bluuebunny/crossref_metadata_2025 huggingface dataset:
Using intentional emergence to dethrone the sage on the stage
Authors: Armstrong Josh P. , Vickers Asiya M.
Published: March 2024

Intentional emergence (IE) as a pedagogy centers students in learning and calls for the educator or facilitator to take a different role. It is important for educators to mindfully regulate their presence in the classroom to allow students to notice the role of authority in leadership practice. This article provides recommendations for productive learning when authority is de‐centered and learners are encouraged to take up their authority. Facilitators who reflect and consider their identities and the identities of their participants will be more prepared for what emerges in the classroom. Finally, educators center student learning by intentionally creating a safe container before giving back the work to students in meaningful ways, allowing themselves to take a backseat and observe students exercising leadership.
The effect of an endovascular Heaney maneuver to achieve total hepatic isolation on survival, hemodynamic stability, retrohepatic bleeding, and collateral flow in a porcine model
Authors: Wikström Maria B. , Stene-Hurtsén Anna , Åström Jens , Hörer Tal M. , Nilsson Kristofer F.
Published: March 2024

Purpose

Combining resuscitative endovascular balloon occlusion of the aorta (REBOA) and the inferior vena cava (REBOVC) with open surgery is a new hybrid approach for treating retrohepatic vena caval injuries. We compared endovascular total hepatic isolation with supraceliac REBOA ± suprahepatic REBOVC and no occlusion in experimental retrohepatic vena cava bleeding regarding survival, bleeding volume, hemodynamic stability, and arterial collateral blood flow.

Methods

Twenty-five anesthetized pigs (n = 6–7/group) were randomized to REBOA; REBOA + REBOVC; REBOA + infra and suprahepatic REBOVC + portal vein occlusion (endovascular Heaney maneuver, four-balloon-occlusion, 4BO) or no occlusion. After balloon inflation, free bleeding was initiated from an open sheath in the retrohepatic vena cava. Bleeding volume, right internal thoracic artery (RITA) blood flow, hemodynamics, and arterial blood variables were measured until death or up to 90 min.

Results

The REBOA group had a longer median survival time (63 min) compared with the 4BO (24 min, P = 0.02) and no occlusion (30 min, P = 0.02) groups, not versus the REBOA + REBOVC group (49 min, P > 0.05). The first 15 min accumulated bleeding was comparable in all groups (P > 0.05); Thereafter, bleeding volume was higher in the REBOA group versus the 4BO group (P < 0.05), not versus the other groups. RITA blood flow and MAP were higher in the REBOA group versus the other groups after 10 min of bleeding (P < 0.05).

Conclusions

Endovascular Heaney maneuver was not beneficial for survival or hemodynamic stability in this porcine model, whereas supraceliac REBOA was. Anatomical differences in thoracoabdominal collaterals between pigs and humans must be considered when interpreting these results.
Rechtliche, fachliche und strukturelle Aspekte einer modernen akutstationären Versorgung von Kindern und Jugendlichen mit psychischen Störungen
Authors: Vloet Timo D. , Geißler Julia , Taurines Regina , Jans Thomas , Bürger Arne , Romanos Marcel
Published: March 2024

In den letzten Jahren ist der Anteil der Notfallvorstellungen in den Versorgungsstrukturen für Kinder und Jugendliche kontinuierlich gestiegen. Die akutstationäre geschlossene Behandlung ist ein wesentlicher Baustein der Versorgung und dient vorrangig dem unmittelbaren Schutz von Kindern und Jugendlichen in psychischen Krisensituationen. Die geschlossene Unterbringung unterliegt strengen rechtlichen Voraussetzungen, die 2017 in Form des § 1631b BGB novelliert wurden und seither erstmals zu einer klaren Trennung der Anwendung von freiheitsentziehenden Maßnahmen (FEM) gegenüber der freiheitsentziehenden Unterbringung (FEU) von Kindern und Jugendlichen geführt hat.

Anhand der Umgestaltung der Intensiveinheit am Universitätsklinikum Würzburg werden in diesem Artikel beispielhaft die Erfordernisse an eine moderne Akutversorgung von Kindern und Jugendlichen mit psychischen Erkrankungen dargestellt. Infolge der Modernisierung am Universitätsklinikum Würzburg konnte Freiheitsentzug auf ein Minimum reduziert werden – auf aktuell durchschnittlich 1,5 Tage bei etwa 500 Aufnahmen mit FEU im Jahr. Die Gefahr der Hospitalisierung insbesondere bei chronisch suizidalen Patienten besteht praktisch nicht mehr. Durch Kooperation mit anderen Kliniken ist es in der Region seit 2017 gelungen, alle minderjährigen Patienten mit akutstationärem Behandlungsbedarf in kinder- und jugendpsychiatrischen Strukturen zu versorgen. Langfristige geschlossen-stationäre Behandlungen über viele Monate kommen bei chronischer Suizidalität nicht mehr vor.
Genes involved in auxin biosynthesis, transport and signalling underlie the extreme adventitious root phenotype of the tomato aer mutant
Authors: Kevei Zoltan , Larriba Eduardo , Romero-Bosquet María Dolores , Nicolás-Albujer Miriam , Kurowski Tomasz J. , Mohareb Fady , Rickett Daniel , Pérez-Pérez José Manuel , Thompson Andrew J.
Published: March 2024

