bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 Outbreak in A Forward-Deployed Expeditionary Military Command: A Retrospective Review on Preventative Measures and Outbreak Characteristics
Authors: Nardi Sean , McGrath Matthew , Wido Daniel , Murray Lauren , Byrne Brendan , Delk Gerald
Published: December 2022

Background

An outbreak of coronavirus disease 2019 (COVID-19) occured within a land based 2,000-member cohort stationed on a remote air base in the Middle East from June to August 2020. We retrospectively reviewed base characteristics and mitigation measures instituted during the outbreak. We also reviewed documentation on the individuals that were either quarantined or placed in isolation and provide data on demographics, real-time reverse transcriptase polymerase chain reaction (rRT-PCR) results, occupation, and workdays lost.

Results

During the reporting period, 46 individuals or 3.84% of the population had a positive COVID-19 rRT-PCR test. Aviation personnel represented 50% of the COVID-19 positive tests. Sixteen percent of health care personnel were tested positive. Overall, 10% of personnel were placed in isolation or quarantine, resulting in the loss of 1,552 workdays.

Conclusions

The data show a disproportionate impact on healthcare workers and personnel involved in aviation operations. The purpose of this study is 2-fold: to describe the characteristics of the outbreak and to highlight the effectiveness of mitigation measures implemented to control it during military operations. This study may serve to inform medical professionals and military leaders in the management of a similar outbreak in a congregate living setting.
The radial profile of dust grain size in the protoplanetary disc of DS Tau
Authors: Li Dafa , Liu Yao , Wang Hongchi , Wang Yao , Ma Yuehui
Published: December 2022

How do dust grains in protoplanetary discs overcome rapid radial drift and grow from micron size particles to planets is not well understood. The key is to search for evidence of dust accumulation and growth as a function of radius in the disc. We investigate the radial profile of grain size in the DS Tau disc by fitting multiband ALMA observations with self-consistent radiative transfer models. The best-fit grain sizes range from centimeters in the inner disc down to ${\sim }\, 30\, \mu {\rm m}$ in the outer regions. Such an inside-out decreasing tendency is consistent with theories of dust evolution. Based on the best-fit model, we find that dust of ${\sim }\, 2$ Jupiter masses has been depleted within the gap. By taking the gas-to-dust mass ratio into account, the lost mass is enough to form the 3.5 Jupiter mass planet inferred by literature hydrodynamic simulations. Moreover, our modelling also indicates that at the interface region between the gap and the ring, the grain size profile shows a discontinuity, with its amplitude dependent on the dust model adopted in the radiative transfer analysis. Future multiwavelength observations at higher angular resolutions are required to better constrain the grain size and its variation in the vicinity of disc substructures.
Dual-corona Comptonization model for the type-b quasi-periodic oscillations in GX 339-4
Authors: Peirano Valentina , Méndez Mariano , García Federico , Belloni Tomaso
Published: December 2022

Characterizing the fast variability in black hole low-mass X-ray binaries (BHXBs) can help us to understand the geometrical and physical nature of the innermost regions of these sources. Particularly, type-B quasi-periodic oscillations (QPOs), observed in BHXBs during the soft-intermediate state (SIMS) of an outburst, are believed to be connected to the ejection of a relativistic jet. The X-ray spectrum of a source in the SIMS is characterized by a dominant soft blackbody-like component – associated with theVaccretion disc – and a hard component – associated with a Comptonizing region or corona. Strong type-B QPOs were observed by NICER and AstroSat in GX 339-4 during its 2021 outburst. We find that the fractional rms spectrum of the QPO remains constant at ∼1 per cent for energies below ∼1.8 keV, and then increases with increasing energy up to ∼17 per cent at 20–30 keV. We also find that the lag spectrum is ‘U-shaped’, decreasing from ∼1.2 rad at 0.7 keV to 0 rad at ∼3.5 keV, and increasing again at higher energies up to ∼0.6 rad at 20–30 keV. Using a recently developed time-dependent Comptonization model, we fit simultaneously the fractional rms and lag spectra of the QPO, and the time-averaged energy spectrum of GX 339-4 to constrain the physical parameters of the region responsible for the variability we observe. We suggest that the radiative properties of the type-B QPOs observed in GX 339-4 can be explained by two physically-connected comptonizing regions that interact with the accretion disc via a feedback loop of X-ray photons.
Balancing the efficiency and stochasticity of star formation with dust extinction in z ≳ 10 galaxies observed by JWST
Authors: Mirocha Jordan , Furlanetto Steven R
Published: December 2022

