bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of isomerisation and oxidation on the immunomodulatory activity of chlorogenic acid in RAW264.7 macrophages
Authors: Guo Chongting , Bi Jinfeng , Li Xuan , Lyu Jian , Liu Xuan , Liu Jianing , Xu Ye , Hu Jiaxing
Published: November 2021

Chlorogenic acid (CA) is one of the major polyphenols in fruit that contributes to most bioactivities. However, it is susceptible to isomerisation and oxidation in processing and thus displays varied bioactivity. This study aimed to evaluate the isomerisation and oxidation effects of CA on the potential immunomodulatory activity in RAW264.7 macrophages through the NF‐E2‐related factor‐2 (Nrf2) and nuclear factor‐kappa B (NF‐κB) signalling pathways. The results showed that isomerisation significantly affected the immunomodulation of CA by reducing Nrf2 and increasing NF‐κB nuclear translocation. The oxidation of CA weakened the effect of immune regulation in macrophages through impacts on the nucleic translocation of Nrf2 and NF‐κB, cellular reactive oxygen species (ROS) accumulation, antioxidant enzyme (superoxide dismutase, SOD) activity and cytokine expression. Consequently, isomerisation and oxidation remarkably affect the immunomodulation of CA via the Nrf2 and NF‐κB pathways.
Plant‐based proteins as encapsulating materials for glucosyl‐hesperidin
Authors: Kopjar Mirela , Buljeta Ivana , Ćorković Ina , Kelemen Vanja , Šimunović Josip , Pichler Anita
Published: November 2021

The application of plant‐based proteins as encapsulating materials of bioactive compounds is on the rise. The aim of this study was to encapsulate glucosyl‐hesperidin (GH) by several plant‐based protein powders such as pea protein, almond protein, brown rice protein and pumpkin protein powders. Amounts of adsorbed GH on pea, almond, brown rice and pumpkin protein powders were 409.07 mg g‐1, 287.41 mg g‐1, 242.87 mg g‐1 and 193.70 mg g‐1, respectively. Pea protein powder had the highest affinity for GH among the selected plant‐based protein powders, and it bonded 81.8% of GH from the initial solution. IR spectra were recorded in order to prove binding between GH and encapsulating material. As a result of GH binding onto proteins, all formulated protein microparticles differ in their IR spectra compared with the corresponding protein powders. Results of this study showed that pea proteins had the highest encapsulation efficiency of water‐soluble glucosyl‐hesperidin among used plant‐based proteins.
Oxymatrine promotes hypertrophic scar repair through reduced human scar fibroblast viability, collagen and induced apoptosis via autophagy inhibition
Authors: Deng Xingwang , Zhao Fang , Zhao Dan , Zhang Qing , Zhu Yongzhao , Chen Qian , Qiang Lijuan , Xie Nan , Ma Jiaxiang , Pan Xiaoliang , Wu Yinsheng , Guan Lifeng , Xie Yan
Published: November 2021

Scars are common complications of burns and trauma, resulting in mental trauma, physical pain, and a heavy financial burden for patients. Specific and effective anti‐scarring drugs are lacking in clinical practice. Phytochemicals are easily accessible, low in toxicity, and have various biological and pharmacological properties. Oxymatrine is a phytochemical that regulates autophagy networks. Autophagy is closely related to the maintenance, activity, differentiation, and life‐death of skin fibroblasts during wound repair, which results in pathological scars. We hypothesised that oxymatrine may promote hypertrophic scar repair by inhibiting fibroblast autophagy. In vitro studies showed that inhibition of autophagy by oxymatrine decreased viability and collagen metabolism, and increased apoptosis of human scar fibroblasts (HSFs). In vivo studies showed that inhibition of autophagy by oxymatrine promoted scar repair, resulting in a significantly improved final outcome of the hypertrophic scars, a smaller scar area, decreased epidermal and dermal thickness, and a significant downregulation of CK10, P63, collagen I, α‐SMA, and TGF‐β1. In summary, oxymatrine promoted hypertrophic scar repair by decreasing HSF viability and collagen, and inducing apoptosis via autophagy inhibition. This study provides a new perspective on the mechanism of hypertrophic burn scar formation, as well as key scientific data for the application of the phytochemical oxymatrine as a new method for the prevention and treatment of hypertrophic scars.
The Moral Significance of Adolescence
Authors: Betzler Monika
Published: November 2021

This article examines whether there is a morally relevant difference between adolescents and adults even if both are similarly autonomous. Understanding that difference accounts for the particular moral significance of adolescence and explains what we owe to adolescents as individual members of that age group. I first raise the plausibility of this morally relevant difference by highlighting the difficulties that any attempts would face which try to assimilate adolescents to either adults or children. I then consider two recent proposals that have been made in the literature in support of the moral significance of adolescence and show that none of them can adequately account for it. In light of this diagnosis, I advance the Relational View according to which it is necessary for the development of adolescents' autonomous capacities that they are supported in both their self‐governance and self‐authorisation in close relationships while they are adolescent. As a result, the morally relevant difference between adolescents and adults consists in the fact that close relationships and the support they provide are necessary for adolescents to become skilled autonomous agents but only causally relevant for adults. An implication of this view is that paternalism is justified only in rare cases, and that friendships and partnerships later in life are unable to make up for what has been missed during adolescence.
From Sovereignty to Guardianship in Ecoregions
Authors: Mancilla Alejandra
Published: November 2021

