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This paper proposes a point-of-interest (POI) sequence recommendation algorithm based on BERT-ACNN-GRU to address the issues faced by the existing POI recommendation model in social network large data, such as the difficulty in extracting deep feature information and the low recommendation performance. Firstly, the semantic relationship between a word and its context in the text is combined using the bidirectional encoder representation from transformers (BERT) model to effectively eliminate the influence of word distance and obtain the contextualized word vector. Secondly, a convolutional neural network (CNN) utilizing a gated recurrent unit (GRU) is employed to capture the feature information of the text. Lastly, the attention method is utilized to assign weight scores to various terms in order to provide more attention to particular words and boost the precision of recommendations. The experiments demonstrate that the precision, recall rate, F1 score and mean average precision (mAP) of the proposed method are 0.097, 0.26, 0.103, and 0.085 on the Gowalla dataset when the recommendation list has a length of 10, respectively. On the Yelp dataset, the precision is 0.093, the recall rate is 0.26, F1 is 0.099, and MAP is 0.089. Hence, the proposed method can effectively enhance the performance of the POI recommendation system. [ABSTRACT FROM AUTHOR]

Background: Nurse practitioners care for patients with cardiovascular disease, particularly those from racial and ethnic minority groups, and can help assure equitable health outcomes. Yet, nurse practitioners practice in challenging care environments, which limits their ability to care for patients. Objective: To determine whether primary care nurse practitioner care environments are associated with racial and ethnic disparities in hospitalizations among older adults with coronary heart disease. Design: In this observational study, a cross-sectional survey was conducted among primary care nurse practitioners in 2018–2019 who completed a valid measure of care environment. The data was merged with 2018 Medicare claims data for patients with coronary heart disease. Participants: A total of 1244 primary care nurse practitioners and 180,216 Medicare beneficiaries 65 and older with coronary heart disease were included. Main Measures: All-cause and ambulatory care sensitive condition hospitalizations in 2018. Key Results: There were 50,233 hospitalizations, 9068 for ambulatory care sensitive conditions. About 28% of patients had at least one hospitalization. Hospitalizations varied by race, being highest among Black patients (33.5%). Care environment moderated the relationship between race (Black versus White) and hospitalization (OR 0.93; 95% CI, 0.88–0.98). The lowest care environment was associated with greater hospitalization among Black (odds ratio=1.34; 95% CI, 1.20–1.49) compared to White beneficiaries. Practices with the highest care environment had no racial differences in hospitalizations. There was no interaction effect between care environment and race for ambulatory care sensitive condition hospitalizations. Nurse practitioner care environment had a protective effect on these hospitalizations (OR, 0.96; 95% CI, 0.92–0.99) for all beneficiaries. Conclusions: Unfavorable care environments were associated with higher hospitalization rates among Black than among White beneficiaries with coronary heart disease. Racial disparities in hospitalization rates were not detected in practices with high-quality care environments, suggesting that improving nurse practitioner care environments could reduce racial disparities in hospitalizations. [ABSTRACT FROM AUTHOR]

Studies on HIV self-testing (HIV-ST) have been limited to adults (age 18+). The study assessed use of HIV-ST among a diverse group of young men who have sex with men (YMSM) in the United States (US) and assessed differences in uptake by demographic characteristics and requirements for parental consent. This study demonstrated feasibility of HIV-ST for YMSM as young as 14 years of age, which suggests potential for increasing HIV testing in this young age group and promoting health equity. [ABSTRACT FROM AUTHOR]

Vegetable oils can be used as an alternative to traditional mineral-based lubricants because of their biodegradation and good lubrication. Considering that vegetable oils are mixtures composed of different types and proportions of fatty acids, if the structure–activity relationship between their chemical structures and anti-wear properties can be obtained, those unknown vegetable oils' anti-wear performances can be predicted accurately. The quantitative structure–property relationship (QSPR) model of the fatty acid structure and the wear scar diameter (WSD) measured by four-ball friction test was established by selecting meaningful molecular descriptors, including the Balaban index, Estate keys and Molecular shadow index. Based on the model with adjusted R2 more than 0.9, the anti-wear properties of fatty acids and vegetable oils were predicted, showing good prediction ability and low deviation. On the basis of 39 different fatty acid composition reported, cluster analysis (CA) and anti-wear property evaluation of vegetable oils were carried out. It was found that fatty acids with carbon length of 18 and short chain fatty acids had adverse effects on the wear resistance of vegetable oils, which provided reference data for the industrial application of vegetable oils. [ABSTRACT FROM AUTHOR]

People with mental illness experience significant health disparities, including morbidity and premature mortality. Evidence suggests that stigma is a contributing factor to these observed inequities. The tripartite conceptualization of stigma proposes that three problems underlie stigma: problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination). There is limited prior research concerning stigma towards mental illness among nurses in the United States (US). The aims of this study were to assess stigma among US nurses towards patients with mental illness, compare the stigma expressed by nurses working in medical/surgical settings with mental health settings, and identify factors associated with stigma. Participants were recruited online from national professional nursing organizations in the US. We collected demographic data and administered measures of mental health stigma and stigma‐related mental health knowledge. Mental health nurses demonstrated comparatively lower levels of stigma and higher levels of knowledge than the medical/surgical nurses. Nursing speciality and personal contact with mental illness were the most significant predictors of stigma and knowledge. Knowledge was found to partially mediate the relationship between nursing speciality and stigma. We found support for the 'contact hypothesis', that is, having a personal experience of mental illness or a friend or family member who has a mental illness is associated with lower stigma towards mental illness. These findings support the development of contact‐based and educational anti‐stigma interventions for nurses in order to reduce stigma towards mental illness. [ABSTRACT FROM AUTHOR]

