bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct Rivaroxaban-Induced Factor XA Inhibition Proves to be Cardioprotective in Rats
Authors: Guillou Sophie , Beaumont Justine , Tamareille Sophie , Giraud Sebastien , Mirebeau-Prunier Delphine , Prunier Fabrice , Macchi Laurent 
Published: July 2019

ABSTRACT

Background:
Acute myocardial infarction is a leading cause of death worldwide. Though highly beneficial, reperfusion of myocardium is associated with reperfusion injury. While indirect inhibition of Factor Xa has been shown to attenuate myocardial ischemia-reperfusion (I/R) injury, the underlying mechanism remains unclear. Our study sought to evaluate the effect of rivaroxaban (RIV), a direct inhibitor of Factor Xa, on myocardial I/R injury and determine its cellular targets.

Experimental Approach:
We used a rat model of 40-min coronary ligation followed by reperfusion. RIV (3 mg/kg) was given per os 1 h before reperfusion. Infarct size and myocardial proteic expression of survival pathways were assessed at 120 and 30 min of reperfusion, respectively. Plasmatic levels of P-selectin and von Willebrand factor were measured at 60 min of reperfusion. Cellular RIV effects were assessed using hypoxia-reoxygenation (H/R) models on human umbilical vein endothelial cells and on rat cardiomyoblasts (H9c2 cell line).

Key Results:
RIV decreased infarct size by 21% (42.9% vs. 54.2% in RIV-treated rats and controls respectively, P < 0.05) at blood concentrations similar to human therapeutic (387.7 ± 152.3 ng/mL) levels. RIV had no effect on H/R-induced modulation of endothelial phenotype, nor did it alter myocardial activation of reperfusion injury salvage kinase and survivor activating factor enhancement pathways at 30 min after reperfusion. However, RIV exerted a cytoprotective effect on H9c2 cells submitted to H/R.

Conclusions:
RIV decreased myocardial I/R injury in rats at concentrations similar to human therapeutic ones. This protection was not associated with endothelial phenotype modulation but rather with potential direct cytoprotection on cardiomyocytes.
Utilizing Precision Medicine to Estimate Timing for Surgical Closure of Traumatic Extremity Wounds
Authors: Lisboa Felipe A. , Dente Christopher J. , Schobel Seth A. , Khatri Vivek , Potter Benjamin K. , Kirk Allan D. , Elster Eric A. 
Published: July 2019

Background:
Both the frequency and high complication rates associated with extremity wounds in recent military conflicts have highlighted the need for clinical decision support tools (CDST) to decrease time to wound closure and wound failure rates.

Methods:
Machine learning was used to estimate both successful wound closure (based on penultimate debridement biomarker data) and the necessary number of surgical debridements (based on presentation biomarkers) in 73 service members treated according to military guidelines based on clinical data and the local/systemic level of 32 cytokines. Models were trained to estimate successful closure including an additional 8 of 80 civilian patients with similar injury patterns. Previous analysis has demonstrated the potential to reduce the number of operative debridements by 2, with resulting decreases in ICU and hospital LOS, while decreasing the rate of wound failure.

Results:
Analysis showed similar cytokine responses when civilians followed a military-like treatment schedule with surgical debridements every 24 to 72 hours. A model estimating successful closure had AUC of 0.89. Model performance in civilians degraded when these had a debridement interval > 72 hours (73 of the 80 civilians). A separate model estimating the number of debridements required to achieve successful closure had a multiclass AUC of 0.81.

Conclusion:
CDSTs can be developed using biologically compatible civilian and military populations as cytokine response is highly influenced by surgical treatment. Our CDSTs may help identify who may require serial debridements versus early closure, and precisely when traumatic wounds should optimally be closed.
Dissecting Cardiac Surgery
Authors: Dias Roger D. , Zenati Marco A. , Conboy Heather M. , Clarke Lori A. , Osterweil Leon J. , Avrunin George S. , Yule Steven J. 
Published: July 2019

Objective:
The aim of this study was to elucidate the cognitive processes involved in surgical procedures from the perspective of different team roles (surgeon, anesthesiologist, and perfusionist) and provide a comprehensive compilation of intraoperative cognitive processes.

