bluuebunny/crossref_metadata_2025 huggingface dataset:
Utility and prognostic value of diagnosing MAFLD in patients undergoing liver transplantation for alcohol‐related liver disease
Authors: Vanlerberghe Benedict T. K. , van Malenstein Hannah , Sainz‐Bariga Mauricio , Jochmans Ina , Cassiman David , Monbaliu Diethard , van der Merwe Schalk , Pirenne Jacques , Nevens Frederik , Verbeek Jef
Published: March 2023

Background

Recently, the term metabolic dysfunction‐associated fatty liver disease (MAFLD) was proposed to replace non‐alcoholic fatty liver disease (NAFLD). This concept enables diagnosing liver disease associated with metabolic dysfunction in patients with alcohol‐related liver disease (ALD), a main indication for liver transplantation (LTx). We assessed MAFLD prevalence in ALD patients undergoing LTx and its prognostic value on post‐LTx outcomes.

Methods

We retrospectively analyzed all ALD patients transplanted at our center between 1990 and August 2020. MAFLD was diagnosed based on the presence or history of hepatic steatosis and a BMI > 25 or type II diabetes or ≥ 2 metabolic risk abnormalities at LTx. Overall survival and risk factors for recurrent liver and cardiovascular events were analyzed by Cox regression.

Results

Of the 371 included patients transplanted for ALD, 255 (68.7%) had concomitant MAFLD at LTx. Median follow‐up post‐LTx was 72 months (IQR: 34.50–122). Patients with ALD‐MAFLD were older at LTx (p = .001), more often male (p < .001) and more frequently had hepatocellular carcinoma (p < .001). No differences in perioperative mortality and overall survival were found. ALD‐MAFLD patients had an increased risk of recurrent hepatic steatosis, irrespective of alcohol relapse, but no superimposed risk of cardiovascular events.

Conclusions

The co‐presence of MAFLD at LTx for ALD is associated with a distinct patient profile and is an independent risk factor for recurrent hepatic steatosis. The use of MAFLD criteria in ALD patients might increase awareness and treatment of specific hepatic and systemic metabolic abnormalities before and after LTx.
Quality of cell blocks prepared from residual pleural effusion and bronchial washing samples for immunocytochemistry
Authors: Harabajsa Suzana , Milutin Lucija , Breški Anita , Ražnjević Katarina , Šimić Vesna , Branica Božica Vrabec , Smojver‐Ježek Silvana
Published: March 2023

Introduction

Cell blocks (CBs) enable the long‐term preservation of cytological samples. The aim of this study was to analyse the quality of CBs prepared from leftover fluid from lung adenocarcinoma pleural effusion samples and residual bronchial washing sediment for immunocytochemistry.

Methods

The residual part of 455 lung adenocarcinoma pleural effusion samples and sediment from 384 bronchial washing samples were used to prepare CBs following the agarose method. The quality of CBs was evaluated based on the quantity of malignant cells in haematoxylin and eosin‐stained slides and interpreted as optimal or insufficient for immunocytochemistry. Immunocytochemistry on CBs was performed using the Dako EnVision™ FLEX detection visualisation system. The CB results for TTF‐1, ALK, and PD‐L1 immunocytochemistry were compared with the corresponding cytological smears.

Results

Among all CBs, 202 (44.4%) from leftover pleural effusion fluid and 85 (22.1%) from residual bronchial washing sediment had an optimal number of lung adenocarcinoma cells. Eight pleural effusion CBs were stained for TTF‐1. Four pleural effusion and two bronchial washing CBs were stained for ALK and PD‐L1. All tested pleural effusion CBs were confirmed positive for TTF‐1 and negative for ALK. The PD‐L1 tumour proportion score (TPS) was ≥ 50% in two pleural effusions. ALK was confirmed negative in bronchial washing CBs. One bronchial washing CB was interpreted as PD‐L1‐negative while the corresponding smear was positive (TPS ≥1%; 2%).

Conclusion

The CB results of TTF‐1, ALK, and PD‐L1 corresponded to the findings for the smears. The inclusion of CBs prepared from leftover fluid from pleural effusion samples and residual bronchial washing sediment in routine cytological practice could provide a source of high‐quality material for immunocytochemistry in addition to smears and cytospins.
Carbon emission reduction policy simulation based on the CGE model
Authors: Lin Yu
Published: March 2023

Carbon peaking and carbon neutrality will be important policies to constrain China's economic and social development in the future. Based on the theory of computable general equilibrium, CGE model of carbon emission was constructed in this paper to simulate the influence of different scenarios of carbon emission reduction on economic and social development. The major contribution is to subdivide the energy sector according to primary energy and secondary energy, and construct the macro SAM table and micro SAM table of 21 energy sectors in 2017 to quantitatively simulate the impact of carbon emission reduction policies on China's economy and society, and put forward some policy suggestions based on this.
Systematic genetic identification of functional domains on collided di‐ribosomes responsible for rescue pathways upon translation arrest in Saccharomyces cerevisiae
Authors: Otsuka Hiroshi , Endo Kei , Wada Miki , Ito Koichi
Published: March 2023

