bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of diaphragmatic hernia following hepatectomy
Authors: Kara Salih , Korkut Ercan , Aksungur Nurhak , Altundas Necip , Ozturk Gurkan
Published: August 2022

Background

The majority of the diaphragmatic hernias developing on the right side are hernias developing after right hepatectomy. We aimed to present the clinical presentation at the time of admission, surgical treatment, and postoperative course of patients that developed DH following a major liver resection in our center.

Patients and Methods

Liver surgeries performed in Ataturk University Organ Transplant Center and Ataturk University Research Hospital General surgery Hepatopancreatobiliary ward between 2012 and 2021 were analysed retrospectively. Demographic information, admission types (emergency or elective), admission clinics, the process of diaphragmatic hernia formation following hepatectomy, imaging methods used for diagnosis, and surgical methods performed were recorded for the patients with diaphragmatic hernia. Qualitative values were tabulated and their percentages were calculated.

Results

Six hundred and sixty patients who underwent major liver surgery in our center between 2012 and 2021 were analysed. It was found that diaphragmatic hernia developed in 9 (1.4%) of those patients. The incidence of diaphragmatic hernia after donor hepatectomy was 3.04% in our study. The mean time from the first surgery until the DH diagnosis was 47.33 ± 38.16 months. 1 (11.1%) patient had small intestine perforation and 1 patient had both small intestine and colon perforation. One patient died before to the surgery.

Conclusion

DH following liver resection can cause fatal complications and it should be intervened when diagnosed. Although it is rare, centers particularly focusing on hepatobiliary surgery should determine a follow‐up protocol to detect DH that develops after major liver resections.
Obstetric anal sphincter injuries—Maternal, fetal and sociodemographic risk factors: A retrospective register‐based study
Authors: André Kristin , Stuart Andrea , Källén Karin
Published: August 2022

Introduction

Obstetric anal sphincter injuries (OASIS) are severe complications to vaginal births with potentially serious long‐term consequences and large impact on quality of life. The aim was to determine risk and protective factors for OASIS.

Material and methods

We performed a retrospective register‐based observational study. A cohort of 988 988 singleton term deliveries 2005–2016 in Sweden were included. Data from the Swedish Medical Birth Registry and Statistics Sweden were extracted to identify cases of OASIS and maternal and fetal characteristics. Modified Poisson Regression analyses were performed to assess risk factors.

Results

The rate of OASIS was 3.5% (n = 34 583). Primiparity (adjusted risk ratio [aRR] 3.13, 95% CI 3.05–3.21), vacuum extraction (aRR 2.79, 95% CI 2.73–2.86), forceps (aRR 4.27, 95% CI 3.86–4.72), and high birthweight (aRR 2.61, 95% CI 2.50–2.72) were associated with a significantly increased risk of OASIS. Increasing maternal age and decreasing maternal height also increased the risk of OASIS. Obesity increased the risk of OASIS (aRR 1.04, 95% CI 1.04–1.08), if fetal birthweight was not adjusted for. Smoking (aRR 0.74, 95% CI 0.70–0.79) and low maternal education (aRR 0.87, 95% CI 0.83–0.92) were associated with a decreased frequency of reported OASIS. Previous cesarean section increased the risk of OASIS (aRR 1.41, 95% CI 1.36–1.47).

Conclusions

Primiparity, instrumental delivery, and high birthweight significantly increased the risk of OASIS. Obesity, low height, increasing age, and previous cesarean section also increased the risk whereas smoking and low maternal educational level were associated with a lower OASIS rate.
Maternal iron deficiency anaemia in pregnancy: Lessons from a national audit
Authors: Churchill David , Ali Hind , Moussa Mahmoud , Donohue Ciara , Pavord Sue , Robinson Susan E. , Cheshire Katherine , Wilson Paul , Grant‐Casey John , Stanworth Simon J.
Published: August 2022

We describe the management and the prevalence of iron deficiency anaemia (IDA) during pregnancy by comparison to standards. A cross‐sectional national cohort study of women who had given birth six weeks prior to data collection was conducted at maternity units in the UK and Ireland. Participating centres collected data from 10 consecutive pregnant women. Analysis was descriptive to define the prevalence of IDA in pregnancy and the puerperium, and to compare the outcomes in women who had IDA with women who did not have anaemia anytime during pregnancy. Eighty‐six maternity units contributed data on 860 pregnancies and births. The overall prevalence of IDA during pregnancy was 30.4% and in the puerperium 20%. Anaemic women were more likely to be from ethnic minorities, odds ratio 2.23 (1.50, 3.32). Adherence to national guidance was suboptimal, and the prevalence of anaemia in pregnancy remains very high. There is pressing need to explore barriers to early identification and effective management of iron deficiency. IDA should be considered a major public health problem in the UK.
A comprehensive review of recent advances in the biological activities of quinazolines
Authors: Gomaa Hesham A. M.
Published: August 2022

Quinazoline heterocycles are critical in the development of medications. Quinazoline derivatives have been intensively researched, providing a wide range of compounds with diverse biological roles. The quinazoline nucleus has garnered a lot of attention in medical chemistry in recent years. It was assumed to be a pharmacophore component in the development of physiologically interesting drugs. This review is an attempt to increase the potential of quinazoline by highlighting a wide range of advancements demonstrated by numerous derivatives of the quinazoline moiety, as well as focusing on diverse pharmacological actions of the quinazoline moiety. This review compiles recent studies on the quinazoline moiety described in the literature by researchers.
Dehydroepiandrosterone sulphate levels at 7 years old are positively associated with more advanced pubertal development between 10 and 13 years old in girls
Authors: Santos‐Silva Rita , Fontoura Manuel , Severo Milton , Santos Ana Cristina
Published: August 2022

Objective

We aimed to explore the association between dehydroepiandrosterone sulphate (DHEAS) levels at age 7, pubertal development between ages 10 and 13, and age at menarche.

