bluuebunny/crossref_metadata_2025 huggingface dataset:
The Healthcare Environment Survey: A multicountry psychometric evaluation of nurses’ job satisfaction
Authors: Nelson John , Vrbnjak Dominika , Thomas Patricia L. , Gözüm Sebahat , de Barros Alba Lucia Bottura Leite , Itzhaki Michal
Published: May 2022

Aim

To evaluate the properties of a reduced‐item Healthcare Environment Survey measuring nurses’ job satisfaction across eight countries.

Background

There is currently no rigorously tested international measure of nurses’ job satisfaction that can be used internationally to improve the nurse work environment.

Methods

Nursing staff from 11 hospitals in eight countries participated in this study. The original 57‐item, 11‐facet Healthcare Environment Survey was evaluated for reliability, validity, and measurement invariance: Cronbach's alpha was used to test for reliability; construct, discriminate, and convergent testing were used to test validity; and invariance testing including configural, metric, and scalar tests were used to study measurement invariance between the countries.

Results

2,046 nursing staff completed the survey. Reliability was established for all six subscales and the combined composite score. Both validity and measurement invariance were supported in every test conducted. An excellent model fit was found for the final 19‐item, 6‐facet Healthcare Environment Survey that explained 82% of the variance of nurses’ job satisfaction.

Conclusions

Findings suggest the instrument is an efficient measure of nurses’ job satisfaction across multiple countries. Longitudinal testing for invariance will be needed to ensure the model remains a good fit. Testing more countries will also verify model fit.

Implications for nursing

The instrument can be used to measure nurse job satisfaction globally.

Implications for nursing policy

The instrument can be used to assess interventions to improve the social (patient, unit manager, and coworker) and technical (professional rewards, autonomy, and professional growth) aspects of nurse job satisfaction.
“The pediatric dentist is different”: A qualitative study of young children's caregivers' experiences of oral health care in the Galapagos Islands
Authors: Burgette Jacqueline M. , Wu Shelly X. , Divaris Kimon
Published: May 2022

Background

Little is known about factors influencing children's access to and use of oral healthcare services in the Galapagos Islands, a resource‐limited setting.

Aim

We sought to understand caregivers' experiences and factors influencing their children's use of dental services on San Cristobal Island in the Galapagos Archipelago.

Design

A community‐based qualitative interview study was carried out among 25 caregivers of children aged 6 months to 10 years. Participants were recruited via a random walk door‐to‐door approach in 10 neighborhoods, and interviews were conducted by a trained research assistant who is native of the Galapagos Islands. We employed a grounded theory‐based qualitative data analysis based on inductive coding to identify and report major emerging themes and illustrative participant quotes.

Results

Two major themes emerged related to children's oral health care. Participants expressed their preference for care provided by paediatric versus general dentists and recognized the important role of school‐based dental care programs, acknowledging their strengths and weaknesses.

Conclusions

Participants' lived experiences were informative and helped improve our understanding of factors influencing children's use of dental services in the Galapagos Islands. Above and beyond their local relevance, these themes and insights are likely applicable to other global communities that experience similar barriers of access to oral healthcare services.
Internet‐based cultural competence training for White undergraduate students at a predominantly White university
Authors: Robey Nyx , Dickter Cheryl
Published: May 2022

College students from underrepresented racial groups often experience racial prejudice and discrimination from their White peers at predominantly White institutions (PWIs). White university students may be misinformed about race and unaware of their privilege. In this study, we investigated the effects of online training that aimed to increase participants' cultural competence through multicultural knowledge, awareness of their own privilege, and skills. White college students at a PWI completed a 4‐week training program adapted from a 1‐day in‐person workshop. The training provided 1‐h weekly online sessions in which White participants (n = 72) were provided resources aimed to develop cultural competence. It utilized student‐acted role plays, reflection questions, articles, and videos to create an interactive experience for students. Results demonstrated that participants showed significant increases in cultural competence and acknowledgment of their White privilege directly following the fourth training session. Further, they exhibited decreases in racial colorblindness. This study suggests that a brief, online training may increase cultural competence in undergraduates which can potentially improve the climates of university campuses.
Thoracoscopic management of iatrogenic cardiac perforations
Authors: Langenaeken Tom , van den Berg Mats , Kaya Abdullah , Yilmaz Alaaddin
Published: May 2022

Aims

Iatrogenic cardiac perforation is an uncommon but potentially fatal complication of invasive cardiac procedures. When nonsurgical management fails, urgent cardiac surgery is required. The standard surgical approach is usually through full sternotomy. However, we propose a less invasive and equally effective technique with video‐assisted thoracoscopic surgery (VATS).

Methods

This single‐center retrospective study in a tertiary hospital identified all patients requiring surgical intervention due to iatrogenic cardiac perforation over a period of 5 years. Patients were grouped by surgical approach, being either sternotomy or VATS. Primary endpoints were operating time, length of ICU stay, hospital stay, 30‐day mortality, and all‐round mortality.

Results

Twenty‐five patients were identified: 11 in the sternotomy group and 14 in the VATS‐group. Preoperative baseline characteristics were equal. Significant difference was found for 30‐day mortality (p < .05). There was no difference for the other endpoints.