The use of tomato rootstocks has helped to alleviate the soaring abiotic stresses provoked by the adverse effects of climate change. Lateral and adventitious roots can improve topsoil exploration and nutrient uptake, shoot biomass and resulting overall yield. It is essential to understand the genetic basis of root structure development and how lateral and adventitious roots are produced. Existing mutant lines with specific root phenotypes are an excellent resource to analyse and comprehend the molecular basis of root developmental traits. The tomato aerial roots (aer) mutant exhibits an extreme adventitious rooting phenotype on the primary stem. It is known that this phenotype is associated with restricted polar auxin transport from the juvenile to the more mature stem, but prior to this study, the genetic loci responsible for the aer phenotype were unknown. We used genomic approaches to define the polygenic nature of the aer phenotype and provide evidence that increased expression of specific auxin biosynthesis, transport and signalling genes in different loci causes the initiation of adventitious root primordia in tomato stems. Our results allow the selection of different levels of adventitious rooting using molecular markers, potentially contributing to rootstock breeding strategies in grafted vegetable crops, especially in tomato. In crops vegetatively propagated as cuttings, such as fruit trees and cane fruits, orthologous genes may be useful for the selection of cultivars more amenable to propagation.
Hybrid PET/MRI of large vessel vasculitis
Authors: Brauner Johanna-Felicia , Rasul Sazan , Berzaczy Dominik , Beitzke Daniela , Wollenweber Tim , Beitzke Dietrich
Published: March 2024

Background

The diagnosis of large vessel vasculitis (LVV) is often challenging due to the various clinical appearances and the low prevalence. Hybrid imaging by positron emission tomography and computed tomography (PET/CT) is a highly relevant imaging modality for diagnostics and disease surveillance but may be associated with a significant amount of radiation dose especially in patients with complications.

Objective

The aim of this retrospective analysis was to compare the image quality and impact of hybrid imaging methods PET/CT and PET/MRI on the potential for dose reduction.

Methods

This retrospective single-center study included a cohort of 32 patients who were referred to PET/MRI for the evaluation of LVV, including graft infections and fever of unknown origin. This cohort was compared to a similar cohort of 37 patients who were examined with PET/CT in the same period. Mean radiation dose as well as image quality to establish a diagnosis were compared between the groups.

Results

The mean radiation dose applied in PET/MRI was significantly lower when compared to PET/CT (mean 6.6 mSV vs. 31.7 mSV; p < 0.001). This effect was based on the partially multiphasic CT protocols. At the same time, diagnostic image quality using a 4-point scale showed similar results for both imaging modalities in the work-up of LVV.

Conclusion

With PET/MRI, the radiation exposure can be significantly reduced with similar image quality and diagnostic impact. Patients with LVV have a higher risk of receiving a clinically relevant cumulative effective dose (CED) and PET/MRI should be made available to them.
Surgical-DINO: adapter learning of foundation models for depth estimation in endoscopic surgery
Authors: Cui Beilei , Islam Mobarakol , Bai Long , Ren Hongliang
Published: March 2024

Purpose

Depth estimation in robotic surgery is vital in 3D reconstruction, surgical navigation and augmented reality visualization. Although the foundation model exhibits outstanding performance in many vision tasks, including depth estimation (e.g., DINOv2), recent works observed its limitations in medical and surgical domain-specific applications. This work presents a low-ranked adaptation (LoRA) of the foundation model for surgical depth estimation.

Methods

We design a foundation model-based depth estimation method, referred to as Surgical-DINO, a low-rank adaptation of the DINOv2 for depth estimation in endoscopic surgery. We build LoRA layers and integrate them into DINO to adapt with surgery-specific domain knowledge instead of conventional fine-tuning. During training, we freeze the DINO image encoder, which shows excellent visual representation capacity, and only optimize the LoRA layers and depth decoder to integrate features from the surgical scene.

Results

Our model is extensively validated on a MICCAI challenge dataset of SCARED, which is collected from da Vinci Xi endoscope surgery. We empirically show that Surgical-DINO significantly outperforms all the state-of-the-art models in endoscopic depth estimation tasks. The analysis with ablation studies has shown evidence of the remarkable effect of our LoRA layers and adaptation.

Conclusion

Surgical-DINO shed some light on the successful adaptation of the foundation models into the surgical domain for depth estimation. There is clear evidence in the results that zero-shot prediction on pre-trained weights in computer vision datasets or naive fine-tuning is not sufficient to use the foundation model in the surgical domain directly.
Coronary computed tomography angiography for clinical practice
Authors: Yoshida Kazuki , Tanabe Yuki , Hosokawa Takaaki , Morikawa Tomoro , Fukuyama Naoki , Kobayashi Yusuke , Kouchi Takanori , Kawaguchi Naoto , Matsuda Megumi , Kido Tomoyuki , Kido Teruhito
Published: March 2024

Coronary artery disease (CAD) is a common condition caused by the accumulation of atherosclerotic plaques. It can be classified into stable CAD or acute coronary syndrome. Coronary computed tomography angiography (CCTA) has a high negative predictive value and is used as the first examination for diagnosing stable CAD, particularly in patients at intermediate-to-high risk. CCTA is also adopted for diagnosing acute coronary syndrome, particularly in patients at low-to-intermediate risk. Myocardial ischemia does not always co-exist with coronary artery stenosis, and the positive predictive value of CCTA for myocardial ischemia is limited. However, CCTA has overcome this limitation with recent technological advancements such as CT perfusion and CT-fractional flow reserve. In addition, CCTA can be used to assess coronary artery plaques. Thus, the indications for CCTA have expanded, leading to an increased demand for radiologists. The CAD reporting and data system (CAD-RADS) 2.0 was recently proposed for standardizing CCTA reporting. This RADS evaluates and categorizes patients based on coronary artery stenosis and the overall amount of coronary artery plaque and links this to patient management. In this review, we aimed to review the major trials and guidelines for CCTA to understand its clinical role. Furthermore, we aimed to introduce the CAD-RADS 2.0 including the assessment of coronary artery stenosis, plaque, and other key findings, and highlight the steps for CCTA reporting. Finally, we aimed to present recent research trends including the perivascular fat attenuation index, artificial intelligence, and the advancements in CT technology.
The Beneficial Effect of Iron in Aluminum-Cerium-Based Cast Alloys
Authors: Moodispaw Michael P. , Cinkilic Emre , Miao Jiashi , Luo Alan A.
Published: March 2024