Summary Background Data:
Nontechnical skills play a crucial role in surgical team performance and understanding the cognitive processes underlying the intraoperative phase of surgery is essential to improve patient safety in the operating room (OR).

Methods:
A mixed-methods approach encompassing semistructured interviews with 9 subject-matter experts. A cognitive task analysis was built upon a hierarchical segmentation of coronary artery bypass grafting procedures and a cued-recall protocol using video vignettes was used.

Results:
A total of 137 unique surgical cognitive processes were identified, including 33 decision points, 23 critical communications, 43 pitfalls, and 38 strategies. Self-report cognitive workload varied substantially, depending on team role and surgical step. A web-based dashboard was developed, providing an integrated visualization of team cognitive processes in the OR that allows readers to intuitively interact with the study findings.

Conclusions:
This study advances the current body of knowledge by making explicit relevant cognitive processes involved during the intraoperative phase of cardiac surgery from the perspective of multiple OR team members. By displaying the research findings in an interactive dashboard, we provide trainees with new knowledge in an innovative fashion that could be used to enhance learning outcomes. In addition, the approach used in the present study can be used to deeply understand the cognitive factors underlying surgical adverse events and errors in the OR.
Reappraisal of a 2-Cm Cut-off Size for the Management of Cystic Pancreatic Neuroendocrine Neoplasms
Authors: Maggino Laura , Schmidt Andrea , Käding André , Westermark Sofia , Ceppa Eugene P. , Falconi Massimo , Javed Ammar A. , Landoni Luca , Pergolini Ilaria , Perinel Julie , Vollmer Charles M. , Sund Malin , Gaujoux Sebastien 
Published: July 2019

Objective:
The aim of this study was to characterize an international cohort of resected cystic pancreatic neuroendocrine neoplasms (cPanNENs) and identify preoperative predictors of aggressive behavior.

Background:
The characteristics of cPanNENs are unknown and their clinical management remains unclear. An observational strategy for asymptomatic cPanNENs ≤2 cm has been proposed by recent guidelines, but evidence is scarce and limited to single-institutional series.

Methods:
Resected cPanNENs (1995–2017) from 16 institutions worldwide were included. Solid lesions (>50% solid component), functional tumors, and MEN-1 patients were excluded. Aggressiveness was defined as lymph node (LN) involvement, G3 grading, distant metastases, and/or recurrence.

Results:
Overall, 263 resected cPanNENs were included, among which 177 (63.5%) were >2 cm preoperatively. A preoperative diagnosis of cPanNEN was established in 162 cases (61.6%) and was more frequent when patients underwent endoscopic ultrasound [EUS, odds ratio (OR) 2.69, 95% confidence interval (CI) 1.52–4.77] and somatostatin-receptor imaging (OR 3.681, 95% CI 1.809–7.490), and for those managed in specialized institutions (OR 3.12, 95% CI 1.57–6.21). Forty-one cPanNENs (15.6%) were considered aggressive. In the whole cohort, LN involvement on imaging, age >65 years, preoperative size >2 cm, and pancreatic duct dilation were independently associated with aggressive behavior. In asymptomatic patients, older age and a preoperative size >2 cm remained independently associated with aggressiveness. Only 1 of 61 asymptomatic cPanNENs ≤2 cm displayed an aggressive behavior.

Conclusions:
The diagnostic accuracy of cPanNENs is increased by the use of EUS and somatostatin-receptor imaging and is higher in specialized institutions. Preoperative size >2 cm is independently associated with aggressive behavior. Consequently, a watch-and-wait policy for sporadic asymptomatic cPanNENs ≤2 cm seems justified and safe for most patients.
Information and Communication Technology Can Increase Patient Participation in Pressure Injury Prevention
Authors: Hultin Lisa , Karlsson Ann-Christin , Öhrvall Margareta , Gunningberg Lena 
Published: July 2019

PURPOSE:
The aim of this study was to assess the participatory capabilities of hospitalized older adults in response to the Continuous Bedside Pressure Mapping system placed on the beds to prevent pressure injuries.

DESIGN:
Descriptive study.

SUBJECTS AND SETTING:
A convenience sample of 31 orthopedic patients were recruited from an orthopedic rehabilitation unit at a university hospital in Uppsala, Sweden, that served patients aged 65 years and older.

