bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shared Decision-Making and Short-Course Radiotherapy for Operable Rectal Adenocarcinoma
Authors: Col Nananda F. , Haugen Vicki 
Published: March 2022

BACKGROUND:
As new treatment options for colorectal cancer (CRC) emerge, physicians and WOC nurses must be prepared to assist patients to choose care that meets their needs and preferences. A patient with T2N0M0 rectal adenocarcinoma was offered the US current standard of practice; he was not offered alternative treatment options. This case study emphasizes the need to ensure patients are offered all reasonable options for treatment. Shared decision-making is a process that helps patients actively participate in their heath choices rather than exclusively relying on the judgment of a health care provider.

CASE:
Mr J was a 70-year-old man with operable CRC who sought care at a health care facility in his community. He was offered a single option, based on standard of care for this tumor stage: long-course neoadjuvant chemoradiotherapy followed by surgery and additional chemotherapy. After seeking a second opinion at a cancer care center in another state, Mr J chose to undergo a viable alternative treatment option (short-course radiotherapy, followed by surgery, with chemotherapy contingent on his nodal status post-surgery). No nodal involvement was found post- surgery (T2N0M0) enabling him to avoid postoperative chemotherapy.

CONCLUSIONS:
This case illustrates the need for all health care providers and carers to regularly engage in shared decision-making when choosing among treatment options. In this case, short-course radiotherapy offered Mr J a shorter duration of treatment and avoided the risk for adverse side effects associated with chemotherapy, resulting in improved health-related quality of life. Initial omission to disclose all treatment options to Mr J may have reflected the preferences of the surgeon, institutional financial pressures, or discomfort with shared decision-making, but it failed to provide him with full range of options, given his diagnosis and tumor stage. All members of the patient's care team, including the WOC nurse, play a pivotal role in ensuring transparency in medical care, including advocating for shared decision-making where patients are made aware of all viable treatments, followed by supporting the patient as they reach a decision.
Incidence of Medical Adhesive–Related Skin Injuries and Associated Factors After Pediatric Congenital Heart Surgery
Authors: Crespo Jeiel Carlos Lamônica , Reuter do Amaral Daniela , Campanili Ticiane Carolina Gonçalves Faustino , Cunha Ligia Cristina Camara , Ferreira Fatima Gil , Gallas Filomena Regina Gomes , Palomo Jurema da Silva Herbas , Ferretti-Rebustini Renata Eloah de Lucena 
Published: March 2022

PURPOSE:
The aim of this study was to identify the incidence, characteristics, and factors associated with medical adhesive–related skin injuries (MARSI).

DESIGN:
Prospective cohort study.

SUBJECTS AND SETTINGS:
The sample comprised 136 children in the postoperative period after congenital heart surgery. The study setting was in a 31-bed pediatric surgical intensive care unit (ICU) of a university hospital in Sao Paulo, Brazil.

METHODS:
Patients were followed from admission, with daily skin assessments, until the onset of MARSI or ICU discharge. Outcomes were compared by Fisher's exact test, Pearson's χ2 test, Mann-Whitney test, Brunner-Munzel test, and Welch 2-sample t test.

RESULTS:
The incidence of MARSI was 60.3%, with 85 injuries in 82 patients. The highest occurrence was on postoperative day 2 (27 wounds; 31.8%). The most frequent medical adhesive associated with MARSI was transparent film dressing (n = 74; 86.6%). Factors associated with MARSI were age (P = .000), number of devices inserted (P = .000), Braden Q Scale score (P = .005), duration of surgery (P = .021), cardiopulmonary bypass duration (P = .000), duration of mechanical ventilation (P = .000), and length of ICU stay (P = .000). Children who developed MARSI received more blood components (P = .039), vasopressors (P = .000), and corticosteroids (P = 0.000); required longer sedation (P = .000); and had more edema (P = .001).

CONCLUSION:
This high incidence indicates the need for greater awareness and prompt action in response to MARSI. Polyurethane transparent film without concurrent use of a skin barrier product should be avoided.
Influence of Foot Ulceration on All-Cause and Cardiovascular Mortality in Diabetic Patients
Authors: Qiu Liangzhi , Li Yongjie , Yang Chuan , Mao Xiaoqun , Mai Lifang , Zhu Lisi , Xie Wen 
Published: March 2022

PURPOSE:
The purpose of this study was to analyze the influence of a diabetic foot ulcer on all-cause and cardiovascular disease (CVD) mortality.