Translation elongation becomes arrested when various obstacles arise, such as a series of inefficient rare codons or stable RNA secondary structures, thus causing ribosomal stalling along the mRNA. Certain wasteful and persistent stalling states are resolved by ribosome rescue pathways. For instance, collisions between stalled and subsequent ribosomes are thought to induce ubiquitination of ribosomal S20 protein by the E3 ubiquitin ligase Hel2, which triggers subsequent rescue reactions. Although structural studies have revealed specific contact sites between collided ribosomes, the ribosomal regions crucial for the rescue reaction remain uncharacterized. In this study, we performed a systematic genetic analysis to identify the molecular regions required for ribosome rescue in Saccharomyces cerevisiae. A series of dominant negative mutations capable of abolishing the rescue reaction were isolated in ribosomal proteins S20 and Asc1. Moreover, mutations in both proteins clustered on the surface of ribosomes between the collided ribosome interfaces, aligned in such a way that they seemingly faced each other. Further analysis via the application of the split‐TRP1 protein assay revealed that the mutation of either protein distinctively affected the functional interaction between Hel2 and Asc1, suggesting the development of differential functionality at the interface between collided ribosomes. Our results provide novel and complementary insights into the detailed molecular mechanisms of ribosomal rescue pathways.
A survey of American paired teachers in dual language Chinese immersion programs
Authors: Hill Sean R.
Published: March 2023

One Mandarin immersion programming model involves a pair of partner teachers switching cohorts of students. Many programs meet their staffing needs with international teachers that remain with the school district for 1–3 years. Due to transient staffing, many partner teachers find themselves as mentors to their immersion teachers and maintain the program's institutional knowledge. A national survey of 106 American teachers examined their attitudes regarding collaboration with their Chinese teacher, identification as a mentor, perceived administrative support, and school climate. Many participants worked in public elementary one‐way immersion programs classified as schools within a school; about 20% worked in full immersion schools. The partner teachers agreed that they felt connected to and supported by other staff in their building, and reported positive structures in place for student success. Respondents signaled a need for more professional development on immersion education, Chinese culture, and the partner teacher role. Some indicated administrators would promote the program without understanding it. Many reported the immersion teachers' needs for more targeted professional development about American culture and the education system because of misunderstandings at the building level. Despite concerns, partner teachers found the role challenging but professionally rewarding.
Coral adaptive capacity insufficient to halt global transition of coral reefs into net erosion under climate change
Authors: Cornwall Christopher Edward , Comeau Steeve , Donner Simon D. , Perry Chris , Dunne John , van Hooidonk Ruben , Ryan James S. , Logan Cheryl A.
Published: March 2023

Projecting the effects of climate change on net reef calcium carbonate production is critical to understanding the future impacts on ecosystem function, but prior estimates have not included corals' natural adaptive capacity to such change. Here we estimate how the ability of symbionts to evolve tolerance to heat stress, or for coral hosts to shuffle to favourable symbionts, and their combination, may influence responses to the combined impacts of ocean warming and acidification under three representative concentration pathway (RCP) emissions scenarios (RCP2.6, RCP4.5 and RCP8.5). We show that symbiont evolution and shuffling, both individually and when combined, favours persistent positive net reef calcium carbonate production. However, our projections of future net calcium carbonate production (NCCP) under climate change vary both spatially and by RCP. For example, 19%–35% of modelled coral reefs are still projected to have net positive NCCP by 2050 if symbionts can evolve increased thermal tolerance, depending on the RCP. Without symbiont adaptive capacity, the number of coral reefs with positive NCCP drops to 9%–13% by 2050. Accounting for both symbiont evolution and shuffling, we project median positive NCPP of coral reefs will still occur under low greenhouse emissions (RCP2.6) in the Indian Ocean, and even under moderate emissions (RCP4.5) in the Pacific Ocean. However, adaptive capacity will be insufficient to halt the transition of coral reefs globally into erosion by 2050 under severe emissions scenarios (RCP8.5).
GOODHART'S LAW AND MACHINE LEARNING: A STRUCTURAL PERSPECTIVE
Authors: Hennessy Christopher A. , Goodhart Charles A. E.
Published: March 2023

We develop a simple structural model to illustrate how penalized regressions generate Goodhart bias when training data are clean but covariates are manipulated at known cost by future agents. With quadratic (extremely steep) manipulation costs, bias is proportional to Ridge (Lasso) penalization. If costs depend on absolute or percentage manipulation, the following algorithm yields manipulation‐proof prediction: Within training data, evaluate candidate coefficients at their respective incentive‐compatible manipulation configuration. We derive analytical coefficient adjustments: slopes (intercept) shift downward if costs depend on percentage (absolute) manipulation. Statisticians ignoring manipulation costs select socially suboptimal penalization. Model averaging reduces these manipulation costs.
Characterisation of gluten‐free breads made with sorghum, teff, and yacon flour using rapid sensory characterisation methodologies
Authors: Pelinson Tridapalli Luiza , Cardoso Flávia Aparecida Reitz , Iwamura Lucas Shinti , Droval Adriana Aparecida , Marques Leila Larisa Medeiros , Bona Evandro , Beneti Stéphani Caroline , Cristaldo Heck Stênio , Fuchs Renata Hernandez Barros
Published: March 2023

