bluuebunny/crossref_metadata_2025 huggingface dataset:
Dürer’s Revenge
Authors: Rublack Ulinka
Published: July 2023

This chapter shows why Dürer was a different man when he delivered the commission to when he started work on it, full of creative hope for such a piece. When he finished it in 1509, it recorded a battle for the recognition of artists that resonates until today. As he painted the panel, Dürer chose to include his own figure, left in the centre background of the painting. He holds a sign on which is written his name and his monogram AD. No other artist ever dared to do the same.
Journey to the Netherlands
Authors: Rublack Ulinka
Published: July 2023

Dürer and his wife Agnes travelled to Frankfurt in 1520, but this chapter argues that it is most likely that they did not meet Heller and look at the altarpiece. It charts the enormous changes in German society and Dürer’s career since 1509. The Reformation was transforming many of his ideas about art, but at the same time he found new inspiration for inspiring, ambitious paintings during his trip to the Netherlands in 1520–21. Dürer’s diary from this trip is a unique document telling us about the place of artists in Renaissance society. Most importantly, it reveals how rarities sourced by global merchants fascinated Dürer. Margaret of Austria, the Regent of the Netherlands, assembled such rarities in a new form of cabinet of curiosities, which Dürer admired. Their wonder about natural artefacts and Dürer’s tremendous esteem of Latin American achievements in crafts shows he saw painting as part of a far wider range of decorative goods that were increasingly marketed and that inspired him. In forging these tastes and networks with merchants, he stood at the vanguard of a new age of collecting.
Hans Fugger and the Age of Curiosity
Authors: Rublack Ulinka
Published: July 2023

The magnitude and speed of change, such as the Reformations and the commercialization and proliferation of the arts as well as the global expansion, at the same time explain why, even for an artist of Dürer’s quality, it appears as anything but a foregone conclusion that we should remember his name and visit museums to revere his paintings. Hence the second part of this book looks at the merchant Hans Fugger and his interests in the arts during the pivotal second half of the sixteenth century, when Europe emerged as a society divided between Protestants and Catholics, its population grew, and statecraft became more sophisticated. Hans Fugger (1531–98), one of the richest men in the world at the time, was a typical collector and purveyor of novelties. Whereas Heller commissioned art because he was worried for his salvation, Hans Fugger was a confident Catholic in an age of religious renewal. Fugger has left us thousands of letters, although only one of them mentions Dürer’s name.
In Style!
Authors: Rublack Ulinka
Published: July 2023

This chapter explores why Hans Fugger cared so greatly about fine shoes, which he sourced from Antwerp. It investigates the great value of leather as decorative material in the Renaissance and Baroque periods more widely. This shows just why it was that leather hangings in rooms could seem far more attractive than canvases. Such ‘decorative’ items could be far more expensive and valued than what was beginning to be distinguished and elevated as ‘fine art’. Leather as material could be manipulated in a growing number of ways. Turned into a luxury good, it was highly attractive for contemporaries and inspired their competition.
The Art Agent
Authors: Rublack Ulinka
Published: July 2023

This part examines an exceptional merchant characteristic of this age. Philipp Hainhofer (1578–1647) was a new type of Protestant luxury merchant who acted internationally as a professional art agent for courts, including the Catholic court of Bavaria. Hainhofer coordinated entire teams of Augsburg’s luxury craftspeople over decades to produce cabinets of curiosities as single pieces of furniture filled with hundreds of exquisite objects. Nowadays his creations feature in the glitziest of artbooks. They represent the best of the best in that age, and encapsulate its philosophical and spiritual programme to reveal the wonders of art and nature pushing the boundaries of perception and categorization of distinctions between both. Philipp Hainhofer’s cabinets adorned stately rooms from Florence and Vienna to Uppsala, and he was keen to find a client in the Americas. A mediator, aesthete, and trader of rare energy and vision, his activities underline how these collections were shaped by cultural entrepreneurs like him and emerging global markets for rarities, rather than by a programmatic vision of art privileging painting. As empires grew, cabinets of curiosities, and the forms of scientific knowledge as well as aesthetic, political, and religious sensibilities interlinked with them, and would continue to shape seventeenth- and eighteenth-century engagements with the arts. This chapter introduces the activities and significance of this foremost figure among European art agents.
The Rise of the Runaway-Woman Novelist
Authors: Gilbert Nora
Published: July 2023

Dubbed in their own time “the Fair Triumvirate of Wit,” Aphra Behn, Delarivier Manley, and Eliza Haywood tantalized and scandalized the public with the sexual promiscuity of the stories they wrote and (it was widely believed) the lives they led. But their fictions and biographies were deemed scandalous on other grounds as well: it was not just that the Fair Triumvirate symbolized overt female sexuality in the public’s eyes, in other words, but that they symbolized unapologetic rejection of the social expectation for women to stay put in the home as well. Through close readings of Behn’s Love-Letters Between a Nobleman and His Sister (1684–87), Manley’s The New Atalantis (1709), and a representative sampling of Haywood’s runaway-woman fiction from the 1720s to the 1750s, this chapter highlights the extent to which the topos of female flight dominated and proliferated in the formative years of the novel form.
Article 2 TEU as Constitutional Core of the EU Legal Order
Authors: Spieker Luke Dimitrios
Published: July 2023