Conclusions

VATS is a promising alternative to standard sternotomy for iatrogenic cardiac perforations after invasive cardiac procedures.
Treatment of diabetes mellitus has borne much fruit in the prevention of cardiovascular disease
Authors: Yagyu Hiroaki , Shimano Hitoshi
Published: May 2022

Cardiovascular (CV) disease is the most alarming complication of diabetes mellitus (DM), and a strategy aiming at cardiovascular event prevention in diabetes mellitus has long been debated. Large landmark clinical trials have shown cardiovascular benefits of intensive glycemic control as a ‘legacy effect’ in newly diagnosed type 2 diabetes mellitus. In contrast, we have learned that excessive intervention aimed at strong glycemic control could cause unexpected cardiovascular death in patients who are resistant to treatments against hyperglycemia. It has also been shown that the comprehensive multifactorial intervention for cardiovascular risk factors that was advocated in the current guideline provided substantial cardiovascular event reduction. The impact of classical antidiabetic agents launched before 1990s on cardiovascular events is controversial. Although there are many clinical or observational studies assessing the impact of those agents on cardiovascular events, the conclusions are inconsistent owing to variable patient backgrounds and concomitant antidiabetic agents among the studies. Moreover, most of them were not large‐scale, randomized, cardiovascular outcome trials. In contrast, GLP‐1RA (glucagon‐like peptide‐1 receptor agonist) and SGLT2 (sodium‐glucose cotransporter 2) inhibitors have demonstrated undeniable cardiovascular benefits in large‐scale, randomized, controlled trials. Whereas GLP‐1RAs decrease atherosclerotic disease, especially stroke, SGLT2 inhibitors mainly prevent heart failure. SGLT2 inhibitors are superior to GLP‐1RAs with respect to hard renal outcomes. Therefore, it can be said that drugs such as GLP‐1RAs and SGLT2 inhibitors that prevent cardiovascular events, in addition to their glucose‐lowering effect, are incredible novel tools that we have gained for use in diabetic treatment.
Perioperative C‐peptide index is associated with the status of diabetes management after pancreatectomy
Authors: Shikata Masataka , Chujo Daisuke , Enkaku Asako , Takikawa‐Nishida Akiko , Honoki Hisae , Yamada‐Matsukoshi Shinnosuke , Nakagawa‐Yokoyama Maki , Kamigishi Miki , Inagawa Shinya , Fujisaka Shiho , Yagi Kunimasa , Shibuya Kazuto , Fujii Tsutomu , Tobe Kazuyuki
Published: May 2022

Aims/Introduction

This study aimed to identify the clinical factors affecting postoperative residual pancreatic β‐cell function, as assessed by the C‐peptide index (CPI), and to investigate the association between perioperative CPI and the status of diabetes management after pancreatectomy.

Materials and Methods

The associations between perioperative CPI and clinical background, including surgical procedures of pancreatectomy, were analyzed in 47 patients who underwent pancreatectomy, and were assessed for pre‐and postoperative CPI. The association between perioperative CPI and glycemic control after pancreatectomy was investigated.

Results

The low postoperative CPI group (CPI <0.7) had longer duration of diabetes (17.5 ± 14.5 vs 5.5 ± 11.0 years, P = 0.004), a higher percentage of sulfonylurea users (41.7 vs 8.7%, P = 0.003) and a greater number of drug categories used for diabetes treatment (1.9 ± 1.1 vs 0.8 ± 0.8, P <0.001) than did the high postoperative CPI group. Postoperative CPI was higher (1.4 ± 1.2 vs 0.7 ± 0.6, P = 0.039) in patients with low glycosylated hemoglobin (<7.0%) at 6 months after pancreatectomy; preoperative (2.0 ± 1.5 vs 0.7 ± 0.5, P = 0.012) and postoperative CPI (2.5 ± 1.4 vs 1.4 ± 1.1, P = 0.020) were higher in non‐insulin users than in insulin users at 6 months after surgery.

Conclusions

The duration of diabetes and preoperative diabetes treatment were associated with residual pancreatic β‐cell function after pancreatectomy. Furthermore, perioperative β‐cell function as assessed by CPI was associated with diabetes management status after pancreatectomy.
Linking and Comparability across Conditions of Measurement: Established Frameworks and Proposed Updates
Authors: Moses Tim
Published: May 2022

One result of recent changes in testing is that previously established linking frameworks may not adequately address challenges in current linking situations. Test linking through equating, concordance, vertical scaling or battery scaling may not represent linkings for the scores of tests developed to measure constructs differently for different examinees, or tests that are administered in different modes and data collection designs. This article considers how previously proposed linking frameworks might be updated to address more recent testing situations. The first section summarizes the definitions and frameworks described in previous test linking discussions. Additional sections consider some sources of more disparate approaches to test development and administrations, as well as the implications of these for test linking. Possibilities for reflecting these features in an expanded test linking framework are proposed that encourage limited comparability, such as comparability that is restricted to subgroups or to the conditions of a linking study when a linking is produced, or within, but not across tests or test forms when an empirical linking based on examinee data is not produced. The implications of an updated framework of previously established linking approaches are further described in a final discussion.
Ontogeny of a tessellated surface: Carapace growth of the longhorn cowfish Lactoria cornuta
Authors: Eigen Lennart , Baum Daniel , Dean Mason N. , Werner Daniel , Wölfer Jan , Nyakatura John A.
Published: May 2022

