bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Movement Theory
Authors: Briscoe Forrest , Rheinhardt Alexandra
Published: September 2020

This article offers an annotated bibliography of selected research linking social movements to the study of organizations and management. Social activists frequently target organizations, like corporations and universities, in an attempt to bring about changes related to social issues such as inequality, climate change, and human rights. Such activists are often members of social movement organizations, with no direct connection to the targeted organization; however, at other times the activists are employees seeking to drive change from within the targeted organization. Either way, activism can involve a spectrum of different protest or influence tactics leveled at the targeted organization, from disruptive product boycotts and employee sit-ins to more persuasion-oriented letter-signing campaigns and boardroom presentations. As activists and organizations respond to one another over time, their interactions may come to incorporate both coercive pressures and cooperative dimensions. Organizations and wider fields and markets can also be more indirectly influenced by activism, as organizational decision makers observe and respond to activist-induced changes taking place in their environments. For example, activists sometimes effect change in a small set of influential organizations, which then helps convince the wider field to follow suit. Overall, research at the nexus of social movements and organization studies has benefited from foundational work in sociology and political science that highlights the role of collective action in empowering social movements. Below, after discussing seminal works, reading suggestions are organized along two dimensions: (a) Outcomes of Social Movements and (b) activist behavior and social movement processes. Of course, many works contribute along both dimensions, but are only listed once for brevity.
Evolution of Mutualism
Authors: Bronstein Judith
Published: September 2020

Mutualisms, interactions between two species that benefit both, have long captured the public imagination. Humans are undeniably attracted to the idea of cooperation in nature. For thousands of years we have been seeking explanations for its occurrence in other organisms, often imposing our own motivations and mores in an effort to explain what we see. However, the importance of mutualisms lies much deeper than simply providing material for philosophical treatises and natural history documentaries. The influence of mutualisms transcends levels of biological organization from cells to populations, communities, and ecosystems. Mutualisms were key to the origin of eukaryotic cells and perhaps to the invasion of the land. Mutualisms occur in every aquatic and terrestrial habitat; indeed, ecologists now believe that almost every species on Earth is involved directly or indirectly in one or more of these interactions. Mutualisms are crucial to the reproduction and survival of many plants and animals and to nutrient cycles in ecosystems. Moreover, the ecosystem services mutualists provide (e.g., seed dispersal, pollination, and carbon, nitrogen, and phosphorus cycles resulting from plant-microbe interactions) are leading to these interactions increasingly being considered conservation priorities, while acute risks to their ecological and evolutionary persistence are being identified. The field of evolution came very late to the study of mutualism. Charles Darwin clearly recognized that it posed an evolutionary puzzle: In The Origin of Species, he wrote, “If it could be proved that any part of the structure of any one species had been formed for the exclusive good of another species, it would annihilate my theory, for such could not have been produced through natural selection.” The past 150 years have been devoted to trying to solve the challenge that Darwin posed to us.
Fully Endoscopic Resection of an Epidermoid Cyst of the Cerebellopontine Angle: Bilateral Resection via a Unilateral Approach
Authors: Gopakumar Sricharan , Srinivasan Visish M , Sharma Himanshu , Cherian Jacob , Patel Akash J
Published: September 2020

BACKGROUND AND IMPORTANCE

Epidermoid cysts are rare, benign intracranial neoplasms that typically arise at the cerebellopontine angle (CPA) and can be extensive lesions that intricately involve many critical neurovascular structures. We describe the case of a patient who presents with the classic picture of CPA epidermoid cyst and describe the value of the 4K endoscope for resection, which is illustrated in our accompanying surgical video.

CLINICAL PRESENTATION

The patient presents with headache, nausea, and vomiting accompanied by dizziness and balance issues. Radiographic imaging demonstrated a large lesion highly consistent with epidermoid cyst which involved the left CPA, encircled the basilar artery, and extended to the opposite side. Surgery was planned with a small left-sided retrosigmoid craniotomy with use of a 2-dimensional 4K endoscope to aid in resection, particularly of the contralateral side. This approach was successful with gross total resection apparent at 14-mo follow-up.

CONCLUSION

We describe the use of a fully endoscopic technique from a unilateral approach for resection of a lesion that extended in the CPA bilaterally. Additionally, we highlight the relevant neuroanatomical and neurovascular structures in this highly critical intracranial region which is well-visualized through endoscopy in the associated surgical video.
Engineering therapeutic antibodies for patient safety: tackling the immunogenicity problem
Authors: Ulitzka Michael , Carrara Stefania , Grzeschik Julius , Kornmann Henri , Hock Björn , Kolmar Harald
Published: September 2020

Established monoclonal antibodies (mAbs) allow treatment of cancers, autoimmune diseases and other severe illnesses. Side effects either arise due to interaction with the target protein and its biology or result from of the patient’s immune system reacting to the foreign protein. This immunogenic reaction against therapeutic antibodies is dependent on various factors. The presence of non-human sequences can trigger immune responses as well as chemical and post-translational modifications of the antibody. However, even fully human antibodies can induce immune response through T cell epitopes or aggregates. In this review, we briefly describe, how therapeutic antibodies can interact with the patient’s immune system and summarize recent advancements in protein engineering and in silico methods to reduce immunogenicity of therapeutic monoclonal antibodies.
The Effect of Bank Supervision and Examination on Risk Taking: Evidence from a Natural Experiment
Authors: Kandrac John , Schlusche Bernd
Published: September 2020

