bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-nuclear valosin-containing protein-like autoantibody is associated with calcinosis and higher risk of cancer in systemic sclerosis
Authors: Perurena-Prieto Janire , Viñas-Giménez Laura , Sanz-Martínez María Teresa , Selva-O’Callaghan Albert , Callejas-Moraga Eduardo Luis , Colobran Roger , Guillén-Del-Castillo Alfredo , Simeón-Aznar Carmen P
Published: September 2023

Objectives

Systemic sclerosis (SSc)-specific autoantibodies allow the diagnosis and predict the prognosis of SSc patients with different clinical characteristics. The aim of this study was to describe new SSc-related autoantibodies by a novel protein immunoprecipitation (IP) assay.

Methods

Serum samples and clinical data were collected from 307 SSc patients. Antinuclear autoantibodies were tested in all patients by indirect immunofluorescence (IIF) on HEp-2 cells. SSc-specific autoantibodies were evaluated with a commercial immunoblot and chemiluminescence immunoassay, and traditional RNA-IP. Patients negative for all these autoantibodies (n = 51) were further tested with a non-radioactive protein IP assay. Protein bands detected on SDS–PAGE were then analysed by mass spectrometry (MS) and confirmed by western blot (WB). Additional 56 patients with nucleolar pattern by IIF were tested by protein IP-WB.

Results

Five patients who underwent protein IP testing showed a 110-115kDa molecular weight band on SDS–PAGE and a homogeneous nucleolar pattern by IIF. MS identified the bands as nuclear valosin-containing protein-like (NVL). An additional positive patient was detected by IP-WB. As compared with the remaining 101 negative patients, anti-NVL positive patients showed a greater prevalence of calcinosis (100% vs 18.9%, P < 0.001), and cancer (66.7% vs 8.9%, P = 0.002), with a particular association with synchronous cancer (OR = 16.3; P = 0.024).

Conclusion

We identified NVL as a new autoantibody target by a novel protein IP assay in SSc patients with a homogeneous nucleolar IIF pattern, testing negative for all known SSc-specific autoantibodies by commercial assays and RNA IP. Anti-NVL identifies a new clinical phenotype, characterized by calcinosis and cancer.
Canada’s Implementation of the UN Global Compacts on Migration and Refugees: Advancing Foreign Policy Objectives and the Status Quo?
Authors: Atak Idil , Linley-Moore Claire , Kim Julie (Ha Young)
Published: September 2023

Canada has been a strong supporter of the 2018 United Nations Global Compacts (GCs) on Migration and Refugees. This article examines Canada’s reception and implementation of the GCs in the policy domains of refugee resettlement, complementary protection pathways, gender equality, and migration governance capacity building. It draws on the analytical framework of “migration diplomacy” to argue that Canada’s efforts to carry out the GC objectives in these areas are primarily motivated by foreign policy considerations, including those with significant domestic implications, rather than efforts to ensure domestic alignment with the GC principles enhancing migrants’ rights and freedoms. By supporting the GCs, Canada has positioned itself as a global leader in migration management. Migration diplomacy has also legitimised the implementation by Canada of exclusionary refugee policies.
Rescuing transparency in the digital economy: in search of a common notion in EU consumer and data protection law
Authors: Jabłonowska Agnieszka , Tagiuri Giacomo
Published: September 2023

Transparency remains a contested concept in European Union (EU) law and policy. All the main instruments of EU consumer and data protection law require that consumers be given access to and understand certain information about their relationships with traders. Improved transparency is also proposed as a response to a variety of problems associated with digital markets, including those experienced by consumers and data subjects. At the same time, transparency is increasingly challenged as ineffective and potentially even counterproductive from doctrinal and critical scholarship alike. First, transparency is seen as inherently unable to transform the economic reality on the ground and to address the power imbalances between consumers and traders. Secondly, it is argued that acts of representation involved in transparency suffer from complexity and are prone to exploitation by the actors who engage in it. This, in turn, casts doubt on the ability of transparency to steer the behaviour of businesses and transform markets to the benefit of consumers and society. This article builds upon prior critiques of transparency and connects them with a doctrinal analysis of EU consumer and data protection law and in particular the Unfair Contract Terms Directive, the Unfair Commercial Practices Directive, and the General Data Protection Regulation. Seven different notions of transparency are identified: (i) Transparency as access to the medium over time; (ii) Transparency as presentation of information that facilitates understanding; (iii) Transparency as formulations that facilitate understanding; (iv) Transparency as non-ambiguity and logical intelligibility; (v) Transparency as the absence of deception and confusion; (vi) Transparency as completeness and specificity; and (vii) Transparency as non-arbitrariness. The article submits that the acts of representation involved in transparency are already recognized in the three legal regimes and attempts are made to leverage the mediated nature of transparency to consumers’ advantage. Crucially, existing efforts to regulate mediation and improve its quality can, nowadays, be reinforced with the help of algorithmic systems geared toward supporting consumers. Moreover, some of the deployments of transparency identified—most notably transparency as non-arbitrariness—push its outer conceptual boundaries in ways that bring transparency very close to fairness. The article ultimately questions a vision of transparency as a necessarily softer-touch protective frame, which cannot alter business conduct. The conceptual richness of transparency offers opportunities for its deployment in more disruptive ways.
Evolution of the ToxB Gene in Pyrenophora tritici-repentis and Related Species
Authors: Hafez Mohamed , Gourlie Ryan , McDonald Megan , Telfer Melissa , Carmona Marcelo A. , Sautua Francisco J. , Moffat Caroline S. , Moolhuijzen Paula M. , See Pao Theen , Aboukhaddour Reem
Published: September 2023

