bluuebunny/crossref_metadata_2025 huggingface dataset:
Facilitating international medical graduates' acculturation: From theory to practice
Authors: Al‐Haddad Mo
Published: August 2023

Context

International medical graduates (IMGs) are forming an ever‐increasing proportion of the medical workforce. Much of the discourse around IMGs is about their performance at work and interventions to improve it. This discourse, however, is rarely situated in the wider context of the experiences of IMGs as migrants despite the wider context of migration and acculturation being likely to have a significant impact on IMGs' well‐being and, ultimately, performance at work.

Objectives

The objectives of this article were to (1) raise awareness of the inextricable broader context within which IMGs are situated as migrants; (2) outline the impact this context might have on IMGs' performance; (3) discuss literature from the social sciences related to acculturation that could better inform the way we view IMG transition and performance; (4) highlight how acculturation theory can help inform the design, implementation and evaluation of interventions to facilitate the transition of IMGs into the host country and the workplace; (5) list some interventions that can provide support; and (6) suggest theory driven lines of enquiry to study acculturation in IMGs and the impact related issues might have on performance.

Methods

This is a cross‐cutting edge review drawing on selected theory and literature from the social sciences to explore its relevance to IMGs.

Conclusion

The broader context of migration and acculturation should not be ignored when discussing IMG performance in the workplace or when instigating interventions to improve it. There is an urgent need to further evaluate the impact this broader context has on IMGs' well‐being and performance.
Trainee selection of tasks in postgraduate medical education: Is there a role for ‘cherry‐picking’ to optimise learning?
Authors: Blissett Sarah , Mensour Emma , Shaw Jennifer M. , Martin Leslie , Gauthier Stephen , de Bruin Anique , Siu Samuel , Sibbald Matt
Published: August 2023

Purpose

Learning is optimised when postgraduate trainees engage in clinical tasks in their zone of proximal development (ZPD). However, workplace learning environments impose additional non‐learning goals and additional tasks that may lead to trainees engaging in tasks that do not fall within their ZPD. We do not fully understand how trainees select clinical tasks in the workplace learning environment. If we knew the goals and factors they consider when selecting a task, we could better equip trainees with strategies to select tasks that maximise learning. We explored how postgraduate trainees select clinical tasks using echocardiography interpretation as a model.

Methods

Canadian General Cardiology residents and Echocardiography fellows were invited to participate in semi‐structured interviews. Aligning with a theory‐informed study, two independent researchers used a deductive, directed content analysis approach to identify codes and themes.

Results

Eleven trainees from seven Canadian universities participated (PGY4 = 4, PGY5 = 3, PGY6 = 1 and echocardiography fellows = 3). Goals included learning content, fulfilling assessment criteria and contributing to clinical demands. Trainees switched between goals throughout the day, as it was too effortful for them to engage in tasks within their ZPD at all times. When trainees had sufficient mental effort available, they selected higher complexity tasks that could advance learning content. When available mental effort was low, trainees selected less complex tasks that fulfilled numerically based assessment goals or contributed to clinical demands. Trainees predominantly used perceived complexity of the echocardiogram as a factor to select tasks to achieve their desired goals.

Conclusion

Postgraduate trainees select tasks within their ZPD that enable them to maximise learning when they perceive to have sufficient mental effort available and workplace affordances are adequate. These findings can inform individual and systemic strategies to maximise learning when selecting tasks.
‘Decisive Victory’ and Israel's Quest For a New Military Strategy
Authors: Samaan Jean‐Loup
Published: August 2023

In 2020, the Israel Defense Forces (IDF) announced the development of a new operational concept called Decisive Victory that aimed to change the way Israel fights wars and to redefine victory on the battlefield. The root cause of this change was the evolution in nonstate threats from armed groups in Gaza and Lebanon. The concept was to drive major reforms of the IDF in training, interoperability among the services, weapons procurement, and civil‐military relations. However, the efforts encountered significant challenges in terms of politics, financial resources, and the implications for the IDF's force structure. This article examines these developments to shed light on the evolving way of war in the Middle East and the struggle within the IDF to redefine its posture.
ecl family genes: Factors linking starvation and lifespan extension in Schizosaccharomyces pombe
Authors: Ohtsuka Hokuto , Otsubo Yoko , Shimasaki Takafumi , Yamashita Akira , Aiba Hirofumi
Published: August 2023

In the fission yeast Schizosaccharomyces pombe, the duration of survival in the stationary phase, termed the chronological lifespan (CLS), is affected by various environmental factors and the corresponding gene activities. The ecl family genes were identified in the genomic region encoding non‐coding RNA as positive regulators of CLS in S. pombe, and subsequently shown to encode relatively short proteins. Several studies revealed that ecl family genes respond to various nutritional starvation conditions via different mechanisms, and they are additionally involved in stress resistance, autophagy, sexual differentiation, and cell cycle control. Recent studies reported that Ecl family proteins strongly suppress target of rapamycin complex 1, which is a conserved eukaryotic nutrient‐sensing kinase complex that also regulates longevity in a variety of organisms. In this review, we introduce the regulatory mechanisms of Ecl family proteins and discuss their emerging findings.
Genetic and other factors contributing to external apical root resorption in orthodontic patients
Authors: Baghaei Nellie N. , Zhai Guihua , Lamani Ejvis
Published: August 2023

Objective

External apical root resorption (EARR) is a multifactorial disorder with adverse clinical outcomes in orthodontic practices often resulting in significant root shortening. This study examined the effect that specific single nucleotide polymorphisms (SNPs) have on the risk of developing EARR in orthodontic patients in X. We also evaluated how other selected patient‐ and treatment‐related factors may contribute to root resorption in these patients.

