bluuebunny/crossref_metadata_2025 huggingface dataset:
GPRASP1 loss-of-function links to arteriovenous malformations by endothelial activating GPR4 signals
Authors: Li Ruofei , Xiao Xiao , Yan Yupeng , Yu Liang , Lv Cheng , Zhang Yu , Hong Tao , Zhang Hongqi , Wang Yibo
Published: September 2023

Arteriovenous malformations (AVMs) are fast-flow vascular malformations and refer to important causes of intracerebral haemorrhage in young adults. Getting deep insight into the genetic pathogenesis of AVMs is necessary.

Herein, we identified two vital missense variants of G protein-coupled receptor (GPCR) associated sorting protein 1 (GPRASP1) in AVM patients for the first time and congruously determined to be loss-of-function variants in endothelial cells. GPRASP1 loss-of-function caused endothelial dysfunction in vitro and in vivo. Endothelial Gprasp1 knockout mice suffered a high probability of cerebral haemorrhage, AVMs and exhibited vascular anomalies in multiple organs. GPR4 was identified to be an effective GPCR binding with GPRASP1 to develop endothelial disorders. GPRASP1 deletion activated GPR4/cAMP/MAPK signalling to disturb endothelial functions, thus contributing to vascular anomalies. Mechanistically, GPRASP1 promoted GPR4 degradation. GPRASP1 enabled GPR4 K63-linked ubiquitination, enhancing the binding of GPR4 and RABGEF1 to activate RAB5 for conversions from endocytic vesicles to endosomes, and subsequently increasing the interactions of GPR4 and ESCRT members to package GPR4 into multivesicular bodies or late endosomes for lysosome degradation. Notably, the GPR4 antagonist NE 52-QQ57 and JNK inhibitor SP600125 effectively rescued the vascular phenotype caused by endothelial Gprasp1 deletion. Our findings provided novel insights into the roles of GPRASP1 in AVMs and hinted at new therapeutic strategies.
Paediatric acrodermatitis continua of Hallopeau: perspectives of a patient and their mother
Authors: O’Malley Seán , Duff Eimear , Collins Sinead
Published: September 2023

Rare dermatological conditions can present profound and unique challenges to paediatric patients and their families. This spans from the challenge of referral to appropriate services to understanding of peers, educators and extended family members. We explore the perspectives of a mother and a patient on the difficulty faced navigating a case of acrodermatitis continua of Hallopeau, from their years managing the condition themselves to the rapid response the patient had to fortnightly adalimumab therapy and the positive impact on their lives.
Inventors, firms and localities: insights into the nexus that forms and alters the evolution of regional knowledge spaces
Authors: Shin Hyunha , Kim Keungoui , Lee Junmin , Kogler Dieter F
Published: September 2023

The present investigation aims to provide insights into the nexus between firms and localities that ultimately shapes the evolution of regional knowledge spaces. The ‘inventive footprint’ of firms, indicated by the spatial distribution of associated inventors across regional economic settings, provides the foundation to analyse whether firms’ external knowledge sourcing contributes to their own evolution, and by extension to their home region’s technological capabilities. Findings indicate that firms’ innovation efforts beyond their home base are subsequently absorbed at home and thus that knowledge-sourcing activities by multi-locational firms significantly contributes to the evolution of regional knowledge space trajectories.
Impact of different in vitro models on functional performance of the self-expanding transcatheter heart valve
Authors: Sadat Najla , Lojenburg John Habakuk , Scharfschwerdt Michael , Fujta Buntaro , Ensminger Stephan
Published: September 2023

OBJECTIVES

Transcatheter heart valves (THVs) are investigated according to International Organization for Standardization requirements using in vitro heart simulators to evaluate hydrodynamic performance. In contrast to surgical valves, a THV’s performance heavily depends on the configuration and shape of the aortic anulus. In International Organization for Standardization regulations, there is no detailed definition for the construction of a compartment in which a THV has to be tested. Therefore, the aim of this in vitro study was to compare different in vitro models for functional testing of THVs.

METHODS

Porcine aortic conduits (23-mm diameter) were implanted in Dacron prostheses and calcified with double-distilled water and calcification buffer at 37°C over 83 million cycles in a Hi-Cycler (durability testing) mimicking nearly 3 patient-years. Hydrodynamic testing of Evolut PRO 26 mm was performed within 3 models (plexiglass, native conduit and calcified conduit; all 23-mm diameter) at a frequency of 64 bpm and different stroke volumes (55–105 ml).

RESULTS

Calcified conduits showed significantly higher mean pressure gradients (MPG) and lower effective orifice areas (EOA) in comparison to native conduits (without THV; P < 0.001). EOA and MPG of Evolut PRO differed depending on the model tested. Calcified conduits resulted in the lowest EOA and highest MPG of the THV compared to plexiglass and the native conduit. Full expansion of the THV was least impaired in the native conduit, while lowest geometric orifice area, lowest minimal internal diameter and highest pin-wheeling index of Evolut PRO were seen in the calcified conduit.

