bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral Arterial Disease Management: Insights From the SerbVasc Registry
Authors: Tanaskovic Slobodan , Ilijevski Nenad , Davidovic Lazar , Petrovic Jovan , Zekic Petar , Milacic Aleksandra , Vujcic Aleksandra , Roganovic Andrija , Martinovic David , Popovic Miroslava , Crnokrak Bogdan , Jokovic Vuk , Damnjanovic Zoran , Vukasinovic Ivan , Tomic Aleksandar , Zoranovic Radivoje , Koncar Igor
Published: December 2024

Background:

This report contributes to VASCUNET data on treating peripheral artery disease (PAD) in Serbia, addressing sex differences, revascularization types, procedure characteristics, and morbidity and mortality.

Methods:

SerbVasc, part of the VASCUNET collaboration, includes vascular procedures from 27 Serbian hospitals. Data from 1681 PAD patients were analyzed, focusing on sex disparities, diabetes prevalence, previous procedures, infection and tissue loss, and morbidity and mortality rates.

Results:

Males formed the majority, comprising 1169 (69.5%) of the patients. Men were significantly more often treated open surgically compared to women (77.6% vs 68.0%; p=0.000). Diabetes stood at 40.2% prevalence. Smoking history was noted in 61.9% of patients, predominantly males. Complication rates stood at 7.5%, with diabetic patients more prone to reinterventions and graft restenosis. The in-hospital mortality rate was 1.6%, with significant predictors of mortality including urgent procedures and recent myocardial infarction. The severity of the infection was correlated with diabetes (r=0.250, p=0.000) and previous amputations (r=0.186, p=0.000). Patients undergoing revascularization followed by minor amputations had a significantly lower incidence of major amputation (0.1% vs 2.9%, p=0.000).

Conclusions:

SerbVasc data provides a comprehensive overview of PAD management, highlighting the significant impact of diabetes and smoking on disease progression and outcomes.

Clinical Impact

This study highlights critical aspects of PAD management in developing countries, emphasizing sex differences, risk factors, and outcomes. Males predominated and are more likely to undergo open surgery. Diabetes and smoking significantly influenc disease progression, with diabetic patients experiencing higher rates of graft restenosis and reinterventions. Urgent procedures and recent myocardial infarctions are key predictors of in-hospital mortality. Combining revascularization with minor amputations reduced major amputation rates. These findings provide valuable data for tailoring treatment strategies, optimizing resource allocation, and improving outcomes for PAD patients, with implications extending beyond Serbia to similar healthcare systems.
Information Disclosure in Franchising Systems: Legal Practice and Prospects for Regulatory Reform in China
Authors: Zhang Hongjiao , Chen Fanhong
Published: December 2024

This study uses doctrinal, empirical, and case analysis methods to examine one of the most important yet controversial issues in franchising systems: information disclosure. It aims to demonstrate the current status of franchise disclosure laws in China, identify related problems, and propose legislative reforms to resolve such problems. In this study, cases heard in Chinese courts from 2017 to 2021 were analyzed. The results suggest that, despite their increasing importance, the current disclosure laws provide insufficient guidance, as courts create discrepancies in applying the laws, resulting in uncertainty. Considering this, and to strike a fine balance between the compliance burden on the franchisor and protection of franchisees, this study proposes a new legal framework in which the disclosed information is classified into two types: a closed record of core information to improve cooperation between the franchisor and franchisees and an open record of general information to promote good faith negotiations. Furthermore, regulation of full disclosure and the liability of its non-compliance with respect to the two types of information can be distinguished. This framework can provide courts with guidance in solving disclosure disputes in a more systematic, transparent, and consistent manner.
The Associations Among Self-Isolation During COVID-19, Depressive Symptoms, and Financial Stress: The Moderation of Technology Use for Relationship Maintenance
Authors: Wright Michelle F. , Wachs Sebastian
Published: December 2024

The purpose of this study was to examine the moderating effects of technology use for relationship maintenance on the longitudinal associations among self-isolation during COVID-19, depressive symptoms, and financial stress. Participants were 606 (53% female; M age = 20.36, SD = .99; 57% Caucasian) emerging adults. Data were collected in May 2020 (Time 1) and again in November 2020 (Time 2). Findings revealed that increases in self-isolation during COVID-19 related positively to technology use for relationship maintenance, Time 2 depressive symptoms, and Time 2 financial stress. High use of technology for relationship maintenance buffered against the negative effects of self-isolation during COVID-19 on emerging adults’ depressive symptoms and financial stress at Time 2, whereas lower use strengthened the positive relationship. These findings suggest the importance of considering the implications of societal crises or pandemics on emerging adults’ mental health and financial stress.
What contributes to older Korean American immigrants becoming frail? A qualitative study
Authors: Sagong Hae , Chon Myoung-Gi , Tsai Pao-Feng , Jang Ah Ram
Published: December 2024

Background

Frailty is prevalent in older adults and represents a dynamic condition that can improve with early detection and interventions focused on influencing factors. Older immigrant populations, marked by diverse cultural backgrounds, distinct health beliefs and behaviors, language barriers, and low health literacy, require a focused exploration of factors influencing frailty. This study examines the perceived factors affecting frailty among older Korean American immigrants (OKAIs).

