bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical utility of elective paediatric flexible bronchoscopy and impact on the quality of life: protocol for a single-centre, single-blind, randomised controlled trial
Authors: Thomas Rahul , Marchant Julie M , Goyal Vikas , Masters Ian Brent , Yerkovich Stephanie T , Chang Anne B
Published: February 2024

Introduction

Elective flexible bronchoscopy (FB) is now widely available and standard practice for a variety of indications in children with respiratory conditions. However, there are no randomised controlled trials (RCTs) that have examined its benefits (or otherwise).

Our primary aim is to determine the impact of FB on the parent-proxy quality-of-life (QoL) scores. Our secondary aims are to determine if undertaking FB leads to (a) change in management and (b) improvement of other relevant patient-reported outcome measures (PROMs). We also quantified the benefits of elective FB (using 10-point Likert scale). We hypothesised that undertaking elective FB will contribute to accurate diagnosis and therefore appropriate treatment, which will in turn improve QoL and will be deemed to be beneficial from patient and doctor perspectives.

Methods and analysis

Our parallel single-centre, single-blind RCT (commenced in May 2020) has a planned sample size of 114 children (aged <18 years) recruited from respiratory clinics at Queensland Children’s Hospital, Brisbane, Australia. Children are randomised (1:1 concealed allocation) within two strata: age (≤2 vs >2 years) and indication for FB (chronic cough vs other indications) to either (a) early arm (intervention where FB undertaken within 2 weeks) or (b) delayed (control, FB undertaken at usual wait time). Our primary outcome is the difference between groups in their change in QoL at the T2 timepoint when the intervention group has had the FB and the control group has not. Our secondary outcomes are change in management, change in PROMs, adverse events and the Likert scales.

Ethics and dissemination

The human research ethics committee of the Queensland Children’s Hospital granted ethical clearance (HREC/20/QCHQ/62394). Our RCT is conducted in accordance with Good Clinical Practice and the Australian legislation. Results will be disseminated through conference presentations, teaching avenues, workshops, websites and publications.

Registration

Australia New Zealand Clinical Trial Registry ACTRN12620000610932.
Risk of exacerbation and mortality in asthma: a 10-year retrospective financial database analysis of the Hungarian Health Insurance Fund
Authors: Tomisa Gábor , Sánta Balázs , Horváth Alpár , Németh László , Tamás Balázs , Gálffy Gabriella , Tamási Lilla , Eszes Noémi
Published: February 2024

Introduction

Asthma is the most prevalent obstructive pulmonary disease, with drastically improved treatment options over the past decades. However, there is still a proportion of patients with suboptimal level of asthma control, leading to multiple hospitalisation due to severe acute exacerbation (SAE) and earlier death. In our study, we aimed to assess the risk of SAEs and mortality in patients who suffered an SAE.

Methods

The database of the National Health Insurance Fund was used to retrospectively analyse the data of all asthmatic patients who had been hospitalised for an SAE between 2009 and 2019. We used a competing risk model to analyse the effect of each exacerbation on the risk of further SAEs with age, sex, Charlson index and the number of severe and moderate exacerbations included as covariates.

Result

Altogether, 9257 asthmatic patients suffered at least one exacerbation leading to hospitalisation during the study time. The majority (75.8%) were women, and the average age was 58.24 years. Most patients had at least one comorbidity. 3492 patients suffered at least one further exacerbation and 1193 patients died of any cause. In the competing risk model, each SAE increased the risk of further exacerbations (HR=2.078–7.026; p<0.0001 for each case) but not death. The risk of SAEs was also increased by age (HR=1.008) female sex (HR=1.102) and with the number of days of the first SAE (HR=1.007).

Conclusions

Even though asthma is generally a well-manageable disease, there still are many patients who suffer SAEs that significantly increase the risk of further similar SAEs.
Real-world treatment trajectories of adults with newly diagnosed asthma or COPD
Authors: Markus Aniek F , Rijnbeek Peter R , Kors Jan A , Burn Edward , Duarte-Salles Talita , Haug Markus , Kim Chungsoo , Kolde Raivo , Lee Youngsoo , Park Hae-Sim , Park Rae Woong , Prieto-Alhambra Daniel , Reyes Carlen , Krishnan Jerry A , Brusselle Guy G , Verhamme Katia MC
Published: February 2024

Background

There is a lack of knowledge on how patients with asthma or chronic obstructive pulmonary disease (COPD) are globally treated in the real world, especially with regard to the initial pharmacological treatment of newly diagnosed patients and the different treatment trajectories. This knowledge is important to monitor and improve clinical practice.

Methods

This retrospective cohort study aims to characterise treatments using data from four claims (drug dispensing) and four electronic health record (EHR; drug prescriptions) databases across six countries and three continents, encompassing 1.3 million patients with asthma or COPD. We analysed treatment trajectories at drug class level from first diagnosis and visualised these in sunburst plots.

Results

In four countries (USA, UK, Spain and the Netherlands), most adults with asthma initiate treatment with short-acting ß2 agonists monotherapy (20.8%–47.4% of first-line treatments). For COPD, the most frequent first-line treatment varies by country. The largest percentages of untreated patients (for asthma and COPD) were found in claims databases (14.5%–33.2% for asthma and 27.0%–52.2% for COPD) from the USA as compared with EHR databases (6.9%–15.2% for asthma and 4.4%–17.5% for COPD) from European countries. The treatment trajectories showed step-up as well as step-down in treatments.

