scAnnoX: an R package integrating multiple public tools for single-cell annotation.

Background: Single-cell annotation plays a crucial role in the analysis of single-cell genomics data. Despite the existence of numerous single-cell annotation algorithms, a comprehensive tool for integrating and comparing these algorithms is also lacking. Methods: This study meticulously investigated a plethora of widely adopted single-cell annotation algorithms. Ten single-cell annotation algorithms were selected based on the classification of either reference dataset-dependent or marker gene-dependent approaches. These algorithms included SingleR, Seurat, sciBet, scmap, CHETAH, scSorter, sc.type, cellID, scCATCH, and SCINA. Building upon these algorithms, we developed an R package named scAnnoX for the integration and comparative analysis of single-cell annotation algorithms. Results: The development of the scAnnoX software package provides a cohesive framework for annotating cells in scRNA-seq data, enabling researchers to more efficiently perform comparative analyses among the cell type annotations contained in scRNA-seq datasets. The integrated environment of scAnnoX streamlines the testing, evaluation, and comparison processes among various algorithms. Among the ten annotation tools evaluated, SingleR, Seurat, sciBet, and scSorter emerged as top-performing algorithms in terms of prediction accuracy, with SingleR and sciBet demonstrating particularly superior performance, offering guidance for users. Interested parties can access the scAnnoX package at https://github.com/XQ-hub/scAnnoX.

[Mixed connective tissue disease and its management]. / La connectivite mixte et sa prise en charge.

Mixed connective tissue disease (MCTD) is a rare autoimmune condition. Since its first description 50 years ago, its mere existence has been debated, given that it shares features of other autoimmune diseases, such as systemic lupus erythematosus (SLE), systemic sclerosis, inflammatory myopathy, rheumatoid arthritis and Sjogren's syndrome. Also, while antibodies to U1-RNP are essential for the diagnosis of MCTD, these antibodies may be expressed in other circumstances, such as in case of SLE. Nevertheless, the patient fulfilling criteria for MCTD needs specific management. In this review, we describe the clinical features and the potential complications of this complex disease, often wrongly disregarded as benign. We will also emphasize the recommended follow-up exams and address treatment, which is currently lacking formal recommendations.

La connectivite mixte (mixed connective tissue disease (MCTD)) est une maladie auto-immune rare. Dès sa description il y a cinquante ans, l'existence propre de la MCTD est débattue, car les limites avec d'autres maladies, comme le lupus érythémateux systémique (LES), la sclérodermie, les myopathies inflammatoires, la polyarthrite rhumatoïde et le syndrome de Sjögren, sont floues. Les anticorps anti-U1-RNP obligatoires au diagnostic de MCTD sont également exprimés dans d'autres circonstances, comme le LES. Quoi qu'il en soit, le patient présentant des critères de MCTD nécessite une prise en charge spécifique. Nous présentons ici les signes cliniques et complications potentielles d'une maladie longtemps estimée à tort comme d'évolution bénigne. Nous abordons aussi les examens de suivi recommandés et la thérapeutique, qui reste à ce jour mal définie.

Enhancing employee wellbeing and happiness management in the wine industry: unveiling the role of green human resource management.

BACKGROUND: In today's business environment, where sustainability has emerged as a strategic axis of business practices, the study of the link between human resources management and environmental management becomes increasingly necessary. In this sense, the present research focuses on analyzing the impact of Green Human Resource Management (GHRM) on the Sustainable Performance (SP) of Spanish wineries, as well as the mediating effect of Employee Wellbeing (EW) and Work Engagement (WE) on this linkage. In addition, age, size and membership in a Protected Designation of Origin (PDO) are introduced as control variables to increase the precision of the cause-effect relationships examined. METHODS: The study proposes a conceptual model based on previous studies, which is tested using structural equations (PLS-SEM) with data collected from 196 Spanish wineries between September 2022 and January 2023. RESULTS: The findings of the research reveal the existence of a positive and significant relationship between the GHRM development and the SP of Spanish wineries, as well as the partial mediation of EW and WE in this association. CONCLUSIONS: The uniqueness and significance of this study can be attributed to several crucial factors. First, it enhances the understanding and knowledge regarding the advantages associated with GHRM development. Second, no prior research has conducted a comprehensive study on GHRM as a catalyst for SP within the context of Spanish wineries. Third, to the best of the authors' knowledge, no previous study has analyzed the mediating role of EW and WE as mediators in the relationship between GHRM and SP of wineries.