Recent scientific studies suggest that the destabilisation of the earth's climate and biodiversity loss are not separate, but interdependent phenomena. In this context, some have proposed the creation of a ‘Global Safety Net’ of ecoregions that should be preserved to stop further biodiversity loss, preventing at the same time the growth of CO2 emissions produced by deforestation and allowing natural carbon removal. In this article, I suggest that a first step to achieve this might be to replace permanent sovereignty over natural resources in these areas with permanent guardianship. I propose to take some inspiration from a model that has already been implemented over an entire continent with a fair degree of success. In 1959, the Antarctic Treaty froze the sovereign claims of seven countries over Antarctica. However, these countries plus 47 others today have been remarkably successful at jointly preserving the continent for peace, science, and the protection of the environment, especially since the signature of the Environmental Protocol in 1991. After outlining some principles that could give form to a Global Environmental Protocol for Ecoregions, I address a series of objections and offer some concluding remarks.
Knockdown of circular RNA VANGL1 inhibits TGF‐β‐induced epithelial‐mesenchymal transition in melanoma cells by sponging miR‐150‐5p
Authors: Zhou Hongfeng , Wu Jin , Leng Shaolong , Hou Chongchao , Mo Laiming , Xie Xue , Wang Ling , Xu Yunsheng
Published: November 2021

Melanoma is one of the most aggressive and life‐threatening skin cancers, and in this research, we aimed to explore the functional role of circular RNA VANGL1 (circVANGL1) in melanoma progression. The expression levels of circVANGL1 were observed to be significantly increased in clinical melanoma tissues and cell lines. Moreover, circVANGL1 knockdown suppressed, while circVANGL1 overexpression promoted the proliferation, migration and invasion abilities of melanoma cells. Further investigations confirmed the direct binding relation between circVANGL1 and miR‐150‐5p in melanoma, and restoration of miR‐150‐5p blocked the effects of circVANGL1 overexpression in melanoma cells. We further found that circVANGL1 was up‐regulated by TGF‐β treatment, and the enhanced EMT of TGF‐β‐treated melanoma cells was blocked by circVANGL1 knockdown. In conclusion, these results indicated that circVANGL1 might serve as a promising therapeutic target for melanoma.
Establishment of a prognostic ferroptosis‐related gene profile in acute myeloid leukaemia
Authors: Shao Ruonan , Wang Huizhong , Liu Wenjian , Wang Jingzi , Lu Shujing , Tang Hailin , Lu Yue
Published: November 2021

Acute myeloid leukaemia (AML) is a heterogeneous disease with a difficult to predict prognosis. Ferroptosis, an iron‐induced programmed cell death, is a promising target for cancer therapy. Nevertheless, not much is known about the relationship between ferroptosis‐related genes and AML prognosis. Herein, we retrieved RNA profile and corresponding clinical data of AML patients from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Univariate Cox analysis was employed to identify ferroptosis‐related genes significantly associated with AML prognosis. Next, the least absolute shrinkage and selection operator (LASSO) regression was employed to establish a prognostic ferroptosis‐related gene profile. 12 ferroptosis‐related genes were screened to generate a prognostic model, which stratified patients into a low‐ (LR) or high‐risk (HR) group. Using Kaplan‐Meier analysis, we demonstrated that the LR patients exhibited better prognosis than HR patients. Moreover, receiver operating characteristic (ROC) curve analysis confirmed that the prognostic model showed good predictability. Functional enrichment analysis indicated that the infiltration of regulatory T cells (Treg) differed vastly between the LR and HR groups. Our prognostic model can offer guidance into the accurate prediction of AML prognosis and selection of personalized therapy in clinical practice.
Cell division cycle associated 8: A novel diagnostic and prognostic biomarker for hepatocellular carcinoma
Authors: Cui Xiao‐Han , Peng Qiu‐Ju , Li Ren‐Zhi , Lyu Xia‐Jie , Zhu Chun‐Fu , Qin Xi‐Hu
Published: November 2021

The cell division cycle associated 8 (CDCA8) is a crucial component of the chromosome passenger complex (CPC). It has been implicated in the regulation of cell dynamic localization during mitosis. However, its role in hepatocellular carcinoma (HCC) is not clearly known. In this study, data of 374 patients with HCC were retrieved from the Cancer Genome Atlas (TCGA) database. Pan analysis of Gene Expression Profiling Interactive Analysis (GEPIA) database was performed to profile the mRNA expression of CDCA8 in HCC. Then, the Kaplan‐Meier plotter database was analysed to determine the prognostic value of CDCA8 in HCC. In addition, samples of tumour and adjacent normal tissues were collected from 88 HCC patients to perform immunohistochemistry (IHC), reverse transcription‐quantitative polymerase chain reaction (qRT‐PCR) and Western blotting. The results obtained from bioinformatic analyses were validated through CCK‐8 assay, EdU assay, colony formation assay, cell cycle assays and Western blotting experiments. Analysis of the Kaplan‐Meier plotter database showed that high expression of CDCA8 may lead to poor overall survival (OS, p = 4.06e‐05) in patients with HCC. For the 88 patients with HCC, we found that stages and grades appeared to be strongly linked with CDCA8 expression. Furthermore, the high expression of CDCA8 was found to be correlated with poor OS (p = 0.0054) and progression‐free survival (PFS, p = 0.0009). In vitro experiments revealed that inhibition of CDCA8 slowed cell proliferation and blocked the cell cycle at the G0/G1 phase. In vivo experiments demonstrated that inhibition of CDCA8 inhibited tumour growth. Finally, blockade of CDCA8 reduced the expression levels of cyclin A2, cyclin D1, CDK4, CDK6, Ki67 and PCNA. And, there is an interaction between CDCA8 and E2F1. In conclusion, this research demonstrates that CDCA8 may serve as a biomarker for early diagnosis and prognosis prediction of HCC patients. In addition, CDCA8 could be an effective therapeutic target in HCC.
Soluble TREM‐1, as a new ligand for the membrane receptor Robo2, promotes hepatic stellate cells activation and liver fibrosis
Authors: Liu Ting , Chen Shujia , Xie Xiaoli , Liu Hongqun , Wang Yongjuan , Qi Shengbin , Shi Linping , Zhou Xue , Zhang Jiuna , Wang Shuling , Wang Yijun , Chen Shengxiong , Dou Shiying , Jiang Xiaoyu , Cui Ruolin , Jiang Huiqing
Published: November 2021

