bluuebunny/crossref_metadata_2025 huggingface dataset:
Designing and Validating an Evidence-Based, Shift-to-Shift Handover Bundle for Nurses and Physicians
Authors: Mahran Ghada Shalaby Khalaf , Mekkawy Mimi M. , Ibrahim Bedour A. , Saber Ebtisam A. , Ali Mostafa , Abbas Mostafa S. , Mohamed Sherif A. A. , Ahmed Ragaa D.
Published: November 2023

This article reports a study aimed at developing and validating an evidence-based, shift-to-shift handover bundle for nurses and physicians to be used at shift changes in intensive care and emergency units. Deficient or absent clinical handovers, or failures to transfer information, responsibility, and accountability can have unwanted consequences for hospitalized patients, particularly those at critical areas. Clinical handovers are practiced every day, in many ways, in all institutional health care settings. Despite increasing demand for structured processes to guide clinical handovers, standardized handover bundles for nurses and physicians are limited in the emergency and intensive care unit. As a result of this study, a shift-to-shift handover bundle was created, which was an evidence-based research design. This bundle is expected to be helpful for proper patient transfers between these critical areas, ensuring patient safety and efficient quality management.
Developing an Operating Room–to-Intensive Care Unit Patient Handover Checklist
Authors: Mahran Ghada Shalaby Khalaf , Mahmoud Ahmed Mahmoud Safaa , Abdelmowla Rasha Ali Ahmed , Abdelmowla Hanan Ali Ahmed , El-aziz Wafaa Wahdan Abd , Mohamed Sherif A. A. , Ali Aida Faried Abdelwanees
Published: November 2023

This article reports a study aimed at developing and validating an Operating Room–to-ICU Patient Handover checklist. Deficient or absent clinical handovers, or failures to transfer information, responsibility, and accountability can have unwanted consequences for hospitalized patients. Clinical handovers are practiced every day, in many ways, in all institutional health care settings. Despite increasing demand for structured processes to guide clinical handovers, standardized handover bundles for nurses and physicians are limited in the intensive care unit. As a result of this study an Operating Room–to-ICU Patient Handover checklist was created, which was based on a quantitative and qualitative research design. This checklist is expected to be helpful for proper patient transfers between these critical areas, ensuring patient safety and efficient quality management.
The ARRIVE Trial
Authors: Grobman William A.
Published: November 2023

Timing of delivery such that maternal and perinatal outcomes are optimized is among the most important and commonplace decisions in obstetric care. Given the importance of this determination, it is somewhat surprising that there has been, until relatively recently, little in the way of high-quality evidence to guide obstetric clinicians in this decision. This chapter describes the evolution of studies examining the effects of labor induction and the importance of the ARRIVE trial in that context.
Characterizing Extreme Phenotypes for Pain Interference in Persons With Chronic Pain Following Traumatic Brain Injury: A NIDILRR and VA TBI Model Systems Collaborative Project
Authors: Hoffman Jeanne M. , Ketchum Jessica M. , Agtarap Stephanie , Dams-O'Connor Kristen , Hammond Flora M. , Martin Aaron M. , Sevigny Mitch , Walker William C. , Harrison-Felix Cynthia , Zafonte Ross , Nakase-Richardson Risa
Published: November 2023

Objective:

To define and characterize extreme phenotypes based on pain interference for persons with chronic pain following traumatic brain injury (TBI).

Setting:

Eighteen Traumatic Brain Injury Model System (TBIMS) Centers.

Participants:

A total of 1762 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview.

Primary Measures:

The Brief Pain Inventory (BPI) interference scale, sociodemographic, injury, functional outcome, pain, and treatment characteristics.

Results:

Participants were predominantly male (73%), White (75%), middle-aged (mean 46 years), and who were injured in motor vehicle accidents (53%) or falls (20%). Extreme phenotypes were identified based on upper and lower 25th percentiles to create low-interference (n = 441) and high-interference (n = 431) extreme phenotypes. Bivariate comparisons found several sociodemographic, injury, function, pain, and treatment differences between extreme phenotype groups, including significant differences (P < .001) on all measures of concurrent function with those in the low-interference extreme phenotype experiencing better function than those in the high-interference extreme phenotype. Lasso regression combined with logistic regression identified multivariable predictors of low- versus high-interference extreme phenotypes. Reductions in the odds of low- versus high-interference phenotypes were significantly associated with higher pain intensity (odds ratio [OR] = 0.33), having neuropathic pain (OR = 0.40), migraine headache (OR = 0.41), leg/feet pain (OR = 0.34), or hip pain (OR = 0.46), and more pain catastrophizing (OR = 0.81).

Conclusion:

Results suggest that for those who experience current chronic pain, there is high variability in the experience and impact of pain. Future research is needed to better understand how pain experience impacts individuals with chronic pain and TBI given that pain characteristics were the primary distinguishing factors between phenotypes. The use of extreme phenotypes for pain interference may be useful to better stratify samples to determine efficacy of pain treatment for individuals with TBI.
What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?
Authors: Walker William C. , Perera Robert A. , Hammond Flora M. , Zafonte Ross , Katta-Charles Sheryl , Abbasi Katherine W. , Hoffman Jeanne M.
Published: November 2023

Objective:

Although headache (HA) is a common sequela of traumatic brain injury (TBI), early predictors of chronic HA after moderate to severe TBI are not well established, and the relationship chronic HA has with psychosocial functioning is understudied. Thus, we sought to (1) determine demographic and injury predictors of chronic HA 1 or more years after moderate to severe TBI and (2) examine associations between chronic HA and psychosocial outcomes.

