bluuebunny/crossref_metadata_2025 huggingface dataset:
The outer membrane protein, OMP71, of Riemerella anatipestifer, mediates adhesion and virulence by binding to CD46 in ducks
Authors: Wang Yanhua , Li Sen , Ning Congran , Yang Rongkun , Wu Yaxin , Cheng Xu , Xu Jike , Wang Yi , Liu Fei , Zhang Yang , Hu Sishun , Xiao Yuncai , Li Zili , Zhou Zutao
Published: October 2024

The Riemerella anatipestifer bacterium is known to cause infectious serositis in ducklings. Moreover, its adherence to the host’s respiratory mucosa is a critical step in pathogenesis. Membrane cofactor protein (MCP; CD46) is a complement regulatory factor on the surface of eukaryotic cell membranes. Bacteria have been found to bind to this protein on host cells. Outer membrane proteins (OMPs) are necessary for adhesion, colonisation, and pathogenicity of Gram-negative bacteria; however, the mechanism by which R. anatipestifer adheres to duck cells remains unclear. In this study, pull-down assays and LC–MS/MS identified eleven OMPs interacting with duck CD46 (dCD46), with OMP71 exhibiting the strongest binding. The ability of an omp71 gene deletion strain to bind dCD46 is weaker than that of the wild-type strain, suggesting that this interaction is important. Further evidence of this interaction was obtained by synthesising OMP71 using an Escherichia coli recombinant protein expression system. Adhesion and invasion assays and protein and antibody blocking assays confirmed that OMP71 promoted the R. anatipestifer YM strain (RA-YM) adhesion to duck embryo fibroblasts (DEFs) by binding to CD46. Tests of the pathogenicity of a Δomp71 mutant strain of RA-YM on ducks compared to the wild-type parent supported the hypothesis that OMP71 was a key virulence factor of RA-YM. In summary, the finding that R. anatipestifer exploits CD46 to bind to host cells via OMP71 increases our understanding of the molecular mechanism of R. anatipestifer invasion. The finding suggests potential targets for preventing and treating diseases related to R. anatipestifer infection.
Optimizing fertilizer use by providing soil quality information: experimental evidence from Madagascar
Authors: Ozaki Ryosuke , Tsujimoto Yasuhiro , Andriamananjara Andry , Rakotonindrina Hobimiarantsoa , Sakurai Takeshi
Published: October 2024

Background

Improving food security in sub-Saharan Africa (SSA) requires increasing agricultural productivity. The increased and effective use of chemical fertilizers is widely recognized as one of the key strategies for achieving this goal. However, many smallholder farmers in SSA still grow crops without using fertilizer, and even when they do use fertilizer, the amount applied is often less than the recommended level. In addition to various constraints related to input markets and farmers’ socioeconomic characteristics, uncertainty about crop yield response is known to discourage fertilizer use. The purpose of this study was to investigate how site-specific information on soil characteristics can help farmers optimize their fertilizer application decisions by reducing uncertainty in yield response. Our unique approach uses simple binary information about the expected effectiveness of nitrogen fertilizer based on a single soil parameter.

Methodology

The simple binary information was generated for a focal rice plot of each 70 household. Based on the evaluation of oxalate-extractable phosphorus content in the soil composites collected from each of these plots, each plot was categorized into either high or low in terms of the expected effectiveness of nitrogen application. A randomized controlled trial was conducted to estimate the impact of providing this simple binary information primarily on nitrogen application rate and, consequently, on rice yield and income at plot-level and household-level.

Results

The results showed that first, compared to those in the target plots of the control households, the nitrogen application rate was greater in the target plots of the treatment households who were informed of the high expected effectiveness. Second, information that the expected effectiveness was high increased the amount of nitrogen fertilizer in the target plot compared to that in other plots with no information about expected effectiveness within a household. Third, this change in fertilizer allocation led to higher rice yields and higher rice incomes at the household level.

Conclusions

These results highlight how the binary information about the expected effectiveness with a single soil parameter can improve fertilizer allocation among rice plots and its use efficiency to increase rice productivity and income.
Investigating the impact of gamification components on online learners’ engagement
Authors: Meng Chen , Zhao Mengyuan , Pan Zilong , Pan Qianqian , Bonk Curtis J.
Published: October 2024

As online learning and teaching are becoming an educational trend, online students’ engagement will directly impact the learning and teaching effects and outcomes. A scientific application of gamification in online learning, teaching, and online course design will improve online learners’ learning experience and help build a better virtual learning context for online learners worldwide. This study focuses on how gamification can engage online students from skills, emotional, participation, and performance perspectives. The gamification components investigated in this study are Points (also called Anar Seeds in the context of this study) and Badges, the most widely used components in gamification design in education, and online instructors have primarily used them to motivate students’ learning and acknowledge their achievements by timely rewarding specific learning behavior or performance. A mixed method has been applied to explore further the relationships between gamification components and online students’ engagement and how online students perceive the impacts of gamification on their online learning experience. The findings show a significant correlation between Points and online students’ skills, emotional, participation, and performance engagement, while it exists only between Badges and online students’ participation engagement. The findings also reveal mixed perceptions of online students towards gamification. Study limitations regarding lack of age criterion, limited measurement indicators, and oversimplification of survey responses have also been discussed. It is suggested that future research can be conducted from either the instructors’ or the gamification designers’ perspectives to determine any other factors that might contribute to the implementation of gamification in the online learning context.
Highly efficient synthesis of the chiral ACE inhibitor intermediate (R)-2-hydroxy-4-phenylbutyrate ethyl ester via engineered bi-enzyme coupled systems
Authors: Dai Yanmei , Wang Jinmei , Tao Zijuan , Luo Liangli , Huang Changshun , Liu Bo , Shi Hanbing , Tang Lan , Ou Zhimin
Published: October 2024

