bluuebunny/crossref_metadata_2025 huggingface dataset:
Developmental stages associated with organizational learning in hospitals: An instrument development study
Authors: Lyman Bret , Ethington Kalene M.
Published: April 2022

Aim

To develop and test the Organizational Learning Instrument: Development Stages instrument, a measure of hospital units' readiness to engage in organizational learning.

Design

Cognitive interviewing, expert review and a quantitative, cross‐sectional survey.

Methods

Item development was informed by previous research on organizational learning. Content validity was assessed and strengthened using cycles of cognitive interviewing and expert review. The resulting instrument was distributed by email to all nurses providing direct patient care in inpatient units in 11 Magnet® hospitals. Data were collected in 2018. Intraclass correlations, using hospital unit as the grouping variable, indicated the need to use multilevel methods to analyse the survey data. Thus, coefficient omega and multilevel confirmatory factor analysis were used to estimate the instrument's reliability and construct validity, respectively.

Results

The Organizational Learning Instrument: Development Stages is a 35‐item survey comprised of four scales: Identity & Ownership, Team & Respect, Accountability & Support and Reliability & Sustainability. The expert review yielded scale‐level content validity scores from 0.90 to 1.0 and item‐level content validity scores from 0.86 to 1.0. Survey participants were 1212 nurses, working in 99 inpatient units, across 11 Magnet® hospitals. Intraclass correlations ranged from 0.113 to 0.158. Coefficient omega reliability for the four scales was 0.981–0.993. Standardized factor loadings for the 35 items were 0.699–0.961, with acceptable model fit statistics (comparative fit index = 0.980, Tucker–Lewis Fit Index = 0.979, and root mean squared error of approximation = 0.060).

Conclusions

These results indicate the instrument meets or exceeds generally accepted criteria for content validity, reliability and construct validity instrument, and is suitable for further use and testing.

Impact

Nurse administrators, managers and researchers now have a valid, reliable instrument to better foster and study organizational learning in hospital units. Advances in organizational learning are expected to improve a variety of patient, staff and organizational outcomes in hospital units.
Systematic review: Perceptions of type 2 diabetes of people of African descent living in high‐income countries
Authors: Love Onuorah , Peter Draper , Julie Santy‐Tomlinson
Published: April 2022

Aims

To describe how people of African descent perceive and understand type 2 diabetes, and to examine the impact of their perceptions and beliefs on the uptake of diet, exercise, weight control and adherence to medication recommendations.

Design

Systematic literature review of quantitative and qualitative studies.

Data sources

We searched MEDLINE, CINAHL Complete, Psych INFO, Academic Search Premier, Education Research Complete, Web of Science and Scopus, World Health Organization (WHO), Diabetes UK and American Diabetes Association for articles published from January 1999 to December 2019.

Review methods

Informed by the PRISMA guidelines, we independently reviewed titles and abstracts, identified articles for full‐text review that met inclusion criteria, conducted a quality assessment and extracted data. Findings were synthesized using a thematic approach.

Results

Twenty‐six studies met the inclusion criteria. Knowledge and understanding of diabetes were poor. Beliefs and behaviours about diet, exercise, weight and health care were erroneous. Most diabetic participants could not recognize diabetes symptoms, failed to take their diagnosis seriously and did not adhere to medication recommendations. The resultant effect was an increased risk of complications with undesirable outcomes.

Conclusion

Poor diabetes perceptions are linked to negative consequences and may be responsible for poorer outcomes among people of African descent. This review highlights the need to consider this population's beliefs and practices in structuring culturally sensitive programmes for diabetes management.

Impact

This systematic literature review is the first to exclusively explore perceptions of people of African descent in relation to diabetes. It is important to consider people of African descents' diabetes perceptions and practices before formulating interventions for their diabetes management.
To come back or not to come back during the coronavirus crisis—A cross‐sectional online survey of inactive nurses
Authors: Lücker Petra , Henning Esther , Hoffmann Wolfgang
Published: April 2022

Aims

To examine whether inactive nurses are willing to return to nursing during the COVID‐19 pandemic, the reasons for or against their decision and further, possibly relevant factors.

Design

Cross‐sectional online survey.

Methods

We developed a questionnaire, addressing registration, professional experiences, anticipations, and internal and external factors that might affect the decision of inactive nurses to return to nursing during the pandemic. Between 27 April and 15 June 2020, we recruited participants in Germany via social networks, organizations and institutions and asked them to forward the link to wherever other inactive nurses might be reached.

Results

Three hundred and thirty‐two participants (73% female) could be included in the analysis. The majority of the participants (n = 262, 79%) were general nurses. The main reason for registering was ‘want to do my bit to manage the crisis’ (n = 73, 22.8%). More than two thirds of the participants (n = 230, 69%) were not or not yet registered. One hundred and twelve (49%) out of 220 participants, who gave reasons why they did not register, selected they ‘could not see a necessity at that time’. The few inactive nurses who were deployed reported a variety of experiences.

Conclusions

Different factors influence the nurses’ decision to register or not. A critical factor for their decision was previous experiences that had made them leave the job and prevented a return—even for a limited time in a special situation.