Biological armors derive their mechanical integrity in part from their geometric architectures, often involving tessellations: individual structural elements tiled together to form surface shells. The carapace of boxfish, for example, is composed of mineralized polygonal plates, called scutes, arranged in a complex geometric pattern and nearly completely encasing the body. In contrast to artificial armors, the boxfish exoskeleton grows with the fish; the relationship between the tessellation and the gross structure of the armor is therefore critical to sustained protection throughout growth. To clarify whether or how the boxfish tessellation is maintained or altered with age, we quantify architectural aspects of the tessellated carapace of the longhorn cowfish Lactoria cornuta through ontogeny (across nearly an order of magnitude in standard length) and in a high‐throughput fashion, using high‐resolution microCT data and segmentation algorithms to characterize the hundreds of scutes that cover each individual. We show that carapace growth is canalized with little variability across individuals: rather than continually adding scutes to enlarge the carapace surface, the number of scutes is surprisingly constant, with scutes increasing in volume, thickness, and especially width with age. As cowfish and their scutes grow, scutes become comparatively thinner, with the scutes at the edges (weak points in a boxy architecture) being some of the thickest and most reinforced in younger animals and thinning most slowly across ontogeny. In contrast, smaller scutes with more variable curvature were found in the limited areas of more complex topology (e.g., around fin insertions, mouth, and anus). Measurements of Gaussian and mean curvature illustrate that cowfish are essentially tessellated boxes throughout life: predominantly zero curvature surfaces comprised of mostly flat scutes, and with scutes with sharp bends used sparingly to form box edges. Since growth of a curved, tiled surface with a fixed number of tiles would require tile restructuring to accommodate the surface's changing radius of curvature, our results therefore illustrate a previously unappreciated advantage of the odd boxfish morphology: by having predominantly flat surfaces, it is the box‐like body form that in fact permits a relatively straightforward growth system of this tessellated architecture (i.e., where material is added to scute edges). Our characterization of the ontogeny and maintenance of the carapace tessellation provides insights into the potentially conflicting mechanical, geometric, and developmental constraints of this species but also perspectives into natural strategies for constructing mutable tiled architectures.
The subcommissural organ maintains features of neuroepithelial cells in the adult mouse
Authors: Corales Laarni Grace , Inada Hitoshi , Hiraoka Kotaro , Araki Shun , Yamanaka Shinya , Kikkawa Takako , Osumi Noriko
Published: May 2022

The subcommissural organ (SCO) is a part of the circumventricular organs located in the dorsocaudal region of the third ventricle at the entrance of the aqueduct of Sylvius. The SCO comprises epithelial cells and produces high molecular weight glycoproteins, which are secreted into the third ventricle and become part of Reissner's fibre in the cerebrospinal fluid. Abnormal development of the SCO has been linked with congenital hydrocephalus, a condition characterized by excessive accumulation of cerebrospinal fluid in the brain. In the present study, we characterized the SCO cells in the adult mouse brain to gain insights into the possible role of this brain region. Immunohistochemical analyses revealed that expression of Pax6, a transcription factor essential for SCO differentiation during embryogenesis, is maintained in the SCO at postnatal stages from P0 to P84. SCO cells in the adult brain expressed known neural stem/progenitor cell (NSPC) markers, Sox2 and vimentin. The adult SCO cells also expressed proliferating marker PCNA, although expression of another proliferation marker Ki67, indicating a G2/M phase, was not detected. The SCO cells did not incorporate BrdU, a marker for DNA synthesis in the S phase. Therefore, the SCO cells have a potential for proliferation but are quiescent for cell division in the adult. The SCO cells also expressed GFAP, a marker for astrocytes or NSPCs, but not NeuN (for neurons). A few cells positive for Iba1 (microglia), Olig2 (for oligodendrocytes) and PDGFRα (oligodendrocyte progenitors) existed within or on the periphery of the SCO. These findings revealed that the SCO cells have a unique feature as secretory yet immature neuroepithelial cells in the adult mouse brain.
Child and adolescent mental health multiaxial classification: A useful biopsychosocial framework for paediatrics?
Authors: Mayall Mark , Teoh Yvonne , McDermott Brett , Sadhu Raja , Bosanquet Margot
Published: May 2022

In child and adolescent psychiatry, the multiaxial classification approach has been developed over some decades and remains very relevant as it encapsulates the biopsychosocial approach, an approach which is also central to paediatric practice. There is considerable overlap between developmental‐behavioural paediatrics and child and adolescent mental health, including presenting clinical problems, diagnoses, multidisciplinary and holistic approach to assessment and management, and similar use of pharmacological agents and psychosocial interventions. Multiaxial classification can be of use to paediatricians in a variety of ways, both in clinical practice and for teaching purposes. It can improve communication between the two disciplines and promotes a more holistic diagnostic representation in a structured and consistent format. Presented here are a number of practical ways in which the multiaxial biopsychosocial framework can be used, including case description, formulation, timeline and interventions, training and teaching.
Scutellarin protects the kidney from ischemia/reperfusion injury by targeting Nrf2
Authors: Dai Jie , Li Chenyu , Zhao Long , Guan Chen , Yang Chengyu , Zhang Ningxin , Zhou Bin , Zhang Yue , Wang Lin , Jiang Wei , Luo Congjuan , Xu Yan
Published: May 2022

Background

Acute kidney injury (AKI) results in high morbidity and mortality among inpatients, while effective treatment and intervention are still absent. Therefore, this study aims to explore the effects of Scutellarin (Scu) in experimental models in vivo and in vitro.

