bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploration of critical care nurses' challenges in caring for enterocutaneous fistula as a complication for an open abdomen: A qualitative study
Authors: Chipu Mpho G. , Kearns Irene , Modula Mantji J. 
Published: May 2024

AbstractBackground and AimsEnterocutaneous fistula is a severe complication of an open abdomen, which poses devastating challenges for critical care nurses. The study aimed to explore and describe the challenges faced by critical care nurses caring for patients with enterocutaneous fistulas in a tertiary public hospital in Gauteng, South Africa.MethodsA qualitative, exploratory, descriptive, and contextual design was conducted to understand the challenges experienced by the critical care nurses caring for patients with enterocutaneous fistulas. The standards for reporting qualitative research checklists are utilized. The study conducted four semistructured focus group interviews with six members in each group.ResultsCritical care nurses revealed two overarching themes: the challenges regarding difficult nursing care and the lack of resources to provide quality patient care. Care of patients with ECF highlighted that nurses were not coping with the care of such patients.ConclusionCollaboration of a multidisciplinary team involving dieticians, surgeons, and enterostomal therapy nurses could improve the management of ECF without surgical intervention, increase the knowledge and skills of nurses, alleviate their challenges, and yield safe patient outcomes. Standardized and updated protocols will ensure the best practices toward quality patient care that facilitate healing, closure, and reducing mortality and morbidity rates. The key principles for caring for patients with open abdomen, presenting with enterocutaneous fistulas, are based on correcting fluids and electrolytes, nutritional optimization and support, control of abdominal sepsis, wound care management, pain control, and emotional support to critical care nurses and ward nurses.
Overstaying our welcome: On the rise of women's seniority in the academy
Authors: Stadnyk T. A. 
Published: May 2024

AbstractIssues surrounding gender equality are—and should be—front and centre in the water resources community, and other science, technology, engineering and mathematics (STEM) fields. Very necessarily, the focus tends to be on recruitment, offering support for students and early career academics. The leaky pipeline concept used to describe the incremental loss of women from STEM fields with career duration describes a disproportionate loss of senior women, creating a parallel problem where highly qualified, top tier academics are lost from the system after significant financial and personnel investment by institutions. Ultimately, the leaky pipeline undermines the extensive investment of the hydrology and other STEM communities in equity, diversity, inclusion and accessibility (EDIA) recruitment and retention programmes by cutting short career ambitions and the trajectories of diverse top performing individuals, resulting in no net benefit of EDIA policy investments and a lack of diversity with seniority. Addressing this critical gender gap requires the attention and support of the hydrology community of practice with specific focus on generating opportunities for advancement, confronting systemic and structural biases and improving education around allyship. Institutions and professional organizations need to consciously grow diversity in leadership and recognize and outwardly manage the perception of academic excellence around slow research and education that attracts increased diversity. Supporting allyship, reducing competitiveness among community members and reinforcing collaboration will not only attract, but retain, a higher proportion of diversity in the hydrology community, academia and STEM professions in general. It is time for the water resources (and other STEM) communities to demand broader accountability and recognition of the barriers to women, implement and reward more diverse definitions of research excellence, and offer allyship training to the community of practice at large.
Genomic progression for local invasion of cutaneous squamous cell carcinoma from the superficial to the deep portion
Authors: Hwang Hye Won , Shin Hyun‐Tae , An Hye Young , Byun Ji Won 
Published: May 2024

AbstractCutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer. While many treatments exist, our understanding of its genomic progression, especially from the epidermis to the deep dermis, remains limited. This study aims to identify genetic mutations associated with the progression of cSCC into the deep dermis, providing insights into its aggressive behavior and high‐risk features. We performed high‐depth whole‐exome sequencing on 12 cSCC tissues, along with paired normal tissues from six patients, using microdissection techniques. The mutational analysis focused on identifying alterations enriched during cSCC progression. Gene Ontology enrichment analysis, immunohistochemical assays, and external single‐cell RNA data were utilized for validation. A total of 8863 non‐synonymous somatic mutations were identified in 4092 genes across the superficial and deep portions of cSCCs. Analysis of deep portion mutations revealed a significant correlation with gene ontology biological processes, particularly cell junction organization, and cell–cell adhesion. Clonal mutations in these processes were more prevalent in the deep portions, indicating their impact on the cSCC mutation landscape. Genetic evolution analysis identified 29 causal genes associated with dermal invasion in cSCC. We highlight somatic mutations in cSCC, revealing heterogeneity between superficial and deep regions. Altered genes in cell junction organization and cell–cell adhesion emerged as pivotal in dermal invasion. We identified 29 causal genes primarily in deep tumor regions. Our findings emphasize analyzing multiple tumor regions to capture varied mutational landscapes. These insights advance our understanding of cSCC progression, emphasizing genetic and cellular changes during tumor evolution.
Cumulative sum learning curve for cordocentesis among maternal‐fetal medicine fellows in a low‐cost simulation model
Authors: Perez‐Estrada Bibiana A. , Acevedo‐Gallegos Sandra , Lumbreras‐Marquez Mario I. , Gardner Roxane , Gallardo‐Gaona Juan M. 
Published: May 2024

AbstractObjectiveTo determine the individual learning curves for cordocentesis in a low‐cost simulator for maternal‐fetal medicine (MFM) fellows.MethodsThis observational, descriptive, educational, and prospective study was performed from July through November 2022. After an introductory course based on a standardized technique for cordocentesis, each second‐year MFM fellow who accepted to participate in the study performed this procedure using a low‐cost simulation model, and experienced operators supervised the cordocenteses. Learning curves were then created using cumulative sum analysis (CUSUM).ResultsSeven second‐year MFM fellows with no previous experience in cordocentesis accepted to participate in the study. A total of 2676 procedures were assessed. On average, residents performed 382 ± 70 procedures. The mean number of procedures to achieve proficiency was 369 ± 70, the overall success rate was 84.16%, and the corresponding failure rate was 15.84%. At the end of the study, all fellows were considered competent in cordocentesis. One fellow required 466 attempts to achieve competency, performing a total of 478 procedures, but the resident with the fewest attempts to reach competency required 219 procedures, completing 232 procedures. Some of the most frequent reasons for failed attempts included not reaching the indicated point for vascular access (20.99%) and being unable to retrieve the sample (69.10%).ConclusionCUSUM analysis to assess learning curves, in addition to using low‐cost simulation models, helped to appraise individualized learning, allowing an objective demonstration of competency for cordocentesis among MFM fellows.
Delivery of AKT1 phospho‐forms to human cells reveals differential substrate selectivity
Authors: Siddika Tarana , Shao Richard , Heinemann Ilka U. , O'Donoghue Patrick 
Published: May 2024

AbstractProtein kinase B (AKT1) is a serine/threonine kinase that regulates fundamental cellular processes, including cell survival, proliferation, and metabolism. AKT1 activity is controlled by two regulatory phosphorylation sites (Thr308, Ser473) that stimulate a downstream signaling cascade through phosphorylation of many target proteins. At either or both regulatory sites, hyperphosphorylation is associated with poor survival outcomes in many human cancers. Our previous biochemical and chemoproteomic studies showed that the phosphorylated forms of AKT1 have differential selectivity toward peptide substrates. Here, we investigated AKT1‐dependent activity in human cells, using a cell‐penetrating peptide (transactivator of transcription, TAT) to deliver inactive AKT1 or active phospho‐variants to cells. We used enzyme engineering and genetic code expansion relying on a phosphoseryl‐transfer RNA (tRNA) synthetase (SepRS) and tRNASep pair to produce TAT‐tagged AKT1 with programmed phosphorylation at one or both key regulatory sites. We found that all TAT‐tagged AKT1 variants were efficiently delivered into human embryonic kidney (HEK 293T) cells and that only the phosphorylated AKT1 (pAKT1) variants stimulated downstream signaling. All TAT‐pAKT1 variants induced glycogen synthase kinase (GSK)‐3α phosphorylation, as well as phosphorylation of ribosomal protein S6 at Ser240/244, demonstrating stimulation of downstream AKT1 signaling. Fascinatingly, only the AKT1 variants phosphorylated at S473 (TAT‐pAKT1S473 or TAT‐pAKT1T308,S473) were able to increase phospho‐GSK‐3β levels. Although each TAT‐pAKT1 variant significantly stimulated cell proliferation, cells transduced with TAT‐pAKT1T308 grew significantly faster than with the other pAKT1 variants. The data demonstrate differential activity of the AKT1 phospho‐forms in modulating downstream signaling and proliferation in human cells.
Firm risk associated with environmental and corporate social disclosure: The moderating role of board gender diversity
Authors: Ali Furman , Shah Syed Sumair 
Published: May 2024

