bluuebunny/crossref_metadata_2025 huggingface dataset:
Contact Days Associated With Cancer Treatments in the CCTG LY.12 Trial
Authors: Gupta Arjun , Hay Annette E , Crump Michael , Djurfeldt Marina S , Zhu Liting , Cheung Matthew C , Shepherd Lois E , Chen Bingshu E , Booth Christopher M
Published: May 2023

Background

When cancer treatments have similar oncologic outcomes, the number of days with in-person healthcare contact (“”contact days’’) can help contextualize expected time use with each treatment. We assessed contact days in a completed randomized clinical trial.

Patients and Methods

We conducted a secondary analysis of the CCTG LY.12 RCT that evaluated 2-3 cycles of gemcitabine, dexamethasone, and cisplatin (GDP) vs. dexamethasone, cytarabine, and cisplatin (DHAP) in 619 patients with relapsed/refractory lymphoma prior to stem cell transplant. Primary analyses reported similar response rates and survival. We calculated patient-level “contact days” by analyzing trial forms. The study period was from assignment to progression or transplant. Days without healthcare contact were considered “home days’’. We compared measures of contact days across arms.

Results

The study period was longer in the GDP arm (median 50, vs. 47 days, P = .007). Contact days were comparable in both arms (median 18 vs 19, P = 0.79), but home days were higher in the GDP arm (median 33 vs 28, P < .001). The proportion of contact days was lower in the GDP arm (34%, vs. 38%, P = .009). The GDP arm experienced more contact days related to planned outpatient chemotherapy (median, 10 vs. 8 days), but the DHAP arm experienced many more inpatient contact days (median, 11 vs. 0 days).

Conclusions

Measures of time use, such as contact days, can be extracted from RCTs. In LY.12, despite comparable oncologic outcomes, GDP was associated with fewer contact days. Such information can guide decision-making for patients with hematological cancers, who already face significant healthcare contact.
Investigating association between gut microbiota and sarcopenia-related traits: a Mendelian randomization study
Authors: Zhao Jiaxi , Liang Rui , Song Quhong , Song Shiyu , Yue Jirong , Wu Chenkai
Published: May 2023

Background

Observational studies have indicated a potential link between gut microbiota and sarcopenia. However, the underlying mechanisms and a causal relationship have not been established. Thus, the objective of this study is to examine the possible causal association between gut microbiota and sarcopenia-related traits, including low hand-grip strength and appendicular lean mass (ALM), to shed light on the gut–muscle axis.

Methods

To investigate the potential impact of gut microbiota on low hand-grip strength and ALM, we utilized a two-sample Mendelian randomization (MR) approach. Summary statistics were obtained from genome-wide association studies of gut microbiota, low hand-grip strength, and ALM. The primary MR analysis employed the random-effects inverse-variance weighted (IVW) method. To assess the robustness, we conducted sensitivity analyses using the MR pleiotropy residual sum and outlier (MR-PRESSO) test to detect and correct for horizontal pleiotropy, as well as the MR-Egger intercept test and leave-one-out analysis.

Results

Alcaligenaceae, Family XIII, and Paraprevotella were positively associated with the risk of low hand-grip strength (P-values < 0.05). Streptococcaceae were negatively associated with low hand-grip strength (P-values < 0.05). Eight bacterial taxa (Actinomycetales, Actinomycetaceae, Bacteroidaceae, Porphyromonadaceae, Prevotellaceae, Bacteroides, Marvinbryantia, and Phascolarctobacterium) were associated with a higher risk of ALM (P-values < 0.05). Eubacterium fissicatena group was negatively associated with ALM (P-values < 0.05).

Conclusion

We found several gut microbiota components causally associated with sarcopenia-related traits. Our findings provided insights into novel strategies for the prevention and treatment of sarcopenia through the regulation of the gut microbiota, contributing to a better understanding of the gut–muscle axis.
High-resolution genome mapping and functional dissection of chlorogenic acid production in Lonicera maackii
Authors: Li Ruili , Xu Jing , Qi Zengxing , Zhao Shiwei , Zhao Ran , Ge Yanrui , Li Ruofan , Kong Xiuya , Wu Zhenying , Zhang Xi , He Qizouhong , Zhang Yan , Liu Ping-Li , Zhu Lei , Mao Jian-Feng , Fu Chunxiang , Komis George , Grünhofer Paul , Schreiber Lukas , Lin Jinxing
Published: May 2023

Amur honeysuckle (Lonicera maackii) is a widely used medicinal plant of the Caprifoliaceae family that produces chlorogenic acid. Research on this plant mainly focuses on its ornamental value and medicinal compounds, but a reference genome sequence and molecular resources for accelerated breeding are currently lacking. Herein, nanopore sequencing and high-throughput chromosome conformation capture (Hi-C) allowed a chromosome-level genome assembly of L. maackii (2n = 18). A global view of the gene regulatory network involved in the biosynthesis of chlorogenic acid and the dynamics of fruit coloration in L. maackii was established through metabolite profiling and transcriptome analyses. Moreover, we identified the genes encoding hydroxycinnamoyl-CoA quinate transferase (LmHQT) and hydroxycinnamoyl-CoA shikimic/quinate transferase (LmHCT), which localized to the cytosol and nucleus. Heterologous overexpression of these genes in Nicotiana benthamiana leaves resulted in elevated chlorogenic acid contents. Importantly, HPLC analyses revealed that LmHCT and LmHQTs recombinant proteins modulate the accumulation of chlorogenic acid (CGA) using quinic acid and caffeoyl CoA as substrates, highlighting the importance of LmHQT and LmHCT in CGA biosynthesis. These results confirmed that LmHQTs and LmHCT catalyze the biosynthesis of CGA in vitro. The genomic data presented in this study will offer a valuable resource for the elucidation of CGA biosynthesis and facilitating selective molecular breeding.
The Surprising Positive Asymmetry in the Impact of Organizational Justice on Police Outcomes
Authors: Peacock Robert P , Ivković Sanja Kutnjak , Wu Yuning , Sun Ivan , Vinogradac Marijan , Vinogradac Valentina Pavlović
Published: May 2023

