bluuebunny/crossref_metadata_2025 huggingface dataset:
Millennials’ Uses and Gratifications on LinkedIn: Implications for Recruitment and Retention
Authors: Smith Stephanie A. , Watkins Brandi
Published: November 2020

While popular press has examined Millennial’s in the workforce, there is limited academic research about Millennials’ job searching strategies. This study draws on uses and gratifications theory to examine the motives, uses, and gratifications of U.S. Millennial job seekers for using LinkedIn. Consistent with previous uses and gratifications research, an online survey found Millennials ( N = 216) use LinkedIn to find information, communicate with others, and for surveillance needs. Millennials use about 42.8% of the features available on LinkedIn for professional development, entertainment, and networking. Finally, this research found that Millennials obtain social/functional and hedonic value from using LinkedIn. Collectively, the results indicate that Millennials are using the site regularly, although at less than half of its capacity, regardless of whether or not they are job searching, but in ways that violate the expectations of potential employers and recruiters. Theoretical contributions and business communication implications are discussed.
Pandemics Past and Present: A Guided Inquiry Approach
Authors: Willey Joanne M , Olvet Doreen M , Bird Jeffrey B , Brenner Judith M
Published: November 2020

Background:

COVID-19 exposed undergraduate medical education curricular gaps in exploring historical pandemics, how to critically consume scientific literature and square it with the lay press, and how to grapple with emerging ethical issues. In addition, as medical students were dismissed from clinical environments, their capacity to build community and promote professional identity formation was compromised.

Methods:

A synchronous, online course entitled Life Cycle of a Pandemic was developed using a modified guided inquiry approach. Students met daily for 2 weeks in groups of 15 to 18 with a process facilitator. During the first week, students reported on lessons learned from past pandemics; in the second week, students discussed ethical concerns surrounding COVID-19 clinical trials, heard from physicians who provided patient care in the HIV and COVID-19 pandemics, and concluded with an opportunity for reflection. Following the course, students were asked to complete an anonymous, voluntary survey to assess their perceptions of the course.

Results:

With a response rate of 69%, an overwhelming majority of students agreed or strongly agreed that learning about historical pandemics helped them understand COVID-19 (72, 99%). The course successfully helped students understand current and potential COVID-19 management strategies as 66 (90%) agreed or strongly agreed they developed a better understanding of nonpharmacological interventions and new pharmacological treatments. Students also gained insight into the experiences of healthcare providers who cared for patients with HIV and COVID-19. Qualitative analysis of the open-ended comments yielded 5 main themes: critical appraisal of resources, responsibility of the physician, humanism, knowledge related to pandemics, and learning from history.

Conclusions:

The onset of the COVID-19 crisis illustrated curricular gaps that could be remedied by introducing the history and biology of pandemics earlier in the curriculum. It was also apparent that learners need more practice in critically reviewing literature and comparing scientific literature with lay press. The flexible format of the course promotes the development of future iterations that could cover evolving topics related to COVID-19. The course could also be repurposed for a graduate or continuing medical education audience.
A nomogram to predict unfavourable outcome in patients receiving oral anticoagulants for atrial fibrillation after stroke
Authors: Cappellari Manuel , Seiffge David J , Koga Masatoshi , Paciaroni Maurizio , Forlivesi Stefano , Turcato Gianni , Bovi Paolo , Yoshimura Sohei , Tanaka Kanta , Shiozawa Masayuki , Yoshimoto Takeshi , Miwa Kaori , Takagi Masahito , Inoue Manabu , Yamagami Hiroshi , Caso Valeria , Tsivgoulis Georgios , Venti Michele , Acciarresi Monica , Alberti Andrea , Toni Danilo , Polymeris Alexandros , Bonetti Bruno , Agnelli Giancarlo , Toyoda Kazunori , Engelter Stefan T , De Marchis GM ,   on behalf of the SAMURAI-NVAF, RAF-NOAC, NOACISP LONG-TERM, and Verona Study Groups
Published: November 2020

Introduction

It is unknown whether the type of treatment (direct oral anticoagulant versus vitamin K antagonist) and the time of treatment introduction (early versus late) may affect the functional outcome in stroke patients with atrial fibrillation. We aimed to develop and validate a nomogram model including direct oral anticoagulant/vitamin K antagonist and early/late oral anticoagulant introduction for predicting the probability of unfavourable outcome after stroke in atrial fibrillation-patients.

Patients and Methods

We conducted an individual patient data analysis of four prospective studies. Unfavourable functional outcome was defined as three-month modified Rankin Scale score 3 -6. To generate the nomogram, five independent predictors including age (<65 years, reference; 65--79; or 80), National Institutes of Health Stroke Scale score (0--5 points, reference; 6--15; 16--25; or >25), acute revascularisation treatments (yes, reference, or no), direct oral anticoagulant (reference) or vitamin K antagonist, and early (7 days, reference) or late (8--30) anticoagulant introduction entered into a final logistic regression model. The discriminative performance of the model was assessed by using the area under the receiver operating characteristic curve.

Results

A total of 2102 patients with complete data for generating the nomogram was randomly dichotomised into training ( n = 1553) and test ( n = 549) sets. The area under the receiver operating characteristic curve was 0.822 (95% confidence interval, CI: 0.800--0.844) in the training set and 0.803 (95% CI: 0.764--0.842) in the test set. The model was adequately calibrated (9.852; p = 0.276 for the Hosmer--Lemeshow test).

