bluuebunny/crossref_metadata_2025 huggingface dataset:
SmartGate is a spatial metabolomics tool for resolving tissue structures
Authors: Xiao Kaixuan , Wang Yu , Dong Kangning , Zhang Shihua
Published: September 2022

Imaging mass spectrometry (IMS) is one of the powerful tools in spatial metabolomics for obtaining metabolite data and probing the internal microenvironment of organisms. It has dramatically advanced the understanding of the structure of biological tissues and the drug treatment of diseases. However, the complexity of IMS data hinders the further acquisition of biomarkers and the study of certain specific activities of organisms. To this end, we introduce an artificial intelligence tool SmartGate to enable automatic peak picking and spatial structure identification in an iterative manner. SmartGate selects discriminative m/z features from the previous iteration by differential analysis and employs a graph attention auto-encoder model to perform spatial clustering for tissue segmentation using the selected features. We applied SmartGate to diverse IMS data at multicellular or subcellular spatial resolutions and compared it with four competing methods to demonstrate its effectiveness. SmartGate can significantly improve the accuracy of spatial segmentation and identify biomarker metabolites based on tissue structure-guided differential analysis. For multiple consecutive IMS data, SmartGate can effectively identify structures with spatial heterogeneity by introducing three-dimensional spatial neighbor information.
Complex scaffold remodeling in plant triterpene biosynthesis
Authors: De La Peña Ricardo , Hodgson Hannah , Liu Jack C.T. , Stephenson Michael J. , Martin Azahara C. , Owen Charlotte , Harkess Alex , Leebens-Mack Jim , Jimenez Luis E. , Osbourn Anne , Sattely Elizabeth S.
Published: September 2022

Triterpenes with complex scaffold modifications are widespread in plants yet little is known regarding biosynthesis. Limonoids are an exemplary family that includes the bitter taste in citrus (e.g., limonin) and the active constituents in neem oil, a widely used bioinsecticide (e.g., azadirachtin). Despite limonoid commercial value, a complete biosynthetic route has not been described. Here, we report the discovery of 22 enzymes that catalyze 12 unique reactions including the 4-carbon scission and furan installation that are a signature of the limonoid family and a pair of sterol isomerases previously unknown in plants. This gene set is then used for the total biosynthesis of kihadalactone A and azadirone in a heterologous plant. These results enable access to valuable limonoids and provide a template for discovery and reconstitution of triterpene biosynthetic pathways in plants that require multiple skeletal rearrangements and oxidations.
The impact of digitalization on firm performance: examining the role of digital culture and the effect of supply chain capability
Authors: Hautala-Kankaanpää Tuire
Published: September 2022

Purpose

The study examines the impact of digital platforms and supply chain capability on operational performance and tests the mediation effect of supply chain capability. Further, the purpose is to examine the moderating effect of digital culture and sharpen our knowledge of how organizational culture as a contextual factor affects the firm's digitalization.

Design/methodology/approach

The data were harvested from 194 Finnish manufacturing companies, and structural equation modeling was used to test the hypotheses.

Findings

The findings show that digital platforms positively and significantly affect supply chain capability. Moreover, supply chain capability mediates the relation between digital platforms and operational performance. Further, this study confirms that digital culture is a contextual factor that explains the differences in the effects of digital platforms on firm performance.

Originality/value

This study is one of the first attempts to examine the effect of digital culture in the context of digital platforms, supply chain capabilities, and operational performance.
China's Reform Spree in 2021: Common Prosperity and Others
Authors: Liu Kerry
Published: September 2022

In 2021, China launched a series of reform initiatives including common prosperity, a property tax, a regulatory crackdown on technology firms, a roadmap for peak carbon dioxide emissions and carbon neutrality and other policies aiming to improve people's lives. This study reviews each of them and finds that they are centred around common prosperity and guiding resource allocation. Based on Google Trends search results, this study creatively created a series of common prosperity policy indices, showing that China in 2021 may have experienced the most important policy shift since at least 2004. Based on EGARCH and ARDL models, this study finds that the whole economy, proxied by two popular composite indices, i.e. the Shanghai Stock Exchange Composite Index and the China Securities Index 300, responded positively to the common prosperity policy. Stock market responses also show that China's policies have successfully guided the resource allocation from the soft technology sector to the hard technology one. This study also discusses the broad implications, such as the role of the government and the evolution of private ownership in the Chinese economy.
Light and storage time influence the microbial quality of minimally processed rocket
Authors: Zappia Angela , Malacrinò Antonino , Belgacem Imen , Abdelfattah Ahmed , Piscopo Amalia
Published: September 2022