MIL-101(Cr)@SiO 2 @Fe 3 O 4 magnetic catalytic supports were synthesized by the in-situ growth method, where a MIL-101(Cr) shell was deposited on the surface of the SiO 2 @Fe 3 O 4 core. A series of Au/MIL-101(Cr)@SiO 2 @Fe 3 O 4 magnetic core-shell catalysts with different Au contents were prepared and Au nanoparticles (Au NPs) were decorated on the magnetic supports by the impregnation-reduction method. The structure of the as-synthesized catalysts was characterized by XRD, FTIR, HRTEM, XPS, N 2 adsorption-desorption, NH 3 -TPD, CO 2 -TPD, and VSM, etc. The N-methylation reaction performance and recyclability performance of the catalysts were evaluated in a high-pressure microreactor. The mechanism of the N-methylation reaction had been deeply studied. The results indicated that the thickness of the MIL-101(Cr) shell was about 120 nm, and the Au NPs (~3 nm) were dispersed on the surface and/or in the pores of MIL-101(Cr). The catalytic performance for N-methylation of CO 2 and aniline/H 2 to N-methylaniline and N,N-dimethylaniline was satisfactory. Moreover, the incredible recyclability performance (external magnet) and applicability of different amine substrates were achieved. Under the optimized conditions, the 2%Au/MIL-101(Cr)@SiO 2 @Fe 3 O 4 catalyst demonstrated the best performance, the aniline conversion nearly 44.0%, the selectivity of N-methylaniline and N,N-dimethylaniline were 71.8% and 27.6%, respectively. The reaction mechanism investigation indicated that, firstly, H 2 was adsorbed and activated on the Au NPs, and CO 2 was adsorbed and activated on the O2- Lewis base sites of MIL-101(Cr) cages. Later, the activated H-atoms reacted with the activated CO 2 to generate the formic acid as an intermediate product. Finally, the formic acid reacted with the adsorbed aniline and activated on the Cr3+ Lewis acid sites to produce N-methylaniline and N,N-dimethylaniline. The enhanced selectivity of the reaction might be attributed to the core-shell architecture, high surface area, plentiful active sites, and synergistic interactions between Au NPs and acid-base sites of the MIL-101(Cr) catalyst. [Display omitted] • The magnetic Au/MIL-101(Cr)@SiO 2 @Fe 3 O 4 core-shell catalysts were prepared. • There were adjustable acid-base sites in the MIL-101(Cr) shell. • The catalysts had satisfactory performance for N-methylation of CO 2 and aniline/H 2. • H 2 was adsorbed and activated on the Au NPs sites. • CO 2 was adsorbed and activated on the O2- Lewis base sites. [ABSTRACT FROM AUTHOR]

Transparent conductors (TCs) with high conductivity and optical transparency are important for high-performance downstream applications. However, silver nanowire (Ag NWs) films have several drawbacks, including the high contact resistance (R c) and large insulating voids, which limits the Ag NW film's conductivity. Herein, a simple solution-based method is demonstrated for formation of hybrid film based on MXene/Ag NWs (MA). The two-dimensional (2D) Ti 3 C 2 T x MXene nanosheet can wrap on 1D Ag NWs to weld Ag NWs and provide extra conductive channels between two adjacent Ag NWs, which can greatly improve the conductivity of Ag NWs. The optimized MA hybrid films show largely improved conductivity (sheet resistance: 15 Ω/sq; T %: 89.3 %), high flexibility and environmental stability, greatly facilitating its application as a high-performance flexible transparent heater (cycling stability, 20 cycles of heating/cooling; temperature rising rate, 56.2 °C within 30 s at 5 V). Therefore, the MA hybrid transparent heating film has potential to be used for deicing and wearable heating device. • A feasible method is for the MXene nanosheet to wrap on Ag NWs. • This process readily results in welding Ag NWs and providing extra conductive channels between two adjacent Ag NWs. • The resultant MXene/Ag NW hybrid film shows largely improved carrier transport properties. • It can serve as high-performance electric component in transparent heater. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to use the most frequent features to establish a vertebral MRI-based radiomics model that could differentiate multiple myeloma (MM) from metastases and compare the model performance with different features number. Methods: We retrospectively analyzed conventional MRI (T1WI and fat-suppression T2WI) of 103 MM patients and 138 patients with metastases. The feature selection process included four steps. The first three steps defined as conventional feature selection (CFS), carried out 50 times (ten times with 5-fold cross-validation), included variance threshold, SelectKBest, and least absolute shrinkage and selection operator. The most frequent fixed features were selected for modeling during the last step. The number of events per independent variable (EPV) is the number of patients in a smaller subgroup divided by the number of radiomics features considered in developing the prediction model. The EPV values considered were 5, 10, 15, and 20. Therefore, we constructed four models using the top 16, 8, 6, and 4 most frequent features, respectively. The models constructed with features selected by CFS were also compared. Results: The AUCs of 20EPV-Model, 15EPV-Model, and CSF-Model (AUC = 0.71, 0.81, and 0.78) were poor than 10EPV-Model (AUC = 0.84, p < 0.001). The AUC of 10EPV-Model was comparable with 5EPV-Model (AUC = 0.85, p = 0.480). Conclusions: The radiomics model constructed with an appropriate small number of the most frequent features could well distinguish metastases from MM based on conventional vertebral MRI. Based on our results, we recommend following the 10 EPV as the rule of thumb for feature selection. Key Points: • The developed radiomics model could distinguish metastases from multiple myeloma based on conventional vertebral MRI. • An accurate model based on just a handful of the most frequent features could be constructed by utilizing multiple feature reduction techniques. • An event per independent variable value of 10 is recommended as a rule of thumb for modeling feature selection. [ABSTRACT FROM AUTHOR]

