location of this elusive fortress, somewhere in, on or near the Firth of Forth in what is now eastern central Scotland. After considering Bede’s abilities as a geographer, it assesses and challenges the persistent suggestion that urbs Giudi was on an island. It then analyses the implications of Bede’s use of Latin in medio sui and sinus by comparing these terms with other examples in Bede’s writings and elsewhere. This points to the importance of secondary and elliptical, rather than literal, senses of in medio sui and sinus respectively. The outcome of this is that urbs Giudi was located neither ‘in the middle of’ the Firth of Forth, nor ‘halfway along’ it, but further inland, on the Links of Forth, the meandering section of the Forth Estuary. This excludes all previously proposed locations for urbs Giudi with the exception of one, Stirling.
Closing the loop between horizon scanning and health technology assessment – an overview of topics submitted for appraisal in England
Authors: Khan Sarah Khalid , Gonzalez-Moral Sonia G. , Lanyi Kate , Ogunbayo Dapo , Craig Dawn
Published: September 2023

Objectives

Horizon scanning for health technology appraisal (HTA) in England involves topic notification to the National Institute for Health and Care Excellence (NICE) via technology briefings. This activity is undertaken by the Innovation Observatory with submission timelines designed to ensure that HTA decisions align with regulatory approval time. In this paper, we aimed to track and assess the progression and current status of the topics notified for HTA and provide a descriptive analysis of these topics.

Methods

Technology briefings were mapped from submission to NICE technology appraisal/highly specialized technologies recommendations from April 2017 until October 2021. This was done using a combination of searches on Google and NICE website, searching a downloadable spreadsheet containing NICE topic selection decisions, and querying NICE Topic Selection team. Analysis was undertaken regarding type of indications and interventions of submitted topics and published guidance.

Results

Six-hundred and ninety-three topics entered the NICE scoping process, of which 94 percent were prioritized. As of November 2021, approximately 39 percent of prioritized topics were in scoping/in progress, 31 percent were proposed/completed, 20 percent were suspended/terminated, and 4 percent were referred back to Innovation Observatory (IO) for further monitoring.

Conclusions

Our work demonstrates that horizon scanning for HTA is a complex and time-intensive process. Timelines and progress through HTA is challenging due to the growing number of innovative medicines, significant uncertainties, and limited transparency in clinical development and regulatory pathways. A better understanding of clinical trials and regulatory requirements may help eliminate some of this uncertainty and improve timely HTA.
Crossing the doorsteps for social reform: The social crusades of Florence Kelley and Ellen Richards
Authors: Soudan Gabrielle , Philippy David , Maas Harro
Published: September 2023

Argument

This paper contrasts the research strategies of two women reformers, Florence Kelley and Ellen Swallow Richards, which entailed different strategies of social reform. In the early 1890s, social activist Florence Kelley used the social survey as a weapon for legal reform of the working conditions of women and children in Chicago’s sweatshop system. Kelley’s case shows that her surveys were most effective as “grounded” knowledge, rooted in a local community with which she was well acquainted. Her social survey, re-enacted by lawmakers and the press, provided the evidence that moved her target audience to legal action. Chemist and propagator of the Home Economics Movement Ellen Richards situated the social problem, and hence its solution, not in exploitative working conditions, but in the inefficient and wasteful usage of available resources by the poor. Laboratory work, she argued, would enable the development of optimal standards, and educational programs should bring these standards to the household by means of models and exhibits. With this aim, she constructed public spaces that she ran as food laboratories and sanitary experiments. Kelley and Richards thus crossed the doorsteps of the household in very different ways. While Florence Kelley entered the household to change the living and working conditions of the poor by changing the law, Richards flipped the household inside out by bringing women into hybrid public laboratory spaces to change their behavior by experiment and instruction.
The correlation between humoral immune responses and severity of clinical symptoms in COVID-19 patients
Authors: Akbarian Shadi , Sheikhi Mehdi , Khedri Parichehr , Baharifar Narges , Khalaf Shamsabadi Fatemeh , Davidi Mohammad Reza , Khazaei Hossein Ali , Assarian Hamidali , Sheikhi Abdolkarim
Published: September 2023