Ready‐to‐eat minimally processed fruits and vegetables are an ideal substrate for the growth of microorganisms, including human pathogens and mycotoxin‐producing species, which question their quality and safety for customers. While we are aware of the importance of production workflows in structuring the products' microbial communities, we still know little about the factors that shape microbiomes during the timeframe products are available to customers, and beyond this timeframe. Here, we study the influence of storage light condition (light or dark) on microbiological and physico‐chemical parameters of minimally processed rocket leaves at different shelf life timepoints (the day the product becomes available to consumers, expiration date, 3 days after the expiration date). Our results suggest that the total microbial load increases from the day the product becomes available to consumers, to the expiry date and after the product's expiration. However, when studying the composition of the fungal microbiome, we did not observe significant changes in its structure as the effect of product shelf life or storage light condition. We also found that products stored under light condition had a higher total bacterial load compared to those stored in darkness. Our results might be helpful in crafting improved workflows for product's storage during its shelf life, which might ultimately lead to a re‐evaluation of storage times resulting in reduced food waste due to product spoilage or expiration.
RNA sequencing of single allergen‐specific memory B cells after grass pollen immunotherapy: Two unique cell fates and CD29 as a biomarker for treatment effect
Authors: McKenzie Craig I. , Varese Nirupama , Aui Pei Mun , Reinwald Simone , Wines Bruce D. , Hogarth P. Mark , Thien Francis , Hew Mark , Rolland Jennifer M. , O'Hehir Robyn E. , van Zelm Menno C.
Published: September 2022

Background

Sublingual immunotherapy (SLIT) for grass pollen allergy can modify the natural history of allergic rhinitis and is associated with increased allergen‐specific IgG4. IgG4 competitively inhibits functional IgE on the surface of effector cells, such as mast cells and basophils, from binding to allergens. To further understand the important role memory B‐cell (Bmem) responses play in mediating the beneficial effects of SLIT, we assessed changes in allergen‐specific Bmem subsets induced by SLIT for grass pollen allergy.

Methods

Blood samples were collected twice outside the pollen season from twenty‐seven patients with sensitization to ryegrass pollen (RGP; Lolium perenne) and seasonal rhinoconjunctivitis. Thirteen received 4‐month pre‐seasonal SLIT for grass pollen allergy, and 14 received standard pharmacotherapy only. Single‐cell RNA sequencing was performed on FACS‐purified Lol p 1‐specific Bmem before and after SLIT from four patients, and significant genes were validated by flow cytometry on the total cohort.

Results

Four months of SLIT increased RGP‐specific IgE and IgG4 in serum and induced two Lol p 1‐specific Bmem subsets with unique transcriptional profiles. Both subsets had upregulated expression of beta 1 integrin ITGB1 (CD29), whereas IGHE (IgE), IGHG4 (IgG4), FCER2 (CD23), and IL13RA1 were upregulated in one subset. There was an increase in the proportion of Lol p 1+ Bmem expressing surface IgG4, CD23, and CD29 after SLIT.

Conclusions

A clinically successful 4 months course of SLIT for grass pollen allergy induces two transcriptionally unique Bmem fates. Associated changes in surface‐expressed proteins on these Bmem subsets can be used as early biomarkers for treatment effects.
The panorama of cerebral palsy in Sweden part XIII shows declining prevalence in birth‐years 2011–2014
Authors: Himmelmann Kate , Påhlman Magnus
Published: September 2022

Aim

To describe epidemiology and characteristics of cerebral palsy (CP) in western Sweden 1954–2014.

Methods

Population‐based study covering 105 935 live births in the area in 2011–2014. Birth characteristics, neuroimaging findings and outcome were analysed and prevalence calculated. Non‐parametric methods were used for group comparisons.

Results

CP was diagnosed in 192 children. Crude prevalence had decreased to 1.81 per 1000 live births (p = 0.0067). Gestational age‐specific prevalence for <28 gestational weeks was 74.8 per 1000 live births, 46.6 for 28–31 weeks, 5.8 for 32–36 weeks and 1.1 per 1000 for >36 weeks of gestation. Hemiplegia, found in 36.2%, had declined (p = 0.03). Diplegia was found in 36.2% and tetraplegia 5.3%. Dyskinetic CP accounted for 18.6% and ataxia for 3.7%. Neuroimaging revealed maldevelopments in 14%, white matter lesions in 44%, cortical/subcortical lesions in 13% and basal ganglia lesions in 17%. Prenatal aetiology was considered in 34%, peri‐ or neonatal in 48%, while in 18% aetiological period remained unclassified. Motor outcome in children who needed neonatal care had improved (p = 0.04). Motor function in dyskinetic CP had improved compared to previous cohorts (p = 0.008).

Conclusion

The prevalence of CP has declined, mainly in term‐born and in hemiplegia, and motor severity has changed compared to previous cohorts.
A patient with bullous pemphigoid presenting with haemorrhagic oral erosions, oral haematoma and haemoptysis
Authors: Phuan Zhen Yu Crystal , Lee Xiu Hue , Tay Hui Ming , Rajaratnam Ratna , Ang Chia Chun
Published: September 2022

We present a case of a patient with bullous pemphigoid presenting with acquired haemophilia A. This is characterized by formation of antibodies or inhibitors against coagulation Factor VIII, leading to a prolonged activated partial thromboplastin time with normal prothrombin time and international normalized ratio. Our case emphasizes the need for increased awareness among dermatologists of this uncommon and potentially life-threatening condition.