Discussion and Conclusion

Our nomogram is the first model including type of oral anticoagulant and time of treatment introduction to predict the probability of three-month unfavourable outcome in a large multicentre cohort of stroke patients with atrial fibrillation.
How to use dialysis wisely in cancer patients?
Authors: van der Veen Annelien , De Vusser Katrien , De Moor Bart , Wildiers Hans , Cosmai Laura , Sprangers Ben
Published: November 2020

Both acute kidney injury (AKI) and chronic kidney disease (CKD) are common in cancer patients and are associated with inferior outcome, higher mortality rates, longer hospital stays and higher costs. In the aging population, the prevalence of both cancer and end-stage renal disease increase and practitioners are faced with difficult decisions regarding initiation of anticancer therapy and renal replacement therapy (RRT). Recent studies have shown no survival benefit of RRT ⩾80 years or even ⩾70 years in combination with severe comorbidities. However cancer itself does not seem to be a determining factor for short-term survival outcome and should not be used as argument alone to withhold RRT. Several prognostic tools can be implemented to identify elderly patients at high risk of functional decline and mortality after initiation of RRT. Advanced care planning focusses on timely discussions between patients, family members and practitioners about the patient’s desires and treatment goals which can help them avoid decisional conflict at the end-of-life and improve the quality of life.
Stress Generated in Customized Versus Non-Customized Rigid Fixation Plates in a Simulation of Mandibular Advancement
Authors: Pinto Leonardo Augustus Peral Ferreira , Ramos Viviane Ferreira , Basting Roberta Tarkany
Published: November 2020

Study design:

A finite element method used to virtually analyze the distribution of stresses in human mandible.

Objective:

The aim of this study was to evaluate the distribution of stresses in 1 customized and 2 non-customized plates used in simulated procedures of mandibular advancement and rigid fixation after bilateral sagittal split osteotomy of the mandibular ramus.

Methods:

The model used was obtained from a tomograph of an 18-year-old patient, and the simulation involved advancing the mandibular body by 4.75 mm. The plates used were Osteomed, double-row medium; Stryker, standard straight; and Traumec, custom-machined double straight. Virtual models of the mandible and the installed plates were generated and submitted to finite element analysis. Two 100-N loads, 1 anterior and 1 posterior, were applied perpendicular to the occlusal plane.

Results:

In the Osteomed and Traumec plate models, the stress peaks occurred near the separation zone of the mandible, adjacent to the connections. In the Stryker plate model, the stress peak occurred in the region between the screws.

Conclusions:

The Stryker plate was associated with the lowest risk of compromising bone repair, followed by the Traumec and Osteomed plates. Stress concentration was related to plate length and to the existence of a connection between the upper and lower portions of the fixation used.
Prospective, Multicenter, Clinical and Radiographic Evaluation of a Biointegrative, Fiber-Reinforced Implant for Proximal Interphalangeal Joint Arthrodesis
Authors: Cicchinelli Luke D. , Štalc Jurij , Richter Martinus , Miller Stuart
Published: November 2020

Background:

A novel biointegrative implant was developed for proximal interphalangeal joint (PIPJ) arthrodesis to treat hammertoe deformity. Composed of continuous reinforcing mineral fibers bound by bioabsorbable polymer matrix, the implant demonstrated quiescent, gradual degradation with complete elimination at 104 weeks in animal models. This prospective trial assessed the implant’s safety, clinical performance, and fusion rate of PIPJ arthrodesis for hammertoe correction.

Methods:

Twenty-five patients (mean age 63.9±7.5 years) who required PIPJ arthrodesis were enrolled at 3 centers. Outcomes included radiographic joint fusion, adverse events, pain visual analog scale (VAS) score, Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) score, and patient satisfaction. Patients were evaluated 2, 4, 6, 12, and 26 weeks postoperatively.

Results:

Twenty-two patients (88%) achieved radiographic fusion at 26 weeks. All joints (100%) were considered clinically stable, with no complications or serious adverse events. Pain VAS improved from 5.3±2.5 preoperatively to 0.5±1.4 at 26 weeks postoperatively. FAAM-ADL total scores and level of functioning improved by mean 19.5±19.0 points and 24.4±15.7 percentage points, respectively, from preoperation to 26 weeks postoperation. Improvements in pain VAS and FAAM scores surpassed established minimal clinically important differences. All patients were very satisfied (84%) or satisfied (16%) with the surgery. Patient-reported postoperative results greatly exceeded (72%), exceeded (20%), or matched (8%) expectations.

Conclusion:

This prospective, multicenter, first-in-human clinical trial of a novel biointegrative fiber-reinforced implant in PIPJ arthrodesis of hammertoe deformity demonstrated a favorable rate of radiographic fusion at 12 and 26 weeks, with no complications and good patient-reported clinical outcomes.

