bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moral Distress in the Italian PICUs: The Role of Individual and Organizational Factors*
Authors: Lamiani Giulia , Barlascini Luca , Borghi Lidia , Giannini Alberto ,   on behalf of the Open Doors in INtensive care (ODIN) Study Group 2
Published: July 2022

Objectives:
To assess the interplay between individual and organizational factors on moral distress in PICUs.

Design:
Cross-sectional, article-based survey administered between June and August 2017.

Setting:
Twenty-three Italian PICUs.

Subjects:
Of 874 eligible clinicians, 635 responded to the survey (75% response rate), and 612 correctly completed the survey. Clinicians were 74% female; 66% nurses and 34% physicians; and 51% had between 6 and 20 years of experience from graduation.

Intervention:
None.

MEASUREMENTS AND MAIN RESULTS:
Clinicians completed the “Italian Moral Distress Scale-Revised,” the “Connor-Davidson Resilience Scale,” and a sociodemographic questionnaire inquiring about sex, profession, years of experience, and spiritual/religious belief. PICU organizational characteristics were also collected (e.g., number of admissions, mortality rate, nurse-patient ratio, presence of parents in PICU, presence of parents during physical examination). To identify individual predictors of moral distress, we used stepwise linear regression. To determine the impact of organizational factors on moral distress, we used analysis of covariance, controlling for those individual factors that emerged as significant in the regression model. Moral distress was associated with being a nurse (B = –0.094; p < 0.05) and not having spiritual/religious belief (B = 0.130; p < 0.01), but not with resilience. Clinicians working in PICUs with a medium number of admissions per year (between 264 and 468), a lower nurse:patient ratio (1:3), and where parents’ presence during physical examination were never allowed experienced higher moral distress even controlling for profession and spiritual/religious belief.

Conclusions:
Organizational factors (medium number of admissions, lower nurse:patient ratio, and parental exclusion from physical examination) played a stronger role than individual factors in increasing moral distress. To decrease moral distress, attention should be paid also to organizational aspects.
Durability of switched therapy after failure of WHO-recommended antiretroviral therapy regimens in a resource-limited setting
Authors: Lumu Ivan , Musaazi Joseph , Castelnuovo Barbara 
Published: July 2022

Objective:
The study investigated the durability of switched therapy and factors associated with the viral rebound among patients on second-line antiretroviral therapy (ART) in Uganda.

Design:
A retrospective dynamic cohort of adults initiated on second-line ART after virological failure to first-line ART.

Methods:
Patients on second-line treatment for at least 6 months between 2007 and 2017 were included. Patients were followed, until they experienced a viral rebound (viral load ≥200 copies/ml). Cumulative probability of viral rebounds and factors associated with viral rebound were determined using Kaplan–Meier methods and Cox proportional hazard models.

Results:
One thousand, one hundred and one participants were enrolled of which 64% were women, the median age was 37 years [interquartile range (IQR) 31–43]. The preswitch median CD4+ cell count and viral load were 128 cells/μl (IQR 58–244) and 45 978 copies/ml (IQR 13 827–139 583), respectively. During the 4190.37 person-years, the incidence rate of viral rebound was 83.29 [95% confidence interval (CI) 74.99–92.49] per 1000 person-years. The probability of viral rebound at 5 and 10 years was 0.29 (95% CI 0.26–0.32) and 0.62 (95% CI 0.55–0.69), respectively. The median rebound-free survival was 8.7 years. Young adults (18–24 years) [adjusted hazard ratio (aHR) 2.49, 95% CI 1.32–4.67], preswitch viral load at least 100 000 copies/ml (aHR 1.53, 95% CI 1.22–1.92), and atazanavir/ritonavir (ATV/r)-based second-line (aHR 1.73, 95% CI 1.29–2.32) were associated with an increased risk of viral rebound.

Conclusion:
Switched therapies are durable for 8 years after failure of recommended regimens. A high preswitch viral load, ATV/r-based regimens, and young adulthood are risk factors for viral rebound, which underscores the need for more durable regimens and differentiated care services.
Orbicularis-Tarsus-Orbital Septum Fixation Technique in Asian Double-Eyelid Blepharoplasty: a Retrospective Study
Authors: Gu Tianyi , Dong Guoxuan , Teng Li , Lu Jianjian 
Published: July 2022

Background:
The skin-tarsus-skin and orbicularis-levator fixation approaches are the 2 most applied techniques for double-eyelid blepharoplasty in China. However, both approaches have their own disadvantages. To achieve stable and dynamic upper eyelid creases, we take the merits of the 2 techniques. In this study, our orbicularis-tarsus-orbital septum fixation technique is introduced and evaluated.