Conclusion

Real-world data from claims and EHRs indicate that first-line treatments of asthma and COPD vary widely across countries. We found evidence of a stepwise approach in the pharmacological treatment of asthma and COPD, suggesting that treatments may be tailored to patients’ needs.
Mycophenolate and azathioprine efficacy in interstitial lung disease: a systematic review and meta-analysis
Authors: Lombardi Francesco , Stewart Iain , Fabbri Laura , Adams Wendy , Kawano-Dourado Leticia , Ryerson Christopher J , Jenkins Gisli
Published: February 2024

Objectives

Mycophenolate mofetil (MMF) and azathioprine (AZA) are immunomodulatory treatments in interstitial lung disease (ILD). This systematic review aimed to evaluate the efficacy of MMF or AZA on pulmonary function in ILD.

Design

Population included any ILD diagnosis, intervention included MMF or AZA treatment, outcome was delta change from baseline in per cent predicted forced vital capacity (%FVC) and gas transfer (diffusion lung capacity of carbon monoxide, %DLco). The primary endpoint compared outcomes relative to placebo comparator, the secondary endpoint assessed outcomes in treated groups only.

Eligibility criteria

Randomised controlled trials (RCTs) and prospective observational studies were included. No language restrictions were applied. Retrospective studies and studies with high-dose concomitant steroids were excluded.

Data synthesis

The systematic search was performed on 9 May. Meta-analyses according to drug and outcome were specified with random effects, I2evaluated heterogeneity and Grading of Recommendations, Assessment, Development and Evaluation evaluated certainty of evidence. Primary endpoint analysis was restricted to RCT design, secondary endpoint included subgroup analysis according to prospective observational or RCT design.

Results

A total of 2831 publications were screened, 12 were suitable for quantitative synthesis. Three MMF RCTs were included with no significant effect on the primary endpoints (%FVC 2.94, 95% CI −4.00 to 9.88, I2=79.3%; %DLco −2.03, 95% CI −4.38 to 0.32, I2=0.0%). An overall 2.03% change from baseline in %FVC (95% CI 0.65 to 3.42, I2=0.0%) was observed in MMF, and RCT subgroup summary estimated a 4.42% change from baseline in %DLCO(95% CI 2.05 to 6.79, I2=0.0%). AZA studies were limited. All estimates were considered very low certainty evidence.

Conclusions

There were limited RCTs of MMF or AZA and their benefit in ILD was of very low certainty. MMF may support preservation of pulmonary function, yet confidence in the effect was weak. To support high certainty evidence, RCTs should be designed to directly assess MMF efficacy in ILD.

PROSPERO registration number

CRD42023423223.
Religion and mental health in young adulthood: a register-based study on differences by religious affiliation in sickness absence due to mental disorders in Finland
Authors: Reini Kaarina Susanna , Kolk Martin , Saarela Jan
Published: February 2024

Background

Religiosity and spirituality are known to be positively correlated with health. This is the first study to analyse the interrelation between religious denomination and sickness absence due to mental disorders using population register data with detailed ICD codes.

Methods

The follow-up study was based on the entire population born in Finland between 1984 and 1996 (N=794 476). Each person was observed from age 20 over the period from 2004 to 2018. Cox proportional hazards models were applied to analyse the association between religious denomination and first-time sickness allowance receipts for any cause and mental disorder. Mental disorders were categorised as severe mental illness (F20–F31), depression (F32–F33), anxiety (F40–F48) and any other mental disorder (all other F codes). Men and women were analysed separately.

Results

The differences in sickness absence due to mental disorder were substantial between religious affiliations. Compared with members of the Evangelical Lutheran state church, the relative hazard for mental disorders among non-affiliated women was 1.34 (95% CI 1.30 to 1.39), while that among women with other religions was 1.27 (95% CI 1.19 to 1.35), after adjusting for own and parental characteristics. The corresponding numbers for men were 1.45 (95% CI 1.39 to 1.50) and 1.42 (95% CI 1.30 to 1.54), respectively. The gradient was larger for severe mental illness and depression than for anxiety and other mental disorders. For any cause of sickness absence, there was no difference between Lutherans, non-affiliated individuals and those with other religions.

Conclusions

Epidemiologists and public health practitioners should further examine the association between mental disorders and church membership using administrative registers.
Novel
TUBA4A
variant causes congenital myopathy with focal myofibrillar disorganisation
Authors: Wan Yalan , Zhou Chao , Chang Xingzhi , Wu Liwen , Zheng Yilei , Yu Jiaxi , Bai Li , Luan Mingyue , Yu Meng , Wang Qi , Zhang Wei , Yuan Yun , Deng Jianwen , Wang Zhaoxia
Published: February 2024

Background

Congenital myopathies are a clinical, histopathological and genetic heterogeneous group of inherited muscle disorders that are defined on peculiar architectural abnormalities in the muscle fibres. Although there have been at least 33 different genetic causes of the disease, a significant percentage of congenital myopathies remain genetically unresolved. The present study aimed to report a novel
TUBA4A
variant in two unrelated Chinese patients with sporadic congenital myopathy.

Methods

A comprehensive strategy combining laser capture microdissection, proteomics and whole-exome sequencing was performed to identify the candidate genes. In addition, the available clinical data, myopathological changes, the findings of electrophysiological examinations and thigh muscle MRIs were also reviewed. A cellular model was established to assess the pathogenicity of the
TUBA4A
variant.

Results

We identified a recurrent novel heterozygous de novo c.679C>T (p.L227F) variant in the
TUBA4A
(NM_006000), encoding tubulin alpha-4A, in two unrelated patients with clinicopathologically diagnosed sporadic congenital myopathy. The prominent myopathological changes in both patients were muscle fibres with focal myofibrillar disorganisation and rimmed vacuoles. Immunofluorescence showed ubiquitin-positive TUBA4A protein aggregates in the muscle fibres with rimmed vacuoles. Overexpression of the L227F mutant TUBA4A resulted in cytoplasmic aggregates which colocalised with ubiquitin in cellular model.