The SARS-CoV-2 pandemic persists with global repercussions. Initial COVID-19 symptoms encompass pneumonia, fever, myalgia, and fatigue. The human immune system produces IgM and IgG antibodies in response to SARS-CoV-2. Despite previous research, a comprehensive understanding of the interplay between clinical manifestations and humoral immune responses remains elusive. This study aims to scrutinize this association. 134 COVID-19 patients were enrolled, and stratified into mild, moderate, and severe symptom groups. Serum IgM and IgG levels were assessed thrice at one-month intervals using ELISA. The findings reveal significant elevation in serum IgG levels in moderate compared to mild cases (P < 0.001). Additionally, IgG production was significantly heightened in severe cases compared to both mild (P < 0.0001) and moderate (P < 0.05) groups. IgM and IgG levels peaked initially and diminished over time. While anti-SARS-CoV-2 antibodies are expected to confer protection, the direct correlation between IgG levels and symptom severity may arise from delayed immune activation, resulting in an intense antibody response in severe cases. Given evidence linking delayed immune function with a dysregulated innate immune response, comprehensive data collection should encompass not only serum IgG and IgM, but also early measurement of type I interferons at symptom onset. This could provide a more thorough understanding of COVID-19 progression.
Relativizing the A Priori By Way of Reflective Judgement
Authors: Vaccarino Bremner Sabina
Published: September 2023

An influential strand in philosophy of science claims that scientific paradigms can be understood as relativized a priori frameworks. Here, Kant’s constitutive a priori principles are no longer held to establish conditions of possibility for knowledge which are unchanging and universally true, but are restricted only to a given scientific domain. Yet it is unclear how exactly a relativized a priori can be construed as both stable and dynamical, establishing foundations for current scientific claims while simultaneously making intelligible the transition to a subsequent framework. In this article, I show that important resources for this problem have been overlooked in Kant’s theory of reflective judgement in the third Critique. I argue that Kant accorded the task of formulating new scientific laws to reflective judgement, which is charged with forming new ‘universals’ that guide the experience of nature. I show that this is the very task attributed to the relativized a priori: the constitution of a given conceptual framework, not of the conditions for object-reference as such. I conclude that Kant’s considered conception of science encompasses the operations of both reflective and determining judgement. Relativizations of the a priori should follow Kant’s lead.
Genetic fingerprinting ofZiziphus jujubaby using SCoT and REMAP molecular markers
Authors: Mohajer Kaboli Zohreh , Sheidai Masoud , Koohdar Fahimeh
Published: September 2023

Jujube is both consumed as a food source and medicinal plant in local markets. It is expected that different geographical populations ofZiziphus jujuba, differ in their genetic content as they grow in different ecological conditions. It is important to have detailed information on population genetic structure and the available genetic variability to make a proper germplasm collection of jujube. We have no data on jujube populations of Iran based on SCoT and REMAP molecular markers, and therefore we planned a population genetic study of these trees in 10 geographical areas. We used SCoT and REMAP molecular markers for our genetic investigation. We found the loci with a high value of Gst (1.00) in SCoT and REMAP markers that can be used in fingerprinting of jujube.
Effect of Inverse Compton Cooling on Relativistic Particles Accelerated at Shear Boundary Layers in Relativistic Jets
Authors: Chand Tej , Böttcher Markus
Published: September 2023

