bluuebunny/crossref_metadata_2025 huggingface dataset:
FIGURE 1 from Cancer-prone Phenotypes and Gene Expression Heterogeneity at Single-cell Resolution in Cigarette-smoking Lungs
Authors: Nakayama Jun , Yamamoto Yusuke
Published: November 2023

Establishment of the integrated lung atlas with cigarette smoking status from eight scRNA-seq cohorts. A, Overview of the establishment of the integrated lung atlas with cigarette smoking status. The control lung scRNA-seq data from eight publicly available datasets were obtained and integrated with smoking status information. B, Flow diagram of the establishment of the integrated scRNA-seq lung atlas with cigarette smoking. Eight publicly available scRNA-seq datasets were downloaded and combined in Seurat. Doublet cells were removed by DoubletFinder. The datasets were normalized by SCTramsform, integrated by Harmony to adjust for batch effects. C, Representative marker expression patterns for the cell type clusters shown in the UMAP plot. D, A UMAP plot displaying 230,890 single human lung cells of 55 smokers and 49 never-smokers. Each dot represents a single cell, and cell clusters are classified as immune cells, epithelial cells, endothelial cells, and fibroblasts. E, Cell populations of immune cell, epithelial cell, endothelial cell, and fibroblast clusters across the 104 samples in the integrated atlas. Smokers, 55 cases; never-smokers, 49 cases.
Lipedematous Scalp Occurring in Two Female Siblings: Further Evidence for a Genetic Role
Authors: Khalil Nada , Carton James , Fernandez Carolina P. , Patel Neil P.
Published: November 2023

Introduction: Lipedematous scalp (LS) is a rare disorder characterized by thickening of the adipose subcutaneous scalp layer without associated hair loss. To date, there have been fewer than 100 reported cases of LS. LS occurring in siblings has not been previously reported. Case Presentation: We present a 58-year-old and 63-year-old pair of black Caribbean female siblings with LS. Scalp thickness on ultrasound of the vertex in each case was 12 mm and 11 mm from skin to periosteum, respectively (normal range: 5–6 mm). Histopathological analysis in the younger sibling demonstrated prominent fat, high in the dermis around hair follicles, with follicular distortion and focal perifollicular fibrosis. Co-morbidities in the younger sibling were obesity (body mass index [BMI] 39.0), paranoid schizophrenia, and bipolar disorder; the older sibling was overweight (BMI 26.0) with co-morbidities of hypercholesterolemia, type 2 diabetes mellitus, hypomania, and migraines; both siblings were taking psychiatric medication. Conclusion: We present an unusual case of LS in a pair of female siblings, adding to the limited existing evidence that there may be a genetic role in the pathogenesis of LS. Furthermore, both siblings in this case had psychiatric co-morbidities and were taking psychiatric medication, which have not been previously identified as associations of LS.
Dose-Response Relationship between C-Reactive Protein/Albumin Ratio and In-Hospital Mortality in Elderly Patients with Acute Ischemic Stroke
Authors: Li Mingquan , Chen Yan , Chen Zhibin , Wang Liumin , Xie Wen , Zhang Yanli , Wang Lina , Liu Ling , Zhao Hui , Wei Pingmin
Published: November 2023

Introduction: The C-reactive protein/albumin ratio is a reliable indicator of outcome risk in several diseases. This study aims to evaluate prognostic power of the C-reactive protein/albumin ratio for in-hospital mortality and the dose-response relationship between the two in the oldest-old patients with acute ischemic stroke. Methods: A longitudinal observational study was conducted on patients with acute ischemic stroke (aged ≥80 years) from two tertiary hospitals between January 1, 2014, and January 31, 2020. Based on the tertiles of the C-reactive protein/albumin ratio, the patients were divided into three groups. Restrictive cubic spline and robust locally weighted regression analysis were performed on continuous variables to examine the dose-response relationship between the C-reactive protein/albumin ratio and in-hospital mortality risk. All-cause mortality during hospitalization was the outcome for this study. Results: The study included 584 patients (mean age = 84.6 ± 3.1 years; 59.6% men). The C-reactive protein/albumin ratio was divided into three groups, namely, T1 of <0.73, T2 of 0.73–2.03, and T3: >2.03. After adjusting for demographic and clinical characteristics, a higher C-reactive protein/albumin ratio was independently associated with in-hospital mortality. The hazard ratio for this association was 2.01 (95% confidence interval: 1.12–3.60, p = 0.019). A dose-response relationship between the C-reactive protein/albumin ratio and in-hospital mortality risk was observed. Sensitivity analysis found no attenuation in the hazard ratio in uninfected individuals, whereas no difference in the hazard ratio was noted in individuals with infections. Conclusions: When predicting in-hospital mortality in the oldest-old patients with ischemic stroke, the C-reactive protein/albumin ratio might be a helpful and convenient metric.
Continuous versus Routine Electroencephalography in the Intensive Care Unit: A Review of Current Evidence
Authors: Fenter Helene , Rossetti Andrea O. , Beuchat Isabelle
Published: November 2023

