Climate change action as a project of identity: Eight meta-analyses

Identity can improve our understanding of personal climate action, particularly when climate action becomes an expression of a person’s self. However, it is unclear which kind of self or identity is most relevant. Building on a comprehensive series of eight meta-analyses (using data from 188 published articles, N = 414,282 participants) this research systematically compares how strongly climate-friendly intentions and behaviors are associated with place identity, personal connectedness to nature, environmental self-identity (i.e., personal self-definition as a pro-environmentally acting person), and social identity (i.e., identification with social groups). Results suggest robust, medium-sized to strong links of both pro-environmental intentions and behaviors to people’s nature connectedness (r = 0.44/0.52), environmental self-identity (r = 0.62/0.56), and identification with groups considered to support climate-friendly behavior (r = 0.48/0.51), but markedly weaker effects for identification with groups which are unrelated to environmental topics (r = 0.30/0.15) and for place identity (r = 0.18/0.32). Implications for policy interventions and psychological theory are discussed.publishedVersio

Neoadjuvant atezolizumab plus bevacizumab prior liver transplantation for hepatocellular carcinoma

Background & Aims: The combination of atezolizumab and bevacizumab offers a novel approach to immunomodulation, showing efficacy as a primary treatment in advanced hepatocellular carcinoma (HCC). Concerns about graft safety and rejection have limited its exploration in the neoadjuvant setting of liver transplantation (LT). In this study, we investigate the clinical efficacy and the safety profile of pre-transplant administration of atezolizumab and bevacizumab for HCC. Methods: Herein, we performed a prospective assessment of 17 patients with HCC treated with neoadjuvant preoperative atezolizumab and bevacizumab prior to LT for HCC, obtained from December 2020 and December 2023 at seven Western transplant centers. Results: Among the 17 patients with HCC included in the study, 16 (94.1%) had a tumor burden outside of Milan criteria. Neoadjuvant locoregional therapies along with the administration of atezolizumab plus bevacizumab (median: 5 months; discontinued at least 4 weeks prior to LT) led to an objective response rate of 94% (complete response: 59%), downstaging to within Milan criteria (82%) and a pathological response at explant examination of 88%. Grade 3-4 treatment-related adverse events accounted for 17.6% of cases and were manageable. During the 25-month median follow-up period, two cases of mild (rejection activity index ≤4), biopsy-proven rejection were reported but no instances of severe allograft rejection or graft loss were reported. The 1-year and 3-year post-LT survival rates were 94.2% and 88.2%, respectively. Conclusions: This study highlights the favorable oncological and survival outcomes associated with atezolizumab and bevacizumab treatment in the pre-LT setting. This immune-based combination was safe in terms of treatment-related adverse events, and absence of severe post-transplant rejection or graft loss. These preliminary results could pave the way for expanding transplant eligibility criteria in patients at more advanced HCC stages. Impact and Implications: Studies on the combination of atezolizumab and bevacizumab in the neoadjuvant setting prior to liver transplantation for hepatocellular carcinoma have been limited, despite its potential to enhance anti-tumor responses and downstaging, owing to concerns about its safety profile. Among 17 patients who underwent successful liver transplantation following neoadjuvant atezolizumab/bevacizumab, 82% achieved downstaging to within Milan criteria, 94% radiological objective response and 88% pathology response, without drop-outs due to treatment-related adverse events or graft loss. The neoadjuvant combination of atezolizumab plus bevacizumab prior to liver transplantation for hepatocellular carcinoma shows an encouraging safety profile and stands out as a promising pre-transplant optimization treatment, leading to improved oncological outcomes

Video review of family medicine resident clinical encounters: a tool for building emotional intelligence

Video Review (VR) is a well established educational tool for developing the practice of patient-centered care in family medicine residents. There are a number of behaviorally-based checklists that can be use in both live observation as well as VR of clinical encounters to identify and promote behaviors associated with patient-centered care, most of which also overlap with behaviors associated with Emotional Intelligence (EI). We propose a VR that is structured less on a seek-and-find of clinician behaviors and more as a self-reflective exercise of how the clinician presents in the room alongside how they were feeling during that encounter. We believe that this exercise promotes the first two skills of EI (self-awareness and self-management) and then provides a foundation on which to build the second pair of skills (social awareness and relationship management). This perspective paper offers guidance, including stepwise instruction, on how to facilitate such a VR curriculum

Increased expression of carbonic anhydrase I in the synovium of patients with ankylosing spondylitis

