bluuebunny/crossref_metadata_2025 huggingface dataset:
M dwarf stars in the b294 field from the VISTA Variables in the Vía Láctea (VVV)
Authors: Cruz Patricia , Cortés-Contreras Miriam , Solano Enrique , Rodrigo Carlos , Minniti Dante , Alonso-García Javier , Saito Roberto K
Published: February 2023

M dwarf stars are the dominant stellar population in the Milky Way, and they are important for a wide variety of astrophysical topics. The Gaia mission has delivered a superb collection of data, nevertheless, ground-based photometric surveys are still needed to study faint objects. Therefore, the present work aims to identify and characterize M dwarf stars in the direction of the Galactic bulge using photometric data and with the help of Virtual Observatory tools. Using parallax measurements and proper motions from Gaia Data Release 3, in addition to different colour-cuts based on VISTA filters, we identify and characterize 7 925 M dwarf stars in the b294 field from the Vista Variables in the Vía Láctea (VVV) survey. We performed a spectral energy distribution fitting to obtain the effective temperature for all objects using photometric information available at Virtual Observatory archives. The objects in our sample have temperatures varying from 2800–3900 K. We also search for periodic signals in VVV light curves with up to 300 epochs, approximately. As a secondary outcome, we obtain periods for 82 M dwarfs by applying two methods: the Lomb–Scargle and Phase Dispersion Minimization methods, independently. These objects, with periods ranging from 0.14–34 d, are good candidates for future ground-based follow up. Our sample has increased significantly the number of known M dwarfs in the direction of the Galactic bulge and within 500 pc, showing the importance of ground-based photometric surveys in the near-infrared.
A study of nine compact triply eclipsing triples
Authors: Rappaport S A , Borkovits T , Gagliano R , Jacobs T L , Tokovinin A , Mitnyan T , Komžík R , Kostov V B , Powell B P , Torres G , Terentev I , Omohundro M , Pribulla T , Vanderburg A , Kristiansen M H , Latham D , Schwengeler H M , LaCourse D , Bíró I B , Csányi I , Czavalinga D R , Garai Z , Pál A , Rodriguez J E , Stevens D J
Published: February 2023

In this work, we report the independent discovery and analysis of nine new compact triply eclipsing triple star systems found with the Transiting Exoplanet Survey Satellite (TESS) mission: TICs 47151245, 81525800, 99013269, 229785001, 276162169, 280883908, 294803663, 332521671, and 356324779. Each of these nine systems exhibits distinct third-body eclipses where the third (‘tertiary’) star occults the inner eclipsing binary (EB), or vice versa. We utilize a photodynamical analysis of the TESS photometry, archival photometric data, TESS eclipse timing variations of the EBs, available archival spectral energy distribution (SED) curves, and, in some cases, newly acquired radial velocity observations, to solve for the parameters of all three stars, as well as most of the orbital elements. From these analyses we find that the outer orbits of all nine systems are viewed nearly edge on (i.e. within ≲4°), and six of the systems are coplanar to within 5°; the others have mutual inclination angles of 20°, 41°, and possibly 179° (i.e. a retrograde outer orbit). The outer orbital periods range from 47.8 to 604 d, with eccentricities spanning 0.004–0.61. The masses of all 18 EB stars are in the range of 0.9–2.6 M⊙ and are mostly situated near the main sequence. By contrast, the masses and radii of the tertiary stars range from 1.4 to 2.8 M⊙ and 1.5 to 13 R⊙, respectively. We make use of the system parameters from these nine systems, plus those from a comparable number of compact triply eclipsing triples published previously, to gain some statistical insight into their properties.
Mining mini-halos with MeerKAT I. Calibration and imaging
Authors: Trehaeven K S , Parekh V , Oozeer N , Hugo B , Smirnov O , Bernardi G , Knowles K , Tasse C , Asad K M B , Giacintucci S
Published: February 2023

Radio mini-halos are clouds of diffuse, low-surface brightness synchrotron emission that surround the Brightest Cluster Galaxy (BCG) in massive cool-core galaxy clusters. In this paper, we use third generation calibration (3GC), also called direction-dependent (DD) calibration, and point source subtraction on MeerKAT extragalactic continuum data. We calibrate and image archival MeerKAT L-band observations of a sample of five galaxy clusters (ACO 1413, ACO 1795, ACO 3444, MACS J1115.8+0129, MACS J2140.2-2339). We use the CARACal pipeline for direction-independent (DI) calibration, DDFacet and killMS for 3GC, followed by visibility-plane point source subtraction to image the underlying mini-halo without bias from any embedded sources. Our 3GC process shows a drastic improvement in artefact removal, to the extent that the local noise around severely affected sources was halved and ultimately resulted in a 7 per cent improvement in global image noise. Thereafter, using these spectrally deconvolved Stokes I continuum images, we directly measure for four mini-halos the flux density, radio power, size, and in-band integrated spectra. Further to that, we show the in-band spectral index maps of the mini-halo (with point sources). We present a new mini-halo detection hosted by MACS J2140.2-2339, having flux density $S_{\rm 1.28\, GHz} = 2.61 \pm 0.31$ mJy, average diameter 296 kpc, and $\alpha ^{\rm 1.5\, GHz}_{\rm 1\, GHz} = 1.21 \pm 0.36$. We also found a ∼100 kpc southern extension to the ACO 3444 mini-halo which was not detected in previous VLA L-band observations. Our description of MeerKAT wide-field, wide-band data reduction will be instructive for conducting further mini-halo science.
Genomic Underpinnings of Population Persistence in Isle Royale Moose
Authors: Kyriazis Christopher C , Beichman Annabel C , Brzeski Kristin E , Hoy Sarah R , Peterson Rolf O , Vucetich John A , Vucetich Leah M , Lohmueller Kirk E , Wayne Robert K
Published: February 2023

