bluuebunny/crossref_metadata_2025 huggingface dataset:
The Intangible Poetic Legacy of Black Voices
Authors: Berruezo-Sánchez Diana
Published: August 2024

This chapter looks at the contributions of black poets to early modern Spanish literature, both oral and written. In particular, it scrutinises a series of sonnets depicting a literary dispute between two poets, named Oña and Sampayo. It argues that Sampayo is one of the first black voices of early modernity that explicitly defends his artistic agency in counter to the anti-black rhetoric that suffused early modern literary contests. It also examines three newly uncovered poems in which black voices also defend their blackness and reject an imposed idea of whiteness. These prompt important discussion about the provenance and circulation of these and similar poems in the late seventeenth century. The chapter’s new evidence belies the common belief that Juan Latino (c.1518–c.1594) was the only black poet in early modern Spain. Rather, these findings and close readings substantiate the important legacy of black poetic voices.
Geographical Differences in Hydrochlorothiazide Associated Risk of Skin Cancer Balanced Against Disability Related to Hypertensive Heart Disease
Authors: Almskou Rasmussen Anders , Buus Niels Henrik , Comerma Steffensen Simon G
Published: August 2024

BACKGROUND

Hypertension affects 25%–30% of the world population. Hydrochlorothiazide (HCTZ) is among the most used and cheapest medications but was in 2018 labeled with a warning stating the increased risk of nonmelanoma skin cancer (NMSC). This study describes geographical differences in the association between HCTZ and NMSC from the perspective of hypertensive heart disease (HHD).

METHODS

We conducted a systematic literature search (PubMed, Embase, Clinicaltrial.gov, and Clinicaltrial.eu) using PICO/PECO acronyms, including case–control, cohort, and randomized controlled trials. We constructed a rate ratio of disability-adjusted life years (DALY) for HHD/NMSC in the global burden of disease (GBD) regions.

RESULTS

No increased risk of NMSC with the use of HCTZ was found in Taiwan, India, and Brazil. A small (hazard ratio (HR)/odds ratio (OR) ≤1.5) but significantly increased risk was seen in Canada, the United States, and Korea. An increased risk (1.5< HR/OR ≤2.5) in Iceland, Spain, and Japan and a highly increased risk (HR/OR >2.5) in the United Kingdom, Denmark, the Netherlands, and Australia. HHD is associated with a more than tenfold DALY rate compared with NMSC in 13 of 21 GBD regions, corresponding to 77.2% of the global population. In none of these 13 regions was there an increased risk of HCTZ-associated NMSC.

CONCLUSIONS

Despite limited information from many countries, our data point to large geographical differences in the association between HCTZ and NMSC. In all GBD regions, except Australasia, HHD constitutes a more than fivefold DALY rate compared to NMSC. This disproportionate risk should be considered before avoiding HCTZ from the antihypertensive treatment.
Differential growth rate, water-use efficiency and climate sensitivity between males and females of Ilex aquifolium in north-western Spain
Authors: Sánchez Vilas Julia , Hernández-Alonso Héctor , Rozas Vicente , Retuerto Rubén
Published: August 2024

Background and aims

Dioecious plant species, i.e. those in which male and female functions are housed in different individuals, are particularly vulnerable to global environmental changes. For long-lived plant species, such as trees, long-term studies are imperative to understand how growth patterns and their sensitivity to climate variability affect the sexes differentially.

Methods

Here, we explore long-term intersexual differences in wood traits, namely radial growth rates and water-use efficiency quantified as stable carbon isotope abundance of wood cellulose, and their climate sensitivity in Ilex aquifolium trees growing in a natural population in north-western Spain.

Key results

We found that sex differences in secondary growth rates were variable over time, with males outperforming females in both radial growth rates and water-use efficiency in recent decades. Summer water stress significantly reduced the growth of female trees in the following growing season, whereas the growth of male trees was favoured primarily by cloudy and rainy conditions in the previous autumn and winter combined with low cloud cover and warm conditions in summer. Sex-dependent lagged correlations between radial growth and water availability were found, with a strong association between tree growth and cumulative water availability in females at 30 months and in males at 10 months.

Conclusions

Overall, our results point to greater vulnerability of female trees to increasing drought, which could lead to sex-ratio biases threatening population viability in the future.
Non-Breast Implantable Medical Devices and Associated Malignancies: A Systematic Review
Authors: Ziolkowski Natalia , Milkovich John , D’Souza Alexandra , Austin Ryan E , McGuire Patricia , Lista Frank , Ahmad Jamil
Published: August 2024

Innovation in healthcare has led to the development of numerous implantable medical devices (IMDs). However, advances in our knowledge of breast implant–associated malignancies have raised questions about the prevalence, etiology, and management of malignancies associated with non-breast IMDs. The objective of this study was to examine the prevalence and characteristics of malignancies associated with non-breast IMDs. An expert medical librarian developed the search strategy for this review. Databases included MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. In addition, gray literature sources were searched, and relevant references from systematic reviews and meta-analyses were included. The PRISMA guideline was followed for the review. Risk of bias was evaluated with the JBI Critical Appraisal tools. A total of 12,230 articles were reviewed, with a total of 77 meeting inclusion criteria. Risk of bias was highest with case reports (moderate, average of 65.1% with range of 37.5% to 100%) and low for the remaining study types. In total, 616 cases of IMD-associated malignancies were identified. Malignancies associated with IMDs were reported in the head and neck (543, 88.1%), lower extremity (57, 9.6%), thorax (9, 1.4%), abdomen (3, 0.5%), and genitourinary system (2, 0.3%). The most common malignancy type in the lower extremity was sarcoma, in the head and neck was squamous cell carcinoma, and in the thorax was lymphoma. This study is the first comprehensive systematic review of its kind. Overall, the oncologic risk of IMDs is low. The discussion of malignancy is an important part of the overall consent process, and malignancy should be considered with any new signs or symptoms in the anatomic area of an implant. More data are needed to better understand how primary malignancies occur around IMDs and how to reduce this risk.

