bluuebunny/crossref_metadata_2025_split huggingface dataset:
Generation and Application of a Versatile CRISPR Toolkit for Mammalian Cell Engineering
Authors: Dang Nghi , Lance-Byrne Alissa , Tung Angela , Guo Xiaoge , Cecchi Ryan J , Buchthal Joanna , Chavez Alejandro , Yeo Nan Cher 
Published: November 2021

Abstract
CRISPR/Cas9 has revolutionized the field of genome engineering. Yet, as the CRISPR toolbox has rapidly expanded, there remains a need for a comprehensive library of CRISPR/Cas9 reagents that allow users to perform complex cellular and genetic manipulations without requiring labor-intensive generation of reagents to meet each user’s unique experimental circumstances. Here we described the creation and validation of a pNAX CRISPR library consisting of 72 different Cas9 and gRNA expression plasmids to allow for efficient multiplex gene editing, activation, and repression in mammalian cells. The toolkit plasmids, which are piggyBac or lentiviral based, provide the means for reliable and rapid delivery of Cas9/gRNA through either transient transfection or stable integration. Using the toolkit, we demonstrate the ease with which users can perform single or multiplex gene editing and modulate the expression of both coding and non-coding genes. We also highlight the use of the comprehensive toolkit to perform combinatorial gene knockout to identify factors that regulate homologous recombination, along with investigating the regulatory role of a 68-kb intronic region associated with human disease.
Copper and zinc hydroxychloride cosupplementation improve growth performance and carcass and reduce diarrhea frequency in grower-finisher pigs
Authors: Mendonça Maitê Vidal , Nakasone Denis Hideki , Martinez Cristian Hernando Garcia , Gemelli Jéssica Luana , Pereira Angélica Simone Cravo , Pugine Silvana Marina Piccoli , de Melo Mariza Pires , de Andrade André Furugen Cesar , Araújo Lúcio Francelino , Augusto Karolina Von Zuben , Yanming Han , Martins Simone Maria Massami Kitamura 
Published: November 2021

Abstract
This study investigated copper (Cu) and zinc (Zn) hydroxychloride cosupplementation on the growth performance, diarrhea frequency, carcass, meat quality, and antioxidant activity in grower-finisher pigs. A total of 256 pigs were used from 70 to 154 days (d) of age, distributed in four treatments, with eight pigs in each pen and eight replications per treatment. Diets were provided to grower pigs from 70 to 112 days old and in the finisher, 112 to 154 days old. Copper was considered the low level at 100 mg Cu/kg and 90 mg Cu/kg, respectively, and 150 mg Cu/kg in both periods as high in the grower and finisher periods. In the grower and finisher period, zinc was cosupplemented in the diet at 80 mg Zn/kg and 70 mg Zn/kg, respectively. In the diets, T1 and T2 groups are the traditional inorganic sources for minerals (copper sulfate, CuSO4; zinc oxide, ZnO) and T3 and T4 hydroxychloride sources (copper hydroxychloride, CHC, and zinc hydroxychloride, ZHC). The flavomycin was associated with treatments with low Cu content in the inclusion of 50 g/ton. The experimental design was in randomized blocks, the data were submitted to analysis of PROC MIXED in SAS, the PDIFF test analyzed the treatment effect. At the finisher period, pigs fed both minerals from hydroxychloride source had a higher BW 154 d, average daily gain (ADG) 70 to 154 d, the hot and cold carcass weight and frequency of normal feces than those fed 150 mg Cu/kg and Zn from a traditional inorganic source (P &lt; 0.05). The animals fed low Cu levels of the sulfate source had a higher ADG 70 to 154 d than those fed high Cu levels of the same source (P &lt; 0.05). Pigs fed 150 mg Cu/kg cosupplemented with Zn from a hydroxychloride source had the highest carcass length (P &lt; 0.05). There was no difference among the treatments for meat quality (P &gt; 0.05). Pigs fed 150 mg Cu/kg and Zn from a traditional inorganic source had a higher superoxide dismutase (SOD) activity than the other treatments (P &lt; 0.05). Animals fed low Cu levels from hydroxychloride had a higher malondialdehyde (MDA) formation than those fed sulfate source, regardless of the Cu levels and those fed high Cu levels of hydroxychloride (P &lt; 0.05). In conclusion, 150 mg Cu/kg as copper sulfate cosupplemented to zinc oxide in the diet of growing and finishing pigs impairs the growth performance, carcass and increases diarrhea frequency, and copper and zinc hydroxychloride cosupplementation improves these characteristics.
Impact of calcium nitrate supplementation on the oxygen-carrying capacity of lactating sows and their offspring
Authors: van de Ligt Jennifer L G , Saddoris-Clemons Kari L , Norton Sharon A , Davis Meagan M , Doepker Candace L 
Published: November 2021