(R)-2-Hydroxy-4-phenylbutyric acid ethyl ester ((R)-HPBE) is an essential chiral intermediate in the synthesis of angiotensin-converting enzyme (ACE) inhibitors. Its production involves the highly selective asymmetric reduction of ethyl 2-oxo-4-phenylbutyrate (OPBE), catalyzed by carbonyl reductase (CpCR), with efficient cofactor regeneration playing a crucial role. In this study, an in-situ coenzyme regeneration system was developed by coupling carbonyl reductase (CpCR) with glucose dehydrogenase (GDH), resulting in the construction of five recombinant strains capable of NADPH regeneration. Among these, the recombinant strain E. coli BL21-pETDuet-1-GDH-L-CpCR, where CpCR is fused to the C-terminus of GDH, demonstrated the highest catalytic activity. This strain exhibited an enzyme activity of 69.78 U/mg and achieved a conversion rate of 98.3%, with an enantiomeric excess (ee) of 99.9% during the conversion of 30 mM OPBE to (R)-HPBE. High-density fermentation further enhanced enzyme yield, achieving an enzyme activity of 1960 U/mL in the fermentation broth, which is 16.2 times higher than the volumetric activity obtained from shake flask fermentation. Additionally, the implementation of a substrate feeding strategy enabled continuous processing, allowing the strain to efficiently convert a final OPBE concentration of 920 mM, producing 912 mM of (R)-HPBE. These findings highlight the system’s improved catalytic efficiency, stability, and scalability, making it highly suitable for industrial-scale biocatalytic production.
Competition between homologous chromosomal DNA and exogenous donor DNA to repair CRISPR/Cas9-induced double-strand breaks in Aspergillus niger
Authors: Forrer Selina , Arentshorst Mark , Koolth Valappil Prajeesh , Visser Jaap , Ram Arthur F. J.
Published: October 2024

Background

Aspergillus niger is well-known for its high protein secretion capacity and therefore an important cell factory for homologous and heterologous protein production. The use of a strong promoter and multiple gene copies are commonly used strategies to increase the gene expression and protein production of the gene of interest (GOI). We recently presented a two-step CRISPR/Cas9-mediated approach in which glucoamylase (glaA) landing sites (GLSs) are introduced at predetermined sites in the genome (step 1), which are subsequently filled with copies of the GOI (step 2) to achieve high expression of the GOI.

Results

Here we show that in a ku70 defective A. niger strain (Δku70), thereby excluding non-homologous end joining (NHEJ) as a mechanism to repair double-stranded DNA breaks (DSBs), the chromosomal glaA locus or homologous GLSs can be used to repair Cas9-induced DSBs, thereby competing with the integration of the donor DNA containing the GOI. In the absence of exogenously added donor DNA, the DSBs are repaired with homologous chromosomal DNA located on other chromosomes (inter-chromosomal repair) or, with higher efficiency, by a homologous DNA fragment located on the same chromosome (intra-chromosomal repair). Single copy inter-chromosomal homology-based DNA repair was found to occur in 13–20% of the transformants while 80–87% of the transformants were repaired by exogenously added donor DNA. The efficiency of chromosomal repair was dependent on the copy number of the potential donor DNA sequences in the genome. The presence of five homologous DNA sequences, resulted in an increased number (35–61%) of the transformants repaired by chromosomal DNA. The efficiency of intra-chromosomal homology based DSB repair in the absence of donor DNA was found to be highly preferred (85–90%) over inter-chromosomal repair. Intra-chromosomal repair was also found to be the preferred way of DNA repair in the presence of donor DNA and was found to be locus-dependent.

Conclusion

The awareness that homologous chromosomal DNA repair can compete with donor DNA to repair DSB and thereby affecting the efficiency of multicopy strain construction using CRISPR/Cas9-mediated genome editing is an important consideration to take into account in industrial strain design.
Achieving automated and high-precision in situ analysis of the dimensional accuracy and dynamic deformation of 3D-printed surgical templates: an in vitro study
Authors: He Lixing , Qin Bowen , Zhu Rongrong , Liu Yunxian , Xu Boya , Li Zhe , Du Liangzhi
Published: October 2024

Purpose

To demonstrate the viability of a coordinate-measuring machine (CMM) for the geometric analysis of 3D printed surgical templates.

Methods

The template was designed and modified by adding 18 cylindrical landmarks for CMM test and then classified into five groups according to the slicing software and resins (opaque and transparent): Streamflow-O, Streamflow-T, Shapeware-T, Rayware-T and Polydevs-T (N = 3). Three standing times (0 w, 1 w, and 2 w) were included to observe possible deformation. All the measurements were performed automatically by the CMM through a preset program. The Euclidian distance (dxyz) was regarded as the representation of global dimension accuracy, and displacements in the x-, y-, and z-axes were also calculated.