Recent theoretical considerations and observational evidence evince the spine-sheath morphology of relativistic jets emitted from active galactic nuclei (AGNs) or gamma-ray bursts (GRBs). The resulting shear boundary layers (SBLs) are likely to be an avenue for particle acceleration in relativistic jets. The effect of radiation drag on radiating particles has yet to be addressed in most studies of particle acceleration at shear boundary layers, even though radiative cooling may considerably affect particle dynamics. By using particle-in-cell simulations, we study the effects of inverse Compton cooling on particle dynamics and emerging particle spectra.
A WISE perspective of the blazar hunt in the γ-ray sky
Authors: Massaro Francesco , D’Abrusco Raffaele
Published: September 2023

Thanks to the data of the WISE all-sky survey we discovered that the non-thermal infrared emission of blazars, the largest population of associated γ-ray sources, has peculiar spectral properties. Here we provide a summary of all results achieved on the infrared–γ-ray connection. We also show results on the latest statistical analysis of the tight correlation between the mid-infrared colors and the γ-ray spectral index for Fermi blazars, a connection that links both emitted powers and spectral shapes of particles accelerated in blazar jets over ten decades in frequency of the electromagnetic spectrum. Finally, we outline all developments performed in the last decade achieved using the infrared– γ-ray connection to discover hundreds of new blazars within the sample of unidentified γ-ray sources thanks to optical spectroscopic observations.
Radio Polarization: A Powerful Resource for Understanding the Blazar Divide
Authors: Baghel Janhavi , Kharb P. , Silpa S. , Ho Luis C. , Harrison C. M.
Published: September 2023

With high-sensitivity kiloparsec-scale radio polarimetry, we can examine the jet-medium interactions and get a better understanding of the blazar divide in radio-loud (RL) AGN. We are analyzing the radio polarimetric observations with the EVLA and GMRT of 24 quasars and BL Lacs belonging to the Palomar-Green (PG) sample. The RL quasars show extensive polarisation structures in their cores, jets, lobes, and hotspots, whereas preliminary results suggest that BL Lacs exhibit polarisation primarily in their cores and inner jet regions. These findings imply that both intrinsic (central engine-related) and extrinsic (environment-related) variables are important in the formation of the blazar subclasses. The Fanaroff-Riley (FR) dichotomy can also be studied assuming RL unification and looking through the lens of blazars. Due to the radio-unbiased nature of the optically/UV-selected PG sample, we find a large fraction of the PG quasars are restarted, distorted (S- or X-shaped), or have a hybrid FR morphology.
Multiwavelength monitoring of the nucleus in PBC J2333.9–2343: A giant radio galaxy with a Blazar-like core
Authors: Hernández-García L. , Panessa F. , Bruni G. , Bassani L. , Arévalo P. , Patiño-Alvarez V. M. , Tramacere A. , Lira P. , Sánchez-Sáez P. , Bauer F. E. , Chavushyan V. , Carraro R. , Förster F. , Muñoz Arancibia A. M. , Ubertini P.
Published: September 2023

We present an observational multiwavelength campaign during 2018–19 for PBC J2333.9–2343, a giant radio galaxy with a bright central core associated to a blazar nucleus, whose structure could be due to a significant jet reorientation. We report flux increases by a factor of two or more on timescales shorter than a month, resembling flaring events. The cross correlation between the NIR and optical bands shows quasi-simultaneous variations arising from the jet. The optical variability properties of PBC J2333.9–2343 are more comparable to a sample of blazars than to non-blazar AGN. The SED of the nucleus shows two peaks, with a derived jet angle of 3 degrees, also typical of a blazar. Therefore, we confirm the presence of a blazar-like core in the center of this galaxy.
3D PIC Simulations for Relativistic Jets with a Toroidal Magnetic Field
Authors: Nishikawa Kenichi , Meli Athina , Köhn Christoph , Duţan Ioana , Mizuno Yosuke , Kobzar Oleh , MacDonald Nicholas , Gómez José L. , Hirotani Kouichi
Published: September 2023