Click here for the corresponding questions to this CME article.
Three‐Dimensional tooth models for better teaching and treatment outcomes
Authors: Fakhr Mohamed , Nagy Mohamed Mokhtar
Published: September 2022

Introduction

The aim of this study was to fabricate 3‐Dimensional (3D) tooth models to overcome procedural errors that occur during treatment and to improve endodontic management of teeth with complex pulp morphology and dental anomalies.

Materials and Methods

Three natural teeth were used to fabricate resinous tooth models (n = 90) and 90 natural teeth were used during root canal treatment. Models were fabricated from 1 mandibular canine (n = 30) and 2 maxillary molars (n = 60). Natural teeth were 30 mandibular canines, 30 mandibular molars and 30 maxillary molars.

Results

Natural teeth and opaque resin models were significantly better than the clear resin models during access preparation (p = .003). In addition, the clear resin models were significantly better than the natural teeth and opaque resin models during shaping, obturation and as an educational tool (p < .001, p < .001 and p < .001 respectively).

Conclusions

Although it takes more time and effort to produce 3D (3D) tooth models from each natural tooth used in the study, it can give more accurate results during evaluation.
Pulmonary function is a strong predictor of 2‐year overall survival and non‐relapse mortality after allogenic hematopoietic cell transplantation
Authors: Schierbeck Frederikke , Mortensen Jann , Andersen Niels S. , Friis Lone S. , Kornblit Brian , Petersen Søren L. , Schjødt Ida , Sengeløv Henrik
Published: September 2022

Objectives

The purpose of the study was to assess the validity of the hematopoietic cell transplantation‐specific comorbidity index (HCT‐CI) and of pulmonary comorbidity prior to HCT in terms of predicting non‐relapse mortality (NRM) and overall survival (OS).

Methods

In this retrospective single‐center study of 663 consecutive adult recipients of HCT, we stratified patients into groups by pulmonary comorbidity: low‐risk, intermediate‐risk, and high‐risk. The predictive value of this pulmonary comorbidity score (PCS) was compared to HCT‐CI.

Results

In univariate analysis, the HCT‐CI and the PCS were associated with OS after transplantation when comparing patients in high‐risk groups with patients in low‐risk groups. Using the PCS, the hazard ratios (HRs) of the 2‐year OS in the entire population and in the myeloablative conditioning (MAC) group were 1.98 (p < .001) and 3.27 (p < .001), respectively, whereas the HRs using the HCT‐CI were 1.83 (p < .001) and 2.57 (p = .002). The 2‐year NRM incidence in the three risk‐groups in the entire population was significant using both indexes. In the MAC group, the 2‐year NRM was significant using the PCS (p = .003), but not using the HCT‐CI (p = .23).

Conclusions

Our study suggest that pulmonary function alone is a strong predictor of 2‐year OS and NRM after HCT.
The incidence, complications, and treatment of iron deficiency in pregnancy
Authors: Benson Ashley E. , Shatzel Joseph J. , Ryan Kim S. , Hedges Madeline A. , Martens Kylee , Aslan Joseph E. , Lo Jamie O.
Published: September 2022

Iron deficiency and/or iron deficiency anemia (IDA) complicate nearly 50% of pregnancies globally, negatively impacting both maternal and fetal outcomes. Iron deficiency can cause a range of symptoms that range from aggravating to debilitating including fatigue, poor quality of life, pagophagia, and restless leg syndrome. Iron deficiency and IDA are also associated with maternal complications including preterm labor, increased rates of cesarean delivery, postpartum hemorrhage, and maternal death. Fetal complications include increased rates of low birth weight and small for gestational age newborns. Prenatal maternal anemia has also been associated with autism spectrum disorders in the neonate, although causation is not established. Deficiency in the newborn is associated with compromised memory, processing, and bonding, with some of these deficits persisting into adulthood. Despite the prevalence and consequences associated with iron deficiency in pregnancy, data show that it is routinely undertreated. Due to the physiologic changes of pregnancy, all pregnant individuals should receive oral iron supplementation. However, the bioavailability of oral iron is poor and it is often ineffective at preventing and treating iron deficiency. Likewise, it frequently causes gastrointestinal symptoms that can worsen the quality of life in pregnancy. Intravenous iron formulations administered in a single or multiple dose series are now available. There is increasing data suggesting that newer intravenous formulations are safe and effective in the second and third trimesters and should be strongly considered in pregnant individuals without optimal response to oral iron repletion.
Exosome‐associated mitochondrial DNA from patients with myalgic encephalomyelitis/chronic fatigue syndrome stimulates human microglia to release IL‐1β
Authors: Tsilioni Irene , Natelson Benjamin , Theoharides Theoharis C.
Published: September 2022

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disease that presents with fatigue, sleep disturbances, malaise, and cognitive problems. The pathogenesis of ME/CFS is presently unknown, and serum levels of potential biomarkers have been inconsistent. Here, we show that mitochondrial DNA (mtDNA) associated with serum exosomes, is increased in ME/CFS patients only after exercise. Moreover, exosomes isolated from patients with ME/CFS stimulate significant release of IL‐1β from cultured human microglia. These results provide evidence that activation of microglia by serum‐derived exosomes may serve as a potential novel pathogenetic factor and target for treatment of ME/CFS.
Thermal sensitivity modulates temporal patterns of ecosystem functioning by freshwater mussels
Authors: van Ee Brian C. , Johnson Paul D. , Atkinson Carla L.
Published: September 2022

The continued global loss of biodiversity highlights the importance of understanding how species loss may impact ecosystem function. Shifting temperatures will accelerate species loss, but will affect species differently.