Methods

A focus group interview was conducted with nine OKAIs (five frail/prefrail and four robust) in Alabama, supplemented by demographic and health-related surveys. Semi-structured questions addressed health literacy, physical activity, nutrition, and mental health. Data analysis included both descriptive and content analysis methods.

Results

Participants displayed notable differences in health literacy scores between Korean and English assessments. Content analysis highlighted that social activities, health behaviors, and healthcare utilization for OKAIs were shaped by distinct environmental and healthcare contexts compared to those in Korea. Limited English proficiency and access to healthcare resources further influenced their experiences. Participants expressed a preference for Korean healthcare providers, interpreters, and traditional food options to maintain well-being.

Conclusion

Interventions aimed at preventing and managing frailty among OKAIs should consider their unique characteristics and challenges to improve effectiveness.
Using co-design to understand consumer’s health information-seeking behaviours and design preferences for a new digital clinical dashboard in aged care
Authors: Nguyen Amy D , Dodds Laura , Ludlow Kristiana , Baysari Melissa , Comi Rosa , Zheng Wu Yi , Westbrook Johanna I
Published: December 2024

Background

Little is known about the information needs of older people and their family caregivers, particularly around medication management. This is largely because this population are infrequently consulted in research. Health technologies such as digital dashboards can present comprehensive and timely data summaries to improve knowledge and guide decision-making.

Objectives

The aim of this study was to understand current information seeking-behaviours of aged care service users and their families, and their preferences for the presentation of these types of information to support the co-design of a digital aged care dashboard.

Methods

Aged care clients (community and residential aged care) and their family members were invited to participate in semi-structured, one-on-one interviews conducted over the telephone. The interviews explored how participants sought health information, how this information supported their clinical decision-making, and how they would want this information to be presented via a digital dashboard. Interviews were audio-recorded, transcribed verbatim and independently analysed using an inductive content approach by three reviewers to identify prominent categories.

Results

Aged care clients and family members sought health information from healthcare providers, aged care facilities and the Internet. Information regarding medications, medical conditions and an overview for family members were of particular importance to participants. Participants saw the usefulness of a digital dashboard displaying relevant information, and provided suggestions regarding presentation of this information. This included the use of large text, representative colours, symbols and graphs. Participants recommended being able to tailor the dashboard to individual end-users.

Conclusions

By engaging aged care clients and their families in research, it was found that they had positive views about a digital dashboard that presented clinical information and was readily accessible. Such a dashboard could complement their current practices of information-seeking. However, for the dashboard to be effective for this population, several suggestions for its design were raised. Understanding the information-seeking behaviours of aged care clients and their families, together with knowledge of the information that is important to them, and then subsequent incorporation of this information into a digital dashboard that reflects their design preferences, could lead to more informed decision-making in this population.
Strategies to reduce 28-day mortality in adult patients with bacteremia in the emergency department
Authors: Laurier Noémie , Karellis Angela , Xue Xiaoqing , Afilalo Marc , Weiss Karl
Published: December 2024

Background

Bacteremia, a common emergency department presentation, has a high burden of mortality, cost and morbidity. We aimed to identify areas for potential improvement in emergency department bacteremia management.

Methods

This retrospective cohort study included adults with bacteremia in an emergency department in 2019 and 2022. The primary outcome was 28-day mortality. Descriptive analyses evaluated demographics, comorbidities and clinical characteristics. Univariate and multivariate analyses identified mortality predictors.

Results

Overall, 433 patients were included [217 males (50.1%), mean ± SD age: 74.1 ± 15.2 years]. The 28-day mortality rate was 15.2% (n = 66). In univariate analysis, age ≥ 70 years, arrival by ambulance, arrhythmia, congestive heart failure, recent steroid use, hypotension (< 90/60 mmHg), mechanical ventilation, cardiac arrest, intensive care unit (ICU) admission, intravenous antibiotics, pneumonia as bacteremia source, non-urinary tract infections, no infectious disease consultation, no antibiotic adjustment and no control blood cultures were significantly associated with 28-day mortality (p < 0.05). Malignancy showed a statistical trend (0.05 < p < 0.15). The above-stated sixteen variables, identified in univariate analysis, were assessed via multivariate analysis. Primarily, clinical relevance and, secondarily, statistical significance were used for multivariate model creation to prioritize pertinent variables. Five risk factors, significantly associated with mortality (p < 0.05), were included in the model: ICU admission [adjusted OR (95% CI): 6.03 (3.08–11.81)], pneumonia as bacteremia source [4.94 (2.62–9.32)], age ≥ 70 [3.16 (1.39–7.17)], hypotension [2.12 (1.02–4.40)], and no infectious disease consultation [2.02 (1.08–3.78)]). Surprisingly, initial antibiotic administration within 6 h, inappropriate initial antibiotic regimen and type of bacteria (Gram-negative, Gram-positive) were non-significant (p > 0.05).