Setting/Sample

Patients included in this case–control study were treated at the University of Alabama at Birmingham School of Dentistry, Department of Orthodontics.

Methods

Panoramic radiographs were used to measure root resorption of the maxillary incisors. EARR was recorded when at least 20% of the root length had been lost with orthodontic treatment. Factors evaluated for association with EARR included ethnicity, sex, age, dental and skeletal classifications, ANB, U1‐SN, overjet, treatment type and time, and SNPs in IL‐1A (rs1800587), IL‐1B (rs1143634), IL‐1RN (rs419598), P2RX7 (rs1718119 and rs2230912), IRAK1 (rs1059703) and CASP1 (rs530537, rs580253 and rs554344). Chi‐square test, Student's t test, Wilcoxon test, Benjamin–Hochberg false discovery rate (FDR) adjustment and logistic regression were used to analyse the data. The significance level was defined as P < .05.

Results

We found that extraction treatment protocol and dental classification displayed significant association with root resorption. Furthermore, the GG genotype of IL‐1A rs1800587 variant (in individuals with an increased overjet) predisposed Caucasians to EARR. While CASP1 (rs530537) variant may contribute to the risk of root resorption, it was not statistically significant after FDR adjustment (P = .09).

Conclusions

Both patient‐ and treatment‐related factors contributed to EARR.
Local snow and fluvial conditions drive taxonomic, functional and phylogenetic plant diversity in tundra
Authors: Rissanen Tuuli , Aalto Aino , Kainulainen Heli , Kauppi Olli , Niittynen Pekka , Soininen Janne , Luoto Miska
Published: August 2023

To understand, how the diversity and hence functioning of tundra ecosystems might respond to altering environmental conditions, fine‐scale studies are needed as local conditions may buffer broad‐scale environmental changes. Furthermore, species functional traits and phylogeny may provide complementary insights to taxonomic diversity patterns as they link plant communities to ecosystem processes often more closely than species count. Here, we examined taxonomic, functional and phylogenetic plant diversity in relation to fundamental environmental factors, namely, growing degree days, snow persistence, soil moisture, pH and fluvial disturbance in northern Norway. The relationships between eight diversity metrics and environmental predictors were investigated using hierarchical generalised additive models. Our results indicated that taxonomic, functional and phylogenetic plant diversity in tundra are all strongly linked to local snow and fluvial conditions, with average variable importance of 0.19 and 0.14, respectively, whereas the importance of other predictors was low (average variable importance < 0.06). The average explained deviance by the models was 0.23. Predicted hotspots of different diversity metrics overlapped notably and were mostly located along the streams. However, when the effect of taxonomic richness was removed from the phylogenetic and functional diversities their connections with environmental predictors were weaker but indicated strongest relationships with snow and soil pH showing distinct diversity hotspots in areas with low species richness. Our study demonstrates that investigating multiple facets of biodiversity enhances understanding on community patterns and their drivers. Furthermore, our results highlight the importance of addressing local hydrological conditions that represent both resources and disturbances for vegetation. As arctic and alpine areas are probably shifting from snow to rain dominated, incorporating snow and fluvial information into the models might be particularly important to better understand tundra ecosystems under global change.
Comparison of Lumbosacral Fusion Grade in Patients after Transforaminal and Anterior Lumbar Interbody Fusion with Minimum 2‐Year Follow‐Up
Authors: Liu Jinping , Xie Rong , Chin Cynthia T. , Rajagopalan Priya , Duan Ping‐Guo , Li Bo , Burch Shane , Berven Sigurd H. , Mummaneni Praveen V. , Chou Dean
Published: August 2023

Objective

Generally, anterior lumbar interbody fusion (ALIF) was believed superior to transforaminal lumbar interbody fusion (TLIF) in induction of fusion. However, many studies have reported comparable results in lumbosacral fusion rate between the two approaches. This study aimed to evaluate the realistic lumbosacral arthrodesis rates following ALIF and TLIF in patients with degenerative spondylolisthesis as measured by CT and radiology.

Methods

Ninety‐six patients who underwent single‐level L5‐S1 fusion through ALIF (n = 48) or TLIF (n = 48) for degenerative spondylolisthesis at the Spine Center, University of California San Francisco, between October 2014 and December 2017 were retrospectively evaluated. Fusion was independently evaluated and categorized as solid fusion, indeterminate fusion, or pseudarthroses by two radiologists using the modified Brantigan–Steffee–Fraser (mBSF) grade. Clinical data on sex, age, body mass index, Meyerding grade, smoking status, follow‐up times, complications, and radiological parameters including disc height, disc angle, segmental lordosis, and overall lumbar lordosis were collected. The fusion results and clinical and radiographic data were statistically compared between the ALIF and TLIF groups by using t‐test or chi‐square test.

