bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Postoperative Infection Rates After Office-based Oculoplastic Procedures Using Sterile and Clean Gloves
Authors: Wang Diane , Shinder Roman
Published: September 2022

Purpose:

To compare postoperative infection (PI) rates using sterile and clean-boxed gloves in office-based oculoplastic procedures.

Methods:

Prospective, comparative study of patients undergoing oculoplastic procedures by a single surgeon (RS) in an office-based procedure room between October 2018 and September 2020. Participants included were 18 years or older. Excluded were patients on oral antibiotics within 2 weeks before the procedure, had a follow-up period of less than 1 week, had a contaminated wound, had complex reconstructions, or had multiple simultaneous procedures performed. Oculoplastic procedures were performed using either sterile or clean-boxed gloves. The main outcome measure was the frequency of postoperative infection.

Results:

Three thousand one hundred twenty-nine patients, 1,815 (58%) of whom were women, with a mean age of 60 (18–102) years were included. One thousand five hundred seventy procedures were performed with sterile gloves, while 1,559 were performed with clean-boxed gloves. The patients in the 2 groups were similar in age, gender, and number of high-risk individuals. One patient in the sterile glove group who underwent upper blepharoplasty (0.064%) and one patient (0.064%) in the clean-boxed glove group who had an external levator advancement blepharoptosis repair developed PI. Neither patient had risk factors for infection, and both infections resolved after 1 week of oral amoxicillin-clavulanate 875/125 mg twice daily.

Conclusions:

In minimally complex in-office oculoplastic procedures, using sterile versus clean-boxed gloves resulted in similar low infection rates in this large cohort. The healthcare benefits may not outweigh the costs of using sterile gloves universally for office-based oculoplastic procedures.
Impact of Child Passenger Safety Education for Pediatric Nurses
Authors: Ramsey Gia C. , Grippi Christine
Published: September 2022

BACKGROUND:

Hospital-based child passenger safety education is effective in decreasing car seat misuse. Although child passenger safety training has been studied with pediatricians, emergency physicians, and emergency nurses, there is a lack of literature regarding child passenger safety training performed by pediatric nurses.

OBJECTIVE:

The purpose of this study was to determine the effect of a 30-min child passenger safety education session on pediatric nurses' child passenger safety knowledge and confidence.

METHODS:

This was a pre- and posttest comparison study of pediatric nurses' knowledge and confidence levels following child passenger safety training in a pediatric trauma center in New York State conducted from September 2018 to March 2019. Registered nurses from the neonatal intensive care unit, pediatric intensive care unit, general pediatric unit, and mother–baby unit participated in the study. The intervention was a single 30-min child passenger safety training session provided by a certified child passenger safety technician. A demographic questionnaire and 11-question pre- and posttest surveys were used. Data were compared using the t test, the chi-square test, and Fisher's exact tests.

RESULTS:

A total of 133 nurses participated, of which 97% were female and 50% were White. Posttest scores significantly increased (3.83; 95% CI [3.1, 3.7], t = 22.54, p≤ .001) in nurses' child passenger safety knowledge and confidence after a 30-min modular educational session.

CONCLUSION:

Passenger safety training increased pediatric nurses' knowledge and confidence to provide child passenger safety education to families and caregivers. Child passenger safety education is recommended for all nurses who are expected to provide child passenger safety education regardless of unit location.
The relationship between nondipper hypertension and triglyceride glucose index
Authors: Emlek Nadir , Aydin Cihan
Published: September 2022

Nondipper hypertensive patients have an increased incidence of damage to end organs, including the brain, heart, and kidney, and a worse cardiovascular prognosis. The triglyceride glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to the traditional risk factors of cardiovascular disease. To the best of our knowledge, whether there is a relationship between the TyG index and impaired diurnal blood pressure (BP) has not been investigated. This study aimed to compare the TyG index between normotensive, nondipper, and dipper hypertensive patients. A total of 1037 patients grouped according to the results of ambulatory BP monitoring were included, with group 1 including dipper hypertensive (n = 368), group 2 including nondipper hypertensive (n = 496), and group 3 including normotensive control (n = 173) patients. In both the univariate and multivariate logistic regression analyses, TyG index [odds ratio (OR), 4.656; 95% confidence interval (CI), 3.014–7.193; P < 0.001], age (OR, 1.011; 95% CI, 1.002–1.021; P = 0.018), and glomerular filtration rate (GFR) (OR, 0.979; 95% CI, 0.971–0.987; P < 0.001) were independent predictors of nondipper hypertension (HT). In the ROC analysis, a TyG index cutoff value of at least 4.74 predicted nondipper hypertensive patients with a sensitivity of 59.7%, and a specificity of 59.9% [area under the curve = 0.647 (0.614–0.680); 95% CI; P < 0.001]. We showed that TyG index, age, and GFR are independent predictors in patients with nondipper HT. TyG index, a simple, cost-effective, and rapid tool can predict the nondipper pattern in essential HT.
Lower paraoxonase 1 paraoxonase activity is associated with a worse prognosis in patients with non-ST-segment elevation myocardial infarction in long-term follow-up
Authors: Leocádio Paola Caroline Lacerda , Goulart Alessandra Carvalho , Santos Itamar Souza , Lotufo Paulo Andrade , Bensenor Isabela Martins , Alvarez-Leite Jacqueline Isaura
Published: September 2022

Background

Acute coronary syndrome (ACS) is one of the main manifestations of coronary artery disease, with a higher prevalence and worst prognosis. Oxidative stress is important in atherosclerosis and ACS, and paraoxonase 1 (PON1) is directly related to reducing the effects of oxidative stress on lipoproteins. The present study evaluated the prognostic value of PON1 activity in patients with non-ST-segment elevation ACS [non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA)], included in the ERICO study.