Level of Evidence: 3
Locuaz: an in silico platform for protein binders optimization
Authors: Barletta German P , Tandiana Rika , Soler Miguel , Fortuna Sara , Rocchia Walter
Published: August 2024

Motivation

Engineering high-affinity binders targeting specific antigenic determinants remains a challenging and often daunting task, requiring extensive experimental screening. Computational methods have the potential to accelerate this process, reducing costs and time, but only if they demonstrate broad applicability and efficiency in exploring mutations, evaluating affinity, and pruning unproductive mutation paths.

Results

In response to these challenges, we introduce a new computational platform for optimizing protein binders towards their targets. The platform is organized as a series of modules, performing mutation selection and application, molecular dynamics simulations to sample conformations around interaction poses, and mutation prioritization using suitable scoring functions. Notably, the platform supports parallel exploration of different mutation streams, enabling in silico high-throughput screening on High Performance Computing (HPC) systems. Furthermore, the platform is highly customizable, allowing users to implement their own protocols.

Availability and implementation

The source code is available at https://github.com/pgbarletta/locuaz and documentation is at https://locuaz.readthedocs.io/. The data underlying this article are available at https://github.com/pgbarletta/suppl_info_locuaz
Accelerated dimensionality reduction of single-cell RNA sequencing data with fastglmpca
Authors: Weine Eric , Carbonetto Peter , Stephens Matthew
Published: August 2024

Motivated by theoretical and practical issues that arise when applying Principal component analysis (PCA) to count data, Townes et al. introduced “Poisson GLM-PCA”, a variation of PCA adapted to count data, as a tool for dimensionality reduction of single-cell RNA sequencing (scRNA-seq) data. However, fitting GLM-PCA is computationally challenging. Here we study this problem, and show that a simple algorithm, which we call “Alternating Poisson Regression” (APR), produces better quality fits, and in less time, than existing algorithms. APR is also memory-efficient and lends itself to parallel implementation on multi-core processors, both of which are helpful for handling large scRNA-seq datasets. We illustrate the benefits of this approach in three publicly available scRNA-seq datasets. The new algorithms are implemented in an R package, fastglmpca.

Availability and implementation

The fastglmpca R package is released on CRAN for Windows, macOS and Linux, and the source code is available at github.com/stephenslab/fastglmpca under the open source GPL-3 license. Scripts to reproduce the results in this paper are also available in the GitHub repository and on Zenodo.
Semiparametric inference of effective reproduction number dynamics from wastewater pathogen surveillance data
Authors: Goldstein Isaac H , Parker Daniel M , Jiang Sunny , Minin Volodymyr M
Published: August 2024

Concentrations of pathogen genomes measured in wastewater have recently become available as a new data source to use when modeling the spread of infectious diseases. One promising use for this data source is inference of the effective reproduction number, the average number of individuals a newly infected person will infect. We propose a model where new infections arrive according to a time-varying immigration rate which can be interpreted as an average number of secondary infections produced by one infectious individual per unit time. This model allows us to estimate the effective reproduction number from concentrations of pathogen genomes, while avoiding difficulty to verify assumptions about the dynamics of the susceptible population. As a byproduct of our primary goal, we also produce a new model for estimating the effective reproduction number from case data using the same framework. We test this modeling framework in an agent-based simulation study with a realistic data generating mechanism which accounts for the time-varying dynamics of pathogen shedding. Finally, we apply our new model to estimating the effective reproduction number of SARS-CoV-2, the causative agent of COVID-19, in Los Angeles, CA, using pathogen RNA concentrations collected from a large wastewater treatment facility.
Coronary computed tomography angiography-derived fat attenuation index predict future percutaneous coronary intervention
Authors: He Wei , Lu Yige , Yin Jiasheng , He Furong , Zhang Yaoyi , Qiao Guanyu , Luan Jingyang , Yao Zhifeng , Li Chenguang , Yang Shan , Zhao Shihai , Shen Li , Guo Weifeng , Zeng Mengsu
Published: August 2024

Objectives

This study aims to investigate the differences in plaque characteristics and fat attenuation index (FAI) between in patients who received revascularization versus those who did not receive revascularization and examine whether the machine learning (ML)-based model constructed by plaque characteristics and FAI can predict revascularization.

Methods

This study was a post hoc analysis of a prospective single-centre registry of sequential patients undergoing coronary computed tomography angiography, referred from inpatient and emergency department settings (n = 261, 63 years ± 8; 188 men). The primary outcome was revascularization by percutaneous coronary revascularization. The computed tomography angiography (CTA) images were analysed by experienced radiologists using a dedicated workstation in a blinded fashion. The ML-based model was automatically computed.