Methods

In vivo experiment, we employed a total of 30 Wistar rats, which further were modelled by a bilateral renal pedicle clip for 45 min, then received 50 mg/kg/day Scu. In vitro, HK‐2 cells were administered with 20μΜ Scu and then incubated in hypoxia/reoxygenation (H/R) conditions for 24 h. The knockdown of Nrf2 expression was conducted by small interfering RNA (siRNA) transfection.

Results

As a result, the AKI model was well established with an increased SCr, BUN, KIM‐1 level, and histological injury score, while Scu treatment reduced the levels above and increased the antioxidative enzyme HO‐1. H/R induced an increase of ROS in HK‐2 cells, while Scu decreased the ROS level. Bioinformatics results showed the transcription factor Nrf2 was a hub protein during the AKI, which also bound to Scu with low binding energy, indicating that the downstream effect of Scu might be mediated by Nrf2. To verify the suppose above, we employed siRNA against Nrf2, which shows a significant increase in ROS after Nrf2 was blocked. Meanwhile, the HO‐1 showed similar expression compared with the ‘H/R + Nrf2 siRNA’ and ‘H/R + Nrf2 siRNA + Scu’ group, implying the protective effect of Scu was mediated by the Nrf2/HO‐1 pathway.

Conclusion

Scu led to up‐regulation of HO‐1 through activating the Nrf2 signalling pathway, protecting the kidneys from ischemia/reperfusion (I/R)‐induced oxidative damage.
The importance of functional diversity in regulating forage biomass and nutrition: evidence from mowing in semiarid grasslands
Authors: Zhao Tianqi , Zhang Feng , Suo Rongzhen , Zhen Jiahua , Qiao Jirong , Zhao Mengli , Bai Keyu , Zhang Bin
Published: May 2022

Mowing removes plant photosynthetic organs, thus decreasing plant biomass and nutrients in the community. Responses of community functional diversity, biomass, and nutrient status to mowing play a crucial role in the restoration and sustainable use of degraded grasslands, but have not been well studied. Our study linked functional diversity with forage biomass and nutrition in a semiarid grassland. We found that annual mowing reduced community biomass, in particular significantly reduced the dominant plants biomass, which was maintained with biennial mowing. In addition, this study showed that functional diversity could be maintained at a high level under biennial mowing compared to unmowed, but significantly decreased under annual mowing. Structural equation modeling indicated that annual mowing reduced dominant plants biomass by reducing community functional diversity. Mowing decreased dominant plants nutrients by decreasing community functional diversity and soil nutrients, but had no significant effect on nutrients of community and nondominant plants. Furthermore, there was a strong positive correlation between community functional diversity with forage production and nutrition. In conclusion, our study demonstrated that biennial mowing increases community biomass, litter mass, and dominant plant nutrition by regulating functional diversity. Therefore, biennial mowing can provide better conservation of grassland ecosystems and is a suitable grassland management practice in semiarid grasslands.
RUScal: Software for the analysis of resonant ultrasound spectroscopy measurements
Authors: Torres James , Flores-Betancourt Alexis , Hermann Raphaël P.
Published: May 2022

Resonant ultrasound spectroscopy is used to nondestructively measure the elastic resonances of small solids to elucidate the material's elastic properties or other qualities like size, shape, or composition. Here, we introduce the software RUScal for the purpose of determining elastic properties by analyzing the eigenfrequencies of solid specimens with common shapes, such as rectangular parallelepipeds, cylinders (solid and hollow tube), ellipsoids, and octahedrons, as well as irregularly shaped ellipsoids that can be described analytically. All symmetry classes are supported, from isotropic to triclinic, along with the option to add or remove up to three orthogonal mirror planes as well as the ability to reorient the crystal axes with respect the sample edges via Euler angles. Additional features include tools to help find initial sets of elastic constants, including grid exploration and Monte Carlo methods, a tool to analyze frequencies as a function of sample length or crystal orientation, an error analysis tool to assess fit quality, and formatting of the input and output files for batch fitting, e.g., as a function of temperature. This software was validated with published resonant ultrasound spectroscopy data for various materials, shapes, and symmetries with noted improvements in calculation time compared to finite element methods.
Reduction of Influenza A Virus Transmission in Mice by a Universal Intranasal Vaccine Candidate is Long-Lasting and Does Not Require Antibodies
Authors: Price Graeme E. , Lo Chia-Yun , Misplon Julia A. , Epstein Suzanne L.
Published: May 2022

Universal influenza virus vaccines targeting antigens conserved among influenza A virus strains can protect from severe disease but do not necessarily prevent infection. Despite allowing low-level infection, intranasal immunization with adenovirus vectors expressing the conserved antigens influenza nucleoprotein (A/NP) and M2 reduces influenza virus transmission from vaccinated to unvaccinated contact mice.
Complete Genome Sequences of Nine Streptococcus pneumoniae Serotype 3 Clonal Complex 180 Strains
Authors: Shambhu Smitha , Cella Eleonora , Jubair Mohammad , Azarian Taj
Published: May 2022