Island ecosystems provide natural laboratories to assess the impacts of isolation on population persistence. However, most studies of persistence have focused on a single species, without comparisons to other organisms they interact with in the ecosystem. The case study of moose and gray wolves on Isle Royale allows for a direct contrast of genetic variation in isolated populations that have experienced dramatically differing population trajectories over the past decade. Whereas the Isle Royale wolf population recently declined nearly to extinction due to severe inbreeding depression, the moose population has thrived and continues to persist, despite having low genetic diversity and being isolated for ∼120 years. Here, we examine the patterns of genomic variation underlying the continued persistence of the Isle Royale moose population. We document high levels of inbreeding in the population, roughly as high as the wolf population at the time of its decline. However, inbreeding in the moose population manifests in the form of intermediate-length runs of homozygosity suggestive of historical inbreeding and purging, contrasting with the long runs of homozygosity observed in the smaller wolf population. Using simulations, we confirm that substantial purging has likely occurred in the moose population. However, we also document notable increases in genetic load, which could eventually threaten population viability over the long term. Overall, our results demonstrate a complex relationship between inbreeding, genetic diversity, and population viability that highlights the use of genomic datasets and computational simulation tools for understanding the factors enabling persistence in isolated populations.
P-TEFb promotes cell survival upon p53 activation by suppressing intrinsic apoptosis pathway
Authors: Wang Zhijia , Mačáková Monika , Bugai Andrii , Kuznetsov Sergey G , Hassinen Antti , Lenasi Tina , Potdar Swapnil , Friedel Caroline C , Barborič Matjaž
Published: February 2023

Positive transcription elongation factor b (P-TEFb) is the crucial player in RNA polymerase II (Pol II) pause release that has emerged as a promising target in cancer. Because single-agent therapy may fail to deliver durable clinical response, targeting of P-TEFb shall benefit when deployed as a combination therapy. We screened a comprehensive oncology library and identified clinically relevant antimetabolites and Mouse double minute 2 homolog (MDM2) inhibitors as top compounds eliciting p53-dependent death of colorectal cancer cells in synergy with selective inhibitors of P-TEFb. While the targeting of P-TEFb augments apoptosis by anti-metabolite 5-fluorouracil, it switches the fate of cancer cells by the non-genotoxic MDM2 inhibitor Nutlin-3a from cell-cycle arrest to apoptosis. Mechanistically, the fate switching is enabled by the induction of p53-dependent pro-apoptotic genes and repression of P-TEFb-dependent pro-survival genes of the PI3K-AKT signaling cascade, which stimulates caspase 9 and intrinsic apoptosis pathway in BAX/BAK-dependent manner. Finally, combination treatments trigger apoptosis of cancer cell spheroids. Together, co-targeting of P-TEFb and suppressors of intrinsic apoptosis could become a viable strategy to eliminate cancer cells.
Simultaneous inhibition of endocytic recycling and lysosomal fusion sensitizes cells and tissues to oligonucleotide therapeutics
Authors: Finicle Brendan T , Eckenstein Kazumi H , Revenko Alexey S , Anderson Brooke A , Wan W Brad , McCracken Alison N , Gil Daniel , Fruman David A , Hanessian Stephen , Seth Punit P , Edinger Aimee L
Published: February 2023

Inefficient endosomal escape remains the primary barrier to the broad application of oligonucleotide therapeutics. Liver uptake after systemic administration is sufficiently robust that a therapeutic effect can be achieved but targeting extrahepatic tissues remains challenging. Prior attempts to improve oligonucleotide activity using small molecules that increase the leakiness of endosomes have failed due to unacceptable toxicity. Here, we show that the well-tolerated and orally bioavailable synthetic sphingolipid analog, SH-BC-893, increases the activity of antisense oligonucleotides (ASOs) and small interfering RNAs (siRNAs) up to 200-fold in vitro without permeabilizing endosomes. SH-BC-893 treatment trapped endocytosed oligonucleotides within extra-lysosomal compartments thought to be more permeable due to frequent membrane fission and fusion events. Simultaneous disruption of ARF6-dependent endocytic recycling and PIKfyve-dependent lysosomal fusion was necessary and sufficient for SH-BC-893 to increase non-lysosomal oligonucleotide levels and enhance their activity. In mice, oral administration of SH-BC-893 increased ASO potency in the liver by 15-fold without toxicity. More importantly, SH-BC-893 enabled target RNA knockdown in the CNS and lungs of mice treated subcutaneously with cholesterol-functionalized duplexed oligonucleotides or unmodified ASOs, respectively. Together, these results establish the feasibility of using a small molecule that disrupts endolysosomal trafficking to improve the activity of oligonucleotides in extrahepatic tissues.
Species-specific regulation ofXISTby theJPX/FTXorthologs
Authors: Rosspopoff Olga , Cazottes Emmanuel , Huret Christophe , Loda Agnese , Collier Amanda J , Casanova Miguel , Rugg-Gunn Peter J , Heard Edith , Ouimette Jean-François , Rougeulle Claire
Published: February 2023