We investigated effects of temperature (10°C, 20°C, or 30°C) on resource acquisition and assimilation (clearance rate, respiration rate, N and P excretion) for 11 freshwater mussel species from a species‐rich assemblage in the Sipsey River, Alabama, U.S.A., to evaluate how temperatures impact co‐occurring species and the ecosystem processes they facilitate. Mussels are assigned to the same guild (i.e., filter‐feeding bivalves), but span a breadth of evolutionary lineages and have a diversity of life history strategies from short‐lived, quickly maturing species to long‐lived, slow‐growing species.

Our results indicated that four species (Cyclonaias asperata, Elliptio arca, Lampsilis ornata, and Obovaria unicolor) were thermally sensitive at 30°C, using more energy than they were acquiring. These species spanned three phylogenetic tribes and two different life‐history strategies suggesting thermal tolerance may not necessarily be linked to life history strategy or phylogenetic constraints.

When laboratory clearance and excretion rates were scaled to a natural mussel community over a year, we found that relative contributions by the proportion of thermally tolerant and sensitive species to total ecosystem function varied temporally across temperature and flow regimes. Thermal stress enhanced contributions by sensitive species' during summer, as individuals attempted to meet metabolic demands by increasing clearance rates and use of energy stores that increased ammonia excretion. River discharge and background nutrient concentrations also modulated the impact of ecosystem functioning facilitated by mussels. High river discharge in winter and high background nutrient concentrations in the summer decreased the relative contribution of the mussel community.

Although mussel species are commonly grouped in a single guild, species‐specific thermal traits modulate their role in the community. As biodiversity decreases, even biomass replacement by surviving mussel species is unlikely to support comparable ecosystem function due to the loss of unique species traits.
Trophic ecology of three stingrays (Myliobatoidei: Dasyatidae) off the Brazilian north‐eastern coast: Habitat use and resource partitioning
Authors: Queiroz Aristóteles Philippe Nunes , Araújo Maria Lúcia Góes , Hussey Nigel E. , Lessa Rosângela P. T.
Published: September 2022

Understanding the ecological role of species with overlapping distributions is central to inform ecosystem management. Here we describe the diet, trophic level and habitat use of three sympatric stingrays,Hypanus guttatus,H. marianaeandH. berthalutzae, through combined stomach content and stable isotope (δ13C and δ15N) analyses. Our integrated approach revealed thatH. guttatusis a mesopredator that feeds on a diverse diet of benthic and epibenthic marine and estuarine organisms, principally bivalve molluscs,Alpheusshrimp and teleost fishes. Isotopic data supported movement of this species between marine and estuarine environments.H. berthalutzaeis also a marine generalist feeder, but feeds primarily on teleost fishes and cephalopods, and consequently occupies a higher trophic level. In contrast,H. marianaeis a mesopredator specialized on shrimps and polychaetas occurring only in the marine environment and occupying a low niche breadth. While niche overlap occurred, the three stingrays utilized the same prey resources at different rates and occupied distinct trophic niches, potentially limiting competition for resources and promoting coexistence. These combined data demonstrate that these three mesopredators perform different ecological roles in the ecosystems they occupy, limiting functional redundancy.
The role of bank lenders in firm leverage adjustments
Authors: Gao Wenlian , Zhu Feifei , Chen Kai
Published: September 2022

In this article we examine the impact of bank loan characteristics on firm leverage adjustments, with a special focus on the conflicts of interest between shareholders and creditors. The results show that, on average, more bank loans slow down leverage adjustments. The subsample analysis reveals that bank loans slow down leverage adjustments in underlevered firms but speed up adjustments in overlevered firms. This finding suggests that bank lenders are able to limit their risk exposure in borrowers and protect their own rights. Further evidence indicates that the effect of bank loans is more notable during the global financial crisis and when a firm is financially constrained. Bank loan concentration and maturity have a significant impact on leverage adjustments as well.
The influence of wearing a mask on the projected first impressions and attractiveness levels of smiling individuals
Authors: Dayan Steven , Fabi Sabrina , Gandhi Nimit , Scharf Isabel , Resner Alexea , Lian Lien , Kola Eljona , Jabri Zainab
Published: September 2022

Objective

To evaluate the effect of mask wearing on facial attractiveness and projected first impressions during the COVID‐19 pandemic.