Results

The study cohort consisted of 261 subjects. Revascularization was performed in 105 subjects. Patients receiving revascularization had higher FAI value (67.35 ± 5.49 vs −80.10 ± 7.75 Hu, P < .001) as well as higher plaque length, calcified, lipid, and fibrous plaque burden and volume. When FAI was incorporated into an ML risk model based on plaque characteristics to predict revascularization, the area under the curve increased from 0.84 (95% CI, 0.68-0.99) to 0.95 (95% CI, 0.88-1.00).

Conclusions

ML algorithms based on FAI and characteristics could help improve the prediction of future revascularization and identify patients likely to receive revascularization.

Advances in knowledge

Pre-procedural FAI could help guide revascularization in symptomatic coronary artery disease patients.
Development of organic photoreactions utilizing the characteristics of elements with low electronegativity
Authors: Nagashima Yuki
Published: August 2024

Organic photoreactions have received much attention as unique tools to access kinetically and/or thermodynamically prohibited products in the ground state. These photoreactions have been based mainly on using elements with high electronegativity such as carbon (C), oxygen (O), nitrogen (N), halogens (F, Cl, Br, and I) as well as transition metals. On the other hand, we have been interested in the characteristics of elements with low electronegativity, such as boron (B), silicon (Si), and tin (Sn), in the excited state, enabling highly reactive and/or selective photoinduced borylations, silylations, and stannylations. In this account, we highlight our latest findings concerning diverse organic photoreactions utilizing B, Si, and Sn elements, which are challenging when using conventional strategies.
One-month DAPT after biodegradable-polymer everolimus-eluting stent implantation in patients at high-bleeding risk: an individual patient data pooled analysis of the SENIOR and POEM trials
Authors: Pivato Carlo A , Stefanini Giulio , Giacoppo Daniele , Sideris Georgios , Testa Luca , Paunovic Dragica , Briguori Carlo , Indolfi Ciro , Reimers Bernhard , Sinnaeve Peter , Varenne Olivier
Published: August 2024

Aims

Dual antiplatelet therapy (DAPT) can be shortened up to 1 month in high-bleeding risk (HBR) patients receiving a contemporary biodegradable-polymer sirolimus-eluting stent. We aimed to summarize the evidence on a similar DAPT regimen after biodegradable-polymer everolimus-eluting stent (EES) implantation in patients at HBR.

Methods and results

We pooled the individual participant data from the available trials evaluating this strategy, namely, the SENIOR and the POEM trials. Inclusion criteria were ≥1 biodegradable-polymer EES implantation and ≤1-month duration of DAPT. The primary endpoint was the 1-year composite of cardiovascular death, myocardial infarction, or stroke. Major bleeding was defined as Bleeding Academic Research Consortium (BARC) type 3–5 bleeding. Landmark analyses were performed at 1 month, the time point for intended DAPT interruption. We included 766 participants (age 77.5 ± 8.2 years, women 31.9%), 323 from the SENIOR and 443 from the POEM trial. The primary endpoint occurred in 45 participants (6.0%; 95% confidence interval [CI], 4.3–7.7%) through 1 year of follow-up, with 21 (2.8%; 95% CI, 1.6–3.9%) events during the first month and 24 (3.4%; 95% CI, 2.0–4.7%) thereafter. The incidences of cardiovascular death, myocardial infarction, and stroke were 2.2% (95% CI, 0.36–2.50%), 3.1% (95% CI, 1.8–4.3%), and 1.2% (95% CI, 0.4–2.0%), respectively. BARC type 3–5 bleeding ocuurred in 1.1% (95% CI, 0.3–1.8%) at 1 month and 2.9% (95% CI, 1.6–4.1%) at 1 year.

Conclusion

HBR patients receiving biodegradable-polymer EES had few ischemic and bleeding events when given 1 month of DAPT. One-month DAPT after biodegradable-polymer EES implantation seems safe in patients at HBR.
Gender gap in cardiothoracic surgery randomized controlled trial and post-hoc analysis of randomized controlled trial authorship from 2014 to 2020
Authors: Shariff Mariam , Kumar Ashish , Stulak John , Naumann Kathryn E , Blackmon Shanda H , Saddoughi Sahar A
Published: August 2024

OBJECTIVES

To estimate gender disparities among first and last authorships in cardiothoracic randomized controlled trials (RCTs) and association of gender with publications in high-impact journals.

METHODS

PubMed/MEDLINE database was searched from 1 January 2014 to 31 December 2020 using R statistical software via the ‘easyPubMed’ package to retrieve pertinent data. The ‘gender’ package was utilized to determine gender using the United States Social Security Administration Baby Name Data. The percentage of female first and last authors were computed along with determining the uniqueness of the names. The association of gender and publication in high-impact peer-reviewed journals was delineated. Jonckheere’s trend was computed.

RESULTS

The database search retrieved a total of 4820 RCTs, of which gender was encoded for the first author in 3247 (67%) RCTs, among which 911 (28%) studies had women as first authors, with a similar trend across 7 years (P = 0.23). Gender was encoded for the last author of 3204 (66%) RCTs, of which 622 (19%) studies had women as last authors, with a similar trend across 7 years (P = 0.45). A total of 627 studies were published in high-impact-factor journals, among which 79 (16%) studies had female first authors and 67 (13%) studies had female last authors.

