bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of gender on 10-year outcome after coronary artery bypass grafting
Authors: Barili Fabio , D’Errigo Paola , Rosato Stefano , Biancari Fausto , Forti Marco , Pagano Eva , Parolari Alessandro , Gellini Mara , Badoni Gabriella , Seccareccia Fulvia
Published: April 2021

OBJECTIVES

Our goal was to evaluate the impact of gender on the 10-year outcome of patients after isolated coronary artery bypass grafting (CABG) included in the Italian nationwide PRedictIng long-term Outcomes afteR Isolated coronary arTery bypass surgery (PRIORITY) study.

METHODS

The PRIORITY project was designed to evaluate the long-term outcomes of patients who underwent CABG and were included in 2 prospective multicentre cohort studies. The primary end point of this analysis was major adverse cardiac and cerebrovascular events. Baseline differences between the study groups were balanced with propensity score matching and inverse probability of treatment. Time to events was analysed using Cox regression and competing risk analysis.

RESULTS

The study population comprised 10 989 patients who underwent isolated CABG (women 19.6%). Propensity score matching produced 1898 well-balanced pairs. The hazard of major adverse cardiac and cerebrovascular event was higher in women compared to men [adjusted hazard ratio (HR) 1.13, 95% confidence interval (CI) 1.03–1.23; P = 0.009]. The incidence of major adverse cardiac and cerebrovascular event in women was significantly higher at 1 year (HR 1.31, 95% CI 1.11–1.55; P < 0.001) and after 1 year (HR 1.11, 95% CI 1.00–1.24; P = 0.05). Mortality at 10 years in the matched groups was comparable (HR 1.04, 95% CI 0.93–1.16; P = 0.531). Women have significantly a higher 10-year risk of myocardial infarction (adjusted HR 1.40, 95% CI 1.17–1.68; P = 0.002) and percutaneous coronary intervention (adjusted HR 1.32, 95% CI 1.10–1.59; P = 0.003).

CONCLUSIONS

The present study documented an excess of non-fatal cardiac events after CABG among women despite comparable 10-year survival with men. These findings suggest that studies investigating measures of tertiary prevention are needed to decrease the risk of adverse cardiovascular events among women.
Deformation Principle and André motives of Projective Hyperkähler Manifolds
Authors: Soldatenkov Andrey
Published: April 2021

Let $X_1$ and $X_2$ be deformation equivalent projective hyperkähler manifolds. We prove that the André motive of $X_1$ is abelian if and only if the André motive of $X_2$ is abelian. Applying this to manifolds of $\mbox {K3}^{[n]}$, generalized Kummer and OG6 deformation types, we deduce that their André motives are abelian. As a consequence, we prove that all Hodge classes in arbitrary degree on such manifolds are absolute. We discuss applications to the Mumford–Tate conjecture, showing in particular that it holds for even degree cohomology of such manifolds.
Fifty Shades of Terrorist Credit-Taking: A Review of the Existing Scholarship on Terrorist Credit-Taking
Authors: Hansen Tanja Marie
Published: April 2021

The consistently low credit-taking rates, 16 percent in 2016 (Global Terrorism Database), continue to challenge the understanding of terrorism as “propaganda of the deed” twenty years after researchers initially pointed out the conundrum. While providing an overview and evaluation of the limited existing literature on credit-taking, this paper draws attention to three core problems in the current literature on terrorist credit-taking, which may have led the low credit-taking rates to appear more puzzling than is due. First, the available explanations struggle to find corroboration when empirically tested and many also show theoretical shortcomings with strong unspoken assumptions and unclear predictions of credit-taking behavior. Second, data structure and data availability unnecessarily narrow our academic understanding of credit-taking. Finally, theories focused on group characteristics such as religious motivation or state sponsorship suffer from severe issues of sample bias due to unintended selection on the dependent variable. The paper concludes with suggestions for future research less prone to the problematic issues identified in the article. A re-orientation toward a less restrictive and more fine-grained understanding of credit-taking is advised.
Continuous monitoring in COVID-19 care: a retrospective study in time of crisis
Authors: de Ree Roy , Willemsen Jorn , te Grotenhuis Gilbert , de Ree Rick , Kolkert Joé , Peppelman Malou
Published: April 2021

Background

A new monitoring system was implemented to support nursing staff and physicians on the COVID-19 ward. This system was designed to remotely monitor vital signs, to calculate an automated Early Warning Score, and to help identify patients at risk of deterioration.

Methods

Hospitalized patients who tested positive for SARS-CoV-2 were connected to 2 wireless sensors measuring vital signs. Patients were divided into 2 groups based on the occurrence of adverse events during hospitalization. Heart and respiratory rate were monitored continuously and an automated EWS was calculated every 5 minutes. Data were compared between groups.

Results

Prior to the occurrence of adverse events, significantly higher median heart and respiration rate and significantly lower median SPO2 values were observed. Mean and median automated EWS were significantly higher in patients with an adverse event.

Conclusion

Continuous monitoring systems might help to detect clinical deterioration in COVID-19 patients at an earlier stage.
Smokeless Tobacco Initiation, Use, and Cessation in South Asia: A Qualitative Assessment
Authors: Siddiqui Faraz , Croucher Ray , Ahmad Fayaz , Ahmed Zarak , Babu Roshani , Bauld Linda , Fieroze Fariza , Huque Rumana , Kellar Ian , Kumar Anuj , Lina Silwa , Mubashir Maira , Nethan Suzanne Tanya , Rizvi Narjis , Siddiqi Kamran , Kumar Singh Prashant , Thomson Heather , Jackson Cath
Published: April 2021

Introduction

Smokeless tobacco (ST) is a significant South Asian public health problem. This paper reports a qualitative study of a sample of South Asian ST users.