METHODS:
Semistructured interviews were conducted between November 2016 and February 2017, audio-recorded, and transcribed verbatim. Data were analyzed using qualitative content analysis.

RESULT:
The overall theme from 21 interviews was “A new way of understanding helped patients to recognize vulnerable pressure points and to take action in their own care” from which 2 categories, “awareness” and “action,” emerged. The study showed that verbally adapted information combined with using information and communication technology increased most participants' knowledge and as they became aware of increased pressure, they started to take preventative action by changing position.

CONCLUSIONS:
It is possible for older participants in a rehabilitation unit who had recent orthopedic surgery to understand and use new information and communication technology and should be invited to participate in pressure injury prevention.
Unusual Set of Adverse Effects During Right-Unilateral Ultrabrief Electroconvulsive Therapy Led to the Discovery of a Brain Tumor
Authors: Buday Jozef , Albrecht Jakub , Mareš Tadeáš , Fabián Vratislav , Buday Jozef , Raboch Jiří , Anders Martin 
Published: July 2019

Abstract
We describe a case of a right-handed, 42-year-old, Caucasian female patient who manifested a set of unusual adverse effects during maintenance ultrabrief right-unilateral electroconvulsive therapy (ECT)—generalized myoclonic secondary seizure with lateralization nonresponsive to repeated intravenous diazepam application, deviation of the tongue and the head to the left, ping-pong gaze with nystagmoid jerks, postictal hypoactive confusion state lasting 15 minutes (with a total time to recovery 30 minutes), and likely Todd's paralysis after the procedure (subsided within 24 hours). These adverse effects led to a thorough clinical investigation and eventually the discovery of a brain tumor. In the article, we hypothesize about the possible interaction between the intracranial mass and ECT and provide a literature overview on the topic. Cases like this are likely underreported, and although several studies demonstrate that ECT can be applied safely to patients with an intracranial mass, this report demonstrates that brain tumor can interfere with ECT in an unpredictable way and have severe consequences (eg, unresponsiveness to diazepam when attempting to halt the seizure as our patient). Unusual symptoms after ECT, albeit reversible, such as in this case report, should be followed by a thorough neurological check-up to exclude any underlying organic pathology.
“Plasma Membrane Calcium Atpase downregulation in dopaminergic neurons alters cellular physiology and behavior in Drosophila melanogaster”
Authors: Erhardt Brenda , Leal María Celeste , Marcora María Silvina , Frenkel Lía , Bochicchio Pablo Alejandro , Bodin Diego Hernán , Silva Berenice Anabel , Farías María Isabel , Ferrari Carina Cintia , Ángel Allo Miguel , Höcht Christian , Castaño Eduardo Miguel , Pitossi Fernando Juan 
Published: July 2019

AbstractAccumulation of calcium is proposed to account for selective dopaminergic neuron (DN) dysfunctionality, a characteristic of Parkinson’s Disease (PD). To test the in vivo impact of calcium increment in DN physiology we downregulated the Plasma Membrane Calcium ATPase (PMCA), a bomb that extrudes cytosolic calcium, in those neurons in Drosophila melanogaster. Using th-GAL4>PMCARNAi, PMCA was selectively reduced, leading to increased cytosolic calcium and mitochondrial oxidative stress with no neurodegeneration. In the eye, PMCARNAi expression provoked a subtle disorganization, suggesting scarce toxicity. Interestingly, we observed several locomotor alterations and a higher level of dopamine in brains. Finally, flies presented a reduction of lifespan and a perimortem non-motor phenotype characterized by abdominal swelling, possibly due to constipation. We conclude that elevated cytosolic calcium in DN could trigger cellular dysfunction generating mitochondrial oxidative stress and motor and non-motor symptoms, typical of PD.
Hypoxia induces transcriptional and translational downregulation of the type I interferon (IFN) pathway in multiple cancer cell types
Authors: Miar Ana , Arnaiz Esther , Bridges Esther , Beedie Shaunna , Cribbs Adam P , Downes Damien J. , Beagrie Robert , Rehwinkel Jan , Harris Adrian L. 
Published: July 2019

