bluuebunny/crossref_metadata_2025 huggingface dataset:
Preserving the Forests and Walks for Peace in Cambodia
Authors: Kittisenee Napakadol
Published: June 2024

This chapter offers a view of the inseparable bond among forests, walking, and the resilience of Buddhism in Cambodia. Forests have borne witness to significant events throughout the history of Buddhism. The forests in Cambodia, however, remember both felicities and atrocities. The series of wars, the nation-wide massacre, and the environmental devastation after the civil wars—all that plagued twentieth-century Cambodia—have disturbed and shattered the forests. Walks for Peace were installed to restore the social, natural, and spiritual environment of Cambodia. Drawing on the experiences of joining the Walks for Peace across the forests in Cambodia from 2010 to 2018, this chapter seeks to reveal and advance the intricate relationship among people, nature, and Buddhism in Cambodia, and this helps to expand the horizon of understanding lived Buddhism.
Beyond Bamboo Diplomacy
Authors: Bui Tung X.
Published: June 2024

Vietnam has emerged as a notable middle power, lauded for its growing influence in Southeast Asia and robust engagement on the global stage. Various political science scholars, seasoned diplomats, and media commentators attribute Vietnam’s rise to its firm commitment to principles of independence and non-interference, combined with a dynamic approach to multilateralism. However, this chapter posits that Vietnam’s diplomatic achievements are not solely a product of its bamboo diplomacy. Instead, the nation’s journey to becoming a regional middle power is significantly influenced by the opportunity it has to exploit a nexus of factors: the geographical proximity to influential states, the historical heritage underpinning its international relationships, and the ability to leverage developments in today’s fractured global environment. Drawing on social welfare theories and the notion of power asymmetry in international relations, the chapter further argues that bamboo diplomacy’s inherent instability renders it unsustainable in the long term. To counter this intrinsic vulnerability, Vietnam, or any state pursuing this multipolar diplomacy approach, must maintain a delicate equilibrium, marked by astute negotiation and strategic concessions. The chapter contends that the viability of this diplomatic approach depends greatly on the stances of pivotal partners, especially those with significant geopolitical and geoeconomic influence, who are willing to engage with or consent to “satisficing” resolutions within the intricate sphere of global diplomacy.
Spatial Analysis in Geoeconomics
Authors: Lin Kun-Chin
Published: June 2024

This chapter provides an interpretative survey of key concepts of geoeconomics across several disciplines, focusing on debates between the Luttwakian and critical geography literature in the aftermath of the Cold War. It proposes expanding the systemic “structure” of geoeconomics to incorporate non-geographical—yet spatially related—features, as well as the cognitive dimensions of territoriality. Similarly, it analyzes economic statecraft as going beyond statist pursuit of self-interests within a grand strategic concept to encompass subnational and non-state agents as well as disparate processes in the socioeconomic and ecological domains that often run counter to intended government policy effects. The chapter pursues these lines of inquiries and data methodology with a highlight of English-language studies on the Chinese Belt and Road Initiative, which demonstrates the diversity of relevant spatial factors that affect global power relations.
Constitution Making and Constitutional Change
Authors: Ginsburg Tom
Published: June 2024

This chapter explores constitution making and amendment in East Asia, defined here as the region stretching from Indonesia to Mongolia. The region is home to a diverse set of constitutional experiences. Three trends make themselves clear. First, the region is characterized by a good deal of constitutional stability in most countries, with Thailand being the only prominent exception. Second, East Asia is also an outlier in terms of the process by which constitutions are made. In recent years, there has been an increasing global emphasis on public participation in the constitutional design process—either in the design, drafting, or approval of the constitutional text. But this is relatively unusual in the region. Finally, with the exceptions of Singapore and Malaysia, constitutional amendment in East Asia is relatively rare and relatively significant, in contrast with regions like South Asia, where constitutions are amended frequently and sometimes for minor ends.
Aquinas and Bonaventure
Authors: Spezzano Daria
Published: June 2024

Thomas Aquinas and Bonaventure draw from common sources (especially Augustine and Dionysius) to integrate the theme of deification into their theologies of sanctification. Nevertheless, they understand deification somewhat differently because of their distinctive theological visions. Both associate it with divine adoption, perfection to the Trinitarian imago Dei, conformation to Christ, and the communication of grace through the sacraments. For both, deification is an ontological transformation that flowers in moral action, leading to union with God. However, Aquinas explains it in terms of participation, Bonaventure of hierarchy. Aquinas underlines the activity of both intellect and will in the cooperation of the deified with grace on the journey to perfect knowledge and love of God in beatitude, Bonaventure emphasizes the ascent of the deiform to an experience of affective union with God beyond intellection.
Martin Luther and the Early Lutherans
Authors: Raunio Antti
Published: June 2024

For Martin Luther, God lives in believers and enables believers to share in his life through the light of faith. Believers take on the image of Christ and are configured to all the mysteries of Christ’s life, sharing in Christ’s salvific works and receiving Christ’s inheritance. By faith and baptism, believers take on Christ’s righteousness in God’s eyes, and this righteousness really becomes true of believers, so that believers are filled with love (which is the divine nature). Following upon Luther, Philip Melanchthon argues that the goal of Christian life is to receive God’s perfect justification, so that God becomes all and all. Even in this life, through imputed righteousness, believers have a spark of this perfect righteousness, so that believers already are being deified by the Spirit. Johannes Bugenhagen (Pomeranus) emphasizes believers’ adoption as God’s children, and Johannes Brenz argues that God communicates Christ’s own qualities to believers.
Pierre de Bérulle and François de Sales
Authors: Wright Wendy M.
Published: June 2024