Early observations with JWST indicate an overabundance of bright galaxies at redshifts z ≳ 10 relative to Hubble-calibrated model predictions. More puzzling still is the apparent lack of evolution in the abundance of such objects between z ∼ 9 and the highest redshifts yet probed, z ∼ 13–17. In this study, we first show that, despite a poor match with JWST luminosity functions (LFs), semi-empirical models calibrated to rest-ultraviolet LFs and colours at 4 ≲ z ≲ 8 are largely consistent with constraints on the properties of individual JWST galaxies, including their stellar masses, ages, and spectral slopes. We then show that order-of-magnitude scatter in the star formation rate of galaxies (at fixed halo mass) can indeed boost the abundance of bright galaxies, provided that star formation is more efficient than expected in low-mass haloes. However, this solution to the abundance problem introduces tension elsewhere: because it relies on the upscattering of low-mass haloes into bright magnitude bins, one expects typical ages, masses, and spectral slopes to be much lower than constraints from galaxies observed thus far. This tension can be alleviated by non-negligible reddening, suggesting that – if the first batch of photometrically selected candidates are confirmed – star formation and dust production could be more efficient than expected in galaxies at z ≳ 10.
The multivalency of the glucocorticoid receptor ligand-binding domain explains its manifold physiological activities
Authors: Jiménez-Panizo Alba , Alegre-Martí Andrea , Tettey Theophilus T , Fettweis Gregory , Abella Montserrat , Antón Rosa , Johnson Thomas A , Kim Sohyoung , Schiltz R Louis , Núñez-Barrios Israel , Font-Díaz Joan , Caelles Carme , Valledor Annabel F , Pérez Paloma , Rojas Ana M , Fernández-Recio Juan , Presman Diego M , Hager Gordon L , Fuentes-Prior Pablo , Estébanez-Perpiñá Eva
Published: December 2022

The glucocorticoid receptor (GR) is a ubiquitously expressed transcription factor that controls metabolic and homeostatic processes essential for life. Although numerous crystal structures of the GR ligand-binding domain (GR-LBD) have been reported, the functional oligomeric state of the full-length receptor, which is essential for its transcriptional activity, remains disputed. Here we present five new crystal structures of agonist-bound GR-LBD, along with a thorough analysis of previous structural work. We identify four distinct homodimerization interfaces on the GR-LBD surface, which can associate into 20 topologically different homodimers. Biologically relevant homodimers were identified by studying a battery of GR point mutants including crosslinking assays in solution, quantitative fluorescence microscopy in living cells, and transcriptomic analyses. Our results highlight the relevance of non-canonical dimerization modes for GR, especially of contacts made by loop L1–3 residues such as Tyr545. Our work illustrates the unique flexibility of GR’s LBD and suggests different dimeric conformations within cells. In addition, we unveil pathophysiologically relevant quaternary assemblies of the receptor with important implications for glucocorticoid action and drug design.
Effectiveness and Acceptability of Conversational Agents for Smoking Cessation: A Systematic Review and Meta-analysis
Authors: He Linwei , Balaji Divyaa , Wiers Reinout W , Antheunis Marjolijn L , Krahmer Emiel
Published: December 2022

Introduction

Conversational agents (CAs; computer programs that use artificial intelligence to simulate a conversation with users through natural language) have evolved considerably in recent years to support healthcare by providing autonomous, interactive, and accessible services, making them potentially useful for supporting smoking cessation. We performed a systematic review and meta-analysis to provide an overarching evaluation of their effectiveness and acceptability to inform future development and adoption.

Aims and Methods

PsycInfo, Web of Science, ACM Digital Library, IEEE Xplore, Medline, EMBASE, Communication and Mass Media Complete, and CINAHL Complete were searched for studies examining the use of CAs for smoking cessation. Data from eligible studies were extracted and used for random-effects meta-analyses.

Results

The search yielded 1245 publications with 13 studies eligible for systematic review (total N = 8236) and six studies for random-effects meta-analyses. All studies reported positive effects on cessation-related outcomes. A meta-analysis with randomized controlled trials reporting on abstinence yielded a sample-weighted odds ratio of 1.66 (95% CI = 1.33% to 2.07%, p < .001), favoring CAs over comparison groups. A narrative synthesis of all included studies showed overall high acceptability, while some barriers were identified from user feedback. Overall, included studies were diverse in design with mixed quality, and evidence of publication bias was identified. A lack of theoretical foundations was noted, as well as a clear need for relational communication in future designs.

Conclusions

The effectiveness and acceptability of CAs for smoking cessation are promising. However, standardization of reporting and designing of the agents is warranted for a more comprehensive evaluation.

Implications

This is the first systematic review to provide insight into the use of CAs to support smoking cessation. Our findings demonstrated initial promise in the effectiveness and user acceptability of these agents. We also identified a lack of theoretical and methodological limitations to improve future study design and intervention delivery.
High-sensitivity VLBI observations of water masers in the Seyfert galaxy NGC 1068
Authors: Morishima Yuna , Sudou Hiroshi , Yamauchi Aya , Taniguchi Yoshiaki , Nakai Naomasa
Published: December 2022

We present observational results of water vapor maser emission with our high-sensitivity 22 GHz very long baseline interferometry (VLBI) imaging of the Seyfert galaxy NGC 1068. In this galaxy, there are the following four nuclear radio sources; NE, C, S1, and S2. Among them, the S1 component has been identified as the nucleus while the C component has been considered as attributed to the radio jet. In our VLBI observation, we find the following two types of water maser emission at the S1 component. One is a linearly aligned component that is considered as an edge-on disk with an inner radius of 0.62 pc. The dynamical mass enclosed within the inner radius was estimated to be 1.5 × 107 M⊙ by assuming the circular Keplerian motion. Note, however, that the best-fitting rotation curve shows a sub-Keplerian rotation (v ∝ r−0.24±0.10). The other is water maser emission distributed around the rotating disk component up to 1.5 pc from the S1 component, suggesting a bipolar outflow from the S1 component. Further, we detected water maser emission in the C component for the first time with VLBI, and discovered a ring-like distribution of water maser emission. It is known that a molecular cloud is associated with the C component (both HCN and HCO+ emission lines are detected by ALMA). Therefore, the ring-like maser emission can be explained by the jet collision to the molecular cloud. However, if these ring-like water masing clouds constitute a rotating ring around the C component, it is likely that the C component also has a supermassive black hole with a mass of ∼106 M⊙ that could be supplied from a past minor merger of a nucleated satellite galaxy.
Perturbative calculation of supersymmetric gradient flow in 𝒩 = 1 supersymmetric QCD
Authors: Kadoh Daisuke , Maru Nobuhito , Suzuki Mitsuyo , Ukita Naoya
Published: December 2022