Impact

From the responses of the participants in this study, it can be deduced that: negative experiences made while working in nursing influence the willingness to volunteer for a deployment; only one‐third of the inactive nurses would be willing to return to the nursing profession to help manage the Corona pandemic; policymakers and nursing leaders should not rely on the availability of inactive nurses in a crisis.
A topical emollient mitigates the progression of cognitive impairment in the elderly: a randomized, open‐label pilot trial
Authors: Ye L. , Wang Z. , Kim Y. , Elias P.M. , Li T. , Wen S. , Song J. , Lv C. , Yang B. , Man M.‐Q.
Published: April 2022

Background

Cognitive impairment is common in the elderly. Prior studies suggest a link between chronic inflammation and cognitive dysfunction, while aging‐associated epidermal dysfunction has been connected to elevations in circulating cytokines.

Objective

We assessed here whether improvements in epidermal function can mitigate the progression of cognitive impairment.

Methods

This randomized, open‐label pilot trial was carried out in two cities in northern China. A total of 200 participants aged ≥65 years were randomly assigned to the emollient‐treated and untreated groups at 1:1 ratio. Participants in the treated group were treated topically with Atopalm cream® twice‐daily from November to the following May each year for three consecutive years, while the untreated subjects served as controls. The Global Deterioration Scale (GDS) was used to assess the severity of cognitive impairment, while epidermal biophysical properties were measured on the forearms and the shins in parallel.

Results

Over the three‐year trial, GDS significantly increased from baseline (P < 0.0001) in the controls, while in the treated group, GDS stabilized. While stratum corneum hydration on the forearms did not change significantly in the controls, transepidermal water loss rates (TEWL), significantly increased by the end of the trial compared to baselines in the controls (P < 0.0001). On the forearms of the treated group, stratum corneum hydration increased (P < 0.0001) while skin surface pH decreased from baseline (P < 0.0001).

Conclusions

These results suggest that improvements in epidermal function with topical emollient can mitigate the progression of cognitive impairment. However, the sample size was relatively small, and trials in a larger cohort are needed to validate the present results.
“Is it time to stop driving?”: A randomized clinical trial of an online decision aid for older drivers
Authors: Betz Marian E. , Hill Linda L. , Fowler Nicole R. , DiGuiseppi Carolyn , Han S. Duke , Johnson Rachel L. , Meador Lauren , Omeragic Faris , Peterson Ryan A. , Matlock Daniel D.
Published: April 2022

Background

Many older adults face the difficult decision of when to stop driving. We sought to test whether an online driving decision aid (DDA) would improve decision quality.

Methods

This prospective two‐arm randomized trial enrolled English‐speaking licensed drivers (age ≥70 years) without significant cognitive impairment but with ≥1 diagnosis associated with increased likelihood of driving cessation; all participants received primary care in clinics associated with study sites in three states. The intervention was the online Healthwise® DDA for older adults addressing “Is it time to stop driving?”; control was web‐based information for older drivers only. The primary outcome was decision conflict as estimated by the Decisional Conflict Scale (DCS; lower scores indicate higher quality). Secondary outcomes were knowledge and decision self‐efficacy about driving decisions. We examined postrandomization differences in primary and secondary outcomes by study arm using generalized linear mixed‐effects models with adjustment for site and prerandomization scores.

Results

Among 301 participants (mean age: 77.1 years), 51.2% identified as female and the majority as non‐Hispanic (99.0%) and white (95.3%); 98.0% lived in an urban area. Participant characteristics were similar by study arm but differed across sites. Intervention participants had a lower mean DCS score (12.3 DDA vs 15.2 control; adjusted mean ratio [AMR] 0.76, 95%CI 0.61–0.95; p = 0.017). Intervention participants had higher mean knowledge scores (88.9 DDA vs. 79.9 control; OR 1.13, 95%CI 1.01–1.27, p = 0.038); there was no difference between groups in self‐efficacy scores. The DDA had high acceptability; 86.9% of those who viewed it said they would recommend it to others in similar situations.

Conclusions

The online Healthwise® DDA decreased decision conflict and increased knowledge in this sample of English‐speaking, older adults without significant cognitive impairment, although most chose to continue driving. Use of such resources in clinical or community settings may support older adults as they transition from driving to other forms of mobility.

Trial registration

ClinicalTrials.gov identifier “Advancing Understanding of Transportation Options (AUTO)” NCT04141891.
Sdr4 dominates pre‐harvest sprouting and facilitates adaptation to local climatic condition in Asian cultivated rice
Authors: Zhao Bo , Zhang Hui , Chen Tianxiao , Ding Ling , Zhang Liying , Ding Xiali , Zhang Jun , Qian Qian , Xiang Yong
Published: April 2022

Pre‐harvest sprouting (PHS), which reduces grain yield and quality, is controlled by seed dormancy genes. Because few dormancy‐related genes have been cloned, the genetic basis of seed dormancy in rice (Oryza sativa L.) remains unclear. Here, we performed a genome‐wide association study and linkage mapping to dissect the genetic basis of seed dormancy in rice. Our findings suggest that Seed Dormancy4 (Sdr4), a central modulator of seed dormancy, integrates the abscisic acid and gibberellic acid signaling pathways at the transcriptional level. Haplotype analysis revealed that three Sdr4 alleles in rice cultivars already existed in ancestral Oryza rufipogon accessions. Furthermore, like the semi‐dwarf 1 (SD1) and Rc loci, Sdr4 underwent selection during the domestication and improvement of Asian cultivated rice. The distribution frequency of the Sdr4‐n allele in different locations in Asia is negatively associated with local annual temperature and precipitation. Finally, we developed functional molecular markers for Sdr4, SD1, and Rc for use in molecular breeding. Our results provide clues about the molecular basis of Sdr4‐regulated seed dormancy. Moreover, these findings provide guidance for utilizing the favorable alleles of Sdr4 and Rc to synergistically boost PHS resistance, yield, and quality in modern rice varieties.
Exosome therapy in hair regeneration: A literature review of the evidence, challenges, and future opportunities
Authors: Kost Yana , Muskat Ahava , Mhaimeed Nour , Nazarian Roya S. , Kobets Kseniya
Published: April 2022