This chapter zooms into the EU dimension of Article 2 TEU. Even without a formal constitution, the Court has started to distinguish a ‘constitutional framework’ from the plethora of Treaty provisions. This chapter pleads for deriving this ‘constitutional framework’ from the Union’s constitutional core enshrined in Article 2 TEU. Such an Article 2 TEU-based constitution would consist of those provisions that give expression to a founding value. Subsequently, this allows the Court to introduce substantive hierarchies between those Treaty provisions that give expression to an Article 2 TEU value and those that do not. This could lead to a threefold, hierarchical division of primary law: Article 2 TEU at its summit (the EU’s constitutional core), provisions giving expression to an EU value on the second level (the EU’s constitution), and the rest of EU primary law on a third one.
Towards a Tyranny of EU Values?
Authors: Spieker Luke Dimitrios
Published: July 2023

This chapter assesses the general risks of mobilizing Article 2 TEU before the Court of Justice. On the one hand, the indeterminacy of these values might provide a gateway for the Luxembourg judges’ political, moral, or ideological convictions thereby jeopardizing the rule of law. The Court can respond to such concerns by deciding value-related cases in the Grand Chamber or full Court, by rigorously applying recognized legal methods, and by making the sources that inspire the concretization of Article 2 TEU more transparent. On the other hand, the judicial enforcement of these indeterminate values might raise democratic concerns. For one, such concerns can emerge when the Court reviews the value compliance of democratically elected national governments. At the same, the judicial activation of Article 2 TEU might further tip the institutional balance, among the Union institutions, towards the EU judiciary. This chapter demonstrates how to mitigate these risks.
Introduction
Authors: Zenobi Luca
Published: July 2023

The Introduction situates the book in the context of three overarching themes: the defining features of medieval borders, the nature of pre-modern forms of territoriality, and the spatial fabric of the state in Italy. It begins by presenting the questions which will lead the inquiry into the world of borders: what can borders tell us about the relationships between a society and its spaces? And similarly, what can they tell us about the polities which they bounded? It then establishes two analytical concepts underlying the book’s investigation. The first is that borders should not be seen as universal artefacts but rather as spatial constructs specific to an era. The second is that the assertion of territoriality—and, with that, the making of borders—should be seen as a practice, not simply as a fact. Finally, it discusses existing interpretations of state and territory formation in late medieval Italy, evaluating their usefulness as well as any shortcomings. This is followed by four preliminary remarks (concerning chronology, source balance, terminology, and geographical definitions respectively) and by an outline of the book’s seven chapters.
Aphantasia and Conscious Thought
Authors: Lennon Preston
Published: July 2023

The sensory constraint on conscious thought says that if a thought is phenomenally conscious, its phenomenal properties must be reducible to some sensory phenomenal character. This chapter argues that the burgeoning psychological literature on aphantasia, an impoverishment in the ability to generate mental imagery, provides a counterexample to the sensory constraint. The best explanation of aphantasics’ introspective reports, neuroimaging, and task performance is that some aphantasics have conscious thoughts without sensory mental imagery. This argument against the sensory constraint supports the existence of a non-sensory phenomenology of thought. Moreover, this argument can be extended to show that this non-sensory phenomenology determines a thought content. Finally, it can potentially diagnose the disagreement over cognitive phenomenology in the philosophy of mind, as such disagreement may turn on interpersonal variation in mental imagery.
Seeing through Transparency
Authors: Bordini Davide
Published: July 2023

Since the 1990s the so-called transparency of experience has played a crucial role in core debates in philosophy of mind. However, recent developments in the literature have made transparency itself quite opaque. The very idea of transparent experience has become quite fuzzy, due to the articulation of many different notions of transparency and transparency theses. Absent a unified logical space where these notions and theses can be mapped and confronted, we are left with an overall impression of conceptual chaos. This is a problem, given the constant and ubiquitous references to transparency in the literature and its prominent position in the contemporary philosophy of mind. My goal in this chapter is to restore clarity through proper analysis of the mutual relations between the different transparency theses. This allows me to uncover a unitary multidimensional logical space where existing (as well as possible) views can be properly singled out and located.
Truth and Content in Sensory Experience
Authors: Mendelovici Angela
Published: July 2023

In The Metaphysics of Sensory Experience, David Papineau argues that sensory experiences are non-relational states that do not essentially have truth conditions. Papineau further claims that sensory experiences are not essentially representational and that truth conditions arise from environmental correlations. While I agree with the first part of the picture––that sensory experiences are intrinsic states that do not essentially have truth conditions––I don’t think Papineau follows his arguments to their proper conclusions. For even on a non-relational view of sensory states, it’s plausible that sensory experiences are essentially representational in that they constitute what we think, perceptually experience, or otherwise entertain. Further, because of this, the truth conditions of perceptual experiences cannot be entirely independent of the relevant non-relational features. If this is right, then we arrive at a version of representationalism that Papineau dismisses, a view he calls “pure phenomenal intentionalism.”
An Argument against Papineau’s Qualitative View of Sensory Experience
Authors: Pautz Adam
Published: July 2023