Background: Electroencephalography (EEG) has long been used to detect seizures in patients with disorders of consciousness. In recent years, there has been a drastically increased adoption of continuous EEG (cEEG) in the intensive care units (ICUs). Given the resources necessary to record and interpret cEEG, this is still not available in every center and widespread recommendations to use continuous instead of routine EEG (typically lasting 20 min) are still a matter of some debate. Considering recent literature and personal experience, this review offers a rationale and practical advice to address this question. Summary: Despite the development of increasingly performant imaging techniques and several validated biomarkers, EEG remains central to clinicians in the intensive care unit and has been experiencing expanding popularity for at least 2 decades. Not only does EEG allow seizure or status epilepticus detection, which in the ICU often present without clinical movements, but it is also paramount for the prognostic evaluation of comatose patients, especially after cardiac arrest, and for detecting delayed ischemia after subarachnoid hemorrhage. At the end of the last Century, improvements of technical and digital aspects regarding recording and storage of EEG tracings have progressively led to the era of cEEG and automated quantitative analysis. Key Messages: As compared to repeated rEEG, cEEG in comatose patients does not seem to improve clinical prognosis to a relevant extent, despite allowing a more performant of detection ictal events and consequent therapeutic modifications. The choice between cEEG and rEEG must therefore always be patient-tailored.
Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association
Authors: Khan Sadiya S. , Coresh Josef , Pencina Michael J. , Ndumele Chiadi E. , Rangaswami Janani , Chow Sheryl L. , Palaniappan Latha P. , Sperling Laurence S. , Virani Salim S. , Ho Jennifer E. , Neeland Ian J. , Tuttle Katherine R. , Rajgopal Singh Radhika , Elkind Mitchell S.V. , Lloyd-Jones Donald M. ,   on behalf of the American Heart Association
Published: November 2023

Cardiovascular-kidney-metabolic (CKM) syndrome is a novel construct recently defined by the American Heart Association in response to the high prevalence of metabolic and kidney disease. Epidemiological data demonstrate higher absolute risk of both atherosclerotic cardiovascular disease (CVD) and heart failure as an individual progresses from CKM stage 0 to stage 3, but optimal strategies for risk assessment need to be refined. Absolute risk assessment with the goal to match type and intensity of interventions with predicted risk and expected treatment benefit remains the cornerstone of primary prevention. Given the growing number of therapies in our armamentarium that simultaneously address all 3 CKM axes, novel risk prediction equations are needed that incorporate predictors and outcomes relevant to the CKM context. This should also include social determinants of health, which are key upstream drivers of CVD, to more equitably estimate and address risk. This scientific statement summarizes the background, rationale, and clinical implications for the newly developed sex-specific, race-free risk equations: PREVENT (AHA Predicting Risk of CVD Events). The PREVENT equations enable 10- and 30-year risk estimates for total CVD (composite of atherosclerotic CVD and heart failure), include estimated glomerular filtration rate as a predictor, and adjust for competing risk of non-CVD death among adults 30 to 79 years of age. Additional models accommodate enhanced predictive utility with the addition of CKM factors when clinically indicated for measurement (urine albumin-to-creatinine ratio and hemoglobin A1c) or social determinants of health (social deprivation index) when available. Approaches to implement risk-based prevention using PREVENT across various settings are discussed.
Trajectories of Blood Lipids Profile in Midlife Women: Does Menopause Matter?
Authors: Wu Bingjie , Fan Bingbing , Qu Yanlin , Li Chunxia , Chen Jiahao , Liu Ying , Wang Jiali , Zhang Tao , Chen Yuguo
Published: November 2023

Background

It remains controversial whether changes of lipids over menopause transition (MT) are more age‐related or more menopause‐related. We aimed to classify women into different trajectory groups based on pattern and level of total cholesterol, low‐density lipoprotein cholesterol, apolipoprotein B (ApoB), high‐density lipoprotein cholesterol (HDL‐C), triglyceride, and apolipoprotein A‐I over the MT, as well as examine the effect of MT‐related factors on lipid trajectory groups and levels.

Methods and Results

The cohort included 2582 subjects from the Study of Women's Health Across the Nation. Different trajectory patterns of lipids during the MT were determined using the latent class growth mixture model. The predictors of distinct blood lipids trajectory groups were determined by multiple linear regression models and multinomial logistic regression models. Women were categorized into either inverse U‐shape or progressing trajectory group in each blood lipids measurement. The inverse U‐shape total cholesterol, low‐density lipoprotein cholesterol, apolipoprotein B, high‐density lipoprotein cholesterol, log(TG), and apolipoprotein A‐I trajectories showed an increasing trend before menopause but a decreasing trend after menopause. The U‐shape total cholesterol, low‐density lipoprotein cholesterol, and apolipoprotein B trajectories started to rise 5 years before menopause. Age at menopause, follicle‐stimulating hormone, vasomotor symptoms, and estradiol predicted the shape and level of the women's lipids over the MT.