Conclusions

We identified significant mortality predictors among emergency department patients presenting with bacteremia. Referral to an infectious disease physician is the only modifiable strategy to decrease 28-day mortality with long-term effect and should be prioritized.
Diet and Immune Effects Trial (DIET)- a randomized, double-blinded dietary intervention study in patients with melanoma receiving immunotherapy
Authors: Farias Rachel M. , Jiang Yan , Levy Erma J. , Hwang Cindy , Wang Jian , Burton Elizabeth M. , Cohen Lorenzo , Ajami Nadim , Wargo Jennifer A. , Daniel Carrie R. , McQuade Jennifer L.
Published: December 2024

Background

Gut microbiome modulation is a promising strategy for enhancing the response to immune checkpoint blockade (ICB). Fecal microbiota transplant studies have shown positive signals of improved outcomes in both ICB-naïve and refractory melanoma patients; however, this strategy is challenging to scale. Diet is a key determinant of the gut microbiota, and we have previously shown that (a) habitual high dietary fiber intake is associated with an improved response to ICB and (b) fiber manipulation in mice impacts antitumor immunity. We recently demonstrated the feasibility of a controlled high-fiber dietary intervention (HFDI) conducted in melanoma survivors with excellent compliance and tolerance. Building on this, we are now conducting a phase II randomized trial of HFDI versus a healthy control diet in melanoma patients receiving ICB.

Methods

This is a randomized, double-blind, fully controlled feeding study that will enroll 45 melanoma patients starting standard-of-care (SOC) ICB in three settings: adjuvant, neoadjuvant, and unresectable. Patients are randomized 2:1 to the HFDI (target fiber 50 g/day from whole foods) or healthy control diet (target fiber 20 g/day) stratified by BMI and cohort. All meals are prepared by the MD Anderson Bionutrition Core and are isocaloric and macronutrient-controlled. The intervention includes a 1-week equilibration period and then up to 11 weeks of diet intervention. Longitudinal blood, stool and tumor tissue (if available) are collected throughout the trial and at 12 weeks post intervention.

Discussion

This DIET study is the first fully controlled feeding study among cancer patients who are actively receiving immunotherapy. The goal of the current study is to establish the effects of dietary intervention on the structure and function of the gut microbiome in patients with melanoma treated with SOC immunotherapies. The secondary endpoints include changes in systemic and tumor immunity, changes in the metabolic profile, quality of life, symptoms, disease response and immunotherapy toxicity.

Trial registration

This protocol is registered with the U.S. National Institutes of Health trial registry, ClinicalTrials.gov, under the identifier NCT04645680. First posted 2020-11-27; last verified 2024-06.
Care coordinator delivered Method of Levels therapy for people reporting first-episode psychosis: Experiences and views of service user, care coordinator, and team manager participants of the CAMEO trial
Authors: Griffiths Robert , Tai Sara , Ormrod Susan , Welsh Natalie , Jones Adam , Palmier-Claus Jasper , Dixon James , Dawber Alison , Lovell Karina
Published: December 2024

Background

Without effective and timely support, psychosis can lead to negative personal, economic, and societal outcomes. Care coordinators play a key role in the delivery of early intervention in psychosis services, which aim to improve outcomes and promote recovery for people experiencing first-episode psychosis. Enhancing the support offered by care coordinators could improve outcomes and reduce levels of service user disengagement. This study aimed to understand participants’ views on the acceptability of a transdiagnostic talking therapy, called Method of Levels (MOL), delivered by care coordinators in early intervention in psychosis services. It also sought to understand participants’ experiences of the MOL training and supervision programme, and to identify any barriers that might impact on the implementation of the approach in routine practice.

Methods

Semi-structured interviews and focus groups were conducted with service users (n = 14), care coordinators (n = 6), and team managers (n = 6) from early intervention in psychosis services. Interviews and focus groups were transcribed and reflexive thematic analysis was used to analyse the data.

Results

Three themes were identified: ‘Digging deeper to find my own solutions’; (2) ‘Prepared for practice?’; and (3) ‘Levels of implementation’. Participants described how the use of MOL enabled service users to explore problems in greater depth and generate their own solutions to these. Care coordinators generally reported feeling ready to deliver the intervention after attending MOL training and were able to integrate the approach into their practice in a flexible way. High workloads limited care coordinators’ capacity to attend MOL supervision regularly, reducing their overall confidence in delivering the approach. This impacted on the degree to which care coordinators used MOL in their practice.

Conclusions

Findings suggest that MOL delivered by care coordinators could be a helpful approach for people experiencing first-episode psychosis. Care coordinators found it difficult to attend clinical supervision, however, which represents a barrier to implementation. This issue will need to be addressed before care coordinator delivered-MOL for first-episode psychosis can be evaluated in a larger study or implemented in practice.
Quality of cognitive-behavioural therapy in routine psychiatric care: therapist adherence and competence, and patient outcomes for depression and anxiety disorders
Authors: Bergvall Hillevi , Linde Johanna , Alfonsson Sven , Sunnhed Rikard , Barber Jacques P. , Lundgren Tobias , Andersson Gerhard , Bohman Benjamin
Published: December 2024

Background

Quality of care is essential for the dissemination of evidence-based practices, yet therapist adherence and competence are seldom assessed. We examined the quality of delivery of cognitive-behavioural therapy (CBT) in routine psychiatric care for depression and anxiety disorders, considering therapist adherence and competence, and therapy effectiveness, as well as their associations.