Background

Alopecia is a common chief complaint and is challenging to treat. As such, regenerative treatments to promote hair growth are an emerging area of research. Exosomes, which are extracellular vesicles involved in cell communication, homeostasis, differentiation, and organogenesis, have been shown to play a central role in hair morphogenesis and regeneration with potential for use as alopecia treatment.

Aims

This review summarizes and assesses the body of literature surrounding exosomes as regenerative therapeutics for alopecia and identifies areas for improvement in future research.

Methods

A review was conducted using a comprehensive list of keywords including “exosome,” “alopecia,” and “hair loss” on PubMed, EMBASE, and Google Scholar databases published from inception to February 2022. Reference lists of identified articles were included. 47 studies were included. Clinical trial databases were searched using the term “exosome”; however, no trials relevant to hair growth were identified.

Results

Our updated and comprehensive review details the history of exosome use in medicine, postulated underlying mechanisms in treating hair loss, and current clinical studies. Preclinical studies demonstrate clear benefits of exosome therapeutics in regenerative medicine and for hair loss treatment. Clinical trials demonstrate safety of exosome use in medicine, but data showing efficacy and safety of exosome therapy for alopecia are lacking. We identified several gaps in knowledge required for effective clinical translation including safety, exosome source, and optimal treatment delivery mechanism and dosage.

Conclusion

Exosomes are on the horizon as an exciting therapeutic for the treatment of alopecia. Further studies and clinical trials are required.
Effect of apical microsurgery on force regulation of incisor teeth during unpredictable force control task
Authors: Al‐Manei Khaled , Almotairy Nabeel , Al‐Manei Kholod Khalil , Grigoriadis Anastasios , Kumar Abhishek
Published: April 2022

Background

Apical microsurgery (AMS) involves removal of the root‐end which can affect the force regulation of teeth.

Objective

To investigate the force regulation of incisor teeth treated with AMS during the unpredictable force control task in comparison with their contralateral teeth with complete root apices, in humans.

Methods

Fifteen eligible participants (8 women and 7 men; mean age 52.9 ± SD 4.4 years) performed a standardised unpredictable force control task, which involved pulling and holding a force transducer with AMS‐treated incisors and their contralateral control teeth (n = 30 teeth). A series of four load masses: 100, 200, 50 and 300 gm were attached to the force transducer through a string in an unpredictable manner. The obtained force profile was divided into initial and later time‐segments. The peak force and peak force rate during the initial time‐segment, and the holding force and coefficient of variability during the later time‐segments were calculated and compared by the repeated measures analysis of variance.

Results

During the initial time‐segment, the peak force and peak force rate were significantly lower in the AMS‐treated teeth than in the controls (p = .001, p = .013, respectively). However, during the later time‐segment, no significant differences in the holding force nor the coefficient of variability were observed between the AMS‐treated teeth and their controls (p = .755, p = .213, respectively).

Conclusion

In contrast to incisors with complete normal root apices, AMS‐treated incisors do not show robust changes in force regulation.
The Roles of Cultural Mistrust and Mentoring in Latinx Adolescents’ Attitudes Toward School
Authors: O’Donnell Alexander J. , Harris Kara , Sánchez Bernadette , Thursby Kay
Published: April 2022

Using the frameworks of Latino Critical Race Theory (LatCrit) and an integrative model of developmental competencies, this study examined the roles of cultural mistrust toward education and natural mentoring relationship quality in the academic outcomes of Latinx adolescents. Participants were 294 Latinx students (52.9% female; mean age 15 years in 9th grade; 21% first‐generation, 63% second‐generation, and 6% third‐generation immigrants) who completed surveys in 9th and 10th grades. The negative effect of cultural mistrust on educational aspirations was greater for students who had poorer quality mentoring relationships. This study addresses gaps in the literature related to cultural mistrust as a coping strategy and discusses the ways in which mentors can serve a protective role.
Invisibly Oppressed: Individual and Ecological Correlates of Chinese American Adolescents’ Perceived Discrimination
Authors: Chen Shanting , Wei Wei , Witherspoon Dawn P. , Kim Su Yeong
Published: April 2022

Despite being portrayed as model minorities, Chinese American adolescents still face challenges of discrimination. Using data from 444 Chinese American adolescents (Mage = 13.04, 54% female), this study examined the independent and joint influence of individual cultural characteristics (adolescents’ acculturation and enculturation) and contextual factors (parental discrimination experiences, neighborhood disadvantage, and ethnic concentration) on Chinese American adolescents’ perception of discrimination experiences. Results showed that acculturation was associated with fewer discrimination experiences; yet, higher levels of neighborhood disadvantage were related to more youth discrimination. Mothers’ discrimination experiences were associated with adolescents’ discrimination experiences when adolescents retained more of their Chinese culture. The findings of the study highlight the importance of considering the interplay between contextual and individual factors in influencing adolescents’ development.
A systematic map of demographic data from elephant populations throughout Africa: implications for poaching and population analyses
Authors: Hauenstein Severin , Jassoy Noémi , Mupepele Anne‐Christine , Carroll Thea , Kshatriya Mrigesh , Beale Colin M. , Dormann Carsten F.
Published: April 2022