Methods

Interviews, using a piloted topic guide, with 33 consenting, urban dwelling adult ST users explored their ST initiation, continued use, and cessation attempts. Framework data analysis was used to analyze country specific data before a thematic cross-country synthesis was completed.

Results

Participants reported long-term ST use and high dependency. All reported strong cessation motivation and multiple failed attempts because of ease of purchasing ST, tobacco dependency, and lack of institutional support.

Conclusions

Interventions to support cessation attempts among consumers of South Asian ST products should address the multiple challenges of developing an integrated ST policy, including cessation services.

Implications

This study provides detailed understanding of the barriers and drivers to ST initiation, use, and cessation for users in Bangladesh, India, and Pakistan. It is the first study to directly compare these three countries. The insight was then used to adapt an existing behavioral support intervention for ST cessation for testing in these countries.
The Total Return and Risk to Residential Real Estate
Authors: Eichholtz Piet , Korevaar Matthijs , Lindenthal Thies , Tallec Ronan
Published: April 2021

We estimate total returns to rental housing by studying over 170,000 hand-collected archival observations of prices and rents for individual houses in Paris (1809–1943) and Amsterdam (1900–1979). The annualized real total return, net of costs and taxes, is 4.0% for Paris and 4.8% for Amsterdam and entirely comes from rental yields. Our returns weakly correlate with the implied returns in Jordà et al. (2019) and are substantially lower. We decompose total return risk at the individual asset level and find that yield risk becomes an increasingly important component of property-level risk for longer investment horizons.
Providing affirming care for LGBTQ patients
Authors: McElwain Sharon D. , Carr Kayla L.
Published: April 2021

Become familiar with inclusion-promoting strategies to help you improve communication and collect important assessment data.
Pediatric Acute Pancreatitis
Authors: Birimberg-Schwartz Liron , Rajiwate Sara , Dupuis Annie , Gonska Tanja
Published: April 2021

Objective

To examine the changes over time of pediatric acute pancreatitis (AP) severity, management, and disease outcomes at our academic tertiary center.

Methods

We reviewed 223 pediatric AP admissions (2002–2018) and used a time-to-event regression model to study changes over time. Disease outcomes were analyzed using a subgroup of 89 patients in whom only the AP event determined length of hospital stay and duration of opioid use.

Results

There was an increase in mild, but not severe, AP episodes over the examined period. June 2014 was identified as a single cutoff point for change in AP management and disease outcomes independent of each other and of disease severity. Timing of initiating enteral nutrition decreased from 5 to 1.6 days (P < 0.0001) in the entire cohort and from 4.1 to 1.8 days in the subgroup (P = 0.0001) after June 2014. Length of hospitalization decreased from 6 to 3.3 days (P = 0.0008) and days of opioid use from 4.1 to 1.3 (P = 0.002) after June 2014.

Conclusions

Timing of initiating enteral nutrition has significantly reduced at our center after June 2014. In parallel, we observed a significant improvement in disease outcomes.
Phase II Study of Adjuvant Chemotherapy With Gemcitabine and Nafamostat Mesilate for Pancreatic Cancer
Authors: Uwagawa Tadashi , Sakamoto Taro , Yasuda Jungo , Shiozaki Hironori , Furukawa Kenei , Onda Shinji , Gocho Takeshi , Shiba Hiroaki , Yanaga Katsuhiko
Published: April 2021

Objectives

The aim of this study was to clarify the effectiveness of combination chemotherapy targeting gemcitabine (GEM)–induced nuclear factor kappa B as adjuvant therapy for pancreatic cancer.

Methods

Patients who were planned after curative surgery (residual tumor classification R0 or R1) for pancreatic cancer to receive six cycles of adjuvant chemotherapy of regional arterial infusion of nafamostat mesilate with GEM between June 2011 and April 2017 were enrolled in this single-center, institutional review board–approved phase II trial (UMIN000006163). The Kaplan-Meier method was used to estimate disease-free survival and overall survival.

Results

In 32 patients [male/female: 18/14; age: median, 65.5 years (range, 48–77 years); pathological stage (Union for International Cancer Control 8th): IA/IB/IIA/IIB/III, 2/2/9/18/1, respectively] who met the eligibility criteria, the median overall survival and disease-free survival were 36.4 months (95% confidence interval, 31.7–48.3) and 16.4 months (95% confidence interval, 14.3–22.0), respectively. Grade 4 treatment-related hematological toxicities were seen in 5 patients (15.6%) (all neutropenia). One patient developed grade 3 nonhematological toxicities (rash).

Conclusions

Adjuvant chemotherapy with regional arterial infusion of nafamostat mesilate and GEM is safe and has potential as an option in adjuvant setting after curative surgery for pancreatic cancer.
The Role of Perioperative Chemotherapy in the Management of Colloid Carcinoma of the Pancreas
Authors: Picado Omar , Dosch Austin R. , Garcia-Buitrago Monica T. , Yakoub Danny , Dudeja Vikas , Rodgers Steven E.
Published: April 2021

Objectives

Colloid carcinoma (CC) of the pancreas is associated with an improved prognosis compared with pancreatic ductal adenocarcinoma (PDAC), yet studies on the optimal management of these rare lesions are lacking.