AbstractHypoxia is a common phenomenon in solid tumours and is considered a hallmark of cancer. Increasing evidence shows that hypoxia promotes local immune suppression. Type I IFN is involved in supporting cytotoxic T lymphocytes by stimulating the maturation of dendritic cells (DCs) and enhancing their capacity to process and present antigens. However, there is little information about the relationship between hypoxia and the type I interferon (IFN) pathway, which comprises the sensing of double-stranded RNA and DNA (dsRNA/dsDNA), followed by IFNα/β secretion and transcription activation of IFN-stimulated genes (ISGs). The aims of this study were to determine both the effect and mechanisms of hypoxia on the I IFN pathway in breast cancer.There was a downregulation of the type I IFN pathway expression at mRNA and protein level in cancer cell lines under hypoxia in vitro and in vivo in xenografts. This pathway was suppressed at each level of signalling, from the dsRNA sensors (RIG-I, MDA5), the adaptor (MAVS), transcription factors (IRF3, IRF7, STAT1) and several ISGs (RIG-I, IRF7, STAT1, ADAR-p150). There was also lower IFN secretion under hypoxic conditions. HIF1 and HIF2 regulation of gene expression did not explain most of the effects. However, ATAC-Seq data revealed that in hypoxia peaks with STAT1 and IRF3 motifs had decreased accessibility.Thus hypoxia leads to an overall 50% downregulation of the type I IFN pathway due to repressed transcription and lower chromatin accessibility in a HIF1/2α-independent manner, which could contribute to immunosuppression in hypoxic tumours.
The role of the lead firm in exploratory projects
Authors: Zhu Fangwei , Jiang Mengtong , Yu Miao 
Published: July 2019

PurposeThe challenge of unforeseen uncertainties in exploratory projects requires the lead firm in a project alliance to effectively manage exploratory co-innovation. The purpose of this paper is to investigate the types of capabilities a lead firm required in exploratory projects and how these capabilities enable the exploratory innovation of the project alliance.Design/methodology/approachA multiple-case study was done to provide empirical evidence for the rationale of the capabilities of the lead firm. The provided analysis used abductive reasoning of two typical exploratory projects in China.FindingsThis paper identifies two types of capabilities: innovation-related capabilities and network-related capabilities. Furthermore, a process model of the capabilities of the lead firm is developed that enables exploratory co-innovation in a project alliance. The capabilities of the lead firm input varied at four different stages.Practical implicationsInnovation-related capabilities and network-related capabilities could form the foundation for the lead firm in an exploratory project alliance. This will enable an exploratory co-innovation and collaboratively overcome the barriers of exploratory projects.Originality/valueAlthough exploratory project attracts extensive attention for its unique characteristics and universal value, there is limited amount of research on the context of joint exploratory projects. This study starts from the role of lead firm in an exploratory project alliance, contributes toward the comprehension of the link between the lead firm’s capabilities and the process of exploratory co-innovation. The findings will be of value in supporting the management of exploratory innovation in a project alliance.
The relationship between project governance mechanisms and project success
Authors: Young Raymond , Chen Wenxin , Quazi Ali , Parry Warren , Wong Adrian , Poon Simon K. 
Published: July 2019

PurposeProject governance has been linked to project success because top management support is necessary for projects to succeed. However, top managers are time poor and it is not clear which project governance mechanisms are effective for project success. The purpose of this paper is to address this issue and identify project governance mechanisms that correlate with success.Design/methodology/approachThis is a quantitative study. A theoretical model of project governance was developed and tested with secondary industry data gathered from 51 global organisations and 66,817 responses.FindingsThe results found five project governance mechanisms (Vision, Change, Sponsor, KPI and Monitor) significantly correlate with project success and are effective at different stages in the project lifecycle.Originality/valueEarlier research has found a relationship between project governance and project success but it has not been specific enough to guide top managers in practice. This is the first research to take this next step and identify project governance mechanisms that correlate with project success. One finding of this research that has particular value is the identification of when in the project lifecycle a particular governance mechanism is most effective.
Improving the effectiveness of public participation in public infrastructure megaprojects
Authors: Wu Lufeng , Jia Guangshe , Zhang Puwei 
Published: July 2019