Methods:
By transversely opening and turning down the anterior orbital septum, we created the septum roll anchored to the tarsus and the pretarsal muscular flap. As the motion transmitter, the roll could receive the pulling power of the levator aponeurosis transmitted to the tarsus and the septum respectively. With the help of the skin-septum roll-skin sutures, the roll passed on the pulling power directly to the pretarsal skin and thus the upper eyelid crease was formed.

Results:
This study identified 105 Chinese patients (210 eyes) who underwent this technique in our department between September 2020 and May 2021. The follow-up ranged from 7 to 15 months. 90, 6, and 7 patients were satisfied, somewhat satisfied, and somewhat unsatisfied with the postoperative outcome, respectively. The satisfaction rate was 91.43% (96/105). Two patients were unsatisfied with the outcome, including 1 case of bilateral crease disappearance and 1 case of sunken upper eyelid.

Conclusions:
The orbicularis-tarsus-orbital septum fixation technique is safe and effective for double-eyelid blepharoplasty. This technique helps to form stable upper eyelid creases. Meanwhile, it is easy to achieve ideal curve and symmetry. By preserving the pretarsal tissue and using the orbital septum, sunken scar formation can be avoided.
Evaluating the Role of Circulating MicroRNAs to Aid Therapeutic Decision Making for Neoadjuvant Chemotherapy in Breast Cancer
Authors: Davey Matthew G. , Casey Maire Caitlin , McGuire Andrew , Waldron Ronan M. , Paganga Maxwell , Holian Emma , Newell John , Heneghan Helen M. , McDermott Ailbhe M. , Keane Maccon M. , Lowery Aoife J. , Miller Nicola , Kerin Michael J. 
Published: July 2022

Objective:
To evaluate whether circulating micro ribonucleic acids (miRNAs) predict response to neoadjuvant chemotherapy (NAC) and inform decision-making in breast cancer patients.

Introduction:
Deciphering response to NAC remains a challenge. Those unlikely to respond may benefit from NAC de-escalation before completion, while “responders” should complete treatment. Establishing biomarkers which identify response to NAC is imperative to personalize treatment strategies. miRNAs are small noncoding RNA molecules which modulate genetic expression. miRNAs are believed to inform response to NAC.

Methods:
This prospective, multicenter trial (NCT01722851) recruited 120 patients treated with NAC across 8 Irish treatment sites. Predetermined miRNAs were quantified from patient whole bloods using relative quantification polymerase chain reactiond. Venous sampling was performed at diagnosis and midway during NAC. Trends in miRNA expression between timepoints were correlated with treatment response. Data analysis was performed using R 3.2.3.

Results:
A total of 120 patients were included (median age: 55 years). Overall, 49.2% had luminal breast cancers (59/120), 17.5% luminal B (L/HER2) (21/120), 12.5% human epidermal growth factor receptor-2 positive (HER2+) (15/120), and 20.8% triple negative disease (25/120). In total, 46.7% of patients responded to NAC (56/125) and 26.7% achieved a pathological complete response (pCR) (32/120). For patients with L/HER2, increased Let-7a predicted response to NAC (P=0.049), while decreased miR-145 predicted response to NAC in HER2+ (P=0.033). For patients with luminal breast cancers, reduced Let-7a predicted achieving a pCR (P=0.037) and reduced miR-145 predicted achieving a pCR to NAC in HER2+ (P=0.027).