As police organizational justice research continues to mature, this article examines whether an asymmetry exists between positive and negative supervisory experiences on officer perceptions of police performance. The study builds on new theoretical developments in organizational justice that argues for better capturing the independent roles of just and unjust supervisory behaviour. A generally held, but untested, view in the organizational behaviour literature suggests a negative bias: perceptions of unjust supervisors affect employee outcomes more than those viewed as procedurally just. This cross-national test of the impact of supervisory procedural justice finds the existence of a strong positive bias across officer attitudes on police-citizen interactions and rule compliance. Specifically, officer perceptions of just supervisors have a greater influence on officer attitudes toward procedural justice, procedural injustice, and rule compliance in their interactions with the public.
Sustained cell-mediated but not humoral responses in rituximab-treated rheumatic patients after vaccination against SARS-CoV-2
Authors: Thomas Κonstantinos , Grigoropoulos Ioannis , Alexopoulou Panagiota , Karofylakis Emmanouil , Galani Irene , Papadopoulou Kyriaki Korina , Tsiavou Anastasia , Ntourou Aliki , Mavrou Eleftheria , Qevani Irina , Katsimbri Pelagia , Koutsianas Christos , Mavrea Evgenia , Vassilopoulos Dimitrios , Pournaras Spyros , Tsiodras Sotirios , Boumpas Dimitrios , Antoniadou Anastasia
Published: May 2023

Objectives

B-cell depleting monoclonal antibodies are associated with increased COVID-19 severity and impaired immune response to vaccination. We aimed to assess the humoral and cell mediated (CMI) immune response after SARS-CoV-2 vaccination in rituximab (RTX)-treated rheumatic patients.

Methods

Serum and whole blood samples were collected from RTX-treated rheumatic patients 3–6 months after last vaccination against SARS-CoV-2. Serum was tested by ELISA for quantitative detection of anti-spike SARS-CoV-2 IgG. Cell-mediated variant-specific SARS-CoV-2 immunity (CMI) was assessed by interferon-γ release assay Covi-FERON FIA. Patients were interviewed for breakthrough COVID-19 infection (BTI) 3 months post sampling.

Results

Sixty patients were studied after a median (IQR) of 179 (117–221.5) days from last vaccine to sampling. Forty (66.7%) patients had positive Covi-FERON and 23 (38.3%) had detectable anti-spike IgG. Covi-FERON positive patients had lower median RTX cumulative dose [6 (4–10.75) vs 11 (6.75–14.75) grams, (P = 0.019)]. Patients with positive anti-spike IgG had received fewer RTX cycles [2 (2–4) vs 6 (4–8), P = 0.002] and cumulative dose [4 (3–7) vs 10 (6.25–13) grams, P = 0.002] and had shorter time from last vaccination to sampling [140 (76–199) vs 192 (128–230) days, P = 0.047]. Thirty-seven percent were positive only for Covi-FERON and 7% only for anti-spike IgG. Twenty (33.3%) BTI occurred post sampling, exclusively during Omicron variant predominance. The proportion of patients with CMI response against Delta variant was lower in patients who experienced BTI (25% vs 55%, P = 0.03).

Conclusions

Four out of ten RTX-treated vaccinated patients show lasting cell-mediated immune response despite undetectable anti-spike antibodies. Cumulative RTX dose affects both humoral and cell-mediated responses to SARS-CoV-2 vaccines. Cell-mediated immune responses call for attention as a vaccine efficacy marker against SARS-CoV-2.
Belimumab and antimalarials combined against renal flares in patients treated for extra-renal systemic lupus erythematosus: results from 4 phase III clinical trials
Authors: Gomez Alvaro , Jägerback Sandra , Sjöwall Christopher , Parodis Ioannis
Published: May 2023

Objectives

To determine the effect of antimalarial agents (AMA) and different doses and pharmaceutical forms of belimumab on preventing renal flares in patients with SLE treated for extra-renal disease.

Methods

We pooled data from the BLISS-52, BLISS-76, BLISS-SC and BLISS-Northeast Asia trials of belimumab (n = 3225), that included patients with active SLE yet no severe ongoing nephritis. Participants were allocated to receive intravenous belimumab 1 mg/kg, intravenous belimumab 10 mg/kg, subcutaneous belimumab 200 mg, or placebo in addition to standard therapy. We estimated hazards of renal flare development throughout the study follow-up (52–76 weeks) using Cox regression analysis.