Pyrenophora tritici-repentis (tan spot) is a destructive foliar pathogen of wheat with global impact. This ascomycete fungus possesses a highly plastic open pangenome shaped by the gain and loss of effector genes. This study investigated the allelic variations in the chlorosis-encoding gene ToxB across 422 isolates representing all identified pathotypes and worldwide origins. To gain better insights into ToxB evolution, we examined its presence and variability in other Pyrenophora spp. A ToxB haplotype network was constructed, revealing the evolutionary relationships of this gene (20 haplotypes) across four Pyrenophora species. Notably, toxb, the homolog of ToxB, was detected for the first time in the barley pathogen Pyrenophora teres. The ToxB/ toxb genes display evidence of selection that is characterized by loss of function, duplication, and diverse mutations. Within the ToxB/ toxb open reading frame, 72 mutations were identified, including 14 synonymous, 55 nonsynonymous, and 3 indel mutations. Remarkably, a, ∼5.6-kb Copia-like retrotransposon, named Copia-1_Ptr, was found inserted in the toxb gene of a race 3 isolate. This insert disrupted the ToxB gene's function, a first case of effector gene disruption by a transposable element in P. tritici-repentis. Additionally, a microsatellite with 25 nucleotide repeats (0 to 10) in the upstream region of ToxB suggested a potential mechanism influencing ToxB expression and regulation. Exploring ToxB-like protein distribution in other ascomycetes revealed the presence of ToxB-like proteins in 19 additional species, including the Leotiomycetes class for the first time. The presence/absence pattern of ToxB-like proteins defied species relatedness compared with a phylogenetic tree, suggesting a past horizontal gene transfer event during the evolution of the ToxB gene.

[Formula: see text] Copyright © 2024 His Majesty the King in Right of Canada, as represented by the Minister of Agriculture and Agri-Food. This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Establishing a Protocol for Determining the Costs of an Integrated Set of Evidence-based Practices Aimed at Reducing Opioid Overdose Deaths
Authors: Tin Yjuliana , Castry Mathieu , Bowers-Sword Rachel , Shantharam Shruti , Aldridge Arnie , Zarkin Gary A. , Starbird Laura , Linas Benjamin P. , Barocas Joshua A. , Morgan Jake R.
Published: September 2023

Objectives

In the midst of the opioid overdose crisis, local jurisdictions face a choice of public health interventions. A significant barrier when considering evidence-based practices (EBPs) is the lack of information regarding their implementation cost. This protocol paper provides the methodological foundation for the economic cost evaluations of community-wide strategies on the scale of a national study. It can serve as a resource for other communities, local policymakers, and stakeholders as they consider implementing possible public health strategies in their unique settings.

Methods

We present a protocol that details (1) the process of identifying, reviewing, and analyzing individual strategies for study-funded and non–study-funded costs; (2) prospective costing tool designation, and; (3) data collection. To do this, we set up working groups with community stakeholders, reviewed financial invoices, and surveyed individuals with detailed knowledge of their community implementation.

Discussion

There were 3 main challenges/limitations. The first was the lack of a standard structure for documenting nonfunded costs associated with each strategy. The second was the need for timely implementation of cost data. The third was generalizability because our study designed its strategies for selected communities due to their high opioid overdose mortality rates. Future steps include more tailored questions to ask during the categorization/filter process and establishing realistic expectations for organizations regarding documenting.

Conclusions

Data collected will provide a critical methodological foundation for costing large community-based EBP strategies and provide clarity for stakeholders on the cost of implementing EBP strategies to reduce opioid overdose deaths.
Continuous Glucose Monitoring in Pregnancy
Authors: Horgan Rebecca , Hage Diab Yara , Fishel Bartal Michal , Sibai Baha M. , Saade George
Published: September 2023

Diabetes mellitus in pregnancy is associated with adverse maternal and neonatal outcomes. Optimal glycemic control is associated with improved outcomes. Continuous glucose monitoring is a less invasive alternative to blood glucose measurements. Two types of continuous glucose monitoring are available in the market: real time and intermittently scanned. Continuous glucose monitoring is gaining popularity and is now recommended by some societies for glucose monitoring in pregnant women. In this review, we discuss the differences between the two types of continuous glucose monitoring, optimal treatment goals, and whether there is an improvement in maternal or neonatal outcomes.
Neonatal and Maternal Outcomes at 22–28 Weeks of Gestation by Mode of Delivery
Authors: Bitas Christiana , Onishi Kazuma , Saade George , Kawakita Tetsuya
Published: September 2023

OBJECTIVE:

To compare neonatal and maternal outcomes after 22- to 28-week delivery between cesarean and vaginal delivery after stratification by gestational age and fetal presentation.

METHODS:

This study was a repeated cross-sectional analysis using U.S. birth certificate data linked to infant death data from 2017 to 2020. We limited analyses to women with singleton pregnancies who gave birth at 22–28 weeks of gestation and whose neonates were admitted to the intensive care unit. Our primary outcome was neonatal death within 28 days. We also examined infant mortality within 1 year and severe maternal morbidity (SMM; any transfusion, unplanned hysterectomy, and intensive care unit admission). Outcomes were compared between cesarean and vaginal delivery after stratification by gestational age and fetal presentation. Multivariable logistic regression was performed to calculate adjusted odds ratios (vaginal delivery as a referent), controlling for potential confounders.