Conclusion

Our findings expanded the phenotypic and genetic manifestations of
TUBA4A
as well as tubulinopathies, and added a new type of congenital myopathy to be taken into consideration in the differential diagnosis.
Numerical modelling of pile jacking in highly sensitive clays
Authors: Karmaker Ripon , Hawlader Bipul , Perret Didier , Dey Rajib
Published: February 2024

This paper presents large deformation finite element (FE) modelling of penetration of solid cylindrical piles into highly sensitive soft clay. The simulations are performed using a Coupled Eulerian–Lagrangian (CEL) FE modeling technique. The pile is penetrated at a constant rate, and the analyses are performed for undrained conditions to simulate the response during penetration. The soil model considers the effects of strain softening and strain rate on the undrained shear strength. The FE-calculated results are compared with available analytical and numerical solutions for idealized soil profiles. Simulations are also performed for two instrumented piles previously installed into highly sensitive clay at Saint-Alban in Québec, Canada. The installation-induced changes in stresses, degradation of undrained shear strength, and tip resistance obtained from FE analyses are consistent with the field test results. Large plastic shear strains develop near the pile, which can significantly remould the soil near the pile shaft. A parametric study shows that a quicker post-peak degradation of undrained shear strength of highly sensitive clay creates a smaller zone of high plastic shear strain near the pile, while the plastic zone is wider for low- to non-sensitive clays.
Reconstructing axion-like particles from beam dumps with simulation-based inference
Authors: Morandini Alessandro , Ferber Torben , Kahlhoefer Felix
Published: February 2024

Axion-like particles (ALPs) that decay into photon pairs pose a challenge for experiments that rely on the construction of a decay vertex in order to search for long-lived particles. This is particularly true for beam-dump experiments, where the distance between the unknown decay position and the calorimeter can be very large. In this work we use machine learning to explore the possibility to reconstruct the ALP properties, in particular its mass and lifetime, from such inaccurate observations. We use a simulation-based inference approach based on conditional invertible neural networks to reconstruct the posterior probability of the ALP parameters for a given set of events. We find that for realistic angular and energy resolution, such a neural network significantly outperforms parameter reconstruction from conventional high-level variables while at the same time providing reliable uncertainty estimates. Moreover, the neural network can quickly be re-trained for different detector properties, making it an ideal framework for optimizing experimental design.
Emotion-Driven Energy Load Forecasting: An Ensemble Leveraging Insights from News
Authors: Liapis Charalampos M. , Karanikola Aikaterini , Kotsiantis Sotiris
Published: February 2024

In modern times, system energy load forecasting is an extremely important process in a variety of contexts. Moreover, energy load time series fluctuations are influenced by a wide range of factors, ranging, inter alia, from environmental conditions, natural events, and demographics to both regional and global geopolitical contexts, economic conditions, energy sources, policies, and regulations. Given these, this paper examines the integration of news information from the global scene into Greek energy load forecasting schemes through the use of sentiment analysis. Investigating the ways the general emotional footprint of news worldwide affects and can be used in an energy modeling context, we benchmark possible ensemble configurations incorporating a multitude of 31 emotion polarities. Building on our previous work, an ensemble method that exploits specific outputs from a multi-label sentiment classifier and a sentiment analysis procedure under a multivariate forecasting scheme is presented. It is shown, through an empirical evaluation of the results, that the integration of emotion representations related to non-Greek news concerning global current affairs improves the predictions.
Few-shot Learning for Heterogeneous Information Networks
Authors: Fang Yang , Zhao Xiang , Xiao Weidong , de Rijke Maarten
Published: February 2024

Heterogeneous information networks (HINs)
are a key resource in many domain-specific retrieval and recommendation scenarios and in conversational environments. Current approaches to mining graph data often rely on abundant supervised information. However, supervised signals for graph learning tend to be scarce for a new task and only a handful of labeled nodes may be available. Meta-learning mechanisms are able to harness prior knowledge that can be adapted to new tasks.

In this article, we design meta-learning framework for heterogeneous information networks (
META-HIN
), for few-shot learning problems on HINs. To the best of our knowledge, we are among the first to design a unified framework to realize the few-shot learning of HINs and facilitate different downstream tasks across different domains of graphs. Unlike most previous models, which focus on a single task on a single graph,
META-HIN
is able to deal with different tasks (node classification, link prediction, and anomaly detection are used as examples) across multiple graphs. Subgraphs are sampled to build the support and query set. Before being processed by the meta-learning module, subgraphs are modeled via a structure module to capture structural features. Then, a heterogeneous Graph Neural Network module is used as the base model to express the features of subgraphs. We also design a Generative Adversarial Network-based contrastive learning module that is able to exploit unsupervised information of the subgraphs.

