bluuebunny/crossref_metadata_2025 huggingface dataset:
The savvy and cheerful employee innovation champions: The roles of political skill and trait‐positive affect in employees' championing and salary levels
Authors: Jønsson Thomas Faurholt , Kähler Helena Grøn
Published: April 2022

As successful innovations depend on how much support an innovation can receive, champion and promote, role theories have investigated characteristics of certain individuals, who promote innovations. Taking an employee‐driven innovation approach, this study enlarges the lens to also include nonmanagerial employees. Compared with champions and people in promotor roles, nonmanagerial employees' championing has received little attention in research. We help in filling this gap by analysing longitudinal questionnaire data from 152 employees from a Danish branch of a global IT consultancy company, who replied to all three questionnaire waves. We investigated how stable championing is across time and examined the relationship between political skills, positive affect, championing behaviour and employee salary level. The findings reveal that employees' level of championing is rather stable. Moreover, the higher level of political skill employees report to have, the more they engage in championing. High levels of positive affect strengthen this relationship between political skill and championing. Additionally, the results reveal a relationship between the level of championing behaviour and the employee's salary band level. This study adds to the extant research in champion and promoter role theories by showing that a sociopolitical approach is also relevant for a broader range of employees.
Extracellular ATP promotes angiogenesis and adhesion of TNBC cells to endothelial cells via upregulation of CTGF
Authors: Zhou Yan‐Ting , Yu Yu‐Qing , Yang Hui , Yang Han , Huo Yan‐Fei , Huang Yang , Tian Xin‐Xia , Fang Wei‐Gang
Published: April 2022

Our previous works have indicated that extracellular ATP is an important prometastasis factor. However, the molecular mechanism involved needs to be further studied. We demonstrated that extracellular ATP treatment could upregulate the expression of connective tissue growth factor (CTGF) in both triple‐negative breast cancer (TNBC) cells and endothelial cells (ECs). Extracellular ATP stimulated the migration of TNBC cells and ECs, and angiogenesis of ECs via the P2Y2––YAP‐CTGF axis. Furthermore, we demonstrated that adenosine triphosphate (ATP) stimulated TNBC cell adhesion to ECs and transmigration through the EC layer via CTGF by upregulation of integrin β1 on TNBC cells and VCAM‐1 on ECs. Both apyrase (ATP‐diphosphohydrolase) and CTGF shRNA treatments could inhibit the metastasis of inoculated tumors to lung and liver in a mouse model, and these treated tumors had fewer blood vessels. Collectively, our data indicated that extracellular ATP promotes tumor angiogenesis and the interactions between TNBC cells and ECs through upregulation of CTGF, thereby stimulating TNBC metastasis. The pleiotropic effects of ATP in angiogenesis and cell adhesion suggest that extracellular ATP or CTGF could be an effective target for TNBC therapy.
Is it safe to expand the indications for split liver transplantation in adults? A single‐center analysis of 155 in‐situ splits
Authors: Lau Ngee‐Soon , Ly Mark , Liu Ken , Majumdar Avik , Strasser Simone I. , Biswas Raaj K. , McCaughan Geoffrey W. , Crawford Michael , Pulitano Carlo
Published: April 2022

Introduction

Split liver transplantation (SLT) enables two recipients to be transplanted using a single donor liver; typically, an adult and a child. Despite equivalent long‐term outcomes to whole grafts in selected adults, the use of these grafts in high‐risk adult recipients with high model for end‐stage liver disease (MELD) scores (≥30), a poor pre‐transplant clinical status (ICU or hospital‐bound), acute liver failure or retransplantation remains controversial.

Methods

We retrospectively analyzed all deceased donor adult liver transplants performed between July 2002 and November 2019 at a single high‐volume center and performed a propensity score‐matched analysis. A subgroup analysis was performed to assess utility of these grafts for high‐risk recipients.

Results

A total of 1090 adult liver transplants were performed, including 155 SLT (14%). Graft survival at 1‐, 3‐ and 5‐years were comparable between recipients of split and whole liver grafts (82%, 79% and 74% vs. 86%, 81% and 77%, respectively, log rank P = .537), as was patient survival at 1‐, 3‐ and 5‐years. Recipients of split grafts were more likely to have biliary complications and hepatic artery thrombosis, but equivalent long‐term survival. Recipients with high MELD scores or a poor pre‐transplant clinical status had similar patient and graft survival and complication profiles irrespective of whether they received split or whole grafts.

Conclusions

SLT is an important method for addressing donor shortages and provides comparable long‐term outcomes in adult recipients despite an increase in short‐term complications. SLT use in high‐risk recipients should be considered to allow for sickest‐first allocation policies.
Effect of divergent continuous glucose monitoring technologies on glycaemic control in type 1 diabetes mellitus: A systematic review and meta‐analysis of randomised controlled trials
Authors: Elbalshy Mona , Haszard Jillian , Smith Hazel , Kuroko Sarahmarie , Galland Barbara , Oliver Nick , Shah Viral , de Bock Martin I. , Wheeler Benjamin J.
Published: April 2022

Aims

We aimed to conduct a systematic review and meta‐analysis of randomised controlled clinical trials (RCTs) assessing separately and together the effect of the three distinct categories of continuous glucose monitoring (CGM) systems (adjunctive, non‐adjunctive and intermittently‐scanned CGM [isCGM]), compared with traditional capillary glucose monitoring, on HbA1c and CGM metrics.