Replacing gluten‐containing flours with gluten‐free ingredients is a challenge for the food industry due to the technological properties of this protein. This work aimed to evaluate, through the acceptance test, Flash Profile, and Just About Right (JAR), gluten‐free bread formulations made with sorghum, teff, and yacon flours. Through experimental design, nine formulations were submitted to acceptance test, which provided the formulation optimised by the overall acceptance scores of the samples. In the subsequent trials, four formulations were evaluated, F1 (100% sorghum), F2 (100% teff), F3 (100% yacon), and F4 (optimised formulation, with 33.33% of each flour). F1 was described by bread yeast odour, crumb texture, and salty taste. F2 presented a salty taste and bread flavour. F3 was characterised by softness, crumb texture, moisture, chewiness, and porosity. F4 was described by pleasant aroma, yeast odour, sweet taste, crumb texture, and porosity, and being the best evaluated in terms of overall acceptance. The descriptive sensory profile of the formulations highlighted attributes that enabled the use of sorghum, teff, and yacon in the preparation of gluten‐free bread and highlighted that the mixture of the three in the optimised formulation positively influences the sensory characteristics of the product, improving flavour, taste, and texture.
Synthesis, high yield strategy and application of nisin: A review
Authors: Wang Rui , Yu Shuang , Huang Yueying , Liu Yanan
Published: March 2023

Nisin is a peptide with antibacterial activity against a variety of pathogens. It was originally obtained from a Lactococcus lactis. It is classified as a class I bacteriocin, as it is synthesised by ribosomes and post‐translationally modified. It has been studied extensively and has a wide range of applications in the food industry, biomedicine, veterinary, and research fields. It is approved as a food preservative by the Food and Agriculture Organization (FAO). What's more, nisin, the only antimicrobial peptide that has generally considered as safe (GRAS) status from both World Health Organization (WHO) and Food and Drug Administration (FDA), has the potential to become an important natural antibiotic as bacteria become more resistant to traditional antibiotics. However, nisin purified from biological sources usually results in low yields and high production costs, limiting industrial‐scale manufacturing and application in other fields. Hence, more methods need to be used to optimise the production of nisin. Therefore, this paper aimed to understand the structure and biosynthesis mechanism of nisin and to summarise the innovative methods for increasing the production of nisin using biosynthesis regulation.
Administration of intravenous iron through a home‐based infusion strategy is safe and has high patient acceptance
Authors: Liu Dorothy , Atienza Eloisa , Santamaria Lynne , Sinnappu Rabin , Garg Mayur
Published: March 2023

Background and Aims

To evaluate the safety and patient experience of a hospital‐initiated home‐based iron infusion service in patients with iron deficiency with or without anaemia.

Methods

Retrospective cohort study, including adult patients who received intravenous iron through a Hospital in The Home service in a single tertiary centre between August 2020 and 2021. A chart review was conducted for documented adverse events (AEs). A telephone survey assessed patient acceptance with three questions on a 5‐point Likert scale: (i) How do you perceive the experience of having your infusion given in the home? (ii) Would you like to have the infusion in the same location if you require one in the future? and (iii) Do you feel safe having your infusion at home?

Outcome measures

Percentage of patients experiencing AEs and patient acceptance of a home‐based iron infusion strategy.

Results

One hundred ninety‐seven patients were included (181 ferric carboxymaltose and 16 ferric derisomaltose). Six (3%) patients (2 of 181 patients who received ferric carboxymaltose compared with 4 of 16 patients who received ferric derisomaltose, P < 0.001, Fisher's exact) experienced AEs, mostly headache and pruritus. Most patients who participated in the telephone survey had a positive experience (57/58 (98%)), felt safe (57/58 (98%)) and preferred future infusions to occur at home (52/58 (90%)).

Conclusion

A home‐based iron infusion strategy was safe and well accepted by patients. Larger studies evaluating the safety profile of different iron formulations in the home setting are required.
CD226 deficiency exacerbated intestinal immune dysregulation in mice with dinitrochlorobenzene‐induced atopic dermatitis
Authors: Wang Tingting , Qiao Wei , Xie Yang , Ma Jingchang , Hu Wei , Yang Lu , Li Xuemei , Duan Chujun , Wu Shuwen , Wang Yuling , Cheng Kun , Zhang Yuan , Zhuang Ran
Published: March 2023

Intestinal mucosal immunity plays a pivotal role in host defence. In this study, we found that cluster of differentiation 226 (CD226) gene knockout (KO) led to more severe atopic dermatitis (AD)‐related skin pathologies and bowel abnormalities in a 2,4‐dinitrochlorobenzene (DNCB)‐induced AD‐like mouse model. Following DNCB administration, the expression of CD226 was elevated in intestinal mucosal tissues, including group 3 innate lymphoid cells (ILC3s) and CD4+ T cells of Peyer's patches (PPs). CD226 deficiency led to an overactive intestinal immune response in the AD‐like mice, as evidenced by increased inflammation and Th1/Th2‐related cytokine levels as well as increased Paneth cell numbers and antimicrobial peptide (AMP) expression, which was likely due to the higher interleukin (IL)‐22 production in the lamina propria. Additionally, CD226 deficiency increased the production of IL‐4 and IL‐17 in mesenteric lymph nodes as well as the number of PPs and expression of immunoglobulin (Ig) A in B cells. Moreover, insufficient expression of CD226 affected the characterization of intraepithelial and lamina propria lymphocytes in the intestinal mucosa. Finally, the number of PPs was increased in CD4+ T cell‐specific CD226 KO and regulatory T (Treg) cell‐specific CD226 KO mice; thus, loss of CD226 in Treg cells resulted in impaired Treg cell‐suppressive function. Therefore, our findings indicate that CD226 deficiency alters intestinal immune functionality in inflammatory diseases.
Estimating the Reciprocal of a Binomial Proportion
Authors: Wei Jiajin , He Ping , Tong Tiejun
Published: March 2023