We demonstrate perturbative calculations of supersymmetric gradient flow in four-dimensional ${\mathcal {N}=1}$ supersymmetric quantum chromodynamics (SQCD). A remarkable property of the gradient flow is to make ultraviolet (UV) divergences of flowed field correlators milder. To illustrate this property, we calculate two-point functions for the flowed fields in SQCD at the one-loop level and investigate their UV divergence structure. After renormalizing the SQCD at the boundary, the two-point functions of flowed gauge supermultiplets are shown to be UV-finite. On the other hand, those for flowed matter supermultiplets require extra wave function renormalization, which are found to be the common factor for all the fields in the multiplets.
In situ self-assembly of amphiphilic dextran micelles and superparamagnetic iron oxide nanoparticle-loading as magnetic resonance imaging contrast agents
Authors: Jiang Linrui , Zheng Rong , Zeng Ni , Wu Changqiang , Su Hongying
Published: December 2022

Polymeric micelles have long been considered as promising nanocarrier for hydrophobic drugs and imaging probes, due to their nanoscale particle size, biocompatibility and ability to loading reasonable amount of cargoes. Herein, a facile method for dextran micelles preparation was developed and their performance as carriers of superparamagnetic iron oxide (SPIO) nanocrystals was evaluated. Amphiphilic dextran (Dex-g-OA) was synthesized via the Schiff base reactions between oxidized dextran and oleylamine, and self-assembled in situ into nano-size micelles in the reaction systems. The self-assembling behaviors of the amphiphilic dextran were identified using fluorescence resonance energy transfer technique by detection the energy transfer signal between the fluorophore pairs, Cy5 and Cy5.5. Hydrophobic SPIO nanoparticles (Fe3O4 NPs) were successfully loaded into the dextran micelles via the in situ self-assembly process, leading to a series of Fe3O4 NPs-loaded micelle nanocomposites (Fe3O4@Dex-g-OA) with good biocompatibility, superparamagnetism and strongly enhanced T2 relaxivity. At the magnetic field of 0.5 T, the Fe3O4@Dex-g-OA nanocomposite with particle size of 116.2 ± 53.7 nm presented a higher T2 relaxivity of 327.9 mMFe−1·s−1. The prepared magnetic nanocomposites hold the promise to be used as contrast agents in magnetic resonance imaging.
Recent advances in regenerative biomaterials
Authors: Cao Dinglingge , Ding Jiandong
Published: December 2022

Nowadays, biomaterials have evolved from the inert supports or functional substitutes to the bioactive materials able to trigger or promote the regenerative potential of tissues. The interdisciplinary progress has broadened the definition of ‘biomaterials’, and a typical new insight is the concept of tissue induction biomaterials. The term ‘regenerative biomaterials’ and thus the contents of this article are relevant to yet beyond tissue induction biomaterials. This review summarizes the recent progress of medical materials including metals, ceramics, hydrogels, other polymers and bio-derived materials. As the application aspects are concerned, this article introduces regenerative biomaterials for bone and cartilage regeneration, cardiovascular repair, 3D bioprinting, wound healing and medical cosmetology. Cell-biomaterial interactions are highlighted. Since the global pandemic of coronavirus disease 2019, the review particularly mentions biomaterials for public health emergency. In the last section, perspectives are suggested: (i) creation of new materials is the source of innovation; (ii) modification of existing materials is an effective strategy for performance improvement; (iii) biomaterial degradation and tissue regeneration are required to be harmonious with each other; (iv) host responses can significantly influence the clinical outcomes; (v) the long-term outcomes should be paid more attention to; (vi) the noninvasive approaches for monitoring in vivo dynamic evolution are required to be developed; (vii) public health emergencies call for more research and development of biomaterials; and (viii) clinical translation needs to be pushed forward in a full-chain way. In the future, more new insights are expected to be shed into the brilliant field—regenerative biomaterials.
Eggplant Fruit Periderm Firmness Correlated with Resistance to Phytophthora nicotianae
Authors: Keinath Anthony P.
Published: December 2022

