bluuebunny/crossref_metadata_2025 huggingface dataset:
“Being Holistic Is a Lot to Ask”: A Qualitative, Cross-National Exploration of Occupational Therapists’ Perceptions and Experiences of Holistic Practice
Authors: Asbjørnslett Mona , Skarpaas Lisebet S. , Stigen Linda
Published: October 2023

Being holistic is often used by occupational therapists to describe their practice and philosophy worldwide. This study explores the perspectives of 33 occupational therapists, working in 13 different countries, on their understanding of holistic epistemology and practice and how they seek to incorporate holism in their work. On the basis of a qualitative study design, individual interviews were conducted with the participants by 18 Norwegian undergraduate occupational therapy students, supported by their supervisors. The authors subsequently analyzed the transcribed data, using a thematic analysis approach. Three principal themes emerged: (1) holism as a broad and narrow concept, (2) being holistic spans from treating body parts to teaching marginalized children, and (3) being holistic is a lot to ask. When talking about holism and holistic practice, participants described their holistic practices in various ways, and their accounts reflected different understandings and cultural contexts. Participants characterized a holistic approach as one emphasizing the importance of occupations and activities and helping patients regain independence in their everyday lives. However, they also highlighted the specific challenges they faced, including cultural factors and inadequate resources. Significantly, participants from both Western and non-Western contexts emphasized the importance of holistic practice, suggesting that a dichotomous understanding of Eastern versus Western philosophical approaches does not necessarily make sense in occupational therapy interventions. Therapists’ degree of commitment to client-centered practice appears of greater relevance. With its international perspective, our study sheds light on important areas of contemporary occupational therapy practice, including the difficulties occupational therapists face when seeking to cover “everything” in an effort to be more holistic.
A Comparison of Nursing Activity Score Means for Missed Care Dimensions in Intensive Care Unit Patients
Authors: Mohammadi Fatemeh , Souza Nogueira Lilia de , Hanifi Nasrin , Bahraminejad Nasrin
Published: October 2023

Background. The workload of nurses in the intensive care unit (ICU) can affect the quality of nursing services. Aim. This study aimed to determine the relationship between the nursing activity score and missed care in patients hospitalized in the ICU in Zanjan, Iran. Methods. This observational and prospective study was conducted from April 3 to September 18 in 2021. The study utilized a patient and nurse profile questionnaire, the Nursing Activity Score (NAS), and a checklist for missed care as research tools. Missed care was observed in the 301 patients for whom the NAS was calculated. Analysis of variance (ANOVA) was used to investigate the differences in mean levels of missed care. Logistic regression models were used to assess the association between factors and missed nursing care. Results. Results show that the medical ICU’s mean NAS was 76.31 (95% CI: −13.06–14.89). In 9 dimensions of care, the extent of missed care was 40.7%. In the care dimensions of assessment, hand hygiene, and infection control, the mean NAS had a statistically significant increase at higher levels of missed care (

P

 < 0.5). Furthermore, work experience was identified as a protective factor for missed care (OR = 0.59, 95% CI: 0.37–0.94, χ2 = = 4.97,

p

 = 0.026). Conclusion. The study revealed a high incidence of missed care. The study revealed that the mean workload was high in certain dimensions of care such as assessment, hand hygiene, and infection control. The increase in workload for nurses results in lost care. Nonetheless, the utilization of experienced nurses can help mitigate this problem. However, utilizing experienced nurses can help reduce this problem.
Gain-of-Function p53 Mutation Acts as a Genetic Switch for TGFβ Signaling–Induced Epithelial-to-Mesenchymal Transition in Intestinal Tumors
Authors: Wang Dong , Nakayama Mizuho , Hong Chang Pyo , Oshima Hiroko , Oshima Masanobu
Published: October 2023

Signaling by TGFβ family cytokines plays a tumor-suppressive role by inducing cell differentiation, while it promotes malignant progression through epithelial-to-mesenchymal transition (EMT). Identification of the mechanisms regulating the switch from tumor suppression to tumor promotion could identify strategies for cancer prevention and treatment. To identify the key genetic alterations that determine the outcome of TGFβ signaling, we used mouse intestinal tumor-derived organoids carrying multiple driver mutations in various combinations to examine the relationship between genotypes and responses to the TGFβ family cytokine activin A. KrasG12D mutation protected organoid cells from activin A–induced growth suppression by inhibiting p21 and p27 expression. Furthermore, Trp53R270H gain-of-function (GOF) mutation together with loss of wild-type Trp53 by loss of heterozygosity (LOH) promoted activin A–induced partial EMT with formation of multiple protrusions on the organoid surface, which was associated with increased metastatic incidence. Histologic analysis confirmed that tumor cells at the protrusions showed loss of apical–basal polarity and glandular structure. RNA sequencing analysis indicated that expression of Hmga2, encoding a cofactor of the SMAD complex that induces EMT transcription factors, was significantly upregulated in organoids with Trp53 GOF/LOH alterations. Importantly, loss of HMGA2 suppressed expression of Twist1 and blocked activin A–induced partial EMT and metastasis in Trp53 GOF/LOH organoids. These results indicate that TP53 GOF/LOH is a key genetic state that primes for TGFβ family-induced partial EMT and malignant progression of colorectal cancer. Activin signaling may be an effective therapeutic target for colorectal cancer harboring TP53 GOF mutations.