Methods

PON1 paraoxonase activity was determined in serum samples from 485 patients collected on admission. The prognostic value in the follow-up of up to 5 years was evaluated according to cutoff points established by tertiles. Kaplan–Meier curves and Cox regression were used for the analysis of all-cause mortality and cardiovascular mortality.

Results

The sample consisted mainly of elderly patients with a high frequency of cardiovascular risk factors. At follow-up of up to 5 years, there were 126 deaths from all causes (80 deaths from CVD). The lowest tertile of PON1 paraoxonase activity was associated with a higher risk of death in patients with NSTEMI, but not in patients with UA.

Conclusion

PON1 paraoxonase activity has potential prognostic value in patients with NSTEMI.
Effectiveness of Nonpharmacologic Interventions for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients
Authors: Liu Yu , Liu Jun-E , Chen Shaohua , Zhao Fuyun , Chen Lu , Li Ruolin
Published: September 2022

Background

Neurotoxicity is a major adverse effect of chemotherapy in breast cancer (BC) patients. A number of nonpharmacologic interventions are used to alleviate chemotherapy-related cognitive impairment (CRCI), but no studies have compared their effectiveness.

Objectives

The aim of this study was to identify and compare the effectiveness of different nonpharmacologic interventions for CRCI in BC patients.

Methods

A systematic review and network meta-analysis was conducted following the Cochrane guidelines. All randomized controlled trials were searched in the Cochrane Library, PubMed, MEDLINE (via OVID), Web of Science, EMBASE, and CINAHL databases from inception to September 2021. Studies using nonpharmacologic interventions to manage CRCI symptoms were included. A network meta-analysis and a comparative effects ranking were completed by STATA v14.0.

Results

Twelve studies with 8 nonpharmacologic interventions were included. For subjective outcomes on CRCI, there was no significant difference between nonpharmacologic interventions. For objective outcomes, qigong and exercise were more effective than the psychotherapy. Qigong and exercise were also more effective than music therapy. The top 3 interventions were psychotherapy (83.4%), music therapy (60.8%), and electroacupuncture (52.5%) for subjective outcomes and qigong (87.7%), exercise (82.1%), and electroacupuncture (70.3%) for objective outcomes.

Conclusion

In the subjective evaluation, it was difficult to judge which interventions are best, but psychotherapy had the greatest probability. For objective evaluation, qigong and exercise may be the best nonpharmacologic interventions.

Implications for Practice

This study provides evidence for the effectiveness of nonpharmacologic interventions for CRCI in BC patients and facilitates support for future clinical trials and work.
Jordanian Nurses’ Perspectives of Spirituality and Spiritual Care
Authors: Ibdah Rufaida , Zeilani Ruqayya , Atout Maha
Published: September 2022

Background

Spirituality is considered one of the main aspects of wholesome care for human beings. Spirituality is a multidimensional concept and has several definitions in the literature. Most of the studies concerning spirituality were conducted in Western cultures and the Middle East; however, there are a limited number of studies regarding spirituality in Jordan.

Objective

The aim of this study was to explore Jordanian nurses’ perspectives on spirituality and spiritual care in a palliative care unit in 1 cancer center in Jordan.

Methods

A descriptive qualitative design with 20 semistructured interviews was used to access Jordanian nurses’ perspectives on spirituality. This study was conducted in the major specialist center for the treatment of cancer in Jordan. A purposive sample of 20 registered nurses who had worked at least 6 months in the palliative care unit was recruited.

Results

Nurses’ perceptions of spirituality were represented by 2 themes: spirituality means connectedness to “Allah,” and spirituality evokes enjoyment in life. Two themes emerged in terms of nurses’ perceptions of spiritual care: ensuring patients’ comfort and relaxation, and sharing patients’ religious rituals.

Conclusion

These findings underscore the importance of the nurses’ perspectives on spirituality in the context of Islamic and Arabic culture, and the need for training in spirituality.

Implications for Practice

The concept of spirituality is recognized as a fundamental aspect of the nurse’s role, making it essential to improve nurses’ capabilities to integrate spirituality courses into the nursing curriculum.
Patient Perception of Fall Risk and Fall Risk Screening Scores
Authors: Solares Nicole P. , Calero Patricia , Connelly Cynthia D.
Published: September 2022

Background:

Falls are the most prevalent adverse event among hospitalized patients. Multilevel risk factors are associated with falls, yet falls continue.

Purpose:

To evaluate the relationship between the Johns Hopkins Fall Risk instrument, patient characteristics, and perception of fall risk.

Methods:

The Johns Hopkins Fall Risk score, patient perception of fall risk, and patient characteristics were analyzed among inpatient adults (n = 201) from 5 acute care units in a large southern California medical center.

Results:

Bivariate analyses revealed that fall risk was inversely associated with participants' confidence in their ability to perform high fall risk behaviors without help and without falling (P = .018).