Triggering receptor expressed on myeloid cells‐1 (TREM‐1) exists in two forms: a transmembrane form and a soluble form (sTREM‐1). The levels of sTREM‐1 are elevated in supernatants of activated HSCs. However, the role of sTREM‐1 in HSC activation and liver fibrosis remains undefined. Previous studies have primarily focused on the transmembrane form of TREM‐1; we innovatively observed the function of sTREM‐1 as a ligand in liver fibrosis and screened its receptor. Here, recombinant sTREM‐1 was used as a stimulator which induced HSC activation and further aggravated liver fibrosis. Then, screening for sTREM‐1 interacting membrane receptors was performed using pull‐down assay followed by mass spectrometry, and the membrane receptor roundabout guidance receptor 2 (Robo2) was identified as a candidate receptor for sTREM‐1. The interaction between sTREM‐1 and Robo2 was verified by pull‐down and immunofluorescence. The role of Robo2 on sTREM‐1‐induced HSC activation and its downstream signal pathways was assessed by knockdown of Robo2 in LX‐2 cells. Furthermore, HSC‐specific knockdown of Robo2 was achieved in a mouse model of liver fibrosis by using a recombinant adeno‐associated virus (AAV) vector to confirm the role of the receptor, and we proved that Robo2 knockdown inhibited the activation of HSC and liver fibrosis, which also led to the inactivation of Smad2/3 and PI3K/Akt pathways in sTREM‐1‐induced HSC activation and liver fibrosis. In conclusion, sTREM‐1 acts as a new ligand of Robo2; the binding of sTREM‐1 to Robo2 initiates the activation of the downstream Smad2/3 and PI3K/Akt signalling pathways, thereby promoting HSC activation and liver fibrosis.
Mucus piRNAs profiles of Vibrio harveyi‐infected Cynoglossus semilaevis: A hint for fish disease monitoring
Authors: Zhao Na , Deng Qiuxia , Zhu Chunhua , Zhang Bo
Published: November 2021

The half‐smooth tongue sole, Cynoglossus semilaevis, is an important cultured flatfish species. Vibrio harveyi is a common pathogen to this fish, which may result in great economic loss to C. semilaevis culture industry. piRNAs, a non‐coding RNAs with 26–32 nt, have been regarded as promising biomarkers for cancer diagnosis and fish diseases. Here, we extracted the RNA from mucus of C. semilaevis and constructed the differential expression profiles of piRNAs between the sick fish (MS) and healthy fish (MC). We identified 45,696 differentially expressed piRNAs including 22,735 up‐regulated piRNAs and 22,961 down‐regulated piRNAs in MS group compared with MC group. The GO enrichment and KEGG pathway enrichment analyses of the differential piRNAs were carried out. The result showed immunity‐related target genes mainly involved in immune system process, response to stimulus, cell killing, immune system, infectious diseases and cell growth and death. The 10 most differentially expressed piRNAs were chosen to perform the qRT‐PCR, while only seven piRNAs were consistent with the sequence result. Compared with MC group, the expression levels of piR‐mmu‐72173>piR‐rno‐62831>piR‐xtr‐704880, piR‐dme‐15546979, piR‐mmu‐49941660, piR‐mmu‐29283297 and piR‐mmu‐1758399 were significantly lower, and piR‐gga‐10574 and piR‐gga‐134812 were significantly higher in MS group. These piRNAs may be potential biomarkers during the V. harveyi infection of C. semilaevis. This study could provide a new method to identify the infection status of C. semilaevis and understand better about the innate and adaptive immune system in C. semilaevis during bacterial infection.
Teaching medicine interns minimum geriatrics competencies within a “4 + 2” schedule
Authors: Chao Serena H. , Kwok Judy Y. , Ubani Benjamin N. , Rogers Rebecca E. P. , Stark Rachel L.
Published: November 2021