In our experiments, we fuse several datasets from multiple domains to verify
META-HIN
’s broad applicability in a multiple-graph scenario.
META-HIN
consistently and significantly outperforms state-of-the-art alternatives on every task and across all datasets that we consider.
Fine-grained Coverage-based Fuzzing - RCR Report
Authors: Wu Wei-Cheng , Nongpoh Bernard , Nour Marwan , Marcozzi Michaël , Bardin Sébastien , Hauser Christophe
Published: February 2024

This is the RCR report of the artifact for the article “Fine-grained Coverage-based Fuzzing.” This report contains scripts and pre-build binary programs to reproduce the results presented in the main article. The artifact is released on Zenodo with DOI: 10.5281/zenodo.7275184. We claim the artifact to be available, functional, and reusable. The technology skills needed to review the artifact are knowing how to use Linux/Unix terminal and a basic understanding of Docker.
Review—Recent Advances of Micro/Nano-Motor-Facilitated Electrochemical Sensor Development
Authors: Mitra Shirsendu , Basak Mitali , Saini Bharti
Published: February 2024

Micro/-nano motors (MNMs) are deployed to perform cutting edge research and development activities that include biomedical engineering, environment monitoring, energy harvesting and more. MNMs progressively strives for miniaturization of MNMs, mightier self-propulsion, precision of motion, and smarter motion control. The last decade published several reports on biosensing applications of MNMs targeting enhanced specificity, selectivity. Among MNM mediated biosensors, the electrochemical biosensor is the most important stake holder. Motion of MNMs enable active transport, augmented reaction kinetics, and better selectivity causing smarter biosensing. This review article explores the most advanced development of electrochemical biosensing deploying MNMs that took place in recent past. Briefly, this article covers chronological development in the field of MNM mediated electrochemical biosensing with emphasis on, conventional working electrode based sensing, DNA walker modificaitons, MNM based real time electrochemical signal monitoring, and scope of MNM mediated electrochemical sensing for intracellular monitoring or drug delivery. Conclusively, the review considers the most recent development in the field of MNM mediated electrochemical sensing that includes both in vitro and in vivo electrochemical biosensing. Additionally, we discuss use of electorchemical redox reactions for imparting motion to the MNMs in physiological fluids for intracellular manipulation, targeted drug delivery, and more.
Voltametric Determination of Dopamine in Urine Samples Using Biochar-Modified Carbon Paste yielded from Spent Coffee Grounds
Authors: da Silva Nathalia Dorigoni , Valenga Marcia Gabriela Pianaro , de Oliveira Geovane Arruda , Gevaerd Ava , Marcolino-Junior Luiz Humberto , Bergamini Márcio F.
Published: February 2024

Dopamine (DA), a crucial neurotransmitter in human systems, coexists with uric acid (UA) and ascorbic acid (AA) in biological fluids, challenging its selective detection due to similar redox behavior. This study introduces a method for selectively preconcentrating dopamine before voltammetric determination. For that, eco-friendly biochar was prepared from spent coffee grounds (400 °C, 60 min), chemically activated with HNO3 (60 °C, 3 h), characterized using FTIR, XDR, and Boehm titration, and then used for assembling carbon paste modified electrodes (CPME). In the electrochemical process, the CPME was immersed in a solution containing the analyte and interferents (0.1 mol l−1 BR buffer, pH = 7.0), and then transferred to the electrochemical cell for detecting preconcentrated DA via differential pulse voltammetry (DPV). The method demonstrated selectivity and sensitivity with a linear dynamic range (LDR) of 10 to 200 μmol l−1, limits of detection (LOD) and quantification (LOQ) of 1.47 and 10.0 μmol l−1. Additionally, synthetic urine samples containing the analyte were analyzed in presence of equimolar concentrations of AA and UA, and the method successfully and selectively determinated DA even in a more complex matrix.
Effect of Applied AC Voltage on the Performance of Non-Faradaic Impedimetric Biosensors
Authors: Alzahrani Khalid E. , Almansour Meshael J. , Qurayshan Shahad M. , Albrithen Hamad , Fakhouri Abdulaziz S. , Alhussaini Khalid , Assaifan Abdulaziz K. , Alodhayb Abdullah N.
Published: February 2024

Electrochemical impedance spectroscopy based non-faradaic biosensors are promising low-cost and rapid detection tool for a variety of biomarkers. Unlike faradaic impedimetric biosensors, non-faradaic impedimetric biosensors are redox-free and do not require the use of three electrodes. Instead, two electrodes are enough to carry out biosensing using non-faradaic biosensors. Commonly used AC perturbation during non-faradaic impedimetric biosensors is 10 mV to maintain the linearity of the electrochemical biosensor. In this work, we investigated the effect of different AC voltages (10, 50, 100, 200, 400, 800 and 1600 mV) on bare gold interdigitated electrodes (Au-IDEs). As the AC voltage increased, the capacitance and phase of bare Au-IDEs increased whereas the impedance decreased. At 800 and 1600 mV, non-linear effects started to appear on the Lissajous plots. Then, the effect of all the AC voltages except 800 and 1600 mV on the performance of fully functionalized non-faradaic LDL-cholesterol sensors were investigated. Increasing the AC voltage resulted in better limit of detection and change in capacitance. However, it also resulted in larger change in capacitance due to testing against negative (control samples). The reported study can be useful for the future development of non-faradaic impedimetric biosensors for the detection of different biomarkers and to achieve different limits of detection as per the application requirements.
Leaf-Like ZIF-Derived Zinc-Cobalt Layered Double Hydroxide@Cerium Dioxide Nanosphere Heterostructure/Nickel Foam Composite Electrode for the Detection of Lead Ions in the Environment
Authors: Jiang Cheng , Luo Zihan , Peng Xuhong , Fang Jian , Zhao Jihua
Published: February 2024