We exploit an exogenous reduction in bank supervision and examination to demonstrate a causal effect of supervisory oversight on financial institutions’ risk taking. The additional risk took the form of risky lending, faster asset growth, and a greater reliance on low-quality capital. This response to less oversight boosted banks’ odds of failure. Lastly, we show that the reduction in oversight capacity led to more costly failures because there were longer delays in closing insolvent institutions, and because more bad assets were passed to the government insurance fund.
Feeding behavior of growing and finishing pigs fed different dietary threonine levels in a group-phase feeding and individual precision feeding system
Authors: Remus Aline , Hauschild Luciano , Létourneau-Montminy Marie-Pierre , Andretta Ines , Pomar Candido
Published: September 2020

Feeding behavior is an important aspect of pig husbandry as it can affect protein deposition (PD) in pigs. A decrease in plasma threonine (Thr) levels may influence feed intake (FI) due to amino acid imbalance. We set out to study whether different Thr inclusion rates of 70%, 85%, 100%, 115%, and 130% of the ideal Thr:lysine (Lys) ratio of 0.65 in two different feeding programs (individual precision feeding and group-phase feeding could affect pig feeding behavior and consequently PD. Two 21-d trials were performed in a 2 × 5 factorial setup (feeding systems × Thr levels) with 110 pigs in the growing phase [25.0 ± 0.8 kg of body weight (BW)] and 110 pigs in the finishing phase (110.0 ± 7.0 kg BW), which correspond to 11 pigs per treatment in each trial. Pigs were housed in the same room and fed using computerized feeding stations. The total lean content was estimated by dual x-ray absorptiometry at the beginning (day 1) and the end (day 21) of the trial. Multivariate exploratory factor analysis was performed to identify related variables. Confirmatory analysis was performed by orthogonal contrasts and Pearson correlation analysis. Graphical analysis showed no difference in feeding patterns between feeding systems during the growing or finishing phase. Pigs exhibited a predominant diurnal feeding, with most meals (73% on average) consumed between 0600 and 1800 h. Exploratory factor analysis indicated that feeding behavior was not related to growth performance or PD in growing or finishing pigs. Changes in feeding behavior were observed during the growing phase, where increasing dietary Thr resulted in a linear increase in the FI rate (P < 0.05). During the finishing phase, the duration of the meal and FI rate increased linearly as dietary Thr increased in the diet (P < 0.05). These changes in feeding behavior are, however, correlated to BW. In conclusion, the exploratory factor analysis indicated that feeding behavior had no correlation with growth performance or protein and lipid deposition in growing or finishing pigs. Dietary Thr levels and feeding systems had no direct effect on FI.
Self-Regulations for Educators Questionnaire (SREQ) for implementation programming
Authors: Vazou Spyridoula , Bai Yang , McLoughlin Gabriella M , Welk Gregory J
Published: September 2020

The adoption and dissemination of evidence-based programs is predicated on multiple factors, including the degree to which key stakeholders are motivated to implement program best practices. The present study focuses on the development of indicators that capture motivations of teachers to adopt school wellness programming since personal motivations are central to achieving sustainable impacts in these settings. The study specifically describes the measurement development and validation of the Self-Regulations for Educators Questionnaire (SREQ), designed to measure educators’ autonomous and controlled motivation for adopting evidence-based programming in their schools. A naturalistic design to study motivation to adopt aspects of NFL PLAY60 programming through the NFL PLAY60 FitnessGram Partnership Project was used. A total of 1,106 teachers completed the SREQ online. Internal validity was assessed through exploratory and confirmatory factor analysis, and predictive validity using structural equation modeling (SEM). The results supported the two-factor solution with separate items capturing aspects of autonomous and controlled motivation. Both factors had good internal reliability and the item-total correlation coefficients were above 0.40 for both factors. The results also supported the predictive validity as autonomous motivation positively predicted the level of overall engagement, teaching effectiveness, fitness testing reports sent home, and completion of fitness testing with students (p < .05). Controlled motivation positively predicted whether the teachers conducted fitness testing and the engagement of Play 60 Challenge (p < .05). Findings suggest that the SREQ displays a number of psychometric characteristics that make the instrument useful for examining motivation of providers to implement evidence-based best practices.
Le silence et le contrat : la consécration d’un antagonisme par le droit OHADA
Authors: Paul Francis Ohandja
Published: September 2020

En théorie générale, la relation entre le silence et le contrat est querellée. Une partie de la doctrine y voit une ambivalence tandis qu’une autre préfère parler de contradiction. À la lecture des contrats OHADA, nous retenons plutôt dans cette relation la consécration d’un antagonisme. Le silence entendu comme le fait de ne rien dire, de ne pas agir, l’absence ou l’omission de mentions ou de formalités dans un acte est inopérant lors de la formation du contrat envisagé comme le lieu et le moyen d’expression substantielle et formelle des volontés. Cette position est consacrée de façon explicite par le législateur OHADA. Seulement, après formation du contrat, le silence devient opérant sur les plans objectif et subjectif. Le législateur OHADA consacre cette seconde position de façon implicite. Au fond, il ne s’agit donc que d’un antagonisme apparent qui permet en réalité de mieux comprendre le régime des contrats OHADA.
New Indication for Cancer-Fighting Drug
Authors: Aschenbrenner Diane S.
Published: September 2020