RESULTS:

Of 69,672 individuals with eligible deliveries, 1,740 (2.5%) delivered at 22 weeks of gestation, 6,155 (8.8%) delivered at 23 weeks, 9,341 (13.4%) delivered at 24 weeks, 10,516 (15.1%) delivered at 25 weeks, 11,994 (17.2%) delivered at 26 weeks, 13,662 (19.6%) delivered at 27 weeks, and 16,264 (23.3%) delivered at 28 weeks. In cephalic fetuses, cesarean delivery compared with vaginal delivery was associated with neonatal death and infant mortality at 24 weeks of gestation and greater (not significant at 22–23 weeks) and SMM in all gestational age groups. In contrast, in noncephalic fetuses, cesarean delivery compared with vaginal delivery was associated with decreased odds of neonatal death and infant mortality in all gestational age groups. Sample size for SMM in noncephalic fetuses precluded multivariable modeling.

CONCLUSION:

Cesarean delivery in cephalic fetuses was associated with increased odds of adverse neonatal outcomes (24 weeks of gestation or greater) and SMM (all gestational age groups). Cesarean delivery was associated with decreased odds of neonatal death compared with vaginal delivery for noncephalic fetuses in all gestational age groups.
Malaria and Pregnancy
Authors: Rasmussen Sonja A. , Arguin Paul M. , Jamieson Denise J.
Published: September 2023

Recent identification of local mosquito-borne transmission of malaria in Florida, Texas, and Maryland and increasing travel to malaria-endemic countries raise the likelihood that U.S. obstetricians might encounter a pregnant patient with malaria. Pregnancy increases the risk of becoming infected with malaria and of developing severe disease. Malaria during pregnancy also increases the risk of adverse pregnancy outcomes, including low birth weight, pregnancy loss, and preterm birth; thus, prevention and prompt diagnosis and treatment are essential. Diagnosis can be challenging during pregnancy among persons with partial immunity because placental sequestration of parasite-infected red blood cells can result in lower parasite levels in peripheral blood. Treatment for uncomplicated malaria depends on the expected resistance pattern, which is determined by the specific Plasmodium species identified and where infection was acquired. For severe disease, parenteral artesunate treatment needs to be initiated immediately. Given the dire consequences of malaria in pregnancy, prevention is crucial. For persons born and raised in endemic areas, interventions include use of insecticide-treated bed nets, intermittent preventive treatment, and prompt diagnosis and treatment of illness. U.S. pregnant persons should avoid travel to endemic countries; for unavoidable travel, pregnant travelers should receive chemoprophylaxis and avoid mosquito bites. Although the risk is low to U.S. pregnant persons who are not traveling internationally, avoiding mosquito bites is important, especially for pregnant persons residing in or visiting areas with recent local mosquito-borne transmission.
Correlations Between Eight Comprehensive Skeletal Maturity Systems in a Modern Peripubertal Pediatric Population
Authors: Chen Kallie J. , Mysore Amog , Furdock Ryan J. , Sattar Abdus , Sinkler Margaret A. , Glotzbecker Michael P. , Liu Raymond W.
Published: September 2023

Background:

Several skeletal maturity systems allow for accurate skeletal age assessment from a wide variety of joints. However, discrepancies in estimates have been noted when applying systems concurrently. The aims of our study were to (1) compare the agreement among 8 different skeletal maturity systems in modern pediatric patients and (2) compare these discrepancy trends qbetween modern and historic children.

Methods:

We performed a retrospective (January 2000 to May 2022) query of our picture archiving and communication systems and included peripubertal patients who had at least two radiographs of different anatomic regions obtained ≤3 months apart for 8 systems: (1) proximal humerus ossification system (PHOS), (2) olecranon apophysis ossification staging system (OAOSS), (3) lateral elbow system, (4) modified Fels wrist system, (5) Sanders Hand Classification, (6) optimized oxford hip system, (7) modified Fels knee system, and (8) calcaneal apophysis ossification staging system (CAOSS). Any abnormal (ie, evidence of fracture or congenital deformity) or low-quality radiographs were excluded. These were compared with a cohort from a historic longitudinal study. SEM skeletal age, representing the variance of skeletal age estimates, was calculated for each system and used to compare system precision.

Results:

A total of 700 radiographs from 350 modern patients and 954 radiographs from 66 historic patients were evaluated. In the modern cohort, the greatest variance was seen in PHOS (SEM: 0.28 y), Sanders Hand (0.26 y), and CAOSS (0.25 y). The modified Fels knee system demonstrated the smallest variance (0.20 y). For historic children, the PHOS, OAOSS, and CAOSS were the least precise (0.20 y for all). All other systems performed similarly in historic children with lower SEMs (range: 0.18 to 0.19 y). The lateral elbow system was more precise than the OAOSS in both cohorts.

Conclusions:

The precision of skeletal maturity systems varies across anatomic regions. Staged, single-parameter systems (eg, PHOS, Sanders Hand, OAOSS, and CAOSS) may correlate less with other systems than those with more parameters.

Level of Evidence:

Level III—retrospective study.
Longitudinal Relationship between Reduced Modic change Edema and Disability and Pain in Patients with Chronic Low Back Pain
Authors: Espeland Ansgar , Kristoffersen Per Martin , Bråten Lars Christian Haugli , Grøvle Lars , Grotle Margreth , Haugen Anne Julsrud , Rolfsen Mads Peder , Hellum Christian , Zwart John-Anker , Storheim Kjersti , Assmus Jörg , Vetti Nils
Published: September 2023

Study Design.

