bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of nurse managers' servant leadership on nurses' innovative behaviors and job performances
Authors: Kül Seval , Sönmez Betül 
Published: August 2021

PurposeThis study aims to determine the effect of servant leadership on nurses' innovative behavior and job performance and to examine the moderator role of servant leadership in the relationship between nurses' innovative behavior and job performance based on the self-determination theory and social exchange theory.Design/methodology/approachThis correlational study included 885 nurses selected from three public hospitals in Istanbul using the convenience sampling method. Data were analyzed using descriptive tests, correlation analysis and linear and hierarchical regression analyses.FindingsThe nurse managers' servant leadership behaviors were statistically significantly related with the nurses' innovative behaviors and job performances: servant leadership behaviors of the nurse managers increased the nurses' innovative behaviors and job performances and found to partially play a role of a moderator in the effect of nurses' innovative behaviors on job performance.Practical implicationsThis study shows that positive nurse outcomes will be achieved when nurse managers show an ethical, humanistic, empathic, mutual benefit and service-oriented approach and adopt a servant leadership approach as appropriate to the nature of nursing.Originality/valueThis study contributes to the literature by revealing the effect of nurse managers' servant leadership on nurses' innovative behavior and job performance, as well as the partial moderator role of servant leadership, which has not been studied before as a part of the relationship between innovative behavior and job performance.
Proteogenomic analysis of Georgfuchsia toluolica revealed unexpected concurrent aerobic and anaerobic toluene degradation
Authors: Atashgahi Siavash , Oosterkamp Margreet J. , Peng Peng , Frank Jeroen , Kraft Beate , Hornung Bastian , Schleheck David , Lücker Sebastian , Jetten Mike S. M. , Stams Alfons J. M. , Smidt Hauke 
Published: August 2021

AbstractDenitrifying Betaproteobacteria play a key role in the anaerobic degradation of monoaromatic hydrocarbons. We performed a multi‐omics study to better understand the metabolism of the representative organism Georgfuchsia toluolica strain G5G6 known as a strict anaerobe coupling toluene oxidation with dissimilatory nitrate and Fe(III) reduction. Despite the genomic potential for degradation of different carbon sources, we did not find sugar or organic acid transporters, in line with the inability of strain G5G6 to use these substrates. Using a proteomics analysis, we detected proteins of fumarate‐dependent toluene activation, membrane‐bound nitrate reductase, and key components of the metal‐reducing (Mtr) pathway under both nitrate‐ and Fe(III)‐reducing conditions. High abundance of the multiheme cytochrome MtrC implied that a porin–cytochrome complex was used for respiratory Fe(III) reduction. Remarkably, strain G5G6 contains a full set of genes for aerobic toluene degradation, and we detected enzymes of aerobic toluene degradation under both nitrate‐ and Fe(III)‐reducing conditions. We further detected an ATP‐dependent benzoyl‐CoA reductase, reactive oxygen species detoxification proteins, and cytochrome c oxidase indicating a facultative anaerobic lifestyle of strain G5G6. Correspondingly, we found diffusion through the septa a substantial source of oxygen in the cultures enabling concurrent aerobic and anaerobic toluene degradation by strain G5G6.
Clozapine levels as a predictor for therapeutic response: A systematic review and meta‐analysis
Authors: Siskind Dan , Sharma Meghna , Pawar Mrinal , Pearson Ella , Wagner Elias , Warren Nicola , Kisely Steve 
Published: August 2021