Atezolizumab (Tecentriq) is now approved for treating patients with BRAF V600 mutation-positive unresectable or metastatic melanoma in combination with cobimetinib and vemurafenib.
Every Front Line Has a Back Line: What Nursing Can Learn from Rugby
Authors: Feury Tess
Published: September 2020

Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely—and often more personal—perspectives on professional, policy, and clinical issues. Best of the Blog is a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.
Improving Quiet at Night on a Telemetry Unit: Introducing a Holistic Sleep Menu Intervention
Authors: Antonio Christian Karl
Published: September 2020

In a patient's recovery process, restful sleep is crucial. Although the essential role of sleep in healing has long been recognized, excessive noise in hospital environments remains a persistent and pervasive problem. For hospitalized patients, environmental noise can result in sleep deprivation and adverse health outcomes; not surprisingly, hospital noise ranks as a major patient complaint. At a small suburban community hospital, patients responding to a quiet-at-night question in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey gave the hospital's telemetry unit the lowest possible score: 1 out of 5 points. In response, the unit's quality improvement team, coordinated by a clinical nurse leader, introduced a holistic “sleep menu” intervention. The multicomponent intervention subsequently improved patients' care experience and staff engagement. The percentage of patients who self-reported five or more hours of uninterrupted sleep rose from 31% at baseline to 80% during the intervention. This improvement was sustained over the three-month intervention period and led to a quiet-at-night HCAHPS score of 4. The sleep menu initiative resulted in substantial benefits that optimized both patient and organizational outcomes.
Vaccine Hesitancy is Prevalent Among U.S. Parents
Authors: Rosenberg Karen
Published: September 2020

According to this study:

Parental hesitancy about vaccines, especially influenza vaccine, is prevalent in the United States.

In a survey of families of children between six months and less than 18 years of age, the prevalence of hesitancy regarding routine childhood vaccines was 6.1%. For the influenza vaccine, it was 25.8%.
Control of Systemic Iron Homeostasis by the 3’ Iron‐Responsive Element of Divalent Metal Transporter 1 in Mice
Authors: Tybl Elisabeth , Gunshin Hiromi , Gupta Sanjay , Barrientos Tomasa , Bonadonna Michael , Celma Nos Ferran , Palais Gael , Karim Zoubida , Sanchez Mayka , Andrews Nancy C. , Galy Bruno
Published: September 2020

Supplemental Digital Content is available in the text
A Phase 2 Study of Nivolumab Using a Fixed Dose of 40 mg (Nivo40) in Patients With Relapsed/Refractory Hodgkin Lymphoma
Authors: Lepik Kirill V. , Fedorova Liudmila V. , Kondakova Elena V. , Zalyalov Yuri R. , Babenko Elena V. , Lepik Elena E. , Kotselyabina Polina V. , Beynarovich Anastasia V. , Popova Marina O. , Volkov Nikita P. , Stelmakh Lilia V. , Baykov Vadim V. , Moiseev Ivan S. , Mikhailova Natalia B. , Kulagin Alexander D. , Afanasyev Boris V.
Published: September 2020

Supplemental Digital Content is available in the text
Kirner's deformity of the fifth finger
Authors: Tianxiao Ma , Wang Dongyue , Song Lihua
Published: September 2020

Rationale:

Kirner's deformity is an uncommon deformity of finger, characterized by palmo-radial curvature of distal phalanx of the fifth finger. The specific mechanism remains unknown yet. This study aims to present a case report to add the knowledge on this type of deformity.

Patient concerns:

A 9-year-old girl presenting with deformity of her fifth finger since she was born was admitted to our hand surgery clinic. MRI findings showed widened epiphyseal plate, L-shaped physis, but normal flexor digitorum profundus tendon insertion, without any significantly enhanced soft issues.

Diagnosis:

Kirner's deformity of the fifth finger.

Interventions:

We presented 2 surgical choices for the patient: one was wedge osteotomy of the distal phalanx to correct the mechanical line of the distal phalanx and fixation with Kirschner wire and the other one was cut-off of deep flexor tendon insertion with brace immobilization, but her guardians refused either of them.

Outcomes:

Consecutive follow-up was performed for 19 months after the first visit, showing no any change in finger shape and function.

Lessons:

The L-shaped epiphyses may be the cause of Kirner's deformity and further attention should be paid on in the clinic. This case report provided a basis for the etiological diagnosis and future treatment of Kirner's deformity.
Acupotomy for patients with tarsal tunnel syndrome
Authors: Sun Xiaojie , Zhou Qiaoyin , Shi Chong , Lan Yangjing , Jia Yan , Qiu Zuyun , Shen Yifeng , Li Shiliang
Published: September 2020

Background:

Tarsal tunnel syndrome (TTS) is a painful condition of the ankle that affects patients’ quality of life and ability to work. Multiple clinical studies of nerve decompression by acupotomy have been published in China, and the results are encouraging. However, the efficacy and security of this treatment have not been evaluated scientifically and systematically. The purpose of this systematic review protocol is to evaluate the efficacy and security of acupotomy treatment in patients with TTS, which will be helpful to clinical acupotomy doctors.

