bluuebunny/crossref_metadata_2025 huggingface dataset:
An Integrative in silico Study to Discover Key Drivers in Pathogenicity of Focal and Segmental Glomerulosclerosis
Authors: Gholaminejad Alieh , Ghaeidamini Maryam , Simal-Gandara Jesus , Roointan Amir
Published: March 2022

Background: Focal and segmental glomerulosclerosis (FSGS) is a clinical-pathologic condition marked by segmental and localized glomerular damages. Despite investigations, the molecular mechanisms behind FSGS development remain to be more clarified. By a comprehensive analysis of an FSGS-related array set, the aim of this study was to unravel the top pathways and molecules involved in the pathogenesis of this disorder. Methods: FSGS-related microarray dataset (GSE129973) from the Gene Expression Omnibus database was quality checked, analyzed, and its differentially expressed genes (DEGs) (log2 fold change > 1) were used for the construction of a protein-protein interaction (PPI) network (STRING). The degree of centrality was considered to select the hub molecules in the network. The weighted gene co-expression network analysis (WGCNA) was utilized to construct co-expression modules. Hub molecules were selected based on module membership and gene significance values in the disease’s most correlated module. After spotting the key molecules considering both strategies, their expression pattern was checked in other FSGS microarray datasets. Gene ontology and Reactome pathway enrichment analyses were performed on the DEGs of the related module. Results: After quality checking, normalization, and analysis of the dataset, 5,296 significant DEGs, including 2,469 upregulated and 2,827 downregulated DEGs were identified. The WGCNA algorithm clustered the DEGs into nine independent co-expression modules. The disease most correlated module (black module) was recognized and considered for further enrichment analysis. The immune system, cell cycle, and vesicle-mediated transports were among the top enriched terms for the identified module’s DEGs. The immune system, cell cycle, and vesicle-mediated transports were among the top enriched terms for the black module’s DEGs. The key molecules (BMP-2 and COL4A1) were identified as common hub molecules extracted from the two methods of PPI and the co-expressed networks. The two identified key molecules were validated in other FSGS datasets, where a similar pattern of expression was observed for both the genes. Conclusions: Two hub molecules (BMP-2 and COL4A) and some pathways (vesicle-mediated transport) were recognized as potential players in the pathogenesis of FSGS.
Plasma Ceramide Levels Are Elevated in Patients With Early Coronary Atherosclerosis and Endothelial Dysfunction
Authors: Akhiyat Nadia , Vasile Vlad , Ahmad Ali , Sara Jaskanwal Deep , Nardi Valentina , Lerman Lilach O. , Jaffe Allan , Lerman Amir
Published: March 2022

Background

Elevated plasma ceramides are independent predictors of cardiovascular disease and mortality in patients with advanced epicardial coronary artery disease. Our understanding of plasma ceramides in early epicardial coronary artery disease, however, remains limited. We examined the role of plasma ceramides in early coronary atherosclerosis characterized by coronary endothelial dysfunction.

Methods and Results

Participants presenting with chest pain and nonobstructive epicardial coronary artery disease underwent coronary endothelial function. Patients (n=90) demonstrated abnormal coronary endothelial function with acetylcholine (≥20% decrease in coronary artery diameter or ≤50% increase in coronary blood flow). A total of 30 controls had normal coronary endothelial function. Concentrations of plasma ceramide 18:0 (
P
=0.038), 16:0 (
P
=0.021), and 24:0 (
P
=0.019) differed between participants with normal and abnormal coronary endothelial function. Ceramide 24:0 (odds ratio [OR], 2.23 [95% CI, 1.07–4.66];
P
=0.033) and 16:0 (OR, 1.91×10
6
[95% CI, 11.93–3.07×10
11
];
P
=0.018) were independently associated with coronary endothelial dysfunction. Among participants with endothelium‐dependent coronary dysfunction (n=78), ceramides 16:0 (OR, 5.17×10
5
[95% CI, 2.83–9.44×10
10
];
P
=0.033), 24:0 (OR, 2.98 [95% CI, 1.27–7.00];
P
=0.012), and 24:1/24:0 (OR, 4.39×10
−4
[95% CI, 4×10
−7
–0.48];
P
=0.030) were more likely to be elevated.

Conclusions

The current study demonstrated an association between increased circulating ceramide levels and coronary endothelial dysfunction in the absence of epicardial coronary artery disease. This study supports the role of plasma ceramides as a potential biomarker or a therapeutic target for early coronary atherosclerosis in humans.
Oral Anticoagulant Treatment and the Risk of Dementia in Patients With Atrial Fibrillation: A Population‐Based Cohort Study
Authors: Bezabhe Woldesellassie M. , Bereznicki Luke R. , Radford Jan , Wimmer Barbara C. , Salahudeen Mohammed S. , Garrahy Edward , Bindoff Ivan , Peterson Gregory M.
Published: March 2022

Background

We compared the dementia incidence rate between users and nonusers of oral anticoagulants (OACs) in a large cohort of primary care patients with atrial fibrillation.