Methods

PubMed, Web of Science, Scopus and Cochrane Central register of clinical trials were searched. Inclusion criteria were as follows: randomised controlled trials; participants with type 1 diabetes of any age and insulin regimen; investigating CGM and isCGM compared with traditional capillary glucose monitoring; and reporting glycaemic outcomes of HbA1c and/or time‐in‐range (TIR). Glycaemic outcomes were extracted post‐intervention and expressed as mean differences and 95%CIs between treatment and comparator groups. Results were pooled using a random‐effects meta‐analysis. Risk of bias was assessed using the Cochrane Rob2 tool.

Results

This systematic review was conducted between January and April 2021; it included 22 RCTs (15 adjunctive, 5 non‐adjunctive, and 2 isCGM)). The overall analysis of the pooled three categories showed a statistically significant absolute improvement in HbA1c percentage points (mean difference (95% CI): −0.22% [−0.31 to −0.14], I2 = 79%) for intervention compared with comparator and was strongest for adjunctive CGM (−0.26% [−0.36, −0.16]). Overall TIR (absolute change) increased by 5.4% (3.5 to 7.2), I2 = 71% for CGM intervention compared with comparator and was strongest with non‐adjunctive CGM (6.0% [2.3, 9.7]).

Conclusions

For individuals with T1D, use of CGM was beneficial for impacting glycaemic outcomes including HbA1c, TIR and time‐below‐range (TBR). Glycaemic improvement appeared greater for TIR for newer non‐adjunctive CGM technology.
Iguratimod inhibits skin fibrosis by regulating TGF‐β1/Smad signalling pathway in systemic sclerosis
Authors: Xie Xi , Gan Haina , Tian Jing , li Fen , Chen Jinwei , Wang Jia , Liao Jiafeng , Li Shu
Published: April 2022

Background

Iguratimod (T‐614), exerting a powerful anti‐inflammatory ability, has therapeutic efficacy in multiple autoimmune diseases. However, the effect of T‐614 on systemic sclerosis (SSc) is unclear. Here, we investigate the effect and molecular mechanism of T‐614 in experimental SSc models.

Methods

In vitro, cultured dermal fibroblasts from four SSc patients were subjected to different doses of T‐614 in the presence or absence of TGF‐β1 stimulation. Cell proliferation, apoptosis and migration were determined by CCK‐8, flow cytometry and transwell assay, respectively. Fibrosis markers and smad signalling pathway‐related proteins were detected by immunoblotting and immunofluorescence. In vivo, a bleomycin‐induced SSc mouse model was used to evaluate the effect of T‐614 on skin fibrosis. Pathological changes in skin tissues were evaluated by HE, Masson staining and immunohistochemistry.

Results

In the study, we found T‐614 inhibited TGF‐β1‐induced cell proliferation, migration and promoted apoptosis in a dose‐dependent manner (all p < 0.01). T‐614 partially reversed TGF‐β1‐induced upregulation of fibrosis markers and phosphorylation of smad2 and smad3 and blocked p‐Smad3 nuclear translocation (all p < 0.05), suggesting T‐614 may inhibit dermal fibroblasts activation by regulating TGF‐β1/smad pathway. In vivo experiments, T‐614 alleviated skin thickness in bleomycin‐induced SSc mice (all p < 0.05). The expression of fibrosis markers and the infiltration of macrophages in skin tissue were significantly decreased after T‐614 treatment (all p < 0.05).

Conclusion

Our preliminary data indicated T‐614 inhibited dermal fibroblasts activation and skin fibrosis at least partly by regulating TGF‐β1/smad pathway in experimental SSc models and may be a promising therapeutic agent for SSc.
Sporothrix schenckii regulates macrophage inflammatory responses via the c‐JUN‐induced Dab2 transcription
Authors: Zhao Shengnan , Qi Rui‐Qun , Gao Xing‐Hua , Chen Hong‐Duo
Published: April 2022

Macrophages, which serve as a bridge between innate and adaptive immunity, play an important role in sporotrichosis. Sporothrix schenckii infections can produce immune responses such as macrophage polarization and inflammatory factor secretion. In the early stages of inflammation, the expression of DAB2 in macrophages is increased, which controls the secretion of inflammatory factors and affects the polarization of macrophages. However, the expressions and mechanisms of DAB2 in sporotrichosis are not clear. In this study, we examined the expression of DAB2 and its regulation of inflammatory factors under conditions of Sporothrix schenckii infection. Our results indicated that the Sporothrix schenckii infection increased the expression of DAB2 and revealed a mixed M1/M2‐like type of gene expression in BMDMs with the inhibited Il‐6, Il1‐β and Arg‐1 and induced Tnf‐α, Il‐10 and Mgl‐1. The deficiency of Dab2 gene suspended the changes of cytokines. In addition, JNK activity in BMDMs was inhibited by Sporothrix schenckii infection, leading to an increase in c‐JUN. We also identified c‐JUN as a transcription factor for Dab2 through chromatin immunoprecipitation and luciferase reporter assays. In an in vivo mouse model, sporotrichosis‐induced skin lesions were accompanied with an upregulation of c‐JUN and inhibition of JNK activity, which were in accord with findings from in vitro experiments. Taken together, these findings indicate that in the early stages of Sporothrix schenckii infection there is a promotion of DAB2 expression through the JNK/c‐JUN pathway, effects that can then control the expression of inflammatory factors.
Wireless electroencephalogram monitoring system for deciphering neurological disorders using brain connectivity patterns
Authors: Das Surya , Puthankattil Subha D.
Published: April 2022