Adoption of health information technology (HIT) in nursing homes (NHs) improves quality of care. Although there is a robust body of research on HIT adoption, the closely related process of technology abandonment is not well understood. As NHs grow more reliant on HIT, problems of technology abandonment, defined as failure to scale up, spread, and sustain HIT need to be studied. Our objective is to describe HIT abandonment and its associations with organizational characteristics among a national sample of US NHs. Longitudinal, retrospective analysis of data from 2 sources: HIT Maturity Survey and Staging model and public data from the Care Compare database. Random sample of NHs (n = 299) representing each US state that completed the HIT maturity survey in 2 consecutive years: year 1 (Y1) was June 2019–August 2020 and year 2 (Y2) was June 2020–August 2021. The primary dependent variable was technology abandonment, operationalized by using total HIT maturity score, HIT maturity stage, and subscale scores within each dimension/domain. Independent variables were NH organizational characteristics including bed size, type of ownership, urbanicity, Centers for Medicare & Medicaid Services Five-Star Overall Rating and Staffing Rating. Over the 2-year period, HIT abandonment occurred in 28% (n = 85) of NHs compared with 44% (n = 133) that experienced growth in HIT systems. HIT capabilities in resident care were abandoned most frequently. Using multivariable multinomial logistic regression, we found that large NHs (bed size greater than 120) were more likely to experience technology abandonment in administrative activities. Technology abandonment can increase strain on scarce resources and may impact administrators' ability to oversee clinical operations, especially in large NHs. This study contributes to the limited understanding of technology abandonment and can serve as a building block for others working to ensure limited resources are used effectively to improve care for NH residents. [ABSTRACT FROM AUTHOR]

Sexual minority adolescents are more likely to have obesity compared to their heterosexual peers, but little is known about potential contributors to this disparity that lie outside of individual-level health behaviors, such as diet and exercise. One possible contributor is school violence victimization, a factor associated with overweight/obesity in adolescence. Another possible contributor is school climate, which is associated with feelings of safety and connectedness that can lower the likelihood of school violence victimization. Moreover, even less is known about relationships among all these factors among sexual minority adolescents. This gap in the literature was addressed by analyzing CDC's district-level data from the Youth Risk Behavior Survey and School Health Profiles (N = 60,625; 50.9% female, Mage = 16 years, 84.7% heterosexual, 15.3% sexual minority). Using multilevel mixed effects logistic regression models and controlling for covariates, it was found that among females and males, those with 2+ counts of last 12-month school violence victimization had higher odds of obesity than those with no school violence victimization (AOR = 1.33; AOR = 1.24). Furthermore, females and males in more positive LGBTQ school climates had lower odds of obesity than those in less positive school climates (AOR = 0.84; AOR = 0.85). There were no sexual identity differences in these models. Findings support the careful consideration of school violence victimization and LGBTQ school climate in future obesity prevention initiatives. [ABSTRACT FROM AUTHOR]

Background: The preoperative prediction of lymph node metastasis (LNM) in pancreatic ductal adenocarcinoma (PDAC) is essential in prognosis and treatment strategy formulation. Purpose: To compare the performance of computed tomography (CT) and magnetic resonance imaging (MRI) radiomics models for the preoperative prediction of LNM in PDAC. Material and Methods: In total, 160 consecutive patients with PDAC were retrospectively included, who were divided into the training and validation sets (ratio of 8:2). Two radiologists evaluated LNM basing on morphological abnormalities. Radiomics features were extracted from T2-weighted imaging, T1-weighted imaging, and multiphase contrast enhanced MRI and multiphase CT, respectively. Overall, 1184 radiomics features were extracted from each volume of interest drawn. Only features with an intraclass correlation coefficient ≥0.75 were included. Three sequential feature selection steps—variance threshold, variance thresholding and least absolute shrinkage selection operator—were repeated 20 times with fivefold cross-validation in the training set. Two radiomics models based on multiphase CT and multiparametric MRI were built with the five most frequent features. Model performance was evaluated using the area under the curve (AUC) values. Results: Multiparametric MRI radiomics model achieved improved AUCs (0.791 and 0.786 in the training and validation sets, respectively) than that of the CT radiomics model (0.672 and 0.655 in the training and validation sets, respectively) and of the radiologists' assessment (0.600–0.613 and 0.560–0.587 in the training and validation sets, respectively). Conclusion: Multiparametric MRI radiomics model may serve as a potential tool for preoperatively evaluating LNM in PDAC and had superior predictive performance to multiphase CT-based model and radiologists' assessment. [ABSTRACT FROM AUTHOR]