AbstractObjectivesClozapine levels may be a more useful predictor of therapeutic response than the dose, given the variability in clozapine metabolism between individuals. We therefore systematically reviewed and meta‐analysed the impact of clozapine levels on response and/or relapse to provide guidance on optimal clozapine levels.MethodsWe systematically searched PubMed, PsycInfo and Embase for studies exploring clozapine levels and response and/or relapse. Our primary meta‐analysis was rates of response above and below clozapine level thresholds of 350 ng/ml and 600 ng/ml. Secondary analyses were undertaken of mean clozapine levels, dose and concentration/dose (C/D) ratio and response and/or relapse. A meta‐regression by study duration was conducted.ResultsTwenty studies met inclusion criteria. Clozapine levels above 350 ng/ml were associated with statistically significantly higher rates of response (OR 2.27 95% CI 1.40–3.67, p < 0.001), but not above 600 ng/ml (OR 1.40 95% CI 0.85–2.31, p = 0.19). Higher mean clozapine levels were associated with better rates of response (SMD 0.24, 95% CI 0.00–0.49, p = 0.05), and lower rates of relapse (SMD −0.72, 95% CI −1.26 to −0.19, p = 0.008). By contrast, neither clozapine dose nor C/D ratio was associated with differing rates of response. Similarly, study duration did not affect outcome.ConclusionsOur findings are in keeping with current guidelines that recommend targeting clozapine levels above 350 ng/ml before augmentation is considered. As some clozapine associated ADRs are dose dependent, levels above 600 ng/ml may have an unfavourable risk‐benefit ratio.
PNPT1, MYO15A, PTPRQ, and SLC12A2‐associated genetic and phenotypic heterogeneity among hearing impaired assortative mating families in Southern India
Authors: Vanniya. S Paridhy , Chandru Jayasankaran , Jeffrey Justin Margret , Rabinowitz Tom , Brownstein Zippora , Krishnamoorthy Mathuravalli , Avraham Karen B. , Cheng Le , Shomron Noam , Srisailapathy C. R. Srikumari 
Published: August 2021

AbstractThe study was conducted between 2018 and 2020. From a cohort of 113 hearing impaired (HI), five non‐DFNB12 probands identified with heterozygous CDH23 variants were subjected to exome analysis. This resolved the etiology of hearing loss (HL) in four South Indian assortative mating families.Six variants, including three novel ones, were identified in four genes: PNPT1 p.(Ala46Gly) and p.(Asn540Ser), MYO15A p.(Leu1485Pro) and p.(Tyr1891Ter), PTPRQ p.(Gln1336Ter), and SLC12A2 p.(Pro988Ser). Compound heterozygous PNPT1 variants were associated with DFNB70 causing prelingual profound sensorineural hearing loss (SNHL), vestibular dysfunction, and unilateral progressive vision loss in one family. In the second family, MYO15A variants in the myosin motor domain, including a novel variant, causing DFNB3, were found to be associated with prelingual profound SNHL. A novel PTPRQ variant was associated with postlingual progressive sensorineural/mixed HL and vestibular dysfunction in the third family with DFNB84A. In the fourth family, the SLC12A2 novel variant was found to segregate with severe‐to‐profound HL causing DFNA78, across three generations. Our results suggest a high level of allelic, genotypic, and phenotypic heterogeneity of HL in these families. This study is the first to report the association of PNPT1, PTPRQ, and SLC12A2 variants with HL in the Indian population.
Laparoscopic totally extraperitoneal hernia repair performed by surgical trainees: overcoming the learning curve
Authors: Hannan Enda , Duggan William , Harding Tim , Brosnan Conor , Maguire Donal , Stafford Anthony T 
Published: August 2021

AbstractBackgroundSurgical trainees struggle to obtain experience in laparoscopic inguinal hernia repair (LIHR) due to a perceived steep learning curve. The purpose of this study was to compare outcomes in totally extraperitoneal (TEP) repair performed by surgical consultants and trainees under supervision as part of a standardised training regimen to assess the safety of residency training in this technique.MethodsA retrospective review of patients managed by TEP repair by either a consultant or a supervised trainee was performed. Demographic, perioperative and postoperative data were collected and compared. All trainees underwent a standardised approach to teaching TEP repair.ResultsTrainees performed 133 procedures and consultants performed 121 procedures. Estimated blood loss was minimal in both cohorts. A significant difference was noted in mean operating time between consultants and trainees (33 vs. 50 min). However, it was also observed that the trainee mean operating time reduced significantly with experience (from 61 to 42 min). No statistically significant difference was demonstrated in postoperative complications, recurrence rate or length of stay. All trainees achieved the ability to complete a laparoscopic TEP repair under unscrubbed consultant supervision during a 1‐year placement.ConclusionWith senior supervision and in the presence of a structured training regimen, trainees can safely and effectively perform LIHR, progressing to performing the procedure under unscrubbed consultant supervision. This is valuable information that can serve to inform the structure and direction of surgical training programmes as the ability to offer LIHR is increasingly becoming an expectation of consultant surgeons.
Long‐term outcomes of breast reconstruction and the need for revision surgery
Authors: Finlay Ben , Kollias Victoria , Hall Kelly A. , Clement Zackariah , Bingham Janne , Whitfield Robert , Kollias James , Bochner Melissa 
Published: August 2021

