bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Evaluation of the Validity and Reliability of the Leading and Managing Care Pre-Registration Nursing Student Assessment Tool
Authors: Unsworth John , Melling Andrew , Porteous Debra 
Published: March 2021

Background Clinical nursing leadership influences patient safety and the quality of care provided. Nurses at all levels require leadership and management skills. Despite recognition of the importance of leadership, student nurses often feel ill prepared to make the transition to Registered Nurse and struggle with prioritisation and delegation. In order to standardise student experience and promote the development of skills and attributes, a leadership and management competency assessment was developed and implemented. Aims This study aimed to identify the constructs that should be part of an assessment of student nurse competence in relation to clinical nursing leadership, and to evaluate the tool’s reliability. Method The first phase was to construct the competency assessment tool, using a mixture of deductive methods, including literature and expert review. Second, psychometric evaluation of the tool, including tests to examine its internal consistency and reliability, comparing test and retest reliability, exploratory factor analysis and generalisability theory analysis to identify reliability and sources of error. Results Five attributes were identified for inclusion in the tool alongside a scale of competence. 150 assessments were conducted with an average time between each assessment of three days. The results show that the tool was consistent over time with no significant difference in the mean scores. The Cronbach alpha was 0.84 and the tool had good internal consistency. The results of the factor analysis revealed loading onto a single construct. Generalisability theory analysis revealed 0.90 global reliability, with students accounting for the majority of the variation in scores. Conclusions The Leading and Managing Care assessment tool represents a valid and reliable assessment of student nurse competence to lead care delivery. Use of the tool during practice placement allows for a structured approach to the development of skills around prioritisation, management of resources, communication and the management of risk.
Regulatory delays in a multinational clinical stroke trial
Authors: de Jonge Jeroen C , Reinink Hendrik , Colam Bridget , Alpers Iris , Ciccone Alfonso , Csiba Laszlo , Kõrv Janika , Kurkowska-Jastrzebska Iwona , Macleod Malcolm R , Ntaios George , Thomalla Götz , Bath Philip M , van der Worp H Bart 
Published: March 2021

Introduction The initiation and conduct of randomised clinical trials are complicated by multiple barriers, including delays in obtaining regulatory approvals. Quantitative data on the extent of the delays due to national or local review in randomised clinical trials is scarce. Materials and methods We assessed the times needed to obtain regulatory approval and to initiate a trial site for an academic, EU-funded, phase III, randomised clinical trial of pharmacological prevention of complications in patients with acute stroke in over 80 sites in nine European countries. The primary outcome was the time from the first submission to a regulatory authority to initiation of a trial site. Secondary outcomes included time needed to complete each individual preparatory requirement and the number of patients recruited by each site in the first 6 and 12 months. Results The median time from the first submission to a regulatory authority to initiation of a trial site was 784 days (IQR: 586–1102). The single most time-consuming step was the conclusion of a clinical trial agreement between the national coordinator and the trial site, which took a median of 194 days (IQR: 93–293). A longer time to site initiation was associated with a lower patient recruitment rate in the first six months after initiation (B = –0.002; p = 0.02). Discussion Conclusion In this EU-funded clinical trial, approximately 26 months were needed to initiate a trial site for patient recruitment. The conclusion of a contract with a trial site was the most time-consuming activity. To simplify and speed up the process, we suggest that the level of detail of contracts for academic trials should be proportional to the risks and commercial interests of these trials.
Uranoclite, a new uranyl chloride mineral from the Blue Lizard mine, San Juan County, Utah, USA
Authors: Kampf Anthony R. , Plášil Jakub , Olds Travis A. , Nash Barbara P. , Marty Joe 
Published: March 2021