Significance:

KRAS and TP53 mutations shift activin-mediated signaling to overcome growth inhibition and promote partial EMT, identifying a subset of patients with colorectal cancer that could benefit from inhibition of TGFβ signaling.
Characterization of Immunosuppressive Myeloid Cells in Merkel Cell Carcinoma: Correlation with Resistance to PD-1 Pathway Blockade
Authors: Tabachnick-Cherny Shira , Pulliam Thomas , Rodriguez Haroldo J. , Fan Xinyi , Hippe Daniel S. , Jones Daniel C. , Moshiri Ata S. , Smythe Kimberly S. , Kulikauskas Rima M. , Zaba Lisa C. , Paulson Kelly G. , Nghiem Paul
Published: October 2023

Purpose:

Merkel cell carcinoma (MCC) is a highly immunogenic skin cancer. Although essentially all MCCs are antigenic through viral antigens or high tumor mutation burden, MCC has a response rate of only approximately 50% to PD-(L)1 blockade suggesting barriers to T-cell responses. Prior studies of MCC immunobiology have focused on CD8 T-cell infiltration and their exhaustion status, while the role of innate immunity, particularly myeloid cells, in MCC remains underexplored.

Experimental Design:

We utilized single-cell transcriptomics from 9 patients with MCC and multiplex IHC staining of 54 patients’ preimmunotherapy tumors, to identify myeloid cells and evaluate association with immunotherapy response.

Results:

Single-cell transcriptomics identified tumor-associated macrophages (TAM) as the dominant myeloid component within MCC tumors. These TAMs express an immunosuppressive gene signature characteristic of monocytic myeloid-derived suppressor cells and importantly express several targetable immune checkpoint molecules, including PD-L1 and LILRB receptors, that are not present on tumor cells. Analysis of 54 preimmunotherapy tumor samples showed that a subset of TAMs (CD163+, CD14+, S100A8+) selectively infiltrated tumors that had significant CD8 T cells. Indeed, higher TAM prevalence was associated with resistance to PD-1 blockade. While spatial interactions between TAMs and CD8 T cells were not associated with response, myeloid transcriptomic data showed evidence for cytokine signaling and expression of LILRB receptors, suggesting potential immunosuppressive mechanisms.

Conclusions:

This study further characterizes TAMs in MCC tumors and provides insights into their possible immunosuppressive mechanism. TAMs may reduce the likelihood of treatment response in MCC by counteracting the benefit of CD8 T-cell infiltration.

See related commentary by Silk and Davar, p. 1076
TABLE 3 from Immune-related Adverse Events after Immune Checkpoint Blockade–based Therapy Are Associated with Improved Survival in Advanced Sarcomas
Authors: Rosenbaum Evan , Seier Kenneth , Bradic Martina , Kelly Ciara , Movva Sujana , Nacev Benjamin A. , Gounder Mrinal M. , Keohan Mary L. , Avutu Viswatej , Chi Ping , Thornton Katherine A. , Chan Jason E. , Dickson Mark A. , Donoghue Mark T.A. , Tap William D. , Qin Li-Xuan , D'Angelo Sandra P.
Published: October 2023

PFS and OS analyses across three trials utilizing immune checkpoint inhibition in sarcoma
TABLE 1 from Immune-related Adverse Events after Immune Checkpoint Blockade–based Therapy Are Associated with Improved Survival in Advanced Sarcomas
Authors: Rosenbaum Evan , Seier Kenneth , Bradic Martina , Kelly Ciara , Movva Sujana , Nacev Benjamin A. , Gounder Mrinal M. , Keohan Mary L. , Avutu Viswatej , Chi Ping , Thornton Katherine A. , Chan Jason E. , Dickson Mark A. , Donoghue Mark T.A. , Tap William D. , Qin Li-Xuan , D'Angelo Sandra P.
Published: October 2023

Patient characteristics
Twenty Years of Quiescence after Nonstop Remicade® (Infliximab) Infusions in a Child with Ocular Behçet Disease Presenting as Hypopyon-Anterior Uveitis Refractory to Immunosuppressants
Authors: Evereklioglu Cem
Published: October 2023

I report a case with ocular Behçet disease presenting as hypopyon-anterior uveitis refractory to conventional immunosuppressive drugs who was safely and effectively managed for 20 years by nonstop infusions of a modern anti-TNF agent, infliximab. A 14-year-old girl who had a history of recurrent oro-genital ulcers, arthralgia, and pathergy test positivity presented with the symptoms of bilateral blurred vision, ocular pain, photophobia, and lacrimation. Initial visual acuities were 20/25 bilaterally, and biomicroscopy revealed bilateral iridocyclitis with left shifting cold hypopyon formation in the anterior chamber of the eye. The diagnosis of ocular Behçet disease was made, and topical anti-inflammatory drops were initiated with a cycloplegic agent. In due course, the child complained of chronic floaters and decreased vision from 20/25 to 20/200 bilaterally. Vitreitis, retinitis, perivasculitis, and cystoid macular edema (CME) were encountered, and the combination of corticosteroid, azathioprine, and cyclosporine-A was immediately started. However, the child did not respond to this conventional management for 3 months. A prompt and dramatic response was obtained with repeated Remicade® (infliximab) infusions (weeks 0, 2, 6, and 10), which led to fast improvement in her systemic and ocular symptoms. Long-term remission of 20 years was obtained by regular infliximab infusions at each 6- to 9-week interval with stabilized vision (20/20) and resolution of CME. The present case shows the significant role of biologicals in pediatric severe panuveitis and that nonstop infliximab infusions initiated early led to rapid and long-term control of intraocular inflammation and recurrent sight-threatening uveitis attacks for protecting the vision in children with severe OBD.
Bilateral Simultaneous Central Retinal Vein Occlusion Secondary to COVID-19: A Case Report
Authors: Lin Chien-Hung , Sun I-Ting
Published: October 2023