DESIGN:
Retrospective case-control study.

SUBJECTS AND SETTING OUTPATIENTS:
Eighty-eight patients with new-onset diabetic foot ulceration (DFU) were paired with 176 patients without DFU (controls). The study setting was the Department of Endocrinology, Sun Yat-sen Memorial Hospital, located in Guangzhou, China.

METHODS:
Cause-specific mortality was recorded during a median follow-up duration of 6.20 years up to 1 March 2016. Records review dates were from January 1, 2004, to December 31, 2010.

RESULTS:
The all-cause mortality rate for the DFU group and the control group was 48.9% and 22.7%, respectively. The risk of all-cause death in the DFU group was 3.126 times higher than that in the control group (risk ratio [RR]= 3.126; 95% CI, 1.998-4.891; P = .000). The CVD mortality rate of the DFU group and the control group was 12.5% and 6.8%, respectively. The risk of CVD death in the DFU group was 3.277 times higher than that in the control group (RR = 3.277; 95% CI, 1.392-7.715; P = .007).

CONCLUSIONS:
Development of a diabetic foot ulcer was associated with a significantly higher all-cause and CVD-related death risk than that in a control group of persons with diabetes mellitus without DFU.
Projected Augmented Reality (P-AR) for Enhancing Nursing Education About Pressure Injury
Authors: Bliss Donna Z. , Becker Adam J. , Gurvich Olga V. , Bradley Cynthia S. , Olson Erica Timko , Steffes Mary T. , Flaten Carol , Jameson Scott , Condon John P. 
Published: March 2022

PURPOSE:
To describe results of a study evaluating a Projected Augmented Reality (P-AR) system for its potential to enhance nursing education about pressure injuries.

DESIGN:
Pilot evaluation survey.

SUBJECTS AND SETTING:
The sample comprised nursing students and faculty at a school of nursing in a large, Midwestern public university. A total of 32 participants, which included 27 students (30% BSN, 44% MN, and 26% DNP students; 81% female) and 5 faculty members (80% female) participated.

METHODS:
The P-AR system was prototyped using commercial-off-the-shelf components and software algorithms, applied to pressure injury nursing education content. After interaction with the P-AR system, participants completed a survey evaluating the following features of the P-AR system for potential: engagement, effectiveness, usefulness, user-friendliness, and realism, and users' overall impression and satisfaction with system features. Evaluation statements used a 5-level Likert-scale; open-ended questions about what was liked, disliked, or anything else offered opportunity for comments.

RESULTS:
Student and faculty median evaluation scores were 5 (strongly agree or very satisfied) and 4 (agree or satisfied) for nearly all evaluation and satisfaction statements. Students' satisfaction with “realism” received a median score of 3 (neutral). The P-AR system was refined to include realistic still and animated images.

CONCLUSION:
The P-AR system, an innovative technology using 3-dimensional dynamic images, was applied to nursing education content about pressure injury and was evaluated as having potential to enhance pressure injury teaching and learning. Education about complex processes of pressure injury development and management may benefit from using cutting-edge simulation technologies such as P-AR.
Abdominal Negative Pressure Wound Therapy Devices for Management of the Open Abdomen
Authors: Crumley Carolyn 
Published: March 2022

PURPOSE:
The purpose of this technologic analysis was to analyze technologic features of abdominal negative pressure wound therapy (NPWT).

APPROACH:
Published literature regarding abdominal negative pressure wound therapy (aNPWT) devices was reviewed. A summary of management approaches for the open abdomen provides a foundation for understanding the benefits of aNPWT. Safety information regarding aNPWT was derived from the Manufacturer and User Facility Device Experience (MAUDE) Database.