Iron (Fe) has been considered a major impurity since it is detrimental to the mechanical properties of many cast aluminum alloys due to the formation of Fe-containing brittle intermetallic phases. Fe is found naturally as an impurity in bauxite ore, resulting in Fe contamination of aluminum alloys with increasing contamination from current recycling practices. The Al–Ce–Fe system was investigated using CALPHAD (CALculation of PHAse Diagrams) modeling and experimental casting techniques. It was found that additions of Fe to the Al–Ce system are beneficial to the strength (slightly) and ductility (significantly) of the ternary alloys, which is attributed to the formation of fine metastable Al8CeFe2 phase with aggregate morphology and equilibrium Al10CeFe2 phase, suppressing coarse proeutectic Al11Ce3 phase in near-eutectic Al–Ce alloys. Heat treatment study showed that the metastable Al8CeFe2 phase transforms to predicted equilibrium Al10CeFe2 phase at 500 °C, with essentially no intermetallic or grain coarsening; thus, the alloy displayed excellent property retention. The Al–Ce–Fe alloy system offers opportunities for sustainable, recyclable alloy development using low-cost Fe and low-cost cerium (a byproduct of rare-earth extraction).
Online Supervisory System for In-Process Optimization of Calcium Additions by Continuously Monitoring the State of Non-metallic Inclusions Inside Low-Alloyed Liquid Steels
Authors: Kuthe Sudhanshu , Rössler Roman , Karasev Andrey , Glaser Björn
Published: March 2024

A decision support system was developed using supervised machine learning (ML) approach for optimization of calcium (Ca) additions by continuously monitoring the physical state of non-metallic inclusions (NMIs) inside low-alloyed liquid steels. In this work, two instances were considered to design the base algorithm for the proposed supervisory system: (1) Clogging of submerged entry nozzle (SEN) during continuous casting of steels due to accumulation of solid oxide non-metallic inclusions (NMIs) and (2) Ca treatment during secondary steelmaking for modification of oxide NMIs from solid to liquid state to avoid SEN clogging. At first, experimental investigations were carried out on liquid steel samples from three low-alloyed Ca-treated steel grades from the same steel family to evaluate the characteristics of solid oxide NMIs that cause SEN clogging. In the next step, data-driven models were developed using an in-house ML algorithm trained primarily with process data for calculating the value of the newly proposed dummy parameter ‘Clog.’ These models, after testing, were architected to develop a supervisory system based on experimental investigations and data-driven models. The objective of this proposed supervisory system was to predict the optimum quantity of Ca needed for successful modification of NMIs from solid to liquid state to avoid SEN clogging based on the forecasted ‘Clog’ value. Finally, industrial data from ~ 3000 heats were tested to verify the results obtained from the developed supervisory system. The results confirmed that this novel supervisory system could predict the optimum class of Ca for all studied steel grades with 95 to 98 pct accuracy. The integration of this online supervisory system in steel production is expected to minimize operators’ corrective actions in achieving realistic control of Ca additions.
A Computational Multiscale Modeling Method for Nanosilver-Sintered Joints with Stochastically Distributed Voids
Authors: Sun Zhongchao , Guo Wendi , Jørgensen Asger Bjørn
Published: March 2024

A high power density is required in wide band gap power semiconductor packaging, which has led to the popularity of sintered nanosilver as an interconnecting material. However, affected by stochastically distributed voids in its microstructure, this material in practice exhibits instability leading to reduced reliability. In this paper, a computational multiscale modeling method is proposed to simulate the influence of micro-voids on macro-properties, providing an efficient tool to analyze the aforementioned problem. At the micro-scale, the three-parameter Weibull distribution of the equivalent Young’s modulus and the normal distribution of the equivalent Poisson’s ratio are captured by Monte Carlo-based finite element simulation on the reconstructed stochastic representative elements, where the density and distribution morphology of micro-voids are taken into consideration. At the macro-scale, the effect of the microscopic voids is transferred through a random sampling process to construct the multiscale model. The effectiveness and validity of the proposed method are verified through experimental case studies involving the modeling of nanosilver-sintered joints sintered at temperatures of 275°C and 300°C. In addition, the effects of the sintering temperature on the dispersion of the micro-voids, the distribution fluctuation of the constitutive parameters, and the mechanical properties are also discussed based on numerical and experimental results.