Design and participants

This is a longitudinal study of 603 individuals (301 girls, 302 boys) from the Generation XXI cohort.

Measurements

Evaluation of the participants at ages 7, 10 and 13 included anthropometry and Tanner staging. Pubertal development between ages 10 and 13 was categorized using latent class analysis, based on Tanner stages. The association between DHEAS at age 7 and pubertal development between ages 10 and 13 was conducted with binomial logistic regression, adjusted for BMI z‐score. The variation of age at menarche in relation to DHEAS levels at age 7, controlling for maternal age at menarche, birth weight z‐score and BMI z‐score, was estimated fitting a linear regression model.

Results

Pubertal development at ages 10−13 was categorized into two classes—Class 1 had a higher probability for the lower Tanner stage (less advanced sexual maturation) and Class 2 had a higher probability for the higher Tanner stage (more advanced sexual maturation). In girls, taking Class 1 as a reference, Class 2 was positively associated with BMI z‐score and DHEAS. In boys, Class 2 was positively associated with BMI, but not with DHEAS. DHEAS levels at age 7 were negatively associated with age at menarche, after adjustment for maternal age at menarche, birth weight and BMI.

Conclusion

In girls, but not in boys, DHEAS at age 7 was positively associated with more advanced pubertal development between ages 10 and 13, and with earlier age at menarche.
Habitat use of and threats to African large carnivores in a mixed‐use landscape
Authors: Strampelli Paolo , Henschel Philipp , Searle Charlotte E. , Macdonald David W. , Dickman Amy J.
Published: August 2022

Large carnivores increasingly inhabit human‐affected landscapes, which exhibit heterogeneity in biotic resources, anthropogenic pressures, and management strategies. Understanding large carnivore habitat use in these systems is critical for their conservation, as is the evaluation of competing management approaches and the impacts of significant land‐use changes. We used occupancy modeling to investigate habitat use of an intact eastern African large carnivore guild across the 45,000 km2Ruaha‐Rungwa landscape in south‐central Tanzania. We determined the relative impact on five large carnivore species of biotic, anthropogenic, and management factors at the scales of home range selection and short‐term use within home ranges. We also specifically tested the effect of abandonment of trophy hunting areas on large carnivore occurrence. Patterns of habitat use differed among species. Lions (Panthera leo) appeared affected by top‐down limitation, as their occurrence was significantly negatively associated with illegal human activity (β = –0.63 [SE 0.28]). African wild dogs (Lycaon pictus), instead, were limited by biotic features; the species was negatively associated with riverine areas of high sympatric predator density (β = –1.00 [SE 0.43]) and used less‐productive habitats. Spotted hyaena (Crocuta crocuta) and leopard (Panthera pardus) persisted in more disturbed areas and across habitat types. Large carnivore occurrence was not affected by whether an area was used for photographic or trophy hunting tourism; regular law enforcement was instead a better predictor of occurrence. All species fared better in actively managed hunting areas than those that had been abandoned by operators. Overall, our findings highlight the divergent habitat requirements within large carnivore guilds and the importance of adopting an integrated approach to large carnivore conservation planning in modern systems. We also identified a novel threat to African conservation areas in the form of decreased management investments associated with the abandonment of trophy hunting areas.
Kidney nonprocurement in deceased donors with acute kidney injury
Authors: Yu Kathleen , Husain Syed A. , King Kristen , Stevens Jacob S. , Parikh Chirag R. , Mohan Sumit
Published: August 2022

Background

Acute kidney injury (AKI) is common in deceased organ donors and is associated with high rates of kidney discard by transplant centers. High discard rates may consequently drive nonprocurement of these kidneys by organ procurement organizations. We aimed to study the relationship between donor AKI and kidney nonprocurement.

Methods

Using U.S. registry data, we identified donors with at least one organ recovered from 2008 to 2018. We compared characteristics of donors with no kidneys procured across AKI stages, and used multivariable logistic regression to evaluate the relationship between AKI severity and kidney nonprocurement.

Results

Overall 14 543 kidneys from 7620 donors were not procured, among which 93% were from donors with AKI. For 6945 donors with no kidneys procured but an extrarenal organ recovered, most had stage 3 (51%), followed by stage 1 (27%) and stage 2 AKI (15%). Nonprocured stage 3 donors were the youngest and had the lowest Kidney Donor Risk Index of all nonprocured donors. Adjusted odds of kidney nonprocurement were 1.14 (95%CI 1.02–1.27) for stage 1, 1.25 (95%CI 1.12–1.41) for stage 2, and 10.37 (95%CI 9.30–11.56) for stage 3 donors, compared to non‐AKI donors. Among donors with minimum creatinine <1.5 mg/dl, stage 2 and 3 AKI were still associated with significantly higher odds of nonprocurement.