Methods:

Relevant randomized controlled trials will be identified by searching 9 databases (PubMed, Embase, Cochrane Library, Chinese literature databases, the Chinese Biomedical Literature Database, China National Knowledge Infrastructure, SinoMed, Technology Journal and the Wanfang Database. Randomized controlled trials examining the use of acupotomy for TTS patients will be identified independently by 2 reviewers by searching the databases from inception to March 2020. Clinical effects will be evaluated as the primary outcome. Visual analog scale scores will be assessed as a secondary outcome. Review Manager 5.3 will be used to perform a fixed effects meta-analysis, and the evidence level will be evaluated by using the Grading of Recommendations Assessment, Development, and Evaluation framework. Continuous outcomes will be presented as mean differences or standard mean differences, while dichotomous data will be expressed as relative risks.

Results:

This study will evaluate the effectiveness and safety of acupotomy in the treatment of TTS in randomized controlled trials with high-quality visual analog scale and Roles and Maudsley score.

Conclusion:

This systematic review will provide evidence to determine whether acupotomy is an effective intervention for patients with TTS.

Registration number:

DOI 10.17605/OSF. IO/9PYC2 (https://osf.io/9pyc2/)
Diagnosis of multiple pulmonary cavernous hemangiomas via dual-layer spectral CT
Authors: Bae Kyungsoo , An Hyo Jung , Jung Jae Jun , Kim Ho Cheol , Jeon Kyung Nyeo
Published: September 2020

Rationale:

Cavernous hemangioma is a benign vascular tumor, which very rarely occurs in the lung. When appearing as multiple nodules on chest CT, this tumor can be misdiagnosed as metastatic malignancy.

Patient concerns:

A 72-year-old woman presented with incidentally found multiple lung nodules on chest radiograph.

Diagnoses:

Based on information derived from dual-layer spectral CT images, the possibility of slow flow vascular tumor such as cavernous hemangioma was suggested. A pathologic diagnosis of pulmonary cavernous hemangioma was made via video-assisted thoracoscopic biopsy.

Interventions:

After tissue confirmation, the patient was discharged without further intervention.

Outcomes:

The patient recovered without any event. Follow-up chest CT performed 6 months later showed no significant interval change in nodule size and distribution.

Lessons:

Material decomposition images obtained from dual energy CT can help physicians understand the character of tumor vascularity for an accurate diagnosis of pulmonary cavernous hemangioma.
(Poly)Phenol Metabolism
Authors: Cladis Dennis P. , Weaver Connie M. , Ferruzzi Mario G.
Published: September 2020

Fruit- and vegetable-derived (poly)phenols have long been lauded for their potential health benefits in humans. Given their ubiquity and diversity in the diet, fully understanding the mechanisms responsible for their health effects is challenging. In light of this, many investigators have sought to understand the absorption, distribution, metabolism, and excretion (ADME) of (poly)phenols, with many now attributing their health effects to the (poly)phenolic metabolites formed within the gastrointestinal tract itself. In addition, given the recognition of the gut microbiome as an important contributor to both (poly)phenol metabolism and overall health status, recent years have seen a flurry of research activity aimed at understanding the bidirectional relationship between bioactive (poly)phenols and the gut microbiota. The goal of this review is to provide practitioners with a rudimentary understanding of how (poly)phenols are processed throughout the body, with a focus on their gut microbial metabolism. Understanding (poly)phenol metabolism is key to identifying the phenolic metabolites in systemic circulation that are ultimately responsible for the health effects derived from these dietary bioactives.
How Community Health Workers Can Improve Workforce Diversity and Dietary Outcomes
Authors: Burt Kate G. , Sisselman-Borgia Amanda
Published: September 2020

This article describes the role of community health workers (CHWs), explores how and why CHWs are used in nutrition education to improve patient outcomes, examines the potential of using CHWs to diversify the credentialed workforce, and identifies challenges to incorporating more CHWs into nutrition programs.
Objective and Subjective Evaluation of Clinical Performance of Scleral Lens with Varying Limbal Clearance in Keratoconus
Authors: Yeung Debby , Murphy Paul J. , Sorbara Luigina
Published: September 2020

SIGNIFICANCE

This study evaluates how limbal clearance (LC) may impact the clinical performance of scleral lenses based on subjective response on comfort and ocular responses. Limbal zone designs in scleral lenses might affect the integrity of the limbal epithelial tissue as a result of a combined hypoxic and compression-related etiology.

PURPOSE

This study aimed to investigate the clinical performance and ocular and subjective responses to the wear of scleral lenses having varying LC.

METHODS

Lenses with varying LC with a difference of 50 μm were fitted on and compared among keratoconic participants. The lenses were worn during a 2-week period. Visual analog scales concerning subjective comfort were completed. Ocular surface findings including hyperemia, limbal staining, and corneal swelling were compared.