Conclusions

Distinct lipid trajectories were identified during the MT, and the existence of at least 1 trajectory in each lipid parameters suggested a contribution of menopause. Our study highlights the need for earlier and continuous surveillance of lipids during the MT.
Theory of Mind and Evidentiality Acquisition in Heritage Bilingual Aymara-Spanish Children in the North of Chile
Authors: Markovits Rojas Jennifer
Published: November 2023

The present work examines the connection between language and conceptual development, investigating whether false-belief reasoning (FBR) and source-monitoring ability (SMA), abilities within the theory of mind (ToM) framework, trigger the comprehension of semantic and pragmatic knowledge (evidential scalar implicatures) encoded in the evidentiality structure (Papafragou et al., 2007). Furthermore, the present work examines whether age modulates the comprehension of ToM abilities, and whether age influences comprehension of grammar knowledge encoded in the target structure. Twenty-one bilingual Aymara-Spanish heritage children performed one FBR task and one SMA task. In addition, the same group and 15 bilingual Aymara-Spanish adults performed one semantic and one pragmatic Aymara evidentiality task. The results showed that age was relevant in developing ToM abilities and comprehending the target structure’s evidential semantic features. Furthermore, the results demonstrated that semantic features had a positive relationship with the acquisition of ToM abilities, as opposed to pragmatic knowledge. These outcomes suggest that the computation of Aymara evidential scalar implicatures is lexically driven as opposed to contextually driven.
The Soul: A Psychological Enquiry
Authors: Peters Frederic
Published: November 2023

Soul beliefs are universal among religious folk but vary tremendously from culture to culture, In fact, in tribal societies without formal religious dogmas, soul beliefs can vary from individual to individual. A review of notions regarding the soul (or souls) amongst tribal and post-tribal societies does evidence, nonetheless, a recurring pattern of focus on the soul envisaged as the vital life energy of the body and/or as encapsulating one of more mental faculties. Not surprisingly, theories as to the psychological basis for soul belief vary as well, but a strong case can be advanced that at its core, soul belief is about the essence of the self, which involves the psychological process of ipseity.
Sympathetic Magic: A Psychological Enquiry
Authors: Peters Frederic
Published: November 2023

Sympathetic magic features strongly in virtually all religious traditions and in folk customs generally. Scholars agree that It is based on the association of ideas perceived as external, mind-independent causal realities, as connections mediating causal influence. Moreover, religious folk believe that this mediation involves forms of supernatural agency. From a psychological perspective, the key question revolves around the principles by which the cognitive system deems some of its content to reference the external world and other content to constitute internal mental forms of activity like thoughts, feelings and attitudes. The paper proposes that the critical factor has to do with the balance between two distinctly different kinds of cognitive content: representations of things (mentation arising in the form of something other than itself), as distinct from registrations referencing the intrinsic phenomenal properties of the mental state itself. The balance between these two determines whether content is perceived as external worldly event or a form of internal mental content.
Nuthatch (Sitta europaea) responses towards simulated territorial intrusion (STI) vary in strength during the non-breeding season — a matter of temperature and photoperiod?
Authors: Randler Christoph , Kalb Nadine , Dutour Mylène
Published: November 2023

Many bird species defend their territories against conspecifics during the breeding season. Although some temperate species have been observed to defend territories outside of the breeding season, such cases are rarely noted in the literature, and it remains largely unknown which environmental factors influence such behaviour. In this study, we investigated non-breeding territorial behaviour in the Eurasian nuthatch (Sitta europaea). Territorial responses were elicited with a simulated territory intrusion (playbacks of calls combined with a wooden model of nuthatch) in autumn, winter and spring. Territorial responses did not differ between autumn and winter but differed between the autumn/winter and spring; they declined until about mid-December (winter) and increased after that into the spring. We found an increase in territorial responses with increasing photoperiod (day length) in autumn and with decreasing ambient temperature during spring. Our study provides novel evidence about non-breeding territorial behaviour in temperate birds and indicates that this behaviour is influenced by environmental factors.
A Contrarian Muʿtazilite Theologian/Poet’s Guide to Fine Poetry: Al-Nāshiʾ al-Akbar (d. 293/906) and How to Write Inimitable Poems
Authors: Gündüz Hacı Osman
Published: November 2023

Boasting of one’s poetic talents was hardly an uncommon feature in Arabic poetry. Poets sang praises for their craft and exalted themselves over their rivals. They sometimes moved beyond braggadocio, however, explaining the particular attributes that made their poetry of unmatched quality. Al-Nāshiʾ al-Akbar (d. 293/906) was one such poet who declared his poetry to be an inimitable product defined by standards that he outlined in his didactic poems. He also penned at least one book on the criticism of poetry which only survives now as excerpts in a number of fourth/eleventh century works of adab. Fine poetry, according to al-Nāshiʾ, is the harmonious articulation of sounds and meanings presented in an accessible way to its audience but is impossible to reproduce. In this respect, I propose that, in expounding the standards of excellent poetry, al-Nāshiʾ alluded to theories of inimitability (iʿjāz) based on composition (naẓm) and divine prevention (ṣarfah). He was a Muʿtazilite theologian who was both celebrated and vilified by his contemporaries, and later scholars. His theological writings have been examined; however, his literary persona is still little-known. In contrast to most considerations of him, this study examines al-Nāshiʾ as a poet and critic foremost.
The Tantalising Islands: Insights from a Textualist Interpretation of Article 121 of the LOSC
Authors: Baptista Eduardo Gracias
Published: November 2023

