bluuebunny/crossref_metadata_2025 huggingface dataset:
Absurd (anti)Heroes’ Journey toward Happiness: A Psychoanalytic Comparison between Arthur Fleck and Meursault
Authors: Rahim Sifatur
Published: November 2023

In his philosophical writing, The Myth of Sisyphus (1979), Albert Camus ponders the futility of the search for unity and absolute in this seemingly indifferent universe, and surmises that true happiness comes from accepting the meaninglessness of human existence. This particular school of thought is known as absurdism, and the narratives that fall under this discipline are referred to as absurdist texts. Camus not only expounds on the scopes of absurdism but also puts them into practice through his fiction. One such seminal absurdist novel by Camus is The Outsider (1987). In the novel, the writer delineates how the protagonist, Meursault, finds contentment by accepting his fate. A similar state of happiness is attained by Arthur Fleck, the protagonist of the film Joker (2019), when he accepts and assumes his proper place in society. From the onset, Fleck and Meursault may appear quite different from each other. However, upon closer inspection, the subtle similarities in their characteristics are perceptible, which bind them to a common threat of absurdity. It is undeniable that both Fleck and Meursault have committed homicide. Nonetheless, there is a greater force behind their acts than free will, and that is their unconscious drive. This paper explores the workings of the unconscious and its manifestation in Fleck and Meursault’s actions while explicitly commenting on the relationships with their respective mothers. This comparative study also highlights how both of them discover true happiness once they finally learn to accept their fate and reality.
Spectrum, Volume 17, June 2022: 101-113
Quantify the Impact of Non-Response and Measurement Error of Sensitive Variable(s) under Two-Phase Sampling employing ORRT Models
Authors: KUMAR Sunil , KOUR Sanam Preet
Published: November 2023

Throughout this article, a two-phase sampling (TPS) technique is employed to estimate the population mean of the sensitive variable. The current article endeavours to develop a chain ratio type estimator for the estimation of sensitive variable(s) in the presence of non-response and measurement error simultaneously by utilizing ORRT models under a two-phase sampling technique. The significant aspects associated with the suggested estimator characterized by bias and mean squared error have been evaluated. Besides this, the utterance for the minimum mean squared error for the optimal values has also been identified. The supremacy of the proposed estimator has been compared with the modified existing estimators under the TPS scheme by using two sensitive auxiliary variables. To clarify the theoretical findings, a simulation study along with a hypothetical generated population and a real population which is based on abortion rates from Statistical Abstract of the United States: 2011 are also addressed in this study.
TABLET DOZAJ FORMLARININ TASARIMINDA VE GELİŞTİRİLMESİNDE ÜÇ-BOYUTLU BASKI TEKNOLOJİSİ
Authors: TEKTAŞ Sevgi , GÜNEŞ Şeyda , YUKSEL Prof. Dr. Nilüfer
Published: November 2023

Amaç: Eklemeli üretim olarak da bilinen üç boyutlu (3B) baskı, mühendislik, mimarlık ve uzay bilimleri gibi çeşitli endüstriyel alanlarda devrim yaratmıştır. Son yıllarda eczacılık alanında da umut vadeden bir teknoloji olarak 3B baskı, kişiselleştirilmiş katı dozaj formları, implantlar ve tıbbi cihazları yüksek hassasiyet ve doğrulukla üretmek için avantajlı bir yaklaşım olarak karşımıza çıkmaktadır. Bu teknoloji, geleneksel farmasötik üretim proseslerinin bazı sınırlamalarının üstesinden gelme potansiyeline sahiptir ve gelişmiş dozaj formu tasarımı, artan hasta uyuncu ve azaltılmış üretim maliyetleri gibi avantajlar sunmaktadır. Bu derleme kapsamında 3B baskılama ile tablet üretim yöntemleri incelenmiştir.
Sonuç ve Tartışma: Dozaj formlarının uygulanmasına yönelik farklı yollar arasında oral yol, hasta uyuncu açısından en çok tercih edilen veriliş yoludur. Oral yolla veriliş için tabletlerin üretimi, işlenmesi ve depolanması diğer dozaj formlarına göre daha kolay ve ekonomiktir. 3B baskı, farklı geometrik şekillerde ve farklı etkin madde salım profillerine sahip tabletlerin formülasyonu ve üretimine imkân sağlamaktadır. Bu baskılama teknolojisi temel olarak aynı baskı aşamalardan oluşsa da kendi içinde oldukça çeşitlenmiş ve Amerikan Test ve Malzemeler Derneği tarafından yedi farklı yönteme ayrılmıştır. Bu çeşitli yöntemler arasında tablet üretiminde oldukça başarı sağlayan eriyik birikim modelleme yöntemi pek çok çalışmaya konu olmuştur. Bununla birlikte tüm 3B baskılama yöntemleri ile tabletler ve kapletler üretilebilmektedir. Ancak kişiselleştirilmiş ilaçlar için kalite ve emniyeti gösterecek belirlenmiş bir çerçeve bulunmamaktadır ve de 3B teknolojinin sahte ilaç, yasal olmayan ilaçların yaygınlaşması ve yanlış etiketleme gibi riskleri de olabilecektir. 3B üretim için iyi imalat uygulamalarının (GMP) benimsenmesi, standart işlem prosedürlerinin oluşturulması, tüm üretim hattında ve sonrasında bitmiş üründe kalite kontrolün (örneğin tabletlerde içerik tektürlülüğü, kütle tektürlülüğü, çözünme testi) yürütülmesi gereklidir.
Climate change and transformations of justice—Views of just distribution in the Finnish policy debate
Authors: Rydenfelt H , Nyfors T
Published: November 2023

