bluuebunny/crossref_metadata_2025 huggingface dataset:
Disease Damage Accrual and Low Bone Mineral Density in Female Patients with Systemic Lupus Erythematosus
Authors: Correa-Rodríguez María , Pocovi-Gerardino Gabriela , Callejas-Rubio José-Luis , Ríos-Fernández Raquel , Rueda-Medina Blanca , Ortego-Centeno Norberto
Published: March 2021

Osteoporosis is a common comorbidity in patients with systemic lupus erythematosus (SLE), but the potential contribution of disease-associated factors to bone status in SLE is not well known because the reported risk factors from different studies differ greatly. We aimed to examine frequency of reduced bone mass in women with SLE, and determine their potential associations with disease activity, damage accrual and SLE-related clinical markers. A cross-sectional study including 121 Caucasian pre-menopausal and postmenopausal women was conducted (mean age 49.2 ± 12.4 years). The SLE Disease Activity Index (SLEDAI-2 K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. Bone mineral density (BMD) of the left femoral neck and lumbar spine (L2–L4) were measured by dual-energy X-ray absorptiometry. Ten patients (8.3%) had osteoporosis, 63 (52.1%) patients had osteopenia and 6.8% of women had history of previous fracture. Patients with low bone mass had a significantly higher mean SDI (1.3 ± 1.2 versus 0.7 ± 1.0 p = 0.003). T-score at lumbar spine was inversely correlated with SDI score (r = -0.222, p = 0.014) and complement C3 level ( r = −0.206, p = .024). SDI scores were significantly different between patients with osteoporosis, osteopenia, and normal BMD after adjusting for covariates ( p = .004). There is a high prevalence of low BMD in Caucasian women with SLE, and this status was associated with higher damage accrual scores, supporting that disease damage may itself be a major contributor to the low BMD. Women with SLE with organ damage require regular bone status monitoring to prevent further musculoskeletal damage.
A Novel 85-Gene Expression Signature Predicts Unfavorable Prognosis in Acute Myeloid Leukemia
Authors: Lai Yanli , Sheng Lixia , Wang Jiaping , Zhou Miao , OuYang Guifang
Published: March 2021

Aim:

Acute myeloid leukemia (AML) is a heterogeneous disorder with complex genetic basis and adverse prognosis. Cytogenetics risk, somatic mutations and gene expression profiles are important prognostic factors for AML patients. However, accurate stratification of patient prognosis remains an unsolved problem in AML. This study was to to develop a novel gene profile to accurately classify AML patients into subgroups with different survival probabilities.

Methods:

Survival-related genes were determined by Kaplan–Meier survival analysis and multivariate analysis using the expression and clinical data of 405 AML patients from Oregon Health & Science University (OHSU) dataset and validated in The Cancer Genome Atlas (TCGA) database. Feature selection was performed by using the Least Absolute Shrinkage and Selection Operator (LASSO) method. With the LASSO model, a prognostic 85-gene score was established and compared with 2 known gene-expression risk scores. The stratification of AML patients was performed by unsupervised hierarchical clustering of 85 gene expression levels to identify clusters of AML patients with different survival probabilities.

Results:

The LASSO model comprising 85 genes was considered as the optimal model based on relatively high area under curve value (0.83) and the minimum mean squared error. The 85-gene score was associated with increased mortality in AML patients. Hierarchical clustering analysis of the 85 genes revealed 3 subgroups of AML patients in the OHSU dataset. The cluster1 AML patients were associated with more female cases, higher percent of bone marrow blast cells, 85-gene score, cytogenetics risk, more frequent FLT3-ITD, DNMT3A, NP1 mutations, less frequent TP53, RUNX1 mutations, poorer overall survival than cluster2 tumors. The 85-gene score had higher AUC (0.75) than the 5-gene risk score and LSC17 score (0.74 and 0.65).

Conclusions:

The 85-gene score is superior to the 2 established prognostic gene signatures in the prediction of prognosis of AML patients.
Integrative Oncology: An International Perspective from Six Countries
Authors: Toledano Alain , Rao Santosh , Frenkel Moshe , Rossi Elio , Bagot Jean-Lionel , Theunissen Ingrid , Díaz-Sáez Gualberto
Published: March 2021

In June 2019, a meeting was held in Paris in which experts from different countries (Israel, Spain, Belgium, Italy, USA, and France) met to discuss a selection of topics in integrative oncology (IO). The objectives were to draw on the delegates’ experience and expertise to begin an international collaboration, sharing details of differing existing models and discussing future perspectives to help define and guide practice in IO and define unmet needs. This report presents a summary of the meeting’s main presentations, and also reports on the experts’ responses to a questionnaire examining different aspects of IO service delivery, infrastructure, and utilization.
Symphony Conductors Lose the Baton: Role of Fast-Spiking Interneurons in Orchestrating DS
Authors: Kadam Shilpa D.
Published: March 2021

[Box: see text]
Risky Business: Traumatic Brain Injury and Epilepsy
Authors: Terman Samuel W
Published: March 2021

[Box: see text]
A Little Goes a Long Way: Adapting an Ethics Training Program to Work for Smaller Universities
Authors: Stenmark Cheryl K. , Miller Robert
Published: March 2021