X chromosome inactivation (XCI) is an essential process, yet it initiates with remarkable diversity in various mammalian species. XIST, the main trigger of XCI, is controlled in the mouse by an interplay of lncRNA genes (LRGs), some of which evolved concomitantly to XIST and have orthologues across all placental mammals. Here, we addressed the functional conservation of human orthologues of two such LRGs, FTX and JPX. By combining analysis of single-cell RNA-seq data from early human embryogenesis with various functional assays in matched human and mouse pluripotent stem- or differentiated post-XCI cells, we demonstrate major functional differences for these orthologues between species, independently of primary sequence conservation. While the function of FTX is not conserved in humans, JPX stands as a major regulator of XIST expression in both species. However, we show that different entities of JPX control the production of XIST at various steps depending on the species. Altogether, our study highlights the functional versatility of LRGs across evolution, and reveals that functional conservation of orthologous LRGs may involve diversified mechanisms of action. These findings represent a striking example of how the evolvability of LRGs can provide adaptative flexibility to constrained gene regulatory networks.
Activatable G-quadruplex based catalases for signal transduction in biosensing
Authors: Iwaniuk Elzbieta E , Adebayo Thuwebat , Coleman Seth , Villaros Caitlin G , Nesterova Irina V
Published: February 2023

Discovery of oxidative catalysis with G-quadruplex•hemin constructs prompted a range of exciting developments in the field of biosensor design. Thus, G-quadruplex based DNAzymes with peroxidase activity found a niche as signal transduction modules in a wide range of analytical applications. The ability of nucleic acid scaffolds to recognise a variety of practically meaningful markers and to translate the recognition events into conformational changes powers numerous sensor design possibilities. In this work, we establish a catalase activity of G-quadruplex•hemin scaffolds. Catalase activated hydrogen peroxide decomposition generates molecular oxygen that forms bubbles. Observation of bubbles is a truly equipment free signal readout platform that is highly desirable in limited resources or do-it-yourself environments. We take a preliminary insight into a G-quadruplex structure—folding topology—catalase activity correlation and establish efficient operating conditions. Further, we demonstrate the platform's potential as a signal transduction modality for reporting on biomolecular recognition using an oligonucleotide as a proof—of—concept target. Ultimately, activatable catalases based on G-quadruplex•hemin scaffolds promise to become valuable contributors towards accessible molecular diagnostics applications.
Nanopore sequencing for N1-methylpseudouridine in RNA reveals sequence-dependent discrimination of the modified nucleotide triphosphate during transcription
Authors: Fleming Aaron M , Burrows Cynthia J
Published: February 2023

Direct RNA sequencing with a commercial nanopore platform was used to sequence RNA containing uridine (U), pseudouridine (Ψ) or N1-methylpseudouridine (m1Ψ) in >100 different 5-nucleotide contexts. The base calling data for Ψ or m1Ψ were similar but different from U allowing their detection. Understanding the nanopore signatures for Ψ and m1Ψ enabled a running start T7 RNA polymerase assay to study the selection of UTP versus ΨTP or m1ΨTP competing mixtures in all possible adjacent sequence contexts. A significant sequence context dependency was observed for T7 RNA polymerase with insertion yields for ΨTP versus UTP spanning a range of 20–65%, and m1ΨTP versus UTP producing variable yields that differ by 15–70%. Experiments with SP6 RNA polymerase, as well as chemically-modified triphosphates and DNA templates provide insight to explain the observations. The SP6 polymerase introduced m1ΨTP when competed with UTP with a smaller window of yields (15–30%) across all sequence contexts studied. These results may aid in future efforts that employ RNA polymerases to make therapeutic mRNAs with sub-stoichiometric amounts of m1Ψ.
DIS3L2 ribonuclease degrades terminal-uridylated RNA to ensure oocyte maturation and female fertility
Authors: Wu Di , Pedroza Monique , Chang Jonathan , Dean Jurrien
Published: February 2023

During oocyte development in mice, transcripts accumulate in the growth phase and are subsequently degraded during maturation. At the transition point between growth and maturation, oocytes have an intact nucleus or germinal vesicle (GV), and terminal uridylation labels RNA for degradation in meiosis I. By profiling the transcriptome using single-oocyte long-read PacBio RNA sequencing, we document that a small cohort of mRNAs are polyadenylated after terminal uridylation in GV oocytes [designated uridylated-poly(A) RNA]. Because DIS3L2 ribonuclease is known to degrade uridylated transcripts, we established oocyte-specific Dis3l2 knockout mice (Dis3l2cKO). Upon DIS3L2 depletion, uridylated-poly(A) RNAs remain intact which increases their abundance, and they predominate in the transcriptome of Dis3l2cKO oocytes. The abundance of uridylated-poly(A) RNA in Dis3l2cKO oocytes arises not only from insufficient degradation, but also from the stabilizing effect of subsequent polyadenylation. Uridylated-poly(A) RNAs have shorter poly(A) tails and their translation activity decreases in Dis3l2cKO oocytes. Almost all Dis3l2cKO oocytes arrest at the GV stage, and female mice are infertile. Our study demonstrates multiple fates for RNA after terminal uridylation and highlights the role of DIS3L2 ribonuclease in safeguarding the transcriptome and ensuring female fertility.
Identifying the economic determinants of individual voting behaviour in UK general elections
Authors: Chrysanthou Georgios Marios , Guilló María Dolores
Published: February 2023