The increased ambulatory training time in an “X + Y” (inpatient + ambulatory) residency schedule affords more opportunities to teach geriatrics principles of care. We describe our internal medicine (IM) residency program's experience in teaching the IM–family medicine (FM) minimum geriatrics competencies (MGC) during a longitudinal geriatrics rotation embedded within interns' yearlong “4 + 2” schedule. Interns spend 1 day of the ambulatory block in a geriatrics outpatient setting (Program of All‐Inclusive Care for the Elderly, house calls, nursing home), during which geriatrics division faculty members give core didactic seminars. We revamped core seminars to address MGC related to medication management, cognitive health, complex chronic illnesses, end of life care, and ambulatory care. Three consecutive intern cohorts completed anonymous surveys pre‐ and postrotation, rating their confidence level in MGC addressed by the curriculum on a 5‐point Likert scale. On postrotation surveys, they also rated the curriculum's contribution to geriatrics skills enhancement. Interns who completed both surveys (N = 22, 92%) reported statistically significant improved confidence ratings on all items, with the greatest point gains seen in performance of functional assessment (1.56), practice of optimal geriatric pharmacotherapy (1.78), and identification of older patients eligible for skilled (1.71) and unskilled home‐based services (1.65). They rated geriatrics curricular components as being more helpful than other rotations and conferences in enhancing their geriatric skills. In conclusion, we developed a longitudinal geriatrics curriculum within the context of our “4 + 2” immersion schedule which other programs can easily adapt. Aligning curricular content with the MGC has resulted in interns' improved confidence in several important geriatrics skills.
Molecular targets of psychedelic‐induced plasticity
Authors: Jaster Alaina M. , de la Fuente Revenga Mario , González‐Maeso Javier
Published: November 2021

Psychedelic research across different disciplines and biological levels is growing at a remarkably fast pace. In the prospect of a psychedelic drug becoming again an approved treatment, much of these efforts have been oriented toward exploring the relationship between the actual psychedelic effects and those manifestations of therapeutic interest. Considering the central role of the serotonin 5‐HT2A receptor in the distinct effects of psychedelics in human psyche, neuropharmacology sits at the center of this debate and exploratory continuum. Here we discuss some of the most recent findings in human studies and contextualize them considering previous preclinical models studying phenomena related to synaptic plasticity. A special emphasis is placed on knowledge gaps, challenges, and limitations to evaluate the underpinnings of psychedelics’ potential antidepressant action.

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Nurses’ attitudes and emotions toward caring for adults with intellectual disability: An international replication study
Authors: Desroches Melissa L. , Howie Virginia A. , Wilson Nathan J. , Lewis Peter
Published: November 2021

Purpose

Negative nurse attitudes and emotions toward caring for adults with intellectual disability have been implicated as a contributing factor to the cascade of health disparities faced by this population. The purpose of this study was to identify influencing factors of nurses’ attitudes and emotions toward caring for adults with intellectual disability that transcend national borders and differing systems of care.

Methods

This cross‐sectional correlational predictive replication study used an online electronic survey with a snowball sample of 115 Australian nurses, from March to August 2020.

Results

Nurses’ attitudes toward adults with intellectual disability were significantly less positive compared to adults without intellectual disability, and nurses’ beliefs about the quality of life of adults with intellectual disability predicted nurses’ attitudes, replicating findings of the USA study. The frequency of both the professional and personal contact was associated with positive and negative emotions in both countries, however no consistent predictive pattern was evident.

Conclusions

Our findings suggest that worldwide, there is room for improvement in nurses’ attitudes and emotions toward this underserved group. Future research should investigate the role of nurses’ beliefs about quality of life of adults with intellectual disability for potential interventions to improve nurses’ attitudes toward care.

Clinical relevance

Assisting nurses to identify misconceptions about the quality of life of adults with intellectual disability is suggested as an intervention to improve nurses’ attitudes toward caring for adults with intellectual disability.
Using infrared imaging and deep learning in fit‐checking of respiratory protective devices among healthcare professionals
Authors: Siah Chiew‐Jiat Rosalind , Lau Siew Tiang , Tng Sian Soo , Chua Chin Heng Matthew
Published: November 2021

Aims

This study aimed to investigate the application of infrared thermal imaging and adopt deep learning to detect air leakage for determining the fitness of respirators during fit‐checks.

Background

The outbreak of Covid‐19 virus constitutes a public health crisis with substantial resultant morbidities and mortalities; has exerted profound impacts.

Methods

This was a prospective observational study, employing a non‐probability sampling method on a convenience sample to recruit the participants and followed the Strengthening the Reporting of Observational Studies in Epidemiology statement guidelines.

Results

The use of infrared thermal imaging identified air leakage points as a disruption to the facial thermal pattern distribution at (a) front of face; (b) right lateral of the face; (c) left lateral of the face; (d) top of the facemask with the head facing down; and (e) bottom of the facemask with the head facing up. Results also indicated that artificial intelligence tools and the proliferation of deep learning have the potential to detect the location of air leakage locations.

Conclusion

The use of infrared thermal imaging provides evidence of the feasibility and applicability of infrared thermal imaging techniques in detecting air leakage for individuals wearing respirators.

Clinical relevance

The use of infrared thermal technology can serve a potential role in complement fit‐checking of respiratory protective devices and offers promising practical utility in determining the fitness of respirators for nurses at the frontline to protect against the air‐borne viruses.
Recurrence of alopecia areata after covid‐19 vaccination: A report of three cases in Italy
Authors: Rossi Alfredo , Magri Francesca , Michelini Simone , Caro Gemma , Di Fraia Marco , Fortuna Maria Caterina , Pellacani Giovanni , Carlesimo Marta
Published: November 2021

Background

Common COVID‐19 vaccines side effects are pain at the injection site, muscle pain, fever, headaches, fatigue. Possible immune‐related side effects in predisposed individuals have not been established so far.