The lead (Pb) in the environment is harmful to human body, so it is of practical significance and application value to develop a method for detecting lead ions (Pb2+) in the environment. Herein, Zeolitic imidazolate framework/nickel foam (ZnCo ZIF-L/NF) was in situ grown on nickel foam (NF) substrate by hydrothermal method, and aged and hydrolyzed at room temperature to transform ZnCo ZIF-L into zinc cobalt layered double hydroxide/nickel foam (ZnCo ZLDH/NF). CeO2 nanospheres were synthesized and loaded onto ZnCo ZLDH/NF materials to prepare ZnCo ZLDH@CeO2/NF heterostructure composite electrodes. Finally, ZnCo ZLDH@CeO2/NF was used to detect divalent lead ion (Pb2+) by differential pulse anodic stripping voltammetry (DPASV). The electrochemical sensor constructed by the ZnCo ZLDH@CeO2/NF composite electrode exhibits the concentration linear range of 0.1 μM–30 μM with a limit of detection 9 nM (S/N = 3) and the sensitivity of 67 A/M. Meanwhile, the ZnCo ZLDH@CeO2/NF composite electrode has good repeatability and anti-interference stability.
Corrosion Behaviour of Ni-based Alloys 230, 617 and 601 in CO2 Gas at 750 and 850 °C
Authors: Li Haoyi , Nguyen Thuan Dinh , Zhang Jianqiang
Published: February 2024

This paper investigated the corrosion behavior of three nickel-based alloys (230, 617 and 601) at 750 °C and 850 °C in a carbon dioxide environment for up to 500 h. All three alloys showed good oxidation resistance by forming mainly a protective chromia layer with low weight gains. Internal Al2O3 was precipitated beneath a thin chromia layer in all cases. For 230 and 617 alloys, NiO and Cr-rich spinel outer layers were formed, but for 601 less iron and nickel outward diffusion was observed at both temperatures. Furthermore, some minor alloy elements (Mn, Ti, and Co) were also observed in the chromia layers. Very limited carburization due to the CO2 reaction was revealed in the matrix underneath the oxide scale. Wagner’s theory was applied to examine the critical chromium concentration for forming a protective chromia scale. This prediction indicated that alloy concentrations were marginal for chromia formation at both temperatures and the critical chromium concentration decreased with increasing the oxidation temperature. The presence of other alloying elements, e.g. Al, Mn, Ti, Si etc could increase corrosion resistance of these alloys by forming either additional protective oxide barriers or integrating with chromium oxide to enhance its protection.
Toxic Leadership in Emergency Nurses: Assessing Abusive Supervision and Its Team-Level Impacts on Conflict Management and Organizational Commitment
Authors: Alsadaan Nourah , Alqahtani Mohammed
Published: February 2024

Background. Emergency departments suffer from authoritarian and manipulative leadership styles that affect team dynamics, emotional exhaustion, and quality patient care. However, little research specifically explores these toxic leadership effects on conflict management and nurses' organizational commitment. Objectives. This cross-sectional study aimed to assess the correlations between perceived toxic leadership, conflict resolution strategies, and commitment dimensions among emergency nurses while evaluating conflict tendencies as a mediating mechanism. Methods. A cross-sectional design that included multiple regression and mediation analyses was utilized. The sample consisted of 387 emergency nurses from five major Saudi hospitals surveyed using validated scales that measure perceived toxic leadership, conflict styles, and organizational commitment. Results. High prevalence rates for perceived authoritarian (77%), narcissistic (75%), and unpredictable (63%) leadership were reported. Increased toxicity was positively related to dominating and avoiding conflict styles but negatively related to integrating and compromising strategies. Toxic leadership is also associated with lower affective/normative commitment but higher continuance commitment. Conflict management partially mediated the leadership-commitment relationship, which explained 29% of the total effect. Finally, higher experience and education predicted greater perceived toxicity. Conclusions. The significant correlations between destructive leadership, adverse conflict, and reduced commitment in emergency nurses underscore the need for context-specific leadership training. Fostering supportive environments through multifaceted interventions can counteract toxicity impacts, impart constructive communication techniques, improve nurse well-being, and ensure high-quality patient care. As conflict tendencies and nurse characteristics influence susceptibility to detrimental leadership, tailored programs addressing experience levels are vital.
The Impact of Grit on Nurses’ Job Performance: Evaluating Chained Mediation through Perceived Social Support and Self-Esteem
Authors: Liu Xiqin , Li Jingguang , Wang Song
Published: February 2024

Background. Nurses play a critical role in the medical workforce during the COVID-19 pandemic while facing various difficulties and challenges. Grit, social support, and self-esteem are important psychosocial factors influencing job performance. However, few studies have explored the relationships among these factors in nurses. Aim. This study aimed to examine the association between grit and nurses’ job performance during the COVID-19 pandemic and to explore the potential chain mediation through perceived social support and self-esteem. Methods. A cross-sectional survey design was employed. From January 2021 to May 2022, a total of 709 Chinese nurses in Chengdu and Kunming completed a web-based cross-sectional survey, which included standard assessments on grit, perceived social support, self-esteem, and job performance as well as Big Five personalities. The chain mediation model was tested using the PROCESS macro program in the SPSS software. Results. There was a moderate-to-large correlation (r = 0.40, p<0.001) between grit and job performance in Chinese nurses. Furthermore, grit was indirectly linked to job performance through the chain mediating effect of perceived social support and self-esteem (all p<0.05). These findings persisted even when Big Five personalities were included as additional controlling variables. Conclusions. This study reveals a stable link between grit and job performance among Chinese nurses and highlights the potential role of perceived social support and self-esteem in mediating this link. Implications for Nursing Management. Nursing managers can improve nurses’ grit level and provide a supportive organizational environment conducive to enhancing self-esteem and thereby promoting their job performance.
Effect of Coating and Coated Paperboard Packaging on the Quality of Grapes and Apple during Storage
Authors: Islam Soriful , Shakil Md , Hossain Sarker Md Sazzat , Nayem Md Faridunnabi , Akter Tanjina , Sachcha Ishmam Haque , Yasmin Sabina
Published: February 2024