Level of Evidence:

Level IV, prospective case series.
Tlingit geographies of hope: Clan, corporation, and sustainable economies of place
Authors: Thornton Thomas F , Hope Ishmael
Published: November 2020

The essay argues that geographies of hope for Tlingit communities in Southeast Alaska begin with a strong sense of place, both social and geographic. In Tlingit, the matrilineal clan—the repository of heritage, identity, and property—constitutes the collective, animate source of resilience, hope, and renewal. We examine the ways in which clans continue to operate as institutions of hope and destiny, especially through the memorial ku.éex’ or “potlatch,” a ritual of restoration and replacement. This ritual is thriving in the 21st century despite no external funding or recognition from the state. It is a wholly Tlingit institution built on socio-geographic values of sustainment of the matrilineal clan as an immortal being. What remains to be re-animated, however, is clan territory. Most Tlingit territory has been appropriated by the Tongass National Forest and Federal and Alaska state waters. Native corporations hold about 2% of the Southeast Alaska land base, and clans hold nothing except, in some cases, recognition of their historical association with particular historic sites and territories. The reinvigoration of cartography with Tlingit place names is a step toward furthering recognition of clans’ historical and contemporary ties to places in a tangible and hopeful way. Yet, culture needs a material base, and mere recognition of traditional toponyms will not be enough. Many clans seek a more substantive livelihood relationships with and custodial role over their territories, not only as sacred properties but as sources of sustainment, strength, and well-being. This requires new thinking on the part of indigenous economic institutions, like Alaska Native business corporations, along the lines of a traditional (Tlingit clan) “house,” an economic unit in the spirit of the original Greek term for economy, oikos (“house”). The integrated restoration of sociocultural, economic, and geographic sources of collective well-being will further enliven Tlingit geographies of hope.
“Essential” services, risk, and child protection in the time of COVID-19: An opportunity to prioritize chronic need
Authors: Caldwell Johanna , Delaye Ashleigh , Esposito Tonino , Petti Tara , Black Tara , Fallon Barbara , Trocmé Nico
Published: November 2020

In many North American jurisdictions, socioeconomically vulnerable families are more likely to be involved with child protection systems and experience ongoing challenges. The current public health response to the COVID-19 pandemic is having a disproportionate impact on these families via unemployment, “essential” work, isolation, and closures of childcare and schools, with negative implications for children’s developmental wellbeing. Experts warn that while child protection referrals have gone down, children who are at risk of maltreatment are less exposed to typical reporters (e.g., school professionals). At the same time, physical distancing measures are prompting many human service settings to shift toward virtual intervention with children and families. In this commentary, we suggest that a focus on short-term risk in the response to COVID-19 may obscure support for children’s long-term outcomes. We propose two policy considerations: (1) in the immediate term, that child protection workers be deemed “essential”; and (2) in the longer term, that permanent, universal basic income guarantees be implemented to support a baseline of predictability both in families’ material wellbeing and in fiscal budgets in the case of a future crisis. As we write, it is impossible to predict the longevity of these closures nor the extent of their impact on children and families. However, the present article mirrors commentary following previous crises noting the importance of going beyond immediate health risk mitigation to consider wellbeing with regard to children’s development and families’ socioeconomic needs in the long term.
A ten-year report of microbial keratitis in pediatric population under five years in a tertiary eye center
Authors: Soleimani Mohammad , Tabatabaei Seyed Ali , Mohammadi S. Saeed , Valipour Niloufar , Mirzaei Arash
Published: November 2020

Purpose

To report characteristics of microbial keratitis in pediatric patients under five years.

Methods

Patients with infectious keratitis under the age of 5 years were included in this retrospective cross-sectional study for ten years. All patients were admitted and corneal scraping was performed in 81 children. Fortified empiric antibiotic eye drops including cefazolin (50 mg/cc) and amikacin (20 mg/cc) were started and the antibiotic regimen was continued or changed according to culture results. In the case of fungal keratitis, topical voriconazole (10 mg/cc) or natamycin (50 mg/cc) and topical chloramphenicol (5 mg/cc) were started. A tectonic procedure was done when corneal thinning or perforation was present.

Results

Ninety-Three Patients between 1 to 60 months with a mean age of 33 ± 18 months old with corneal ulcer were included in the study. The most common risk factor was trauma (40.9%) followed by contact lens use (8.6%). Cultures were negative for microbial growth in 28 (30.1%) patients. The most common pathogens wereS. epidermidis(10.8%) andP. aeruginosa(10.8%). Fluoroquinolone antibiotics (ciprofloxacin; 93.8% sensitivity) were the most potent antibiotic against bacterial pathogens. Forty-one patients underwent tectonic procedures, which the most common ones were cyanoacrylate glue 18.3% followed by keratoplasty 16.1%.

Conclusion

This study emphasizes the role of trauma as the primary cause andS. epidermidisas the most frequent microorganism in pediatric keratitis; according to antibiogram results and poor cooperation of patients under five years, monotherapy with fluoroquinolones could be a good regimen in small non-central lesions without thinning.
HOme-based Longitudinal Investigation of the multidiSciplinary Team Integrated Care (HOLISTIC): protocol of a prospective nationwide cohort study
Authors: Liao Jung-Yu , Chen Ping-Jen , Wu Yu-Lin , Cheng Ching-Hsia , Yu Sang-Ju , Huang Chi-Hsien , Li Chia-Ming , Wang Ying-Wei , Zhang Kai-Ping , Liu I-Te , Umegaki Hiroyuki , Hamano Jun , Mori Masanori , Petersen Irene , Sampson Elizabeth L. , Hsiung Chao A.
Published: November 2020

Background

The use of home health care (HHC) is increasing worldwide. This may have an impact not only on patients and their caregivers’ health but on care resource utilization and costs. We lack information on the impact of HHC on the broader dimensions of health status and care resource utilization. More understanding of the longitudinal HHC impact on HHC patients and caregivers is also needed. Moreover, we know little about the synergy between HHC and social care. Therefore, the present study aims to observe longitudinal changes in health, care resource utilization and costs and caregiving burden among HHC recipients and their caregivers in Taiwan.