CONCLUSIONS:
The open abdomen approach with temporary abdominal closure may be employed for patients with a variety of conditions. Specialized abdominal NPWT devices, either singly or in combination with other approaches, may contribute to improved outcomes in this high-risk patient population. Manufacturer recommendations and clinical guidelines should be followed to minimize patient risk.
Speleological and environmental history of Lida Ajer cave, western Sumatra
Authors: Louys Julien , Duval Mathieu , Price Gilbert J. , Westaway Kira , Zaim Yahdi , Rizal Yan ,   Aswan, Puspaningrum Mika , Trihascaryo Agus , Breitenbach Sebastian F. M. , Kwiecien Ola , Cai Yanjun , Higgins Penny , Albers Paul C. H. , de Vos John , Roberts Patrick 
Published: March 2022

Some of the earliest evidence for the presence of modern humans in rainforests has come from the fossil deposits of Lida Ajer in Sumatra. Two human teeth from this cave were estimated to be 73–63 thousand years old, which is significantly older than some estimates of modern human migration out of Africa based on genetic data. The deposits were interpreted as being associated with a rainforest environment based largely on the presence of abundant orangutan fossils. As well as the main fossil-bearing chamber, fossil-bearing passages are present below a sinkhole, although the relationship between the different fossil deposits has only been tenuously established. Here, we provide significant new sedimentological, geochronological and palaeoecological data aimed at reconstructing the speleological and environmental history of the cave and the clastic and fossil deposits therein. Our data suggest that the Lida Ajer fossils were deposited during Marine Isotope Stage 4, with fossils from the lower passages older than the main fossil chamber. Our use of stable carbon and oxygen isotope analyses of mammalian tooth enamel demonstrates that early humans probably occupied a closed-canopy forest very similar to those present in the region today, although the fossil orangutans may have occupied a slightly different niche.
This article is part of the theme issue ‘Tropical forests in the deep human past’.
Remodelling of potassium currents underlies arrhythmic action potential prolongation under beta-adrenergic stimulation in hypertrophic cardiomyopathy
Authors: Doste Ruben , Coppini Raffaele , Bueno-Orovio Alfonso 
Published: March 2022

AbstractHypertrophic cardiomyopathy (HCM) patients often present an enhanced arrhythmogenicity that can lead to lethal arrhythmias, especially during exercise. Recent studies have indicated an abnormal response of HCM cardiomyocytes to β-adrenergic receptor stimulation (β-ARS), with prolongation of their action potential rather than shortening. The mechanisms underlying this aberrant response to sympathetic stimulation and its possible proarrhythmic role remain unknown. The aims of this study are to investigate the key ionic mechanisms underlying the HCM abnormal response to β-ARS and the resultant repolarisation abnormalities using human-based experimental and computational methodologies. We integrated and calibrated the latest models of human ventricular electrophysiology and β-ARS using experimental measurements of human adult cardiomyocytes from control and HCM patients. Our major findings include: (1) the developed in silico models of β-ARS capture the behaviour observed in the experimental data, including the aberrant response of HCM cardiomyocytes to β-ARS; (2) the reduced increase of potassium currents under β-ARS was identified as the main mechanism of action potential prolongation in HCM, rather than a more sustained inward calcium current; (3) dispersion of repolarisation between healthy and HCM tissue was increased upon β-ARS, while transmural dispersion in HCM tissue was reduced; (4) models presenting repolarisation abnormalities were characterised by downregulation of the rapid delayed rectifier potassium current and the sodium-potassium pump, while inward currents were upregulated. In conclusion, our results identify causal relationships between the HCM phenotype and its arrhythmogenic response to β-ARS through the downregulation of potassium currents.
Loss of LGR5 through plasticity or gene ablation is associated with therapy resistance and enhanced MET-STAT3 signaling in colorectal cancer cells
Authors: Posey Tressie A. , Jacob Joan , Parkhurst Ashlyn N. , Subramanian Shraddha , Francisco Liezl E. , Liang Zhengdong , Carmon Kendra S. 
Published: March 2022