The binomial proportion is a classic parameter with many applications and has also been extensively studied in the literature. By contrast, the reciprocal of the binomial proportion, or the inverse proportion, is often overlooked, even though it also plays an important role in various fields. To estimate the inverse proportion, the maximum likelihood method fails to yield a valid estimate when there is no successful event in the Bernoulli trials. To overcome this zero‐event problem, several methods have been introduced in the previous literature. Yet to the best of our knowledge, there is little work on a theoretical comparison of the existing estimators. In this paper, we first review some commonly used estimators for the inverse proportion, study their asymptotic properties, and then develop a new estimator that aims to eliminate the estimation bias. We further conduct Monte Carlo simulations to compare the finite sample performance of the existing and new estimators, and also apply them to handle the zero‐event problem in a meta‐analysis of COVID‐19 data for assessing the relative risks of physical distancing on the infection of coronavirus.
Nurses' perception of identity, practice and support needed in primary care: A descriptive qualitative study
Authors: Brzozowski Sarah L. , King Barbara , Steege Linsey M.
Published: March 2023

Aims

To explore how primary care registered nurses (PCRNs) describe their professional identity, their perception of their practice, and the support they need to effectively perform the responsibilities of their role.

Design

A qualitative descriptive design using inductive content analysis.

Methods

Semi‐structured interviews were conducted with registered nurses (n = 14) working in primary care settings in the United States between June 2018 and December 2020. Inductive content analysis was used and comprised three phases: preparation, organizing, and reporting. COREQ reporting guidelines were used.

Results

Three categories were discovered related to PCRN identity and practice: Wearing Multiple Hats, Practicing Within Bounds and Change is a Part of Practice. There were also three categories for support needed: Entering In, Ongoing Support and Making it a Better Place. Within each category, subcategories were identified.

Conclusion

Primary care registered nurses have a unique professional identity and practice. When entering the setting, nurses must acquire the skills and knowledge to ask the right questions and navigate the system to meet the diverse and complex needs of their patients. PCRNs recognize change is a part of practice and have ideas and visions for what the role of PCRNs could be.

Implications for Profession

Recognizing the unique identity and practice of PCRNs is necessary to create an environment that leverages their skills and knowledge.

Impact

We identified key elements of PCRN identity and practice and the support necessary to meet their needs. Healthcare organizations must ensure nurses new to the practice setting receive training and support for their unique and essential role. Additionally, leaders must partner with nurses to enhance nursing practice and achieve optimal patient outcomes.

Reporting Method

Adherence to COREQ guidelines were maintained.

Patient or Public Contribution

No patient or public contribution.
Acute and intensive care nurses' perspectives on suicide prevention with medically hospitalized patients: Exploring barriers, facilitators, interests, and training opportunities
Authors: Darnell Doyanne , Pierson Andria , Whitney Joanne D. , Wolkow Catherine A. , Dorsey Shannon , Boudreaux Edwin D. , Areán Patricia A. , Comtois Katherine Anne
Published: March 2023

Aims

To explore opportunities for acute and intensive care nurses to engage in suicide prevention activities with patients hospitalized for medical, surgical or traumatic injury reasons.

Design

A qualitative descriptive study.

Methods

We conducted two studies consisting of 1‐h focus groups with nurses. Study 1 occurred prior to the onset of the COVID‐19 pandemic during January and February of 2020 and identified barriers and facilitators of engaging in an eLearning training in suicide safety planning and engaging patients on their units in suicide safety planning. Study 2 occurred in December of 2020 and explored nurses' perspectives on their role in suicide prevention with patients on their units and training needs related to this. The research took place at an urban level 1 trauma center and safety net hospital where nurses universally screen all admitted patients for suicide risk. We conducted a rapid analysis of the focus group transcripts using a top‐down, framework‐driven approach to identify barriers, facilitators, strategies around barriers, and training interests mentioned.

Results

Twenty‐seven registered nurses participated. Nurses indicated they serve a population in need of suicide prevention and that the nursing role is an important part of suicide care. A primary barrier was having adequate uninterrupted time for suicide prevention activities and training; however, nurses identified various strategies around barriers and offered suggestions to make training successful.

Conclusion

Findings suggest training in suicide prevention is important for nurses in this context and there are opportunities for nurses to engage patients in interventions beyond initial screening; however, implementation will require tailoring interventions and training to accommodate nurses' workload in the hospital context.

Impact

Acute and intensive care nurses play a key role in the public health approach to suicide prevention. Understanding perspectives of bedside nurses is critical for guiding development and deployment of effective brief interventions.