We announce the complete genomes of nine
Streptococcus pneumoniae
strains belonging to serotype 3 clonal complex 180 (CC180). The genomes consist of a single circularized contig with an average length of 2.033 Mbp. Pangenome analysis identified 1,762 core genes and 412 accessory genes. These genomes are the basis for future population genomic studies.
Draft Genome Sequences of Eight Bacilli Isolated from an Ancient Roman Amphora
Authors: Colautti Andrea , Comi Giuseppe , De Paoli Emanuele , Peterlunger Enrico , Novello Marta , Braidotti Elena , Pasini Daniele , Iacumin Lucilla
Published: May 2022

Paleomicrobiology, the study of ancient microbiological material, allows us to understand different evolutionary phenomena in bacteria. In this study, eight bacilli isolated from an ancient Roman amphora, which dates to the IV to V sec. AD, were sequenced and functionally annotated.
ROCker Models for Reliable Detection and Typing of Short-Read Sequences Carrying β-Lactamase Genes
Authors: Zhang Si-Yu , Suttner Brittany , Rodriguez-R Luis M. , Orellana Luis H. , Conrad Roth E. , Liu Fang , Rowell Jessica L. , Webb Hattie E. , Williams-Newkirk Amanda J. , Huang Andrew , Konstantinidis Konstantinos T.
Published: May 2022

Resistance genes encoding β-lactamases (BLs) confer resistance to the widely prescribed antibiotic class β-lactams. Therefore, it is important to assess the prevalence of BL genes in clinical or environmental samples for monitoring the spreading of these genes into pathogens and estimating public health risk.
Role of the Two-Component System CiaRH in the Regulation of Efflux Pump SatAB and Its Correlation with Fluoroquinolone Susceptibility
Authors: Yang Xia , Peng Wei , Wang Ningning , Dou Beibei , Yang Fengming , Chen Huanchun , Yuan Fangyan , Bei Weicheng
Published: May 2022

Streptococcus suis
is a zoonotic pathogen with high incidence and mortality rates in both swine and humans. Following antibiotic treatment, the organism has evolved many resistance mechanisms, among which efflux pump overexpression can promote drug extrusion from the cell.
Transcriptome Analysis and SNP Identification Reveal That Heterologous Overexpression of Two Uncharacterized Genes Enhances the Tolerance of Magnaporthe oryzae to Manganese Toxicity
Authors: Wang Yi , Liu Lina , Pu Xin , Ma Chan , Qu Hao , Wei Mian , Zhang Ke , Wu Qi , Li Chengyun
Published: May 2022

Heavy metals are used for fungicides as they target phytopathogen in multiple ways.
Magnaporthe oryzae
is the most destructive rice pathogen and is threatening global rice production. In the eukaryotes, the regulation mechanisms of Mn homeostasis often focus on the posttranslation, there were a few results about regulation at transcript level.
Manganese Modulates Metabolic Activity and Redox Homeostasis in Translationally Blocked
Lactococcus cremoris
, Impacting Metabolic Persistence, Cell Culturability, and Flavor Formation
Authors: Nugroho Avis Dwi Wahyu , van Olst Berdien , Bachtiar Stephanie Agnes , Boeren Sjef , Kleerebezem Michiel , Bachmann Herwig
Published: May 2022

In nature as well as in various biotechnology applications, microorganisms are often in a nongrowing state and their metabolic persistence determines cell survival and functionality. Industrial examples are dairy fermentations where bacteria remain active during the ripening phases that can take up to months and even years.
Seed-Derived Microbial Community of Wild
Cicer
Seedlings: Composition and Augmentation to Domesticated
Cicer
Authors: Lalzar Maya , Zeevi Adi , Frenkel Omer , Gamliel Abraham , Abbo Shahal , Iasur Kruh Lilach
Published: May 2022

Chickpea (garbanzo bean, hummus,
Cicer arietinum
) representing the third legume crop produced globally. As is the case for many other domesticated crops, the adaptation and resistance of chickpea to biotic and abiotic stresses is inferior compared to that of their wild progenitors and relatives. Re-establishing desirable characteristics from wild to domesticated species may be achieved by reconstructing beneficial microbiota.
High-Performance Heterogeneous Oxidative Desulfurization Catalyst with Brønsted Acid Sites
Authors: Akopyan A. V. , Shlenova A. O. , Polikarpova P. D. , Vutolkina A. V.
Published: May 2022

A new heterogeneous catalyst containing two types of active sites, sulfo group and ammonium heptamolybdate, on ASKG silica gel support was synthesized. The influence of oxidation conditions (temperature, reactant ratio, reaction time) on the conversion of a model substrate, dibenzothiophene (DBT), was examined. Conditions were found for exhaustive oxidation of DBT. The catalyst synthesized is stable under the oxidation conditions and preserves its activity in five oxidation cycles. The combination of two types of active sites not only considerably enhances the catalyst performance but also reduces to a minimum the possible washout of molybdenum compounds from the support surface.
Atypical trigeminocardiac reflex during intranasal dexmedetomidine sedation of a 6-month-old premature baby
Authors: Bayard Denise , Lersch Friedrich , Ugen Gesar , Schaller Bernhard
Published: May 2022

The trigeminocardiac reflex (TCR) is an established brainstem reflex leading to parasympathetic dysrhythmias—including haemodynamic irregularities, apnoea and gastric hypermotility—during stimulation of any sensory branches of the trigeminal nerve. Most of the clinical knowledge about TCR was gathered from general anaesthesia observations, not from procedural sedation.