Particle-in-Cell simulations can provide a possible answer to an important key issue for astrophysical plasma jets; namely on how a toroidal magnetic field affects the evolution of pair and electron-ion jets. We show that Weibel, mushroom, and kinetic Kelvin-Helmhotz instabilities excited at the linear stage, generate a quasi-steady x-component of the electric field which accelerates and decelerates electrons. We observe significant differences in the structure of the strong electromagnetic fields that are driven by the kinetic instabilities with the pair jet. We find that the two different jet compositions (e± and e– - i+) generate different instability modes respectively. Moreover, the magnetic field in the non-linear stage generated by different instabilities is dissipated and reorganized into new topologies. A 3D magnetic field topology depiction indicates possible reconnection sites in the non-linear stage where the particles are significantly accelerated by the dissipation of the magnetic field associated to a possible reconnection manifestation.
Kommunikation mit Sterbenden
Authors: Dunphy Janet
Published: September 2023

Janet Dunphy leitet in ihrem Praxisleitfaden auf sachliche und empathische Art dazu an, mit Menschen in palliativen Lebenssituationen zu kommunizieren. Sie erörtert ausführlich die ethischen Aspekte wichtiger Probleme in der Palliativpflege und geht besonders auf die hohe Kunst der Palliative-Care-Kommunikation ein. Die zahlreichen authentischen Fallbeispiele helfen theoretisches Wissen in die Praxis zu übertragen und anzuwenden.Das Besondere an diesem Buch ist die Fähigkeit von Janet Dunphy, Wissen in Geschichten zu verpacken und mit Menschlichkeit zu kombinieren, sodass ihr Wissen und ihre Weisheit einfühlsam und menschenwürdig in die Praxis einfliessen können.Die dritte Auflage wurde ergänzt um aktuelle Literatur und neue Beiträge über Aufmerksamkeit als Haltung, die Pflegeintervention Trösten und Geborgenheit geben, physiologische und soziale Funktionen des Weinens und eine Anleitung, wie Angehörige einem Verlust durch „Andenken“ begegnen können.
Aus dem Inhalt

Einleitung
Beziehungen
Professionelles Verhalten
Fähigkeiten, die für das Assessment wichtig sind
Die Diagnose
Die Behandlung
Die Auswirkungen einer schweren Krankheit
Die Bestätigung einer schlechten Prognose
Wichtige ethische Aspekte der Kommunikation
Die Vorteile eines umfassenden Versorgungsplans
Schlechte Nachrichten überbringen
Der Sterbeprozess
Fragen, die häufig gestellt werden
Geben Sie auf sich Acht
Anhang
Ungeheuer wütend
Authors: Rietzler Stefanie , Völker-Munro Nora , Grolimund Fabian , Amthor René
Published: September 2023

Die Prinzessin von Wohl-Herzogien und ihr Drache sind allerbeste Freunde. Auch wenn diesen witzigen und liebenswerten Drachen manchmal eine rasende Drachenwut packt. Er faucht und brüllt, wenn etwas nicht nach seinem Willen geht! Er tobt, wenn er sich so sehr auf etwas gefreut hat – aber die Pläne sich plötzlich ändern! Ja, er schnappt sogar zu, wenn er sich ungerecht behandelt fühlt!

Als der Drache immer größer wird, bekommen es der König und die Königin mit der Angst zu tun und verbannen ihn in den Wald. Schluchzend sitzt der Drache am Wasserfall. Doch plötzlich taucht die Prinzessin auf: Sie lässt ihn nicht im Stich!