Methods

A total of eight models were evaluated by 200 live raters and 750 online raters both with and without masks while smiling maximally. Both live and online raters looked at the models for 15 s, then completed a first impressions questionnaire.

Results

Overall ratings for attractiveness were higher for both masked and unmasked conditions in‐person versus online. Males were perceived more favorably both in impressions and attractiveness online when masked, whereas in person they were more favorable when unmasked. Females were perceived more favorably in impressions when unmasked both online and in person, but their attractiveness rating was higher when masked both online and in person. Regardless of gender and masking state, all first impressions were more favorable in person versus online. The differences were statistically significant (all p < 0.05).

Conclusions

Face masks have different effects for males versus females in both an online and in‐person setting. Men are perceived more positively in‐person when they smile unmasked while they are better ranked online when they smile masked. Females are better perceived in all domains other than attractiveness when smiling unmasked both online and in person. To optimize first impressions, individuals should seek to meet in person whenever possible when forming new relationships.
Economic living standard and abdominal pain mediate the association between functional gastrointestinal disorders and depression or anxiety
Authors: M. H. Simon , P. E. Heenan , C. Frampton , S. Bayer , J. I. Keenan , N. K. Boer de , N. C. Roy , N. J. Talley , R. B. Gearry
Published: September 2022

Background

Functional gastrointestinal disorders (FGIDs) are common and cause significant morbidity. Psychiatric comorbidities associated with FGIDs include anxiety and depression. However, little is understood about the factors that modulate this association. The aim of this study was to examine the association between FGIDs and depression and anxiety, and to determine the covariates influencing this association in a New Zealand cohort.

Methods

The Christchurch IBS cOhort to investigate Mechanisms FOr gut Relief and improved Transit (COMFORT) study is an observational case–control study that recruited FGID cases and healthy controls between 2016 and 2018. In addition to the collection of a wide range of biological samples, participants completed questionnaires concerning socioeconomic status, physical activity, smoking, alcohol intake, anxiety, and depression (the latter two measured using the Hospital Anxiety and Depression Score [HADS]). A multivariate analysis was performed using the significant covariates from the univariate analyses to test whether their effect was independently significant on anxiety and depression.

Key Results

A total of 315 participants (57 with diarrhea‐predominant IBS (IBS‐D), 30 with constipation‐predominant IBS (IBS‐C), 41 with mixed‐IBS (IBS‐M), 16 with functional diarrhea (FD), 42 with functional constipation (FC), and 129 controls); mean age 53 years (range 18–70 years), 221 (70%) female) completed the questionnaires. Anxiety (odds ratio [OR] 2.85 [95% confidence interval [CI] 1.64–4.94, p < 0.01) and depression (OR 3.40 [95% CI 1.35–8.55, p = 0.01]) were strongly associated with FGID cases versus controls. Lower economic living status (p < 0.01) was an independent covariate associated with depression, while lower economic living status (p < 0.005) and abdominal pain (p = 0.005) were both independently associated with anxiety.

Conclusions & Inferences

In addition to the established associations between FGIDs and anxiety and depression, we have shown that the economic standard of living, pain, and IBS phenotype are significant independent covariates. This study demonstrates the range of lifestyle and demographic factors that modulate morbidity associated with FGIDs and may provide targets for intervention.
Visible abdominal distension in functional gut disorders: Objective evaluation
Authors: Barba Elizabeth , Burri Emanuel , Quiroga Sergio , Accarino Anna , Azpiroz Fernando
Published: September 2022

Background

Visible abdominal distension has been attributed to: (A) distorted perception, (B) intestinal gas accumulation, or (C) abdominophrenic dyssynergia (diaphragmatic push and anterior wall relaxation).

Methods

A pool of consecutive patients with functional gut disorders and visible abdominal distension included in previous studies (n = 139) was analyzed. Patients (61 functional bloating, 74 constipation‐predominant irritable bowel syndrome and 4 with alternating bowel habit) were evaluated twice, under basal conditions and during a self‐reported episode of visible abdominal distension; static abdominal CT images were taken in 104 patients, and dynamic EMG recordings of the abdominal walls in 76, with diaphragmatic activity valid for analysis in 35.

Key Results

(A) Objective evidence of abdominal distension was obtained by tape measure (increase in girth in 138 of 139 patients), by CT imaging (increased abdominal perimeter in 96 of 104 patients) and by abdominal EMG (reduced activity, i.e., relaxation, in 73 of 76 patients). (B) Intestinal gas volume was within ±300 ml from the basal value in 99 patients, and above in 5 patients, who nevertheless exhibited a diaphragmatic descent. (C) Diaphragmatic contraction was detected in 34 of 35 patients by EMG (increased activity) and in 82 of 103 patients by CT (diaphragmatic descent).