RESULTS

Participants reported greater comfort achieved with high LC. No difference in limbal and bulbar hyperemia was found (P> .05). Corneal response to scleral lens wear with both low and high LCs seems to result in similar perilimbal staining and negative corneal staining. An increase in corneal pachymetric values was noted at the central and peripheral cornea, with no difference between low- and high-LC lenses (all,P< .05). Quadrant-specific analysis indicated that all meridians at both 6 and 8 mm were increased for the low-LC lenses (all,P< .05) and only the temporal region for the high-LC lenses (P= .02).

CONCLUSIONS

Limbal clearance may play an important role in subjective performance in scleral lenses but does not impact the degree of hyperemia in either the limbal or bulbar region. Although low LC might result in more compression-related changes to ocular surface, high LC is associated with greater comfort and greater edematous changes. Limbal zone designs in scleral lenses might affect the integrity of the limbal epithelial tissue as a result of a combined hypoxic and compression-related etiology.
Application of a Hybrid Method for Performance Evaluation of Teaching Hospitals in Tehran
Authors: Firouzi Jahantigh Farzad , Ostovare Maryam
Published: September 2020

Background and Objectives:

Teaching hospitals often face budget limitations and lack of investment. Therefore, the optimal allocation of budget and resources plays an important role in improving the performance and service quality of these hospitals. This research aims to evaluate the performance and determine the efficiency of medical science university hospitals in Tehran.

Methods:

This study identified and categorized 47 effective factors in the performance assessment of hospital units using the Preference Ranking Organization METHod for Enrichment of Evaluation II (PROMETHEE II) method. Moreover, the performance of 40 medical science university hospitals in Tehran was evaluated using an outcome-based model of data envelopment analysis (DEA) with 4 input and 8 output factors and the assumption of scale-dependent efficiency. The hospitals were also ranked according to the Andersen-Petersen (AP) method.

Results:

PROMETHEE II results identified 12 factors as the most important in hospital performance evaluation. DEA indicated that 16 hospitals had performance scores below 1 and are thus inefficient. The AP method identified Hospital 28, which had an efficiency value of 4.533, as the best hospital.

Conclusion:

Given the results of this approach and the identification of a considerable number of teaching hospitals as inefficient hospitals, top managers of medical centers must adopt the necessary planning to improve system performance and realize the optimal application of resources.
Addressing Behavioral Health Concerns in Trauma: Using Lean Six Sigma to Implement a Depression Screening Protocol in a Level I Trauma Center
Authors: Moran Mary E. , Sedorovich Ashley , Kish Jamie , Gothard Andrew , George Richard L.
Published: September 2020

Background:

Patients with physical injuries or chronic conditions may be impacted by mental health conditions, which significantly affect their participation and progress in treatment. The Patient Health Questionnaire-2 (PHQ-2) depression screening can identify patients who are at greatest risk for depression to provide better whole-person care.

Objective:

The quality improvement project objective was to identify and design a process that would result in the PHQ-2 depression screening for admitted trauma patients with a minimum 75% completion rate.

Methods:

Lean Six Sigma (LSS) process design methodology, DMADV (define, measure, analyze, design, and verify), drove process improvement. Medical records from before (December 2018 through February 2019) and after (March 2019 through May 2019) the intervention were evaluated using frequencies, percentages, χ2, and multivariable logistic regression to determine the effectiveness of the intervention.

Results:

PHQ-2 document location was imperative to successful compliance, which increased from 60.74% (78 of 128) to 80.56% (87 of 108). Specifically, weekend compliance increased from 42.9% (18 of 42) to 82.8% (24 of 29).

Conclusion:

LSS DMADV methodology helped health care professionals design a process to facilitate compliance with the PHQ-2 depression screening protocol in trauma patients. Adherence with this screening can help increase the number of behavioral health consultations, which in turn improves the treatment of traumatic injury survivors.
Using Failure Mode and Effects Analysis in Blood Administration Process in Surgical Care Units: New Categories of Errors
Authors: Aly Nagah Abd El-fattah Mohamed , El-Shanawany Safaa M. , Maher Ghoneim Tamer A.
Published: September 2020

Background:

Blood administration failures and errors have been a crucial issue in health care settings. Failure mode and effects analysis is an effective tool for the analysis of failures and errors in such lifesaving procedures. These failures or errors would lead to adverse outcomes for patients during blood administration.

Objectives:

The study aimed to: use health care failure mode and effect analysis (HFMEA) for assessing potential failure modes associated with blood administration processes among nurses; develop a categorization of blood administration errors; and identify underlying reasons, proactive measures for identified failure modes, and corrective actions for identified high-risk failures.

Methods:

A cross-sectional descriptive study was conducted in surgical care units by using observation, HFMEA, and brainstorming techniques. Prioritization of detected potential failures was performed by Pareto analysis.

Results:

Eleven practical steps and 38 potential failure modes associated with 11 categories of errors were detected in this process. These categories of errors were newly developed in this study. In total, 17 of 38 potential failures were detected as high-risk failures that occurred during the sample-drawing, checking, preparing, administering, and monitoring steps. For cause analysis of failures and errors, proactive suggested actions were undertaken for 38 potential failure modes, and corrective actions for 17 high-risk failures.