AbstractThe new mineral uranoclite (IMA2020-074), (UO2)2(OH)2Cl2(H2O)4, was found in the Blue Lizard mine, San Juan County, Utah, USA, where it occurs as tightly intergrown aggregates of irregular yellow crystals in a secondary assemblage with gypsum. The streak is very pale yellow and the fluorescence is bright green–white under 405 nm ultraviolet light. Crystals are translucent with vitreous lustre. The tenacity is brittle, the Mohs hardness is ~1½, the fracture is irregular. The mineral is soluble in H2O and has a calculated density of 4.038 g⋅cm–3. Electron microprobe analyses provided (UO2)2(OH)2.19Cl1.81(H2O)4. The six strongest powder X-ray diffraction lines are [dobs Å(I)(hkl)]: 8.85(38)(002), 5.340(100)(200, 110), 5.051(63)($\bar{2}$02), 4.421(83)(112, 004, 202), 3.781(38)($\bar{2}$12) and 3.586(57)(014, $\bar{2}$04). Uranoclite is monoclinic, P21/n, a = 10.763(8), b = 6.156(8), c = 17.798(8) Å, β = 95.656(15)°, V = 1173.5(18) Å3 and Z = 4. The structure is the same as that of synthetic (UO2)2(OH)2Cl2(H2O)4 in which the structural unit is a dimer consisting of two pentagonal bipyramids that share an equatorial OH–OH edge. The dimers are linked to one another only by hydrogen bonding. This is the second known uranyl mineral containing essential Cl and the first in which Cl coordinates to U6+.
Antineoplastic and anti-inflammatory effects of bortezomib on systemic chronic active EBV infection
Authors: Yoshimori Mayumi , Shibayama Haruna , Imadome Ken-Ichi , Kawano Fuyuko , Ohashi Ayaka , Nishio Miwako , Shimizu Norio , Kurata Morito , Fujiwara Shigeyoshi , Arai Ayako 
Published: March 2021

AbstractSystemic chronic active Epstein-Barr virus (EBV; sCAEBV) infection, T- and natural killer (NK)-cell type (sCAEBV), is a fatal disorder accompanied by persisting inflammation harboring clonal proliferation of EBV-infected T or NK cells. Today’s chemotherapy is insufficient to resolve disease activity and to rid infected cells of sCAEBV. The currently established treatment strategy for eradicating infected cells is allogeneic hematopoietic stem cell transplantation. In this study, we focused on the effects of proteasome inhibitor bortezomib on the disease. Bortezomib suppressed survival and induced apoptosis of EBV+ T- or NK-cell lines and peripheral mononuclear cells containing EBV-infected T or NK cells of sCAEBV patients. Bortezomib enhanced binding immunoglobulin protein/78-kDa glucose-regulated protein (Bip/GRP78) expression induced by endoplasmic reticulum stress and activated apoptosis-promoting molecules JNK and p38 in the cell lines. Bortezomib suppressed the activation of survival-promoting molecule NF-κB, which was constitutively activated in EBV+ T- or NK-cell lines. Furthermore, quantitative reverse transcription–polymerase chain reaction demonstrated that bortezomib suppressed messenger RNA expression of proinflammatory cytokines tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ) in EBV+ T or NK cells from the patients. Finally, we examined the effects of bortezomib using xenograft models of sCAEBV generated by IV injection of patients’ cells. The intraperitoneal administration of bortezomib significantly reduced EBV-DNA load in peripheral blood and the infiltration of EBV-infected cells in the models’ livers. Moreover, the serum concentration of TNF-α and IFN-γ decreased after bortezomib treatment to the models. Our findings will be translated into the treatment of sCAEBV not only to reduce the number of tumor cells but also to suppress inflammation.
Functional characterization of PD1+TIM3+ tumor-infiltrating T cells in DLBCL and effects of PD1 or TIM3 blockade
Authors: Roussel Mikaël , Le Kieu-Suong , Granier Clémence , Llamas Gutierrez Francisco , Foucher Etienne , Le Gallou Simon , Pangault Céline , Xerri Luc , Launay Vincent , Lamy Thierry , Tartour Eric , Olive Daniel , Fest Thierry 
Published: March 2021

Abstract
In diffuse large B-cell lymphoma (DLBCL), tumor-infiltrating T lymphocytes (TILs) are involved in therapeutic responses. However, tumor-specific TILs can be dysfunctional, with impaired effector functions. Various mechanisms are involved in this exhaustion, and the increased expression of programmed cell death receptor 1 (PD1) and TIM3 on dysfunctional cells suggests their involvement. However, conflicting data have been published regarding their expression or coexpression in DLBCL. We evaluated the presence and phenotype of CD4+ and CD8+ TILs in freshly collected tumor tissues in DLBCL and compared the results with those in follicular lymphoma, classical Hodgkin lymphoma, and nonmalignant reactive lymphadenopathy. We found that TILs expressing both PD1 and TIM3 were expanded in DLBCL, particularly in the activated B cell–like subgroup. Isolated PD1+TIM3+ TILs exhibited a transcriptomic signature related to T-cell exhaustion associated with a reduction in cytokine production, both compromising the antitumor immune response. However, these cells expressed high levels of cytotoxic molecules. In line with this, stimulated PD1+TIM3+ TILs from DLBCL patients exhibited reduced proliferation and impaired secretion of interferon-γ, but these functions were restored by the blockade of PD1 or TIM3. In summary, the PD1+TIM3+ TIL population is expanded and exhausted in DLBCL but can be reinvigorated with appropriate therapies.
Involved-site radiotherapy for Helicobacter pylori–independent gastric MALT lymphoma: 26 years of experience with 178 patients
Authors: Yahalom Joachim , Xu Amy J. , Noy Ariela , Lobaugh Stephanie , Chelius Monica , Chau Karen , Portlock Carol , Hajj Carla , Imber Brandon S. , Straus David J. , Moskowitz Craig H. , Coleman Morton , Zelenetz Andrew D. , Zhang Zhigang , Dogan Ahmet 
Published: March 2021