Sedation indicated?-rethinking existential suffering: a narrative review.

BACKGROUND AND OBJECTIVE: The indication "existential suffering (ES)" for palliative sedation therapy is included in most frameworks for palliative sedation and has been controversially discussed for decades. The appellative character of ES demands rapid relief and sedation often appears to be the best or only solution. ES is still poorly understood and so often neglected by health care professionals due to a lack of consensus regarding assessment, definition and treatment in the international medical literature. Based on a selective review of the literature on ES we propose a different view on the underlying processes of ES and the resulting consequences on medical treatment. METHODS: A narrative review was performed after PubMed search using key terms related to ES and sedation, covering the period from 1950 to April 2023, additionally a selective search in specialist literature on Existential Analysis. Reverse and forward snowballing followed. The language of analyzed publications was restricted to English and German. KEY CONTENT AND FINDINGS: ES is a multidimensional experience that tends to turn into despair and ultimately into a wish to die due to perceived hopelessness and meaninglessness. Pharmacological treatment or sedation do not meet the holistic needs of existential sufferers. The risk of harmful effects by continuous deep sedation seems to be significantly increased for existentially suffering patients. Professional caregivers are burdened by the appellative character of ES, limited treatment options and perceived empathic distress. Without a holistic understanding of the human condition in palliative care, ES cannot be fundamentally alleviated, and existential sufferers have no opportunity to transform and thus mitigate their condition. The recognition of underlying causes of suffering-moods is facilitated by the comprehensive approach of Existential Analysis. CONCLUSIONS: The presented concept of Existential Analysis and the triad of ES are useful instruments for health care professionals to recognize and support underlying moods of existentially suffering patients. Further studies are required. Comprehensive training for professional caregivers on ES is essential to enable them to reflect on their own existential concerns and finiteness as well as those of patients. Continuous deep sedation for ES must remain the exception, equivalent to a last resort option.

What counts as relevant criticism? Longino's critical contextual empiricism and the feminist criticism of mainstream economics.

I identify and resolve an internal tension in Critical Contextual Empiricism (CCE) - the normative account of science developed by Helen Longino. CCE includes two seemingly conflicting principles: on one hand, the cognitive goals of epistemic communities should be open to critical discussion (the openness of goals to criticism principle, OGC); on the other hand, criticism must be aligned with the cognitive goals of that community to count as "relevant" and thus require a response (the goal-relativity of response-requiring criticism principle, GRC). The co-existence of OGC and GRC enables one to draw both approving and condemning judgments about a situation in which an epistemic community ignores criticism against its goals. This tension results from conflating two contexts of argumentation that require different regulative standards. In the first-level scientific discussion, GRC is a reasonable principle but OGC is not; in the meta-level discussion about science, the reverse holds. In meta-level discussion, the relevance of criticism can be established by appealing to goals of science that are more general than the goals of a specific epistemic community. To illustrate my revision of CCE, I discuss why feminist economists' criticism of the narrowness of the goals pursued in mainstream economics is relevant criticism.

Engineered platelet-based immune engager for tumor post-surgery treatment.

Tumor metastasis and recurrence are principal reasons for the high mortality and poor prognosis of cancers. Inefficient engagement between T cell and tumor cell, as well as the universal existence of immune checkpoints, are important factors to the limited immunological surveillance of the immune systems to tumor cells. Herein, an immune engager based on engineered platelets with CD3 antibody modification (P-aCD3) was constructed to facilitate the contact between T cell and tumor cell via providing the anchoring sites of above two cells. Combined with the immune checkpoint blockade strategy, P-aCD3 effectively enhanced T cell mediated cytotoxicity and inhibited tumor recurrence and metastasis in mice melanoma postoperative model and breast cancer model, resulting in significantly prolonged survival of mice.

[When physicians and patients face the existential dimensions of illness]. / Quand médecins et patients-es sont confrontés-es aux dimensions existentielles de la maladie.