Conclusions and Inferences

In most patients complaining of episodes of visible abdominal distention: (A) the subjective claim is substantiated by objective evidence; (B) an increase in intestinal gas does not justify visible abdominal distention; (C) abdominophrenic dyssynergia is consistently evidenced by dynamic EMG recording, but static CT imaging has less sensitivity.
Voice battle to be a saint in Love Medicine
Authors: Chen Qianqian , Tan Joan Qionglin
Published: September 2022

Love Medicine is the debut novel of Chippewa writer Louise Erdrich, the winner of the 2021 Pulitzer Prize for Fiction. On the basis of Michel Foucault's theory of discourse, this article examines the voice battle between the two American Indian heroines in the novel, pupil Marie Lazzarre and Sister Leopolda, who both aspire to be a saint. Marie, though muted and disempowered at first, by unveiling Leopolda's lies and fraud, relinquishes her Catholic‐saint identity, achieves harmony in her Self, regains her free voice, and finally becomes a real saint. Conversely, the initially sonorous and dominant Leopolda, after denying her Indian roots, persecuting her tribal people, cheating the nuns and her parishioners, turns out to be a fake saint, consequently losing her voice and power. By probing into the two women's conflicts, the paper unfolds that behind their voice battle lies the contradictions between Indian holistic ecological ideology and Euro‐American values which compete for discourse and power within the postcolonial context. It also contends that, for the oppressed Native Americans, retaining Indian ethnicity and strengthening cultural bonds could be the right way to deconstruct the dualistic power hierarchy and have their voices heard.
The haze of the Shoah
Authors: Grenaudier‐Klijn France
Published: September 2022

When Holocaust survivor Anna Langfus (1920–1966) left Poland for France in 1946, she broke all ties with her home country. French became her language of choice for the three novels she published between 1960 and 1965, and she never used Polish at home nor taught it to her only daughter. Yet, in a contribution to a volume on Chopin published a few months before her death, she had the famous composer cry out: ‘I do not want to die in this country. […] No, not here. But at home, in my home, the only home I ever owned, my parents' home. A home I shall never see again; a country I have abandoned.’ Drawing on the work of Julia Kristeva (abjection) and Dominick LaCapra (empathic unsettlement) I explore representations of exile in Langfus's fiction in three respects: the incommunicability of the Shoah and the ensuing exilic condition of the Holocaust survivor (exile from others); the fragmentation/dislocation of the narrator's body as expression of the survivor's existential anguish (exile from self); the fleeting solace offered by creative fiction and the connection established with readers (suspension of exile). Throughout this discussion, I will be guided by the motif of the fog, which features strongly in Langfus's Chopin text.
Prevalence of delayed puberty and low bone density in patients with epidermolysis bullosa: Insight from a large single center's experience
Authors: Wasserman Halley , Dumenigo Andrea , Hornung Lindsey , Augsburger Bret , Marathe Kalyani , Lucky Anne W.
Published: September 2022

Background

Epidermolysis bullosa (EB) is a group of rare genetic skin conditions that result in skin fragility. EB can be quite severe with chronic inflammation and malnutrition impairing growth and pubertal development. These factors have potential consequences for skeletal health. We aimed to determine the prevalence of delayed puberty and low bone mineral density (BMD) for age in children and young adults with EB.

Methods

Electronic medical records (EMR) of patients with confirmed EB <30 years of age at time of initial encounter at Cincinnati Children's Hospital Medical Center between January 1, 2010 and September 30, 2020 were reviewed. Natural language processing software was used to categorize pubertal status of patients with EB as early, normal or delayed. BMD was measured by dual energy x‐ray absorptiometry and categorized as low if height adjusted Z‐score was <−2.0 using age, sex and race specific reference ranges.

Results

29% of individuals with EB had low BMD with most cases occurring prior to 10 years of age. Of patients who reached adolescence, 23% failed to develop any signs of puberty in the normal range (before age 13 in females or 14 in males) and BMD Z‐scores further declined in these individuals.

Conclusion

Delayed puberty is an under‐recognized comorbidity of individuals with EB, especially in those with recessive dystrophic EB, and can have a significant impact on BMD.
Queers in quarantine: Young LGBTQ+ people's experiences during the COVID‐19 pandemic in Sweden
Authors: Malmquist Anna , Bredenberg Cecilia , Melin Jennifer , Wurm Matilda , Tasker Fiona , Gato Jorge
Published: September 2022

The COVID‐19 pandemic led to major restrictions of everyday life activities. This worsened the social situation of many people, and marginalized groups have been especially affected. This article explores how LGBTQ+ young adults in Sweden have been affected by the COVID‐19 pandemic and the subsequent recommendations and restrictions. Fifteen participants between 20–29 years, who self‐identified as lesbian, gay, bisexual, transgender, and queer (LGBTQ+), were interviewed about their experiences. A thematic analysis of the data showed that the participants perceived their psychological wellbeing to have been greatly affected by the pandemic. Several reported symptoms of clinical depression, as well as anxiety, worry, rumination, and a heightened sensitivity to stress. Stressors included fear of the disease itself, and fear of spreading the virus, as well as the negative consequences of adhering to the recommendations of social distancing, which constantly interplayed with the marginalized position of being a young LGBTQ+ person. Most participants experienced a decrease in minority stress in face‐to‐face interaction with social distancing measures in place, but an increase in minority stress online. Those who faced minority stress at home experienced the isolation as particularly stressful. Limited access to the LGBTQ+ community was a common stressor. For transgender participants, the effects on transgender healthcare, such as prolonged waiting times for gender dysphoria assessment and hormone treatment, were a major challenge. Our results have added valuable knowledge to research indicating how vulnerable young adults were highly affected by the COVID‐19 pandemic restrictions.
The Structures of Visual Components on a Print Advertisement: A Case on Multimodal Analysis
Authors: Herman Herman , Sulistyani Sulistyani , Ngongo Magdalena , Fatmawati Endang , Saputra Nanda
Published: September 2022