The crisis facing Africa’s elephant populations is a notorious example of ongoing wildlife declines caused by illegal harvesting. Targeted conservation interventions require detailed knowledge about changes in population sizes and the effect of illegal activities. However, accurately quantifying poaching intensity is a difficult task: commonly calculated from ranger‐based carcass‐encounter data, the proportion of illegally killed elephants (PIKE) is a function of poaching and background mortality. Hence, at constant poaching intensity, PIKE decreases with increasing natural mortality and also with hunting, management interventions, and other anthropogenically induced deaths. Natural mortality is often more difficult to quantify with accuracy than mortality due to illegal killing, as elephants that die naturally are more likely to be missed than those taken by poachers. In recent analyses, constant background mortality rates were assumed. Yet, for example climate‐driven fluctuations in natural mortality, if not quantified and accounted for, may lead to biased estimates of poaching intensity.

Varying background mortality rates can be accounted for in the analysis of PIKE, but this requires near‐complete counts of natural and management‐related deaths and hunting records. Carefully developed population models, which simulate population dynamics and demographic changes while accounting for variation in environmental conditions and management strategies, are alternatives. However, successful calibration of such models requires integrating comprehensive demographic data.

We systematically review the scientific and ‘grey’ literature on African elephant demography with the objective of facilitating poaching and population analysis possibilities through an inventory of information relevant to demography.

Our screening of 10900 publications resulted in the review of relevant information provided by 431 studies from 420 study sites throughout Africa. From these, we extracted demographic data collected between 1900 and 2017, and collated them in the newly created African Elephant Demographic Database (AEDD; 10.6084/m9.figshare.19387085). We found 37 natural mortality estimates from five different study sites. Other mortality data, demographic rates, and age‐ and sex‐structured population data were substantially more abundant, both temporally and spatially.

This new collection of demographic rates, age‐ and sex‐structured population data, and cause‐partitioned mortality estimates identifies spatial and temporal data gaps and provides prior information needed for African elephant population models. Closing these data gaps and subsequent analyses of realistic population models may aid elephant conservation via improved policies, legislation, and protection.
Evolved components in the eucrite parent body: Records in the layered eucrite Northwest Africa 8021
Authors: He Yang , Liu Xiao‐Wen , Zhang Ai‐Cheng
Published: April 2022

In this study, we report the petrography and mineralogy of a brecciated eucrite Northwest Africa (NWA) 8021, which shows a locally layered texture with one layer containing graphic clasts and Si,Ti‐rich regions. The graphic clasts contain rod‐like grains of silica phases, augite, K‐feldspar, and Ca‐phosphate minerals included in anorthite. Some of the clasts contain relatively coarse grains of quartz, K‐feldspar, and augite, which are chemically different from the rod‐like phases, indicating different origins. All of the augite grains in the graphic clasts have rare earth element (REE) concentrations higher than those in typical eucrites. The bulk Na2O+K2O contents of the graphic clasts are higher than typical eucrites. All of these chemical features indicate that the graphic clasts were probably derived from an evolved parent rock. Low‐degree partial melting of the eucritic crust (<10%) is required to generate a melt equilibrated with the REE‐rich rod‐like pyroxene from the graphic clasts. The Si,Ti‐rich regions contain high abundances of silica phases (~52 vol%) and ilmenite (~9 vol%), probably derived from an evolved Si,Ti‐rich rock (dacite). The evolved components observed in NWA 8021 are different from other evolved components observed in howardites and indicate more diverse evolution in the eucrite parent body than previously thought.
Decomposing relevance in conditionals
Authors: Lassiter Daniel
Published: April 2022

Conditionals frequently convey that the antecedent is relevant to the consequent. Recently many authors have argued that this relevance is part of the conventional meaning of conditionals, but this approach fails to account for many examples where a conditional is used to conveyirrelevance of antecedent to consequent. Both types of conditionals are best explained by a conventional meaning with no relevance requirement, and a separate process of coherence establishment among successive clauses in discourse. This account is supported by the distribution of discourse particles and is able to account for experimental studies used to support the conventionalist position.
Immune recognition of the secreted serine protease ChpG restricts the host range of Clavibacter michiganensis from eggplant varieties
Authors: Verma Raj Kumar , Teper Doron
Published: April 2022