Our self-consciousness allows us to know that we exist and to situate ourselves in the world. However, self-consciousness also makes us realize that our existence is characterized by vulnerabilities, that we are individuals with experiences which cannot be experienced by the other and that we will not escape finitude. This selfconsciousness is usually in the background of our mind but may be brought to centre stage in case of illnesses which evolve toward death. Certain disciplines of medicine try to consider the existential dimensions of disease. The question remains what medicine can offer in such situations and why and for whom interventions to increase the well-being of patients under existential threat are proposed. An analysis of these developments needs to focus not only on patients, but also the clinician, medicine, and society.

La conscience de soi nous permet de savoir que nous existons dans le monde et de nous y situer. Elle nous fait aussi réaliser que notre existence est caractérisée par des vulnérabilités, que nous sommes des individus avec des expériences que personne ne peut vivre à notre place et que nous n'échapperons pas à la finitude. Cette conscience peut être propulsée sur le devant de la scène en cas de maladie évoluant vers la mort. Certaines disciplines de la médecine tentent ainsi d'en tenir compte. La question reste de savoir ce que le médecin peut véritablement offrir dans pareilles situations et pourquoi/pour qui des interventions auprès des patients sous menace existentielle sont proposées. Une lecture de ces développements implique de se centrer non seulement sur les patient-es, mais aussi sur les cliniciens-nes, la médecine et la société.

Is Dignity Still Necessary in Health Care? From Definition to Recognition of Human Dignity.

The concept of dignity is not, as some scholars claim, an unnecessary moral idea, and nor need it have religious overtones or be characterised by speciesism. In this article, I try to show that dignity can be defined and recognised. The starting point for the argumentation is the four typologies of dignity, which show that the term 'dignity' can denote significantly different concepts, and that the different concepts of dignity can have significantly different ontological senses. A unified typology of dignity allows for five categories to be distinguished: inherent dignity, dignity based on changeable qualities, moral dignity, bestowed dignity and comportment dignity. I take the first two categories of dignity as the object of the analysis, with which I seek to formulate a philosophical response to the charge of speciesism and to show on what basis it can be maintained that all human beings possess dignity. To this end, I distinguish between existential dignity, actual dignity, and potential dignity. Distinguishing these types of dignity becomes possible in the light of Aquinas' and Aristotle's views. In the final section, I point to two ways of recognising dignity. The first is based on certain narratives and emotional states ('ecumenical model of dignity'), while the second is related to a specific moral experience developed within ethical personalism.

A systematic review of conference papers presented at two large Japanese psychology conferences in 2013 and 2018: did Japanese social psychologists selectively report p < 0.05 results without peer review?

We conducted a systematic review of conference papers in social psychology at two large psychology conferences in Japan: the Japanese Psychological Association and the Japanese Society for Social Psychology. The conference papers were effectively not subjected to peer review; hence, they were suitable for testing if psychologists selectively reported statistically significant findings without pressure from journal editors and reviewers. We investigated the distributions of z-values converted from the p-values reported in the articles presented at the 2013 and 2018 conferences. The z-curve analyses suggest the existence of selective reporting by the authors in 2013. The expected discovery rate (EDR) was much lower than the observed discovery rate (ODR; 7% vs. 76%, respectively), and the 95% confidence interval (CI) did not include the ODR. However, this does not mean that the set of studies completely lacked evidential value. The expected replication rate (ERR) was 31%; this is significantly higher than 5%, which was expected under the null hypothesis of no effect. Changes were observed between 2013 and 2018. The ERR increased (31% to 44%), and the EDR almost doubled (7% to 13%). However, the estimation of the maximum false discovery rate (FDR; 68% in 2013 and 35% in 2018) suggested that a substantial proportion of the reported findings were false positives. Overall, while social psychologists in Japan engaged in selective reporting, this does not mean that the entire field was covered with false positives. In addition, slight signs of improvement were observed in how they reported their findings. Still, the evidential value of the target studies was weak, even in 2018, allowing for no optimism.

'I am just a shadow of who I used to be'-Exploring existential loss of identity among people living with chronic conditions of Long COVID.