Secondary analyses of a randomized trial (Antibiotics In Modic changes (AIM) study).

Objective.

To assess whether or not reduced Modic change (MC) edema over time is related to reduced disability and pain in patients with chronic low back pain (LBP).

Summary of Background Data.

It is not clear whether or not reduced MC oedema implies improved clinical outcomes.

Methods.

Linear regression was conducted separately in two subgroups with MC oedema at baseline on short tau inversion recovery (STIR) or T1/T2-weigthed magnetic resonance imaging, respectively. Independent variable: reduced edema (yes/no) at 1 year on STIR or T1/T2-series, respectively. Dependent variable: 1-year score on the Roland Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI), or 0–10 numeric rating scale for LBP intensity, adjusted for the baseline score, age, smoking, body mass index, physical workload, and baseline edema on STIR (STIR analysis only).Post-hoc, we additionally adjusted all analyses for baseline edema on STIR, treatment group (amoxicillin/placebo) and prior disc surgery – or for disc degeneration.

Results.

Among patients with MC edema on STIR at baseline (n=162), reduced edema on STIR was not significantly related to the RMDQ (B -1.0, 95% CI -2.8, 0.8;P=0.27), ODI (B -1.4, 95% CI -5.4, 2.6;P=0.50) or LBP intensity scores (B -0.05, 95% CI -0.8, 0.7;P=0.90) after 1 year. Among patients with MC edema on T1/T2-series at baseline (n=116), reduced edema on T1/T2 (i.e., reduced volume of the type 1 part of MCs) was not significantly related to RMDQ (B -1.7, 95% CI -3.8, 0.3;P=0.10) or ODI score (B -2.3, 95%CI -7.1, 2.5;P=0.34) but was significantly related to LBP intensity at 1 year (B -0.9, 95% CI -1.8, -0.04;P=0.04; correlation coefficient 0.24). Thepost-hocanalyses supported these results.

Conclusion.

Reduced MC edema over 1 year was not significantly associated with pain-related disability but was (on T1/T2-series) significantly but weakly related to reduced LBP intensity.

Level of evidence.

3.
Comparison of the Safety of Inpatient versus Outpatient Lumbar Fusion
Authors: Subramanian Tejas , Akosman Izzet , Amen Troy B. , Pajak Anthony , Kumar Neerav , Kaidi Austin , Araghi Kasra , Shahi Pratyush , Asada Tomoyuki , Qureshi Sheeraz A. , Iyer Sravisht
Published: September 2023

Study Design.

Systematic Review and Meta-Analysis

Objective.

The objective of this study is to synthesize the early data regarding and analyze the safety profile of outpatient lumbar fusion.

Summary of Background Data.

Preforming lumbar fusion in an outpatient or ambulatory setting is becoming an increasingly employed strategy to provide effective value-based care. As this is an emerging option for surgeons to employ in their practices, the data is still in its infancy.

Methods.

This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that described outcomes of inpatient and outpatient lumbar fusion cohorts were searched from PubMed, Medline, The Cochrane Library, and Embase. Rates of individual medical and surgical complications, readmission, and reoperation were collected when applicable. Patient reported outcomes were additionally collected if reported. Individual pooled comparative meta-analysis was performed for outcomes of medical complications, surgical complications, readmission, and reoperation. Patient reported outcomes were reviewed and qualitatively reported.

Results.

The search yielded 14 publications that compared outpatient and inpatient cohorts with a total of 75,627 patients. Odds of readmission demonstrated no significant difference between outpatient and inpatient cohorts (OR=0.94 [0.81 - 1.11]). Revision surgery similarly was no different between the cohorts (OR=0.81 [0.57 - 1.15]). Pooled medical and surgical complications demonstrated significantly decreased odds for outpatient cohorts compared to inpatient cohorts (OR=0.58 [0.34 - 0.50], OR=0.41 [0.50 - 0.68] respectively). Patient reported outcome measures were largely the same between the cohorts when reported, with few studies showing better ODI and VAS-Leg outcomes among outpatient cohorts compared to inpatient cohorts.

Conclusion.

Preliminary data regarding the safety of outpatient lumbar fusion demonstrates a favorable safety profile in appropriately selected patients, with patient reported outcomes remaining comparable in this setting. There is no data in the form of prospective and randomized trials which is necessary to definitively change practice.
The Use of mHealth in Promoting Therapeutic Adherence
Authors: Liquori Gloria , Pio Posa Vincenzo , De Leo Aurora , Giannetta Noemi , Di Simone Emanuele , Di Muzio Marco , Dionisi Sara
Published: September 2023

Nonadherence to therapy negatively impacts mortality and quality of life and results in suboptimal efficacy of treatment regimens, threats to patient safety, and increased healthcare costs for disease management. Mobile health solutions can offer users instruments that can promote therapeutic adherence. The objective of this review is to investigate the impact mobile health systems have on therapeutic adherence. Specifically, we want to map the main systems used, the functions implemented, and the different methods of adherence detection used. For this purpose, a scoping review was conducted. The following databases were consulted: PubMed, Cochrane Library, EBSCO (including APA PsycINFO, CINAHL Plus with Full Text, ERIC), including English-language studies published in the last 10 years (2012–2022). The main mobile health systems used are as follows: applications, automated messaging, interactive voice response, and mobile video games. The main features implemented to support medication management were as follows: reminders, self-monitoring instruments, educational support, and caregiver involvement. In conclusion, the use of interactive mobile health instruments intended for use by the patient and/or caregiver can improve objectively and subjectively detected therapeutic adherence. The use of these systems in the therapeutic pathway of users, with a special focus on people with comorbidities and in polypharmacy treatment, represents a challenge to improve caregiver health.
Incidence and factors for pseudoaccommodation after monofocal lens implantation: the Monofocal Extended Range of Vision study
Authors: Nanavaty Mayank A. , Mukhija Ritika , Ashena Zahra , Bunce Catey , Spalton David J.
Published: September 2023

Purpose:

To screen patients with a monofocal intraocular lens (IOL) for incidence of unaided 20/40 and 0.3 LogMAR for distance and near (pseudoaccommodation) and to find factors for pseudoaccommodation.