Setting:

Community.

Participants:

Participants in the TBI Model System (TBIMS) with moderate to severe TBI who consented for additional chronic pain questionnaires at the time of TBIMS follow-up.

Design:

Multisite, observational cohort study using LASSO (least absolute shrinkage and selection operator) regression for prediction modeling and independentttests for psychosocial associations.

Main Outcome Measure(s):

Chronic HA after TBI at year 1 or 2 postinjury and more remotely (5 or more years).

Results:

The LASSO model for chronic HA at 1 to 2 years achieved acceptable predictability (cross-validated area under the curve [AUC] = 0.70). At 5 or more years, predictability was nearly acceptable (cross-validated AUC = 0.68), but much more complex, with more than twice as many variables contributing. Injury characteristics had stronger predictive value at postinjury years 1 to 2 versus 5 or more years, especially sustained intracranial pressure elevation (odds ratio [OR] = 3.8) and skull fragments on head computed tomography (CT) (OR = 2.5). Additional TBI(s) was a risk factor at both time frames, as were multiple socioeconomic characteristics, including lower education level, younger age, female gender, and Black race. Lower education level was a particularly strong predictor at 5 or more years (OR up to 3.5). Emotional and participation outcomes were broadly poorer among persons with chronic HA after moderate to severe TBI.

Conclusions:

Among people with moderate to severe TBI, chronic HA is associated with significant psychosocial burden. The identified risk factors will enable targeted clinical screening and monitoring strategies to enhance clinical care pathways that could lead to better outcomes. They may also be useful as stratification or covariates in future clinical trial research on treatments.
Long-term Participation and Functional Status in Children Who Experience Traumatic Brain Injury
Authors: Ewing-Cobbs Linda , Clark Amy , Keenan Heather
Published: November 2023

Objective:

To evaluate the effect of child and family factors on children's participation outcomes 2 to 3 years following traumatic brain injury (TBI).

Setting:

Two level 1 pediatric trauma centers.

Participants:

Children aged 0 to 15 years with TBI at all severity levels or an orthopedic injury.

Design:

Prospective cohort.

Main Measures:

Caregivers completed the Child and Adolescent Scale of Participation (CASP) at 2- and 3-year follow-ups. The CASP was categorized as more than 90 or 90 or less on a 100-point scale, with 90 or less representing the 10th percentile and below in this sample. Modified Poisson regression models were used to describe relative risk of the CASP at 90 or less at 2 to 3 years postinjury, adjusting for preinjury family environment variables and injury group. A secondary analysis only included children who were 31 months or older at injury (n = 441) to determine whether changes in functional outcome (Pediatric Injury Functional Outcome Scale, PIFOS) and executive functions (Behavior Rating Inventory of Executive Function, BRIEF) from preinjury to 1 year after injury predicted CASP scores at the 2- or 3-year follow-up.

Results:

Seventy-eight percent (596/769) of children who had a completed preinjury survey had a completed CASP. In the adjusted model, children with severe TBI had a nearly 3 times higher risk (RR = 2.90; 95% CI, 1.43-5.87) of reduced participation than children with an orthopedic injury. In the secondary analysis, lower functional skills (5-point increase in 1-year postinjury PIFOS score) (RR = 1.36; 95% CI, 1.18-1.57) and less favorable family function (RR = 1.46; 95% CI, 1.02-2.10) were associated with reduced participation in both girls and boys.

Conclusion:

Participation in home, school, and community activities after TBI is related to multiple biopsychosocial factors. Participation-focused interventions are needed to reduce barriers to involvement and assist children and families to close the participation gap across settings.
Caronia Glaucoma Card Versus Amsler Grid for Monitoring Patients With Advanced Glaucoma
Authors: Caronia Ronald M.
Published: November 2023

Précis:

Caronia Glaucoma Card (CGC) design incorporates a vertical and horizontal line and seven concentric circles corresponding to 1o arc at normal reading distance. The study showed that the CGC is preferred by study patients compared to Amsler Grid and can detect central scotomas.

Purpose:

Evaluate patient acceptance and efficacy of the Caronia Glaucoma Card (CGC) in monitoring patients with severe glaucoma.

Methods:

A retrospective study of consecutive patients with severe glaucoma who agreed to monitor their visual function. Patients were given a two-sided sheet of paper. An Amsler grid was printed on one side, and a CGC was printed on the other side. The patient was given verbal and written instructions on how to perform each test. They were asked to use either one or both tests to monitor their visual function on a weekly basis. Upon return, they were asked which test they preferred and if they appreciated or noticed any change in their scotoma. Patient comments were recorded.

Results:

Sixty-seven patients were given the test card whose reported past ocular history consisted solely of severe glaucoma. Seventeen patients were eventually excluded. Fourteen patients had 1 eye that fulfilled the inclusion criteria for the study, while the other eye was excluded. Eighty-six eyes of fifty patients satisfied the inclusion criteria and were enrolled in the study. Thirty of the patients were male (60%) and 20 were female (40%). The average age was 71.8 +/− 10.7 years. They all carried a diagnosis of severe glaucoma. When asked the question which test design they preferred to use, 30 patients preferred the CGC (60%), while 8 patients preferred the Amsler grid (16%). Twelve patients found no difference between the 2 test designs (24%). [χ2 (2, 50)=16.480, ρ=0.000]. Five patients noticed a change in their scotoma while using the card (5.8%, 5 of 86 eyes). All were exclusively using the CGC.