AbstractCalcium nitrate supplementation has recently been suggested to provide potential benefits to sows and, in particular, their offspring when administered at a level of 1,200 ppm in feed shortly before farrowing through lactation. More specifically, nitrate supplementation has been suggested as one opportunity for improved placental and/or fetal blood flow and has been hypothesized in previous work to be important to the swine industry in light of the global trend toward larger litter sizes. The benefit is likely manifested through exposure to the nitrate moiety, but interestingly, nitrate has historically been considered a compound of concern for swine. High levels of nitrate once metabolized to nitrite can interfere with the oxygen-carrying capacity of hemoglobin, resulting in increased methemoglobin and, subsequently, methemoglobinemia (MetHb) if the animal is deprived of significant amounts of oxygen; however, the level of nitrate exposure necessary to induce MetHb in sows is not clearly defined. This work was undertaken to examine methemoglobin levels in sows and piglets exposed to the potentially beneficial levels of 1,200 and 6,000 ppm nitrate added to their diets over the course of the periparturient period. Other oxygen capacity blood variables were evaluated (e.g., hemoglobin, hematocrit, and various measures of hemoglobin and red blood cell volumes and concentrations), as well as performance endpoints (weight changes and feed intake) and general observations over the 27-d period. No evidence of treatment-related toxicity manifestation was observed at these supplemental levels. Nearly all oxygen-related variables were affected by time (independent of treatment), indicating adaptive general effects of farrowing. These findings support the hypothesis that MetHb is not a concern up to at least 6,000 ppm supplemental nitrate exposure, even in combination with additional nitrate in the sow’s daily diet. This work is important to help swine producers understand that consideration of nitrate benefit should outweigh concern for risk of nitrate-induced toxicity.
Communication strategies to facilitate the implementation of new clinical practices: a qualitative study of community mental health therapists
Authors: Albright Karen , Navarro Elena I , Jarad Iman , Boyd Meredith R , Powell Byron J , Lewis Cara C 
Published: November 2021

Lay SummaryThere has been a great deal of attention recently to the study of implementation, or how something (e.g., a new clinical practice or initiative) is actually put into effect. Many studies have found a number of barriers to and facilitators of the implementation process. But despite this increased attention, the field of implementation science may not have paid enough attention to the role of communication. Although communication is generally acknowledged as important, precisely how it impacts implementation—and, importantly, the ways it might be improved—is typically unexplored. This study conducted focus groups with mental health therapists in 12 clinics which were about to implement a new clinical practice: measurement-based care for depressed adults receiving psychotherapy. What these therapists shared about their perspectives and experiences suggest that there are at least five ways to facilitate effective communication when introducing a new clinical practice: communicating a clear rationale for the new practice, providing necessary procedural knowledge, using multiple methods to communicate about the change, giving sufficient lead time to prepare for the change, and providing the opportunity for bidirectional engagement.
Nurses Spreading Misinformation
Authors: Grace Pamela J. 
Published: November 2021

ABSTRACT:
Nurses are trusted to be truthful and to provide considered, substantiated information in a neutral way. Yet the COVID-19 crisis has highlighted how some nurses engage in misinformation on social media and in other venues. This article explores the reasons why people believe they are fully informed, including the possible influence of confirmation biases. It also describes the augmented ethical responsibilities of nurses to examine in depth what they think they know and understand and to account for cognitive biases. Strategies for nurse leaders, managers, and educators are provided to facilitate good practice and help ensure nurses are held accountable for their actions and social media postings.
The Prevalence and Work-Related Factors of Burnout Among Public Health Workforce During the COVID-19 Pandemic
Authors: Ibrahim Farha , Samsudin Ely Zarina , Chen Xin Wee , Toha Haidar Rizal 
Published: November 2021