Graphical Abstract
Rate-induced tipping can trigger plankton blooms
Authors: Vanselow Anna , Halekotte Lukas , Pal Pinaki , Wieczorek Sebastian , Feudel Ulrike
Published: March 2024

Plankton blooms are complex nonlinear phenomena whose occurrence can be described by the two-timescale (fast-slow) phytoplankton-zooplankton model introduced by Truscott and Brindley (Bulletin of Mathematical Biology 56(5):981–998, 1994). In their work, they observed that a sufficiently fast rise of the water temperature causes a critical transition from a low phytoplankton concentration to a single outburst: a so-called plankton bloom. However, the dynamical mechanism responsible for the observed transition has not been identified to the present day. Using techniques from geometric singular perturbation theory, we uncover the formerly overlooked rate-sensitive quasithreshold which is given by special trajectories called canards. The transition from low to high concentrations occurs when this rate-sensitive quasithreshold moves past the current state of the plankton system at some narrow critical range of warming rates. In this way, we identify rate-induced tipping as the underlying dynamical mechanism of largely unpredictable plankton blooms such as red tides, or more general, harmful algal blooms. Our findings explain the previously reported transitions to a single plankton bloom, and allow us to predict a new type of transition to a sequence of blooms for higher rates of warming. This could provide a possible mechanism of the observed increased frequency of harmful algal blooms.
Immunophenotypic and Gene Expression Analyses of the Inflammatory Microenvironment in High-Grade Oral Epithelial Dysplasia and Oral Lichen Planus
Authors: Flores-Hidalgo Andres , Phero James , Steward-Tharp Scott , Williamson Megumi , Paquette David , Krishnan Deepak , Padilla Ricardo
Published: March 2024

Background

Oral lichen planus (OLP) and oral epithelial dysplasia (OED) present diagnostic challenges due to clinical and histologic overlap. This study explores the immune microenvironment in OED, hypothesizing that immune signatures could aid in diagnostic differentiation and predict malignant transformation.

Methods

Tissue samples from OED and OLP cases were analyzed using immunofluorescence/immunohistochemistry (IF/IHC) for CD4, CD8, CD163/STAT1, and PD-1/PDL-1 expression. RNA-sequencing was performed on the samples, and data was subjected to CIBERSORTx analysis for immune cell composition. Gene Ontology analysis on the immune differentially expressed genes was also conducted.

Results

In OED, CD8 + T-cells infiltrated dysplastic epithelium, correlating with dysplasia severity. CD4 + lymphocytes increased in the basal layer. STAT1/CD163 + macrophages correlated with CD4 + intraepithelial distribution. PD-1/PDL-1 expression varied. IF/IHC analysis revealed differential immune cell composition between OED and OLP. RNA-sequencing identified upregulated genes associated with cytotoxic response and immunosurveillance in OED. Downregulated genes were linked to signaling, immune cell recruitment, and tumor suppression.

Conclusions

The immune microenvironment distinguishes OED and OLP, suggesting diagnostic potential. Upregulated genes indicate cytotoxic immune response in OED. Downregulation of TRADD, CX3CL1, and ILI24 implies dysregulation in TNFR1 signaling, immune recruitment, and tumor suppression. This study contributes to the foundation for understanding immune interactions in OED and OLP, offering insights into future objective diagnostic avenues.
Post-stack seismic inversion through probabilistic neural networks and deep forward neural networks
Authors: Sotelo Víctor , Almanza Ovidio , Montes Luis
Published: March 2024

Seismic inversion, a nonlinear, non-unique-solution, and human-prone error problem, seeks the optimal solution in multivariate space, a task that AI algorithms perform better. So, inversion with AI becomes appropriate to extract information from post-stack data. A probabilistic neural network (PNN) and deep feedforward neural network (DFNN) inverted seismic data using multiattributes, and their results were compared with those provided by a model-based inversion (MBI). Applied to a post-stack volume of the Frontier Formation at the Teapot-Dome field, Wyoming-USA, the three methods provided porosity volumes (ϕ), gamma rays (GR), and Lamé impedances (µρ, λρ). The comparison between well-logs and the provided volumes revealed a reliable PNN prediction, while DFNN achieved the best geologically correlated parameter sections and a less reliable MBI prediction. The geomorphological time-slice analysis discriminated high ϕ-µρ areas and low GR–λρ areas, geologically interpreted as a deltaic environment, with distributary channels and beachfront lobes subject to the action of the tides, which agrees with the well-log interpretation and the basin geological evolution. The results enhanced the stacked section’s importance by the geological information contained, which would contribute to reducing the prospecting risk. Finally, PNN and DFNN encouraging results reaffirm their best searching-in-multivariate space ability.
Social Cognitive Predictors of Bystander Intervention in Racial Microaggressions Among College Students
Authors: Marks Laura Reid , Jenkins Lyndsay , Perez-Felkner Lara , Templeton Da’Shay Portis , Verma Khyati
Published: March 2024

Integrating microintervention strategies and the bystander intervention model, we examined social cognitive predictors (i.e., moral disengagement, empathy, and self-efficacy) of the five steps of the bystander intervention model (i.e., Notice, Interpret, Accept, Know, and Act) to address racial microaggressions in a sample of 452 racially diverse college students. Data were collected using an online survey. Path analyses showed that moral disengagement was significantly and negatively related to each step of the model for White students, but for students of color, it was only significantly negatively associated with Act. Empathy was significantly and positively associated with Interpret, Accept, and Act for White students. For student of color, however, there was a significant and positive association solely between Empathy and Act. For both White students and students of color, self-efficacy was positively associated with Notice, Interpret, Accept, Know, and Act. Finally, race did not significantly moderate any relationships. Strengths, limitations, future directions for research, and implications of the study findings are discussed.
Microfluidic Capture Device for Simple, Cell Surface Marker-Based Quantification of Senescent CD8+ T Cells
Authors: Choi Yo-han , Kim Woo-Joong , Lee Dongwoo , Jung Bum-Joon , Shin Eui-Cheol , Lee Wonhee
Published: March 2024