CONCLUSIONS

Full expansion and functional performance of the Evolut PRO THV depends on the configuration of the testing compartment in an in vitro setting.
Procedural outcome and follow-up of stylet-driven leads compared with lumenless leads for left bundle branch area pacing
Authors: Sritharan Aarthiga , Kozhuharov Nikola , Masson Nicolas , Bakelants Elise , Valiton Valérian , Burri Haran
Published: September 2023

Aims

Left bundle branch area pacing (LBBAP) is most often delivered using lumenless leads (LLLs), but may also be performed using stylet-driven leads (SDLs). There are limited reports on the comparison of these tools, mainly limited to reports describing initial operator experience or without detailed procedural data. Our aim was to perform an in-depth comparison of SDLs and LLLs for LBBAP at implantation and follow-up in a larger cohort of patients with experience that extends beyond that of the initial learning curve.

Methods and results

A total of 306 consecutive patients (age 77 ± 11 years, 183 males) undergoing LBBAP implantation at a single centre were prospectively included. The population was split into two groups of 153 patients based on the initial use of an SDL (from 4 manufacturers) or an LLL. After having discounted the initial learning curve of 50 patients, there was no difference in the success rate between the initial use of lead type (96.0% with SDL vs. 94.3% with LLL, P = 0.56). There were no significant differences in success between lead models. Electrocardiogram and electrical parameters were comparable between the groups. Post-operative macro-dislodgement occurred in 4.3% of patients (essentially within the first day following implantation) and presumed micro-dislodgement with loss of conduction system capture or rise in threshold (occurring mostly during the first month) was observed in 4.7% of patients, without differences between groups.

Conclusion

Left bundle branch area pacing may be safely and effectively performed using either LLLs or SDLs, which provides implanters with alternatives for delivering this therapy.
Changing microbiome community structure and functional potential during permafrost thawing on the Tibetan Plateau
Authors: Tang Xiaotong , Zhang Miao , Fang Zhengkun , Yang Qing , Zhang Wan , Zhou Jiaxing , Zhao Bixi , Fan Tongyu , Wang Congzhen , Zhang Chuanlun , Xia Yu , Zheng Yanhong
Published: September 2023

Large amounts of carbon sequestered in permafrost on the Tibetan Plateau (TP) are becoming vulnerable to microbial decomposition in a warming world. However, knowledge about how the responsible microbial community responds to warming-induced permafrost thaw on the TP is still limited. This study aimed to conduct a comprehensive comparison of the microbial communities and their functional potential in the active layer of thawing permafrost on the TP. We found that the microbial communities were diverse and varied across soil profiles. The microbial diversity declined and the relative abundance of Chloroflexi, Bacteroidetes, Euryarchaeota, and Bathyarchaeota significantly increased with permafrost thawing. Moreover, warming reduced the similarity and stability of active layer microbial communities. The high-throughput qPCR results showed that the abundance of functional genes involved in liable carbon degradation and methanogenesis increased with permafrost thawing. Notably, the significantly increased mcrA gene abundance and the higher methanogens to methanotrophs ratio implied enhanced methanogenic activities during permafrost thawing. Overall, the composition and functional potentials of the active layer microbial community in the Tibetan permafrost region are susceptible to warming. These changes in the responsible microbial community may accelerate carbon degradation, particularly in the methane releases from alpine permafrost ecosystems on the TP.
Impact of different environmental pollution processes on bacterial key-indicators in tropical rivers: scoping review
Authors: Bohórquez-Herrera Jimena , Abad Matías Isaac David , Gutiérrez Castañeda Clara Gilma
Published: September 2023

Freshwater ecosystems are an essential resource for human use and natural populations, but they are exposed to different sources of man-made pollution. This study analyses how different environmental pollution processes influence the structure of bacterial communities in tropical rivers. A scoping review was performed to characterize the bacterial communities in freshwater ecosystems in tropical regions that have been reported to be associated with pollution of different kinds. The statistical analyses allowed us to categorize the genera found into three large groups (pollution generalists, middle types, and pollution specialists) according to the types of pollutants with which they were associated. The results show that Escherichia has a greater association with fecal contamination, while Enterococcus is more associated with domestic wastewater and organic and synthetic chemicals. The present study proposes Streptomyces as a potential indicator of waters with microbial contamination, as well as some other genera as possible indicators of waters with heavy metal contamination.
Longitudinal Associations Between Higher Self-Reported Energy, Gait Speed, and Cognition in Older Adults With Fatigue
Authors: Ehrenkranz Rebecca , Zhu Xiaonan , Glynn Nancy W , Bertolet Marnie , Berman Sarah B , Hengenius James B , Rosano Caterina
Published: September 2023

Background

Older adults reporting higher energy levels have better physical function. It is not known if these associations persist among older adults reporting fatigue or if higher energy is associated with cognitive function. We examined longitudinal associations between self-reported energy, gait speed, and cognition, stratified by fatigue, in 2 613 participants (aged 74.6 ± 2.87 years) in the Health, Aging and Body Composition Study.

Methods

Self-reported energy (0–10, dichotomized at median) and fatigue (present/absent) were measured at baseline. Usual and rapid-paced gait speed (m/s), modified Mini-Mental State Examination (3MS), and Digit Symbol Substitution Test (DSST) were measured at baseline and annually over 8 years. Linear mixed effect models compared changes in gait speed, 3MS, and DSST between higher and lower energy groups within fatigue strata.