Worldwide, Phytophthora nicotianae and Pythium aphanidermatum are the Phytophthora and Pythium species most frequently reported on eggplant ( Solanum melongena). Both species were identified on the fruit of several eggplant cultivars grown in Charleston, South Carolina, in spring 2018. The objectives of this study were to determine whether seven cultivars, each representing a different fruit type, differed in susceptibility to Phytophthora nicotianae and whether periderm or flesh firmness or fruit density was associated with differences. Eggplant fruit were inoculated with colonized agar plugs and incubated for 4 days at high relative humidity. Japanese eggplant cultivar Millionaire had a greater incidence of fruit infection, wider lesion diameter, and greater percentage of lesion area with pathogen growth than the six other cultivars. Patio Baby, an Indian type, and Fairy Tale, a graffiti type, had the lowest incidence compared with the other five cultivars and no pathogen growth in lesions. Periderm firmness was negatively correlated with incidence, lesion diameter, and diameter of pathogen growth within lesions ( P ≤ 0.01). The significant correlations of lesion size with the size of pathogen growth suggest that the same characteristics that limit lesion expansion (e.g., some aspect of periderm firmness) could also limit mycelial growth and sporangial production. Growers might need to apply oomycete-specific fungicides registered on eggplant more frequently to Japanese cultivars than to cultivars that produce graffiti- or Indian-type fruit.
Effects of Substrate and Processing Conditions on Nematode Suppressiveness of Anaerobic Biogas Digestates
Authors: Eberlein Caroline , Edalati Abdelhossein , Zhang Ruihong , Westphal Andreas
Published: December 2022

Biogas digestates produced from anaerobically processed food or dairy manure have demonstrated some potential to suppress different pathogens and pests. In this study, digestates from these two substrates processed mesophilically (20 to 40°C) or thermophilically (>40°C) were compared for their nematode-suppressive potential. In bioassays, the suppressive potential of Heterodera schachtii or Meloidogyne incognita was tested at different amendment rates. Testing was expanded to field microplot experiments with M. incognita and greenhouse tests with Pratylenchus vulnus. In the bioassay with H. schachtii, fewer nematodes penetrated radish roots after amendment with thermophilic than with mesophilic digestates. Root penetration was lowest after treatment with digestates of food waste and thermophilic dairy manure at the highest rate. In a watermelon bioassay with M. incognita, nematode-induced galling and egg mass production were reduced after amendment with food waste digestates compared with manure digestates and after thermophilic compared with mesophilic digestates in the case of egg masses. In a greenhouse experiment with peach rootstock ‘Nemaguard’, the numbers of P. vulnus in roots were diminished after amendment with digestates at the highest rate. In microplot experiments with bell peppers, plants initially were more vigorous after amendment with thermophilic digestates than after mesophilic digestate additions. This effect was transient and was no longer measurable at harvest. In summary, food waste digestates, especially those that were thermophilically produced, had nematode suppressive and plant growth-improving properties. These effects were not long lasting and probably need additional mitigation for practical utility.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
The Chances of Obtaining a Euploid Embryo and Subsequent Live Birth Remain Consistent With National Age-Based Rates After an In Vitro Fertilization Cycle That Produced Only Aneuploid Embryos
Authors: Herlihy Nola S. , Klimczak Amber M. , Cheung Jessica K. W. , Seli Emre , Scott Richard T.
Published: December 2022

(Abstracted from Fertil Steril 2022;118:484–491)

Despite significant advances over the last several decades in assisted reproductive technology, many embryos still fail to get implanted. Preimplantation embryo diagnostics has received considerable attention to identify markers of true “reproductive competence.” One consequence of having more information on embryo quality in a single cohort is when all embryos are diagnosed as being abnormal, including aneuploid.
General Anesthesia and the Premature Baby: Identifying Risks for Poor Neurodevelopmental Outcomes
Authors: Price Jerri C. , Lei Susan , Diacovo Thomas G.
Published: December 2022

Preterm birth affects 1 in every 10 infants born in the United States. Importantly, more preterm infants are surviving to discharge from hospital, including those born at the cusp of viability (eg, 22 to 24 wk gestation). Such improvements, however, come at a cost as those delivered at less than 28 weeks gestation have the highest rates of morbidity and mortality. To complicate matters, these extremely preterm infants often require multiple surgical procedures resulting in repeated and prolonged exposures to anesthetic, analgesic, and sedative agents both during procedures and in the neonatal intensive care unit. Consequently, all of these factors, including premature birth itself, correlate with a higher risk for neurodevelopmental disabilities. More studies are needed to address the effects of prematurity-related morbidities and drug exposures on this vulnerable population, with the goal of improving neurodevelopmental outcomes. This brief review will discuss risk factors that impact neurodevelopmental outcomes in premature infants, with a particular focus on anesthetic, analgesic, and sedative agents.
Memory Problems in Children With Congenital Heart Disease: A Narrative Review
Authors: Jackson William M. , Monteleone Matthew , Kim An , Ko Riva
Published: December 2022

Introduction:

Care for congenital heart diseases (CHD) has improved significantly over the past several decades, and children with CHD are now surviving into adulthood. Cognitive and behavioral problems affect children with CHD more than healthy peers. A review of performance on neuropsychological memory tasks has not been reported. We aimed to summarize the published literature on memory problems in people with CHD.

Methods:

We searched Pubmed, Medline, and PsycINFO from January 1, 1986 to March 22, 2022 to reflect modern care for people with CHD. Our inclusion criteria were randomized controlled trials or observational studies that included children with CHD older than age 3 years, which reported the results of at least 1 neuropsychological test of memory in the CHD group. Our exclusion criteria were studies that included heart transplant recipients and studies that included children who required extracorporeal membrane oxygenation.