Among human CD8+ T cells, senescent cells are marked by the expression of CD57. The frequency of senescent CD57+CD8+ T cells is significantly correlated with aging and age-associated disorders, and it can be measured by multi-color flow cytometry. However, multi-color flow cytometry presents challenges in terms of accessibility and requires significant resource allocation. Therefore, developing a rapid and straightforward method for quantifying CD57+CD8+ T cells remains a key challenge. This study introduces a microfluidic device composed of a PDMS microfluidic channel with a pre-modified glass substrate for anti-CD8 antibody immobilization. This design allows blood samples to flow through, enabling the selective capture of CD8+ T cells while minimizing the required blood sample volume. This technology enables accurate and reliable quantification of CD57+ cells among captured CD8+ T cells through fluorescence image analysis. The ability of the device to easily quantify senescent CD57+CD8+ T cells is anticipated to contribute significantly to both immunological research and clinical applications.
Wildfires as legacies of agropastoral abandonment: Gendered litter raking and managed burning as historic fire prevention practices in the Monte Pisano of Italy
Authors: Mathews Andrew S. , Malfatti Fabio
Published: March 2024

Agropastoral practices that historically reduced the flammability of Mediterranean landscapes are poorly understood due to state prohibitions and lack of scientific interest. Oral histories, analysis of agronomical writings, transect walks, and ethnographic study of fire managers and community members in the Monte Pisano of Italy, find legacies of traditional agropastoral practices in present-day landscapes. Forest leaf litter raking, largely carried out by women, combined with fire wood cutting and burning to greatly reduce fire risk. Historic stigmatization of traditional burning and ignoring gendered peasant labor have reduced contemporary scientists’ and fire managers’ understandings of ecological processes and of options for reducing fire risk. Fire managers in the Mediterranean, and in areas around the world affected by rural depopulation, would benefit from a better understanding of traditional agropastoral and fire management practices. Litter raking has been understudied outside Central Europe, is often gendered, and may have important ecological consequences around the world.
Uitkomsten in de dagelijkse praktijk van eerstelijnschemotherapie voor niet-resectabel stadium III en IV urotheelcarcinoom van de blaas
Authors: Reesink Daan J. , van de Garde Ewoudt M. W. , van der Nat Paul B. , Los Maartje , Horenblas Simon , van Melick Harm H. E. ,   Santeon MIBC-studiegroep, Biesma D. H. , Stijns P. E. F. , Lavalaye J. , de Bruin P. C. , Peters B. J. M. , Somford D. M. , Berends M. , Richardson R. , Van Andel G. , Klaver O. S. , Haberkorn B. C. M. , Van Rooijen J. M. , Korthorst R. A. , Meijer R. P. , Van der Voort Van Zyp J. R. N.
Published: March 2024

Samenvatting

Dit onderzoek evalueert de kloof tussen de werkzaamheid (efficacy) van palliatieve eerstelijns (1L) chemotherapiebehandeling (CTx) voor urotheelcarcinoom van de blaas in klinische onderzoeken en de effectiviteit (effectiveness) in de dagelijkse praktijk (efficacy-effectiveness gap (EE gap). Van zeven Nederlandse opleidingsziekenhuizen werden alle patiënten geïncludeerd die tussen 2008 en 2016 werden gediagnosticeerd met niet-resectabel stadium III (cT2-4aN1-3M0) en IV (cT4b en/of cM1)-ziekte en die 1L-CTx ondergingen. De mediane algehele overleving (mOS) van gemcitabine + cisplatine (GemCis)-patiënten was 10,4 maanden (95 %-BI 7,9–13,0), wat korter is vergeleken met de klinische onderzoeken (bereik mOS: 12,7–14,3 maanden), ondanks vergelijkbare klinische kenmerken. Een EE gap lijkt te bestaan. De mOS van gemcitabine + carboplatine (GemCarbo)-patiënten was 9,3 maanden (95 %-BI 7,5–11,1). GemCarbo-patiënten hadden slechtere prognostische kenmerken (hogere leeftijd, verminderde nierfunctie en een slechtere performance status (alle p-waarden < 0,001) vergeleken met GemCis-patiënten, maar de overleving verschilde niet significant in een multivariabele regressieanalyse (HR 0,90 (95 %-BI 0,55–1,47), p-waarde = 0,674).
Safety and efficacy of extended versus standard interval dosing of natalizumab in multiple sclerosis patients: a systematic review and meta-analysis
Authors: Rabea Eslam Mohammed , Belal Mohamed Mohamed , Hafez Abdelrahman H. , Elbanna Ashraf Hassan , Khalifa Mahmoud Ahmed , Nourelden Anas Zakarya , Mahmoud Nada H. , Zaazouee Mohamed Sayed
Published: March 2024

Background

Multiple sclerosis (MS) is a chronic inflammatory, immune-mediated disease affecting the central nervous system. Natalizumab, an FDA-approved monoclonal antibody for MS, has been explored for its off-label extended interval dosing (EID), suggesting a potential reduction in the risk of progressive multifocal leukoencephalopathy (PML) compared to standard interval dosing (SID). Our objective was to assess the efficacy and safety of EID in comparison to SID for natalizumab treatment in patients with MS.