Materials and Methods

We report three cases of recurrence of alopecia areata (AA) occurred after the first dose of COVID‐19 vaccine.

Results

All patients had previous episodes of AA with total hair regrowth and stable remission during the months preceding the vaccination. Rapid hair loss occurred 2‐3 weeks after BNT162b2 mRNA (patient 1) and AZD1222/ChAdOx1 vaccine (patient 2 and 3), with widespread hair loss in two cases and a single patch of the vertex in one case, with typical trichoscopic features of AA.

Discussion

Both BNT162b2 mRNA and AZD1222/ChAdOx1 vaccines share the same goal of inducing the immune system, with antibodies production and Th1 cells activation with release of pro‐inflammatory cytokines. Thus, in patients with pre‐existing inflammatory dysregulated pathways, the interaction between the immune system and vaccines may enhance other autoimmune mechanisms. In our cases, we speculate that vaccine may have induced the hair loss focusing on components having a key role in both COVID‐19 vaccination and AA pathogenesis.

Conclusion

This report may help to collect new data concerning possible immune‐related effects of vaccines. Certainly, only three cases are not sufficient to draw conclusion, thus a large‐scale study is necessary. Immune‐mediated side effects remain a rare event, thus the benefits of COVID‐19 vaccines outweigh the risk of disease flares and we strongly recommend it in all eligible patients with AA.
Pilot study of histology aspect of cellulite in seventy patients who differ in BMI and cellulite grading
Authors: Scarano Antonio , Petrini Morena , Sbarbati Andrea , Amore Roberto , Iorio Eugenio Luigi , Marchetti Marco , Amuso Domenico
Published: November 2021

Background

Cellulite is a topographic alteration of the skin with unknown etiology and is characterized by the presence of a dimpled or puckered aspect, as resembling an orange peel and cottage cheese or as having mattress‐like appearance.

Aim

The aim of this research was to find the different histological aspect of cellulite in sixty patients.

Materials and Methods

A total of 60 women, mean age 48.8 ( ± 11.08) were included in the study. Among these, 11 women were in menopause (18.33%). All patients after physical examination, aesthetic, and dermatological evaluation were subjected to five cellulite biopsies with a 2.0 mm diameter and 1.5 mm in length in the trochanteric region affected by cellulite. The descriptive statistics were performed for each study predictors demographic age, height, bmi, waist, belly, hip thigh, and knee.

Results

The histological analysis of the stained slides showed five different histological features were present in the most of patient.

Conclusion

In conclusion, the outcome of this study shows that the histological evidence does not characterize the different states of cellulite, but several different histological aspects were present in the same patient, which effectively eliminates staging and could consider cellulite as a degenerative disease.
Full title: The prevalence of and predictors for perioperative hypothermia in postanaesthesia care unit
Authors: Zhang Hong , Wang Jiechu , Zhu Sainan , Li Jinlei
Published: November 2021

Background

Hypothermia is a common clinical issue during the perioperative period. The patients with perioperative inadvertent hypothermia are associated with higher risk of postoperative complications and higher hospitalisation costs.

Aims

The aim of this study is to explore the prevalence of and predictors for hypothermia in patients entering postanaesthesia care unit.

Design

Retrospective cohort study.

Methods

A rigorous retrospective cohort study was conducted according to the STROBE reporting checklist. A total of 7216 patients were enrolled in this study. The perioperative variables potentially related to hypothermia were collected. Univariate analysis and multivariate logistic regression analysis were performed to investigate the contributing factors.

Results

The overall prevalence of inadvertent hypothermia in postanaesthesia care unit was 21.3% (n = 1505). The multivariate logistic regression analysis showed that age >65 (OR = 1.561, 95% CI 1.371–1.778, p < .001), non‐supine position [lateral decubitus position (OR = 1.341, 95% CI 1.133–1.586, p = .001), lithotomy position (OR = 1.639, 95% CI 1.295–2.075, p < .001)], non‐superficial surgery (OR = 2.195, 95% CI 1.566–3.077, p < .001), non‐open surgery [laparoscopic surgery (OR = 1.205, 95% CI 1.020–1.423, p = .029), endoscopic surgery (OR = 1.430, 95%CI 1.084–1.887, p = .011)], the volume of intravenous infusion fluid >1000 ml (OR = 1.814, 95% CI 1.500–2.194, p < .001), blood transfusion (OR = 1.552, 95% CI 1.159–2.078, p = .003), operation performed in the summer or fall (OR = 1.874, 95%CI 1.656–2.122, p < .001) and use of dexmedetomidine (OR = 1.147, 95%CI 1.015–1.296, p = .028) were associated with increased risk of hypothermia. In contrast, our finding showed that body mass index ≥25 kg/m2 (OR = 0.556, 95%CI 0.491–0.630, p < .001), higher baseline body temperature (OR = 0.641, 95%CI 0.541–0.761, p < .001) and duration of fasting ≥18 h (OR = 0.487, 95%CI 0.345–0.689, p < .001) were associated with decreased risk of hypothermia. Compared with non‐hypothermic patients, patients with hypothermia were associated with prolonged length of hospital days (5 vs. 4 days, p < .001).