Results:

Thirty-one studies that met our inclusion criteria and avoided exclusion criteria were included in this review. Several studies reported deficits in the subdomains of short-term and long-term memory and visual and verbal memory, though we found substantial heterogeneity across studies. The most likely subdomain to be affected in children with CHD appears to be short-term visual memory.

Conclusions:

There is likely an increased risk of memory problems for children and adults with CHD. We were unable to quantify the risk of memory problems due to the heterogeneity of published studies. Future research should make efforts to account for confounding variables and standardize outcome measures.
Combining Medial Patellofemoral Ligament Reconstruction With Patellar Tendon Repair Using Biocomposite Swivel Lock Anchors: Surgical Technique and Case Report
Authors: Falbo Ryan A. , Simmons Elizabeth , Singleton Amy , Stegelmann Samuel D. , Miller Richard M.
Published: December 2022

Introduction:

Injuries to the medial patellofemoral ligament (MPFL) and patellar tendon in isolation are well-documented entities. There is a paucity of literature describing this combination of injuries and treatment of this concomitant injury pattern.

Objective:

The intent of this manuscript was to document the combined injury pattern of a concomitant MPFL rupture and patellar tendon disruption. We also aimed to describe a treatment option for this rarely documented injury pattern.

Materials and Methods:

Our MPFL reconstruction technique utilized a gracilis allograft and 2 biocomposite anchors for the patella. Our patellar tendon repair utilized Ethibond suture in a Krakow stitch fashion, which was subsequently incorporated into the anchors used for the MPFL reconstruction.

Results:

Our patient successfully transitioned through a specific postoperative range of motion protocol by increasing knee flexion 30 degrees every 2 weeks, beginning at 0 to 30 degrees at the first postoperative visit. Our patient was able to straight leg raise by 6 weeks, began formal physical therapy at 8 weeks, and resumed all normal activity at 6 months.

Conclusion:

We demonstrated a novel technique to repair a combined injury of the MPFL and patellar tendon that produced good clinical outcomes through 6 months.
Fostering Resilience in Nursing Through R.E.S.T.
Authors: Rajamohan Santhiny , Chalmers Kristen , Bennett Erin , Brzoza Sandra “Sam”
Published: December 2022

With about one-third of nurses having expressed an intention to leave the profession or change jobs in 2022, the effects of nursing job stress are evident. For nurses to continue to provide care in high stress, they must practice self-compassion and build resilience. The importance of resilience education and self-compassion for nurses and in nursing education is discussed from a Christian perspective, along with self-care strategies using the R.E.S.T. (Relationship, Exercise, Self-Compassion, Transformative Thinking) framework. Strategies for building resilience for both individuals and organizations are offered.
Elevated serum levels of diamine oxidase, D-lactate and lipopolysaccharides are associated with metabolic-associated fatty liver disease
Authors: Zhang Ruike , Chen Ya-nan , Zhang Jixia , Liu Jing
Published: December 2022

Background

Studies have suggested an association between metabolic-associated fatty liver disease (MAFLD) and intestinal barrier function. The present study aims to investigate the association between MAFLD and intestinal barrier impairment in humans and identify potential risk factors for MAFLD.

Methods

A total of 491 patients were retrospectively enrolled in this study. The serum levels of diamine oxidase, D-lactate and lipopolysaccharide were measured to evaluate intestinal barrier integrity in patients with and without MAFLD. Binary logistic regression and correlational analyses were conducted to verify the association between MAFLD and serum levels of intestinal barrier biomarkers.

Results

We enrolled 294 patients with MAFLD and 197 patients without MAFLD in this study. Patients with MAFLD had higher serum levels of diamine oxidase, D-lactate and lipopolysaccharide (P < 0.001) than those without MAFLD. Multivariate logistic regression analyses showed that BMI [odds ratio (OR) 1.324; P < 0.001], triglycerides (OR 2.649; P = 0.002), nonesterified fatty acids (OR 1.002; P = 0.011), diamine oxidase (OR 1.149; P = 0.011) and D-lactate (OR 1.221; P < 0.001) were independent risk factors for MAFLD. Additionally, serum levels of diamine oxidase and D-lactate increase as liver steatosis became more severe. MAFLD patients with ≥2 metabolic abnormalities had higher serum levels of lipopolysaccharide (P = 0.034).

Conclusions

MAFLD is associated with intestinal barrier impairment. Diamine oxidase and D-lactate are potential predictors of MAFLD, and their serum levels are related to liver steatosis. Intestinal barrier impairment is related to metabolic disorders in patients with MAFLD.
Efficacy evaluation and prognostic risk factors analysis of precise hepatectomy in the treatment of intermediate and advanced hepatocellular carcinoma
Authors: Zhang Junhong , Zeng Qiang , Zhang Pengfei , Chen Yajie , Cao Jinglin
Published: December 2022

Background

To investigate the efficacy of precise hepatectomy in the treatment of patients with intermediate and advanced hepatocellular carcinoma and analyze the risk factors affecting prognosis.

Methods

Totally 104 patients with intermediate and advanced hepatocellular carcinoma from January 2018 to January 2019 were enrolled in this retrospective analysis. Of these, four patients lost to follow-up. Logistic regression was conducted to explore the odds ratio (OR) and 95% confidence interval (CI).