Results

In total, 192 patients developed a renal flare after a median of 197 days. Compared with placebo, the risk of renal flares was lower among patients receiving intravenous belimumab 10 mg/kg (HR: 0.62; 95% CI: 0.41, 0.92; P = 0.018) and intravenous belimumab 1 mg/kg (HR: 0.42; 95% CI: 0.22, 0.79; P = 0.007), while no significant association was found for subcutaneous belimumab 200 mg. AMA use yielded a lower hazard of renal flares (HR: 0.66; 95% CI: 0.55, 0.78; P < 0.001). The protection conferred was enhanced when belimumab and AMA were co-administered; the lowest flare rate was observed for the combination intravenous belimumab 1 mg/kg and AMA (18.5 cases per 1000 person-years).

Conclusions

The protection conferred from belimumab against renal flare development in patients treated for extra-renal SLE appears enhanced when belimumab was administered along with AMA. The prominent effect of low-dose belimumab warrants investigation of the efficacy of intermediate belimumab doses.

Clinical trial identification

BLISS-52: NCT00424476; BLISS-76: NCT00410384; BLISS-SC: NCT01484496; BLISS-NEA: NCT01345253.
Effects of rainfall and temperature on background signal of radiation portal monitor
Authors: Sim Hayoung , Choi Hyosang , Baek Seungho , Seo Hee , Choi Hyeonjun , Kim Haneul , Jang Jaeho
Published: May 2023

For homeland security, radiation portal monitors (RPMs) have been widely used to detect illegal radioactive materials at seaports, airports, nuclear facilities and other highly secured establishments. In general, commercial RPMs are based on a large plastic (i.e. PVT-polyvinyl toluene) scintillator detector and the associated electronics. In order to detect radioactive materials passing through the RPM, the alarm criterion should be set according to the background level, which depends on the operating location due to not only composition differences in soil and rocks but also weather variation (i.e. rainfall and temperature). It is well known that RPM background signal level increases with rainfall and that the PVT signal depends on the temperature due to scintillation light yield variation. In this study, the background signal level of two commercial RPMs (models: 4525-3800 and 7000, Ludlum), both of which are installed and operated at the Incheon and Donghae ports in Korea, was analysed by reference to a 3-year database of minute-to-minute RPM background signals and a rainfall-and-temperature database provided by the Korea Meteorological Administration (KMA). In terms of rainfall, the variation of the background signal level was examined with reference to the amount of rainfall. The averaged variation in the background signal level, which was as high as ~20% as a function of the amount of rainfall, was found to be dependent on a region’s specific concentration of 222Rn in the atmosphere. In terms of temperature, the background signal level varied by ~4.7% within the temperature range of −5 to 30°C for the four studied sites (i.e. two sites per region for the Incheon and Donghae regions). Knowledge of the dependency of RPM background signal level on rainfall amount and temperature could be used to achieve more realistic estimation of the background radiation level for optimising commercial RPMs’ alarm criteria.
PyMCGPU-IR Monte Carlo code test for occupational dosimetry
Authors: Balcaza Víctor García , Bosman David Fernández , Badal Andreu , Von Barnekow Ariel , O’Connor Una , Camp Anna , López Joan Aranda , Ginjaume Mercè , Duch María Amor
Published: May 2023

PyMCGPU-IR is an innovative occupational dose monitoring tool for interventional radiology procedures. It reads the radiation data from the Radiation Dose Structured Report of the procedure and combines this information with the position of the monitored worker recorded using a 3D camera system. This information is used as an input file for the fast Monte Carlo radiation transport code MCGPU-IR in order to assess the organ doses, Hp(10) and Hp(0.07), as well as the effective dose. In this study, Hp(10) measurements of the first operator during an endovascular aortic aneurysm repair procedure and a coronary angiography using a ceiling suspended shield are compared to PyMCGPU-IR calculations. Differences in the two reported examples are found to be within 15%, which is considered as being very satisfactory. The study highlights the promising advantages of PyMCGPU-IR, although there are still several improvements that need to be implemented before its final clinical use.
Should the ISO slab phantom be used for calibrations in terms of the new ICRU 95 operational quantity personal dose?
Authors: Merza Victor , Hranitzky Christian , Steurer Andreas , Maringer Franz Josef
Published: May 2023

The applicability of the ISO slab phantom as calibration phantom for the new ICRU report 95 quantity personal dose should be legitimated by simulations and measurements of backscatter factors on the ISO slab phantom and, comparatively, on a human-like Alderson Rando phantom. An ionization chamber was used to determine backscatter factors for standardized X-ray spectra in the energy range of 16–250 keV and for gamma radiation of 137Cs (662 keV) and 60Co (1250 keV). For the validation of measurement results on the ISO slab, the results were compared with those obtained by means of Monte Carlo simulations using MCNP 6.2. Since the deviations of the backscatter factors on the ISO slab from those on the Alderson Rando were within ±5%, it could be concluded that it is not necessary to develop a new calibration phantom for the assessment of personal dose.
Some considerations on the challenges related to the use of the new ICNIRP restrictions for human exposure to radiofrequency fields
Authors: Goiceanu Cristian , Danulescu Razvan , Danulescu Eugenia
Published: May 2023

