bluuebunny/crossref_metadata_2025 huggingface dataset:
A long-read and short-read transcriptomics approach provides the first high-quality reference transcriptome and genome annotation for Pseudotsuga menziesii (Douglas-fir)
Authors: Velasco Vera Marjorie Elauria , Ferreira Alyssa , Zaman Sumaira , Noordermeer Devin , Ensminger Ingo , Wegrzyn Jill L
Published: December 2022

Douglas-fir (Pseudotsuga menziesii) is native to western North America. It grows in a wide range of environmental conditions and is an important timber tree. Although there are several studies on the gene expression responses of Douglas-fir to abiotic cues, the absence of high-quality transcriptome and genome data is a barrier to further investigation. Like for most conifers, the available transcriptome and genome reference dataset for Douglas-fir remains fragmented and requires refinement. We aimed to generate a highly accurate, and complete reference transcriptome and genome annotation. We deep-sequenced the transcriptome of Douglas-fir needles from seedlings that were grown under nonstress control conditions or a combination of heat and drought stress conditions using long-read (LR) and short-read (SR) sequencing platforms. We used 2 computational approaches, namely de novo and genome-guided LR transcriptome assembly. Using the LR de novo assembly, we identified 1.3X more high-quality transcripts, 1.85X more “complete” genes, and 2.7X more functionally annotated genes compared to the genome-guided assembly approach. We predicted 666 long noncoding RNAs and 12,778 unique protein-coding transcripts including 2,016 putative transcription factors. We leveraged the LR de novo assembled transcriptome with paired-end SR and a published single-end SR transcriptome to generate an improved genome annotation. This was conducted with BRAKER2 and refined based on functional annotation, repetitive content, and transcriptome alignment. This high-quality genome annotation has 51,419 unique gene models derived from 322,631 initial predictions. Overall, our informatics approach provides a new reference Douglas-fir transcriptome assembly and genome annotation with considerably improved completeness and functional annotation.
A Local Trace Formula for p-adic Infinitesimal Symmetric Spaces: the Case of Guo–Jacquet
Authors: Li Huajie
Published: December 2022

We establish an invariant local trace formula for the tangent space of some symmetric spaces over a non-archimedean local field of characteristic zero. These symmetric spaces are studied in Guo–Jacquet trace formulae, and our methods are inspired by works of Waldspurger and Arthur. Some other results are given during the proof including a noninvariant local trace formula, Howe’s finiteness for weighted orbital integrals, and the representability of the Fourier transform of weighted orbital integrals. These local results are preparations for the comparison of regular semi-simple terms, which are weighted orbital integrals, appearing in an infinitesimal variant of Guo–Jacquet trace formulae.
On a Conjecture of Khoroshkin and Tolstoy
Authors: Appel Andrea , Gautam Sachin , Wendlandt Curtis
Published: December 2022

We prove a no-go theorem on the factorization of the lower triangular part in the Gaussian decomposition of the Yangian’s universal $R$-matrix, yielding a negative answer to a conjecture of Khoroshkin and Tolstoy from [11].
Emergency Department Presentation of Life-threatening Symptomatic Hyperkalemia From an Angiotensin Receptor Blocker in a Low-risk Individual
Authors: Dockery Samuel , Dupré Alan , Deflorio Paul , Murray Brian Patrick
Published: December 2022

Hyperkalemia is a common electrolyte abnormality with characteristic electrocardiogram changes. Both angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) increase the risk of developing hyperkalemia. This case highlights a rare life-threatening episode of hyperkalemia in an individual whose only risk factor was an ARB. A 58-year-old female presented with sudden-onset chest pressure, light-headedness, and diaphoresis. Her initial electrocardiogram showed a nearly sinusoidal rhythm with a widened ventricular depolarization (QRS) and prolonged QT-interval (QTc). Life-threatening hyperkalemia of 9.1 mmol/L was confirmed with a rapid point-of-care electrolyte panel. She was rapidly treated with calcium, potassium-shifting and eliminating medications, and emergent hemodialysis. After stabilization, a thorough workup found that the patient’s only risk factor for hyperkalemia was her use of an ARB. While both ARBs and ACEIs are commonly associated with mild hyperkalemia, life-threatening hyperkalemia is rare, particularly in patients without concomitant renal failure, diabetes mellitus, adrenal disease, or potassium-sparing diuretic use. However, this case illustrates that life-threatening hyperkalemia is possible in patients solely taking an ARB without prior significant risk factors. Despite normal renal function in an individual without heart failure or diabetes, this patient developed life-threatening hyperkalemia.
Cerebrospinal fluid methylome-based liquid biopsies for accurate malignant brain neoplasm classification
Authors: Zuccato Jeffrey A , Patil Vikas , Mansouri Sheila , Voisin Mathew , Chakravarthy Ankur , Shen Shu Yi , Nassiri Farshad , Mikolajewicz Nicholas , Trifoi Mara , Skakodub Anna , Zacharia Brad , Glantz Michael , De Carvalho Daniel D , Mansouri Alireza , Zadeh Gelareh
Published: December 2022

Background

Resolving the differential diagnosis between brain metastases (BM), glioblastomas (GBM), and central nervous system lymphomas (CNSL) is an important dilemma for the clinical management of the main three intra-axial brain tumor types. Currently, treatment decisions require invasive diagnostic surgical biopsies that carry risks and morbidity. This study aimed to utilize methylomes from cerebrospinal fluid (CSF), a biofluid proximal to brain tumors, for reliable non-invasive classification that addresses limitations associated with low target abundance in existing approaches.