Herein, we report a case of bilateral simultaneous central retinal vein occlusion (CRVO) secondary to coronavirus disease 2019 (COVID-19). A 48-year-old man, with hypertension, type 2 diabetes mellitus, and stage 4 chronic kidney disease, diagnosed with COVID-19 1 month ago presented to the ophthalmology department with blurred vision in both eyes for 2 weeks. Ocular examination revealed a classic clinical presentation of CRVO in both eyes. Optical coherence tomography revealed increased central macular thickness with intraretinal and subretinal fluid in both eyes. Laboratory data revealed elevated D-dimer and C-reactive protein (CRP) levels. The levels of other hypercoagulability markers were normal. The patient received intravitreal anti-vascular endothelial growth factor therapy in both eyes, followed by regular follow-up every month until complete resolution of symptoms and gradual improvement of the retinal vascular appearance. COVID-19 can cause a variety of coagulation abnormalities and thromboembolic complications such as bilateral simultaneous CRVO. Clinicians and patients should be aware of ocular symptoms and presentations that are probably associated with COVID-19.
CD34+ Cell Mobilization, Autograft Cellular Composition and Outcome in Mantle Cell Lymphoma Patients
Authors: Turunen Antti Samuli , Kuittinen Outi , Kuitunen Hanne , Vasala Kaija , Penttilä Karri , Harmanen Minna , Keskinen Leena , Mäntymaa Pentti , Pelkonen Jukka , Varmavuo Ville , Jantunen Esa , Partanen Anu
Published: October 2023

Backgound: Autologous stem cell transplantation (ASCT) is a standard treatment in transplant-eligible mantle cell lymphoma (MCL) patients after first-line chemoimmunotherapy. Study Design and Methods: This prospective multicenter study evaluated the impact of CD34+ cell mobilization and graft cellular composition analyzed by flow cytometry on hematologic recovery and outcome in 42 MCL patients. Results: During CD34+ cell mobilization, a higher blood CD34+ cell count (>30 × 106/L) was associated with improved overall survival (median not reached [NR] vs. 57 months, p = 0.04). The use of plerixafor did not impact outcome. Higher number of viable cryopreserved graft CD34+ cells (>3.0 × 106/kg) was associated with faster platelet (median 11 vs. 15 days, p = 0.03) and neutrophil (median 9 vs. 10 days, p = 0.02) recovery posttransplant. Very low graft CD3+CD8+ cell count (≤10 × 106/kg) correlated with worse progression-free survival (PFS) (HR 4.136, 95% CI 1.547–11.059, p = 0.005). On the other hand, higher absolute lymphocyte count >2.5 × 109/L at 30 days after ASCT (ALC-30) was linked with better PFS (median NR vs. 99 months, p = 0.045) and overall survival (median NR in either group, p = 0.05). Conclusions: Better mobilization capacity and higher graft CD3+CD8+ cell count had a positive prognostic impact in this study, in addition to earlier lymphocyte recovery (ALC-30>2.5 × 106/L). These results need to be validated in another study with a larger patient cohort.
Trocar Site Recurrence after Laparoscopic Cholecystectomy for Unsuspected Isolated Gallbladder Metastasis of Melanoma: A Case Report and Review of the Literature
Authors: Sergeant Céline , Kerger Joseph , Drowart Annie , Sales François , Langouo Mireille
Published: October 2023

Cutaneous melanoma can metastasize to almost any organ, including in-transit metastases, lymph nodes, liver, lungs, brain, and bones. Spread to the gastrointestinal tract is less common and generally concerns the small bowel, colon, and stomach. Gallbladder involvement is rarer, and only few cases describe it as the sole site of metastasis upon diagnosis. Melanoma metastases to the gallbladder are usually detected on staging or surveillance imaging, as patients usually show few or no symptoms. In resectable stage IV melanoma patients, complete surgical resection appears to improve the prognosis. However, due to the rarity of isolated gallbladder metastasis of melanoma, there are no guidelines regarding the optimal surgical approach (endoscopic or open cholecystectomy). Here, we report the case of isolated gallbladder melanoma metastasis found after laparoscopic cholecystectomy performed in a 46-year-old female patient with no known history of cancer presenting with acute cholecystitis symptoms. Six weeks after surgery, the patient developed trocar site recurrence. This case highlights the importance of a planned and open surgery for resectable melanoma metastases rather than a laparoscopic approach.
Chronic Inflammation in Chronic Kidney Disease
Authors: Yan Zhipeng , Shao Tingting
Published: October 2023