ICNIRP 2020 guidelines for limiting exposure to radiofrequency fields replace the radiofrequency part of the ICNIRP 1998 guidelines for limiting exposure to time-varying electric, magnetic and electromagnetic fields. Besides setting new restrictions that prevent thermal effect they also took over the 100 kHz to 10 MHz part of the ICNIRP 2010 guidelines for limiting exposure to low-frequency electromagnetic fields, which provides restrictions that prevent nerve stimulation effect. The latest guidelines brought many changes to the system of protection against exposure to radiofrequency fields starting with the physical quantities used to express restrictions and continuing with specific restrictions and new exposure metrics employed. For the first time, the case of brief local exposure to intense radiofrequency fields was accounted by ICNIRP for setting new types of exposure restrictions. All these changes led to more detailed and complex guidelines, but their provisions are more difficult to apply in practice. Our paper presents some of the challenges related to the use in practice of the new ICNIRP restrictions for human exposure to radiofrequency fields.
Analysis of indoor air pollution with radon in the kindergartens of two Bulgarian districts
Authors: Djounova Jana , Ivanova Kremena , Kunovska Bistra , Dzhunakova Desislava , Tasev Ilia , Stojanovska Zdenka
Published: May 2023

The study presents the analysis of the results for indoor radon concentration in the kindergartens of two Bulgarian districts. The study presents the analysis of indoor radon concentration results in kindergartens of two Bulgarian districts. Measurements were performed with a passive method for the period from February to May 2015, in 411 children’s rooms situated in 157 kindergartens. The measured radon concentrations in the children’s rooms were between 10 and 1087 Bq per m. The evaluation of the results showed that in 10% of the kindergarten rooms, the radon concentration is above the national reference level of 300 Bq per m. The influence of the presence of a basement and the implementation of building renovation on the radon concentration were examined. The presence of a basement is a prerequisite for reducing the concentration of radon in the building. It has been proven that renovating the building increases the radon concentration in it. The analysis confirms the necessity of measuring the indoor radon concentration before the renovation and repair of the building, especially the implementation of energy efficiency measures.
Extremity dosimetry for exposed workers in positron emission tomography in Bosnia and Herzegovina
Authors: Beganović Adnan , Petrović Biljana , Surić Mihić Marija
Published: May 2023

Occupational exposure in Bosnia and Herzegovina is regulated by the national regulation on radiation protection for occupational and public exposure. All radiation workers are required to be monitored using whole body passive thermoluminescent dosemeters and, in case of non-uniform external exposures, by dosemeters that would indicate dose to the most affected body parts. Exposed workers are almost exclusively employed in the medical field, and some of them work in nuclear medicine departments where they handle unsealed radioactive sources. Introduction of the positron emission tomography–computed tomography (PET–CT) in two largest clinical centers in the country was expected to cause the increase of equivalent doses to hands received by staff handling the positron emitting radionuclides. Hence, routine monitoring of finger doses became a necessity. The purpose of this study was to evaluate the available data on monitoring with ring dosemeters during PET–CT procedure in two hospitals in Bosnia and Herzegovina and compare them with other practices in the nuclear medicine department, as well as with the results of monitoring in other countries. In general, results confirm that effective doses, as well as equivalent doses to hands, are well below annual dose limits. Finger dosemeters have been proven to be an invaluable asset in the incidental situations that sometimes occur in nuclear medicine departments. Different number of patients and differences in injection methodologies are identified as a possible source of differences between doses in two hospitals. Overall, routine evaluation of doses to hands provides a sound basis for possible optimization processes, as well as confirmation of good practices.
Energy-based Hp(3) measurement using solid-state detector
Authors: Ichikawa Nao , Matsubara Kosuke , Fukuda Atsushi , Hayashi Takuma , Takamatsu Kunihiko , Kuramoto Taku
Published: May 2023

This study aimed to develop an energy-based Hp(3) measurement method using a solid-state detector (SSD). Incident and entrance surface air kerma were measured using an ionization chamber placed free-in-air and in front of an anthropomorphic or slab phantom. Subsequently, three SSDs were placed free-in-air, and half-value layer and readings were obtained. After measurements, an X-ray beam quality correction factor $\left ({{k}}_{{Q},{{Q}}_{\mathbf{0}}}^{{SSD}}\right)$, backscatter factor (BSF) and conversion factor from incident air kerma to Hp(3) (C3) were determined. Then, the incident air kerma by SSD $\left ({{K}}_{{a},{i}}^{{SSD}}\right )$, Hp(3) and Hp(3)/${{K}}_{{a},{i}}^{{SSD}}$ were calculated. The ${{k}}_{{Q},{{Q}}_{\mathbf{0}}}^{{SSD}}$ was almost consistent for all SSDs. The C3 and BSF were found to increase as tube potential increased. The Hp(3)/${{K}}_{{a},{i}}^{{SSD}}$ calculated with the anthropomorphic and slab phantoms were consistent within 2.1% and 2.6% for all SSDs, respectively. This method improves the energy dependence of Hp(3) measurement and can estimate the Hp(3) measurement error for dedicated Hp(3) dosemeters.
Simulation of cosmic rays inside an aircraft: spectral perturbation and dose reduction due to aircraft structures and contents
Authors: Yang Zi-Yi , Tsai Bo-Shu , Huang Yu-Shiang , Sheu Rong-Jiun
Published: May 2023

In this study, an intricate combinatorial geometry model of a Boeing 777-300ER aircraft was constructed for Monte Carlo transport simulations. The aircraft-induced perturbations of the energy spectra and effective doses of secondary cosmic rays at a typical civil aviation altitude (10 km) were investigated on a component-by-component basis, which included neutrons, protons, photons, electrons, positrons, muons and charged pions. Two geomagnetic cutoff rigidities (1.35 and 15.53 GV) and two solar modulation parameters (430 and 1360 MV) were considered in the aforementioned simulations. The characteristics of various cosmic-ray components at six locations along the fuselage were assessed and compared with those of an unperturbed radiation field in the atmosphere. Aircraft structures and contents reduced the effective doses of personnel inside the aircraft to varying degrees, up to an ~32% reduction in the middle section of the passenger cabin. On average, the dose reduction was ~12–16% depending on geomagnetic and solar conditions. Quantifying the aircraft’s self-shielding effects can further improve the estimation accuracy of aircrew and passengers’ exposure to cosmic radiation. Information regarding the perturbed energy spectra of cosmic rays may be useful for designing onboard experiments or analyzing onboard measurement data.
The reception of OHADA law in anglophone Cameroon: appraisal and proposals
Authors: Essoh Clotilde Etoula
Published: May 2023