Edible coatings and active packaging have become more prevalent in response to changing consumption patterns and market trends to enhance the quality and safety of fresh products. In this work, we investigated the effect of aloe vera gel (AVG) coating and paraffin wax-coated paperboard (PWB) packaging on the postharvest quality attributes of both grapes and apples during storage. The fruits were coated with 50% AVG concentrations, and the inner wall of the corrugated paperboard was coated with paraffin wax emulsion. The grapes and apples were stored for 12 and 35 days, respectively, at ambient conditions (25 ± 3°C and 80–85% relative humidity). The physicochemical properties, microbiological attributes, and decay incidence of the fruits were analyzed at intervals during storage. Both fruits treated with AVG and PWB packaging retained better qualities than the control at the final day of the storage period. Particularly, PWB packaging provided considerably superior quality from the control sample in terms of weight loss (≈54% and 32%), firmness (≈48% and 68%), and color difference (≈30% and 28%) for both grapes and apples. These findings would introduce a novel approach for preserving the quality attributes of both climacteric and nonclimacteric fruits for a prolonged storage period at ambient temperature by PWB packaging and AVG coating.
Severity of Complications and Duration of Type 2 Diabetes and the Risk of Cancer: A Population-Based Study
Authors: Hu Yu-Wen , Yeh Chiu-Mei , Liu Chia-Jen , Chen Tzeng-Ji , Huang Nicole , Chou Yiing-Jenq
Published: February 2024

Background:

The literature on the association between diabetes severity and cancer risk is limited and inconclusive. The study aimed to evaluate the association between the adapted Diabetes Complications Severity Index (aDCSI) and the duration of type 2 diabetes and cancer risk.

Methods:

Patients ages 20 years or older with newly diagnosed type 2 diabetes between January 1, 2007, and December 31, 2011, were identified from Taiwan National Health Insurance claims data. Standardized incidence ratios (SIR) were calculated to compare cancer incidence in people with diabetes with that in the general population. Poisson regression was used to examine whether SIRs differed by age, sex, aDSCI, and duration of diabetes.

Results:

A total of 756,547 patients were included, with a median follow-up of 8.8 years. Excluding the first year after diagnosis, the SIR for overall cancer was 1.18 [95% confidence interval (CI) 1.17–1.19]. Higher aDCSI was associated with increased SIRs for overall [SIR ratio 1.03 (1.02–1.03) per point increase], head and neck (1.03; 1.01–1.04), liver (1.04; 1.03–1.05), pancreas (1.03; 1.00–1.05), kidney (1.13; 1.10–1.15), and leukemia (1.09; 1.06–1.13). There was no association between aDCSI and colorectal, extrahepatic biliary tract, uterus and thyroid cancer, and a negative association with breast cancer (0.97; 0.95–0.98). Type 2 diabetes duration was associated with increased SIRs for overall [1.01 (1.00–1.02) per year increase], head and neck (1.03; 1.01–1.05), and liver cancer (1.04; 1.02–1.05).

Conclusions:

The heterogeneity in the association between diabetes severity and diabetes-related cancers suggests diverse underlying connections.

Impact:

Adopting distinct approaches in further research and prevention strategies for different kinds of diabetes-related cancers is important.
Adult-Onset Cancer Predisposition Syndromes in Children and Adolescents—To Test or not to Test?
Authors: Kratz Christian P. , Lupo Philip J. , Zelley Kristin , Schienda Jaclyn , Nichols Kim E. , Stewart Douglas R. , Malkin David , Brodeur Garrett M. , Maxwell Kara , Plon Sharon E. , Walsh Michael F.
Published: February 2024

With the increasing use of comprehensive germline genetic testing of children and adolescents with cancer, it has become evident that pathogenic variants (PV) in adult-onset cancer predisposition genes (aoCPG) underlying adult-onset cancer predisposition syndromes, such as Lynch syndrome or hereditary breast and ovarian cancer, are enriched and reported in 1% to 2% of children and adolescents with cancer. However, the causal relationship between PVs in aoCPGs and childhood cancer is still under investigation. The best-studied examples include heterozygous PVs in mismatch repair genes associated with Lynch syndrome in children with mismatch repair deficient high-grade glioma, heterozygous PVs in BARD1 in childhood neuroblastoma, and heterozygous PVs in BRCA2 in children with rhabdomyosarcoma. The low penetrance for pediatric cancers is considered to result from a combination of the low baseline risk of cancer in childhood and the report of only a modest relative risk of disease in childhood. Therefore, we do not advise that healthy children empirically be tested for PVs in an aoCPG before adulthood outside a research study. However, germline panel testing is increasingly being performed in children and adolescents with cancer, and exome and genome sequencing may be offered more commonly in this population in the future. The precise pediatric cancer risks and spectra associated with PVs in aoCPGs, underlying cellular mechanisms and somatic mutational signatures, as well as treatment response, second neoplasm risks, and psycho-oncological aspects require further research.
Thio-2 Inhibits Key Signaling Pathways Required for the Development and Progression of Castration-resistant Prostate Cancer
Authors: Neeb Antje , Figueiredo Ines , Bogdan Denisa , Cato Laura , Stober Jutta , Jiménez-Vacas Juan M. , Gourain Victor , Lee Irene I. , Seeger Rebecca , Muhle-Goll Claudia , Gurel Bora , Welti Jonathan , Nava Rodrigues Daniel , Rekowski Jan , Qiu Xintao , Jiang Yija , Di Micco Patrizio , Mateos Borja , Bielskutė Stasė , Riisnaes Ruth , Ferreira Ana , Miranda Susana , Crespo Mateus , Buroni Lorenzo , Ning Jian , Carreira Suzanne , Bräse Stefan , Jung Nicole , Gräßle Simone , Swain Amanda , Salvatella Xavier , Plymate Stephen R. , Al-Lazikani Bissan , Long Henry W. , Yuan Wei , Brown Myles , Cato Andrew C.B. , de Bono Johann S. , Sharp Adam
Published: February 2024