Two seminal figures emerged amid the Catholic spiritual renewal following the French Wars of Religion: Pierre de Bérulle and François de Sales. While employing distinctive spiritual and theological languages both explored what they saw as the goal of human existence, the radially transformed—deified—life. The Pauline injunction, “I no longer live but Christ lives in me” was refracted uniquely by each. For Bérulle, the means toward this goal was to be lost in God through adhering to the inner life (states) of Jesus instantiated at the time of the Incarnation and to become, like the Son, perfect adorers of the Father. De Sales’ vision proposed that the Divine desire for union with creation is met by the innate God-ward desire of humankind through the “exchange” of human hearts for the gentle, humble heart of Jesus actualized by the exercise of love of God and neighbor.
Karl Barth’s Critique of Deification
Authors: Kaltwasser Cambria
Published: June 2024

Barth’s criticism of deification is no stand-alone critique but the outcome of structural decisions integral to his mature theology. As such, his criticism says as much about his own theology as it does about his target. This chapter highlights three interrelated grounds of Barth’s criticism of deification: The first ground is Barth’s historicized Christology, aimed at differentiating divine and human actors in the covenant of grace. The second is Barth’s revised ontology, which, stemming from his doctrine of God, obviates the traditional substance ontology in which deification takes root. The third is Barth’s unconventional doctrine of sanctification, in which the far-reaching consequences of his previous decisions come into clearest focus: Barth rules out not merely deification, but its underlying presupposition that the Christian life necessarily yields visible transformation and growth into holiness.
Twentieth-Century Russian Orthodox Theologians
Authors: Gavrilyuk Paul L.
Published: June 2024

This chapter begins by discussing the work of schema-monk Antonii Bulatovich (1870–1919) and his development of the doctrine of deification in application to the Name-Glorifiers controversy. The following sections bring out the centrality of deification and its deeply original articulations by the four leaders of the Russian religious renaissance: Fr. Pavel Florensky (1882–1937), Fr. Sergius Bulgakov (1871–1944), Nicholas Berdyaev (1874–1948), and Lev Karsavin (1882–1952). The final sections treat the émigré theologians of the younger generation, who were aligned with the neopatristic trend in Russian theology: Fr. Georges Florovsky (1893–1979), Myrrha Lot-Borodine (1882–1954), Vladimir Lossky (1903–1958), and Fr. John Meyendorff (1926–1992). Cumulatively, these efforts at the historical retrieval and the constructive appropriation of deification had the effect of making deification the defining feature of Orthodox theology.
Deification and the Metaphysics of Participation
Authors: Davison Andrew
Published: June 2024

Deification has been set out as participation in God, both on biblical grounds (2 Pet. 1:4) and on account of the rich discussions of participation in Platonic texts, and theological writing influenced by them. In recent decades, participation has been celebrated by theologians, across confessional lines, as central to a theological and philosophical vision shared by writers down Christian history. In this chapter, the idea of a “metaphysics of participation” (largely illustrated by the works of Thomas Aquinas) is used to explore what has been meant by deification. The dependence of the creature on God is stressed, as is its transformation by grace, while also preserving the unalterable distinction between creature and Creator. After consideration of some objections to treating the relation of the creature to God in such metaphysical terms, the chapter concludes by showing how the theme of participation can serve to connect deification to other doctrinal topics.
Deification and Ecclesiology
Authors: Hovorun Cyril
Published: June 2024

The chapter explores connections between two phenomena: theosis and the church. Initially, such connections were not obvious, as the notion of the church was rudimentary and expressed mainly through metaphors. One may discern early metaphors referring to the church and theosis, such as the images of the second Adam and recapitulation. Pseudo-Dionysius the Areopagite introduced a new way of thinking about the church and theosis. This way was restrictive and hierarchical. The adoption of dialectical categories by the Christian theology advanced the understanding of theosis and its connectedness with the church. Theologians, especially in the East, came to distinguish between the common potentiality and particular actuality of deification. The former, which they called isotheon, transformed to the latter, theosis in the church. The Russian religious philosophy provided a framework for a modern synthesis between the ideas of the Incarnation, the church, and deification.
Deification and Ecology
Authors: Theokritoff Elizabeth
Published: June 2024

The chapter considers how the perspective of deification colors people’s relationship with the material world: the Orthodox monastic tradition, intensely focused on deification, also affords outstanding contemporary examples of ecological living. The Greek patristic tradition establishes the “greater arc” of creation for deification, God’s presence in creation through the logoi of beings (St. Maximus), and matter deified through God’s incarnate presence. The ascetic emphasis on bodily transformation extends transfiguration through the material world. The legacy of Russian religious philosophy is a cosmic vision, but also the idea of deification as human task. Themes of “humanizing” and technological mastery in Bulgakov, Teilhard de Chardin, and, later, Stăniloae are contentious; but they and others, notably Clément, also highlight the progressive transfiguration of the material world through the church and especially the Eucharist. Deification is thus a reality already glimpsed—dependent however not on humans nor on pristine nature, but on God alone.
The “Non-Biblical” Writings of Early Judaism
Authors: Macaskill Grant
Published: June 2024