AbstractBackgroundBreast reconstruction (BR) often forms part of a patient's breast cancer journey. Revision surgery may be required to maintain the integrity of a BR, although this is not commonly reported in the literature. Different reconstructive methods may have differing requirements for revision. It is important for patients and surgeons to understand the factors leading to the need for revision surgery.MethodsThis retrospective cohort study analyses BRs performed by oncoplastic breast surgeons in public and private settings between 2005 and 2014, with follow‐up until December 2018. Surgical and patient factors were examined, including types of BR, complications and reasons for revision surgery.ResultsA total of 390 women with 540 reconstructions were included, with a median follow‐up of 61 months. Twenty‐eight percent (151/540) of reconstructions required at least one revision operation. Overall, implant‐based reconstructions (direct‐to‐implant [DTI] and two‐stage expander‐implant) had a higher revision rate compared to pedicled flap reconstructions (odds ratio 1.91, 95% confidence interval 1.08, 3.38). DTI reconstructions had the highest odds, and pedicled flap without implants the lowest odds of requiring revision. Post‐reconstruction radiotherapy increased the chance of revision surgery, while pre‐reconstruction radiotherapy did not. Odds of revision were higher in implant‐based reconstructions compared to pedicled flap reconstructions that had radiotherapy. Other factors increasing the rates of revision surgery were being a current smoker and post‐operative infection.ConclusionAlmost one‐third of reconstructive patients require revision surgery. Autologous pedicled flap reconstructions have lower rates of revision compared to implant‐based reconstructions. Radiotherapy increases the need for revision surgery, particularly in implant‐based reconstructions.
Mental health monitoring in parents after very preterm birth
Authors: Vriend Eline , Leemhuis Aleid , Flierman Monique , van Schie Petra , Nollet Frans , Jeukens‐Visser Martine 
Published: August 2021

AbstractAimTo evaluate parental mental health monitoring during follow‐up care for very preterm (VPT) infants, describe symptoms of anxiety and depression and risk factors for mothers and fathers at 1 and 12 months of corrected age.MethodsParents completed the Hospital Anxiety and Depression Scale (HADS). Psychological symptoms and risk factors were analysed within and between mothers and fathers.ResultsIn 4 years, the monitoring reached 1260 (48%) families. Of these, 693 mothers and 340 fathers (300 couples) completed the HADS twice. At 1 month, 22% and 15% of the mothers and 10% and 9% of the fathers, respectively, reported elevated symptoms of anxiety and depression. At 12 months, these rates were significantly reduced to 14% and 9% for mothers and 5% and 4% for fathers respectively. Within couples, anxiety and depression were positively associated. At 12 months, in 20% of the couples, one or both parents reported elevated symptoms. Risk factors were length of hospital stay, migration background, educational level and employment status.ConclusionThe mental health of parents of VPT infants improved, but elevated symptoms were still observed in 17% of included families after one year. Acknowledging and remediating parental mental health remain essential during follow‐up care.
Free‐range system and supplementation of 25‐hydroxicholecalciferol increases the performance and serum vitamin levels in mixed‐parity sows
Authors: Panisson Josiane C. , Oliveira Nathália C. , Sá‐Fortes Cristina M. , Passos Adsos A. , da Silva Claudia C. , Araújo Wagner A. G. , Lopes Idael M. G. , Costa Gleison M. S. , Ataíde Iara Q. , Silva Bruno A. N. 
Published: August 2021