Methods

Patients with CC or PDAC treated from 2004 to 2014 were identified in the National Cancer Database. Clinicopathologic characteristics were compared between groups and stratified by disease stage. Survival analysis evaluating the role of perioperative chemotherapy was performed.

Results

A total of 1295 CC patients (11%) and 10,855 PDAC patients (89%) were identified. Pancreatic ductal adenocarcinoma was associated with a higher likelihood of mortality compared with CC (hazard ratio, 1.35; 95% confidence interval, 1.25–1.45; P < 0.001). When stratifying by stage, perioperative chemoradiation improved overall survival in early stage (I/IIA) PDAC but had no effect in CC patients. However, for node-positive disease (stage IIB), median overall survival was improved with adjuvant chemoradiation for both CC patients (22 vs 13 months; P < 0.001) and PDAC patients (20 vs 11 months; P < 0.001) compared with surgery alone.

Conclusions

Surgery alone may be sufficient for the management of node-negative (I/IIA) CC lesions in contrast to conventional PDAC, whereas CC patients with stage IIB disease have a survival benefit from perioperative chemoradiation.
Low mammalian species richness is associated with Kyasanur Forest Disease outbreak risk in deforested landscapes in the Western Ghats, India
Authors: Walsh Michael G. , Bhat Rashmi , Nagarajan-Radha Venkatesh , Narayanan Prakash , Vyas Navya , Sawleshwarkar Shailendra , Mukhopadhyay Chiranjay
Published: April 2021

Kyasanur forest disease virus (KFDV) is a rapidly expanding tick-borne zoonotic virus with natural foci in the forested region of the Western Ghats of South India. The Western Ghats is one of the world’s most important biodiversity hotspots and, like many such areas of high biodiversity, is under significant pressure from anthropogenic landscape change. The current study sought to quantify mammalian species richness using ensemble models of the distributions of a sample of species extant in the Western Ghats and to explore its association with KFDV outbreaks, as well as the modifying effects of deforestation on this association. Species richness was quantified as a composite of individual species’ distributions, as derived from ensembles of boosted regression tree, random forest, and generalised additive models. Species richness was further adjusted for the potential biotic constraints of sympatric species. Both species richness and forest loss demonstrated strong positive associations with KFDV outbreaks, however forest loss substantially modified the association between species richness and outbreaks. High species richness was associated with increased KFDV risk but only in areas of low forest loss. In contrast, lower species richness was associated with increased KFDV risk in areas of greater forest loss. This relationship persisted when species richness was adjusted for biotic constraints at the taluk-level. In addition, the taluk-level species abundances of three monkey species (Macaca radiata, Semnopithecus hypoleucus, andSemnopithecus priam) were also associated with outbreaks. These results suggest that increased monitoring of wildlife in areas of significant habitat fragmentation may add considerably to critical knowledge gaps in KFDV epidemiology and infection ecology and should be incorporated into novel One Health surveillance development for the region. In addition, the inclusion of some primate species as sentinels of KFDV circulation into general wildlife surveillance architecture may add further value.

Highlights

Local mammalian species richness is estimated across the entire Western Ghats region

Low species richness is associated with high KFDV risk in deforested landscapes

This work identifies key landscapes for wildlife disease surveillance development
Host cell membrane capture by the SARS CoV-2 spike protein fusion intermediate
Authors: Su Rui , Zeng Jin , O’Shaughnessy Ben
Published: April 2021

Cell entry by SARS-CoV-2 is accomplished by the S2 subunit of the spike S protein on the virion surface by capture of the host cell membrane and fusion with the viral envelope. Capture and fusion require the prefusion S2 to transit to its potent, fusogenic form, the fusion intermediate (FI). However, the FI structure is unknown, detailed computational models of the FI are unavailable, and the mechanisms and timing of membrane capture and fusion are not established. Here, we constructed a full-length model of the CoV-2 FI by extrapolating from known CoV-2 pre- and postfusion structures. In atomistic and coarse-grained molecular dynamics simulations the FI was remarkably flexible and executed large bending and extensional fluctuations due to three hinges in the C-terminal base. Simulations suggested a host cell membrane capture time of ∼ 2 ms. Isolated fusion peptide simulations identified an N-terminal helix that directed and maintained binding to the membrane but grossly underestimated the binding time, showing that the fusion peptide environment is radically altered when attached to its host fusion protein. The large configurational fluctuations of the FI generated a substantial exploration volume that aided capture of the target membrane, and may set the waiting time for fluctuation-triggered refolding of the FI that draws the viral envelope and host cell membrane together for fusion. These results describe the FI as a machinery designed for efficient membrane capture and suggest novel potential drug targets.