Conclusion:

HFMEA is an efficient and well-organized tool for identification of and reduction in high-risk failures and errors in the blood administration process among nurses without building punitive culture. This tool also helps pay attention to redesigning and standardizing the blood administration process as well as providing training and educational programs for providing knowledge.
Preparation and physicochemical quality characteristics of salted
kimchi cabbage using high-hydrostatic-pressure salting process
Authors: Choi Eun Ji , Lee Jeong Hyeon , Son Jae Yong , Park Chun Wan , Chun Ho Hyun
Published: September 2020

The effects of high-hydrostatic-pressure (HHP) conditions on the physicochemical
quality and histological changes in kimchi cabbage (Brassica
rapa L. ssp. pekinensis) during salting were
investigated. The salinity and electrical conductivity of shred-type kimchi
cabbage salted for 5 min with 15% brine at 200 MPa were 2.52% and
36.25 S/m, respectively, which were 2.8 and 2.3 times higher than those
associated with shred-type control. The solid gain and water loss of kimchi
cabbage samples during HHP salting increased with the NaCl concentration in the
brine and the pressure levels, irrespective of the type of kimchi cabbage. After
salting at 50 to 200 MPa, the moisture content and whiteness index of the
shred-type samples were significantly (p<0.05) reduced compared to those
of the shred-type control. However, no significant differences (p>0.05)
were observed among the instrumental firmness of kimchi cabbage samples salted
with 12 and 15% brines at 50, 100, and 200 MPa. During HHP salting, brine
containing neutral red rapidly penetrated and stained the structurally deformed
or damaged cells in the cabbage. These results indicate that the time required
to prepare salted kimchi cabbage can be shortened using HHP salting.
Characteristics of fermented vinegar using mulberry and its
antioxidant activity
Authors: Bang Se-In , Gwon Geon Hyeong , Cho Eun Ju , Lee Ah Young , Seo Weon Taek
Published: September 2020

This study was carried out to investigate the physicochemical characteristics and
antioxidant properties of mulberry juice (MJ) and mulberry vinegar (MV). MV,
with acidity of 6.05% and a pH 3.06, was obtained from MJ after 8 days
with alcohol fermentation and 20 days with acetic acid fermentation at
30°C. After fermentation, the major sugars in MV were lactose, glucose,
and fructose, showing 1,310.06, 293.20, and 41.25 mg%, respectively. The
major organic acids in MV were acetic acid (2,725.59 mg%), citric acid
(524.66 mg%), and succinic acid (480.63 mg%). The total free amino
acid content of MV, such as lysine, arginine, phenylalanine, and tyrosine, was
34.52 mg%. MJ and MV showed radical scavenging activities with respect to
1,1-diphenyl-2-picrylhydrazyl (DPPH), hydroxyl (OH), superoxide anion
(O2−), and nitric oxide (NO) radicals in
dose-dependent manner, which were closely related to the total polyphenol and
flavonoid contents in MJ and MV. In addition, a strong scavenging effect with
regards to the OH radical was observed in MJ and MV, an IC50 value of
0.04 μg/mL. In particular, MV showed a higher
O2− radical scavenging activity than that of
MJ. These results suggest that MV can be used as a functional vinegar with
antioxidant activity against free radicals.
CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF COVID-19 PATIENTS IN LAGOS, NIGERIA: A DESCRIPTIVE STUDY
Authors: Otuonye Ngozi Mirabel , Olumade Testimony Jesupamilerin , Ojetunde Mercy Mayowa , Holdbrooke Susan Abba , Ayoola Joy Boluwatife , Nyam Itse Yusuf , Iwalokun Bamidele , Onwuamah Chika , Uwandu Mabel , Salako Babatunde Lawal , Abayomi Akinola , Osibogun Akin , Bowale Abimbola , Osikomaiya Bodunrin , Thomas Babafemi , Mutiu Bamidele , Odunukwe Nkiruka Nnonyelum
Published: September 2020

Introduction

COVID-19 is an emerging, rapidly evolving global situation, infecting over 25 million people and causing more than 850,000 deaths. Several signs and symptoms have been described to be characteristic of the disease. However, there is a dearth of report on the description of the clinical characteristics of the disease in patients from Nigeria. This study was designed to provide a description of the clinical and demographic characteristics of COVID-19 patients in Nigeria.

Methods

This study is a case series that includes patients that are evaluated between June and August 30, 2020, and diagnosed with COVID-19. Patient health records were reviewed and evaluated to describe the clinical characteristics on presentation.

Results

A total of 154 COVID-19 patients were included in this study, with a mean age (S.D.) of 46.16 (13.701). Most of the patients survived (mortality rate of 2.6%), and were symptomatic (89.6%). There were more males (74.7%) than females, and the most common symptoms were fever, breathing difficulty, dry cough and malaise. Co-morbidities were also present in almost half of the study participants (49.4%).