Over the last two decades, there has been a tremendous increase in research activity on brain connectivity studies and its application in different neurological disorders. Studies have been focused on different connectivity patterns generated and potential biomarkers that could be derived to find the etymology of the disorder. In this review, the focus is on the utilization of wireless electroencephalogram monitoring system for functional connectivity analysis and its capacity for deciphering neurological disorders. The paper reviews different methods adopted to estimate connectivity and the possible convergence of connectivity patterns in four neurological disorders: epilepsy, autism spectrum disorder, Alzheimer and Parkinson's disease. The paper reviews the current status of connectivity research in the aforementioned neurological disorders and its potential in developing a smart e‐health service.
Two cases of ceftriaxone‐induced encephalopathy treated by hemoperfusion in hemodialysis patients
Authors: Onogi Chikao , Osada Akinori , Imai Kentaro , Mimura Tetsushi , Saka Yosuke , Urahama Yoshimichi , Oishi Hideto , Naruse Tomohiko
Published: April 2022

Ceftriaxone is a third‐generation cephalosporin commonly used to treat infection. However, encephalopathy is an emerging adverse effect of ceftriaxone infusion. These patients present with various symptoms, including those of neurotoxicity, that typically resolve 1 week after discontinuation of ceftriaxone. We experienced two cases of ceftriaxone‐induced encephalopathy that were successfully treated by rapid removal of ceftriaxone by hemoperfusion.
ENDOGENOUS SOCIAL NETWORKS AND INEQUALITY IN AN INTERGENERATIONAL SETTING
Authors: Ioannides Yannis M.
Published: April 2022

The article examines the joint evolution of human capital investment and social networking where the network may be endogenous or exogenous. It extends Cabrales et al. (Games and Economic Behavior72 (2011), 339–60) to dynamic settings to allow for intergenerational transfers of human capital and social networking endowments as joint decisions. Social multipliers characterize the social equilibria. The associated intergenerational transfer elasticities exhibit rich dependence on social effects allowing the intergenerational transfers elasticity to be increasing with inequality in parents' human capitals. The stochastic steady states highlight the cross‐sectional human capital distribution as outcome of shocks to cognitive and social skills coefficients.
Physicochemical, techno‐functional and structural properties of gluten‐free crackers developed from sorghum (Sorghum bicolor (L.)) varieties
Authors: Perraulta Lavanya J. , Gowthamraj G. , Hemalatha V. , Sadashiv S.O. , Sharath R. , Sangeetha N.
Published: April 2022

The present study was conducted to develop gluten‐free crackers using six different white varieties of sorghum, namely CO30, K12, Parbhani Moti (PM), Parbhani Shakti (PS), ICSV15021 and M35‐1. The physico‐chemical, mineral and functional properties of developed crackers were studied. The crackers from soft wheat flour serve as a control. Highest protein (7.35 g/100 g), iron (6.63 mg/100 g) and potassium (199.86 mg/100 g) were found in ICSV15021 crackers, whereas highest total dietary fibre (9.01 g/100 g), magnesium (31.13 mg/100 g), copper (1.47 mg/100 g), zinc (1.92 g/100 g) and manganese (1.32 mg/100 g) were found in PS crackers. All exhibited A‐type crystallinity pattern except PS crackers (V‐type pattern). Overall acceptability of K12 sorghum crackers was found to be similar to control. In conclusion, this study evidenced that gluten‐free sorghum crackers exhibited higher nutrients and mineral composition and can be regarded as health‐promoting functional food, which is also cost‐effective than commercially available gluten‐free products.
Hemoglobinopathies and preimplantation diagnostics
Authors: Mamas Thalia , Kakourou Georgia , Vrettou Christina , Traeger‐Synodinos Joanne
Published: April 2022

Hemoglobinopathies constitute some of the most common inherited disorders worldwide. Manifestations are very severe, patient management is difficult and treatment is not easily accessible. Preimplantation genetic testing for monogenic disorders (PGT‐M) is a valuable reproductive option for hemoglobinopathy carrier‐couples as it precludes the initiation of an affected pregnancy. PGT‐M is performed on embryos generated by assisted reproductive technologies and only those found to be free of the monogenic disorder are transferred to the uterus. PGT‐M has been applied for 30 years now and β‐thalassemia is one of the most common indications. PGT may also be applied for human leukocyte antigen typing to identify embryos that are unaffected and also compatible with an affected sibling in need of hemopoietic stem cell transplantation. PGT‐M protocols have evolved from PCR amplification‐based, where a small number of loci were analysed, to whole genome amplification‐based, the latter increasing diagnostic accuracy, enabling the development of more generic strategies and facilitating multiple diagnoses in one embryo. Currently, numerous PGT‐M cycles are performed for the simultaneous diagnosis of hemoglobinopathies and screening for chromosomal abnormalities in the embryo in an attempt to further improve success rates and increase deliveries of unaffected babies.
Looking through racism in the nurse–patient relationship from the lens of culturally congruent care: A scoping review
Authors: Vaismoradi Mojtaba , Fredriksen Moe Cathrine , Ursin Gøril , Ingstad Kari
Published: April 2022

Aim

This review aimed to identify the nature of racism in the nurse–patient relationship and summarize international research findings about it.

Design

A scoping review of the international literature.

Data sources

The search process encompassed three main online databases of PubMed (including MEDLINE), Scopus and Embase, from 2009 until 2021.

Review methods

The scoping review was informed by the Levac et al.’s framework to map the research phenomenon and summarize current empirical research findings. Also, the review findings were reflected in the three‐dimensional puzzle model of culturally congruent care in the discussion section.

Results

The search process led to retrieving 149 articles, of which 10 studies were entered into data analysis and reporting results. They had variations in the research methodology and the context of the nurse–patient relationship. The thematical analysis of the studies' findings led to the development of three categories as follows: bilateral ignition of racism, hidden and manifest consequences of racism and encountering strategies.

Conclusion

Racism threatens patients' and nurses' dignity in the healthcare system. There is a need to develop a framework of action based on the principles of culturally congruent care to eradicate racism from the nurse–patient relationship in the globalized context of healthcare.