Conclusions:

Perception of fall risk is a promising new indicator in preventing falls. Patient perception of fall risk may elicit a behavior change to help prevent falls. Increased health care provider awareness of patient perception of fall risk may improve fall risk interventions and prevention programs.
Nurse Leader Preparation for Disasters
Authors: Reedy James C. , Zedreck Judith F. , Ren Dianxu , Warburton Cindi M. , Fennimore Laura
Published: September 2022

OBJECTIVE

The aim of this study was to evaluate nurse leader confidence in emergency management and disaster preparedness.

BACKGROUND

There is a dearth of evidence in the literature regarding the preparation of nurse leaders to manage emergencies and disasters. Research suggests significant gaps in nurse leader confidence across roles and in structured education that prepares nurse leaders across the spectrum of experience to manage in a crisis.

METHODS

An exploratory, cross-sectional survey included a sample of 432 RNs who are members of the Northwest Organization for Nurse Leaders.

RESULTS

Results indicate significant variance in nurse leader confidence across roles, experience, and previous disaster-related education. Positive associations regarding nurse leaders' confidence in managing disasters exist with more advanced positions, advanced education, and structured training.

CONCLUSIONS

Nursing leaders lack consistent education that prepares them for emergency and disaster management. Nurse leaders across all levels would benefit from formal education in these areas.
The Nurse Empowerment Program for Nurses in Direct Care Positions
Authors: Bard Kristin , Cornell Julie A. , Cunningham Shayna D. , Madigan Elizabeth A. , Solomon Julie
Published: September 2022

OBJECTIVE

An educational program including online generic and nursing-specific content was evaluated for self-assessed leadership skill outcomes.

BACKGROUND

Leadership development for nurses in direct care positions has not received the same support as for nurses in formal leadership positions. Pandemic and workforce changes make it critical that leadership skills be built at all levels of nursing.

METHODS

Early-career nurses (≤10 years of experience) were recruited to participate in an online leadership development program offering 9 LinkedIn Learning courses, 3 leadership courses from Sigma, an e-book, and a discussion board.

RESULTS

Most participants who responded to both immediate postsurvey and 3-month follow-up survey (98.6% of n = 69) reported having applied new or improved abilities in their nursing practice to at least a small degree, and the majority reported having done so to a moderate or great degree.

CONCLUSION

This online leadership development program was valued and was associated with improved self-assessed leadership.
Enhancing the Content Validity of Self-Reported Physical Activity Self-Efficacy in Adolescents: A Qualitative Study
Authors: Algheryafi Reem A. , Bevans Katherine B. , Hiremath Shivayogi V. , Lai Jin-Shei , Tucker Carole A.
Published: September 2022

Purpose:

This study's primary purpose was to enhance the content validity of a self-reported measure of self-efficacy for physical activity (PA) in adolescents. This was addressed through assessment of younger and older adolescents' understanding of the construct of self-efficacy for PA, coupled with assessment of the content coverage and comprehensibility of items derived from existing measures.

Methods:

Participants completed individual semistructured and cognitive debriefing interviews as well as 3 PA self-efficacy questionnaires.

Results:

Thematic analysis identified personal and environmental facilitators and barriers to PA self-efficacy. The major categories were physical; psychological; interaction with surroundings; support and relationships; attitudes; and services, systems, and natural environments. Cognitive interviews resulted in the retention of 52 final items: 24 for self-efficacy with perceived facilitators and 28 for self-efficacy to overcome barriers.

Conclusions:

This study provides a PA self-efficacy instrument with expanded content coverage that is relevant to adolescents as young as 11 years. With further validation testing in future studies, this instrument will enable pediatric physical therapists and researchers to assess PA self-efficacy and design effective intervention strategies to improve PA.
The Effect of Pretreatment Potential Resistance to NNRTIs on Antiviral Therapy in Patients With HIV/AIDS
Authors: Li Cui-Lin , Liang Hong-Yuan , Xiao Jing , Li Rui , Yu Feng-Ting , Zeng Yong-Qin , Pang Xiao-Li , Wang Di , Liu Ying , Li Bei , Han Jun-Yan , Zhao Hong-Xin
Published: September 2022

Background:

With the increasing coverage of antiretroviral therapy, concerns for the emergence and transmission of HIV drug resistance (HIVDR) are arising. HIVDR was divided into 5 levels: sensitive, potentially resistant, low resistant, intermediate resistant, and high resistant. Most of the articles on HIVDR involved low-level, intermediate-level, and high-level drug resistance to antiretroviral drug, and few articles deal with potential drug resistance. Treatment failure associated with the level of low-level, intermediate-level, and high-level resistance to antiretroviral drug has been reported. However, whether virological failure (VF) is related to potential resistance remains unclear. In this study, we aimed to describe the situation of potential resistance to antiretroviral drug and whether it is related to VF.

Methods:

We analyzed the demographic, behavioral information, medical history, and drug resistance–associated mutation data from subjects. Drug resistance mutations at baseline and time of failure in patients suffering VF were detected by using the Vela automated next-generation sequencing platform. The χ2 test or Fisher exact test and logistic regression were used to assess the risk factors that contribute to VF in the potential drug-resistant people.

Results:

The prevalence of overall pretreatment drug resistance was 7.06% (233/3300), and the prevalence of pretreatment potential resistance was 8.79% (290/3300). All these patients with pretreatment potential first-line drugs resistance showed potential resistance to nonnucleoside reverse transcriptase inhibitors (NNRTIs), and some of them had potential drug resistance to NNRTIs and NRTIs or NNRTIs and PIs; among these patients, 94.71% (179/189) had V179 D/E mutations. The VF rate of first-line treatment for potentially resistant people is 17.99%. CD4+ T-cell count ≤200 cells/L at antiretroviral therapy initiation are risk factors for the failure of first-line treatment.