The present project modified an existing ethics intervention aimed at graduate students, which had previously been evaluated and determined to be effective. The existing program was modified to shorten it from a 2 full-day training to a 1 full-day training. The effectiveness of the modified training program was evaluated using multiple dependent measures: perceptions of ethical dilemmas, ethical decision making and the using of cognitive strategies for ethical decision making, and reactions to the training. The results of the present study indicated that there were significant differences from pretraining to posttraining on measures of perceptions of ethical problems and markers of the cognitive processes involved in ethical decision making, including a focus on the ethical elements of the problem, and overall decision ethicality. Finally, participants reacted favorably to the program. Implications of these results are discussed.
Surface treated cotton fabric with stain repellent property for the use in aircraft upholstery
Authors: Kuruppu Kuruppu Achchige Dulani Daminda
Published: March 2021

Nanotechnology modifications play a major role in textile industry due to extraordinary properties exhibit in fabrics due to nanomaterials. It offers different functionalities namely self-cleaning, wrinkle resistance, flame retardancy, protection from UV radiations or antibacterial property. Further, it is important to maintain cleanliness in aircraft upholstery always but the airliners have to bear a considerable amount of money to clean up the aircraft upholstery. Interestingly, nanotechnology can provide stain repellence property for fabrics in aircraft upholstery. This study covers a method of developing a stain repellent fabric which was stable even after 25 standard laundering conditions. In this study nanotechnology was used to modify a cotton fabric with stain repellant property. After nanotechnology modification, the surface wettability of the treated fabrics was characterized by static water contact angle measurements before and after 25 washes carried out under standard laundering conditions. Similar testings were carried out for the untreated fabric samples. The static water contact angle for the treated fabric was 161° with the recovery of 97.5% after 25 washing cycles. SEM and AFM micrographs were used to analyze the coatings. Further, the stability of hydrophobicity in the modified cotton fabric after 25 washes was also tested for tea, coffee, and water solutions which are vulnerable stain types in aircraft upholstery. It clearly proved that the modified cotton fabric even after 25 washes showed hydrophobicity for tea, coffee, and water. Therefore, it could be concluded that the developed modified cotton fabric can consider to be used as an aircraft upholstery.
Possible Potential Effects of Honey and Its Main Components Against Covid-19 Infection
Authors: Abedi Farshid , Ghasemi Saeedeh , Farkhondeh Tahereh , Azimi-Nezhad Mohsen , Shakibaei Mehdi , Samarghandian Saeed
Published: March 2021

Coronavirus disease 2019 (COVID-19) is a viral pneumonia that is spreading rapidly worldwide. The main feature of this disease is a severe acute respiratory syndrome and caused by coronavirus 2 (SARS-CoV-2). There are several unknowns about the pathogenesis and therapeutically treatment of COVID-19 infection. In addition, available treatment protocols have not been effective in managing COVID-19 infection. It is proposed that natural anti-oxidants such as lemon, green tea, saffron, curcuma longa, etc. with high flavonoids like safranal, crocin, crocetin, catechins, resveratrol, calebin A, curcumin have therapeutic potential against viral infections. In this context, honey and its main components are being investigated as an option for patients with COVID-19. The present study may indicate that honey and its main components inhibit the entry of the virus into the host cell and its replication as well as modulate the inflammatory cascade. This review provides basic information for the possible potential effects of honey and its main components for fighting with SARS-CoV-2.
Optimized Self-Nanoemulsifying Delivery System Based on Plant-Derived Oil Augments Alpha-Lipoic Acid Protective Effects Against Experimentally Induced Gastric Lesions
Authors: Badr-Eldin Shaimaa M. , Fahmy Usama A. , Aldawsari Hibah M. , Ahmed Osama A. A. , Alhakamy Nabil A. , Okbazghi Solomon Z. , El-Moselhy Mohamed A. , Alghaith Adel F. , Anter Aliaa , Matouk Asmaa I. , Mahdi Wael Ali , Alshehri Sultan , Bakhaidar Rana
Published: March 2021

Peptic ulcer disease is an injury of the alimentary tract that leads to a mucosal defect reaching the submucosa. Alpha-lipoic acid (ALA), a natural potent antioxidant, has been known as a gastroprotective drug yet its low bioavailability may restrict its therapeutic efficacy. This study aimed to formulate and optimize ALA using a self-nanoemulsifying drug delivery system (SNEDDS) with a size of nano-range, enhancing its absorption and augmenting its gastric ulcer protection efficacy. Three SNEDDS components were selected as the design factors: the concentrations of the pumpkin oil (X1, 10–30%), the surfactant tween 80 (X2, 20–50%), and the co-surfactant polyethylene glycol 200 (X3, 30–60%). The experimental design for the proposed mixture produced 16 formulations with varying ALA-SNEDDS formulation component percentages. The optimized ALA-SNEDDS formula was investigated for gastric ulcer protective effects by evaluating the ulcer index and by the determination of gastric mucosa oxidative stress parameters. Results revealed that optimized ALA-SNEDDS achieved significant improvement in gastric ulcer index in comparison with raw ALA. Histopathological findings confirmed the protective effect of the formulated optimized ALASNEDDS in comparison with raw ALA. These findings suggest that formulation of ALA in SNEDDS form would be more effective in gastric ulcer protection compared to pure ALA.
Phytochemical Analysis, Antioxidant and Antimicrobial Screening of Seriphidium Oliverianum Plant Extracts
Authors: Abbas Ali , Naqvi Syed Ali Raza , Rasool Muhammad Hidayat , Noureen Asma , Mubarik Muhammad Samee , Tareen Rasool Baksh
Published: March 2021