Conclusion:

The CGC is a convenient and inexpensive tool that was able to detect a change in scotoma. It may be helpful to add to the armamentarium to monitor glaucoma and its possible progression in patients with advanced disease.
Glaucoma Detection Using Optical Coherence Tomography: Reviewing the Pitfalls of Comparison to Normative Data
Authors: Leshno Ari , De Moraes Carlos Gustavo , Tsamis Emmanouil , La Bruna Sol , Cioffi George A. , Liebmann Jeffrey M. , Hood Donald C.
Published: November 2023

Précis:

Optical coherence tomography is essential in managing glaucoma. This review describes various artifacts that originate from using a normative database to compare the individual’s scans. This is a review paper regarding artifacts in optical coherence tomography imaging for glaucoma arising from using a normative database as a reference for healthy retinal nerve fiber layer and ganglion cell layer.
Increased Glaucoma Case-Finding Through Routine Optical Coherence Tomography in Optometry Practice
Authors: Paul Joseph P. , McGuinness Myra B. , Ashby Benjamin D. , Tan Jeena , Barber Naomi M. , Weisinger Harrison S. , Martin Keith R. , van Wijngaarden Peter , Larsen Peter D.
Published: November 2023

Précis:

Optometrists employing OCT as a routine clinical tool have a higher chance of referring patients for specialist glaucoma management than those without OCT.

Objective:

Timely detection of glaucoma is key to preventing or delaying vision loss. This study aimed to assess whether the routine use of optical coherence tomography (OCT) by optometrists for the detection of glaucomatous changes in the optic nerve and retina increased glaucoma referrals to ophthalmologists.

Design:

This study was a retrospective review of routinely collected electronic medical records of patients from a chain of 331 optometry practices in Australia.

Participants:

Electronic medical records were reviewed for every patient aged 18–99 years who attended an included practice between January 1 and July 31, 2019.

Methods:

Odds of referral for glaucoma assessment were compared between practices performing OCT routinely on all patients (OCT practices, n=175) and without OCT (non-OCT practices, n=20). A subset of referrals were assessed by ophthalmologists to determine the false positive referral rate.

Main Outcome Measures:

The primary outcome measure of this study was referral to an ophthalmologist for glaucoma assessment. A secondary outcome was the rate of false positive referrals, analyzed in a subset of patients referred for glaucoma assessment.

Results:

Records from 994,461 patients (59% female) were included, and 10,475 (1.1%) were referred for glaucoma assessment. Most referrals were associated with normal intraocular pressure (non-OCT practices: n=496, 66%; OCT practices: n=6,603, 68%). Referral for glaucoma was higher in OCT practices (n=9,719, 1.1%) compared with non-OCT practices (n=756, 0.8%, age-adjusted, gender-adjusted, and location-adjusted odds ratio 1.39, 95% confidence interval 1.10–1.76). Of 318 referred patients (3%, all from OCT practices) for whom ophthalmologist feedback was available, 68 (21%) were considered not to have glaucoma.

Conclusions:

The routine use of OCT in optometric practice may lead to more timely glaucoma detection and prevention of avoidable vision loss.
Comparison of Structural and Functional Features in Primary Angle Closure and Open Angle Glaucomas
Authors: Sun Jessica A. , Yuan Melissa , Johnson Grace E. , Pasquale Louis R. , Boland Michael V. , Friedman David S. , Elze Tobias , Shen Lucy Q. , Wang Mengyu
Published: November 2023

Précis:

Using a large data set, we showed structural and functional differences between primary angle closure glaucoma (PACG) and primary open angle glaucoma (POAG). Primary angle closure glaucoma has relative structural preservation and worse functional loss inferiorly.

Purpose:

To identify structural and functional differences in PACG and POAG.

Materials and Methods:

In this large cross-sectional study, differences in structural and functional damage were assessed among patients with POAG and PACG with optical coherence tomography and reliable visual field testing.

Results:

In all, 283 patients with PACG and 4110 patients with POAG were included. Despite similar mean deviation on visual fields (mean [SD] –7.73 [7.92] vs. –7.53 [6.90] dB, P=0.72), patients with PACG had thicker global retinal nerve fiber layer (RNFL), smaller cup volume, smaller cup-to-disc ratio, and larger rim area than POAG (77 [20] vs. 71 [14] µm, 0.32 [0.28] vs. 0.40 [0.29] mm3, 0.6 [0.2] vs. 0.7 [0.1], 1.07 [0.40] vs. 0.89 [0.30] mm2, P<0.001 for all), while patients with POAG had more pronounced inferior RNFL thinning (82 [24] vs. 95 [35] µm, P<0.001). In a multivariable analysis, hyperopia [odds ratio (OR): 1.24, confidence interval (CI): 1.13–1.37], smaller cup-to-disc ratio (OR: 0.69, CI: 0.61–0.78), thicker inferior RNFL (OR: 1.15, CI: 1.06–1.26) and worse mean deviation (OR: 0.95, CI: 0.92–0.98) were associated with PACG. Functionally, POAG was associated with superior paracentral loss and PACG with inferior field loss. After adjusting for average RNFL thickness, PACG was associated with more diffuse loss than POAG (total deviation differences 1.26–3.2 dB).