Abstract Figure
Welch-weighted Egger regression reduces false positives due to correlated pleiotropy in Mendelian randomization
Authors: Brown Brielin C. , Knowles David A.
Published: April 2021

Modern population-scale biobanks contain simultaneous measurements of many phenotypes, providing unprecedented opportunity to study the relationship between biomarkers and disease. However, inferring causal effects from observational data is notoriously challenging. Mendelian randomization (MR) has recently received increased attention as a class of methods for estimating causal effects using genetic associations. However, standard methods result in pervasive false positives when two traits share a heritable, unobserved common cause. This is the problem of correlated pleiotropy. Here, we introduce a flexible framework for simulating traits with a common genetic confounder that generalizes recently proposed models, as well as simple approach we call Welch-weighted Egger regression (WWER) for estimating causal effects. We show in comprehensive simulations that our method substantially reduces false positives due to correlated pleiotropy while being fast enough to apply to hundreds of phenotypes. We first apply our method to a subset of the UK Biobank consisting of blood traits and inflammatory disease, and then a broader set of 411 heritable phenotypes. We detect many effects with strong literature support, as well as numerous behavioral effects that appear to stem from physician advice given to people at high risk for disease. We conclude that WWER is a powerful tool for exploratory data analysis in ever-growing databases of genotypes and phenotypes.
Towards developing a comprehensive conceptual understanding of positive hospital culture and approaches to healthcare organisational culture change in Australia
Authors: Pavithra Antoinette
Published: April 2021

Purpose

The key aim of this narrative literature review, therefore, is to identify the key conceptual categories that inform the construction of positive person-centred culture within hospitals, and how these frameworks are brought to bear upon organisational culture within healthcare systems in Australia.

Design/methodology/approach

This narrative review presents a thematic synthesis of literature identified through a systematic search protocol undertaken across 19 academic databases and Google Scholar as an additional search tool. Thematic qualitative analysis was performed on the research results to determine the common themes within the diverse literature presented within this study.

Findings

Culture change interventions in hospitals attempt to address the problem of widespread unprofessional behaviour within healthcare systems. However, diverse definitions and seemingly fragmented approaches to understanding and enacting organisational culture change present a significant hurdle in achieving cohesive and sustainable healthcare reform. This narrative literature review offers a comprehensive conceptual view of the key approaches that inform positive person-centred culture within hospital settings. In total, three primary dimensions, belonging, behaving and being, aligned against organisational goals, individual behaviours and worker as well as organisational identity were identified. Other individual and group interactional dynamics that give rise to negative organisational culture are further analysed to understand the fault lines along which existing culture change interventions are typically operationalised.

Research limitations/implications

This review is not exhaustive and is limited in its methodological scope. The central values and themes identified within the literature are integral to designing humanised healthcare systems. However, owing to the qualitative nature and contextual variability of these factors, these themes do not lend themselves to replicable quantification.

Social implications

This analysis contributes to foundational research efforts towards transforming healthcare practice to be more aligned with humanised and equitable values within increasingly complex healthcare organisational settings. Designing culture change interventions that align more suitably with the values-driven categories identified in this literature review may increase the effectiveness and sustainability of these interventions and reform efforts at organisational and systemic levels.

Originality/value

This article presents a comprehensive framework to approach healthcare organisational reform through shared and equitable models of operation, management and governance rather than continuing to promote narrowly defined outcomes derived from commodified models of healthcare practice.
Three historical narratives on advertising self-control in Brazil
Authors: Rodrigues Laís , Costa Alessandra de Sá Mello da , Hemais Marcus Wilcox
Published: April 2021

Purpose

The purpose of this paper is to analyze how, in three different contexts, the National Council for Advertising Self-Regulation narratively uses its past to build an official history concerning its origins that legitimates advertising self-control as a hegemonic narrative.

Design/methodology/approach

By using the historical research and the “uses of the past” approach, this study identifies, analyzes and confronts three organizational histories of Conar’s origins (both its official and unofficial versions) in the context of the creation of the Brazilian system of advertising self-regulation.

Findings

After a thematic analysis of the documentary sources, the narratives on the National Council for Advertising Self-Regulation’s origins and the self-control process were grouped into three versions: the narrative under the military regime: 1976/1980; the narrative during the process of re-democratization of the country: 1981/1991 and the contemporary narrative: from 2005 onwards. These narratives were confronted and, in consequence, provided, each of them, a different interpretation of the context surrounding the creation and justification for advertising self-control.

Originality/value

The study shows how a consumer defense organization re-historicized its past strategically to gain legitimacy in three different ways through time. It also reveals that organizations strategically use their past to build an intended vision of the future, thus having more agency than the hegemonic literature in management studies usually guarantees. Finally, it exposes the malleability of past narratives through which organizations play a critical role in the ongoing struggle for competing uses of the past. Therefore, the study identifies different organizational stories through time that allow researchers to reflect on several strategic uses of the past by organizations.
Leadership as an art: an enduring concept framed within contemporary leadership
Authors: Caulfield Jay L. , Lee Felissa K. , Richards Bret A.
Published: April 2021

Purpose

The aim of this viewpoint paper is to refine the meaning of “leadership as an art” in the context of wicked (complex) social problems and in the realm of contemporary leadership research and practice.

Design/methodology/approach

In this paper we explore the meaning of “leadership as an art,” a concept often alluded to but rarely defined concretely. The authors examine the concept by comparing artistic and scientific knowledge paradigms, identifying descriptors of the “leadership as art” concept appearing in the literature and illustrating key attributes of the “leadership as art” concept with real-world examples.

Findings

Leadership as an art is conceptualized as empathetically engaging and normatively uniting people in a vision to promote the common good through collectively formulating an understanding of a complex social problem and its resolution that when courageously and creatively pursued has the potential to make an extraordinary contribution to humanity.

Social implications

The magnitude and complexity of social problems impact communities on a daily basis, making them worthy of attention. History has demonstrated that practicing leadership as an art from a normative power base has the potential of uniting diverse collectives in creatively resolving wicked social problems for the benefit of the common good.