CONCLUSIONS

There is an obvious gender disparity of first and last authors in cardiothoracic surgery-related RCTs, with a similar trend across 7 years. However, the post-hoc analysis did demonstrate a positive trend with an increase in the number of female first authors, demonstrating progress.
Impact of chitin-derived β-N-acetyl-d-glucosaminyl-(1,4)-d-glucosamine on chitinase upregulation in Shewanella baltica
Authors: Hirano Takako , Yokoyama Masahiro , Ikejima Masafumi , Shiraishi Haruka , Hakamata Wataru , Nishio Toshiyuki
Published: August 2024

The first steps in chitin degradation in marine bacteria involve chitinase, which produces N,N′-diacetylchitobiose (GlcNAc)2 from chitin. Moreover, in Vibrio bacteria, chitinase activity is enhanced by heterodisaccharide β-N-acetyl-d-glucosaminyl-(1,4)-d-glucosamine (GlcNAc–GlcN) produced from (GlcNAc)2 by chitin oligosaccharide deacetylase (COD). However, the role of COD in other marine bacteria, such as Shewanella, remains unexplored. This study investigates GlcNAc–GlcN’s impact on chitinase gene expression and enzyme production in S. baltica ATCC BAA-1091, drawing parallels with Vibrio parahaemolyticus RIMD2210633. Using real-time quantitative PCR, the study assesses the upregulation of chitinase gene expression in S. baltica in response to GlcNAc–GlcN, informed by COD’s known ability to produce GlcNAc–GlcN from (GlcNAc)2. In Vibrio, GlcNAc–GlcN considerably upregulates chitinase gene expression. This study posits a similar regulatory mechanism in S. baltica, with preliminary investigations indicating COD’s capacity to produce GlcNAc–GlcN. This study highlights the importance of exploring GlcNAc–GlcN’s regulatory role in chitin metabolism across diverse marine bacteria. The potential induction of chitinase production in S. baltica suggests broader ecological implications. Further research is crucial for a comprehensive understanding of chitin utilization and regulatory pathways in marine bacterial genera.
The role of uncertainty and negative feedback loops in the evolution of induced immune defenses
Authors: Asgari Danial , Stewart Alexander J , Meisel Richard P
Published: August 2024

Organisms use constitutive or induced defenses against pathogens and other external threats. Constitutive defenses are constantly on, whereas induced defenses are activated when needed. Each of these strategies has costs and benefits, which can affect the type of defense that evolves in response to pathogens. In addition, induced defenses are usually regulated by multiple negative feedback mechanisms that prevent overactivation of the immune response. However, it is unclear how negative feedback affects the costs, benefits, and evolution of induced responses. To address this gap, we developed a mechanistic model of the well-characterized Drosophila melanogaster immune signaling network that includes 3 separate mechanisms of negative feedback as a representative of the widespread phenomenon of multilevel regulation of induced responses. We show that, under stochastic fly–bacteria encounters, an induced defense is favored when bacterial encounters are rare or uncertain, but in ways that depend on the bacterial proliferation rate. Our model also predicts that the specific negative regulators that optimize the induced response depend on the bacterial proliferation rate, linking negative feedback mechanisms to the factors that favor induction.
A hybrid genome assembly of the endangered aye-aye (Daubentonia madagascariensis)
Authors: Versoza Cyril J , Pfeifer Susanne P
Published: August 2024

The aye-aye (Daubentonia madagascariensis) is the only extant member of the Daubentoniidae primate family. Although several reference genomes exist for this endangered strepsirrhine primate, the predominant usage of short-read sequencing has resulted in limited assembly contiguity and completeness, and no protein-coding gene annotations have yet been released. Here, we present a novel, fully annotated, chromosome-level hybrid de novo assembly for the species based on a combination of Oxford Nanopore Technologies long reads and Illumina short reads and scaffolded using genome-wide chromatin interaction data—a community resource that will improve future conservation efforts as well as primate comparative analyses.
Characterization of the rainbow trout (Oncorhynchus mykiss) mucosal glycosphingolipid repertoire and Aeromonas salmonicida binding to neutral glycosphingolipids
Authors: Benktander John , Sundh Henrik , Sundell Kristina , Sharba Sinan , Teneberg Susann , Lindén Sara K
Published: August 2024

Infections pose a challenge for the fast growing aquaculture sector. Glycosphingolipids are cell membrane components that pathogens utilize for attachment to the host to initiate infection. Here, we characterized rainbow trout glycosphingolipids from five mucosal tissues using mass spectrometry and nuclear magnetic resonance and investigated binding of radiolabeled Aeromonas salmonicida to the glycosphingolipids on thin-layer chromatograms. 12 neutral and 14 acidic glycosphingolipids were identified. The glycosphingolipids isolated from the stomach and intestine were mainly neutral, whereas glycosphingolipids isolated from the skin, gills and pyloric caeca were largely acidic. Many of the acidic structures were poly-sialylated with shorter glycan structures in the skin compared to the other tissues. The sialic acids found were Neu5Ac and Neu5Gc. Most of the glycosphingolipids had isoglobo and ganglio core chains, or a combination of these. The epitopes on the rainbow trout glycosphingolipid glycans differed between epithelial sites leading to differences in pathogen binding. A major terminal epitope was fucose, that occurred attached to GalNAc in a α1-3 linkage but also in the form of HexNAc-(Fuc-)HexNAc-R. A. salmonicida were shown to bind to neutral glycosphingolipids from the gill and intestine. This study is the first to do a comprehensive investigation of the rainbow trout glycosphingolipids and analyze binding of A. salmonicida to glycosphingolipids. The structural information paves the way for identification of ways of interfering in pathogen colonization processes to protect against infections in aquaculture and contributes towards understanding A. salmonicida infection mechanisms.
CaMYB80 enhances the cold tolerance of pepper by directly targeting CaPOA1
Authors: Xiao Jiachang , Wang Dong , Liang Le , Xie Minghui , Tang Yi , Lai Yun-Song , Sun Bo , Huang Zhi , Zheng Yangxia , Li Huanxiu
Published: August 2024