Gemeinsam erleben sie ein Abenteuer, bei dem die Drachenwut ihre Freundschaft auf die Probe stellt. Zum Glück entdecken die beiden eines Nachts, wie sich die glühend heiße Drachenwut abkühlen lässt …

Ein spannendes Abenteuer für Kinder zwischen 5 und 9 Jahren, die erfahren möchten:warum wir alle manchmal wütend werden, was die Wut uns sagen will, wie man seine Wut ausdrücken kann, ohne zerstörerisch zu sein und andere zu verletzen, wie man sich selbst wieder beruhigen kann und wie gut es tut, wenn man bei schwierigen Gefühlen jemanden an seiner Seite hat.
Unhealthy Alcohol Use in Older Adults
Authors: Woodhead Erin L.
Published: September 2023

As our population ages, practitioners find themselves working with older adults more frequently. Alcohol use problems among older adults are often underdiagnosed and undertreated, and there are few treatments designed specifically for this client group. This practical guide provides practitioners with up-to-date information on assessing and treating unhealthy alcohol use among older adults. With a focus on evidence-based treatments, it is highly relevant to practitioners working across a variety of settings. Through the author’s expertise, we learn about the prevalence of alcohol use among older adults, the models for understanding unhealthy use, and the different screening and assessment options as well as the treatment possibilities relevant to health care and social service providers. Assessment and treatment options highlight the need to consider lifespan development when providing care as well as the relevance of common life transitions and generational differences. Clinical pearls and vignettes illuminate treatment approaches and further sections discuss pharmacological interventions and cultural considerations. Printable tools are available in an appendix. This book is a must for practitioners from diverse settings who work with older adults.
Satellite Observed Multisource Internal Tide Radiation and Interference in the Banda Sea
Authors: Zhang Peiwen , Xu Zhenhua , You Jia , Hao Zhanjiu , Yin Baoshu , Hou Yijun , Robertson Robin
Published: September 2023

Both the semidiurnal and diurnal internal tides in the Banda Sea were investigated using multi‐satellite altimeter data, through a combination of plane wave analysis technique and two‐dimensional band‐pass spatial filtering. The west and central Banda Sea are found to be dominated by semidiurnal internal tides, while the diurnal internal tides dominate the east. Multiple internal tidal sources were located at or nearby the Banda Arc, radiating significant internal tides inwards in complex interference patterns in the Banda Sea basin. The semidiurnal sources were situated on the northern and southern sides of the Banda Arc, emanating internal tides in opposite meridional directions. The semidiurnal tidal beams then experienced interference, shaping the heterogeneous energy fields in the west and central Banda Sea. The primary diurnal source was situated over the steep slope in the Aru Basin, with significant energy radiation westward and diffraction in the east Banda Sea. Based on the estimation of 27‐year coherent satellite results, the total energy flux of mode‐1 internal tides into the Banda Sea is about 4.82 GW, 58% contributed by semidiurnal tides and 42% by diurnal tides. This study represents the first observed mapping of the complex and inhomogeneous mode‐1 semidiurnal and diurnal internal tidal energy fields over the entire Banda Sea. Furthermore, this study enables further characterization of tidal mixing properties and improvement of model mixing parameterizations in the Indonesian seas.
Heterogeneous Strain Distribution in the Malawi (Nyasa) Rift, East Africa: Implications for Rifting in Magma‐Poor, Multi‐Segment Rift Systems
Authors: Wright Lachlan J. M. , Scholz Christopher A. , Muirhead James D. , Shillington Donna J.
Published: September 2023