Results

At baseline, 724 participants (27%) were fatigued; 240 (33%) coreported higher energy (9% of total). The remaining 1 889 participants were fatigue-free (73%); 1 221 (65%) coreported higher energy (47% of total). Those with fatigue and higher energy had average rapid gait declines of 0.007 m/s per year (p = .04) after adjustment for demographics, comorbidities, depressive symptoms, and exercise. DSST declines were found among only fatigue-free participants (β = 0.17, p = .01). No statistically significant associations with energy were found for fatigue-free participants, or for usual gait or 3MS.

Conclusions

Asking about older adults’ energy levels as well as fatigue may identify a subgroup of older adults protected against physical and cognitive decline, even among those with fatigue.
Towards a Judicial Sustainability Test in Cases Concerning the Enforcement of Intellectual Property Rights
Authors: Vrendenbarg Charlotte J S
Published: September 2023

The environmentally harmful yet common practice of storing and destroying IP-infringing goods is untenable. This contribution discusses a number of more sustainable alternative remedies that can be considered with the aim of creating a balance between the interests of rights holders in ending infringements and the societal interest in environmental protection, which lies in preventing the wasting of scarce raw materials and pollution of the air and soil. A sustainable IP enforcement practice is very much dependent on the willingness of rights holders and their attorneys to consider more sustainable alternatives. Courts also have a part to play, by applying what is called a sustainability test when examining the proportionality of the remedies and measures claimed by rights holders.
Positivity of Higher Exterior Powers of the Tangent Bundle
Authors: Gachet Cécile
Published: September 2023

We prove that a smooth projective variety $X$ of dimension $n$ with strictly nef third, fourth, or $(n-1)$-th exterior power of the tangent bundle is a Fano variety. Moreover, in the first two cases, we provide a classification for $X$ under the assumption that $\rho (X)\ne 1$.
Impact of Human Immunodeficiency Virus and Peripartum Period on Mycobacterium tuberculosis Infection Detection
Authors: Escudero Jaclyn N , Mecha Jerphason , Richardson Barbra A , Maleche-Obimbo Elizabeth , Matemo Daniel , Kinuthia John , John-Stewart Grace , LaCourse Sylvia M
Published: September 2023

Background

Pregnancy and human immunodeficiency virus (HIV) may influence tuberculosis infection detection using interferon (IFN)-γ release assay (QFT-Plus; Qiagen) and tuberculin skin test (TST).

Methods

Participants in Western Kenya underwent QFT-Plus and TST in pregnancy, 6 weeks postpartum (6wkPP) and 12 months postpartum (12moPP).

Results

400 participants (200 with HIV [WHIV], 200 HIV-negative) enrolled during pregnancy (median 28 weeks’ gestation [interquartile range, 24–30]). QFT-Plus positivity prevalence was higher than TST in pregnancy (32.5% vs 11.6%) and through 12moPP (6wkPP, 30.9% for QFT-Plus vs 18.0% for TST; 12moPP, 29.5% vs 17.1%; all P < .001), driven primarily by QFT-Plus–positive/TST-negative discordance among HIV-negative women. Tuberculosis infection test conversion incidence was 28.4/100 person-years (PY) and higher in WHIV than HIV-negative women (35.5 vs 20.9/100 PY; hazard ratio, 1.73 [95% confidence interval, 1.04–2.88]), mostly owing to early postpartum TST conversion among WHIV. Among QFT-Plus–positive participants in pregnancy, Mycobacterium tuberculosis  (Mtb)–specific IFN-γ responses were dynamic through 12moPP and lower among WHIV than HIV-negative women with tuberculosis infection at all time points.

Conclusions

QFT-Plus had higher diagnostic yield than TST in peripartum women. Peripartum QFT-Plus positivity was stable and less influenced by HIV than TST. Mtb–specific IFN-γ responses were dynamic and lower among WHIV. Tuberculosis infection test conversion incidence was high between pregnancy and early postpartum, potentially owing to postpartum immune recovery.
Clustering rare diseases within an ontology-enriched knowledge graph
Authors: Sanjak Jaleal , Binder Jessica , Yadaw Arjun Singh , Zhu Qian , Mathé Ewy A
Published: September 2023

Objective

Identifying sets of rare diseases with shared aspects of etiology and pathophysiology may enable drug repurposing. Toward that aim, we utilized an integrative knowledge graph to construct clusters of rare diseases.

Materials and Methods

Data on 3242 rare diseases were extracted from the National Center for Advancing Translational Science Genetic and Rare Diseases Information center internal data resources. The rare disease data enriched with additional biomedical data, including gene and phenotype ontologies, biological pathway data, and small molecule-target activity data, to create a knowledge graph (KG). Node embeddings were trained and clustered. We validated the disease clusters through semantic similarity and feature enrichment analysis.

Results

Thirty-seven disease clusters were created with a mean size of 87 diseases. We validate the clusters quantitatively via semantic similarity based on the Orphanet Rare Disease Ontology. In addition, the clusters were analyzed for enrichment of associated genes, revealing that the enriched genes within clusters are highly related.

Discussion

We demonstrate that node embeddings are an effective method for clustering diseases within a heterogenous KG. Semantically similar diseases and relevant enriched genes have been uncovered within the clusters. Connections between disease clusters and drugs are enumerated for follow-up efforts.