In his excellent book The Metaphysics of Sensory Experience (2021), David Papineau argues against standard theories of sensory experience: the sense datum view, representationalism, naïve realism, and so on. The only view left standing is his own “qualitative view.” On Papineau’s physicalist version, all experiences are nothing but neural states, and the only features essentially involved in experience are intrinsic neural properties. This essay argues that Papineau’s view is inconsistent with the essentially spatial character of visual experience. Along the way it answers Papineau’s objection against representationalism about experience—my own preferred view of sensory experience. His objection is that representationalism is inconsistent with the claim that experiences are “here-and-now” states with causes and effects. It is shown that representationalism is quite consistent with that claim.
Unfitting Absent Emotion
Authors: Fritz James
Published: July 2023

The world provides us with an ocean of opportunities for fitting emotion. But we are beings with limited emotional resources, so missed opportunities are common. This chapter argues that these failures to take up fitting emotions are very frequently unfitting in their own right—so frequently, in fact, that most of us lead lives replete with unfitting absences of emotion. It begins by showing that, whenever an emotion can be unfitting in virtue of being too weak, the absence of that emotion can also be unfitting, and for just the same reason. But emotional responses to a host of everyday objects—a funny joke, a nasty insult, and so on—can be unfittingly weak. This means that failures to respond emotionally to an enormous host of everyday objects are similarly unfitting.
Actual Dialogue
Authors: Ingram Stephen
Published: July 2023

This chapter explores what is required for moral dialogue to be appropriately inclusive and cooperative. In doing so, it fleshes out the intuitionist view of dialogical moral inquiry defended in Chapter 6, and sets up claims that will play an important role in the discussion of disagreement and debunking arguments in Chapter 8. More specifically, this chapter explains how dialogical moral inquiry would have to work in practice in order to refine our intuitions and enable justified moral beliefs at the frontiers of moral inquiry. It offers accounts of inclusion and cooperation in which empathy—specifically, a virtue of empathic cooperation—plays a central role, and it explains how significant institutional, structural changes will be needed to facilitate inclusive and cooperative dialogue in practice.
Contactless and longitudinal monitoring of nocturnal sleep and daytime naps in older men and women: a digital health technology evaluation study
Authors: Ravindran Kiran K G , della Monica Ciro , Atzori Giuseppe , Lambert Damion , Hassanin Hana , Revell Victoria , Dijk Derk-Jan
Published: July 2023

Study Objectives

To compare the 24-hour sleep assessment capabilities of two contactless sleep technologies (CSTs) to actigraphy in community-dwelling older adults.

Methods

We collected 7–14 days of data at home from 35 older adults (age: 65–83), some with medical conditions, using Withings Sleep Analyser (WSA, n = 29), Emfit QS (Emfit, n = 17), a standard actigraphy device (Actiwatch Spectrum [AWS, n = 34]), and a sleep diary (n = 35). We compared nocturnal and daytime sleep measures estimated by the CSTs and actigraphy without sleep diary information (AWS-A) against sleep-diary-assisted actigraphy (AWS|SD).

Results

Compared to sleep diary, both CSTs accurately determined the timing of nocturnal sleep (intraclass correlation [ICC]: going to bed, getting out of bed, time in bed >0.75), whereas the accuracy of AWS-A was much lower. Compared to AWS|SD, the CSTs overestimated nocturnal total sleep time (WSA: +92.71 ± 81.16 minutes; Emfit: +101.47 ± 75.95 minutes) as did AWS-A (+46.95 ± 67.26 minutes). The CSTs overestimated sleep efficiency (WSA: +9.19% ± 14.26%; Emfit: +9.41% ± 11.05%), whereas AWS-A estimate (−2.38% ± 10.06%) was accurate. About 65% (n = 23) of participants reported daytime naps either in bed or elsewhere. About 90% in-bed nap periods were accurately determined by WSA while Emfit was less accurate. All three devices estimated 24-hour sleep duration with an error of ≈10% compared to the sleep diary.

Conclusions

CSTs accurately capture the timing of in-bed nocturnal sleep periods without the need for sleep diary information. However, improvements are needed in assessing parameters such as total sleep time, sleep efficiency, and naps before these CSTs can be fully utilized in field settings.
Social Media Usage by United States Plastic Surgery Subspecialty Fellowship Programs
Authors: Tian William M. , Sergesketter Amanda R. , Yi Victoria N. , Sizemore J. Alexander , Record Sydney M. , Zeng Steven L. , Phillips Brett T.
Published: July 2023

Background:

Social media can be a powerful tool for plastic surgery training programs. Previous studies have shown the value social media may have in integrated residency program recruitment and program reputation. These findings may generalize to fellowship programs, but this space has not been comprehensively studied to date. Therefore, this study aims to characterize plastic surgery fellowship programs’ social media usage and identify subsequent opportunities for program leadership to generate engagement.

Methods:

United States plastic surgery fellowship programs in four major subspecialties (hand, microsurgery, craniomaxillofacial, and aesthetic) were identified and evaluated for social media presence on Instagram, Facebook, and Twitter. Platform-specific parameters were collected and statistically analyzed in aggregate.