Background: Chronic kidney disease (CKD) is an increasingly prevalent disease that affects approximately 10–12% of the global population. Therefore, it is considered a public health priority. Persistent and systemic low-grade chronic inflammation (CI) is an important part of the poor prognosis in CKD, especially for patients with advanced disease. For example, CI worsens anemia and promotes atherosclerosis. Therefore, CI deserves our attention. Summary: The formation of CI in CKD involves many aspects. Among them, the decline in the glomerular filtration rate leads to the influence of substances or inflammatory cytokines that should be cleared in time. In addition, oxidative stress, the gut, and the gut microbiota are also influencing factors. Key Messages: In this review, we highlight the mechanisms involved in the development of CI in CKD.
Auctoritas & Fama: reflexões sobre o reconhecimento do arquiteto na sociedade antiga a partir do texto vitruviano
Authors: Manenti Leandro
Published: October 2023

Este artigo discute o tema do reconhecimento público dos arquitetos e artistas na sociedade antiga a partir do texto vitruviano. Aborda-se o conceito de auctoritas como o mais amplo reconhecimento, alcançado a partir do escrutínio público das ações, confrontando-o com a noção de fama, ou notoriedade, alcançada por meios distintos e, por vezes, menos nobres. A partir dessas questões chave, perscruta-se o texto vitruviano em busca dos indícios de seu posicionamento a respeito do tema, recorrendo-se, sobretudo, aos prefácios e pequenas parábolas às quais o autor se vale como forma de ilustrar seus juízos. Por meio dessas diferentes passagens, discute-se, também, a noção de autoria a partir da identificação de traços dessa forma de reconhecimento, muito embora ainda estranha ao mundo antigo, e sua associação com a própria ideia de imitação e o ambiente tardo-republicano no qual Vitrúvio está inserido.
Whole grain products in Brazil: the need for regulation to ensure nutritional benefits and prevent the misuse of marketing strategies
Authors: Andrade Giovanna Calixto , Mais Laís Amaral , Ricardo Camila Zancheta , Duran Ana Clara , Martins Ana Paula Bortoletto
Published: October 2023

OBJECTIVE: This study aims to evaluate the use of “whole grains” claims in food products marketed in Brazil and evaluate the nutrient profile of these products. METHODS: Data from 775 grain-based packaged foods collected in Brazil from April to July 2017 were analyzed. Based on the INFORMAS protocol for food labeling, the prevalence of packaged foods with “whole grains” claims was estimated. Information on the list of ingredients was analyzed to evaluate the presence and amount of whole or refined grains in six food groups. The nutrient profiles of the products with and without “whole grains” claims were compared using the Pan American Health Organization (PAHO) nutrient profile model. RESULTS: The packages of about 19% of the evaluated products showed “whole grains” claims in their front panel. Of these, 35% lacked any whole grains among their top three ingredients. Breakfast cereals, granola bars, bread, cakes and other bakery products, cookies, and pasta had higher amounts of refined flour than whole grain ingredients in their compositions. We found 66% of products with “whole grains” claims were high in nutrients of concern according to PAHO’s criteria. CONCLUSION: Our results showed that over a third of the products in Brazil with “whole grains” claims lacked whole grains as one of their main ingredients. Most had a high content of nutrients associated with noncommunicable chronic disease risk factors, indicating the overestimation of their health benefits.
Facilitating Harmonization of Variables in Framingham, MESA, ARIC, and REGARDS Studies Through a Metadata Repository
Authors: Mallya Pratheek , Stevens Laura M. , Zhao Juan , Hong Chuan , Henao Ricardo , Economou-Zavlanos Nicoleta , Wojdyla Daniel M. , Schibler Tony , Manchanda Vihaan , Pencina Michael J. , Hall Jennifer L.
Published: October 2023

BACKGROUND:

High-quality research in cardiovascular prevention, as in other fields, requires inclusion of a broad range of data sets from different sources. Integrating and harmonizing different data sources are essential to increase generalizability, sample size, and representation of understudied populations—strengthening the evidence for the scientific questions being addressed.

METHODS:

Here, we describe an effort to build an open-access repository and interactive online portal for researchers to access the metadata and code harmonizing data from 4 well-known cohort studies—the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study, FHS (Framingham Heart Study), MESA (Multi-Ethnic Study of Atherosclerosis), and ARIC (Atherosclerosis Risk in Communities) study. We introduce a methodology and a framework used for preprocessing and harmonizing variables from multiple studies.

RESULTS:

We provide a real-case study and step-by-step guidance to demonstrate the practical utility of our repository and interactive web page. In addition to our successful development of such an open-access repository and interactive web page, this exercise in harmonizing data from multiple cohort studies has revealed several key themes. These themes include the importance of careful preprocessing and harmonization of variables, the value of creating an open-access repository to facilitate collaboration and reproducibility, and the potential for using harmonized data to address important scientific questions and disparities in cardiovascular disease research.

CONCLUSIONS:

By integrating and harmonizing these large-scale cohort studies, such a repository may improve the statistical power and representation of understudied cohorts, enabling development and validation of risk prediction models, identification and investigation of risk factors, and creating a platform for racial disparities research.