The aim of this study was to investigate the phytochemicals using reverse-phase high pressure liquid chromatography (RP-HPLC), antioxidant, antifungal and antibacterial activities of Seriphidium oliverianum stem extracts. The extraction was carried out by conventional shaking process (CSP) and ultrasonic assisted process (UAP). The highest total phenolic contents (97.85 ± 0.735 mg gallic acid equivalent (GAE)/g sample) and flavonoid contents (188.15 ± 0.53 mg catechin equivalent (CE)/g sample) were found in methanol extract obtained by CSP. Antioxidant activity was investigated using DPPH° scavenging assay and reducing power assay. Methanol extract using UAP showed the highest DPPH° scavenging activity (79.95% ± 1.80%) followed by methanol and butanol extracts obtained through CSP. Moreover, methanol extracts using CSP showed highest reducing activity (1.032 ± 0.0205 absorbance). In-vitro antimicrobial activity was studied using most common infection causing fungal and bacterial strains. Anti-fungal activity of methanol extract using CSP showed the highest zone of inhibition (10.5 mm) against F. avenaceum fungal strain, while aqueous extracts obtained through showed the highest antibacterial activity (22 ± 1.32 mm zone of inhibition) against S. aureus. The results showed that the methanol stem extract of S. oliverianum is a valued candidate for further screening and could be processed for in-vivo infection induced animal trials.
Smells Influence Perceived Pleasantness but Not Memorization of a Visual Virtual Environment
Authors: Sabiniewicz Agnieszka , Schaefer Elena , Guducu Cagdas , Manesse Cedric , Bensafi Moustafa , Krasteva Nadejda , Nelles Gabriele , Hummel Thomas
Published: March 2021

The present study aimed to investigate whether the perception of still scenes in a virtual environment in congruent versus incongruent condition can be influenced by odors. Ninety healthy participants were divided into three groups, including two experimental virtual reality (VR) environments: a rose garden, an orange basket, and a control condition. In each VR condition, participants were exposed to a rose odor, an orange odor, or no odor, resulting in congruent, incongruent, and control conditions. Participants were asked to describe (a) the content of the VR scene and rate its overall pleasantness and (b) the smell and to rate its intensity and pleasantness. For each condition, participants were tested twice. During the second test, participants provided ratings and descriptions of the content of the VR scenes without being exposed to odors or VR environments. Virtual scenarios tended to be remembered as more pleasant when presented with congruent odors. Furthermore, participants used more descriptors in congruent scenarios than in incongruent scenarios. Eventually, rose odor appeared to be remembered as more pleasant when presented within congruent scenarios. These findings show that olfactory stimuli in congruent versus incongruent conditions can possibly modulate the perception of the pleasantness of visual scenes but not the memorization.
Teaching user-friendly web design: A case study on Zillow.com in the real estate industry
Authors: Manko Barbara A
Published: March 2021

When designing websites and planning marketing concepts, students need to understand how to create an experience that is user-friendly in order to build traffic over time. Users want a website that is both intuitive and informative, while simultaneously providing an ultra-efficient search experience. They want information that is essential and specific to them, for their own precise needs and purposes. The key to designing a successful interface is to meet the user’s expectations of finding a suitable fact, product, or service expeditiously. Examining the case of Zillow.com, a highly successful real estate portal website, provides students with an effective example of underlying web design principles, such as user knowledge, ease of navigation, content adjustment, and the site’s fit within the digital marketplace. Zillow.com exemplifies incredible ease of use through various aspects of superior web design, such as the accessibility and functionality of both of the top menu and submenu links and the ability to filter search results using data fields with key requirements, leading to instant, valuable results. By looking at what Zillow has done right, students can glean a set of best practices in web design that not only apply to the real estate industry, but can be translated broadly across websites in all industries.
“Alone in a Crowd: Indigenous Migrants and Language Barriers in American Immigration”
Authors: Obinna Denise N.
Published: March 2021

Indigenous migrants in American custody often speak neither English nor Spanish. This leaves them at risk for family separation, deportation and due process violations. In this article, I discuss the challenges which indigenous migrants face in American immigration. Examining linguistic variations, this manuscript illustrates that American immigration policies have not adjusted to the linguistic diversity at the border—or in the immigration courts. Despite the growing number of indigenous migrants seeking asylum, most are assumed to speak only Spanish. This assumption neglects the wide linguistic diversity of immigrants and directly impacts their experience through the immigration bureaucracy. For indigenous migrants, linguicism or the exclusion of native languages can have life or death consequences—especially if they are unable to secure interpreters or relay crucial aspects of their case. As such, linguicism perpetuates an unequal justice system which fails to provide an understanding of the asylum process for those who speak indigenous languages.
What Are Social Workers Currently Doing to Positively Impact How People Access Public Housing Services in Spain?
Authors: Álvarez-Pérez Pablo , Relinque-Medina Fernando , Vázquez-Aguado Octavio , Harris Victor W.
Published: March 2021