This chapter discusses the traditions regarding human or creaturely deification in writings of Early Judaism that are often categorized as “non-biblical,” “non-canonical,” or “intertestamental.” These categories are highlighted as problematic, reflecting a distinctly Christian viewpoint, and the difficulties involved in reconstructing the true extent of early Jewish literature are considered. Focusing on demonstrably Jewish literature, particularly the Dead Sea Scrolls and the writings of Philo of Alexandria, the chapter examines various points of equivalence in the early Jewish representations of exalted humans with the theological traditions of deification. A central claim is that the traditions about exalted humans and their relationship to both God and the angels have been widely misread because of a problematic understanding of “monotheism” in Early Judaism. The possibility that Early Judaism affirmed the realities of other gods, while maintaining the categorical uniqueness of Israel’s God, reframes the significance of both exalted humans and angelic figures.
Reduced Tensor Network Formulation for Non-Abelian Gauge Theories in Arbitrary Dimensions
Authors: Yosprakob Atis
Published: June 2024

Formulating non-Abelian gauge theories as a tensor network is known to be challenging due to the internal degrees of freedom that result in the degeneracy in the singular value spectrum. In two dimensions, it is straightforward to “trace out” these degrees of freedom with the use of character expansion, giving a reduced tensor network where the degeneracy associated with the internal symmetry is eliminated. In this work, we show that such an index loop also exists in higher dimensions in the form of a closed tensor network that we call the “armillary sphere”. This allows us to completely eliminate the matrix indices and reduce the overall size of the tensors in the same way as is possible in two dimensions. This formulation allows us to include significantly more representations with the same tensor size, thus making it possible to reach a greater level of numerical accuracy in the tensor renormalization group computations.
Deciphering difficult-to-treat psoriatic arthritis (D2T-PsA): a GRAPPA perspective from an international survey of healthcare professionals
Authors: Ribeiro Andre L , Singla Shikha , Chandran Vinod , Chronis Nicholas , Liao Wilson , Lindsay Christine , Soriano Enrique R , Mease Philip J , Proft Fabian
Published: June 2024

Objectives

This study contributes to the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)’s effort to define ‘difficult-to-treat’ PsA (D2T-PsA), leveraging insights of healthcare professionals who are GRAPPA members. The primary objective is to inform GRAPPA’s D2T PsA project, ensuring the consensus definition reflects clinical experience and expertise.

Methods

An online survey was conducted among GRAPPA’s healthcare professionals managing PsA patients. The survey covered demographic details, structured questions, and open-ended queries to gather comprehensive insights into the experts’ viewpoints.

Results

About 223 physicians completed the survey, comprising 179 (80.2%) rheumatologists and 40 (17.9%) dermatologists. The majority, 184 (82.5%), favoured establishing distinct definitions for D2T-PsA and complex-to-manage PsA (C2M-PsA). Furthermore, 202 (90.5%) supported a definition that includes objective inflammation signs (clinical, laboratory, imaging, among others). However, opinions varied on the criteria for prior treatment failures, with most (93, 41.7%) favouring a definition that includes at least one conventional synthetic disease-modifying anti-rheumatic drug and two or more biological- or targeted-synthetic-DMARDs with different mechanisms of action.

Conclusion

The survey reveals a majority opinion among GRAPPA experts favouring the differentiation between D2T-PsA and C2M-PsA, and the inclusion of objective inflammatory markers in these definitions. However, there is less than 50% agreement on the specific treatment failure criteria, particularly regarding the number of therapies needed to classify PsA as D2T. These findings suggest a need for continued discussion to reach a more unified approach in defining D2T-PsA, reflecting the complexity of the condition.
A composite PET-matrix patch enhances tendon regeneration and tendon-to-bone integration for bridging repair of the chronic massive rotator cuff tears in a rabbit model
Authors: Na Yuyan , Jue Hao , Xia Tian , Li Moxin , Xue Xiaoao , Hua Yinghui
Published: June 2024

In recent years, bridging repair has emerged as an effective approach for the treatment of massive rotator cuff tears (MRCTs). The objective of this study was to develop a composite patch that combines superior mechanical strength and biocompatibility and evaluate its potential for enhancing the outcomes of bridging repair for MRCTs. The composite patch, referred to as the PET-matrix patch (PM), was fabricated by immersing a plain-woven PET patch in decellularized matrix gel and utilizing the freeze-drying technique. The results demonstrated that the PM has reliable mechanical properties, with a maximum failure load of up to 480 N. The decellularized matrix sponge (DMS), present on the surface of the PM, displayed a loose and porous structure, with an average pore size of 62.51 μm and a porosity of 95.43%. In vitro experiments showed significant elongation of tenocytes on the DMS, with cells spanning across multiple pores and extending multiple protrusions as observed on SEM images. In contrast, tenocytes on the PET patch appeared smaller in size and lacked significant elongation. Additionally, the DMS facilitated the proliferation, migration and differentiation of tenocytes. In a rabbit model of chronic MRCTs, the PM group showed superior outcomes compared to the PET group at 4, 8 and 12 weeks after bridging repair. The PM group displayed significantly higher tendon maturing score, larger collagen diameter in the regenerated tendon and improved tendon-to-bone healing scores compared to the PET group (P < 0.05). Moreover, the maximum failure load of the tendon–bone complex in the PM group was significantly higher than that in the PET group (P < 0.05). In summary, the PM possesses reliable mechanical properties and excellent cytocompatibility, which can significantly improve the outcomes of bridging repair for chronic MRCTs in rabbits. Therefore, it holds great potential for clinical applications.
In situ co-deposition synthesis for collagen-Astragalus polysaccharide composite with intrafibrillar mineralization as potential biomimetic-bone repair materials
Authors: Li Han , Guan Ziying , Wei Liren , Lu Jian , Tan Yanfei , Wei Qingrong
Published: June 2024