Methods

Twenty-nine therapists recruited 85 patients with a principal diagnosis of depression or anxiety disorder from two routine psychiatric outpatient clinics in Stockholm, Sweden. Therapist adherence was assessed mid-CBT by observers and post-CBT by patients and therapists, respectively, using an instrument developed as part of the present study. Therapist competence was assessed using role-plays with a standardised patient. Patients rated symptoms, functional impairment, and global health pre- and post-CBT. Linear mixed models were used to analyse associations.

Results

Therapist adherence was high according to patients, moderate to high according to therapists, and moderate according to observers. Most therapists demonstrated competence in CBT, as assessed using the Cognitive Therapy Scale-Revised (M = 40.5, SD = 6.5; 76% passed the ≥ 36 points competence threshold). Patients improved significantly from pre- to post-CBT across outcome measures (Cohen’s ds = 0.80 – 1.36). Neither therapist adherence nor competence was associated with patient outcomes.

Conclusions

In routine psychiatric care, therapists delivered CBT with adherence, competence, and improvements for patients with depression and anxiety disorders, on par with previous research results in controlled settings. The implications for quality assessment and improvement are discussed.

Trial registration

ClinicalTrials.gov NCT03625024 10/08/2018.
Overdiagnosis of dental caries in South Korea: a pseudo-patient study
Authors: Son Ji-Young , Park Yuyi , Park Ji-Yeon , Kim Min-Ji , Han Dong-Hun
Published: December 2024

Background

To evaluates the tendency of South Korean dentists to over-diagnose clinically healthy teeth in pseudo-patients.

Methods

We conducted a pseudo-patient, cross-sectional study in 196 private dental clinics with 58 pseudo-patients in South Korea between August and December 2018. Trained pseudo-patients with no previous oral diseases, including dental caries, diagnosed by two experienced dentists, were sent to each dental clinic. Before visiting each private dental clinic, participants were instructed to state, “I have no symptoms, but I would like to have a dental caries examination”. The oral examination was performed using visual and tactile inspection methods only. The interactions between the dental clinic staff and the pseudo-patient were documented on a data collection form shortly after each visit.

Results

In 33.2% (65/196) of these interactions, the pseudo-patients were diagnosed as having no dental caries. 11.7% (23/196), 12.8% (25/196), 10.7% (21/196), and 10.7% (21/196) of the sample were diagnosed with dental caries in one, two, three, and four teeth, respectively. Dentists diagnosed five or more dental caries in 20.9% (41/196) of the sample. 196 dental clinics diagnosed a total of 503 dental caries. Of these, 392 were in molars. Small solo practice dentists diagnosed 3.54 dental caries and large group practice dentists 1.57, but the difference was not significant (p = 0.07). The recommendation rate for dental caries treatment was highest among 43 (55.1%) large solo practices, and lowest in 7 (33.3%) large group practices. However, small solo practices had the lowest rate of preventive care recommendations at 12 (30.8%) and 10 (47.6%) in large group practices. The data shows that preventive care recommendations increased as the practice size increased.

Conclusion

The study findings indicate that Korean dentists tend to over-diagnose dental caries, which could pose a threat to public health both in Korea and worldwide. Therefore, it is important to carefully consider strategies to improve the correct diagnosis and standard of care for dental caries by private dentists.
Lost in translation: a qualitative study of medical students’ experiences of theoretical and practical teaching of empathy
Authors: von Knorring Johanna , Salmi Johanna , Lehti Arja , Semb Olof
Published: December 2024

Background

Empathy has proven to be a fundamental component in the patient-doctor relationship and correlates to several positive outcomes in patient care. Despite this, research suggests that empathy decreases during medical education. To increase the understanding of empathy development during medical education, this study explores medical students’ experiences of learning empathy in the transition from theoretical to practical context.

Methods

Eleven semi-structured interviews with students at a medical school in Sweden. The interviews were transcribed verbatim and analysed using grounded theory.

Results

The analysis resulted in three categories and a core category “Lost in translation”. Early on, students regard empathy as a valued and necessary skill. While students generally encounter high expectations of being empathic, they also met gendered expectations. There is a mismatch between the theoretical and the practical teaching of empathy. The core category refers both to the students feeling lost in their own professional development and empathy becoming lost in the translation from theory to clinical practice.

Conclusion

The results describe clashes between theory and clinical reality and the efforts of the students to develop and maintain empathy in this context. To encourage students to develop empathy it is necessary for both educators and practitioners to acknowledge, and attempt to bridge, the gap between the theoretical and the practical curriculum regarding empathy.
Systematic quantitative modeling of the natural history of Aicardi syndrome: A cross sectional study of 245 published cases
Authors: Urban Oliver Y. , Driedger Jan H. , Garbade Sven F. , Hoffmann Georg F. , Kölker Stefan , Ries Markus , Syrbe Steffen
Published: December 2024

Purpose

Aicardi syndrome is a rare epileptic encephalopathy, almost exclusively affecting girls. It was first described as a triad of infantile spasms, chorioretinal defects and agenesis of the corpus callosum. The etiology remains unknown and there is uncertainty on best practice therapy and outcome. We aimed at defining quantitative clinical endpoints that will inform future research and clinical trials.