Results

The mean follow‐up period was 37.5 (ranging from 24 to 51) months. Clear, solid radiographic fusions were higher in the ALIF group compared with the TLIF group at the last follow‐up (75% vs 47.9%, p = 0.006). Indeterminate fusion occurred in 20.8% (10/48) of ALIF cases and in 43.8% (21/48) of TLIF cases (p = 0.028). Radiographic pseudarthrosis was not significantly different between the TLIF and ALIF groups (16.7% vs 8.3%; p = 0.677). In subgroup analysis of the patients without bone morphogenetic protein (BMP), the solid radiographic fusion rate was significantly higher in the ALIF group than that in the TLIF group (78.6% vs 45.5%; p = 0.037). There were no differences in sex, age, body mass index, Meyerding grade, smoking status, or follow‐up time between the two groups (p > 0.05). The ALIF group had more improvement in disc height (7.8 mm vs 4.7 mm), disc angle (5.2° vs 1.5°), segmental lordosis (7.0° vs 2.5°), and overall lumbar lordosis (4.7° vs 0.7°) compared with the TLIF group (p < 0.05). Overall complication rates were similar between the TLIF and ALIF groups (10.4% vs 8.33%; p > 0.999).

Conclusions

With a minimum 2‐year radiographic analysis of arthrodesis at lumbosacral level by radiologists, the rate of solid radiographic fusions was higher in the ALIF group compared with the TLIF group, whereas the TLIF group had a higher rate of indeterminate fusion. Radiographic pseudarthrosis did not differ significantly between the TLIF and ALIF groups.
Limb Reconstruction System Assisted Reduction and Internal Fixation for Intra‐Articular Calcaneal Fractures: A New Application
Authors: Jiang Guiyong , Li Jie , Zhang Xiaolong , Shu Shan , Ma Yunfei , Zhang Ping , Wang Gang , Liao Hua , Hu Jijie
Published: August 2023

Background

Minimally invasive reduction and fixation of intra‐articular calcaneal fractures poses great challenges for orthopaedic surgeons. The aim of the present study was to report the technical points, evaluate the efficacy of minimally invasive reduction and internal fixation assisted by the temporary limb reconstruction system (LRS) external fixator for intra‐articular calcaneal fractures, and propose the indications of our protocol.

Methods

In this retrospective study, a series of 34 consecutive closed and displaced intra‐articular calcaneal fractures involving the articular surface were treated by this technology between June 2016 and April 2018. X‐ray and computed tomography (CT) scans were performed before and after surgery to measure Bohler's angle; the length, height, and width of the calcaneus; and the mechanical axis of the hindfoot. Postoperative complications were recorded. Imaging and clinical outcomes were comprehensively evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot‐ankle scoring system. After testing the normality of the data, Bohler's angle and the length of calcaneus were compared using the Wilcoxon signed‐rank test. The height, width of the calcaneus, and the mechanical axis of the hindfoot were compared using the Paired‐Samples t‐test.

Results

Thirty‐two fractures were followed up for an average of 20.66 months (from 12 to 32 months). All fractures achieved stable reduction and bony union. The articular surface was reduced and fixed with direct vision through the sinus tarsi incision. No failure of internal fixation or loss of reduction was detected during follow‐up. There were no soft tissue complications. Bohler's angle; the length, height, and width of the calcaneus; and the mechanical axis of the hindfoot improved significantly. The AOFAS scores averaged 84.12 points; seven cases were rated excellent, 20 good, four fair, and one poor.

Conclusions

For intra‐articular calcaneal fractures, minimally invasive surgery assisted with temporary LRS external fixation can reconstruct the calcaneal shape and the sub‐talar articular surface. This simple surgical modality with limited complications may be helpful in the surgical treatment of most type II and III calcaneal fractures except comminuted fractures of the calcaneal tuberosity.
Preoperative Skull Traction, Anterior Debridement, Bone Grafting, and Internal Fixation for Cervical Tuberculosis with Severe Kyphosis
Authors: Zhang Zhuang , Zhu Ce , Liu Li‐min , Li Tao , Yang Xi , Song Yue‐ming
Published: August 2023

Objective

Cervical tuberculosis (CTB) readily causes local kyphosis, and its surgical strategy remains controversial. Although some previous studies suggested that the anterior approach could effectively treat CTB, patients in these studies only suffered mild to moderate kyphosis. Therefore, little is known about whether the anterior approach can achieve satisfactory outcomes in CTB patients with severe kyphosis. This study was performed to evaluate the safety and efficacy of preoperative skull traction combined with anterior surgery for the treatment of CTB patients with a severe kyphosis angle of more than 35°.

Methods

In this retrospective study, we enrolled 31 CTB patients with severe kyphosis who underwent preoperative skull traction combined with anterior surgery from April 2015 to January 2021. Patients were followed up for at least 2 years. Clinical data, such as operative time, blood loss, and postoperative hospital stay, were collected. The clinical outcomes included American Spinal Injury Association (ASIA) spinal cord injury grade, Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, and related complications. The radiological outcomes included the Cobb angle of cervical kyphosis at each time point and the bony fusion state. Clinical efficacy was evaluated by paired Student's t‐test, Mann–Whitney U‐test, and others.