Therapies that abrogate persistent androgen receptor (AR) signaling in castration-resistant prostate cancer (CRPC) remain an unmet clinical need. The N-terminal domain of the AR that drives transcriptional activity in CRPC remains a challenging therapeutic target. Herein we demonstrate that BCL-2–associated athanogene-1 (BAG-1) mRNA is highly expressed and associates with signaling pathways, including AR signaling, that are implicated in the development and progression of CRPC. In addition, interrogation of geometric and physiochemical properties of the BAG domain of BAG-1 isoforms identifies it to be a tractable but challenging drug target. Furthermore, through BAG-1 isoform mouse knockout studies, we confirm that BAG-1 isoforms regulate hormone physiology and that therapies targeting the BAG domain will be associated with limited “on-target” toxicity. Importantly, the postulated inhibitor of BAG-1 isoforms, Thio-2, suppressed AR signaling and other important pathways implicated in the development and progression of CRPC to reduce the growth of treatment-resistant prostate cancer cell lines and patient-derived models. However, the mechanism by which Thio-2 elicits the observed phenotype needs further elucidation as the genomic abrogation of BAG-1 isoforms was unable to recapitulate the Thio-2–mediated phenotype. Overall, these data support the interrogation of related compounds with improved drug-like properties as a novel therapeutic approach in CRPC, and further highlight the clinical potential of treatments that block persistent AR signaling which are currently undergoing clinical evaluation in CRPC.
Video S3 from Cancer-associated Fibroblast–specific Expression of the Matricellular Protein CCN1 Coordinates Neovascularization and Stroma Deposition in Melanoma Metastasis
Authors: Hutchenreuther James , Nguyen John , Quesnel Katherine , Vincent Krista M. , Petitjean Louis , Bourgeois Sophia , Boyd Mark , Bou-Gharios George , Postovit Lynne-Marie , Leask Andrew
Published: February 2024

CCN1 +/+ stroma vasculature microct
Video S2 from Cancer-associated Fibroblast–specific Expression of the Matricellular Protein CCN1 Coordinates Neovascularization and Stroma Deposition in Melanoma Metastasis
Authors: Hutchenreuther James , Nguyen John , Quesnel Katherine , Vincent Krista M. , Petitjean Louis , Bourgeois Sophia , Boyd Mark , Bou-Gharios George , Postovit Lynne-Marie , Leask Andrew
Published: February 2024

CCN1 +/+ stroma vasculature microct
TABLE 1 from Cancer-associated Fibroblast–specific Expression of the Matricellular Protein CCN1 Coordinates Neovascularization and Stroma Deposition in Melanoma Metastasis
Authors: Hutchenreuther James , Nguyen John , Quesnel Katherine , Vincent Krista M. , Petitjean Louis , Bourgeois Sophia , Boyd Mark , Bou-Gharios George , Postovit Lynne-Marie , Leask Andrew
Published: February 2024

Multivariate analysis of CAF-specific CCN1 score as a prognostic marker for reduced overall survival in GSE78220 (36) in patients on anti-PD1 checkpoint inhibitors
FIGURE 6 from Cancer-associated Fibroblast–specific Expression of the Matricellular Protein CCN1 Coordinates Neovascularization and Stroma Deposition in Melanoma Metastasis
Authors: Hutchenreuther James , Nguyen John , Quesnel Katherine , Vincent Krista M. , Petitjean Louis , Bourgeois Sophia , Boyd Mark , Bou-Gharios George , Postovit Lynne-Marie , Leask Andrew
Published: February 2024

Deletion of Ccn1 in Col1A2-Cre-fibroblasts reduces tumor vasculature. A, Tumors in wild-type or mice deleted for Ccn1 in Col1A2-Cre-fibroblasts were perfused with a CT-contrast agent, as described in Materials and Methods. Volume (mL) of tumor occupied by vasculature was calculated. Mice lacking Ccn1 in their fibroblasts had significantly reduced vascular volume (t test, n = 3, P < 0.05). B, Tumors and associated stroma in wild-type or mice deleted for Ccn1 in fibroblasts were stained with anti-CD31 antibodies (t test; n = 3; *, P < 0.05).
FIGURE 5 from Cancer-associated Fibroblast–specific Expression of the Matricellular Protein CCN1 Coordinates Neovascularization and Stroma Deposition in Melanoma Metastasis
Authors: Hutchenreuther James , Nguyen John , Quesnel Katherine , Vincent Krista M. , Petitjean Louis , Bourgeois Sophia , Boyd Mark , Bou-Gharios George , Postovit Lynne-Marie , Leask Andrew
Published: February 2024

Loss of CCN1 expression from CAFs does not affect cell proliferation or apoptosis in a syngeneic model of melanoma metastasis. A, PCNA assay in (top) tumor and (bottom) stroma. Cell proliferation was detected using an anti-PCNA antibody. Representative images shown; graphs show the mean percentage of PCNA positive cells in CAFs ± SEM; CCN1f/fn = 7 and CCN1−/−n = 4, Student t test. B, TUNEL assay to detect apoptosis in stroma. Representative images shown; graphs show the mean percentage of TUNEL positive cells in stroma ± SEM, CCN1f/fn = 7 and CCN1−/−n = 4, Student t test.
FIGURE 2 from Cancer-associated Fibroblast–specific Expression of the Matricellular Protein CCN1 Coordinates Neovascularization and Stroma Deposition in Melanoma Metastasis
Authors: Hutchenreuther James , Nguyen John , Quesnel Katherine , Vincent Krista M. , Petitjean Louis , Bourgeois Sophia , Boyd Mark , Bou-Gharios George , Postovit Lynne-Marie , Leask Andrew
Published: February 2024