Results:

There were a total of 25 Instagram accounts, four Facebook accounts, and three Twitter accounts across all investigated subspecialties. Hand surgery had the greatest social media presence on Instagram (19.5%) and Twitter (3.4%). Microsurgery had the greatest presence on Facebook (4.7%). Between 2015 and 2022, Instagram was the platform with the greatest increase in adoption by fellowship programs. Geographically, microsurgery and craniomaxillofacial accounts were primarily owned by Midwest programs (66.7%, 100%), and aesthetic primarily by programs in the South (83.3%). Number of Instagram posts and followers were not significantly correlated with hospital reputation (P = 0.12, P = 0.63).

Conclusions:

Social media is underutilized by plastic surgery fellowship programs. While Instagram metrics such as posts and followers are not correlated with hospital reputation, the skewed distributions of fellowship accounts, both geographically and across platforms, represent areas of potential growth.
Carpal Tunnel Syndrome: As Seen from the Perspective of the Patient
Authors: Blough Christian L. , Kuschner Stuart H. , Berihun Haben , Tseng Cassie C. , Kulber David A.
Published: July 2023

Background:

Carpal tunnel syndrome (CTS) is the most common nerve compression syndrome in the upper extremity and is one of the most common problems treated by hand surgeons. Despite its ubiquity—or perhaps because of it—there is a lack of unanimity regarding how best to treat CTS and what the options for treatment are. This study aimed to explore what patients find important when deciding on treatment of CTS in an effort to improve the physician–patient shared decision-making process.

Methods:

An online crowdsourcing platform was used to recruit participants for this study. Study participants were first led through a clinical scenario in which the symptoms of CTS were explained. They were then asked a series of questions regarding what was important to them when deciding upon treatment. A Likert scale was used for responses.

Results:

In total, 268 participant responses were included in the study. A majority of patients responded that all surveyed factors were either very important or important when considering treatment. The risk of surgery was most important, whereas postoperative pain was least important. The risk of surgery was significantly more important to patients than postoperative pain and time out of work. The cost of surgery was significantly more important to patients than postoperative pain.

Conclusions:

Given the lack of consensus regarding an algorithm for the treatment of CTS, the patient’s preference is increasingly important when formulating a treatment plan. The results of this study may better help physicians frame the discussion of treatment options for CTS with their patients.
An Examination of the Use of Large Language Models to Aid Analysis of Textual Data
Authors: Tai Robert H. , Bentley Lillian R. , Xia Xin , Sitt Jason M. , Fankhauser Sarah C. , Chicas-Mosier Ana M. , Monteith Barnas G.
Published: July 2023

The increasing use of machine learning and Large Language Models (LLMs) opens up opportunities to use these artificially intelligent algorithms in novel ways. This article proposes a methodology using LLMs to support traditional deductive coding in qualitative research. We began our analysis with three different sample texts taken from existing interviews. Next, we created a codebook and inputted the sample text and codebook into an LLM. We asked the LLM to determine if the codes were present in a sample text provided and requested evidence to support the coding. The sample texts were inputted 160 times to record changes between iterations of the LLM response. Each iteration was analogous to a new coder deductively analyzing the text with the codebook information. In our results, we present the outputs for these recursive analyses, along with a comparison of the LLM coding to evaluations made by human coders using traditional coding methods. We argue that LLM analysis can aid qualitative researchers by deductively coding transcripts, providing a systematic and reliable platform for code identification, and offering a means of avoiding analysis misalignment. Implications of using LLM in research praxis are discussed, along with current limitations.
Epigenetic Age Acceleration in Surviving versus Deceased COVID-19 Patients with Acute Respiratory Distress Syndrome following Hospitalization
Authors: Bejaoui Yosra , Amanullah Fathima Humaira , Saad Mohamad , Taleb Sarah , Bradic Martina , Megarbane Andre , Hssain Ali Ait , Khalil Charbel Abi , Hajj Nady El
Published: July 2023

Aging has been reported as a major risk factor for severe symptoms and higher mortality rates in COVID-19 patients. Molecular hallmarks such as epigenetic alterations and telomere attenuation reflect the biological process of aging. Epigenetic clocks have been shown to be valuable tools for measuring biological age in a variety of tissues and samples. As such, these epigenetic clocks can determine accelerated biological aging and time-to-mortality across various tissues. Previous reports have shown accelerated biological aging and telomere attrition acceleration following SARS-CoV-2 infection. However, the effect of accelerated epigenetic aging on outcome (death/recovery) in COVID-19 patients with Acute Respiratory Distress Syndrome (ARDS) has not been well investigated. In this study, we measured DNA methylation age and telomere attrition in 87 severe COVID-19 cases with ARDS under mechanical ventilation. Furthermore, we compared dynamic changes in epigenetic aging across multiples time-points until recovery or death. Epigenetic age was measured using the Horvath, Hannum, DNAm skin and blood, GrimAge, and PhenoAge clocks, whereas telomere length was calculated using the surrogate marker DNAmTL. Our analysis revealed significant accelerated epigenetic aging but no telomere attrition acceleration in severe COVID-19 cases. In addition, we observed epigenetic age deceleration at inclusion vs end of follow-up in recovered but not in deceased COVID-19 cases using certain clocks. When comparing dynamic changes in epigenetic age acceleration (EAA), we detected higher EAA using both the Horvath and PhenoAge clocks in deceased vs recovered patients. The DNAmTL measurements revealed telomere attrition acceleration in deceased COVID19 patients between inclusion and end of follow-up as well as a significant change in dynamic telomere attrition acceleration when comparing patients who recovered vs those who died. In conclusion, EAA and telomere attrition acceleration was associated with treatment outcome in hospitalized COVID-19 Patients with ARDS. A better understanding of the long-term effects of EAA in COVID19 patients and how they might contribute to Long COVID symptoms in recovered individuals is urgently needed.
Transfer of mitochondrial DNA into the nuclear genome during gene editing
Authors: Wu Jinchun , Liu Yang , Ou Liqiong , Gan Tingting , Zhangding Zhengrong , Yuan Shaopeng , Liu Mengzhu , Liu Xinyi , Li Jiasheng , Yin Jianhang , Xin Changchang , Tian Ye , Hu Jiazhi
Published: July 2023