Results

The average dxyz values of Streamflow-O, Streamflow-T, Shapeware-T, Rayware-T and Polydev-T are 32.6 μm, 31.3 μm, 56.4 μm, 96.4 μm, and 55.3 μm, respectively. Deviations were mainly induced by the upward bending of the free end region (positive direction of the z-axis). Different resins did not have a significant influence on the dimensional accuracy. Moreover, deformation appeared to be negligible after 2 weeks of storage, and the z-axis displacements were only approximately 30 μm at week 1 and 10 μm at week 2.

Conclusions

The deviations of the DLP-printed template are induced mainly by z-axis displacements and are determined by the processing accuracy. After 2 weeks, the dimensional stabilities of these templates are reliable, which is encouraging for clinicians. Moreover, the CMM is preliminarily demonstrated to be a feasible tool for achieving automated geometric analysis of surgical templates.
A cross-sectional survey of prehabilitation among surgeons and anesthesiologists
Authors: Sato Mariko , Ida Mitsuru , Nakatani Shohei , Kawaguchi Masahiko
Published: October 2024

Background

Prehabilitation, which includes nutritional and exercise therapies, is recommended for patients before surgery to improve physical and cognitive functions. This study aimed to identify the awareness, understanding, and issues among surgeons and anesthesiologists regarding the implementation of prehabilitation.

Methods

We conducted a survey on prehabilitation targeting surgeons and anesthesiologists working at a university hospital and two private hospitals. The survey collection period was set for 1 month, commencing on February 5, 2024. Descriptive statistics were employed to summarize the characteristics of the participants.

Results

A total of 254 surgeons and 49 anesthesiologists from three hospitals participated, with a response rate of 61.7%. Regarding the understanding of prehabilitation, 16.7% of anesthesiologists and only 2% of surgeons had a good grasp of its content. When enquired about the necessity of prehabilitation, 100% of anesthesiologists indicated it as necessary or somewhat necessary, whereas 98.7% of surgeons responded similarly. Several barriers to the implementation of prehabilitation were identified, with the most common reason being the busy schedule of outpatient services.

Conclusion

This study highlights that while both surgeons and anesthesiologists recognize the importance of prehabilitation, significant challenges exist in its practical implementation. This underscores the need for simple explanatory tools for patients, the introduction of remote care options, and simple orders to relevant departments, which are essential and require multidisciplinary collaboration.
Ischemic stroke incidence in intermediate or high-risk patients undergoing transcatheter aortic valve replacement versus surgical aortic valve replacement: a comparative systematic review and meta-analysis
Authors: Rehman Shahzaib , Ghani Mahrukh , Riaz Anshahrah , Raza Syeda Sadia Masood , Zahid Mariam , Malik Muhammad Hammad Zahid , Amir Arman , Lokesh Ethuri , Ashrita Kovvuru , Kachhadia Meet Popatbhai , Karmani Vikash Kumar
Published: October 2024

Background and purpose

This comparative systematic review and meta-analysis investigated the incidence of ischemic stroke in intermediate-to-high-risk patients undergoing transcatheter aortic valve replacement versus surgical aortic valve replacement.

Methods

We conducted a systematic review and meta-analysis following the PRISMA guidelines, searching PubMed, Google Scholar, Embase, Web of Science, and Cochrane CENTRAL databases from their inception to December 2023. The evaluated outcomes were primarily incidence of stroke and transient ischemic attack (TIA), along with other secondary safety end-points at 30 days and 1 year post-procedure. Odds ratios (ORs) with 95% confidence intervals (CIs) were utilized for each study, employing a random-effects model for data synthesis irrespective of heterogeneity. Statistical heterogeneity was assessed using I2 statistics. All statistical analyses were conducted using Review Manager.

Results

We screened 8028 articles and included 8 studies consisting of 5 randomized controlled trials and 3 observational studies. The studies examining 30-day and 1-year stroke incidence found no significant difference between TAVR and SAVR patients (OR 0.83, 95% CI 0.59 to 1.17, p = 0.30, OR 0.92, 95% CI 0.64 to 1.33, p = 0.67, respectively). Both TAVR and SAVR also had a comparable risk of having a transient ischemic attack within 30 days (OR 0.93, 95% CI 0.24 to 3.63, p = 0.92, I2 52%) and 1 year (OR 1.15, 95% CI 0.72 to 1.82, p = 0.56, I2 0%) following the procedure. Regarding safety endpoints, TAVR had lower rates of all-cause mortality and acute kidney injury at 1 year post-procedure, but a higher incidence of major vascular complications at both 30 days and 1 year compared with SAVR.

Conclusion

The results suggest that TAVR and SAVR have comparable outcomes for both TIA and stroke incidence at 30 days and 1 year post-procedure, but display varying safety profiles in intermediate-to-high surgical risk patients.
Artificial potential field-empowered dynamic holographic optical tweezers for particle-array assembly and transformation
Authors: Li Xing , Yang Yanlong , Yan Shaohui , Gao Wenyu , Zhou Yuan , Yu Xianghua , Bai Chen , Dan Dan , Xu Xiaohao , Yao Baoli
Published: October 2024