Originality/value

Although leadership as an art has been discussed in the literature over several decades, the term has not been positioned explicitly within contemporary leadership in the context of resolving complex social problems within social networks.
Long-term orientation of South Asian leadership and organizational competitiveness and survival of Sasken Technologies Limited
Authors: Venkateswaran Ramya T. , Vadivelu Selvaraj , Krishnan Swaminathan
Published: April 2021

Purpose

The objective of this paper is to understand the perspectives of the chief executive officer (CEO), chairman and managing director of Sasken Technologies Limited, Shri. Rajiv C. Mody who co-founded this high-technology firm, which has survived three decades of turbulence in technology and the market. This is an interview-based study focused on South Asian CEOs, with the goal of better understanding the cultural elements of strategic leadership and organizational values and its influence on organizational competitiveness and survival.

Design/methodology/approach

The paper uses primary data from one in-depth interview and supplements the analyses with secondary sources of data. The literature on the cultural dimension of long-term orientation (LTO) is discussed for understanding its possible linkage with strategic leadership, organizational values and thereby organizational competitiveness and survival.

Findings

This study found that the national cultural dimension of LTO of the South Asian leadership, as embedded, nurtured and practiced in the organization's values by the strategic leadership, plays an important role in explaining the organizational competitiveness and survival of South Asian firms while facing challenges and opportunities in a turbulent global business context.

Originality/value

This paper offers the perspective of a chairman and CEO of a high-technology firm with global experience and with a South Asian base of operations. His experiences in managing the organization add value to the discussion on managing business in South Asia.
Risk of recurrent stillbirth: a cohort study
Authors: Wood SL , Tang S
Published: April 2021

Objectives

To evaluate the recurrence risk of stillbirth.

Design

Retrospective cohort study.

Setting and population

All births 1992–2017, Alberta, Canada.

Methods

Retrospective cohort study.

Main outcome measures

Stillbirth was defined as the death in utero of a fetus with gestational age ≥20 weeks or weighing ≥500 g. Stillbirths were further subdivided into those occurring before labour and those in labour.

Results

We identified 744 897 births from 308 478 women. Of these, 3698 women experienced a stillbirth and, of these, 97.7%, experienced only one. For women with a small‐for‐gestational‐ age stillbirth in the first birth, their risk of a subsequent antepartum stillbirth was increased substantially: 4.09%, relative risk (RR) 10.39, 95% CI 5.81–18.59. For women with a first birth appropriate‐for‐gestational‐age stillbirth with no risk factors such as pregnancy induced hypertension, the risk with pre‐existing diabetes mellitus or hypertension was also increased but to a much lesser degree (RR 2.46, 95% CI 1.23–4.91). For women who had experienced a first birth intrapartum stillbirth, the risk of another intrapartum stillbirth was very high (3.59%, RR 36.50, 95% CI 20.17–66.05). Most of these births also occurred prior to 24 weeks’ gestation: 83% (10/12).

Conclusions

The risk of recurrent antepartum stillbirth is low. The increase in risk in instances where the antepartum stillbirth was not growth‐restricted is not clinically meaningful. Given the very low risk in any given gestational week, fetal surveillance is unlikely to be effective and may lead to unnecessary interventions. Intrapartum stillbirth has a very high recurrence risk but may not be preventable.

Tweetable abstract

Stillbirth recurrence is rare.
Effect of cataract surgery on wet age‐related macular degeneration activity
Authors: Karesvuo Petteri , Elbaz Uri , Achiron Asaf , Hecht Idan , Kaarniranta Kai , Tuuminen Raimo
Published: April 2021

Background

Wet age‐related macular degeneration (AMD) and age‐related cataract are often coexisting causes of visual impairment. Yet, the timing of cataract surgery in wet AMD patients is controversial.

Methods

One hundred and eleven eyes of 111 patients with wet AMD underwent cataract surgery at Helsinki University Hospital in Finland during 2014–2018. Best‐corrected visual acuity and central subfield macular thickness (CSMT) were analysed at the time of wet AMD diagnosis, at the last recording prior to cataract surgery and at the first recording and at 1 year after surgery. The cumulative number of antivascular endothelial growth factor (anti‐VEGF) injections at surgery, systemic and topical medication and postoperative anti‐VEGF burden were recorded.

Results

Mean age was 78.9 ± 5.6 years at the time of surgery. Central subfield macular thickness (CSMT) significantly decreased (280.1 ± 75.0 µm preoperatively to 268.6 ± 67.6 µm at the first postoperative recording, p = 0.001, and to 265.9 ± 67.9 µm at 1 year, p = 0.003), visual acuity improved (0.70 ± 0.46 logMAR units preoperatively to 0.39 ± 0.40 at the first postoperative recording, and to 0.33 ± 0.34 at 1 year, p < 0.001 for both) and anti‐VEGF treatment intervals lengthened despite the surgery (6.53 ± 2.08 weeks prior to surgery to 7.03 ± 2.23 weeks at 1 year, p = 0.246, and to 7.05 ± 2.57 weeks at the last documented visit, p = 0.035). A CSMT increase of over 30% from the preoperative values was seen in only one case (1 out of 111 eyes, 0.9%). Macular status at surgery, wet AMD subtype, comorbidity of type II diabetes, systemic drugs and topical anti‐inflammatory medication were not associated with macular changes nor with treatment intervals after surgery. The cumulative number of anti‐VEGF injections correlated neither with CSMT change postoperatively (r = −0.051, p = 0.619) nor with CSMT change at 1 year (r = 0.091, p = 0.426).