Settings:

University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom.

Design:

Prospective study.

Methods:

This was a single-eye study (ClinicalTrials.gov: NCT04011696). At 3 to 9 months, refraction, uncorrected and corrected distance and uncorrected near visual acuity (logMAR), spherical equivalent (SEQ), mesopic pupil size (PS), total eye spherical (Z4
0), vertical coma (Z3
−1) aberrations, reading speed and smallest print size were assessed. Refractive astigmatism (RA) was classified as against-the-rule, with-the-rule, oblique and no astigmatism. Data on preoperative axial length (AL) and anterior chamber depth (ACD) were collected.

Results:

29 patients (9.6%, 95% CI, 6.5-13.5) had pseudoaccommodation. In cases vs controls, median SEQ, PS, total Z4
0, Z3
−1, reading speed, smallest print size, preoperative ACD, preoperative AL were: −0.39 vs 0.0 diopters; 3.62 vs 4.10 mm; 0.01 vs 0.02 μm; 0.018 vs 0.022 μm; 106 vs 133 words per minute; 0.30 vs 0.50 logMAR; 2.94 vs 3.13 mm, 23.4 vs 23.7 mm, respectively. RA was not different between the groups. Univariate analysis revealed preoperative ACD (odds ratio [OR], 0.38, 95% CI, 0.16-0.94, P = .04), SEQ (OR, 0.61, 95% CI, 0.42-0.88, P = .01), total Z4
0 (OR, 0.0003, 95% CI, 0.00-0.39, P = .03) and PS (OR, 0.39, 95% CI, 0.22-0.69, P < .041) to be significant. Whereas multivariable logistic regression identified: preoperative AL (OR, 0.62, 95% CI, 0.42-0.91, P = .02), SEQ (OR, 0.49, 95% CI, 0.31-0.78, P = .01), Z4
0 (OR, 0.00, 95% CI, 0.0-0.01, P = .01) and PS (OR, 0.41, 95% CI, 0.23-0.75, P = .01) to be significant.

Conclusions:

A combination of low myopic SEQ, lower Z4
0, shorter preoperative AL, and smaller PS increases the chances of pseudoaccommodation.
Association Between Authentic Leadership in Nurse Managers and Performance and Intention to Leave Among Registered Nurses
Authors: ALLAN Safa'a Ali , RAYAN Ahmad Hussien
Published: September 2023

Background

Authentic leadership in nurse managers has been identified as a strong predictor of multiple nurse outcomes. However, its association with staff performance and nurses' intention to leave has yet to be established.

Purpose

This study was designed to identify the predictive effect of sociodemographic variables on nurse performance and intention to leave and to examine the relationship between authentic leadership in nurse managers and, respectively, nurse performance and intention to leave.

Methods

A comparative and correlational design and a cross-sectional survey approach were used. A convenience sample of 166 registered nurses working in a government hospital in Jordan was recruited. Data collection was performed online using the sociodemographics questionnaire, the Authentic Leadership Questionnaire, the Turnover Intention Scale, and the Six Dimensions of Nurse's Performance Scale. Data were analyzed using descriptive statistics, independent t test, one-way analysis of variance, Pearson correlation, and multiple hierarchical linear regression.

Results

The overall mean score was 2.08 (SD = 0.87) for the Authentic Leadership Questionnaire, 3.57 (SD = 1.76) for the Turnover Intention Scale, and 3.00 (SD = 0.51) for the Staff Performance Scale. Mean nursing performance differed significantly based on marital status, whereas intention to leave differed significantly based on marital status and the respondent's perception of their first-line manager. A statistically significant, positive correlation between authentic leadership and staff performance and a statistically significant, negative correlation between authentic leadership and intention to leave were found. In addition, authentic leadership was uniquely associated with staff performance (B = 0.19, p < .05) and intention to leave (B = −0.39, p < .05) in the hierarchical regression analysis after controlling for sociodemographic variables.

Conclusions/Implications for Practice

Authentic leadership from nurse managers is associated with improved nurse performance and lower nurse intention to leave. Nurse managers may enhance authentic leadership attributes to better retain nurses in hospitals and improve nurse job performance.
Experiences and Perceptions of E-Cigarette Cessation for Young Adults in Rural Communities
Authors: Gwon Seok Hyun , Thongpriwan Vipavee , Mobarki Amani , Eyadat Anwar , Noonan Devon
Published: September 2023

Background

Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are the most commonly used tobacco products among young adults in the United States. Young adults in rural areas have a higher prevalence of ENDS use compared to their urban counterparts, yet there is limited evidence regarding the in-depth understanding of experiences and perspectives directly from young adults.

Objectives

The aim of this study was to explore individual experiences and perspectives about use and cessation of ENDS from young adults in rural areas.