Conclusion

For patients admitted to postanaesthesia care unit after elective procedures, old age, non‐supine position, non‐open surgery, non‐superficial surgery, large volume of intravenous infusion fluid, dexmedetomidine, blood transfusion and Summer or Fall operative season were associated with increased risk of hypothermia, whereas high body mass index, high baseline body temperature and long fasting duration were associated with decreased risk of hypothermia.

Relevance to clinical practice

The outcomes of this study will raise the concerns of perioperative care team on hypothermia in surgical patients. Measures should be taken to improve perioperative hypothermia and clinical outcome.
Actors and Resources in the Deinstitutionalization and Reproduction of Educational Inequalities: A Comparative Historical Analysis
Authors: Aïssaoui Rachida
Published: November 2021

This study reports on the findings of a comparative historical analysis uncovering three inequality projects aimed at either deinstitutionalizing or reproducing inequalities in school organizations in Memphis, Shelby County, Tennessee. My investigation covers a long period, from the mid‐1800s when the first public schools were created in Memphis, to 2014 when the suburban schools opted to permanently separate from the urban school district. The insights from this study make three key contributions. First, I develop a model of inequality work that uncovers the interactional mechanisms linking unequal impact to unequal treatment. Second, I explain why efforts at distributing resources equally can only temporarily resolve inequalities. Lastly, I identify valuation work as a central link between the material forms of institutional work to access resources and the symbolic form of institutional work to deinstitutionalize or reproduce the unequal treatment of actors.
Use of a CAD‐CAM Surgical Template to Improve Accuracy for Simultaneous Implant Removal, New Implant Placement, and Bone Graft
Authors: Gadah Thuraya , Dutra Vinicius , Polido Waldemar , Al‐Shahrani Ahid , Lin Wei‐Shao , Morton Dean
Published: November 2021

A fractured implant is considered a catastrophic failure that leads to the loss of the implant and the prosthesis. Available methods of implant removal include the reverse screw technique, use of trephines, or osteotomies around the implant. In case of a fractured implant, the access hole for the reverse screw technique is impossible, leading to the need for an osteotomy. When the apical part of the fractured implant is embedded in bone, finding the piece may lead to a more ample osteotomy and significant bone loss, complicating future implant placement. This technique presented utilized a CAD‐CAM surgical template that was designed with the purpose of improving accuracy in finding the fractured part with minimal osteotomy, allowing for simultaneous placement of a new implant in the same site, with additional bone graft, utilizing the same template.
Dietary mulberry‐leaf flavonoids supplementation improves liver lipid metabolism and ovarian function of aged breeder hens
Authors: Huang Zhenwu , Lv Zengpeng , Dai Hongjian , Li Simeng , Jiang Jingle , Ye Nanwei , Zhu Shanli , Wei Quanwei , Shi Fangxiong
Published: November 2021

Mulberry‐leaf flavonoids (MF), extracted from mulberry leaves, exert antioxidant and hypolipidemic effects. The purpose of this experimental study was to investigate the effects of dietary MF on the ovarian function and liver lipid metabolism of aged breeder hens. We used 270 (60‐weeks‐old) Qiling breeder hens randomly assigned in 3 treatments with supplemental dietary MF doses (0, 30, 60 mg/kg). The results showed that dietary MF significantly improved the egg‐laying rate, followed by the reduced feed conversion rate (FCR) (p < 0.05). However, there is no obvious difference in hatchability and fertilised eggs hatchability among the three groups (p > 0.05). The level of T‐CHO, LDL‐C and AKP in serum was reduced, and the HDL‐C concentrations were increased by dietary MF (p < 0.05). MF treatment also improved the antioxidant capacity and reduced the apoptotic index of the ovary (p < 0.05). Additionally, dietary MF significantly increased the serum estradiol (E2) levels (p < 0.05) and the transcription level of CYP19A1 and LHR in the ovary (p < 0.05). Dietary MF enhanced fatty acid β‐oxidation in the liver via up‐regulating the mRNA expressions of PPARα and CPT‐I (p < 0.05). Moreover, the HMF group significantly decreased mRNA expressions of SREBP‐1c (p < 0.05) and increased mRNA expressions of ERα, VTG‐Ⅱ and ApoB in the liver (p < 0.05). In conclusion, dietary MF could improve the reproduction performance of aged breeder hens through improving ovary function and hepatic lipid metabolism.
Sleep duration and mortality, influence of age, retirement, and occupational group
Authors: Åkerstedt Torbjörn , Trolle‐Lagerros Ylva , Widman Linnea , Ye Weimin , Adami Hans‐Olov , Bellocco Rino
Published: November 2021

Previous work has shown that both long and short sleep duration is associated with increased mortality, with lowest risk around 7 hr. This has had widespread impact on views on the optimal sleep duration. However, age, being employed/retired, and blue‐/white‐collar status, may influence the time available for sleep and thus, confound the association. We investigated the role of these factors on the association between sleep duration and mortality. We used employed and retired participants (N = 25,430) from the Swedish National March Cohort and Cox proportional hazards regression to model the shape of the association. We found a significant U‐shaped association in a multivariable model with a hazard ratio (HR) of 1.24 (95% confidence interval [CI] 1.10, 1.39) for <5‐hr sleep duration, and a HR of 1.30 (95% CI 1.12, 1.51) for ≥9‐hr sleep duration, with the lowest HR for 7 hr, but with a span of low HRs from 5 to 8 hr. Unadjusted values showed a pronounced U‐shape. Adjusting for age accounted for most of the attenuation in the multivariable model. Stratification into five age groups showed a significant U‐shape only in those aged >60.3 years at baseline. The shape of the association did not differ between blue‐/white‐collar workers, nor between employed and retired groups. We conclude that the U‐shaped association between sleep duration and mortality is present only in older individuals.
Making meaning of the new identity‐as‐resident: A grounded theory study
Authors: Gautam Sital , Montayre Jed , Neville Stephen
Published: November 2021