Mitochondria serve as the cellular powerhouse, and their distinct DNA makes them a prospective target for gene editing to treat genetic disorders. However, the impact of genome editing on mitochondrial DNA (mtDNA) stability remains a mystery. Our study reveals previously unknown risks of genome editing that both nuclear and mitochondrial editing cause broad transfer of mitochondrial DNA segments into the nuclear genome in various cell types including human cell lines, primary T cells, retinal cells, and mouse embryos. Furthermore, drug-induced mitochondrial stresses and mtDNA breaks exacerbate this transfer of mtDNA into the nuclear genome. Notably, we observe that the newly developed mitochondrial base editor DdCBE can also cause widespread mtDNA integrations. However, we provide a practical solution to suppress the transfer of mtDNA by co-expressing TREX1 or TREX2 exonucleases during DdCBE editing. These findings also shed light on the origins of mitochondrial-nuclear DNA segments.
Spatio-temporal diversity and genetic architecture of pyrantel resistance in Cylicocyclus nassatus, the most abundant horse parasite
Authors: Sallé Guillaume , Courtot Elise , Cabau Cédric , Parrinello Hugues , Serreau Delphine , Reigner Fabrice , Gesbert Amandine , Jacquinot Lauriane , Lenhof Océane , Aimé Annabelle , Picandet Valérie , Kuzmina Tetiana , Holovachov Oleksandr , Bellaw Jennifer , Nielsen Martin K , von Samson-Himmelstjerna Georg , Valière Sophie , Gislard Marie , Lluch Jérôme , Kuchly Claire , Klopp Christophe
Published: July 2023

Cyathostomins are a complex of 50 intestinal parasite species infecting horses and wild equids. The massive administration of modern anthelmintic drugs has increased their relative abundance in horse helminth communities and selected drug-resistant isolates worldwide. Cylicocyclus nassatus is the most prevalent and the most abundant species. The tedious identification and isolation of these worms have hampered studies of their biology that remain largely uncharacterised. Here we have leveraged ultra-low input sequencing protocols to build a reference genome for the most prevalent horse strongyle species. Using this resource, we have established the first estimates of its genetic diversity and population structure on a gradient ranging from Ukraine (close to modern horse domestication area) to North America, while capturing a 19th-century snapshot of C. nassatus diversity in Egypt. Our results support a diverse and lowly structured global population. Modern populations displayed lower nucleotide diversity relative to the old North African isolate. We identified the first genetic candidates upon which pyrantel (an anthelmintic drug used in companion animals) selection likely applied in field populations, highlighting previously suspected genes coding for nicotinic acetylcholine receptor subunits, and identifying new candidates showing differential expression in independently evolved Caenorhabditis elegans lines. These results offer a first resource to widen current knowledge on cyathostomin biology, unravel novel aspects of pyrantel resistance mechanisms and provide candidate genes to track pyrantel resistance in the field.
Homeostatic macrophages prevent preterm birth and improve neonatal outcomes by mitigatingin uterosterile inflammation
Authors: Garcia-Flores Valeria , Liu Zhenjie , Romero Roberto , Pique-Regi Roger , Xu Yi , Miller Derek , Levenson Dustyn , Galaz Jose , Winters Andrew D. , Farias-Jofre Marcelo , Panzer Jonathan J. , Theis Kevin R. , Gomez-Lopez Nardhy
Published: July 2023

Preterm birth (PTB), often preceded by preterm labor, is a major cause of neonatal morbidity and mortality worldwide. Most PTB cases involve intra-amniotic inflammation without detectable microorganisms, termedin uterosterile inflammation, for which there is no established treatment. Here, we propose homeostatic macrophages to prevent PTB and adverse neonatal outcomes caused byin uterosterile inflammation. Single-cell atlases of the maternal-fetal interface revealed that homeostatic maternal macrophages are reduced with human labor. M2 macrophage treatment prevented PTB and reduced adverse neonatal outcomes in mice within uterosterile inflammation. Specifically, M2 macrophages halted premature labor by suppressing inflammatory responses in the amniotic cavity, including inflammasome activation, and mitigated placental and offspring lung inflammation. Moreover, M2 macrophages restored neonatal gut homeostasis and enhanced resistance to systemic bacterial infection. Our findings show that M2 macrophages are a promising strategy to mitigate PTB and improve neonatal outcomes fromin uterosterile inflammation.
Migration and standing variation in vaginal and rectal yeast populations in recurrent vulvovaginal candidiasis
Authors: Adamu Bukari Abdul-Rahman , Kukurudz-Gorowski Rebekah , de Graaf Alexia , Habon Devin , Manyaz Beamlak , Syvolos Yana , Sumanarathnea Aruni , Poliquin Vanessa , Gerstein Aleeza C
Published: July 2023