Conclusions:
This study illustrates the potential value of circulatory miRNA measurement in predicting response to NAC. Further interrogation of these findings may see miRNAs personalize therapeutic decision-making for patients undergoing NAC for early breast cancer.
Polygenic Risk Prediction in Diverticulitis
Authors: De Roo Ana C. , Chen Yanhua , Du Xiaomeng , Handelman Samuel , Byrnes Mary , Regenbogen Scott E. , Speliotes Elizabeth K. , Maguire Lillias H. 
Published: July 2022

Objective:To derive and validate a polygenic risk score (PRS) to predict the occurrence and severity of diverticulitis and to understand the potential for incorporation of a PRS in current decision-making.Background:PRS quantifies genetic variation into a continuous measure of risk. There is a need for improved risk stratification to guide surgical decision-making that could be fulfilled by PRS. It is unknown how surgeons might integrate PRS in decision-making.Methods:We derived a PRS with 44 single-nucleotide polymorphisms associated with diverticular disease in the UK Biobank and validated this score in the Michigan Genomics Initiative (MGI). We performed a discrete choice experiment of practicing colorectal surgeons. Surgeons rated the influence of clinical factors and a hypothetical polygenic risk prediction tool.Results:Among 2812 MGI participants with diverticular disease, 1964 were asymptomatic, 574 had mild disease, and 274 had severe disease. PRS was associated with occurrence and severity. Patients in the highest PRS decile were more likely to have diverticulitis [odds ratio (OR)=1.84; 95% confidence interval (CI), 1.42–2.38)] and more likely to have severe diverticulitis (OR=1.61; 95% CI, 1.04–2.51) than the bottom 50%. Among 213 surveyed surgeons, extreme disease-specific factors had the largest utility (3 episodes in the last year, +74.4; percutaneous drain, + 69.4). Factors with strongest influence against surgery included 1 lifetime episode (−63.3), outpatient management (−54.9), and patient preference (−39.6). PRS was predicted to have high utility (+71).Conclusions:A PRS derived from a large national biobank was externally validated, and found to be associated with the incidence and severity of diverticulitis. Surgeons have clear guidance at clinical extremes, but demonstrate equipoise in intermediate scenarios. Surgeons are receptive to PRS, which may be most useful in marginal clinical situations. Given the current lack of accurate prognostication in recurrent diverticulitis, PRS may provide a novel approach for improving patient counseling and decision-making.
Postoperative Serum Hyperamylasemia Adds Sequential Value to the Fistula Risk Score in Predicting Pancreatic Fistula after Pancreatoduodenectomy
Authors: Bannone Elisa , Marchegiani Giovanni , Vollmer Charles , Perri Giampaolo , Procida Giuseppa , Corvino Gaetano , Peressotti Sara , Vacca Pier Giuseppe , Salvia Roberto , Bassi Claudio 
Published: July 2022

Objective:
To evaluate whether postoperative serum hyperamylasemia (POH), with drain fluid amylase (DFA) and C-reactive protein (CRP), improves the Fistula Risk Score (FRS) accuracy in assessing the risk of a postoperative pancreatic fistula (POPF).

Summary Background Data:
The FRS predicts POPF occurrence using intraoperative predictors with good accuracy but intrinsic limits.

Methods:
Outcomes of patients who underwent pancreaticoduodenectomies between 2016 and 2021 were evaluated across FRS-risk zones and POH occurrence. POH consists of serum amylase activity greater than the upper limit of normal (52 U/l), persisting within the first 48 hours postoperatively (postoperative day –POD– 1 and 2).

Results:
Out of 905 pancreaticoduodenectomies, some FRS elements, namely soft pancreatic texture (odds ratio (OR) 11.6), pancreatic duct diameter (OR 0.80), high-risk pathologic diagnosis (OR 1.54), but not higher blood loss (OR 0.99), were associated with POH. POH was an independent predictor of POPF, which occurred in 46.8% of POH cases (P<0.001). Once POH occurs, POPF incidence rises from 3.8% to 42.9%, 22.9% to 41.7%, and 48.9% to 59.2% in patients intraoperatively classified at low, moderate and high FRS risk, respectively. The predictive ability of multivariable models adding POD 1 drain fluid amylase, POD 1-2 POH and POD 3 C-reactive protein to the FRS showed progressively and significantly higher accuracy (AUC FRS=0.82, AUC FRS-DFA=0.85, AUC FRS-DFA-POH=0.87, AUC FRS-DFA-POH-CRP=0.90, DeLong always P<0.05).