Results

Six patients had involvement of one vertebra, 21 had involvement of two vertebrae, and four had involvement of three vertebrae. The most common level of vertebral involvement was C4‐5, whereas the most common apical vertebra of kyphosis was C4. The mean kyphosis angle was 46.1° ± 7.7° preoperatively, and the flexibility on dynamic extension‐flexion X‐rays and cervical MRI was 17.5% ± 7.8% and 43.6% ± 11.0%, respectively (p = 0.000). The kyphosis angle significantly decreased to 13.2° ± 3.2° after skull traction, and it further corrected to −6.1° ± 4.3° after surgery, which was well maintained at the final follow‐up with a mean Cobb angle of −5.4° ± 3.9°. The VAS and JOA scores showed significant improvement after surgery. The erythrocyte sedimentation rate (ESR) and C‐reactive protein (CRP) levels normalized at 3 months after surgery. All patients achieved solid bone fusion, and no complications related to the instrumentation or recurrence were observed.

Conclusion

Preoperative skull traction combined with anterior debridement, autologous iliac bone grafting, and internal plate fixation can be an effective and safe surgical method for the treatment of cervical tuberculosis with severe kyphosis. Skull traction can improve the safety and success rate of subsequent anterior corrective surgery.
Simple Minimally Invasive Method to Reduce Valgus‐Impacted and Tilted Femoral Neck Fractures without Soft Tissue or Cartilage Injury: Radiological and Clinical Results
Authors: Kweon Seok‐Hyun , Song Joo‐Hyoun , Park Hyun Woo , Kang Muhyun , Lim Young‐Wook , Lee Se‐Won , Parikh Darshil , Oh Seungbae
Published: August 2023

Objective

This is a rare study comparing the radiological and functional outcomes of fixation after reduction with in situ fixation group using Femoral Neck System (FNS). The aim of this study was to introduce a simple, innovative, minimally invasive method to reduce valgus‐impacted and tilted femoral neck fractures without soft tissue or cartilage injury.

Methods

A retrospective comparative analysis of 46 patients between May 2020 and February 2022 was performed. In the control group, 23 patients underwent in situ fixation without reduction. In the study group, another 23 patients were managed by fixation after reduction using a percutaneous pull‐out technique with a full threaded Steinmann pin. Caput‐collum‐diaphysis (CCD) angle, tilt, and femoral neck shortenings were compared between the two groups. In addition, Harris Hip Score (HHS) was evaluated and compared at 1 year after surgery. Basically, independent samples t‐test was used to compare radiological and functional results.

Results

Patients' initial valgus and tilt angles were not significantly different between the groups (n.s.). However, the CCD and tilt angles measured immediately and at one year postoperatively were significantly different between the groups (p < 0.05). Regarding femoral neck shortening, shortening in the three directions, the x, y, and z vectors, was significantly less in the reduction group immediately postoperatively and at 1 year post‐surgery (p < 0.05). The mean HHS at 1 year postoperatively was 79.7 ± 8.4 in the in situ fixation group and 87.9 ± 6.6 in the reduction groups, and there was a significant difference (p < 0.05).

Conclusion

The pull‐out method with a threaded Steinmann pin to reduce valgus‐impacted and tilted femoral neck fracture is safe and effective for accomplishing anatomical restoration. This may achieve successful bone union and maintain the femoral neck length and original tilt without nearby soft tissue or cartilage injury.
Drug provocation tests in children: All that glitters is not gold
Authors: Moral Luis , Mori Francesca
Published: August 2023

A proper allergy work‐up, based on the gold standard drug provocation test (DPT), usually rules out suspected drug hypersensitivity in children. These tests are generally open, given their high efficiency compared with double‐blind placebo‐controlled DPTs. Although their negative predictive value is excellent, no studies have calculated their positive predictive value, highly dependent on the prevalence of the disease. Most studies have found a rate of <5%–10% of true beta‐lactam hypersensitivity in children. Given this low prevalence (pre‐test probability), a few false‐positive results can significantly reduce the estimated positive predictive value. False positives may arise from the nocebo effect during the test, including nocebo by proxy, or from observer bias, which depends on professional expertise and organizational circumstances. Some studies have found a high rate of tolerance on a second DPT in children who failed the first, but these results may be affected by the interval between the two tests, of a year or more in most cases, reflecting a loss of hypersensitivity over time. Taking into account the low rate of positive DPTs, with commonly mild reactions, we suggest confirming nonsevere positive DPTs with a second provocation performed soon after the first, especially in the case of beta‐lactam antibiotics, in order to improve the diagnostic accuracy, de‐label more patients, and achieve a better estimation of true drug hypersensitivity prevalence. In case of mild immediate reactions, the potential benefits of a second DPT should be carefully weighed against the risk of anaphylaxis.
Inhalation anesthesia without any intravenous management for pediatric proton beam therapy
Authors: García‐Aroca Miguel A. , Fernández‐de Miguel José M. , Franceschi María Aymerich‐de , Fernández‐Vaquero Miguel A. , Meléndez‐Salinas Diego A. , Piñero‐Merino María , Álvarez‐Avello José M.
Published: August 2023

Introduction

Proton beam therapy is an oncological treatment, argued to be an appropriate tumor irradiation technique for childhood solid tumors. Due to its duration and the need for immobility, many children require anesthesia for proton therapy sessions. As not many centers in the world provide this therapy, there is little published research about pediatric anesthesia for these cases, and the available data suggest a preference for intravenous anesthesia or combined intravenous and inhalation anesthesia. We conducted this study with the aim of describing and analyzing the inhalation anesthetic management of children undergoing proton therapy at our medical center, comparing our results with studies that have followed different anesthetic protocols.