Methods

This was a qualitative study using interpretive description for analysis. Young adults (18–24 years) who used ENDS every day but not other tobacco products (cigarettes, smokeless, etc.) in the past month and had an address in a rural county of Wisconsin were eligible; there were nine participants interviewed using Zoom. Interview questions focused on initial use, maintenance of use, experiences of quitting, and social and rural environmental contexts regarding ENDS.

Results

Three themes emerged with eight categories: (a) addiction to ENDS and health, (b) cessation and resources, and (c) rural environment and culture in ENDS addiction.

Discussion

Findings have implications for ENDS cessation interventions targeting young adults in rural areas.
Happy Family, Healthy Kids
Authors: Ling Jiying , Chen Sisi , Zhang Nanhua , Robbins Lorraine B. , Kerver Jean M.
Published: September 2023

Background

Substantial effort has been invested to combat childhood obesity, but overall effects are disappointing, especially in low-income racial minority children. One possible reason is a lack of focus on the important stress–eating connection. Stress can negatively influence eating behaviors, leading to an increased appetite for high-fat and energy-dense foods.

Objective

This study aimed to evaluate the preliminary effects of a healthy eating and stress management program targeting multiple theoretical variables on improving eating behavior (dyads’ fruit/vegetable intake, emotional eating), food insecurity, anthropometric characteristics (dyads’ body mass index, % body fat), cardiovascular health (dyads’ blood pressure), and mental well-being (parental stress).

Methods

A one-group, quasi-experimental pilot study was conducted among 107 low-income parent–preschooler dyads. The 14-week program included a parent component, a parent–preschooler learning component, and a day care-based preschooler component.

Results

The program had positive effects on improving dyads’ fruit/vegetable intake, food insecurity, body mass index, and blood pressure and parents’ nutrition knowledge, self-efficacy, support, food resource management behavior, problem-focused coping, and home eating environment. The overall satisfaction rate was 95.2%, and 88.1% stated that the program assisted their families with having a healthy lifestyle.

Discussion

Results support the preliminary effects of the program on improving health outcomes in rural and urban low-income families. Although warranting further investigation with a more rigorous randomized controlled trial, the healthy eating and stress management program provides a potential solution to the current coexistence of an obesity epidemic and mental health crisis.
Transthoracic Echocardiography in the Preoperative Assessment of Newborn Coarctation: Limiting Risks Associated with Advanced Imaging Techniques
Authors: Benjamin Christina L. , Ellsworth Erik G. , Bryant Roosevelt , Bhat Deepti P.
Published: September 2023

Patient Anecdote

A newborn male child with prenatally identified aortic arch hypoplasia presented to our facility for cardiac management. He had been started on prostaglandins at the delivery facility and was subsequently placed on a high-flow nasal cannula due to associated apnea. On the day of life three, the patient underwent cardiac computed tomography scan for delineation of his anatomy. The patient remained intubated after his imaging study in anticipation of surgical intervention, which took place at the age of 5 days. The patient required a peritoneal dialysis catheter placement 2 days after his procedure due to oliguria. He progressed into renal failure requiring continuous renal replacement therapy.

This patient was subsequently discussed at our departmental morbidity and mortality conference. The short time frame between contrast administration for the computed tomography and surgical intervention was thought to have contributed to his renal failure. We discussed the adequacy of transverse aortic arch imaging by echocardiogram and the utility of advanced imaging in the fragile neonatal period. This discussion resulted in our department asking, “Is transthoracic echocardiography accurate when diagnosing and characterizing aortic coarctation at our institution? Are advanced imaging studies necessary in instances of simple coarctation?”
Efficacy and Safety of Surgical Procedures for Congenital Moderate and Severe Blepharoptosis: A Network Meta-analysis
Authors: Yue Qiang , Fu Ao , Wang Tailing
Published: September 2023

Background:

There are various surgical approaches to treat congenital moderate and severe blepharoptosis (CMSBP), but their efficacy and safety remain unclear owing to a lack of high-level evidence. This network meta-analysis aimed to evaluate the efficacy and safety of 3 classical operations: and their modifications frontal muscle flap suspension (FMS), levator palpebrae muscle shortening (LMS), conjoint fascial sheath suspension (CFSS), and modified CFSS.

Methods:

We searched the PubMed, MEDLINE, Cochrane Library, CNKI, and Wanfang databases until March 2022. A Bayesian network meta-analysis was conducted for the 5 most common treatments. Outcome indicators were the number of patients with good correction and adverse events.

Results:

Twenty-one studies were included, with 2402 eyes in 1863 patients. Five surgical methods were evaluated: FMS, LMS, CFSS, and conjoint fascial sheath suspension combined with levator muscle shortening (CFSS+LMS), or with levator palpebrae muscle composite flap suspension (CFS+L). Meta-analysis indicated that CFSS is more effective than LMS and FMS, but inferior to CFSS+LMS and CFS+L. Efficacy rates of CFSS+LMS and CFS+L were comparable. Frontal muscle flap suspension was more effective than LMS. Safety data meta-analysis found CFSS safer than FMS and LMS but with more complications than CFSS+LMS and CFS+L. Complication rates were comparable between CFS+L and CFSS+LMS, and also for FMS and LMS.

Conclusions:

When correcting CMSBP, CFSS+LMS, and CFS+L may be better therapeutic strategies for effectiveness and safety. Conjoint fascial sheath suspension also yielded good surgical effects. Plastic surgeons should be cautious about LMS and FMS.

Level of Evidence:

Level IV.
Vaccination in Kidney Transplant Candidates
Authors: Gajurel Kiran , Ngo Tue , Fairman Robert T. , McCurdy Lewis H.
Published: September 2023

Background:

Kidney transplant (KT) candidates have historically low immunization rates against recommended vaccines. A retrospective single-center study of contemporary KT candidates was conducted to assess vaccination rates and vaccine uptake.