Methods

Quantitative natural history modeling of cases with Aicardi syndrome from published clinical reports. Main outcome measures were age at disease onset, survival and diagnostic delay. Phenotypic features of affected individuals as well as neuroradiological and ophthalmological features were descriptively stated. STROBE criteria were respected.

Results

Two hundred forty-five cases were available for analysis. Median age at disease onset was 2.2 months. Median diagnostic delay was 1 month. Mortality was estimated with 6% at 1 and 17% at 5 years of age. 60% of children showed the classic clinical features, while 40% met the revised diagnostic criteria. We delineate possible predictors of disease severity and of seizure control.

Conclusion

We provide natural history data including geographical localization of 245 published patients with Aicardi syndrome. Quantitative history modeling in rare epileptic encephalopathies will help to raise disease awareness and facilitate future clinical trials as one core element of quantitative systems pharmacology.
Revisiting mutational resistance to ampicillin and cefotaxime in Haemophilus influenzae
Authors: Diricks Margo , Petersen Sabine , Bartels Lennart , Lâm Thiên-Trí , Claus Heike , Bajanca-Lavado Maria Paula , Hauswaldt Susanne , Stolze Ricardo , Vázquez Omar Jiménez , Utpatel Christian , Niemann Stefan , Rupp Jan , Wohlers Inken , Merker Matthias
Published: December 2024

Background

Haemophilus influenzae is an opportunistic bacterial pathogen that can cause severe respiratory tract and invasive infections. The emergence of β-lactamase-negative ampicillin-resistant (BLNAR) strains and unclear correlations between genotypic (i.e., gBLNAR) and phenotypic resistance are challenging empirical treatments and patient management. Thus, we sought to revisit molecular resistance mechanisms and to identify new resistance determinants of H. influenzae.

Methods

We performed a systematic meta-analysis of H. influenzae isolates (n = 291) to quantify the association of phenotypic ampicillin and cefotaxime resistance with previously defined resistance groups, i.e., specific substitution patterns of the penicillin binding protein PBP3, encoded by ftsI. Using phylogenomics and a genome-wide association study (GWAS), we investigated evolutionary trajectories and novel resistance determinants in a public global cohort (n = 555) and a new clinical cohort from three European centers (n = 298), respectively.

Results

Our meta-analysis confirmed that PBP3 group II- and group III-related isolates were significantly associated with phenotypic resistance to ampicillin (p < 0.001), while only group III-related isolates were associated with resistance to cefotaxime (p = 0.02). The vast majority of H. influenzae isolates not classified into a PBP3 resistance group were ampicillin and cefotaxime susceptible. However, particularly group II isolates had low specificities (< 16%) to rule in ampicillin resistance due to clinical breakpoints classifying many of them as phenotypically susceptible. We found indications for positive selection of multiple PBP3 substitutions, which evolved independently and often step-wise in different phylogenetic clades. Beyond ftsI, other possible candidate genes (e.g., oppA, ridA, and ompP2) were moderately associated with ampicillin resistance in the GWAS. The PBP3 substitutions M377I, A502V, N526K, V547I, and N569S were most strongly related to ampicillin resistance and occurred in combination in the most prevalent resistant haplotype H1 in our clinical cohort.

Conclusions

Gradient agar diffusion strips and broth microdilution assays do not consistently classify isolates from PBP3 groups as phenotypically resistant. Consequently, when the minimum inhibitory concentration is close to the clinical breakpoints, and genotypic data is available, PBP3 resistance groups should be prioritized over susceptible phenotypic results for ampicillin. The implications on treatment outcome and bacterial fitness of other extended PBP3 substitution patterns and novel candidate genes need to be determined.
Behavioral decline in Shank3Δex4–22 mice during early adulthood parallels cerebellar granule cell glutamatergic synaptic changes
Authors: Kshetri Rajaram , Beavers James O. , Hyde Romana , Ewa Roseline , Schwertman Amber , Porcayo Sarahi , Richardson Ben D.
Published: December 2024

Background

SHANK3, a gene encoding a synaptic scaffolding protein, is implicated in autism spectrum disorder (ASD) and is disrupted in Phelan-McDermid syndrome (PMS). Despite evidence of regression or worsening of ASD-like symptoms in individuals with PMS, the underlying mechanisms remain unclear. Although Shank3 is highly expressed in the cerebellar cortical granule cells, its role in cerebellar function and contribution to behavioral deficits in ASD models are unknown. This study investigates behavioral changes and cerebellar synaptic alterations in Shank3Δex4–22 mice at two developmental stages.

Methods

Shank3Δex4–22 wildtype, heterozygous, and homozygous knockout mice lacking exons 4–22 (all functional isoforms) were subjected to a behavioral battery in both juvenile (5–7 weeks old) and adult (3–5 months old) mouse cohorts of both sexes. Immunostaining was used to show the expression of Shank3 in the cerebellar cortex. Spontaneous excitatory postsynaptic currents (sEPSCs) from cerebellar granule cells (CGCs) were recorded by whole-cell patch-clamp electrophysiology.