Methods

We reviewed two major databases (Web of Science and Scopus) to find papers that had addressed, to date, anesthesia for pediatric proton therapy. To describe our anesthetic management, we included all pediatric patients treated with proton therapy under anesthesia in our center between June 2020 and August 2021. The characteristics of the patients, their diagnoses, treatments, airway management, drugs administered, duration of induction, and recovery from anesthesia, and adverse effects where all recorded. All anesthesiologists followed a strict anesthetic protocol based only on inhalational anesthesia with sevoflurane delivered via laryngeal mask airway.

Results

Of the total of 1082 papers found in Web of Science and Scopus on pediatric proton therapy, 11 have addressed its anesthetic management, using intravenous or combined intravenous and inhalation anesthesia. Between June 2020 and August 2021, 31 children were anesthetized in our center to receive proton therapy under inhalational anesthesia (total number of sessions: 873). The mean anesthesia induction time was 4.1 min (SD = 0.7, 95% CI [3.9, 4.4]). The mean anesthesia recovery time was 13.8 min (SD = 4.1, 95% CI [12.3, 15.3]). The percentage of non‐serious adverse effects was 0.7% (Clopper–Pearson 95% CI [0.3, 1.5]). The percentage of serious adverse effects was 0.1% (Clopper–Pearson 95% CI [0, 0.6]), without statistically significant difference with other published works with different anesthetic approaches.

Conclusion

Inhalation anesthesia without any intravenous management for pediatric proton therapy is, in our experience, an effective technique with a complication rate similar to other anesthetic approaches.
HIV testing among immigrant men who have sex with men in Brazil
Authors: Cruz Aiala Xavier Felipe da , Neto João Cruz , Araújo Agostinho Antônio Cruz , Sousa Anderson Reis de , Oliveira Layze Braz de , Sena Inara Viviane de Oliveira , Sena Sousa Luciana , Santos Jaqueline dos , Batista Odinea Maria Amorim , Mendes Isabel Amélia Costa , Fronteira Inês , Sousa Álvaro Francisco Lopes de
Published: August 2023

Objective

To evaluate the prevalence of non‐testing for HIV among immigrant men who have sex with men (MSM) residing in Brazil and identify associated factors.

Design

An analytical web‐survey study was conducted across all Brazilian states from January 2020 to May 2021.

Sample

The study included 804 MSM immigrants from Portuguese‐speaking countries.

Measurements

Odds ratio (OR) and adjusted Odds Ratio (AOR) were utilized to determine the strength of the association between non‐HIV testing and associated factors.

Results

Among the participants, 63.7% had never undergone HIV testing. Multivariate analysis revealed several factors associated with a higher likelihood of not being tested for HIV: having a steady/monogamus partner (AOR: 1.5; 95%CI: 1.1‐2.3) or both casual and steady partners (AOR: 1.8; 95%CI: 1.2‐3.4), not engaging in bareback sex (AOR: 1.91; 95%CI: 3‐3.5), being an immigrant in the country for less than 12 months (AOR: 3.7; 95%CI: 2.5‐9.7), and having a preference for insertive (AOR: 1.5; 95%CI: 1.1‐2.5) or receptive (AOR: 2.9; 95%CI: 1.4‐5.7) roles. However, practicing chemsex was found to be a protective factor for testing (AOR: 4).

Conclusion

To enhance HIV prevention strategies, it is crucial to implement specific measures that ensure accessibility, confidentiality, and a reduction in stigma associated with HIV testing.
Understanding regulation using the Institutional Grammar 2.0
Authors: Siddiki Saba , Frantz Christopher K.
Published: August 2023

Over the last decade, there has been increased interest in understanding the design (i.e., content) of regulation as a basis for studying regulation formation, implementation, and outcomes. Within this line of research, scholars have been particularly interested in investigating regulatory dynamics relating to features and patterns of regulatory text and have engaged a variety of methodological approaches to support their assessments. One approach featured in this research is the Institutional Grammar (IG). The IG supports syntactic and semantic analyses of institutional statements (e.g., regulatory provisions) that embed within regulatory text. A recently revised version—called the IG 2.0—further supports robust analyses of regulatory text by offering an expanded feature set particularly well‐suited to extracting and classifying content relevant for the study of regulation. This paper (i) provides a brief introduction to the IG 2.0 and (ii) discusses theoretical and analytical advantages of using the IG 2.0 to study regulation.
Partial correlation graphical LASSO
Authors: Carter Jack Storror , Rossell David , Smith Jim Q.
Published: August 2023

Standard likelihood penalties to learn Gaussian graphical models are based on regularizing the off‐diagonal entries of the precision matrix. Such methods, and their Bayesian counterparts, are not invariant to scalar multiplication of the variables, unless one standardizes the observed data to unit sample variances. We show that such standardization can have a strong effect on inference and introduce a new family of penalties based on partial correlations. We show that the latter, as well as the maximum likelihood, and logarithmic penalties are scale invariant. We illustrate the use of one such penalty, the partial correlation graphical LASSO, which sets an penalty on partial correlations. The associated optimization problem is no longer convex, but is conditionally convex. We show via simulated examples and in two real datasets that, besides being scale invariant, there can be important gains in terms of inference.
Understanding the utility of “Talk‐to‐Me” an online suicide prevention program for Australian university students
Authors: Afsharnejad Bahareh , Milbourn Ben , Brown Cherylee , Clifford Rhonda , Foley Kitty‐Rose , Logan Alexandra , Lund Stephan , Machingura Tawanda , McAuliffe Tomomi , Mozolic‐Staunton Beth , Sharp Nicole , Hayden‐Evans Maya , Baker Young Ellie , Black Melissa , Zimmermann Frank , Kacic Viktor , Bölte Sven , Girdler Sonya
Published: August 2023

Background

Australian university students are at risk of experiencing poor mental health, being vulnerable to self‐harm and suicidal ideation.