Vulvovaginal candidiasis is one of the most common vaginal and fungal infections. The majority of infections are successfully treated with antifungal drugs. However, ~ 8% of cases lead to chronic recurrent vulvovaginal candidiasis ("RVVC"), and approximately half of RVVC cases are idiopathic. Previous research has generally found closely-related isolates within vaginal and rectal populations and between subsequent infections. However, their coarse methods preclude assessing the fine-scale relationships among closely related isolates and measuring standing genetic variation, a fundamental property of populations with implications for evolutionary potential. To address this gap, we isolated 12 vaginal and 12 rectal yeast isolates during symptomatic relapse from four individuals with a history of RVVC. Three participants hadCandida albicansinfections, while the fourth hadNakaseomyces glabratus. All isolates were whole-genome sequenced and phenotyped. The isolates were placed into the global phylogenies, which included constructing an updatedN. glabratustree containing over 500 isolates. Multiple analyses were consistent with frequent migration between sites. Although there are extremely few comparables,C. albicanspopulation nucleotide diversity was similar to most commensal oral and rectal populations, whileN. glabratuswas similar to some bloodstream infections, yet higher than others. Diversity was largely driven by single nucleotide changes; no aneuploidies were found, and although loss-of-heterozygosity tracts were common in the populations, only a single region on chr1L varied among isolates from one participant. There was very little phenotypic diversity for drug response or growth and no consistent difference between isolates from different sites for invasive growth. Combined, this study provides baseline measurements and describes analysis techniques to quantify within-population diversity. We highlight a critical need for comparable studies that use the same sampling effort, sequencing, and analysis methods to understand the interplay between selection, drift, and migration in shaping fungal microbial communities in this and other important contexts.
Self-assembling Gn head ferritin nanoparticle vaccine provides full protection from lethal challenge of Dabie Bandavirus in aged ferrets
Authors: Kim Dokyun , Kim Eunha , Kim Semi , Chung Youseung , Cho Sung-Dong , Choi Yunseo , Lai Chih-Jen , Dai Xinghong , Kang Seokmin , Kwak Mi-Jeong , Cha Inho , Liu Ziyi , Choi Younho , Park Su-Hyung , Choi Young Ki , Jung Jae U.
Published: July 2023

Dabie Bandavirus (DBV), previously known as Severe Fever with Thrombocytopenia Syndrome (SFTS) Virus, induces a characteristic thrombocytopenia with a mortality rate ranging from 12% to as high as 30%. The sero-prevalence of DBV in healthy people is not significantly different among age groups, but clinically diagnosed SFTS patients are older than ∼50 years, suggesting that age is the critical risk factor for SFTS morbidity and mortality. Accordingly, our immune-competent ferret model demonstrates an age (>4 years old)-dependent DBV infection and pathogenesis that fully recapitulates human clinical manifestation. To protect the aged population from DBV-induced SFTS, vaccine should carry robust immunogenicity with high safety profile. Previous studies have shown that glycoproteins Gn/Gc are the most effective antigens for inducing both neutralizing antibody (NAb)- and T cell-mediated immunity and, thereby, protection. Here, we report the development of a protein subunit vaccine with 24-mer self-assembling ferritin (FT) nanoparticle to present DBV Gn head region (GnH) for enhanced immunogenicity. Anion exchange chromatography and size exclusion chromatography readily purified the GnH-FT nanoparticles to homogeneity with structural integrity. Mice immunized with GnH-FT nanoparticles induced robust NAb response and T-cell immunity against DBV Gn. Furthermore, aged ferrets immunized with GnH-FT nanoparticles were fully protected from DBV challenge without SFTS symptoms such as body weight loss, thrombocytopenia, leukopenia, and fatality. This study demonstrates that DBV GnH-FT nanoparticles provide an efficient vaccine efficacy in mouse and aged ferret models and should be an outstanding vaccine candidate targeted for the aged population against fatal DBV infection.

Importance

Dabie Bandavirus (DBV) is an emerging tick-borne virus that causes Severe Fever with Thrombocytopenia Syndrome (SFTS) in infected patients. Human SFTS symptoms progress from fever, fatigue, and muscle pain to the depletion of white blood cells and platelets with fatality rates up to 30%. The recent spread of its vector tick to over 20 states in the United States increases the potential for outbreaks of the SFTS beyond the East Asia. Thus, the development of vaccine to control this rapidly emerging virus is a high priority.

In this study, we applied self-assembling ferritin (FT) nanoparticle to enhance the immunogenicity of viral Gn head domain as a vaccine target. Mice immunized with the GnH-FT nanoparticle vaccine induced potent antibody responses and cellular immunity. Immunized aged-ferrets were fully protected from the lethal challenge of DBV. Our study describes the GnH-FT nanoparticle vaccine candidate that provides protective immunity against the emerging DBV infection.
Healthcare service quality and patient satisfaction: a conceptual framework
Authors: Ali Javed , Jusoh Ahmad , Idris Norhalimah , Nor Khalil Md
Published: July 2023

Purpose

The current study aims at developing a conceptual framework containing original dimensions of SERVQUAL and adding two modified dimensions: patient safety and medical professionalism in healthcare service quality (HSQ) model.