AbstractThis study examines the relationship among corporate social and environmental disclosures, firm risk, and board gender diversity. This paper offers fresh insights into the relationship between corporate social and environmental disclosures and gender diversity and firm risk., Using panel data of Chinese nonfinancial A‐share‐listed companies from 2008 to 2020, we discover that the correlation between gender diversity on the board and corporate social and environmental disclosures has a significant negative influence on firm risk. The findings also revealed that the impact of gender diversity and corporate social and environmental disclosures is more pronounced to mitigate firm risk in nonstate‐owned enterprises than in state‐owned enterprises. For robustness, we used the generalized method of moments to control for reverse causality and endogenous variables' existence; the findings are similar to the main results. The study contributes to the literature by offering a contingency approach to examine the relationship between corporate social and environmental disclosures and firm risk and sheds light on the relationship in the context of a developing economy.
Transfer of the Dual Orexin Receptor Antagonist Daridorexant into Breast Milk of Healthy Lactating Women
Authors: Kaufmann Priska , Muehlan Clemens , Anliker‐Ort Marion , Sabattini Giancarlo , Siebers Nicholas , Dingemanse Jasper 
Published: May 2024

AbstractThe novel dual orexin receptor antagonist daridorexant was approved in 2022 for the treatment of adult patients with insomnia. The aim of this post‐marketing study was to measure daridorexant and its major metabolites in breast milk and plasma of 10 healthy lactating subjects.This single‐center, open‐label study evaluated the transfer of the analytes into breast milk. A single dose of 50 mg was orally administered in the morning. Milk and blood samples were collected pre‐dose and over a period of 72 h after dosing. The pharmacokinetics of daridorexant in milk and plasma were assessed including the cumulative amount and fraction of dose excreted, daily infant dose, and relative infant dose. Safety and tolerability were also investigated.All subjects completed the study. Daridorexant was rapidly absorbed into and distributed from plasma. Daridorexant and its major metabolites were measurable in breast milk. The cumulative total amount of daridorexant excreted over 72 h was 0.010 mg, which corresponds to 0.02% of the maternal dose. This corresponds to a mean daily infant dose of 0.009 mg/day and a relative infant dose of less than 0.22% over 24 h. The maternal safety profile was similar to that observed in previous studies.Low amounts of daridorexant and its metabolites were detected in the breast milk of healthy lactating women. Since the exposure and potential effects on the breastfed infant are unknown, a risk of somnolence or other depressant effects cannot be excluded.
Bone mineral density changes around the stem correlate with stress changes after total hip arthroplasty: A study using thermoelastic stress analysis
Authors: Watanabe Ryunosuke , Mishima Hajime , Takehashi Hironori , Wada Hiroshi , Totsuka Sho , Nishino Tomofumi , Yamazaki Masashi 
Published: May 2024

AbstractPurposeThermoelastic stress analysis (TSA) was used to evaluate stress changes over the entire surface of a specimen. This study aimed to assess the relationship between femoral stress distribution, analysed using TSA and changes in bone mineral density (BMD) after total hip arthroplasty (THA).MethodsStress changes in the simulated bone before and after taper‐wedge stem insertion were measured using the TSA. Stress changes were compared with BMD changes around the stem 1 year after surgery in a THA patient (58 hips) with the same taper‐wedge stem. Subsequently, we compared the correlation between stress changes and BMD changes.ResultsTSA revealed significant stress changes before and after stem insertion, with prominent alterations in the proximal medial region. The BMD changes at 1 year post‐THA exhibited a 15%–25% decrease in the proximal zones, while Zones 2–6 showed a −6% to 3% change. Notably, a strong positive correlation (0.886) was found between the stress change rate and BMD change rate.ConclusionsThis study demonstrated a high correlation between femoral stress distribution assessed using TSA and subsequent BMD changes after THA. The TSA method offers the potential to predict stress distribution and BMD alterations postsurgery, aiding in implant development and clinical assessment. Combining TSA with finite element analysis could provide even more detailed insights into stress distribution.Level of EvidenceCase series (with or without comparison).
Diagnostic markers of acute encephalitis syndrome and COVID‐associated multisystem inflammatory syndrome in children from Southern India
Authors: Damodar Tina , Dunai Cordelia , Prabhu Namratha , Jose Maria , Akhila L. , Kinhal Uddhava V. , Anusha Raj K. , Marate Srilatha , Lalitha A. V. , Dsouza Fulton Sebastian , Sajjan Sushma Veeranna , Gowda Vykuntaraju K. , Basavaraja G. V. , Singh Bhagteshwar , Prathyusha P. V. , Tharmaratnam Kukatharmini , Ravi Vasanthapuram , Kolamunnage‐Dona Ruwanthi , Solomon Tom , Turtle Lance , Yadav Ravi , Michael Benedict D. , Mani Reeta S. 
Published: May 2024