Owing to the ability to parallel manipulate micro-objects, dynamic holographic optical tweezers (HOTs) are widely used for assembly and patterning of particles or cells. However, for simultaneous control of large-scale targets, potential collisions could lead to defects in the formed patterns. Herein we introduce the artificial potential field (APF) to develop dynamic HOTs that enable collision-avoidance micro-manipulation. By eliminating collision risks among particles, this method can maximize the degree of parallelism in multi-particle transport, and it permits the implementation of the Hungarian algorithm for matching the particles with their target sites in a minimal pathway. In proof-of-concept experiments, we employ APF-empowered dynamic HOTs to achieve direct assembly of a defect-free 8 × 8 array of microbeads, which starts from random initial positions. We further demonstrate successive flexible transformations of a 7 × 7 microbead array, by regulating its tilt angle and inter-particle spacing distances with a minimalist path. We anticipate that the proposed method will become a versatile tool to open up new possibilities for parallel optical micromanipulation tasks in a variety of fields.
Effectiveness of website-based education program on activities of daily living and fear of falls among sub-acute stroke survivors: a pilot study in South Gujarat Region of India
Authors: Kachhadiya Roshni G. , Ramanandi Vivek H. , Pathan Rumana Khatun A. , Vekariya Hemanshi N.
Published: October 2024

Background

Stroke survivors and their caregivers have numerous and diverse educational needs, many of which are unmet because of inadequate training from healthcare professionals. As stroke recovery and rehabilitation can continue for years post-stroke, it is critical that stroke survivors are provided with and have access to a range of support options and evidence-based information. Website-based education programs (WEP) have been adopted in recent years to manage health problems. The present pilot study aims to evaluate the effect of WEP on activities of daily living (ADLs) and the fear of falls among sub-acute stroke survivors.

Methods

A total of 16 eligible post-stroke survivors were recruited from multiple study settings across Surat City of Gujarat state in western India and were randomly assigned using a lottery method to either the experimental group (n = 8) receiving WEP or the control group (n = 8) receiving conventional physiotherapy for 4 weeks. Outcome measures were the Indian Stroke Scale (ISS), Modified Barthel Index (MBI), and Falls Efficacy Scale-International (FES-I).

Results

Both groups showed statistically significant improvements in all outcomes but the experimental group showed more significant improvements in ADLs and fear of falls among sub-acute stroke survivors (p < 0.05).

Conclusion

WEP for sub-acute stroke survivors is an effective intervention. It improves the performance of ADLs for stroke survivors and helps in better fall management indicating that web-based education programs shall be implemented on a regular basis to improve patient care.
The Holiday Card
Authors: Vater Laura B.
Published: October 2024

Dr Vater shares about processing the unexpected loss of a patient and how a colleague unknowingly helped her cope.
Forest Lost
Authors: Greenleaf Maron E.
Published: October 2024

Forest Lost is an ethnography of forest carbon offsets and the wider effort to make the living rainforest valuable in the Brazilian Amazon. Unlike other forest commodities, forest carbon offsets do not involve resource extraction; instead, they require keeping carbon in place through forest protection. Maron E. Greenleaf explores forest carbon offsets to understand green capitalism—the use of capitalist logics and practices to mitigate environmental damage. She traces cultural, environmental, governmental, material, and multispecies relations involved in making forest carbon valuable as well as how forest carbon’s commodification in the Amazon turned it into a source of redistributable public environmental wealth. At the same time, Greenleaf shows how making forest carbon monetarily valuable created an unexpected set of uneven, contingent, and contested social and political relations. While forest carbon in the Amazon demonstrates that green capitalism can be socially inclusive, it also shows that green capitalism can reinforce the marginalization it purportedly seeks to combat. By outlining these complex relations and tensions, Greenleaf elucidates broader efforts to create a capitalism suited to the Anthropocene and those efforts’ alluring promises and vexing failures.
Ο σχολικός τουρισμός ως μέσο αξιοποίησης του τοπικού πολιτισμικού κεφαλαίου και η σημασία του στην εκπαίδευση και την τοπική ανάπτυξη
Authors: Γκουρνέλης Παύλος
Published: October 2024