We characterized bullying among rural adolescents and examined the association between asthma and bullying victimization. Participants (N = 1905; 44.5% Black) were students attending rural high schools who were screened for a randomized trial to address uncontrolled asthma. Screening questions asked students about asthma diagnosis and symptoms, bullying victimization, and demographic characteristics. Logistic regression analyses with school as a fixed effect were employed to examine the extent to which demographic factors, asthma diagnosis, asthma status (i.e. current asthma, no asthma, possible undiagnosed asthma), and among those with current asthma, asthma severity, were associated with bullying victimization. Sensitivity analyses using bullying frequency as the outcome were also conducted. 26.0% reported being bullied. Younger age and self-identifying as White were associated with increased risk of bullying victimization. Compared to those with no asthma, those with current asthma or possible undiagnosed asthma were at increased risk for bullying victimization (adjusted odds ratio [AOR] = 2.46; 95% confidence interval (CI) = 1.76–3.46 and AOR = 2.42; 95% CI = 1.87–3.14, respectively). Among those with current asthma, persistent symptoms increased the risk for bullying victimization (AOR = 2.59; 95% CI = 1.45–4.71). Similar results were obtained with sensitivity analyses. In a large rural community cohort, asthma was associated with bullying victimization. Findings suggest that rural students with asthma, with or without diagnosis, could benefit from schools creating inclusive environments that reduce victimization based on this medical condition. School administrators should foster environments that are accepting of all students' abilities and statuses, and healthcare providers can provide proper asthma management education to these adolescents. [ABSTRACT FROM AUTHOR]

Objective: The Health Information Technology Usability Evaluation Scale (Health-ITUES) is a validated and reliable instrument to evaluate usability of information technology (IT) tools. In this study, we aimed to establish the optimal cut-point of the Health-ITUES to identify usability of IT tools.Methods: Adult participants were recruited to a trial evaluating a mobile app for self-managing HIV. Participants completed the Health-ITUES at the 3- and 6-month follow-up. Health-ITUES is a 20-item questionnaire that assesses four subscales: impact, perceived usefulness, perceived ease of use, and user control. The total score ranged from 1 to 5 and a higher score indicates greater usability. App use was defined as the proportion of activities completed by participants in both study arms. The selection of an optimal cut-point involved a series of multiple linear regression models with 500 bootstrap replications to examine the relationship between the Health-ITUES total score and app use, controlling for potential covariates.Results: We included 158 participants; mean age was 49.7 years (SD 10.3), 71% were African American/Black, and 72% were non-Hispanic. Mean Health-ITUES total scores at 3 and 6 months were 4.39 (SD 0.75) and 4.43 (SD 0.75), respectively. App use completedby participants from baseline to the 3-month follow-up visits was 0.61 (SD 0.36, range 0-1.72) and from 3-month to the 6-month follow-up visits was 0.51 (SD 0.37). Participants who reported greater Health-ITUES total score completed more activities [β = 0.18, 95% Confidence Interval (CI) 0.10-0.27]. The optimal cut-point of 4.32 (95% CI: 4.25-4.56) yielded the lowest p-value to identify usability of IT tools.Conclusions: In this study of adults with HIV, we identified an optimal cut-point of 4.32 on the Health-ITUES total score to define usability. Further studies are needed to validate this cut-point. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has forced nursing homes to adapt new models of care in response to the evolving crisis including rapid implementation of telehealth services. The purpose of our study was to investigate implementation of telehealth in nursing homes amidst the COVID‐19 pandemic using a human factors model. Methods: Using a mixed methods design, we conducted a secondary analysis of data from a national survey of nursing home administrative leaders (n = 204). Using six survey questions, we calculated a total telehealth score (range 0–42). Descriptive statistics and paired sample t‐test were used to explore the change in telehealth in two consecutive years (2019–2021). Next, we conducted semi‐structured interviews with (n = 21) administrators and clinicians to assess differences in implementation according to extent of telehealth use. Results: The mean telehealth score in year 1 was 12.11 (SD = 9.85) and year 2 was 19.25 (SD = 11.25). There was a significant difference in telehealth scores from year 1 to year 2 (t = 6.83, p < 0.000). While 64% of nursing homes reported higher telehealth scores in year 2 compared to year 1, over 32% reported a decline. Qualitative analysis revealed facilitators of telehealth including training, use of integrated equipment, having staff present for the visit, and using telehealth for different types of visits. Barriers included using smart phones to conduct the visit, billing, interoperability and staffing. Conclusion: Training, adaptation of work processes to support communication, and restructuring teams and tasks are the result of interactions between system components that could improve usability and sustainability of telehealth in nursing homes. [ABSTRACT FROM AUTHOR]

Aims: To explore the relationship between nurse practitioner work environment and nurse practitioner outcomes (job satisfaction and intent to leave) in the United States. Design The study used a cross‐sectional survey design to collect survey data from primary care nurse practitioners in six states in the United States. Methods: We sent mail surveys to 5689 eligible nurse practitioners in Arizona, New Jersey, Washington, Pennsylvania, California and Texas. The mail also contained an online link. Participants could complete either the paper or online questionnaire. In total, 1244 participants completed the survey in 2018–2019. The work environment was measured using the Nurse Practitioner‐Primary Care Organizational Climate Questionnaire comprised of four subscales: Nurse Practitioner‐Administration Relations, Nurse Practitioner‐Physician Relations, Independent Practice and Support and Professional Visibility. Global items measured job satisfaction and intent to leave. We used mixed‐effect proportional‐odds cumulative logit models to assess the association between work environment and job satisfaction and intent to leave. Results: Overall, 90% of participants were either very satisfied or somewhat satisfied with their job and 22% reported intent to leave their job in 1 year. With a one‐unit increase in the organizational‐level Nurse Practitioner‐Administration Relations score, the odds of having a higher job satisfaction level increased by about four times and the odds of intent to leave job decreased by about 60%. A higher organizational‐level Nurse Practitioner‐Physician Relations score was significantly associated with higher job satisfaction and lower odds of intent to leave. Conclusion: Improvements in work environments may improve nurse practitioner job satisfaction and retention. Impact This study examined the relationship between work environment, job satisfaction and turnover intention of nurse practitioners. Better work environment is associated with higher job satisfaction and lower turnover intention. Findings have implications for clinical leadership who can take actions to create better work environments to increase the nurse practitioner workforce capacity. [ABSTRACT FROM AUTHOR]