Methods

Binomial GLMnet classifiers of tumor type were built, in fifty iterations of 80% discovery sets, using CSF methylomes obtained from 57 BM, GBM, CNSL, and non-neoplastic control patients. Publicly-available tissue methylation profiles (N = 197) on these entities and normal brain parenchyma were used for validation and model optimization.

Results

Models reliably distinguished between BM (area under receiver operating characteristic curve [AUROC] = 0.93, 95% confidence interval [CI]: 0.71–1.0), GBM (AUROC = 0.83, 95% CI: 0.63–1.0), and CNSL (AUROC = 0.91, 95% CI: 0.66–1.0) in independent 20% validation sets. For validation, CSF-based methylome signatures reliably distinguished between tumor types within external tissue samples and tumors from non-neoplastic controls in CSF and tissue. CSF methylome signals were observed to align closely with tissue signatures for each entity. An additional set of optimized CSF-based models, built using tumor-specific features present in tissue data, showed enhanced classification accuracy.

Conclusions

CSF methylomes are reliable for liquid biopsy-based classification of the major three malignant brain tumor types. We discuss how liquid biopsies may impact brain cancer management in the future by avoiding surgical risks, classifying unbiopsiable tumors, and guiding surgical planning when resection is indicated.
Meeting the Challenges of Sepsis in Severe Coronavirus Disease 2019: A Call to Arms
Authors: Walsh Thomas J , Bright Rick A , Ahuja Aparna , McCarthy Matthew W , Marfuggi Richard A , Simpson Steven Q
Published: December 2022

Sepsis is a life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Sepsis may be caused by bacterial, fungal, or viral pathogens. The clinical manifestations exhibited by patients with severe coronavirus disease 2019 (COVID-19)-related sepsis overlap with those exhibited by patients with sepsis from secondary bacterial or fungal infections and can include an altered mental status, dyspnea, reduced urine output, tachycardia, and hypotension. Critically ill patients hospitalized with severe acute respiratory syndrome coronavirus 2 infections have increased risk for secondary bacterial and fungal infections. The same risk factors that may predispose to sepsis and poor outcome from bloodstream infections (BSIs) converge in patients with severe COVID-19. Current diagnostic standards for distinguishing between (1) patients who are critically ill, septic, and have COVID-19 and (2) patients with sepsis from other causes leave healthcare providers with 2 suboptimal choices. The first choice is to empirically administer broad-spectrum, antimicrobial therapy for what may or may not be sepsis. Such treatment may not only be ineffective and inappropriate, but it also has the potential to cause harm. The development of better methods to identify and characterize antimicrobial susceptibility will guide more accurate therapeutic interventions and reduce the evolution of new antibiotic-resistant strains. The ideal diagnostic test should (1) be rapid and reliable, (2) have a lower limit of detection than blood culture, and (3) be able to detect a specific organism and drug sensitivity directly from a clinical specimen. Rapid direct detection of antimicrobial-resistant pathogens would allow targeted therapy and result in improved outcomes in patients with severe COVID-19 and sepsis.
Increased Prevalence of Rare Copy Number Variants in Treatment-Resistant Psychosis
Authors: Farrell Martilias , Dietterich Tyler E , Harner Matthew K , Bruno Lisa M , Filmyer Dawn M , Shaughnessy Rita A , Lichtenstein Maya L , Britt Allison M , Biondi Tamara F , Crowley James J , Lázaro-Muñoz Gabriel , Forsingdal Annika E , Nielsen Jacob , Didriksen Michael , Berg Jonathan S , Wen Jia , Szatkiewicz Jin , Mary Xavier Rose , Sullivan Patrick F , Josiassen Richard C
Published: December 2022

Background

It remains unknown why ~30% of patients with psychotic disorders fail to respond to treatment. Previous genomic investigations of treatment-resistant psychosis have been inconclusive, but some evidence suggests a possible link between rare disease-associated copy number variants (CNVs) and worse clinical outcomes in schizophrenia. Here, we identified schizophrenia-associated CNVs in patients with treatment-resistant psychotic symptoms and then compared the prevalence of these CNVs to previously published schizophrenia cases not selected for treatment resistance.

Methods

CNVs were identified using chromosomal microarray (CMA) and whole exome sequencing (WES) in 509 patients with treatment-resistant psychosis (a lack of clinical response to ≥3 adequate antipsychotic medication trials over at least 5 years of psychiatric hospitalization). Prevalence of schizophrenia-associated CNVs in this sample was compared to that in a previously published large schizophrenia cohort study.

Results

Integrating CMA and WES data, we identified 47 cases (9.2%) with at least one CNV of known or possible neuropsychiatric risk. 4.7% (n = 24) carried a known neurodevelopmental risk CNV. The prevalence of well-replicated schizophrenia-associated CNVs was 4.1%, with duplications of the 16p11.2 and 15q11.2-q13.1 regions, and deletions of the 22q11.2 chromosomal region as the most frequent CNVs. Pairwise loci-based analysis identified duplications of 15q11.2-q13.1 to be independently associated with treatment resistance.