Aim

“Talk‐to‐Me” is a suicide ideation prevention Massive open online course (MOOC) previously showing it can support Western Australian university students' knowledge of identifying and responding to suicide ideation in themselves and others.

Methods

A multi‐site one‐group pre‐test/post‐test design with a 12‐week follow‐up explored the efficacy of “Talk‐to‐Me” for university students Australia‐wide, evaluating the influence of COVID‐19 and location. Overall, 217 students (55% female; mage = 24.93 years [18, 60]) enrolled in this study from 2020 to 2021. Participants' responses to suicidal statements, mental health literacy, generalized self‐efficacy, help‐seeking behavior, and overall utility of the program were collected at baseline, post‐MOOC (10 weeks from baseline) and 12‐week follow‐up. The effect of time and location interaction was explored using a random‐effects regression model.

Results

Findings indicated significant improvement in participants' knowledge of positive mental health support strategies (ES = 0.42, p < 0.001) and recognizing appropriate responses to suicidal statements (ES = 0.37, p < 0.001) at 10‐weeks, with further improvement at 12 weeks follow‐up (ES = 0.47 and 0.46, p < 0.001). Students reported higher generalized self‐efficacy at the 12‐week follow‐up compared to baseline (ES = 0.19, p = 0.03) and an increased tendency to seek professional help for mental health issues (ES = 0.22, p = 0.02).

Conclusion

These findings provide preliminary evidence of the efficacy of the “Talk‐to‐Me” program in supporting ‎university students across Australia to increase their suicide‐related knowledge and skills, ‎general self‐efficacy, and overall mental fitness.
Cross‐sector collaboration for refugee employment: An anthropology of development perspective
Authors: Gunasekara Asanka , Eversole Robyn , Hiruy Kiros , Sendjaya Sen , Breitbarth Tim
Published: August 2023

Employment plays a crucial role in the successful resettlement of migrants. However, there is a paucity of research on how to facilitate refugee employment outcomes and the role of cross‐sector collaborations. Using a qualitative, multi‐layered analysis of primary and secondary data from Australian settlement service providers (SSPs) and the businesses they work with, this study explores how public service organisations co‐create value with stakeholders (i.e., public service logic) through cross‐sector collaborations. By identifying differing notional and strategic logics of both SSPs and employing businesses in supporting refugee migrants, we reveal the dynamics of cross‐sector value co‐creation in refugee management settings. We also identify four main strategic logics that SSPs use to address barriers and connect refugee migrants to employment. Our study offers theoretical contributions and practical implications for public, private, not‐for‐profit and community organisations working together to support refugee employment.
Chern class inequalities for nonuniruled projective varieties
Authors: Rousseau Erwan , Taji Behrouz
Published: August 2023

It is known that projective minimal models satisfy the celebrated Miyaoka–Yau inequalities. In this article, we extend these inequalities to the set of all smooth, projective, and nonuniruled varieties.
Teología, fenomenología y representaciones sociales: un ejercicio investigativo e interdisciplinar del teólogo
Authors: Moncada Guzmán Ciro Javier , López Saavedra Camilo Alfonso , Escobar Mejía José Edwar , Quintero Torres Fredy Alonso
Published: August 2023

La dinámica teológica debe estar vinculada profundamente con los retos de su tiempo y los contextos de los sujetos, de tal forma que no puede ser ajena a las circunstancias del mundo de la vida que la rodean. De ahí que este artículo tenga por objetivo analizar los aportes que la fenomenología y la teoría de las representaciones sociales tienen para el diario quehacer del teólogo. La reflexión será motivada a partir de los resultados de diversas experiencias investigativas propuestas por los autores, donde se ponen en diálogo los saberes propios de cada una de las disciplinas abordadas, pero en prospectiva de la cualificación de los procesos de investigación que se circunscriben en la teología cuando es vista desde la frontera. Al final se podrá concluir que la tarea circunscrita presupone la inter y transdisciplinariedad, no en perspectiva meramente especulativa sino principalmente práxica.
On the Verification of Finite Element Determinations of Stress Concentration Factors for Handbooks
Authors: Kardak A. A. , Sinclair G. B.
Published: August 2023