REGISTRATION:

URL:
https://precision.heart.org/duke-ninds
.
Clinical Usefulness of Echocardiographic Measurement of Proximal Aortic Diameter in Early Differentiation Between Type A Acute Aortic Dissection and ST‐Segment–Elevation Myocardial Infarction
Authors: Kirigaya Jin , Iwahashi Noriaki , Abe Takeru , Gohbara Masaomi , Hanajima Yohei , Horii Mutsuo , Okada Kozo , Matsuzawa Yasushi , Yasuda Shota , Kosuge Masami , Ebina Toshiaki , Takeuchi Ichiro , Uchida Keiji , Tamura Kouichi , Hibi Kiyoshi
Published: October 2023

Background

Contradictions between management modalities of type A acute aortic dissection (TAAAD) and ST‐elevation–myocardial infarction (STEMI) may result in clinical catastrophe. Therefore, we aimed to explore which 2‐dimensional echocardiography (2DE) findings are optimal for differentiating TAAAD from STEMI.

Methods and Results

This study included 340 patients with STEMI and 340 patients with TAAAD who underwent 2DE in the emergency department between 2012 and 2021. The proximal ascending aorta (PAA) diameter and other echocardiographic parameters were analyzed. PAA diameters were measured at 4 levels in the parasternal view: Valsalva, the sinotubular junction (STJ), the PAA at 1 cm above the STJ, and the PAA at 2 cm above the STJ. Receiver‐operating characteristic curve analysis showed that Valsalva, STJ, PAA at 1 cm above the STJ, and PAA at 2 cm above the STJ were significant predictors of TAAAD (areas under the curve: 0.777, 0.924, 0.965, and 0.975, respectively;
P
<0.001) with the respective cutoff values of 39.4, 38.5, 39.8, and 41.2 mm. Multivariable analysis suggested that all 2DE parameters were significant predictors of TAAAD. Among the 2DE parameters examined, the incorporation of PAA at 2 cm above the STJ to clinical indicators exhibited the most significant diagnostic capability (C‐statistics, 0.97; net reclassification improvement, 1.81; integrated discrimination improvement, 0.61). When only TAAAD with coronary malperfusion and STEMI were analyzed, the diagnostic utility of PAA at 1 cm above the STJ was evident (C‐statistics, 0.99; net reclassification improvement, 1.79; integrated discrimination improvement, 0.67), with PAA at 2 cm above the STJ ranking second in diagnostic significance (C‐statistics, 0.99; net reclassification improvement, 1.12; integrated discrimination improvement, 0.66).

Conclusions

PAA measurements were the most beneficial for diagnosing TAAAD in all 2DE findings and TAAAD from STEMI.
Stroke‐Heart Syndrome: Does Sex Matter?
Authors: Rosso Michela , Ramaswamy Srinath , Kvantaliani Nino , Mulatu Yohannes , Little Jessica N. , Marczak Izabela , Brahmaroutu Ankita , Deo Rajat , Lewey Jennifer , Messé Steven R. , Cucchiara Brett L. , Levine Steven R. , Kasner Scott E.
Published: October 2023

Background

Cardiovascular complications after acute ischemic stroke (AIS) can be related to chronic/comorbid cardiac conditions or acute disruption of the brain–heart autonomic axis (stroke‐heart syndrome). Women are known to be more vulnerable to certain stress‐induced cardiac complications, such as Takotsubo cardiomyopathy. We investigated sex differences in cardiac troponin (cTn) elevation, cardiac events, and outcomes after AIS.

Methods and Results

We retrospectively analyzed consecutive patients with AIS from 5 stroke centers. Patients with AIS with elevated baseline cTn and at least 2 cTn measurements were included, while patients with acute comorbid conditions that could impact cTn levels were excluded. Poststroke acute myocardial injury was defined as the presence of a dynamic cTn pattern (rise/fall >20% in serial measurements) in the absence of acute atherosclerotic coronary disease (type 1 myocardial infarction) or cardiac death (type 3 myocardial infarction). From a total cohort of 3789 patients with AIS, 300 patients were included in the study: 160 were women (53%). Women were older, had a lower burden of cardiovascular risk factors, and more frequently had cardioembolic stroke and right insula involvement (
P
values all <0.05). In multivariate analysis, women were more likely to have a dynamic cTn pattern (adjusted odds ratio, 2.1 [95% CI, 1.2–3.6]) and develop poststroke acute myocardial injury (adjusted odds ratio, 2.1 [95% CI, 1.1–3.8]). Patients with poststroke acute myocardial injury had higher 7‐day mortality (adjusted odds ratio, 5.5 [95% CI, 1.2–24.4]).

Conclusions

In patients with AIS with elevated cTn at baseline, women are twice as likely to develop poststroke acute myocardial injury, and this is associated with higher risk of short‐term mortality. Translational studies are needed to clarify mechanisms underlying sex differences in cardiac events and mortality in AIS.
Ultraearly Intraventricular Hemorrhage Growth Predicts Early Neurologic Deterioration and Poor Functional Outcome After Acute Intracerebral Hemorrhage
Authors: Lv Xin‐Ni , Cheng Jing , Liu Xue‐Yun , Liu Jin‐Cheng , Deng Lan , Li Zuo‐Qiao , Pu Ming‐Jun , Chen Chu , Li Qi
Published: October 2023

Background

The presence of intraventricular hemorrhage (IVH) was extensively investigated and was associated with poor outcome in patients with intracerebral hemorrhage (ICH). However, the effect of the speed of ventricular bleeding on outcomes is unknown.