AbstractPlasticity plays a significant role in colorectal tumor initiation, progression, and drug resistance. LGR5 is highly expressed in colorectal cancer (CRC) and marks functional cancer stem cells (CSCs). While LGR5+ CSCs are tumor-initiating, the majority of CRC cells that disseminate to seed metastases are LGR5-; however, reemergence of LGR5+ CSCs is required to drive metastatic outgrowth. LGR5+ CSCs have been shown to convert to LGR5- CRC cells in response to chemotherapies and this loss of LGR5 promotes a more drug-resistant phenotype. However, the molecular mechanisms that mediate plasticity remain elusive. In this study, we demonstrate conversion of LGR5+ CRC cells to an LGR5- state in response to chemotherapy, LGR5-targeted antibody-drug conjugates (ADCs), or LGR5 gene ablation, led to activation of STAT3. Further investigation revealed increased STAT3 activation occurred a result of increased MET activity. LGR5 overexpression decreased MET-STAT3 activity and sensitized CRC cells to therapy. STAT3 inhibition suppressed MET phosphorylation, while constitutively active STAT3 reduced LGR5 levels and increased MET activity, suggesting a potential feedback mechanism. Combination treatment of MET-STAT3 inhibitors with irinotecan or ADCs substantiated synergistic effects in vitro. In CRC xenografts, STAT3 inhibition combined with irinotecan enhanced tumor growth suppression and prolonged survival. These findings suggest a mechanism by which drug-resistant LGR5- CRC cells acquire a survival advantage through activation of MET-STAT3 and provide rationale for new treatment strategies that target CRC cell plasticity.SignificanceThis study reveals that transition of highly plastic LGR5+ CRC cells to a more drug-resistant LGR5- state involves activation of MET-STAT3 signaling and provides new insight into therapeutic strategies to combat plasticity.
Developmentally programmed epigenome regulates cellular plasticity at the parental-to-zygote transition
Authors: Gleason Ryan J. , Semancik Christopher S. , Lakshminarayanan Gitanjali , Chen Xin 
Published: March 2022

AbstractDuring metazoan development, the dramatic potency change from germline to embryos raises an important question regarding how the new life cycle is reset. Here, we report a tightly regulated epigenome landscape change from the parental germline to embryos in C. elegans. The epigenome is enriched with histone H3 in early-stage germ cells but switches to a histone variant H3.3-enriched epigenome in the mature egg. This H3.3-dominant epigenome persists in early-stage embryos until gastrulation, when the epigenome becomes H3 abundant again. We further demonstrate that this developmentally programmed H3 → H3.3 → H3 epigenome landscape change is regulated through differential expression of distinct histone gene clusters and is required for both germline integrity and early embryonic cellular plasticity. Together, this study reveals that a bimodal expression of H3 versus H3.3 is important for epigenetic reprogramming during gametogenesis and embryonic plasticity.One Sentence SummaryDevelopmentally programmed epigenome resets cellular plasticity at the parental-to-zygote transition in C. elegans.
A New Power Law Linking the Speed to the Geometry of Tool-Tip Orientation in Teleoperation of a Robot-Assisted Surgical System
Authors: Zruya Or , Sharon Yarden , Kossowsky Hanna , Forni Fulvio , Geftler Alex , Nisky Ilana 
Published: March 2022

AbstractFine manipulation is important in dexterous tasks executed via teleoperation, including in robot-assisted surgery. Discovering fundamental laws of human movement can benefit the design and control of teleoperated systems, and the training of their users. These laws are formulated as motor invariants, such as the well-studied speed-curvature power law. However, while the majority of these laws characterize translational movements, fine manipulation requires controlling the orientation of objects as well. This subject has received little attention in human motor control studies. Here, we report a new power law linking the speed to the geometry in orientation control – humans rotate their hands with an angular speed that is exponentially related to the local change in the direction of rotation. We demonstrate this law in teleoperated tasks performed by surgeons using surgical robotics research platforms. Additionally, we show that the law’s parameters change slowly with the surgeons’ training, and are robust within participants across task segments and repetitions. The fact that this power law is a robust motor invariant suggests that it may be an outcome of sensorimotor control. It also opens questions about the nature of this control and how it can be harnessed for better control of human-teleoperated robotic systems.
Fusion with heat-resistant obscure (Hero) proteins have the potential to improve the molecular property of recombinant proteins
Authors: Morimoto Eri , Tsuboyama Kotaro , Tomari Yukihide 
Published: March 2022