Impact

Racism in the nurse–patient relationship has remained a relatively unexplored area of the nursing literature. It hinders efforts to meet patients' and families' needs and increases their dissatisfaction with nursing care. Also, racism from patients towards nurses causes emotional trauma and enhances job‐related stress among nurses. Further research should be conducted on this culturally variant phenomenon. Also, the participation of patients and nurses should be sought to prohibit racism in healthcare settings.
Grid‐mapping catheters versus PentaRay catheters for left atrial mapping on ensite precision mapping system
Authors: Saito Jumpei , Yamashita Kennosuke , Numajiri Takaki , Gibo Yuma , Usumoto Soichiro , Narui Syuro , Fujioka Tatsuki , Asukai Yu , Igawa Wataru , Ono Morio , Ebara Seitaro , Okabe Toshitaka , Isomura Naoei , Ochiai Masahiko
Published: April 2022

Introduction

Areas displaying reduced bipolar voltage are defined as low‐voltage areas (LVAs). Moreover, left atrial (LA) LVAs after pulmonary vein isolation (PVI) have been reported as a predictor of recurrent atrial fibrillation (AF). In this study, we compared grid mapping catheter (GMC) with PentaRay catheter (PC) for LA voltage mapping on Ensite Precision mapping system.

Methods

Twenty‐six consecutive patients with LVAs and border zone within the LA were enrolled. After achieving PVI, voltage mapping under high right atrial pacing for 600 ms was performed twice using each catheter type (GMC first, PC next). Furthermore, LVA was defined as a region with a bipolar voltage of <0.50, and border zone was defined as a region with a bipolar voltage of <1.0, or <1.5 mV.

Results

Compared with PC, using GMC, voltage mapping contained more mapping points (20 242 [15 859, 26 013] vs. 5589 [4088, 7649]; p < .0001), and more mapping points per minute(1428 [1275, 1803] vs. 558 [372, 783]; p < .0001). In addition, LVA and border zone size using GMC was significantly less than that reported using PC: <1.0 mV (5.9 cm2 [2.9, 20.2] vs. 13.9 cm2 [6.3, 24.1], p  =  .018) and <1.5 mV voltage cutoff (10.6 cm2 [6.6, 27.2] vs. 21.6 cm2 [12.6, 35.0], p  =  .005).

Conclusion

Bipolar voltage amplitude estimated by GMC was significantly larger than that estimated by PC on Ensite Precision mapping system. GMC may be able to find highly selective identification of LVAs with lower prevalence and smaller LVA and border zone size.
Efficacy and safety of high‐power short duration atrial fibrillation ablation in elderly patients
Authors: Müller Julian , Nentwich Karin , Berkovitz Artur , Ene Elena , Sonne Kai , Chakarov Ivaylo , Barth Sebastian , Waechter Christian , Lüsebrink Ulrich , Behnes Michael , Akin Ibrahim , Deneke Thomas
Published: April 2022

Introduction

Data about atrial fibrillation (AF) ablation using high‐power short duration (HPSD) radiofrequency ablation in the elderly population is still scarce. The aim of our study was to investigate the efficacy and safety of HPSD ablation in patients over 75 years compared to younger patients.

Methods

Consecutive patients older than 75 years with paroxysmal or persistent AF undergoing a first‐time AF ablation using 50 W HPSD ablation approach were analyzed in this retrospective observational analysis and compared to a control group <75 years. Short‐term endpoints included intraprocedural reconnection of at least one pulmonary vein (PV) and intrahospital and AF recurrence during 3 months blanking period, as well as a long‐term endpoint of freedom from atrial arrhythmias of antiarrhythmic drugs after 12 months.

Results

A total of 540 patients underwent a first AF ablation with HPSD (66 ± 10 years; 58% male; 47% paroxysmal AF). Mean age was 78 ± 2.4 and 63 ± 6.3 years (p < .001), respectively. Elderly patients were significantly more often women (p < .001). The procedure, fluoroscopy, and ablation were comparable. Elderly patients revealed significantly more often extra‐PV low‐voltage areas requiring additional left atrial ablations (p < .001). Overall complication rates were low; however, elderly patients revealed higher major complication rates mainly due to unmasking sick sinus syndrome (p = .003). Freedom from arrhythmia recurrences was comparable (68% vs. 76%, log‐rank p = .087). Only in the subgroup of paroxysmal AF, AF recurrences were more common after 12 months (69% vs. 82%; log‐rank p = .040; hazard ratio: 1.462, p = .044) in the elderly patients. In multivariable Cox regression analysis of the whole cohort persistent AF, female gender, diabetes mellitus and presence of left atrium low‐voltage areas, but not age >75 years were associated with AF recurrences.

Conclusion

HPSD AF ablation of patients >75 years in experienced centers is safe and effective. Therefore, age alone should not be the reason to withhold AF ablation from vital elderly patients due to only a slightly worse outcome and safety profile. In paroxysmal AF, elderly patients have more recurrences compared to the younger control group.
Comprehensive analysis identified a reduction in ATP1A2 mediated by ARID3A in abdominal aortic aneurysm
Authors: Wang Qunhui , Li Na , Guo Xian , Huo Bo , Li Rui , Feng Xin , Fang Zemin , Zhu Xue‐Hai , Wang Yixiang , Yi Xin , Wei Xiang , Jiang Ding‐Sheng
Published: April 2022