Mice harboring Col1A2-Cre-fibroblast–specific deletion for Ccn1 show impaired metastasis of B16F10 melanoma cells to the lung. A–C, Mice were examined after 14 days of tumor growth. A, Sections of tumor stroma were stained with anti-CCN1 antibody (N = 3, representative images are shown), verifying loss of CCN1 protein expression in mice deleted for CCN1 in fibroblasts. Note CCN1 staining remains in the tumor. Scale bar = 50 µm. B, Representative images of lung sections from wild-type or mice harboring a deletion for Ccn1 in Col1A2-Cre-fibroblasts. Hematoxylin and eosin was used to reveal detect dense metastatic foci (purple). Scale Bar = 300 µm. Total area of the lung section covered by metastases was quantified. Deletion of Ccn1 caused reduced metastasis (N = 6, ***, P < 0.001). C, Reduced CCN2 expression in the stroma did not significantly alter tumor growth. Kruskal–Wallis analysis (N = 8). D, To more accurately define the cells in which CCN1 was deleted, three-week old Col1A2-cre(ER)T/); mTmG mice were injected for 5 consecutive days with tamoxifen to activate Cre recombinase. Six weeks later, skin was isolated, digested with collagenase, and cells expressing GFP were isolated by FACS, and subjected to RNA-seq analysis. Col1A2 lineage fibroblasts were identified as universal fibroblasts based on the gene expression of Pi16, Col15a1, C3, and Cd84 genes, but not papillary or reticular fibroblasts based on the gene expression of Crabp1 and Defb8 or Nexn, Trim63, Actn2, and Hspb7, respectively.
High Flow Nasal Cannula for Weaning Nasal Continuous Positive Airway Pressure in Preterm Infants: A Systematic Review and Meta-Analysis
Authors: Balhareth Yasser , Razak Abdul
Published: February 2024

Introduction: The aim of this study was to systematically review the benefits and harms of using a high-flow nasal cannula (HFNC) for weaning continuous positive airway pressure (CPAP) support in preterm infants. Methods: Cochrane Central, EMBASE, Medline, and Web of Science were searched from inception to July 15, 2023. Randomised clinical trials (RCTs) comparing weaning CPAP using HFNC versus weaning CPAP alone and evaluating predefined outcomes were included. Two authors independently performed data extraction and methodological quality assessment. Meta-analysis was conducted using a random-effects model, and the certainty of evidence was assessed using Cochrane GRADE. Results: Among 843 identified records, seven RCTs involving 781 preterm infants were eligible for analysis. The meta-analysis found no statistically significant difference in duration of respiratory support when using HFNC for weaning compared to weaning CPAP alone (mean difference (95% confidence interval) 3.52 (−0.02, 7.05); 5 RCTs; participants = 488; I2 = 29%). The evidence certainty was downgraded to low due to study limitations and imprecision. There were no significant differences in secondary outcomes, except for a lower occurrence of nasal trauma with HFNC for weaning CPAP compared to weaning CPAP alone (relative risk (95% confidence interval) 0.61 (0.38, 0.99); 4 RCTs; participants = 335; I2 = 0%). The evidence certainty for the secondary outcomes was low to very low. Conclusion: Low certainty of evidence suggests using HFNC for weaning CPAP in preterm infants may not impact the duration of respiratory support. Caution is advised when considering HFNC for weaning CPAP, especially in extremely preterm infants, until additional supportive evidence on its safety becomes available.
Vagal Sparing Gastrectomy: A Systematic Review and Meta-Analysis
Authors: Tokhi Ashraf M. , George Sam V. , Cabalag Carlos S. , Liu David S. , Duong Cuong P.
Published: February 2024

Introduction: Radical gastrectomy is associated with significant functional complications. In appropriate patients may be amenable to less invasive resection aimed at preserving the vagal trunks. The aim of this systematic review and meta-analysis was to assess the functional consequences and oncological safety of vagal sparing gastrectomy (VSG) compared to conventional non-vagal sparing gastrectomy (CG). Methods: A systematic review of four databases in accordance with PRISMA guidelines was undertaken for studies published between January 1, 1990, and December 15, 2021, comparing patients who underwent VSG to CG. We meta-analysed the following outcomes: operative time, blood loss, nodal yield, days to flatus, body weight changes, as well as the incidence of post-operative cholelithiasis, diarrhoea, delayed gastric emptying, and dumping syndrome. Results: Thirty studies were included in the meta-analysis with a selection of studies qualitatively analysed. VSG was associated with a lower rate of cholelithiasis (OR: 0.25, 95% CI: 0.15–0.41, p < 0.010) and early dumping syndrome (OR: 0.42, 95% CI: 0.21–0.86; p = 0.02), less blood loss (mean difference [MD]: −51 mL, 95% CI: −89.11 to −12.81 mL, p = 0.009), less long-term weight loss (MD: 2.03%, 95% CI: 0.31–3.76%, p = 0.02) and a faster time to flatus (MD: −0.42 days, 95% CI: −0.48 to 0.36, p < 0.001). There was no significant difference in nodal harvest, overall survival, and all other endpoints. Conclusion: VSG significantly reduces the incidence of post-operative cholelithiasis and dumping syndrome, decreases weight loss, and facilitates an earlier return of gut motility. Although technically more challenging, VSG should be considered for prophylactic surgery.