This article assesses the extent to which the law under the Organisation pour l’Harmonisation en Afrique du Droit des Affaires (OHADA) has been received in anglophone Cameroon after 26 years of existence, with specific focus on the Fako judicial division.1 With regard to the tenets of qualitative research, it is observed that, from the viewpoint of the legal reception technique, it is indisputable that OHADA law has been infused into the English-speaking legal system in Cameroon through legal techniques of transposition. Through the use of interviews and questionnaires as our research tools, it is revealed that this reception remains limited because most judicial actors still find it difficult to implement legislation that they have not yet mastered. Linguistic issues and the difficulties faced in accessing the Common Court of Justice and Arbitration based in Ivory Coast in Abidjan on OHADA-related matters are serious obstacles to its effective implementation. This situation has been worsened by the poor articulation of clichés that tend to radically oppose OHADA law compared to common law principles. This article tries to deconstruct the ideas received as it shows some of the similarities in the substantive law under the two systems and consequently advocates on this basis the idea that efforts be made to familiarize common law jurists with the content of OHADA law. The article recommends that linguistic issues be tackled by OHADA lawmakers right from the stage of legal drafting by using drafting techniques that will reduce the feeling that the common law is being neglected. For uniform acts yet to be translated, the translation process should associate experts in comparative law to enable the use of appropriate legal language in translation from French into English. Only such efforts will entice the common law African countries that are still hesitating to join OHADA law and, by so doing, will render investment in Africa more attractive.
Iron Sulfate and Phosphorous Acid Affect Turfgrass Surface pH and Microdochium Patch Severity on Annual Bluegrass
Authors: Mattox Clint M. , Dumelle Michael J. , McDonald Brian W. , Gould Micah A. , Olsen Conner J. , Braithwaite Emily T. , Kowalewski Alec R.
Published: May 2023

Microdochium patch is a turfgrass disease caused by the fungal pathogen Microdochium nivale. Iron sulfate heptahydrate (FeSO4•7H2O) and phosphorous acid (H3PO3) applications have previously been shown to suppress Microdochium patch on annual bluegrass putting greens when applied alone, although either disease suppression was inadequate or turfgrass quality was reduced from the applications. A field experiment was conducted in Corvallis, Oregon, U.S.A., to evaluate the combined effects of FeSO4•7H2O and H3PO3 on Microdochium patch suppression and annual bluegrass quality. The results of this work suggest that the addition of 3.7 kg H3PO3 ha−1 with 24 or 49 kg FeSO4•7H2O ha−1 applied every 2 weeks improved the suppression of Microdochium patch without substantially compromising turf quality, which occurred when 98 kg FeSO4•7H2O ha−1 was applied with or without H3PO3. Spray suspensions reduced the pH of the water carrier, therefore two additional growth chamber experiments were conducted to better understand the effects of these treatments on leaf surface pH and Microdochium patch suppression. On the application date in the first growth chamber experiment, at least a 19% leaf surface pH reduction was observed compared with the well water control when FeSO4•7H2O was applied alone. When 3.7 kg H3PO3 ha−1 was combined with FeSO4•7H2O, regardless of the rate, the leaf surface pH was reduced by at least 34%. The second growth chamber experiment determined that sulfuric acid (H2SO4) at a 0.5% spray solution rate was always in the group that produced the lowest annual bluegrass leaf surface pH, but did not suppress Microdochium patch. Together, these results suggest that while treatments decrease leaf surface pH, this decrease in pH is not responsible for the suppression of Microdochium patch.
Paternal Western diet causes transgenerational increase in food consumption in Drosophila with parallel alterations in the offspring brain proteome and microRNAs
Authors: Murashov Alexander K. , Pak Elena S. , Mar Jordan , O'Brien Kevin , Fisher‐Wellman Kelsey , Bhat Krishna M.
Published: May 2023

Several lines of evidence indicate that ancestral diet might play an important role in determining offspring's metabolic traits. However, it is not yet clear whether ancestral diet can affect offspring's food choices and feeding behavior. In the current study, taking advantage of Drosophila model system, we demonstrate that paternal Western diet (WD) increases offspring food consumption up to the fourth generation. Paternal WD also induced alterations in F1 offspring brain proteome. Using enrichment analyses of pathways for upregulated and downregulated proteins, we found that upregulated proteins had significant enrichments in terms related to translation and translation factors, whereas downregulated proteins displayed enrichments in small molecule metabolic processes, TCA cycles, and electron transport chain (ETC). Using MIENTURNET miRNA prediction tool, dme‐miR‐10‐3p was identified as the top conserved miRNA predicted to target proteins regulated by ancestral diet. RNAi‐based knockdown of miR‐10 in the brain significantly increased food consumption, implicating miR‐10 as a potential factor in programming feeding behavior. Together, these findings suggest that ancestral nutrition may influence offspring feeding behavior through alterations in miRNAs.
Where are Canada's PAs in 2023?
Authors: Jones Ian W.
Published: May 2023