No public or patient involvement

This study is focused on eliciting and exploring perspectives of acute and intensive care nurses.
An empirical analysis of the effects of the Dodd–Frank Act on determinants of credit ratings
Authors: Ahmed Anwer S. , Wang Dechun , Xu Nina
Published: March 2023

We study the effects of the Dodd–Frank Act (“Dodd–Frank”) on determinants of credit ratings. We predict that the increase in regulatory oversight and litigation risk prompted by Dodd–Frank, as well as requirements for improved disclosures and governance, motivated credit rating agencies (CRAs) to increase the reliance on verifiable quantitative fundamental information in determining ratings. We find that the power of firm fundamentals in explaining credit ratings increases significantly after Dodd–Frank. Furthermore, we find that the greater reliance on quantitative firm fundamentals at least partially drives the improvement in credit ratings’ ability to predict future defaults. Collectively, our evidence suggests that Dodd–Frank incentivizes CRAs to use more quantitative information in making rating decisions, which improves credit rating quality.
Accuracy of the Apple watch for detection of AF: A multicenter experience
Authors: Wasserlauf Jeremiah , Vogel Kelly , Whisler Cailin , Benjamin Emelia , Helm Robert , Steinhaus Daniel A. , Yousuf Omair , Passman Rod S.
Published: March 2023

Introduction

The Apple watch (AW) irregular rhythm notification (IRN) feature uses photoplethysmography to identify prolonged episodes of irregular rhythm suggestive of atrial fibrillation (AF). IRN is FDA cleared for those with no previous history of AF, however, these devices are increasingly being used for AF management.

 The objective of the present study was to determine the accuracy of the IRN in subjects with a previous diagnosis of nonpermanent AF.

Methods

Subjects with a history of nonpermanent AF and either an insertable cardiac monitor (ICM) or cardiac implanted electronic device (CIED) with <5% ventricular pacing were fitted with an AW Series 5 for 6 months. AF episodes were compared between the ICM/CIED and IRN. The primary endpoints were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the IRN by subject for AF ≥1 h. Secondary endpoints were sensitivity and PPV by AF episode ≥1 h. Analysis was limited to a maximum of 10 ICM/CIED episodes per subject and included only those AF episodes occurring during active AW use confirmed by activity data.

Results

Thirty participants were enrolled. Mean age was 65.4 ± 12.2 years and 40% were female. There were 10 ICMs and 20 CIEDs. Eleven subjects had AF on ICM/CIED while the AW was worn, of whom 8 were detected by IRN. There were no false positive IRN detections by subject (“by subject” 72% sensitivity, 100% specificity, 100% PPV, and 90% NPV). Five subjects had AF only when the AW was not worn. There were a total of 70 AF episodes on ICM/CIED, 35 of which occurred while the AW was being worn. Of these, 21 were detected by IRN with 1 false positive (“by episode” sensitivity = 60.0%, PPV = 95.5%).

Conclusion

In a population with known AF, the AW IRN had a low rate of false positive detections and high specificity. Sensitivity for detection by subject and by AF episode was lower. The current IRN algorithm appears accurate for AF screening as currently cleared, but increased sensitivity and wear times would be necessary for disease management.
Ultrasound guidance for femoral venous access in patients undergoing pulmonary vein isolation: A quasi‐randomized study
Authors: Kupo Peter , Riesz Tamas Janos , Saghy Laszlo , Vamos Mate , Bencsik Gabor , Makai Attila , Kohari Maria , Benak Attila , Miklos Marton , Pap Robert
Published: March 2023

Introduction

Routine ultrasound (US) guidance for femoral venous access to decrease vascular complications of atrial fibrillation (AF) ablation procedures has been advocated. However, the benefit has not been unequivocally demonstrated by randomized‐trial data.

Methods

Consecutive patients undergoing pulmonary vein isolation (PVI) on uninterrupted anticoagulant treatment were included. A quasi‐random allocation to either US‐guided or conventional puncture group was based on which of the two procedure rooms the patient was scheduled in, with only one of the rooms equipped with a US machine including a vascular transducer. The same four novice operators in rotation, with no relevant previous experience in US‐guided vascular access performed venous punctures in both rooms. Major and minor vascular complications and the rate of prolonged hospitalization were compared. Major vascular complication was defined as groin hematoma, arteriovenous fistula, or pseudoaneurysm. Hematoma was considered as a major vascular complication if it met type 2 or higher Bleeding Academic Research Consortium criteria (requiring nonsurgical, medical intervention by a health care professional; leading to hospitalization or increased level of care, or prompting evacuation).

Results

Of the 457 patients 199 were allocated to the US‐guided puncture group, while the conventional, palpation‐based approach was performed in 258 cases. Compared with the conventional technique, US guidance reduced the rate of any vascular complication (11.63% vs. 2.01%, p < .0001), including both major (4.26% vs. 1.01%, p = .038) and minor (7.36% vs. 1.01%, p = .001) vascular complications. In addition, the rate of prolonged hospitalization was lower in the US‐guided puncture group (5.04% vs. 1.01%, p = .032).