AbstractImprovements in sow productivity have raised questions regarding dietary vitamin D recommendations. The present study aimed to evaluate the effects of the housing system with access to sunlight exposure and supplementation of 25‐hydroxicholecalciferol on performance and serum levels of 25(OH)D3in sows during gestation and lactation. Sows were distributed in an experimental design with two housing systems: gestation crates or gestation free‐range system with external area for sunlight exposure; and two diets: 0 or 50 μg of 25‐hydroxicholecalciferol kg−1. The use of 25‐hydroxicholecalciferol tended (P = 0.052) to improve total born and influenced (P = 0.046) on number of born alive. Litter weight at birth was also increased (P = 0.01) by 25‐hydroxicholecalciferol supplementation; 25‐hydroxicholecalciferol supplementation and housing system (free‐range with sunlight exposure) tended to increase weaning weight (P = 0.07) and litter daily gain (P = 0.051) during lactation. Exposure to sunlight and 25‐hydroxicholecalciferol supplementation increased 25(OH)D3serum levels when compared with control treatment during gestation (136.95 vs. 113.92 ng mL−1;P = 0.035) and lactation (120.29 vs. 88.93 ng mL−1;P = 0.026). In conclusion, the association of 25‐hydroxicholecalciferol supplementation with exposure to sunlight during gestation improved significantly 25(OH)D3serum levels and consequently performance traits in gestation and lactation.
Analysis of fecal nutrients and particle size in captive proboscis monkeys (Nasalis larvatus) fed seasonal dietary foliage at a Japanese zoo
Authors: Kawasaki Ryuta , Kawakita Maki , Kurosawa Kenta , Asano Sanae , Kajikawa Hiroshi 
Published: August 2021

AbstractOne male and three female captive proboscis monkeys (Nasalis larvatus) were used as test animals to compare fecal nutrients after being fed seasonal foliage. Foliage and fecal samples were collected during three seasons (spring, summer, and winter). We analyzed crude ash (CA), ether extract (EE), crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), and acid detergent lignin (ADL). In addition to the above components, for the fecal samples, we examined total fecal nitrogen (TFN), nitrogen in fecal NDF (NDF‐N), metabolic fecal nitrogen (MFN), and particle size distribution (MPS). Seasonal differences in foliage components were observed, with NDF and ADF being lowest in spring (p < 0.05). Fecal NDF and ADF also tended to be lowest in spring. Further, the distribution of fecal particle size indicated that MPS tended to increase in winter. The mean fecal NDF content (47.4%) for all three seasons measured in this study was as much as 1.3 times lower than previously reported values in free‐ranging specimens. These data provide useful information that can be used to find some suitable food items for the endangered highly folivorous monkeys in captivity.
Out‐of‐hospital cardiac arrest and differential risk of cardiac and non‐cardiac QT‐prolonging drugs in 37 000 cases
Authors: Eroglu Talip E. , Barcella Carlo A. , Blom Marieke T. , Mohr Grimur H. , Souverein Patrick C. , Torp‐Pedersen Christian , Folke Fredrik , Wissenberg Mads , de Boer Anthonius , Schwartz Peter J. , Gislason Gunnar H. , Tan Hanno L. ,   for the ESCAPE‐NET Investigators
Published: August 2021

AimsDrugs that prolong the QT interval, either by design (cardiac QT‐prolonging drugs: anti‐arrhythmics) or as off‐target effect (non‐cardiac QT‐prolonging drugs), may increase the risk of ventricular arrhythmias and out‐of‐hospital cardiac arrest (OHCA). Risk mitigation measures were instituted, in particular, surrounding prescription of cardiac QT‐prolonging drugs. We studied OHCA risk of both drug types in current clinical practice.MethodsUsing data from large population‐based OHCA registries in the Netherlands and Denmark, we conducted two independent case–control studies. OHCA cases with presumed cardiac causes were matched on age/sex/index date with up to five non‐OHCA controls. We calculated odds ratios (ORs) for the association of cardiac or non‐cardiac QT‐prolonging drugs with OHCA risk using conditional logistic regression analyses.ResultsWe identified 2503 OHCA cases and 10 543 non‐OHCA controls in the Netherlands, and 35 017 OHCA cases and 175 085 non‐OHCA controls in Denmark. Compared to no use of QT‐prolonging drugs, use of non‐cardiac QT‐prolonging drugs (Netherlands: cases: 3.0%, controls: 1.9%; Denmark: cases: 14.9%, controls: 7.5%) was associated with increased OHCA risk (Netherlands: OR 1.37 [95% CI: 1.03–1.81]; Denmark: OR 1.63 [95% CI: 1.57–1.70]). The association between cardiac QT‐prolonging drugs (Netherlands: cases: 4.0%, controls: 2.5%; Denmark: cases: 2.1%, controls: 0.9%) and OHCA was weaker (Netherlands: OR 1.17 [95% CI: 0.92–1.50]; Denmark: OR 1.21 [95% CI: 1.09–1.33]), although users of cardiac QT‐prolonging drugs had more medication use and comorbidities associated with OHCA risk than users of non‐cardiac QT‐prolonging drugs.ConclusionIn clinical practice, cardiac QT‐prolonging drugs confer lower OHCA risk than non‐cardiac QT‐prolonging drugs, although users of the former have higher a priori risk. This is likely due to risk mitigation measures surrounding prescription of cardiac QT‐prolonging drugs.
Decoding the intricacies of the mast cell compartment
Authors: Carter Melody C. , Metcalfe Dean D. 
Published: August 2021