Conclusions

These findings suggest that CNVs may uniquely impact clinical phenotypes beyond increasing risk for schizophrenia and may potentially serve as biological entry points for studying treatment resistance. Further investigation will be necessary to elucidate the spectrum of phenotypic characteristics observed in adult psychiatric patients with disease-associated CNVs.
Do the Components of Attenuated Positive Symptoms Truly Represent One Construct?
Authors: Pratt Danielle N , Bridgwater Miranda , Schiffman Jason , Ellman Lauren M , Mittal Vijay A
Published: December 2022

Background and Hypotheses

Psychosis-risk inventories, like the Structured Interview for Psychosis-Risk Syndromes (SIPS), utilize symptom components and coalesce the information into a single-severity rating. These components include frequency, duration, in-the-moment conviction, retrospective insight, distress, and effect on social/role functioning. While combining components distills a great deal of important information into one practical symptom rating, this approach may mask important details of the greater clinical picture.

Study Design

Individuals at clinical high risk for psychosis (n = 115) were assessed with the SIPS Score Separable Components (SSSC) scale, created to accompany the SIPS positive items by dividing each item into the 7 components identified above. The latent structure of the SSSC was identified with an exploratory factor analysis (EFA). The factors were followed up with validation analyses including hypothesized cognitive, functioning, and symptom measures. Finally, clinical utility analyses were conducted to understand relationships between psychosis risk and common comorbidities.

Study Results

EFA revealed that the SSSC had 3 interpretable factors with the appropriate fit (rmsr = 0.018, TLI = 0.921): Conviction (in-the-moment conviction, retrospective insight), Distress-Impairment (distress, social/role functioning), and Frequency/Duration (frequency, duration). Conviction was minimally valid, Distress-Impairment had excellent validity, and Frequency/Duration was not related to any of the candidate validators. Conviction significantly predicted elevated psychosis risk. Distress-Impairment was related to common comorbid symptoms. Notably, the factors associated more strongly with clinical features than the traditional SIPS scores.

Conclusions

The SSSC offers a supplemental approach to single-severity ratings, providing useful clinical insight, mechanistic understanding, and the potential for better capturing heterogeneity in this population.
Maternal exposure to perfluorobutane sulfonate (PFBS) during pregnancy: evidence of adverse maternal and fetoplacental effects in New Zealand White (NZW) rabbits
Authors: Crute Christine E , Landon Chelsea D , Garner Angela , Hall Samantha M , Everitt Jeffery I , Zhang Sharon , Blake Bevin , Olofsson Didrik , Chen Henry , Stapleton Heather M , Murphy Susan K , Feng Liping
Published: December 2022

Perfluorobutanesulfonic acid (PFBS) is a replacement for perfluorooctanesulfonic acid (PFOS) that is increasingly detected in drinking water and human serum. Higher PFBS exposure is associated with risk for preeclampsia, the leading cause of maternal and infant morbidity and mortality in the United States. This study investigated relevant maternal and fetal health outcomes after gestational exposure to PFBS in a New Zealand White rabbit model. Nulliparous female rabbits were supplied drinking water containing 0 mg/l (control), 10 mg/l (low), or 100 mg/l (high) PFBS. Maternal blood pressure, body weights, liver and kidney weights histopathology, clinical chemistry panels, and thyroid hormone levels were evaluated. Fetal endpoints evaluated at necropsy included viability, body weights, crown-rump length, and liver and kidney histopathology, whereas placenta endpoints included weight, morphology, histopathology, and full transcriptome RNA sequencing. PFBS-high dose dams exhibited significant changes in blood pressure markers, seen through increased pulse pressure and renal resistive index measures, as well as kidney histopathological changes. Fetuses from these dams showed decreased crown-rump length. Statistical analysis of placental weight via a mixed model statistical approach identified a significant interaction term between PFBS high dose and fetal sex, suggesting a sex-specific effect on placental weight. RNA sequencing identified the dysregulation of angiotensin (AGT) in PFBS high-dose placentas. These results suggest that PFBS exposure during gestation leads to adverse maternal outcomes, such as renal injury and hypertension, and fetal outcomes, including decreased growth parameters and adverse placenta function. These outcomes raise concerns about pregnant women’s exposure to PFBS and pregnancy outcomes.
Solid Organ Injury Grading in the Abdomen: A Primer for Emergency Radiology
Authors: Roth Bradley , Meraz Jeanette , Bui Thanh-Lan , Lebby Elliott , Fanucci Louis , Kakish David , Houshyar Roozbeh , Kampalath Rony
Published: December 2022