Justice is a central concept in the international regime of climate change mitigation and adaptation and in proposals for the transition towards a low-carbon society. However, in documents on climate policy, the notion is seldom explicated in any detail. Research on environmental change has typically advanced specific and diverse visions of justice, and does not yet provide a comprehensive theoretical framework of different alternative notions. In this article, we present such a framework that incorporates 6 central conceptions of distributive justice and which indicates the relations between them. Based on in-depth interviews with a selected group of relevant actors in the debate on climate change in Finland—high-ranking professional politicians, leaders, researchers and activists—we study the interplay of environmental change and notions of justice. We show how articulations of justice can be connected with this framework, enabling the identification of their points of agreement and contention as well as their main lines of redefinition and transformation that stimulate acceptance and rejection of climate policy.
Ontogenetic patterns in juvenile blue crab density: effects of habitat and turbidity in a Chesapeake Bay tributary
Authors: Hyman AC , Chiu GS , Seebo MS , Smith A , Saluta GG , Lipcius RN
Published: November 2023

Nursery habitats are characterized by favorable conditions for juveniles, including higher food availability and lower predation risk, and disproportionately contribute more individuals per unit area to adult populations compared to other habitats. However, nursery habitat inference is complicated by changes in habitat preferences with ontogeny; individuals in early-life stages frequently inhabit different habitats than older juveniles or adults. In this field experiment, we modeled the density of 4 size classes of juvenile blue crabs Callinectes sapidus based on carapace width (CW) across multiple habitats at various locations within an estuarine seascape during the blue crab recruitment season. We examined 4 habitat types—unstructured sand, seagrass meadows, salt marsh edges (SME), and shallow detrital habitat (SDH). Results indicated that densities of small juvenile blue crabs (≤10 mm CW) were highest in seagrass, whereas densities of larger juveniles (16-25 mm CW) were highest in SME. Although densities of juveniles declined in seagrass habitat as a function of size, densities in SME remained consistently high, suggesting that secondary dispersal to SME by smaller juveniles after settlement and recruitment in seagrass may supplement losses in SME due to mortality. Turbidity was positively correlated with densities of both size classes, although our model did not address whether this was due to top-down (refuge) or bottom-up (food availability) mechanisms. Observed patterns in size-specific habitat utilization may result from changing requirements of juvenile blue crabs with size, as animals minimize mortality-to-growth ratios. Our findings emphasize the role of both seagrass and salt marsh habitat within juvenile blue crab ontogeny and emphasize the significance of structurally complex SME habitat in supporting juvenile blue crabs at sizes smaller than previously recognized, challenging past notions about the singular importance of seagrass habitat in this system. Our findings also underscore the need to quantify and preserve the complete chain of habitats used by juveniles.
Black Women-Owned Businesses: High-Level Growth Disparity
Authors: Young, DBA Dr. Tia , Paudel, MBA Garima
Published: November 2023

This study explores the alarming disproportion of Black women-owned businesses achieving high growth, profitability, and sustainability compared to their White counterparts. Investigating the issue is vital because these businesses are the fastest-growing population of entrepreneurs in the United States, yet they struggle to survive. Black female companies are important because they can significantly stimulate the economy, introduce innovative and niche products to markets, create jobs, reinvest in their communities, build generational wealth, and close the business ownership disparity gap. The sample was 100 black female business owners. The instrumentation was an open-ended survey, and the framework was empirical probability.
Efisiensi Implementasi Unit Kegiatan Belajar Mandiri (UKBM) dalam Peningkatan Assesmen Sumatif Pembelajaran Bahasa Indonesia P5 Kurikulum Merdeka Di MAN 3 Kediri
Authors: Mayada
Published: November 2023

Suatu pembelajaran tentunya tidak terlepas dari perangkat pembelajaran ataupun strategi perencanaan sebelum memulai proses pembelajaran. Pendidik berusaha menentukan platform yang tepat dalam pembelajaran, untuk mencapai tujuan yang dinginkan. Penelitian ini bertujuan untuk mengetahui efisiensi implementasi unit kegiatan belajar mandiri (UKBM), dalam pembelajaran Bahasa Indonesia yang dilandasi dengan projek penguatan profil pelajar pancasila (P5) kurikulum merdeka di MAN 3 Kediri. Metode yang digunakan ialah deskriptif kualitatif yang memaparkan objek dan hasil kajian dalam bentuk naratif. Sumber data diambil dari penyebaran kueisoner yang berisi mengenai implementasi dalam pembelajaran Bahasa Indonesia pada siswa MAN 3 Kediri sebagai instrumen penelitian. Teknik analisis data yang digunakan adalah analisis data kualitatif, dengan menggunakan pendekatan studi naratif yang berorientasi pada pendeskripsian terhadap observasi penyebaran questioner yang diperoleh. Hasil analisis penelitian ini yakni, secara sepenuhnya proses belajar dalam pembelajaran Bahasa Indonesia di MAN 3 Kediri, telah mengimplementasikan perangkat UKBM. Kesesuaian UKBM bagi siswa dalam pembelajaran Bahasa Indonesia sudah selaras. Tingkat keterbacaannya pun tepat bagi siswa. Kepraktisan perangkat tersebut cukup praktis dan efisien.
Pola Makan Anak Baduta Stunting Usia 6-23 Bulan di Wilayah Kerja Puskesmas Sangurara Kota Palu
Authors: Kusumawati Dwi Erma , Sari Dwi Ratna , Candriasih Putu , Nurjaya  , Ansar  , Bahja  , Hafid Fahmi , Faisal Elvyrah
Published: November 2023