Bacterial wilt and canker caused by Clavibacter michiganensis (Cm) inflict considerable damage in tomato‐growing regions around the world. Cm has a narrow host range and can cause disease in tomato but not in many eggplant varieties. The pathogenicity of Cm is dependent on secreted serine proteases, encoded by the chp/tomA pathogenicity island (PI), and the pCM2 plasmid. Screening combinations of PI deletion mutants and plasmid‐cured strains found that Cm‐mediated hypersensitive response (HR) in the Cm‐resistant eggplant variety Black Queen is dependent on the chp/tomA PI. Singular reintroduction of PI‐encoded serine proteases into Cm∆PI identified that the HR is elicited by the protease ChpG. Eggplant leaves infiltrated with a chpG marker exchange mutant (CmΩchpG) did not display an HR, and infiltration of purified ChpG protein elicited immune responses in eggplant but not in Cm‐susceptible tomato. Virulence assays found that while wild‐type Cm and the CmΩchpG complemented strain were nonpathogenic on eggplant, CmΩchpG caused wilt and canker symptoms. Additionally, bacterial populations in CmΩchpG‐inoculated eggplant stem tissues were c.1000‐fold higher than wild‐type and CmΩchpG‐complemented Cm strains. Pathogenicity tests conducted in multiple Cm‐resistance eggplant varieties demonstrated that immunity to Cm is dependent on ChpG in all tested varieties, indicating that ChpG‐recognition is conserved in eggplant. ChpG‐mediated avirulence interactions were disabled by alanine substitution of serine231 of the serine protease catalytic triad, suggesting that protease activity is required for immune recognition of ChpG. Our study identified ChpG as a novel avirulence protein that is recognized in resistant eggplant varieties and restricts the host range of Cm.
An investigation into possible sex differences in Association of Haemoglobin with survival among Haemodialysis patients in the J‐DOPPS cohort
Authors: Hanafusa Norio , Tu Charlotte , McCullough Keith , Bieber Brian , Pisoni Ronald L. , Robinson Bruce M. , Hasegawa Takeshi , Nangaku Masaomi
Published: April 2022

Aims

Lower haemoglobin levels are common among females without kidney diseases. However, little is known about the sex‐specific management of anaemia in haemodialysis patients.

Methods

This prospective cohort study investigated the role of sex differences in the association between categorical baseline or time‐varying haemoglobin levels and all‐cause mortality via cox regression using data from 6890 patients in the Japan Dialysis Outcomes and Practice Patterns Study (J‐DOPPS, 2005–2015). Likelihood ratio tests were used to evaluate the effect modification of sex on the relationship between haemoglobin and mortality.

Results

A total of 781 patients died during the median follow‐up of 31 months. Mortality risk, adjusted for case mix, varied between five haemoglobin categories, with the highest category (≥12 g/dL) having a hazard ratio of 0.73 (0.41–1.29) for females and 2.02 (1.03–3.95) for males versus 10–10.9 g/dL. Despite this difference, the p‐value comparing the overall among males versus females was.35. Similar associations were observed in models stratified by patient age (<75 years), time on dialysis (≤1 year), and models lagging the haemoglobin exposure.

Conclusion

The results based on this sample of Japanese haemodialysis patients did not support the hypothesis that the association between haemoglobin and survival differed by sex. We also could not conclude that the association was identical, as the parameter estimates are consistent with male patients having a relatively greater mortality risk than female patients at higher haemoglobin levels. More detailed investigations into the effects of higher haemoglobin levels by sex might help better understand strategies for anaemia management.
Early Intervention of Perioperative Delirium in Older Patients (>60 years) with Hip Fracture: A Randomized Controlled Study
Authors: Jing Guang‐Wu , Xie Qin , Tong Jie , Liu Lian‐Zhong , Jiang Xue , Si Liang
Published: April 2022

Objective

To explore the effect of early intervention for perioperative delirium in older (> 60 years) hip fracture patients.

Methods

This prospective study enrolled hip fracture patients aged ≥60 years who were admitted into our hospital between July 2011 and August 2019. Hip fractures were classified according to the Arbeitsgemeinschaft für Osteo‐synthesefragen (AO) classification. This study included patients with isolated hip fracture and excluded patients with pathological or peri prosthetic fracture or patients with multiple traumatic injuries and high‐energy trauma. They were randomized to receive conventional orthopedic care group (n = 65) or comprehensive orthopedic care group including preoperative psychological counseling and preventative risperidone (n = 63). Daily assessment was based on patient interview with the CAM‐CR, and delirium was diagnosed by the Delirium Rating Scale (DRS‐R‐98). The rate, severity and duration of perioperative delirium and the length of postoperative stay were analyzed.

Results

Totally 200 patients were screened for eligibility. Twenty patients were excluded due to alcohol abuse and 40 were excluded because of brain lesions on head CT. In addition, 12 patients were excluded because of impaired cognition. Finally 128 patients were enrolled. Their mean age was 75.3 ± 2.2 years for the comprehensive orthopedic care group and 73.5 ± 6.1 years for the conventional orthopedic care group, and 53.9% of the patients were female. Sixty‐eight (53.1%) patients had intertrochanteric fracture, 39.8% patients had femoral head fracture, and 7.0% patients had subtrochanteric fracture. In addition, 58.6% patients underwent internal fixation and 41.4% patients received arthroplasty. In this study, 63 patients were randomized to the comprehensive orthopedic care group and 65 patients to the conventional orthopedic care group. The two groups were comparable in demographic and baseline characteristics (P > 0.05). The rate of perioperative delirium was significantly lower in the comprehensive care group vs the conventional care group (15.9% vs. 30.8%; P < 0.05). The comprehensive care group had significantly reduced length of postoperative hospital stay vs the conventional care group (11.3 ± 2.5 days vs. 14.2 ± 2.2 days, P < 0.01). The mean DRS‐R‐98 score was 7.1 ± 2.7 for the comprehensive care group, and was significantly lower than that of the conventional orthopedic care group (11.2 ± 3.0; P < 0.05).