Objective:To examine the prevalence of burnout and its work-related factors among public health providers (PHP) during the COVID-19 pandemic.Methods:We surveyed 366 PHP in May 2021 on their burnout, demographic, and work-related characteristics. Logistic regression analyses were conducted to identify associated factors.Results:45% PHP reported burnout. Higher PHP burnout was associated with younger age (AOR 0.96, 95% CI 0.93–0.99), prolonged COVID-19 involvement (AOR 2.35, 95% CI 1.16–4.72), as well as perceiving medium (AOR 2.10, 95% CI 1.27–3.48) and high emotional demand (AOR 4.45, 95% CI 1.67–11.77), low (AOR 2.10, 95% CI 1.27–3.48) and medium (AOR 4.18, 95% CI 1.64–10.59) role clarity, medium job satisfaction (AOR 3.21, 95% CI: 1.11–9.29), and low organisational justice (AOR 3.32, 95% CI 1.51–7.27).Conclusions:Improving job content and organisational characteristics may be key to reducing PHP burnout.
Expression of Protein SOX9 in Biliary Atresia
Authors: Arboleda‐Bustan Jenny E. , Ribalta Teresa , Albert Asteria , Cuadras Daniel , Martín‐Solé Oriol 
Published: November 2021

ABSTRACTObjectives:Biliary atresia (BA) is still an enigmatic disease. Deeper knowledge of its pathophysiology could help develop better treatments. SOX9 regulates bile duct development, liver regeneration and fibrosis; therefore, it could be determinant in characterizing BA liver damage. Aim: To study if there is a SOX9 expression pattern in liver biopsies from BA patients.Methods:Liver biopsies from BA patients (group BA), from age‐matched infants without primary hepatic disease (group Control), and from patients with other liver conditions (group OLC) were compared. Expression of SOX9 was checked for: amount, intensity of immunoreaction, localization within ductular structures, perifibrotic epithelial cells, and lobular cells. The scores were added to create a scale from 0 to 11 that allowed group comparison. SOX9 Scale and liver survival were also looked for a correlation.Results:All BA cases had a score >4, while all controls scored <4. OLC livers scored 1 to 8 (3.5 ± 2.0) (P < 0.001 between all groups). A cut‐off at 4 had 100% sensitivity and 88.24% specificity to differentiate BA from Controls and from OLC (area under receiver operating characteristic curve: 0.9989 (95% confidence interval: 0.9964–1.000). Strong expression of SOX9 was observed mainly in the nuclei of proliferated ductules of portal spaces and fibrotic bridges. SOX9 Scale score could not be related to liver survival in this study.Conclusion:In BA livers, SOX9 is mainly expressed in reactive ductular epithelium, following a pattern significantly different from that seen in non‐BA patients; thus, SOX9 Scale may have a role in the diagnosis of BA.
Factors Influencing Role Ambiguity and Role Conflict Among Intensive Care Unit Nurses Providing End of Life Care
Authors: Wells Celia M. 
Published: November 2021

AIM
The aim of this study was to determine the relationship of compassion satisfaction, compassion fatigue, and death anxiety with role ambiguity and role conflict in intensive care unit (ICU) nurses providing care at end of life.

BACKGROUND
Understanding the factors that impact care for patients and families at the end of life is important for nursing practice and nursing leaders.

METHODS
A quantitative nonexperimental correlation design was used, with 216 critical care nurses recruited using an Internet-based website. Data were analyzed using, Pearson product-moment correlation, χ
2 test of independence, and the independent-samples t test or analysis of variance as appropriate.

RESULTS
Role ambiguity and role conflict were negatively related to compassion satisfaction and were positively related to compassion fatigue and death anxiety. There was no relationship between increased years of ICU experience and role ambiguity and role conflict.

CONCLUSION
Compassion satisfaction is a significant predictor for role ambiguity, whereas burnout is best predicted by role conflict for ICU nurses providing end of life care.
Qualifications of Executive Nurses for Service on Hospital Boards
Authors: Foxx Michelle , Garner Catherine 
Published: November 2021

Objective
The purpose of this qualitative survey was to document executive nurse leaders' perception of their own leadership qualities in the context of the American Hospital Association (AHA) recommended membership requirements for executive hospital board appointment.

Background
Hospital boards of trustees are increasingly responsible for the quality of care and its impact on financial performance. High-performing boards are focused on the accountability of chief executive officer for quality metrics. Nurse leaders have valuable insight into key shared governance issues such as quality of care, financial performance, legal requirements, and regulatory oversight.

Methods
Fifty senior-level nurse executive members polled from the American Organization of Nurse Leaders, the Texas Organization of Nurse Leaders, and the Texas Nurse Practitioners Association completed an online quantitative survey using The Center for Healthcare Governance (CHG) Assessment Tool© of the AHA, which details a list of skills, experience, and personal qualities for executive hospital board placement. Respondents ranked their individual knowledge and skills on a 4-point Likert scale.