Methods and Results

We prospectively included patients with ICH who had baseline computed tomography scans within 6 hours after ictus between January 2016 and October 2021. The clinical characteristics were compared between patients with and without early neurologic deterioration (END). Ultraearly IVH growth (uIVHG) was defined as baseline IVH volume by onset‐to‐imaging time. The association between uIVHG and outcomes was assessed by using multivariable logistic regression analysis. We established the ultraearly IVH growth (uIVH) score and compared the areas under the receiver operating characteristic curves of the existing scores for predicting END. A total of 299 patients were finally enrolled. Of those, 38 patients (12.7%) experienced END at 24 hours and 89 patients (29.8%) had poor outcomes at 90 days. After adjustment for confounding factors, uIVHG (odds ratio, 1.061 [95% CI, 1.011–1.113];
P
=0.016) was independently associated with END in multivariable analysis. A prediction score was developed on the basis of the logistic model. The uIVH score was developed as a sum of individual points (0–6) based on age, hematoma volume, National Institutes of Health Stroke Scale, hematoma expansion, and uIVHG ≥2.5 mL/h. In comparison with the ICH score and modified Emergency Department ICH Scale, the uIVH score exhibited best performance in the prediction of END.

Conclusions

uIVHG is associated with early neurologic deterioration and poor functional outcome in patients with ICH.
City as Human Good and Epiphany
Authors: Byrne Patrick H.
Published: October 2023

In response to rising awareness of environmental and climate change crises, some theologians have examined more deeply the ways in which God’s presence is revealed through the natural world. While such explorations are important and necessary, they need to be balanced by complementary reflections on God’s presence in human activities as well. Cities have posed a special problem for such reflections. Cities are commonly regarded as sources of the corruption of human beings and the natural environment alike. While the problems posed by cities cannot be denied, this one-sided view obscures the special ways in which God’s presence is also manifested in urban life. This article draws upon the work of Jane Jacobs, Bernard Lonergan, M. Shawn Copeland and Gregory Boyle to draw attention to these manifestations.
The Interaction Between the Obligation to Warn and Other Rules of ihl
Authors: Benabbass Sara (S) , Zwanenburg Marten (M.C.)
Published: October 2023

The obligation to give effective advance warning of an attack which may affect the civilian population is one of the precautions in attack parties to an armed conflict must take under ihl. Recent practice has shown this duty may interact with other rules of ihl. This article discusses this interaction. It focuses on warnings that spread terror, that may be used as a ruse or that lead to displacement of civilians, cases in which warnings arguably breach the principle of distinction, and cases in which warnings lead to human shields. The article concludes that in some cases the object and purpose of ihl may provide guidance in navigating the tension between the obligation to warn and another rule of ihl. It also concludes that the intention with which a warning is given may be decisive for distinguishing between a warning as required under ihl and as a violation of ihl.
A novel species of Loculosulcatispora (Sulcatisporaceae, Pleosporales) on Juglans regia from Sichuan, China
Authors: WANG FEI-HU , WANG YAN-LIN , ZENG QIAN , XU XIU-LAN , Liu Yinggao , YANG CHUN-LIN
Published: October 2023

A novel species, Loculosulcatispora juglans, dwelling on twigs of the English walnut (Juglans regia), is introduced through a combination of phylogenetic analysis utilizing LSU, SSU, ITS, rpb2, and tef1-α sequence data, as well as morphological characteristics. Multi-locus phylogenetic analysis revealed that L. juglans forms a clade (MLBP/BYPP, 98%/0.95) together with L. hongheensis, L. thailandica, and Parasulcatispora clematidis. L. juglans distinguishes itself from phylogenetically similar species due to its unique characteristics, including exclusively 4-spored asci and larger ascospores encased in a thinner mucilaginous sheath.
Demand response strategy study of a radiant roof cooling system based on the thermal inertia of the building envelope
Authors: Guo Yidan , Xia Xueying , Wang Zhaotai , Liu Yuhan , Li Zhen
Published: October 2023

There is an imbalance between supply and demand in the power system. Implementing demand response control strategies for air-conditioning systems is beneficial to optimize the allocation of power resources. Here, we use two single strategies and a combination strategy for the radiant roof cooling system: passive energy storage, global temperature reset, and the passive energy storage-global temperature reset combination strategy to implement demand response control, all of which achieve peak load reduction or shifting by changing the indoor controlled parameters. Based on the thermal inertia of the building envelope, we utilize a TRNSYS model to analyze the performance of three demand response strategies of radiant roof cooling systems in terms of thermal comfort, energy consumption, operating costs, and peak load shifting rates. The findings reveal that implementing demand response strategies can reduce the operating energy consumption of radiant roof cooling systems and facilitate peak load shifting. Among them, the combined response strategy shows the best peak load transfer effect, with a transfer rate of 19.84% and a better operating economy. Meanwhile, we find that the outdoor temperature affects the implementation of demand response strategies for the radiant roof cooling system based on the thermal inertia of the building envelope.