PurposeThe purpose of this paper is to investigate how to improve the effectiveness of public participation in public infrastructure megaprojects (PIMs). Conflicts among stakeholders and uncertainty disrupt the success of PIMs when public participation is ineffective.Design/methodology/approachSecondhand data are collected to study the effectiveness of public participation in the Beijing–Shenyang High-Speed Rail (China) and the California High-Speed Rail (USA). The employed research method is an inductive case study.FindingsIneffective public participation can cause schedule and cost overruns and increase uncertainty in PIMs. The ambiguity of meaningful public participation, ineffective participatory approaches and overburden of public participation in environmental impact assessment are the causes of ineffective public participation in PIMs.Research limitations/implicationsPublic participation has become an essential part in PIMs management. This study looks at the understanding of the relationship between public participation and the success of PIMs.Practical implicationsLegislative bodies should perfect the laws to guarantee meaningful public participation. Lead agencies should adopt additional effective participatory approaches to solicit public comments and identify critical voices. A dispute solution mechanism is necessary to solve public participation disputes in PIMs in practice.Originality/valueStakeholder and uncertainty management are important to the success of PIMs. This study reveals methods to improve the effectiveness of public participation to alleviate the conflicts among stakeholders and reduce uncertainty in PIMs.
Service marketing mix as input and output of higher and technical education
Authors: Mahajan Prashant , Golahit Suresh 
Published: July 2019

Purpose
The purpose of this paper is to examine the relationships of service marketing mix (SMM) as service input and service output in terms of students’ performance, satisfaction and referral act in context to higher and technical education (HTE) through the application of structural equation modeling.

Design/methodology/approach
A quantitative research, conducted through a self-administered survey composed by a closed-ended structured questionnaire, was incorporated for the students who were enrolled in the technical educational institutions situated in the Khandesh region of India.

Findings
The findings of this study revealed that traditional SMM is statistically linked with the performance of students in terms of skill and knowledge enhancement, satisfaction and referral act of students, which are perceptible new emerging SMM; performance, pleasure and pointing out in terms of service output.

Practical implications
Integrating SMM as service input and service output are productive for HTE in enhancing growth (quantitatively) by the inclusivity of diversified students and development (qualitatively) by enhancing their performance for global standing, making them satisfied and motivating them for recommending their institution to others. This integration can be utilized as a yardstick by the institutions for staying ahead in students’ market with a distinctive competitive advantage.

Social implications
Growth and development of HTE will raise a society’s quality of life and thereby increase a country’s socio-economic status.

Originality/value
The study has exhibited SMM as input and output of a service system that is useful for the growth and development of HTE. The measurement tool presented is effective in (re)framing policies on SMM as service input based on desired service output.
Factors predicting job satisfaction among faculty members of a Saudi higher education institution
Authors: Kuwaiti Ahmed Al , Bicak Hasan Ali , Wahass Saeed 
Published: July 2019

PurposeThe purpose of this paper is to evaluate the level of job satisfaction among faculty members of the health sciences program at a Saudi higher education institution; and predict the influence of various factors on overall job satisfaction. However, this study is quite different since it intended to evaluate the level of job satisfaction of faculty members using a self-structured questionnaire and ascertained the various factors influencing the overall job satisfaction of Saudi academics.Design/methodology/approachAn exploratory study design was adopted and Academic Job Satisfaction (AJS) survey was administered to 943 faculty members of the health sciences program through an online system. A total of 850 faculty members responded to 47 items and one global rating item (overall job satisfaction) using a five-point ordinal scale.FindingsThe level of job satisfaction of health sciences’ faculty members on all dimensions of AJS is observed to be high (>3.5) except salary, which is shown as medium (2.5–3.49). Regression analysis indicates the factors other than Imam Abdulrahman Bin Faisal University (IAU) administrative policies and interpersonal relationships are significant predictors of overall job satisfaction; and salary is the most significant predictor of overall job satisfaction among health sciences’ faculty members.Originality/valueThis study adds a value to the existing literature by exploring the factors influencing job satisfaction of health sciences’ faculty members working in Saudi Universities. This would aid policy makers to focus on these factors, thereby improve and maintain job satisfaction among healthcare academics.