Conclusion

We lay out a method for clustering rare diseases using graph node embeddings. We develop an easy-to-maintain pipeline that can be updated when new data on rare diseases emerges. The embeddings themselves can be paired with other representation learning methods for other data types, such as drugs, to address other predictive modeling problems.
Model-based detection and classification of premature contractions from photoplethysmography signals
Authors: Regis Marta , Eerikäinen Linda M , Haakma Reinder , van den Heuvel Edwin R , Serra Paulo
Published: September 2023

The detection of arrhythmias from wearable devices is still an open challenge, while the availability of screening tools for the large population would allow reduced complications and costs. We propose a model-based approach to the detection and classification of premature contractions into atrial and ventricular. The extracted signal morphology and the deviations from the expected stationarity are used to detect and classify premature contractions. Our approach is self-contained, patient-specific and robust to mis-segmentation. Both model fit, and detection and classification accuracy of the proposed methods are evaluated on two real cases and a simulated dataset, and show promising results.
Bronchospasm
Authors: LaGrew Joseph , Chadwick Adam , Gonzalez Sandra , Mehta Sonia
Published: September 2023

Bronchospasm is a relatively common occurrence in the perioperative period with estimates as high as 20% in high-risk patients. Consideration of relative risk, disease severity and control, and examination and presentation on the day of surgery must be balanced with the response to short-acting beta agonists immediately before surgery and the need for surgery. Risk factors for bronchospasm are primarily modifiable and include poorly controlled or undiagnosed asthma, poorly controlled chronic bronchitis, smoking or second-hand smoke exposure, current or recent upper respiratory tract infection, gastroesophageal reflux disease, insufficient depth of anesthesia, and with endotracheal intubation, thoracic or abdominal surgeries. As inflammation and bronchoconstriction worsen, air trapping occurs, leading to rising airway pressures. Hypoxic pulmonary vasoconstriction can help to compensate initially, but increasing inflammation may obliterate this response. Intravenous epinephrine in low doses helps to stabilize mast cells, preventing further inflammation, and acts as a bronchodilator. Epinephrine is the treatment of choice in bronchospasm with inadequate ventilation in addition to positive pressure ventilation with appropriate expiratory time. After successful treatment, identifying the underlying etiology of bronchospasm is helpful in preventing future episodes.
Foreign Bodies in the Airway and Esophagus
Authors: Moore Lauren , Wester Tracy , Ellis Alison
Published: September 2023

Foreign body removal is a common emergency managed by the anesthesiologist, especially in pediatrics. Foreign bodies of the airway or esophagus occur purposefully or accidentally. In the pediatric population, children have a tendency to immediately place any accessible objects in their mouths. Foreign bodies in the airway are risk factors for obstruction given the smaller size of pediatric airways and can cause a localized inflammatory reaction, making them harder to remove with the passage of time. Large foreign bodies in the esophagus can impinge upon the trachea and cause stridor, retching, or anorexia. While foreign body aspiration is less common in adults, it remains an urgent concern because of airway reactions to the foreign body and concern for postobstructive pneumonia. Anesthesiologists manipulate airways daily and therefore the risk of losing a tooth into the airway or esophagus is ever present in patients.
Laryngospasm
Authors: LaGrew Joseph , Chadwick Adam , Gonzalez Sandra , Mehta Sonia
Published: September 2023

Laryngospasm has an estimated incidence of 0.78% and is found in higher proportions in the pediatric and neonatal populations, with certain types of surgeries and medical comorbidities. Infants, children, and those undergoing oropharyngeal, esophageal, and airway surgeries as well as hypospadias repair are associated with increased risk of laryngospasm. Non modifiable risk factors include obesity with obstructive sleep apnea (OSA), gastroesophageal reflux disease (GERD), recent or active upper respiratory tract infection (URI), passive cigarette smoke exposure, airway manipulation, volatile anesthetics, depth of anesthesia, use of supraglottic airway, and supraglottic secretions, blood, and tumors/masses. Effective screening and balancing the need for surgery against the risk of laryngospasm is critical to preoperative assessment. Treatment focuses on inhibiting the glottic reflex by removing stimulation, providing stimulation of afferent relaxation of the cords, deepening anesthesia, or paralyzing the patient. While other methods may effectively treat laryngospasm, paralysis is the definitive treatment for laryngospasm for a patient refractory to other methods or who is in extremis. Identifying the underlying cause is critical once ventilation is restored to prevent recurrence.
Arrhythmias
Authors: Francis Loren R. , Nelson Eric W.
Published: September 2023