Practical application

The study has significant application value in the following aspects: Implementing a demand response strategy for the radiant roof cooling system, based on the thermal inertia of the building envelope, can reduce operational energy consumption and achieve peak load shifting. This approach effectively addresses the issue of supply-demand imbalance in the power system. The application of the work could facilitate improved operational energy efficiency, contributing to emissions reduction goals and optimizing the use of intermittent renewable energy systems in power grids.
Smart manufacturing and tasks automation in the steel industry: Reflecting on routine work and skills in Industry 4.0
Authors: Antonazzo Luca , Stroud Dean , Weinel Martin
Published: October 2023

This article presents the findings of research on the European steel industry as it transitions toward Industry 4.0. Drawing on data generated through semi-structured interviews, the authors reflect on the distinction between routine and non-routine work which has informed much recent research on technology effects on jobs. First, they propose to distinguish between ‘deterministic’ and ‘probabilistic’ technological approaches, the latter illustrative of the Industry 4.0 model and characterised by the use of algorithms and statistical learning. Next, the authors maintain that jobs that have been labelled as ‘routine’ may entail a range of tasks that Industry 4.0 technologies remain unable to entirely automatise, which has led to broadening skillsets and a prominence acquired by transversal skills. Hence, the authors suggest overcoming the routine/non-routine dichotomy and deterministic assumptions on workers’ substitution in favour of a continuum-based conceptualisation of tasks and a more nuanced investigation of technology effects.
Feminist Theories and Activist Practices in Organization Studies
Authors: Fotaki Marianna , Pullen Alison
Published: October 2023

This piece reflects on the untapped potential of feminist theories and activist practices to address vital organizational issues and societal challenges such as inequality, sustainability and care for the environment. While we recognize and briefly review the progress on gender issues in organization studies achieved over the last decades, our focus is on identifying the critical and underutilized strands of feminist thinking offering fresh responses to these problems, including decolonial feminism, feminist ethics of care, posthuman feminism and ecofeminism. By way of illustrating our theoretical arguments, we discuss how five different papers recently published in Organization Studies address some of these issues, including the uncovering of hidden entanglements of power and performativity in a global bank and in the beauty industry by paying attention to body and affect, the underrepresented struggles of women in the Global South as they disrupt gendered practices through consciousness raising, contesting gender regimes at organizational social events and, finally, how the social media operate at the intersection of gender and occupation. We conclude by outlining future directions for research as we discuss the contributions of anti-racist feminist theory and decolonial feminist practice to completing the unfinished project of social change while making our scholarship more reflexive and inclusive.
The Complexity of the Seasonality of Nutritional Status: Two Annual Peaks in Child Wasting in Eastern Chad
Authors: Marshak Anastasia , Young Helen , Naumova Elena N.
Published: October 2023

Background:

Understanding seasonal patterns in nutritional status is critical for achieving and tracking global nutrition goals. However, the majority of nutrition seasonality research design draws on 2 or 3 within-year time points based on existing assumptions of seasonality, missing a more nuanced pattern.

Objective:

We aimed to identify the intra-year variability of childhood wasting, severe wasting, and weight-for-height z-scores (WHZ) in a dryland single wet-season context and illustrate an analytical approach for improving analysis of the seasonality of nutritional status.

Methods:

To quantify the intra-year variability in nutritional status, we use data from a 23-month panel study (May 2018 to March 2020) following 231 children (6-59 months of age) in eastern Chad. We apply a mixed-effects harmonic regression with child- and village-level fixed effects on the odds of being wasted, severely wasted, and on WHZ, testing for multiple and nonsymmetrical seasonal peaks, adjusted for child sex and age. We triangulate our findings using climate data on temperature, vegetation, and precipitation.

Results:

We identify 2 annual peaks of wasting and severe wasting. Wasting peaks at 14.7% (confidence interval [CI], 11.8-18.2) at the end of the dry season, while the smaller peak corresponds to the start of the harvest period at 13.4% (CI, 10.7-16.6). The odds of being wasted decline during the rainy season to 11.8% (CI, 9.4-14.7), with the lowest prevalence of 8.8% (CI, 6.9-11.1) occurring during the start of the dry season. In addition, a 1°C monthly increase in temperature is significantly associated with a 5% (CI, 1.4-8.7) and 12% (CI, 3.0-20.3) increase in the odds that a child is wasted and severely wasted, respectively.

Conclusions:

Intra-year variability of child wasting is far more complex and nuanced than identified by the literature, with 2 peaks, as opposed to 1, likely corresponding to different seasonal drivers, such as food insecurity, disease, water contamination, and care practices at different times of year. Better seasonality analysis can go a long way in improving the timing and content of programming with the goal of reducing child wasting.
Chinese EAP Teachers’ Identity Development: A Comparative Analysis of Teacher Metaphors From Students and Teachers
Authors: Liu Xiao
Published: October 2023

The study investigates the metaphorical images of English teachers formulated by English for Academic Purpose (EAP) teachers and postgraduate students in a Chinese Sci-tech University. Student Participants ( n = 171) and teacher participants ( n = 51) completed questionnaires including the metaphor-eliciting prompts to express their perceptions of English teachers. The results revealed a similar three-level categorization (information, disposition, and status) of teachers’ features from the two groups, as well as similarities and discrepancies in the perceptions of certain conceptual teacher metaphors. Based on the comparison, implications for EAP teaching and EAP teachers’ identity development in China are discussed.
An Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears: An Experimental Study in Rats
Authors: Jo Seong Kyeong , Yoo In Ha , Park Hyeon Yeong , Kang Chan , Han Seung Yun , Moon Ji Hyun , Park Won Ho , Yeo Yong Ho , Jun Sangmi , Yi Yoon-Sun , Lee Su Jeong , Tae Jung Yeon , Song Jae Hwang
Published: October 2023

Background:

There is growing interest in nonoperative treatment for the management of Achilles tendon ruptures (ATRs). However, nonoperative treatment is limited by the risk of tendon reruptures and low satisfaction rates. Recently, atelocollagen injections have been reported to have beneficial effects on tendon healing.