Abdominal aortic aneurysm (AAA) is characterized by abdominal aorta dilatation and progressive structural impairment and is usually an asymptomatic and potentially lethal disease with a risk of rupture. To investigate the underlying mechanisms of AAA initiation and progression, seven AAA datasets related to human and mice were downloaded from the GEO database and reanalysed in the present study. After comprehensive bioinformatics analysis, we identified the enriched pathways associated with inflammation responses, vascular smooth muscle cell (VSMC) phenotype switching and cytokine secretion in AAA. Most importantly, we identified ATPase Na+/K+ transporting subunit alpha 2 (ATP1A2) as a key gene that was significantly decreased in AAA samples of both human and mice; meanwhile, its reduction mainly occurred in VSMCs of the aorta; this finding was validated by immunostaining and Western blot in human and mouse AAA samples. Furthermore, we explored the potential upstream transcription factors (TFs) that regulate ATP1A2 expression. We found that the TF AT‐rich interaction domain 3A (ARID3A) bound the promoter of ATP1A2 to suppress its expression. Our present study identified the ARID3A‐ATP1A2 axis as a novel pathway in the pathological processes of AAA, further elucidating the molecular mechanism of AAA and providing potential therapeutic targets for AAA.
TNFα‐induced abnormal activation of TNFR/NF‐κB/FTH1 in endometrium is involved in the pathogenesis of early spontaneous abortion
Authors: Wen Yuting , Cheng Meng , Qin Lang , Xu Wenming
Published: April 2022

Early spontaneous abortion (ESA) is one of the most common complications during pregnancy and the inflammation condition in uterine environment such as long‐term exposure to high TNFα plays an essential role in the aetiology. Ferritin heavy chain (FTH1) is considered to be closely associated with inflammation and very important in normal pregnancy, yet the underlying mechanism of how TNFα induced abortion and its relationship with FTH1 remain elusive. In this study, we found that TNFα and FTH1 were positively expressed in decidual stromal cells and increased significantly in the ESA group compared with the normal pregnancy group (NP group). Besides, TNFα expression was positively correlated with FTH1 expression. Furthermore, in vitro cell model demonstrated that high TNFα could induce the abnormal signals of TNFR/NF‐κB/FTH1 and activate apoptosis both in human endometrium stromal cells (hESCs) and in local decidual tissues. Taken together, the present findings suggest that the excessive apoptosis in response to TNFα‐induced upregulation of FTH1 may be responsible for the occurrence of ESA, and thus provide a possible therapeutic target for the treatment of ESA.
Comparative salary‐related costs of a brief app‐directed delirium identification protocol by hospitalists, nurses, and nursing assistants
Authors: Leslie Douglas L. , Fick Donna M. , Moore Amber , Inouye Sharon K. , Jung Yoojin , Ngo Long H. , Boltz Marie , Husser Erica , Shrestha Priyanka , Boustani Malaz , Marcantonio Edward R.
Published: April 2022

Background

Systematic screening can improve delirium identification among hospitalized older adults. Prior studies have shown clinicians and health system leaders may believe they do not have the time and resources for assessment. We conducted a comparative salary‐related cost analysis of an adaptive delirium identification protocol directed by an iPad app.

Methods

We recruited 527 older adult medicine patients from an urban academic medical center (n = 269) and a rural community hospital (n = 258). Physicians and nurses completed the two‐step Ultra‐brief Confusion Assessment Method (UB‐CAM) protocol (with or without a skip pattern), while certified nursing assistants completed only the UB‐2 ultra‐brief screen. The sample included 527 patients (average age 80, 57% women, 35% with dementia). Time required to administer the protocol was collected automatically by the iPad app. Salary‐related costs of screening were determined by multiplying the time required by the hourly wage for the three disciplines, as obtained from national and regional published healthcare salary cost data. Cost estimates for entire hospital implementation were also calculated.

Results

Participants were screened on 924 hospital days by 399 clinicians (53 physicians, 236 nurses, 110 CNAs). For the UB‐2, CNAs cost per screen was lower than the other clinician types ($0.37 per screen vs. $0.73 for nurses and $2.39 for hospitalists). For the UB‐CAM with skip (UB‐CAM), costs per protocol were $1.10 for nurses vs. $3.61 for physicians. The annual salary–related costs of hospital‐wide implementation of a nurse‐based UB‐CAM protocol in a medium‐sized (300‐bed) hospital was $63,015 plus $4356 for initial and annual training.

Conclusions

CNAs and nurses had the lowest salary‐associated costs for app‐directed CAM‐based delirium screening and identification, respectively. Salary‐related annual hospital costs for the most efficient protocols in a medium‐sized hospital were less than the annual cost of hiring 1 FTE of the discipline performing the protocols.
Low diet quality is associated with adverse levels of metabolic health markers and clustering of risk factors in adults with type 2 diabetes
Authors: Sanjeevi Namrata , Freeland‐Graves Jeanne H.
Published: April 2022

Background

Nutritional recommendations for diabetes management emphasise an overall, healthful diet consistent with the guidelines for the general population. The present study assessed the relationship of diet quality, as measured by Healthy Eating Index‐2015 (HEI‐2015), with metabolic health markers and risk factor clustering in type 2 diabetes patients using National Health and Nutrition Examination Survey 2011–2016 data.

Methods

HEI‐2015 diet quality scores were calculated using 24‐h dietary recalls. Adults with type 2 diabetes (n = 2220) were assessed for: (1) hyperglycaemia; (2) overweight/obesity; (3) dyslipidaemia; and (4) hypertension. Logistic regression examined associations of diet quality quartiles with odds of hyperglycaemia, overweight/obesity, dyslipidaemia and hypertension, as well as odds of clustering of these risk factors.