Residential living has the potential to threaten older adults' established identity. This study utilized grounded theory methodology to explore how older adults make meaning of the new identity‐as‐resident in a residential aged care facility. Using theoretical sampling, in‐depth semi‐structured interviews and observation within interviews were conducted with 17 residents from two Nepalese residential aged care facilities. Data analysis involved the process of open, axial, selective coding, and constant comparative analysis as specified by grounded theory methodology. The process that older adults experience in making meaning of their new identity‐as‐resident involved phases of isolating, exploring, evaluating, and compromising, which led in consequence to internalization of the new identity. Furthermore, it was found that this process depends on the facility structure, rules and regulations, and the attitudes and practices of nurses/caregivers. A focus on these facilitators is crucial for managers and nurses/caregivers working in residential aged care to assist residents in constructing a positive identity‐as‐resident. The findings can potentially be beneficial for raising awareness, educating nurses/caregivers, developing policies for promoting a positive identity‐as‐resident in residential aged care facilities worldwide.
Engaging consumers and health professionals in collaborative decision‐making to optimize care
Authors: Wu Chiung‐Jung ( Jo) , Giles Megan , Terblanche Morne , Drabble Anne
Published: November 2021

Shared communication and collaborative decision‐making between consumers and health professionals is essential in optimizing the quality of consumer care. However, the consumers' ability to ask questions and seek answers, as well as health professionals' communication skills to engage with the consumer, are necessary considerations for the collaborative decision‐making process. This quality improvement initiative sought to understand the context of collaborative decision making from the perspective of consumers and health professionals adapted from the international Choosing Wisely program. Findings indicated health professionals acknowledged a problem with unnecessary and overuse of tests, treatments, and procedures. Consumers suggested they were confident asking questions about their health and care. The findings of this study highlight collaborative decision‐making as a worthwhile and beneficial undertaking.
Group‐based instant messaging in Finnish residential elder care work: Taming the technology or vice versa?
Authors: Hirvonen Helena , Tammelin Mia , Hämäläinen Antti , Taipale Sakari
Published: November 2021

As new communication technologies become embedded in care work, there is a need to understand how they affect its temporal order. This article analyses group‐based mobile instant messaging (IM) in residential elder care work in Finland. The article asks (i) how care workers use group‐based messaging for work; and (ii) how they negotiate the rules for its use. Theoretically, the article draws on science and technology studies focusing on ‘taming’ and ‘unleashing’ (Pols, 2017), and temporality (Wajcman, 2008). Analysis is based on a qualitative interview study of care workers and nurses (n = 25) conducted in 2018. The results showed how the time‐shifting functionality of IM allows employees to ‘tame the technology’ and unleash effective communication practices. However, IM also increases a risk of boundless accessibility and tames its users, pointing to a growing need for time work to manage their work‐life balance in the complex temporal order of care work.
Phenotype transition of fibroblasts incorporated into patient‐derived oral carcinoma organoids
Authors: Chen Xu , Li Rui , Zhao Hui , Wang Xinmiao , Shao Zhe , Shang Zhengjun
Published: November 2021

Objective

Cancer‐associated fibroblasts (CAFs) are abundantly infiltrated in oral squamous cell carcinoma (OSCC), but the contact‐dependent mechanisms that regulate CAFs phenotype in precursor cells, such as paracancerous fibroblasts (PFs), remain unclear. Here, a fibroblast‐attached organoid (FAO) model was initiated to determine phenotype transition of fibroblasts triggered by contact with OSCC.

Material and methods

Organoids and fibroblasts were generated using OSCC and adjacent tissues. Cell‐clusters containing fibroblasts and tumour cells were aggregated to allow for FAOs expansion. Immunoblotting assay was performed to compare expression of Notch intracellular domain (NICD) in CAFs and PFs. Colony formation assay was employed to evaluate morphological activation of fibroblasts.

Results

Compared to traditional 3D co‐culture, FAOs better modulated the spatial distribution of fibroblasts with tumour nests. The presence of CAFs with multiple branches was stably observed in FAOs during serial passage. Incorporation with organoids promoted the ability of PFs to form multiple branches. Immunoblotting assay confirmed higher NICD level in CAFs than PFs. Treatment with Notch inhibitor, N‐[N‐(3, 5‐difluorophenacetyl)‐l‐alanyl]‐S‐phenylglycine t‐butyl ester (i.e. DAPT) blocked morphological activation of fibroblasts incorporated into FAO.

