bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motivation to Carry Naloxone: A Qualitative Analysis of Emergency Department Patients
Authors: Spadaro Anthony , Agarwal Anish K. , Sangha Hareena K. , Perrone Jeanmarie , Delgado Mucio Kit , Lowenstein Margaret 
Published: June 2022

Purpose Our aim was to explore perspectives of patients who received naloxone in the emergency department (ED) about (1) naloxone carrying and use following an ED visit and (2) motivation for performing these behaviors. Design Semi-structured interviews of patients prescribed naloxone at ED discharge. Settings Three urban academic EDs in Philadelphia, PA. Participants 25 participants completed the in-depth, semi-structured interviews and demographic surveys. Participants were majority male, African American, and had previously witnessed or experienced an overdose. Methods Interviews were recorded, transcribed and analyzed using content analysis. We used a hybrid inductive-deductive approach that included prespecified and emergent themes. Results We found that naloxone carrying behavior was variable and influenced by four main motivators: (1) naloxone access; (2) personal experience and salience of naloxone, (3) comfort with naloxone administration, and (4) societal influences on naloxone carrying. In particular, those with personal history of overdose or close friends or family at risk were motivated to carry naloxone. Conclusions Participants in this study reported several important motivators for naloxone carrying after an ED visit, including ease of naloxone access and comfort, perceived risk of experiencing or encountering an overdose, and social influences on naloxone carrying behaviors. EDs, health systems, and public health officials should consider these factors influencing motivation when designing future interventions to increase access, carrying, and use of naloxone.
The clinical significance of low complement levels in patients with catastrophic antiphospholipid syndrome: A descriptive analysis of 73 patients from the “Catastrophic antiphospholipid syndrome registry”
Authors: Ponce Ana , Rodríguez-Pintó Ignasi , Basauli José M , Espinosa Gerard , Erkan Doruk , Shoenfeld Yehuda , Cervera Ricard ,   On Behalf the CAPS Registry Project Group/European Forum on Antiphospholipid Antibodies
Published: June 2022

Objectives To explore the prevalence and clinical significance of low complement levels in patients with catastrophic antiphospholipid syndrome (CAPS). Methods We reviewed data from the “CAPS Registry” on C3 and/or C4 complement plasma protein levels during acute CAPS episodes. Patients were classified into those with low and normal complement levels. Data on clinical presentation, with special focus on thrombotic microangiopathy (TMA) features, diagnosis of systemic lupus erythematosus (SLE), and antiphospholipid antibody (aPL) profile were reviewed. The chi-square exact test was performed to evaluate differences between categorical data. Results The “CAPS Registry” includes 566 patients with a total of 578 episodes of CAPS. Data on complement plasma protein levels was available in 73 episodes from the same number of patients. Low levels of C3 and/or C4 complement plasma proteins were detected in 42 (58%) CAPS episodes. Low complement levels were more common in SLE patients (55% SLE vs. 19% No SLE; p<0.001). The frequencies of clinical TMA (72% vs. 80%; p=0.4) or TMA syndrome (86% vs. 84%, p=0.9), frequency of triple aPL triple positivity (67% vs 33%; p=0.3), or the mortality (35% vs. 31%; p=0.7) were similar between low and normal complement groups. Conclusion In our study, low levels of C3 and C4 plasma proteins are detected in 58% episodes of CAPS, which were not associated with clinical presentation including TMA features, aPL triple positivity, or mortality.
Falling into an identity crisis: Integrating identity into the assessment and management of falls in older adults
Authors: Yong Yun Ming , Wand Anne PF 
Published: June 2022

Objectives This article examines the psychological effects of falls for older adults through the lens of identity and suggests these may be integrated in the assessment and management of older patients within acute care and rehabilitation settings post-fall. An illustrative vignette is described to demonstrate this approach. Conclusion Falls in older adults are complex phenomena which can lead to an identity threat, sometimes manifest as psychological symptoms and poor engagement in post-fall rehabilitation. A psychiatric formulation which incorporates an older person’s self-identity and agency may inform interventions to address psychological and behavioural sequelae of falls.
Improving Cultural Competence and Self-Efficacy Among Postgraduate Nursing Students: Results of an Online Cultural Care Training Program
Authors: Fadaeinia Mohammad Mahdi , Miri Sakineh , Azizzadeh Forouzi Mansooreh , Roy Callista , Farokhzadian Jamileh 
Published: June 2022