Results

Odds of overweight/obesity and hyperglycaemia were significantly greater for participants in the lowest HEI‐2015 quartile compared to those in the highest quartile. Furthermore, individuals in the bottom two HEI‐2015 quartiles had increased odds of dyslipidaemia. Those in the lowest quartile also had significantly higher odds of having ≥ 2, ≥ 3 and 4 risk factors (vs. having ≤ 1 risk factor).

Conclusions

Low diet quality was related to increased odds of hyperglycaemia, dyslipidaemia, overweight/obesity and risk factor clustering. Findings imply poorer prognosis of diabetes in individuals with low diet quality.
Poly‐L‐lysine/hyaluronan nanocarriers as a novel nanosystem for gene delivery
Authors: Souri Masoumeh , Bagherzadeh Mohammad Aref , Mofazzal Jahromi Mirza Ali , Mohammad‐Beigi Hossein , Abdoli Amir , Mir Hamed , Roustazadeh Abazar , Pirestani Majid , Sahandi Zangabad Parham , Kiani Jafar , Bakhshayesh Amirmahmoud , Jahani Mehdi , Joghataei Mohammad Taghi , Karimi Mahdi
Published: April 2022

The present research comes up with a novel DNA‐loaded poly‐L‐lysine (PLL)/hyaluronan (HA) nanocarrier (DNA‐loaded PLL/HA NCs) for gene delivery applications, as a promising candidate for gene delivery into diverse cells. A straightforward approach was employed to prepare such a nanosystem through masking DNA‐loaded PLL molecules by HA. Fourier‐transform infrared (FTIR) spectroscopy, dynamic light scattering (DLS), field emission‐scanning electron microscopy (FE‐SEM) and transmission electron microscopy (TEM) were used to analyse the interaction of the molecules as well as the physicochemical properties of the NCs. The NCs showed a negative charge of –24 ± 3 mV, with an average size of 138 ± 6 nm, in an ellipsoid‐shape with smooth surfaces. The DNA loading efficiency (LE) measured by DNA absorbance was around 95 %. The MTT assay showed that the developed NCs are non‐toxic to the cells. Furthermore, the uptake of the DNA‐loaded PLL/HA NCs by the human embryonic kidney (HEK)‐293T cells was evaluated by a flow cytometry method, and demonstrated high potential cellular uptake over 90% for transferring the gene to HEK‐293T cells at the optimised conditions. Therefore, the DNA‐loaded PLL/HA NCs are the potent strategy for developing nanosystems for gene delivery applications.
TRAF3IP2 regulated by FOXO4 affects fibroblast proliferation, migration, and extracellular matrix deposition in keloid through the TGF‐β1/Smad pathway
Authors: Yan Qiaoyu , Li Bin
Published: April 2022

Background

Keloids are "tumor‐like" scars that grow beyond the boundary of injury. Its pathogenesis is complex. This paper will discuss the pathogenesis of keloid from the transcriptional regulation mechanism of TRAF3IP2.

Methods

IL‐17 was utilized to induce human keloid fibroblasts (KFs) and normal dermal fibroblasts. With the application of RT‐qPCR and Western blot, TRAF3IP2 expression was detected. Subsequently, the expression of TRAF3IP2 was interfered by cell transfection and the effects of interfering TRAF3IP2 on cell proliferative rate, migration rate, and extracellular matrix were assessed with CCK‐8, Wound Healing, immunofluorescence, and Western blot techniques. Proliferation, migration, and (ECM) deposition were detected by JASPAR software predicted the binding sites of transcription factors FOXO4 and TRAF3IP2 promoters. The relationship between FOXO4 and TRAF3IP2 was verified by Dual luciferase activity assay and ChIP. Finally, the expression of TRAF3IP2 and FOXO4 was interfered simultaneously to further explore the mechanism.

Results

TRAF3IP2 was enhanced in IL‐17 induced KFs. Interference with TRAF3IP2 imparted suppressive effects on the proliferation, migration, and ECM deposition of KFs. FOXO4 could inhibit TRAF3IP2 transcription, and interference with FOXO4 reversed the effect of TRAF3IP2 down‐regulation on KFs via TGF‐β1/Smad pathway.

Conclusion

TRAF3IP2 was regulated by FOXO4 and affected fibroblast proliferation, migration, and ECM deposition in keloid through the TGF‐β1/Smad pathway.
Incidental Learning of Collocations in an Academic Lecture Through Different Input Modes
Authors: Dang Thi Ngoc Yen , Lu Cailing , Webb Stuart
Published: April 2022

In this quasi‐experimental study, 165 learners of English for academic purposes at a university in China were randomly assigned to five experimental groups and a control group. Each experimental group encountered 19 target collocations in the same academic lecture in one of the following input modes: (a) reading, (b) listening, (c) reading while listening, (d) viewing, and (e) viewing with captions. The control group did not receive any treatment. The results revealed that reading, viewing, and viewing with captions led to learning at the form recognition level, but no significant differences were found in the learning gains across these modes. Nonverbal elaboration, type of vocabulary, and type of verbal elaboration affected learning, but frequency of occurrence, strength of association, comprehension, and prior knowledge of general vocabulary did not. This study provides further evidence supporting the use of academic lectures for incidental learning of collocations as well as expanding on the multimedia learning theory.
Nutrition modeling tools: a qualitative study of influence on policy decision making and determining factors
Authors: Knight Frances , Bourassa Megan W. , Ferguson Elaine , Walls Helen , de Pee Saskia , Vosti Stephen , Martinez Homero , Levin Carol , Woldt Monica , Sethurman Kavita , Bergeron Gilles
Published: April 2022