We present a case of a 6-month-old premature baby experiencing the reflex twice under dexmedetomidine–propofol-sedation while undergoing ophthalmic and ear examination. This was interpreted as cross-over sensitisation between the facial and trigeminal cranial nerve (N V and N VII).

The present case demonstrates that different TCR subtypes can occur during the same anaesthetic procedure. Triggering TCR seems to be based on several factors and not just on a single stimulus as often presumed. Therefore, for premature babies, there is a risk for TCR under procedural sedation, and we recommend using glycopyrrolate as preventive treatment.
Batwing incision for a case of bilateral fungal zygomatic osteomyelitis
Authors: Yadav Sanjeev , Saini Ashish , Singh Abhimanyu , Verma Hitesh
Published: May 2022

Zygomatic osteomyelitis is a rare occurrence due to rich collateral blood supply of bone. A man in his 30s presented with complaints of pain over bilateral cheek and pus discharge below the eye on lateral aspect. He was a known case of COVID-19 associated mucormycosis postendoscopic debridement of sinuses 3 months back. Radiology revealed bilateral destruction of zygoma with discharging sinus. Microbiological analysis confirmed aseptate hyphae in pus, and a diagnosis of bilateral fungal zygomatic osteomyelitis made. Under general anaesthesia, sequestrectomy done using bilateral lateral rhinotomy with extended Dieffenbach’s approach (batwing incision). Postsurgery 3000 mg of liposomal amphotericin was administered. There was no enophthalmos or restricted eye movements postoperatively. Follow-up MRI suggested minimal inflammatory enhancement in maxillary sinus. Patient was discharged on oral antifungals.
Closed loop small bowel obstruction due to herniation through silastic ring after bariatric surgery
Authors: Chidambaram Rama , Pradhan Sharin
Published: May 2022

Bariatric surgery is an effective treatment for obesity and obesity-related complications. Weight regain after surgery plagues all methods of bariatric procedures including the minigastric bypass. The use of a ‘silastic ring’ around the gastric pouch has been shown to reduce weight regain. We present here a very rare complication of silastic ring use, in which a loop of small bowel had herniated through the ring and produced a closed loop small bowel obstruction. The patient was successfully treated with an emergency laparotomy to resect the silastic ring and release the herniated bowel. This case highlights the hernia risk that silastic rings pose and cautions careful consideration before their use.
Three-muscle surgery for large-angle esotropia in chronic sixth nerve palsy: comparison of two approaches
Authors: Yao Jing , Xia Weiyi , Wang Xiying , Zhu Wenqing , Jiang Chao , Ling Ling , Wu Lianqun , Zhao Chen
Published: May 2022

Aims

To report the effect of two three-muscle surgeries, inferior rectus belly transposition plus augmented superior rectus transposition plus medial rectus recession (ISM) and modified vertical rectus belly transposition plus medial rectus recession (VM), in the management of large-angle esotropia in Chinese patients with chronic sixth nerve palsy.

Methods

Twenty-eight consecutive patients with large-angle esotropia ≥50Δwere prospectively enrolled and underwent either ISM or VM. Main outcomes included preoperative and postoperative deviation in primary position, abduction limitation and complications. Follow-up was at least 6 months.

Results

Of the included patients, 13 underwent ISM and 15 underwent VM. Preoperatively, ISM group displayed larger esotropia and more severe abduction limitation. 27 patients completed the follow-up. The postoperative horizontal deviation and abduction limitation were similar in both groups. At the last follow-up, ISM group demonstrated greater improvement of abduction limitation than VM group in both grading (group difference −2.1, p<0.001) and quantitation (group difference 2.6 mm, p=0.001). However, eight (30%) patients revealed an induced adduction limitation ≤−1. Of the 22 patients with unilateral palsy, more esotropia of 14.8Δwas corrected in ISM group, compared with VM group (p=0.003). Three patients (14%) developed vertical diplopia and three (14%) developed torsional diplopia. Unexpectedly, keratitis was observed in 4 of 27 (15%) patients, all with concurrent fifth and/or seventh nerve palsy. Three patients aggravated to corneal ulceration.

Conclusions

Two three-muscle surgeries, ISM and VM were both effective for large-angle esotropia in Chinese patients with chronic sixth nerve palsy. However, attention should be paid to potential complications.
Returning to clinical work and doctors’ personal, social and organisational needs: a systematic review
Authors: Attoe Chris , Matei Raluca , Thompson Laura , Teoh Kevin , Cross Sean , Cox Tom
Published: May 2022

Objective

This systematic review aims to synthesise existing evidence on doctors’ personal, social and organisational needs when returning to clinical work after an absence.

Design

Systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

AMED, BNI, CINAHL, EMBASE, EMCARE, HMIC, Medline, PsycINFO and PubMed were searched up to 4 June 2020. Non-database searches included references and citations of identified articles and pages 1–10 of Google and Google Scholar.

Eligibility criteria

Included studies presented quantitative or qualitative data collected from doctors returning to work, with findings relating to personal, social or organisational needs.