Introduction: Since nurses and nursing students interact with culturally diverse clients in health care settings, training programs are required to improve cultural competence and self-efficacy among them. This study aimed to investigate the effect of an online cultural care training program on cultural competence and self-efficacy among postgraduate nursing students. Methods: The present interventional study used random sampling to allocate 80 postgraduate nursing students into the intervention and control groups. Cultural care training program was held for the intervention group. Results: No significant difference in cultural competence and self-efficacy scores was found between the intervention and control groups in the pretest. However, the intervention group scored higher in terms of cultural competence and self-efficacy after the intervention. Discussion: Given cultural diversity and prevalence of medical tourism, nursing instructors need to pay special attention to cultural care education at all academic levels.
Childbearing Perceptions Among Taiwanese Women Undergoing In Vitro Fertilization Treatment: A Qualitative Study
Authors: Hwu Lien-Jen , Hsu Ming-Yi , Chuang Hsiao-Ling , Shih Fen-Fen , Lu Yen-Chiao Angel , Lee Shu-Hsin 
Published: June 2022

Introduction: Some infertile women are eager to have children. The purpose of this study was to explore the childbearing perceptions of women who undergo in vitro fertilization (IVF) treatment. Methodology: Qualitative phenomenological data were collected from 20 infertile women who received IVF treatment in Taiwan. We conducted one-on-one in-depth interviews with the women. Audio recordings were transcribed as textual data and analyzed using Giorgi content analysis until saturation was achieved. Results: Three themes were identified: important tasks related to practicing the family life cycle, ensuring a tight circle of marriage, and the hope to change health. Discussion: Perceptions regarding childbearing in women undergoing IVF treatment in the context of the traditional Chinese fertility culture are multifaceted. To improve the overall integrity of health care provided to infertile women, nurses should be encouraged to consider the cultural connotations and needs of infertile women in the clinic.
Sirolimus-coated balloon angioplasty in maintaining the patency of thrombosed arteriovenous graft: 1-year results of a prospective study
Authors: Tan Ru Yu , Tng Alvin Ren Kwang , Tan Chee Wooi , Pang Suh Chien , Zhuang Kun Da , Tay Kiang Hiong , Tang Tjun Yip , Chong Tze Tec , Tan Chieh Suai 
Published: June 2022

Background: A prospective, pilot study was designed to test the feasibility of using sirolimus-coated balloon (SCB) to treat graft vein junction of thrombosed arteriovenous graft (AVG) following successful pharmacomechanical thrombectomy. The present report provides the 1-year results of this study. Methods: This is a 1-year follow-up of a single, prospective, single-arm study that was conducted from 2018 to 2019 in 20 patients who presented to a tertiary institution with thrombosed AVG. The recruited patients received SCB angioplasty at the graft-vein junction following successful endovascular thrombectomy of a thrombosed AVG. One year after recruitment, there were three deaths, one AVG revision, and one AVG explantation among the participants recruited. The outcomes of 15 subjects at 1-year following the index procedure obtained from electronic medical records were re-examined. Results: The 1-year access circuit primary patency rate was 40%, while assisted primary and secondary patency rates were 46.7% and 73.3%, respectively. A total of 16 interventions (4 angioplasties, 12 thrombectomies) were performed in 9 patients over the 12 months. Four AVGs were abandoned. The median number of interventions per patient was 1 (0–3) per year. Using Kaplan-Meier analysis, the mean estimated post-intervention access circuit primary patency was 230 (95% CI: 162–300) days, while access circuit assisted primary patency was 253 (95% CI: 187–320) days, and access circuit secondary patency was 292 (95% CI: 230–356) days. Sub-group analysis did not show a significant difference in the mean estimated primary patency between AVG with de novo and recurrent stenosis (245 days, 95% CI: 151–339 vs 210 days, 95% CI: 113–307; p = 0.29). Conclusions: SCB may help sustain the patency of thrombosed AVG following successful thrombectomy.
Use of peripherally inserted central catheters with a dedicated vascular access specialists team versus centrally inserted central catheters in the management of septic shock patients in the ICU
Authors: Raza Hassan A , Nokes Brandon T , Alvarez Bruno , Colquist Julie , Park John , Kashyap Rahul , Patel Bhavesh , Cartin-Ceba Rodrigo 
Published: June 2022