Results
Participant responses indicated that senior-level nurse executives have significant expertise in the key areas of quality, patient safety and performance, healthcare administration and policy, and business management. Areas ranking lower are those associated with organizational specialties: legal, construction project management, and finance.

Conclusion
This information can be used to educate executive hospital boards regarding the qualifications of nurse leaders members. Nursing leaders, professional organizations, and academia can use this information to assess the skills of senior nursing leaders as it relates to potential board appointments.
Impact of Evidence-Based Charge Nurse Education on Charge Nurse Skills and Nurse-Specific Metrics
Authors: Dols Jean Dowling , Ramirez Monica N. , Hernandez Ashley D. , Allen David , Kloewer Theresa , Aguillon Virginia 
Published: November 2021

OBJECTIVE
This research study was designed to analyze the impact of an evidence-based charge nurse (CN) education program on novice and experienced CNs' self-confidence and satisfaction with the role, skill competencies, and nursing metrics.

BACKGROUND
Charge nurses are critical to effective daily unit operations. However, executive nursing leadership found that unit performance varied by CN despite experience.

METHODS
University faculty partnering with nurse leaders developed an evidence-based CN education program including a series of classes, coaching in skills and role responsibilities by nurse leaders, and evaluation of skills competencies before and after the CN education program.

RESULTS
The CN program was associated with significant positive changes in CN performance, nurse-specific metrics, hospital-acquired events, and patient satisfaction.

CONCLUSIONS
Interventions targeting frontline leaders positively impact CN performance.
Application of a myoelectric elbow flexion assist orthosis in adult traumatic brachial plexus injury: patient perspectives
Authors: Webber Christina M. , Egginton Jason S. , Shin Alexander Y. , Kaufman Kenton R. 
Published: November 2021

Background:
Individuals with brachial plexus injuries (BPIs) can be prescribed assistive devices, including myoelectric elbow orthoses (MEOs), for rehabilitation or functional use after failed treatment for elbow flexion restoration. Although recent case studies indicate potential for clinical improvements after using an MEO after BPI, the patients' perspectives on such use are still unknown.

Objective:
To explore patient perspectives on the use of an MEO after surgical treatment for a traumatic BPI.

Study design:
Qualitative using both a focus group and semistructured interviews.

Methods:
Patients with BPI that used an MEO were recruited. Five patients participated in an in-person focus group, whereas three patients participated in individual phone interviews. Themes that emerged from the focus group were compared against those that emerged from the personal interviews.

Results:
Feedback was grouped into three themes: device usage, hardware performance, and device design. Within each theme, positive elements, areas for improvement, and additional considerations emerged. Patients indicated a positive attitude toward using an MEO as a rehabilitation tool. They desired a streamlined, stronger device to support them and assist during activities of daily living.

Conclusions:
For patients with BPI, a well-designed MEO that meets their needs could assist with rehabilitation and increase independence in daily activities. Continued patient engagement in the evaluation and development of both medical devices and treatment plans offers the best opportunity for improved outcomes that are important to the patient.
Prosthesis satisfaction and quality of life in US service members with combat-related major lower-limb amputation
Authors: Eskridge Susan L. , Dougherty Amber L. , Watrous Jessica R. , McCabe Cameron T. , Cancio Jill M. , Mazzone Brittney N. , Galarneau Michael R. 
Published: November 2021

Background:
Military amputee patient care programs offer extensive services, including advanced prosthetic devices, to restore function and improve quality of life (QOL) among veterans and service members with combat-related limb loss, but research on satisfaction with these devices is limited.

Objective:
To assess prosthesis satisfaction and QOL in US service members and veterans with combat-related major lower-limb amputation.

Study design:
Cross-sectional study.

Methods:
Eighty-six participants with combat-related major lower-limb amputation completed the Orthotics and Prosthetics Users' Survey (OPUS) Satisfaction with Device scale and Quality of Well-Being Scale, Self-Administered, for the Wounded Warrior Recovery Project.

Results:
Most participants (62%–88%) responded Agree or Strongly Agree to OPUS Satisfaction with Device items on the fit, weight, comfort, ease of donning, appearance, and durability of their prosthesis. By contrast, the majority of participants (55%–79%) responded Disagree or Strongly Disagree to items on clothes being free of wear and tear, skin free of abrasions and irritations, and the affordability of their prosthesis. In linear regression analysis, total OPUS Satisfaction with Device score was positively associated with Quality of Well-Being Scale, Self-Administered score (β = 0.0058; P = 0.004).