AbstractAcute encephalitis syndrome (AES) in children poses a significant public health challenge in India. This study aims to explore the utility of host inflammatory mediators and neurofilament (NfL) levels in distinguishing etiologies, assessing disease severity, and predicting outcomes in AES. We assessed 12 mediators in serum (n = 58) and 11 in cerebrospinal fluid (CSF) (n = 42) from 62 children with AES due to scrub typhus, viral etiologies, and COVID‐associated multisystem inflammatory syndrome (MIS‐C) in Southern India. Additionally, NfL levels in serum (n = 20) and CSF (n = 18) were examined. Clinical data, including Glasgow coma scale (GCS) and Liverpool outcome scores, were recorded. Examining serum and CSF markers in the three AES etiology groups revealed notable distinctions, with scrub typhus differing significantly from viral and MIS‐C causes. Viral causes had elevated serum CCL11 and CCL2 compared with scrub typhus, while MIS‐C cases showed higher HGF levels than scrub typhus. However, CSF analysis showed a distinct pattern with the scrub typhus group exhibiting elevated levels of IL‐1RA, IL‐1β, and TNF compared with MIS‐C, and lower CCL2 levels compared with the viral group. Modeling the characteristic features, we identified that age ≥3 years with serum CCL11 < 180 pg/mL effectively distinguished scrub typhus from other AES causes. Elevated serum CCL11, HGF, and IL‐6:IL‐10 ratio were associated with poor outcomes (p = 0.038, 0.005, 0.02). Positive CSF and serum NfL correlation, and negative GCS and serum NfL correlation were observed. Median NfL levels were higher in children with abnormal admission GCS and poor outcomes. Measuring immune mediators and brain injury markers in AES provides valuable diagnostic insights, with the potential to facilitate rapid diagnosis and prognosis. The correlation between CSF and serum NfL, along with distinctive serum cytokine profiles across various etiologies, indicates the adequacy of blood samples alone for assessment and monitoring. The association of elevated levels of CCL11, HGF, and an increased IL‐6:IL‐10 ratio with adverse outcomes suggests promising avenues for therapeutic exploration, warranting further investigation.
Association between isolated or combined malnutrition and sarcopenia and quality of life in heart failure outpatients: A cross‐sectional study
Authors: Knobloch Ingrid da Silveira , Souza Gabriela Corrêa , Vale Marla Darlene Machado , Ribeiro Édina Caroline Ternus , Silva Flávia Moraes 
Published: May 2024