Objectives: Peripherally inserted central catheters (PICCs) are increasingly recognized as an alternative to centrally inserted central catheters (CICCs) in critical care, yet the data regarding the safety and feasibility of this choice in septic shock management is growing but still lacking. In this study, we aimed to determine the feasibility, safety, and impact on outcomes of using dedicated vascular access specialist (VAS) teams to insert PICCs versus CICCs on patients admitted to the ICU with septic shock. Design: Retrospective cohort study. Setting: Mayo Clinic Rochester Medical ICU and Mayo Clinic Arizona Multidisciplinary ICU from 2013 to 2016. Patients: All adult patients hospitalized with diagnosis of septic shock excluding patients who declined authorization for review of their medical records, mixed shock states, and readmissions. Interventions: None. Measurement and main results: Comprehensive data regarding septic shock diagnosis and resuscitation were abstracted from electronic medical records. A total of 562 patients with septic shock were included in the study; 215 patients were resuscitated utilizing a PICC and 347 were resuscitated using a CICC. On univariate analysis, the time to central line insertion and time to vasopressor initiation were found to be reduced in those who received PICC at time of ICU admission versus CICC. Other favorable outcomes were also observed in those who received PICC versus CICC including shorter ICU length of stay and lower unadjusted hospital mortality. A multivariable analysis for hospital mortality showed that after adjusting for important covariates, neither the time to central line insertion nor the time to vasopressor initiation was associated with a lower hospital mortality. Conclusions: Across two tertiary referral centers within the same enterprise, use of a dedicated VAS team for insertion of PICCs for initial resuscitation in patients with septic shock was feasible and associated with shorter time to central venous access and initiation of vasopressors; however, adjusted hospital mortality was not different between the two groups.
Systematic validation of the PAAShA shielding prediction method
Authors: Thomas Russell H , Guo Yueping 
Published: June 2022

Based on classical diffraction theories with modifications and extensions in analytical formulations and numerical implementations, a new code has been developed at NASA for the prediction of aircraft noise shielding, named as Propulsion Airframe Aeroacoustic Shielding Attenuation (PAAShA). The code is developed primarily for aircraft system noise predictions, although it may also be useable in other applications with acoustic shielding. The requirements for this code are driven by the need for a robust, capable code to use with NASA’s Aircraft Noise Prediction Program (ANOPP) for aircraft integration and system noise research. The requirements are met and include capabilities to use a wide range of aircraft geometries, rapid calculation times consistent with aircraft system noise problems, and the flexibility to model realistic noise source characteristics and distributions. The accuracy and robustness of the method are demonstrated in this paper with a set of problems, including a cylinder, a finite plate, a symmetrical two-dimensional airfoil, and a full three-dimensional hybrid wing body aircraft model tested in a wind tunnel. This range of problems demonstrates both smooth and sharp edge diffraction capabilities for a wide range of frequencies and low Mach number flow effects at low angles of attack. Predictions are shown to be accurate to within 1–4 dB over a wide range of the most significant frequencies and directivity angles. This is determined by comparing with data, which have experimental uncertainties, particularly at high frequencies, high angles, and source characteristics. The accuracy diminishes for geometries that include a significant reflection component, which is not calculated by the code. Accuracy can also be somewhat diminished for high azimuthal angles. Accurate modeling of the noise source, particularly its frequency and directivity characteristics, is essential to obtaining accurate results.
Selective Angioembolisation of Iatrogenic Renal Artery Pseudoaneurysms Following Minimally Invasive Urological Procedures: A Single Centre Case Series
Authors: Narroway Harry G. , Kovacic James L. , Bourke Bernard M. , Louis-Johnsun Mark , Latif Edward R. , Bourke Victor C. 
Published: June 2022