Identity loss and (re)construction forms a central debate in sociology of chronic illness. Living with chronic/persistent health conditions may raise questions about how disruptions can touch upon and further threaten the very roots of existence, by which people reflexively perceive a coherent and stable sense of 'being-in-the-world'. Whilst medical sociologists have shown interest in 'existential loss' in chronic illness, this question remains largely underexplored. Adopting a qualitative study on Long COVID (LC) as an example, this article illuminates existential identity loss as a deeply painful experience of losing body as a fundamental medium to retain continuity and consistency of one's narratively constructed identity. Interviews with 80 LC sufferers in the UK revealed that living with persistent and often uncertain symptoms and disruptions can cause the loss of biographical resources and resilience, making it difficult to reflexively understand their own being within the world. Their dynamic responses to LC also highlighted how sufferers' longing for a narratively coherent self can profoundly shape the ongoing construction of their identity in chronic health conditions. These insights into the complicated and often hard-to-express existential pain of identity loss can also nurture more holistic understandings of and support for LC and chronic illness more broadly.

Hospital space interpreted according to Heidegger's concepts of care and dwelling.

Modern hospitals have succeeded in saving humans from numerous diseases owing to the rapid development of medical technology. However, modern medical science, combined with advanced technology, has developed a strong tendency to view human beings as mere targets of restoration and repair, with modern hospitals characterised as spaces centred on technology-focused treatment. This results in a situation where human beings are reduced to objects and alienated. This study, integrating Heidegger's concepts of dwelling and care, contends that 'care' is a vital concept in terms of the fundamental spatiality of hospitals and needs to be restored as the key guiding principle affecting hospital space. The loss of the caring spirit in the development of modern hospitals affects how hospitals are conceived, built and managed, as well as how human experiences within hospitals are dealt with or allowed for appropriately. This study offers critical reflection on how future planning of hospital spaces can be better conducted to ensure that human experiences, and the care needed to appropriately value such experiences, are adequately expressed, and the complexity of human existence is suitably considered.

Lifeworld hermeneutics: An approach and a method for research on existential issues in caring science.

BACKGROUND AND AIM: The aim of the present article was to elaborate on a research approach and method called 'lifeworld hermeneutics'. Significant to lifeworld hermeneutics is that interpretation is the main methodological instrument for explaining and understanding existential research questions and lived experiences. From a caring science perspective, this often refers to research that aims to gain a deeper understanding of existential phenomena and issues, such as existential meaning of health, well-being, homelessness, lostness, suffering and ageing, as well as what it means to experience unhealthiness and illness, the need for care, and caring that responds to such needs. DESIGN: Theoretical paper. RESULT: The article briefly covers ontology and epistemology that clarifies the meaning and importance of a lifeworld hermeneutic attitude. This is followed by suggestions for how to perform a lifeworld hermeneutic study, expressed in relation to methodological principles for the interpretation, validation and structuring of interpretations. Thereafter, follow reflections on how to use theoretical or philosophical support to develop and deepen existential interpretations. The findings of lifeworld hermeneutic research consist of existential interpretations where the researcher, with an open and pliable attitude towards the phenomenon and the aim of the study, clarifies, explains and suggests new ways of understanding participants' lived experiences; the researcher should maintain such an attitude towards their understanding of the phenomenon as well. CONCLUSION: The lifeworld hermeneutical approach and method described in this article makes it possible to further deepen the understanding and knowledge about existential issues that is relevant for caring and caring science.

Existential meaning, spiritual unconscious and spirituality in Viktor Frankl.

There is robust evidence to support the relationship between spirituality and mental health, but the mechanisms of this association are not well-understood. The existential meaning provided by spirituality may be one of these mechanisms. This was the central theme of Viktor Frankl's psychology, which he explained using the notion of the spiritual unconscious. Thus, we sought to explain how Frankl understands this spiritual unconscious and the two pieces of evidence he presents for its existence: the phenomenological description of responsible action and the analysis of dreams. Lastly, we discuss his contribution to the current understanding of the relationship between having an overarching purpose and/or religious meaning and improvement in mental health.

Is it true that all human beings have dignity?