The American Association for the Surgery of Trauma (AAST) established the Organ Injury Scale (OIS) in 1984, making an initial revision in 1994, and the most recent revision in 2018. This recent revision was made to better predict the need for operative or angiointervention management, considering active hemorrhage or other vascular complications. Diagnosis of hemodynamically stable patients is made by CT; however, hemodynamically unstable patients may be diagnosed via focused assessment with sonography in trauma (FAST) ultrasound or emergency laparotomy.1–3 In this article, we discuss in depth the different OIS gradings for renal, hepatic, and splenic trauma and demonstrate the necessary information that an emergency radiologist must know through a series of cases. This knowledge will allow radiologists to concisely communicate with referring teams and help them make the appropriate management decisions for each patient case.1
,
4
Multistate Modeling of Clinical Trajectories and Outcomes in the ICU: A Proof-of-Concept Evaluation of Acute Kidney Injury Among Critically Ill Patients With COVID-19
Authors: Lyons Patrick G. , Mody Aaloke , Bewley Alice F. , Schoer Morgan , Neelam Raju Bharat , Geng Elvin , Payne Philip R. O. , Sinha Pratik , Vijayan Anitha
Published: December 2022

IMPORTANCE:

Multistate models yield high-fidelity analyses of the dynamic state transition and temporal dimensions of a clinical condition’s natural history, offering superiority over aggregate modeling techniques for addressing these types of problems.

OBJECTIVES:

To demonstrate the utility of these models in critical care, we examined acute kidney injury (AKI) development, progression, and outcomes in COVID-19 critical illness through multistate analyses.

DESIGN, SETTING, AND PARTICIPANTS:

Retrospective cohort study at an urban tertiary-care academic hospital in the United States. All patients greater than or equal to 18 years in an ICU with COVID-19 in 2020, excluding patients with preexisting end-stage renal disease.

MAIN OUTCOMES AND MEASURES:

Using electronic health record data, we determined AKI presence/stage in discrete 12-hour time windows and fit multistate models to determine longitudinal transitions and outcomes.

RESULTS:

Of 367 encounters, 241 (66%) experienced AKI (maximal stages: 88 stage-1, 49 stage-2, 104 stage-3 AKI [51 received renal replacement therapy (RRT), 53 did not]). Patients receiving RRT overwhelmingly received invasive mechanical ventilation (IMV) (n = 60, 95%) compared with the AKI-without-RRT (n = 98, 53%) and no-AKI groups (n = 39, 32%; p < 0.001), with similar mortality patterns (RRT: n = 36, 57%; AKI: n = 74, 40%; non-AKI: n = 23, 19%; p < 0.001). After 24 hours in the ICU, almost half the cohort had AKI (44.9%; 95% CI, 41.6–48.2%). At 7 days after stage-1 AKI, 74.0% (63.6–84.4) were AKI-free or discharged. By contrast, fewer patients experiencing stage-3 AKI were recovered (30.0% [24.1–35.8%]) or discharged (7.9% [5.2–10.7%]) after 7 days. Early AKI occurred with similar frequency in patients receiving and not receiving IMV: after 24 hours in the ICU, 20.9% of patients (18.3–23.6%) had AKI and IMV, while 23.4% (20.6–26.2%) had AKI without IMV.

CONCLUSIONS AND RELEVANCE:

In a multistate analysis of critically ill patients with COVID-19, AKI occurred early and heterogeneously in the course of critical illness. Multistate methods are useful and underused in ICU care delivery science as tools for understanding trajectories, prognoses, and resource needs.
Associations of Prenatal First Trimester Essential and Nonessential Metal Mixtures with Body Size and Adiposity in Childhood.
Authors: Smith Anna R. , Lin Pi-I D. , Rifas-Shiman Sheryl L. , Wright Robert O. , Coull Brent , Hivert Marie-France , Hubbard Alan , Oken Emily , Cardenas Andres
Published: December 2022

Background:

Prenatal nonessential metals may contribute to postnatal adiposity, whereas essential metals may have metabolic benefits. We evaluated joint and individual associations between prenatal metals and childhood adiposity.

Methods:

We measured concentrations of six nonessential (arsenic, barium, cadmium, cesium, lead, and mercury) and four essential (magnesium, manganese, selenium, and zinc) metals in first trimester maternal blood from a prebirth cohort. We collected anthropometric measures in early childhood, mid-childhood, and early adolescence including subscapular+tricep skinfold thickness (mm) (N = 715–859), waist circumference (cm) (N = 717–882), and body mass index (BMI) (z-score) (N = 716–875). We measured adiposity in mid-childhood and early adolescence using bone densitometry total- and trunk- fat mass index (kg/m2) (N = 511–599). We estimated associations using adjusted quantile g-computation and linear regression.

Results:

The nonessential metal mixture was associated with higher total (β = 0.07, 95% CI = 0.01, 0.12) and trunk fat mass index (β = 0.12, CI = 0.02, 0.22), waist circumference (β = 0.01, CI = 0.00, 0.01), and BMI (β = 0.24, CI = 0.07, 0.41) in mid-childhood, and total fat mass index (β = 0.07, CI = 0.01, 0.14), and BMI (β = 0.19, CI = 0.02, 0.37) in early adolescence. The essential metal mixture was associated with lower early adolescence total-(β = –0.11, CI = –0.17, –0.04) and trunk- fat mass index (β = –0.13, CI = –0.21, –0.05), subscapular+tricep skinfold thickness (β = –0.02, CI = –0.03, –0.00), waist circumference (β = –0.003, CI = –0.01, –0.00), and BMI (β = –0.16, CI = –0.28, –0.04). Cadmium and cesium were individually associated with childhood adiposity at different timepoints.