We explore the economic determinants of individual voting behaviour in five UK electoral cycles during 1992–2014. Using the Understanding Society and the British Household Panel Surveys, we investigate the importance of political sentiments and subjective economic evaluations disentangling persistence of party support and unobserved heterogeneity effects. We estimate joint dynamic tripartite models of party support and egocentric perceptions of current and prospective finances, permitting longitudinal simultaneous determination of perceptions of personal finances and political preferences. The results validate the economic voting hypothesis in cycles adjacent to economic downturns: support for the governing political party is positively related to individual perceptions of own financial well-being. Failing to account for simultaneity and not accounting for dynamics and initial political party support inflate the impact of personal financial evaluations.
In vivo protein kinase activity of SnRK1 fluctuates in Arabidopsis rosettes during light-dark cycles
Authors: Avidan Omri , Moraes Thiago A , Mengin Virginie , Feil Regina , Rolland Filip , Stitt Mark , Lunn John E
Published: February 2023

Sucrose-nonfermenting 1 (SNF1)–related kinase 1 (SnRK1) is a central hub in carbon and energy signaling in plants, and is orthologous with SNF1 in yeast and the AMP-activated protein kinase (AMPK) in animals. Previous studies of SnRK1 relied on in vitro activity assays or monitoring of putative marker gene expression. Neither approach gives unambiguous information about in vivo SnRK1 activity. We have monitored in vivo SnRK1 activity using Arabidopsis (Arabidopsis thaliana) reporter lines that express a chimeric polypeptide with an SNF1/SnRK1/AMPK-specific phosphorylation site. We investigated responses during an equinoctial diel cycle and after perturbing this cycle. As expected, in vivo SnRK1 activity rose toward the end of the night and rose even further when the night was extended. Unexpectedly, although sugars rose after dawn, SnRK1 activity did not decline until about 12 h into the light period. The sucrose signal metabolite, trehalose 6-phosphate (Tre6P), has been shown to inhibit SnRK1 in vitro. We introduced the SnRK1 reporter into lines that harbored an inducible trehalose-6-phosphate synthase construct. Elevated Tre6P decreased in vivo SnRK1 activity in the light period, but not at the end of the night. Reporter polypeptide phosphorylation was sometimes negatively correlated with Tre6P, but a stronger and more widespread negative correlation was observed with glucose-6-phosphate. We propose that SnRK1 operates within a network that controls carbon utilization and maintains diel sugar homeostasis, that SnRK1 activity is regulated in a context-dependent manner by Tre6P, probably interacting with further inputs including hexose phosphates and the circadian clock, and that SnRK1 signaling is modulated by factors that act downstream of SnRK1.
ON LIVING THE TESTIMONIAL SCEPTIC’S LIFE: CAN TESTIMONIAL SCEPTICISM BE DISMISSED?
Authors: Keren Arnon
Published: February 2023

Within the contemporary epistemology of testimony, it is widely assumed that testimonial scepticism can be dismissed without engaging with possible reasons or arguments supporting the view. This assumption of dismissibility both underlies the debate between reductionist and non-reductionist views of testimony and is responsible for the neglect of testimonial scepticism within contemporary epistemology. This paper argues that even given liberal assumptions about what may constitute valid grounds for the dismissal of a sceptical view, the assumption that testimonial scepticism is dismissible should be rejected. For even if familiar sceptical positions and scepticism about testimonial justification can be dismissed on such grounds, scepticism about testimonial knowledge cannot.
Establishment of coverage-mass equation to quantify the corrosion inhomogeneity and examination of medium effects on iron corrosion
Authors: Li Xin , Ding Jiandong
Published: February 2023

Metal corrosion is important in the fields of biomedicine as well as construction and transportation etc. While most corrosion occurs inhomogeneously, there is so far no satisfactory parameter to characterize corrosion inhomogeneity. Herein, we employ the Poisson raindrop question to model the corrosion process and derive an equation to relate corrosion coverage and corrosion mass. The resultant equation is named coverage-mass equation, abbreviated as C-M equation. We also suggest corrosion mass at 50% coverage, termed as half-coverage mass Mcorro50%, as an inhomogeneity parameter to quantify corrosion inhomogeneity. The equation is confirmed and the half-coverage mass Mcorro50% is justified in our experiments of iron corrosion in five aqueous media, normal saline, phosphate-buffered saline, Hank’s solution, deionized water and artificial seawater, where the former three ones are biomimetic and very important in studies of biomedical materials. The half-coverage mass Mcorro50% is proved to be more comprehensive and mathematically convergent than the traditional pitting factor. Iron corrosion is detected using visual observation, scanning electron microscopy with a build-in energy dispersive spectrometer, inductive coupled plasma emission spectrometry and electrochemical measurements. Both rates and inhomogeneity extents of iron corrosion are compared among the five aqueous media. The factors underlying the medium effects on corrosion rate and inhomogeneity are discussed and interpreted. Corrosion rates of iron in the five media differ about 7-fold, and half-coverage mass values differ about 300 000-fold. The fastest corrosion and the most significant inhomogeneity occur both in biomimetic media, but not the same one. The new equation (C-M equation) and the new quantity (half-coverage mass) are stimulating for dealing with a dynamic and stochastic process with global inhomogeneity including but not limited to metal corrosion. The findings are particularly meaningful for research and development of next-generation biodegradable materials.
Central Bank Balance Sheet Policies Without Rational Expectations
Authors: Iovino Luigi , Sergeyev Dmitriy
Published: February 2023