Conclusions

AKI severity is a strong risk factor for kidney nonprocurement. Efforts to address the organ shortage should focus on encouraging procurement and utilization of kidneys from deceased donors with severe AKI, given the large and rising prevalence of donor AKI and excellent transplant outcomes with these kidneys.
Quantification of stress‐induced hyperglycaemia associated with key diagnostic categories using the stress hyperglycaemia ratio
Authors: Roberts Gregory W. , Larwood Crystal , Krinsley James S.
Published: August 2022

Aim

Stress‐induced hyperglycaemia (SIH) is the acute increase from preadmission glycaemia and is associated with poor outcomes. Early recognition of SIH and subsequent blood glucose (BG) management improves outcomes, but the degree of SIH provoked by distinct diagnostic categories remains unknown. Quantification of SIH is now possible using the stress hyperglycaemia ratio (SHR), which measures the proportional change from preadmission glycaemia, based on haemoglobin A1c (HbA1c).

Methods

We identified eligible patients for eight medical (n = 892) and eight surgical (n = 347) categories. Maximum BG from the first 24 h of admission for medical, or postoperatively for surgical patients was used to calculate SHR.

Results

Analysis of variance indicated differing SHR and BG within both the medical (p < 0.0001 for both) and surgical cohort (p < 0.0001 for both). Diagnostic categories were associated with signature levels of SHR that varied between groups. Medically, SHR was greatest for ST‐elevation myocardial infarction (1.22 ± 0.33) and sepsis (1.37 ± 0.43). Surgically, SHR was greatest for colectomy (1.62 ± 0.48) and cardiac surgeries (coronary artery graft 1.56 ± 0.43, aortic valve replacement 1.71 ± 0.33, and mitral valve replacement 1.75 ± 0.34).

SHR values remained independent of HbA1c, with no difference for those with HbA1c above or below 6.5% (p > 0.11 for each). BG however was highly dependent on HbA1c, invariably elevated in those with HbA1c ≥ 6.5% (p < 0.001 for each), and unreliably reflected SIH.

Conclusion

The acute stress response associated with various medical and surgical categories is associated with signature levels of SIH. Those with higher expected SHR are more likely to benefit from early SIH management, especially major surgery, which induced SIH typically 40% greater than medical cohorts. SHR equally recognised the acute change in BG from baseline across the full HbA1c spectrum while BG did not and poorly reflected SIH.
Transitioning a traditional introductory information systems course to a data analytics focused course
Authors: Tiahrt Thomas , Hanus Bartlomiej , Porter Jason C.
Published: August 2022

Firms desire graduates capable of executing current and future business practices, many of which revolve around data. To meet those needs, we shifted the orientation of our required information systems course from technology to data. Instead of a survey of information systems, students learn the data acquisition–preparation–mining–presentation process in an information‐systems setting. The scope of the revised undergraduate introductory course includes decision trees, Bayesian classifiers, and clustering; it uses Microsoft's Excel, Access, SQL Server, Power BI, and SQL Server Analysis Services to reveal the basics of data analytics to students. Students have welcomed the change and understand that the course material directly applies to what they will experience as working professionals. Similarly, employers have appreciated the change and tell us that our graduates are better prepared to perform data analysis with minimal training.
Phage‐bacterium interactions and nutrient availability can shape C and N retention in microbial biomass
Authors: Wu Hanqing , Wan Sichen , Ruan Chujin , Niu Xinyao , Chen Guowei , Liu Ying , Zhu Kun , Schulin Rainer , Wang Gang
Published: August 2022

Phage‐bacterium interactions influence soil microbial life and ecological functions, including microbial evolution, community patterns, and nutrient cycling. However, understanding of phage‐mediated soil bacterial lysis dynamics, and impacts on soil carbon (C) and nitrogen (N) cycling, remains elusive. Here, we used a short‐term laboratory incubation microcosm model system (which did not contain actual soil) consisting of a soil bacterium Bacillus cereus LB2 and an exclusive B. cereus phage SWEP1 to illustrate how a single soil phage manipulates bacterial lysis and the associated necromass formation under different nutrient conditions, and the associated changes on C and N dynamics. Results showed that the phage‐induced bacterial lysis significantly increased the total amounts of necromass C and N, which was correlated to nutrient conditions. Bacteria populations were effectively eliminated by phages under eutrophic conditions, whereas the lysis rate of SWEP1 slowed down under oligotrophic conditions. The presence of phage clearly stimulated necromass accumulation, albeit with a reduced proportion of dissolved NH4+‐N content from the supernatant. Therefore, phages may enhance microbial necromass formation, and actively contribute to soil organic matter (SOM) stabilisation and C and N cycling in soil ecosystem.

Highlights

Phage‐mediated bacterial lysis increased C and N contents in necromass

Eutrophic conditions facilitate phage‐mediated bacteria elimination

The lysis rate of phage slows down under oligotrophic conditions

The contribution of bacterial necromass to SOM may be underestimated
Menu simplification for portfolio selection under short‐sales constraints
Authors: AitSahlia Farid , Doellman Thomas , Sardarli Sabuhi
Published: August 2022

We introduce a risk‐reduction‐based procedure to identify a subset of funds with a resulting opportunity set that is at least as good as the original menu when short‐sales are imposed. Relying on Wald tests for mean‐variance spanning, we show that the better results for the subset can be explained by a higher concentration of covariance entries between its assets, ultimately leading to smaller Frobenius norms of the associated matrices. With data on US‐defined contribution plans, where participants have limited financial literacy, tend to be overwhelmed and prefer to make decisions among fewer choices, we obtain a 75% average reduction.
Oral health of schoolchildren in Slovenia: Prospective epidemiological study
Authors: Egić Boris
Published: August 2022

Background

The quality of oral health can be estimated by its own indicators, one of which is the Decayed‐Missing‐Filled index (DMF‐T for permanent teeth and dmf‐t for deciduous teeth index). Caries can be prevented and successfully controlled by comparing clinical and epidemiological data. The basic prerequisite for this approach is data collection through systematic examinations, the results of which are a starting point for a prevention programme. The aim of the study is to define the oral health of elementary schoolchildren in one municipality of Slovenia, focusing on 6‐, 12‐ and 15‐year‐old children.