The physician assistant/associate (PA) role in Canada is slowly expanding from two provinces and 301 PAs in 2012 to five provinces with 959 PAs and 119 clinical assistants in 2022. This article reviews Canadian PA education, healthcare challenges, and future growth, providing a brief look at where in 2023 the 1,215 members of the Canadian Association of Physician Assistants are found, and some anticipated directions.
Caring for nonbinary patients
Authors: Curl Kara-anne
Published: May 2023

Nonbinary is an umbrella term that encompasses any person whose gender identity is outside the binary construct of man or woman. An estimated 1.2 million people in the United States identify as nonbinary, a number that most likely will continue to increase as the visibility of people who live outside binary gender increases in our society. Healthcare providers are likely to encounter nonbinary patients but may lack confidence in treating these patients appropriately. This article describes terminology, concepts, and suggestions for clinicians to provide basic respectful and competent care for nonbinary patients.
What is the relationship between photosensitizing drugs and skin cancer?
Authors: Weidman-Evans Emily , Rhodes Andrea , Ferrington Lindsay
Published: May 2023

Many medications are associated with phototoxicity or photoallergy, the two types of photosensitivity. Recently, a warning related to increased skin cancer risk was added to the labeling of the popular diuretic hydrochlorothiazide. This article reviews some photosensitizing medications and describes patient education on preventing and recognizing photosensitivity reactions and skin cancer.
Addressing Incarceration as a Social Determinant of Health
Authors: Hameroff Erin
Published: May 2023

Newly released patients face daunting requirements and obstacles.
Mesenteric ischemia in the acute care setting
Authors: Bagley Kimberly , Schuller Jana Grissom
Published: May 2023

Mesenteric ischemia is a group of disorders requiring prompt identification, supportive care, and treatment. Chronic mesenteric ischemia can develop into acute mesenteric ischemia, which has high mortality. Acute mesenteric ischemia can be occlusive (caused by arterial embolism, arterial thrombosis, or mesenteric venous thrombosis) or nonocclusive, with treatment depending on the underlying cause.
Obesity-related hypertension
Authors: Benenson Irina , Prado Kimberly
Published: May 2023

Obesity increases the risk of hypertension and other cardiometabolic comorbidities. Lifestyle modifications are usually recommended, though lasting effects on weight and BP reduction are limited. Weight-loss medications, especially incretin mimetics, are effective for short- and long-term treatment. Metabolic surgery provides cure of obesity-related hypertension in some patients. NPs are well positioned to manage obesity-related hypertension to improve clinical outcomes of affected individuals.
Complete response of recurrent perihilar cholangiocarcinoma following sintilimab combined with lenvatinib plus S-1: a case report and review of literature
Authors: Liu Qin-qin , Yu Xian-huan , Tang Qi-bin , Chen Dong , Zhang Rui , Liu Chao , Shi Xiang-de
Published: May 2023

Perihilar cholangiocarcinoma is a refractory malignancy with an unfavorable prognosis and a high probability of recurrence. Systemic chemotherapy is critical for palliative treatment, but effective therapeutic strategies for perihilar cholangiocarcinoma after first-line chemotherapy failure are scarce. Here, we introduced a sustained benefit following sintilimab combined with lenvatinib plus S-1 in a patient with recurrent perihilar cholangiocarcinoma. A 52-year-old female patient was admitted to our hospital due to yellow skin and sclera, and further radiological examination revealed perihilar cholangiocarcinoma. The patient underwent surgery and histopathological results confirmed moderately differentiated adenocarcinoma with metastatic lymph nodes. Postoperative adjuvant chemotherapy with gemcitabine and S-1 was given. One year after surgery, the patient experienced hepatic recurrence. Then, she received radiofrequency ablation combined with gemcitabine and cisplatin. Unfortunately, radiological assessment revealed progressive disease with multiple liver metastases after treatment. Subsequently, she received sintilimab combined with lenvatinib plus S-1 and the lesions were completely regressed following 14 cycles of combination therapy. The patient recovered well without disease recurrence at the last follow-up. Sintilimab combined with lenvatinib plus S-1 may be an alternative therapeutic option for chemotherapy-refractory perihilar cholangiocarcinoma, and further evaluation in a larger number of patients is needed.
Effect of statin use on risk and mortality of gastric cancer: a meta-analysis
Authors: Chen Yi , Zhang Jianshu , Zhang Yin , Zhu Linlin
Published: May 2023

The effect of statins on gastric cancer risk is still controversial. And studies on the association between statins and gastric cancer mortality are very limited. Therefore, we conducted this systemic review and meta-analysis to evaluate the association between the use of statin and gastric cancer. Searched studies were published before November 2022. Odds ratios (ORs)/relative risks (RRs) or hazard ratios (HRs) and their 95% confidence intervals (CIs) were computed using STATA 12.0 software. The study showed that the statin use group showed a significantly lower risk of gastric cancer, compared to no statin use group (OR/RR, 0.74; 95% CI: 0.67–0.80, P < 0.001). The study showed that the statin use group showed significantly lower all-cause mortality and cancer-specific mortality of gastric cancer, compared to no statin use group (all-cause mortality: HR, 0.70; 95% CI: 0.52–0.95, P = 0.021; cancer-specific mortality: HR, 0.70; 95% CI: 0.58–0.84, P < 0.001). Overall, results from this meta-analysis showed the protective effect of statins exposure on the risk and prognosis of gastric cancer; however, we still need more well designed, large-scale studies and randomized clinical trials to pinpoint the effect of statins on gastric cancer in future clinical practice.
Dexmedetomidine
Authors: Thomas Amy , Ullrich Marie
Published: May 2023