Residents of Andalusia (Spain) experienced major public housing challenges during the financial crisis. In this study, social work practices in the public housing field in Andalusia and the primary roles they are playing to help negotiate these challenges and influence housing policy are analyzed. Twenty-eight in-depth qualitative interviews were conducted among 15 social workers, four provincial managers, and eight lawyers from the Housing and Rehabilitation Public Agency of Andalusia to triangulate and explore perceptions about the roles and contributions of social workers in public housing. Content analysis was used to analyze the results. Findings indicated that this sample of professionals coordinated multiple levels of public housing issues and directed attention and resources to the needs of public housing users, especially those associated with the social needs of tenants, such as reducing conflicts associated with late payments. The findings also revealed a lack of clear guidelines for satisfactory work performance, particularly in the areas of prevention and evaluation. Evaluation and systematization of the effectiveness of social work professional practices is recommended. In addition, there is a necessity of correcting the identified shortfalls in the execution of tasks and interventions with tenants of social housing.
Combined Effects of Drivers and Impact of Customer Satisfaction on Brand Loyalty: The Contingent Effect of Social Trust
Authors: Javed Sara , Rashidin Md. Salamun , Zhu Mingxia , Xu Zhexiao , Jian Wang , Zuo Siming
Published: March 2021

We strived to examine the combined effects of drivers and consequences of customers’ satisfaction particularly in quick-meal restaurants besides examining the interaction effect of social trust on the association between customers’ satisfaction and brand loyalty. Offline survey was conducted to approach the respondents of fast-food visitors. The valid data were assessed and analyzed through structural equation modeling and moderation step-by-step approach. The findings demonstrate that restaurant stimuli—food, service, atmosphere, location, price, and a variety of food—have robust effects on customers’ satisfaction and eventually on brand loyalty. Social trust has rigorous effect on the association between customers’ satisfaction and brand loyalty. Customers with high social trust have a positive strong bonding with restaurants than those holding low social trust. Theoretical and practical implications have been deliberated and offer some valuable recommendations along for future scholars.
The Impact of Game-Based, Modeling, and Collaborative Learning Methods on the Achievements, Motivations, and Visual Mathematical Literacy Perceptions
Authors: İlhan Aziz
Published: March 2021

The present study aimed to investigate the effects of geometry instruction activities conducted in nature based on modeling, game-based, and cooperative learning methods on achievement, mathematical motivation, and visual mathematical literacy perceptions of third-grade elementary school students. The present study is a quantitative study conducted with a pre-test/post-test experimental design with a control group. The study was conducted with 61 students (35 students in the experimental group and 26 students in the control group). Modeling-, game-, and collaborative learning-based activities were conducted with the students in the experimental group. It was determined that the achievements of students who were instructed with modeling-based activities in geometry were high when compared to that of the students instructed with collaborative learning- and game-based methods, and those in the control group where no intervention was applied. This group was followed by the game-based and collaborative learning groups. Based on the variable of motivation, the mean motivation of the students in the modeling group was higher when compared to that of the students in the collaborative learning, game-based, and conventional instruction groups. This group was followed by the collaborative and game-based learning groups. Also, based on the visual mathematical literacy perception variable, the mean visual mathematics literacy perception of the students in the collaborative learning group was higher when compared to that of the students in the groups where the modeling, game-based, and conventional instruction methods were used. This group was followed by the modeling and game-based learning groups.
Job Autonomy and Career Commitment: A Moderated Mediation Model of Job Crafting and Sense of Calling
Authors: Chang Po-Chien , Rui Honglei , Wu Ting
Published: March 2021

This study aims to examine the mediating effect of job crafting on the relationship between job autonomy and career commitment, as well as the moderating effect sense of calling has on job crafting and career commitment. The data for this three-wave study were collected from 350 R&D engineers at 25 high-tech companies in Guangdong Province, China. The PROCESS macro for SPSS was used to analyze the proposed hypotheses. The results revealed that (a) job crafting mediates the positive relationship between job autonomy and career commitment and (b) sense of calling moderates the indirect effect of job autonomy and career commitment through job crafting, such that the indirect effect is stronger in people with higher sense of calling than those with lower sense of calling. Theoretical and practical implications of the findings are discussed.
Belief Change Before and After the Teaching Practicum Among Chinese Pre-Service ELT Teachers
Authors: Qiu Qing , Xie Zhilong , Xiong Yueya , Zhou Fen
Published: March 2021