Nutrition modeling tools (NMTs) generate evidence to inform policy and program decision making; however, the literature is generally limited to modeling methods and results, rather than use cases and their impacts. We aimed to document the policy influences of 12 NMTs and identify factors influencing them. We conducted semistructured interviews with 109 informants from 30 low‐ and middle‐income country case studies and used thematic analysis to understand the data. NMTs were mostly applied by international organizations to inform national government decision making. NMT applications contributed to enabling environments for nutrition and influenced program design and policy in most cases; however, this influence could be strengthened. Influence was shaped by processes for applying the NMTs; ownership of the analysis and data inputs, and capacity building in NMT methods, encouraged uptake. Targeting evidence generation at specific policy cycle stages promoted uptake; however, where advocacy capacity allowed, modeling was embedded ad hoc into emerging policy discussions and had broader influence. Meanwhile, external factors, such as political change and resource constraints of local partner organizations, challenged NMT implementation. Importantly, policy uptake was never the result of NMTs exclusively, indicating they should be nested persistently and strategically within the wider evidence and advocacy continuum, rather than being stand‐alone activities.
Assessing heritability of biochemical limitations in photosynthesis can help elucidate new targets for improvement
Authors: Acevedo‐Siaca Liana G. , Long Stephen P.
Published: April 2022

Understanding heritability has historically been critical to the incorporation of traits of interest into plant breeding programmes for improvement. In our previous study, we assessed the heritability of several photosynthetic traits in indica rice, including biochemical limitations of photosynthesis. Here, we discuss that even without directly evaluating sink limitation, there is still great value in this study for understanding how photosynthetic traits in rice could be incorporated into a breeding programme and which traits could be given priority. Additionally, we assert that limitation by Jmax will likely be more relevant than TPU limitation in the immediate future and could be a valuable factor for selection. However, we agree with Fabre and Dingkuhn (2022, https://doi.org/10.1111/pbr.13000) that sink limitation should be further examined within the context of plant improvement in the future.
Quantifying the Photochemical Damage Potential of Contrast‐Enhanced Fluorescence Imaging Products: Singlet Oxygen Production
Authors: Gaitan Brandon , Frankle Lucas , Vig Shruti , Oskoui Ellen , Adwan Miriam , Chen Yu , Elespuru Rosalie , Huang Huang‐Chiao , Pfefer T. Joshua
Published: April 2022

The benefits of contrast‐enhancing imaging probes have become apparent over the past decade. However, there is a gap in the literature when it comes to the assessment of the phototoxic potential of imaging probes and systems emitting visible and/or near‐infrared radiation. The primary mechanism of fluorescent agent phototoxicity is thought to involve the production of reactive molecular species (RMS), yet little has been published on the best practices for safety evaluation of RMS production levels for clinical products. We have proposed methods involving a cell‐free assay to quantify singlet oxygen [(SO) a known RMS] generation of imaging probes, and performed testing of Indocyanine Green (ICG), Proflavine, Methylene Blue, IR700 and IR800 at clinically relevant concentrations and radiant exposures. Results indicated that SO production from IR800 and ICG were more than two orders of magnitude below that of the known SO generator Rose Bengal. Methylene Blue and IR700 produced much higher SO levels than ICG and IR800. These results were in good agreement with data from the literature. While agents that exhibit spectral overlap with the assay may be more prone to errors, our tests for one of these agents (Proflavine) appeared robust. Overall, our results indicate that this methodology shows promise for assessing the phototoxic potential of fluorophores due to SO production.
Alteplase Dose Assessment for Pleural infection Therapy (ADAPT) Study‐2: Use of 2.5 mg alteplase as a starting intrapleural dose
Authors: Popowicz Natalia , Ip Hugh , Lau Estee P. M. , Piccolo Francesco , Dootson Kirstie , Yeoh Cindy , Phu Wint Ywe , Brown Rebecca , West Alex , Ahmed Liju , Lee Y. C. Gary
Published: April 2022

Background and objective

Intrapleural tissue plasminogen activator/deoxyribonuclease (tPA/DNase) therapy is increasingly used in pleural infection. Bleeding risks and costs associated with tPA remain the clinical concerns. Our dose de‐escalation series aims to establish the lowest effective dosing regimen for tPA/DNase. This study assesses the intrapleural use of 2.5 mg tPA/5 mg DNase for pleural infection.

Methods

Consecutive patients with pleural infection treated with a starting regime of 2.5 mg tPA/5 mg DNase were included from two centres in Australia and UK. Escalation of tPA dose was permitted if clinical response was inadequate.

Results

Sixty‐nine patients (mean age 61.0 years) received intrapleural 2.5 mg tPA/5 mg DNase. Most (88.4%) were treated successfully and discharged from hospital without surgery by 90 days. Patients received a median of 5 [interquartile range [IQR] = 3–6] doses of tPA/DNase. Total amount of tPA used per patient was 12.5 mg [median, IQR = 7.5–15.0]. Seventeen patients required dose escalation of tPA; most (n = 12) for attempted drainage of distant non‐communicating locule(s). Treatment success was corroborated by clearance of pleural opacities on radiographs (from median 27.0% [IQR = 17.1–44.5] to 11.0% [IQR = 6.4–23.3] of hemithorax, p < 0.0001), increased pleural fluid drainage (1.98 L [median, IQR = 1.38–2.68] over 72 h following commencement of tPA/DNase) and reduction of serum C‐reactive protein level (by 45.0% [IQR = 39.3–77.0] from baseline at day 5, p < 0.0001). Two patients required surgery. Six patients with significant comorbidities (e.g., advanced cancer) had ongoing infection when palliated and died. Two patients experienced self‐limiting pleural bleeding and received blood transfusion.