Cold temperatures negatively impact crop yield and quality, posing significant limitations to the advancement of the vegetable industry. MYB transcription factors are pivotal in enhancing plant resilience against various abiotic stresses, including low-temperature stress. Pepper (Capsicum annuum L.) is a nutrient-rich vegetable crop sensitive to low temperatures. This study aimed to determine the function of CaMYB80 in the cold stress response of pepper through virus-induced silencing. The study also conducted heterologous expression of CaMYB80 in Arabidopsis and tomato plants. The results showed that CaMYB80 could respond to low-temperature stress in pepper. CaMYB80 was localized in the nucleus and cytoplasm and exhibited transcriptional activation ability. Moreover, CaMYB80 silencing decreased cold tolerance in pepper, while its heterologous overexpression increased cold tolerance in Arabidopsis and tomato. Further analysis showed that CaMYB80 interacted with CaPOA1 (peroxidase N1-like). Similarly, the expression of CaPOA1 also responded to low-temperature stress. Overexpression of CaPOA1 enhanced freezing tolerance in Arabidopsis, while its silencing reduced cold stress tolerance in pepper. Furthermore, overexpression of CaMYB80 in Arabidopsis and tomato could increase the activity of peroxidases and the expression levels of genes in the ICE-CBF-COR (inducer of CBF expression, C-repeat binding factor, cold-responsive) regulatory network. In conclusion, our research results indicate that CaMYB80 enhances pepper cold tolerance by interacting with CaPOA1 to increase peroxidase activity and influence the expression of ICE-CBF-COR related genes.
A comparative study of home healthcare quality in urban and rural home health agencies throughout the USA (2010–22)
Authors: Zhang Yili , Koru Güneş
Published: August 2024

Urban–rural disparities in medical care, including in home healthcare, persist globally. With aging populations and medical advancements, demand for home health services rises, warranting investigation into home healthcare disparities. Our study aimed to (i) investigate the impact of rurality on home healthcare quality, and (ii) assess the temporal disparities and the changes in disparities in home healthcare quality between urban and rural home health agencies (HHAs), incorporating an analysis of geospatial distribution to visualize the underlying patterns. This study analyzed data from HHAs listed on the Centers for Medicare and Medicaid Services website, covering the period from 2010 to 2022. Data were classified into urban and rural categories for each HHA. We employed panel data analysis to examine the impact of rurality on home healthcare quality, specifically focusing on hospital admission and emergency room (ER) visit rates. Disparities between urban and rural HHAs were assessed using the Wilcoxon test, with results visualized through line and dot plots and heat maps to illustrate trends and differences comprehensively. Rurality is demonstrated as the most significant variable in hospital admission and ER visit rates in the panel data analysis. Urban HHAs consistently exhibit significantly lower hospital admission rates and ER visit rates compared to rural HHAs from 2010 to 2022. Longitudinally, the gap in hospital admission rates between urban and rural HHAs is shrinking, while there is an increasing gap in ER visit rates. In 2022, HHAs in Mountain areas, which are characterized by a higher proportion of rural regions, exhibited higher hospital admission and ER visit rates than other areas. This study underscores the persistent urban–rural disparities in home healthcare quality. The analysis emphasizes the ongoing need for targeted interventions to address disparities in home healthcare delivery and ensure equitable access to quality care across urban and rural regions. Our findings have the potential to inform policy and practice, promoting equity and efficiency in the long-term care system, for better health outcomes throughout the USA.
A Disputed Hegemony: Negotiating Neurosurgical Patient Care in the Netherlands, 1930–1952
Authors: Lutters Bart
Published: August 2024

The emergence of the neurosurgical patient as a novel clinical entity in the Netherlands was marked by a lingering conflict between neurologists and neurosurgeons, in which both types of specialists sought to assume the clinical and institutional leadership of neurosurgical patient care. In the 1920s and 1930s, neurologists had facilitated the establishment of the first generation of neurosurgeons in the country, and in the process, had managed to clinically and institutionally subordinate neurosurgery to neurology. As the demand for neurosurgical patient care grew, the neurosurgeons began to challenge this hegemonic relationship. The neurologists, however, were unwilling to give up their control, fearing that they would be bypassed in the diagnosis of patients eligible to neurosurgery. These conflicting aims and interests resulted in an intricate demarcation battle, in which the boundary work between neurologists and neurosurgeons was directly played out at the local workplace and at the meetings of the Study Club for Neuro-Surgery, and indirectly at various other sites of contestation, such as medical journals and academic lecture halls, as both parties sought to rally external stakeholders to their cause. During these negotiations, local, national, and international forces increasingly intertwined to shape the particular organization of Dutch neurosurgery in the middle of the twentieth century. By analyzing this multilayered demarcation process, this article draws attention to the complexity of medical boundary work, and to the way in which, despite pervasive international influences, specialist practice was ultimately negotiated at the local and national levels.
Equality, Diversity and Inclusion within Ireland’s Police Service, An Garda Síochána: Bridging the Gap between Commitments and Reality
Authors: Sweeney Caroline
Published: August 2024