Abstract
Treatment options for Helicobacter pylori–independent gastric mucosa-associated lymphoid tissue (MALT) lymphoma (GML) include surgery, immunotherapy, chemotherapy, and radiation therapy (RT). The purpose of this study was to investigate the efficacy and safety of RT and routine endoscopic surveillance, hypothesizing that most patients are curable with RT alone. We queried a single institution database at a tertiary referral cancer center for patients with H pylori–independent GML treated with RT between 1991 and 2017. Response was assessed by follow-up endoscopies (EGDs) starting 10 to 12 weeks post-RT. Computed tomography scans were also part of the follow-up program, and positron emission tomography was added when clinically appropriate. We identified 178 patients (median age, 63 years; range, 25-89 years); 86% had stage I disease, 7% had stage II disease, and 7% had stage IV disease. Median RT dose was 3000 cGy over 20 fractions. Ninety-five percent of patients exhibited complete pathologic response on posttreatment EGD. Two patients experienced grade 3 toxicity, and 2 patients experienced in-field secondary malignancies. Over a median follow-up of 6.2 years, 9.6% experienced local failures, and 11.8% developed distant sites of disease. Five-year and 10-year overall survival were 94% and 79%, respectively, from last date of RT. RT is a highly effective and safe treatment for GML with excellent overall survival and very rare acute or late treatment-related toxicities. Favorable outcomes from this large retrospective sample of patients provide credible and compelling support for RT as standard of care for H pylori–independent GML.
The prognostic significance of combined geriatric nutritional risk index and psoas muscle volume in older patients with pancreatic cancer
Authors: Sakamoto Teruhisa , Yagyu Takuki , Uchinaka Ei , Miyatani Kozo , Hanaki Takehiko , Kihara Kyoichi , Matsunaga Tomoyuki , Yamamoto Manabu , Tokuyasu Naruo , Honjo Soichiro , Fujiwara Yoshiyuki 
Published: March 2021

Abstract
Background
The geriatric nutritional risk index (GNRI), originally developed as a nutritional assessment tool to evaluate mortality and morbidity in older hospitalized patients (i.e., those aged ≥65 years), is regarded as a prognostic factor in several cancers. Body composition is also an important consideration when predicting the prognosis of patients with cancer. This study aimed to investigate the relationship between the GNRI and psoas muscle volume (PMV) for survival outcomes in patients with pancreatic cancer.

Methods
This retrospective study evaluated the prognostic significance of the GNRI and PMV in 105 consecutive patients aged ≥65 years who underwent pancreatectomy for histologically confirmed pancreatic cancer. The patients were divided into high (GNRI > 98) and low GNRI groups (GNRI ≤98), and into high (PMV > 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) and low PMV (PMV ≤ 61.5 mm3/m3 for men and 44.1 mm3/m3 for women) groups.

Results
Both the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly greater among patients in the high GNRI group than among patients in the low GNRI group. Similarly, both the 5-year OS and RFS rates were significantly greater among patients in the high PMV group than among patients in the low PMV group. Patients were stratified into three groups: those with both high GNRI and high PMV; those with either high GNRI or high PMV (but not both); and those with both low GNRI and low PMV. Patients with both low GNRI and low PMV had a worse 5-year OS rate, compared with patients in other groups (P <  0.001). The C-index of the combination of the GNRI and PMV for predicting 5-year OS was greater than the C-indices of either the GNRI or PMV alone. Multivariate analysis revealed that the combination of the GNRI and PMV was an independent prognostic factor in patients aged ≥65 years with pancreatic cancer (P = 0.003).