Conclusions:

The prevalence of potential drug resistance among individuals with HIV and the VF rate of first-line treatment for potential drug-resistant people were high. To better optimize clinical management, prevention, and control of HIV, attention should be devoted to the potential resistance of nonnucleoside drugs.
Effectiveness and Safety of Dolutegravir Versus Efavirenz-Based Antiviral Regimen in People Living With HIV-1 in Sichuan Province of China: A Real-World Study
Authors: Tongtong Yang , Shenghua He , Yin Wang , Lin Cai , Huanxia Liu , Chunrong Lv , Ruifeng Zhou , Xiaojing Yang , Yuan Yao , Yuanhong He , Ke Yin
Published: September 2022

Background:

The application time of dolutegravir (DTG) is relatively short, and the treatment experience is insufficient. Therefore, evidence is required to shed more light on the effectiveness and safety issues of DTG in China.

Objectives:

To assess the effectiveness and safety of a DTG vs. efavirenz (EFV) antiviral regimens (the current mainstream regimen).

Methods:

This was a retrospective cohort study. Data of people with HIV (PWH), who started initial DTG-based or EFV-based antiretroviral therapy at the Chengdu Public Health Clinical Medical Center from January 2018 to October 2020, were collected. Effectiveness indicators such as CD4+ T-cell recovery and HIV viral suppression, and safety indicators, including blood routine, liver and kidney function, and occurrence of abnormal blood lipids after DTG vs. EFV-based antiviral regimen treatments, were analyzed.

Results:

A total of 656 patients were eligible, of which 611 patients were included in the study. Most of the PWHs in our center were young men (86.25%). Nearly one-third of the participants were coinfected with syphilis. The median baseline HIV viral load was 4.70 log10 copies/mL. The median CD4+ T-cell count was 254 cells/mm3. More participants started on EFV-based regimens than DTG-based regimens (82.32% vs. 17.67%). The time to reach the target value (CD4 > 350 cells/mm3) in the DTG group was shorter than that in the EFV group (408 days vs. 522 days), and the percentage of reaching the CD4 target value of the DTG group was higher than that of the EFV group (41.04% vs. 33.76%) in 1 year. The effect of virologic suppression (<50 copies/mL) in the DTG group was superior to that in the EFV group. The use of DTG-containing treatment regimens was significantly related to a quicker virologic suppression (hazard ratio, 1.76; 95% confidence interval of 1.40–2.21, P < 0.0001). The safety data analysis of laboratory indicators showed that there was no significant difference in the incidence of adverse events between the 2 groups.

Conclusions:

A DTG-based regimen may be more conducive to the CD4 recovery than the EFV-based regimen. The virologic suppression of the DTG group may be superior to that of the EFV group. DTG-based regimens might be the preferred treatment option for people with HIV for initial HIV treatment.
Dolutegravir Plus Lamivudine Dual-Drug Regimen in Treatment-Naive HIV-1—Infected Patients With High-Level Viral Load: Preliminary Data From the Real World
Authors: Zhao Fang , Rao Man , Chen Weimei , Cai Kanru , Zhang Lukun , Xu Liumei , Sun Liqing , Liu Xiaoning , He Yun , Wang Hui
Published: September 2022

Background:

Some inpatients with HIV-RNA ≥500,000 copies/mL in China need to use 2-drug regimen for some reasons, although limited data are available for dolutegravir plus lamivudine (3TC) in those patients with ultra-high viral loads.

Methods:

We conducted a single-center retrospective–prospective study in China and enrolled 42 ART-naive HIV-infected inpatients who use a once-daily 2-drug regimen because of various reasons (drug interaction, renal impairment, age, and other related comorbidities).They were divided into 2 groups, low viral load group (baseline viral load <500,000 copies/mL, n = 20) and high viral load group (baseline viral load ≥500,000 copies/mL, n = 22). All patients were followed up for 48 weeks.

Results:

The median of baseline viral load was 5.74 log10 copies/mL and CD4+ T-cell count was 59 cells/μL. At week 48, there was no significant difference (P = 0.598) in proportions of participants with HIV-1 RNA <50 copies/mL [90%, 95% confidence interval (CI) (75.6% to 104.4%) in low viral load groups vs 95.5%, 95% CI (86.0% to 104.9%) in high viral load groups]. No differences were found in mean increase of CD4+ T-cell count from baseline between 2 groups (218 ± 122 vs 265 ± 127 cells/μL, P = 0.245). There is no grade 3 or higher treatment-related adverse events and none discontinued treatment because of adverse events.

Conclusions:

The results of our study in real world support dolutegravir + 3TC dual regimen as a promising therapy option for treatment-naive HIV-infected patient with baseline viral load ≥500,000 copies/mL.
Lesion-Specific Metabolic Alterations in Relapsing-Remitting Multiple Sclerosis Via 7 T Magnetic Resonance Spectroscopic Imaging
Authors: Lipka Alexandra , Niess Eva , Dal-Bianco Assunta , Hangel Gilbert J. , Rommer Paulus S. , Strasser Bernhard , Motyka Stanislav , Hingerl Lukas , Berger Thomas , Hnilicová Petra , Kantorová Ema , Leutmezer Fritz , Kurča Egon , Gruber Stephan , Trattnig Siegfried , Bogner Wolfgang
Published: September 2022

Background

Magnetic resonance spectroscopic imaging (MRSI) of the brain enables in vivo assessment of metabolic alterations in multiple sclerosis (MS). This provides complementary insights into lesion pathology that cannot be obtained via T1- and T2-weighted conventional magnetic resonance imaging (cMRI).