Methods

A prospective epidemiological study of elementary school children (aged 6, 12 and 15) of municipality Murska Sobota, Slovenia, was performed over four years. Data were obtained from the dental records of elementary schoolchildren acquired from a specialist in paediatric dentistry. Collected data included age, gender, the number of carious teeth and tooth fillings per child in deciduous and permanent teeth, dmf‐t/DMF‐T index and the percentage of primary and secondary healthy children. Statistical analysis was performed using SPPS 25.

Results

Data from schoolchildren were used (1256 girls, 1281 boys). The number of carious deciduous teeth per person in 6‐year‐olds (3.2–3.8) was higher than the number of (carious) permanent teeth in 12‐year‐olds (0.3–1.2). The number of filings per person in deciduous teeth in 6‐year‐olds (0.5–0.6) was lower than it was in permanent teeth in 12‐year‐olds (0.3–1.2). Dmf‐t index in 6‐year‐olds was from 4 to 4.6; DMF‐T index in 12‐year‐olds were from 1.2 to 2.2 and in 15‐year‐olds from 2.4 to 3.8. The percentage of primary healthy children was lower for older children, but the percentage of secondary healthy children was higher for older children.

Conclusions

Monitoring oral health is important, and school has an important role in it; however, caries control has yet to be successful.
Laparoscopic procedures‐induced keloids: A retrospective case series study
Authors: Wang Hayson Chenyu , Li Zhijin , Yu Nanze , Huang Jiuzuo , Long Xiao
Published: August 2022

The abdominal skin is not a common area for keloid formation. The knowledge of laparoscopically induced keloids (LIK) remains little. This article aimed to review the case series of LIK and analyse the characteristics. A retrospective and descriptive study was conducted. Patients' clinical records in the database were collected, including the demographics, medical history, laparoscopic surgery information, keloid information, and the severity of LIKs recorded using the Patient and Observer Scar Assessment Scale. Twenty‐four LIK patients were enrolled. 18 patients were female and 10 had chronic diseases. 11 patients had non‐LIKs. 91.6% patients received laparoscopic cholecystectomy. LIKs were mainly located under the xiphoid process (N = 20), followed by the umbilicus (N = 16). 41.7% patients developed keloids at all trocha sites. The severity of the LIK was significantly negatively associated with the presence of the non‐LIK. Laparoscopic procedures could lead to the formation of keloids. Two types of LIKs were noticed: extended incisions induced long “spreading” type and trocha induced round bulging type. The presence of non‐LIKs could significantly reduce the severity of LIKs.
Lack of attention to sex and gender in periodontitis‐related randomized clinical trials: A meta‐research study
Authors: Michelson Courtney , Al‐Abedalla Khadijeh , Wagner Julie , Swede Helen , Bernstein Eric , Ioannidou Effie
Published: August 2022

Aim

This meta‐research study aimed to investigate the level of compliance with the Sex and Gender Equity in Research (SAGER) Guidelines for the inclusion, analysis, and reporting of sex/gender, in periodontitis‐related randomized controlled trials (RCTs).

Materials and Methods

Following the inclusion of RCTs related to the treatment of periodontitis published between 2018 and 2019, we applied the SAGER checklist to assess the adherence to sex/gender reporting guidelines. We used non‐parametric descriptive statistics and correlation models to test the association of the dependent outcome with other variables.

Results

One hundred and one articles were included in the analysis. The female enrolment ranged between 30% and 94%. Twenty‐six studies enrolled less than 50% of female participants. The overall SAGER score (OSS) of item fulfilment ranged between 0 and 7 items with an average of 1.9 items signifying poor guideline adherence to the SAGER guidelines. These findings were not associated with the corresponding author gender (p = .623), publication year (p = .947), and funding source (p = .133). However, a significant but negative correlation with journal impact factor (r = −0.253, p = .026) was observed.

Conclusions

Sex and gender were frequently disregarded in clinical trial reporting. This oversight might limit the understanding of sex/gender differences in periodontitis‐related clinical trials.
Methylated miRNAsmay serve as potential biomarkers and therapeutic targets for hidradenitis suppurativa
Authors: Radhakrishna U. , Ratnamala U. , Jhala D.D. , Vadsaria N. , Patel M. , Uppala L.V. , Vishweswaraiah S. , Vedangi A. , Saiyed N. , Damiani G. , Jemec G.B.E.
Published: August 2022

Background

Hidradenitis suppurativa (HS) is a chronic inflammatory disease influenced by genetics, non‐genetic and environmental factors that modulate miRNA expression. Currently, no miRNA data are available for HS. In this study, we profiled DNA methylation patterns of miRNA genes associated with HS susceptibility.