Here we offer an approach for being reasonably sure that finite element determinations of stress concentration factors are accurate enough to be included in engineering handbooks. The approach has two contributors. The first consists of analyzing a stress concentration on a sequence of systematically refined meshes until the error estimates of ASME have that sufficient accuracy has been achieved. The second consists of constructing a test problem with an exact and somewhat higher value of its stress concentration factor, then analyzing this test problem with the same sequence of meshes and showing that, in fact, sufficient accuracy has been achieved. In combination, these two means of verification are applied to a series of U-notches in a plate under tension. Together they show that it is reasonable to regard finite element values of stress concentration factors on the finest meshes as being accurate to three significant figures. Given this level of accuracy, it is then also reasonable to use the approach to verify other existing stress concentration factors and resolve any discrepancies between them, as well as to verify new stress concentration factors.
Uncertainty Quantification and Sensitivity Analysis for the Self-Excited Vibration of a Spline-Shafting System
Authors: Ma Xinxing , Zhong Yucai , Cao Peng , Yuan Jie , Zhang Zhenguo
Published: August 2023

Self-excited vibrations can occur in the spline-shafting system due to internal friction of the tooth surface. However, due to manufacturing errors, design tolerances, and time-varying factors, the parameters that induce self-excited vibrations are always uncertain. This study provides new insights into the uncertainty quantification and sensitivity analysis of a spline-shaft system suffering from self-excited vibrations. The nonintrusive generalized polynomial chaos expansion (gPCE) with unknown deterministic coefficients is used to represent the propagation of uncertainties in the rotor dynamics, which allows rapid estimation of the statistics of the nonlinear responses. Furthermore, the global sensitivity analysis of the stochastic self-excited vibration response of the rotor system with probabilistic uncertain parameters is evaluated by Sobol indices. The relative influence of different random parameters on the vibration behavior and initial displacement conditions for the occurrence of self-excited vibration is investigated. The accuracy of the adopted method based on the gPCE metamodel is validated by conventional Monte Carlo simulation (MCS). Finally, the effects of parameter uncertainties considering random distribution characteristics on the stochastic vibration characteristics of the rotor system are discussed, which demonstrates the need to consider input uncertainties in analysis and design to ensure robust system performance.
Compilation of a Solar Mirror Materials Database and an Analysis of Natural and Accelerated Mirror Exposure and Degradation
Authors: Farrell Tucker , Cao Yue , Burkholder Frank , Celvi Daniel , Schreiber Christa , Zhu Guangdong
Published: August 2023

The National Renewable Energy Laboratory (NREL) has been conducting exposure experiments on solar reflectors for over four decades. Thousands of mirror samples from over 100 suppliers have been exposed to and monitored in a range of relevant environments. These test conditions include outdoor test settings and several controlled laboratory environments. These samples have been rigorously individually characterized using a series of reflectance measurements, visual inspections and, in some cases, in-depth composition analysis to identify degradation modes, reflectance losses, and other mirror properties integral to understanding the solar reflector’s life cycle. This article compiles the decades of measurement data into a concise statistical analysis. It includes exposure and degradation data for numerous reflector types, including secondary-surface reflector permutations of polymer and glass superstrates with silver and aluminum reflectors as well as front-surface reflectors. The results herein are intended to analyze environmental stressors and degradation trends among various historical and state-of-the-art solar reflectors. This article may be used to support solar reflector design, effective testing methodology, and inform manufacturing decisions moving forward. Presented are the results of the compiled database and an initial analysis for degradation rate modeling using full-spectrum and wavelength-dependent approaches. The database is a growing resource hosted on a live, publicly accessible website. In conjunction with the analysis presented here, the database provides a valuable resource to the solar reflector manufacturing and testing industry.
Multiple cancers escape from multiple MAPK pathway inhibitors and use DNA replication stress signaling to tolerate aberrant cell cycles
Authors: Hoffman Timothy E. , Nangia Varuna , Ill C. Ryland , Passanisi Victor J. , Armstrong Claire , Yang Chen , Spencer Sabrina L.
Published: August 2023

Many cancers harbor pro-proliferative mutations of the mitogen-activated protein kinase (MAPK) pathway. In BRAF-driven melanoma cells treated with BRAF inhibitors, subpopulations of cells escape drug-induced quiescence through a nongenetic manner of adaptation and resume slow proliferation. Here, we found that this phenomenon is common to many cancer types driven by EGFR, KRAS, or BRAF mutations in response to multiple, clinically approved MAPK pathway inhibitors. In 2D cultures and 3D spheroid models of various cancer cell lines, a subset of cells escaped drug-induced quiescence within 4 days to resume proliferation. These “escapee” cells exhibited DNA replication deficits, accumulated DNA lesions, and mounted a stress response that depended on the ataxia telangiectasia and RAD3-related (ATR) kinase. We further identified that components of the Fanconi anemia (FA) DNA repair pathway are recruited to sites of mitotic DNA synthesis (MiDAS) in escapee cells, enabling successful completion of cell division. Analysis of patient tumor samples and clinical data correlated disease progression with an increase in DNA replication stress response factors. Our findings suggest that many MAPK pathway–mutant cancers rapidly escape drug action and that suppressing early stress tolerance pathways may achieve more durable clinical responses to MAPK pathway inhibitors.
Pathogen-specific structural features of
Candida albicans
Ras1 activation complex: uncovering new antifungal drug targets
Authors: Manso José A. , Carabias Arturo , Sárkány Zsuzsa , de Pereda José M. , Pereira Pedro José Barbosa , Macedo-Ribeiro Sandra
Published: August 2023