O εκπαιδευτικός τουρισμός περιλαμβάνει ένα μεγάλο πληθυσμιακό φάσμα συμμετεχόντων, από μικρούς μαθητές μέχρι ηλικιωμένους εκδρομείς, οι οποίοι έχουν ως κύριο ή δευτερεύον κίνητρο την εκπαίδευση ή τη μάθηση. Στην περίπτωση των μαθητών η εκπαίδευση αποτελεί τον πρώτο στόχο, ενώ στην περίπτωση των ενηλίκων ο πρώτος στόχος συνήθως είναι ο τουρισμός. Ο σχολικός τουρισμός είναι μία υποκατηγορία του εκπαιδευτικού τουρισμού και με τον όρο αυτό εννοείται κάθε οργανωμένη μετακίνηση μέρους ή του συνόλου των μαθητών μιας σχολικής μονάδας (εκπαιδευτική επίσκεψη, εκπαιδευτική εκδρομή ολιγόωρη, ολοήμερη ή με διανυκτέρευση), που πραγματοποιείται στο πλαίσιο συμμετοχής ή υλοποίησης σχολικών προγραμμάτων και έχει στόχο εκπαιδευτικό, παιδαγωγικό, ψυχαγωγικό και κοινωνικοποιητικό. Παρόλο που οι εκπαιδευτικές εκδρομές αποτελούν αναπόσπαστο κομμάτι της σχολικής ζωής και η σημασία τους αναγνωρίζεται διεθνώς όλο και περισσότερο, λίγες είναι οι έρευνες που αφορούν τον σχολικό τουρισμό. Ειδικά στην ελληνική βιβλιογραφία είναι σπάνιες αντίστοιχες μελέτες.Η παρούσα διδακτορική διατριβή προσπαθεί να καλύψει αυτό το κενό και έχει ως σκοπό, μέσα από τις συνεντεύξεις εκπαιδευτικών Πρωτοβάθμιας Εκπαίδευσης και γονέων μαθητών αντίστοιχων ηλικιών, την εκπαιδευτική εμπειρία του γράφοντα και τη μελέτη της βιβλιογραφίας, να διερευνήσει τη συμβολή των εκπαιδευτικών εκδρομών και επισκέψεων στην εκπαίδευση των μαθητών, τόσο ως υποστηρικτικό μέσο στη διαδικασία της μάθησης, όσο και στην ολόπλευρη ανάπτυξη των προσωπικοτήτων των μαθητών. Αναδεικνύεται η σημασία της βιωματικής μάθησης και προσεγγίζονται η περιβαλλοντική εκπαίδευση και η μουσειακή αγωγή ως καινοτόμες παρεμβάσεις που εισάγουν νέες μορφές διδασκαλίας, προωθώντας παράλληλα τις εκπαιδευτικές δράσεις εκτός του σχολείου και οδηγώντας στην ενεργητική συμμετοχή των μαθητών στο επισκέψιμο πεδίο. Επίσης, η διατριβή έχει πρόθεση να εξετάσει τον τρόπο με τον οποίον ο σχολικός τουρισμός μπορεί να αποτελέσει το μέσο για την αξιοποίηση και ανάδειξη του τοπικού πολιτισμικού κεφαλαίου, καθώς οι μαθητές που συμμετέχουν σε αυτές τις δράσεις γίνονται, από τη μια μεριά, οι επισκέπτες-τουρίστες και από την άλλη μπορούν να βρεθούν στη θέση του «οικοδεσπότη», συμβάλλοντας και στις δύο περιπτώσεις στην προβολή ενός μέρους και την τοπική ανάπτυξη.
Factors contributing to persistent shoulder pain after arthroscopic rotator cuff repair: Protocol for a scoping review
Authors: Prabhu B Anupama , Maiya G Arun , Pandey Vivek , Acharya Kiran K V , Raja G Prabu , Elliott M James , Meeus Mira
Published: October 2024

Introduction Rotator cuff (RC) tears are the most common and disabling musculoskeletal ailments among patients with shoulder pain. Although most individuals show improvement in function and pain following arthroscopic rotator cuff repair (ARCR), a subgroup of patients continue to suffer from persistent shoulder pain following the surgical procedure. Identifying these factors is important in planning preoperative management to improve patient outcomes. Objective This scoping review aims to identify biological factors, psychological factors, and social determinants of health contributing to the development of persistent pain in individuals after the ARCR procedure. Inclusion criteria All prospective and retrospective longitudinal studies reporting the risk factors contributing to persistent pain three months or longer after the ARCR surgery will be considered for this scoping review. Methods Our review will adhere to the Joanna Briggs Institute (JBI) scoping review methodology. Four electronic databases PubMed, CINAHL, Embase, and Scopus will be searched for studies in the English language. Additional studies can be found by conducting a citation analysis of the included studies. Title and abstract screening will be performed by two independent reviewers following the inclusion criteria, a third reviewer will be consulted about any differences. Next, full-text screening will be conducted, and the remaining search results will be reviewed to extract data, as well as to synthesize findings from all research. An overview of findings will be depicted in tabular format accompanied with a narrative summary of various factors contributing to persistent pain.
Fostering Inclusivity in the Clinical Learning Environment
Authors: Smith Teresa Y. , Terhune Kyla , Caniano Donna A.
Published: October 2024

Despite the Supreme Court’s decision on race-based admissions, academic medical centers, medical societies, and accreditation bodies remain committed to recruiting a diverse workforce. Many medical schools and graduate medical education programs created initiatives to expand their census of underrepresented in medicine (UIM) as the key to addressing health care disparities. As a result, an influx of an UIM physician workforce has entered clinical learning environments, often without consideration of the inclusivity of these settings. To create inclusive, safe, and comfortable CLEs, we must first recognize the challenges faced by UIM trainees, students, and faculty and the complex ways in which discrimination manifests. Ultimately, having inclusive CLEs allows all learners, especially those from historically excluded identities, to thrive in their training and working environment, making it essential to retain the diverse workforce necessary. Using case examples, we discuss strategies of inclusivity and ways in which we can maintain clinical learning environments where learners feel safe and supported through their training.
Workplace mental health promotion in a large state organization: Perceived needs, expected effects, neglected side effects
Authors: Werk Lilly Paulin , Muschalla Beate
Published: October 2024