Half‐graben basins bounded by border faults typify early‐stage continental rifts. Deciphering the role that intra‐rift faults play in rift basin development is challenging as patterns of early‐stage faulting are commonly overprinted by subsequent deformation; yet the characterization of these faults is crucial to understand the fundamental controls on their evolution, their contribution to rift opening, and to assess their seismic hazard. By integrating multiple offshore seismic reflection data sets with age‐dated drill core, late‐Quaternary and cumulative faulting patterns are characterized in the Central and South Basins of the Malawi (Nyasa) Rift, an active, early‐stage rift system. Almost all intra‐rift faults offset a late‐Quaternary lake lowstand surface, suggesting they are active and should be considered in hazard assessments. Fault throw profiles reveal sawtooth patterns indicating segmented slip histories. Observed extension on intra‐rift faults is approximately twice that predicted from hanging wall flexure of the border fault, suggesting that intra‐rift faults accommodate a proportion of the regional extension. Cumulative and late‐Quaternary throws on intra‐rift faults are correlated with throw measured on the border fault in the Central Basin, whereas an anticorrelation is observed in the South Basin. Viewed in a regional context, these differences do not relate solely to the proposed southward younging of the rift. Instead, it is inferred that the distribution of extension is also influenced by variations in lithospheric structure and crustal heterogeneities that are documented along the rift axis.
Magnitude, Trends, and Variability of the Global Ocean Carbon Sink From 1985 to 2018
Authors: DeVries Tim , Yamamoto Kana , Wanninkhof Rik , Gruber Nicolas , Hauck Judith , Müller Jens Daniel , Bopp Laurent , Carroll Dustin , Carter Brendan , Chau Thi‐Tuyet‐Trang , Doney Scott C. , Gehlen Marion , Gloege Lucas , Gregor Luke , Henson Stephanie , Kim Ji Hyun , Iida Yosuke , Ilyina Tatiana , Landschützer Peter , Le Quéré Corinne , Munro David , Nissen Cara , Patara Lavinia , Pérez Fiz F. , Resplandy Laure , Rodgers Keith B. , Schwinger Jörg , Séférian Roland , Sicardi Valentina , Terhaar Jens , Triñanes Joaquin , Tsujino Hiroyuki , Watson Andrew , Yasunaka Sayaka , Zeng Jiye
Published: September 2023

This contribution to the RECCAP2 (REgional Carbon Cycle Assessment and Processes) assessment analyzes the processes that determine the global ocean carbon sink, and its trends and variability over the period 1985–2018, using a combination of models and observation‐based products. The mean sea‐air CO2 flux from 1985 to 2018 is −1.6 ± 0.2 PgC yr−1 based on an ensemble of reconstructions of the history of sea surface pCO2 (pCO2 products). Models indicate that the dominant component of this flux is the net oceanic uptake of anthropogenic CO2, which is estimated at −2.1 ± 0.3 PgC yr−1 by an ensemble of ocean biogeochemical models, and −2.4 ± 0.1 PgC yr−1 by two ocean circulation inverse models. The ocean also degasses about 0.65 ± 0.3 PgC yr−1 of terrestrially derived CO2, but this process is not fully resolved by any of the models used here. From 2001 to 2018, the pCO2 products reconstruct a trend in the ocean carbon sink of −0.61 ± 0.12 PgC yr−1 decade−1, while biogeochemical models and inverse models diagnose an anthropogenic CO2‐driven trend of −0.34 ± 0.06 and −0.41 ± 0.03 PgC yr−1 decade−1, respectively. This implies a climate‐forced acceleration of the ocean carbon sink in recent decades, but there are still large uncertainties on the magnitude and cause of this trend. The interannual to decadal variability of the global carbon sink is mainly driven by climate variability, with the climate‐driven variability exceeding the CO2‐forced variability by 2–3 times. These results suggest that anthropogenic CO2 dominates the ocean CO2 sink, while climate‐driven variability is potentially large but highly uncertain and not consistently captured across different methods.
Numerical Investigation on the Height and Intensity Variations of Sporadic E Layers at Mid‐Latitude
Authors: Qiu Lihui , Yamazaki Yosuke , Yu Tao , Miyoshi Yasunobu , Zuo Xiaomin
Published: September 2023