Methods

We searched PubMed, Embase, WOS, Scopus, Ovid, Science Direct, Clinical trials.gov, and Cochrane Library. Our assessed outcomes were clinical relapses, MRI activity, change in expanded disability status scale [EDSS], and the risk of PML. The EID group was defined as 5 to 8 weeks [EID (Q5-8W)]. The analysis was conducted using RevMan ver. 5.4. The effect estimates were presented as a risk ratio [RR] or mean difference with 95% confidence intervals [CI] using SID group as the reference for comparisons.

Results

Fourteen studies met our inclusion criteria: 2 RCTs, 1 switched single-arm trial, and 12 observational studies. No significant differences were found in all efficacy outcomes of interest. Risk of clinical relapses [RR = 0.90, (95%CI 0.80, 1.02)], risk of new or newly enlarging T2 hyperintense MRI lesions [RR = 0.78, (95%CI 0.59, 1.04)], risk gadolinium enhancing lesions [RR = 1.30, (95%CI 0.98, 1.72)], change in EDSS [MD = 0.09 (95%CI − 0.57, 0.76)], risk of PML [RR = 1.09, 95%CI (0.24, 4.94)].

Conclusion

In summary, our meta-analysis indicates that natalizumab maintains its effectiveness under extended interval dosing [up to 8 weeks], presenting comparable risks for clinical relapses, MRI lesions, EDSS, and PML. Caution is advised given study limitations and heterogeneity. Robust conclusions necessitate well-designed high-quality prospective studies.
Mutations associated with boscalid and pyraclostrobin resistance of Botrytis cinerea from vegetable fields in Turkey
Authors: Gül Esra , Karakaya Aziz , Ergül Ali
Published: March 2024

Botrytis cinerea Pers. is a polyphagous fungal pathogen that can cause significant damage in the field, warehouse, and greenhouse conditions. In Turkey, fungicides with site-specific modes containing the active ingredients boscalid and pyraclostrobin are used to control B. cinerea. In this study, it was aimed to determine the mutations associated with resistance to boscalid and pyraclostrobin active substances in B. cinerea isolates obtained from tomato, pepper, eggplant, and lettuce in Turkey. In the in vitro bioassay, a conidial germination test was performed. It was determined that 26% of the isolates used in the bioassay test were resistant. After that, mutations associated with resistance were investigated. Mutations associated with boscalid resistance were found in 18 isolates whose SdhB gene was sequenced. No mutations were detected in sensitive MH51 and Ant34 isolates. It has been determined that N230I and H272R mutations were found to be frequent in B. cinerea populations in Turkey. P225F mutation was detected only in the B4 isolate obtained from the pepper in Antalya. The mutations associated with boscalid resistance detected in this study are reported for the first time in Turkey. The G143A mutation associated with pyraclostrobin resistance was detected in all the isolates sequenced.
Um der Freiheit willen: Der demokratische Rechtsstaat bleibt Europas Verfassungszukunft
Authors: Kotzur Markus
Published: March 2024

Liberale Demokratien befinden sich durch ineinandergreifende Krisenereignisse und den daraus resultierenden Vorschub autoritärer Kräfte in einem Zustand demokratischer Selbstentfremdung. Die klassischen Krisennarrative ordnen dabei oft fälschlich dauerhafte politische Wirklichkeiten als kurzfristig zu lösende Probleme ein. Die responsive Verfassung kann im Zusammenspiel mit dem Unionsrecht darauf durchaus effektive normative Antworten geben, insbesondere durch die Anerkennung des Individuums in seinem Selbst-Sein und seinen Grundrechten. Wichtige Akteure in diesem Prozess sind europäische (Verfassungs‑)Gerichte, die kontextbewusst die Responsivität des Rechts vermitteln.
Spontaneous hypoglycemia: should we mind the gap? Long-term follow-up of healthy people who met Whipple’s triad criteria
Authors: Adelmeyer Jan , Schauer Christian Marcel , Kann Peter Herbert
Published: March 2024

Context

Patients discharged as “healthy” with the symptoms of spontaneous hypoglycemia, commonly known as Whipple’s triad, need more attention.

Objective

Characterization and long-term follow-up of symptom development in patients with spontaneous hypoglycemia discharged as “healthy”. The objective was to ascertain whether any conditions related to the symptoms were diagnosed during the follow-up period.

Methods

Retrospective analysis of patient data and evaluation of a specific questionnaire on the development of symptoms of spontaneous hypoglycemia. In addition, patient questionnaires were evaluated and primary care physicians were asked about possible diseases not recorded at baseline that occurred during the follow-up period.

Setting

Center for Endocrinology, Diabetology, and Osteology at the University Hospital Marburg, Inpatient Department, Germany.

Patients

All patients who presented to our center for the 72-hour fast between 2005 and 2018 and were discharged without an internal medicine diagnosis were included.

Interventions

Survey by questionnaire, via telephone interview.

Main outcome measures

Patient-reported information on current symptoms compared to original symptoms, diagnosis of insulinoma or diabetes mellitus during follow-up, matched with primary care physician data, and metabolic and biometric data such as body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA IR), insulin sensitivity Matsuda Index (ISI-M), and area under the curve.

Results

A total of 41 datasets were evaluated at baseline and 38 patients were followed for an average of approximately 10 years. In total, 61% of respondents still reported the same symptoms as at baseline. No insulinoma was missed in these patients. Only two of the 38 patients developed diabetes mellitus.