<p>Abstract</p> <p>Background</p> <p>One of the most distinctive features of ankylosing spondylitis (AS) is new bone formation and bone resorption at sites of chronic inflammation. Previous studies have indicated that the hyperplasia and inflammation of synovial tissues are significantly related to the pathogenic process of AS. The present study used a proteomic approach to identify novel AS-specific proteins by simultaneously comparing the expression profiles of synovial membranes from patients with AS, rheumatoid arthritis (RA) and osteoarthritis (OA).</p> <p>Methods</p> <p>Synovial tissues were collected from the hip joints of patients with AS and knee joints of patients with RA or OA (n = 10 for each disease) during joint replacement surgery. Proteins extracted from the synovial tissues were separated by 2-D electrophoresis (2-DE), and the proteins with significantly increased expression in the AS samples were subjected to MALDI-TOF/TOF-MS analysis. The results were verified using western blotting and immunohistochemistry. Levels of the candidate proteins in synovial fluids from knee joints (n = 40 for each disease) were measured using ELISA.</p> <p>Results</p> <p>The proteomic approach revealed significantly increased expression of carbonic anhydrase I (CA1) in the synovial membrane of patients with AS as compared with the RA and OA tissue samples. Immunohistochemistry and western blotting analysis confirmed the findings described above. The ELISA detected a higher level of CA1 in synovial fluids from patients with AS than those with OA. The mean value of the CA1 level was also higher in AS patients as compared with RA patients. This study also detected increased expression of alpha-1-antitrypsin in the synovial tissues from AS patients, which is in agreement with other reports.</p> <p>Conclusion</p> <p><it>In vitro </it>experiments by other groups indicated that CA1 catalyzes the generation of HCO₃^-through the hydration of CO₂, which then combines with Ca²⁺to form a CaCO3 precipitate. Calcification is an essential step of bone formation. Substantial evidence indicates that carbonic anhydrase also stimulates bone resorption. Hence, overexpression of CA1 in the synovial tissues of AS patients may promote improper calcification and bone resorption in AS.</p

A cross-cultural examination of adolescent civic engagement: Comparing Italian and American community-oriented and political involvement

The purpose of this study was to investigate community-oriented and political civic engagement activities and intentions among youth in Italy and the United States. Adolescents (N=566) from academically rigorous schools in both countries completed surveys assessing frequency of civic activity participation, motivation for activity, evaluations of activity, and intentions for future civic engagement. Results suggest that youth in both countries were more likely to participate in community-oriented than political civic activities and that youth in both countries found their civic experiences to be meaningful. American youth reported more past civic activities of both types and higher intentions for future community-oriented civic engagement compared to Italian youth. Finally, a model was tested to examine links between peer and school contexts and civic activities and intentions. Findings highlighted that, in both countries, peer and school contexts had a stronger impact on community-oriented than on political civic activity

Youth Sociopolitical Action and Well-Being: Costs, Benefits, and How to Support Sustainable Sociopolitical Practices

This Special Issue examines the links between sociopolitical action and healthy youth development. The 12 featured studies use diverse conceptual and methodological approaches to advance understanding of how the costs and benefits of youth sociopolitical action are dependent on identity, context, and structural factors. Key findings demonstrate that intersectional identities shape youth experiences of activism and that social contexts can exacerbate or buffer against personal risks, underscoring the importance of supportive environments that are attentive to each young person&rsquo;s experiences of oppression. The contributing authors propose pragmatic strategies to encourage mutually reinforcing associations between personal well-being and sociopolitical action, such as integrating healing-centered approaches into youth programming and contextualizing resistance to systemic oppression as a component of healthy development. This Special Issue calls for future research to refine theoretical models and develop sustainable, health-promotive strategies to support young people in their vital work to advance justice and equity

Civic Orientation in Cultures of Privilege

The context of privilege provides unique opportunities and challenges for youth civic development. A mixed-method approach was used to examine links between school-based community service, school climate, and civic orientation among students in cultures of privilege. Surveys completed by students ( N = 376) at two private high schools—one with an extracurricular community service requirement and one without—suggest that students in the school without the service requirement report similar, and in some cases more positive, civic attitudes than students from the school with the requirement. Focus-group data indicated that the service requirement was viewed positively, but illuminated other school experiences that might promote community orientation in cultures of privilege, such as an emphasis on global awareness and making civic priorities fundamental to school identity.</jats:p