Objectives

Identify miRNA gene methylation profiles associated with HS susceptibility. This study examined the methylation patterns of DNAs from 24 healthy controls and 24 patients with HS using Illumina Infinium MethylationEPIC BeadChip array analysis. Methylation patterns of miRNA genes were analysed using KEGG pathway analysis to explore the inversely correlated pathways regulated by miRNAs.

Results

We identified 60 CpG sites representing 65 unique microRNA genes including 54 hypomethylated and 6 hypermethylated CpGs as potentially associated with HS. Some of these CpGs were found to be critical for skin function, such as miR‐29, miR‐200, miR‐205, miR‐548 and miR‐132. The miR‐192 is implicated in non‐alcoholic fatty liver disease. The miR‐200c gene was identified as a vital determinant in regulating skin repair after injury and may contribute to age‐associated alterations in wound repair. miR‐132 was significantly upregulated during the inflammation phase of wound repair, enhancing the activity of STAT3 and ERK pathways that promote keratinocyte proliferation.

Conclusions

Epigenetically altered microRNA genes are implicated in wound healing, inflammation, keratinocyte proliferation and wound modulation. This is the first study to analyse methylation profiles of miRNA genes in the HS population, highlighting the unique role that miRNAs might play in diagnosing and treating HS.
Orthogonal optimization for effective classification of different tea leaves by a novel pressure stabilized inclined chamber classifier
Authors: Cao Miaolong , Zhu Jiayi , Zhang Jinli , Cao Shi , Pang Mao
Published: August 2022

In the field of tea separation and processing, modern high‐tech can realize the nondestructive separation of tea and improve the quality of tea. In this study, a novel pressure‐stabilizing inclined chamber classifier was proposed, which was used to adjust the particle size distribution of tea at the entrance of the classifier. A suitable cavity can control the change of wind speed so that tea leaves are not easy to bend and deform, and the success rate of grading is improved. Second, three parameters that affect the success rate of tea classification are put forward: suction wind speed V, suction distance H, and suction distance L. When the parameters are V = 6 m/s, H = 40 mm, and L = 20 mm, the best response value is obtained, thus the most suitable entrance shape is obtained. Finally, the internal flow field of the classifier is analyzed, and different sizes of tea leaves are classified according to the change of air pressure flowing through the closed structure cavity. With the distribution of air velocity, tea leaves fall into collectors with different widths. Therefore, the flow field simulation test shows that the classifier can classify high‐quality tea according to the airflow. The model lays a foundation for further study of the fluid–solid coupling process and interaction between particles.

Practical Applications

In this study, a novel pressure‐stabilized inclined chamber classifier was designed, and three parameters that affect the success rate of tea classification were put forward. The process conditions were optimized by orthogonal tests, and the number of experiments was reduced. This method can be used to evaluate the influence of various technological parameters on tea classification. In order to improve the classification success rate, it is necessary to statistically discuss the results of the orthogonal test and flow field analysis.
Effect of operating parameters on performance of finger millet pearling machine
Authors: Powar Ranjit , Aware Vijay , Chavan Prasad , Jaiswal Amit K.
Published: August 2022

The effect of operational parameters such as feed rate (FR), drum speed (DS), and concave clearance (CC) was studied on the performance of a pearling drum. The pearling drum consists of pearling cylinder, pearling sieve, concave, and outer casing of the drum. The response surface method with CCRD experimental design was used to study the effect of operational parameters on pearling drum. The considered levels for optimizing operational parameters viz., FR, DS, and CC were 40–80 kg/h, 5–10 m/s, and 3–15 mm, respectively. The maximum pearling efficiency (PE) and minimum grain damage (GD) were found to be 98.40%, and 0.12%, respectively at FR, DS, and CC of 71.89 kg/h, 7.13 m/s, and 5.13 mm, respectively. The validation of the performance of pearling drum was carried out at optimized levels of parameters, the PE was found to be 99% with no GD against predicted PE of 98.40% and GD of 0.12%.
Engagement of older adults in STRIDE's multifactorial fall injury prevention intervention
Authors: McMahon Siobhan K. , Greene Erich J. , Latham Nancy , Peduzzi Peter , Gill Thomas M. , Bhasin Shalender , Reuben David B.
Published: August 2022

Background

Evidence‐based multifactorial fall prevention interventions in clinical practice have been less effective than expected. One plausible reason is that older adults' engagement in fall prevention care is suboptimal.

Methods

This was a post‐hoc analysis of 2403 older adults' engagement in a multifactorial fall prevention intervention in the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) pragmatic trial. Based on the direct clinical care level of the Patient and Family Continuum of Engagement (CE) framework, three indicators of progressively interactive engagement were assessed: (1) Consultation (receiving information), (2) Involvement (prioritizing risks), and (3) Partnership (identifying prevention actions). Drop off at each step was determined as well as predictors of engagement.

Results

The participants' engagement waned with increasingly interactive CE domains. Although all participants received information about their positive fall risk factors (consultation) and most (51%–96%) prioritized them (involvement), fewer participants (33%–55%) identified fall prevention actions (partnership) for most of their risk factors, except for strength gait or balance problems (95%). More participants (70%) identified home exercises than other actions. Finally, fall prevention actions were identified more commonly among participants who received two visits compared to one (OR = 2.33 [95% CI, 2.06–2.64]), were ≥80 years old (OR = 1.83 [95% CI, 1.51–2.23]), and had fewer fall risk factors (OR = 0.90 [95% CI, 0.83–0.99]).