Conclusions:

Prenatal first-trimester essential metals were associated with lower childhood adiposity, whereas nonessential metals were associated with higher adiposity into adolescence.
Age-related patterns of ambulatory blood pressure in a large cohort of individuals referred to Italian community pharmacies: results from the templar project
Authors: Omboni Stefano , Ballatore Tommaso , Rizzi Franco , Tomassini Fernanda , Campolo Luca , Panzeri Edoardo
Published: December 2022

Objectives:

Ambulatory blood pressure monitoring (ABPM) provides extensive information on several BP parameters other than the average BP during daily life. Through this analysis of the TEMPLAR study, we sought to understand better the features of age-related changes in ABP patterns and phenotypes.

Methods:

ABPMs were obtained in 53 350 individuals visiting 866 Italian community pharmacies (age 3–101 years, 54.3% female individuals). ABPM patterns were assessed across 10-year age categories.

Results:

SBP steadily increased with age. DBP increased from the youth to the middle adulthood and then declined. Daytime BP was higher than night-time BP, but the difference narrowed with aging, reducing the prevalence of dippers. An enhanced SBP morning surge and increased prevalence of abnormal morning rise were observed with aging. SBP and DBP variabilities increased with age with a typical U or J shape, more evident in the case of DBP. The proportion of participants with ambulatory hypertension increased with age. However, an elevated daytime BP was more common in younger individuals and elevated night-time hypertension in older individuals. The prevalence of white-coat hypertension remained stable or slightly declined through the age groups, whereas that of masked hypertension steadily increased.

Conclusion:

Our results confirm that ABP patterns interplay and change in a complex way with age. Such changes, particularly the age-related increase in BP variability and prevalence of nocturnal hypertension, nondipping, enhanced morning rise, and masked hypertension, may increase the risk of cardiovascular events and must be carefully considered by the physician when managing BP in the elderly.
Congenital Corneal Opacity in 22q11.2 Deletion Syndrome: A Case Series
Authors: Franco Elena , Iqbal Naeem , Shah Parth R. , Alabek Michelle , Tripi Kelly S. , Prescott Christina , Scanga Hannah L. , Chu Charleen T. , Nischal Ken K.
Published: December 2022

Purpose:

The purpose of this study was to describe the deep phenotype of congenital corneal opacities (CCO) in patients with 22q11.2 deletion syndrome (22q11.2 DS) and to identify putative regions or genes that could explain the CCO.

Methods:

A retrospective chart review was conducted to identify patients with 22q11.2 DS seen in the ophthalmology clinic of a tertiary referral children's hospital. Thirty patients were identified, with molecular confirmation. Twenty-six did not show structural anterior segment anomalies aside from posterior embryotoxon (n = 4), whereas 4 had bilateral CCO, of which 3 had preoperative images. We reviewed medical, operative, and pathology reports; anterior segment optical coherence tomography; high-frequency ultrasound; histopathologic slides; and genetic testing. To identify putative genes responsible for CCO, chromosomal breakpoints in patients with and without CCO were compared.

Results:

In the 3 patients with preoperative imaging and CCO, a pattern of paracentral corneal opacification with central clearing accompanied by iridocorneal or keratolenticular adhesions was observed. Anterior segment optical coherence tomography and histopathologic images showed central stromal thinning with a residual structure consistent with Descemet membrane. One patient presented at birth with unilateral corneal perforation, suggestive of likely stromal thinning. A comparison of the breakpoints across all cases failed to reveal unique regions or genes in patients with CCO.

Conclusions:

22q11.2 DS can rarely be associated with CCO. We describe a consistent pattern of central clearing related to posterior stromal thinning, with or without ICA/KLA. Possible candidate genes for corneal opacification in 22q11.2 DS remain elusive.
Implementation of a Nurse-Driven Medication Ordering Protocol to Improve Clinician and Nursing Experiences
Authors: Ford Claire C. , Clements James B. , Luty Jacob T. , Sharpe Jackie K. , Caldera Brittney N. , Hunter Alan J.
Published: December 2022

Paging and text messaging to request new orders remain common means of communication between clinicians and nurses in the hospital setting. However, sending and triaging multiple pages can lead to interruptions in other clinical duties. A medication order delegation protocol allowing for nurse-driven ordering of low-risk medications was developed with an objective of decreasing potentially avoidable pages. The aim of this study was to evaluate the impact of implementing this protocol on nurse and clinician perceptions of clerical burden and satisfaction. A survey assessing satisfaction with the process of obtaining medications in this protocol and the perception of clerical burden associated with ordering them before and after delegation protocol implementation was completed by over 160 clinicians and nurses. Survey respondents reported increased satisfaction and decreased clerical burden associated with the implementation of the delegation protocol. These results suggest the potential for delegation protocols to limit clerical burden associated with paging.
Shared governance council to engage advanced practice registered nurses in a hospital setting
Authors: Gooden Angela , Cole Linda
Published: December 2022

Background:

Health care organizations use advanced practice registered nurses (APRNs) to expand patient access and support high-quality care. However, turnover, often exacerbated by inadequate engagement, has steep financial and experiential costs.