Thoracic aortic dissection (TAD) is a severe disease, characterized by numerous apoptotic vascular smooth muscle cells (VSMCs). EDIL3/Del-1 is a secreted protein involved in macrophage efferocytosis in acute inflammation. Here, we aimed to investigate whether EDIL3 promoted the internalization and degradation of apoptotic VSMCs during TAD. The levels of EDIL3 were decreased in the serum and aortic tissue from TAD mice. Global edil3 knockout (edil3−/−) mice and edil3−/− bone marrow chimeric mice exhibited a considerable exacerbation in β-aminopropionitrile monofumarate (BAPN)-induced TAD, accompanied with increased apoptotic VSMCs accumulating in the damaged aortic tissue. Two types of phagocytes, RAW264.7 cells and bone marrow-derived macrophages (BMDMs) were used for in vitro efferocytosis assay. edil3-deficient phagocytes exhibited inefficient internalization and degradation of apoptotic VSMCs. Instead, EDIL3 promoted the internalization phase through interacting with phosphatidylserine (PtdSer) on apoptotic VSMCs and binding to the macrophage ITGAV/αv-ITGB3/β3 integrin. In addition, EDIL3 accelerated the degradation phase through activating LC3-associated phagocytosis (LAP). Mechanically, following the engulfment, EDIL3 enhanced the activity of SMPD1/acid sphingomyelinase in the phagosome through blocking ITGAV-ITGB3 integrin, which facilitates phagosomal reactive oxygen species (ROS) production by NAPDH oxidase CYBB/NOX2. Furthermore, exogenous EDIL3 supplementation alleviated BAPN-induced TAD and promoted apoptotic cell clearance. EDIL3 may be a novel factor for the prevention and treatment of TAD.Abbreviations: BAPN: β-aminopropionitrile monofumarate; BMDM: bone marrow-derived macrophage; C12FDG: 5-dodecanoylaminofluorescein-di-β-D-galactopyranoside; CTRL: control; CYBB/NOX2: cytochrome b-245, beta polypeptide; DCFH-DA: 2’,7’-dichlorofluorescin diacetate; EDIL3/Del-1: EGF-like repeats and discoidin I-like domains 3; EdU: 5-ethynyl-2’-deoxyuridine; EVG: elastic van Gieson; H&E: hematoxylin and eosin; IL: interleukin; LAP: LC3-associated phagocytosis; MAP1LC3/LC3: microtubule-associated protein 1 light chain 3; NAC: N-acetylcysteine; PtdSer: phosphatidylserine; rEDIL3: recombinant EDIL3; ROS: reactive oxygen species; SMPD1: sphingomyelin phosphodiesterase 1; TAD: thoracic aortic dissection; TEM: transmission electron microscopy; VSMC: vascular smooth muscle cell; WT: wild-type [ABSTRACT FROM AUTHOR]

High quality human tissue is essential for molecular research, but pre-analytical conditions encountered during tissue collection could degrade tissue RNA. We evaluated how prolonged exposure of non-diseased breast tissue to ambient room temperature (22±1°C) impacted RNA quality. Breast tissue received between 70 to 190 minutes after excision was immediately flash frozen (FF) or embedded in Optimal Cutting Temperature (OCT) compound upon receipt (T0). Additional breast tissue pieces were further exposed to increments of 60 (T1 = T0+60 mins), 120 (T2 = T0+120 mins) and 180 (T3 = T0+180 mins) minutes of ambient room temperature before processing into FF and OCT. Total exposure, T3 (T0+180 mins) ranged from 250 minutes to 370 minutes. All samples (FF and OCT) were stored at -80°C before RNA isolation. The RNA quality assessment based on RNA Integrity Number (RIN) showed RINs for both FF and OCT samples were within the generally acceptable range (mean 7.88±0.90 to 8.52±0.66). No significant difference was observed when RIN at T0 was compared to RIN at T1, T2 and T3 (FF samples, p = 0.43, 0.56, 0.44; OCT samples, p = 0.25, 0.82, 1.0), or when RIN was compared between T1, T2 and T3. RNA quality assessed by quantitative real-time PCR (qRT-PCR) analysis of beta-actin (ACTB), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), cyclophilin A (CYPA), and porphobilinogen deaminase (PBGD) transcripts showed threshold values (Ct) that indicate abundant and intact target nucleic acid in all samples (mean ranging from 14.1 to 25.3). The study shows that higher RIN values were obtained for non-diseased breast tissue up to 190 minutes after resection and prior to stabilization. Further experimental exposure up to 180 minutes had no significant effect on RIN values. This study strengthens the rationale for assessing RIN and specific gene transcript levels as an objective method for determining how suitable RNA will be for a specific research purpose ("fit-for purpose"). [ABSTRACT FROM AUTHOR]