Conclusions

The drop‐off in participants' engagement based on the level of their interaction with clinicians suggests that future multifactorial fall prevention interventions need to be more focused on interactive patient‐clinician partnerships that help older adults increase and maintain fall prevention actions. Our analyses suggest that more frequent contact with clinicians and more monitoring of the implementation and outcomes of Fall Prevention Care Plans could potentially improve engagement and help older adults maintain fall prevention actions.
Evaluation of a state‐wide effort to improve COVID‐19 infection control in Massachusetts nursing homes
Authors: Lipsitz Lewis A. , Kosar Cyrus , Dufour Alyssa B. , Travison Thomas G. , Mor Vincent
Published: August 2022

Background

During the deadly 2020 SARS‐CoV‐2 surge in nursing homes (NHs), Massachusetts (MA) initiated a multicomponent infection control intervention to mitigate its spread.

Methods

We aimed to assess the intervention's impact by comparing the weekly risk of PCR‐confirmed infections among MA NH residents to those in neighboring New England states, all managed similarly by a single NH provider. We studied 2085 residents in 20 MA NHs and 4493 residents in 45 comparator facilities. The intervention included: (1) A 28‐item infection control checklist of best practices, (2) incentive payments to NHs contingent on scoring ≥24 on the checklist, meeting 6 core competencies, testing residents and staff for SARS‐COV‐2 RNA, uploading data, and enabling virtual visits; (3) on‐site and virtual infection control consultations for deficient facilities; (4) 6 weekly webinars; (5) continuous communication with the MA Department of Public Health; and (6) access to personal protective equipment, temporary staff, and SARS‐CoV‐2 testing. Weekly rates of infection were adjusted for county COVID‐19 prevalence.

Results

The adjusted risk of infection started higher in MA, but declined more rapidly in its NHs compared to similarly managed facilities in other states. The decline in infection risk during the early intervention period was 53% greater in MA than in Comparator States (state‐by‐time interaction HR = 0.47; 95% CI 0.37–0.59). By the late intervention period, the risk of infection continued to decline in both groups, and the change from baseline in MA was marginally greater than that in the Comparator States (interaction HR 0.80; 95% CI 0.64–1.00).

Conclusions

The MA NH intervention was associated with a more rapid reduction in the rate of SARS‐CoV‐2 infections compared to similarly managed NHs in neighboring states. Although several unmeasured factors may have confounded our results, implementation of the MA model may help rapidly reduce high rates of infection and prevent future COVID‐19 surges in NHs.
Molecular and structural characterization of a promiscuous chalcone synthase from the fern species Stenoloma chusanum
Authors: Ni Rong , Niu Meng , Fu Jie , Tan Hui , Zhu Ting‐Ting , Zhang Jing , Lou Hong‐Xiang , Zhang Peng , Li Jian‐Xu , Cheng Ai‐Xia
Published: August 2022

The key enzymes involved in the flavonoid biosynthesis pathway have been extensively studied in seed plants, but relatively less in ferns. In this study, two 4‐Coumarate: coenzyme A ligases (Sc4CL1 and Sc4CL2) and one novel chalcone synthase (ScCHS1) were functionally characterized by mining the Stenoloma chusanum transcriptome database. Recombinant Sc4CLs were able to esterify various hydroxycinnamic acids to corresponding acyl‐coenzyme A (CoA). ScCHS1 could catalyze p‐coumaroyl‐CoA, cinnamoyl‐CoA, caffeoyl‐CoA, and feruloyl‐CoA to form naringenin, pinocembrin, eriodictyol, and homoeriodictyol, respectively. Moreover, enzymatic kinetics studies revealed that the optimal substrates of ScCHS1 were feruloyl‐CoA and caffeoyl‐CoA, rather than p‐coumaroyl‐CoA, which was substantially different from the common CHSs. Crystallographic and site‐directed mutagenesis experiments indicated that the amino acid residues, Leu87, Leu97, Met165, and Ile200, located in the substrate‐binding pocket near the B‐ring of products, could exert a significant impact on the unique catalytic activity of ScCHS1. Furthermore, overexpression of ScCHS1 in tt4 mutants could partially rescue the mutant phenotypes. Finally, ScCHS1 and Sc4CL1 were used to synthesize flavanones and flavones with multi‐substituted hydroxyl and methoxyl B‐ring in Escherichia coli, which can effectively eliminate the need for the cytochrome P450 hydroxylation/O‐methyltransferase from simple phenylpropanoid acids. In summary, the identification of these important Stenoloma enzymes provides a springboard for the future production of various flavonoids in E. coli.
Burnout and impostor phenomenon in nursing and newly licensed registered nurses: A scoping review
Authors: Edwards‐Maddox Shermel
Published: August 2022

Aims and objective

To identify the prevalence and severity of impostor phenomenon and burnout in newly licensed registered nurses, map the current literature on impostor phenomenon in nursing, and identify related factors affecting the new nurse's transition to practice.

Background

Impostor phenomenon is an internalised intellectual phoniness resulting in persistent self‐doubt despite prior success. It can evoke feelings of emotional exhaustion associated with burnout, negatively affecting employee retention. Due to changes in nursing education resulting from COVID‐19, self‐doubt and uncertainty among new nurses are expected to be heightened, leading to burnout which adversely effects nurse well‐being, patient care and retention.