Arrhythmias are a common perioperative complication. How a patient tolerates an arrhythmia depends on the heart rate, how long the arrhythmia lasts, and if the patient has coexisting cardiac disease. Arrhythmias may present as a previously known comorbidity or as a new condition. They may be the result of inadequate anesthesia, a surgical cause, or a myocardial abnormality. Some arrhythmias, such as certain bradycardias, heart block, and atrial arrhythmias, do not require immediate treatment if the patient is hemodynamically stable. On the other hand, there are arrhythmias that cause hemodynamic instability and require urgent intervention with medication, electrical and mechanical support, or advanced cardiac life support (ACLS). It is important as an anesthesiologist to quickly diagnose, identify the cause, and treat any arrhythmia that may occur during the perioperative period. Patients with internal pacemakers and/or defibrillators should be allotted special consideration. If there is concern for electromagnetic interference during the procedure (such as monopolar cautery above the umbilicus), the pacemaker should be placed in an asynchronous mode to avoid undersensing and the implantable cardioverter-defibrillator should be disabled to prevent oversensing.
Pulseless Electrical Activity (PEA) and Asystole
Authors: Sotillo Claudia , Mohamed Basma
Published: September 2023

Cardiac arrest in the perioperative setting is caused by multiple etiologies and pathologies that are different from the non-perioperative setting. Cardiac arrest in the operating room is unique in that it is witnessed by providers who are familiar with the patient’s comorbidities, the event is usually preceded by hemodynamic instability, and the underlying etiology can be rapidly identified. Early identification of patients in crisis can prevent further progression to cardiac arrest and preclude the initiation of advanced cardiac life support. In turn, this directly affects prognosis by allowing the anesthesiology team to provide focused, etiology-based resuscitative efforts and early mobilization of advanced levels of care. Causes of cardiac arrest in the perioperative setting are quite different compared to out-of-hospital or in-hospital arrest. Cardiac causes can be related to anesthetic sympatholytic effects, vagotonic effects of surgical manipulation, severe hypovolemia in bleeding patients, or blockade of cardiac accelerator fibers associated with neuraxial anesthesia. Respiratory causes of cardiac arrest can be related to hypoxia that is associated with difficult airway management or bronchospasm. As a result, management of cardiac arrest in the perioperative setting should focus on certain differentials related to the anesthetic and surgical causes of arrest. This chapter will focus on the common causes of pulseless electrical activity (PEA)/asystole in the perioperative period and will provide the anesthesiology team with a step-by-step guide to help predict, prevent, and manage PEA/asystole in these patients.
Amniotic Fluid Embolism
Authors: Wendling Adam , Lopez Brandon
Published: September 2023

Amniotic fluid embolism (AFE) is a devastating condition that develops during pregnancy, delivery, or shortly thereafter. Incidence varies by inclusion criteria from as low as <2 out of 100,000 pregnancies to as high as 1 out of 8000 with a mortality rate from 10% to 60% depending on inclusion criteria and initial presentation. Of those that survive, as many as 85% suffer severe disability. Pathophysiology of the condition remains largely unknown. Risk factors for AFE are nonspecific and do not warrant an alteration of routine obstetric management for this rare condition. AFE classically presents with severe hemodynamic instability or cardiac arrest, severe respiratory distress, disseminated intravascular coagulation, or seizures or coma not otherwise explained. Treatment is largely supportive. Recent large registries are providing insight into common factors in parturients who suffer AFE. Promising future treatment strategies could include C1 esterase inhibitor concentrates, extracorporeal membrane oxygenation, and cardiopulmonary bypass.
The Style and Spirit of Motivational Interviewing
Authors: Douaihy Antoine , Gold Melanie A. , Gutman Gail , Romo Dina
Published: September 2023

As trainees, we have good intentions and we want to help our patients make healthy choices. The spirit of Motivational Interviewing (MI) calls for practitioners to recognize the critical elements of autonomy and self-determination in their relationships with patients. This chapter focuses on the differences in styles of communicating (i.e., directing, following, and guiding). The guiding approach is discussed herein as the primary method for conducting MI. The guiding style calls for a collaboration with the patient, whereby the practitioner exhibits acceptance and accurate empathy for the patient. Such an environment provides a valuable opportunity for practitioners to evoke patients’ own priorities and their associated thoughts and feelings. The process results in the patient’s ability to resolve ambivalence and adopt behaviors consistent with healthful outcomes. A personal reflection is offered by one of the authors, describing how she developed the spirit of MI and how it helps her in relating to patients.
Motivational Interviewing, Cardiovascular Health, and Diabetes Care
Authors: Salahuddin Daniel , Davis Esa Matius
Published: September 2023

Cardiovascular disease (CVD) and diabetes mellitus (DM) contribute to a significant degree of morbidity and mortality in our society. This chapter reviews the application of Motivational Interviewing (MI) in primary care settings, with a specific focus on diabetes management and primary, secondary, and tertiary prevention of CVD. MI is well suited to addressing these conditions as they can be effectively treated with lifestyle and behavior modification. We provide a review of the literature on MI in medical settings. We also present an overview of MI strategies that are useful to prepare medical trainees for engaging with patients. These interventions increase patients’ intrinsic motivation to improve self-management of their health and optimize their overall health outcomes. We present case vignettes of using MI strategies to address common but complex primary care conditions. A personal reflection is offered by one of the authors who discusses the importance of “being MI” rather than “doing MI.”
Integrating Community Psychiatry and Motivational Interviewing
Authors: Morra Joshua T. , Cohen Daniel , Armstead Melinda , Douaihy Antoine
Published: September 2023