The Black Lives Matter movement highlighted the importance of equality, diversity and inclusion (EDI) in a policing context. Using the Irish police service, An Garda Síochána, as a case study, this article critically evaluates efforts to promote EDI within a policing organization that has been characterized as resistant to change. It focuses primarily on the implementation of relevant recommendations contained in the landmark 2018 Report of the Commission on the Future of Policing in Ireland. It demonstrates that while building a culture that respects and promotes EDI within any organization is a challenging process, it can be even more difficult in policing organizations due to police sub-culture. It submits that laws, policies and commitments, while necessary, are insufficient of themselves to achieve transformative change. Strong and committed leadership is also required, as well as measures to recruit and retain a diverse workforce at all levels, sufficient resourcing for EDI initiatives, EDI training that accords with international best practice, efforts to improve relationships with marginalized communities, measures to combat hate crime and racial profiling, effective mechanisms for collecting EDI data and evaluating EDI policies, and a robust governance, oversight and accountability framework. While identifying and welcoming measures undertaken to date by An Garda Síochána to convert EDI policy commitments into reality, the article also highlights areas where improvements are necessary. Finally, aligning with several theorists of police sub-culture, the article concludes that any efforts to promote EDI within An Garda Síochána will need to be accompanied by efforts to combat structural inequality in wider society.
Combinators as presheaves
Authors: Gangle Rocco , Tohmé Fernando , Caterina Gianluca
Published: August 2024

Computer scientists, logicians and other researchers have recently paid renewed attention to the model of computation based on the logic of combinators. We develop a new formalization of the syntax of combinators employing the ‘generic figures’ approach to the categories of presheaves that provides an intuitive and easily interpreted diagrammatic syntax for combinators, one that eschews the need to label proper combinators with variable names. Furthermore, we show that this formal framework provides the possibility of representing choices of operand from among given alternatives at each level of a combinatory term, allowing for a more general type of combinatory expression, which we call a multi-combinator.
Wounded but unstressed: Moose tolerate injurious flies in the boreal forest
Authors: Benedict Bridgett M , Thompson Daniel P , Crouse John A , Hamer Gabriel L , Barboza Perry S
Published: August 2024

Moose (Alces alces) in boreal habitats feed and rest where they are exposed to Dipteran flies and the parasites they carry. We collected 31,905 flies during the summer from 12 habituated moose on the Kenai Peninsula, Alaska. Moose flies, Haematobosca alcis (Snow), Diptera: Muscidae—a species that completes its entire life cycle on or around moose—accounted for 91% of flies collected; the reminder of the flies collected included mosquitoes (Culicidae), black flies (Simuliidae), and deer flies (Tabanidae). Flies impose physiological costs for moose, e.g., vectors for parasites such as Legworm (Onchocerca spp.) which causes sores on the hind legs of moose. We found that the number of sores present on the hind legs of moose is positively correlated with body fat, which suggests a correlation between gains of energy and damage from flies. We also found that the number of sores is negatively correlated with serum albumin, which is indicative of an inflammatory response and body protein being used to repair injuries from flies and parasites. The number or type of flies present on a Moose were not correlated with the concentration of corticosteroids in saliva or feces. Flies do not elicit a stress response in moose even though the costs of repairing wounds and resisting infections of those wounds likely reduce gains of protein from summer foraging. Moose can tolerate the injuries from biting flies with regular gains from summer foraging but exposure to insect-borne parasites poses a risk to reproduction and survival.
Costs of care during chimeric antigen receptor T-cell therapy in relapsed or refractory B-cell lymphomas
Authors: Di Mengyang , Potnis Kunal C , Long Jessica B , Isufi Iris , Foss Francine , Seropian Stuart , Gross Cary P , Huntington Scott F
Published: August 2024

High upfront cost may be a barrier to adopting chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory B-cell lymphoma. Data on the real-world costs are limited. Using the Blue Cross Blue Shield Axis database, we evaluated 271 commercially insured patients who received CAR-T therapy for B-cell lymphoma (median age = 58 years; men = 68%; diffuse large B-cell lymphoma = 87%; inpatient CAR-T therapy = 85%). Our peri–CAR-T period of interest was from 41 days before to 154 days after CAR-T therapy index divided into seven 28-day intervals. Median total costs were $608 100 (interquartile range, IQR = $534 100-$732 800); 8.5% of patients had total costs exceeding $1 million. The median cost of CAR-T therapy products was $402 500, and the median out-of-pocket copayment was $510. Monthly costs were highest during the month of CAR-T therapy administration (median = $521 500), with median costs below $25 000 in all other 28-day intervals. Costs of CAR-T therapy use were substantial, largely driven by product acquisition. Future studies should examine the relationship between costs, access, and financial outcomes.
The association of perceived cannabis risks and benefits with cannabis use since cancer diagnosis
Authors: McDaniels-Davidson Corinne , Parada Jr Humberto , Kasiri Nasim , Patel Sandip P , Strong David , Doran Neal
Published: August 2024

Background

Many patients with cancer use cannabis to help alleviate untreated cancer symptoms and side effects.