Purpose

The aims of this study were to assess focal metabolic alterations inside and at the periphery of lesions that are visible or invisible on cMRI, and to correlate their metabolic changes with T1 hypointensity and the distance of lesions to cortical gray matter (GM).

Methods

A 7 T MRSI was performed on 51 patients with relapsing-remitting MS (30 female/21 male; mean age, 35.4 ± 9.9 years). Mean metabolic ratios were calculated for segmented regions of interest (ROIs) of normal-appearing white matter, white matter lesions, and focal regions of increased mIns/tNAA invisible on cMRI. A subgroup analysis was performed after subdividing based on T1 relaxation and distance to cortical GM. Metabolite ratios were correlated with T1 and compared between different layers around cMRI-visible lesions.

Results

Focal regions of, on average, 2.8-fold higher mIns/tNAA than surrounding normal-appearing white matter and with an appearance similar to that of MS lesions were found, which were not visible on cMRI (ie, ~4% of metabolic hotspots). T1 relaxation was positively correlated with mIns/tNAA (P ≤ 0.01), and negatively with tNAA/tCr (P ≤ 0.01) and tCho/tCr (P ≤ 0.01). mIns/tCr was increased outside lesions, whereas tNAA/tCr distributions resembled macroscopic tissue damage inside the lesions. mIns/tCr was −21% lower for lesions closer to cortical GM (P ≤ 0.05).

Conclusions

7 T MRSI allows in vivo visualization of focal MS pathology not visible on cMRI and the assessment of metabolite levels in the lesion center, in the active lesion periphery and in cortical lesions. This demonstrated the potential of MRSI to image mIns as an early biomarker in lesion development.
Intense Diffuse Lung Uptake Due to Interstitial Pneumopathy Related to Polyangiitis Granulomata in 68Ga-PSMA-11 PET/CT
Authors: Moreau Aurélie , Pretet Valentin , Paquet Emilie , Giraudet Anne Laure , Kryza David
Published: September 2022

We reported the case of a 73-year-old man for whom a prostatic adenocarcinoma with synchronous bone metastases was diagnosed. Because his disease was progressing despite several lines of chemotherapy and hormonotherapy, he was screened with a 68Ga-PSMA PET/CT for a possible 177Lu-PSMA-617 therapy. The examination demonstrated an intense diffuse bone uptake related to the known bone involvement. It also showed an unexpected diffuse and intense lung uptake, secondary to an active polyangiitis granulomata. This intense lung uptake prohibits the radioligand therapy.
Hair-Bearing Expanded Scalp Flap for Total Beard Reconstruction in Patients With Chin and Submental Postburn Scars
Authors: Ding Jianke , Chu Feifei , Yu Zhou , Liu Chaohua , Yang Qing , Tang Yinke , Ma Xianjie
Published: September 2022

Background:

Loss of beard in adult male caused by severe burn may cause cosmetic and psychological problems for these patients. Reconstruction of the beard with hair-bearing skin flaps in similar color and texture of the surrounding tissues remains a challenge.

Methods:

Eight male patients suffered from submental postburn scar and beard loss were treated by using the hair-bearing expanded scalp flap. A 1000 mL nephroid tissue expander was first implanted under the frontal and mid scalp. After a 3 to 4-month tissue expansion, the expanded hair-bearing scalp flap based on bilateral superficial temporal vessels were raised and transferred for beard reconstruction, and the cutaneous pedicles were curled into tubes. Delay and division of the pedicles were performed 3 to 4 weeks after flap transfer.

Results:

Eight male patients with postburn scar and beard loss were successfully treated with no major complication. One patient suffered from edge necrosis at distal end of the flap and healed after daily dressing change. Chin and submental areas were repaired by expanded scalp flap and total beard was reconstructed at the same time. All donor sites were closed directly without skin grafting.

Conclusions:

The modified expanded bipedicled scalp flap provides an easy and reliable way for total beard reconstruction and large-scale submental scars repairment.
Ocrelizumab for Post-Alemtuzumab Paradoxical Disease Activity in Highly Active Multiple Sclerosis
Authors: Adamec Ivan , Habek Mario
Published: September 2022

Alemtuzumab is a humanized anti-CD52 antibody that is registered for treatment of highly active relapsing-remitting multiple sclerosis. Disease activity after alemtuzumab treatment is infrequent. It may be a result of lack of lymphocyte depletion due to development of neutralizing autoantibodies. On the other hand, severe disease activity has been described after alemtuzumab, which is suggested to be caused by B-cell hyperpopulation. We present a case of a person with multiple sclerosis with severe disease activation after alemtuzumab administration that may represent paradoxical B cell–mediated disease activity. The patient was successfully treated with ocrelizumab.
Cultural Considerations in Fahr's Syndrome: A Case Report
Authors: Ots Heather D. , Zagade Tarek A. , Chung James P. , Torres Giovanni , Petri Justin D.
Published: September 2022

Objectives

Many psychiatrists, and other providers alike, find difficulty integrating a culture-centered approach to clinical practice and navigating the challenges when they arise. We call attention to the ongoing challenges of addressing the cultural barriers between patient and physician.