Concerns around medication adherence, substance use, and other behavioral determinants of patient health are commonplace in community psychiatry. Patients seen in outpatient community treatment programs often experience multiple behavioral comorbidities, and effective care often requires an engaged and collaborative treatment relationship. Motivational Interviewing (MI) can be an ideal fit as it assists a largely disempowered patient population to identify their strengths and aspirations and promotes autonomy around decision-making. The need for MI with its core skillset and strategies in community psychiatry seems clear. There is just one problem: community systems of care are not structured with this approach in mind. In this chapter, we introduce a novel framework for understanding the natural synergies and dissonances of “motivational psychiatry.” We offer an account of what well-integrated community practice can look like. We also review the higher order skillsets needed to mitigate the logistical and philosophical tensions that emerge when MI becomes a way of practice.
Motivational Interviewing in Pediatric Settings
Authors: Blackburn Katelin , Burke Pamela
Published: September 2023

Pediatric settings generally provide health care to children from birth to age 21 years, typically in an alliance with their parent(s). Motivational Interviewing (MI) has been widely used with adults and adolescents; however, its use with school age children has been less well studied. In order to provide a context for when MI may be appropriate for use with children at various developmental stages, we present a summary of relevant cognitive, verbal, and social-emotional milestones. We also provide examples of integrating MI use with parents and children at all levels, early childhood, middle childhood, and adolescence. Threaded throughout this chapter are examples of the “spirit” of MI in action and applications of core MI skills, including OARS or open-ended questions, affirmations, reflections, and summaries, in the context of the MI processes, which involves engaging, focusing, evoking, and planning.
Cryptococcus neoformans requires the TVF1 gene for thermotolerance and virulence
Authors: Ueno Keigo , Nagamori Akiko , Honkyu Nahoko Oniyama , Kataoka Michiyo , Shimizu Kiminori , Chang Yun C , Kwon-Chung Kyung J , Miyazaki Yoshitsugu
Published: September 2023

Cryptococcus neoformans is the primary causative agent of cryptococcosis. Since C. neoformans thrives in environments and its optimal growth temperature is 25–30°C, it needs to adapt to heat stress in order to cause infection in mammalian hosts. In this study, we aimed to investigate the role of an uncharacterized gene, CNAG_03308. Although the CNAG_03308 deletion strain grew as well as the parent strain KN99, it produced yeast cells with abnormal morphology at 37°C and failed to propagate at 39°C. Furthermore, the deletion strain exhibited slower growth at 37°C in the presence of congo red, which is a cell wall stressor. When cultured at 39°C, the deletion strain showed strong staining with fluorescent probes for cell wall chitin and chitosan, including FITC-labeled wheat germ agglutinin, Eosin Y, and calcofluor white. The transmission electron microscopy of the deletion strain revealed a thickened inner layer of the cell wall containing chitin and chitosan under heat stress. This cell-surface altered deletion strain induced dendritic cells to secrete more interleukin (IL)-6 and IL-23 than the control strains under heat stress. In a murine infection study, C57BL/6 mice infected with the deletion strain exhibited lower mortality and lower fungal burden in the lungs and brain compared to those infected with the control strains. Based on these findings, we concluded that CNAG_03308 gene is necessary for C. neoformans to adapt to heat stress both in vitro and in the host environment. Therefore, we designated the CNAG_03308 gene as TVF1, which stands for thermotolerance and virulence-related factor 1.
Machine learning and structure formation in modified gravity
Authors: Betts Jonathan C , van de Bruck Carsten , Arnold Christian , Li Baojiu
Published: September 2023

In general relativity, approximations based on the spherical collapse model such as Press–Schechter theory and its extensions are able to predict the number of objects of a certain mass in a given volume. In this paper, we use a machine learning algorithm to test whether such approximations hold in screened modified gravity theories. To this end, we train random forest classifiers on data from N-body simulations to study the formation of structures in lambda cold dark matter (ΛCDM) as well as screened modified gravity theories, in particular f(R) and nDGP gravity. The models are taught to distinguish structure membership in the final conditions from spherical aggregations of density field behaviour in the initial conditions. We examine the differences between machine learning models that have learned structure formation from each gravity, as well as the model that has learned from ΛCDM. We also test the generalizability of the ΛCDM model on data from f(R) and nDGP gravities of varying strengths, and therefore the generalizability of extended Press–Schechter spherical collapse to these types of modified gravity.
Machine learning uncovers the universe’s hidden gems: A comprehensive catalogue of C iv absorption lines in SDSS DR12
Authors: Monadi Reza , Ho Ming-Feng , Cooksey Kathy L , Bird Simeon
Published: September 2023