Methods

A prospective cohort study “Home-based Longitudinal Investigation of the Multidisciplinary Team Integrated Care (HOLISTIC)” will be conducted and 600 eligible patient-caregiver dyads will be recruited and followed with comprehensive quantitative assessments during six home investigations over two years. The measurements include physical function, psychological health, cognitive function, wellbeing, shared decision making and advance care planning, palliative care and quality of dying, caregiving burden, continuity and coordination of care, care resource utilization, and costs.

Discussion

The HOLISTIC study offers the opportunity to comprehensively understand longitudinal changes in health conditions, care resource utilization and costs and caregiving burden among HHC patients and caregivers. It will provide new insights for clinical practitioners and policymakers.

Trial registration

ClinicalTrials.gov Identifier is NCT04250103 which has been registered on 31st January 2020.
Risk factors and socio-economic burden in pancreatic ductal adenocarcinoma operation: a machine learning based analysis
Authors: Zhang Yijue , Zhu Sibo , Yuan Zhiqing , Li Qiwei , Ding Ruifeng , Bao Xunxia , Zhen Timing , Fu Zhiliang , Fu Hailong , Xing Kaichen , Yuan Hongbin , Chen Tao
Published: November 2020

Background

Surgical resection is the major way to cure pancreatic ductal adenocarcinoma (PDAC). However, this operation is complex, and the peri-operative risk is high, making patients more likely to be admitted to the intensive care unit (ICU). Therefore, establishing a risk model that predicts admission to ICU is meaningful in preventing patients from post-operation deterioration and potentially reducing socio-economic burden.

Methods

We retrospectively collected 120 clinical features from 1242 PDAC patients, including demographic data, pre-operative and intra-operative blood tests, in-hospital duration, and ICU status. Machine learning pipelines, including Supporting Vector Machine (SVM), Logistic Regression, and Lasso Regression, were employed to choose an optimal model in predicting ICU admission. Ordinary least-squares regression (OLS) and Lasso Regression were adopted in the correlation analysis of post-operative bleeding, total in-hospital duration, and discharge costs.

Results

SVM model achieved higher performance than the other two models, resulted in an AU-ROC of 0.80. The features, such as age, duration of operation, monocyte count, and intra-operative partial arterial pressure of oxygen (PaO2), are risk factors in the ICU admission. The protective factors include RBC count, analgesic pump dexmedetomidine (DEX), and intra-operative maintenance of DEX. Basophil percentage, duration of the operation, and total infusion volume were risk variables for staying in ICU. The bilirubin, CA125, and pre-operative albumin were associated with the post-operative bleeding volume. The operation duration was the most important factor for discharge costs, while pre-lymphocyte percentage and the absolute count are responsible for less cost.

Conclusions

We observed that several new indicators such as DEX, monocyte count, basophil percentage, and intra-operative PaO2showed a good predictive effect on the possibility of admission to ICU and duration of stay in ICU. This work provided an essential reference for indication in advance to PDAC operation.
A modelling study highlights the power of detecting and isolating asymptomatic or very mildly affected individuals for COVID-19 epidemic management
Authors: Mayorga Lía , García Samartino Clara , Flores Gabriel , Masuelli Sofía , Sánchez María V. , Mayorga Luis S. , Sánchez Cristián G.
Published: November 2020

Background

Mathematical modelling of infectious diseases is a powerful tool for the design of management policies and a fundamental part of the arsenal currently deployed to deal with the COVID-19 pandemic.

Methods

We present a compartmental model for the disease where symptomatic and asymptomatic individuals move separately. We introduced healthcare burden parameters allowing to infer possible containment and suppression strategies. In addition, the model was scaled up to describe different interconnected areas, giving the possibility to trigger regionalized measures. It was specially adjusted to Mendoza-Argentina’s parameters, but is easily adaptable for elsewhere.

Results

Overall, the simulations we carried out were notably more effective when mitigation measures were not relaxed in between the suppressive actions. Since asymptomatics or very mildly affected patients are the vast majority, we studied the impact of detecting and isolating them. The removal of asymptomatics from the infectious pool remarkably lowered the effective reproduction number, healthcare burden and overall fatality. Furthermore, different suppression triggers regarding ICU occupancy were attempted. The best scenario was found to be the combination of ICU occupancy triggers (on: 50%, off: 30%) with the detection and isolation of asymptomatic individuals. In the ideal assumption that 45% of the asymptomatics could be detected and isolated, there would benoneed for complete lockdown, and Mendoza’s healthcare system would not collapse.

Conclusions

Our model and its analysis inform that the detection and isolation ofallinfected individuals, without leaving aside the asymptomatic group is the key to surpass this pandemic.
Psychological distress among infectious disease physicians during the response to the COVID-19 outbreak in the Republic of Korea
Authors:   The Korean Society of Infectious Diseases, Park Se Yoon , Kim Bongyoung , Jung Dong Sik , Jung Sook In , Oh Won Sup , Kim Shin-Woo , Peck Kyong Ran , Chang Hyun-Ha
Published: November 2020

Background

This study aimed to investigate psychological distress among infectious disease (ID) physicians during the coronavirus disease 2019 (COVID-19) outbreak in the Republic of Korea.