Background Work ability and mental health in the workplace is increasingly promoted in terms of workplace health management. In order to select suitable interventions at work in a concrete context, employees and managers of a large state organization (science and development sector) were asked about perceived needs, desired effects and possible side effects of health promotion interventions. Methods 13 semi-structured interviews with managers and three focus group interviews with employees (N = 20) were conducted in autumn 2020 by a behavior therapist in training. The evaluation was carried out by a qualitative content analysis of the interview transcripts according to a deductive procedure and was checked by two independent raters. Results Most frequently, need was expressed for individual case counselling by a health expert due to the diversity of work-related problems. Managers would like to see more health-related leadership training, and a review of the various communication channels of their organization. Expected positive effects are increased self-efficacy, higher person-job-fits and reduced absenteeism. Side effects were mentioned, such as confusion of health management activities with therapy, or sensitization effects when speaking too much about mental health in mentally healthy teams. Lack of competence with the topic of mental health was mentioned as a reason for non-participation in mental health promotion activities. Conclusions The role of managers in relation to mental health needs to be more defined. Side effects related to mental health activities should be considered in evaluations. Selection of health interventions should depend on the concrete needs of the organization.
Collaborative design approach to identify research and innovation needs within the European smart building community
Authors: COUJARD Clémentine , Laffont Eloire Karine
Published: October 2024

Background Upgrading the level of smartness in buildings can significantly contribute to improve our quality and sustainability of living, through increased energy efficiency, optimised resource management, and improved air quality and comfort. However, the fragmented nature of the sector makes it challenging to identify what is technically, socially and economically achieved today in Europe in terms of building smartness, and what should be developed and financially supported tomorrow to accelerate the roll-out of smart and energy efficient buildings. Methods This paper introduces the collaborative process developed to involve a large community of experts in detecting and formalising research and innovation gaps related to smart buildings. This process is composed of four successive steps: 1) a communication phase to invite volunteer experts to join the proposed task forces; 2) The organisation and facilitation of online brainstorming workshops to identify research & innovation (R&I) gaps; 3) the collective drafting of a white paper synthesising the brainstorming outcomes; and 4) an open consultation to collect additional external feedback before finalising the white paper. Results The collaborative process developed was tested over 18 months and implemented on 12 different topics relying on 27 brainstorming workshops. Building on the collective knowledge of 135 participants, it enabled identification a significant series of R&I gaps related to smart buildings. Conclusions The collective sessions as well as the open consultation phases showed overall some clear convergence on the gaps identified. It can therefore be concluded the outcome of the collaborative process reached a consensus among the targeted innovation community. The feedback collected on the process, shows that the frequency, duration and attendance of the brainstorming workshops proposed were very relevant, while the selection of online participatory tools could still be improved. This process could be replicated in other frameworks where research and innovation gaps are sought for.
Drying out fish ponds, for an entire growth season, as an agroecological practice: maintaining primary producers for fish production and biodiversity conservation
Authors: GIRARD Léo , WEZEL Alexander , ROBIN Joël
Published: October 2024

Agroecology largely focusses on terrestrial agroecosystems, but it can also be applied to fish farming. Indeed, ponds are typically used for fish production in Europe, but are also important reservoirs of biodiversity. Numerous studies demonstrate that both fish production and biodiversity are strongly determined by human management. One key practice in extensive fish farming, although more rare in Europe, is to dry out ponds. They are left dry for a complete year after several years of fish production. However, the extent to which this practice affects the functioning of the ecosystem, its biodiversity and fish production remain unclear. We investigated data from 85 fish ponds in the Dombes region, France, sampled between 2007 and 2014. We related variation in key abiotic characteristics to the time since last dry out. The dataset included organic matter content in pond sediments and concentrations of inorganic nitrogen and phosphorus in the water column, and biotic components such as macrophytes cover and richness, phytoplankton concentration and richness, macroinvertebrates density, and fish yield. Our results show that drying out facilitates the mineralization of organic matter in sediments and results in higher concentrations of inorganic nitrogen in the water column. Macrophytes cover is highest during the first year after drying out, and gradually declines after at the expense of increasing phytoplankton concentration. The diversity of both is highest in the first year after drying out and declines rapidly, especially for macrophytes. Fish yield is at its maximum in the second year. Drying out fish ponds appears to be an important agroecological practice in extensive fish farming with an application every three to four years. By nutrient recycling, this practice has a positive impact on the balance between primary producers and indirectly on the whole food web during two years. It optimizes fish production and allows biodiversity conservation.
Exploring self-care and self-development practices among refugee adolescents through photos: An art-based participatory qualitative study
Authors: Mohammadzadeh Marjan , Taras Asra , Stock Christiane
Published: October 2024

Introduction Photovoice and photo-elicitation are art-based participatory methods aiming to enable community members to create powerful visual representations to highlight the community issues/manners. This paper attempted to investigate self-care/self-development (SC/SD) practices among refugee adolescents in Germany, as part of a needs assessment based on triangulation (including three qualitative datasets from in-depth interviews, focus group discussions, and photographic data). Methods Sixteen male and female refugee adolescents (aged 14–19) from 4 countries participated in the study. Before research implementation, a briefing session was held to explain the details of the project. Participants were asked to take their photos within 6 weeks and send them to the research team along with the answers to 5 questions, following a modified version of PHOTO protocol. For the photo-elicitation study, the participants were invited to join a group discussion session. Results From the collected data including 41 photos and their related statements, four major themes of: “I adapt to the new situation”, “I start to learn again”, “I find new opportunities”, and “I love myself” emerged, illustrating how the refugee adolescents visualized their perspective and practices toward SC/SD. In the group discussion session, the participants mainly emphasized the importance of keeping the good aspects of the original culture in their SC/SD practices. Conclusions The results of this study improve the understanding about SC/SD practices among refugee adolescents and provide a support to the existing literatures for using art-based methods as an effective participatory tool to communicate with adolescents, especially in hard-to-reach populations. The findings also reveal the capacity of refugee adolescents to be involved in youth-based program planning, which can be a significant potential in health care services for this population.
The genome sequence of the Long-tailed duck, Clangula hyemalis (Linnaeus, 1758)
Authors: O’Brien Michelle F. , Lopez Colom Rosa ,   Natural History Museum Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: October 2024