Salah satu penyebab stunting adalah pola makan yang kurang beragam. Penelitian ini bertujuan untuk mengetahui pola makan anak baduta stunting usia 6-23 bulan di wilayah kerja Puskesmas Sangurara Kecamatan Tatanga Kota Palu. Penelitian ini merupakan jenis penelitian deskriptif. Penelitian ini dilaksanakan di wilayah kerja Puskesmas Sangurara Kecamatan Tatanga Kota Palu pada bulan April-Mei 2021. Populasi penelitian ini adalah baduta stunting usia 6-23 bulan di wilayah kerja Puskesmas Sangurara berjumlah 201 baduta. Besar sampel diambil dengan menggunakan rumus slovin. Teknik pengambilan sampel yang digunakan adalah simple random sampling dengan cara wawanacara dan observasi menggunakan kuisioner Food Frequency Questionnaire dengan jumlah 67 responden. Hasil penelitian menunjukan bahwa makanan sumber makanan pokok yang sering dikonsumsi adalah beras (86,8%). Sumber lauk hewani yang sering dikonsumsi adalah telur ayam (61,2%). Sumber lauk nabati yang sering dikonsumsi adalah tempe (70,1%). Sayuran yang sering dikonsumsi adalah wortel (65,7%) dan buah-buahan yang sering dikonsumsi adalah pisang (86,8%). Kesimpulan dari penelitian ini yaitu pola makan anak baduta stunting kurang bervariasi, penelitian ini menyarankan kepada ibu baduta agar meningkatkan variasi makanan sejak anak berumur 6 bulan.
CTCF deletion alters the pluripotency and DNA methylation profile of human iPSCs
Authors: Puri Deepika , Maaßen Catharina , Varona Baranda Monica , Zeevaert Kira , Hahnfeld Lena , Hauser Annika , Fornero Giulia , Elsafi Mabrouk Mohamed H. , Wagner Wolfgang
Published: November 2023

Pluripotent stem cells are characterized by their differentiation potential toward endoderm, mesoderm, and ectoderm. However, it is still largely unclear how these cell-fate decisions are mediated by epigenetic mechanisms. In this study, we explored the relevance of CCCTC-binding factor (CTCF), a zinc finger-containing DNA-binding protein, which mediates long-range chromatin organization, for directed cell-fate determination. We generated human induced pluripotent stem cell (iPSC) lines with deletions in the protein-coding region in exon 3 of CTCF, resulting in shorter transcripts and overall reduced protein expression. Chromatin immunoprecipitation showed a considerable loss of CTCF binding to target sites. The CTCF deletions resulted in slower growth and modest global changes in gene expression, with downregulation of a subset of pluripotency-associated genes and neuroectodermal genes. CTCF deletion also evoked DNA methylation changes, which were moderately associated with differential gene expression. Notably, CTCF-deletions lead to upregulation of endo-mesodermal associated marker genes and epigenetic signatures, whereas ectodermal differentiation was defective. These results indicate that CTCF plays an important role in the maintenance of pluripotency and differentiation, especially towards ectodermal lineages.
Receptors for the recognition and extraction of lithium
Authors: Zhang Jianfeng , Wenzel Marco , Yang Liangrong , Luckay Robert C. , Weigand Jan J.
Published: November 2023

We summarize advances in lithium recognition receptors, focusing on their use as active reagents in circular processes such as liquid–liquid extraction, an established industrial process that is advantageous due to its large processing capacity and high selectivity. High-performance systems are required, given the increasing demand for effective separation processes for the recovery of valuable substances from spent lithium-ion batteries or the exploration of brines. Hence, the availability of powerful and highly selective receptors is particularly crucial. This mini-review summarizes the development of active receptors for lithium ion extraction and covers advances in receptors for both lithium ions and lithium salts. It discusses various receptor types, ranging from heteroditopic macrocyclic systems to simple β-diketones. The latter achieve particularly high lithium ion extraction yields in the presence of phosphine oxides such as trioctylphosphine oxide. Structural studies employing 4-phosphorylpyrazolone exhibited diverse coordination modes of lithium and represent clear evidence for the synergistic role of the co-ligand on a molecular level.
A comprehensive model of intercultural communication for international students living in culturally diverse societies: evidence from China
Authors: Nadeem Muhammad Umar , Zabrodskaja Anastassia
Published: November 2023