Conclusions

Our early intervention may reduce the incidence of perioperative delirium in elderly hip fracture patients (>60 years).
Effectiveness of Ilizarov Ankle Arthrodesis in the Treatment of End‐Stage Varus Ankle Osteoarthritis: A Retrospective Study
Authors: Li Bohua , Wang Shanxi , Li Qin , Zhang Zhengdong , Li Jun , Yang Hai , Liu Lei
Published: April 2022

Objective

To evaluate the outcomes of Ilizarov ankle arthrodesis in the treatment of end‐stage varus ankle osteoarthritis (OA).

Methods

This was a retrospective study of 63 patients with varus ankle OA who underwent Ilizarov ankle arthrodesis between June 2013 and December 2018. There were 24 males and 39 females with an average age of 56.57 ± 4.45 years (range, 47–64 years). Thirty‐six cases were affected on the left side, and 27 were affected on the right side. The patients' mean body mass index (BMI) was 25.18 ± 2.93 kg/m2. According to the modified Takakura staging criteria, there were 18 cases of stage 3b (28.57%) and 45 cases of stage 4 (71.43%). Nine patients were primary (14.29%), 48 were traumatic (76.19%), and six were caused by rheumatoid OA (9.52%). Functional assessments were performed according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle‐hindfoot score, Ankle Osteoarthritis Scale (AOS), and visual analogue scale (VAS). The tibial anterior surface angle (TAS), coronal plane tibial‐talar angle (CPT), talar tilt angle (TT), deformity angle (DA), and tibial lateral surface angle (TLS) were assessed on X‐ray films.

Results

The average operation time was 147.84 ± 13.67 min (range, 135–168 min). The average follow‐up time was 34.24 ± 8.72 months (range, 24–61 months). Bony fusion was achieved in all ankles, and the fusion time was 12.43 ± 1.99 weeks on average. The average AOFAS score at the final follow‐up increased from 42.14 ± 8.66 to 80.90 ± 6.80. The average VAS score and AOS pain and disability scores at the final follow‐up decreased from 7.29 ± 1.27 to 2.24 ± 0.94, from 67.94 ± 7.68 to 27.92 ± 5.82, and from 71.64 ± 9.37 to 41.32 ± 8.99, respectively. The average TAS, CPT, and TLS at the final follow‐up increased from 77.76° ± 4.44° to 89.81° ± 1.25°, from 69.04° ± 3.73° to 90.43° ± 1.80°, and from 82.14° ± 3.77° to 88.67° ± 2.50°, respectively. The average TT and DA at the final follow‐up decreased from 8.76° ± 4.30° to 2.05° ± 1.28° and from 20.95° ± 3.73° to 1.57° ± 0.93°, respectively. Three patients developed superficial pin tract infections, all settled with local dressing and antibiotic treatment. Two patients were found to have subtalar arthritis and underwent conservative treatment.

Conclusion

Ankle arthrodesis using the Ilizarov technique is efficient in treating end‐stage varus ankle OA.
Market positioning in food industry in response to public health policies
Authors: Sajeesh S. , Araz Ozgur M. , Huang Terry T.‐K.
Published: April 2022

Public health agencies have designed and implemented interventions to control the global obesity epidemic using healthfulness messaging and policy changes such as taxation. These changes in the policy environment and marketplace dynamics have shifted consumer trends and have challenged food producers in the industry. The following questions are considered in the food industry in such a context: (i) Should firms offer similar or very different quality offerings? (ii) How should a firm's positioning strategies change as consumers' perceptions of healthful messaging and taxation change? and (iii) How do these factors impact firm profits and social welfare (SW)? Using an analytical model of duopolistic competition, we highlight that both firm profits as well as SW could increase when the importance of healthfulness messaging to consumers increases. Furthermore, we show that increased taxation could reduce the quality gap between alternatives in the market, forcing firms to lower prices. In contrast, when healthfulness messaging becomes more important to consumers, the quality gap between both firms increases. Our results provide important implications for public policy as well as firm profits as a consequence of the strategic decisions of firms in a health policy context.
On place and privilege: Varieties of affluence in cities and neighborhoods
Authors: Paulsen Krista E. , Stuber Jenny
Published: April 2022

Affluent people have long used places, including residential areas and their associated commercial districts and public spaces, as markers of class status. In doing so, they have often sought places that are homogeneous in terms class, and often race/ethnicity, and sought to preserve elite enclaves through a variety of policies and practices. But as we detail here, affluent people are now drawn to different types of residential settings, and their presence influences these places in sometimes surprising ways. In this essay, we review both exclusionary forms of affluent placemaking and more complex and varied forms emerging in gentrifying and super‐gentrifying places. There, the strategies that affluent residents use to create and preserve places have become more varied, as have the relationships between place and class status. These more nuanced understandings of class and place reflects scholars' heightened interest in the cultural dimensions of social class, intersections of race and class, and attention to the ways in which class and affluence reflect and influence the political context.
The Recipient Epidemiology and Donor Evaluation Study‐IV‐Pediatric (REDS‐IV‐P): A research program striving to improve blood donor safety and optimize transfusion outcomes across the lifespan
Authors: Josephson Cassandra D. , Glynn Simone , Mathew Sunitha , Birch Rebecca , Bakkour Sonia , Baumann Kreuziger Lisa , Busch Michael P. , Chapman Kathleen , Dinardo Carla , Hendrickson Jeanne , Hod Eldad A. , Kelly Shannon , Luban Naomi , Mast Alan , Norris Philip , Custer Brian , Sabino Ester , Sachais Bruce , Spencer Bryan R. , Stone Mars , Kleinman Steve ,   for the National Heart, Lung, and Blood Institute (NHLBI) Recipient Epidemiology and Donor Evaluation Study‐IV‐Pediatric (REDS‐IV‐P)
Published: April 2022

Background

The Recipient Epidemiology and Donor Evaluation Study‐IV‐Pediatric (REDS‐IV‐P) is a new iteration of prior National Heart, Lung, and Blood Institute (NHLBI) REDS programs that focus on improving transfusion recipient outcomes across the lifespan as well as the safety and availability of the blood supply.