The discussion around dignity in nursing philosophy has been underway for many years. The literature still lacks philosophical arguments that would justify the thesis that all people have dignity. Scholars who defend dignity as an intrinsic value most often refer to Kant. However, Kant does not seem to be the most suitable candidate to defend the thesis that all human beings possess dignity. In this paper, I attempt to show that Aristotle's and Aquinas's views can help justify this thesis. To this end, I distinguish between actual dignity, potential dignity, and existential dignity. I state that all human beings have existential dignity or potential dignity.

How might cancer patients experience existential guilt? A qualitative research.

OBJECTIVES: Existential guilt is a deep and multidimensional concept that is correlated with concepts, such as in/authenticity, existential anxiety, decisiveness, and personal and social responsibility. The aim of the present study is to investigate the experience of existential guilt among cancer patients. METHODS: The present research was conducted with a qualitative method with a content analysis design. A purposeful sampling method was used to select the participants and the sampling procedure went on until we reached data saturation. Data were obtained using semi-structured interviews with the participants. RESULTS: From a total of 18 interviews, 94 codes related to existential guilt were obtained. After the analysis, three main concepts were extracted: (1) incompleteness, (2) passivity, and (3) feelings of harm to self and others. Each of these had a number of subcategories. SIGNIFICANCE OF RESULTS: The participants of the present research were found to experience existential guilt in different ways. The research showed that it is necessary to find the sources of existential guilt in order that effective therapeutic attention can be given cancer patients.

El tiempo de juego del niño se revela durante una sesión de juego dramático terapéutico / O tempo da brincadeira da criança revelado durante sessão de brinquedo terapêutico dramático / Child's playtime revealed during therapeutic dramatic play session

Introduction: playing, as an activity inherent to childhood, enables the child to acquire new knowledge about the world and to come across their own individuality expressing the world that is meaningful to him. The child's temporality composes his existence and drives him in the search for authentic existence. Objective: To describe the child's temporality during the stages of bonding and stopping playing in dramatic therapeutic play sessions. Method: phenomenological study in the light of the Heideggerian philosophical framework, with 12 children, aged between three and 11 years. For data collection, phenomenological interviews were conducted, mediated by the dramatic therapeutic toy. Results: the following thematic axis emerged: - The child's play time: being open. Conclusion: play reveals existential aspects of the child in chronological time and it fosters the sharing of new possibilities of relationship, in a free way, with the world. However, playing time might be elastic and negotiable according to individual need, so that all the expressions of the child becoming in their facticity during play would be considered. Therefore, regardless of the way and time they play, this study highlights the importance of respecting the child's existence at that moment.(AU)

Introducción: el juego, como actividad inherente a la infancia, permite al niño adquirir nuevos conocimientos sobre el mundo y encontrarse a sí mismo con su propia individualidad, expresando el mundo que le es significativo. La temporalidad del niño compone su existencia y lo impulsa en la búsqueda de la existencia auténtica. Objetivo: describir la temporalidad del niño durante las etapas de creación de vínculo y de cese del juego en sesiones de juego dramático terapéutico. Método: estudio fenomenológico a la luz del marco filosófico heideggeriano, con 12 niños, con edades entre tres y 11 años. Para la recolección de datos se realizaronentrevistas fenomenológicas, mediadas por juguetes dramáticos terapéuticos. Resultados: surgieron los siguientes ejes temáticos: El tiempo dejuego del niño: estar en apertura. Conclusión: el juego revela aspectos existenciales del niño en el tiempo cronológico y favorece compartir nuevas posibilidades de relación, libremente, con el mundo. Sin embargo, el tiempo dedicado al juego podría ser elástico y negociable según las necesidades individuales, de modo que todas las expresiones del devenir del niño en su facticidad durante el juego podrían ser consideradas. Por ello, independientemente de la forma y el momento en que jueguen, este estudio resalta la importancia de respetar la existencia del niño en ese momento.(AU)