Results

Deletion of Shank3 caused deficits in motor function, heightened anxiety, and repetitive behaviors. These genotype-dependent behavioral alterations were more prominent in adult mice than in juveniles. Reduced social preference was only identified in adult Shank3Δex4–22 knockout male mice, while self-grooming was uniquely elevated in males across both age groups. Heterozygous mice showed little to no changes in behavioral phenotypes in most behavioral tests. Immunofluorescence staining indicated the presence of Shank3 predominantly in the dendrite-containing rosette-like structures in CGCs, colocalizing with presynaptic markers of glutamatergic mossy fiber. Electrophysiological findings identified a parallel relationship between the age-related exacerbation of behavioral impairments and the enhancement of sEPSC amplitude in CGCs.

Limitations

Other behavioral tests of muscle strength (grip strength test), memory (Barnes/water maze), and communication (ultrasonic vocalization), were not performed. Further study is necessary to elucidate how Shank3 modulates synaptic function at the mossy fiber-granule cell synapse in the cerebellum and whether these changes shape the behavioral phenotype.

Conclusions

Our findings reveal an age-related exacerbation of behavioral impairments in Shank3Δex4–22 mutant mice. These results suggest that Shank3 may alter the function of glutamatergic receptors at the mossy fiber-cerebellar granule cell synapse as a potential mechanism causing cerebellar disruption in ASD.
Illuminating the shadows: the role of private supplementary tutoring on student math performance in PISA 2022
Authors: Karakus Mehmet , Tlessov Alisher , Hajar Anas , Courtney Matthew
Published: December 2024

Recent decades have witnessed a global expansion of private supplementary tutoring, known as shadow education—additional support in academic subjects that takes place outside of regular school hours. Using the data of 55 countries from the Programme for International Student Assessment (PISA) 2022, this study examines the association between students’ participation in shadow education and their academic achievement in mathematics and how these relationships change for developed, developing, and East Asian regions. This study also sheds light on the moderating effect that socio-economic status has on the relationship between engagement in shadow education and math performance. Multilevel regression analyses revealed that, at the between-school level, only one of the five forms of shadow education, namely the degree to which students received asynchronous video-recorded instruction, was associated with improved math performance. Similarly, at the within-school level, only the degree to which students received video-recorded instruction was statistically significantly associated with improved mathematical outcomes. Incidentally, we find that institutional-related school-level factors such as the overall quality of student–teacher relationships, provision of math-related extra-curricular activities, and support in terms of peer-to-peer tutoring appear to be associated with improved school math performance, while the quality of student–teacher relationships and level of math teacher support also feature positively for students within-schools. Regarding differential effects by region, at the between-school level, only the degree to which students received large-group study or practice was associated with math performance in East Asian countries. With regards to the moderating effect of SES on the positive relationship between asynchronous shadow education and math performance, we find the effects to be negative, suggesting that asynchronous engagement might be more beneficial for students from lower SES backgrounds. Finally, while the overall negative relationships between synchronous forms of shadow education and math performance appear counter-intuitive, we speculate that this may reflect the use of such tutoring for remedial purposes. We suggest that further research into these “remedial reverse effects” in post-COVID AI-bot-capable educational contexts may provide a more definitive understanding of the role that student engagement in shadow education has on their academic performance.
Recent progress in realizing novel one-dimensional polymorphs via nanotube encapsulation
Authors: Lee Yangjin , Choi Uje , Kim Kwanpyo , Zettl Alex
Published: December 2024

Encapsulation of various materials inside nanotubes has emerged as an effective method in nanotechnology that facilitates the formation of novel one-dimensional (1D) structures and enhances their functionality. Because of the effects of geometrical confinement and electronic interactions with host nanotubes, encapsulated materials often exhibit low-dimensional polymorphic structures that differ from their bulk forms. These polymorphs exhibit unique properties, including altered electrical, optical, and magnetic behaviors, making them promising candidates for applications in electronics, energy storage, spintronics, and quantum devices. This review explores recent advancements in the encapsulation of a wide range of materials such as organic molecules, elemental substances, metal halides, metal chalcogenides, and other complex compounds. In particular, we focus on novel polymorphs formed through the geometrical confinement effect within the nanotubes. The atomic structure, other key properties, and potential applications of these encapsulated materials are discussed, highlighting the impact of nanotube encapsulation on their functionalities.

Graphical Abstract
Evaluation of the contralateral ear in cases of unilateral chronic otitis media: a cross sectional observational study
Authors: Khan Yasir Abbas , Kanotra Sonika , Zehra Mehvish , Anjum Areena , Sharma Preeti , Majeed Farkhanda
Published: December 2024

Aims and objectives

To study the clinical status of contralateral ear in cases of unilateral CSOM.

Introduction

In the medical field, understanding the clinical status of the contralateral ear in cases of unilateral Chronic Suppurative Otitis Media (CSOM) is crucial for effective treatment. This study was conducted at Shri Maharaja Ghulab Singh Hospital in Jammu, India from November 2020 to October 2021, involving 105 patients who met the inclusion criteria.

Materials and methods

A thorough examination was carried out, including taking a detailed history of symptoms such as hearing loss, discharge, vertigo, tinnitus, and pain. An ENT examination was conducted, assessing the pinna, external auditory canal, tympanic membrane, and ossicles. Otoendoscopic examination of the ear and diagnostic nasal endoscopy were also performed to rule out any nasal pathology.