Methods

Using an online-based survey link sent via text message and email, we conducted a survey from April 21 to 25, 2020, targeting all ID physicians currently working in ID (n = 265). The questionnaire was based on the Maslach Burnout Inventory-Human Services Survey and the Depression, Anxiety, and Stress Scales, and information was collected on factors protecting against psychological distress and difficulties in relation to COVID-19.

Results

Of 265 ID physicians, 115 (43.3%) responded, showing burnout (97, 90.4%), depression (20, 17.4%), anxiety (23, 20.0%), and stress (5, 4.3%). There were no differences in terms of distress between ID physicians who were directly involved in the care of patients with COVID-19 or not. Greater than 50% of physicians valued their work and felt recognized by others, whereas < 10% indicated that sufficient human and financial support and private time had been provided during the outbreak. The most challenging issues concerned a lack of attending physicians caring for COVID-19 patients or infection control practitioners, a shortage of personal protective equipment or airborne infection isolation rooms, pressure for research, and lack of guidelines for COVID-19 management.

Conclusions

During the COVID-19 outbreak in the Republic of Korea, most respondents reported psychological distress. Preparing strategies to secure human resources are crucial to prepare effectively for future epidemics and pandemics.
Correction to: How do combinations of unhealthy behaviors relate to attitudinal factors and subjective health among the adult population in the Netherlands?
Authors: Dieteren Charlotte M. , Brouwer Werner B. F. , van Exel Job
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Association between non-traumatic vertebral fractures and adjacent discs degeneration: a cross-sectional study and literature review
Authors: Takegami Norihiko , Akeda Koji , Murata Koichiro , Yamada Junichi , Sudo Akihiro
Published: November 2020

Background

Previous clinical studies reported that thoracolumbar vertebral fractures (VFs) associated with high energy spine trauma cause adjacent intervertebral disc (IVD) degeneration; however, the effect of non-traumatic VFs on the progression of adjacent disc degeneration remains to be determined. The purpose of this study was to examine the association between non-traumatic VFs and degenerative changes of adjacent IVDs.

Methods

Ninety-eight consecutive patients undergoing spinal surgery were included in this study. VFs were semi-quantitatively evaluated by lateral lumbar radiography. Five hundred eighty-eight vertebral bodies (from T12 to L5) and 486 discs (from T12/L1 to L4/L5) were analyzed. The degree of IVD degeneration was evaluated by magnetic resonance imaging (MRI) and classified into two groups according to Pfirrmann’s classification. Grades I, II and III were defined as the early stage of IVD degeneration and Grades IV and V as the advanced stage. Intradiscal vacuum phenomena (VPs) were evaluated by computed tomography. Adjacent IVDs were categorized according to the locations of VFs (superior, inferior, and bilateral). Associations between the presence of VFs and the extent of IVD degeneration or the presence of VPs were statistically analyzed.

Results

IVDs adjacent to VFs were identified in 115 IVDs (31.1% of total; superior: 11.4%, bilateral: 8.6%, inferior: 11.1%). The presence of VFs was significantly associated with MRI grades of adjacent IVD degeneration (P < 0.01) and the prevalence of VPs within adjacent IVDs (P < 0.01). From logistic regression analysis, age, disc level, and VFs were independent related factors for disc degeneration (P < 0.05).

Conclusion

This study showed that VFs were an independent related factor for adjacent disc degeneration and occurrence of intradiscal VPs. VFs may affect the micro-environment of adjacent IVDs, leading to disc degeneration and disc rupture.
The impact of individual creativity, psychological capital, and leadership autonomy support on hospital employees’ innovative behaviour
Authors: Slåtten Terje , Mutonyi Barbara Rebecca , Lien Gudbrand
Published: November 2020

Background

There is growing interest in and focus on healthcare services research to identify factors associated with innovation in healthcare organizations. However, previous innovation research has concentrated primarily on the organizational level. In contrast, this study focuses on innovation by individual employees. The specific aim is to examine factors with potential impact on individual employee innovation in hospital organizations. Thus, the study significantly deepens and broadens previous research on innovation in the domain of health services.

Methods

A conceptual model was developed and tested on a sample of hospital employees (n = 1008). Partial least-squares structural equation modelling (PLS-SEM) was used to analyse the data with SmartPLS 3 software in two steps involving a measurement model and a structural model. Mediation analysis was used to test the proposed indirect effects.

Results

Hospital employees’ individual innovative behaviour is directly and positively associated with individual creativity (β = 0.440), psychological capital (β = 0.34) and leadership autonomy support (β = 0.07). The relationships between leadership autonomy support, psychological capital and individual innovative behaviour are all mediated by employees’ creativity. Psychological capital mediates the relationship between leadership autonomy support and individual innovative behaviour. Overall, the proposed model explains 50% of the variance in hospital employees’ innovative behaviour.