Conclusion

Satisfactory visual outcomes and controlled disease activity were seen in patients with wet AMD undergoing cataract surgery. We found no evidence to support delaying surgery in patients who require it.
Impact of induction strategy change on first‐year rejection in pediatric heart transplantation at a single center—From postoperative basiliximab to either postoperative anti‐thymocyte globulin or preoperative basiliximab
Authors: Sisson Thomas Miller , Padilla Luz A. , Hubbard Meloneysa , Smith Sally , Pearce Frank Bennett , Collins Jacqueline Leslie , Carlo Waldemar F.
Published: April 2021

Background

Our pediatric heart transplant center transitioned from post‐bypass basiliximab (BAS) induction to either anti‐thymocyte globulin (ATG) or pre‐bypass BAS. The purpose of this study was to compare first‐year rejection rates before and after this change.

Methods

A single‐center retrospective analysis was conducted of pediatric heart transplant recipients from 2010 to 2019. Primary outcome was first‐year rejection. Bivariate analysis, Kaplan‐Meier curves, and multivariable regression were performed across eras.

Results

Forty‐three early era patients (55%) received post‐bypass BAS, and 35 late era patients (45%) received pre‐bypass BAS (n = 17) or ATG (n = 18). First‐year rejection decreased in the late era (31% vs 53%, p = .05). This finding was more pronounced after excluding infants (38% vs 73%, p = .006). Late era was associated with a decreased likelihood of rejection (all cohort OR 0.19, 95% CI 0.05‐0.66; infants excluded OR 0.17, 95% CI 0.04‐0.61). No differences in post‐transplant lymphoproliferative disease, donor‐specific antibody, or infection were observed.

Conclusions

Fewer late era patients receiving ATG or pre‐bypass BAS induction had first‐year rejection compared to the early era patients receiving standard post‐bypass BAS induction. This programmatic shift in induction strategy was readily achievable and potentially effective in reducing first‐year rejection.
Determination of phenolic antioxidants in tuna fillets canned in hydrosols with HPLC‐DAD
Authors: Kalogiouri Natasa P. , Kokokiris Lambros E. , Doulgeraki Stephania , N. Papadopoulos Athanasios , Samanidou Victoria F.
Published: April 2021

Canned tuna was fortified with a mixture of brine and hydrosols of aromatic plants (i.e. oregano, laurel, sage and lemon balm). An HPLC‐DAD method was developed and validated for the simultaneous determination of thirteen antioxidants in tuna fillets, including phenolic acids (gallic acid, vanillic acid, syringic acid and rosmarinic acid), flavonoids (catechin, epicatechin, vanillin, myricetin, rutin, quercetin, luteolin and apigenin) and one hydroxybenzaldehyde (syringaldehyde). The analytes showed satisfying recovery efficiency (82.1–92.1%), and the method presented excellent linearity (r2 > 0.99). The precision limit was ≤5.6% RSDr for intra‐day and ≤7.2% RSDR for inter‐day experiments. The determined analytes ranged between 8.86 mg (quercetin) and 512 mg (rosmarinic acid) per 100g tuna flesh (n = 10), verifying that the hydrosols fortified the tuna fillets.
Early hematological indicators of severe COVID‐19 disease in hospitalized patients: Data from a South Asian population
Authors: Sharif Fatima , Khan Samreen , Junaid Ayesha , Jahangir Sehreen , Saeed Maria , Ijaz Maira , Ahmad Imran Nazir , Kamran Shawana
Published: April 2021

Introduction

Outbreak of corona virus disease in 2019 (COVID‐19) has resulted in significant morbidity and mortality worldwide. Our aim is to document hematological parameters of patients with COVID‐19 during initial stage of diagnosis and to identify early hematological indicators of severe infection.

Materials and methods

This retrospective study was conducted at Shifa International Hospital, Pakistan from April to November 2020. Patients hospitalized with COVID‐19, diagnosed on RT‐PCR and had a complete blood count (CBC) done within 48 hours of diagnosis were included. Data was analyzed using IBM® SPSS Statistics.

Results

A total of 425 patients were included in this study out of whom 272(64%) were males. The mean age was 55.61 ± 17.84 years. 95 patients (22.4%) had normal blood counts within 48 hours of COVID‐19 diagnosis. Cytopenias were seen in 193(45.4%) patients. There were 75(17.6%) mortalities during the study period. Chi‐square test showed that thrombocytopenia, lymphopenia and neutrophilic leucocytosis were significantly associated with mortality (P = .037, P < .001, P < .001 respectively) and need for ventilator (P = .009, P < .001, P < .001, respectively). Neutrophilia was also associated with development of Acute Respiratory Distress Syndrome (P < .001). On ROC analysis, Neutrophil‐to‐Lymphocyte Ratio yielded an area under the curve (AUC) of 0.693 and 0.660 for the outcomes mortality and need for ventilator, respectively. For a subset of 288 patients who had D‐dimer levels checked within 48 hours of COVID‐19 diagnosis, the AUC for mortality and ventilator need was 0.708 and 0.671, respectively.