Intercultural communication (IC) and international students go side by side in this era of internationalization of higher education. The key concepts of IC, namely intercultural effectiveness (ICE), intercultural competence (ICC), intercultural adjustment (ICA), and intercultural adaptation (ICN) are used interchangeably in the literature. However, the present study argues that the stated concepts are theoretically different and further proposes that ICE, ICC, ICA, and ICN are phases of IC. Based on these conceptual differences, a comprehensive model of IC (CMIC) is proposed in this study. The CMIC explains that these four concepts are principally developmental phases for international students to become interculturally effective in adapting to a new culture. The current research further offers preliminary testing of CMIC, which is applied to international students in Shanghai, China through quantitative research followed by a survey. Instruments developed by experts were used in this study. International students were approached to participate in the survey at the convenience of the researcher. One hundred and seventy-one international students represented 18 different cultures, which reconfirms the culture-general approach by considering the stance of more than two different cultures. The findings revealed that international students became interculturally effective and competent which further enabled them to adjust to China. Later, their adjustment helped them adapt better to the new culture. The findings of this study validated the core predictions of the CMIC. As this is the first testing of CMIC on a relatively small sample, more extensive testing is expected soon to validate its assumptions in different contexts, such as Pakistan, Malaysia, and Australia, among others. The CMIC also suggests practical implications for policymakers and institutes of host countries regarding international students and other people living in a culturally different society.
Case Report: Acute arterial occlusion of the right lower extremity due to left atrial invasion from pulmonary metastases of thyroid cancer
Authors: Akabane Kentaro , Watanabe Tetsuo , Tajima Yuta , Toyama Shuji , Tamate Yoshihisa , Uchida Tetsuro
Published: November 2023

Cardiac metastases of thyroid cancer are rare. The most common metastatic route is through lymphatic or hematogenous spread to the right side of the heart. Direct invasion of metastases from other adjacent organs to the left side of the heart is even rarer. In many cases, the disease progresses asymptomatically, and symptoms appear only when it is already fatal. A 68-year-old woman underwent total thyroidectomy and right-side lymph node dissection for papillary thyroid cancer and multiple lung metastases 7 years previously. The patient was referred to our hospital due to sudden pain in the right lower extremity and motor disturbance. Computed tomography revealed acute arterial occlusion of the right lower extremity due to tumor dispersal from a left atrial invasion caused by multiple pulmonary metastases of thyroid cancer, and only emergency thrombectomy was performed. Although blood flow was restored, the patient died of respiratory failure 2 months after the procedure. Radical resection is considered difficult in cases of direct invasion of metastases from other adjacent organs because multiple metastases have often already occurred. Therefore, in the terminal stage, it might be too invasive to resect a tumor only to prevent embolism recurrence. The treatment strategy should depend on the patient's prognosis and choice.
High-sensitivity troponin T levels before and after cardiac surgery and the 30-day mortality: a retrospective cohort study
Authors: Liang Jian-Wei , Zhou Min , Jin Yong-Qiang , Li Ting-Ting , Wen Jiang-Ping
Published: November 2023

Background

The suggested threshold level of cardiac troponin T elevation after cardiac surgery is not very clear, and the values recommended by various guidelines and literature reports are quite different.

Methods

In this retrospective cohort study, we collected clinical data of patients who underwent heart surgery at Tsinghua University First Hospital between January 2015 and December 2022. Using the high-sensitivity cardiac troponin T levels (reference upper limit: 14 ng/L) measured at 1–3 days postoperation, the relationship between the cardiac troponin T level and the 30-day mortality risk was evaluated using Cox regression analysis.

Results

Among the 3,128 patients included in this study, the types of operations mainly consisted of coronary artery bypass graft (CABG, 1,164, 37.2%), aortic valve replacement (AVR, 735, 23.5%), and other cardiac operations (1,229, 39.3%). Within 30 days postoperation, 57 patients (1.8%) died and 72 patients (2.3%) developed major vascular complications. In patients undergoing CABG or AVR, the cardiac troponin T threshold level measured within one day postoperation related to an increased 30-day mortality was determined to be 3,012 ng/L (95% CI: 1,435–3,578 ng/L), which is 218 times higher than the reference upper limit. In patients undergoing other cardiac operations, this threshold was 5,876 ng/L (95% CI: 2,458–8,119 ng/L), which is 420 times higher than the reference upper limit.

Conclusion

The high-sensitivity cardiac troponin T level associated with an increased 30-day mortality risk after cardiac surgery is significantly higher than the current recommendations for defining clinically important perioperative myocardial injury.
Relations between pre-service teacher gaze, teacher attitude, and student ethnicity
Authors: Keskin Özün , Gabel Sylvia , Kollar Ingo , Gegenfurtner Andreas
Published: November 2023

In classrooms, ethnic minority students are often confronted with several disadvantages – such as lower academic achievement, more negative teacher attitudes, and less teacher recognition – which are all well examined in educational research. This study sought to understand if more negative teacher attitudes and lower teacher recognition are reflected in teacher gaze. Controlling for student behavior, do teachers look more on ethnic majority than on ethnic minority students? If teachers have a visual preference for ethnic majority students in their classrooms, then we would expect that teachers show a higher number of fixations, longer duration of fixations, and shorter times to first fixation on ethnic majority compared with ethnic minority students. To test this assumption, we designed an explanatory sequential mixed-method study with a sample of 83 pre-service teachers. First, pre-service teachers were invited to watch a video of a classroom situation while their eye movements were recorded. Second, after watching the video, they were asked to take written notes on (a) how they perceived the teacher in the video attended to ethnic minority students and (b) which own experiences they can relate to situations in the video. Finally, a standardized survey measured participants’ age, gender, ethnic background, explicit attitudes toward ethnic minority students, self-efficacy for teaching ethnic minority students, and stereotypes associated with the motivation of ethnic minority students. Results indicated that, in contrast to our hypothesis, pre-service teachers had longer fixation durations on ethnic minority compared with ethnic majority students. In addition, pre-service teachers’ explicit attitudes correlated positively with number (r = 0.26,p < 0.05) and duration (r = 0.31,p < 0.05) of fixations, suggesting that pre-service teachers with more positive attitudes toward ethnic minority students also looked more and longer on ethnic minority students. Furthermore, qualitative analyses indicated that pre-service teachers associated the disadvantaged situations for ethnic minority students with teachers’ stereotypes and student language difficulties; they also referred to their own ethnic minority when reflecting on specific situations in the video. We discuss these findings considering their significance for teacher education and professional development and their implications for further research on dealing with student diversity.
Prominent muscle involvement in a familial form of mitochondrial disease due to a COA8 variant
Authors: Rimoldi Martina , Magri Francesca , Antognozzi Sara , Ripolone Michela , Salani Sabrina , Piga Daniela , Bertolasi Letizia , Zanotti Simona , Ciscato Patrizia , Fortunato Francesco , Moggio Maurizio , Corti Stefania , Comi Giacomo Pietro , Ronchi Dario
Published: November 2023