Conclusions

This study reveals a complex pattern of links between innovative behaviour and leadership autonomy support, employees’ creativity and employees’ psychological capital. However, the findings indicate that leadership autonomy support has an influential and multifaceted impact on hospital employees’ innovative behaviour.
Mapping the past, present and future research landscape of paternal effects
Authors: Rutkowska Joanna , Lagisz Malgorzata , Bonduriansky Russell , Nakagawa Shinichi
Published: November 2020

Background

Although in all sexually reproducing organisms an individual has a mother and a father, non-genetic inheritance has been predominantly studied in mothers. Paternal effects have been far less frequently studied, until recently. In the last 5 years, research on environmentally induced paternal effects has grown rapidly in the number of publications and diversity of topics. Here, we provide an overview of this field using synthesis of evidence (systematic map) and influence (bibliometric analyses).

Results

We find that motivations for studies into paternal effects are diverse. For example, from the ecological and evolutionary perspective, paternal effects are of interest as facilitators of response to environmental change and mediators of extended heredity. Medical researchers track how paternal pre-fertilization exposures to factors, such as diet or trauma, influence offspring health. Toxicologists look at the effects of toxins. We compare how these three research guilds design experiments in relation to objects of their studies: fathers, mothers and offspring. We highlight examples of research gaps, which, in turn, lead to future avenues of research.

Conclusions

The literature on paternal effects is large and disparate. Our study helps in fostering connections between areas of knowledge that develop in parallel, but which could benefit from the lateral transfer of concepts and methods.
Colored visual stimuli evoke spectrally tuned neuronal responses across the central nervous system of zebrafish larvae
Authors: Fornetto Chiara , Tiso Natascia , Pavone Francesco Saverio , Vanzi Francesco
Published: November 2020

Background

Visually guided behaviors such as optomotor and optokinetic responses, phototaxis, and prey capture are crucial for survival in zebrafish and become apparent after just a few days of development. Color vision, which in zebrafish is based on a spatially anisotropic tetrachromatic retina, provides an additional important component of world representation driving fundamental larval behaviors. However, little is known about the central nervous system (CNS) circuitry underlying color vision processing downstream of the retina, and its activity correlates with behavior. Here, we used the transparent larva of zebrafish to image CNS neurons and their activity in response to colored visual stimuli.

Results

To investigate the processing of chromatic information in the zebrafish larva brain, we mapped with cellular resolution, spectrally responsive neurons in the larva encephalon and spinal cord. We employed the genetically encoded calcium indicator GCaMP6s and two-photon microscopy to image the neuronal activity while performing visual stimulation with spectrally distinct stimuli at wavelengths matching the absorption peaks of the four zebrafish cone types. We observed the presence of a high number of wavelength-selective neurons not only in the optic tectum, but also in all other regions of the CNS, demonstrating that the circuitry involved in processing spectral information and producing color-selective responses extends to the whole CNS.

Conclusions

Our measurements provide a map of neurons involved in color-driven responses, revealing that spectral information spreads in all regions of the CNS. This suggests the underlying complexity of the circuits involved and opens the way to their detailed future investigation.
Neuroprotective epi-drugs quench the inflammatory response and microglial/macrophage activation in a mouse model of permanent brain ischemia
Authors: Mota Mariana , Porrini Vanessa , Parrella Edoardo , Benarese Marina , Bellucci Arianna , Rhein Sina , Schwaninger Markus , Pizzi Marina
Published: November 2020

Background

Activation of NF-kappaB RelA deacetylated at the lysine residues, except the lysine 310, drives pro-apoptotic transcription in noxious brain ischemia. We showed that the sinergistic combination of the histone deacetilase inhibitor MS-275 with the sirtuin 1 activator resveratrol, at very low doses, restores normal RelA acetylation and elicit neuroprotection in mice subjected to transient middle cerebral artery occlusion (tMCAO) and primary cortical neurons exposed to oxygen-glucose-deprivation (OGD). The present study aims at corroborating the neuroprotective potential of the epigenetic treatment in a model of permanent brain ischemia and investigate its effect on post-ischemic inflammation and microglia activation.

Methods

Male mice subjected to permanent occlusion of the distal MCAO (pMCAO) were treated with vehicle or MS-275 (20 μg/kg) and resveratrol (680 μg/kg) i.p. immediately after the ischemia. Microglia-containing mixed glial cultures were prepared from the brain of 1–3-day-old mice. Primary cortical neurons were prepared from 15-day-old embryonic mice.

Results

MS-275 and resveratrol in combination, but not individually, reduced infarct volume and neurological deficits evaluated 48 h after the pMCAO. At 24 h, the treatment inhibited the RelA binding to Nos2 promoter, reduced the elevated expression of Nos2, Il6, Il1b, Mrc1 and Ym1 and the leukocytes infiltration in the ischemic area. The effect was nonpermanent. The treatment did not limit the sustained leukocyte infiltration or Nos2 and Il1b transcription observed at 7 days. Though, it induced alternative activation markers of microglia/macrophages, Arg1, Ym1 and Fcgr2b that could be added to Mrc1, Tgfb1 and Trem2 spontaneously increased at 7 days after ischemia.

At 24 hours the drug treatment quenched the microglia/macrophages activation in the ischemic cortical sections, as shown by the recovered ramified morphology and lowered iNOS or CD68 immunoreactivity in Iba1-positive cells.

Both microglia and astrocytes in mixed glial cultures, but not pure astrocytes, displayed signs of activation and iNOS-immunoreactivity when treated with a conditioned medium (NCM) from OGD-exposed cortical neurons. The epigenetic drugs limited the OGD-NCM-mediated activation.