Study Design and Methods

The US program includes blood centers and hospitals (22 including 6 free‐standing Children's hospitals) in four geographic regions. The Brazilian program has 5 participating hemocenters. A Center for Transfusion Laboratory Studies (CTLS) and a Data Coordinating Center (DCC) support synergistic studies and activities over the 7‐year REDS‐IV‐P program.

Results

The US is building a centralized, vein‐to‐vein (V2V) database, linking information collected from blood donors, their donations, the resulting manufactured components, and data extracts from hospital electronic medical records of transfused and non‐transfused patients. Simultaneously, the Brazilian program is building a donor, donation, and component database. The databases will serve as the backbone for retrospective and prospective observational studies in transfusion epidemiology, transfusion recipient outcomes, blood component quality, and emerging blood safety issues. Special focus will be on preterm infants, patients with sickle cell disease, thalassemia or cancer, and the effect of donor biologic variability and component manufacturing on recipient outcomes. A rapid response capability to emerging safety threats has resulted in timely studies related to Severe Acute Respiratory Syndrome Corona Virus‐2 (SARS‐CoV‐2).

Conclusions

The REDS‐IV‐P program endeavors to improve donor‐recipient‐linked research with a focus on children and special populations while also maintaining the flexibility to address emerging blood safety issues.
Digitally enabled hemovigilance allows real time response to transfusion reactions
Authors: Villamin Colleen , Bates Tonita , Mescher Benjamin , Benitez Sandy , Martinez Fernando , Knopfelmacher Adriana , Correa Medina Mayrin , Klein Kimberly , Dasgupta Amitava , Jaffray David A. , Porter Carol , Tereffe Welela , Gallardo Luisa , Kelley James
Published: April 2022

Background

Transfusion carries a risk of transfusion reaction that is often underdiagnosed due to reliance on passive reporting. The study investigated the utility of digital methods to identify potential transfusion reactions, thus allowing real‐time intervention for affected patients.

Method

The hemovigilance unit monitored 3856 patients receiving 43,515 transfusions under the hemovigilance program. Retrospective comparison data included 298,498 transfusions. Transfusion medicine physicians designed and validated algorithms in the electronic health record that analyze discrete data, such as vital sign changes, to assign a risk score during each transfusion. Dedicated hemovigilance nurses remotely monitor all patients and perform real‐time chart reviews prioritized by risk score. When a reaction is suspected, a hemovigilance trained licensed clinician responds to manage the patient and ensure data collection. Board‐certified transfusion medicine physicians reviewed data and classified transfusion reactions under various categories according to the Centers for Disease Control hemovigilance definitions.

Results

Transfusion medicine physicians diagnosed 564 transfusion reactions (1.3% of transfusions)—a 524% increase compared to the previous passive reporting. The rapid response provider reached the bedside on average at 12.4 min demonstrating logistic feasibility. While febrile reactions were most diagnosed, recognition of transfusion‐associated circulatory overload demonstrated the greatest relative increase. Auditing and education programs further enhanced transfusion reaction awareness.

Discussion

The model of digitally‐enabled expert real‐time review of clinical data that prompts rapid response improved recognition of transfusion reactions. This approach could be applied to other patient deterioration events such as early identification of sepsis.
Evaluation of the anti‐tumour activity of Coriolus versicolor polysaccharopeptide (I'm‐Yunity) alone or in combination with doxorubicin for canine splenic hemangiosarcoma
Authors: Gedney Allison , Salah Pascale , Mahoney Jennifer A. , Krick Erika , Martins Reenie , Scavello Heather , Lenz Jennifer A. , Atherton Matthew J.
Published: April 2022

Canine splenic hemangiosarcoma (HSA) is an aggressive tumour of vascular endothelium that carries a grave prognosis following standard of care treatment with surgery and doxorubicin. A previous pilot study revealed potential anti‐tumour activity of I'm‐Yunity polysaccharopeptide (PSP) for canine HSA. The aim of this prospective study was to assess patient outcome when treated with PSP alone or in combination with doxorubicin post‐splenectomy compared to patients treated with surgery and doxorubicin that received a placebo in place of PSP. Dogs undergoing splenectomy for splenic HSA were eligible. Following splenectomy, owners were offered treatment with PSP alone or adjuvant doxorubicin chemotherapy (unblinded). Patients with owners that selected to proceed with doxorubicin chemotherapy were blindly randomized to receive placebo or PSP. Dogs were evaluated weekly for 15 weeks, then scheduled for monthly visits until death. One hundred and one dogs were included in the final analysis: 51 PSP alone, 25 doxorubicin/placebo, and 25 combination PSP/doxorubicin. On multivariate analysis, dogs treated with single agent PSP, female dogs, decreased haematocrit at diagnosis, and stage III disease were negatively significantly associated with outcome; however, an interaction between treatment group and sex was documented. Gender‐specific outcomes revealed no significant difference in survival between treatment groups for male dogs, but female dogs treated with PSP alone had significantly reduced survival compared to females receiving doxorubicin/placebo (HR 0.21; p = .004). Anaemia (HR 5.28; p < .001) and stage III disease (HR 2.9; p = .014) remained negatively associated with survival when controlling for sex and treatment group. The addition of PSP to doxorubicin post‐splenectomy did not improve survival in dogs with splenic HSA.
Clinical features and posttreatment monitoring of dogs administered rivaroxaban (2018–2020): 19 cases
Authors: Tracy Alyxandra L. , Goggs Robert , Brooks Marjory B. , Lynch Alex M.
Published: April 2022

Objective

To describe a population of sick dogs administered rivaroxaban monitored with a rivaroxaban‐calibrated anti‐Xa activity assay (aXa).