Isolated mitochondrial respiratory chain Complex IV (Cytochrome c Oxidase or COX) deficiency is the second most frequent isolated respiratory chain defect. Causative mutations are mainly identified in structural COX subunits or in proteins involved in the maturation and assembly of the COX holocomplex. We describe an Italian familial case of mitochondrial myopathy due to a variant in the COX assembly factor 8 gene (COA8). Patient 1 is a 52-year-old woman who presented generalized epilepsy and retinitis pigmentosa at 10 years of age. From her early adulthood she complained about cramps and myalgia after exercise, and bilateral hearing loss emerged. Last neurological examination (52 years of age) showed bilateral ptosis, muscle weakness, peripheral neuropathy, mild dysarthria and dysphonia, cognitive impairment. Muscle biopsy had shown the presence of ragged-red fibers. Patient 2 (Patient 1’s sister) is a 53-year-old woman presenting fatigability, myalgia, and hearing loss. Neurological examination showed ptosis and muscle weakness. Muscle biopsy displayed a diffuse reduction of COX activity staining and ragged-red fibers. Both sisters presented secondary amenorrhea. After ruling out mtDNA mutations, Whole Exome Sequencing analysis identified the novel homozygous COA8 defect c.170_173dupGACC, p.(Pro59fs) in the probands. Loss-of-function COA8 mutations have been associated with cavitating leukoencephalopathy with COX deficiency in 9 reported individuals. Disease course shows an early-onset rapid clinical deterioration, affecting both cognitive and motor functions over months, followed by stabilization and slow improvement over several years. Our findings expand the clinical spectrum of COA8-related disease. We confirm the benign course of this rare disorder, highlighting its (intrafamilial) clinical variability.
The role of midkine in health and disease
Authors: Neumaier Emely Elisa , Rothhammer Veit , Linnerbauer Mathias
Published: November 2023

Midkine (MDK) is a neurotrophic growth factor highly expressed during embryogenesis with important functions related to growth, proliferation, survival, migration, angiogenesis, reproduction, and repair. Recent research has indicated that MDK functions as a key player in autoimmune disorders of the central nervous system (CNS), such as Multiple Sclerosis (MS) and is a promising therapeutic target for the treatment of brain tumors, acute injuries, and other CNS disorders. This review summarizes the modes of action and immunological functions of MDK both in the peripheral immune compartment and in the CNS, particularly in the context of traumatic brain injury, brain tumors, neuroinflammation, and neurodegeneration. Moreover, we discuss the role of MDK as a central mediator of neuro-immune crosstalk, focusing on the interactions between CNS-infiltrating and -resident cells such as astrocytes, microglia, and oligodendrocytes. Finally, we highlight the therapeutic potential of MDK and discuss potential therapeutic approaches for the treatment of neurological disorders.
The outcome and the risk factors of mucormycosis among patients with hematological diseases: a systematic and meta-analysis
Authors: Shen Meixiao , Wang Juan , Lei Meiqing , Wang Zhiming
Published: November 2023

Objectives

Mucorale has come into a significant pathogen over recent decades. Nonetheless, mucormycosis-related mortality rates among patients with hematological disorders remain unascertained. Thus, we conducted a meta-analysis to determine mortality rates of mucormycosis in patients with hematology-related conditions.

Methods

We scoured PubMed, Embase, and Web of Science for original papers exploring the intersection of Mucormycosis and Hematological Diseases (from 2000 to 2022). We scrutinized the overall mortality across three distinct periods, as well as differentiating between high-income and middle-income nations. We further evaluated the pooled mortality and the risk differential (RD) across several subgroups.

Results

The overall mortality rate for hematology patients with mucormycosis was 61%, within a 95% confidence interval (CI) of 0.54–0.68. A significant observation was that mortality rates were somewhat lower in high-income countries compared to middle-income countries (0.60 versus 0.64, p = 0.45). Importantly, we discovered that a combination of surgical and medical treatment significantly improved survival rates compared to medical treatment alone [mortality 0.49 versus 0.67, RD -0.19 (95%CI -0.38-0.00, I2 63.7%)]. As might be expected, disseminated mucormycosis posed a significantly higher risk of death compared to isolated mucormycosis [0.60 versus 0.57, RD death 0.16 (95%CI 0.03–0.28)]. Additionally, our analysis showed no discernible differences in survival rates between genders, between patients with and without breakthrough infection, between those who received mucor-active or mucor-inactive drugs prior to mucor infection, or between those on a multi-drug regimen and those on a single drug treatment.