We assemble the largest C iv absorption line catalogue to date, leveraging machine learning, specifically Gaussian processes, to remove the need for visual inspection for detecting C iv absorbers. The catalogue contains probabilities classifying the reliability of the absorption system within a quasar spectrum. Our training set was a sub-sample of DR7 spectra that had no detectable C iv absorption in a large visually inspected catalogue. We used Bayesian model selection to decide between our continuum model and our absorption-line models. Using a random hold-out sample of 1301 spectra from all of the 26 030 investigated spectra in DR7 C iv catalogue, we validated our pipeline and obtained an 87 per cent classification performance score. We found good purity and completeness values, both $\sim 80{{\ \rm per\ cent}}$, when a probability of $\sim 95{{\ \rm per\ cent}}$ is used as the threshold. Our pipeline obtained similar C iv redshifts and rest equivalent widths to our training set. Applying our algorithm to 185 425 selected quasar spectra from SDSS DR12, we produce a catalogue of 113 775 C iv doublets with at least 95 per cent confidence. Our catalogue provides maximum a posteriori values and credible intervals for C iv redshift, column density, and Doppler velocity dispersion. We detect C iv absorption systems with a redshift range of 1.37–5.1, including 33 systems with a redshift larger than 5 and 549 absorbers systems with a rest equivalent width greater than 2 Å at more than 95 per cent confidence. Our catalogue can be used to investigate the physical properties of the circumgalactic and intergalactic media.
Internal kinematics of dwarf satellites of MW/M31-like galaxies in TNG50
Authors: Martínez-García Alberto Manuel , del Pino Andrés , Łokas Ewa L , van der Marel Roeland P , Aparicio Antonio
Published: September 2023

We present a kinematic study of a thousand of dwarf satellites of MW/M31-like hosts from the IllustrisTNG50 simulation. Internal kinematics were derived for all the snapshots to obtain a historical record of their rotation velocity in the plane of the sky (|VT|) and the amplitude of their velocity gradients along the line of sight ($A_{\rm grad}^{v_z}$) measured from the host. For the majority of the satellites, we initially detected rotation in the plane of the sky (65 per cent) or velocity gradients (80 per cent), and this was progressively reduced to 45 per cent and 68 per cent at z = 0, respectively. We find that the evolution of the rotation in the plane of the sky and the velocity gradients differs according to type of dwarfs, which could be explained in terms of their different masses and orbital histories. We observe that interaction with the host has an impact on the evolution of the internal kinematics of the satellites. The rotation signal of the satellites is progressively reduced during pericentric passages, the first pericentre being especially disruptive for the initial kinematics. We observe temporary increases in $A_{\rm grad}^{v_z}$ during pericentric passage caused by tidal interaction with the host, $A_{\rm grad}^{v_z}$ increasing as the satellites approach their pericentre and dropping as they move away. In summary, we conclude that the presence of detectable rotation in dwarf satellites is not uncommon, and that the evolution of their internal kinematics is clearly affected by their interaction with the host.
Exotic image formation in strong gravitational lensing by clusters of galaxies – IV. Elliptical NFW lenses and hyperbolic umbilics
Authors: Meena Ashish Kumar , Bagla Jasjeet Singh
Published: September 2023

A source lying near a hyperbolic umbilic (HU) singularity leads to a ring-like image formation, constituting four images with high magnification factors and lying in a small region of the lens plane. Since (based on our earlier work) the observed number of HU image formations in cluster lenses is expected to increase in the future, it is timely to investigate them in more detail. Like fold and cusp singularities, HU also satisfies the magnification relation, i.e. the signed magnification sum of the four images equals zero. This work presents a detailed study of the HU magnification relation (Rhu) considering the elliptical Navarro–Frenk–White (eNFW) lens profile suitable for cluster scale dark matter haloes. Our results show that for an isolated eNFW lens, Rhu is more sensitive to ellipticity than its mass or concentration parameter. An ellipticity greater than 0.3 results in Rhu lying close to zero with a small scatter around it. A substructure near the HU image formation causes the average Rhu value to deviate from zero and increases the scatter, with the amount of deviation depending on the image type near which the substructure lies. However, a population of substructures in the lens plane (equivalent to the galaxies inside the cluster) does not significantly shift the average Rhu value from zero but increases the scatter around it. We find that Rhu ≃ 0 for HU image formation in the Abell 1703 cluster. Repeating this test in other clusters with HU formations can be a useful indicator of substructure in cluster haloes.
“Here I Stand I Can Do No Other”: Martin Luther in German and American Biopics
Authors: Wipfler Esther P.
Published: September 2023

The famous Protestant leader in history, Martin Luther (1483–1546), has been represented in film since 1911. Though standing at the end of an iconographical tradition that goes back to Luther’s lifetime, his portrayal in feature films has been anything but uniform. As this chapter shows, his on-screen story has had several mythmaking purposes that have served the ideological projects of different nations. Luther films have always been—apart from some exceptions at the very beginning of the history of the genre—ambitious undertakings. As far as we know, all the initiators of these movies sympathized with the protagonist and his issues, and so for them, the historical figure required a form on film adequate to his status as a national myth in Germany or a church founder in America.
Protestant Ambivalence Toward Allegory in Wim Wenders’s The Scarlet Letter
Authors: Redling Erik
Published: September 2023

This chapter picks up on the idea that European auteurs experiment with cinematic styles in reaction against Hollywood’s mainstream films and shows how Wim Wenders, who shares with Luther and other reformers a Protestant skepticism toward allegory, tends to use a plain style of camera work in his film adaptation of Nathaniel Hawthorne’s novel The Scarlet Letter, Der Scharlachrote Buchstabe (1973). Wenders’s adaptation counters the dominant allegorical mode found in earlier Scarlet Letter movies such as the critically well-regarded 1926 American silent film. As the chapter points out, however, Wenders is at the same time drawn toward the allegorical mode, as he intends to shift his movie from a mere literal meaning to a transliteral dimension of meaning.
“Where Were You?” The Problem of Evil in Terrence Malick’s The Tree of Life
Authors: Scott Mark S. M.
Published: September 2023