Local problem:

The project site, a large urban academic institution with quaternary care capabilities, employs more than 300 APRNs to provide patient care. Due to variations in hiring entity, leadership structure, and organizational visibility, efforts to maintain APRN engagement were complex. In addition, inconsistencies in standardization of clinical, credentialing, and privileging procedures created organizational risk.

Methods:

Quality improvement principles informed the implementation of a shared governance council for APRNs that included nurse practitioners and certified registered nurse anesthetists. Data were collected pre and postintervention using validated engagement questions.

Intervention:

Implementation of a shared governance council to support the organizational engagement of APRNs through decisional involvement in professional practice issues.

Results:

Analysis included the percentage of change in aggregate scores and the Wilcoxon rank-sum test to obtain p values of the 2 independent samples. There was an 8.9% increase in aggregate postintervention scores and statistical improvement in measures of quality improvement involvement.

Conclusion:

Participation in the shared governance council increased APRN engagement through enhanced opportunities to communicate professional and clinical practice issues, decisional involvement, and collaboration. Statistically significant improvements in quality improvement involvement values potentially affirm the council's role in facilitating work environment improvements. Potential long-term gains include improved job satisfaction, retention, and organizational cost savings.
When Recurrent Strokes, Back Pain, and Alopecia Constitute a Hereditary Cause of Small-Vessel Disease, CARASIL in an Arabic Woman
Authors: Al Nidawi Firas , Wael Mohamed , Alkhater Noora , Asil Talip , Fida Mariam
Published: December 2022

Introduction:

Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a rare autosomal recessive etiology of cerebral small-vessel disease. The bulk of CARASIL cases reported in the literature was from Japan and China. Herein, we report the first genetically confirmed case of CARASIL in the Arabic population.

Case Presentation:

We present the case of a 35-year-old Bahraini woman diagnosed with an acute ischemic stroke after experiencing right-sided weakness and slurred speech. She had complained of persistent headaches, decreased memory, hair loss, joint pain, and personality changes. CARASIL was suspected on her medical history and brain imaging results, and genetic testing confirmed the diagnosis.

Conclusion:

This case contributes to our understanding of CARASIL, which is an extremely rare disease. It adds to the growing data on disease reporting outside China and Japan. We also report the first case of CARASIL in an Arabic patient and describe magnetic resonance spectroscopy finding partially different from what has been reported before.
A CRISPRi-based investigation reveals that multiple promoter elements drive gene expression from the genome of mycobacteriophage D29
Authors: Barman Anik , Shaw Rahul , Bhawsinghka Niketa , Das Gupta Sujoy K.
Published: December 2022

A unique feature found in the genomes of mycobacteriophages such as L5 belonging to the A cluster is the presence of multiple dispersed repeated elements known as stoperators. The phage repressor binds these repeat elements, shutting off transcription globally and thereby promoting lysogeny. Interestingly, the sequence of these stoperators closely matches that of the consensus −35 region of prokaryotic promoters, leading us to propose that they may have a role to play in the initiation of transcription by serving as RNA polymerase binding sites. Mycobacteriophage D29 is closely related to phage L5, and their genome organizations are very similar. As in L5, there are multiple stoperators in the genome of D29. The positions occupied by the stoperators in the two genomes are almost identical. The significant difference between the two phages is that D29 lacks the gene encoding the equivalent of the L5 repressor. Since phage D29 does not produce a repressor, we considered it to be a suitable model for testing our hypothesis that the stoperators function as promoters in the absence of the repressor. To prove our point, we targeted CRISPR guide RNAs against six stoperators. In the case of five out of the six, we found a significant reduction in downstream gene expression and phage growth. Based on this observation and primer extension assays, we conclude that promoting gene expression is likely to be the primary function of stoperators.
AP2XII-2 coordinates transcriptional repression forToxoplasma gondiisexual commitment
Authors: Srivastava Sandeep , Holmes Michael J. , White Michael W. , Sullivan William J.
Published: December 2022

Toxoplasma gondiiis a widespread protozoan parasite that has significant impact on human and veterinary health. The parasite undergoes a complex life cycle involving multiple hosts and developmental stages. HowToxoplasmatransitions between life cycle stages is poorly understood, yet central to controlling transmission. Of particular neglect are the factors that contribute to its sexual development, which takes place exclusively in feline intestines. While epigenetic repressors have been shown to play an important role in silencing spurious gene expression of sexually committed parasites, the specific factors that recruit this generalized machinery to the appropriate genes remains largely unexplored. Here, we establish that a member of the AP2 transcription factor family, AP2XII-2, is targeted to genomic loci associated with sexually committed parasites along with the epigenetic regulators of transcriptional silencing, HDAC3 and MORC. Despite widespread association with gene promoters, AP2XII-2 is required for silencing of relatively few genes. Using CUT&Tag methodology, we identify two major genes associated with sexual development downstream of AP2XII-2 control, AP2X-10 and the amino acid hydroxylase AAH1. Our findings show that AP2XII-2 is a key contributor to the gene regulatory pathways modulatingToxoplasmasexual development.