Conclusions

Our findings indicate that single treatment with MS-275 and resveratrol can reduce stroke-mediated brain injury and inflammation observed 2 days after the pMCAO and put the rational to test repeated administration of the drugs. The anti-inflammatory property of MS-275 and resveratrol combination can be ascribed to both primary direct inhibition of microglia/macrophage activation and secondary glial/macrophages inhibition mediated by neuroprotection.
An allosteric interleukin-1 receptor modulator mitigates inflammation and photoreceptor toxicity in a model of retinal degeneration
Authors: Dabouz Rabah , Cheng Colin W. H. , Abram Pénélope , Omri Samy , Cagnone Gael , Sawmy Khushnouma Virah , Joyal Jean-Sébastien , Desjarlais Michel , Olson David , Weil Alexander G. , Lubell William , Rivera José Carlos , Chemtob Sylvain
Published: November 2020

Background

Inflammation and particularly interleukin-1β (IL-1β), a pro-inflammatory cytokine highly secreted by activated immune cells during early AMD pathological events, contribute significantly to retinal neurodegeneration. Here, we identify specific cell types that generate IL-1β and harbor the IL-1 receptor (IL-1R) and pharmacologically validate IL-1β’s contribution to neuro-retinal degeneration using the IL-1R allosteric modulator composed of the amino acid sequence rytvela (as well as the orthosteric antagonist, Kineret) in a model of blue light–induced retinal degeneration.

Methods

Mice were exposed to blue light for 6 h and sacrificed 3 days later. Mice were intraperitoneally injected with rytvela, Kineret, or vehicle twice daily for 3 days. The inflammatory markers F4/80, NLRP3, caspase-1, and IL-1β were assessed in the retinas. Single-cell RNA sequencing was used to determine the cell-specific expression patterns of retinal Il1b and Il1r1. Macrophage-induced photoreceptor death was assessed ex vivo using retinal explants co-cultured with LPS-activated bone marrow–derived macrophages. Photoreceptor cell death was evaluated by the TUNEL assay. Retinal function was assessed by flash electroretinography.

Results

Blue light markedly increased the mononuclear phagocyte recruitment and levels of inflammatory markers associated with photoreceptor death. Co-localization of NLRP3, caspase-1, and IL-1β with F4/80+ mononuclear phagocytes was clearly detected in the subretinal space, suggesting that these inflammatory cells are the main source of IL-1β. Single-cell RNA sequencing confirmed the immune-specific expression of Il1b and notably perivascular macrophages in light-challenged mice, while Il1r1 expression was found primarily in astrocytes, bipolar, and vascular cells. Retinal explants co-cultured with LPS/ATP-activated bone marrow–derived macrophages displayed a high number of TUNEL-positive photoreceptors, which was abrogated by rytvela treatment. IL-1R antagonism significantly mitigated the inflammatory response triggered in vivo by blue light exposure, and rytvela was superior to Kineret in preserving photoreceptor density and retinal function.

Conclusion

These findings substantiate the importance of IL-1β in neuro-retinal degeneration and revealed specific sources of Il1b from perivascular MPs, with its receptor Ilr1 being separately expressed on surrounding neuro-vascular and astroglial cells. They also validate the efficacy of rytvela-induced IL-1R modulation in suppressing detrimental inflammatory responses and preserving photoreceptor density and function in these conditions, reinforcing the rationale for clinical translation.
Biopsychosocial factors associated with disordered eating behaviors in schizophrenia
Authors: Khosravi Mohsen
Published: November 2020

Background

Recent hypotheses have suggested that schizophrenic patients are more likely to consume unhealthy foods, causing increased rates of mortality and morbidity associated with metabolic syndrome. This raises the need for more in-depth research on disordered eating behaviors (DEBs) in schizophrenic patients. This study, therefore, aimed to investigate biopsychosocial factors associated with DEBs in schizophrenia.

Methods

In this cross-sectional study, a total of 308 participants (including 83 subjects in the active phase of schizophrenia, 71 subjects in the remission phase of schizophrenia, and 154 control subjects) were recruited through convenience sampling among patients who referred to the Baharan Psychiatric hospital in Zahedan, Iran. Patients were assessed through Eating Attitudes Test (EAT-26), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), and Positive and Negative Syndrome Scale (PANSS). Data were analyzed using SPSS v25 software. Further, the statistical significance level was set at p < 0.05.

Results

The prevalence of DEBs was 41.5% in schizophrenic patients (vs. 10.3% in the control group, p = 0.012). No significant difference was observed in the EAT-26 scores based on gender and phases of schizophrenia. According to multiple linear regression analysis, lack of psychosocial rehabilitation, use of atypical antipsychotics, early stages of psychosis, high level of anxiety and depression, expression of more active psychotic symptoms, tobacco smoking, and suffering from type 2 diabetes were all associated with increased development of DEBs among schizophrenic patients.