We study the effects of central bank balance sheet policies—namely, quantitative easing and foreign exchange interventions—in a model where people form expectations through an iterative level-k thinking process. We emphasize two main theoretical results. First, under a broad set of conditions, central bank interventions are effective under level-k thinking, while they are neutral in the rational expectations equilibrium. Second, when preferences exhibit constant relative risk aversion, asset purchases increase aggregate output if they target assets with pro-cyclical returns but reduce it if asset returns are counter-cyclical. Finally, we empirically show that forecast errors about future asset prices are predictable by balance sheet interventions, a property that differentiates our channel from popular alternatives, such as portfolio-balance and signaling channels.
DELTA AIR LINES, INC v ONTRO LTD
Authors:   Appointed Person (Trade Marks)
Published: February 2023

H1 Trade marks—Opposition proceedings—Device marks—SKYCLUB—Pleadings—Inadequacy of counterstatement—Applications to amend—Amendment on appeal—Comparison of goods and services—Interpretation of the word “featuring”—Whether air transportation services similar to in-flight magazines, loyalty schemes, chauffeur services, storage and collection of luggage and arrangement of meals for travellers—Likelihood of confusion—Applications to stay pending EUIPO proceedings—Appeal to Appointed Person
Ethical Practice in a Post-RoeWorld: A Guide for Social Workers
Authors: Reamer Frederic G
Published: February 2023

On June 24, 2022, the U.S. Supreme Court voted to overturn Roe v. Wade, concluding that the Constitution of the United States does not confer a right to abortion. The court’s decision in Dobbs immediately introduced challenging ethical issues for social workers who serve people who become pregnant. Key questions concern social workers’ ability to protect clients’ privacy and confidentiality, documentation protocols, and client abandonment. In addition, social workers must be concerned about the possibility that they are at risk of being named in licensing board and ethics complaints, lawsuits, and criminal court indictments because of their work with people who seek abortion-related information and services. The purpose of this article is to provide an overview of the Dobbs decision; discuss compelling ethical issues facing social workers who work with people who seek reproductive health information and services; present guidelines to assist social workers who face ethical dilemmas related to reproductive health services; and highlight the critical importance of ethics-informed social work advocacy related to reproductive health.
Assessing Color-Blind Racism in Nursing Students
Authors: Ramsay-Seaner Kristine , Letcher Amber , Isaacson Mary J. , Fenster Kathryn , Heckmann Benjamin
Published: February 2023

The nursing workforce does not mirror the demographics of the United States, contributing to health disparities related to race. The purpose of this study was to assess possible changes in racial bias among undergraduate nursing students. Students in their first (n = 58) or fifth (n = 50) semester completed the Color-Blind Racial Attitudes Scale via an online survey. Fifth-semester students reported significantly more racial bias than first-semester students. Further investigation revealed more influence of students’ race: White students indicated greater color-blind attitudes than students of color. Recommendations for integrating multicultural curricula into nursing programs are included.
From Relational Uncertainty to Interpersonal Sensitivity
Authors: Rojas Reyes Jennifer , Arias-Rojas Mauricio
Published: February 2023

AIM

The aim of our study was to understand how nursing students develop interpersonal competencies during a faculty-supervised practicum.

BACKGROUND

Researchers have studied the interpersonal competencies of nursing students in a fragmented way.

METHOD

A constructivist grounded theory approach was used for the study.

RESULTS

Four categories emerged from the data: Coping With Practicum-Related Challenges and Insecurities, Learning to Identify the Interpersonal Dimension of Nursing Care, Pedagogical Influence: Promoting (De)constructive Processes for Learning and Care, and Transforming the Self as a Nurse Through Interpersonal Relationships. A core category, From Relational Uncertainty to Interpersonal Sensitivity: A Transition of the Nursing Self Within Reflective Environments of Practice, also emerged.

CONCLUSION

The interpersonal competencies of nursing students develop in reflective environments within practicums because of interactions with patients and under the influence and modeling of the educator. Acknowledging the importance of interactions with the educator and patients within practicums can contribute to promoting more thoughtful follow-up processes from educators.
Development of Nurse Practitioner Student Self-Perception of Clinical Reasoning and Diagnostic Ability
Authors: Cantero Deborah , Comer Linda , Radecki Melissa
Published: February 2023

Nurse practitioner faculty identified student struggles to gain diagnostic reasoning competence. The National Council of State Boards of Nursing developed a clinical judgment action model (CJAM) for the NCLEX (NextGen) that can be used in prelicensure nursing education to design educational interventions and has potential applicability toward diagnostic reasoning development in nurse practitioner students. The purpose of this project was to evaluate the impact of a didactic education intervention aligned with the CJAM on the development of clinical reasoning cognitive skills. The use of the CJAM demonstrated a positive outcome among nurse practitioner students in clinical reasoning development.
Effect of Telerehabilitation Versus In-Clinic Rehabilitation Delivery on Self-Efficacy in Breast Cancer–Related Lymphedema
Authors: Helm Erin E. , Crowley Brenda , Crowell Tara L. , Galantino Mary Lou
Published: February 2023

Background:

Individuals with breast cancer–related lymphedema (BCRL) require self-management strategies to reduce risk of infection, exacerbation, and/or progression of lymphedema. The coronavirus pandemic thrust the medical field into the world of telehealth; both patients and providers were forced to reduce in-person treatments and engage in this new platform of rehabilitation delivery. The role of telehealth in promotion of self-management for BCRL is unknown.