The goal of this study is to undertake a multimodal analysis of a print advertisement for the Samsung Galaxy S5. According to Cheong (2004), the  general structure of print advertisements is as follows: Capture^Focus^Justification. This structure encompasses both the verbal and visual aspects of advertising. The goal of this study is to describe the structure of multimodal analysis observed in a print advertisement for the Samsung Galaxy S5. To achieve the research's goal, descriptive qualitative research was used. The information, which is a print advertisement, was gathered via Google image results. As a result, some data analysis procedures include searching for and printing the Samsung Galaxy S5 print advertisement from a google image result, reading the text and attempting to analyze the advertisement, classifying and analyzing the data (advertisement) according to the verbal and visual components as presented by Cheong (2004), and finally drawing a conclusion. Finally, the researchers discovered that the structure of verbal (Announcement, Enhancer, Emblem, Tag, Cal-and-visit information) and visual (Lead, Display, and Emblem) components are included in the advertisement.
Modern Communication Techniques as Means of Breaking the Cultural Barrier of Arab-Bedouin Youth and Jewish Youth
Authors: Abu-Gweder Aref
Published: September 2022

New media have facilitated communication all over the world and we are able to maintain long-distance relationships. The purpose of this study was to investigate how young Arab Bedouin people engage with their friends online via social networking sites. The researchers employed 200 questionnaires to gather information from Jewish and Arab-Bedouin users of social networking sites. According to the findings, online interaction between Bedouin and Jewish teenagers in the Arab world helped them acquire social and emotional experiences. Additionally, many mentioned how communicating online has improved their perceptions of and relationships with Jews. This kind of communication is more important for exposing people to different cultures because it does not put their community membership at risk. The results of this study are an initial encouragement to modify the relations between young people in the country. It is also a golden opportunity for Arab Bedouin youth to get to know the Jewish community. Therefore, this study emphasizes the interaction between the two communities, which differ in religion, language and cultural heritage.
Scalable Multi-Material Additive Manufacturing of Bioinspired Polymeric Material With Metallic Structures Via Electrically Assisted Stereolithography
Authors: Tang Tengteng , Ahire Bhushan , Li Xiangjia
Published: September 2022

Heterogeneous material systems consisting of metallic structures and polymer matrixes are of significance for applications such as integrated circuits, microelectromechanical devices, antennas, sensors, actuators, and metamaterials. Scaly-foot snail which lives in the deep ocean exhibits high strength and temperature resistance due to unique shells made of metal and polymer. Recently, different multi-material structures have been fabricated with metal deposition using multiple manufacturing processes. However, using these complicated hybrid processes is challenging to construct complexthree-dimensional (3D) structures of heterogeneous material with enhanced properties, high resolution, and time efficiency. Here, we establish a novel manufacturing strategy to build bioinspired hierarchical structures with heterogeneous material systems using electrically assisted stereolithography. The photocurable printing solution that can act as an electrolyte for charge transfer was developed, and the curing characteristic of the printing solution was further investigated. A fundamental understanding of the formation mechanism of metallic structures on the polymer matrix was studied through physics-based multi-scale modeling and simulations. The correlation between metallic structures morphology, printing solution properties, and printing process parameters, and their effects in building bioinspired hierarchical structures with heterogeneous materials were identified. Demonstrative test cases were built to verify the printing performance of the proposed approach. This research work will deliver a scalable additive manufacturing (AM) process that can facilitate various interesting applications based on bioinspired heterogeneous material and structures.
A Voxel-Based End Milling Simulation Method to Analyze the Elastic Deformation of a Workpiece
Authors: Kaneko Kazuki , Shimizu Jun , Shirase Keiichi
Published: September 2022