Conclusions:
POPF risk assessment should follow a dynamic process. The stepwise retrieval of early, postoperative biological markers improves clinical risk stratification by increasing the granularity of POPF risk estimates and affords a possible therapeutic window before the actual morbidity of POPF occurs.
Revisiting the human ‘interaction engine’: comparative approaches to social action coordination
Authors: Heesen Raphaela , Fröhlich Marlen 
Published: July 2022

The evolution of language was likely facilitated by a special predisposition for social interaction, involving a set of communicative and cognitive skills summarized as the ‘interaction engine'. This assemblage seems to emerge early in development, to be found universally across cultures, and to enable participation in sophisticated joint action through the addition of spoken language. Yet, new evidence on social action coordination and communication in nonhuman primates warrants an update of the interaction engine hypothesis, particularly with respect to the evolutionary origins of its specific ingredients. However, one enduring problem for comparative research results from a conceptual gulf between disciplines, rendering it difficult to test concepts derived from human interaction research in nonhuman animals. The goal of this theme issue is to make such concepts accessible for comparative research, to promote a fruitful interdisciplinary debate on social action coordination as a new arena of research, and to enable mutual fertilization between human and nonhuman interaction research. In consequence, we here consider relevant theoretical and empirical research within and beyond this theme issue to revisit the interaction engine's shared, convergently derived and uniquely derived ingredients preceding (or perhaps in the last case, succeeding) human language.This article is part of the theme issue ‘Revisiting the human ‘interaction engine’: comparative approaches to social action coordination’.
The coordination of attention and action in great apes and humans
Authors: Tomasello Michael 
Published: July 2022

Great apes can discern what others are attending to and even direct others' attention to themselves in flexible ways. But they seemingly do not coordinate their attention with one another recursively—understanding that the other is monitoring their attention just as they are monitoring hers—in acts of joint attention, at least not in the same way as young human children. Similarly, great apes collaborate with partners in many flexible ways, but they seemingly do not coordinate with others to form mutually obligating joint goals and commitments, nor regulate the collaboration via acts of intentional communication, at least not in the same way as young human children. The hypothesis defended here is that it is precisely in their capacities to coordinate attention and action with others—that is, in their capacities for shared intentionality—that humans are most clearly distinguished from other great apes.
This article is part of the theme issue ‘Revisiting the human ‘interaction engine’: comparative approaches to social action coordination’.
Anti-apoptotic BH3-only proteins inhibit Bak-dependent apoptosis
Authors: Ruehl Sebastian , Guy Clifford S. , Li Zhenrui , Yang Mao , Moldoveanu Tudor , Green Douglas R. 
Published: July 2022

SummaryBcl-2 family proteins regulate induction of intrinsic apoptosis through initiating mitochondrial outer membrane permeabilization (MOMP). Activation of the MOMP effectors Bax and Bak is controlled by interplay levels of anti-apoptotic Bcl-2 proteins (e.g. Mcl-1) and pro-apoptotic BH3-only proteins (e.g. BIM). Using a genome-wide CRISPR-dCas9 transactivation screen we identified two Bcl-2 family proteins, BNIP5 and Bcl-G, as inhibitors of Bak, but not Bax induced apoptosis. BNIP5 was able to block Bak activation in different cell types and in response to various cytotoxic therapies. The BH3 domain of BNIP5 was both necessary and sufficient to block Bak activation. Mechanistically, the BH3 domains of BNIP5 and Bcl-G act as a selective Bak activators, while not inhibiting anti-apoptotic proteins. This led to increased binding of activated Bak to Mcl-1, which prevented apoptosis engagement, identifying BNIP5 and Bcl-G as anti-apoptotic BH3-only proteins.
Combined sensor-based monitoring of mycothiol redox potential and DNA-damage response in Corynebacterium glutamicum
Authors: Hartmann Fabian Stefan Franz , Anastasiou Ioannis , Weiß Tamara , Lkhaasuren Tsenguunmaa , Seibold Gerd Michael 
Published: July 2022