IMPORTANCE

Toxoplasma gondiiis a parasite that undergoes its sexual stage exclusively in feline intestines, making cats a major source of transmission. A better understanding of the proteins controlling the parasite’s life cycle stage transitions is needed for the development of new therapies aimed to treat toxoplasmosis and transmission of the infection. Genes that regulate the sexual stages need to be turned on and off at the appropriate times, activities that are mediated by specific transcription factors that recruit general machinery to silence or activate gene expression. In this study, we identify a transcription factor called AP2XII-2 as being important for repression of a subset of sexual stage genes, including a sexual stage-specific AP2 factor (AP2X-10) and a protein (AAH1) required to construct the infectious oocysts expelled by infected cats.
Detection of IL23p40 via Positron Emission Tomography Visualized Inflammatory Bowel Disease
Authors: Rezazadeh Farzaneh , Ramos Nicholas , Saliganan Allen-Dexter , Al-Hallak Najeeb , Chen Kang , Mohamad Bashar , Wiesend Wendy N. , Viola Nerissa T.
Published: December 2022

Background and aims

Inflammatory bowel disease (IBD), which includes both Crohn’s Disease (CD) and ulcerative colitis (UC), is a relapsing inflammatory disease of the gastrointestinal (GI) tract. Long term chronic inflammatory conditions elevate patients’ risk for colorectal cancer (CRC). Currently, diagnosis requires endoscopy with biopsy. This procedure is invasive and requires bowel preparatory regimen, adding to patient burden. Interleukin 23 (IL23) plays a key role in inflammation especially in the pathogenesis of IBD and is an established therapeutic target. We propose that imaging of IL23 via immunopositron emission tomography (immunoPET) will potentially lead to a new non-invasive diagnostic approach.

Methods

The aim of the present study is to investigate the potential of immunoPET to image inflammation in a chemically induced mouse model of colitis using dextran sodium sulfate (DSS) by targeting IL23 via its p40 subunit with a89Zr-radiolabeled α-IL23p40 antibody.

Results

High uptake of the IL23p40 immunoPET agent in mice were displayed in DSS-administered mice, which correlated with increased IL23p40 present in sera. Competitive binding studies confirmed the specificity of the radiotracer for IL23p40 in the GI tract.

Conclusion

Taken together, these promising results set the stage for developing this radiotracer as an imaging biomarker for IBD diagnosis. Noninvasive imaging of IBD with IL23p40 immunoPET may help physicians in their treatment decisions for IBD management.
Adult neurogenesis improves spatial information encoding in the mouse hippocampus
Authors: Frechou M. Agustina , Martin Sunaina S. , McDermott Kelsey D. , Gökhan Şölen , Tomé Wolfgang A. , Coen-Cagli Ruben , Gonçalves J. Tiago
Published: December 2022

Adult neurogenesis is a unique form of neuronal plasticity in which newly generated neurons are integrated into the adult dentate gyrus in a process that is modulated by environmental stimuli. Adult-born neurons can contribute to spatial memory but it is unknown whether they alter neural representations of space in the hippocampus. Usingin vivotwo-photon calcium imaging, we found that mice that were previously housed in an enriched environment, which triggers an increase in neurogenesis, had increased spatial information encoding in the hippocampal dentate gyrus during novel context exposure. Ablating adult neurogenesis by prior focal irradiation of the hippocampus blocked the effect of enrichment and lowered spatial information content, as did the chemogenetic silencing of adult-born neurons. Both ablating neurogenesis and silencing adult-born neurons decreased the calcium activity rates of dentate gyrus neurons, resulting in a decreased amplitude of place-specific responses. These findings are in contrast to previous studies that suggested a predominantly inhibitory action for adult-born neurons. We propose that adult neurogenesis improves neural representations of space by increasing the gain of dentate gyrus neurons and thereby improving their ability to tune to spatial features. This mechanism may mediate the beneficial effects of environmental enrichment on spatial learning and memory.
The structure of a tautomerase superfamily member linked to the type VI secretion system of Acinetobacter baumannii
Authors: Pankov Genady , Mol Avelar Gabriela , Buchanan Grant , Coulthurst Sarah J. , Hunter William N.
Published: December 2022

Bacteria exploit specialized secretion systems to assist in competition for resources, in collaboration and in communication. Here, a protocol for the recombinant production, purification and crystallization of a protein linked to the Acinetobacter baumannii type VI secretion system is provided. A high-resolution structure of this trimeric protein is reported, revealing the characteristic dual β–α–β subunit fold typical of longer subunit members of the tautomerase superfamily. The protein does not appear to be toxic to bacteria or yeast under the conditions tested. The possible biological role of this protein is discussed.
Distributed UAV swarm control framework with limited interaction for obstacle avoidance
Authors: Zhu Baitao , Deng Yimin
Published: December 2022

Purpose

The purpose of this paper is to propose a distributed unmanned aerial vehicle (UAV) swarm control method to ensure safety and obstacle avoidance during swarm flight and realize effective guidance.

Design/methodology/approach

This paper proposes a distributed UAV swarm control framework with limited interaction. UAVs in the swarm realize the selection of limited interactive neighbors according to the random line of sight and limited field of view. The designed interaction force and obstacle avoidance mechanism are combined to ensure the safety of UAVs and avoid collisions and obstacles. Informed UAVs are deployed to guide the swarm to move in the desired direction.

Findings

The proposed distributed swarm control framework achieves high safety of swarm motion and the participation of informed UAVs is conducive to the guidance of the UAV swarm. Simulation results demonstrate the feasibility and effectiveness of the proposed approach.