Design

The scoping review follows the methodological framework developed by Arksey and O'Malley (2005) and the Reporting Checklist for Scoping Reviews (PRISMA‐ScR) guidelines.

Methods

The literature search was conducted utilising PubMed, CINAHL and PsycINFO. Inclusion criteria were studies published between 2011 and 2021, written in English, peer‐reviewed, and focused on newly licensed registered nurses. Eighteen articles were reviewed.

Results

Studies on impostor phenomenon in nursing are limited to nursing students and clinical nurse specialists. Prevalence of impostor feelings in these populations range from 36% to 75%, and 12.3% to 46% of new nurses report burnout. Impostor feelings arise from role ambiguity, lack of self‐compassion, transitions, and minimal clinical experience. Burnout was associated with stress, feeling unprepared, inadequate socialisation, and lack of self‐compassion. Overlap in these factors could increase impostor feelings and burnout in new nurses.

Conclusions

Effects of impostor phenomenon and burnout can negatively impact the well‐being of the new nurse. Currently, no studies simultaneously examine impostor phenomenon and burnout in new nurses. Further research on the relationship between these phenomena should be conducted.

Relevance to clinical practice

Understanding the impact of impostor phenomenon and burnout on new nurses could help mitigate challenges they face transitioning into practice.
Good Trouble, Necessary Trouble: Expanding Thinking and Research on Youth of Color’s Resistance to Oppression
Authors: Wray‐Lake Laura , Halgunseth Linda , Witherspoon Dawn P.
Published: August 2022

This special section focuses on resistance and activism among youth of color, and is the last installment of a four‐part special series on “Dismantling Systems of Racism and Oppression during Adolescence.” Using diverse methods, nine papers and two commentaries shed important light on youth of color’s resistance to racism and other forms of oppression and identify factors that inform the development of sociopolitical actions. In this introduction to the special section, we synthesize four main contributions of this collection of work. Specifically, this special section offers an expanded conceptualization of youth resistance, advances sociopolitical development theory, provides new models and insights into anti‐racist identity and action, and examines schools as sites of oppression and resistance.
The diversity officer: Police officers' and black women civilians' epistemologies of race and racism in policing
Authors: Malone Gonzalez Shannon , Simon Samantha J. , Rogers Katie Kaufman
Published: August 2022

Diversifying police forces has been suggested to improve “police-minority relations” amidst national uprisings against police violence. Yet, little research investigates how police and black civilians—two groups invoked in discourse on “police-minority relations”—understand the function of diversity interventions. We draw on 100 in-depth interviews with 60 black women civilians and 40 police from various racial and ethnic backgrounds to explore how they understand the function of racial diversity in policing. Findings highlight discrepancies in how these two groups frame the utility of racial diversity in policing, revealing conflicting epistemologies of race and racism. Police draw on an epistemology of racial ignorance (Mills 1997, 2007, 2015) to selectively accommodate race-conscious critique while denying the history and power dynamics between the institution and minority communities. Conversely, black women civilians, grounded in a standpoint epistemology (Collins, 1986, 2009), emphasize the historical roots of policing, along with collective memories, and lived experiences to understand the relationship between the institution and minority communities. Through a comparative analysis of these frames, we theorize dominant/state-sponsored discourse on diversity and police-minority relations as form of racecraft (Fields & Fields 2012, 2014) that serves to legitimize negligible institutional change to policing in an era of renewed scrutiny of police racism.
Racial equity in eligibility for a clean slate under automatic criminal record relief laws
Authors: Mooney Alyssa C. , Skog Alissa , Lerman Amy E.
Published: August 2022

States have begun to pass legislation to provide automatic relief for eligible criminal records, potentially reducing the lifelong collateral consequences of criminal justice involvement. Yet numerous historical examples suggest that racially neutral policies can have profoundly disparate effects across racial groups. In the case of criminal record relief, racial equity in eligibility for a clean slate has not yet been examined. We find that in California, one in five people with convictions met criteria for full conviction relief under the state's automatic relief laws. Yet the share of Black Americans eligible for relief was lower than White Americans, reproducing racial disparities in criminal records. We identify two policy amendments that would reduce the share of Black men in California with convictions on their criminal records from 22% to 9%, thereby narrowing the difference compared to White men from 15 to seven percentage points. Put another way, an additional one in seven Black men currently has a conviction record, compared to their White counterparts. This would decline to an additional one in 14 if both hypothetical policy amendments were incorporated. We close with discussion of criminal history data quality limitations, which pose a second key challenge to equitable implementation of automatic criminal record relief reforms nationwide.
FoxR is an AraC‐like transcriptional regulator of ferrioxamine uptake in Salmonella enterica
Authors: Saldaña‐Ahuactzi Zeus , Knodler Leigh A.
Published: August 2022