Data extraction and synthesis

Data were extracted using a piloted template. Risk of bias assessment used the Medical Education Research Study Quality Instrument or Critical Appraisal Skills Programme Qualitative Checklist. Data were not suitable for meta-analyses and underwent narrative synthesis due to varied study designs and mixed methods.

Results

Twenty-four included studies (14 quantitative, 10 qualitative) presented data from 92 692 doctors in the UK (n=13), US (n=4), Norway (n=3), Japan (n=2), Spain (n=1), Canada (n=1). All studies identified personal needs, categorised as work–life balance, emotional regulation, self-perception and identity, and engagement with return process. Seventeen studies highlighted social needs relating to professional culture, personal and professional relationships, and illness stigma. Organisational needs found in 22 studies were flexibility and job control, work design, Occupational Health services and organisational culture. Emerging resources and recommendations were highlighted. Variable quality and high risk of biases in data collection and analysis suggest cautious interpretation.

Conclusions

This review posits a foundational framework of returning doctors’ needs, requiring further developed through methodologically robust studies that assess the impact of length and reason for absence, before developing and evaluating tailored interventions. Organisations, training programmes and professional bodies should refine support for returning doctors based on evidence.
Does weight management research for adults with severe obesity represent them? Analysis of systematic review data
Authors: Robertson Clare , Aceves-Martins Magaly , Cruickshank Moira , Imamura Mari , Avenell Alison
Published: May 2022

Objective

Our objective was to determine the extent to which current evidence from long-term randomised controlled trials (RCTs) of weight management is generalisable and applicable to underserved adult groups with obesity (body mass index (BMI) ≥35 kg/m2).

Methods

Descriptive analysis of 131 RCTs, published after 1990–May 2017 with ≥1 year of follow-up, included in a systematic review of long-term weight management interventions for adults with BMI ≥35 kg/m2(the REBALANCE Project). Studies were identified from MEDLINE, EMBASE, PsychINFO, SCI, CENTRAL and from hand searching. Reporting of trial inclusion and exclusion criteria, trial recruitment strategies, baseline characteristics and outcomes were analysed using a predefined list of characteristics informed by the PROGRESS (Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital)-Plus framework and the UK Equality Act 2010.

Results

Few (6.1%) trials reported adapting recruitment to appeal to underserved groups. 10.0% reported culturally adapting their trial materials. Only 6.1% of trials gave any justification for their exclusion criteria, yet over half excluded participation for age or mental health reasons. Just over half (58%) of the trials reported participants’ race or ethnicity, and one-fifth reported socioeconomic status. Where outcomes were reported for underserved groups, the most common analysis was by sex (47.3%), followed by race or ethnicity (16.8%). 3.1% of trials reported outcomes according to socioeconomic status.

Discussion

Although we were limited by poor trial reporting, our results indicate inadequate representation of people most at risk of obesity. Guidance for considering underserved groups may improve the appropriateness of research and inform greater engagement with health and social care services.

Funding

National Institute for Health Research Health Technology Assessment Programme (project number: 15/09/04).

PROSPERO registration number

CRD42016040190.
Increased early mortality after total knee arthroplasty using conventional instrumentation compared with technology-assisted surgery: an analysis of linked national registry data
Authors: Harris Ian A , Kirwan David P , Peng Yi , Lewis Peter L , de Steiger Richard N , Graves Stephen E
Published: May 2022

Objectives

This study aims to compare early mortality after total knee arthroplasty (TKA) using conventional intramedullary instrumentation to TKA performed using technology-assisted (non-intramedullary) instrumentation.

Design

Comparative observational study. Using data from a large national registry, the 30-day mortality after unilateral TKA performed for osteoarthritis was compared between procedures using conventional instrumentation and those using technology-assisted instrumentation. Firth logistic regression was used to calculate ORs, adjusting for age, sex, use of cement and procedure year for the whole period, and additionally adjusting for American Society of Anesthesiologists physical status classification system class and body mass index (BMI) for the period 2015 to 2019. This analysis was repeated for 7-day and 90-day mortality.

Setting

National arthroplasty registry.

Participants

People undergoing unilateral, elective TKA for osteoarthritis from 2003 to 2019 inclusive.

Interventions

TKA performed using conventional intramedullary instrumentation or technology-assisted instrumentation.

Main outcome measures

30-day mortality (primary), and 7-day and 90-day mortality.

Results

A total of 581 818 unilateral TKA procedures performed for osteoarthritis were included, of which 602 (0.10%) died within 30 days of surgery. The OR of death within 30 days following TKA performed with conventional instrumentation compared with technology-assisted instrumentation, adjusted for age, sex, cement use, procedure year, American Society of Anesthesiologists and BMI was 1.72 (95% CI, 1.23 to 2.41, p=0.001). The corresponding ORs for 7-day and 90-day mortality were 2.21 (96% CI, 1.34 to 3.66, p=0.002) and 1.35 (95% CI, 1.07 to 1.69, p=0.010), respectively.