Methods and Results

We performed a retrospective study using an Australia‐wide primary care data set, MedicineInsight. Patients aged ≥18 years and newly diagnosed with atrial fibrillation between January 1, 2010, and December 31, 2017, and with no recorded history of dementia or stroke were included and followed until December 31, 2018. We applied a propensity score for 1:1 pair matching of baseline covariates and Cox regression for comparing the dementia incidence rates for OAC users and nonusers. Data were analyzed for 18 813 patients with atrial fibrillation (aged 71.9±12.6 years, 47.1% women); 11 419 had a recorded OAC prescription for at least 80% of their follow‐up time. During the mean follow‐up time of 3.7±2.0 years, 425 patients (2.3%; 95% CI, 2.1%–2.5%) had a documented diagnosis of dementia. After propensity matching, the incidence of dementia was significantly lower in OAC users (hazard ratio [HR], 0.59; 95% CI, 0.44–0.80;
P
<0.001) compared with nonusers. Direct‐acting oral anticoagulant users had a lower incidence of dementia than non‐OAC users (HR, 0.49; 95% CI, 0.33–0.73;
P
<0.001) or warfarin users (HR, 0.46; 95% CI, 0.28–0.74;
P
=0.002). No significant difference was seen between warfarin users and non‐OAC users (HR, 1.08; 95% CI, 0.70–1.70;
P
=0.723).

Conclusions

In patients with atrial fibrillation, direct‐acting oral anticoagulant use may result in a lower incidence of dementia compared with treatment with either warfarin or no anticoagulant.
MicroRNAs Regulate TASK‐1 and Are Linked to Myocardial Dilatation in Atrial Fibrillation
Authors: Wiedmann Felix , Kraft Manuel , Kallenberger Stefan , Büscher Antonius , Paasche Amelie , Blochberger Pablo L. , Seeger Timon , Jávorszky Natasa , Warnecke Gregor , Arif Rawa , Kremer Jamila , Karck Matthias , Frey Norbert , Schmidt Constanze
Published: March 2022

Background

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. However, underlying molecular mechanisms are insufficiently understood. Previous studies suggested that microRNA (miRNA) dependent gene regulation plays an important role in the initiation and maintenance of AF. The 2‐pore‐domain potassium channel TASK‐1 (tandem of P domains in a weak inward rectifying K
+
channel–related acid sensitive K
+
channel 1) is an atrial‐specific ion channel that is upregulated in AF. Inhibition of TASK‐1 current prolongs the atrial action potential duration to similar levels as in patients with sinus rhythm. Here, we hypothesize that miRNAs might be responsible for the regulation of
KCNK3
that encodes for TASK‐1.

Methods and Results

We selected miRNAs potentially regulating
KCNK3
and studied their expression in atrial tissue samples obtained from patients with sinus rhythm, paroxysmal AF, or permanent/chronic AF. MiRNAs differentially expressed in AF were further investigated for their ability to regulate
KCNK3
mRNA and TASK‐1 protein expression in human induced pluripotent stem cells, transfected with miRNA mimics or inhibitors. Thereby, we observed that miR‐34a increases TASK‐1 expression and current and further decreases the resting membrane potential of
Xenopus laevis
oocytes, heterologously expressing hTASK‐1. Finally, we investigated associations between miRNA expression in atrial tissues and clinical parameters of our patient cohort. A cluster containing AF stage, left ventricular end‐diastolic diameter, left ventricular end‐systolic diameter, left atrial diameter, atrial COL1A2 (collagen alpha‐2(I) chain), and TASK‐1 protein level was associated with increased expression of miR‐25, miR‐21, miR‐34a, miR‐23a, miR‐124, miR‐1, and miR‐29b as well as decreased expression of miR‐9 and miR‐485.

Conclusions

These results suggest an important pathophysiological involvement of miRNAs in the regulation of atrial expression of the TASK‐1 potassium channel in patients with atrial cardiomyopathy.
Navigating the Complex Web of Prescribing Amyloidosis Therapeutics: A Primer
Authors: Chen Hongya , Chandrashekar Pranav , Fischer Katherine , Carlson Dayna , Narayan Urja , Chen Jack , Masri Ahmad
Published: March 2022

Advancement in the diagnosis and treatment of transthyretin amyloid cardiomyopathy has made great strides in recent years. Novel therapeutics for transthyretin amyloidosis such as tafamidis, patisiran, and inotersen have shown significant benefits in a not‐so‐rare disease but come with high listing price tags ranging from a quarter to more than a half million dollars per year. These costs create significant financial barriers for the majority of patients, especially those with existing Medicare insurance plans. Of 72 patients reviewed, 67% were Medicare beneficiaries. Financial assistance was explored for the majority, and 37 (51%) patients with Medicare Part D received financial assistance that reduced their copayments to $0. Only one‐third of our patients were able to afford these medications without any forms of financial assistance. Of these patients, 4 (6%) had the highest copayments ranging from $13 000 to $15 000 per year. To navigate the complexities of prescribing and affordability in amyloidosis, a multidisciplinary team including a dedicated clinical pharmacist is crucial in guaranteeing patients’ success to secure these novel therapeutics. In this article, we discuss our experiences with prescribing, acquiring insurance authorizations, and financing these life‐saving medications based on patient‐specific insurance plans and socioeconomic status.
End‐Diastolic Forward Flow and Restrictive Physiology in Repaired Tetralogy of Fallot: A Systematic Review and Meta‐Analysis
Authors: Van den Eynde Jef , Derdeyn Emilie , Schuermans Art , Shivaram Pushpa , Budts Werner , Danford David A. , Kutty Shelby
Published: March 2022

Background

Pulmonary arterial end‐diastolic forward flow (EDFF) following repaired tetralogy of Fallot has been thought to represent right ventricular (RV) restrictive physiology, but is not fully understood. This systematic review and meta‐analysis sought to clarify its physiological and clinical correlates, and to define a framework for understanding EDFF and RV restrictive physiology.