Background: New York State (NYS) has approximately 4.7 million Medicaid beneficiaries with 75% having at least one or more chronic conditions. An estimated 10% of Medicaid beneficiaries seek emergency department (ED) services for nonurgent matters. It is unclear if an increased supply of nurse practitioners (NPs) and physician assistants (PAs) impact utilization of ED and subsequent hospitalizations for chronic conditions. Purpose: To investigate the relationship between NYS workforce supply (physicians, NPs, and PAs) and 1) ED use and 2) in-patient hospitalizations for chronically ill Medicaid beneficiaries. Methods: A cross-sectional study design was employed by calculating total workforce supply per NYS county and the proportion of physicians, NPs, and PAs per total number of Medicaid beneficiaries. We extracted the frequencies of all NYS Medicaid beneficiary chronic condition–related ED visits and in-patient admissions. Medicaid beneficiaries were considered to have a chronic condition if there was a claim indicating that the beneficiary received a service or treatment for this specific condition. We calculated the proportion of ED visits/beneficiary for each chronic disease category and the proportion of category-specific in-patient hospitalizations per the number of beneficiaries with that diagnosis. Results: As the NP/beneficiary proportion increased, ED visits for dual and nondual eligible beneficiaries decreased (p =.007; β = −2.218; 95% confidence interval [CI]: −3.79 to −0.644 and p =.04; β = −2.698; 95% CI: −5.268 to −0.127, respectively). Implications for practice: Counties with a higher proportion of NPs and PAs had significantly lower numbers of ED visits and hospitalizations for Medicaid beneficiaries. [ABSTRACT FROM AUTHOR]

Immune response plays a crucial role in post-myocardial infarction (MI) myocardial remodeling. Neogenin (Neo1), a multifunctional transmembrane receptor, plays a critical role in the immune response; however, whether Neo1 participates in pathological myocardial remodeling after MI is unclear. Our study found that Neo1 expression changed significantly after MI in vivo and after LPS + IFN-γ stimulation in bone marrow-derived macrophages (BMDMs) in vitro. Neo1 functional deficiency (using a neutralizing antibody) and macrophage-specific Neo1 deficiency (induced by Neo1flox/flox;Cx3cr1cre mice) increased infarction size, enhanced cardiac fibrosis and cardiomyocyte apoptosis, and exacerbated left ventricular dysfunction post-MI in mice. Mechanistically, Neo1 deficiency promoted macrophage infiltration into the ischemic myocardium and transformation to a proinflammatory phenotype, subsequently exacerbating the inflammatory response and impairing inflammation resolution post-MI. Neo1 deficiency regulated macrophage phenotype and function, possibly through the JAK1-STAT1 pathway, as confirmed in BMDMs in vitro. Blocking the JAK1-STAT1 pathway with fludarabine phosphate abolished the impact of Neo1 on macrophage phenotype and function, inflammatory response, inflammation resolution, cardiomyocyte apoptosis, cardiac fibrosis, infarction size and cardiac function. In conclusion, Neo1 deficiency aggravates inflammation and left ventricular remodeling post-MI by modulating macrophage phenotypes and functions via the JAK1-STAT1 signaling pathway. These findings highlight the anti-inflammatory potential of Neo1, offering new perspectives for therapeutic targets in MI treatment. Neo1 deficiency aggravated inflammation and left ventricular remodeling after MI by modulating macrophage phenotypes and functions via the JAK1-STAT1 signaling pathway. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that bone morphogenetic proteins (BMPs) play important roles in cardiovascular diseases, including atherosclerosis, artery calcification, myocardial remodeling, pulmonary arterial hypertension, and diabetic cardiomyopathy. Kielin/chordin-like protein (KCP) is a secreted protein that regulates the expression and function of BMPs. However, the role of KCP in cardiac aging remains unknown. In this study, we aimed to investigate the role of KCP in cardiac aging and its possible mechanisms. Echocardiogram showed that heart function was impaired in aged mice (24 months). In addition, analysis of heart structure showed that KCP knockout (KO) aggravated cardiac remodeling in aged mice. Moreover, KCP KO increased p-smad2/3 and TGF-β expression, while decreased BMP-2 expression in aged mice. Furthermore, KCP KO increased the expression of cardiac senescence-related proteins in aged mice. KCP KO aggravated the imbalance of oxidants and antioxidants and increased the expression of proinflammatory cytokines and cardiomyocyte apoptosis in aged mice. Our study demonstrated that KCP KO aggravated cardiac aging in mice by increasing the levels of oxidative stress, inflammation, and cardiomyocyte apoptosis. Key message: KCP KO aggravated aging-related cardiac dysfunction and remodeling in male mice. KCP KO aggravated cardiac aging by increasing the levels of oxidative stress, inflammation, and cardiomyocyte apoptosis. [ABSTRACT FROM AUTHOR]

Background: Asthma and COVID-19 have overlapping symptoms. During the 2019–2022 pandemic, pediatric asthma control appears to have improved, with some researchers theorizing that that is due to changes in asthma self-management. This study examined adolescents' views regarding how the pandemic impacted their asthma severity and self-management. Differences by urbanicity, sex, and race/ethnicity were explored. Methods: We utilized baseline data from adolescents with poorly controlled asthma (n = 183) who were participating in 1 of 2 school-based clinical trials—1 in rural schools and 1 in urban schools—testing the impact of interventions to improve asthma control. Adolescents reported if they believed their asthma severity remained the same, improved, or worsened during the pandemic, and if it changed, how it changed. They also reported if and how they modified their asthma management since the pandemic. We used multinomial logistic regression and binary logistic regression to assess the relationship between demographic factors and changes in asthma severity during the pandemic, and if adolescents altered their asthma management. Results: Adolescents' mean age was 15.9 years; most lived in rural communities (65.6%) and identified as female (66.7%). About half (56.2%) self-identified as black, 13.1% as Hispanic, and 10.4% as another race/ethnicity. Most (68.4%) reported that their asthma severity remained unchanged; 26.0% reported it worsened. Nearly 30% reported they altered how they managed their asthma, with most (80%) reporting additional efforts. Compared with asthma remaining the same, females had a higher relative risk than males of reporting that their asthma worsened [adjusted relative risk ratio = 3.65, 95% confidence interval (CI) = 1.34–9.90, P < 0.05]. Urban youth had greater odds (adjusted odds ratio = 5.4, 95% CI = 2.0–14.5, P < 0.001) of reporting they changed their asthma self-management compared with rural peers. Conclusion: This study demonstrates that during the 2019–2022 pandemic, adolescents generally believed their asthma severity stayed consistent and many took additional self-management efforts. [ABSTRACT FROM AUTHOR]