An important feature associated with
Candida albicans
pathogenicity is its ability to switch between yeast and hyphal forms, a process in which CaRas1 plays a key role. CaRas1 is activated by the guanine nucleotide exchange factor (GEF) CaCdc25, triggering hyphal growth-related signaling pathways through its conserved GTP-binding (G)-domain. An important function in hyphal growth has also been proposed for the long hypervariable region downstream the G-domain, whose unusual content of polyglutamine stretches and Q/N repeats make CaRas1 unique within Ras proteins. Despite its biological importance, both the structure of CaRas1 and the molecular basis of its activation by CaCdc25 remain unexplored. Here, we show that CaRas1 has an elongated shape and limited conformational flexibility and that its hypervariable region contains helical structural elements, likely forming an intramolecular coiled-coil. Functional assays disclosed that CaRas1-activation by CaCdc25 is highly efficient, with activities up to 2,000-fold higher than reported for human GEFs. The crystal structure of the CaCdc25 catalytic region revealed an active conformation for the α-helical hairpin, critical for CaRas1-activation, unveiling a specific region exclusive to CTG-clade species. Structural studies on CaRas1/CaCdc25 complexes also revealed an interaction surface clearly distinct from that of homologous human complexes. Furthermore, we identified an inhibitory synthetic peptide, prompting the proposal of a key regulatory mechanism for CaCdc25. To our knowledge, this is the first report of specific inhibition of the CaRas1-activation via targeting its GEF. This, together with their unique pathogen-structural features, disclose a set of novel strategies to specifically block this important virulence-related mechanism.

IMPORTANCE

Candida albicans
is the main causative agent of candidiasis, the commonest fungal infection in humans. The eukaryotic nature of
C. albicans
and the rapid emergence of antifungal resistance raise the challenge of identifying novel drug targets to battle this prevalent and life-threatening disease. CaRas1 and CaCdc25 are key players in the activation of signaling pathways triggering multiple virulence traits, including the yeast-to-hypha interconversion. The structural similarity of the conserved G-domain of CaRas1 to those of human homologs and the lack of structural information on CaCdc25 has impeded progress in targeting these proteins. The unique structural and functional features for CaRas1 and CaCdc25 presented here, together with the identification of a synthetic peptide capable of specifically inhibiting the GEF activity of CaCdc25, open new possibilities to uncover new antifungal drug targets against
C. albicans
virulence.
Isolation and genome sequencing of five lytic bacteriophages from hospital wastewater in the Philippines
Authors: Nada Michael Angelou L. , Ancla Joseph B. , Yadao Nikka Mae R. , de Paz Virgilio P. , Manalaysay Jessica G. , Samante Fred Lawrence D. , Bigol Ursela G.
Published: August 2023

Here, we report the genome sequences of five bacteriophages isolated from hospital wastewater, including two new species and two candidates for therapeutic application. No virulence, temperate marker and antibiotic resistance genes were found in the genomes of
Escherichia
phage vB_VIPECOOM03 and
Klebsiella
phage vB_VIPKPNUMC01, making them suitable candidate for therapy.
Supplemental Material: Offshore-onshore record of Last Glacial Maximum–to–present grounding line retreat at Pine Island Glacier, Antarctica
Authors: Nichols Keir A. , al. et
Published: August 2023

Detailed description of the methods used in this study, as well as sample locations, analytical data, exposure ages, and linear thinning rates. 
Restoration of right ventricular function in the treatment of pulmonary arterial hypertension
Authors: Celant Lucas R , Wessels Jeroen N , Kianzad Azar , Marcus J Tim , Meijboom Lilian J , Bogaard Harm Jan , de Man Frances S , Vonk Noordegraaf Anton
Published: August 2023

Objective

A 45% threshold of right ventricular ejection fraction (RVEF) is proposed clinically relevant in patients with pulmonary arterial hypertension (PAH). We aim to determine treatment response, long-term right ventricular (RV) functional stability and prognosis of patients with PAH reaching or maintaining the RVEF 45% threshold.

Methods

Incident, treatment-naive, adult PAH patients with cardiac magnetic resonance imaging at baseline and first follow-up were included (total N=127) and followed until date of censoring or death/lung transplantation. Patients were categorised into two groups based on 45% RVEF. Baseline predictors, treatment response and prognosis were assessed with logistic regression analyses, two-way analysis of variance and log-rank tests.

Results

Patients were 50±17 years old, 73% female, of which N=75 reached or maintained the 45% RVEF threshold at follow-up (RVEF≥45%@FU), while N=52 patients did not (RVEF<45%@FU). RV end-diastolic volume and N-terminal pro-B-type natriuretic peptide at baseline were multivariable predictors of an RVEF ≥45% at follow-up. A 40% pulmonary vascular resistance (PVR) reduction resulted in greater improvement in RV function (ΔRVEF 17±11 vs. 5±8; pinteraction<0.001) compared to a PVR reduction <40%, but did not guarantee an RVEF ≥45%. Finally, the 45% RVEF threshold was associated with stable RV function during long-term follow-up and better survival (HR: 1.91 (95% CI: 1.11 to 3.27)). Patients failing to reach or maintain the 45% RVEF threshold at first follow-up mostly stayed below this threshold over the next consecutive visits.

Conclusion

After treatment initiation, 60% of patients with PAH reach or maintain the 45% RVEF threshold, which is associated with a long-term stable RV function and favourable prognosis.