Purpose:

This study examines self-efficacy during cancer rehabilitation for in-clinic versus telehealth visits among individuals with BCRL during the pandemic quarantine April to November 2020.

Methods:

Forty women who recently completed oncology rehabilitation for BCRL were asked to complete demographics and 2 Likert surveys, including the Exercise Self-Efficacy Scale (ESES) and the Self-Care Self-Efficacy Scale (SCSE), to compare the efficacy of telehealth versus in-person treatment modalities.

Results:

Thirty-two participants completed the survey and indicated that the percentage of telehealth visits was less than face-to-face visits. Despite this, the participants indicated numerous positive moderately strong correlations between self-care self-efficacy and exercise self-efficacy for both types of visits (P < .05).

Limitations:

Self-report surveys by a convenience sample, multifactorial characteristics of rehabilitation treatment across modes, and varying severity of lymphedema may limit study findings.

Conclusion:

Telehealth provided safe and effective care to participants and bolstered confidence in self-care and self-management of BCRL. Data support that telehealth visits can be considered an essential part of comprehensive cancer rehabilitation care. Future research is needed to establish and optimize practice guidelines in both health delivery systems.
Development and Validation of a Novel Instrument to Measure the Community Well-Being of Residency Programs
Authors: Vermette David , Reardon Juliann L. , Israel Hayley P. , Zhen Shirley , Windish Donna M. , White Marney A.
Published: February 2023

Purpose

To develop and validate the Residency Community Well-Being (RCWB) instrument, a novel instrument to measure the subjective community well-being of an individual residency program, and to explore differences in RCWB scores between demographic groups.

Method

An initial questionnaire to measure a residency program’s community well-being was developed after literature review. Items were pilot tested, and the questionnaire was reviewed by experts in the fields of residency education, survey design, and sociology. The questionnaire was administered electronically between March and July 2021 to U.S. residents in 18 specialties recruited through convenience and snowball sampling using social media, a listserv, and personal emails to residency program leaders. Three previously validated instruments were administered as well to examine criterion validity: the Professional Fulfillment Index, the Brief Inventory of Thriving, and a single-item burnout measure. Data were analyzed with descriptive statistics, and exploratory factor analysis was performed using principal axis factoring with direct oblimin rotation to reduce the items and identify subscales.

Results

Of the 366 participants who opened and started the survey, 219 completed it (completion rate: 59.8%). Most respondents were women (133, 60.7%), 26–30 years old (132, 60.3%), and White (149, 68.0%). Three subscales emerged with 18 items: program leadership, structures, and practices (PLSP); resident interpersonal relationships (RIR); and resident mistreatment (RM). The Cronbach’s alphas were 0.96 for PLSP, 0.92 for RIR, 0.82 for RM, and 0.95 for the overall RCWB. RCWB score positively correlated with professional fulfillment (r = .52, P < .001) and thriving (r = .45, P < .001) and inversely correlated with burnout (r = −.39, P < .001).

Conclusions

The RCWB instrument demonstrates strong internal consistency and content and criterion validity that shows that a residency program’s subjective community well-being is primarily composed of program leadership quality, supportive interpersonal relationships, and the absence of mistreatment.
Is a Patient Blood Management programme economically reasonable?
Authors: Hof Lotta , Choorapoikayil Suma , Meybohm Patrick , Zacharowski Kai
Published: February 2023

Purpose of review

The value of healthcare is defined as the achieved health outcome in relation to the incurred costs. Patient Blood Management (PBM) is a multidisciplinary, evidence-based and patient-centred concept to optimize the patient's red blood cell mass, minimize blood loss and bleeding and secure the physiological reserve, including the promotion of evidence-based transfusion strategies. This review describes the healthcare value and cost effectiveness of individual PBM measures as well as the implementation of comprehensive PBM programmes.

Recent findings

Overall, measures improving surgical outcome and reducing hospital length of stay, such as intravenous iron supplementation in iron deficient anaemic patients, use of antifibrinolytic agents for the treatment of bleeding, use of cell salvage, restrictive transfusion strategy, are associated with cost savings.

Although several individual PBM measures have been shown to be effective and cost-efficient, it remains challenging to compare the results among differing healthcare systems.
Cannabis Use Disorder Treatment Preferences: A Pilot Survey in Current Users of Cannabis
Authors: Lile Joshua A. , Turner Brian W. , Cox David H. , Bonn-Miller Marcel O. , Katz Ned R. , Shellenberg Thomas P. , Stoops William W. , Strickland Justin C.
Published: February 2023

Objectives

Highly effective treatments for cannabis use disorder (CUD) are lacking, and patient preferences have not been considered during treatment development. We therefore conducted an exploratory crowdsourced survey of individuals reporting current cannabis use and a willingness to cut down or quit their cannabis use, to determine their interest in various treatment aspects.