We present a genome assembly from an individual male Clangula hyemalis (the Long-tailed duck; Chordata; Aves; Anseriformes; Anatidae). The genome sequence spans 1,206.10 megabases. Most of the assembly is scaffolded into 41 chromosomal pseudomolecules, including the Z sex chromosome. The mitochondrial genome has also been assembled and is 16.63 kilobases in length.
Reduced cardiovascular events through dynamic lifestyle modification
in individuals with prediabetes or prehypertension in Korea: a nationwide cohort
study
Authors: Kim Yeji , Song Shinjeong , Moon Chang Mo , Lee Hye Ah , Park Junbeom
Published: October 2024

Objectives: There is limited knowledge regarding the impact of
lifestyle changes on cardiovascular events and mortality among individuals with
prehypertension or prediabetes.
Methods: This was a serial retrospective cohort study utilizing data
from the Korean National Health Insurance Service Health Screening Cohort. The
primary outcome considered in the study was major adverse cardiovascular events
(MACE).
Results: A higher risk of MACE was found in men with prehypertension
whose unhealthy lifestyle deteriorated (hazard ratio [HR], 1.13; 95% CI,
1.04–1.23; P=0.004), those who gained weight (HR, 1.15; 95% CI,
1.03–1.28; P=0.010), and those who began smoking (HR, 1.34; 95% CI,
1.17–1.55; P<0.001). Conversely, a reduced risk of MACE was
observed in men with prehypertension who improved their unhealthy lifestyle,
quit smoking, reduced alcohol consumption, or increased the frequency of
physical activity. In men with prediabetes, the risk of MACE was higher in those
whose unhealthy lifestyle worsened (HR, 1.23; 95% CI, 1.12–1.35;
P<0.001), those who gained weight (HR, 1.19; 95% CI, 1.06–1.33;
P=0.003), those who started smoking (HR, 1.41; 95% CI, 1.22–1.64;
P<0.001), and those who decreased their physical activity frequency (HR,
1.21; 95% CI, 1.09–1.35; P<0.001).
Conclusion: Preventive lifestyle changes reduce cardiovascular
events and mortality, particularly in men at risk of developing hypertension or
type 2 diabetes.
Adequacy of the physician workforce for preparing for future society
in Korea: an English translation
Authors: Hong Yun-Chul
Published: October 2024

Objectives: This study aimed to assess whether the current physician
workforce in Korea is sufficient to meet future healthcare demands, considering
demographic changes and increasing medical needs. The objective was to project
the future supply and demand for physicians and identify potential regional
disparities.
Methods: Data on outpatient and inpatient utilization rates were
obtained from the 2018 Health Insurance Statistical Yearbook, and population
projections were sourced from Statistics Korea (2017–2067). Medical
demand was estimated by multiplying these utilization rates by the population
projections. The supply of physicians was projected using a cohort-component
model that incorporated medical school quotas and age-specific attrition rates.
Two scenarios were developed to account for changes in productivity: Scenario 1
assumed a 50% decrease in productivity for physicians aged 65–75, and
Scenario 2 assumed a 75% decrease. Additionally, regional projections were
analyzed using data from provincial and secondary medical service areas.
Results: National-level projections suggest a looming shortage of
physicians, despite an increase in medical school admissions. Both scenarios
predict a physician shortage, particularly in regions such as North Gyeongsang,
South Chungcheong, and Jeju Island, by 2047. In contrast, Seoul is likely to see
a surplus of physicians. The regional analysis underscores substantial
disparities in physician distribution, with underserved areas experiencing
increasingly severe shortages.
Conclusion: The study concludes that without flexible adjustments to
medical school admission quotas and healthcare delivery systems, Korea will face
significant physician shortages in the coming decades. To address this, it is
necessary to increase the number of physicians in underserved regions and
improve the efficiency of healthcare utilization.
Imaging findings of intrahepatic cholangiocarcinoma for prognosis
prediction and treatment decision-making: a narrative review
Authors: Kang Jun Gu , Chung Taek , Kim Dong Kyu , Rhee Hyungjin
Published: October 2024