Article 121 of the United Nations Convention on the Law of the Sea continues to generate vigorous debate amongst interpreters. The aim of this article is to contribute to this prevailing debate by providing a systematic analysis of the provision, and a novel logical-mathematical interpretation of Article 121(3). Through these elements, it adds a textualist analysis of Article 121 to the toolbox of interpreters. An approach of this kind sheds light on the conceptual underpinning of the provision, and on the definition and demarcation of the different types of features regulated therein.
Examining the Potential of Cartoon-Based Simulations for Studying Mathematics Teachers’ Handling of Student Emotions: A Replication Study
Authors: Brown A. M. , Bardelli E. , Herbst P. G. , Dimmel J. K.
Published: November 2023

Technology-mediated simulations of teaching are used increasingly to represent practice in the context of professional development interventions and assessment. Some such simulations represent students as cartoon characters. An important question in this context is whether simplified cartoon representations of students can convey similar meanings as real facial expressions do. Here, we share results from an implementation and replication study designed to observe whether and how (1) cartoon-based representations of emotion using graphical facial expressions can be interpreted at similar levels of accuracy as photo representations of emotions using actors and (2) the inclusion of markers of student emotions in storyboard-based scenarios of secondary mathematics teaching affects teachers’ appropriateness rating of the actions taken by a teacher represented in the storyboard. We show graphical representations of emotions can evoke particular intended emotions and that markers of student emotions in representations of practice could cue mathematics teachers into particular judgments of action.

The Impact Sheet to this article can be accessed at 10.6084/m9.figshare.24219964
Friction and damage of carbon fiber in tow-metal friction during the formation of flexible-oriented three-dimensional composite preforms
Authors: Li Siyuan , Shan Zhongde , Du Dong , Chang Baohua , Wang Li
Published: November 2023

As the main structure of fiber-reinforced composite, the preform affected the mechanical properties of the composite. The forming of preforms is associated with the damage of fiber due to tow-metal friction, which can compromise the properties of the composite component. This study simulated the frictional behavior of carbon fibers during flexible-oriented three-dimensional woven process to reveal the mechanism of damage and determine the process window, and the effects of processing-related parameters on friction and carbon fiber were discussed. The normal load and pre-tension played a dominant role in generation of hairiness and wear, while the weaving speed had a minimal effect. The different parameters affected the damage of tow by changing the contact area between filament and metal. According to the results, the process window of pre-tension on filament was set to [0.083 mN, 0.183 mN]. The normal load should be within the window of pre-tension, as normal load was determined by pre-tension. The process window of weaving speed was set to [1 Hz, 5 Hz]. The optimized process parameters could improve the tensile strength of woven carbon fiber by 25.7%.
Differences in the Preferred Trustworthiness Between High-level and Low-Level Leaders
Authors: Yan Shimei , Chen Lizhe , Zhang Gang
Published: November 2023

Drawing upon implicit leadership theories (ILTs), this research argues that the trustworthiness factors of leaders perceived by subordinates may vary with hierarchical levels of leaders. Based on this argument, a scenario simulation study (220 participants), an experimental study (562 participants), and an empirical survey (193 samples) were conducted. The findings show that subordinates are more concerned with the emotional stability, extraversion, agreeableness, and benevolence-related trustworthiness factors of low-level leaders and with the ability-related trustworthiness of high-level leaders; and leaders’ integrity is the most crucial factor in trustworthiness for upward trust, while there were no obvious significant differences among different leader levels. This study contributes to the literature on trust in leadership and various ILTs and has human resource management implications.
Re-forming resource entrepôts: Urban investment, extraction, and Beira’s Grande and Golden Peacock Hotels
Authors: Lazzarini Alicia Hayashi
Published: November 2023

Recent literature on investment and African infrastructure have called for examining ‘Global China’s’ urban impacts. This article investigates these in the entrepôt city of Beira, Mozambique, offering an approach to urban investment that centers cities’ rural-urban, and historically entangled connections. Through what I term ‘vertical’ and ‘horizontal’ aspects, I introduce an analytical and conceptual approach to attend to these temporal and spatial dynamics of not only city-making, but capitalist-oriented, extractivist place-making. Analyzing a set of historical and colonial hotels and special economic zones (SEZs), I demonstrate how, rather than being a Chinese model for implementation in various locales, new Mozambican-Chinese projects in Beira articulate with and create new spatial connections that are innately interlinked with European extractive practices and designs. I also de-center the city, demonstrating how urban space is reconfigured through its relationship with its outsides, rather than the other way around. By investigating Beira as a re-forming resource entrepôt, I challenge the above scholarship to take seriously deeper histories of infrastructure investment in Africa, and attend to the inextricable nature of especially city-hinterland regional ties. Ultimately, I examine temporal and spatial entanglements of capitalist extraction, entrepôt construction, and Southern African urbanism, through a historically situated and regional view.
The Stroop effect and mental imagery
Authors: Nanay Bence
Published: November 2023