Methods and Results

PubMed/MEDLINE, Embase, Scopus, and reference lists of relevant articles were searched for observational studies published before March 2021. Random‐effects meta‐analysis was performed to identify factors associated with EDFF. Forty‐two individual studies published between 1995 and 2021, including a total of 2651 participants (1132 with EDFF; 1519 with no EDFF), met eligibility criteria. The pooled estimated prevalence of EDFF among patients with repaired tetralogy of Fallot was 46.5% (95% CI, 41.6%–51.3%). Among patients with EDFF, the use of a transannular patch was significantly more common, and their stay in the intensive care unit was longer. EDFF was associated with greater RV indexed volumes and mass, as well as smaller E‐wave velocity at the tricuspid valve. Finally, pulmonary regurgitation fraction was greater in patients with EDFF, and moderate to severe pulmonary regurgitation was more common in this population.

Conclusions

EDFF is associated with dilated, hypertrophied RVs and longstanding pulmonary regurgitation. Although several studies have defined RV restrictive physiology as the presence of EDFF, our study found no clear indicators of poor RV compliance in patients with EDFF, suggesting that EDFF may have multiple causes and might not be the precise equivalent of RV restrictive physiology.
Adherence With Lipid Screening Guidelines in Children With Acquired and Congenital Heart Disease: An Observational Study Using Data From The MarketScan Commercial and Medicaid Databases
Authors: Berger Justin H. , Faerber Jennifer A. , Chen Feiyan , Lin Kimberly Y. , Brothers Julie A. , O’Byrne Michael L.
Published: March 2022

Background

Universal lipid screening in children provides an opportunity to mitigate the lifetime risk of atherosclerosis, particularly in children with chronic conditions that are predisposed to early atherosclerosis. In response, national guidelines recommend additional early screening in a subset of cardiac conditions. The penetration of such guidelines has not been evaluated.

Methods and Results

We performed a retrospective study of a geographically representative sample of US children using the MarketScan Commercial and Medicaid claims databases. The study population was children with cardiac disease between ages 2 and 18 years and ≥3 years of continuous coverage from January 1, 2013, to June 30, 2018, divided into 4 major strata of heart disease. We assessed the likelihood of screening between these classifications and compared with healthy children and calculated multivariate models to identify patient factors associated with screening likelihood. Of the eligible 8.4 million children, 155 000 children had heart disease, of which 1.8% (31 216) had high‐risk conditions. Only 17.5% of healthy children underwent lipid screening. High‐risk children were more likely to be screened (odds ratio [OR], 2.1; 95% CI, 2.09–2.19;
P
<0.001) than standard‐risk children, but that likelihood varied depending on strata of cardiac disease (22%–77%). Timing of screening also varied, with most occurring between ages 9 and 11 years. Among cardiac conditions, heart transplantation (OR, 16.8; 95% CI, 14.4–19.7) and cardiomyopathy (OR, 2.9; 95% CI, 2.8–3.1) were associated with the highest likelihood of screening.

Conclusions

Children with cardiac disease are more likely to undergo recommended lipid screening than healthy children, but at lower rates and later ages than recommended, highlighting the importance of quality improvement and advocacy for this vulnerable population.
From Modeling the Interactions among Institutions to Modeling the Evolution of an Ecosystem: A Reflection on the Triple Helix Model and Beyond
Authors: Xue Lan , Gao Yuchen
Published: March 2022

By decomposing and analyzing the quadruple helix model and N-tuple helices into interacting triple helices, Leydesdorff and Lawton Smith’s (2022) research promises to open further the black box inside the higher-order helices, and provides a theoretical basis and guidance for the subsequent governance on the innovation in the higher-order helices model. In this commentary, we have argued that a framework based on agile governance can be applied to the governance of this higher-order helices model with interactions among multiple triple helices. A set of flexible and adaptive actions or methods are necessary to make the governance on the higher-order helices model to be more agile to keep pace with the rapid changes of society.
The Emerging Anti-Stereotyping Principle under Article 14 echr
Authors: Henningsen Liv N
Published: March 2022

Anti-stereotyping as a legal principle is emerging as a transformative device in European human rights law. In this article, the anti-stereotyping principle in the case law of the European Court of Human Rights (ECtHR) is analysed and discussed. The article employs a multidimensional approach to discrimination and theorises a transformative dimension in relation to the stereotyping cases. First, the early cases on stereotyping are analysed in relation to different theoretical concepts. Thereafter, the Morais case is analysed and discussed in relation to the broader case law. It is argued that the anti-stereotyping principle is instituted more authoritatively in this case but requires further theorisation. Moreover, the comparator assessment is less significant in relation to the anti-stereotyping principle. Finally, it is argued that the ECtHR should be more explicit about intersectionality in its discrimination assessments and avoid essentialism. Aspects of case law are critiqued in this respect.
Stretchable interfaces with conformal contact
Authors: Lim Jong Tae , Ahn Seong-Deok
Published: March 2022