Background: US primary care practices are actively identifying strategies to improve outcomes and reduce costs among high-need high-cost (HNHC) patients. HNHC patients are adults with high health care utilization who suffer from multiple chronic medical and behavioral health conditions such as depression or substance abuse. HNHC patients with behavioral health conditions face heightened challenges accessing timely primary care and managing their conditions, which is reflected by their high rates of emergency department (ED) utilization and preventable spending. Structural capabilities (i.e., care coordination, chronic disease registries, shared communication systems, and after-hours care) are key attributes of primary care practices which can enhance access and quality of chronic care delivery. Objective: The purpose of this study was to analyze the association between structural capabilities and ED utilization among HNHC patients with behavioral health conditions. Design and Measures: We merged cross-sectional survey data on structural capabilities from 240 primary care practices in Arizona and Washington linked with Medicare claims data on 70,182 HNHC patients from 2019. Key Results: Using multivariable Poisson models, we found shared communication systems were associated with lower rates of all-cause and preventable ED utilization among HNHC patients with alcohol use (all-cause: aRR 0.72, 95% CI: 0.62, 0.84; preventable: aRR 0.5, 95% CI: 0.40, 0.64) and HNHC patients with substance use disorders (all-cause: aRR 0.76, 95% CI: 0.68, 0.85; preventable: aRR 0.61, 95% CI: 0.52, 0.71). Care coordination was also associated with decreased rates of ED utilization among the overall HNHC population and those with alcohol use, but not among HNHC patients with depression or substance use disorders. Conclusion: Shared communication systems and care coordination have the potential to increase the effectiveness of primary care delivery for specific HNHC patients. [ABSTRACT FROM AUTHOR]

Efferocytosis is defined as the clearance of apoptotic cells (ACs) in physiological and pathological states and is performed by efferocytes, such as macrophages. Efferocytosis can lead to the resolution of inflammation and restore tissue homoeostasis; however, the mechanisms of efferocytosis in determining inflammation resolution are still not completely understood, and the effects of efferocytosis on other proresolving properties need to be explored and explained. In this review, the process of efferocytosis will be summarized briefly, and then these mechanisms and effects will be thoroughly discussed. In addition, the association between mechanisms of efferocytosis in determining resolution of inflammation and cardiovascular diseases will also be reviewed, as an understanding of this association may provide information on novel treatment targets. [ABSTRACT FROM AUTHOR]

Semaphorins (Semas), which belongs to the axonal guidance molecules, include 8 classes and could affect axon growth in the nervous system. Recently, semaphorins were found to regulate other pathophysiological processes, such as immune response, oncogenesis, tumor angiogenesis, and bone homeostasis, through binding with their plexin and neuropilin receptors. In this review, we summarized the detailed role of semaphorins and their receptors in the pathological progression of various cardiovascular diseases (CVDs), highlighting that semaphorins may be potential therapeutic targets and novel biomarkers for CVDs. [ABSTRACT FROM AUTHOR]

Purpose: To primarily evaluate the diagnostic performance of the monoexponential and intravoxel incoherent motion (IVIM) diffusion weighted imaging (DWI) models for differentiating between nonhypervascular pancreatic neuroendocrine tumors (PNETs) and pancreatic ductal adenocarcinomas (PDACs).Methods: 63 patients with PNETs (35 nonhypervascular PNETs and 28 hypervascular PNETs) and 164 patients with PDACs were retrospectively enrolled in the study and underwent multiple b-value DWI. Intraobserver and interobserver reliabilities of DWI parameters were assessed by using the intraclass correlation coefficient (ICC). The parameters of apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) of nonhypervascular PNETs were compared with PDACs and hypervascular PNETs using the independent sample t test or the Mann-Whitney U test. The diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis.Results: All DWI parameters values showed good to excellent intra- and interobserver agreements (ICC = 0.743-0.873). Nonhypervascular PNETs had significantly lower ADC and D, but significantly higher f than PDACs (P = 0.005, P < 0.001 and P < 0.001, respectively). ADC, D and f of nonhypervascular PNETs were lower than hypervascular PNETs (P = 0.001, <0.001 and 0.093, respectively). D* of nonhypervascular PNETs showed no statistically significant differences with PDACs and hypervascular PNETs (P = 0.809 and 0.420). D showed a higher area under the curve (AUC), followed by ADC and f (AUC = 0.885, 0.665 and 0.740, respectively) in differentiating nonhypervascular PNETs from PDACs.Conclusion: Monoexponential and IVIM diffusion models are valuable to differentiate nonhypervascular PNETs from PDACs. D showed better performance than f and ADC. [ABSTRACT FROM AUTHOR]