Conclusion

The use of US for femoral vein puncture in patients undergoing PVI decreased the rate of both major and minor vascular complications. This quasi‐randomized comparison strongly supports adapting routine use of US for AF ablation procedures.
Jagged/Notch proteins promote endothelial‐mesenchymal transition‐mediated pulmonary arterial hypertension via upregulation of the expression of GATAs
Authors: Lin Kun‐Chen , Yeh Jui‐Ning , Shao Pei‐Lin , Chiang John Y. , Sung Pei‐Hsun , Huang Chi‐Ruei , Chen Yi‐Ling , Yip Hon‐Kan , Guo Jun
Published: March 2023

This study tested the hypothesis that Jagged2/Notches promoted the endothelial‐mesenchymal transition (endMT)‐mediated pulmonary arterial hypertension (PAH) (i.e. induction by monocrotaline [MCT]/63 mg/kg/subcutaneous injection) through increasing the expression of GATA‐binding factors which were inhibited by propylthiouracil (PTU) (i.e. 0.1% in water for daily drinking since Day 5 after PAH induction) in rodent. As compared with the control (i.e. HUVECs), the protein expressions of GATAs (3/4/6) and endMT markers (Snail/Zeb1/N‐cadherin/vimentin/fibronectin/α‐SMA/p‐Smad2) were significantly reduced, whereas the endothelial‐phenotype markers (CD31/E‐cadherin) were significantly increased in silenced JAG2 gene or in silenced GATA3 gene of HUVECs (all p < 0.001). As compared with the control, the protein expressions of intercellular signallings (GATAs [3/4/6], Jagged1/2, notch1/2 and Snail/Zeb1/N‐cadherin/vimentin/fibronectin/α‐SMA/p‐Smad2) were significantly upregulated in TGF‐ß/monocrotaline‐treated HUVECs that were significantly reversed by PTU treatment (all p < 0.001). By Day 42, the results of animal study demonstrated that the right‐ventricular systolic‐blood‐pressure (RVSBP), RV weight (RVW) and lung injury/fibrotic scores were significantly increased in MCT group than sham‐control (SC) that were reversed in MCT + PTU groups, whereas arterial oxygen saturation (%) and vasorelaxation/nitric oxide production of PA exhibited an opposite pattern of RVW among the groups (all p < 0.0001). The protein expressions of hypertrophic (ß‐MHC)/pressure‐overload (BNP)/oxidative‐stress (NOX‐1/NOX‐2) biomarkers in RV and the protein expressions of intercellular signalling (GATAs3/4/6, Jagged1/2, notch1/2) and endMT markers (Snail/Zeb1/N‐cadherin/vimentin/fibronectin/TGF‐ß/α‐SMA/p‐Smad2) in lung parenchyma displayed an identical pattern of RVW among the groups (all p < 0.0001). Jagged‐Notch‐GATAs signalling, endMT markers and RVSBP that were increased in PAH were suppressed by PTU.
Comparison accuracy of digital and analog method using milled occlusal splints
Authors: Blasi Álvaro , Henarejos‐Domingo Víctor , Palacios‐Bañuelos Ricardo , Aparicio Conrado , Roig Miguel
Published: March 2023

Objective

This clinical trial aims to compare the accuracy of interocclusal registration in centric relation taken with polyvinyl siloxane and intraoral scanner (IOS) with the fabrication of occlusal devices.

Methods

Thirty‐one participants were included in the trial registered at ClinicalTrials.gov (NCT05317182) receiving two different occlusal devices from two different workflows. One workflow was performed using polyvinyl siloxane impression material and the other with IOS. Every splint was scanned before and after the occlusal adjustments to compare the volumetric changes using the Root Mean Square deviation (RMS). Furthermore, three evaluators assessed the 3D comparison using color maps in a Visual Analog Scale (VAS).

Results

The average values of RMS were higher for the analog approach (0.01 ± 0.067) than the digital approach (0.065 ± 0.035). However, the differences were not statistically significant (p < 0.063) between the two impression techniques. For the semiquantitative analysis performed by blinded evaluators, differences in VAS values between the impression for the digital (2.08 ± 2.4) and analog (3.80 ± 3.3) technique were statistically significant. The three evaluators agreed in more than 90% of the qualitative dichotomous evaluation.

Conclusion

Digital impressions did not show inferior accuracy compared to conventional impressions when assessed using quantitative measurements.

Clinical Significance

This clinical trial provided evidence on registering interocclusal relationship at increased vertical dimension with fully digital workflow for complete arch prosthesis.
The evaluation and downscaling‐calibration of IMERG precipitation products at sub‐daily scales over a metropolitan region
Authors: Zhuang Qi , Zhou Zhengzheng , Liu Shuguang , Wright Daniel B. , Gao Lisha
Published: March 2023

The Global Precipitation Measurement (GPM) Integrated Multi‐satellitE Retrievals for GPM products (i.e., IMERG) provide new‐generation satellite precipitation measurements. For urban contexts, however, the issues of its bias and insufficient resolutions still exist. This study aims to develop high‐precision and high‐resolution (e.g., 0.01°/1 h) data for a metropolitan region based on IMERG and gauge precipitations. The original IMERG product is evaluated using hourly in situ precipitations from 47 gauges. A spatial downscaling‐calibration (DC) technique is then developed to enhance the IMERG using the Normalized Difference Vegetation Index. The results show the limited capability of IMERG to capture sub‐daily precipitation and high‐intensity precipitation. The proposed DC method significantly improves IMERG performance, with correlation coefficient (CC) increasing from 0.07 to 0.75, and probability of detection improving from 0.34 to 0.90 at the hourly scale. In terms of spatial rainfall distribution, 86% of mean absolute error and 80% of RMSE are improved with CC increasing from 0.07 to 0.91 on average. Additionally, the calibrated downscaled product provides finer information in local areas, capturing three times more spatial variabilities of urban precipitation against the original IMERG input data. The results highlight the necessity of improving urban observations for flood risk management at fine spatiotemporal resolutions.
Patients want to talk about their out‐of‐pocket costs—Can real‐time benefit tools help?
Authors: Sloan Caroline E. , Ubel Peter A.
Published: March 2023