Introduction The purpose of this study was to report our centre’s experience using selective angioembolisation in the treatment of iatrogenic renal artery pseudoaneurysms (RAP) following minimally invasive urological procedures. Methods Our retrospective analysis included four consecutive patients treated with angioembolisation for iatrogenic RAP between October 2016 and October 2021. Data on demographics, minimally invasive urological intervention, clinical features, imaging findings, embolization procedure and perioperative details were collected. Rates of technical and clinical success, defined as 1. total occlusion of the extravasation site on completion digital subtraction angiography (DSA), and 2. resolution of symptoms, signs, and serum hemoglobin (Hb) derangements secondary to RAP, were analysed. Renal function, measured by serum creatinine (Cr) and estimated glomerular filtration rate (eGFR), was recorded prior to and post - angioembolisation procedure and compared. Results Mean time between urological intervention and angioembolisation was 9 days (range, 2–17 days). Rates of technical and clinical success were 100% and 100% respectively. No additional angioembolisation procedures were required, and there were no peri or post-operative complications identified during mean follow-up of 662 days (range, 30–1845 days). Mean serum Cr prior to and post angioembolisation was 83 mmol/L and 79.5 mmol/L. Mean eGFR prior to and post angioembolisation was 73.8 and 77.8 mL/min/1.73 m2. In all patients, no significant difference was observed in serum Cr and eGFR prior to and post angioembolisation. Conclusion Iatrogenic renal artery pseudoaneurysms can occur following a range of minimally invasive urological procedures. This retrospective review highlights the utility of angioembolisation as a safe and effective treatment with high clinical and technical success rates. Further studies involving larger populations are required to validate its broader application.
Epigallocatechin Gallate Induces the Demethylation of Actinin Alpha 4 to Inhibit Diabetic Nephropathy Renal Fibrosis via the NF-KB Signaling Pathway In Vitro
Authors: He Chunling , Wang Dong , Wang Ruoling , Huang Yongli , Huang Xin , Shen ShuMin , Lv Jun , Wu Mingcai 
Published: June 2022

Actinin alpha 4 ( ACTN4) is expressed in the kidney podocytes. ACTN4 gene methylation in patients with diabetic nephropathy (DN) remains high. Underlying mechanism of epigallocatechin-3-gallate (EGCG) inducing ACTN4 demethylation, and its inhibitory effect on DN renal fibrosis remains unclear. Methods: Human podocyte cell line, HPC, was treated with high glucose to establish model of DN. The levels of cytokines, vascular endothelial growth factor (VEGF) and interleukin (IL)-8, and fibrosis markers, alpha smooth muscle actin (α-SMA) and fibronectin (FN), were determined using enzyme-linked immunosorbent assay. HPC cells were treated with EGCG, and cell viability was determined by MTT assay, ACTN4 gene methylation was analyzed by MSP. mRNA and protein expression levels were measured using RT-qPCR and Western blotting, respectively. Results: Actinin alpha 4 gene promoter was hypermethylated in the high glucose-treated groups. EGCG reversed the hypermethylated status of ACTN4, along with the upregulation of ACTN4 levels and downregulation of DNA methyltransferase 1 (DNMT1), NF-κB p65, p-NF-κB p65, IκB-α, VEGF, IL-8, α-SMA, and FN levels ( P<.05). Conclusion: Epigallocatechin-3-gallate reduced hypermethylation of ACTN4 in HPC cells by downregulating DNMT1 expression and restoring ACTN4 expression, contributing to the upregulation of the NF-KB p65, p-NF-KB p65, IKB-α, VEGF, IL-8, α-SMA, and FN levels (P<.05).
Ukraine 2022, through the leadership binoculars
Authors: Sanders Paul 
Published: June 2022