Design/methodology/approach

An extensive review of HSQ literature pertaining to its dimensions and models with respect to content analysis and bibliometric studies of service quality in healthcare and SERVQUAL in healthcare were performed on 47 relevant studies, 4,689 and 529 documents after applying inclusion and exclusion criteria. Google Scholar and Scopus were the primary sources to find the relevant documents.

Findings

The content analysis was conducted to group HSQ dimensions into seven themes. Co-occurrence analysis of author keywords was performed in VOSviewer to find the links between service quality, SERVQUAL and proposed dimensions. Organization and analysis of different HSQ models and dimensions emerged from the literature result in a comprehensive conceptual framework comprising modified dimensions of healthcare service quality – medical professionalism and patient safety.

Originality/value

SERVQUAL is a widely accepted, tested and validated model in perceiving HSQ from the lenses of patients. But it does not cover the complex nature of healthcare service, thus requiring modification and the addition of new contextual dimensions. Therefore, a comprehensive conceptual framework is developed to validate and test quantitatively.
Investigating the performance of quality management practices induced by top management commitment and Kaizen initiatives: evidence from Jordanian public hospitals in the aftermath of COVID-19
Authors: Alsmairat Mohammad A.K. , El Baz Jamal , Al-Ma'aitah Noor
Published: July 2023

Purpose

This study investigates the effects of top management commitment (TMC) and Kaizen on quality management practices (QMP) and how the latter influence the performance of Jordanian public hospitals in the aftermath of COVID-19.

Design/methodology/approach

A survey-based questionnaire was employed to collect data from 222 practitioners and professionals working in public hospitals in Jordan. Partial least squares structural equation modeling (PLS-SEM) was undertaken to analyze data.

Findings

Significant and positive effects of TMC and Kaizen (continuous improvement) on QMP are highlighted by the results. The findings also show that QMP has a positive and significant impact on public hospitals' performance. Furthermore, the effects of TMC and Kaizen on performance were also found to be significant.

Research limitations/implications

Practitioners and researchers will gain a greater understanding of how implementing QMP can enhance the performance of public hospitals in the context of the COVID-19 outbreak. The results underline the important role of Kaizen and TMC in the success of QMP and their effect on performance. This research is a cross-sectional study, and there is a need to conduct further empirical investigation based on secondary data or objective measurement of performance.

Originality/value

This research is one of the first studies to investigate the effects of QMP on public hospitals' performance following the COVID-19 outbreak. This study is one of the empirical examinations of QMP and Kaizen in developing countries by investigating Jordanian public hospitals.
Who wants to be a social entrepreneur? Exploring the antecedents interrelationship via modified Mair Noboa model
Authors: Iqbal Mehree , Geneste Louis , Weber Paull
Published: July 2023

Purpose

This paper aims to contribute to the field of social entrepreneurship by exploring the interrelationships among the antecedents of social entrepreneurial intention (SEI) through the lens of Mair Noboa model (MNM). In recent years, many researchers have applied the antecedents of MNM to determine SEI. However, interrelationship among these antecedents has not been a focus of enquiry despite the repeated scholarly calls.

Design/methodology/approach

Applying quantitative methodology, the data was collected from a Web-based survey distributed across Bangladesh (N = 412). Data analysis was carried out based on the covariance-based structural equation modelling technique to confirm the hypotheses. The final measurement and structural models met all the requirements for reliability, model fit, convergent validity and discriminant validity. The proposed hypotheses were tested based on direct relationships and mediating effects.

Findings

The findings suggested that interrelationships among these antecedents do increase individuals’ intentions to become social entrepreneurs.

Originality/value

This paper fills an important knowledge gap by exploring the interrelationships among moral obligation, empathy, perceived social support and social entrepreneurial self-efficacy. This paper stressed identifying whether the SEI enhances through the interrelationships among these antecedents or not. The study findings bring new theoretical and practical implications on the role of empathy, moral obligation, perceived social support and social entrepreneurial self-efficacy.
Evaluation of portable gas chromatography–mass spectrometry (GC–MS) for the analysis of fentanyl, fentanyl analogs, and other synthetic opioids
Authors: Leary Pauline E. , Kizzire Koby L. , Chan Chao Rebecca , Niedziejko Michael , Martineau Noah , Kammrath Brooke W.
Published: July 2023

Potent synthetic opioids including fentanyl and its analogs are frequently encountered in the field and require detection and identification by first responders to maintain the safety of drug abusers, first responders, health‐care providers, and the public at large. Due to the low concentration at which these substances may be encountered and the complicating matrices within which they may be dispersed, the use of portable gas chromatography–mass spectrometry (GC–MS) for their identification in the field offers great potential value. This research established that portable GC–MS is a useful method for the detection and identification of a large number of synthetic opioids, especially fentanyl and its analogs. In this study, 250 synthetic opioids and related substances including 210 fentanyl analogs were analyzed using portable GC–MS. It was concluded that 225 of the 250 (90.0%) opioids analyzed were successfully detected onboard at the time of analysis and identified as either the substance (55.2%) or an analog (34.8%). These outcomes have equivalent benefit for the field analysis of illicit drugs due to both initiating the same subsequent actions by first responders.
High prevalence of HPV16 and high‐grade cytology in women undergoing active surveillance for cervical intraepithelial neoplasia grade 2
Authors: Damgaard Rikke Kamp , Jenkins David , Stoler Mark H. , van de Sandt Miekel M. , Lycke Kathrine Dyhr , de Koning Maurits N. C. , Quint Wim G. V. , Steiniche Torben , Petersen Lone Kjeld , Hammer Anne
Published: July 2023