Results

Out of 105 patients in our study, 61 were females and 44 were males.

The main presenting symptoms were ear discharge alone in 84 patients followed by associated hearing impairment in 15, and 6 patients had tinnitus. Among 105 patients, the duration of ear discharge from > 5 years was seen in 36 patients, followed by 1–2 years in 29 patients, 2–5 years in 22 patients, and from < 1 year in 18 patients. Ninety-five patients were diagnosed to have mucosal COM and 10 had active squamosal disease. Thirty-four patients had subtotal perforation of pars tensa in the ipsilateral diseased, 26 patients had medium-sized perforation, 18 patients had small-sized perforations, 12 had large perforation, 10 had attic perforation, and 5 had total perforation. Thirty-four patients had a normal tympanic membrane of the contralateral ear and abnormalities of contralateral tympanic membrane were seen in 71 patients. Eighty-eight patients had deviated nasal septum on DNE. Among 105 patients, PTA assessment showed that 103 patients had a conductive hearing loss in the diseased ipsilateral ear. B type tympanogram was found in 70 diseased ears and the contralateral ear of those patients showed A type tympanogram in 20 and B-type tympanogram in 50 ears. C type tympanogram was seen in 35 diseased ears and the contralateral ear of those patients showed A type tympanogram in 12 patients and C type tympanogram in 23 patients. Contralateral mastoid X-ray showed well pneumatization in 45 patients followed by diploic type of pneumatization in 55 patients and sclerotic mastoid in 5 patients.

Conclusion

The findings of this study emphasize the importance of considering both ears in the treatment of CSOM. It is crucial to educate patients about the potential bilateral effects of the disease for proper therapy planning. This study sheds light on the significance of examining the contralateral ear in patients with unilateral CSOM. Understanding the clinical status of both ears can lead to more comprehensive treatment strategies and better outcomes for patients.
Social contagion, the psychiatric symptom pool and non-suicidal self-injury
Authors: Paris Joel
Published: December 2024

There is evidence that social contagion plays a role in shaping the clinical presentation of some psychiatric symptoms, particularly affecting features that vary over time and culture. Some symptoms can increase so rapidly in prevalence that they become ‘epidemic’. The mechanism involves a spread through peers and/or the media. Within broader domains of psychopathology, this process draws from a ‘symptom pool’ that can determine which specific symptoms will appear. This article illustrates these mechanisms by focusing on non-suicidal self-injury (NSSI), a syndrome that has been subject to social contagion and whose prevalence may have increased among adolescents.
The hypothalamic–pituitary–thyroid axis, depression and risk of suicide: commentary, Luo et al
Authors: Nemeroff Charles B.
Published: December 2024

There is a considerable literature on the relationship of thyroid function with risk of depression and responsiveness to depression treatment. This literature is briefly reviewed here, followed by a focus on the incremental advance provided by the findings of Luo et al on autoimmune thyroiditis and suicide attempts.
Parsing stigma's relationship with the psychosocial functioning of youth identified as at clinical high risk for psychosis: evaluating whether symptom stigma or labelling stigma is stronger
Authors: Yang Lawrence H. , Grivel Margaux M. , Blasco Drew , Girgis Ragy R. , Huang Debbie , Woodberry Kristen A. , Corcoran Cheryl M. , McFarlane William R. , Link Bruce G.
Published: December 2024

Background

The clinical high risk for psychosis (CHR-p) syndrome enables early identification of individuals at risk of schizophrenia and related disorders. We differentiate between the stigma associated with the at-risk identification itself (‘labelling-related’ stigma) versus stigma attributed to experiencing mental health symptoms (‘symptom-related’ stigma) and examine their relationships with key psychosocial variables.

Aims

We compare labelling- and symptom-related stigma in rates of endorsement and associations with self-esteem, social support loss and quality of life.

Method

We assessed stigma domains of shame-related emotions, secrecy and experienced discrimination for both types of stigma. Individuals at CHR-p were recruited across three sites (N = 150); primary analyses included those who endorsed awareness of psychosis risk (n = 113). Paired-sample t-tests examined differences in labelling- versus symptom-related stigma; regressions examined associations with psychosocial variables, controlling for covariates, including CHR-p symptoms.

Results

Respondents reported greater symptom-related shame, but more labelling-related secrecy. Of the nine significant associations between stigma and psychosocial variables, eight were attributable to symptom-related stigma, even after adjusting for CHR-p symptoms.

Conclusions

Stigma attributed to symptoms had a stronger negative association with psychosocial variables than did labelling-related stigma among individuals recently identified as CHR-p. That secrecy related to the CHR-p designation was greater than its symptom-related counterpart suggests that labelling-related stigma may still be problematic for some CHR-p participants. To optimise this pivotal early intervention effort, interventions should address the holistic ‘stigmatising experience’ of having symptoms, namely any harmful reactions received as well as participants’ socially influenced concerns about what their experiences mean, in addition to the symptoms themselves.
Adolf Weber's Munich School of Economics and Its Influence on the Early Bundesbank: The Example of Bernhard Benning
Authors: Greitens Jan
Published: December 2024