Methods

We present a case of an African patient with a rare case of Fahr's syndrome whose clinical diagnostic course was complicated by culture and language barriers.

Results

The patient's hospital course was challenged by cultural and language barriers that were difficult to integrate into her care, likely contributing to a prolonged diagnostic course and hospitalization.

Conclusions

Cultural considerations in medicine can enhance patient-physician relationships and ultimately strengthen clinical outcomes.
A recurrent prosthetic joint infection caused by Erysipelothrix rhusiopathiae: case report and literature review
Authors: Boukthir Sarrah , Common Harold , Arvieux Cédric , Cattoir Vincent , Patrat-Delon Solène , Jolivet-Gougeon Anne
Published: September 2022

Prosthetic knee joint infection caused by

Erysipelothrix rhusiopathiae

is uncommon and only one case of recurrent infection has previously been described. Here, we describe the case of a 77-year-old male patient who was admitted to the teaching hospital of Rennes (France) with bilateral and nocturnal gonalgia evolving for 1 month. He had bilateral knee prosthesis 10 years ago, and a history of large B-cell lymphoma in remission. A diagnosis of infective endocarditis, with prosthetic knee infection, was made, with positive cultures of synovial fluids and blood; colonies of

E. rhusiopathiae

were identified by MALDI-TOF MS. Initial treatment involved debridement, implant retention surgery and intravenous amoxicillin (12 g day–1) for 6 weeks with gentamicin 3 mg kg–1 day–1 added for the first 4 days. One year later, a second episode of

E. rhusiopathiae

infection occurred, suggesting a recurrence or reinfection due to the same bacterial species. The patient was finally cured after a two-stage exchange with a cemented articulated spacer and a 3 month course of amoxicillin (12 g day–1, iv). Different characteristics of

E. rhusiopathiae

infection were discussed, with a review of all cases of prosthetic joint infections caused by

Erysipelothrix

species. This case highlights the need for a long-term survey of patients, and a good knowledge of their environment to avoid any risk of reinfection.
CD4-binding site immunogens elicit heterologous anti-HIV-1 neutralizing antibodies in transgenic and wildtype animals
Authors: Gristick Harry B. , Hartweger Harald , Loewe Maximilian , van Schooten Jelle , Ramos Victor , Oliviera Thiago Y. , Nishimura Yoshiaki , Koranda Nicholas S. , Wall Abigail , Yao Kai-Hui , Poston Daniel , Gazumyan Anna , Wiatr Marie , Horning Marcel , Keeffe Jennifer R. , Hoffmann Magnus A.G. , Yang Zhi , Abernathy Morgan E. , Dam Kim-Marie A. , Gao Han , Gnanapragasam Priyanthi N.P. , Kakutani Leesa M. , Pavlovitch-Bedzyk Ana Jimena , Seaman Michael S. , Howarth Mark , McGuire Andrew T. , Stamatatos Leonidas , Martin Malcolm A. , West Anthony P. , Nussenzweig Michel C. , Bjorkman Pamela J.
Published: September 2022

Passive transfer of broadly neutralizing anti-HIV-1 antibodies (bNAbs) protects against infection, and therefore eliciting bNAbs by vaccination is a major goal of HIV-1 vaccine efforts. bNAbs that target the CD4-binding site (CD4bs) on HIV-1 Env are among the most broadly active, but to date, responses elicited against this epitope in vaccinated animals have lacked potency and breadth. We hypothesized that CD4bs bNAbs resembling the antibody IOMA might be easier to elicit than other CD4bs antibodies that exhibit higher somatic mutation rates, a difficult-to-achieve mechanism to accommodate Env’s N276gp120 N-glycan, and rare 5-residue light chain complementarity determining region 3s (CDRL3s). As an initial test of this idea, we developed IOMA germline-targeting Env immunogens and evaluated a sequential immunization regimen in transgenic mice expressing germline-reverted IOMA. These mice developed CD4bs epitope-specific responses with heterologous neutralization, and cloned antibodies overcame neutralization roadblocks including accommodating the N276gp120 glycan, with some neutralizing selected HIV-1 strains more potently than IOMA. The immunization regimen also elicited CD4bs-specific responses in animals containing polyclonal antibody repertoires. Thus, germline-targeting of IOMA-class antibody precursors represents a potential vaccine strategy to induce CD4bs bNAbs.
Locus-specific proteomics identifies new aspects of the chromatin context involved in V region somatic hypermutation
Authors: Yu GuoJun , Duan Zhi , Zhang Yongwei , Aguilan Jennifer T , Sidoli Simone , Scharff Matthew D
Published: September 2022

Activation-induced cytidine deaminase (AID) somatically hypermutates the immunoglobulin heavy chain variable region (IGHV) gene to create the antibody diversity required to resist infections. This hypermutational process involves many pathways including transcription, DNA structural change and repair. While many of the proteins involved have been identified, their relative abundance, organization and regulation have not been resolved and additional factors and pathways need to be identified. To identify the proteome occupying IGHV, we have utilized dCas9-APEX targeted by guide RNAs to biotinylate and enrich the proteins associated with the mutating V region chromatin in the Ramos human B cell line and compared them to the non-mutating downstream constant region (C) chromatin. We identified hundreds of proteins specifically enriched on the V or C region. We confirmed the functionality of selected factors by examining the changes in the V region-specific proteome after inhibiting transcriptional elongation and somatic mutation with the Dot1L inhibitor EPZ004777.