Without conformal contact, stretchable electronic devices are significantly degraded during device operation and post treatment, due to air trapping and the resulting formation of uneven surface. In this work, under the hard condition that a stretchable polyacrylate elastomer (VHB)
layer with high porosity which can lead to more pore formation at the VHB interface is introduced in the stretchable device preparation, conformal contact is achieved by vacuum process (VP). Planar images indicate that, although the conventional process results in the formation of pore with
a size of 0.1 mm at the vacuum pressure of 10-6 Torr, the VP prevents it until 10-6 Torr. Surface analysis using near-edge X-ray absorption fine structure indicates the VP leads to less corrugation in the surface of graphene electrode located near the VHB; thus, finally
resulting in significantly higher performance of an organic light emitting diode having the VHB and the graphene.
Usage of fingolimod combined with polyacetone system in the treatment of mouse kidney transplantation model
Authors: Li Xiaoli , Guo Hua , Du Yaze
Published: March 2022

A kidney transplantation model was established with mouse subjects, which was treated with the fingolimod (FTY720) combined with polyacetone (PCL) membrane controlled release system to analyze its therapeutic effect on kidney transplantation. 45 C57BL/6 (H-2b) mice were randomly enrolled
into 3 groups, 9 in the Sham group did not receive any treatment, 18 in the model group and FTY720-PCL group, with 9 donors and recipients, respectively. The mice in model group were treated with kidney transplantation, and those in the FTY720-PCL group were treated with FTY720-PCL based on
the model group. The three groups of mice were analyzed for serum creatinine (Scr), urine output, survival time of transplanted kidney (SToTK), overall survival time (OST), and the spleen tissue of the recipient mice. RT-PCR was used to detect the expression of IL-2 and ICAM-1 mRNA, and Western
blot was used to detect the expression of CTLA4Ig and Fas/FasL protein. The pathological changes of the transplanted kidney were graded and evaluated according to the BanffSchema pathological diagnostic criteria. The results showed that the Scr level of the recipient mice in the FTY720-PCL
group was greatly reduced (P < 0.05). Compared with the model group, urine output, SToTK, and OST were greatly increased (P < 0.05). The levels of interleukin 2 (IL-2) and intercellular adhesion molecule 1 (ICAM-1) mRNA in the spleen (P < 0.05) of the mice in
the FTY720-PCL group were obviously reduced, the level of cytotoxic T lymphocyte-associated antigen 4 immunoglobulin (CTLA4Ig) in the kidney was increased obviously, and factor related apoptosis (Fas) and factor related apoptosis ligand (FasL) (P < 0.05) levels dropped dramatically
compared with the model group. The results of hematoxylin-eosin staining (HE staining) showed that the rejection rate of transplanted kidneys in the FTY720-PCL group was greatly reduced. In summary, FTY720-PCL membrane system can reduce the rejection rate of mouse kidney transplantation and
prolong SToTK.
Impact of metal ions (Cr+6/Mn+7) loaded CaCO3 extracted from tap water for adsorption/ degradation of toxic pollutants under sunlight
Authors: Bathla Aadil , Kaur Davinder , Pal Bonamali
Published: March 2022

The present work involves the extraction and characterization of highly efficient CaCO3 from tap water. The resulting white powder was sintered at 900 °C and study for the adsorption/degradation of Rhodamine-B (RB) dye. After sintering at a higher temperature, it was
found that CaCO3 was decomposed into CaO and Ca(OH)2 which results in the superior adsorption of RB dye relative to CaCO3 dried at room temperature. The degradation efficiency of CaCO3 was further enhanced by loading two metal ions (Cr+6,
Mn+7) having different oxidation states. The as-prepared composites were characterized by different techniques i.e., dynamic light scattering, X-ray diffraction, diffuse reflectance spectroscopy, scanning electron microscopy (SEM) and UV-Visible spectrophotometer and examined for
photocatalytic degradation of Rhodamine-B (RB) dye under sunlight. The average hydrodynamic size of bare CaCO3 (900 °C) found to be 0.63 µm which was increased to 1.34 µm and 1.48 µm after loading of Cr+6 and Mn+7
ions respectively. SEM images suggested the hierarchical morphology of CaCO3 and energy dispersive X-ray spectroscopy (EDS)-mapping also confirms the presence of Cr+6 and Mn+7 ions on the surface CaCO3. It was observed that Mn+7-CaCO3
(900 °C) shows higher degradation efficiency of RB dye under solar radiation relative to bare and Cr+6 loaded CaCO3 and exhibited a higher rate constant of 4.6 × 10-2 min-1.
Gender Differences in Cyberbullying Victimization From a Developmental Perspective: An Examination of Risk and Protective Factors
Authors: Lee Yeungjeom , Harris Michelle N. , Kim Jihoon
Published: March 2022