Conclusions:
Findings indicate the majority of participants were satisfied with the overall functionality of their prosthesis, but dissatisfied with the effect of their prosthesis on clothing and skin, as well as expenses related to their prosthesis. Additionally, prosthesis satisfaction was positively associated with QOL.
Circumferential Resection Margin is Associated With Distant Metastasis After Rectal Cancer Surgery
Authors: Agger Erik , Jörgren Fredrik , Lydrup Marie-Louise , Buchwald Pamela 
Published: November 2021

Objective:
To evaluate circumferential resection margin (CRM) as a risk factor for distant metastasis (DM) in rectal cancer.

Summary of Background Data:
The treatment of rectal cancer has evolved over the last decades. Surgical radicality is considered the most important factor in preventing recurrences including local and distant. CRM ≤1.0 mm is considered to increase recurrence risk. This study explores the risk of DM in relation to exact CRM.

Methods:
All patients treated with abdominal resection surgery for rectal cancer between 2005 and 2013 in Sweden were eligible for inclusion in this retrospective study. Primary endpoint was DM.

Results:
Twelve thousand one hundred forty-six cases were identified. Eight thousand five hundred ninety-three cases were analyzed after exclusion. Seven hundred seventeen (8.6%) patients had CRM ≤1.0mm and 7577 (91.4%) patients had CRM >1.0 mm. DM recurrence rate at 5 years was 42.1% (95% CI 32.5–50.3), 31.5% (95% CI 27.3–35.5), 25.8% (95% Confidence Interval (CI) 16.2–34.4), and 19.5% (95% CI 18.5–19.5) when CRM was 0.0 mm, 0.1 to 1.0 mm, 1.1 to 1.9 mm, and CRM ≥2mm, respectively. Multivariable analysis revealed higher DM risk in CRM 0.0–1.0 mm versus >1.0 mm (hazard ratio 1.30, 95% CI 1.05–1.60; P = 0.015). No significant difference in DM risk in CRM 1.1–1.9 mm versus ≥2.0 mm (hazard ratio 0.66, 95% CI 0.34–1.28; P = 0.224) could be detected.

Conclusions:
The risk of DM decreases with increasing CRM. Moreover, CRM ≤1.0 mm is a significant risk factor for DM. Thus, CRM is a dominant factor when discussing risk of DM after rectal cancer surgery.
Performance of the 7th and 8th Editions of the American Joint Committee on Cancer Staging System in Patients with Intraductal Papillary Mucinous Neoplasm-Associated PDAC
Authors: Margonis Georgios Antonios , Pulvirenti Alessandra , Morales-Oyarvide Vicente , Buettner Stefan , Andreatos Nikolaos , Kamphues Carsten , Beyer Katharina , Wang Jane , Kreis Martin E. , Cameron John L. , Weiss Matthew J. , Soares Kevin , Fernández-del Castillo Carlos , Allen Peter J. , Wolfgang Christopher L. 
Published: November 2021

Objective:
To validate the 7th and 8th editions of the AJCC staging system for patients with invasive carcinomas arising in association with IPMN (IPMN-associated PDAC).

Background Data:
Although several studies have validated AJCC systems in patients with conventional PDAC, their applicability to IPMN-associated PDAC has not been assessed.

Methods:
Two hundred seventy-five patients who underwent resection for IPMN-associated PDAC between 1996 and 2015 at 3 tertiary centers and had data on the size of the invasive component and lymph node status were identified. Concordance probability estimates (CPE) were calculated and recursive partitioning analysis was employed to identify optimal prognostic cutoffs for T and N.

Results:
The CPE for the 7th and 8th editions of the AJCC schema were relatively good (0.64 for both) and similar for colloid and tubular subtypes (0.64 for both). The 8th edition introduced T1a sub-staging and a new distinction between N1 and N2. The utility of the former was confirmed, although the latter did not improve prognostic discrimination. The successful validation of the 8th edition of the AJCC criteria in patients with tubular and colloid subtypes allowed us to compare these patients in early vs late T and N stages which showed that with advanced disease, the prognostic superiority of colloid tumors over their tubular counterparts diminishes.

Conclusions:
Our findings support the use of the AJCC 8th edition in the IPMN-associated PDAC population, but suggest that certain cutoffs may need to be revisited. In advanced AJCC stages, patients with colloid vs tubular subtypes have comparable prognosis.