Conclusion

The high percentage of patients who are discharged as “healthy” and still have symptoms after many years is disturbing. It is possible that the symptoms are not due to low blood glucose. We urge caution with use of the term “healthy”. We advocate a multidisciplinary therapeutic approach after an organic cause of hypoglycemia has been ruled out. Psychosomatic treatment seems to be useful. In addition, more research should be conducted on this topic.
Knowledge, attitudes, and practices of health professions students on mentorship: a cross-sectional study at a sub-Saharan African medical school
Authors: Tamale Elvis , Atuhairwe Irene , Ssemwogerere Arnold , Muhimbura Brian , Atimango Lorna , Malinga Paddy Derrick , Mulungi Jonathan , Ssekitto Joseph , Naigaga Josephine , Kintu Timothy Mwanje , Masood Kiran Mitha , Ohuruogu Victor , Ngonzi Joseph
Published: March 2024

Background

Mentoring involves the informal conveyance of knowledge, social capital, and support, as perceived by the recipient to be pertinent to aspects of work, career, and personal or professional development. Students pursuing health-related courses need access to mentorship and its benefits during their formative academic and career states. However, in Sub-Saharan Africa, many institutions have not fully embraced this despite the benefits of mentorship.

Aim

The primary purpose of this study was to assess medical students’ knowledge about mentorship and explore their attitudes and practices toward mentorship.

Methodology

We held an online cross-sectional study utilizing a pre-tested self-reported questionnaire targeting health professional students in the faculty of medicine, Mbarara University of Science and Technology (MUST). The collected data were coded and summarized using descriptive statistics and thematic analysis.

Results

Two hundred eighty-three (283) students participated in this study. Of this group, 79.9% were aware of mentorship, 61% were willing to commit 1–2 h a week for mentorship, and Zoom was the preferred mode of communication; 98.2% expressed the need for a structured student-led hybrid mentorship program.

Conclusion

Mentorship at Mbarara University of Science and Technology was considered beneficial by health professions students in the Faculty of Medicine.

Recommendation

Future studies should explore accessibility to mentorship and the effectiveness of existing mentorship processes.
Team science competencies across the career life course for translational science teams
Authors: Mendell Angela M. , Knerich Verena , Ranwala Damayanthi , Jones Carolynn T. , Piechowski Patricia , Striley Catherine W. , McCormack Wayne T. , Cross Jennifer E.
Published: March 2024

Introduction:

Translational science (TS) teams develop and conduct translational research. Academic TS teams can be categorized under three constituency groups: trainees and faculty, clinical research professionals (CRP), and community partners. Our study objectives were to define individual and team competencies of these three constituency groups during their career life course and determine relative importance and the level of mastery of each of the competencies needed at different stages of their life course.

Methods:

Each group was composed of experts for their constituency group. We applied individual and team competencies in TS teams by Lotrecchiano et al. (2020) as a starting point for structured expert discussions following a modified Delphi approach that we adapted based on the emergent needs and insights per constituency group.

Results:

The degree of relevance and level of mastery for individual and team competencies varies for trainees and faculty members across the career life course based on opportunities provided and relative importance at that career stage. However, CRPs enter TS teams at various career stages with fundamental, skilled, or advanced levels of smart skills that may or may not be contextual to their role. Community partners equally possess and develop competencies in a non-linear and contextual fashion that are required to facilitate constructive, bi-directional collaboration with other members of TS teams.

Conclusions:

Team science competencies across the career life course do not develop linearly among different constituency groups and require an adaptive framework to enhance TS team effectiveness.
Superjudges and the Separation of Powers: A Case Study of Judicial Informality in Czechia
Authors: Kadlec Ondřej , Blisa Adam
Published: March 2024

Examining the practices of i) the selection of judges, ii) panel composition and case assignment, and iii) judicial off-bench activities, the article argues that some Czech judges, most often court presidents and apex court judges, use informal judicial institutions as tools to increase their influence on judicial administration and the decision-making of courts. As a result, these judges have far greater influence than the formal account of their roles might suggest. The article explores the context which facilitated the informal rise of these “Superjudges”, asserting that the key factors were institutionally independent judiciaries with individually dependent judges, the absence of a shared understanding of fundamental constitutional concepts, and the underperformance of Czech legal academia. The article then contends that while Superjudges may contribute to an informed, effective, and politically independent functioning of the judiciary, they also risk eroding important divisions of power which, in turn, might compromise the integrity of the judicial process, undermine the authority of courts, and disconnect the content of the law from the general interest.
Civil Society as an Informal Institution in Ukraine’s Judicial Reform Process
Authors: Lashyn Serhii , Leshchyshyn Anastasia , Popova Maria
Published: March 2024

Since the Revolution of Dignity, civil society has become a major stakeholder in Ukraine's multiple reform processes. Judicial reform has been particularly salient as it aims to transform the country’s judiciary, long plagued by interrelated problems of political dependence, oligarchic capture, and internal corruption, into an autonomous guarantor of the rule of law. This Article examines how Ukrainian civil society has developed into an informal institution in Ukraine’s judicial reform. Building upon an overview of judicial reform efforts in Ukraine and a general theoretical framework of informality, this contribution studies how Ukrainian civil society influences the reform process, using the example of the country’s Constitutional Court. We argue that civil society has become an influential informal institution which plays an increasingly important role in judicial reform in Ukraine.
Informality as a Virtue: Exploring Positive Informal Judicial Institutions
Authors: Smekal Hubert
Published: March 2024