This article aims to study the dynamic change of teachers’ beliefs among pre-service teachers. A longitudinal design was adopted to investigate English language teaching (ELT) pre-service teachers’ belief change after a 3-month teaching practicum by administering pretest and posttest questionnaires, semistructured interviews, and reflective journals. Repeated measures and paired sample t-test analyses showed significant differences across different aspects of beliefs in all the participants, but belief changes were significant after the practicum only within the experimental group, particularly in the aspects of student management, teaching evaluation, and student learning. In contrast, belief changes were not significant within the control group. Further inductive content analyses of semistructured interviews and reflective journals from the experimental group confirmed these changes and conclusively revealed some potential factors contributing to the changes. The results shed light on how pre-service teachers evolve in their career development and help educators adjust appropriate education policies to improve the quality of English teacher education, particularly in the Chinese context.
How Does Corporate Environmental Strategy Contribute to Voluntary Environmental Behavior? Influence of Psychological Green Climate, Firms’ Size, and Employees’ Age
Authors: Biswas Shetu Ranjan , Dey Mouri , Bhattacharjee Swadip , Uddin Md. Aftab
Published: March 2021

Considering the gravity of issues, the present study investigates the influence of corporate environmental strategy (CES) on the voluntary environmental behavior (VEB) of employees along with the potential moderating variables. The research questions and hypotheses are built based on the essence of an integrated theory of corporate environmental behavior and social identity theory. Data were collected from numerous organizations and analyzed following the deductive reasoning approach. Partial least square–based structural equation modeling was used to test the hypotheses. The result highlighted that CES influences psychological green climate (PGC), which leads to an effect on VEB. We also examined the moderating effects of employees’ age, firms’ size on the influence of CES on PGC, and the PGC on VEB. The result showed that the moderating effect of age affects the influence of CES on PGC and other’s influences are not found significant. Managerial implications were also discussed.
Psychometric Properties of the Turkish Version of the Experiences in Close Relationships–Relationship Structures Questionnaire (ECR-RS)
Authors: Deveci Şirin Hatice , Şen Doğan Rana
Published: March 2021

The aim of this study was to adapt the Turkish version of the Experiences in Close Relationships–Relationship Structures Questionnaire in a sample of Turkey. Study I was conducted to prove the reliability and validity of the results obtained as a result of the adaptation of the Experiences in Close Relationships–Relationship Structures (ECR-RS) Questionnaire to Turkish culture. The study showed that the Experiences in Close Relationships–Relationship Structures Questionnaire and its subscales were reliable and valid. The study showed that the ECR-RS subscales correlated with the Relationship Questionnaire, the Relationship Styles Questionnaire, the Rosenberg Self-Esteem Subscale, the Sociotropy-Autonomy Scale, the Contact with parents and the Relationship experience, denoting content validity of the Experiences in Close Relationships–Relationship Structures Questionnaire. According to the research results, the Experiences in Close Relationships–Relationship Structures Questionnaire are a reliable and valid measurement tool that can be used for the purpose of evaluating attachment representation in Turkish culture. In addition, this study provides attachment researchers with a basis for reviewing the assumption that dimensional models overlap with categorical models. It is suggested that The Experiences in Close Relationships-Relationship Structures Questionnaire be adapted to different relationship structures (e.g., therapist, god, ideological groups), retested on different age groups and its relationship with personality traits and psychological problems be investigated.
The Virtue of School Leadership: Three Paths to Fulfilling Value Forms
Authors: Whang Nai-Ying
Published: March 2021

This study discusses the fulfillment of value forms by examining the virtue of school leadership. The virtue of school leadership stresses character traits in leaders that focus on the pursuit of excellence, appear as a value form, comprise paths to fulfilling values, reinforce leaders’ positive motivation, and foster reform in schools. To investigate this phenomenon, a qualitative method was adopted to interview 18 leaders from schools in northern Taiwan. The analysis of the findings suggests that staff who exhibit the virtue of school leadership focus on leading by example, satisfying others, surmounting failures, and adhering to ideals, which involve three paths to fulfilling value forms.
Development and Evaluation of the Validity and Reliability of the Leading and Managing Care Pre-Registration Nursing Student Assessment Tool
Authors: Unsworth John , Melling Andrew , Porteous Debra
Published: March 2021

Background

Clinical nursing leadership influences patient safety and the quality of care provided. Nurses at all levels require leadership and management skills. Despite recognition of the importance of leadership, student nurses often feel ill prepared to make the transition to Registered Nurse and struggle with prioritisation and delegation. In order to standardise student experience and promote the development of skills and attributes, a leadership and management competency assessment was developed and implemented.

Aims

This study aimed to identify the constructs that should be part of an assessment of student nurse competence in relation to clinical nursing leadership, and to evaluate the tool’s reliability.

Method

The first phase was to construct the competency assessment tool, using a mixture of deductive methods, including literature and expert review. Second, psychometric evaluation of the tool, including tests to examine its internal consistency and reliability, comparing test and retest reliability, exploratory factor analysis and generalisability theory analysis to identify reliability and sources of error.

Results

Five attributes were identified for inclusion in the tool alongside a scale of competence. 150 assessments were conducted with an average time between each assessment of three days. The results show that the tool was consistent over time with no significant difference in the mean scores. The Cronbach alpha was 0.84 and the tool had good internal consistency. The results of the factor analysis revealed loading onto a single construct. Generalisability theory analysis revealed 0.90 global reliability, with students accounting for the majority of the variation in scores.