Methods

We examined associations of perceived benefits and risks and postdiagnosis cannabis use in a weighted sample of adult cancer survivors through a 1-time survey. Fifteen perceived cannabis use benefits and 19 perceived risks were operationalized as both summary scores and report of any benefits or risks. Survey-weighted logistic regression provided covariate-adjusted odds of postdiagnosis cannabis use for each benefit-risk measure.

Results

Among the weighted population of 3785 survivors (mean [SD] age = 62.2 [13.5] years), one-third used cannabis after diagnosis. Perceiving any benefits increased the odds of postdiagnosis cannabis use more than 500%, and perceiving any risks lowered the odds by 59%. Each SD increase in endorsed benefits doubled the odds of postdiagnosis cannabis use, while each SD increase in endorsed risks reduced the odds by 36%.

Conclusion

An accurate understanding of benefits and risks is critical for informed decision making.
Cannabis and opioid perceptions, co-use, and substitution among patients across 4 NCI-Designated Cancer Centers
Authors: Ashare Rebecca L , Worster Brooke , Nugent Shannon M , Smith Danielle M , Morasco Benjamin J , Leader Amy E , Case Amy A , Meghani Salimah H
Published: August 2024

Prescription opioids are used for managing pain in persons with cancer, however, there are socioeconomic and racial disparities in medication access. Cannabis is increasingly used for cancer symptom management and as an opioid alternative. Limited data are available about patterns of opioid and cannabis use among patients with cancer. We used survey data from 4 National Cancer Institute–designated cancer centers in 3 states (n = 1220) to assess perceptions, use of cannabis and opioids for pain, their substitution, and racial and ethnic differences in each outcome. Compared with White patients, Black patients were less likely to use opioids for pain (odds ratio [OR] = 0.66; P = .035) and more likely to report that cannabis was more effective than opioids (OR = 2.46; P = .03). Race effects were mitigated (P > .05) after controlling for socioeconomic factors. Further research is needed to understand cannabis and opioid use patterns and how overlapping social determinants of health create a disadvantage in cancer symptom management for Black patients.
Patient out-of-pocket costs for cannabis use during cancer treatment
Authors: Lapen Kaitlyn , Mishra Meza Akriti , Dee Edward Christopher , Mao Jun J , Raghunathan Nirupa Jaya , Jinna Sankeerth , Brens Jessica , Korenstein Deborah , Furberg-Barnes Helena , Salz Talya , Chino Fumiko
Published: August 2024

Background

We assessed patient costs associated with cannabis use during cancer treatment.

Methods

Adults treated for cancer at a large, comprehensive center completed an anonymous survey regarding their thoughts and experiences with cannabis and cancer. Bivariate and weighted multivariable logistic regression assessed clinical and sociodemographic factors associated with patient-reported out-of-pocket costs for cannabis products.

Results

Overall, 248 cannabis users provided data on cost and were analyzed. Median monthly out-of-pocket cost for cannabis was $80 (interquartile range = $25-$150). On regression analysis, male gender (odds ratio = 2.5, 95% confidence interval = 1.2 to 5.5, P = .026) and being 45 years of age or older (odds ratio = 7.5, 95% confidence interval = 1.9 to 30.0, P = .0042) were associated with spending $100 a month or more on cannabis. Of the 166 patients who stopped using cannabis early or used less than preferred, 28% attributed it to cost and 26% to lack of insurance coverage.

Conclusion

Cannabis use during cancer treatment may contribute to significant out-of-pocket costs, with men and younger patients more likely to pay higher costs.
Concurrent substance use among cancer patients with and without a history of cannabis use since cancer diagnosis at an NCI-Designated Cancer Center in Florida
Authors: Islam Jessica Y , Nguyen Oliver T , Turner Kea , Martinez Yessica C , Rodriguez Omar Garcia , Rodriguez Diane Irlanda , Rajasekhara Sahana , Chang Young D , Gonzalez Brian D , Jim Heather S L , Egan Kathleen M
Published: August 2024

Background

Although substance use may have adverse impacts on cancer outcomes, little is known regarding patterns of concurrent substance use with cannabis among cancer patients. Our objective was to examine predictors of concurrent substance use with cannabis among cancer patients since their cancer diagnosis and explore perceptions of cannabis among these patients.

Methods

Patients treated at a National Cancer Institute–designated comprehensive cancer center were invited to participate in an electronic survey regarding medical cannabis from August to November 2021. Survey data were linked to internal data resources including electronic health records and patient intake forms to obtain history of substance use (defined as within at least 3 months of cancer diagnosis) of cigarettes, injection drugs, high levels of alcohol, or clinically unsupervised prescription drugs (total n = 1094). Concurrent substance users were defined as those with any reported substance use and cannabis use at the time of cancer diagnosis. We used descriptive statistics (χ2 or exact tests) to compare groups and estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) to identify predictors of substance use among users and nonusers of cannabis.

Results

Approximately 45% (n = 489) of the sample reported cannabis use since their cancer diagnosis. Of patients who reported using cannabis, 20% self-reported concurrent polysubstance use, while 8% of cannabis nonusers reported substance use (P < .001). Among patients who use cannabis, those who reported 2 or more self-reported treatment-related symptoms (eg, pain, fatigue) were more likely to have self-reported concurrent substance use (AOR = 3.15, 95% CI = 1.07 to 9.27) compared with those without any symptoms. Among nonusers, those with lower educational background were more likely to have a history of concurrent substance use (AOR = 3.74, 95% CI = 1.57 to 8.92). Patients who use cannabis with concurrent substance use were more likely to report improved sleep (P = .04), increased appetite (P = .03), and treatment of additional medical conditions (P = .04) as perceived benefits of cannabis use.