Conclusions

The use of conventional instrumentation during TKA is associated with higher odds of early postoperative death than when technology-assisted instrumentation is used. This difference may be explained by complications related to fat embolism secondary to intramedullary rods used in conventional instrumentation. Given the high number of TKA performed annually worldwide, increasing the use of technology-assisted instrumentation may reduce early post-operative mortality.
Adjuvant testosterone therapy in chronic heart failure (ATTIC): a randomised open-label trial
Authors: Dhar Minakshi , Mittal Kartik , Parchani Ashwin , Sharma Manu , Bahurupi Yogesh , Kalra Sanjay , Bhat Nowneet Kumar
Published: May 2022

Introduction

Heart failure is a major contributor to morbidity and mortality in the geriatric population, with no promising therapy currently available with considerable benefit. Testosterone therapy is an emerging viable treatment option given its beneficial effects, including improving cardiac functional capacity, alleviating symptoms and low cost, among others.

Methods

We have planned an open-label, parallel design, 1:1 randomised controlled trial, which aims to recruit 986 adult males above the age of 60 diagnosed with chronic stable heart failure fulfilling the eligibility criteria. The participants will be randomised into 2 groups of 493 each. Both groups will receive standard recommended treatment regimen of chronic stable heart failure and intervention arm participants will receive additional testosterone gel. All participants will be assessed at baseline, 4 weeks, 6 weeks and 12 weeks. The primary endpoints will assess the differences in functional capacity, frailty and quality of life at 3 months compared with baseline. The secondary endpoints will include the mean change from baseline at 3 months in cardiac remodelling using echocardiography, serum brain natriuretic peptide levels, the incidence of adverse drug reaction.

Statistical analysis

The data will be analysed with the help of SPSS 23 software. Primary objectives of change in 6-minute walk test, frailty index and quality of life will be analysed using the student’s t-test. The statistical significance will be defined as p value<0.05 and taking confidence level as 95%.

Ethical clearance

Institutional Ethics Committee clearance taken via letter no AIIMS/IEC/20/847, dated 21 November 2020. This study involves human participants and was approved by institutional ethical committee, DHR Reg: EC/NEW/Inst/2020/1046CDSCO, Reg No: ECR/736/Inst/UK/2015/RR-18. Participants gave informed consent to participate in the study before taking part.

Trial registration number

(CTRI)—REF/2020/12/030292.
Remodeling the tumor microenvironment by oncolytic viruses: beyond oncolysis of tumor cells for cancer treatment
Authors: Wang Lihong , Chard Dunmall Louisa S , Cheng Zhenguo , Wang Yaohe
Published: May 2022

Tumor cells manipulate the local environment in which they grow, creating a tumor microenvironment (TME) that promotes tumor survival and metastasis. The TME is an extremely complex environment rich in immunosuppressive cells and cytokines. Various methods to therapeutically target the complicated TME are emerging as a potential approach for cancer treatment. Oncolytic viruses (OVs) are one of the most promising methods for remodeling the TME into an antitumor environment and can be used alone or in combination with other immunotherapy options. OVs replicate specifically in tumor cells and can be genetically engineered to target multiple elements of the TME simultaneously, thus representing a therapeutic with the potential to modify the TME to promote activation of antitumor immune cells and overcome tumor therapeutic resistance and recurrence. In this review, we analyze the tropism of OVs towards tumor cells and explore the interaction between OVs and immune cells, tumor stroma, vasculature and the metabolic environment in detail to help understand how OVs may be one of our most promising prospects for long-term curative therapies. We also discuss some of the challenges associated with TME therapies, and future perspectives in this evolving field.
Thrombectomy aspiration post-market study in acute stroke with the Q aspiration catheter: the TAPAS study
Authors: Espinosa de Rueda Mariano , Ballenilla Marco Federico , Garmendia Lopetegui Eñaut , Pumar Jose M , Zamarro Joaquin , García-Villalba Blanca , Díaz-Pérez Jose , Mosqueira Antonio , Lüttich Alex , Larrea Jose-Angel , Parrilla Guillermo
Published: May 2022

Background

The Q Aspiration Catheter (MIVI Neuro) has demonstrated greater aspiration flow rates and ingestion forces compared with conventional catheters in vitro. The safety and performance of the Q Catheter was assessed using a direct aspiration first pass technique in patients with acute ischemic stroke at four neurointerventional centers in Spain.

Methods

We included adult patients who underwent mechanical thrombectomy between March 2019 and March 2020 using the Q Catheter as first-line therapy. Performance endpoints included final successful revascularization of the target vessel (defined as modified thrombolysis in cerebral infarction (mTICI) grade 2B/3), first pass revascularization, and overall Q Catheter revascularization. Safety endpoints were symptomatic intracranial hemorrhage (sICH), embolization to new territory (ENT), and procedural complications. Modified Rankin Scale (mRS) score and all-cause mortality were also assessed.

Results

Forty-five subjects were enrolled. The Q Catheter successfully navigated to the lesion in 95.5% (43/45) of patients. Final successful mTICI 2B/3 revascularization was achieved in 93.3% (42/45), first pass mTICI 2B/3 revascularization with the Q Catheter was 55.3% (21/38), and overall with Q Catheter mTICI 2B/3 revascularization was 65.8% (25/38). Favorable clinical outcome of mRS 0–2 was achieved in 55.6% (25/45). There were no cases of ENT. sICH and mortality rates were 2.2% (1/45) and 13.3% (6/45), respectively.

Conclusion

In this multicenter, observational study, the Q Aspiration Catheter used as first-line therapy demonstrated a good and safe profile in terms of navigation, revascularization, and safety in patients with acute ischemic stroke.