Methods:

All KT candidates ≥18 y evaluated between January 1, 2020, and December 31, 2020, were retrospectively reviewed for history of prior vaccination against tetanus, diphtheria, and pertussis; 13-valent pneumococcal conjugate vaccine; 23-valent pneumococcal polysaccharide vaccine; and recombinant zoster vaccine. Positive hepatitis A IgG total, hepatitis B surface antibody, measles, mumps, rubella, and varicella IgG were assessed as surrogate markers of immunity. Vaccine uptake among vaccine-eligible candidates was also assessed.

Results:

Among 150 KT candidates, the rate of prior vaccination against tetanus, diphtheria, and pertussis; 13-valent pneumococcal conjugate vaccine; 23-valent pneumococcal polysaccharide vaccine; and recombinant zoster vaccine (latter among patients ≥50 y) was found to be as low as 11%. Hepatitis A IgG total, hepatitis B surface antibody, measles, mumps, rubella, and varicella IgG seropositivity rates were 30%, 66%, 88%, 78%, 90%, and 96%, respectively. Only 7 (5%) of 150 patients had complete immunization or seropositivity. Five (3%) of 143 vaccine-eligible patients declined vaccination. Hepatitis A vaccine declination was relatively common with 15 (16%) of 94 vaccine-eligible patients declining it.

Conclusions:

KT candidates have low baseline rates of prior immunization/seropositivity against most recommended vaccines. Overall vaccine uptake among eligible candidates was high.
Streptomyces silvisoli sp. nov., a polyene producer, and Streptomyces tropicalis sp. nov., two novel actinobacterial species from peat swamp forests in Thailand
Authors: Klaysubun Chollachai , Butdee Waranya , Suriyachadkun Chanwit , Igarashi Yasuhiro , Duangmal Kannika
Published: September 2023

Two novel actinobacterial strains, designated RB6PN23T and K1PA1T, were isolated from peat swamp soil samples in Thailand and characterized using a polyphasic taxonomic approach. The strains were filamentous Gram-stain-positive bacteria containing
ll
-diaminopimelic acid in their whole-cell hydrolysates. Phylogenetic analysis of their 16S rRNA gene sequences revealed that strain RB6PN23T was most closely related to

Streptomyces rubrisoli

(99.1 % sequence similarity) and

Streptomyces ferralitis

(98.5%), while strain K1PA1T showed 98.8 and 98.7% sequence similarities to

Streptomyces coacervatus

and

Streptomyces griseoruber

, respectively. However, the average nucleotide identity (ANI) and digital DNA–DNA hybridization (dDDH) values were below the species-level thresholds (95–96 % ANI and 70 % dDDH). The genomes of strains RB6PN23T and K1PA1T were estimated to be 7.88 Mbp and 7.39 Mbp in size, respectively, with DNA G+C contents of 70.2 and 73.2 mol%. Moreover, strains RB6PN23T and K1PA1T encode 37 and 24 putative biosynthetic gene clusters, respectively, and in silico analysis revealed that these new species have a high potential to produce unique natural products. Genotypic and phenotypic characteristics confirmed that strains RB6PN23T and K1PA1T represented two novel species in the genus

Streptomyces

. The names proposed for these strains are Streptomyces silvisoli sp. nov. (type strain RB6PN23T=TBRC 17040T=NBRC 116113T) and Streptomyces tropicalis sp. nov. (type strain K1PA1T=TBRC 17041T=NBRC 116114T). Additionally, a giant linear polyene compound, neotetrafibricin A, exhibiting antifungal activity in strain RB6PN23T, was identified through HPLC and quadrupole time-of-flight MS analysis. The crude extract from the culture broth of strain RB6PN23T exhibited strong antifungal activity against Fusarium verticillioides, Fusarium fujikuroi and Bipolaris zeicola. This finding suggests that strain RB6PN23T could be a promising candidate for biological control of fungal diseases.
Genomic analyses correspond with deep persistence of peoples of Blackfoot Confederacy from glacial times
Authors: First Rider Dorothy , Crop Eared Wolf Annabel , Murray John , de Flamingh Alida , Campelo dos Santos Andre Luiz , Lanoë François , Zedeño Maria N. , DeGiorgio Michael , Lindo John , Malhi Ripan S.
Published: September 2023

Mutually beneficial partnerships between genomics researchers and North American Indigenous Nations are rare. Here, we present one such partnership that provides insight into the peopling of the Americas and furnishes a new line of evidence that can be used to further treaty and Indigenous rights. We show that the genomics of sampled individuals from the Blackfoot Confederacy belong to a previously undescribed ancient lineage that diverged from other genomic lineages in the Americas in Late Pleistocene times. Using multiple complementary forms of knowledge, we provide a scenario for Blackfoot population history that fits with oral tradition and provides a plausible model for the evolutionary process of the peopling of the Americas.