Practical implications

The UAV swarm control method developed in this paper can be applied to the practice of UAV swarm control.

Originality/value

A distributed UAV swarm control method is proposed to ensure the effective control of the consistency and safety of swarm motion.
The impact of Covid-19 on the capital structure in emerging economies: evidence from India
Authors: Prakash Nisha , Maheshwari Aditya , Hawaldar Aparna
Published: December 2022

Purpose

Capital structure is an important corporate financing decision, particularly for companies in emerging economies. This paper attempts to understand whether the pandemic had any significant impact on the capital structure of companies in emerging economies. India being a prominent emerging economy is an ideal candidate for the analysis.

Design/methodology/approach

The study utilizes three leverage ratios in an extended market index, BSE500, for the period 2015–2021. The ratios considered are short-term leverage ratio (STLR), long-term leverage ratio (LTLR) and total leverage ratio (TLR). A dummy variable differentiates the pre-epidemic (2015–2019) and pandemic (2020–2021) period. Control variables are used to represent firm characteristics such as growth, tangibility, profit, size and liquidity. Dynamic panel data regression is employed to address endogeneity.

Findings

The findings point out that Covid-19 has had a significant, negative effect on LTLR, while the impact on STLR and TLR was insignificant. The findings indicate that companies based in a culturally risk-averse environment, such as India, would reduce the long-term debt to avoid bankruptcy in times of uncertainty.

Research limitations/implications

The study covers the impact of the pandemic on Indian companies. Hence, generalization of the findings to global context might not be valid.

Practical implications

To maintain economic growth in the post-crisis period, Indian policymakers should ensure accessibility to low-cost capital. The findings provide impetus to deepen the insignificant corporate bond market in India for future economic revival.

Originality/value

Developing countries are struggling to revive the economies postpandemic. This is particularly true for Asian economies which are heavily reliant on banks for survival. This research finds evidence to utilize bond market as a source of raising capital for economic revival.
Food demand and the nutrient intake of households in underdeveloped rural regions of China: an instrumental variable approach
Authors: Kuhlgatz Christian H. , Huang Jiaqi , Antonides Gerrit
Published: December 2022

Purpose

The purpose of this paper is to evaluate the effects of price and income changes on food and nutrient demand of rural households by including own-produced food and production-side effects in the demand estimation to correct potential measurement bias in the income and price elasticities for rural households in underdeveloped areas. Simulation results of income and grain price changes on food and nutrition security are provided for economic nutrition security policy applications.

Design/methodology/approach

This study analyzes survey data of 1,555 households from underdeveloped rural areas of China to find out how price and income changes affect food and nutrition insecurity of rural households. The authors employ the quadratic almost ideal demand system (QUAIDS) in a two-stage budgeting framework, using quality adjusted prices that were retrieved with regressions of the difference between the unit value surveyed at household level and its village average on household characteristics. The bias correction is implemented by using an augmented IV (instrumental variable) method, in which each market price is instrumented with farm-specific variables. Important macro- and micronutrient elasticities are computed for (a) households with agriculture as main income and (b) other households (of which still many have agriculture as a side business). Finally, the authors use these elasticities to simulate how changes in income or grain prices affect the food and nutrition security in the studied areas.

Findings

In general, food income elasticities of agricultural households are at a higher level than those for other households, and so are the food price elasticities. Income changes also have a greater nutritional effect on agricultural households than on other households. Nutrient income elasticities ranged from 0.22 (energy) to 0.27 (Vitamin A) for agricultural households and from 0.19 (energy) to 0.23 (Vitamin A) for other households. Grain price increases have greater effect on nutritional status of non-agricultural households, while a grain price reduction is not clearly favoring the nutritional situation of a particular household group.

Originality/value

This demand study contributes to the literature by taking into account differences in consumption of own production between households and the potential endogeneity of prices resulting thereof. The authors also demonstrate that merely reporting nutrient elasticities might not be sufficient for policy recommendations, and simulations should be reported as a valuable addition.
Recovering in the post-pandemic era: the role of employee voice, knowledge sharing, employee innovation, and service recovery performance in the hotel industry
Authors: Alzyoud Sultan , Abuzaid Ruba , Hamdan Haneen
Published: December 2022

Purpose

Covid-19 pandemic is perceived as one of the great disasters in history. It forced countries to impose travel restrictions and lockdowns, and it negatively influenced hotels’ performance. Therefore, this article aims to provide explanations of how hotels can survive, recover and succeed in the post-pandemic period. This article focuses on the role of employee voice, knowledge sharing, and employee innovation in promoting service recovery performance.

Design/methodology/approach

This is a conceptual paper that focuses on discussing the relationships between employee voice, knowledge sharing, employee innovation, and service recovery performance.

Findings

The study suggests that employee voice is a vital element that can enhance knowledge sharing at hotels. Furthermore, knowledge sharing is proposed to encourage employees to engage in innovative behavior, which, in turn, can promote service recovery performance.

Originality/value

The study provides a framework that explains a mechanism of how hotels can accelerate recovery efforts from Covid-19 repercussions by shedding light on the important role of employee voice, knowledge sharing, and employee innovation.