Conclusions

The Leading and Managing Care assessment tool represents a valid and reliable assessment of student nurse competence to lead care delivery. Use of the tool during practice placement allows for a structured approach to the development of skills around prioritisation, management of resources, communication and the management of risk.
Regulatory delays in a multinational clinical stroke trial
Authors: de Jonge Jeroen C , Reinink Hendrik , Colam Bridget , Alpers Iris , Ciccone Alfonso , Csiba Laszlo , Kõrv Janika , Kurkowska-Jastrzebska Iwona , Macleod Malcolm R , Ntaios George , Thomalla Götz , Bath Philip M , van der Worp H Bart
Published: March 2021

Introduction

The initiation and conduct of randomised clinical trials are complicated by multiple barriers, including delays in obtaining regulatory approvals. Quantitative data on the extent of the delays due to national or local review in randomised clinical trials is scarce.

Materials and methods

We assessed the times needed to obtain regulatory approval and to initiate a trial site for an academic, EU-funded, phase III, randomised clinical trial of pharmacological prevention of complications in patients with acute stroke in over 80 sites in nine European countries. The primary outcome was the time from the first submission to a regulatory authority to initiation of a trial site. Secondary outcomes included time needed to complete each individual preparatory requirement and the number of patients recruited by each site in the first 6 and 12 months.

Results

The median time from the first submission to a regulatory authority to initiation of a trial site was 784 days (IQR: 586–1102). The single most time-consuming step was the conclusion of a clinical trial agreement between the national coordinator and the trial site, which took a median of 194 days (IQR: 93–293). A longer time to site initiation was associated with a lower patient recruitment rate in the first six months after initiation (B = –0.002; p = 0.02).

Discussion

Conclusion

In this EU-funded clinical trial, approximately 26 months were needed to initiate a trial site for patient recruitment. The conclusion of a contract with a trial site was the most time-consuming activity. To simplify and speed up the process, we suggest that the level of detail of contracts for academic trials should be proportional to the risks and commercial interests of these trials.
Intra Cranial Dislocation of Mandibular Condyle—10 Year Follow up of a Case and Review of Literature
Authors: Ramani Vimalambiga , Balaraman Kannan , Bharathi R Ravindra , Sabapathy S Raja
Published: March 2021

Dislocation of the mandibular condyle into the middle cranial fossa is a rare event with only 59 cases having been reported in the English literature. The common etiology is road traffic accident. Epidemiology wise this injury is found commonly in children and young adults. This has been attributed to the undeveloped condyle being small and rounded. In this report we present a case of central dislocation of the mandibular condyle into the middle cranial fossa in a 20 year old female patient sustained in a road traffic accident. Computed tomography helped in early diagnosis and treatment of the patient. We also stress upon the need for long term follow up of the patient to prevent secondary complications of ankylosis.
Receptors and Channels Associated with Alcohol Use: Contributions from Drosophila
Authors: Scaplen Kristin M , Petruccelli Emily
Published: March 2021

Alcohol Use Disorder (AUD) is a debilitating disorder that manifests as problematic patterns of alcohol use. At the core of AUD’s behavioral manifestations are the profound structural, physiological, cellular, and molecular effects of alcohol on the brain. While the field has made considerable progress in understanding the neuromolecular targets of alcohol we still lack a comprehensive understanding of alcohol’s actions and effective treatment strategies. Drosophila melanogaster is a powerful model for investigating the neuromolecular targets of alcohol because flies model many of the core behavioral elements of AUD and offer a rich genetic toolkit to precisely reveal the in vivo molecular actions of alcohol. In this review, we focus on receptors and channels that are often targeted by alcohol within the brain. We discuss the general roles of these proteins, their role in alcohol-associated behaviors across species, and propose ways in which Drosophila models can help advance the field.
Uranoclite, a new uranyl chloride mineral from the Blue Lizard mine, San Juan County, Utah, USA
Authors: Kampf Anthony R. , Plášil Jakub , Olds Travis A. , Nash Barbara P. , Marty Joe
Published: March 2021

The new mineral uranoclite (IMA2020-074), (UO2)2(OH)2Cl2(H2O)4, was found in the Blue Lizard mine, San Juan County, Utah, USA, where it occurs as tightly intergrown aggregates of irregular yellow crystals in a secondary assemblage with gypsum. The streak is very pale yellow and the fluorescence is bright green–white under 405 nm ultraviolet light. Crystals are translucent with vitreous lustre. The tenacity is brittle, the Mohs hardness is ~1½, the fracture is irregular. The mineral is soluble in H2O and has a calculated density of 4.038 g⋅cm–3. Electron microprobe analyses provided (UO2)2(OH)2.19Cl1.81(H2O)4. The six strongest powder X-ray diffraction lines are [dobs Å(I)(hkl)]: 8.85(38)(002), 5.340(100)(200, 110), 5.051(63)($\bar{2}$02), 4.421(83)(112, 004, 202), 3.781(38)($\bar{2}$12) and 3.586(57)(014, $\bar{2}$04). Uranoclite is monoclinic, P21/n, a = 10.763(8), b = 6.156(8), c = 17.798(8) Å, β = 95.656(15)°, V = 1173.5(18) Å3 and Z = 4. The structure is the same as that of synthetic (UO2)2(OH)2Cl2(H2O)4 in which the structural unit is a dimer consisting of two pentagonal bipyramids that share an equatorial OH–OH edge. The dimers are linked to one another only by hydrogen bonding. This is the second known uranyl mineral containing essential Cl and the first in which Cl coordinates to U6+.
Antineoplastic and anti-inflammatory effects of bortezomib on systemic chronic active EBV infection
Authors: Yoshimori Mayumi , Shibayama Haruna , Imadome Ken-Ichi , Kawano Fuyuko , Ohashi Ayaka , Nishio Miwako , Shimizu Norio , Kurata Morito , Fujiwara Shigeyoshi , Arai Ayako
Published: March 2021