The classic Stroop task is very simple: you have to name the color of words printed on a page. If these words are color words (like “red” or “blue”), where the color named and the color it is printed in are different (say, “red” printed in blue), the reaction time increases significantly. My aim is to argue that the existing psychological explanations of the Stroop effect need to be supplemented. The Stroop effect is not exclusively about access to motor control. It is also, to a large extent, about interferences in perceptual processing. To put it briefly, reading the color word triggers—laterally and automatically—visual imagery of the color and this interferes with the processing of the perceived color of the word. In other words, the Stroop effect is to a large extent a sensory phenomenon, and it has less to do with attention, conflict monitoring, or other higher-level phenomena.
Operationalizing the role of the nurse ethicist: More than a job
Authors: Morley Georgina , Robinson Ellen M , Wocial Lucia D
Published: November 2023

The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists.
E-walks bring ethics to the bedside: A nurse ethicist’s reflections
Authors: Barnum Brenda
Published: November 2023

The unique role of the nurse ethicist in the clinical setting is one meant to enhance the ethical capacity of nurses, and front-line healthcare providers. As a nurse ethicist, it is also my goal to enhance the ethical climate of each individual work area, patient care unit, and the broader institution by encouraging ethical conversations, navigating ethical dilemmas, and seeking creative solutions to minimize moral distress and burnout. To provide preventive ethics support and education, I began regularly visiting patient care areas for ethics rounds, which I affectionately named “E-walks” (for Ethics Walks). I will discuss and reflect upon the lessons that have emerged as three key components of “E-Walks”: Recognition, Solidarity and Dialogue. These themes will speak to the unique presence and availability of a nurse ethicist as a valuable resource to front-line healthcare providers who face ethical dilemmas and morally concerning cases. I will go on to argue and demonstrate that my role as the nurse ethicist lies at the intersection of bioethics and the theoretical framework of the “ethic of care,” which is focused on building, creating, and sustaining caring interprofessional relationships through the work of ethics, nursing, and education.
Stuck in 2012: The hesitant geographies of European financial integration since the Eurozone crisis
Authors: Bassens David , Lindo Duncan
Published: November 2023

At the heart of the Eurozone crisis was a dramatic divergence in interest rates between member states and a reversal of previously booming cross-border credit expansion from ‘core’ to ‘periphery’ by European banks. The resulting crisis and retreat behind national borders across the Eurozone challenged European elites’ decade-long project of producing European scale as a space for financial accumulation. The Eurozone crisis has been well-described but post-crisis geographies of financial integration have received limited attention. We chart the financial positionality of member states and the relations between them in the period 2012–2019 using a variety of metrics including intra-Eurozone cross-border bank lending. The post-crisis period is dominated by the European Central Bank’s determination to do ‘whatever it takes’ to save the Euro and its financial system. The resulting asset purchases give it a qualitatively different place in the Eurozone financial system and end the crisis period’s retreat behind national borders. But they do not restore pre-crisis dynamics, and, in addition, unevenness along national lines remains. The crisis era core and peripheral labels still hold but the data also reveal important nuances: not least that the distribution of giant banks matters and offshore financial centres cut across core/periphery boundaries. Yet, even as there is no return to booming core-to-periphery credit, German lending into the Eurozone and its counterpart, Italian borrowing, symbolizes the continuing fragility of the Eurozone banking system. European Central Bank efforts ended the crisis, but more than asset purchases will be required if we are not to remain stuck in 2012.
Impact of political risk and economic growth on the tourism industry: Evidence from a dynamic threshold panel model
Authors: Jaisinghani Dinesh , Kaur Muskan , Joshi Mahesh , Sharma Sharad , Ahmed Abdullahi D
Published: November 2023

This paper analyzes the nonlinear impact of political risk and economic development on tourism revenues. A dynamic threshold panel model is applied to a sample of 119 countries over 8 years. A positive association between economic development and tourism revenues is identified. The results also show that the impact of improvements in political stability on growth in tourism revenues is dependent on the current level of economic development. For highly developed countries, increased political stability does not impact tourism revenues. However, there is a significant positive impact of improved political stability on tourism revenues for less-developed countries.
Classical sociology from the metropolis
Authors: Holzhauser Nicole , Moebius Stephan
Published: November 2023