Conclusion

A starting intrapleural regime of 2.5 mg tPA/5 mg DNase, with up‐titration if needed, can be effective and deserves further exploration.
Quantitative evaluation of the roles of ocean chemistry and climate on ooid size across the Phanerozoic: Global versus local controls
Authors: Koeshidayatullah Ardiansyah , Trower Elizabeth J. , Li Xiaowei , Mukerji Tapan , Lehrmann Daniel J. , Morsilli Michele , Al‐Ramadan Khalid , Payne Jonathan L.
Published: April 2022

Ooid size in natural systems can be predicted based on the expected equilibrium between precipitation and abrasion rates. Therefore, ooid size distributions may enable quantitative inferences about past ocean and climate conditions from sedimentology that complement insights from geochemistry. A few previous attempts have been made to compile information on ooid sizes across the Phanerozoic, but no systematic ooid size dataset is available and equilibrium models of ooid growth have not been explored comprehensively. In this study, convolutional neural network‐based segmentation was used to automate ooid size measurement and provide a systematic sampling of ooid sizes spanning the Phanerozoic. This data set is coupled with Monte Carlo simulations to quantitatively explore the interplay between three testable physicochemical parameters (long‐term average carbonate saturation state, bed shear velocity and intermittency of transport) in determining equilibrium ooid size. The numerical model shows that a typical‐sized ooid (≤1000 µm) can grow under a wide range of parameter combinations whereas giant ooids (>2000 µm) can only form under a more restricted set of circumstances. Furthermore, the model predicts that the formation of giant ooids is common when conditions favourable for rapid CaCO3 precipitation are achieved. This finding is consistent with the naturally rare occurrences of giant ooids, which developed under exceptional environmental conditions and are primarily associated with intervals of bimineralic seas and elevated sea‐surface temperature (greenhouse or transitional climate). Whereas global controls could help explain secular trends in ooid size, significant spatial variability of ooid size in several time intervals further demonstrates the importance of local environmental parameters in the growth of ooids. Together, spatial and temporal variation in ooid size distributions can complement geochemical proxies in quantitatively reconstructing ancient tropical marine environments.
Urological outcomes in children with congenital Zika syndrome: The experience of a cohort in Campina Grande, Brazil
Authors: Ferreira Rayssa Vieira Brandão , Pinheiro Hannah Cavalcante Guedes , de Oliveira Melo Fabiana , Gama Gabriela Lopes , Monteiro Lucia Maria Costa , Fontes Juliana Marin , de Oliveira Cruz Glaura Nisya , de Araújo Grace Ferreira , Amorim Melania Maria Ramos , Melo Adriana
Published: April 2022

Objective

To describe the urological outcomes in children with congenital Zika syndrome (CZS) and investigate the relationship between clinical and urological findings in this population.

Methods

This cross‐sectional study involved children with CZS followed up by a referral centre for children with microcephaly in the state of Paraiba in northeast Brazil. The urological evaluation included clinical history, urine culture results, ultrasonography of the urinary tract, and urodynamic evaluation, following the protocol proposed by Costa Monteiro et al. (2017). Descriptive statistical analysis was performed in addition to association and correlation tests, considering clinical and urodynamic variables.

Results

Among the 88 children with CZS (35.5 ± 5.5 months), 97.7% had microcephaly, and 51% presented urinary tract infection (UTI) confirmed with clinical history and lab tests. The number of confirmed UTI episodes varied from one to 14 per child. The urodynamic evaluation confirmed the presence of an overactive bladder in 78 children and incomplete voiding in 50. Urodynamic findings were associated with the number of confirmed UTI episodes, child's sex, and actual weight, in addition to the use of anticonvulsant and myorelaxant drugs.

Conclusions

UTIs were confirmed in most children. Other urological outcomes observed were overactive bladder and low bladder capacity, which were associated with the number of confirmed UTI episodes, use of anticonvulsants and myorelaxants, and the child's sex and weight. These are treatable conditions, and it is paramount that paediatricians, neonatologists, and infectious disease specialists are aware of them to make clinical decisions and help reduce the risk of renal damage and other morbidities.
Effect of extension tube length on the damping coefficient and natural frequency in normotensive dogs
Authors: Cha Jeesoo , Son Won‐gyun , Kim Hyunseok , Kim Dalhae , Lee Inhyung
Published: April 2022

Objective

To establish an acceptable extension tube length (ETL) to measure direct blood pressure (BP) in dogs.

Design

Prospective, experimental study.

Setting

University‐based small animal research facility.

Animals

Eight healthy Beagle dogs: 6 males and 2 females.

Interventions

Each extension tube with lengths of 25, 50, 75, 115, 145, 205, and 275 cm were connected after the catheterization with a 22‐Ga catheter in the dorsal pedal artery in sternal recumbency. A square wave from the fast‐flush test was consecutively recorded 5 times to analyze the system's dynamic response characteristics according to the ETL. After recording the square wave, the ETL was converted to a Latin square. The dynamic response was analyzed using natural frequency (NF) and the damping coefficient (DC), both of which affect the damping factor. The average values of NF and DC were plotted against a graph showing the damping factor. Linear regression was used to evaluate the between‐group changes in NF and DC.

Measurements and Main Results

The DC gradually increased from 0.21 to 0.29 ξ, and the NF gradually decreased from 38 to 14 Hz according to the increase in ETL (P < 0.05). The dynamic response showed adequate damping with all ETLs.

Conclusion

With an increase in ETL, the NF decreased significantly, while the DC demonstrated a less significant change. Therefore, NF had a greater influence on the damping factor of arterial BP measurement. There was no difference between ETLs from 25 to 275 cm lines for measuring BP. An ETL of less than 275 cm is recommended as the damping amount is adequate. Moreover, an ETL less than 275 cm does not meaningfully affect BP measurement in dogs.