Conclusion

Hematological indices are vital indicators in the prognosis and risk stratification of COVID‐19 during initial stages of disease.
Risk factors for incorrect surgical count during surgery: An observational study
Authors: Fang Juanmei , Yuan Xi , Fan Li , Du Meilan , Sui Wenjie , Ma Wenxia , Wang Haiying , Pan Ai‐fen
Published: April 2021

Background

Incorrect surgical counts are closely related to retained surgical items, which pose a threat to patients. However, the risk factors for incorrect surgical counts have not been identified yet.

Aim

To identify the risk factors associated with incorrect surgical counts during surgery in a tertiary hospital.

Design

An observational case–control study.

Methods

Seventy cases of incorrect surgical counts were reviewed in this study. Data were collected from January 1, 2014, to April 4, 2019. For each case, we included four randomly selected control cases involving the same surgical procedures by the same surgeon within a 6‐month period for comparison. The medical data of these cases were extracted for further statistical analysis.

Results

A higher incidence of incorrect surgical counts was observed among surgical counts performed between 8:00 a.m. to 12:00 a.m., emergency operations, prolonged procedures, and/or after addition of surgical items.

Conclusion

Prolonged surgical procedures, emergency operations, time of occurrence, and addition of surgical items were the risk factors related to incorrect surgical counts during surgery.
Unveiling the presence of mixed oxidation states of Europium in Li7+δEuxLa3−δZr2−δO12−δ garnet and its impact on the Li‐ion conductivity
Authors: Salimkhani Hamed , Erdem Emre , Alkan Gursel Selmiye , Yurum Alp
Published: April 2021

Recently, lanthanides have been employed by researchers to examine their impact on the structure and properties of Li7La3Zr2O12 (LLZO) garnets. In this regard, we developed Europium oxide (Eu2O3) doped LLZO (Li7+δEuxLa3−δZr2−δO12−δ) solid electrolyte which demonstrates a cubic phase with the symmetry of Iad (No.230) at room temperature. In this investigation, different concentrations of Eu ranging from 0.1 to 0.6 atoms per formula unit (pfu) were doped into Li7La3Zr2O12 to evaluate the impact of Eu on the stability of the cubic phase and thereby the ionic conductivity. The results unveiled that upon doping Eu3+ ions, the Eu2+ state is also formed and is then self‐doped into the structure in which Rietveld refinement coupled with XPS, EPR, and solid‐state NMR suggests that Eu3+ ions most probably partially occupy Zr4+ (16a) site, the Eu2+ ions occupy La3+ (24d) site, and the Li+ ions occupy two different sites (24d and 96h). It was further found that such a site preference induces distortion at LaO8 polyhedrons opening up the neck for Li‐ions diffusion, thereby enhancing the ionic conductivity. Moreover, it was revealed that Li‐ions probably hop from 96h to 24d and then to 96h site to generate the Li‐ion movement. Overall, by introducing Eu ions into the LLZO structure, an enhanced bulk ionic conductivity of 0.30 × 10−3 S/cm at 298 K with a minimum electronic conductivity of 2.547 × 10−9 S/cm at 298 K was achieved.
Terminology and Design Capital: Examining the Pedagogic Status of Graphic Design through Its Practitioners’ Perceptions of Their Job Titles
Authors: Meron Yaron
Published: April 2021

Graphic design has long been hampered by its indeterminate educational disciplinary status, resulting in it being subsumed within wider visual arts studies. Arguing that this permeates into professional practice, this article explores the ambivalence of professional graphic designers towards the term ‘graphic design’ itself. Drawing on interviews with practitioners and discussions in online graphic design forums, the article argues this ambivalence derives from perceptions that the term reduces the design capital held by graphic designers. In turn, this negatively influences the graphic designers’ perceptions of professional relationships with creative stakeholders. Placing the study outcomes alongside existing academic literature, this article confirms anecdotal industry narratives about graphic designers’ perceptions of their capital. Moreover, it identifies a series of nuances to these narratives, challenging stereotypical educational and industry assumptions. In doing so, it argues that practitioner ambivalence towards the term ‘graphic design’ is symptomatic of an academic gap, resulting from inadequate pedagogic engagement with the specific discipline and practice of graphic design. This poses challenges for practitioners, as well as for the organisations they work within, at the same time presenting opportunities for researchers to make further headway into the specific discipline and methods of graphic design.
Long non‐coding RNA MFAT1 promotes skeletal muscle fibrosis by modulating the miR‐135a‐5p‐Tgfbr2/Smad4 axis as a ceRNA
Authors: Lin Jinrong , Yang Xiaobao , Liu Shaohua , Luo Zhiwen , Chen Qingyan , Sun Yaying , Ding Zheci , Chen Jiwu
Published: April 2021