In the last 20 years, the occurrences of drug shortages have increased in frequency as well as duration before returning to the mainstream market. This has prompted intensive care unit nurses and medical staff to seek alternate medication infusion options that provide safe yet effective sedation for patients admitted to intensive care units across the country. Dexmedetomidine (PRECEDEX) emerged in 1999 after the Federal Drug Administration approved it for intensive care use but was quickly embraced by anesthesia providers as it rendered patients undergoing procedures or surgery with adequate analgesia and sedation. Dexmedetomidine (PRECEDEX) continued to maintain patients who required short-term intubation and mechanical ventilation with adequate sedation throughout the entire perioperative period. With patients remaining hemodynamically stable in the initial postoperative period, critical care nurses embraced the use of dexmedetomidine (PRECEDEX) in the intensive care unit setting. As dexmedetomidine (PRECEDEX) gained popularity, it has been used to help manage multiple disease processes such as delirium, agitation, alcoholic withdrawal, and anxiety. Dexmedetomidine (PRECEDEX) has been indicated to be a safer alternative to benzodiazepines, narcotics, or propofol (Diprivan), while providing adequate sedation and allowing patients to maintain hemodynamic stability.
The Impact of Universal Screening for Substance Use Disorders During Emergency Services Within an Integrated Health Care System
Authors: Carruthers Serene , Sutton-Inocencio Elliot
Published: May 2023

Each day, across America, people come to emergency service providers in need of care and support. Although not ideal, emergency departments have become the de facto outpatient treatment center in many communities. This positions emergency department providers to be ideal partners in the treatment of substance use disorders. Substance use and deaths by overdose have been of great concern for many years, and since the start of the pandemic, the trends have caused further concern. Drug overdoses have claimed the lives of more than 932 000 Americans over the past 21 years. Excessive alcohol use is a leading cause of premature death in the United States. In 2020, of people identified as needing substance use treatment in the past year, only 1.4% received any treatment. As we watch the death tolls and cost of care continue to trend upward, emergency service providers have the unique opportunity to quickly screen, intervene, and refer to help get these complex and sometimes challenging patients better care, while also avoiding the worsening of the crisis in which we find ourselves.
Effect of Electronic Rounding Board on Falls and Self-harm Among Psychiatric Inpatients
Authors: Kay Shibley Mary , Chae Kim Son , Ecoff Laurie
Published: May 2023

More than 1 million falls are reported in US hospitals each year. Psychiatric inpatients are at high risk for self-harm behaviors with reported suicide rate of 6.5 per 1000 patients. Patient observation is the primary risk management intervention in preventing adverse patient safety incidents. This project aimed to examine the effectiveness of handheld electronic rounding board (ObservSMART) implementation on falls and self-harm incidents among psychiatric inpatients. A retrospective review of adverse patient safety incidents was conducted to compare the 6-month preimplementation period versus the 6-month postimplementation period with staff training and implementation in July 2019. The monthly fall rates per 1000 patient-days were 3.53 versus 3.80 during the pre- and postimplementation periods, respectively. About one-third of the falls resulted in mild or moderate injuries for both periods. The incidence of self-harm was 3 versus 7 during the pre- and postimplementation periods, with incidence of 1 versus 6, respectively, among adult patients, who are more likely to hide self-harm. Although there were no changes in falls, the implementation of ObservSMART markedly increased the detection of patient self-harm, including self-injury and suicide attempts. It also ensures staff accountability and provides an easy-to-use tool to perform timely, proximity-based patient observations.
Are Apologies a Way to Reduce Malpractice Risks?
Authors: Sanfilippo Joseph S. , Kettering Caroline , Smith Steven R.
Published: May 2023

Apologies are a means of responding to a medical error. Explanation of information related to the episode often fills a need for the patient and family to feel adequately informed. There are pros and cons related to the apology. The American College of Physicians, the American Medical Association, and the Joint Commission of the Accreditation of Health Care Organization Hospital strongly encourage practitioners to disclose when an error or complication occurs. Apologies can be admissible in the courtroom and much of this is state dependent. An apology will be an integral part of the clinician's armamentarium.
Medical Malpractice Lawsuits
Authors: Robinson Clayton , Kettering Caroline , Sanfilippo Joseph S.
Published: May 2023

The tenets of a lawsuit are a deviation from the applicable standard of care that caused an injury. Elements must be addressed, including duty of care, deviation or breach of the duty to care, evidence the breach caused injury, and the identification of associated damages. Steps include consultation by a plaintiff with the attorney, pertinent records and imaging studies, and a review of the material by an expert. A complaint is filed and served upon each party. The defendant(s) must respond typically within 20 days. The parties then engage in discovery. The case may be referred to mediation, trial settlement, or dismissal.
Integration of the Registered Nurse Care Coordinator Role in a Federally Qualified Health Center
Authors: Alicea-Planas Jessica , Burger Susan
Published: May 2023