This editorial comments on the article by Mattingly et al.
Assessing the fulfillment of nurses' full potential in diverse geriatric settings—moving towards change
Authors: Romem Anat , Pinchas‐Mizrachi Ronit , Abramovich Nataly , Wagman Shir , Ravid Talya Shahnis , Lizeachin Alla , David Tova , Diamant Tsaffy Hillel , Mekadesh Keren , Goldberg Shoshy , Rozani Violetta
Published: March 2023

Background

In response to the aging population, the Department for Professional Development in the Nursing Division at the Israeli Ministry of Health has invested significant resources in training registered nurses for post‐basic certification in the field of geriatrics. However, little is known about how the nurses implement the scope of practice in the field and how they maximize their full potential following the training.

Aims and objectives

To assess whether nurses' full potential is maximized in geriatric acute and long‐term geriatric care, and community settings in Israel.

Design

A quantitative, cross‐sectional study.

Methods

The study population is a convenience sample of registered nurses who completed post‐basic certification in geriatric care (n = 287). The participants completed a self‐administered questionnaire addressing socio‐demographic and occupational characteristics, implementation of the scope of practice, and a professional satisfaction questionnaire.

Baseline demographic variables were summarized using means and counts, with frequency counts and percentages used for the scope of practice. A one‐way ANOVA was utilized to examine the differences between the workplace and the scope of practice. Chi‐square was used to examine practice types and the workplace.

Results

Nurses in all surveyed geriatric settings reported average to high overall performance in independent decision‐making activities and delegated duties. The majority (66%) reported very high satisfaction with the completion of the post basic certification education However overall performance differed significantly between the different geriatric settings.

Conclusion

Most of the nurses with a post‐basic geriatric certification are satisfied with their scope of practice, feel valued by colleagues and managers, and are able to practice independently within their professional scope. This can have a positive impact on the care of the older adult population.

Clinical Relevance

Administrators should ensure that nurses with a post‐basic geriatric certification are able to maximize their scope of practice. Specifically, we recommend nurse managers to leverage the results of this study and advocate for nurses to fulfill their full potential in their scope of practice.
Morning perception of sleep, stress, and mood, and its relationship with overnight physiological sleep: findings from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study
Authors: Albinni Benedetta , Baker Fiona C. , Javitz Harold , Hasler Brant P. , Franzen Peter L. , Clark Duncan B. , de Zambotti Massimiliano
Published: March 2023

This cross‐sectional study investigated objective–subjective sleep discrepancies and the physiological basis for morning perceptions of sleep, mood, and readiness, in adolescents. Data collected during a single in‐laboratory polysomnographic assessment from 137 healthy adolescents (61 girls; age range: 12–21 years) in the United States National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study were analysed. Upon awakening, participants completed questionnaires assessing sleep quality, mood, and readiness. We evaluated the relationship between overnight polysomnographic, electroencephalographic, sleep autonomic nervous system functioning measures, and next morning self‐reported indices. Results showed that older adolescents reported more awakenings, yet they perceived their sleep to be deeper and less restless than younger adolescents. Prediction models including sleep physiology measures (polysomnographic, electroencephalographic, and sleep autonomic nervous system) explained between 3% and 29% of morning sleep perception, mood, and readiness indices. The subjective experience of sleep is a complex phenomenon with multiple components. Distinct physiological sleep processes contribute to the morning perception of sleep and related measures of mood and readiness. More than 70% of the variance (based on a single observation per person) in the perception of sleep, mood, and morning readiness is not explained by overnight sleep‐related physiological measures, suggesting that other factors are important for the subjective sleep experience.
Supratentorial multifocal gliomas associated with Ollier disease harboring IDH1 R132H mutation: A case report
Authors: Ikeda Hiroshi , Yamaguchi Shigeru , Ishi Yukitomo , Wakabayashi Kento , Shimizu Ai , Kanno‐Okada Hiromi , Endo Takeshi , Ota Mitsutoshi , Okamoto Michinari , Motegi Hiroaki , Iwasaki Norimasa , Fujimura Miki
Published: March 2023

Somatic mosaicism of isocitrate dehydrogenase 1/2 (IDH1/2) mutation is a cause of Ollier disease (OD), characterized by multiple enchondromatosis. A 35‐year‐old woman who was diagnosed with OD at age 24 underwent resection surgery for multifocal tumors located at the right and left frontal lobes that were discovered incidentally. No apparent spatial connection was observed on preoperative magnetic resonance imaging. Pathological examinations revealed tumor cells with a perinuclear halo in the left frontal lobe tumor, whereas astrocytic tumor cells were observed in the right frontal lobe tumor. Based on positive IDH1 R132H immunostaining and the result of 1p/19q fluorescent in situ hybridization, pathological diagnoses were IDH mutant and 1p/19q‐codeleted oligodendroglioma in the right frontal lobe tumor and IDH mutant astrocytoma in the left frontal lobe tumor, respectively. The DNA sequencing revealed IDH1 R132H mutation in the peripheral blood sample and frontal lobe tumors. This case suggested that in patients with OD, astrocytoma and oligodendroglioma can co‐occur within the same individual simultaneously, and IDH1 R132H mutation was associated with supratentorial development of gliomas.
Porphyromonas gingivalis triggers inflammation in hepatocyte depend on ferroptosis via activating the NF‐κB signaling pathway
Authors: Yao Chao , Lan Dongmei , Li Xue , Wang Yan , Qi Shengcai
Published: March 2023