One-Sentence Summary

Previously unknown genomic lineage in North America revealed in present-day Indigenous community and historic ancestors.
Science abhors a surveillance vacuum: detection of ticks and tick-borne bacteria in southern New Mexico through passive surveillance
Authors: Harman Paige R. , Mendell Nicole L. , Harman Maysee M. , Draney Puck A. , Boyle Anna T. , Gompper Matthew E. , Orr Teri J. , Bouyer Donald H. , Teel Pete D. , Hanley Kathryn A.
Published: September 2023

Robust tick surveillance enhances diagnosis and prevention of tick-borne pathogens, yet surveillance efforts in the U.S. are highly uneven, resulting in large surveillance vacuums, one of which spans the state of New Mexico. As part of a larger effort to fill this vacuum, we conducted both active and passive tick sampling in New Mexico, focusing on the southern portion of the state. We conducted active tick sampling using dragging and CO2trapping at 45 sites across Hidalgo, Doña Ana, Otero, and Eddy counties periodically between June 2021 and August 2022. We also conducted opportunistic, passive tick sampling in 2021 and 2022 from animals harvested by hunters or captured or collected by researchers and animals housed in animal hospitals, shelters, and farms. All pools of ticks were screened forRickettsia rickettsii, R. parkeri, R. amblyommatis, Ehrlichia ewingii, andE. chaffeensis. Active sampling yielded no ticks. Passive sampling yielded 497 ticks comprisingCarios kelleyifrom pallid bats,Rhipicephalus sanguineusfrom dogs, mule deer, and Rocky Mountain elk,Otobius megninifrom dogs, cats, horses, and Coues deer,Dermacentor parumapertusfrom dogs and black-tailed jackrabbits,D. albipictusfrom domesticated cats, mule deer and Rocky Mountain elk, andDermacentor spp. from American black bear, Rocky Mountain elk, and mule deer. One pool ofD. parumapterusfrom a black-tailed jackrabbit in Luna County tested positive forR. parkeri, an agent of spotted fever rickettsiosis. Additionally, a spotted fever groupRickettsiawas detected in 6 of 7Carios kelleyipools. Two ticks showed morphological abnormalities; however, these samples did not test positive for any of the target pathogens, and the cause of the abnormalities is unknown. Passive surveillance yielded five identified species of ticks from three domestic and six wild mammal species. One tick pool from a black-tailed jackrabbit was found to harborRickettsia parkeri, and six pools ofCarios kelleyiticks, argasid ticks that have been reported to bite humans, were found to harbor a spotted fever groupRickettsia. Our findings update tick distributions and inform the public, medical, and veterinary communities of the potential tick-borne pathogens present in southern New Mexico.
Association of Depression Symptoms and Biomarkers of Risk on Clinical Outcomes in HFrEF
Authors: Sherwood Andrew , Blumenthal James A. , Mentz Robert J. , Koch Gary G. , Rogers Joseph G. , Chang Patricia P. , Chien Christopher , Adams Kirkwood F. , Rose-Jones Lisa J. , Jensen Brian C. , Johnson Kristy S. , Hinderliter Alan L.
Published: September 2023

BACKGROUND

Prior studies have demonstrated an association of depression with adverse clinical outcomes in patients with HFrEF, but the possible mechanisms responsible for the association are not unserstood.

METHODS

142 men and women with HFrEF were enrolled through HF clinics and followed over time. At baseline and 6-months, depression was assessed by the Beck Depression Inventory (BDI-II) and disease activity by B-type natriuretic peptide (BNP). Proportional Hazards Regression Models assessed the contribution of depressive symptoms and HFrEF disease biomarkers on death or cardiovascular hospitalization.

RESULTS

Over a median follow-up period of 4 years, 42 patients (30%) died, and 84 (60%) had cardiovascular hospitalizations. A 10-point higher baseline BDI-II score was associated with a 35% higher hazard of death or cardiovascular hospitalization. Greater baseline BDI-II scores were associated with poorer HF self-care maintenance (R=-0.30, p<0.001) and fewer daily steps (R=-0.19, p=0.04), suggesting that depression may adversely affect important health behaviors. Increases in plasma BNP over 6 months were associated with worse outcomes. Changes in BDI-II score and plasma BNP over 6 months were positively correlated (R=0.25, p=0.004).

CONCLUSIONS

This study underscores the importance of elevated depression symptoms and their association with an increased likelihood of adverse clinical outcomes in patients with HFrEF. Health behaviors may play a greater role than direct biobehavioral pathways in the adverse effects of depression on the HF disease trajectory and resultant clinical outcomes.
Sex divergent behavioral responses in platform-mediated avoidance and glucocorticoid receptor blockade
Authors: Halcomb Carly J. , Philipp Trey R. , Dhillon Parker S. , Cox J. Hunter , Aguilar-Alvarez Ricardo , Vanderhoof Samantha O. , Jasnow Aaron M.
Published: September 2023

Women are more likely than men to develop anxiety or stress-related disorders. A core behavioral symptom of all anxiety disorders is avoidance of fear or anxiety eliciting cues. Recent rodent models of avoidance show reliable reproduction of this behavioral phenomenon in response to learned aversive associations. Here, a modified version of platform-mediated avoidance that lacked an appetitive task was utilized to investigate the learning and extinction of avoidance in male and female C57BL6/J mice. Here, we found a robust sex difference in the acquisition and extinction of platform-mediated avoidance. Across three experiments, 63.7% of female mice acquired avoidance according to our criterion, whereas 83.8% of males acquired it successfully. Of those females that acquired avoidance, they displayed persistent avoidance after extinction compared to males. Given their role in regulating stress responses and habitual behaviors, we investigated if glucocorticoid receptors (GR) mediated avoidance learning in males and females. Here we found that a subcutaneous injection (25mg/kg) of the GR antagonist, RU486 (mifepristone), significantly reduced persistent avoidance in females but did not further reduce avoidance in males after extinction. These data suggest that GR activation during avoidance learning may contribute to persistent avoidance in females that is resistant to extinction.