Introdução: o brincar como atividade inerente à infância, possibilita quea criança adquira novos conhecimentos sobre o mundo e se depare com a própriaindividualidade, expressando o mundo que lhe seja significativo. A temporalidade da criança compõe seu existir e a impulsiona na busca pela existência autentica. Objetivo: descrever a temporalidade da criança durante as etapas criandovínculo e parando de brincar em sessões de brinquedo terapêutico dramático. Método: estudo fenomenológico à luz do referencial filosófico heideggeriano, com 12crianças, com idades entre três e 11 anos. Para a coleta de dados foram realizadasentrevistas fenomenológicas, mediadas pelo brinquedo terapêutico dramático.Resultados: emergiu o seguinte eixo temático: O tempo de brincar da criança:sendo em abertura. Conclusão: a brincadeira revela aspectos existenciais da criança no tempo cronológico e, favorece o compartilhar de novas possibilidades derelação, de modo livre, com o mundo. No entanto, o tempo que brinca pôde serelástico e negociável mediante a necessidade individual, para que fossem consideradas todas as expressões da criança vir a ser na sua facticidade durante a brincadeira. Portanto, independentemente do modo e do tempo que brinca este estudodestaca a importância de se respeitar a existência da criança nesse momento.(AU)

The Architecture of the mind: A Psychodynamic Case Study of Dissociated Selves.

The author seeks to explore the development and treatment of dissociative symptoms emerging in a 17-year-old nonbinary individual throughout two inpatient psychiatric hospitalizations. The patient endorsed the presence of multiple selves that remained connected with reality and internally with each other, emphasizing their existence in spatial allocations within the patient's mind both while dreaming and in waking life. The author highlights the therapeutic space as an opportunity to allow the interaction between dissociated selves surging from violent childhood experiences in hopes of allowing the integration of the fragmented parts of the main self. The roles of dreamwork, creative expressions, and language will be highlighted as essential components that allowed symbolization for a bicultural, bilingual individual who recently immigrated to the United States. Treatment was conducted within the limitations and particularities of inpatient psychiatric treatment, restricting treatment to a preliminary phase of exploration and containment.

"It's a feeling of complete disconnection": experiences of existential loneliness from youth to older adulthood.

BACKGROUND: Existential loneliness is a feeling which stems from a sense of fundamental separation from others and the world. Although commonly mentioned in the loneliness literature, there is relatively little empirical work on this construct, and existing work tends to focus on older and seriously ill individuals. The present study aimed to understand how people experience existential loneliness without specific constraints on precipitating factors like illness or age. METHODS: A qualitative online survey collected data from 225 adults aged 16 to 72 years old. Participants were asked to write about their experiences of existential loneliness and how these experiences compared to non-existential loneliness. Data were analysed using reflexive thematic analysis. RESULTS: Of 225 participants, 51% knew the meaning of "existential loneliness" upon accessing the survey and in total, 83% had experienced existential loneliness. 93% of these participants had also experienced loneliness that was not existential in nature. 175 participants provided qualitative data regarding their experiences of existential loneliness, from which four themes were identified: Existential loneliness is (1) A deeper form of loneliness, and (2) A feeling of deep disconnection, in which (3) Cognitive evaluations and negative emotions are central elements, and (4) Stress and mental health issues are perceived as relevant factors. CONCLUSIONS: Existential loneliness is a deeply rooted and impactful form of loneliness which involves feelings of profound separateness. This aspect of loneliness is deserving of further attention. Future research directions are suggested.

Existential Matters and Quality of Dying: A Model of Maturation Processes.

Background: How people face mortality is a crucial matter for medicine. Yet, there is not a coherent and comprehensive understanding of how people can process the experience such that it is not traumatic. Methods: This article offers a "logic model" of how existential maturation occurs, using analogies from cell biology to explain the process. Results: This model depicts 10 mechanisms that together deal with mortality-salient events. Collectively, they are termed the existential function, which is seen as an innate, ever-evolving, integral part of the mind. An operational boundary selectively manages how realities are taken in. Processing is initiated with other essential people, ushering in reiterative steps of listening, finding, exploring, making meaning, and adjusting. The result is adaptive, integrated, mortality-acknowledging dispositions of mind. The process allows quality of life at the end of life and healthy mourning; impediments to it make for existential suffering and complicated grief. Conclusions: This conceptual model describes how people can face mortality. Its merit depends on its source in human experience, its explanatory power, its ability to guide people as they face mortality, and its ability to stimulate productive perspectives. It is therefore offered as an invitation for discussion, research, revision, and evolution.