AbstractAlthough recombinant proteins are widely used in biotechnology and pharmaceutical industries, improving their solubility and stability is often a challenging issue. We recently discovered a class of highly unstructured heat-resistant obscure (Hero) proteins, which function to protect other “client” proteins in trans from various stresses in vitro and in vivo. Here, we show that fusion of Hero proteins in cis can enhance the molecular property of recombinant proteins. Fusion with Hero11 improved the otherwise challenging production of TAR DNA-binding protein of 43 kDa (TDP-43) in Escherichia coli. Moreover, fusing with Hero9 strongly protected the activity of firefly luciferase bearing destabilizing mutations against heat and other stress conditions. These data suggest that Hero proteins have the potential to be used as versatile stabilization tags for recombinant protein production.
Emotion schema effects on associative memory differ across emotion categories at the behavioural, physiological and neural level
Authors: Riegel Monika , Wypych Marek , Wierzba Małgorzata , Szczepanik Michał , Jednoróg Katarzyna , Vuilleumier Patrik , Marchewka Artur 
Published: March 2022

AbstractPrevious behavioural and neuroimaging studies have consistently reported that our memory is enhanced for associations congruent or incongruent with the structure of our prior knowledge, termed as schemas. However, it remains unclear if similar effects exist if encoded associations are emotional. Do emotional schemas also facilitate learning and subsequent retrieval? Does it depend on the type of experienced emotions?Using a novel face-word pair association paradigm combined with fMRI and eye-tracking techniques, we demonstrated and replicated in two independent studies that congruency with emotion schemas and emotion category interact to affect associative memory. Overall, emotion schemas facilitated memory for associative context, paralleled by the recruitment of left inferior frontal gyrus (IFG) during successful encoding of emotionally congruent vs. incongruent pairs. However, emotion schema effects differed across two negative emotion categories: disgust and fear, with disgust remembered better than fear. The IFG engagement was higher during successful encoding of congruent vs. incongruent pairs, but only in the case of disgust, suggestive of more semantic processing involved in learning disgust-related associations. On the contrary, the encoding of congruent vs. incongruent fear-related pairs was supported by activity in right fusiform gyrus (FG), suggesting greater sensory processing of faces. Successful memory formation for congruent disgust-related pairs was associated with a higher loading of pupil dilation component related to sympathetic activation, longer gaze time on words compared to faces, and more gaze switches between the two. This was reversed for fear-related pairs where the faces attracted more attention, as reflected by longer gaze time (compared to words).Overall, our results at the behavioural, physiological, and neural level converge to suggest that emotional congruency influences memory similar to semantic schemas. However, encoding processes and neural effects vary depending on emotion category, reflecting the differential role of semantic processing and visual attention processes in the modulation of memory by disgust and fear.
Human NMDAR autoantibodies disrupt excitatory-inhibitory balance leading to hippocampal network hypersynchrony
Authors: Ceanga Mihai , Rahmati Vahid , Haselmann Holger , Schmidl Lars , Hunter Daniel , Kreye Jakob , Prüss Harald , Groc Laurent , Hallermann Stefan , Dalmau Josep , Ori Alessandro , Heckmann Manfred , Geis Christian 
Published: March 2022

AbstractSpecific autoantibodies against the NMDA-receptor (NMDAR) GluN1 subunit cause severe and debilitating NMDAR-encephalitis. Autoantibodies induce prototypic disease symptoms resembling schizophrenia, including psychosis and cognitive dysfunction. Using a mouse passive transfer model applying human monoclonal anti-GluN1-autoantibodies, we observed CA1 pyramidal neuron hypoexcitability, reduced AMPA-receptor (AMPAR) signaling, and faster synaptic inhibition resulting in disrupted excitatory-inhibitory balance. Functional alterations were supported by widespread remodeling of the hippocampal proteome, including changes in glutamatergic and GABAergic neurotransmission. At the network level, anti-GluN1-autoantibodies amplified gamma oscillations and disrupted theta-gamma coupling. A data-informed network model revealed that lower AMPAR strength and faster GABAA-receptor current kinetics chiefly account for these abnormal oscillations. As predicted by our model and evidenced experimentally, positive allosteric modulation of AMPARs alleviated aberrant gamma activity and thus reinforced the causative effects of the excitatory-inhibitory imbalance. Collectively, NMDAR-hypofunction-induced aberrant synaptic, cellular, and network dynamics provide new mechanistic insights into disease symptoms in NMDAR-encephalitis and schizophrenia.