Objective

Non‐alcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome characterized by excessive fat deposition in hepatocytes caused by non‐alcoholic liver injury. Porphyromonas gingivalis (P.g) is the main pathogen causing periodontitis, which can aggravate the progression of NAFLD in our previously study. The objective of this study was to further investigate the pathogenesis and moleculer michanisma of NAFLD aggravated by P.g.

Methods

A mouse model of NAFLD was established, and the changes of inflammatory factors and NF‐κB signaling pathway in liver tissue and L‐02 cells were analyzed by transcriptome sequencing, Western blot, IHC and RT‐PCR. In addition, the NF‐κB signaling pathway inhibitor QNZ and ferroptosis inhibitor Fer‐1 were used to analyze the relationship between NF‐κB signaling pathway and ferroptosis in vitro.

Results

In vivo and in vitro experiments, P.g can induce liver inflammation and activate NF‐κB signaling pathway. At the same time, P.g promotes ferroptosis and inflammation in L‐02 in vitro. QNZ alleviates ferroptosis and inflammatory activation in L‐02. Fer‐1 can relieve the L‐02 inflammation caused by P.g products.

Conclusion

Porphyromonas gingivalis can induce ferroptosis and inflammation in hepatocytes and further worsen liver lesions. The mechanism of ferroptosis in hepatocytes depends on NF‐κB signaling pathway, which provides a new strategy for clinical treatment and prevention of NAFLD.
High‐frequency ultrasound point‐of‐care device to quantify myopia‐induced microstructural changes in the anterior sclera
Authors: Hoerig Cameron , Hoang Quan V. , Aichele Johannes , Catheline Stefan , Mamou Jonathan
Published: March 2023

Purpose

To develop a point‐of‐care (POC) device using high‐frequency ultrasound (US) for evaluating microstructural changes in the anterior sclera associated with myopia.

Methods

The proposed POC device must satisfy four primary requirements for effective clinical use: the measurement component is handheld; the software must be simple and provide real‐time feedback; patient safety and health data security requirements set forth by relevant governing bodies must be satisfied and the measurement data must have sufficient signal‐to‐noise ratio (SNR) and repeatability. Radiofrequency (RF) echo data acquired by the POC device will be processed using our quantitative US methods to characterise tissue microstructure and biomechanical properties.

Results

All stated requirements have been met in the developed POC device. The high‐frequency transducer is housed in a custom, 3D‐printed, pen‐like holder that allows for easy measurements of the anterior sclera. Custom software provides a simple interface for data acquisition, real‐time data display and secure data storage. Exposimetry measurements of the US pressure field indicate device compliance with United States Food and Drug Administration limits for ophthalmic US. In vivo measurements on a volunteer suggest the RF data SNR and acquisition consistency are suitable for quantitative analysis.

Conclusions

A fully functioning POC device using high‐frequency US has been created for evaluating the microstructure of the anterior sclera. Planned studies using the POC device to scan the eyes of myopia patients will help clarify how the anterior sclera microstructure may be affected by myopia. If effective, this portable, inexpensive and user‐friendly system could be an important part of routine eye examinations.
Pure experience revisited: A critical reassessment of Nishida Kitaro's radicalization of William James' empiricism
Authors: Stone Richard , Altobrando Andrea
Published: March 2023

In this paper, we will revisit the relation between the respective conceptions of pure experience of Nishida Kitaro and William James. As various authors have previously shown, comparing Nishida and James can not only help us better understand both of their specific understandings of pure experience, and consequently its position within their respective enterprises, but also give a platform with which to see how these two authors could contribute to contemporary discussions on philosophical methodology. However, despite the long history of comparative research on these two thinkers, there is still no consensus about the extent to which Nishida's philosophy actually resembles James' work at all. Was Nishida's interest in James' work found only in superficial similarities between two authors interested in overcoming the subject–object distinction? Or did Nishida attempt to somehow develop or radicalize James' work, taking his notion of pure experience into the realm of religion and metaphysics? In this contribution, we will agree with previous authors who have argued that Nishida is best understood as trying to go beyond or develop James' work. However, we will make this claim with the caveat that James had good reason not to take the avenues Nishida pursued, and that Nishida's attempt to radicalize some ideas in James may have led to some difficult points within his early philosophy.
How to be an antirealist about metaphysical explanation
Authors: Thompson Naomi
Published: March 2023

Antirealism about metaphysical explanation is relatively underexplored. This paper maps out the territory for the antirealist, explaining what it would take to be an antirealist given various different conceptions of metaphysical explanation, and of the relationship between metaphysical explanation and grounding.