Results

Compared with the control group, the precise hepatectomy decreased intraoperative blood loss (331.2928.91 to 203.29 ± 29.34 ml), operation time (198.29 ± 19.38 to 150.28 ± 18.27 min), perioperative blood transfusion volume (376.22 ± 25.93 to 228.29 ± 22.19 ml) (all P < 0.001). Logistic regression analysis of study group showed that hepatitis B infection (OR  = 1.746; 95% CI, 1.068–2.976), P  =  0.021, Child-Pugh classification (OR  =  2.319; 95% CI, 1.428–3.213), P < 0.001, Eastern Cooperative Oncology Group (ECOG) score (OR  =  2.287; 95% CI, 1.098–3.876; P  =  0.013) and Barcelona-Clinic Liver Cancer (BCLC) staging (OR = 2.029; 95% CI, 1.086–3.671; P = 0.022) were independent risk factors for prognosis of the precise hepatectomy.

Conclusion

Hepatitis B virus infection, Child-Pugh grade, ECOG score and BCLC staging grade were the independent risk factors affecting the prognosis of precise hepatectomy.
Geographical region and clinical outcomes of patients with primary biliary cholangitis from Western Europe
Authors: Murillo Perez Carla F. , Gerussi Alessio , Trivedi Palak J. , Corpechot Christophe , van der Meer Adriaan J. , Maria Battezzati Pier , Lindor Keith D. , Nevens Frederik , Kowdley Kris V. , Bruns Tony , Cazzagon Nora , Floreani Annarosa , Tanaka Atsushi , Ma Xiong , Mason Andrew L. , Gulamhusein Aliya , Ponsioen Cyriel Y. , Carbone Marco , Lleo Ana , Mayo Marlyn J. , Dalekos George N. , Gatselis Nikolaos K. , Thorburn Douglas , Verhelst Xavier , Parés Albert , Janssen Harry L.A. , Hirschfield Gideon M. , Hansen Bettina E. , Invernizzi Pietro , Lammers Willem J. ,   on behalf of the GLOBAL PBC Study Group
Published: December 2022

Background and aims

The are geographic variations in the incidence and prevalence of primary biliary cholangitis (PBC). The aim was to explore whether clinical outcomes of patients within Western Europe differ according to geographical region.

Methods

Ursodeoxycholic acid-treated patients from European centers from the Global PBC database diagnosed from 1990 onwards were included. Patients with a time lag > 1 year from diagnosis to start of follow-up were excluded. Differences in baseline characteristics were studied according to North/South and East/West, whereas outcomes (transplant-free survival and decompensation) were studied with center latitude and longitude. Cox regression analyses were adjusted for age, sex, diagnosis year, biochemical markers, and cirrhosis as a time-dependent covariate.

Results

One thousand eight hundred seventy-eight patients were included, and there were no geographical differences in age or sex, with a mean age of 54 years and 89% female patients. Those in North Europe were more often of a moderately advanced/advanced Rotterdam biochemical stage (28.4%) compared with South Europe (20.6%). Additionally, they exhibited higher median alkaline phosphatase (2.0 ×ULN vs. 1.4 ×ULN) and transaminases. In multivariable analysis, there was a significant interaction between center latitude and longitude for decompensation (P < 0.001) and a trend for transplant-free survival, in which the Northwestern area demonstrated an increased risk for poor outcomes as compared to the reference (Paris).

Conclusion

We describe geographic variations in outcomes for patients across Europe from specialist centers in the Global PBC Study Group. Further study is important to explore the potential individual, environmental, and healthcare-related factors that may be contributors.
Creating Value Through Learning Health Systems
Authors: Wasylak Tracy , Benzies Karen , McNeil Deborah , Zanoni Pilar , Osiowy Kevin , Mullie Thomas , Chuck Anderson
Published: December 2022

Design, implementation, and evaluation of effective multicomponent interventions typically take decades before value is realized even when value can be measured. Value-based health care, an approach to improving patient and health system outcomes, is a way of organizing health systems to transform outcomes and achieve the highest quality of care and the best possible outcomes with the lowest cost. We describe 2 case studies of value-based health care optimized through a learning health system framework that includes Strategic Clinical Networks. Both cases demonstrate the acceleration of evidence to practice through scientific, financial, structural administrative supports and partnerships. Clinical practice interventions in both cases, one in perioperative services and the other in neonatal intensive care, were implemented across multiple hospital sites. The practical application of using an innovation pipeline as a structural process is described and applied to these cases. A value for money improvement calculator using a benefits realization approach is presented as a mechanism/tool for attributing value to improvement initiatives that takes advantage of available system data, customizing and making the data usable for frontline managers and decision makers. Health care leaders will find value in the descriptions and practical information provided.
Trust and Nursing
Authors: Wymer Joshua A. , Stucky Christopher H.
Published: December 2022