This chapter argues that Terrence Malick’s acclaimed art film The Tree of Life (2011) explores the mystery of evil through biblical symbolism, particularly from the Book of Job. Through an experimental narrative, viewers witness a midwestern family face loss and the crises of faith it engenders. Malick’s own youngest brother, Lawrence, a gifted guitarist, committed suicide, so the film, which wrestles with the loss of a brother and son, functions both as a semi-autobiographical artistic tribute to him and as a profound theological meditation on the meaning of suffering. The chapter argues that the poetic imagery and reflective voice-overs—Malick’s stylistic signatures—contribute to his aesthetic exploration of theodicy.
A Tender View of Conservative Evangelicalism in Higher Ground
Authors: Kane Paula M.
Published: September 2023

This chapter discusses a unique addition to American cinema: star and director Vera Farmiga’s Higher Ground (2011), a film based on Carolyn Briggs’s memoir. Though there is a wealth of scholarship on women in conservative evangelicalism, Pentecostalism, and fundamentalism, this is an underrepresented subject on film, and the few examples—The Miracle Woman (1931), Tobacco Road (1941), Elmer Gantry (1960), and Angel Baby (1961)—tend to focus on faith healers like Aimee Semple McPherson. In a nuanced and historically sensitive reading, this chapter shows that Higher Ground is a tender and subtle but highly natural look at the role of faith across several decades in the heroine’s life, which takes a path away from the religious patriarchy of her church community.
Latino Mental Health
Authors: Organista Kurt C.
Published: September 2023

This chapter provides an overview of Latino mental health with an emphasis on the relationship between acculturation and mental illness. The problematic pattern of limited mental health literacy and access to care (e.g., via insurance) resulting in limited care is underscored, as is needed attention to trauma-informed care and major depression. Effective socioculturally responsive mental health care is reviewed, including integrated behavioral health care (IBHC), and culturally adapted evidence-based practice. The chapter also demonstrates that promotores de salud [community health care workers] represent an especially effective cultural resource capable of supporting and leading mental health interventions within Latino communities.
What is swearing?
Authors: Roache Rebecca
Published: September 2023

This chapter introduces the concept of swearing. According to Cambridge University Press’ online dictionary, the definition of swearing is the rude or offensive language that someone uses, especially when they are angry. Some definitions of swearing also involve taboo language, but not all offensive taboo language is swearing like slurs that are often associated with hate speech that degrades a person's race, sexual orientation, disability, gender, or religion. The chapter considers the spectrum of offensiveness and the correlation of swearing with emotion. It references the versatility of the term fuck, which highlights that swearing does not always involve considering the literal meanings of swear words.
Swearing’s secret offensive ingredient
Authors: Roache Rebecca
Published: September 2023

This chapter considers the offensiveness of swearing. It explains how swearing was taught as something to be avoided in polite society but simultaneously opens the door to the excitement of taboo breaking. The literal meaning of many swear words often denotes sexual or lavatorial notions, which are often frowned upon in many social contexts. Moreover, the connotations of swear words result in an involuntary emotional response in the listener, which can also trigger the offensiveness of swear words. The chapter also notes the correlation of swearing with taboos, wherein swearing as historically rooted in religious language in almost all cultures.
There is no secret ingredient
Authors: Roache Rebecca
Published: September 2023

This chapter clarifies that the offensiveness of swearing lies in its unspoken connotation instead of the word's literal definition. It highlights that swearing's offensiveness primarily depends on the context that relates to the social environment or the wider cultural environment. After all, similar swear words have different connotations at different times and in different cultures and places. Moreover, a word being linked to a taboo topic helps ensure that it can undergo offense escalation on the culture-wide scale necessary to become a swear word. The chapter mentions that the offense escalation forms the core explanation of swearing’s offensiveness, but it does not entirely tell the whole story.
How to be a really offensive swearer
Authors: Roache Rebecca
Published: September 2023

This chapter notes how swearing is objectionable depending on the context. It notes how nuisances can gauge how concerned people should be about offensive behavior. Tone and body language affect the offensiveness of swearing, similar to how significant both factors are in communication generally. The chapter explains how inappropriate swearing risks causing offense by conveying disrespect and politeness, referencing how people might view direct and indirect swearing differently. Additionally, the deliberateness of the swear is another factor relevant to the offensiveness of swearing. The chapter cites how swearing is a more serious matter when it is done both angrily and repeatedly while repetitive swearing at nothing in particular is less objectionable.
Cunt and cocksucker
Authors: Roache Rebecca
Published: September 2023

This chapter focuses on the prejudicial attitudes that influenced the offensiveness of cunt and cocksucker. It starts with how slurs are offensive because using them contributes to the ongoing oppression of certain groups of people. Calling someone a cunt or a cocksucker is offensive because cunt and cocksucker are understood to be offensive words. However, the terms are offensive words because women’s genitals and the act of performing fellatio were regarded with distaste The chapter details the unusual offensiveness of cunt and the misogynistic attitudes that underlie its offensiveness. It then explains how etiquette expresses respect and embodies unjust attitudes.