Locus-specific proteomics using dCas9-APEX identifies new aspects of the chromatin context involved in V region somatic hypermutation (SHM) in the human Ramos B cell line. An inhibitor of Dot1L which participates in SHM is used to identify functional SHM-related factors.
Improving biome labeling for tens of thousands of inaccurately annotated microbial community samples based on neural network and transfer learning
Authors: Wang Nan , Wang Teng , Ning Kang
Published: September 2022

Microbiome samples are accumulating at a fast speed, leading to millions of accessible microbiome samples in the public databases. However, due to the lack of strict meta-data standard for data submission and other reasons, there is currently a non-neglectable proportion of microbiome samples in the public database that have no annotations about where these samples were collected, how they were processed and sequenced, etc., among which the missing information about collection niches (biome) is one of the most prominent. The lack of sample biome information has created a bottleneck for mining of the microbiome data, making it difficult in applications such as sample source tracking and biomarker discovery. Here we have designed Meta-Sorter, a neural network and transfer learning enabled AI method for improving the biome labeling of thousands of microbial community samples without detailed biome information. Results have shown that out of 16,507 samples that have no detailed biome annotations, 96.65% could be correctly classified, largely solving the missing biome labeling problem. Interestingly, we succeeded in classify 250 samples, which were sampled from benthic and water column but vaguely labeled as “Marine” in MGnify, in more details and with high fidelity. What’s more, many of successfully predicted sample labels were from studies that involved human-environment interactions, for which we could also clearly differentiated samples from environment or human. Taken together, we have improved the completeness of biome label information for thousands of microbial community samples, facilitating sample classification and knowledge discovery from millions of microbiome samples.
NAD(H) homeostasis is essential for host protection mediated by glycolytic myeloid cells in tuberculosis
Authors: Pacl Hayden T. , Chinta Krishna C. , Reddy Vineel P. , Nadeem Sajid , Sevalkar Ritesh R. , Nargan Kierveshan , Lumamba Kapongo , Naidoo Threnesan , Glasgow Joel N. , Agarwal Anupam , Steyn Adrie J. C.
Published: September 2022

Mycobacterium tuberculosis (Mtb) disrupts glycolytic flux in infected myeloid cells through an unclear mechanism. Flux through the glycolytic pathway in myeloid cells is inextricably linked to the availability of NAD+, which is maintained by NAD+ salvage and lactate metabolism. Using lung tissue from tuberculosis (TB) patients and myeloid deficient LDHA (LdhaLysM−/−) mice, we demonstrate that glycolysis in myeloid cells is essential for protective immunity in TB. Glycolytic myeloid cells are essential for the early recruitment of multiple classes of immune cells and the protective effects of IFNγ. We identified NAD+ depletion as central to the glycolytic inhibition caused by Mtb. Lastly, we show that the NAD+ precursor nicotinamide exerts a host-directed, antimycobacterial effect, and that nicotinamide prophylaxis and treatment reduces Mtb lung burden in vivo. These findings provide new insight into how Mtb alters host metabolism through perturbation of NAD(H) homeostasis and reprogramming of glycolysis, highlighting this pathway as a potential therapeutic target.
An ensemble of interconverting conformations of the elemental paused transcription complex creates regulatory options
Authors: Kang Jin Young , Mishanina Tatiana V. , Bao Yu , Chen James , Llewellyn Eliza , Liu James , Darst Seth A. , Landick Robert
Published: September 2022

Transcriptional pausing underpins regulation of cellular RNA synthesis but its mechanism remains incompletely understood. Sequence-specific interactions of DNA and RNA with the dynamic, multidomain RNA polymerase (RNAP) trigger reversible conformational changes at pause sites that temporarily interrupt the nucleotide addition cycle. These interactions initially rearrange the elongation complex (EC) into an elemental paused EC (ePEC). ePECs can form longer-lived PECs by further rearrangements or interactions of diffusible regulators. For both bacterial and mammalian RNAPs, a half-translocated state in which the next DNA template base fails to load into the active site appears central to the ePEC. Some RNAPs also swivel interconnected modules that may stabilize the ePEC. However, it is unclear if swiveling and half-translocation are requisite features of a single ePEC state or if multiple ePEC states exist. Here we use cryo-EM analysis of ePECs with different RNA–DNA sequences combined with biochemical probes of ePEC structure to define an interconverting ensemble of ePEC states. ePECs occupy either pre- or half-translocated states but do not always swivel, indicating that difficulty in forming the post-translocated state at certain RNA–DNA sequences may be the essence of the ePEC. The existence of multiple ePEC conformations has broad implications for transcriptional regulation.

SIGNIFICANCE

Transcriptional pausing provides a hub for gene regulation. Pausing provides a timing mechanism to coordinate regulatory interactions, co-transcriptional RNA folding and protein synthesis, and stop signals for transcriptional termination. Cellular RNA polymerases (RNAPs) are complex, with multiple mobile modules shifting positions to control its catalytic activity and pause RNAP in response to DNA-encoded pause signals. Understanding how these modules move to enable pausing is crucial for a mechanistic understanding of gene regulation. Our results clarify the picture significantly by defining multiple states among which paused RNAP partitions in response to different pause signals. This work contributes to an emerging theme wherein multiple interconverting states of the RNAP proceed through a pathway (e.g., initiation or pausing), providing multiple opportunities for regulation.
An iterative learning control with learnable band extension for the nanopositioning stage
Authors: Huang Chengsi , Yang Zhichao , Li Jiedong
Published: September 2022

Purpose

Due to the advantages of fast response, high positioning precision and large stiffness, the piezoelectric-actuated nanopositioning stage is widely used in the micro/nanomachining fields. However, due to the inherent nonlinear hysteresis of the piezoelectric-actuator, the positioning accuracy of nanopositioning stage is greatly degraded. Besides, the nanopositioning stage is always performed with repetitive trajectories as the reference signals in applications, which makes the hysteresis behavior periodic. To this end, an adaptive resonance suppression iterative learning control (ARS-ILC) is proposed to address the hysteresis effect. With this effort, the positioning accuracy of the nanopositioning stage is improved.