Trust is foundational for all interpersonal communication and activities in an increasingly networked and interdependent world. Trust is also essential to the effective delivery of health care and for building collegial environments rich in innovation and readily adaptable to change. As the world's most trusted profession and vested peer collaborators across interprofessional health care teams, nurses are uniquely qualified to shepherd change and foster an innovation mindset across organizations and systems. Innovation requires creative teams that are appropriately resourced and supported, and team-based innovation requires time, space, and safety for groups to realize their full potential and maximize contributions. Appropriate staffing, resourcing, internal engagement, and external partnerships are essential to successfully conceive, launch, sustain, and deliver change initiatives that successfully challenge the status quo. Diverse teams are vital to enhancing the performance, effectiveness, and delivery of change and innovation. Effective change management and innovation practices require courage and imagination, skills that nurses have long possessed. Nurses are uniquely equipped to champion human-centered design through all phases of innovation while bringing knowledge of patients and communities to bear in ways that deliver innovation, are respectful of challenges, and mindful of opportunities to strengthen individuals and communities.
The Creation of a Novel Undergraduate Nursing Employee/Student Hybrid Role in the COVID-19 Response
Authors: Shajani Zahra , Laing Catherine M. , Robinson Fadumo , Yun Lira , Patterson J. David , Rieder Linda
Published: December 2022

The COVID-19 pandemic impacted nursing education and health care systems alike. Increases in staff absenteeism along with increased hospitalizations have strained health systems across the globe. Postsecondary institutions (PSIs) were required to remove students from clinical placements, thus delaying nursing students' ability to complete their programs, and in turn, contributing to the nursing workforce challenges. Health care organizations and PSIs had to collaborate innovatively to support the health care response to the pandemic while continuing to educate and graduate students to expand the nursing workforce. In Alberta, the collaboration between the health system and PSIs led to the creation of an undergraduate nursing employee/student hybrid (UNE/Hybrid) role. This role was not only a response to the nursing workforce challenges created by the pandemic, but it provided nursing students with positive learning clinical placements ensuring that they completed their program in a timely manner. This role was designed to assist with the fourth wave of the pandemic (omicron variant), which was expected to be the most severe wave in terms of hospitalizations and increased staff absences. The UNE/Hybrid role allowed nursing students to complete the required learning for their final preceptorships and/or complete leadership placements in a paid role while being integrated into the unit culture and becoming part of the team. The initiative's results, including its successes, challenges, and lessons, are discussed.
Reducing Staff Turnover and Clinician Burnout With a Structured Support Group During the COVID-19 Pandemic
Authors: Drexler Diane , Cornell Diane , Cherrie Carrie , Consolo Christina , Doonan Ronda L.
Published: December 2022

Retention and burnout have always been a challenge for nurse leaders, but the pandemic brought these concerns to a whole new level. And now the Great Resignation is affecting health care. So how can nurse leaders at hospitals and health care systems create a supportive environment for staff during a public health emergency? Structured support groups are a viable option for emphasizing self-care and wellness. We explain why we decided to form a structured support group for our intensive care unit nurses and illustrate the results from our clinical research team. In addition, we share feedback we received from participating nurses and offer advice on forming a structured support group in acute care settings. This strategy resulted in a change in the participant's behaviors after attending the structured emotional support group. This finding aligns with the literature, which supports strategies to protect nurses' mental well-being and to take preventive measures in critical situations. Using this as a foundation, a structured emotional support group can change nurse engagement and involvement in their process and practice, during times of crisis. Many other benefits could be realized from this strategy such as improved nursing practice and processes, improved nurse satisfaction, and improved recruitment and retention.
Perceptions and Use of Safe Sleep Baby Boxes at Hospital Discharge by New Mothers
Authors: Hughes Kimberly , Gill Sara L. , Berndt Andrea
Published: December 2022

Background:

A large community hospital in South Texas began distributing safe sleep baby boxes to reduce sudden unexplained infant death (SUID) in 2017.

Purpose:

To describe safe sleep practices among new mothers who received a safe sleep baby box at hospital discharge.

Methods:

An information sheet containing a link to an online survey was mailed to all women who received a safe sleep baby box prior to discharge from the hospital from January 2018 to January 2019.

Results:

N = 84 women participated. Most reported using the safe sleep baby box only during nap time (n = 62, 88.6%). Only 70.2% of participants reported that baby always slept their back (n = 59). Most reported their baby did not use a pacifier (n = 62, 73.8%), and many reported they were not breastfeeding their baby (n = 38, 45.2%).

Clinical Implications:

Many women were not using the safe sleep baby box as intended and were not following many of the other safe sleep guidelines. Nurses should ask their patients about plans for infant safe sleep after discharge to provide individualized education or recommend specific resources to address the family's needs.
Social Interactions and Institutional Structures that Influence 24-Hour Rooming-in for New Mothers and Newborns in the Hospital Setting
Authors: McRae Maureen J. , Miraglia Robbin
Published: December 2022

Purpose:

To describe the social interactions and institutional structures that influence the consistent practice of 24-hour rooming-in of new mothers and newborns in the hospital setting.

Study Design and Method:

Using an institutional ethnographic design, data were gathered via semistructured interviews and on-unit observations. Data were recorded, transcribed, and analyzed for themes. Study interviews were conducted between February 2020 and June 2021.

Results:

Seven mother–baby nurses were interviewed, and three on-unit observations of 2 hours each were conducted. Analysis of interview data revealed a consensus that Baby-Friendly does not always feel mother-friendly. Three major themes identifying social interactions were identified: the mother as a patient, managing expectations, and inconsistencies in practice. Three themes identified institutional structures that influenced 24-hour rooming-in: rates of induction of labor and cesarean birth, nurse staffing, and monitoring of nursery use.