Systemic chronic active Epstein-Barr virus (EBV; sCAEBV) infection, T- and natural killer (NK)-cell type (sCAEBV), is a fatal disorder accompanied by persisting inflammation harboring clonal proliferation of EBV-infected T or NK cells. Today’s chemotherapy is insufficient to resolve disease activity and to rid infected cells of sCAEBV. The currently established treatment strategy for eradicating infected cells is allogeneic hematopoietic stem cell transplantation. In this study, we focused on the effects of proteasome inhibitor bortezomib on the disease. Bortezomib suppressed survival and induced apoptosis of EBV+ T- or NK-cell lines and peripheral mononuclear cells containing EBV-infected T or NK cells of sCAEBV patients. Bortezomib enhanced binding immunoglobulin protein/78-kDa glucose-regulated protein (Bip/GRP78) expression induced by endoplasmic reticulum stress and activated apoptosis-promoting molecules JNK and p38 in the cell lines. Bortezomib suppressed the activation of survival-promoting molecule NF-κB, which was constitutively activated in EBV+ T- or NK-cell lines. Furthermore, quantitative reverse transcription–polymerase chain reaction demonstrated that bortezomib suppressed messenger RNA expression of proinflammatory cytokines tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ) in EBV+ T or NK cells from the patients. Finally, we examined the effects of bortezomib using xenograft models of sCAEBV generated by IV injection of patients’ cells. The intraperitoneal administration of bortezomib significantly reduced EBV-DNA load in peripheral blood and the infiltration of EBV-infected cells in the models’ livers. Moreover, the serum concentration of TNF-α and IFN-γ decreased after bortezomib treatment to the models. Our findings will be translated into the treatment of sCAEBV not only to reduce the number of tumor cells but also to suppress inflammation.
Functional characterization of PD1+TIM3+ tumor-infiltrating T cells in DLBCL and effects of PD1 or TIM3 blockade
Authors: Roussel Mikaël , Le Kieu-Suong , Granier Clémence , Llamas Gutierrez Francisco , Foucher Etienne , Le Gallou Simon , Pangault Céline , Xerri Luc , Launay Vincent , Lamy Thierry , Tartour Eric , Olive Daniel , Fest Thierry
Published: March 2021

In diffuse large B-cell lymphoma (DLBCL), tumor-infiltrating T lymphocytes (TILs) are involved in therapeutic responses. However, tumor-specific TILs can be dysfunctional, with impaired effector functions. Various mechanisms are involved in this exhaustion, and the increased expression of programmed cell death receptor 1 (PD1) and TIM3 on dysfunctional cells suggests their involvement. However, conflicting data have been published regarding their expression or coexpression in DLBCL. We evaluated the presence and phenotype of CD4+ and CD8+ TILs in freshly collected tumor tissues in DLBCL and compared the results with those in follicular lymphoma, classical Hodgkin lymphoma, and nonmalignant reactive lymphadenopathy. We found that TILs expressing both PD1 and TIM3 were expanded in DLBCL, particularly in the activated B cell–like subgroup. Isolated PD1+TIM3+ TILs exhibited a transcriptomic signature related to T-cell exhaustion associated with a reduction in cytokine production, both compromising the antitumor immune response. However, these cells expressed high levels of cytotoxic molecules. In line with this, stimulated PD1+TIM3+ TILs from DLBCL patients exhibited reduced proliferation and impaired secretion of interferon-γ, but these functions were restored by the blockade of PD1 or TIM3. In summary, the PD1+TIM3+ TIL population is expanded and exhausted in DLBCL but can be reinvigorated with appropriate therapies.
Involved-site radiotherapy for Helicobacter pylori–independent gastric MALT lymphoma: 26 years of experience with 178 patients
Authors: Yahalom Joachim , Xu Amy J. , Noy Ariela , Lobaugh Stephanie , Chelius Monica , Chau Karen , Portlock Carol , Hajj Carla , Imber Brandon S. , Straus David J. , Moskowitz Craig H. , Coleman Morton , Zelenetz Andrew D. , Zhang Zhigang , Dogan Ahmet
Published: March 2021