Conclusion

We developed a robust strategy to study contact‐dependent mechanisms underlying tumour‐stromal interaction, and suggested that Notch activity contributes to biogenesis of OSCC‐associated fibroblasts.
Going around in circles. Is there a continuing need to use the T‐piece circuit in the practice of pediatric anesthesia?
Authors: Arnold Philip , Kaufmann Jost
Published: November 2021

Anesthetic equipment, including breathing circuits, has evolved over time. The T‐piece circuit, in its various forms, was designed to meet the needs of its time. As equipment and techniques have moved on, it is timely to consider the place of the T‐piece in modern pediatric anesthetic practice. Today the circle system is a ubiquitous part of anesthesia. When integrated with a modern anesthetic machine it offers precise control of ventilation together with continuous monitoring of airway pressure and flow: but at the cost of complexity. In comparison the T‐piece offers a simple cheap lightweight design, so ergonomic in use that it almost becomes part of the anesthetist: but lacks the control and the barriers to unsafe use of more sophisticated systems. In addition, it requires high fresh gas flow adding to cost and environmental pollution. This pro‐con debate discusses whether there remains a case for continuing to use the T‐piece circuit in preference over other options. Possible indications for the T‐Piece are discussed together with alternative strategies. The limitations of the circle system, the T‐piece, and other alternative (such as self‐inflating resuscitator bag) are discussed with respect to pediatric anesthetic practice.
Extracorporeal membrane oxygenation as rescue therapy in a pediatric liver transplant recipient with very severe hepatopulmonary syndrome
Authors: Huang Joy , Yoeli Dor , Sundaram Shikha S , Carpenter Todd , Annam Aparna , Pahlavan Sheila , Wachs Michael , Adams Megan A.
Published: November 2021

Background

In children with cirrhosis, the prevalence of HPS ranges from 3% to 20%, resulting in impaired gas exchange due to alterations in pulmonary microvasculature. LT is the gold‐standard cure for cirrhosis complicated by HPS and should ideally be performed prior to the development of severe HPS due to increased risk for post‐transplant hypoxia, right heart failure, and outflow obstruction.

Methods

We present a case of a 13‐year‐old man, who underwent pediatric LT for severe HPS complicated by postoperative respiratory collapse, requiring a 92‐day course of veno‐venous ECMO.

Results

Post‐transplant, despite BiPAP, inhaled nitric oxide and isoproterenol infusion, he remained hypoxic postoperatively and acutely decompensated on postoperative day 25, requiring veno‐venous ECMO. After 84 days on ECMO, a persistent large splenorenal shunt was identified that was embolized by interventional radiology, and 8 days after shunt embolization and ASD closure, he was successfully weaned off ECMO.

Conclusions

This case describes the longest known duration of ECMO in a pediatric LT recipient and a unique improvement in hypoxemia following a portosystemic shunt closure. ECMO presents a heroic rescue measure for pediatric LT recipients with HPS that develops acute respiratory failure postoperatively refractory to alternative measures.
Flower morphology and plant–bee pollinator interactions are related to stamen dimorphism in Melastomataceae
Authors: Valadão‐Mendes L. B. , Rocha I. , Meireles D. A. L. , Leite F. B. , Sazima M. , Maruyama P. K. , Brito V. L. G.
Published: November 2021

Approximately 20,000 species of flowering plant offer mainly pollen to their pollinators, generally bees. Stamen dimorphism, a floral trait commonly present in some pollen flowers, is thought to be associated with exclusive pollen provision for highly effective bee pollinators. Notwithstanding, little is known about how stamen dimorphism is related to other floral morphological traits and, consequently, plant–pollinator interactions at the community scale. Here we investigated the relationship between stamen dimorphism and other floral morphological traits, as well as the interactions with pollinators in plants of Melastomataceae.

We characterized each plant species as stamen dimorphic or stamen isomorphic according to differences in size and shape between stamen sets. Data on interactions between the plants and their bee pollinators were analysed as quantitative bipartite networks.

We found that petal and style size and shape were correlated to stamen dimorphism. Stamen dimorphic species present larger flowers and less variable style shapes than stamen isomorphic species. Furthermore, stamen dimorphism is associated with higher richness of visiting bees, i.e. higher ecological generalization.

During the evolutionary history of Melastomataceae, the dependence on pollinators for fruit set has possibly favoured the evolution of larger flowers with dimorphic stamens, which in turn are able to make use of a larger spectrum of pollen‐collecting bees, leading to ecological generalization.
When Blockchain Creates Shareholder Value: Empirical Evidence from International Firm Announcements
Authors: Klöckner Maximilian , Schmidt Christoph G. , Wagner Stephan M.
Published: November 2021

Blockchain is a prominently discussed technology in operations and supply chain management and firms increasingly engage in blockchain initiatives. Yet, an understanding of the technology's financial value remains elusive. Based on 175 firm announcements between 2015 and 2019, we conduct an international event study to estimate the impact of blockchain initiatives on the market value of the firm. We empirically demonstrate that blockchain announcements are associated with a significant average abnormal return of 0.30% on the announcement day, and that there are indications of positive long‐term effects on shareholder value. We further demonstrate how blockchain use case, project, and firm characteristics affect the stock market reaction. Specifically, we find that the stock market reaction to blockchain announcements is less positive when blockchain is used to trace physical objects or to share sensitive data, providing empirical evidence for the risk associated with current challenges in the design of blockchain use cases. Our results also suggest that the involvement of an external information technology service provider in a blockchain project attenuates the positive stock market reaction. Interestingly, more innovative firms do not experience a stronger stock market reaction to blockchain announcements. Leveraging the international scope of our sample, we further shed light on how the firm's competitive (i.e., industry factors) and macro environment (i.e., country factors) affect the stock market reaction. Our findings indicate that the industry's R&D intensity and the country's data restriction level play a crucial role in driving the value attributed to blockchain initiatives.