Clinical Implications:

Our findings provide insights about how the everyday work of 24-hour rooming-in is organized and experienced by nurses on the mother–baby units at the study hospital. Themes highlight specific social interactions and institutional structures that affect the practice and can be used by hospital leaders and educators to develop targeted interventions for ensuring consistent 24-hour rooming-in.
Subchorionic Hemorrhage in the Second and Third Trimesters of Pregnancy: A Review
Authors: Pagan Megan , Monson Joshua , Strebeck Ryan , Edwards Sarah , Magann Everett F.
Published: December 2022

Importance

Subchorionic hemorrhage (SCH) in the second and third trimesters of pregnancy can be associated with maternal morbidity and fetal morbidity/mortality. Management of SCH in the second or third trimesters can be complicated, especially in the setting of a large SCH that requires hospitalization and blood transfusion.

Objective

The aim of this review is to describe SCH in second and third trimesters, risk factors, diagnosis, maternal and fetal outcomes, and management of this uncommon pregnancy complication.

Evidence Acquisition

A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched.

Results

There were 123 abstracts and/or articles reviewed, with 48 articles being the basis of review. The only known risk factors for SCH are maternal factor deficiency and anticoagulation therapy. The diagnosis is usually made by ultrasound imaging. Subchorionic hemorrhage in second and third trimesters has been associated with several adverse fetal outcomes including preterm birth, preterm prelabor rupture of membranes, fetal growth restriction, fetal demise, and neonatal pulmonary morbidity. There is no proven treatment for SCH, although there are several investigational therapies reported.

Conclusions

Subchorionic hemorrhage can be complex and difficult to manage in the second and third trimesters. There are no recommendations or guidelines for management; however, serial growth ultrasounds, umbilical artery Doppler studies, and antenatal fetal testing should be considered particularly if the SCH is large or treatment requires a maternal blood transfusion.

Relevance

Subchorionic hemorrhage in the second and third trimester is associated with poor fetal outcomes and maternal morbidity, especially if the SCH is significant.

Target Audience

Obstetricians and gynecologists, midwives, family physicians.

Learning Objectives

After completion of this article, the reader should be better able to identify SCH in the second and third trimesters; describe potential complications associated with SCH; and predict adverse outcomes associated with SCH.
Postpartum Psychosis: The Role of Women’s Health Care Providers and the Health Care System
Authors: Stacy Meaghan , Schulkin Jay
Published: December 2022

Importance

The postpartum period is a time of high risk for serious psychiatric symptoms and hospitalization. Postpartum psychosis (PPP) is the most severe disorder that emerges during this time, with significant and wide-ranging consequences that can include suicide and infanticide.

Evidence Acquisition

A PubMed, MEDLINE, and PsycINFO search was completed for English-language publications about PPP, including subtopics (eg, infanticide, maternal suicide). Citations in these articles were also reviewed for relevant references.

Results

Although it is clear that the triggering event for PPP is childbirth, the processes by which this occurs are not fully understood, which is a critical need for being able to predict, prevent, and manage PPP. There are risk factors that contribute to PPP, and specific groups of women may be at increased risk (eg, women with bipolar disorder). Many questions and challenges remain related to the phenomenology, nosology, prevention, and treatment of PPP. However, there are changes that women's health care providers and systems can take to improve the care of women at risk of and experiencing PPP.

Conclusions and Relevance

Postpartum psychosis is a rare but serious condition. However, recovery is possible. Women's health care providers and systems can improve the care by better understanding the needs of women and families, offering patient-centered discussions and options for care, particularly those that promote recovery, minimize risk, and limit the interruption of the maternal-infant bond. Improving the prevention and treatment of PPP can have a broad impact for women, children, and families.

Target Audience

Obstetricians and gynecologists, family physicians

Learning Objectives

After participating in this activity, readers should be better able to describe risk factors that contribute to the onset of PPP; discuss best practices for preventing and treating PPP; and identify at least one way in which health care providers or health care systems can improve the care offered to women and families who experience PPP.
Changes in Obstetrical Practices and Pregnancy Outcomes Following the ARRIVE Trial
Authors: Gilroy Laura C. , Al-Kouatly Huda B. , Minkoff Howard L. , McLaren Rodney A.
Published: December 2022

(Abstracted from Am J Obstet Gynecol 2022;226:716.e1–716.e12)

Rising cesarean delivery (CD) rates have been associated with increased rates of maternal and neonatal morbidities. Low-risk, nulliparous people have been the target of efforts to reduce CD rates while optimizing outcomes.
Diagnostic Yield of Exome Sequencing in Fetuses With Multisystem Malformations: Systematic Review and Meta-analysis
Authors: Pauta M. , Martinez-Portilla R. J. , Borrell A.
Published: December 2022

(Abstracted from Ultrasound Obstet Gynecol 2022;59:715–722)

Fetal structural anomalies occur in approximately 2.5% of pregnancies, and many of these are identified via ultrasound examination. Following detection of a fetal structural anomaly, chromosomal microarray analysis (CMA) is offered.