Intrahepatic cholangiocarcinoma (iCCA) is a heterogeneous bile duct
adenocarcinoma with a rising global incidence and a poor prognosis. This review
aims to present a comprehensive overview of the most recent radiological
research on iCCA, focusing on its histopathologic subclassification and the use
of imaging findings to predict prognosis and inform treatment decisions.
Histologically, iCCA is subclassified into small duct (SD-iCCA) and large duct
(LD-iCCA) types. SD-iCCA typically arises in the peripheral small bile ducts and
is often associated with chronic hepatitis or cirrhosis. It presents as a
mass-forming lesion with a relatively favorable prognosis. LD-iCCA originates
near the hepatic hilum, is linked to chronic bile duct diseases, and exhibits
more aggressive behavior and poorer outcomes. Imaging is essential for
differentiating these subtypes and assessing prognostic factors like tumor size,
multiplicity, vascular invasion, lymph node metastasis, enhancement patterns,
and intratumoral fibrosis. Imaging-based prognostic models have demonstrated
predictive accuracy comparable to traditional pathological staging systems.
Furthermore, imaging findings are instrumental in guiding treatment decisions,
including those regarding surgical planning, lymphadenectomy, neoadjuvant
therapy, and the selection of targeted therapies based on molecular profiling.
Advancements in radiological research have improved our understanding of iCCA
heterogeneity, facilitating prognosis prediction and treatment personalization.
Imaging findings assist in subclassifying iCCA, predicting outcomes, and
informing treatment decisions, thus optimizing patient management. Incorporating
imaging-based approaches into clinical practice is crucial for advancing
personalized medicine in the treatment of iCCA. However, further high-level
evidence from international multicenter prospective studies is required to
validate these findings and increase their clinical applicability.
Detection of Vocabulary Delay through Syntactic Complexity in Sentence Comprehension
Authors: Yang Yoonhee , Yim Dongsun , Sung Jee Eun
Published: October 2024

Objectives: This study investigated the best condition for capturing signs of vocabulary delay in children using the sentence comprehension task (SCT), which consists of active and passive sentence structures with canonical and non-canonical word order conditions; and to determine whether working memory has significant explanatory power for SCT in children with vocabulary delay. Methods: Thirty-two children participated in this study, 16 vocabulary delayed (VD) children and 16 typically developing (TD) children aged 4 to 6 years. Participants completed the SCT, which is designed to focus only on syntactic features by minimizing top-down semantic processing in sentence processing. Four working memory (WM) tasks (Non-word repetition, NWR; Sentence repetition, SR; Digit-forward span, DF; and Digit-backward span, DB) were also administered. Results: The VD group showed greater difficulties in sentence comprehension, especially in the passive-canonical (P-C) condition. However, discriminant analysis results showed that the sum of all conditions in the SCT robustly discriminated these groups. In the VD group, sentence-level WM tasks predicted the passive-canonical (P-C) complex condition in the SCT. Conclusion: The current findings suggest that the VD group had greater difficulty processing more complex sentences, and WM has significant explanatory power for understanding complex syntactic structures in the VD group.
The Relationship of Word-Finding Behaviors and Naming in Mild Cognitive Impairment and Dementia of Alzheimer’s Type
Authors: Kim Hayoung , Choi Hyunjoo
Published: October 2024

Objectives: Anomia, a fundamental language difficulty, presents in various forms of wordfinding behaviors in individuals with Mild Cognitive Impairment (MCI) and Dementia of Alzheimer’s Type (DAT). This study aims to compare the rates of word-finding behavior among these groups and determine the correlation between these rates and the results of naming tests. Methods: This study included 101 participants, consisting of forty-one healthy elderly adults, thirty individuals with MCI, and thirty individuals with DAT. Spontaneous speech data were collected using a picture description task. For the naming tests, we used the confrontation naming test (K-BNT) and the generative naming test (KCOWAT). Results: First, significant differences were observed in the rates of word-finding behavior among the three groups, especially in the global index, which indicates the overall rate of word-finding behaviors. Second, the correlation analysis results showed a significant negative correlation between the ratios of the global index, word reformulations, empty words, and performance on the confrontation naming test. Finally, there was a significant negative correlation between the ratios of the global index, word reformulations, repetitions, delays, insertions, and performance on the generative naming tests. Conclusion: These results suggest the necessity of developing a naming evaluation scale based on spontaneous speech to effectively assess anomia in individuals with MCI and DAT. The study found significant differences in the rates of word-finding behavior among healthy elderly adults, individuals with MCI, and individuals with DAT, and a correlation between the rates of word-finding behavior and naming tests.
Narrative Retelling Abilities of Kindergarteners Considering Early Literacy and Language Skills
Authors: Eom Jimok , Cheon Haein , Jang Jaejin , Pae Soyeong
Published: October 2024

Objectives: This study investigated the narrative retelling abilities of 5-year-old children at risk of narrative development, early literacy, and language skills focusing on story grammar, linguistic cohesive devices, and semantic-grammatical index.Methods: Narrative Retelling production using KONA was conducted on a total of fifty kindergarten children, 10 typically developing children (TD), 10 at risk of developmental dyslexia (DD), 10 at risk of narrative discourse (ND), 10 at risk of narrative discourse and early literacy (ND·DD), and 10 at risk of early literacy and language as well as narrative discourse to compare the production of story grammars, linguistic cohesive markers, and use of linguistic indicators total number of words (NTW), number of grammatical morphemes, mean length of T-units in morpheme (MLT-m), grammatical morpheme error rate (GME) between groups.Results: ND, ND·DD and ND·DD·SLI groups showed lower performance in producing story grammars, linguistic cohesive markers, NTW, and number of grammatical morphemes compared to the TD and DD groups. There were no significant differences between groups in the number of inappropriate uses of linguistic cohesive devices, MLT-m, and grammatical morpheme error rate.Conclusion: The ND·DD·SLI group with poor semantics and grammar showed significantly lower narrative retelling ability. This suggests that early intervention may be beneficial for children at risk for difficulties in language and narrative development. The ND group with good semantics and grammar was identified with their low narrative retelling abilities. In addition to typical development in semantics and grammar, there were children at risk of narratives with low abilities in early literacy. In addition to language skills, we need to screen and identity narrative abilities considering early literacy skills during the kindergarten period.