This introductory article to the special issue ‘Classical Sociology from the Metropolis’ provides a comprehensive exploration of the profound influence of metropolises, particularly Berlin, on the development and discourse of classical sociology. Emphasizing the metropolis as a social space and promoter of sociological thought, it delves into the lives and works of key figures such as Georg Simmel, Robert E. Park, W.E.B. Du Bois, Frieda Wunderlich and Rose Laub Coser. Their interactions, perspectives and transnational exchanges, particularly between Berlin and other urban centres such as Chicago and New York, are highlighted, illustrating the global interconnectedness of sociological discourse. While acknowledging established sociological icons, the article also highlights the often overlooked contributions of women and scholars of colour, challenging and expanding the traditional understanding of the ‘classical’ in sociological thought. The narrative travels from the early urban sociological and feminist theories that emerged in the metropolis of the 1920s to the complexities of Marxist sociology in a divided Berlin after the Second World War. Through a curated selection of articles in the special issue, the work underlines the central role of the metropolis in shaping foundational sociological concepts and the thinkers who championed them.
Financial Exigency and Mergers: Considering Identities and Interactions
Authors: Moore Chase , Thomas James W. , Foster Holly
Published: November 2023

This case study is designed for graduate students interested in higher education finances. It presents the challenges that higher education is facing regarding financial exigency elements that have led to responses with a primary focus on mergers. This financial exigency process has also caused increased legal considerations in higher education settings as administrators, faculty, staff, and alumni challenge finances in academic settings. This case highlights the complex issues that administrators must confront while considering mergers that will provide students an opportunity to evaluate the complex issues related to the financial status of an institution of higher education.
DRUJ Capsular Release for Forearm Rotational Limitation: Surgical Technique and Case Series
Authors: Kooi Kevin , Shoji Monica M. , Jupiter Jesse B. , Chen Neal C. , Garg Rohit
Published: November 2023

Background:

Forearm stiffness can be caused by distal radioulnar joint (DRUJ) capsular contractures, which can occur after trauma such as a distal radius fracture. In this setting, a DRUJ capsular release may help improve forearm rotation, but the long-term functional outcomes remain unknown. The purpose of this case series is to investigate the short-term improvement in total pronosupination arc range of motion and long-term patient-reported outcomes (PROs) after DRUJ capsular release.

Methods:

We performed a retrospective review of consecutive patients who underwent DRUJ capsular release. Range of motion prior to surgery and at final short-term follow-up was collected and analyzed with a Wilcoxon signed-rank test. Patient-reported outcomes including QuickDASH and Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) scores were obtained as medians with interquartile range (IQR), while patient satisfaction was measured on a 4-point Likert scale.

Results:

Five patients met the inclusion criteria with a median short-term follow-up of 5.5 (IQR: 4.3-10.3) months. The median preoperative supination was 25° (IQR: 0°-35°), and the median postoperative supination was 50° (IQR: 40°-60°; P = .03). The median preoperative pronation was 45° (IQR: 10°-60°), and the median postoperative pronation was 70° (IQR: 60°-80°; P = .04). After the long-term median follow-up of 10.9 (IQR 9.7-11.2) years, all the patients were satisfied or very satisfied with the results of the surgery. The median QuickDASH score was 13.6 (IQR: 9.1-20.5), and the median PROMIS UE score was 46.5 (IQR: 43.8-47.7).

Conclusions:

Distal radioulnar joint capsular release can improve pronation and supination in patients with posttraumatic forearm stiffness and is associated with high long-term patient satisfaction.
Necrotizing Sweet Syndrome of the Hand and Forearm in the Immediate Postoperative Period: Case Report
Authors: Hresko Andrew M. , Pickrell Brent B. , Harper Carl M.
Published: November 2023

Necrotizing soft tissue infection (NSTI) is a feared and potentially morbid postoperative complication requiring prompt surgical intervention. Cutaneous conditions that mimic NSTI have been reported and rarely occur in the postoperative period. Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a dermatologic condition characterized by fever, neutrophil-predominant leukocytosis, and painful skin lesions. Necrotizing Sweet syndrome (NSS) is an aggressive variant that causes a clinical appearance of localized skin necrosis and histologic evidence of necrotic foci extending to the deep aspects of the soft tissues and involving fascia and/or skeletal muscle. Necrotizing Sweet syndrome can be easily mistaken for NSTI. Contrary to infection, Sweet syndrome and NSS are worsened by surgical intervention due to the phenomenon of pathergy and readily respond to corticosteroid treatment. We present the case of a 54-year-old woman who developed NSS following an uncomplicated fasciectomy for Dupuytren disease.
Predicting the Risk of Developing Type 1 Diabetes Using a One-Week Continuous Glucose Monitoring Home Test With Classification Enhanced by Machine Learning: An Exploratory Study
Authors: Montaser Eslam , Brown Sue A. , DeBoer Mark D. , Farhy Leon S.
Published: November 2023

Background:

Detection of two or more autoantibodies (Ab) in the blood might describe those individuals at increased risk of developing type 1 diabetes (T1D) during the following years. The aim of this exploratory study is to propose a high versus low T1D risk classifier using machine learning technology based on continuous glucose monitoring (CGM) home data.