Conclusions

Since the occurrence of DEBs is independent of different phases of schizophrenia, the risk of DEBs is required to be evaluated during the entire course of schizophrenia especially at earlier stages of schizophrenia. Moreover, the use of psychosocial interventions, treatment of affective disorders (i.e., anxiety and depression), antipsychotic medication switching, treatment of tobacco smoking and type 2 diabetes may reduce the risk of DEBs among schizophrenic patients. However, further investigations are required to prove the actual roles of the above factors in developing DEBs among schizophrenic patients.
Assessing the effect of hyperbaric oxygen therapy in breast cancer patients with late radiation toxicity (HONEY trial): a trial protocol using a trial within a cohort design
Authors: Batenburg M. C. T. , van den Bongard H. J. G. D. , Kleynen C. E. , Maarse W. , Witkamp A. , Ernst M. , Doeksen A. , van Dalen T. , Sier M. , Schoenmaeckers E. J. P. , Baas I. O. , Verkooijen H. M.
Published: November 2020

Background

Breast cancer treatment with radiotherapy can induce late radiation toxicity, characterized by pain, fibrosis, edema, impaired arm mobility, and poor cosmetic outcome. Hyperbaric oxygen therapy (HBOT) has been proposed as treatment for late radiation toxicity; however, high-level evidence of effectiveness is lacking. As HBOT is standard treatment and reimbursed by insurers, performing classic randomized controlled trials is difficult. The “Hyperbaric OxygeN therapy on brEast cancer patients with late radiation toxicity” (HONEY) trial aims to evaluate the effectiveness of HBOT on late radiation toxicity in breast cancer patients using the trial within cohorts (TwiCs) design.

Methods

The HONEY trial will be conducted within the Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaluation (UMBRELLA). Within UMBRELLA, breast cancer patients referred for radiotherapy to the University Medical Centre Utrecht are eligible for inclusion. Patients consent to collection of clinical data and patient-reported outcomes and provide broad consent for randomization into future intervention studies. Patients who meet the HONEY in- and exclusion criteria (participation ≥ 12 months in UMBRELLA, moderate/severe breast or chest wall pain, completed primary breast cancer treatment except hormonal treatment, no prior treatment with HBOT, no contraindications for HBOT, no clinical signs of metastatic or recurrent disease) will be randomized to HBOT or control group on a 2:1 ratio (n = 120). Patients in the control group will not be informed about participation in the trial. Patients in the intervention arm will undergo 30–40 HBOT treatment sessions in a high pressure chamber (2.4 atmospheres absolute) where they inhale 100% oxygen through a mask. Cohort outcome measures (i.e., physical outcomes, quality of life, fatigue, and cosmetic satisfaction) of the HBOT group will be compared to the control group at 3 months follow-up.

Discussion

This pragmatic trial within the UMBELLA cohort was designed to evaluate the effectiveness of HBOT on late radiation toxicity in breast cancer patients using the TwiCs design. Use of the TwiCs design is expected to address issues encountered in classic randomized controlled trials, such as contamination (i.e., HBOT in the control group) and disappointment bias, and generate information about acceptability of HBOT.

Trial registration

ClinicalTrials.gov. NCT04193722. Registered on 10 December 2019.
A randomized, multicentre, open-label phase II proof-of-concept trial investigating the clinical efficacy and safety of the addition of convalescent plasma to the standard of care in patients hospitalized with COVID-19: the Donated Antibodies Working against nCoV (DAWn-Plasma) trial
Authors: Devos Timothy , Geukens Tatjana , Schauwvlieghe Alexander , Ariën Kevin K. , Barbezange Cyril , Cleeren Myriam , Compernolle Veerle , Dauby Nicolas , Desmecht Daniël , Grimaldi David , Lambrecht Bart N. , Luyten Anne , Maes Piet , Moutschen Michel , Romano Marta , Seyler Lucie , Nevessignsky Michel Toungouz , Vandenberghe Katleen , van Griensven Johan , Verbeke Geert , Vlieghe Erika , Yombi Jean Cyr , Liesenborghs Laurens , Verhamme Peter , Meyfroidt Geert
Published: November 2020

Background

The COVID-19 pandemic has imposed an enormous burden on health care systems around the world. In the past, the administration of convalescent plasma of patients having recovered from SARS and severe influenza to patients actively having the disease showed promising effects on mortality and appeared safe. Whether or not this also holds true for the novel SARS-CoV-2 virus is currently unknown.

Methods

DAWn-Plasma is a multicentre nation-wide, randomized, open-label, phase II proof-of-concept clinical trial, evaluating the clinical efficacy and safety of the addition of convalescent plasma to the standard of care in patients hospitalized with COVID-19 in Belgium. Patients hospitalized with a confirmed diagnosis of COVID-19 are eligible when they are symptomatic (i.e. clinical or radiological signs) and have been diagnosed with COVID-19 in the 72 h before study inclusion through a PCR (nasal/nasopharyngeal swab or bronchoalveolar lavage) or a chest-CT scan showing features compatible with COVID-19 in the absence of an alternative diagnosis. Patients are randomized in a 2:1 ratio to either standard of care and convalescent plasma (active treatment group) or standard of care only. The active treatment group receives 2 units of 200 to 250 mL of convalescent plasma within 12 h after randomization, with a second administration of 2 units 24 to 36 h after ending the first administration. The trial aims to include 483 patients and will recruit from 25 centres across Belgium. The primary endpoint is the proportion of patients that require mechanical ventilation or have died at day 15. The main secondary endpoints are clinical status on day 15 and day 30 after randomization, as defined by the WHO Progression 10-point ordinal scale, and safety of the administration of convalescent plasma.

Discussion

This trial will either provide support or discourage the use of convalescent plasma as an early intervention for the treatment of hospitalized patients with COVID-19 infection.

Trial registration

ClinicalTrials.govNCT04429854. Registered on 12 June 2020 - Retrospectively registered.