Conclusion

Despite the high mortality rates associated with mucormycosis in patients with hematological disorders, those receiving both medical and surgical interventions, as well as those with isolated infection sites, exhibited improved survival outcomes. Conversely, factors such as gender, the presence of breakthrough infection, the use of mucor-active drugs before mucor infection, and multi-drug administration did not significantly influence patient outcomes.
The effects of prolonged stress exposure on the brain of rats and insights to understand the impact of work-related stress on caregivers
Authors: Pujo Jean Marc , Fitriani Dewi Yunia , Ben Saad Hajer , Ghariani Marwa , Dghim Amel , Mellouli Manel , Burin Antoine , Mutricy Remi , Houcke Stephanie , Roujansky Ariane , Mansyur Muchtaruddin , Nkontcho Flaubert , de Toffol Bertrand , Ben Amara Ibtissem , Kallel Hatem
Published: November 2023

Introduction

Stress exposure is a significant concern in the healthcare sector. This animal model study aims to reproduce caregivers’ working conditions and determine their impact on the brain.

Method

Twenty-four healthy male rats of the Wistar strain were divided into four groups. Three groups were submitted each to one stressor for 21 days, while the fourth group was used as a control. Stressors were food and water deprivation (FW), permanent illumination (PI), and forced swimming (FS). At the end of the experiment, rats were euthanized, and stress biomarkers, biological parameters, and DNA damage were measured.

Results

Prooxidant biomarker rates increased in the different groups (+50 to +75%) compared to the control (p < 0.0001). Urinary corticosterone rates increased in all stressed animals, mainly in the PI group, with changes of up to +50% compared to the control group. Acetylcholinesterase levels decreased to −50% (p < 0.0001 for the three exposed groups). Total ATPase, (Na+/K+)-ATPase, and Mg2+-ATPase activities decreased in all stressed groups. The percentage of brain cell congestion and apoptosis was 3% for the FW group (p < 0.0001), 2% for the PI group (p < 0.0001), and 4% for the FS group (p < 0.0001) compared to the control (0.8%). DNA damage was observed in all exposed groups. Finally, we noticed behavioral changes and a depression-like syndrome in all stressed rats.

Conclusion

Stressful conditions such as the working environment of caregivers can trigger several pathophysiological processes leading to oxidative, neurochemical, and hypothalamic–pituitary–adrenal disorders. These changes can progress to cell damage and apoptosis in the brain and trigger psychological and physical disorders.
Trophoblast glycoprotein is required for efficient synaptic vesicle exocytosis from retinal rod bipolar cells
Authors: Wakeham Colin M. , Shi Qing , Ren Gaoying , Haley Tammie L. , Duvoisin Robert M. , von Gersdorff Henrique , Morgans Catherine W.
Published: November 2023

Introduction

Rod bipolar cells (RBCs) faithfully transmit light-driven signals from rod photoreceptors in the outer retina to third order neurons in the inner retina. Recently, significant work has focused on the role of leucine-rich repeat (LRR) proteins in synaptic development and signal transduction at RBC synapses. We previously identified trophoblast glycoprotein (TPBG) as a novel transmembrane LRR protein localized to the dendrites and axon terminals of RBCs.

Methods

We examined the effects on RBC physiology and retinal processing of TPBG genetic knockout in mice using immunofluorescence and electron microscopy, electroretinogram recording, patch-clamp electrophysiology, and time-resolved membrane capacitance measurements.

Results

The scotopic electroretinogram showed a modest increase in the b-wave and a marked attenuation in oscillatory potentials in the TPBG knockout. No effect of TPBG knockout was observed on the RBC dendritic morphology, TRPM1 currents, or RBC excitability. Because scotopic oscillatory potentials primarily reflect RBC-driven rhythmic activity of the inner retina, we investigated the contribution of TPBG to downstream transmission from RBCs to third-order neurons. Using electron microscopy, we found shorter synaptic ribbons in TPBG knockout axon terminals in RBCs. Time-resolved capacitance measurements indicated that TPBG knockout reduces synaptic vesicle exocytosis and subsequent GABAergic reciprocal feedback without altering voltage-gated Ca2+ currents.

Discussion

TPBG is required for normal synaptic ribbon development and efficient neurotransmitter release from RBCs to downstream cells. Our results highlight a novel synaptic role for TPBG at RBC ribbon synapses and support further examination into the mechanisms by which TPBG regulates RBC physiology and circuit function.
Visualizing traumatic stress-induced structural plasticity in a medial amygdala pathway using mGRASP
Authors: Bartsch Caitlyn J. , Jacobs Jessica T. , Mojahed Nooshin , Qasem Elana , Smith Molly , Caldwell Oliver , Aaflaq Sophia , Nordman Jacob C.
Published: November 2023