Purpose:

To evaluate the beneficial effects of injected atelocollagen on Achilles tendon healing and investigate the mechanism of atelocollagen on tendon healing.

Study Design:

Controlled laboratory study.

Methods:

Percutaneous tenotomy of the right Achilles tendon in 66 rats was performed. The animals were equally divided into the noninjection group (NG) and the collagen injection group (CG). At 1, 3, and 6 weeks, the Achilles functional index, cross-sectional area, load to failure, stiffness, stress, and the modified Bonar score were assessed. Transmission electron microscopy, western blotting, and immunohistochemistry were also performed.

Results:

The Achilles functional index (–6.8 vs −43.0, respectively; P = .040), load to failure (42.1 vs 27.0 N, respectively; P = .049), and stiffness (18.8 vs 10.3 N/mm, respectively; P = .049) were higher in the CG than those in the NG at 3 weeks. There were no significant differences in histological scores between the 2 groups. Transmission electron microscopy analysis showed that the mean diameter of collagen fibrils in the CG was greater than that in the NG at 3 weeks (117.2 vs 72.6 nm, respectively; P < .001) and 6 weeks (202.1 vs 144.0 nm, respectively; P < .001). Western blot analysis showed that the expression of collagen type I in the CG was higher than that in the NG at 1 week ( P = .005) and 6 weeks ( P = .001).

Conclusion:

An atelocollagen injection had beneficial effects on the healing of nonoperatively treated Achilles tendon injuries. The Achilles tendon of CG rats exhibited better functional, biomechanical, and morphological outcomes compared with NG rats. The molecular data indicated that the mechanism of atelocollagen injections may be associated with an increased amount of collagen type I.

Clinical Relevance:

An atelocollagen injection might be a good adjuvant option for the nonoperative treatment of ATRs.
Towards a Survey of Differences in Preferred Meeting Styles Across Cultures
Authors: de Jongste Henri
Published: October 2023

Meetings are an essential part of organizational life everywhere. Although research has shown that meeting styles differ among cultures, studies focusing on a broad set of data to compare the prevalent meeting styles systematically are rare, partly because of the high academic standards required by researchers. There is, however, much informal data on meeting styles aimed at practitioners, which despite its shortcomings, can be useful. The information provided is largely based on the experiences made by internationally active businesspeople. Under the author’s supervision, students of the author’s business school analyzed a great number of descriptions of meeting practices to investigate in what respects meetings differ. The results were combined with earlier research and general situational context models to come to a meeting-specific model that enables a systematic comparison of meeting practices. This model can be applied for educational as well as for practical purposes.
Dynamic Simulation and Test Verification of Hydraulic Automatic Tensioner for an Engine Timing Chain Drive System
Authors: Feng Zengming , Yang Jinxing , Wang Fei
Published: October 2023

As a fundamental component of an automobile engine's timing chain drive system, the hydraulic automatic tensioner significantly enhances fuel economy while minimizing system vibrations and noise. However, there is a noticeable lack of research on automatic hydraulic tensioners. This study presents a comprehensive calculation approach for the principal parameters of a hydraulic automatic tensioner. An effective method, grounded in hydraulics and multibody dynamics, was introduced for estimating the dynamic response of such a tensioner. The simulation model developed for the hydraulic tensioner is characterized by its rapid dynamic response, consistent operation, and high accuracy. The dynamic behavior of the tensioner was analyzed under varying boundary conditions, using sinusoidal signal excitation. It was observed that the maximum damping force increases with a decreasing leakage gap. Conversely, an increase in oil temperature or air content leads to a decrease in the maximum damping force. The reaction forces derived from these calculations align well with experimental results. This calculation and simulation approach offers considerable value for the design of innovative hydraulic tensioners. It not only streamlines the design phase, minimizes the number of trials, and reduces product costs, but also provides robust insights for evaluating the performance of hydraulic tensioners.
Advances and challenges in Bioinformatics and Biomedical Engineering: IWBBIO 2020
Authors: Valenzuela Olga , Cannataro Mario , Rusur Irena , Wang Jianxin , Zhao Zhongming , Rojas Ignacio
Published: October 2023

This Supplement issue, presents five research articles which are distributed, mainly due to the subject they address, from the 8th International Work-Conference on Bioinformatics and Biomedical Engineering (IWBBIO 2020), which was held on line, during September, 30th–2nd October, 2020. These contributions have been chosen because of their quality and the importance of their findings. Those contributions were then invited to participate in this supplement for the following journals of BMC: BMC Bioinformatics and BMC Genomics. In the present Editorial in BMC journal, we summarize the contributions that provide a clear overview of the thematic areas covered by the IWBBIO conference, ranging from theoretical/review aspects to real-world applications of bioinformatic and biomedical engineering.