A hybrid material possessing both componential and structural imitation of bone tissue is the preferable composites for bone defect repair. Inspired by the microarchitecture of native bone, this work synthesized in vitro a functional mineralized collagen fibril (MCF) material by utilizing the method of in situ co-precipitation, which was designed to proceed in the presence of Astragalus polysaccharide (APS), thus achieving APS load within the biomineralized collagen-Astragalus polysaccharide (MCAPS) fibrils. Transmission electron microscope (TEM), selected area electron diffraction (SAED) and scanning electronic microscopy (SEM) identified the details of the intrafibrillar mineralization of the MCAPS fibrils, almost mimicking the secondary level of bone tissue microstructure. A relatively uniform and continuous mineral layer formed on and within all collagen fibrils and the mineral phase was identified as typical weak-crystalline hydroxyapatite (HA) with a Ca/P ratio of about 1.53. The proliferation of bone marrow-derived mesenchymal stem cells (BMSC) and mouse embryo osteoblast precursor cells (MC3T3-E1) obtained a significant promotion by MCAPS. As for the osteogenic properties of MCAPS, a distinct increase in the alkaline phosphatase (ALP) activity and the number of calcium nodules (CN) in BMSC and MC3T3-E1 was detected. The up-regulation of three osteogenic-related genes of RUNX-2, BMP-2 and OCN were confirmed via reverse transcription-quantitative polymerase chain reaction (RT-qPCR) to further verify the osteogenic performance promotion of MCAPS. A period of 14 days of culture demonstrated that MCAPS-L exhibited a preferable efficacy in enhancing ALP activity and CN quantity, as well as in promoting the expression of osteogenic-related genes over MCAPS-M and MCAPS-H, indicating that a lower dose of APS within the material of MCAPS is more appropriate for its osteogenesis promotion properties.
Nurse Scientists
Authors: Muoki Deltra
Published: June 2024

These nurses bridge the gap between research and clinical practice.
Methods to Disseminate Nursing Research: A Brief Overview
Authors: Capili Bernadette , Anastasi Joyce K.
Published: June 2024

Editor's note: This is the 22nd article in a series on clinical research by nurses. The series is designed to be used as a resource for nurses to understand the concepts and principles essential to research. Each column will present the concepts that underpin evidence-based practice—from research design to data interpretation. To see all the articles in the series, go to https://links.lww.com/AJN/A204.
Touch Interventions Beneficial for Physical and Mental Health
Authors: Rosenberg Karen
Published: June 2024

According to this study:
Atopic Dermatitis: Clinical Aspects and Treatments
Authors: Geng Ryan S. Q. , Sibbald R. Gary
Published: June 2024

Atopic dermatitis is the most common eczematous inflammatory skin condition, presenting with lesions that typically appear as poorly demarcated erythematous and scaly papules and plaques. The lesions most commonly occur on flexural surfaces of the knees, elbows, and wrists and are associated with moderate to severe itching. This article focuses on the clinical presentation of atopic dermatitis and treatment options. Other related topics include epidemiology, pathogenesis, risk factors, triggers, and differential diagnoses.

GENERAL PURPOSE

To review issues related to atopic dermatitis, including its classification, clinical presentation, potential triggers, and treatment options.

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will:

1. Synthesize a differential diagnosis for atopic dermatitis (AD).

2. Explain the classification of AD cases.

3. Select triggers or exacerbating factors for AD.

4. Explain pharmacologic and nonpharmacologic treatment options for patients with AD.
Grade IV Radiation Skin Injury on the Neck of a Patient with Tonsillar Carcinoma: A Case Report
Authors: Zhang Li , Liu Sicong
Published: June 2024

Radiation therapy is often accompanied by skin toxicity in the irradiated area and radiation-induced DNA damage to skin tissue cells in the surrounding pigmented area. This case report describes a patient with radiation-induced skin injury who received wound treatment and psychological intervention with satisfactory results. A 60-year-old woman was admitted to the authors’ hospital on January 18, 2021, with radiation-induced skin injury caused by carbon ion radiotherapy for tonsillar carcinoma. The patient underwent wound repair combined with psychological intervention (30 minutes per dressing change). Over a period of 1 month, the wound area was reduced from 11 × 12 cm2 to 1 × 1 cm2, and wound symptoms (exudate, blood odor, wound infection, wound edge dehydration and curling, periwound skin peeling, dryness, and hyperkeratosis) improved. The patient’s anxiety factor scores decreased from 18 to 1, and her depression factor scores decreased from 16 to 3. When the patient was discharged from the hospital after 1 month of treatment, she had a satisfactory self-image and normal social activities.
Trajectories of Hearing From Childhood to Adulthood
Authors: Leung Joan H. , Thorne Peter R. , Purdy Suzanne C. , Cheyne Kirsten , Steptoe Barbara , Ambler Antony , Hogan Sean , Ramrakha Sandhya , Caspi Avshalom , Moffitt Terrie E. , Poulton Richie
Published: June 2024

Objectives:

The Dunedin Multidisciplinary Health and Development Study provides a unique opportunity to document the progression of ear health and hearing ability within the same cohort of individuals from birth. This investigation draws on hearing data from 5 to 13 years and again at 45 years of age, to explore the associations between childhood hearing variables and hearing and listening ability at age 45.