This article analyses the early years of the history of the Bundesbank from a history of economic thought perspective. The study uses the example of Bernhard Benning, who headed the Economics Department of the Reichs-Kredit-Gesellschaft, one of the major banks owned by the German Reich during the National Socialist era. After the war Benning was appointed a member of the board of directors of the Deutsche Bundesbank for twenty-two years. As a student of Adolf Weber and his Munich school of economics, Benning's views were shaped by classical liberal rather than ordoliberal ideas. His legitimacy in postwar Germany stemmed from his public opposition to war financing and warnings about inflation during the Donner-Benning Debate of 1942–43. In this tradition, the early Bundesbank was Weberian rather than ordoliberal, so, for instance, fixed exchange rates were favored, and a strong business and investment perspective was adopted.
James Weldon Johnson’s Feminization of Biraciality
Authors: Walker Rafael
Published: December 2024

In considering fictions centered on characters of mixed Black-and-white parentage, critics tend to assimilate these stories into African American literary paradigms—in much the same way that, in real life, America considers biracial people as simply black. Working against this reductive reflex, this essay reads James Weldon Johnson’s 1912 novel The Autobiography of an Ex-Colored Man as a serious exploration of biracial identity and experience. Specifically, the article argues that Johnson draws on early twentieth-century conceptions of femininity as a vehicle for rendering mainly three facets of the lives of many biracial men: (1) hypervisibility (in a world obsessed with skin color), (2) sexuality (when identification is distorted), and (3) self-determination (where a racial hierarchy appears to eliminate agency). In its conclusion, the article suggests that the prevailing tendencies among readers of the novel to condemn the ex-colored man stems from an investment in the trope of the “tragic mulatto”—a plot device that at once sentimentalizes the fates of biracial characters and links those fates inextricably to biology rather than ideology.
A Pax3 lineage gives rise to transient haematopoietic progenitors
Authors: Canu Giovanni , Correra Rosamaria , Diez-Pinel Guillermo , Castellan Raphaël F. P. , Denti Laura , Fantin Alessandro , Ruhrberg Christiana
Published: December 2024

During embryonic development, muscle tissues, skin, and a subset of vascular endothelial cells arise from Pax3-expressing embryonic progenitors defined as paraxial mesoderm. By contrast, haemogenic potential is well established for extra-embryonic mesoderm and intra-embryonic lateral plate mesoderm, which do not express Pax3. To date, it is not known whether the haematopoietic system also contains Pax3 lineage cells. Here, we show that the mouse foetal liver and foetal circulation contain a transient population of Pax3 lineage cells with hallmarks of haematopoietic progenitors and the potential to generate both myeloid and erythroid cells. We propose that Pax3 lineage haematopoietic cells should be investigated to better understand normal haematopoietic development from different mesodermal derivatives. Further, genetic alterations of Pax3 lineage haematopoietic cells should be investigated for their potential to cause haematopoietic malignancies.
Hedgehog-dependent and hedgehog-independent roles for growth arrest specific 1 in mammalian kidney morphogenesis
Authors: Franks Nicole E. , Allen Benjamin L.
Published: December 2024

Growth arrest specific 1 (GAS1) is a key regulator of mammalian embryogenesis, best known for its role in hedgehog (HH) signaling, but with additional described roles in the FGF, RET, and NOTCH pathways. Previous work indicated a later role for GAS1 in kidney development through FGF pathway modulation. Here, we demonstrate that GAS1 is essential for both mesonephrogenesis and metanephrogenesis – most notably, Gas1 deletion in mice results in renal agenesis in a genetic background-dependent fashion. Mechanistically, GAS1 promotes mesonephrogenesis in a HH-dependent fashion, performing a unique co-receptor function, while promoting metanephrogenesis in a HH-independent fashion, acting as a putative secreted RET co-receptor. Our data indicate that Gas1 deletion leads to renal agenesis through a transient reduction in metanephric mesenchyme proliferation – a phenotype that can be rescued by exogenous RET pathway stimulation. Overall, this study indicates that GAS1 contributes to early kidney development through the integration of multiple different signaling pathways.
Reprogramming of cells during embryonic transfating: overcoming a reprogramming block
Authors: Berrio Alejandro , Miranda Esther , Massri Abdull J. , Afanassiev Anton , Schiebinger Geoffrey , Wray Gregory A. , McClay David R.
Published: December 2024

Regulative development, demonstrated by many animal embryos, is the ability to replace missing cells or parts. The underlying molecular mechanism(s) of that ability is not well understood. If sea urchin micromeres (skeletogenic cell progenitors) are removed at the 16-cell stage, early endoderm initiates a sequential switch in cell fates, called transfating. Without micromeres, other mesoderm cells are absent as well, because their specification depends on signaling from micromeres. Most mesoderm cells later return by transfating, but pigment cells do not. Single-cell RNA sequencing, tracked over time, reveals the reprogramming sequence of those replacements. Beginning with an early endoderm specification state, cells progress through endomesoderm, then mesoderm, and finally distinct skeletogenic and blastocoelar cell specification states emerge, but pigment cells do not. Rescue of pigment cells was found to be a consequence of signal timing: if Delta is expressed prior to Nodal, pigment cells return. Thus, transfating operates through a series of gene regulatory state transitions, and reprogramming fails if endogenous negative signals occur prior to positive signals in the reprogramming sequence.