Conclusions
The combination of the GNRI and PMV might be useful to predict prognosis in patients aged ≥65 years with pancreatic cancer.
Posttraumatic stress disorder (PTSD) and depression severity in sexually assaulted women: hypothalamic-pituitary-adrenal (HPA) axis alterations
Authors: D’Elia Ana Teresa D. , Juruena Mario F. , Coimbra Bruno M. , Mello Marcelo F. , Mello Andrea F. 
Published: March 2021

Abstract
Background
Sexual assault is implicated in several adverse psychological and physical health outcomes, including posttraumatic stress disorder (PTSD) and depression. Neurobiological research has shown variations related to the hypothalamic-pituitary-adrenal (HPA) axis, immune alterations, metabolic function, and brain circuitry. Although these mechanisms have been extensively studied, the results have demonstrated different outcomes in PTSD.

Methods
We compared the plasma adrenocorticotropin (ACTH) and salivary cortisol levels of fifty-eight women with PTSD developed after sexual assault to those of forty-four female controls with no history of trauma. We also evaluated the psychiatric diagnosis and symptom severity of PTSD and depression. The participants’ clinical conditions were associated with their hormonal levels to assess whether symptom severity was related to hormonal imbalance.

Results
A large percentage of sexually assaulted women had PTSD and comorbid depression. The ACTH levels were higher in the PTSD group than the control group and increased as PTSD severity increased, considering depressive symptoms, measured by the Beck Depression Inventory (BDI) (p < 0.0001), as well as PTSD symptoms, measured by subscale D of the Clinician-Administered PTSD Scale (CAPS-5) (p = 0.045) and the CAPS-5 total scale (p = 0.026). Cortisol levels measured at 10 pm were higher for the PTSD group than the control group (p = 0.045, p = 0.037, respectively), and the cortisol awakening response showed elevated cortisol levels for the PTSD group.

Conclusions
These results show a correlation between symptom severity and HPA axis imbalance in patients with PTSD. Elevated ACTH and an elevated cortisol response in patients with comorbid depressive symptoms were the opposite of the expected response for patients with PTSD only. This association leads to the hypothesis that the neurobiological alterations of PTSD are related to the type of symptoms presented and their severity. These manifestations likely influence the disease course, prognosis and response to treatment. These outcomes highlight the need to discuss particular neurobiological alterations in patients with PTSD developed after sexual assault, mainly those with severe depressive symptoms.
Increased neutrophil–lymphocyte ratio predicts recurrence in patients with well-differentiated pancreatic neuroendocrine neoplasm based on the 2017 World Health Organization classification
Authors: Miura Takayuki , Ohtsuka Hideo , Aoki Takeshi , Aoki Shuichi , Hata Tatsuo , Takadate Tatsuyuki , Maeda Shimpei , Ariake Kyohei , Kawaguchi Kei , Masuda Kunihiro , Ishida Masaharu , Mizuma Masamichi , Nakagawa Kei , Morikawa Takanori , Fujishima Fumiyoshi , Kamei Takashi , Sasano Hironobu , Unno Michiaki 
Published: March 2021

Abstract
Background
The prognostic values of inflammation-based markers in well-differentiated pancreatic neuroendocrine neoplasms, diagnosed according to the new 2017 World Health Organization classification, have remained unclear. Therefore, we assessed the ability to predict the recurrence of such markers after curative resection in patients with these neoplasms.

Methods
Circulating/systemic neutrophil–lymphocyte, monocyte–lymphocyte, platelet–lymphocyte, and platelet–white cell ratios were evaluated in 120 patients who underwent curative resection for well-differentiated pancreatic neuroendocrine neoplasms without synchronous distant metastasis between 2001 and 2018. Recurrence-free-survival and overall survival were compared using Kaplan–Meier analysis and log-rank tests. Univariate or multivariate analyses, using a Cox proportional hazards model, were used to calculate hazard ratios with 95% confidence intervals.

Results
Univariate analysis demonstrated that preoperative neutrophil–lymphocyte ratio, tumor size, European Neuroendocrine Tumor Society TMN classification, 2017 World Health Organization classification, and venous invasion were associated with recurrence. The optimal preoperative neutrophil–lymphocyte ratio cut-off value was 2.62, based on receiver operating characteristic curve analysis. In multivariate analysis, a higher preoperative neutrophil–lymphocyte ratio (HR = 3.49 95% CI 1.05–11.7; P = 0.042) and 2017 World Health Organization classification (HR = 8.81, 95% CI 1.46–168.2; P = 0.015) were independent recurrence predictors.