Conclusions

High symptom burden may be associated with concurrent substance use with cannabis among cancer patients.
Cannabis use and patient-reported outcomes among patients at a comprehensive cancer center
Authors: Gonzalez Brian D , Li Xiaoyin , Martinez Yessica C , Jim Heather S L , Oswald Laura B , Islam Jessica Y , Turner Kea , Egan Kathleen M
Published: August 2024

Background

Patients with cancer report increasing rates of cannabis use, often to manage symptoms and toxicities. The efficacy and safety of cannabis, however, for some use cases remains unclear. To better understand characteristics of patients with cancer who report using cannabis, we examined data from a cannabis use survey of among patients with cancer seen at a National Cancer Institute–Designated Cancer Center.

Methods

In late 2021, patients with cancer (N = 1608) treated between July 2017 and December 2019 provided cannabis use data. Additional data were obtained from medical records data and routine patient-reported outcomes collected for clinical purposes. Univariable analyses and multivariable regression analyses were conducted to identify correlates of cannabis use at different stages in the cancer care trajectory.

Results

Rates of self-reported cannabis use by patients with cancer were 59% before cancer diagnosis and 47% after diagnosis. Longitudinal rates of cannabis use were 29% for no cannabis use, 23% before diagnosis, 12% after diagnosis, and 35% for both before and after diagnosis. Demographic factors associated with cannabis use included age, sex, race, and educational achievement. Tobacco use and binge drinking were associated with higher odds of cannabis use. Cannabis use was also associated with greater self-reported interference with physical functioning due to pain and interference with social functioning due to health problems.

Conclusions

We found high rates of cannabis use among patients with cancer, both before and after their cancer diagnosis. Future studies should further investigate psychosocial factors associated with cannabis use among patients with cancer as well as psychosocial outcomes among patients with cancer using cannabis.
Optimizing the shape of space-constrained silencers composed of multiple straight/reverse chambers using the simulated annealing method
Authors: Chiu Min-Chie , Cheng Ho-Chih , Wang Yu-Hsin
Published: August 2024

To address the issue of hearing health problems caused by the broadband noise emitted from space-constrained marine diesel engines on a ship, an efficient silencer equipped at the engine's venting outlet is necessary. In consideration of the space-constrained situation that often occurs in ships, a reverse silencer with multiple chambers is introduced. A mathematical model of eigenfunction is adopted to consider the acoustic effect at high frequencies. An optimization of the silencer will be performed using the acoustic model of an eigenfunction together with the simulated annealing (SA) method under space-constrained conditions to achieve the best design. To pursue an efficient silencer design, two types of reverse silencers (silencers A and B) are adopted to reduce the engine's venting noise. Acoustical models for straight chamber and reverse chamber silencers are checked before optimization. To assure the reliability of the SA scheme, a pure tone optimization at 250 Hz is exemplified. Results in silencers A and B show that the sound transmission loss is approximately maximized at the desired frequency. Thereafter, a broadband noise elimination of engine noise using silencers A and B is performed. Simulated results show that overall noise abatement can be improved when the number of inverse chambers increases. The optimization of space-constrained reverse silencers with multiple chambers using eigenfunction in cooperation with SA has been accomplished. The overall silencer system's 4-pole matrix is used to predict the silencer's acoustical performance of STL, which is achieved by multiplying individual 4-pole matrices. With the introduction of the reverse silencer, the hearing health of workers can be protected, and noise pollution can be reduced in industrial settings.
The potential of ALFA-tag and tyramide-based fluorescence signal amplification to expand the CRISPR-based DNA imaging toolkit
Authors: Potlapalli Bhanu Prakash , Fuchs Jörg , Rutten Twan , Meister Armin , Houben Andreas
Published: August 2024

Understanding the spatial organization of genomes within chromatin is crucial for deciphering gene regulation. A recently developed CRISPR–dCas9-based genome labeling tool, known as CRISPR–FISH, allows efficient labeling of repetitive sequences. Unlike standard fluorescence in situ hybridization (FISH), CRISPR–FISH eliminates the need for global DNA denaturation, allowing for superior preservation of chromatin structure. Here, we report on further development of the CRISPR–FISH method, which has been enhanced for increased efficiency through the engineering of a recombinant dCas9 protein containing an ALFA-tag. Using an ALFA-tagged dCas9 protein assembled with an Arabidopsis centromere-specific guide RNA, we demonstrate target-specific labeling with a fluorescence-labeled NbALFA nanobody. The dCas9 protein possessing multiple copies of the ALFA-tag, in combination with a minibody and fluorescence-labeled anti-rabbit secondary antibody, resulted in enhanced target-specific signals. The dCas9–ALFA-tag system was also instrumental in live cell imaging of telomeres in Nicotiana benthamiana. This method will further expand the CRISPR imaging toolkit, facilitating a better understanding of genome organization. Furthermore, we report the successful integration of the highly sensitive tyramide signal amplification method with CRISPR–FISH, demonstrating effective labeling of Arabidopsis centromeres.