Treatment options for Helicobacter pylori–independent gastric mucosa-associated lymphoid tissue (MALT) lymphoma (GML) include surgery, immunotherapy, chemotherapy, and radiation therapy (RT). The purpose of this study was to investigate the efficacy and safety of RT and routine endoscopic surveillance, hypothesizing that most patients are curable with RT alone. We queried a single institution database at a tertiary referral cancer center for patients with H pylori–independent GML treated with RT between 1991 and 2017. Response was assessed by follow-up endoscopies (EGDs) starting 10 to 12 weeks post-RT. Computed tomography scans were also part of the follow-up program, and positron emission tomography was added when clinically appropriate. We identified 178 patients (median age, 63 years; range, 25-89 years); 86% had stage I disease, 7% had stage II disease, and 7% had stage IV disease. Median RT dose was 3000 cGy over 20 fractions. Ninety-five percent of patients exhibited complete pathologic response on posttreatment EGD. Two patients experienced grade 3 toxicity, and 2 patients experienced in-field secondary malignancies. Over a median follow-up of 6.2 years, 9.6% experienced local failures, and 11.8% developed distant sites of disease. Five-year and 10-year overall survival were 94% and 79%, respectively, from last date of RT. RT is a highly effective and safe treatment for GML with excellent overall survival and very rare acute or late treatment-related toxicities. Favorable outcomes from this large retrospective sample of patients provide credible and compelling support for RT as standard of care for H pylori–independent GML.
The prognostic significance of combined geriatric nutritional risk index and psoas muscle volume in older patients with pancreatic cancer
Authors: Sakamoto Teruhisa , Yagyu Takuki , Uchinaka Ei , Miyatani Kozo , Hanaki Takehiko , Kihara Kyoichi , Matsunaga Tomoyuki , Yamamoto Manabu , Tokuyasu Naruo , Honjo Soichiro , Fujiwara Yoshiyuki
Published: March 2021

Background

The geriatric nutritional risk index (GNRI), originally developed as a nutritional assessment tool to evaluate mortality and morbidity in older hospitalized patients (i.e., those aged ≥65 years), is regarded as a prognostic factor in several cancers. Body composition is also an important consideration when predicting the prognosis of patients with cancer. This study aimed to investigate the relationship between the GNRI and psoas muscle volume (PMV) for survival outcomes in patients with pancreatic cancer.

Methods

This retrospective study evaluated the prognostic significance of the GNRI and PMV in 105 consecutive patients aged ≥65 years who underwent pancreatectomy for histologically confirmed pancreatic cancer. The patients were divided into high (GNRI > 98) and low GNRI groups (GNRI ≤98), and into high (PMV > 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) and low PMV (PMV ≤ 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) groups.

Results

Both the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly greater among patients in the high GNRI group than among patients in the low GNRI group. Similarly, both the 5-year OS and RFS rates were significantly greater among patients in the high PMV group than among patients in the low PMV group. Patients were stratified into three groups: those with both high GNRI and high PMV; those with either high GNRI or high PMV (but not both); and those with both low GNRI and low PMV. Patients with both low GNRI and low PMV had a worse 5-year OS rate, compared with patients in other groups (P <  0.001). The C-index of the combination of the GNRI and PMV for predicting 5-year OS was greater than the C-indices of either the GNRI or PMV alone. Multivariate analysis revealed that the combination of the GNRI and PMV was an independent prognostic factor in patients aged ≥65 years with pancreatic cancer (P = 0.003).

Conclusions

The combination of the GNRI and PMV might be useful to predict prognosis in patients aged ≥65 years with pancreatic cancer.
Posttraumatic stress disorder (PTSD) and depression severity in sexually assaulted women: hypothalamic-pituitary-adrenal (HPA) axis alterations
Authors: D’Elia Ana Teresa D. , Juruena Mario F. , Coimbra Bruno M. , Mello Marcelo F. , Mello Andrea F.
Published: March 2021

Background

Sexual assault is implicated in several adverse psychological and physical health outcomes, including posttraumatic stress disorder (PTSD) and depression. Neurobiological research has shown variations related to the hypothalamic-pituitary-adrenal (HPA) axis, immune alterations, metabolic function, and brain circuitry. Although these mechanisms have been extensively studied, the results have demonstrated different outcomes in PTSD.

Methods

We compared the plasma adrenocorticotropin (ACTH) and salivary cortisol levels of fifty-eight women with PTSD developed after sexual assault to those of forty-four female controls with no history of trauma. We also evaluated the psychiatric diagnosis and symptom severity of PTSD and depression. The participants’ clinical conditions were associated with their hormonal levels to assess whether symptom severity was related to hormonal imbalance.

Results

A large percentage of sexually assaulted women had PTSD and comorbid depression. The ACTH levels were higher in the PTSD group than the control group and increased as PTSD severity increased, considering depressive symptoms, measured by the Beck Depression Inventory (BDI) (p < 0.0001), as well as PTSD symptoms, measured by subscale D of the Clinician-Administered PTSD Scale (CAPS-5) (p = 0.045) and the CAPS-5 total scale (p = 0.026). Cortisol levels measured at 10 pm were higher for the PTSD group than the control group (p = 0.045, p = 0.037, respectively), and the cortisol awakening response showed elevated cortisol levels for the PTSD group.

Conclusions

These results show a correlation between symptom severity and HPA axis imbalance in patients with PTSD. Elevated ACTH and an elevated cortisol response in patients with comorbid depressive symptoms were the opposite of the expected response for patients with PTSD only. This association leads to the hypothesis that the neurobiological alterations of PTSD are related to the type of symptoms presented and their severity. These manifestations likely influence the disease course, prognosis and response to treatment. These outcomes highlight the need to discuss particular neurobiological alterations in patients with PTSD developed after sexual assault, mainly those with severe depressive symptoms.