Salmonella enterica spp. produce siderophores to bind iron with high affinity and can also use three xenosiderophores secreted by other microorganisms, ferrichrome, coprogen, and ferrioxamine. Here we focused on FoxA, a TonB‐dependent transporter of ferrioxamines. Adjacent to foxA is a gene annotated as a helix‐turn‐helix (HTH) domain‐containing protein, SL0358 (foxR), in the Salmonella enterica serovar Typhimurium SL1344 genome. FoxR shares homology with transcriptional regulators belonging to the AraC/XylS family. foxR is syntenic with foxA in the Enterobacteriaceae family, suggesting their functional relatedness. Both foxA and foxR are repressed by the ferric uptake regulator (Fur) under iron‐rich growth conditions. When iron is scarce, FoxR acts as a transcriptional activator of foxA by directly binding to its upstream regulatory region. A point mutation in the HTH domain of FoxR abolished this binding, as did mutation of a direct repeat motif in the foxA upstream regulatory region. Desferrioxamine (DFOE) enhanced FoxR protein stability and foxA transcription but did not affect the affinity of FoxR binding to the foxA regulatory region. In summary, we have identified FoxR as a new member of the AraC/XylS family that regulates xenosiderophore‐mediated iron uptake by S. Typhimurium and likely other Enterobacteriaceae members.
Research Progress on Exosomes in Osteonecrosis of the Femoral Head
Authors: Liu Xiuzhi , Wang Cheng , Meng Haoye , Liao Sida , Zhang Jian , Guan Yanjun , Tian Hua , Peng Jiang
Published: August 2022

Osteonecrosis of the femoral head (ONFH) is a progressive disease that often necessitates hip replacement if hip preservation therapy fails. ONFH places a heavy economic burden and severe psychological pressure on patients. At present, ONFH is treated by either surgical or non‐surgical methods. In clinical practice, stem cells combined with surgery has achieved some positive results, but many problems remain to be resolved. Exosomes are small vesicles of 30–150 nm, which are rich in various nucleic acids, proteins, and small molecules depending on the cells from which they are derived. A growing number of studies have found that exosomes play an important role in tissue damage repair. In comparison with stem cells, exosomes have lower immunogenicity. Also, exosomes can promote cell proliferation and inhibit tumor growth. In addition, exosomes can also be used as natural carriers of drugs. Many studies have shown that exosomes have therapeutic effects in hormone‐induced ONFH. Exosomes have the effect of promoting vascular regeneration and show good application prospects in ONFH. Here, we present a review of studies on the application of exosomes in ONFH to provide a reference for future research.
Fine‐tuning OsCPK18/OsCPK4 activity via genome editing of phosphorylation motif improves rice yield and immunity
Authors: Li Hong , Zhang Yun , Wu Caiyun , Bi Jinpeng , Chen Yache , Jiang Changjin , Cui Miaomiao , Chen Yuedan , Hou Xin , Yuan Meng , Xiong Lizhong , Yang Yinong , Xie Kabin
Published: August 2022

Plants have evolved complex signalling networks to regulate growth and defence responses under an ever‐changing environment. However, the molecular mechanisms underlying the growth‐defence tradeoff are largely unclear. We previously reported that rice CALCIUM‐DEPENDENT PROTEIN KINASE 18 (OsCPK18) and MITOGEN‐ACTIVATED PROTEIN KINASE 5 (OsMPK5) mutually phosphorylate each other and that OsCPK18 phosphorylates and positively regulates OsMPK5 to suppress rice immunity. In this study, we found that OsCPK18 and its paralog OsCPK4 positively regulate plant height and yield‐related traits. Further analysis reveals that OsCPK18 and OsMPK5 synergistically regulate defence‐related genes but differentially regulate development‐related genes. In vitro and in vivo kinase assays demonstrated that OsMPK5 phosphorylates C‐terminal threonine (T505) and serine (S512) residues of OsCPK18 and OsCPK4, respectively. The kinase activity of OsCPK18T505D, in which T505 was replaced by aspartic acid to mimic T505 phosphorylation, displayed less calcium sensitivity than that of wild‐type OsCPK18. Interestingly, editing the MAPK phosphorylation motif in OsCPK18 and its paralog OsCPK4, which deprives OsMPK5‐mediated phosphorylation but retains calcium‐dependent activation of kinase activity, simultaneously increases rice yields and immunity. This editing event also changed the last seven amino acid residues of OsCPK18 and attenuated its binding with OsMPK5. This study presents a new regulatory circuit that fine tunes the growth‐defence tradeoff by modulating OsCPK18/4 activity and suggests that CRISPR/Cas9‐mediated engineering phosphorylation pathways could simultaneously improve crop yield and immunity.
The kidney allocation system and pediatric transplantation at 5 years
Authors: Engen Rachel M. , Smith Jodi M. , Bartosh Sharon M.
Published: August 2022

Background

A new Kidney Allocation System (KAS) was implemented in the United States in 2014 with the goal of improving equity and utility.

Methods

In this study, we compare outcomes for kidney‐alone candidates less than 18 years of age, at the time of listing, in the 5 years prior to and following policy implementation using Organ Procurement and Transplantation Network data.

Results

While the pediatric deceased donor transplant rate increased under KAS, this increase was due solely to improved access for children aged 11–17 years; there was an 18.9% decrease in the deceased donor transplant rate among children 0–5 years old, from 117.94 to 95.8 transplants per 100 person‐years (p = .001). The cumulative incidence of deceased donor transplantation by 1 year after listing decreased from 39.3% in the pre‐KAS era to 35.5% in the post‐KAS era (p = .004), a decline that was driven entirely by longer wait times for children 0–5 years old (p = .017). Candidates with a calculated panel reactive antibody of 98%–100% experienced a significant increase in transplant rate, but there was no change in transplant rate for Black or Hispanic candidates.

Conclusion

Overall, KAS increased transplantation access for teenaged and highly sensitized candidates but resulted in decreased access for the youngest children with no improvement in racial/ethnic equality.