Most scholarly writings focus on the harmful effects of informal institutions. This article explores the positive influence of informal judicial institutions on the fundamental values of judicial systems. It develops a framework for assessing such institutions. The paper argues that the normative evaluation of informal judicial institutions is highly context-specific. Depending on their historical trajectories, different jurisdictions may emphasize different interests. Because of this, when evaluating informal judicial institutions, balancing the same values may yield different results in different jurisdictions. The recent trend towards formalization, supported by supranational institutions, goes hand-in-hand with the spreading narrative of good governance, emphasizing principles such as transparency or inclusion, principles that generally stand in tension with informality. This article cautions against emerging supranational templates insensitive to local practice.
Attitudes, subjective norms and perceived behavioural control factors influencing Canadian secondary school students’ milk and milk alternatives consumption
Authors: Thompson Carise M , Elliott Susan J , Meyer Samantha , Leatherdale Scott T , Majowicz Shannon E
Published: March 2024

Objective:

The research objectives were to evaluate factors that influence Canadian secondary school students’ milk and milk alternatives (MMA) consumption and to explore associations through age and gender lenses.

Design:

A qualitative design was used, consisting of semi-structured interviews and photo-elicitation methods. Analysis was guided by the Theory of Planned Behaviour (TPB). Deductive and inductive thematic analyses were used to generate themes, charting data based on attributes such as gender and age.

Setting:

Interviews were held virtually or via telephone.

Participants:

Participants were twenty-eight high school students from Ontario, Canada, diverse in terms of gender and age.

Results:

Both desirable and undesirable beliefs about the health outcomes of consuming MMA were commonly discussed. These included health benefits such as strong bones, muscular strength, and growth, and health consequences like unwanted skin conditions, weight gain, and diseases. While boys and girls associated MMA consumption with muscular strength, boys predominantly considered this favourable, while girls discussed outcomes like unwanted skin conditions and weight gain more often. Adolescents’ perspectives on taste/perceived enjoyment, environmentally friendly choices and animal welfare also influenced their MMA preferences. Parental influences were most cited among social factors, which appeared to be stronger during early adolescence. Factors involving cost, time and accessibility affected adolescents’ beliefs about how difficult it was to consume MMA.

Conclusions:

Recommendations for shifting attitudes towards MMA are provided to address unfavourable beliefs towards these products. Interventions to increase MMA consumption among adolescents should include parents and address cost barriers.
Rift Propagation Interacting With Pre‐Existing Microcontinental Blocks
Authors: Qing Jiarong , Liao Jie , Brune Sascha
Published: March 2024

Rift propagation is a 3D thermo‐mechanical process that often precedes continental breakup. Pre‐existing microcontinental blocks and the associated lithospheric strength heterogeneities influence the style of rift propagation. Interestingly, some rifts propagate into pre‐existing blocks and eventually cut through them (e.g., the Zhongsha Block and the Reed Bank), while others bypass these microcontinental blocks forming distinct overlapping rift branches (e.g., the East African Rift System). In this study, we use 3D numerical models to investigate the interaction between microcontinental blocks and rift propagation under different far‐field extension rates. In doing so, we assess the impact of mantle lithospheric thicknesses and lower crustal rheology on the style of rift propagation. Our models reproduce the two types of rift propagation, characterized by propagating rifts that either split or bypass the pre‐existing microcontinental blocks. We find that lithospheric thickness exerts dominant control, while lower crustal rheology of microcontinental blocks and the extension rate have less effect on rift propagation. Our model results can explain rift propagation patterns, block rotation and strong lithospheric thinning in the South China Sea, the East African Rift System, and the Woodlark Basin.
Perseverance MEDA Atmospheric Pressure Observations—Initial Results
Authors: Harri Ari‐Matti , Paton Mark , Hieta Maria , Polkko Jouni , Newman Claire , Pla‐Garcia Jorge , Leino Joonas , Mäkinen Terhi , Kauhanen Janne , Jaakonaho Iina , Sánchez‐Lavega Agustin , Hueso Ricardo , Genzer Maria , Lorenz Ralph , Lemmon Mark , Vicente‐Retortillo Alvaro , Tamppari Leslie K. , Viudez‐Moreiras Daniel , Torre‐Juarez Manuel de la , Savijärvi Hannu , Rodríguez‐Manfredi Javier A. , Martinez German
Published: March 2024

The Mars2020 Perseverance Rover landed successfully on the Martian surface on the Jezero Crater floor (18.44°N, 77.45°E) at Martian solar longitude, Ls, ∼5° in February 2021. Since then, it has produced highly valuable environmental measurements with a versatile scientific payload including the MEDA (Mars Environmental Dynamics Analyzer) suite of environmental sensors. One of the MEDA systems is the PS pressure sensor system, which weighs 40 g and has an estimated absolute accuracy of better than 3.5 Pa and a resolution of 0.13 Pa. We present initial results from the first 414 sols of Martian atmospheric surface pressure observations by the PS, whose performance was found to meet its specifications. Observed sol‐averaged atmospheric pressures follow an anticipated pattern of pressure variation in the course of the advancing season and are consistent with data from other landing missions. The observed daily pressure amplitude varies by ∼2%–5 % of the sol‐averaged pressure, with absolute amplitude 10–35 Pa in an approximately direct relationship with airborne dust. During a regional dust storm, which began at Ls ∼ 135°, the daily pressure amplitude roughly doubled. The daily pressure variations were found to be remarkably sensitive to the seasonal evolution of the atmosphere. In particular, analysis of the daily pressure signature revealed diagnostic information likely related to the regional scale structure of the atmosphere. Comparison of Perseverance pressure observations with data from other landers reveals the global scale seasonal behavior of Mars' atmosphere.