Conclusions
The circulating/systemic neutrophil–lymphocyte ratio is a useful and convenient preoperative prognostic marker of recurrence in patients with well-differentiated pancreatic neuroendocrine neoplasm based on the 2017 World Health Organization classification.
Antimicrobial and antibiofilm potentials of cinnamon oil and silver nanoparticles against Streptococcus agalactiae isolated from bovine mastitis: new avenues for countering resistance
Authors: Abd El-Aziz Norhan K. , Ammar Ahmed M. , El-Naenaeey El-sayed Y. M. , El Damaty Hend M. , Elazazy Asmaa A. , Hefny Ahmed A. , Shaker Asmaa , Eldesoukey Ibrahim E. 
Published: March 2021

Abstract
Background
Streptococcus agalactiae (S. agalactiae) is a contagious pathogen of bovine mastitis. It has financial implications for the dairy cattle industry in certain areas of the world. Since antimicrobial resistance increases in dairy farms, natural antimicrobials from herbal origins and nanoparticles have been given more attention as an alternative therapy. Hence, this study reported the antimicrobial and antibiofilm potentials of cinnamon oil, silver nanoparticles (AgNPs), and their combination against multidrug-resistant (MDR) S. agalactiae recovered from clinical bovine mastitis in Egypt.

Results
Our findings revealed that 73% (146/200) of the examined milk samples collected from dairy cows with clinical mastitis were infected with Streptococci species. Of these, 9.59% (14/146) were identified as S. agalactiae and categorized as MDR. S. agalactiae isolates expressed four virulence genes (Hyl, cylE, scpB, and lmb) and demonstrated an ability to produce biofilms. Cinnamon oil showed high antimicrobial (MICs ≤0.063 μg /mL) and antibiofilm (MBIC50 = 4 μg/mL) potentials against planktonic and biofilms of S. agalactiae isolates, respectively. However, AgNPs showed reasonable antimicrobial (MICs ≤16 μg/mL) and relatively low antibiofilm (MBIC50 = 64 μg/mL) activities against screened isolates. Synergistic antimicrobial or additive antibiofilm interactions of cinnamon oil combined with AgNPs were reported for the first time. Scanning electron microscope (SEM) analysis revealed that biofilms of S. agalactiae isolates treated with cinnamon oil were more seriously damaged than observed in AgNPs cinnamon oil combination. Moreover, reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) showed that cinnamon oil exerted a remarkable down-regulation of pili biosynthesis genes (pilA and pilB) and their regulator (rogB) against S. agalactiae biofilms, meanwhile the AgNPs cinnamon oil combination demonstrated a lower efficacy.

Conclusions
This is an in vitro preliminary approach that documented the antibiofilm potential of cinnamon oil and the inhibitory activity of cinnamon oil and its combination with AgNPs against MDR S. agalactiae recovered from clinical mastitis. Further in vivo studies should be carried out in animal models to provide evidence of concept for implementing these alternative candidates in the treatment of dairy farms infected by streptococcal mastitis in the future.
Spectrometric prediction of wood basic density by comparison of different grain angles and variable selection methods
Authors: Li Yanjie , Liu Wenjian , Cao Ruishu , Tan Zifeng , Liu Jun , Jiang Jingmin 
Published: March 2021

Abstract
Background
Wood basic density (WBD) is one of the most crucial wood property in tree and mainly determined the end use of wood for industry. However, the measurement WBD is time- and cost-consuming, which an alternatively fast and no-destructive measurement is needed. In this study, capability of NIR spectroscopy combined with partial least squares regression (PLSR) to quantify the WBD were examined in multiple wood species. To obtain more accurate and robust prediction models, the grain angle (0° (transverse surface), 45°, 90° (radial surface)) influence on the collection of solid wood spectra and a comparison of found variable selection methods for NIR spectral variables optimization were conducted, including significant Multivariate Correlation (sMC), Regularized elimination procedure (Rep), Iterative predictor weighting (Ipw) and Genetic algorithm (Ga). Models made by random calibration data selection were conducted 200 times performance evaluation.

Results
These results indicate that 90° angle models display relatively highest efficiency than other angle models, mixed angle model yield a satisfied WBD prediction results as well and could reduce the influence of grain angle. Rep method shows a higher efficiency than other methods which could eliminate the uninformative variables and enhance the predictive performance of 90° angle and mix angle models.

Conclusions
This study is potentially shown that the WBD (g/cm3) on solid wood across grain angles and varies wood species could be measured in a rapid and efficient way using NIR technology. Combined with the PLSR model, our methodology could serve as a tool for wood properties breeding and silviculture study.