AbstractBackgroundHeart failure (HF) is a chronic condition with symptoms linked to worse quality of life. Malnutrition and sarcopenia are conditions frequently found in patients with HF. This study aims to evaluate the association between isolated or combined malnutrition and sarcopenia and quality of life in outpatients with HF.MethodsThis is a cross‐sectional study with a sample of outpatients with HF aged ≥18 years. Malnutrition was assessed according to the criteria of the Global Leadership Initiative on Malnutrition, and sarcopenia was evaluated by the European Working Group on Sarcopenia in Older People. Quality of life was assessed using the Minnesota Living with HF questionnaire (MLHFQ). Clinical and sociodemographic data were collected.ResultsOne hundred and fifty‐one patients were included in this study, with a median (interquartile range) age of 58 (48–65) years, 58.9% were adults, and 68.9% were male. A total of 29.5% of the patients were malnourished, and 28.5% and 2.6% were identified with probable sarcopenia and sarcopenia, respectively. Of the total, 15.9% of patients were identified with both conditions. Sarcopenia was associated with higher odds of increase in the MLHFQ total score, indicating worse quality of life (odds ratio [OR] = 3.61; 95% CI, 1.65–7.89). The same was found in the presence of two conditions (OR 3.97; 95% CI, 1.32–11.54), whereas isolated malnutrition was not related to life quality (OR = 1.62; 95% CI, 0.73–3.60).ConclusionThe presence of malnutrition and sarcopenia simultaneously were associated with worse quality of life scores when compared with these isolated conditions.
Osteotomy around the painful degenerative varus knee has broader indications than conventionally described but must follow a strict planning process: ESSKA Formal Consensus Part I
Authors: Dawson Matthew , Elson David , Claes Steven , Predescu Vlad , Khakha Raghbir , Espejo‐Reina Alejandro , Schröter Steffen , van Heerwarden Ronald , Menetrey Jacques , Beaufils Philippe , Seil Roman , Beker Roland , Mabrouk Ahmed , Ollivier Matthieu 
Published: May 2024

AbstractPurposeThe European consensus was designed with the objective of combining science and expertise to produce recommendations that would educate and provide guidance in the treatment of the painful degenerative varus knee. Part I focused on indications and planning.MethodsNinety‐four orthopaedic surgeons from 24 European countries were involved in the consensus, which focused on the most common indications for osteotomy around the knee. The consensus was performed according to an established ESSKA methodology. The questions and recommendations made were initially designed by the consensus steering group. And ‘best possible’ answers were provided based upon the scientific evidence available and the experience of the experts. The statements produced were further evaluated by ratings and peer review groups before a final consensus was reached.ResultsThere is no reliable evidence to exclude patients based on age, gender or body weight. An individualised approach is advised; however, cessation of smoking is recommended. The same applies to lesser degrees of patellofemoral and lateral compartment arthritis, which may be accepted in certain situations. Good‐quality limb alignment and knee radiographs are a mandatory requirement for planning of osteotomies, and Paley's angles and normal ranges are recommended when undertaking deformity analysis. Emphasis is placed upon the correct level at which correction of varus malalignment is performed, which may involve double‐level osteotomy. This includes recognition of the importance of individual bone morphology and the maintenance of a physiologically appropriate joint line orientation.ConclusionThe indications of knee osteotomies for painful degenerative varus knees are broad. Part I of the consensus highlights the versatility of the procedure to address multiple scenarios with bespoke planning for each case. Deformity analysis is mandatory for defining the bone morphology, the site of the deformity and planning the correct procedure.Level of EvidenceLevel II, consensus.
Synergetic Improvement of Flexoelectric Coefficient in Liquid Crystal Embedded Flexible PVDF Polymer Composite for Energy Harvesting Applications
Authors: Bora Kaustav Jit , Sinha Aloka 
Published: May 2024

AbstractFlexoelectricity is the universal electric polarization of dielectrics upon exertion of a non‐uniform strain gradient. With the advancement of nano‐technology and miniaturization of electronic devices, flexoelectricity holds the promise to address the power requirements for such device operation. The direct flexoelectric effect in liquid crystal (LC) embedded poly(vinylidene fluoride) (PVDF) polymer films is examined for the first time by the application of external strain on the films. Physical characterizations such as Differential Scanning Calorimetry (DSC), dielectric spectroscopy, X‐ray diffraction, and field emission scanning electron microscopy (FESEM) are carried out to study the composite films’ intrinsic and extrinsic properties like dielectric, crystallinity, and morphologies. The value of the flexoelectric coefficient (μ12) increases with the concentration of LC incorporation. At 3 wt%, μ12 attains a maximum value of 68 nC m−1, which is more than a threefold increase compared to that of the pure PVDF film. The role of Maxwell–Wagner–Sillars (MWS) polarization in determining flexoelectric polarization in polymer composites is also discussed. Moreover, the influence of the microstructure and domain size formation in determining the flexoelectric response are discussed in detail to infer the behavior of the flexoelectric coefficients of the films. Potential device applications based on this phenomenon have been proposed for future research in sensing and actuation.