Methods

Subjects (n = 63) were queried about their willingness to take medications as a function of type, route, and regimen and to participate in adherence monitoring. Subjects were also asked about their willingness to engage in behavioral/psychosocial interventions as a function of type, setting, and duration. Measures theorized to be associated with treatment preferences were also collected, including cannabis use variables, readiness to change, reduction or cessation goal, perceived cessation barriers, and medication use beliefs and behaviors.

Results

Survey responses indicated that efforts to develop CUD medications should focus on nonsynthetic compounds administered orally or by mouth spray no more than once per day to maximize patient acceptance. Remote adherence monitoring and one-on-one outpatient behavioral treatment approaches, especially contingency management, are also anticipated to enhance participation. Most subjects indicated a preference to reduce their cannabis use rather than quit.

Conclusions

These data provide guidance for the development of CUD interventions based on the preferences of individuals interested in treatment for their cannabis use. Additional research is needed to confirm these results in a larger sample and determine if matching CUD patients with their preferred treatments improves success rates.
Individuals Reporting Past 3-month Smoked Stimulant Use Are Placed at Risk for Infection and Injury Amid COVID-19
Authors: Applewhite Dinah , Regan Susan , Mackin Sarah , Schmidt Clare , Duffy Jim , Washington Kenneth , Micklos Nathaneal , Casey Sarah , Sawyer Samantha , Kehoe Laura , Howard Sydney , Yacorps Giovanie , Wakeman Sarah E.
Published: February 2023

Objectives

Smoking stimulants, such as methamphetamine and “crack” cocaine, can spread infections, including hepatitis C and COVID-19, and lead to injuries, particularly when individuals share or use makeshift pipes. The purpose of the study was to assess the practices of people who inhale (“smoke”) stimulants to guide future clinical harm reduction efforts.

Methods

Anonymous surveys were administered to participants reporting inhalation of crack cocaine and/or methamphetamine in the past 3 months. Participants were eligible if they sought services from an outreach team staffed by a municipal syringe service program (SSP) or if they were patients at a low-threshold substance use disorder treatment program, the Massachusetts General Hospital Bridge Clinic.

Results

The survey was administered to 68 total participants, 30% of whom were recruited in the Massachusetts General Hospital Bridge Clinic and 70% through SSP outreach. Unsafe smoking practices were reported by 93% of participants. Among the 46% of participants surveyed who both smoked and injected stimulants, 61% of those participants stated that they injected instead of smoked stimulants because of lack of access to pipes. Amid COVID-19, 35% of participants adopted safer smoking practices. Most participants reported that they would be more likely to attend an SSP or health center if pipes were provided.

Conclusions

Inhalational practices that place participants at risk of injury and illness are common. Providing safer smoking equipment may promote health and engage individuals in care.
Extended-release Naltrexone Is Not Linked to Hepatotoxicity in Adults Experiencing Homelessness and Alcohol Use Disorder
Authors: Vutien Philip , Kim Nicole J. , Merrill Joseph O. , Duncan Mark H. , Ioannou George N. , Collins Susan E.
Published: February 2023

Objectives

The use of extended-release naltrexone (XR-NTX) as treatment for alcohol use disorder (AUD) has been limited by a prior black box warning for hepatotoxicity. We performed a secondary analysis of data from a randomized clinical trial to compare serum liver enzyme levels for those randomized to XR-NTX versus placebo.

Methods

The parent study aimed to test the efficacy of combined pharmacobehavioral harm-reduction treatment in improving alcohol and quality-of-life outcomes for adults experiencing homelessness and AUD. We compared the 2 arms that received intramuscular injections of either 380 mg XR-NTX (n = 74) or placebo (n = 77). Outcomes included (a) liver enzyme levels and (b) liver enzyme values categorized as normal (<1× upper limit of normal [ULN]), elevated (1–3× ULN), or high (>3× ULN). We performed multinomial logistic regression and negative binomial generalized estimating equations modeling to assess the effects of treatment group and the time × treatment group interaction on liver enzyme outcomes.

Results

The mean age was 47.9 ± 9.9 years, and the mean baseline alcohol consumption was 23.2 ± 14.0 drinks per day. There were no significant differences in the development of liver enzyme elevations 1 to 3× ULN or more than 3× ULN (all Ps > 0.25) or in the change in liver enzyme values (all Ps > 0.41) between the placebo and the XR-NTX groups over the treatment course.

Conclusions

In our study of adults experiencing homelessness and AUD, receipt of XR-NTX was not associated with hepatotoxicity. These findings support the use of XR-NTX to treat AUD even in patients who are drinking heavily and physiologically dependent on alcohol.
Comparative Study of Opioid Initiation With Tramadol, Short-acting Hydrocodone, or Short-acting Oxycodone on Opioid-related Adverse Outcomes Among Chronic Noncancer Pain Patients
Authors: Acharya Mahip , Hayes Corey J. , Li Chenghui , Painter Jacob T. , Dayer Lindsey , Martin Bradley C.
Published: February 2023

Objective:

To compare the safety profiles of low and high-dose tramadol, short-acting hydrocodone, and short-acting oxycodone therapies among chronic noncancer pain individuals.