Conclusion

This study presents the most extensive description, to date, on the clinical and demographic characteristics of COVID-19 patients in Nigeria. Males are more likely than females to be infected with COVID-19 and the most occurring symptoms are fever, breathing difficulty, malaise, dry cough and chest pain. Old age and the presence of co-morbidities may also be associated with developing the severe disease.
Cannabis use and risk of type 2 diabetes: a two-sample Mendelian randomization study
Authors: Baumeister Sebastian-Edgar , Nolde Michael , Alayash Zoheir , Leitzmann Michael , Baurecht Hansjörg , Meisinger Christa
Published: September 2020

Cannabis has effects on the insulin/glucose metabolism. As the use of cannabis and the prevalence of type 2 diabetes increase worldwide, it is important to examine the effect of cannabis on the risk of diabetes. We conducted a Mendelian randomization study by using 19 single-nucleotide polymorphisms as instrumental variables for lifetime cannabis use and 14 SNPs to instrument cannabis use disorder, and linking these to type 2 diabetes risk using genome-wide association study data (lifetime cannabis use [N = 184,765]; cannabis use disorder [2,387 cases / 48,985 controls], type 2 diabetes [74,124 cases / 824 controls]). The MR analysis suggested no effect of lifetime cannabis use (inverse variance weighted odds ratio [95% confidence interval] = 1.00 [0.93-1.09], P-value = 0.935) and cannabis use disorder (OR = 1.03 [0.99-1.08]) on type 2 diabetes. Sensitivity analysis to assess potential pleiotropy led to no substantive change in the estimates. This study adds to the evidence base that cannabis use does not play a causal role in type 2 diabetes.
Establishment of multiple novel patient-derived models of desmoplastic small round cell tumor enabling functional characterization of ERBB pathway signaling and pre-clinical evaluation of a novel targeted therapy approach
Authors: Smith Roger S. , Odintsov Igor , Liu Zebing , Lui Allan Jo-Weng , Hayashi Takuo , Vojnic Morana , Suehara Yoshiyuki , Delasos Lukas , Mattar Marissa S. , Hmeljak Julija , Ramirez Hillary A. , Shaw Melissa , Bui Gabrielle , Hartono Alifiani B. , Gladstone Eric , Kunte Siddharth , Magnan Heather , Khodos Inna , De Stanchina Elisa , La Quaglia Michael P. , Yao Jinjuan , Laé Marick , Lee Sean B. , Spraggon Lee , Pratilas Christine A. , Ladanyi Marc , Somwar Romel
Published: September 2020

Desmoplastic small round cell tumor (DSRCT) is characterized by the t(11;22)(p13;q12) chromosomal translocation, which fuses the transcriptional regulatory domain ofEWSR1with the zinc finger DNA-binding domain ofWT1, resulting in the oncogenic transcription factor EWS-WT1. DSRCT primarily affects young males and has a 5-year overall survival of about 15%. Typical treatment approaches for patients with DSRCT involve a multi-modal combination of surgery, chemotherapy and radiation. The paucity of DSRCT disease models has hampered functional and pre-clinical therapeutic studies in this aggressive cancer. Here, we developed robust preclinical disease models and mined DSRCT expression profiling data to identify genetic vulnerabilities that could be leveraged for the identification of rational therapies. Specifically, we developed four new DSRCT cell lines and one patient-derived xenograft (PDX) model. Transcriptomic and proteomic profiling showed evidence of activation of the ERBB pathway. Ectopic expression of EWSR1-WT1 resulted in upregulation of ERRB family ligands and downstream signaling. Treatment of DSRCT cell lines with ERBB ligands resulted in activation of EGFR, ERBB2, ERK1/2 and AKT, and stimulation of cell growth. Conversely, targeting of EGFR using shRNA, small molecule inhibitors (afatinib, neratinib) or an anti-EGFR antibody (cetuximab) inhibited growth and induced apoptosis in DSRCT cells. Finally, treatment of mice bearing DSRCT xenografts with a combination of cetuximab and afatinib significantly reduced tumor growth. These data provide a rationale for the clinical evaluation of EGFR antagonists in patients with DSRCT.
Prospective comparison of saliva and nasopharyngeal swab sampling for mass screening for COVID-19
Authors: Nacher Mathieu , Mergeay-Fabre Mayka , Blanchet Denis , Benois Orelie , Pozl Tristan , Mesphoule Pauline , Sainte-Rose Vincent , Vialette Véronique , Toulet Bruno , Moua Aurélie , Saout MONA , Simon Stéphane , Guidarelli Manon , Galindo Muriel , Biche Barbara , Faurous William , Abad Fanny , Fahrasmane Aniza , Rochemont Devi , Vignier Nicolas , Vabret Astrid , Demar Magalie
Published: September 2020