Traumatic stress has been shown to contribute to persistent behavioral changes, yet the underlying neural pathways are not fully explored. Structural plasticity, a form of long-lasting neural adaptability, offers a plausible mechanism. To scrutinize this, we used the mGRASP imaging technique to visualize synaptic modifications in a pathway formed between neurons of the posterior ventral segment of the medial amygdala and ventrolateral segment of the ventromedial hypothalamus (MeApv-VmHvl), areas we previously showed to be involved in stress-induced excessive aggression. We subjected mice (7–8 weeks of age) to acute stress through foot shocks, a reliable and reproducible form of traumatic stress, and compared synaptic changes to control animals. Our data revealed an increase in synapse formation within the MeApv-VmHvl pathway post-stress as evidenced by an increase in mGRASP puncta and area. Chemogenetic inhibition of CaMKIIα-expressing neurons in the MeApv during the stressor led to reduced synapse formation, suggesting that the structural changes were driven by excitatory activity. To elucidate the molecular mechanisms, we administered the NMDAR antagonist MK-801, which effectively blocked the stress-induced synaptic changes. These findings suggest a strong link between traumatic stress and enduring structural changes in an MeApv-VmHvl neural pathway. Furthermore, our data point to NMDAR-dependent mechanisms as key contributors to these synaptic changes. This structural plasticity could offer insights into persistent behavioral consequences of traumatic stress, such as symptoms of PTSD and social deficits.
Efficacy and safety of hypoxia-inducible factor-prolyl hydroxylase inhibitor treatment for anemia in chronic kidney disease: an umbrella review of meta-analyses
Authors: Ren Song , Yao Xiaoxiu , Li Yi , Zhang Ying , Tong Chao , Feng Yunlin
Published: November 2023

The objective was to provide a comprehensive summary of existing evidence on the efficacy and safety of hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) for the treatment of anemia in chronic kidney disease (CKD). A systematic search was conducted in the Medline, Embase, and Cochrane databases. Only meta-analyses that evaluated the efficacy and safety of HIF-PHI treatment for anemia in CKD were included. The efficacy outcomes included hemoglobin levels and iron metabolism indices, while the safety outcomes were assessed by examining adverse events. The qualities of methodologies and evidence were assessed using the AMSTAR 2 system and the NutriGrade tool, respectively. Fourteen meta-analyses, comprising 105 distinct comparisons, were included. The comparisons were backed by evidence of high, moderate, and low levels, distributed in approximately equal proportions. None of the studies were deemed to possess a high level of confidence. In both the overall and individual treatment groups of HIF-PHI, there was an increase in the levels of hemoglobin, transferrin, and transferrin saturation, while the levels of hepcidin and total iron binding capacity decreased. Serum ferritin exhibited a reduction to some extent, while serum iron did not show significant alterations following HIF-PHI treatments. There were no notable disparities in safety outcomes between the HIF-PHI and erythropoietin stimulating agents or placebo groups. This umbrella review suggests that HIF-PHI treatment can effectively increase hemoglobin levels in CKD patients and enhance iron metabolism by decreasing hepcidin levels and improving iron transport. The safety profiles of HIF-PHIs were generally comparable to those of ESA therapies or placebos.
Childcare burden and changes in fertility desires of mothers during the COVID-19 pandemic
Authors: Golovina Kateryna , Nenko Ilona , Marcinkowska Urszula Maria
Published: November 2023

Objectives

Previous studies have documented a decline in fertility desires and intentions following the COVID-19 outbreak, but the reasons for this decline are not well understood. This study examined whether childcare burden on mothers during the lockdown and quarantines, COVID-related stress, and COVID exposure were associated with a change in the desired number of children.

Methods

The survey was conducted online, in Poland from April to July 2021 on a sample of 622 non-pregnant mothers without diagnosed infertility.

Results

Associations were observed between childcare responsibilities during the quarantine and fertility desires: mothers who solely or mainly took care of their children during the quarantine(s) were more likely to decrease their desired number of children ([adjusted] aOR = 1.91, 95% CI = 1.16–3.15). Mothers with higher levels of COVID-related stress (aOR = 1.81, 95% CI = 1.48–2.22) and a greater COVID exposure index (aOR = 1.39, 95% CI = 1.12–1.72) were more likely to decrease their fertility desires.

Conclusion

Higher childcare burden during quarantines was related to a lower desired number of children among mothers. Both greater COVID-related stress and COVID exposure were associated with fertility desires, regardless of childcare responsibilities during the pandemic.
Emotional labor among team members: do employees follow emotional display norms for teams, not for customers?
Authors: Hong DaEun , Kim MinSoo
Published: November 2023

Emotional labor is typically conceptualized as a process in which individuals regulate their emotions in response to display rules. Most research on emotional labor has focused on the influence of display rules at individual-level perceptions but is rarely examined at the team level. We examine the influence of the shared display rules in teams as emotional display norms. This study considers emotional dissonance as the difference between the positive emotional display norm at the team level and positive emotion at the individual level. To examine the purpose of this study, data were collected from leader-follower pairs within teams and based on a three-wave design. Thus, this study conducted a multi-level polynomial regression analysis and used the response surface methodology to interpret the incongruence effect. The results show that the incongruence effect of emotional dissonance is positively related to surface acting. In addition, the moderating effect of regulatory focus significantly strengthens the positive relationship between emotional dissonance and emotion regulation strategies. The results also show that surface acting strategy is negatively related to selfless Organizational citizenship behaviors (OCB). These findings highlight that emotional display norms play an important role as the standard for emotional experience in teams, and especially with the moderating effect of self-regulatory focus, emotion regulation strategies affect the selfless OCB rating of observers.
Nurturing resilience in American Indian/Alaska Native preschool children: the role of cultural socialization, executive function, and neighborhood risk
Authors: Merculief Alexis , Lipscomb Shannon , McClelland Megan M. , Geldhof G. John , Tsethlikai Monica
Published: November 2023

Introduction

American Indian and Alaska Native (AI/AN) children possess numerous cultural assets, yet higher exposures to neighborhood risks (e.g., lack of housing, crime) may present barriers to healthy cognitive development, including executive function (EF). Cultural socialization may promote resilience and support children’s early cognition, but this has not been adequately studied. The present study examined the effects of neighborhood risk and cultural socialization on EF for AI/AN preschool children.