Conclusions:

Patients with PACG had less structural damage than patients with POAG despite similar degrees of functional loss. Regional differences in patterns of functional and structural loss between POAG and PACG may improve disease monitoring for these glaucoma subtypes.
The Safety and Efficacy of Using Uremic Clearance Granules for Treating Stages 3 to 5 of Chronic Kidney Disease: A Meta-analysis
Authors: Yin Jiazhen , Chen Hongyu , Zhu Bin
Published: November 2023

Background:

To evaluate the effectiveness and safety of uremic clearance granules for treating stages 3 to 5 of chronic kidney disease (CKD), and to provide evidence-based support for the clinical application of uremic clearance.

Methods:

All randomized controlled trials (RCTs) addressing the use of uremic clearance granules for the treatment of CKD were collected from China Biology Medicine (CBM) database, China National Knowledge Infrastructure (CNKI), WanFang Data, PubMed, Cochrane Library, and Web of Science. After two researchers had independently screened and extracted data, the quality of the included literature was evaluated according to the modified Jadad rating scale. Finally, Stata11 was used for the meta analysis.

Results:

A total of 36 RCTs were obtained that included 3058 patients, comprising 1538 experimental group and 1520 control group participants. Meta analysis indicated that uremic clearance granules treatment yielded promising results in lowering the levels of serum creatinine (Scr, weekly hemodialysis [WHD] = −52.42, 95% confidence interval [CI]: −62.64 to −42.21), triglyceride (TG, WHD = −0.45, 95% CI: −0.85 to −0.04), total cholesterol (TC, WHD = −1.41, 95% CI: −1.78 to −1.04) and increasing the glomerular filtration rate (GFR, WHD = 3.26, 95% CI: 3.70 to 6.99) and hemoglobin (HB, WHD = 5.79, 95% CI: 2.66 to 8.92) levels. In addition, this treatment can improve the overall signs and symptoms of patients with CKD [relative risk (RR) = 1.37, 95% CI: 1.24 to 1.51]. However, there was no statistically significant reduction in the 24 hours total urine protein (24hUpro) Hb levels (WHD = −194.95, 95% Cl: −425.92 to 36.01) compared with control therapy alone.

Conclusion:

Uremic clearance granules treatment significantly reduced Scr, TG, TC levels and increased GFR and HB levels while improving the signs and symptoms of patients with CKD. Due to the low quality of the methodological approaches used in the included studies, further high quality research initiatives are needed to further explore the merits of this therapy.
Preparing Preschool Educators to Monitor Child Progress
Authors: Shepley Collin , Graley Devin , Lane Justin D.
Published: November 2023

The provision of progress monitoring is mandated under federal law for children receiving special education services. In recent years, professional organizations have recommended that this provision be extended to include children receiving services within multitiered systems of support. Organizations representing the field of early childhood education have embraced this focus on progress monitoring to include all children, regardless of ability or disability. To understand how to effectively prepare preschool educators to engage in progress monitoring practices, we conducted a systematic review of the literature. Results of repeated and extended search methods identified only four studies. We present our findings and stress the need for researchers and funding agencies to work toward establishing a rigorous body of literature devoted to professional development and teacher training surrounding progress monitoring.
Prevalence and Correlates of Serotonin Syndrome in Real-World Inpatients
Authors: Di Salvo Gabriele , Porceddu Giorgia , Perotti Camilla , Maina Giuseppe , Rosso Gianluca
Published: November 2023

Background

Serotonin syndrome (SS) is a potentially life-threatening adverse drug reaction due to an increased central and peripheral serotonin activity, which usually presents as a triad of behavioral changes, neuromuscular excitability, and autonomic instability. Probably SS is often misdiagnosed, and its symptoms are mistaken for psychiatric symptoms or general medical issues: the true incidence of SS is not clear, and literature concerning potential risk factors is scarce. Our aims were to examine the prevalence of SS in a naturalistic sample of hospitalized patients and to evaluate potential factors related to the risk of developing the condition.

Methods

The sample included 133 patients being treated with serotonergic medications admitted to the psychiatric inpatient unit of the San Luigi Gonzaga Hospital. All patients received a medical examination (including a neurological examination) within 24 hours of admission. Serotonin syndrome was diagnosed according to Hunter Criteria.

Results

Sixteen patients (12%) were diagnosed with SS. In the subgroup of subjects with SS, we found a higher rate of male patients when compared with subjects with no SS (62.5% vs 33.3%,P= 0.023).

Conclusions

SS probably is an underestimated condition, which should be carefully assessed in patients on serotonergic medications. Male gender was the only factor found to be significantly related to a higher risk of developing SS. Further studies on larger samples are needed, to gain more information on possible risk factors and to identify subjects more prone to developing SS, given the potential risk for patients' health.
Relationship Between Anxiety, Coping Strategies, and Perfectionism in Entry-level Doctor of Physical Therapy Students
Authors: Worst Haley , Adams Katherine , Thompson Anne
Published: November 2023

Introduction.

Doctor of Physical Therapy (DPT) students must meet high standards throughout their lives and careers, which can cause stress and anxiety, with potentially devastating impacts. This quantitative study examined whether and to what extent perfectionism, demographic characteristics, and coping strategies relate to state (situation-related) and trait (personality-related) anxiety in DPT students.

Review of Literature.

Existing literature demonstrates high anxiety levels in DPT students; also, maladaptive perfectionism is associated with higher levels of stress. The predictive relationship between coping, perfectionism, and anxiety in DPT students has not been assessed.

Subjects.

Convenience sample of DPT students in their first through third years across 8 different DPT programs (n = 206).

Methods.

This paper was a cross-sectional, nonexperimental, multisite project. A hierarchical linear regression assessed the relationship between variables (demographics, coping, perfectionism, state anxiety, and trait anxiety).

Results.

Approximately 81.5% of the sample reported being not a perfectionist, 7.0% maladaptive perfectionists, and 11.5% adaptive perfectionists. Students using adaptive coping comprised 72.3% of the sample, whereas 28.0% used primarily maladaptive coping mechanisms. State Trait Anxiety Inventory scores were higher for this sample of DPT students when compared with published studies in the normal population. Significant predictor variables for state anxiety were sex, type of coping strategies used, and class year in the DPT program. For trait anxiety, sex, coping strategy type, maladaptive perfectionism, and class year were significant.

Discussion and Conclusion.

There is a predictive relationship between sex, type of coping strategies used, and year within the DPT program for both state and trait anxiety in DPT students. Presence of maladaptive perfectionism was an additional predictive variable for trait anxiety. This knowledge can help educational institutions better identify at-risk students for anxiety and tailor programs to better meet the individual needs of our students.
Case of Hemolytic Disease of the Fetus and Newborn Treated Without Blood Products
Authors: Hirschman Leah , Munchel Ashley
Published: November 2023

Hemolytic disease of the fetus and newborn (HDFN) affects 3/100,000 to 80/100,000 patients yearly and can cause severe anemia and hyperbilirubinemia. Recombinant human erythropoietin has been used as an adjunct therapy in patients with HDFN and hypo-regenerative anemia in the setting of receiving intrauterine blood transfusions. This case describes a patient with HDFN, in which the family were Jehovah Witnesses, and blood transfusions were declined. The patient had symptomatic anemia with a hematocrit nadir of 18.6%. The patient was successfully treated with recombinant human erythropoietin, ferrous sulfate, and folic acid, avoiding the need for transfusion.
Cross-Cultural Validation of the TeamSTEPPS Teamwork Perceptions Questionnaire-Spanish in Colombia
Authors: Amaya-Arias Ana C. , García-Valencia Jenny , Jaimes Fabián
Published: November 2023

Background:

Teamwork influences health care quality and patient safety. Yet, validated instruments for assessing teamwork in Colombia are lacking.

Purpose:

The purpose of this study was to validate the Spanish version of the TeamSTEPPS-Teamwork Perceptions Questionnaire (T-TPQ-S) for the Colombian health care context.

Methods:

The T-TPQ-S underwent translation, cultural adaptation, and comprehensive psychometric testing, including reliability and confirmatory factor analyses and item difficulty and discrimination analyses.

Results:

The T-TPQ-S demonstrated high internal consistency and excellent fit to the theoretical model. Item discrimination was within expected ranges, with response thresholds displaying an ascending order. The tool better differentiated subjects with low and high teamwork perceptions.

Conclusions:

The T-TPQ-S is an effective, reliable, and valid instrument for assessing teamwork perception among Colombian health care workers.
Implementing Tai Chi Exercise in Long-Term Care to Reduce Falls
Authors: Miles Angela F. , Mulkey David C.
Published: November 2023

Background:

Falls are a frequent occurrence in older adults in long-term care facilities.

Local Problem:

At our long-term care facility, the percentage of patients who fell increased from 45% in 2021 to 68% in 2022, indicating a need for an evidence-based solution.

Methods:

We used an evidence-based quality improvement framework to pilot a tai chi exercise program.

Interventions:

Residents were invited to participate in the Tai Ji Quan: Moving for Better Balance program for 12 weeks. Classes were 30 minutes long and included a 5-minute warm-up and 5-minute cooldown.

Results:

Seventy-five residents participated in the tai chi program. There was a significant 32.3% reduction in falls (P =.001). Residents' fall risk scores decreased 14% (P < .001).

Conclusions:

Implementing a tai chi exercise project may affect falls and decrease the overall fall risk.
The Use of Medical Chaperones During Physical Examinations
Authors: Wilson Meghan , Patel Seema M. , Langhan Melissa L.
Published: November 2023

Purpose

A medical chaperone serves as a witness for a patient and health care practitioner during a medical examination. We sought to better understand the preferences of parents and children toward the use of chaperones during pediatric physical examinations.

Methods

This cross-sectional study surveyed patients aged 8 to 18 years and their parents presenting primarily to the emergency department as well as primary care ambulatory clinic and inpatient units. Participants were asked which individuals (patient alone, parent, or medical chaperone) should be present for each aspect of the child's physical examination.

Results

The survey was completed by 121 patients (mean age 14 years, 58.5% girls) and 122 parents (mean age 42 years, 82.8% women) in a variety of clinical settings (17 in inpatient, 17 in outpatient clinic, and 87 emergency department admissions). Significant differences existed between male and female patients regarding preferred presence for every body part being examined (P ≤ 0.002). Female patients preferred to have a same-sex parent in the room, particularly for examination of the breasts, genitalia, or rectum and when the examination was performed by a male provider. Male patients preferred to be alone or with either parent for any body part being examined, regardless of provider sex.

Conclusions

Adolescents have significant differences in who they prefer to be in the room for the physical examination based on patient and provider sex in settings where they are unfamiliar with the health care examiner. Few patients and parents preferred a medical chaperone; most preferred a parent to be in the room. Patient and parent considerations should be prioritized when creating policies for the use of medical chaperones.
The formation of ubiquitin rich condensates triggers recruitment of the ATG9A lipid transfer complex to initiate basal autophagy
Authors: Broadbent DG , McEwan CM , Tsang TM , Poole DM , Naylor BC , Price JC , Schmidt JC , Andersen JL
Published: November 2023

Autophagy is an essential cellular recycling process that maintains protein and organelle homeostasis. ATG9A vesicle recruitment is a critical early step in autophagy to initiate autophagosome biogenesis. The mechanisms of ATG9A vesicle recruitment are best understood in the context of starvation-induced non-selective autophagy, whereas less is known about the signals driving ATG9A vesicle recruitment to autophagy initiation sites in the absence of nutrient stress. Here we demonstrate that loss of ATG9A or the lipid transfer protein ATG2 leads to the accumulation of phosphorylated p62 aggregates in the context of basal autophagy. Furthermore, we show that p62 degradation requires the lipid scramblase activity of ATG9A. Lastly, we present evidence that poly-ubiquitin is an essential signal that recruits ATG9A and mediates autophagy foci assembly in nutrient replete cells. Together, our data support a ubiquitin-driven model of ATG9A recruitment and autophagosome formation during basal autophagy.
High resolution long-read telomere sequencing reveals dynamic mechanisms in aging and cancer
Authors: Schmidt Tobias T. , Tyer Carly , Rughani Preeyesh , Haggblom Candy , Jones Jeffrey R. , Dai Xiaoguang , Frazer Kelly A. , Gage Fred H. , Juul Sissel , Hickey Scott , Karlseder Jan
Published: November 2023

Telomeres are the protective nucleoprotein structures at the end of linear eukaryotic chromosomes. Telomeres’ repetitive nature and length have traditionally challenged the precise assessment of the composition and length of individual human telomeres. Here, we present Telo-seq to resolve bulk, chromosome arm-specific and allele-specific human telomere lengths using Oxford Nanopore Technologies’ native long-read sequencing. Telo-seq resolves telomere shortening in five population doubling increments and reveals intrasample, chromosome arm-specific, allele-specific telomere length heterogeneity. Telo-seq can reliably discriminate between telomerase- and ALT-positive cancer cell lines. Thus, Telo-seq is a novel tool to study telomere biology during development, aging, and cancer at unprecedented resolution.
Multi-ContrastiveVAE disentangles perturbation effects in single cell images from optical pooled screens
Authors: Wang Zitong Jerry , Lopez Romain , Hütter Jan-Christian , Kudo Takamasa , Yao Heming , Hanslovsky Philipp , Höckendorf Burkhard , Moran Rahul , Richmond David , Regev Aviv
Published: November 2023

Optical pooled screens (OPS) enable comprehensive and cost-effective interrogation of gene function by measuring microscopy images of millions of cells across thousands of perturbations. However, the analysis of OPS data still mainly relies on hand-crafted features, even though these are difficult to deploy across complex data sets. This is because most unsupervised feature extraction methods based on neural networks (such as auto-encoders) have difficulty isolating the effect of perturbations from the natural variations across cells and experimental batches. Here, we propose a contrastive analysis framework that can more effectively disentangle the phenotypes caused by perturbation from natural cell-cell heterogeneity present in an unperturbed cell population. We demonstrate this approach by analyzing a large data set of over 30 million cells imaged across more than 5, 000 genetic perturbations, showing that our method significantly outperforms traditional approaches in generating biologically-informative embeddings and mitigating technical artifacts. Furthermore, the interpretable part of our model distinguishes perturbations that generate novel phenotypes from the ones that only shift the distribution of existing phenotypes. Our approach can be readily applied to other small-molecule and genetic perturbation data sets with highly multiplexed images, enhancing the efficiency and precision in identifying and interpreting perturbation-specific phenotypic patterns, paving the way for deeper insights and discoveries in OPS analysis.
Targeting PKC alleviates iron overload in diabetes and hemochromatosis
Authors: Banerjee Somesh , Lu Shaolei , Jain Anand , Wang Irene , Tao Hui , Srinivasan Shanthi , Nemeth Elizabeta , He Peijian
Published: November 2023

Diabetes is one of the most prevalent chronic diseases worldwide. Iron overload increases the incidence of diabetes and aggravates diabetic complications that cause mortality. Reciprocally, diabetes potentially promotes body iron loading, but the mechanism remains not well understood. In this study, we demonstrated systemic iron excess and the upregulation of iron exporter ferroportin (Fpn) in the enterocytes and macrophages of multiple diabetic mouse models. Increased Fpn expression and iron efflux was also seen in the enterocytes of type 2 diabetic human patients. We further showed that protein kinase C (PKC), which is activated in hyperglycemia, was responsible for the sustained membrane expression of Fpn in physiological and in diabetic settings. For the first time, we identified that PKCs were novel binding proteins and positive regulators of Fpn. Mechanistically, hyperactive PKC promoted exocytotic membrane insertion while inhibited the endocytic trafficking of Fpn in the resting state. PKC also protected Fpn from internalization and degradation by its ligand hepcidin dependent on decreased ubiquitination and increased phosphorylation of Fpn. Importantly, the loss-of-function and pharmacological inhibition of PKC alleviated systemic iron overload in diabetes and hemochromatosis. Our study thus highlights PKC as a novel target in the control of systemic iron homeostasis.
CHIP is associated with cardiovascular disease in the UK Biobank
Authors: Vlasschaert Caitlyn , Genovese Giulio , Pershad Yash , Jaiswal Siddhartha , Natarajan Pradeep , Bick Alexander G.
Published: November 2023

Clonal hematopoiesis (CH) is a form of age-related somatic mosaicism. CH encompasses both clonal events with recognizable leukemic driver mutations, such as CH of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs), as well as clonal states without clear driver mutations. Staceyet al. identify cases of CH from whole genome sequencing (WGS) data in a subset of 130,709 UK Biobank (UKB) participants and in 45,510 individuals from an Icelandic cohort. They report that CH is not associated with cardiovascular disease (CVD) and posit that the multiple prior CH studies did not fully account for smoking-related confounding. We find that the conclusion reached by Staceyet al. is specific to their particular CH definition which groups well-established and clinically meaningful CH subtypes together despite evidence from multiple previous reports that distinct forms of CH have distinct phenotypic consequences. We show that (1) the CHIP/ CVD association in the UK Biobank is not confounded by smoking and (2) CH subtypes which Staceyet al. have lumped together have heterogenous associations with CVD. We suggest that Stacey et al.’s failure to identify an association between CHIP and CVD is perhaps related to methodologic differences compared to prior reports.
Time-resolved high-energy X-ray diffraction studies of ultrathin Ni ferrite films on MgO(001)
Authors: Alexander Andreas , Pohlmann Tobias , Hoppe Martin , Röh Jan , Gutowski Olof , Küpper Karsten , Bertram Florian , Wollschläger Joachim
Published: November 2023

Time-resolved high-energy X-ray diffraction was used during growth of ultrathin Ni
x
Fe3−x
O4 films with varying Ni content (0 ≤ x ≤ 1.5) deposited on MgO(001) substrates by reactive molecular beam epitaxy, providing an insight into the growth dynamics of these films. In order to obtain structural information, reciprocal-space maps were recorded and the temporal evolution of the Bragg peaks specific to the octahedral and tetrahedral lattice sites of the inverse spinel structure of Ni
x
Fe3−x
O4 was observed during growth of the films. A time delay, corresponding to a coverage of 1.2–1.8 nm, between the appearance of the Bragg reflections originating from octahedral sites and reflections originating exclusively from tetrahedral sites indicates that the ferrite films grow in two stages. In the initial growth phase, a rock salt interface layer is formed. Afterwards, a structural transition occurs and the films grow in an inverse spinel structure. The thickness of the initial rock salt phase was found to increase with Ni content and to be responsible for atypical strain in the thin films. Films with Ni contents x > 1 do not show a structural transition. These films remain in a (deficient) rock salt structure consisting of a mixed Ni–Fe oxide and do not form a spinel structure at all. They show an increased number of NiO clusters as detected by X-ray photoelectron spectroscopy of the valence band, accompanied by a significant roughening of the films.
Isogonal 2-periodic polycatenanes: chain mail
Authors: O'Keeffe Michael , Treacy Michael M. J.
Published: November 2023

For 2-periodic polycatenanes with isogonal (vertex-transitive) embeddings, the basic units linked are torus knots and links including the unknots (untangled polygons). Twenty-four infinite families have been identified, with hexagonal, tetragonal or rectangular symmetry. The simplest members of each family are described and illustrated. A method for determining the catenation number of a ring based on electromagnetic theory is described.
Synthesis, crystal structure and Hirshfeld surface analysis of the tetrakis complex NaNdPyr4(i-PrOH)2·i-PrOH with a carbacylamidophosphate of the amide type
Authors: Kariaka Nataliia S. , Dyakonenko Viktoriya V. , Znovjyak Kateryna O. , Shishkina Svitlana V. , Amirkhanov Volodymyr M.
Published: November 2023

The tetrakis complex of neodymium(III), tetrakis{μ-N-[bis(pyrrolidin-1-yl)phosphoryl]acetamidato}bis(propan-2-ol)neodymiumsodium propan-2-ol monosolvate, [NaNd(C10H16Cl3N3O2)4(C3H8O)2]·C3H8O or NaNdPyr4(i-PrOH)2·i-PrOH, with the amide type CAPh ligand bis(N,N-tetramethylene)(trichloroacetyl)phosphoric acid triamide (HPyr), has been synthesized, crystallized and characterized by X-ray diffraction. The complex does not have the tetrakis(CAPh)lanthanide anion, which is typical for ester-type CAPh-based coordination compounds. Instead, the NdO8 polyhedron is formed by one oxygen atom of a 2-propanol molecule and seven oxygen atoms of CAPh ligands in the title compound. Three CAPh ligands are coordinated in a bidentate chelating manner to the NdIII ion and simultaneously binding the sodium cation by μ2-bridging PO and CO groups while the fourth CAPh ligand is coordinated to the sodium cation in a bidentate chelating manner and, due to the μ2-bridging function of the PO group, also binds the neodymium ion.
Deep pockets or empty coffers? Functional expenses, contribution revenue and the ability of nonprofits to pivot during COVID-19
Authors: Burke-Kolehmainen Cari , Intindola Melissa
Published: November 2023

Purpose

Within the context of the nonprofit resiliency framework, the authors use nonprofit functional expenses and contribution revenue to explore how the COVID-19 pandemic affected the ability of nonprofits in different subsectors to carry out their mission, as well as their ability to “pivot” fundraising strategies to integrate social media and digital engagement.

Design/methodology/approach

The authors use IRS form 990 return data for organizations with a year-end return that includes at least six months of COVID-19 impact (“Wave 1 Effects” period) and also have a prior-year return (“Business as Usual” period). The authors use Wilcoxon signed rank tests to examine whether there are differences in our variables of interest between the two periods.

Findings

While the majority of nonprofits in most subsectors experienced a significant decrease in program spending, fundraising spending and fundraising efficiency ratios between the two time periods, the authors found variation in the change in contribution revenue and fundraising ratio between the two periods between subsectors. The authors also find that the percentage of nonprofits able to “pivot” their fundraising strategies varies by subsector between 13.33 and 31.23%.

Originality/value

This paper provides new information regarding the pandemic's initial effect on nonprofit program and fundraising spending, the related contribution revenue and the ability of nonprofits to “pivot” fundraising to remote strategies. The authors propose a more robust fundraising efficiency measure and a new measure indicating a nonprofit's “ability to pivot” their fundraising strategy. The authors encourage future researchers to conduct further longitudinal studies to understand how these effects may continue or change.
Digital transformation of the wood construction supply chain through building information modelling: current state of practice
Authors: Gharaibeh Lina , Matarneh Sandra , Eriksson Kristina , Lantz Björn
Published: November 2023

Purpose

This study aims to present a state-of-the-art review of building information modelling (BIM) in the Swedish construction practice with a focus on wood construction. It focuses on examining the extent, maturity and actual practices of BIM in the Swedish wood construction industry, by analysing practitioners’ perspectives on the current state of BIM and its perceived benefits.

Design/methodology/approach

A qualitative approach was selected, given the study’s exploratory character. Initially, an extensive review was undertaken to examine the current state of BIM utilisation and its associated advantages within the construction industry. Subsequently, empirical data were acquired through semi-structured interviews featuring open-ended questions, aimed at comprehensively assessing the prevailing extent of BIM integration within the Swedish wood construction sector.

Findings

The research concluded that the wood construction industry in Sweden is shifting towards BIM on different levels, where in some cases, the level of implementation is still modest. It should be emphasised that the wood construction industry in Sweden is not realising the full potential of BIM. The industry is still using a combination of BIM and traditional methods, thus, limiting the benefits that full BIM implementation could offer the industry.

Originality/value

This study provided empirical evidence on the current perceptions and state of practice of the Swedish wood construction industry regarding BIM maturity.
Determinants of adopting eCourier services: the moderating role of resistance to change
Authors: Gani Mohammad Osman , Bhuiya Naimul , Swarna Anika Afrin , Alam Muhammad Intisar , Faruq Mohammad Omar
Published: November 2023

Purpose

The purpose of this paper is to understand the determinants affecting the adoption behavior of eCourier services and to establish a moderating role of resistance to change between behavioral intention and actual usage behavior.

Design/methodology/approach

Data were collected through a survey questionnaire that was distributed to the eCourier users. A total of 260 collected data were analyzed by using structural equation modeling.

Findings

The results of the study demonstrate that all the factors considered for the study have a significant impact on the adoption of eCourier except social influence and customer service. The results also confirm that there is no moderating effect of resistance to change in the relationship between behavioral intention and actual usage.

Practical implications

This research provides theoretical contribution by extending the practical knowledge focusing on the adoption intention of eCourier, and actual usage behavior using Unified Theory of Acceptance and Use of Technology model—a pertinent and unresearched topic in the existing literature that presents a number of potential avenues for further study.

Originality/value

This study provides a general understanding of consumers in underdeveloped nations and advances earlier research on the usage of e-commerce in the courier sector.
Climate change needs behavior change: a team mechanism of team green creative behavior
Authors: Farrukh Muhammad , Rafiq Muhammad , Raza Ali , Ansari Nabeel Younus
Published: November 2023

Purpose

This study aims to examine the influence of team-level green human resource management practices (TGHRM) on team-level green creative behavior (TGCB) through team green psychological climate (TGPC). Additionally, it delves into the moderating effects of ethical leadership (EL) and green culture (GC) on the relationships among team-level GHRM, TGPC and TGCB.

Design/methodology/approach

Using a cross-sectional design, data were gathered from hotel teams and were analyzed using the PROCESS model.

Findings

The results indicate that TGHRM significantly impacts TGCB via TGPC. Moreover, the study provides partial evidence supporting the moderating roles of EL and GC in the relationships between TGHRM, TGPC and TGCB.

Practical implications

These findings offer valuable insights for managers and practitioners. They highlight the potential to enhance TGCB by implementing GHRM practices, nurturing a TGPC and cultivating both EL and a GC within teams.

Originality/value

This research addresses a gap in the literature, focusing on the effects of TGHRM on TGCB and shedding light on the intertwined social and psychological processes. Further, it broadens the discourse by analyzing the moderating influence of EL and GC in the dynamics between TGHRM, TGPC and TGCB.