The essay provides a take, by a historian, on the 2022 Ukraine war. It draws attention to the fact that, over the past 20 years, terms such as “game-changer” or “turning point” have been frequently employed to characterize important junctures. However, 2022 is qualitatively different from all of these, as it represents the antithesis to 1989 and marks the end of an entire era. From the leadership perspective, one immediate effect of a turning point is the reckoning with the past that it entails. It forces a rethink on past behavior. And this collective cognitive rewiring triggers the questioning of the legacy of leaders associated with the now discredited course of action. Taking the example of the crisis of conscience currently underway in Germany, the essay cautions against scapegoating that relies on retrospective selection bias; suggesting instead, that the focus of attention should be shifted to the collective cognitive blinders that prevented the numerous Cassandras, who understood the genuine nature of Putinist aggression, from being listened to. The essay then turns its attention to the proliferation of historical analogies and comparisons, arguing that this tells us less about the event and more about the fact that our compasses have gone haywire. As corollaries of our profound disarray, they even prevent us from gaining a better understanding of the phenomenon. This is addressed in the final part, which includes reflections on Putin as a leader, Putinist followership, as well as the challenges Western leaders are likely to face in the future.
Quercetin ameliorates XIAP deficiency–associated hyperinflammation
Authors: Chiang Samuel C. C. , Owsley Erika , Panchal Neelam , Chaturvedi Vijaya , Terrell Catherine E. , Jordan Michael B. , Mehta Parinda A. , Davies Stella M. , Akeno Nagako , Booth Claire , Marsh Rebecca A. 
Published: June 2022

Abstract
XIAP (X-linked inhibitor of apoptosis) deficiency is a rare inborn error of immunity. XIAP deficiency causes hyperinflammatory disease manifestations due to dysregulated TNF (tumor necrosis factor)-receptor signaling and NLRP3 (NOD- [nucleotide-binding oligomerization domain], LRR- [leucine-rich repeat] and pyrin domain-containing protein 3) inflammasome function. Safe and effective long-term treatments are needed and are especially important to help prevent the need for high-risk allogeneic hematopoietic cell transplantation. Here we evaluated inflammasome inhibitors as potential therapeutics with a focus on the natural flavonoid antioxidant quercetin. Bone marrow (BM)-derived macrophages were derived from XIAP-deficient or wild-type (WT) mice. Human monocytes were obtained from control or XIAP-deficient patients. Cells were stimulated with TLR (Toll-like receptor) agonists or TNF-α ± inhibitors or quercetin. For in vivo lipopolysaccharide (LPS) challenge experiments, XIAP-deficient or WT mice were fed mouse chow ± supplemental quercetin (50 mg/kg per day exposure) for 7 days followed by a challenge with 10 ng/kg LPS. IL-1β (interleukin-1β) and IL-18 were measured by ELISA (enzyme-linked immunosorbent assay). In murine studies, quercetin prevented IL-1β secretion from XIAP knockout cells following TLR agonists or TNF-α stimulation (P &lt; .05) and strongly reduced constitutive production of IL-18 by both WT and XIAP-deficient cells (P &lt; .05). At 4 hours after in vivo LPS challenge, blood levels of IL-1β and IL-18 were significantly decreased in mice that had received quercetin-supplemented chow (P &lt; .05). In experiments using human cells, quercetin greatly reduced IL-1β secretion by monocytes following TNF-α stimulation (P &lt; .05). Our data suggest that quercetin may be an effective natural therapeutic for the prevention of XIAP deficiency-associated hyperinflammation. Clinical trials, including careful pharmacokinetic and pharmacodynamic studies to ensure that effective levels of quercetin can be obtained, are warranted.
Global, highly specific and fast filtering of alignment seeds
Authors: Ebel Matthis , Migliorelli Giovanna , Stanke Mario 
Published: June 2022

Abstract
Background
An important initial phase of arguably most homology search and alignment methods such as required for genome alignments is seed finding. The seed finding step is crucial to curb the runtime as potential alignments are restricted to and anchored at the sequence position pairs that constitute the seed. To identify seeds, it is good practice to use sets of spaced seed patterns, a method that locally compares two sequences and requires exact matches at certain positions only.

Results
We introduce a new method for filtering alignment seeds that we call geometric hashing. Geometric hashing achieves a high specificity by combining non-local information from different seeds using a simple hash function that only requires a constant and small amount of additional time per spaced seed. Geometric hashing was tested on the task of finding homologous positions in the coding regions of human and mouse genome sequences. Thereby, the number of false positives was decreased about million-fold over sets of spaced seeds while maintaining a very high sensitivity.

Conclusions
An additional geometric hashing filtering phase could improve the run-time, accuracy or both of programs for various homology-search-and-align tasks.