Although a growing number of studies have examined the underlying mechanisms of cyberbullying victimization, less is known about the gender differences in developmental nature of cyberbullying victimization. This study aims to examine (1) developmental pathways of cyberbullying victimization by gender, and (2) gender differences in the risk and protective factors. Relying on longitudinal data of Korean youth, we found three latent trajectories for girls and four subgroups for boys. In general, results found somewhat different developmental patterns of cyberbullying victimization by gender. Also, results showed both gender similarities and differences in predictors. Peer support was the only consistent factor across boys and girls and there were gendered predictors as well. Implications for practice and suggestions for future research are discussed.
Development of a futuristic technology programme: How the aerospace industry (almost) transformed ground transportation in the United States (1960–1972)
Authors: K Cohen James
Published: March 2022

After a long policy development process under Presidents Kennedy and Johnson, the High-Speed Ground Transportation Act of 1965 was enacted. Section One of the Act called for developing futuristic ground transport systems with, for example, high-speed vehicles floating on cushions of air over specialised guideways and inside vacuum tubes. These unconventional technologies were conceived and promoted by aerospace companies and military agencies that exercised increasing influence within the federal government after World War II. During the implementation of the 1965 Act, contractors such as Grumman Aerospace made tangible progress towards a prototype air-cushion system. However, just when it was ready for testing, President Nixon changed course and terminated the Section One programme in 1972. An important lesson derived from this generally unknown chapter in American transport history is that the promotion of futuristic technologies by powerful corporations creates seductive, but often perilous choices for governments.
Recent Incarceration Exposure Among Parents of Live-Born Infants and Maternal and Child Health
Authors: Lee Rosalyn D. , D’Angelo Denise V. , Dieke Ada , Burley Kim
Published: March 2022

Objective:

Women who have direct exposure to incarceration or indirect exposure through their partner are at high risk for poor health behaviors and outcomes, which may have lasting impacts on their children. The objectives of this study were to estimate the prevalence of recent incarceration exposure among women with a recent live birth and assess the relationship between incarceration exposure and maternal and child health.

Methods:

We used data from the Pregnancy Risk Assessment Monitoring System (36 states and New York City, 2012-2015; N = 146 329) to estimate the prevalence of women reporting that they or their husband/partner spent time in jail during the 12 months before giving birth. We used multivariable logistic regression to assess associations between incarceration exposure and maternal and infant health conditions.

Results:

The prevalence of incarceration exposure shortly before or during pregnancy was 3.7% (95% CI, 3.6%-3.9%). Women with incarceration exposure had increased odds of prepregnancy hypertension (adjusted odds ratio [aOR] = 1.51; 95% CI, 1.26-1.81), prepregnancy and postpartum depressive symptoms (aOR = 1.95 [95% CI, 1.73-2.19] and 1.49 [95% CI, 1.32-1.67], respectively), and having an infant admitted to the neonatal intensive care unit (aOR = 1.18; 95% CI, 1.04-1.33).

Conclusion:

Because a parent’s incarceration exposure is an adverse childhood experience with the potential to disrupt important developmental periods and have negative impacts on the socioemotional and health outcomes of children, it is critical for researchers and health care providers to better understand its impact on maternal and infant health. Prenatal and postnatal care may provide opportunities to address incarceration-related health risks.
Knowledge of Critical Care Nurses about End-of-Life Care towards Terminal Illnesses: Levels and Correlating Factors
Authors: Subih Maha , Al-Amer Rasmieh , Malak Malakeh Z. , Randall Duncan C , Darwish Rima , Alomari Domam , Mosleh Sultan
Published: March 2022

Introduction

The preparedness of nurses in relation to providing palliative care is not always adequate, indeed, it is sometimes unsatisfactory; this may be caused by lack of knowledge and limited experience in end-of-life care (EOLC). Thus, this study purposed to assess the levels of registered nurses' knowledge about EOLC, examine the relationships between EOLC knowledge and some demographic variables, and explore predictors of EOLC knowledge.

Methods

A cross-sectional design survey was conducted with Jordanian registered nurses in critical care units (N = 175) in different heath sectors in Jordan. The End-of Life Professional Caregiver Survey (EPCS) was used.

Results

Findings showed that nurses had moderate/quite a lot of knowledge (M (SD) = 2.58 (.48)) about EOLC. The cultural and ethical values was the highest subscale of knowledge about EOLC (M (SD) = 2.74 (.52)), while effective care delivery subscale was the lowest one ( (M (SD) = 2.33 (.66). Knowledge about EOLC was correlated with age ( r = .145, P < .05), work experience ( r = .173, P < .05), and training course in palliative or EOLC (r = .217, P < .01). The main predictor of EPCS was training courses in palliative or EOLC (B = .190, P < .05).

Conclusion

The nurses need to enhance their knowledge about EOLC and correlating factors should be taken into consideration when developing any intervention program. Nurses need palliative care training courses; also more attention is required in palliative care education particularly in clinical skills in effective care delivery.
Closed cavity façade, an innovative energy saving façade
Authors: Michael Michalis , Overend Mauro
Published: March 2022