Introduction

Many countries have adopted active surveillance in women with cervical intraepithelial neoplasia grade 2 (CIN2), leaving the lesion untreated. However, there is a lack of consensus on the eligibility criteria for active surveillance across countries, with some abstaining from active surveillance in women with human papilloma virus 16 (HPV16) or a high‐grade cytology. Here, we aimed to describe the distribution of HPV genotypes, age, and cytology in women undergoing active surveillance for CIN2.

Material and methods

We conducted a single‐center cross‐sectional study on women aged 23–40 undergoing active surveillance for CIN2 during 2000–2010. Women were identified through the Danish Pathology Data Bank (DPDB) at Aarhus University Hospital, Denmark. We collected information on basic characteristics and results of histopathological examinations via DPDB. Women were deemed eligible for inclusion if they had a subsequent biopsy after index CIN2, and had no prior record of CIN2+, hysterectomy, or cone biopsy. Archived biopsies underwent HPV genotyping using the HPV SPF10‐ DEIA‐LiPA25 system, and the diagnosis was re‐evaluated by three expert pathologists. We used the Chi squared‐test (p‐value) for comparison across groups.

Results

We identified 3623 women with CIN2 of whom 455 (12.6%) were included. Most women were 30 years or younger (73.8%), and half (48.8%) had a high‐grade index cytology. The prevalence of any high‐risk HPV was 87.0%, with HPV16 being the most prevalent genotype (35.6%). The prevalence of HPV16 was significantly higher in women aged 30 or younger (39.3%) compared to women older than 30 years (25.2%) (p = 0.006). Upon expert review, 261 (57.4%) had CIN2 confirmed, whereas 56 (12.3%) were upgraded to CIN3 and 121 (26.6%) were downgraded to CIN1/normal. While the HPV16 prevalence was similar between community and expert confirmed CIN2, the prevalence of HPV16 was significantly higher in women with expert CIN3 compared to women with expert CIN1/normal (64.3% vs. 19.0%, p = 0.001).

Conclusions

The high prevalence of HPV16 and high‐grade cytology imply that these women may be perceived as a high‐risk population and non‐eligible for active surveillance in countries outside Denmark. Future studies should investigate the importance of HPV, age, cytology, and expert review on risk of progression to help refine criteria for active surveillance.
Open versus robot‐assisted radical cystectomy: pentafecta and trifecta achievement comparison from a randomised controlled trial
Authors: Mastroianni Riccardo , Tuderti Gabriele , Ferriero Mariaconsiglia , Anceschi Umberto , Bove Alfredo Maria , Brassetti Aldo , Misuraca Leonardo , D'Annunzio Simone , Guaglianone Salvatore , Gallucci Michele , Simone Giuseppe
Published: July 2023

Objectives

To compare University of Southern California (USC) Institute of Urology pentafecta and trifecta achievement comparing open radical cystectomy (ORC) vs robot‐assisted RC (RARC) with totally intracorporeal urinary diversion (iUD) from a randomised controlled trial (RCT).

Patients and Methods

Patients were eligible for randomisation if they had a diagnostic transurethral resection of bladder tumour with clinical T stage (cT)2–4, cN0, cM0, or recurrent high‐grade non‐muscle‐invasive bladder cancer and no anaesthesia contraindications to robotic surgery. Patients were enrolled with a covariate adaptive randomisation process based on the following variables: body mass index, American Society of Anesthesiologists score, preoperative haemoglobin, planned UD, neoadjuvant chemotherapy, and cT stage. USC pentafecta was defined as the combination at 1 year after surgery of: negative soft tissue surgical margins, ≥16 lymph node (LN) yield, absence of major (Clavien–Dindo Grade ≥III) complications at 90 days, absence of UD‐related long‐term sequalae, and absence of clinical recurrence. Trifecta was defined as the coexistence of daytime urinary continence, absence of major complications and recurrence‐free status, all assessed at 1 year. Continuous and categorical variables were compared using Student's t‐test and chi‐square test, respectively. Univariable logistic regression analysis was performed to assess the role of USC pentafecta and trifecta achievement on health‐related quality of life (HRQoL).

Results

There was no statistically significant difference in USC pentafecta and trifecta achievement between groups. Among secondary outcomes, univariable logistic regression analysis was performed and both 1‐year USC pentafecta and trifecta achievement were predictors of 2‐year unmodified global HRQoL.

Conclusions

This study supports equivalence of RARC‐iUD and ORC with regard to surgical quality as described by the USC pentafecta and trifecta. We described a significant impact of USC pentafecta and trifecta achievement on global health status/HRQoL, providing a strict correlation between objective evaluation of surgical outcomes and self‐reported HRQoL.