In previous studies, various physical parameters, such as vertical wind shear null, vertical ion velocity null (IVN), and maximum gradient of vertical ion velocity, have been used as an indicator of Es layer height in light of the wind shear theory. Using a numerical Es layer model, we investigated which parameter represents the height of Es layer over Wuhan (114.4°E, 30.5°N) most precisely. The simulation results show that the height of Es layer above 110 km depends most strongly on the height of vertical IVN. However, below 110 km, the height of vertical IVN does not always agree with the height of Es layer. The analysis of simulation results suggests that the vertical gradient of the ratio of the ion‐neutral collision frequency (νi) to the ion gyrofrequency (ωi) affects the Es layer formation at lower altitudes (below 110 km). We also examined the effect of electric fields on the height and intensity of Es layers over Wuhan. It is found that eastward/upward electric fields can lift the Es layer height and reduce the Es layer intensity.
Indirect Observations of Electric Fields at Comet 67P
Authors: Moeslinger A. , Nilsson H. , Stenberg Wieser G. , Gunell H. , Goetz C.
Published: September 2023

No spacecraft visiting a comet has been equipped with instruments to directly measure the static electric field. However, the electric field can occasionally be estimated indirectly by observing its effects on the ion velocity distribution. We present such observations made by the Rosetta spacecraft on 19 April 2016, 35 km from the nucleus. At this time comet 67P was at a low outgassing rate and the plasma environment was relatively stable. The ion velocity distributions show the cometary ions on the first half of their gyration. We estimate the bulk drift velocity and the gyration speed from the distributions. By using the local measured magnetic field and assuming an E × B drift of the gyrocentre, we get an estimate for the average electric field driving this ion motion. We analyze a period of 13 hr, during which the plasma environment does not change drastically. We find that the average strength of the perpendicular electric field component is 0.21 mV/m. The direction of the electric field is mostly anti‐sunward. This is in agreement with previous results based on different methods.
Microbiota-dependent regulation of costimulatory and coinhibitory pathways via innate immune sensors and implications for immunotherapy
Authors: Park Joon Seok , Gazzaniga Francesca S. , Kasper Dennis L. , Sharpe Arlene H.
Published: September 2023

Our bodies are inhabited by trillions of microorganisms. The host immune system constantly interacts with the microbiota in barrier organs, including the intestines. Over decades, numerous studies have shown that our mucosal immune system is dynamically shaped by a variety of microbiota-derived signals. Elucidating the mediators of these interactions is an important step for understanding how the microbiota is linked to mucosal immune homeostasis and gut-associated diseases. Interestingly, the efficacy of cancer immunotherapies that manipulate costimulatory and coinhibitory pathways has been correlated with the gut microbiota. Moreover, adverse effects of these therapies in the gut are linked to dysregulation of the intestinal immune system. These findings suggest that costimulatory pathways in the immune system might serve as a bridge between the host immune system and the gut microbiota. Here, we review mechanisms by which commensal microorganisms signal immune cells and their potential impact on costimulation. We highlight how costimulatory pathways modulate the mucosal immune system through not only classical antigen-presenting cells but also innate lymphocytes, which are highly enriched in barrier organs. Finally, we discuss the adverse effects of immune checkpoint inhibitors in the gut and the possible relationship with the gut microbiota.
Zanubrutinib: past, present, and future
Authors: Tam Constantine S. , Muñoz Javier L. , Seymour John F. , Opat Stephen
Published: September 2023

In recent years, Bruton tyrosine kinase (BTK) inhibitors have provided significant advances in the treatment of patients with B-cell malignancies. Ibrutinib was the first BTK inhibitor to be approved, and it changed the standard-of-care treatment for diseases such as chronic lymphocytic leukemia, mantle cell lymphoma, marginal zone lymphoma, and Waldenström macroglobulinemia, improving efficacy outcomes and safety compared to chemotherapy. In this article, we review the development of zanubrutinib, a next-generation BTK inhibitor, from molecular design to patient-related outcomes. We start this journey by providing insights into the discovery of BTK and the physiologic, genetic, and molecular characterization of patients lacking this kinase, together with the brief treatment landscape in the era of chemo-immunotherapies. Zanubrutinib was originally developed by applying a structure-activity strategy to enhance the specificity as well as enzymatic and pharmacokinetic properties. Preclinical studies confirmed greater specificity and better bioavailability of zanubrutinib compared with that of ibrutinib, which supported the initiation of clinical trials in humans. Preliminary clinical results indicated activity in B-cell malignancies together with an improved safety profile, in line with less off-target effects described in the preclinical studies. The clinical program of zanubrutinib has since expanded significantly, with ongoing studies in a wide range of hemato-oncological diseases and in combination with many other therapies. Zanubrutinib currently is approved for various B-cell malignancies in multiple countries. This story highlights the importance of multidisciplinary collaborative research, from bench to bedside, and provides an example of how the commitment to finding improved treatment options should always run parallel to patient care.
Treatment of older adults with FLT3-mutated AML: Emerging paradigms and the role of frontline FLT3 inhibitors
Authors: Short Nicholas J. , Nguyen Daniel , Ravandi Farhad
Published: September 2023