Method

Parents/caregivers of 768 AI/AN preschoolers from the 2015 AI/AN Head Start Family and Community Experiences (FACES) Study rated neighborhood risk via two scales: “Neighborhood Problems” and “Environmental Conditions,” and cultural socialization practices via two scales: cultural activities and tribal language activities. Children’s EF was measured directly using the Pencil Tap Task and the Leiter-R attention subscale.

Results

Families perceived neighborhood risks as relatively low, and overall risk did not predict children’s EF. However, higher average language socialization was significantly related to higher EF, as were two specific language activities (encouraging children to learn their tribal language, making sure children heard their tribal language) and two cultural activities (playing AI/AN games, participating in tribal ceremonies), controlling for neighborhood risk.

Discussion

Findings suggest some aspects of cultural socialization may promote resilience among AI/AN preschoolers by supporting early EF. Mechanisms may include increased spiritual, social, and cultural connections, and practice with EF skills during cultural games. Future research should partner with AI/AN communities to investigate culturally grounded EF interventions and reevaluate measures of neighborhood risk to promote resilience and connectedness for AI/AN children.
Improvement of working memory in older adults with mild cognitive impairment after repetitive transcranial magnetic stimulation – a randomized controlled pilot study
Authors: Senczyszyn Adrianna , Szcześniak Dorota , Wieczorek Tomasz , Maciaszek Julian , Małecka Monika , Bogudzińska Bogna , Zimny Anna , Fila-Pawłowska Karolina , Rymaszewska Joanna
Published: November 2023

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique that could improve cognitive function. It is being developed as a non-pharmacological intervention to alleviate symptoms of cognitive deterioration. We assessed the efficacy of rTMS in improving cognitive functioning among people with Mild Cognitive Impairment (MCI) in a partially-blinded, sham-controlled randomized trial. Out of 91 subjects screened, 31 participants with MCI (mean age 70.73; SD = 4.47), were randomly assigned to one of three groups: (A) Active rTMS; (B) Active rTMS with Computerized Cognitive Training RehaCom; and (C) Sham control. The study evaluated cognitive function using the DemTect, FAS, and CANTAB tests before and after the stimulation. The following treatment protocol was applied: 2000 pulses at 10 Hz, 5-s train duration, and 25-s intervals at 110% of resting MT delivered over the left Dorsolateral Prefrontal Cortex (DLPFC) five times a week for 2 weeks. After 10 sessions of high-frequency rTMS, there was an improvement in overall cognitive function and memory, assessed by the DemTect evaluation, with no serious adverse effects. Analysis of differences in time (after 10 sessions) between studied groups showed statistically significant improvement in DemTect total score (time by group interaction p = 0.026) in favor of rTMS+RehaCom. The linear regression of CANTAB Paired Associates Learning revealed significant differences in favor of rTMS+RehaCom in three subtests. Our study shows that 10 sessions of rTMS over the left DLPFC (alone as well as combined with Computerized Cognitive Training) can have a positive impact on cognitive function in people with MCI. Further research should investigate the underlying mechanism and determine the optimal parameters for rTMS, which will be important for its efficacy in clinical settings.
A randomized controlled trial of a targeted support program for informal caregivers in adult psychiatry
Authors: Rexhaj Shyhrete , Martinez Debora , Golay Philippe , Coloni-Terrapon Claire , Monteiro Shadya , Buisson Leslie , Drainville Anne-Laure , Bonsack Charles , Ismailaj Alban , Nguyen Alexandra , Favrod Jérôme
Published: November 2023

Background

The importance of informal caregivers for persons with severe mental illness has been demonstrated. However, this role may cause a high care burden that considerably affects caregiver health. The Ensemble program is a five-session brief individual intervention designed to support informal caregivers. This trial aimed to assess the efficacy of the program versus SAU (support as usual) for participants with a high care burden.

Methods

A single-center randomized controlled trial including 149 participants was conducted. Caregivers in the intervention arm participated in the Ensemble program. The effects of the intervention were assessed using mixed models for repeated measures analysis of variance on improvements in informal caregivers’ psychological health status, optimism levels, burden scores, and quality of life at three time points (T0 = pretest; T1 = posttest at 2 months, and T2 = follow-up at 4 months).

Results

Analysis of the Global Psychological Index showed no significant effect at the two endpoints in favor of the Ensemble group. However, the Brief Symptom Inventory-Positive Symptom Distress Index was significantly lower at the two-month follow-up. A significant reduction in burden on the Zarit Burden Interview was observed post-intervention, along with an increase in optimism levels on the Life Orientation Test-Revised at follow-up in the Ensemble group. No significant differences were observed in quality of life. Clinical improvements in both psychological health status and burden levels were also identified.

Conclusion

The Ensemble program offers an inclusive approach based on a recovery perspective that significantly reduces symptom distress and burden and increases optimism among informal caregivers.

Clinical trial registration: https://clinicaltrials.gov/, NCT04020497.