In its simplest form, a Closed Cavity Façade (CCF) consists of a double or triple glazing unit (DGU or TGU) on the inner layer and single glazing on the outer one, forming a sealed non-ventilated cavity with an automated shading device in between. Given its dynamic behaviour, this technology can dynamically control the flow of solar energy and light penetrating the building. Using EnergyPlus and IDA ICE, several CCF configurations were investigated and compared to the baseline (TGU). MATELab, an office-like test facility at the University of Cambridge, was used as the model, which was beforehand experimentally validated. The results show extensive benefits of CCFs compared to traditional TGU systems, in terms of thermal performance and occupants’ comfort. The CCF configurations investigated led to an improvement of energy performance in the range of 18–37% compared to the traditional TGU, depending on the CCF configuration and the climate while a previous study, using CCF configurations with DGU as inner skin, revealed an improvement of energy performance in the range of 22–41% compared to the conventional DGU. Further investigation showed that glass coatings and solar shading characteristics play an important role in cutting down overheating phenomenon while increasing occupants’ comfort. Practical application: Governments are making ever more stringent energy regulations for the building industry aiming to reduce energy consumption and carbon emissions. At the same time, building owners and architects are looking at cost-effective solutions for the long-term performance of buildings while tenants/occupants are more than ever aware of the fact that building comfort increases well-being and productivity. In all these regards, this work focuses and accentuates that substantial improvements can be achieved by designing and using suitable configurations of the innovative Closed Cavity Façade according to the climatic conditions of each location. The results presented indicate that there is much potential in improving the energy and comfort performance of a building, raising awareness to help deploy innovative glazing technologies.
Moving toward stronger advising practices: How Black males’ experiences at HPWIs advance a more caring and wholeness-promoting framework for graduate advising
Authors: Burt Brian A. , Mccallum Carmen M. , Wallace Joshua D. , Roberson Justin J. , Bonanno Anne , Boerman Emily
Published: March 2022

Background:

Graduate education provides students with specialized skills needed to advance science and discovery and prepares future educators and role models for future generations of learners. Given the importance of graduate education, the estimate that more than half of the students who begin it do not complete their degrees is troubling. Existing scholarship suggests that this substantial attrition from graduate school is in part due to inadequate advising. To address this concern, it is important to examine students’ experiences with graduate advising.

Purpose:

This article presents a new model—the Model of Wholeness in Graduate Advising (MWGA)—that characterizes a range of students’ advising experiences. In so doing, it encourages faculty to move toward a more caring and wholeness-promoting framework in graduate advising.

Research Design:

To better understand the complexities of graduate advising and the various types of experiences—and relationships—that students have, desire, expect, and need to thrive both professionally and personally, this study included interviews with 42 Black male graduate students attending historically and predominantly White institutions (HPWIs). Thematic analysis revealed that students’ advising experiences included aspects of “ethics of care” (or degrees of care: whole, partial, empty). Iterative analysis of data led to the creation of the practice-informing model: the Model of Wholeness in Graduate Advising (MWGA).

Findings:

Although some students described experiencing positive interactions and teachable moments with their advisors, others painted pictures of demoralizing encounters and public shaming practices. Still others described advising experiences they did not have but would want. Accounting for this range, the MWGA denotes an upwardly moving relationship between degrees of care (i.e., empty, partial, whole) and students’ perceptions of their advising experiences and relationships (i.e., weak, basic, strong) in part shaped by students’ expectations for their advising experiences and relationships, and their lived experiences.

Conclusions and Recommendations:

The findings from this study, represented in the MWGA, illustrate theoretical linkages between students’ expectations of advising, the levels of their advising experiences and relationships, and degrees of care demonstrated by their advisors. Most notably, more elements of care tend to result in better lived advising experiences and relationships. For current and future faculty, moving toward a more caring and wholeness-promoting framework might start with recognizing the needs of students as whole people. Creating more caring advising experiences and developing more caring relationships may better assist students in progressing through degree completion, and doing so more fully whole.
Preventing Challenging Behavior Using Physical Activity With Young Children
Authors: Winchester Claire , Barton Erin E. , Trimlett Gabrielle , Ledford Jennifer R.
Published: March 2022

Antecedent exercise (AE) is an intervention used to promote moderate-to-vigorous physical activity and improve subsequent behavior in non-exercise contexts. We used withdrawal and multitreatment single case research designs to compare the effects of baseline, AE alone, and AE + visual supports condition. Two preschool-age boys participated in this study. A masked secondary observer recorded interobserver agreement data for 100% of sessions; these data were continually monitored to detect biases. For one participant, AE alone was sufficient to reduce instances of challenging behavior during morning circle time. For the other participant, AE + visual supports was more effective than AE alone. These results point to the need for continued, rigorous research on the nuances of antecedent interventions for young children who demonstrate challenging behaviors. AE is but one such intervention requiring further investigation into for whom and under what conditions it might be effective.
Serum MIG6 concentration is increased by cholesterol-lowering treatment in patients with type 2 diabetes mellitus and hypercholesterolemia
Authors: Lee Jun Choul , Kim Ji Min , Joung Kyong Hye , Kang Seon Mee , Kim Hyun Jin , Ku Bon Jeong
Published: March 2022

Objective

The protein encoded by mitogen-inducible gene 6 (MIG6) plays an essential role in the regulation of cholesterol homeostasis and bile acid synthesis in mice. However, the physiological functions of MIG6 remain poorly understood in humans. Therefore, we aimed to evaluate the relationship between the serum MIG6 concentration and low-density lipoprotein (LDL)-cholesterol in patients undergoing cholesterol-lowering treatment.