Fibrosis after skeletal muscle injury is common in sports and can cause irreversible damage to the biomechanical properties of skeletal muscle. Long non‐coding RNAs (lncRNAs) have been validated to act as important modulators in the fibrosis of various organs. Here, we reported a novel lncRNA (the skeletal muscle fibrosis‐associated transcript 1, lnc‐MFAT1), which was highly expressed in skeletal muscle fibrosis. We demonstrate that lnc‐MFAT1 knockdown can reduce TGFβ‐induced fibrosis in vitro and attenuate skeletal muscle fibrosis after acute contusion in mice. Further study showed that lnc‐MFAT1 acted as a competitive endogenous RNA of miR‐135a‐5p. Besides, the miR‐135a‐5p inhibition obviously promoted TGFβ‐induced fibrosis in vitro via enhancing its target genes Tgfbr2/Smad4. Moreover, we discovered that lnc‐MFAT1 regulates Tgfbr2/Smad4 expression by sponging miR‐135a‐5p to exert competing endogenous RNA function, resulting in TGFβ pathway activation. In conclusion, our study identified a crucial role of lnc‐MFAT1‐miR‐135a‐Tgfbr2/Smad4 axis in skeletal muscle fibrosis, providing a promising treatment option against skeletal muscle fibrosis.
Insights into the regulatory role of Plexin D1 signalling in cardiovascular development and diseases
Authors: Zhang Yi‐Fei , Zhang Yu , Jia Dong‐Dong , Yang Hong‐Yu , Cheng Meng‐Die , Zhu Wen‐Xiu , Xin Hui , Li Pei‐Feng , Zhang Yin‐Feng
Published: April 2021

Plexin D1 (PLXND1), which was previously thought to mediate semaphorin signalling, belongs to the Plexin family of transmembrane proteins. PLXND1 cooperates mostly with the coreceptor neuropilin and participates in many aspects of axonal guidance. PLXND1 can also act as both a tumour promoter and a tumour suppressor. Emerging evidence suggests that mutations in PLXND1 or Semaphorin 3E, the canonical ligand of PLXND1, can lead to serious cardiovascular diseases, such as congenital heart defects, CHARGE syndrome and systemic sclerosis. Upon ligand binding, PLXND1 can act as a GTPase‐activating protein (GAP) and modulate integrin‐mediated cell adhesion, cytoskeletal dynamics and cell migration. These effects may play regulatory roles in the development of the cardiovascular system and disease. The cardiovascular effects of PLXND1 signalling have gradually been elucidated. PLXND1 was recently shown to detect physical forces and translate them into intracellular biochemical signals in the context of atherosclerosis. Therefore, the role of PLXND1 in cardiovascular development and diseases is gaining research interest because of its potential as a biomarker and therapeutic target. In this review, we describe the cardiac effects, vascular effects and possible molecular mechanisms of PLXND1 signalling.
Screening and identification of autophagy‐related biomarkers for oral squamous cell carcinoma (OSCC) via integrated bioinformatics analysis
Authors: Huang Guang‐zhao , Lu Zhi‐yun , Rao Yu , Gao Hai , Lv Xiao‐zhi
Published: April 2021

Increasing evidences have showed that autophagy played a significant role in oral squamous cell carcinoma (OSCC). Purpose of our study was to explore the prognostic value of autophagy‐related genes (ATGs) and screen autophagy‐related biomarkers for OSCC. RNA‐seq and clinical data were downloaded from The Cancer Genome Atlas (TCGA) database following extracting ATG expression profiles. Then, differentially expressed analysis was performed in R software and a risk score model according to ATGs was established. Moreover, comprehensive bioinformatics analyses were used to screen autophagy‐related biomarkers which were later verified in OSCC tissues and cell lines. A total of 232 ATGs were extracted, and 37 genes were differentially expressed in OSCC. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis demonstrated that these genes were mainly located in autophagosome membrane and associated with autophagy. Furthermore, the risk score on basis of ATGs was identified as potential independent prognostic biomarker. Moreover, ATG12 and BID were identified as potential autophagy‐related biomarkers of OSCC. This study successfully constructed a risk model, and the risk score could predict the prognosis of OSCC patients accurately. Moreover, ATG12 and BID were identified as two potential independent prognostic autophagy‐related biomarkers and might provide new OSCC therapeutic targets.
Self‐compassion training for certified nurse assistants in nursing homes
Authors: Bluth Karen , Lathren Christine , Silbersack Hickey Johanna V. T. , Zimmerman Sheryl , Wretman Christopher J. , Sloane Philip D.
Published: April 2021

Background/Objectives

Certified nursing assistants (CNAs) who work in nursing homes (NHs) face significant work and personal stress. Self‐compassion training has been shown to decrease stress postintervention in previous studies among healthcare providers and those in helping professions. This study examines the feasibility, acceptability, and preliminary outcomes of self‐compassion training to address CNA stress and well‐being.

Design

Pre–post intervention.

Setting

Three mid‐size, nonprofit NHs in North Carolina.

Participants

Thirty CNAs, with a mean age of 49, 96% of whom were female, and 83% black/African American.

Intervention

In one NH, participants received an 8‐week, 2.5‐h/session (20 h total) group intervention. At the time of recruitment for NHs 2 and 3, a briefer format (6‐week, 1‐h/session; 6 h total) became available and was preferred by CNAs, thus both NHs 2 and 3 participants received a 6‐h group intervention. All interventions occurred in meeting rooms within participating NHs during shift changes.

Measurements

Intervention attendance, retention, and acceptability; self‐compassion, stress, burnout, depression, and attitudes toward residents with dementia, and job satisfaction pre‐, post‐, 3‐month post‐, and 6‐month postintervention were assessed.

Results

Attendance and program satisfaction were high, and attrition was low for both training formats. Self‐compassion was significantly improved at all time periods (p < 0.001), and stress and depression improved significantly through 3 months (p < 0.05), but not 6 months. No statistically significant change in job satisfaction was noted.

Conclusion

Self‐compassion interventions are feasible and acceptable for CNAs working in NHs and show promise for managing stress and improving well‐being and compassion toward residents. The briefer 6‐h format may maximize participation, while still providing benefits.