Design:

Multiple linear regression analyses were used to assess associations between childhood hearing (otological status and mid-frequency pure-tone average) and (a) age 45 peripheral hearing ability (mid-frequency pure-tone average and high-frequency pure-tone average), and (b) age 45 listening ability (listening in spatialized noise and subjective questionnaire on listening experiences). Sex, childhood socioeconomic status, and adult IQ were included in the model as covariates.

Results:

Peripheral hearing and listening abilities at age 45 were consistently associated with childhood hearing acuity at mid-frequencies. Otological status was a moderate predicting factor for high-frequency hearing and utilization of spatial listening cues in adulthood.

Conclusions:

We aim to use these findings to develop a foundational model of hearing trajectories. This will form the basis for identifying precursors, to be investigated in a subsequent series of analyses, that may protect against or exacerbate hearing-associated cognitive decline in the Dunedin Study cohort as they progress from mid-life to older age.
What is the role of plastic surgery for incisional closures in pediatric spine surgery? Results from a pediatric spine study group survey
Authors: Zusman Natalie L. , Valenzuela-Moss Jacquelyn N. , Wren Tishya A.L. , Tetreault Tyler A. , Illingworth Kenneth D. , Brooks Jaysson T. , Skaggs David L. , Andras Lindsay M. , Heffernan Michael J. ,   Pediatric Spine Study Group
Published: June 2024

Current best practice guidelines recommend a plastics-style multilayer wound closure for high-risk pediatric spine surgery. However, plastic surgery closure of spinal incisions remains controversial. This study investigates surgeon perceptions and practice patterns regarding plastic surgery multilayered closure (PMC) in pediatric spine surgery. All surgeons in an international pediatric spine study group received a 30-question survey assessing incisional closure practices, frequency of plastic surgery collaboration, and drain management. Relationship to practice size, setting, geographic region, and individual diagnoses were analyzed. 87/178 (49%) surgeons responded from 79% of participating sites. Plastics utilization rates differed by diagnosis: neuromuscular scoliosis 16.9%, early onset scoliosis 7.8%, adolescent idiopathic scoliosis 2.8% (P < 0.0001). Plastics were used more for early onset scoliosis [odds ratio (OR) 18.5, 95% confidence interval (CI): 8.5, 40.2; P < 0.001] and neuromuscular scoliosis [OR 29.2 (12.2, 69.9); P < 0.001] than adolescent idiopathic scoliosis. Plastics use was unrelated to practice size, setting, or geographic region (P ≥ 0.09). Respondents used plastics more often for spina bifida and underweight patients compared to all other indications (P < 0.001). Compared to orthopaedic management, drains were utilized more often by plastic surgery (85 vs. 21%, P = 0.06) and for longer durations (P = 0.001). Eighty-nine percent of surgeons felt plastics increased operative time (58 ± 37 min), and 34% felt it increased length of hospitalization. Surgeons who routinely utilize plastics were more likely to believe PMC decreases wound complications (P = 0.007). The perceived benefit of plastic surgery varies, highlighting equipoise among pediatric spine surgeons. An evidence-based guideline is needed to optimize utilization of plastics in pediatric spine surgery.
Transcriptional regulation of CYR61 and CTGF by LM98: a synthetic YAP-TEAD inhibitor that targets in-vitro vasculogenic mimicry in glioblastoma cells
Authors: Roy Marie-Eve , Veilleux Carolane , Paquin Alexis , Gagnon Alexandre , Annabi Borhane
Published: June 2024

Glioblastoma (GBM) is a highly angiogenic malignancy of the central nervous system that resists standard antiangiogenic therapy, in part because of an alternative process to angiogenesis termed vasculogenic mimicry. Intricately linked to GBM, dysregulation of the Hippo signaling pathway leads to overexpression of YAP/TEAD and several downstream effectors involved in therapy resistance. Little is known about whether vasculogenic mimicry and the Hippo pathway intersect in the GBM chemoresistance phenotype. This study seeks to investigate the expression patterns of Hippo pathway regulators within clinically annotated GBM samples, examining their involvement in vitro regarding vasculogenic mimicry. In addition, it aims to assess the potential for pharmacological targeting of this pathway. In-silico analysis of the Hippo signaling members YAP1, TEAD1, AXL, NF2, CTGF, and CYR61 transcript levels in low-grade GBM and GBM tumor tissues was done by Gene Expression Profiling Interactive Analysis. Gene expression was analyzed by real-time quantitative PCR from human U87, U118, U138, and U251 brain cancer cell lines and in clinically annotated brain tumor cDNA arrays. Transient gene silencing was performed with specific small interfering RNA. Vasculogenic mimicry was assessed using a Cultrex matrix, and three-dimensional capillary-like structures were analyzed with Wimasis. CYR61 and CTGF transcript levels were elevated in GBM tissues and were further induced when in-vitro vasculogenic mimicry was assessed. Silencing of CYR61 and CTGF, or treatment with a small-molecule TEAD inhibitor LM98 derived from flufenamic acid, inhibited vasculogenic mimicry. Silencing of SNAI1 and FOXC2 also altered vasculogenic mimicry and reduced CYR61/CTGF levels. Pharmacological targeting of the Hippo pathway inhibits in-vitro vasculogenic mimicry. Unraveling the connections between the Hippo pathway and vasculogenic mimicry may pave the way for innovative therapeutic strategies.
Measurement of humanity among interns of Internal Medicine Department, Damascus University: a cross-sectional study
Authors: Drie Tasneem , Hodifa Yara , Haidar Ghina , Soud Alkousa Hamzeh , Khalayli Naram , Hodaifa Amr , Hoha Ghofran , Alghawe Fatima , Kudsi Maysoun
Published: June 2024