FLT3 is the most frequently mutated gene in acute myeloid leukemia (AML), with FLT3 internal tandem duplication (ITD) mutations being associated with a more aggressive clinical course. While two large, randomized clinical trials have shown a survival benefit with the frontline use of an oral FLT3 inhibitor (midostaurin or quizartinib) in patients with FLT3-mutated AML, the role of FLT3 inhibitors in older adults with newly diagnosed FLT3-mutated AML remains unclear. A definitive improvement in survival has not been observed in intensively treated patients over 60 years of age receiving frontline FLT3 inhibitors. Furthermore, many patients with FLT3-mutated AML are unsuitable for intensive chemotherapy due to age and/or comorbidities, and this population represents a particular unmet need. For these older patients who are unfit for intensive approaches, azacitidine + venetoclax is a new standard of care and is used by many clinicians irrespective of FLT3 mutation status. However, FLT3-ITD mutations confer resistance to venetoclax and are a well-established mechanism of relapse to lower-intensity venetoclax-based regimens, leading to short durations of remission and poor survival. Preclinical and clinical data suggest synergy between FLT3 inhibitors and venetoclax, providing rationale for their combination. Novel strategies to safely incorporate FLT3 inhibitors into the standard hypomethylating agent + venetoclax backbone are now being explored in this older, less fit population with newly diagnosed FLT3-mutated AML, with encouraging early results. Herein, we discuss the frontline use of FLT3 inhibitors in older adults with FLT3-mutated AML, including the potential role of FLT3 inhibitors in combination with intensive chemotherapy and as part of novel, lower-intensity doublet and triplet regimens in this older population.
Adverse outcomes for chronic myeloid leukemia patients with splenomegaly and low in vivo kinase inhibition on imatinib
Authors: Kok Chung H. , Saunders Verity A. , Dang Phuong , Shanmuganathan Naranie , White Deborah , Branford Susan , Yeung David , Hughes Timothy P.
Published: September 2023

Variability in the molecular response to frontline tyrosine kinase inhibitor (TKI) therapy in chronic myeloid leukemia may be partially driven by differences in the level of kinase inhibition induced. We measured in vivo BCR::ABL1 kinase inhibition (IVKI) in circulating mononuclear cells after 7 days of therapy. In 173 patients on imatinib 600 mg/day, 23% had low IVKI (<11% reduction in kinase activity from baseline); this was associated with higher rates of early molecular response (EMR) failure; lower rates of major molecular response (MMR), and MR4.5 by 36 months, compared to high IVKI patients. Low IVKI was more common (39%) in patients with large spleens (≥10 cm by palpation). Notably 55% of patients with large spleens and low IVKI experienced EMR failure whereas the EMR failure rate in patients with large spleens and high IVKI was only 12% (p = 0.014). Furthermore, patients with large spleen and low IVKI had a higher incidence of blast crisis, inferior MMR, MR4.5, and event-free survival compared to patients with large spleen and high IVKI and remaining patients. In nilotinib-treated patients (n = 73), only 4% had low IVKI. The combination of low IVKI and large spleen is associated with markedly inferior outcomes and interventions in this setting warrant further studies.