Methods:

Forty-two healthy relatives of people with T1D with mean ± SD age of 23.8 ± 10.5 years, HbA1c (glycated hemoglobin) of 5.3% ± 0.3%, and BMI (body mass index) of 23.2 ± 5.2 kg/m2 with zero (low risk; N = 21), and ≥2 (high risk; N = 21) Ab, were enrolled in an NIH (National Institutes of Health)-funded TrialNet ancillary study. Participants wore a CGM for a week and consumed three standardized liquid mixed meals (SLMM) instead of three breakfasts. Glycemic features were extracted from two-hour post-SLMM CGM traces, compared across groups, and used in four supervised machine learning Ab risk status classifiers. Recursive Feature Elimination (RFE) algorithm was used for feature selection; classifiers were evaluated through 10-fold cross-validation, using the receiver operating characteristic area under the curve (AUC-ROC) to select the best classification model.

Results:

The percent time of glucose >180 mg/dL (T180), glucose range, and glucose CV (coefficient of variation) were the only significant differences between the glycemic features in the two groups with P values of .040, .035, and .028 respectively. The linear SVM (Support Vector Machine) model with RFE features achieved the best performance of classifying low-risk versus high-risk individuals with AUC-ROC = 0.88.

Conclusions:

A machine learning technology, combining a potentially self-administered one-week CGM home test, has the potential to reliably assess the T1D risk.
A Molecular Framework for Delirium
Authors: Lyman Kyle A.
Published: November 2023

Over 2.6 million adults over the age of 65 develop delirium each year in the United States (US). Delirium is associated with a significant increase in mortality and the US health care costs associated with delirium are estimated at over $164 billion annually. Despite the prevalence of the condition, the molecular pathophysiology of delirium remains unexplained, limiting the development of pharmacotherapies. Delirious patients can be identified by prominent impairments in attention and working memory (WM), two cognitive domains that localize to the dorsolateral prefrontal cortex (dlPFC). The dlPFC is also a key site for Alzheimer’s disease (AD) pathology, and given the high risk of delirium in AD patients, suggests that efforts at understanding delirium might focus on the dlPFC as a final common endpoint for cognitive changes. Preclinical studies of the dlPFC reproduce many of the pharmacological observations made of delirious patients, including sensitivity to anticholinergics and an ‘inverted U’ pattern of dependence on monoaminergic input, with diminished performance outside a narrow range of signaling. Medications like guanfacine, which influence the dlPFC in the context of attention-deficit/hyperactivity disorder (ADHD), have emerged as therapies for delirium and motivate a detailed understanding of the influence of α-2 agonists on WM. In this review, I will discuss the neural circuitry and molecular mechanisms underlying WM and the function of the dlPFC. Localizing the cognitive deficits that are commonly seen in delirious patients may help identify new molecular targets for this highly prevalent disease.
Prognostic and clinicopathological impacts of systemic immune-inflammation index on patients with diffuse large B-cell lymphoma: a meta-analysis
Authors: Fan Zaijing , Shou Lihong
Published: November 2023

Background:

The systemic immune-inflammation index (SII) represents the immunoinflammatory score and can be considered as a prognostic marker; however, its relevance to the prognosis in patients with diffuse large B-cell lymphoma (DLBCL) remains unclear.

Objectives:

The present meta-analysis was conducted to comprehensively evaluate the relationship between the SII and prognosis in patients with DLBCL.

Design:

This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Data sources and methods:

The PubMed, Web of Science, Embase, and Cochrane Library databases were comprehensively searched from inception to 16 March 2023. We calculated combined hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate the prognostic significance of the SII for overall survival (OS) and progression-free survival (PFS) in DLBCL. In addition, this study determined odds ratios (ORs) and their 95% CIs to evaluate the correlation of SII with the clinicopathological features of DLBCL.

Results:

Five articles including 592 cases were enrolled in the current meta-analysis. According to our combined findings, the higher SII significantly predicted worse OS (HR = 3.87, 95% CI: 2.48–6.04, p < 0.001) together with inferior PFS (HR = 2.38, 95% CI: 1.12–5.08, p = 0.024) in DLBCL. Furthermore, a high SII was significantly correlated with B symptoms (OR = 2.52, 95% CI: 1.66–3.81, p < 0.001), III–IV Ann Arbor stage (OR = 2.86, 95% CI: 1.84–4.45, p < 0.001), high–intermediate/high National Comprehensive Cancer Network International Prognostic Index (OR = 2.25, 95% CI: 1.52–3.31, p < 0.001), increased neutrophil-to-lymphocyte ratio (OR = 33.76, 95% CI: 17.18–66.35, p < 0.001), and increased platelet-to-lymphocyte ratio (OR = 44.65, 95% CI: 5.80–343.59, p < 0.001). Nonetheless, the SII was not significantly related to sex, age, lactic dehydrogenase level, Eastern Cooperative Oncology Group performance status, or histology.

Conclusion:

According to this meta-analysis, the higher SII dramatically predicted inferior OS and PFS of DLBCL. Furthermore, an increased SII significantly correlated with some clinicopathological features representing the disease progression of DLBCL.