The purpose of this 1-group, retrospective case study was to analyze the expanded role of registered nurse care coordination (RNCC) on health outcomes in a primary care setting in its real-life context. The convenience sample consisted of 244 adults diagnosed with uncontrolled diabetes mellitus and/or hypertension. Secondary data entered into the electronic health record by the health care team during patient visits pre- and post-implementation of the RNCC program were analyzed. Clinical findings suggest that RNCC may provide a valuable service. Additionally, financial analysis demonstrated that the cost of the RNCC position was both self-sustaining and revenue producing.
Association of preoperative nutritional status evaluated by the controlling nutritional status score with walking independence at 180 days postoperatively: a prospective cohort study in Chinese older patients with hip fracture
Authors: Cheng Xinqun , Chen Wei , Yan Jincheng , Yang Zhenbang , Li Chengsi , Wu Dongwei , Wang Tianyu , Zhang Yingze , Zhu Yanbin
Published: May 2023

Background:

Malnutrition is significantly associated with unfavorable outcomes, but there is little high-level evidence to elucidate the association of malnutrition with losing walking independence (LWI) after hip fracture surgery. This study aimed to assess the association between preoperative nutritional status evaluated by the Controlling Nutritional Status (CONUT) score and walking independence at 180 days postoperatively in Chinese older hip fracture patients.

Methods:

This prospective cohort study included 1958 eligible cases from the SSIOS database. The restricted cubic spline was used to assess the dose-effect relationship between the CONUT score and the recovery of walking independence. Propensity score matching was performed to balance potential preoperative confounders, and multivariate logistic regression analysis was applied to assess the association between malnutrition and LWI with perioperative factors for further adjustment. Furthermore, inverse probability treatment weighting and sensitivity analyses were performed to test the robustness of the results and the Fine and Gray hazard model was applied to adjust the competing risk of death. Subgroup analyses were used to determine potential population heterogeneity.

Results:

The authors found a negative relationship between the preoperative CONUT score and recovery of walking independence at 180 days postoperatively, and that moderate-to-severe malnutrition evaluated by the CONUT score was independently associated with a 1.42-fold (95% CI, 1.12–1.80; P=0.004) increased risk of LWI. The results were overall robust. And in the Fine and Gray hazard model, the result was still statistically significant despite the apparent decrease in the risk estimate from 1.42 to 1.21. Furthermore, significant heterogeneities were observed in the subgroups of age, BMI, American Society of Anesthesiologists score, Charlson’s comorbidity index, and surgical delay (P for interaction < 0.05).

Conclusion:

Preoperative malnutrition is a significant risk factor for LWI after hip fracture surgery, and nutrition screening on admission would generate potential health benefits.
Evaluation of a New Faculty Teaching Workload Model
Authors: Ludwig-Beymer Patti , Rogers Julia L. , Bowers Heather M. , Vottero Beth , Coates Annette
Published: May 2023

Background:

Creating an equitable faculty workload model is an ongoing concern. This research evaluated the effectiveness of and satisfaction with a new faculty teaching workload model 1 year after implementation.

Methods:

Data were collected through secondary analysis of faculty assignment spreadsheets, online survey of all full-time nursing faculty members, online survey of college of nursing administrators, and financial analysis.

Results:

Individual faculty teaching loads were not consistent with the workload model. Tenure-track faculty members were assigned higher workloads than the model. Faculty members strongly preferred to have input into their schedule. Both faculty members and administrators identified strengths and opportunities for the model.

Conclusions:

Creating equitable faculty assignments is complex. Administrators and faculty members need to establish a mutual understanding of the process used to calculate equitable workloads and protect time for service and scholarship commensurate with faculty rank.
Examining the Impact of State-Level Factors on HIV Testing for Medicaid Enrollees With Schizophrenia
Authors: Thomas Marilyn D. , Vittinghoff Eric , Koester Kimberly A. , Dahiya Priya , Riano Nicholas S. , Cournos Francine , Dawson Lindsey , Olfson Mark , Pinals Debra A. , Crystal Steven , Walkup James , Shade Starley , Mangurian Christina , Arnold Emily A.
Published: May 2023

Background:

People with schizophrenia experience unique barriers to routine HIV testing, despite increased risk of HIV compared with the general US population. Little is known about how health care delivery system factors affect testing rates or whether there are testing differences for people with schizophrenia.

Setting:

Nationally representative sample of Medicaid enrollees with and without schizophrenia.

Methods:

Using retrospective longitudinal data, we examined whether state-level factors were associated with differences in HIV testing among Medicaid enrollees with schizophrenia compared with frequency-matched controls during 2002–2012. Multivariable logistic regression estimated testing rate differences between and within cohorts.

Results:

Higher HIV testing rates for enrollees with schizophrenia were associated with higher state-level Medicaid spending per enrollee, efforts to reduce Medicaid fragmentation, and higher federal prevention funding. State-level AIDS epidemiology predicted more frequent HIV testing for enrollees with schizophrenia versus controls. Living in rural settings predicted lower HIV testing, especially for people with schizophrenia.

Conclusion:

Overall, state-level predictors of HIV testing rates varied among Medicaid enrollees, although rates were generally higher for those with schizophrenia than controls. Increased HIV testing for people with schizophrenia was associated with coverage of HIV testing when medically necessary, higher Centers for Disease Control and Prevention prevention funding, and higher AIDS incidence, prevalence, and mortality when compared with controls. This analysis suggests that state policymaking has an important role to play in advancing that effort. Overcoming fragmented care systems, sustaining robust prevention funding, and consolidating funding streams in innovative and flexible ways to support more comprehensive systems of care delivery deserve attention.