Background:

Although humanity is important within the medical health field, the authors lack studies that address this topic.

Objective:

The authors aimed to assess humanity among a sample of Syrian internal medicine interns.

Methods:

The authors have used a validated scale based on the Medical Humanity Scale (MHS) categorized into seven human values included in 30 questions (patient-oriented care, respect, empathy, ethics, altruism, and compassion). The scale can test the differentiation between these interns with different levels of medical humanity. A 7-point Likert scale was adopted. Six hundred sixty-five participants from the Internal Medicine Department, Faculty of Medicine, Damascus University entered our study.

Results:

The mean score of the MHS was 147.14 (13.1) Female residents humanity scores (mean 149.14, SD 15.1) was significantly higher than male students’ scores (mean 145.48, SD 13.35; P=.007), KMO=0.843>0.7, which is near 1, and the Bartlett test of sphericity =4187.043 (df=465; P=.01). The Cronbach α was >0.683, was indicating the validity and reliability of the scale.

Conclusions:

The results of this study suggest that the humanity level is accepted by using a scale based on MHS among interns of the Internal Medicine Department, Damascus University.
Pseudofilariasis, a Presenting Sign of Alkaptonuria
Authors: Marrero Frances , Perry Henry D. , Iacob Codrin E. , Sachs David
Published: June 2024

Purpose:

To report the association of Pseudofilariasis as a presenting sign of Alkaptonuria.

Method:

Case Report.

Results:

A 49-year-old Indian man was referred because of wormlike objects in his left conjunctiva. Ocular and family history was non-contributory. He had not been to India in 15 years. Past medical history revealed hypertension, hypercholesterolemia, arthritis, and a myocardial infarct. He had undergone two stents, bilateral Achilles tendon repairs and bilateral knee replacements. ROS showed longstanding back stiffness and pain. On ocular examination the vision was 20/25 in each eye and positive findings were in the left eye bulbar conjunctival which showed stationary black vermiform (filarial in appearance) foreign bodies along with 2 small corneal limbal pigmented deposits. Conjunctival biopsy showed dilated lymph channels with interstitial proteinaceous material of a light brown color consistent with Ochronotic pigment; hence diagnostic of Alkaptonuria.

Conclusions:

Pseudofilariasis may be a presenting sign of Alkaptonuria and occur years before a clinical diagnosis is made. Filariasis is always involves white worms and never black. Knowing the ophthalmic signs of this rare disease may lead to an accurate diagnosis earlier thusly avoiding unnecessary tests and examinations.
Epidemiology and Management of Pediatric Group A Streptococcal Pneumonia With Parapneumonic Effusion: An Observational Study
Authors: Lees Emily A. , Williams Thomas C. , Marlow Robin , Fitzgerald Felicity , Jones Christine , Lyall Hermione , Bamford Alasdair , Pollock Louisa , Smith Andrew , Lamagni Theresa , Kent Alison , Whittaker Elizabeth ,   for the Group A Streptococcal Disease Consortium
Published: June 2024

Background:

During autumn/winter 2022, UK pediatricians reported an unseasonal increase in invasive group A streptococcal infections; a striking proportion presenting with pneumonia with parapneumonic effusion.

Methods:

Clinicians across the United Kingdom were requested to submit pseudonymized clinical data using a standardized report form for children (<16 years) admitted between September 30, 2022 and February 17, 2023, with microbiologically confirmed group A streptococcal pneumonia with parapneumonic effusion.

Results:

From 185 cases submitted, the median patient age was 4.4 years, and 163 (88.1%) were previously healthy. Respiratory viral coinfection was detected on admission for 101/153 (66.0%) children using extended respiratory pathogen polymerase chain reaction panel. Molecular testing was the primary method of detecting group A streptococcus on pleural fluid (86/171; 50.3% samples). Primary surgical management was undertaken in 171 (92.4%) children; 153/171 (89.4%) had pleural drain inserted (96 with fibrinolytic agent), 14/171 (8.2%) had video-assisted thoracoscopic surgery. Fever duration after admission was prolonged (median, 12 days; interquartile range, 9–16). Intravenous antibiotic courses varied in length (median, 14 days; interquartile range, 12–21), with many children receiving multiple broad-spectrum antibiotics, although evidence for additional bacterial infection was limited.