Trial registration:

The protocol was registered in INPLASY under the number INPLASY202380106.
Moving from development to implementation of digital innovations within the NHS: myHealthE, a remote monitoring system for tracking patient outcomes in child and adolescent mental health services
Authors: Morris Anna C , Ibrahim Zina , Moghraby Omer S , Stringaris Argyris , Grant Ian M , Zalewski Lukasz , McClellan Stuart , Moriarty Garry , Simonoff Emily , Dobson Richard JB , Downs Johnny
Published: November 2023

Objective

This paper aims to report our experience of developing, implementing, and evaluating myHealthE (MHE), a digital innovation for Child and Adolescents Mental Health Services (CAMHS), which automates the remote collection and reporting of Patient-Reported Outcome Measures (PROMs) into National Health Services (NHS) electronic healthcare records.

Methods

We describe the logistical and governance issues encountered in developing the MHE interface with patient-identifiable information, and the steps taken to overcome these development barriers. We describe the application's architecture and hosting environment to enable its operability within the NHS, as well as the capabilities needed within the technical team to bridge the gap between academic development and NHS operational teams.

Results

We present evidence on the feasibility and acceptability of this system within clinical services and the process of iterative development, highlighting additional functions that were incorporated to increase system utility.

Conclusion

This article provides a framework with which to plan, develop, and implement automated PROM collection from remote devices back to NHS infrastructure. The challenges and solutions described in this paper will be pertinent to other digital health innovation researchers aspiring to deploy interoperable systems within NHS clinical systems.
The Value of Plastic Surgery Closure in Adults Undergoing Scoliosis Surgery
Authors: Nathaniel Sarah , Doan Jared , Oleru Olachi , Seyidova Nargiz , Lonner Baron , Taub Peter J.
Published: November 2023

Introduction: Surgical treatment for scoliosis can be done for functional and esthetic concerns. Surgical intervention may be associated with a complication rate of up to 40% in patients with non-idiopathic scoliosis, and 3% in patients with idiopathic scoliosis. In the present study, the authors sought to evaluate patients undergoing surgery for scoliosis with closure by the plastic and reconstructive surgery service. Methods: A retrospective cohort study was performed by extracting data, including demographics, surgical characteristics, and outcomes, from the electronic medical records of a single, large, tertiary care hospital and from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Data was collected for patients aged 18 to 75 undergoing spinal surgery for scoliosis from 2012 to 2020. Data collected from institutional records included only patients whose incision was closed by plastic and reconstructive surgery, while data from NSQIP was collected from all scoliosis surgery patients regardless of closure type. Results: A total of 98 scoliosis patients were identified who underwent closure by the plastic and reconstructive surgery service. These were compared to 1390 scoliosis patients in NSQIP for whom no specific closure details were noted. At 30-day post-operatively, readmission rates were 2.04% and 7.34% for the institutional and NSQIP cohorts, respectively ( P = 0.041), reoperation rates were 1.04% and 5.83% for the institutional and NSQIP cohorts, respectively ( P = 0.0384), and overall complication rates were 2.04% and 12.52% for the institutional and NSQIP cohorts, respectively ( P = 0.0005). Conclusion: Surgical intervention for scoliosis may benefit from closure by the plastic and reconstructive surgery service, which may yield potential lower rates of readmission, reoperation, and post-operative complication.
Construction of disulfidptosis-related lncRNA signature for predicting the prognosis and immune escape in colon adenocarcinoma
Authors: Chen Pan , Yu Jun , Luo Qian , Li Jie , Wang Wei
Published: November 2023

Colon adenocarcinoma (COAD) is one of the most frequent types of cancer worldwide. Disulfidptosis has been identified as a new mode of cell death recently. The goal of this study was to explore the possibility of a connection between disulfidptosis and COAD. RNA sequencing data from COAD patients were retrieved from the The Cancer Genome Atlas (TCGA) database for this investigation. R software and various methods were used to identify disulfidptosis-related lncRNAs (DRLs) in COAD, and a prognostic model was created based on 6 DRLs (AP003555.1, AL683813.1, SNHG7, ZEB1-AS1, AC074212.1, RPL37A-DT). The prognostic model demonstrated a good accuracy in predicting the prognosis of COAD patients, according to receiver operating characteristic (ROC) curve and Concordance index (C-index) analyses. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed significant differences in biological functions and signaling pathways involved in differential genes in risk subgroups, including protein − DNA complex subunit organization, Hippo signaling pathway, Wnt signaling pathway. TIDE analysis was done on risk groupings in this study, and it found that patients in the high-risk group had more immune escape potential and were less probable to react to immunotherapy. Real-time quantitative pcr (qRT-PCR) was used to identify the relatively high expression of 6 DRLs in colon cancer cell lines. In summary, 6 DRLs were identified as possible novel molecular therapy targets for COAD in this investigation. This prognostic model has the potential to be a novel tool for forecasting COAD prognosis in clinical practice, as well as providing new insights on the potential function and mechanism of disulfidptosis in the COAD process.