AbstractExcessive amounts of reactive oxygen species (ROS) can cause irreversible damages to essential cellular components such as DNA. Genetically encoded biosensors targeting oxidative stress and DNA-stress have emerged to a powerful analytical tool to assess physiological states in a non-invasive manner. In this study, we aimed to combine the redox biosensor protein Mrx1-roGFP2 with a transcriptional biosensor for DNA-damage based on the PrecA promoter fused to a reporter gene (e2-crimson) in Corynebacterium glutamicum. Therefore, the redox biosensor strains C. glutamicum WT_Mrx1-roGFP2 and the mycothiol (MSH)-deficient mutant strain C. glutamicum ΔmshC_Mrx1-roGFP2 were equipped with the DNA-stress reporter plasmid pJC1_PrecA_e2-crimson. Exposure of the double-sensor equipped C. glutamicum WT strain to hypochlorite resulted in an oxidative redox shift, accompanied by an induction of the DNA-stress reporter system. In absence of the major non-enzymatic antioxidant MSH, the induction of the DNA-stress response was even more pronounced. This confirms the linkage of oxidative stress and DNA-damage response, and therefore making antioxidants a crucial player to protect DNA. Furthermore, exposure of the double biosensor strains to a DNA-damage inducing agent resulted in an oxidative redox shift. These results suggest a direct link of DNA-damage and oxidative stress response in C. glutamicum. Finally, we observed that inhibition of cell wall biosynthesis by penicillin caused both an oxidative redox shift and a DNA-damage response in C. glutamicum. The excellent compatibility of Mrx1-roGFP2 with E2-Crimson shown here provides a powerful combinatorial biosensor concept for in-depth studies of redox-related physiology in future studies.
Rhizocarpon geographicumlichen discloses a highly diversified microbiota carrying antibiotic resistance and Persistent Organic Pollutants tolerance
Authors: Miral Alice , Kautsky Adam , Alves-Carvalho Susete , Cottret Ludovic , Guillerm-Erckelboudt Anne-Yvonne , Buguet Manon , Rouaud Isabelle , Tranchimand Sylvain , Tomasi Sophie , Bartoli Claudia 
Published: July 2022

AbstractAs rock-inhabitants, lichens are exposed to extreme and fluctuating abiotic conditions associated with poor sources of nutriments. These extreme conditions confer to lichens the unique ability to develop protective mechanisms. Consequently, lichen-associated microbes disclose highly versatile lifestyles and ecological plasticity, enabling them to withstand extreme environments. Because of their ability to grow on poor and extreme habitats, bacteria associated with lichens can tolerate a wide range of pollutants and on the other hand secrete antimicrobial compounds. In addition, lichen-associated bacteria were described to harbor ecological functions crucial for the evolution of the lichen holobiont. Nevertheless, the ecological features of lichen-associated microbes are still underestimated. To explore the untapped ecological diversity of lichen-associated bacteria, we adopted a novel culturomic approach on the crustose lichenRhizocarpon geographicum. We sampledR. geographicumin French habitats exposed to oil spill and we combined 9 culturing methods with 16S rRNA sequencing to capture the largest bacterial diversity. A deep functional analysis of the lichen-associated bacterial collection showed the presence of a set of bacterial strains resistant to a wide range of antibiotics and displaying tolerance to Persistent Organic Pollutants (POP). Our study is a starting point to explore the ecological features of the lichen microbiota.
Responsible leadership, job satisfaction and duty orientation: lessons from the manufacturing sector in Ghana
Authors: Ansong Abraham , Agyeiwaa Angelina Afua , Gnankob Robert Ipiin 
Published: July 2022

Purpose
This study aims to investigate the influence of responsible leadership on employee duty orientation in the manufacturing sector of Ghana by using job satisfaction as a mediating variable.

Design/methodology/approach
This study relied on the quantitative approach and explanatory research design for the execution. This study gathered data from 325 employees across three manufacturing firms and applied the partial least squares structural equation modelling technique to test hypotheses.

Findings
This study established that responsible leadership had significant positive relationship with duty orientation and job satisfaction. The findings further disclosed that job satisfaction was positively related to duty orientation. This study provided evidence that job satisfaction serves as a mechanism through which responsible leadership could influence duty orientation.

Practical implications
This study recommends that for manufacturing firms to enhance job satisfaction, which will eventually lead to employees’ demonstrating duty orientation, the employers and relevant stakeholders such as board of directors and shareholders should emphasise responsible leadership traits among various managers and supervisors.

Originality/value
This study contributes to knowledge in a novel research area. It adds to empirical evidence by highlighting the possible variables that may influence employees to engage in duty orientation.