Methods

We performed a non-randomized, prospective controlled trial. In total, 63 patients with type 2 diabetes and hypercholesterolemia were treated using either rosuvastatin monotherapy or rosuvastatin/ezetimibe combination therapy for 12 weeks. We then compared their serum lipid and MIG6 concentrations before and after treatment.

Results

The serum LDL-cholesterol concentration of the participants significantly decreased and the concentration of MIG6 significantly increased during treatment. In addition, higher pre-treatment serum concentrations of MIG6 were associated with larger reductions in LDL-cholesterol, regardless of the therapeutic agent used.

Conclusions

Serum MIG6 concentration significantly increases alongside the reduction in LDL-cholesterol achieved using cholesterol-lowering therapies in patients with diabetes and hypercholesterolemia. This is the first study to provide evidence that MIG6 may be involved in human cholesterol metabolism. CRIS registration number: KCT0003477. https://cris.nih.go.kr .
Stellate ganglion block successfully relieved medically unexplained chronic pain: a case report
Authors: Huang Yiting , Xu Jian , Liu Qingyan , Zeng Zhimin , Zhang Yuenong
Published: March 2022

Medically unexplained symptoms refers to a clinical syndrome characterized by somatic symptoms that cannot be reasonably explained by any organic disease. Chronic pain can be a type of medically unexplained symptom. The current treatment modalities for chronic pain mainly include drugs and psychotherapy. The use of stellate ganglion block for treatment of chronic pain has rarely been reported. Herein, we report a patient whose chronic pain was completely relieved after receiving a stellate ganglion block.
Effect of ultrasound-guided erector spinae plane block on post-surgical pain in patients undergoing nephrectomy: a single-center, randomized, double-blind, controlled trial
Authors: Şahin Ayhan , Baran Onur
Published: March 2022

Objective

Erector spinae plane (ESP) block is an alternative to neuraxial block for post-surgical pain in nephrectomy patients. However, no clinical trial has directly compared ESP block with a control group.

Methods

In a single-center, double-blind randomized comparative trial, patients undergoing nephrectomy with a subcostal flank incision under general anesthesia were divided into the following two groups: ESP block group (ESP block before anesthesia) and non-ESP (control) group (no intervention). The primary outcome measure was pain score (Numeric Rating Scale [NRS] 0 to 10). Secondary outcomes were postoperative opiate use, anesthetic and surgical complications, length of hospital stay, and patient-reported outcomes.

Results

Postoperatively (0 to 24 hours), the ESP block group experienced less pain and had lower NRS pain scores 0 to 24 hours postoperatively than the non-ESP group. Opioid consumption and the number of rescue analgesic doses decreased significantly in the ESP group compared with the non-ESP group. Patient-Reported Outcomes Information System (Quality of Recovery-15) scores significantly improved in the ESP group compared with the non-ESP block group.

Conclusions

Patients receiving an ESP block for intraoperative and postoperative analgesia during radical nephrectomies experienced less postoperative pain 0 to 24 hours compared with the non-ESP group.
An audit of perioperative end-of-life care practices and documentation relating to patients who died in a surgical unit in three Victorian hospitals
Authors: Keon-Cohen Zoe M , Story David A , Moran Juli A , Jones Daryl A
Published: March 2022

The number of older, frail patients undergoing surgery is increasing, prompting consideration of the benefits of intensive treatment. Despite collaborative decision-making processes such as advance care planning being supported by recent Australian legislation, their role in perioperative care is yet to be defined. Furthermore, there has been little evaluation of the quality of end-of-life care in the surgical population. We investigated documentation of the premorbid functional status, severity of illness, intensity of treatment, operative management and quality of end-of-life care in patients who died in a surgical unit, with a retrospective study of surgical mortality which was performed across three hospitals over a 23-month period in Victoria, Australia. Among 99 deceased patients in the study cohort, 68 had a surgical operation. Preoperative functional risk assessment by medical staff was infrequently documented in the medical notes (5%) compared with activities of daily living (69%) documented by nursing staff. Documented preoperative discussions regarding the risk of death were rarely and inconsistently done, but when done were extensive. Documented end-of-life care discussions were identified in 71%, but were frequently brief, inconsistent, and in 60% did not occur until 48 hours from death. In 35.4% of instances, documented discussions involved junior staff (registrars or residents), and 43.4% involved intensive care unit staff. Palliative or terminal care referrals also occurred late (1–2 days prior to death). Not-for-resuscitation orders were frequently changed when approaching the end of life. Overall, 57% of deceased patients had a documented opportunity for farewell with family. We conclude that discussions and documentation of end-of-life care practices could be improved and recommend that all surgical units undertake similar audits to ensure that end-of-life care discussions occur for high-risk and palliative care surgical patients and are documented appropriately.
Comprehensive Investigation of Commercial Motor Vehicle Crashes along Roadway Segments in Kentucky
Authors: Hosseinpour Mehdi , Love Ryan , Williams Baron , Haleem Kirolos
Published: March 2022