Materials and Methods:

A retrospective cohort study of individuals with back/neck pain/osteoarthritis with an initial opioid prescription for tramadol, hydrocodone, or oxycodone was conducted using IQVIA PharMetrics Plus claims for Academics database (2006 to 2020). Two cohorts were created for separately studying opioid-related adverse events (overdoses, accidents, self-inflicted injuries, and violence-related injuries) and substance use disorders (opioid and nonopioid). Patients were followed from the index date until an outcome event, end of enrollment, or data end. Time-varying exposure groups were constructed and Cox regression models were estimated.

Results:

A total of 1,062,167 (tramadol [16.5%], hydrocodone [61.1%], and oxycodone [22.4%]) and 986,809 (tramadol [16.5%], hydrocodone [61.3%], and oxycodone [22.2%]) individuals were in the adverse event and substance use disorder cohorts. All high-dose groups had elevated risk of nearly all outcomes, compared with low-dose hydrocodone. Compared with low-dose hydrocodone, low-dose oxycodone was associated with a higher risk of opioid overdose (hazard ratio: 1.79 [1.37 to 2.33]). No difference in risk was observed between low-dose tramadol and low-dose hydrocodone (hazard ratio: 0.85 [0.64 to 1.13]). Low-dose oxycodone had higher risks of an opioid use disorder, and low-dose tramadol had a lower risk of accidents, self-inflicted injuries, and opioid use disorder compared with low-dose hydrocodone.

Discussion:

Low-dose oxycodone had a higher risk of opioid-related adverse outcomes compared with low-dose tramadol and hydrocodone. This should be interpreted in conjunction with the benefits of pain control and functioning associated with oxycodone use in future research.
Risk Factors for Early Conversion Total Hip Arthroplasty After Pipkin IV Femoral Head Fracture
Authors: Cichos Kyle H. , White Parker A. , Bergin Patrick F. , Ghanem Elie S. , McGwin Gerald , Hawkins Jacob , Spitler Clay A.
Published: February 2023

Objectives:

To determine risk factors for early conversion total hip arthroplasty (THA) in Pipkin IV femoral head fractures.

Design:

Retrospective cohort.

Setting:

Two level I trauma centers.

Patients and Intervention:

One hundred thirty-seven patients with Pipkin IV fractures meeting inclusion criteria with 1 year minimum follow-up managed from 2009 to 2019.

Main Outcome Measurement:

Patients were separated into groups by the Orthopaedic Trauma Association/AO Foundation (OTA/AO) classification of femoral head fracture: 31C1 (split-type fractures) and 31C2 (depression-type fractures). Multivariable regression was performed after univariate analysis comparing patients requiring conversion THA with those who did not.

Results:

We identified 65 split-type fractures, 19 (29%) underwent conversion THA within 1 year. Surgical site infection (P = 0.002), postoperative hip dislocation (P < 0.0001), and older age (P = 0.049) resulted in increased rates of conversion THA. However, multivariable analysis did not identify independent risk factors for conversion. There were 72 depression-type fractures, 20 (27.8%) underwent conversion THA within 1 year. Independent risk factors were increased age (P = 0.01) and posterior femoral head fracture location (P < 0.01), while infrafoveal femoral head fracture location (P = 0.03) was protective against conversion THA.

Conclusion:

Pipkin IV fractures managed operatively have high overall risk of conversion THA within 1 year (28.5%). Risk factors for conversion THA vary according to fracture subtype. Hip joint survival of fractures subclassified OTA/AO 31C1 likely depends on patient age and postoperative outcomes such as surgical site infection and redislocation. Pipkin IV fractures subclassified to OTA/AO 31C2 type with suprafoveal and posterior head impaction and older age should be counseled of high conversion risk with consideration for alternative management options.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Reliability of the Modified Radiographic Union Score for Tibia Fractures (mRUST) for Femoral Shaft Fractures
Authors: Schmidt Gregory , Foley David , Simpson Austin , Farooq Hassan , Sharma Ishani , Slaven James , Lopas Luke , Jang Yohan , McKinley Todd , Mullis Brian
Published: February 2023

Objectives:

To evaluate the interobserver and intraobserver reliability of the modified Radiographic Union Score for Tibia Fractures (mRUST) and the effect of rater experience in evaluation of femoral fractures.

Design:

Retrospective cohort study.

Setting:

Single Level 1 trauma center.

Patients/Participants:

Patients 18–55 years of age with a femur shaft fracture.

Intervention:

Intramedullary nail fixation.

Main Outcome Measurement:

Interobserver and intraobserver reliability using the intraclass correlation coefficient.

Results:

The overall interobserver reliability was 0.96. Among fellowship-trained evaluators, the interobserver reliability was 0.94, and it was 0.92 among trainees. The overall intraobserver reliability was 0.98. The intraobserver reliability was 0.97 among fellowship-trained evaluators and 0.96 for trainees.

Conclusions:

These results show high interobserver and intraobserver reliability of mRUST in the evaluation of radiographic healing for femur shaft fractures treated with intramedullary nail. This high reliability was further demonstrated throughout different postoperative healing time frames. In addition, mRUST appears to be reliable when used both by trainees and experienced surgeons for the evaluation of femur shaft fractures.

Level of Evidence:

Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence.