bluuebunny/crossref_metadata_2025 huggingface dataset:
Essential competencies required of nurse managers in times of COVID‐19: A scoping review
Authors: Velasco Arias Jina Mariont , Peres Aida Maris , Nunes Mario Gilberto Jesus , Escandell Rico Francisco Miguel , Noreña‐Peña Ana
Published: November 2024

Aim

To identify the essential competencies required of nurse managers in healthcare services during the COVID‐19 pandemic.

Background

Nurse managers play a vital role in healthcare services organization, requiring a diverse set of competencies. The increasing occurrence of epidemics in recent decades underscores the importance of understanding these competencies in pivotal junctures. The challenges faced during the COVID‐19 pandemic present valuable opportunities to recognize the competencies of nurse managers and guide their responsiveness in addressing future health crises.

Methods

A scoping review following the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews guidelines was conducted. A comprehensive search was conducted across six databases (LILACS, BDENF, EMBASE, MEDLINE, SCOPUS, and Web of Science). Results were categorized according to the nurse manager competencies model by the American Organization for Nursing Leadership and were analyzed using the competing values framework model.

Results

Out of 2033 potentially relevant sources identified, 17 studies met inclusion criteria. A total of 52 competencies were identified and categorized into four thematic categories: (1) the ability to collaborate in times of crisis; (2) maintaining control during a crisis; (3) adapting to changes caused by the crisis; and (4) preserving competitiveness through the crisis.

Conclusions

The findings highlight communication, decision‐making, training, adaptability to change, and leadership as essential competencies required of nurse managers to address crises, such as pandemics.

Implications for nursing policy

This body of knowledge can serve as a reference point to enhance the response of nurse managers in the face of future health crisis scenarios. Additionally, it can serve as a framework for healthcare organizations to develop or improve their crisis management training programs.
How nurses’ moral competence can be supported: Findings from international focus groups with professionals
Authors: Wiisak Johanna , Suhonen Riitta , Galazzi Alessandro , Gastmans Chris , Keogh Brian , Papastavrou Evridiki , Stefanopoulos Nikos , Palese Alvisa , Stolt Minna ,   the PROMOCON Consortium
Published: November 2024

Aim

To describe how nurses’ moral competence can be supported from the perspective of nurses, nurse managers, researchers, educators, and nursing students.

Background

Moral competence is the capacity or ability of nurses to recognise one's own emotions of what is right or wrong, to reflect on these emotions, to make decisions, and to act in ways that bring the highest level of benefit to patients. Moral competence is part of professional competence. However, little is known about how nurses’ moral competence can be supported.

Methods

A qualitative descriptive study design was applied. Stratified purposive sampling was employed and focus group discussions were conducted in Belgium, Cyprus, Finland, Greece, Ireland, and Italy in 2023. A total of 38 informants (5–8 per focus group) who were registered nurses or nursing students participated. The data were analysed using both deductive and inductive content analysis. The COnsolidated criteria for REporting Qualitative research were adhered to.

Results

Seven themes were developed following analysis, which suggested that support for nurses’ moral competence can be located at individual‐relational, organisational, and societal levels. Several approaches and/or tools were also identified to support moral competence.

Conclusion

Nurses’ moral competence could benefit from continuous support from colleagues, those in leadership positions, organisations and society. Practical tools and approaches can also successfully support nurses’ moral competence.

Implications for nursing and health policy

Support for nurses’ moral competence forms a continuum from the beginning of nursing studies throughout nursing careers. Thus, educational interventions and training programmes are needed both at basic and continuous ethics education. There is also a need for investments in and development of strategies and regulations on ethics management in health systems, national‐ and international‐level ethics indicators for health policy‐making, and implementation of existing practices, interventions, and procedures in nursing practice.
When Expertise Is Not Enough: Explaining the European Commission's Non‐success in the Integration of Public Sector Accounting
Authors: Horni Pascal
Published: November 2024

The European Commission crucially relies on expertise and advice to fulfil its focal role in drafting policies. For this reason, it maintains numerous expert groups. When handling technical complex cases, expert groups engage in deliberative supranationalist problem‐solving that is driven by logic and knowledge. Based on the Commission's policy initiative to develop European Public Sector Accounting Standards (EPSAS) for the integration of European Union member states' government accounting practices, this study investigates how and under what conditions policy incentives translate via expert group deliberations into draft policies. Drawing on policy design literature and using process tracing, this study finds that pre‐existing policy instruments or design choices on higher order policy elements could lead to challenges in achieving the integrity and superiority of solutions at the level of calibration and street‐level requirements, thus failing to produce the necessary expert consensus.
Morphometry of choroid plexus epithelial cells in neurodegenerative diseases
Authors: Murakami Ryuta , Chiba Yoichi , Miyatake Nobuyuki , Miyai Yumi , Matsumoto Koichi , Wakamatsu Keiji , Saito Yuko , Hara Manato , Murayama Shigeo , Ueno Masaki
Published: November 2024

The choroid plexus not only secretes the majority of cerebrospinal fluid but also controls the circadian rhythm, which can be impaired in the presence of neurodegenerative diseases. In addition, many studies have reported the contribution of choroid plexus abnormalities to the pathogenesis of neurodegenerative diseases, including Alzheimer's disease (AD). Formalin‐fixed paraffin‐embedded blocks were obtained from the lateral ventricles of the brains of four subjects with AD, four with vascular dementia, four with Parkinson's disease, three with multiple system atrophy, and five control patients with unremarkable neuropathological findings. They were sectioned and routinely stained with hematoxylin and eosin. Morphological analysis of epithelial cells in 10 high‐power fields or a total area per case was conducted using digital images. There were no significant changes in any of the measurements: epithelial cell area, long and short axes, and ratio of the epithelial cell area to total stained area among the five groups. However, a simple linear regression analysis of epithelial cells in 20 patients showed that age was significantly correlated with the cell area, long axis, and short axis but not ratio. There were no effects of hypertension, diabetes mellitus, or calcification in the stroma on the measurements. These findings indicate that age was associated with the cell area and size in choroid plexus epithelial cells, whereas no significant changes in any epithelial cell measurements were present in neurodegenerative diseases.
The sustainability of U.S. debt and potential reforms: Fiscal rules, spending and taxes, and a fiscal commission
Authors: McBride William , York Erica , Durante Alex , Watson Garrett
Published: November 2024

In this study, we assess current projections of U.S. deficits and debt, establishing the recent history, causes, and consequences of the growing fiscal gap. We review the fiscal consolidation literature, finding successful debt reductions primarily focus on spending reforms. In the U.S. context, we assess options to reform the budget process, major spending programs, and taxes. We simulate six potential changes in U.S. tax policy that would substantially alter tax revenues, finding substantial effects on the economy over the long run that tend to reduce the impact on the debt burden, leaving the debt‐to‐GDP ratio on an unsustainable course.
Introversion and Trait Incongruent Work Demands: Episodic Misfit at Work
Authors: Wanberg Connie R. , Park YoungAh , Ren Shuai L.
Published: November 2024

Even if individuals are in a job or organization that is generally a good fit for them, they can still experience misfit with specific work demands. This study examines the proximal experiences of trait‐incongruent work demands among highly introverted individuals, offering a novel episodic and trait‐specific perspective on workplace misfit. Through narrative surveys and semi‐structured interviews, we identify four broad trait‐incongruent work demands that spur episodic misfit at work for introverts. We introduce an integrated process model that reveals how individuals’ reactions to introversion‐incongruent work demands evolve in the time proximal to the work demand. We build theory about (1) how individuals navigate and cope with introversion‐incongruent work demands before, during, and after they occur (and how these adaptations affect immediate and subsequent reactions); (2) why reactions of individuals are sometimes amplified or attenuated across various experiences of trait‐incongruent work demands; and (3) how subsequent exposure to these work demands (i.e., experience) plays a role in repeating this cycle. We offer new insights into how and why individual reactions to episodic misfit evolve before, during, and after a specific situation, and factors that may moderate these reactions—a topic that has received scant attention in the person‐environment fit literature. We provide propositions for future research and practice‐related implications.
The Effects of a Smartphone App‐Supported Nursing Care Program on the Disease Self‐Management of Hypertensive Patients: A Randomized Controlled Study
Authors: Arabaci Zeynep , Uysal Toraman Aynur
Published: November 2024

Aim

Hypertension is one of the most common chronic diseases worldwide. Therefore, it is essential to improve patients' adherence to treatment in order to control their blood pressure. The present study aims to examine the effect of a smartphone application‐supported nursing care program provided by a nurse on medication adherence and achievement of normal systolic and diastolic blood pressure levels among patients diagnosed with primary hypertension and registered at the Family Health Center within the context of patients' self‐management behaviors.

Methods

A randomized controlled experimental study design. CONSORT flow chart was used in the study. The study sample consisted of 41 hypertensive patients in the intervention group and 41 hypertensive patients in the control group. The intervention group was supported with a smartphone application named “HiperDostum” based on the health belief model, whereas the control group continued to receive standard healthcare services provided by the Family Health Center, to which they were affiliated. Data were collected using the “Patient Information Form,” “Blood Pressure Monitoring Form,” and the “Medication Adherence Self‐Efficacy Scale—Short Form.”

Results

It was observed that the intervention group participants had higher medication adherence self‐efficacy scale scores when compared to the control group participants. Comparing the blood pressure values by group, time, and group*time interaction, it was determined that there were statistically significant differences in systolic blood pressure values by time and group*time interaction.

Conclusion

Considering the widespread use of smartphones and smartphone application‐supported nursing care can be successfully used to enhance self‐management and improve treatment adherence among hypertensive patients in primary healthcare institutions.

Trial Registration

Registration number: NCT0532140;

Name of trial registry

The Effect of Smart Phone Application Supported Nursing Care Program on the Self‐Management of Hypertensive Patients
A new vision for American science
Authors: Parikh Sudip S. , McNutt Marcia K. , Gil Darío
Published: November 2024

America’s scientific success is no accident. It has been powered by a decades-long commitment to federal investment in fundamental research that, in turn, nurtured both domestic and foreign talent and prompted the translation of breakthroughs to fuel the economy, improve health, fortify national security, and inspire awe. The world has benefited from the proliferation of this model, and partnerships between the US and other countries have resulted in game-changing discoveries, from medicines to machine learning. Yet what got America to this point will not get the country to where it needs to go. A new vision is required to respond to an evolving global science and technology ecosystem.
Black hole to grey hole metamorphosis in the deep quantum regime
Authors: Singh Harpreet , Nandy Malay K.
Published: November 2024

In order to search for new solutions for collapsed objects in quantum gravity, we consider in this paper a Kantowski–Sachs metric labelled by parameters that have no classical significance. In addition, we include a Klein–Gordon field to represent in a simple manner the inevitable zero-point vacuum fluctuations that permeate the spacetime. With this framework, we quantize the system and obtain the Wheeler–DeWitt equation in order to focus upon the deep quantum regime of the interior and to analyze any kind of transition that the black hole may undergo. The Wheeler–DeWitt equation reveals the existence of new solutions of different nature, designated herein as “quantum grey holes,” in addition to the existence of quantum black holes, with all solutions satisfying the DeWitt boundary condition. The existence of new solutions gives rise to the novel possibility of a quantum black hole making a transition to a quantum grey hole. We find that there exists non-zero probability of quantum black-to-grey hole transition. These transition probabilities exhibit resonances for a continuous range of eigenvalues of the system.
Sympathetic nerves, salivary secretion, and the parched mouth of fear: unraveling historical perspectives on persistent contradiction in physiology textbooks
Authors: Zagvazdin Yuri , Mashukova Anastasia , Purvis Cheryl
Published: November 2024

We have observed two starkly contradictory notions regarding the sympathetic influence on the salivary outflow in discussions with our students. Most of them believe that sympathetic nerves decrease salivation and are antagonistic to parasympathetic nerves. Some students, however, show awareness of the cooperative stimulatory action of both types of autonomic fibers. We have found a similar dichotomy in the descriptions of the sympathetic effect on secretion of the main salivary glands and their inconsistent illustrations in Anatomy/Physiology textbooks. We have investigated the historical roots of this discrepancy. Ludwig discovered excitatory actions of both parasympathetic and sympathetic nerves on salivary flow by 1856. The next year, Czermak proposed the hypothesis of an inhibitory effect of sympathetic nerves, observing their interference with salivation induced by the chorda tympani (i.e., parasympathetic) stimulation. Bernard and Eckhard soon confirmed Ludwig’s findings, but Czermak’s notion persisted because sympathetically evoked salivation was unstable and potentially abatable by glandular vasoconstriction. The salivary secretory response to moderate sympathetic nerve electrostimulation was reaffirmed by Langley who also discovered salivation in response to adrenaline injection at the beginning of the 20th century. A few years later, Cannon, on a purely theoretical basis, attributed the sensation of dry mouth occasionally associated with fear to hyposalivation induced by elevated sympathetic discharge. Despite subsequent researchers’ inability to find unequivocal evidence of salivary flow reduction by sympathetic activation, Cannon’s assumption gained acceptance in some textbooks. Most Anatomy/Physiology textbook authors, however, recognized the excitatory action of sympathetic nerves on salivary glands established by Ludwig and Bernard.
Virtual Inertial Control of Small‐ and Medium‐Sized Wind Turbines on Mobile Offshore Platforms with DC Microgrids
Authors: Zhang Ruifang , Wang Guoling , Li Zhenyu , He Fuqiao , Luo Chenghan , Cao Wensheng
Published: November 2024

The renewable energy mobile offshore platform, which adopts the combined power supply of renewable energy and energy storage, is an important carrier for the development and utilization of marine resources. The randomness of renewable energy generation has a more prominent effect on the bus voltage stability and transient voltage deviation of the power system with small capacity and low inertia. Considering the operation and maintenance characteristics of the offshore platform, a virtual inertia control method for small‐ and medium‐sized wind turbines is proposed. Firstly, by analyzing the characteristics of the renewable energy microgrid of the unattended offshore platform, considering the operating environment with high average wind speed at sea, the mechanical inertia in the wind turbine is selected as the energy source of virtual inertia. The structure of the wind power generation unit is analyzed, and small signal modeling is carried out. A virtual inertia control method based on power droop is proposed, and the rotational inertia and the damping coefficient are obtained from the characteristics of transient and steady‐state analysis of the system. Finally, the DC microgrid experiment platform of the offshore platform is constructed, and it is verified that the proposed method makes full use of the characteristics of the offshore platform to enhance system inertia and improve the operational stability of the offshore platform DC microgrid system.
Role of the NOD1/Rip2 Signaling Pathway in Macrophage Inflammatory Activation Induced by ox‐LDL
Authors: Hou Liang , Liu Jinli , Yuan Yuhui , Ding Yanchun
Published: November 2024

Aim: This study aimed to investigate the impact of the NOD1/Rip2 signaling pathway on macrophage inflammatory activation and polarity switching in ox‐LDL‐induced THP‐1‐derived macrophages.

Methods: THP‐1‐derived macrophages were stimulated with various concentrations (10, 25, or 50 mg/L) of ox‐LDL for different durations (8, 16, or 24 h). Quantitative real‐time PCR was used to measure the mRNA expression of NOD1, Rip2, IL‐10, IL‐12, iNOS, and Arg‐1. Western blotting was used to determine the protein levels of NOD1 and Rip2. The secretion of TNF‐α and MCP‐1 in the cell culture supernatants was measured via ELISA. Rip2 siRNA was used to inhibit the NOD1/Rip2 signaling pathway. Oil Red O staining was employed to visualize foam cell formation. CD86, CD80, and CD163 membrane molecules were analyzed via FACS.

Results: After exposure to ox‐LDL, the expression levels of NOD1 and Rip2 mRNAs and proteins in THP‐1‐derived macrophages increased in a dose‐ and time‐dependent manner. This upregulation was accompanied by increased concentrations of TNF‐α and MCP‐1 in the cell culture supernatants. The effects of NOD1 and Rip2 expression upregulation were mitigated by Rip2 siRNA, as evidenced by decreased concentrations of TNF‐α and MCP‐1. Furthermore, ox‐LDL downregulated the expression of M2 macrophage markers CD163, IL‐12, and Arg‐1 and upregulated the expression of M1 macrophage markers CD86, CD80, IL‐10, and iNOS. The inhibition of Rip2 by siRNA reversed these effects and prevented the formation of foam cells.

Conclusion: Our data show that the NOD1/RIP2 signaling pathway regulates the inflammatory activation of macrophages induced by ox‐LDL and controls the macrophage polarity switch.
Healthcare Utilization and Costs in Patients With Somatic Symptom and Related Disorders Compared With Those With Depression and Healthy Controls: A Nationwide Cohort Study
Authors: Seo Jun Ho , Han Minkyung , Kang Sunghyuk , Kim Se Joo , Jung Inkyung , Kang Jee In
Published: November 2024

Introduction: Patients with somatic symptom and related disorders (SSRDs) often face diagnostic delays, leading to frustration, unnecessary medical procedures, and excessive costs. This study examines healthcare utilization and costs in the 3 years before diagnosing SSRDs, comparing them to patients with depressive disorders and individuals with no mental disorder using data from the Korean National Health Insurance claims database. The analysis also addresses the influence of medical comorbidities by focusing on patients without them.

Methods: Utilizing Korean nationwide medical claims database covering all South Koreans, we identified individuals aged 15–64 diagnosed with SSRDs between 2015 and 2019. A corresponding group diagnosed with depression served as controls for nonpsychotic mental disorders. We analyzed medical costs and healthcare utilization comparing the SSRDs group to the depression group and the group with no mental disorder using nonparametric tests, including a specific analysis for those with a Charlson Comorbidity Index (CCI) of zero.

Results: The study encompassed 84,223 SSRD patients, 336,919 with depressive disorders, and 269,444 individuals with no mental disorder. Patients with SSRDs had significantly higher healthcare costs and made more frequent use of outpatient and emergency services than both control groups, a pattern consistent even in patients without medical comorbidities.

Conclusion: This large nationwide cohort study confirmed that patients with SSRDs frequently used the healthcare system and incurred considerable costs before their diagnosis. The findings suggest that plans for early recognition and intervention, along with mental health support for this population, are urgently needed to assist them and improve the efficiency of the healthcare system.
SFCNN: Separation and Fusion Convolutional Neural Network for Radio Frequency Fingerprint Identification
Authors: Wang Shiyuan , Yao Rugui , Zuo Xiaoya , Fan Ye , Li Xiongfei , Guo Qingyan , Li Xudong
Published: November 2024

The unique fingerprints of radio frequency (RF) devices play a critical role in enhancing wireless security, optimizing spectrum management, and facilitating device authentication through accurate identification. However, high‐accuracy identification models for radio frequency fingerprint (RFF) often come with a significant number of parameters and complexity, making them less practical for real‐world deployment. To address this challenge, our research presents a deep convolutional neural network (CNN)–based architecture known as the separation and fusion convolutional neural network (SFCNN). This architecture focuses on enhancing the identification accuracy of RF devices with limited complexity. The SFCNN incorporates two customizable modules: the separation layer, which is responsible for partitioning the data group size adapted to the channel dimension to keep the low complexity, and the fusion layer which is designed to perform deep channel fusion to enhance feature representation. The proposed SFCNN demonstrates improved accuracy and enhanced robustness with fewer parameters compared to the state‐of‐the‐art techniques, including the baseline CNN, Inception, ResNet, TCN, MSCNN, STFT‐CNN, and the ResNet‐50‐1D. The experimental results based on the public datasets demonstrate an average identification accuracy of 97.78% among 21 USRP transmitters. The number of parameters is reduced by at least 8% compared with all the other models, and the identification accuracy is improved among all the models under any considered scenarios. The trade‐off performance between the complexity and accuracy of the proposed SFCNN suggests that it is an effective architecture with remarkable development potential.
Supplementary Data from The Significance of Comprehensive Metabolic Phenotypes in Cancer Risk: A Japan Multi-Institutional Collaborative Cohort Study
Authors: Watanabe Takeshi , Nguyen Tien Van , Katsuura-Kamano Sakurako , Arisawa Kokichi , Ishizu Masashi , Unohara Taichi , Tanaka Keitaro , Shimanoe Chisato , Nagayoshi Mako , Tamura Takashi , Kubo Yuko , Kato Yasufumi , Oze Isao , Ito Hidemi , Michihata Nobuaki , Nakamura Yohko , Tanoue Shiroh , Koriyama Chihaya , Suzuki Sadao , Nakagawa-Senda Hiroko , Koyama Teruhide , Tomida Satomi , Kuriki Kiyonori , Takashima Naoyuki , Harada Akiko , Wakai Kenji , Matsuo Keitaro
Published: November 2024

Supplementary Table S1-S14
Epidemiology, Real-World Treatment Patterns, and Patient Outcomes of Primary Advanced or Recurrent Endometrial Cancer in Germany between 2015–2021
Authors: Mevius Antje , Lutter Johanna , Karl Florian M. , Tuffy Liam , Schochter Fabienne , Fuchs Andreas , Wilke Thomas
Published: November 2024

Introduction: The aim of this study was to describe the epidemiology of primary advanced or recurrent endometrial cancer and the outcomes from real-world treatment patterns of patients affected in Germany between 2015 to 2021. Methods: In this retrospective cohort study covering the period from 1 January 2015 to 31 December 2021, data from patients with primary advanced or recurrent endometrial cancer who initiated systemic treatment for their disease were extracted from an anonymized claims dataset. Epidemiologic outcomes were cumulative incidence of endometrial cancer and point prevalence. Overall survival after the index date was assessed, with all-cause death used as an event. Endometrial cancer-related real-world treatment patterns were described for the post-index period. Results: The incidence of primary advanced or recurrent endometrial cancer in 2021 was 4.77 cases/100 000 persons, with no substantial change over time (4.63 in 2018; 4.93 in 2019; 4.45 in 2020). The point prevalence on 1 January 2022 was 0.023%, with a slight increase in prevalence observed from 1 January 2019 onwards. Among 466 patients with confirmed endometrial cancer, the mean (standard deviation) age was 68.0 (11.6) years; the tumor material from 86 patients (18.5%) underwent immunohistochemistry or polymerase chain reaction testing. Median overall survival was estimated to be 47.5 months (95% CI 35.1 to 70.4) and the 5-year survival probability was 46.2%. The most frequent first-line systemic therapies were carboplatin (45.7%) and paclitaxel (43.1%). Second-line therapy was received by 153 patients (32.8%). Conclusion: The analysis of the German claims data produced contemporary epidemiologic estimates for advanced or recurrent endometrial cancer. Treatments were aligned with guideline recommendations during the study period, with tumor testing yet to enter mainstream practice.
Impact of small body surface area on clinical and culprit lesion characteristics and outcomes in Japanese patients with acute coronary syndrome
Authors: Kobayashi Nobuaki , Shibata Yusaku , Kurihara Osamu , Shigihara Shota , Sawatani Tomofumi , Shirakabe Akihiro , Takano Masamichi , Asai Kuniya
Published: November 2024

Background: The disadvantages of small body size in patients with cardiovascular disease have not been fully investigated. The aim of our current study is to examine the impact of body surface area (BSA) on clinical characteristics and outcomes in patients with acute coronary syndrome (ACS).
Methods: Patients with ACS (n=1829) were retrospectively compared in the small BSA (S-BSA; BSA <1.65 m2), medium BSA (M-BSA; BSA 1.65–1.80 m2) and large BSA (L-BSA; BSA>1.8 m2) groups. Optical coherence tomography (OCT) findings were also compared among groups.
Results: The frequency of in-hospital left ventricular rupture was higher in the S-BSA group than in the M-BSA and L-BSA groups (3% vs. 1% vs. 1%, p<0.001). Peak creatine kinase-MB levels were lower in the S-BSA group (median [U/L]; 83 vs. 94 vs. 106). OCT data showed that distal (median [mm2]; 4.26 vs. 4.90 vs. 5.00, p=0.003) and proximal (median [mm2]; 6.00 vs. 6.61 vs. 7.14, p<0.001) reference lumen areas were smaller in the S-BSA group. Calcified plaques were more common in the S-BSA group (51% vs. 45% vs. 37%, p=0.008). The S-BSA group had significantly higher incidences of cardiovascular death (11.2% vs. 3.3% vs. 5.7%, p<0.001), major bleeding (11.2% vs. 3.3% vs. 5.7%, p<0.001) and rehospitalization for heart failure (6.1% vs. 3.8% vs. 2.8%, p=0.033%) during the two-year follow-up period.
Conclusion: ACS patients with a small BSA had smaller vessels and more advanced atherosclerosis than those with a larger BSA, and showed a higher prevalence of two-year adverse events.
miRNA‐6236 Regulation of Postischemic Skeletal Muscle Angiogenesis
Authors: Mani Arul M. , Lamin Victor , Peach Ronan C. , Friesen Eli H. , Wong Thomas , Singh Madhu V. , Dokun Ayotunde O.
Published: November 2024

Background

Peripheral arterial disease affects >200 million people worldwide and is characterized by impaired blood flow to the lower extremities. There are no effective medical treatments available. Using the mouse hind‐limb ischemia model and miRNA sequencing, we identified a novel miRNA, miR‐6236, whose expression significantly elevated in ischemic mouse limbs compared with nonischemic limbs. The role of miR‐6236 in general or in postischemic angiogenesis is not known. Here we describe its role using in vivo and in vitro models of peripheral arterial disease.

Methods and Results

In primary mouse and human endothelial cells, we studied the effect of simulated ischemia on miR‐6236 expression and assessed its role in cell viability, apoptosis, migration, and tube formation during ischemia. Furthermore, we developed miR‐6236 null mice and tested its role in postischemic perfusion recovery using the hind‐limb ischemia model. Lastly, using bioinformatics and gene expression analysis, we identified putative angiogenic miR‐6236 targets. In vitro simulated ischemia‐enhanced miR‐6236 expression in mouse and human endothelial cells, whereas its inhibition improved viability, migration, tube formation, and reduced apoptosis. In vivo ischemic mouse skeletal muscle tissue showed higher miR‐6236 expression compared with nonischemic muscles. Loss of miR‐6236 improved impaired postischemic perfusion recovery and poor angiogenesis associated with streptozotocin‐induced diabetes in mice. Six of the 8 miR‐6236 predicted angiogenic target mRNAs showed expression consistent with regulation by miR‐6236 in ischemic skeletal muscle.

Conclusions

Our results show for the first time that miR‐6236 plays a key role in regulating postischemic perfusion recovery and angiogenesis.
Effect of Combination Antihypertensive Pills on Blood Pressure Control
Authors: Heaton Joseph , Johal Anmol , Alshami Abbas , Okoh Alexis , Udongwo Ndausung , Schoenfeld Matthew , Saybolt Matthew , Almendral Jesus , Sealove Brett
Published: November 2024

Background

Hypertension is a global health issue causing increased cardiovascular morbidity and mortality. Adherence to prescribed medication is a crucial factor in obtaining targeted outcomes, and fixed‐dose combined antihypertensive pills (FCAPs) have been shown to help combat difficulties associated with polypharmacy management. This study investigated the influence of combination antihypertensives on blood pressure (BP) management.

Methods and Results

Data from the 2013 to 2020 NHANES (National Health and Nutrition Examination Survey) were analyzed. Participants were included if between 18 and 79 years of age and were prescribed 2 antihypertensive classes. BP was deemed controlled if <140/<90 mm Hg. Examiner documentation and questionnaire data determined prescription antihypertensive medication usage and the presence of an FCAP. Descriptive statistics and multivariate regression analyses were used to compare the 2 groups. Subgroup analysis was performed for stricter BP goals of <130/<80 mm Hg. A total of 15 927 747 weighted participants met the inclusion criteria, 32.7% of whom were undergoing management with an FCAP. Participants with an FCAP were 1.78 (95% CI, 1.28–2.47,
P
=0.001) times more likely to have controlled BP (76.4% versus 67.3%) than those without an FCAP. Subgroup analysis revealed that FCAPs were associated with stricter BP goals (odds ratio [OR], 1.65,
P
=0.008; 87.6% versus 71.2%) compared with those without.

Conclusions

Participants with an FCAP were more likely to exhibit controlled BP, including participants with clinical atherosclerotic cardiovascular disease and those targeting stricter control. Clinicians can immediately and meaningfully affect their patient's BP by opting for FCAPs.
Identification of Novel Proteins Mediating Causal Association Between Smoking and Essential Hypertension: A Mendelian Randomization Study
Authors: Shi Jikang , Liang Zhuoshuai , Liu Zhantong , Pan Lingfeng , Hu Xinmeng , Tian Yuyang , Jin Huizhen , Liu Yawen , Cheng Yi , Zhang Ming
Published: November 2024

Background

Smoking is a factor for hypertension. We aim to reveal novel plasma proteins mediating the relationship of smoking with hypertension and identify potential drug targets for hypertension on the basis of Mendelian randomization design.

Methods and Results

Data for smoking were selected from the largest genome‐wide association study meta‐analysis performed by the Genome‐Wide Association Study and Sequencing Consortium of Alcohol and Nicotine Use. Data for plasma proteins were selected from the deCODE Health study and the UK Biobank Pharma Proteomics Project. Data for hypertension were extracted from the FinnGen Study. Moreover, proteome‐wide Mendelian randomization and colocalization analyses, 2‐step Mendelian randomization, and gene function and network prediction, as well as druggability assessment were performed. We finally identified 8 proteins (ANXA4 [annexin A4], DLK1 [protein delta homolog 1], KLB [β‐klotho], MMP8 [matrix metallopeptidase 8], PLAT [tissue‐type plasminogen activator], POSTN [periostin], SAT2 [thialysine N‐ε‐acetyltransferase], and IFNLR1 [interferon λ receptor 1]) mediating association of smoking with hypertension. PLAT and IFNLR1 were identified to be involved in the complement and coagulation cascades and the Janus kinase/signal transducer and activator of transcription signaling pathway. ANXA4, KLB, MMP8, PLAT, and IFNLR1 had druggability. Moreover, IFNLR1 had strong evidence of genetic colocalization, because the posterior probability for H4 of IFNLR1 was 91.3%.

Conclusions

This study identified the 8 proteins that mediate causal association between smoking and essential hypertension. Interferon λ receptor agonist targeting IFNLR1 may open a new avenue for treating hypertension. Our discoveries provide new insights into protein pathogenesis of hypertension and to better guide hypertension prevention and treatment among smokers.
The Right to Strike before the icj: A Historical Challenge to the Coherence and Impact of the ilo Supervisory System
Authors: Maupain Francis
Published: November 2024

The International Labour Organization’s request for an International Court of Justice (icj) advisory opinion on protection of the right to strike under the Freedom of Association and Right to Organise Convention, 1948 (No. 87) entails much more than first meets the eye. At stake is the coherence of the regular and special procedures available under the ilo Constitution in case of a failure to give effect to a ratified Convention, and ultimately, also the raison d’être and functioning of the tripartite organization itself. This article traces the emergence of the practice of the various procedural bodies involved (with a focus on the Committee of Experts on the Application of Conventions and Recommendations and the Committee on Freedom of Association), the origins of the current controversy over the right to strike, and challenges arising out of recent jurisprudence of the European Court of Human Rights (ECtHR) on the topic. Exploring the judicial/legislator dialectic, this article points out the contradictions and offers solutions for achieving coherence based on ilo constitutional provisions.
Discovery of the digger wasp genus Pseudoscolia Radoszkowski, 1876 (Hymenoptera: Crabronidae: Philanthinae: Pseudoscoliini) in Indian Sub-continent, with description of a new species
Authors: SAINI VARUN
Published: November 2024

The digger wasp genus Pseudoscolia Radoszkowski, 1876 is newly reported from India with a new species: Pseudoscolia anuae Saini sp. nov. from the State of Haryana.
The checklist of the tribe Olethreutini (Lepidoptera: Tortricidae) of Qinghai-Tibet Plateau
Authors: MA SHUANG , HU ZHURONG , DONG RUIQIN , ZHANG BINGYI , YU HAILI
Published: November 2024

We present a catalogue of the species of Olethreutini from Qinghai-Tibet Plateau, China with an account of 85 species in 32 genera. One species, Neostatherotis spinosa sp. nov., is described as new; five species, Apotomis generosa (Meyrick, 1909), Celypha sapaecola Razowski, 2009, Dicephalarcha herbosa (Meyrick, 1909), Eppihus hippeus Razowski, 2006, and Eudemis brevisetosa Oku, 2005, are recorded for the first time from China; the female of Demeijerella catharota (Meyrick, 1928) is for the first time. Each species is listed along with specimens examined and geographical distribution. Photographs of adults and genitalia of the new and newly recorded species are provided, along with a map of all collecting sites.
Comparison of mortality and cardiovascular complications due to COVID-19, RSV, and influenza in hospitalized children and young adults
Authors: Khanal Sagya , Khanal Bishes , Chou Fu-Sheng , Moon-Grady Anita J. , Ghimire Laxmi V.
Published: November 2024

Background

Respiratory viruses are linked to cardiovascular complications. We aim to compare cardiovascular complications due to COVID-19, influenza and RSV.

Methods

We analyzed cross-sectional data from hospitalized children and young adults (≤ 20 years) from 2020 and 2021 using National Inpatient Sample (NIS). We included individuals hospitalized for COVID-19, RSV, and influenza, and weighted data were used to compare cardiovascular complications.

Results

Of 212,655 respiratory virus admissions, 85,055 were from COVID-19, 103,185 were from RSV, and 24,415 were from influenza. Myocarditis was higher in COVID-19 [0.9%, n = 740] as compared to influenza [0.2%, n = 55] and RSV [0.1%, n = 65]. In the adjusted logistic regression, the odds of myocarditis was 61% lower in influenza [aOR = 0.39 (0.20–0.76), P = 0.006], and 85% lower in RSV [aOR = 0.15 (0.07–0.34) P < 0.001] as compared to COVID-19. Bradyarrhythmias/heart block was higher in COVID-19 [0.8%, n = 690] versus influenza [0.5%, n = 110] and RSV [0.2%, n = 205]. After adjusting for confounders for bradyarrhythmias/heart block, compared to COVID-19, the odds were 49% lower in RSV [aOR = 0.51 (0.33–0.80), P = 0.004] but no statistically significant difference in influenza [aOR = 0.79 (0.48–1.31), P = 0.374] was seen. Tachyarrhythmias, sudden cardiac arrest, and in-hospital mortality showed no differences after adjusting for covariates.

Conclusion

Individuals with COVID-19 infection are more likely to develop cardiovascular complications compared to influenza and RSV, highlighting the need for higher index of suspicion and prompt treatment, as well as steps to limit infection and transmission of this virus in children.
Self-monitoring blood pressure in pregnancy: evaluation of women’s experiences of the BUMP trials
Authors: Chisholm Alison , Tucker Katherine L , Crawford Carole , Green Marcus , Greenfield Sheila , Hodgkinson James , Lavallee Layla , Leeson Paul , Mackillop Lucy , McCourt Christine , Sandall Jane , Wilson Hannah , Chappell Lucy C , McManus Richard J , Hinton Lisa
Published: November 2024

Background

The COVID-19 pandemic accelerated the adoption of remote care, or telemedicine, in many clinical areas including maternity care. One component of remote care, the use of self-monitoring of blood pressure in pregnancy, could form a key component in post-pandemic care pathways. The BUMP trials evaluated a self-monitoring of blood pressure intervention in addition to usual care, testing whether it improved detection or control of hypertension for pregnant people at risk of hypertension or with hypertension during pregnancy. This paper reports the qualitative evaluation which aimed to understand how the intervention worked, the perspectives of participants in the trials, and, crucially, those who declined to participate.

Methods

The BUMP trials were conducted between November 2018 and May 2020. Thirty-nine in-depth qualitative interviews were carried out with a diverse sample of pregnant women invited to participate in the BUMP trials across five maternity units in England.

Results

Self-monitoring of blood pressure in the BUMP trials was reassuring, acceptable, and convenient and sometimes alerted women to raised BP. While empowering, taking a series of self-monitored readings also introduced uncertainty and new responsibility. Some declined to participate due to a range of concerns. In the intervention arm, the performance of the BUMP intervention may have been impacted by women’s selective or delayed reporting of raised readings and repeated testing in pursuit of normal BP readings. In the usual care arm, more women were already self-monitoring their blood pressure than expected.

Conclusions

The BUMP trials did not find that among pregnant individuals at higher risk of preeclampsia, blood pressure self-monitoring with telemonitoring led to significantly earlier clinic-based detection of hypertension nor improved management of blood pressure. The findings from this study help us understand the role that self-monitoring of blood pressure can play in maternity care pathways. As maternity services consider the balance between face-to-face and remote consultations in the aftermath of the COVID-19 pandemic, these findings contribute to the evidence base needed to identify optimal, effective, and equitable approaches to self-monitoring of blood pressure.
Estimating the link between service-user patient safety perceptions, incidents and subsequent contagion in acute mental health wards
Authors: Baker John , Kendal Sarah , Sturley Charlotte , Louch Gemma , Bojke Chris
Published: November 2024

Background

Safety incidents are common in adult acute inpatient mental health services, and detrimental to all. Incidents spread via social contagion within the ward, but social contagion is difficult to quantify. Better measures of social contagion could support a milieu in which safety incidents are less likely to be prolonged, spread, or repeated, with widespread benefits.

The WardSonar project, based in the United Kingdom (UK), developed and evaluated a prototype digital safety monitoring tool to collect real-time information from patients on acute adult mental health wards, about their perceptions of ward safety. A prototype Wardsonar tool was developed from a collaborative, co-design approach, and implemented in real-world hospital settings. The current study aimed to understand whether the tool can help to predict incidents, by examining (i) the feasibility of capturing real-time feedback from patients about safety and (ii) how the resulting data related to quality and safety metrics.

This study was registered as ISRCTN14470430 on 10/January/2022.

Method

Patients can record real-time perceptions of ward safety using the tool, and staff can access these as anonymous, aggregated data. The tool was implemented in the UK in six National Health Service adult acute mental health wards. A novel approach to analysis involved construction of an hour-by-hour dataset over each ward. This revealed relationships between quantity and content of patient reports, staffing, time of day, and ward incidents, per ward.

Results

There is strong evidence that an incident leads to increased probability of further incidents within the next four hours. This supports the idea of social/behavioural contagion and puts a measure on the extent to which the contagion persists. COVID-19 impacted the research processes.

Conclusions

There is potential to use the WardSonar digital tool for proactive real-time safety monitoring, to identify developing incidents and help staff to facilitate timely preventative or de-escalating interventions. Further refinement and testing in a post COVID-19 context are needed.

Trial registration

ISRCTN14470430 https://doi.org/10.1186/ISRCTN14470430. Registered 10/January/2022.
Web discussions on cardiovascular diseases: pre-COVID-19 evaluation and impact of the COVID-19 pandemic – Web listening analysis in the Italian population
Authors: Cecchini Isabella , Biroli Matteo , Massaroni Katia , Folco Emanuela , Montebelli Maria Rita , Ciancamerla Giuseppe , Giudice Daniela , Pedretti Roberto Franco Enrico , Magni Paolo
Published: November 2024

Background

Web discussions on health issues are becoming very relevant in the general public. In this context, little information is available regarding cardiovascular diseases, which remain the first cause of morbidity, disability and mortality worldwide. The central objective of the study was to conduct a Web listening analysis on discussions about cardiovascular diseases in Italy, comparing the data relative to the 2-year pre-COVID-19 pandemic period with those collected during the COVID-19 pandemic lockdown (March-July 2020), with quantification of conversations on cardiovascular disease and Web-based discussions and specific evaluation of COVID-19 lockdown impact.

Methods

A retrospective Web listening analysis using publicly available data was conducted, using validated methods that allow to estimate cardiovascular disease awareness. Digital sources were identified to retrieve data (Italian language), relevant to cardiovascular disease topics. Data were analysed by Google Trends methodology and the Digital Intelligence Platform Brandwatch. Natural Language Processing algorithms enabled comparative analysis, topic detection, classification, leading to a 279,790-item dataset.

Results

News channels and Twitter were the most important platforms feeding cardiovascular disease information. Facebook was mostly relevant for information sharing. In the pre-COVID-19 period, cardiovascular disease ranked 5th among main health issues (vaccines, tumors, influenza, diabetes) on the Web, and the most discussed cardiovascular disease themes were symptoms/diagnosis (34%), treatments (20%), disease causes/triggers (11%), disease information (9%), quality of life (8%). Conversations on cardiovascular disease prevention were marginal (5%). The COVID-19 pandemic lockdown strongly impacted on discussed topics; novel themes emerged: hospitalization, death risk/occurrence, greater cardiovascular disease risk. Discussions on cardiovascular disease prevention remained marginal (4%). COVID-19 pandemic increased fear of severe COVID-19 among patients with cardiovascular disease and worsened quality of relationship/contact with physicians.

Conclusions

A limited awareness of cardiovascular disease and their prevention was observed before and during the COVID-19 pandemic. Patients/caregivers need more information and contact with physicians, as it emerged during COVID-19 pandemic. It is urgent to promote novel prevention strategies and to engage people leveraging digital channels and social media.

Graphical Abstract