A new method to analyze the elastic deformation of a workpiece during end milling is proposed. One of the advantages of this method is the possibility of easily combining it with a voxel-based milling simulation, which is often used to predict cutting force, and to predict machining error due to workpiece deflection. With this method, the workpiece is discretely represented by voxels connected to their neighboring voxels with beam elements. Although the finite element method (FEM) is generally used for deformation analysis, it requires substantial time to analyze the deformation. In contrast, the proposed method does not require much time for remeshing, as the workpiece shape change is represented by removing voxels, and the stiffness matrix can be easily updated from the stiffness matrix obtained before the shape change. By conducting the preliminary analysis using coarse voxels and estimating the initial value of the solution, our method also reduces the number of iterations required to determine the deformation. The proposed method was integrated into the voxel-based cutting force prediction method in order to simulate the workpiece deformation caused by the cutting force. Therefore, the cutting force and the resulting workpiece deflection are seamlessly predicted using a voxel model. The results of a verification experiment showed that the analyzed workpiece deformation was in rough agreement with the measured deformation. Our future work is to predict the machining error induced by the workpiece elastic deformation based on this method and to integrate it with our previous work on the prediction of machining error induced by elastic deformation of the tool.
Conservativity Spectra and Joosten–Fernández Model
Authors: Beklemishev L. D.
Published: September 2022

We study a generalization of the notion of conservativity spectrum of an arithmetical theory to a language with transfinitely many truth definitions. We establish a natural correspondence of conservativity spectra and points of a special Kripke model introduced and studied by D. Fernández–Duque and J. Joosten. For iterated reflection principles over theories of truth definitions we also establish conservation results analogous to the well-known Schmerl formulas.
Game mechanics in eHealth interventions promoting self-management in young people with chronic diseases: a protocol for a systematic review and meta-analyses from the eHealth Junior Consortium
Authors: Estévez-López Fernando , Levelt Lisa , van ’t Veer Job , Hrehovcsik Micah M , Visch Valentijn , Bramer Wichor M , Hillegers Manon H. J. , van de Putte Elise , Veltkamp Remco C , Nijhof Sanne L
Published: September 2022

Introduction

Young people (aged 10–25 years) with chronic diseases are vulnerable to have reduced social participation and quality of life. It is important to empower young people to engage in their chronic diseases self-management. In comparison with traditional face-to-face care, interventions delivered through the internet and related technologies (eHealth) are less stigmatising and more accessible. Gamified eHealth self-management interventions may be particularly promising for young people. This systematic review aims at identifying (1) the game mechanics that have been implemented in eHealth interventions to support young people’s self-management of their chronic (somatic or psychiatric) diseases, (2) the investigators’ rationale for implementing such game mechanics and, if possible, (3) the effects of these interventions.

Methods and analysis

The Preferred Reporting Items for Systematic reviews and Meta-Analysis statement guidelines will be followed. A systematic search of the literature will be conducted in Embase, Psycinfo and Web of Science from inception until 30 August 2022. Studies will be eligible if focused on (1) young people (aged 10–25 years) with chronic diseases and (2) describing gamified eHealth self-management interventions. When possible, the effects of the gamified interventions will be compared with non-gamified interventions or care-as-usual. Primary quantitative, qualitative or mixed-method studies written in English will be included. Two independent reviewers will (1) select studies, (2) extract and summarise the implemented game mechanics as well as the characteristics of the intervention and study, (3) evaluate their methodological quality and (4) synthesise the evidence. The reviewers will reach a consensus through discussion, and if required, a third researcher will be consulted.

Ethics and dissemination

As systematic reviews use publicly available data, no formal ethical review and approval are needed. Findings will be published in peer-reviewed journals, presented at conferences and communicated to relevant stakeholders including patient organisations via the eHealth Junior Consortium.

PROSPERO registration number

CRD42021293037.
Modification of social determinants of health by critical illness and consequences of that modification for recovery: an international qualitative study
Authors: McPeake Joanne , Boehm Leanne , Hibbert Elizabeth , Hauschildt Katrina , Bakhru Rita , Bastin Anthony , Butcher Brad , Eaton Tammy , Harris Wendy , Hope Aluko , Jackson James , Johnson Annie , Kloos Janet , Korzick Karen , McCartney Judith , Meyer Joel , Montgomery-Yates Ashley , Quasim Tara , Slack Andrew , Wade Dorothy , Still Mary , Netzer Giora , Hopkins Ramona O , Mikkelsen Mark E , Iwashyna Theodore , Haines Kimberley , Sevin Carla
Published: September 2022

Objectives

Social determinants of health (SDoH) contribute to health outcomes. We identified SDoH that were modified by critical illness, and the effect of such modifications on recovery from critical illness.

Design

In-depth semistructured interviews following hospital discharge. Interview transcripts were mapped against a pre-existing social policy framework: money and work; skills and education; housing, transport and neighbourhoods; and family, friends and social connections.

Setting

14 hospital sites in the USA, UK and Australia.

Participants

Patients and caregivers, who had been admitted to critical care from three continents.

Results

86 interviews were analysed (66 patients and 20 caregivers). SDoH, both financial and non-financial in nature, could be negatively influenced by exposure to critical illness, with a direct impact on health-related outcomes at an individual level. Financial modifications included changes to employment status due to critical illness-related disability, alongside changes to income and insurance status. Negative health impacts included the inability to access essential healthcare and an increase in mental health problems.

Conclusions

Critical illness appears to modify SDoH for survivors and their family members, potentially impacting recovery and health. Our findings suggest that increased attention to issues such as one’s social network, economic security and access to healthcare is required following discharge from critical care.