The negative binomial (NB) model, traditionally used for safety performance function (SPF) development, suffers from a fixed over-dispersion parameter and is only valid for over-dispersed data (i.e., data exhibiting greater variance than the mean). A more flexible approach that handles over-dispersed data, under-dispersed data, and excess zero counts, in addition to exhibiting varying dispersion parameter as a function of site-specific characteristics, is the zero-inflated heterogeneous Conway–Maxwell–Poisson (ZI-HTCMP) model, which is an extension of Conway–Maxwell–Poisson (CMP)-based models. This study develops fatal + injury (FI) commercial motor vehicle (CMV) crash-specific SPFs along four roadway segment facilities in Kentucky, U.S., (urban multilane, rural multilane, urban two-lane, and rural two-lane segments). The traditional NB and newly introduced CMP-based models—ZI-HTCMP, zero-inflated Conway–Maxwell–Poisson (ZI-CMP), heterogeneous Conway–Maxwell–Poisson (HTCMP), and CMP—were compared using 14,967 CMV-related crashes on Kentucky’s road segments (between 2015 and 2019) and various roadway variables, for example, shoulder width, annual average daily traffic (AADT), and heavy vehicle percentage (HVP). From the developed SPFs, AADT and HVP >10% significantly increased FI CMV-related crashes on all four segment facilities. Various goodness-of-fit (GOF) statistics, including Akaike information criterion (AIC), mean absolute deviance (MAD), and mean square prediction error (MSPE), were used for model assessment and selection. For all four roadway facilities, CMP-based models showed better model fitting and prediction performance than the NB models. Furthermore, ZI-HTCMP was the best-fit model for urban multilane segments, which had high representation of zero-crash sites. CMP-family models could be used for effectively predicting FI CMV-related crashes (with excess zeros) on road segments.
Orthosis and Foot Structure Affect the Fifth Metatarsal Principal Strains During Simulated Level Walking
Authors: Hoffman Jeffrey W. , Bitar Rogerio C. , Williams Nicholas , Steineman Brett D. , Sturnick Daniel R. , Garrison Glenn W. , Demetracopoulos Constantine A. , Drakos Mark C. , O’Malley Martin J.
Published: March 2022

Background:

Fractures of the proximal fifth metatarsal bone are common injuries in elite athletes and are associated with high rates of delayed union and nonunion. Structural features of the foot may increase fracture risk in some individuals, emphasizing the need for intervention strategies to prevent fracture. Although orthotic devices have shown promise in reducing fractures of the fifth metatarsal bone, the effect of orthosis on fifth metatarsal strains is not well understood.

Purpose:

To quantify the effects of different foot orthotic constructs on principal tensile strains in the proximal fifth metatarsal bone during cadaveric simulations of level walking. An additional purpose was to investigate the relationships between structural features of the foot and corresponding strains on the fifth metatarsal bone during level walking.

Study Design:

Controlled laboratory study.

Methods:

A total of 10 midtibial cadaveric specimens were attached to a 6 degrees of freedom robotic gait simulator. Strain gauges were placed at the metaphyseal-diaphyseal junction (zone II) and the proximal diaphysis (zone III) during level walking simulations using 11 different foot orthotic configurations. Images of each specimen were used to measure structural features of the foot in an axially loaded position. The peak tensile strains were measured and reported relative to the sneaker-only condition for each orthotic condition and orthotic-specific association between structural features and principal strains of both zones.

Results:

In total, 2 of the 11 orthotic conditions significantly reduced strain relative to the sneaker-only condition in zone II. Further, 6 orthotic conditions significantly reduced strain relative to the sneaker-only condition in zone III. Increased zone II principal strain incurred during level walking in the sneaker-only condition showed a significant association with increases in the Meary’s angle. Changes in zone III principal strain relative to the sneaker-only condition were significantly associated with increases in the Meary’s angle and fourth-fifth intermetatarsal angle.

Conclusion:

The use of orthotic devices reduced principal strain relative to the condition of a sneaker without any orthosis in zone II and zone III. The ability to reduce strain relative to the sneaker-only condition in zone III was indicated by increasing values of the Meary’s angle and levels of the fourth-fifth intermetatarsal angle.

Clinical Relevance:

Clinicians can use characteristics of foot structure to determine the proper foot orthosis to potentially reduce stress fracture risk in high-risk individuals.
Examining challenges and multi-strategic approaches in waste management during the COVID-19 pandemic: A systematic review
Authors: Ali Sk Ajim , Parvin Farhana
Published: March 2022

The COVID-19 pandemic has a negative impact on the environment. Waste generation and improper management during the COVID-19 pandemic posed a major threat to human health and the environment. Irregular and improper waste collection, handling, suspension of waste recycling and unsanitary disposal were all important issues in the processing and management of generated waste. This study emphasised a systematic review and content analysis to categorise all types of waste management (WM) during the COVID-19 pandemic to accomplish a well understanding of the relation between the COVID-19 pandemic and its impacts on WM within the literature. In this systematic review, a number of published papers on different aspects of WM during March 2020 to February 2021 were considered in order to identify major challenges in handling WM during the pandemic time and highlight multi-strategic approaches suggested. A content analysis of the 58 relevant papers was carried out by incorporating different types of WM at local as well as global scales. The present review results revealed that the COVID-19 has impacted the quantity and composition of waste, and the crisis caused by the pandemic has also altered the nature of global WM system. A comprehensive analysis on how the systems of WM were affected through the advancement of COVID-19 and what would be the healthier solutions was also highlighted in this systematic review. The results of this systematic review would be beneficial for better policymakers to holistically address potential future pandemics, if any.