Design

Descriptive retrospective study.

Setting

Two veterinary teaching hospitals.

Animals

Client‐owned dogs administered rivaroxaban and monitored with aXa from January 2018 to January 2020 were eligible for study.

Interventions

None.

Measurements and Main Results

Medical records were reviewed and 19 dogs with a variety of underlying disease processes were identified. Rivaroxaban was administered to 12 of 19 dogs (63%) with confirmed thrombosis, 4 of 19 dogs (21%) with a strong clinical suspicion of thrombosis, and in 3 of 19 dogs (16%) with no current evidence of thrombosis. The median rivaroxaban dose administered was 0.96 mg/kg/day (0.62–1.58 mg/kg/day), with 15 of 19 dogs (79%) receiving rivaroxaban once daily. Clopidogrel was concurrently administered to 11 of 19 dogs (58%). Complete or partial thrombus resolution was identified in 5 of 12 (42%) and 3 of 12 (25%) dogs, respectively. Rivaroxaban appeared safe, with only 1 of 19 dogs (5%), concurrently administered clopidogrel, developing evidence of mild hematuria. Posttreatment monitoring revealed that 8 of 19 dogs (42%) had aXa below the target (aXa range of 150–250 ng/ml associated with effective treatment and prevention of venous thrombosis in people). The remaining 3 to 19 dogs (16%) achieved this range, and 8 of 19 dogs (42%) exceeded the range. No significant relationship between the initial rivaroxaban dose administered and the corresponding aXa result was identified. There were also no significant differences in baseline clinicopathological variables in dogs in which aXa fell within or outside this range.

Conclusions

aXa was most commonly measured in dogs receiving rivaroxaban with confirmed or suspected thrombosis. Dogs in this study received a range of rivaroxaban dosages and attained variable aXa values that were not directly correlated with dosage.
PH-DEPENDENT ADSORPTION/DESORPTION OF DYE MOLECULES USING MAGNETICALLY SEPARABLE QUARTZ SAND
Authors: Chan Mei Yee , Lee Yit Kwan , Yeap Swee Pin
Published: April 2022

Adsorption has been a feasible process to remove dye molecules from water resources. However, some of the proposed adsorbents required high temperature to be synthesized or hard to be separated towards the end of their applications. Realizing this, this study aims to fabricate Fe3O4-decorated sand that does not require high temperature in production. More importantly, the attached Fe3O4 nanoparticles provide intrinsic magnetic properties to ease the subsequent separation. The ability of this adsorbent to remove methylene blue (cationic dye), tartrazine (anionic dye), and disperse yellow 3 (non-ionic dye) at different medium pHs were investigated. Results showed that the Fe3O4-decorated sand performed better in dye removal as compared to the pure sand counterpart. In specific, sand doped with 5000 mg/L of Fe3O4 successfully removed 75.01 % of methylene blue, as compared to the 68.01 % achieved by using pure sand alone. It was also found that the effectiveness of dye adsorption and desorption strongly depends on the medium pH mostly due to the amphoteric nature of the Fe3O4 nanoparticles. The desorption of methylene blue, tartrazine, and disperse yellow 3 from the adsorbent best to be done using 30 % v/v acetone, 0.1 M NaOH, and 30 % v/v ethanol, respectively. Additionally, it was found that this adsorbent can be effectively separated using either high or low gradient magnetic fields.
SYNTHETIC MULTIVARIATE DATA GENERATION PROCEDURE WITH VARIOUS OUTLIER SCENARIOS USING R PROGRAMMING LANGUAGE
Authors: Syed Abd Mutalib Sharifah Sakinah , Satari Siti Zanariah , Wan Yusoff Wan Nur Syahidah
Published: April 2022

A synthetic data generation procedure is a procedure to generate data from either a statistical or mathematical model. The data generation procedure has been used in simulation studies to compare statistical performance methods or propose a new statistical method with a specific distribution. A synthetic multivariate data generation procedure with various outlier scenarios using R is formulated in this study. An outlier generating model is used to generate multivariate data that contains outliers. Data generation procedures for various outlier scenarios by using R are explained. Three outlier scenarios are produced, and graphical representations using 3D scatterplot and Chernoff faces for these outlier scenarios are shown. The graphical representation shows that as the distance between outliers and inliers by shifting the mean, increases in Outlier Scenario 1, the outliers and inliers are completely separated. The same pattern can also be seen when the distance between outliers and inliers, by shifting the covariance, increase in Outlier Scenario 2. For Outlier Scenario 3, when both values  and  increase, the separation of outliers and inliers are more apparent. The data generation procedure in this study will be continually used in other applications, such as identifying outliers by using the clustering method.