SummaryHistorically, understanding of the human mast cell (MC) compartment has lagged behind the appreciation of other cell lineages. MCs exist in vascularised tissues but do not under normal circumstances circulate in blood, and there has been no pharmacological agent identified that totally and selectively inhibits human MC function. There are no substantiated accounts of an apparently healthy individual who is severely lacking in MCs. Thus, some of the approaches employed to understand the function of a specific immune cell are not available to the MC biologist. The disease categories that have provided the greatest insight into MC biology have been monoclonal and IgE‐mediated MC disorders. This has led to the categorisation of MC diseases as intrinsic or extrinsic to the MC compartment and to the recognition of the role of mediators in MC activation disorders. Mastocytosis as a clonal disorder not only impacts the MC compartment through changes intrinsic to the MC, but also by the effects of episodes of significant release of MC mediators. The availability of newer therapeutic approaches developed to treat monoclonal MC disorders offer insights into how to more selectively approach management of MC centric diseases.
Observing physicians acting with different levels of empathy modulates later assessed pain tolerance
Authors: Käthner Ivo , Eidel Matthias , Häge Anne‐Sophie , Gram Annika , Pauli Paul 
Published: August 2021

ObjectivesThe patient–physician relationship is essential for treatment success. Previous studies demonstrated that physicians who behave empathic in their interaction with patients have a positive effect on health outcomes. In this study, we investigated if the mere perception of physicians as empathic/not empathic modulates pain despite an emotionally neutral interaction with the patients.MethodsN = 60 women took part in an experimental study that simulated a clinical interaction. In the paradigm, each participant watched two immersive 360° videos via a head‐mounted display from a patient’s perspective. The physicians in the videos behaved either empathic or not empathic towards a third person. Importantly, these physicians remained emotionally neutral in the subsequent virtual interaction with the participants. Finally, participants received a controlled, painful pressure stimulus within the narratives of the videos.ResultsThe physicians in the high compared with the low empathy videos were rated as more empathic and more likable, indicating successful experimental manipulation. In spite of later neutral behaviour of physicians, this short observation of physicians’ behaviour towards a third person was sufficient to modulate pain tolerance of the participants.ConclusionsThe finding of this study that the mere observation of physicians’ behaviour towards a third person modulates pain, despite a neutral direct interaction with the participants, has important clinical implications. Further, the proposed paradigm enables investigating aspects of patient–physician communication that are difficult to examine in a clinical setting.
What do we know about growth of vessel elements of secondary xylem in woody plants?
Authors: Miodek Adam , Gizińska Aldona , Włoch Wiesław , Kojs Paweł 
Published: August 2021

ABSTRACTDespite extensive knowledge about vessel element growth and the determination of the axial course of vessels, these processes are still not fully understood. They are usually explained as resulting primarily from hormonal regulation in stems. This review focuses on an increasingly discussed aspect – mechanical conditions in the vascular cambium. Mechanical conditions in cambial tissue are important for the growth of vessel elements, as well as other cambial derivatives. In relation to the type of stress acting on cambial cells (compressiveversustensile stress) we: (i) discuss the shape of the enlarging vessel elements observed in anatomical sections; (ii) present hypotheses regarding the location of intrusive growth of vessel elements and cambial initials; (iii) explain the relationship between the growth of vessel elements and fibres; and (iv) consider the effect of mechanical stress in determining the course of a vessel. We also highlight the relationship between mechanical stress and transport of the most extensively studied plant hormone – auxin. We conclude that the integration of a biomechanical factor with the commonly acknowledged hormonal regulation could significantly enhance the analysis of the formation of vessel elements as well as entire vessels, which transport water and minerals in numerous plant species.