Current testing for COVID-19 relies on quantitative reverse-transcriptase polymerase chain reaction from a nasopharyngeal swab specimen. Saliva samples have advantages regarding ease and painlessness of collection, which does not require trained staff and may allow self-sampling. We enrolled 776 persons at various field-testing sites and collected nasopharyngeal and pooled saliva samples. 162 had a positive COVID-19 RT-PCR, 61% were mildly symptomatic and 39% asymptomatic. The sensitivity of RT-PCR on saliva samples versus nasopharygeal swabs varied depending on the patient groups considered or on Ct thresholds. There were 10 (6.2%) patients with a positive saliva sample and a negative nasopharyngeal swab, all of whom had Ct values<25. For symptomatic patients for whom the interval between symptoms onset and sampling was <10 days sensitivity was 77% but when excluding persons with isolated Ngen positivity (54/162), sensitivity was 90%. In asymptomatic patients, the sensitivity was only 24%. When we looked at patients with Cts <30, sensitivity was 83% or 88.9% when considering 2 genes. The relatively good performance for patients with low Cts suggests that Saliva testing could be a useful and acceptable tool to identify infectious persons in mass screening contexts, a strategically important task for contact tracing and isolation in the community.
Longitudinal analysis of T-cell receptor repertoires reveals persistence of antigen-driven CD4+ and CD8+ T-cell clusters in Systemic Sclerosis
Authors: Servaas N.H. , Zaaraoui-Boutahar F. , Wichers C.G.K. , Ottria A. , Chouri E. , Affandi A.J. , Silva-Cardoso S. , van der Kroef M. , Carvalheiro T. , van Wijk F. , Radstake T.R.D.J. , Andeweg A.C. , Pandit A.
Published: September 2020

The T-cell receptor (TCR) is a highly polymorphic surface receptor that allows T-cells to recognize antigenic peptides presented on the major histocompatibility complex (MHC). Changes in the TCR repertoire have been observed in several autoimmune conditions, and these changes are suggested to predispose autoimmunity. Multiple lines of evidence have implied an important role for T-cells in the pathogenesis of Systemic Sclerosis (SSc), a complex autoimmune disease. One of the major questions regarding the roles of T-cells is whether expansion and activation of T-cells observed in the diseases pathogenesis is (auto)antigen driven.

To investigate the temporal TCR repertoire dynamics in SSc, we performed high-throughput sequencing of CD4+ and CD8+ TCRβ chains on longitudinal samples obtained from four SSc patients collected over a minimum of two years. Repertoire overlap analysis revealed that samples taken from the same individual over time shared a high number of TCRβ sequences, indicating a clear temporal persistence of the TCRβ repertoire in CD4+ as well as CD8+ T-cells. Moreover, the TCRβs that were found with a high frequency at one time point were also found with a high frequency at the other time points (even after almost four years), showing that frequencies of dominant TCRβs are largely consistent over time. We also show that TCRβ generation probability and observed TCR frequency are not related in SSc samples, showing that clonal expansion and persistence of TCRβs is caused by antigenic selection rather than convergent recombination. Moreover, we demonstrate that TCRβ diversity is lower in CD4+ and CD8+ T-cells from SSc patients compared to healthy memory T-cells, as SSc TCRβ repertoires are largely dominated by clonally expanded persistent TCRβ sequences. Lastly, using “Grouping of Lymphocyte Interactions by Paratope Hotspots” (GLIPH2), we identify clusters of TCRβ sequences with homologous sequences that potentially recognize the same antigens and contain TCRβs that are persist in SSc patients.

In conclusion, our results show that that CD4+ and CD8+ T-cells are highly persistent in SSc patients over time, and this persistence is likely a result from antigenic selection. Moreover, persistent TCRs form high similarity clusters with other (non-)persistent sequences, that potentially recognize the same epitopes. These data provide evidence for an (auto-)antigen driven expansion of CD4/CD8+ T-cells in SSc.
Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes
Authors: Batra Mayank , Tian Runxia , Zhang Chongxu , Clarence Emile , Sacher Camila Sofia , Miranda Justin Nestor , De La Fuente Justin Rafa O , Mathew Megan , Green Desmond , Patel Sayari , Bastidas Maria Virginia Perez , Haddadi Sara , Murthi Mukunthan , Gonzalez Miguel Santiago , Kambali Shweta , Santos Kayo H M , Asif Huda , Modarresi Farzaneh , Faghihi Mohammad , Mirsaeidi Mehdi
Published: September 2020

The Nucleocapsid Protein (N Protein) of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) is located in the viral core. Immunoglobulin G (IgG) targeting N protein is detectable in the serum of infected patients. The effect of high titers of IgG against N-protein on clinical outcomes of SARS-CoV2 disease has not been described. We studied 400 RT-PCR confirmed SARS-CoV2 patients to determine independent factors associated with poor outcomes, including MICU admission, prolonged MICU stay and hospital admissions, and in-hospital mortality. We also measured serum IgG against the N protein and correlated its concentrations with clinical outcomes. We found that several factors, including Charlson comorbidity Index (CCI), high levels of IL6, and presentation with dyspnea were associated with poor clinical outcomes. It was shown that higher CCI and higher IL6 levels were independently associated with in-hospital mortality. Anti-N protein IgG was detected in the serum of 55 (55%) patients at the time of admission. A high concentration of antibodies, defined as signal to cut off ratio (S/Co)> 1.5 (75 percentile of all measurements), was found in 25 (25%) patients. The multivariable logistic regression models showed that between being an African American, higher CCI, lymphocyte counts, and S/Co ratio> 1.5, only S/Co ratio were independently associated with MICU admission and longer length of stay in hospital. This study recommends that titers of IgG targeting N-protein of SARS-CoV2 at admission is a prognostic factor for the clinical course of disease and should be measured in all patients with SARS-CoV2 infection.