Conclusions:

Most cases occurred with viral coinfection, a previously well-recognized risk with influenza and varicella zoster, highlighting the need to ensure routine vaccination coverage and progress on vaccines for other common viruses (eg, respiratory syncytial virus, human metapneumovirus) and for group A streptococcus. Molecular testing is valuable to detect viral coinfection and confirm invasive group A streptococcal diagnosis, expediting the incorporation of cases into national reporting systems. Range and duration of intravenous antibiotics administered demonstrated the need for research on the optimal duration of antimicrobials and improved stewardship.
Pediatric Endophthalmitis Over the Last Five Decades: A Case Report and Systematic Review
Authors: Kasem Ali Sliman Rim , Khoury Lana , Shehadeh Shereen
Published: June 2024

Introduction:

Pediatric infectious endophthalmitis is a rare, severe ocular infection that can have devastating consequences. It may be exogenous or endogenous, with exogenous endophthalmitis being more common. Current data on the etiology, microbiology, antibiotic treatments and outcomes in pediatric cases is limited.

Purpose:

To summarize the etiology, microbiology, visual outcomes and management of pediatric endophthalmitis.

Methods:

A literature review was conducted on cases of pediatric endophthalmitis published from 1980 to 2022, identified through searches of PubMed, Medline, Web of Science and Google Scholar databases.

Results:

A total of 796 patients were included. Ocular trauma was the most common cause with 623 patients (78.3%), followed by posteye surgery with 100 patients (12.6%) and endogenous endophthalmitis with 67 patients (70 eyes) (8.4%). Among culture-positive cases, gram-positive microorganisms predominated. Treatment involved pars plana vitrectomy in 608 patients (76%) and intraocular antibiotics in 590 patients (74%). Favorable visual acuity (≥20/200) was achieved in 30.5% of patients, 20% had no light perception and 12.5% developed poor anatomical outcomes with phthisis bulbi.

Conclusion:

Our review provides insights into the etiology, epidemiology, microbiology, treatment and visual outcomes of pediatric endophthalmitis based on available literature worldwide.
Postdiscontinuation Antibiotic Exposure in Hospitalized Infants at Risk for Late-onset Sepsis in the Neonatal Intensive Care Unit
Authors: Wade Kelly C. , Greenberg Rachel G. , Benjamin Daniel K. , Chen Lydia Li-Hui , Vo Brandon , Ang Berwyn Liselle , Boutzoukas Angelique , Zimmerman Kanecia , Clark Reese H. , Cohen-Wolkowiez Michael , Le Jennifer ,   on behalf of the Administrative Core Committee of the Best Pharmaceuticals for Children Act – Pediatric Trials Network
Published: June 2024

Background:

In the neonatal intensive care unit, infants are at risk for late-onset sepsis. When blood cultures are negative, antibiotic stewardship efforts encourage stopping antibiotics, yet the duration of therapeutic exposure after the last dose is unknown.

Methods:

This retrospective cohort study of simulated antibiotic exposures used published population pharmacokinetic models within drug-specific neonatal intensive care unit cohorts of preterm and term infants, postnatal age 7–60 days and exposed to cefepime, piperacillin-tazobactam or tobramycin. Monte Carlo simulations (NONMEM 7.3) were used to predict steady-state exposures after a 72-hour antibiotic course per Neofax dosing. Exposure was assessed relative to drug-specific minimum inhibitory concentration (MIC) targets between 1 and 16 mcg/mL for Pseudomonas and Enterobacteriaceae species. Postdiscontinuation antibiotic exposure (PDAE) was defined as the time from the last dose to when antibiotic concentration decreased below a specific MIC.

Results:

Piperacillin-tazobactam, cefepime and tobramycin cohorts included infants with median gestation age 29, 32 and 32 weeks and postnatal age 17, 19 and 15 days, respectively. The mean PDAE was 19–68 hours, depending on the specific antibiotic/MIC combination. PDAE was longer for infants <28 days old and preterm (vs. term) infants. Cefepime exhibited the longest mean PDAE of 68 hours for Enterobacteriaceae MIC 1. Piperacillin mean PDAE was 25 hours for Enterobacteriaceae MIC 8. Tobramycin had a short mean PDAE of 19 hours.

Conclusions:

Piperacillin and cefepime exposures remained therapeutic long after the expected 8- to 12-hour dosing interval. PDAE is an important consideration for antibiotic stewardship among hospitalized infants, particularly premature infants and those within 1 month postbirth.
Clinical Characteristics of Pediatric Parainfluenza Virus Infections: A Comparative Analysis of Parainfluenza Virus Serotypes 1–4 From April 2021 to October 2023 in Hokkaido, Japan
Authors: Sanada Atsushi , Kondo Kenji , Takahashi Funa , Higashide Yukiko , Kunizaki Jun , Hoshino Emiko , Sakurai Nodoka , Mori Toshihiko
Published: June 2024

Background:

Parainfluenza virus (PIV) is widely known as a causative virus of acute respiratory tract infections in children, and 4 serotypes (PIV-1–PIV-4) have been identified. The purpose of the present study was to clarify the clinical characteristics of the PIV serotypes in pediatric PIV infections in Japan.

Methods:

Between April 2021 and October 2023, 8821 children aged <16 years who presented with respiratory symptoms underwent multiplex polymerase chain reaction analyses at the Department of Pediatrics, NTT Medical Center Sapporo. All 1490 cases in which PIV was detected were analyzed for their clinical characteristics by PIV serotypes.