Design/methodology/approach

The hysteresis behavior is identified by the Prandtl–Ishlinskii model. By establishing a convergence function, it is demonstrated that the learnable band of ILC is restricted by the lightly damping resonance of nanopositioning stage. Then, an adaptive notch filter (ANF) with constrained poles and zeros is adopted to suppress the resonant peak. Finally, online stability supervision (OSS) is used to ensure that the estimated frequency converges to the resonant frequency.

Findings

A series of experiments were carried out in the nanopositioning stage, and the results validated that the OSS is available to ensure the convergence of the ANF. Furthermore, the learnable band was extended via ARS-ILC; thus, the hysteresis behavior of nanopositioning stage has been canceled.

Originality/value

Due to high accuracy and easy implementation, the ARS-ILC can be used in not only nanopositioning stage control but other fabrication process control with repetitive motion.
Analyzing external environmental, strategic alliance, and strategic alliance of Kingdom of Saudi Arabia firms – an empirical research
Authors: Abdalkrim Gafar , Guizani Moncef
Published: September 2022

Purpose

This study investigates the effect of strategic internal critical factors on strategic alliance performance in an emerging market, the Kingdom of Saudi Arabia.

Design/methodology/approach

Multivariate statistical analysis technique Partial Least Square-Squared Equation Model is used for data analysis considering a survey of 260 alliance managers.

Findings

Environmental complexity moderates the relationship between strategic internal critical factors and strategic performance. A significant positive effect of strategic internal critical factors on corporation strategic performance was found. It suggests that environment and strategic alliance enable alliance managers and decision-makers to translate alliance strategies and improve the overall organization’s performance outcome, productivity, efficiency, availability of a product and profitability.

Practical implications

The findings disseminate beneficial implications for alliance managers regarding how they can best use their capability to maximize alliance performance. Realizing the antecedents of strategic alliance performance allows a manager to be sensitive about the influent factors and try to improve the alliance performance.

Originality/value

This paper shows how to create associations between interfirm coordination as a framework of new ventures for implementing radical technological change, firm performance in the post-innovation period, industry and firm innovative output.
Luxury is dead, long live luxury! Resonance as an alternative lens to advance our understanding of an eternal desire and a global business
Authors: Duma Fabio
Published: September 2022

Purpose

In contemporary business and marketing literature luxury is mainly approached from the perspectives of production, communication and consumption. The author argues that to understand the phenomenon in the future, different, more contextualized and human-focused lenses and methodologies are needed. He ventures out into philosophy, sociology and anthropology to broaden the perspective on the matter and proposes resonance, the theory of successful world relations, as an alternative view on luxury and luxury consumption.

Design/methodology/approach

The paper is based on the authors' reflections and an extensive review of literature, including contributions from different academic disciplines.

Findings

With introduction of resonance the author provides an alternative theoretical and practical lens on a multifaceted and dynamic phenomenon that nurtures lucrative markets which must adapt and fundamentally redefine themselves in response to changing social, ecological, technological and economic circumstances and evolving customer needs pointing towards a new social paradigm.

Originality/value

The author presents a critical view on luxury and enriches the discussion in the marketing and business-related literature with the perspectives of philosophy, sociology and other disciplines, linking the phenomenon to resonance theory and the notions of rebellion and escape. The paper suggests new ways of intellectually, scientifically and commercially engaging with the notion luxury and aims at serving as a springboard for further research.
Preferred local electrical heating and its effect on overall thermal response
Authors: Chen Xue , Zhang Zhaohua , Yang Yutong
Published: September 2022

Purpose

The purpose of this paper is to explore the distribution of local thermal sensitivity of human body heating and the local preferred heating temperature, and the influence of this sensitive division on thermal response when heating human body in cold environment.

Design/methodology/approach

Eight subjects were invited to use carbon fiber heating patches in an environment of 5 and RH 50%, and eight body parts were selected to explore the heating sensitivity. By measuring the skin temperature and evaluating the subjective thermal sensation and thermal comfort, the thermal sensitivity of local body segments and the influence of single-zone and double-zone heating on human thermal response were explored.

Findings

The sensitivity of local heating on overall thermal sensation (OTS) was foot > back > chest > abdomen > waist > elbow > hand > knee. Both single-zone and double-zone heating can improve the OTS, but double-zone heating can reach thermal neutrality and thermal comfort. In order to prevent the high temperature of heating patches from damaging human body, the local skin temperature should be monitored in the design of local heating clothing, and 39.6 should be taken as the upper limit of local skin temperature.

Originality/value

The results provide a theoretical basis for the selection of heating position in local electric heating clothing (EHC) and the design of intelligent temperature adjustment heating clothing, improve the performance of local EHC and reduce energy consumption.