Results:

Of the 1490 cases, 608 were positive for a single PIV serotype: 91 (13.5%) for PIV-1, 54 (4.8%) for PIV-2, 361 (62.1%) for PIV-3 and 102 (19.6%) for PIV-4. The median ages were 3.5 years for PIV-1, 5.4 years for PIV-2, 1.9 years for PIV-3 and 2.2 years for PIV-4, with a significantly older age for PIV-2. Compared with the other serotypes, croup was significantly more common in PIV-1 and lower respiratory tract infection was significantly more common in PIV-4. Of the 608 cases with a single PIV serotype, 114 were hospitalized. The proportion of hospitalized patients was higher for PIV-4 than for the other PIV serotypes, but the difference was not significant.

Conclusions:

Lower respiratory tract infection was more frequent in PIV-4 than in the other PIV serotypes, and PIV-4 infection may increase the risk of hospitalization.
Association Between Menopausal Symptoms and Work-Related Factors Among Female Workers in Japan
Authors: Sawamoto Naoya , Okawara Makoto , Ishimaru Tomohiro , Tateishi Seiichiro , Horie Shigeo , Yasui Toshiyuki , Fujino Yoshihisa
Published: June 2024

Objective

Although menopausal symptoms are an important issue for female workers, their association with work-related factors is not well studied. Here, we explored the association between work-related factors and menopausal symptoms in Japan.

Methods

A cross-sectional study was conducted in 2023 among all 1465 female employees of a large Japanese company. Associations between occupational factors and moderate or severe menopausal symptoms, as measured by the Menopause Rating Scale (MRS), were examined using logistic regression analysis.

Results

Several workplace-related factors were significantly associated with moderate or severe menopausal symptoms, including company support and the number of night shifts. A marginally significant association was also seen for commuting time.

Conclusions

Workplace menopause interventions for the factors identified in this study may satisfy unmet needs.
Schistosomal colitis mimicking inflammatory bowel disease: a case report from Sudan
Authors: Alajab Mohamed B. , Rafei Ahmed , Abdo Abdelmoneim E.
Published: June 2024

Introduction:

Schistosomiasis, caused by parasitic Schistosoma species, is a common neglected tropical disease prevalent in sub-Saharan Africa, including Sudan. While urinary tract infections are more frequent, intestinal schistosomiasis is rare. The disease presents with nonspecific symptoms, often leading to misdiagnosis as inflammatory bowel disease (IBD).

Case presentation:

A 23-year-old male farmer from Gezira, Sudan, presenting with intermittent bloody diarrhea and mild left lower abdominal pain for 6 months. Despite multiple diagnoses and treatments for dysentery and IBD, his symptoms persisted. Colonoscopy revealed edematous mucosa with scattered whitish spots in the rectum, sigmoid, descending, and transverse colon, with normal findings in the ascending colon and cecum. Biopsies confirmed eosinophilic colitis with schistosomal egg shells. The patient was treated with praziquantel, leading to the resolution of symptoms within 2 weeks.

Clinical discussion:

Schistosomiasis, caused by Schistosoma mansoni, commonly manifests with myalgia, fever, and rash, alongside abdominal symptoms. Diarrhea, abdominal pain, constipation, and weight loss are common. Stool examination and serological tests aid in diagnosis, but colonoscopy can reveal characteristic findings, such as edematous mucosa and schistosomal nodules. Early diagnosis and treatment with praziquantel are essential to prevent complications and improve patient outcomes.

Conclusion:

This case emphasizes the importance of considering schistosomiasis in endemic areas when evaluating patients with colitis symptoms. Healthcare providers should maintain a high index of suspicion for this condition, especially in patients with nonspecific gastrointestinal symptoms and a history of travel to endemic areas. Early diagnosis and treatment are crucial to prevent complications and improve outcomes.
Exploring emotional intelligence in artificial intelligence systems: a comprehensive analysis of emotion recognition and response mechanisms
Authors: Narimisaei Jale , Naeim Mahdi , Imannezhad Shima , Samian Pooya , Sobhani Mohammadreza
Published: June 2024

This study aims to dissect the current state of emotion recognition and response mechanisms in artificial intelligence (AI) systems, exploring the progress made, challenges faced, and implicit operations of integrating emotional intelligence into AI. This study utilized a comprehensive review approach to investigate the integration of emotional intelligence (EI) into artificial intelligence (AI) systems, concentrating on emotion recognition and response mechanisms. The review process entailed formulating research questions, systematically searching academic databases such as PubMed, Scopus, and Web of Science, critically evaluating relevant literature, synthesizing the data, and presenting the findings in a comprehensive format. The study highlights the advancements in emotion recognition models, including the use of deep literacy ways and multimodal data emulsion. It discusses the challenges in emotion recognition, similar to variability in mortal expressions and the need for real-time processing. The integration of contextual information and individual traits is emphasized as enhancing the understanding of mortal feelings. The study also addresses ethical enterprises, similar as sequestration and impulses in training data. The integration of emotional intelligence into AI systems presents openings to revise mortal-computer relations. Emotion recognition and response mechanisms have made significant progress, but challenges remain. Unborn exploration directions include enhancing the robustness and interpretability of emotion recognition models, exploring cross-cultural and environment-apprehensive emotion understanding, and addressing long-term emotion shadowing and adaption. By further exploring emotional intelligence in AI systems, further compassionate and responsive machines can be developed, enabling deeper emotional connections with humans.