Background: The application of deep learning has allowed significant progress in medical imaging. However, few studies have focused on the diagnosis of benign and malignant spinal tumors using medical imaging and age information at the patient level. This study proposes a multi-model weighted fusion framework (WFF) for benign and malignant diagnosis of spinal tumors based on magnetic resonance imaging (MRI) images and age information. Methods: The proposed WFF included a tumor detection model, sequence classification model, and age information statistic module based on sagittal MRI sequences obtained from 585 patients with spinal tumors (270 benign, 315 malignant) between January 2006 and December 2019 from the cooperative hospital. The experimental results of the WFF were compared with those of one radiologist (D1) and two spine surgeons (D2 and D3). Results: In the case of reference age information, the accuracy (ACC) (0.821) of WFF was higher than three doctors' ACC (D1: 0.686; D2: 0.736; D3: 0.636). Without age information, the ACC (0.800) of the WFF was also higher than that of the three doctors (D1: 0.750; D2: 0.664; D3:0.614). Conclusions: The proposed WFF is effective in the diagnosis of benign and malignant spinal tumors with complex histological types on MRI. [ABSTRACT FROM AUTHOR]

Purpose: This study was to explore the role of pre-existing small vessel disease (SVD) on the 3-month outcomes of acute cardioembolic stroke (CES) patients. Patients and Methods: Data of 189 consecutive acute CES patients at a single center were retrospectively enrolled. SVD imaging markers of lacunes, white matter hyperintensities (WMH) and enlarged perivascular spaces (EPVS) were evaluated and their total burden score (0– 3 points) was calculated. Patients were divided into the good functional outcome group (modified Rankin scale, mRS ≤ 2) and the poor functional outcome group (mRS ≥ 3) at 3 months after stroke onset. The effect of each single SVD marker and its total burden score on the outcome was identified using binary logistic regression. Results: Overall, 100 (52.9%), 52 (27.1%), 28 (14.8%) and 9 (4.8%) patients had 0, 1, 2 and 3 SVD imaging markers. Patients with a total SVD burden score of 2 and 3 were significantly older and had higher baseline National Institutes of Health Stroke Scale (NIHSS) score than those with a score of 0 and 1 (P< 0.01). Forty-seven (24.9%) patients had a poor outcome. Patients in the poor outcome group had significantly higher baseline NIHSS score, increased incidence of stroke associated pneumonia, and heavier burden of lacunes, WMH and EPVS, and thus had elevated total SVD burden score than those in good outcome group (P< 0.05). After adjusting for potential confounders, the WMH (odds ratio [OR] = 2.6777, 95% confidence interval [CI] = 1.052– 6.812, P = 0.039) and the total SVD burden score (OR = 1.717, 95% CI = 1.072– 2.749, P = 0.024) were, respectively, independent risk factors for a poor outcome. Conclusion: The pre-existing SVD may be associated with the 3-month prognosis of CES. [ABSTRACT FROM AUTHOR]

Mixed lineage leukemia (MLL) T10 is a relatively rare partner for the KMT2A lysine (K)-specific methyltransferase 2A gene. The common features and coexisting mutations of acute myeloid leukemia (AML) patients with KMT2A-MLLT10 remain unknown. In this study, 10 adult AML patients with KMT2A-MLLT10 fusions were picked up from 496 AML patients by using RT-polymerase chain reaction (PCR) and/or fluorescence in situ hybridization, and then screened for mutations in the 49 genes panel with next-generation sequencing and PCR, followed by direct Sanger sequencing. Of the 10 unique individuals identified, 6 were male and 4 were female (M:F ratio, 1.5:1) with ages ranging from 19 to 52 years (median 39.5 years). Most (90%, 9/10) patients with KMT2A-MLLT10 were accompanied by additional mutations. Twelve mutated genes were detected, averaging 2.1 mutations per patient (range, 0–4). The most frequently mutated gene was NRAS (n = 5). Clinical and laboratory data pointed to common features: French American British-M5 subtype (n = 7), a high rate of relapse, and biomarkers CD33 (n = 10), CD117 (n = 9), CD13 (n = 8), and CD64 (n = 8). Overall, most patients harbored at least one mutation. A high incidence of mutations affecting the RAS signaling pathway or RAS regulating components was found in 50% (5/10) patients. The overall survival is about 12.0 months. Allogeneic-hematopoietic stem cell transplantation trends to improve survival in selected patients. [ABSTRACT FROM AUTHOR]

• (1) Based on 119 groups of fatty acid structure information and principal component regression method, a model containing 9 descriptors was construct to predict the anti-wear properties of fatty acids. • (2) According to the model analysis, the main factors affecting the anti-wear properties of fatty acids were the carbon chain length and double bonds number. • (3) The WSDs of common fatty acids in vegetable oils and different vegetable oils were estimated. • (4) Unsaturated fatty acid content (UFA%), polyunsaturated fatty acid content (PUFA%), saturated fatty acid content (SFA%) and U/S (UFA%/ SFA%) values were selected as evaluation indexes for oxidation stability. WSD was a reflection index of anti-wear properties. Finally, factor score and cluster analysis were used to evaluate the quality of different vegetable oils. With the increasing awareness of human environmental protection, it is urgent to find potential bio-lubricants. Vegetable oil has attracted the interest of scientists because of its good lubricity and biodegradability. The external properties of vegetable oils are closely related to their internal chemical composition. Fatty acids are the main chemical components in vegetable oils. The industrial capacity of fatty acids is accurately predicted and evaluated by theory, which is very helpful for the auxiliary design of green lubricants. Combining 9 meaningful molecular descriptors and principal component regression, a calculation scheme for predicting the anti-wear properties of fatty acids and vegetable oils was proposed. The training set and validation set of the model proved that the model had excellent predictive performance. Then, on this basis, through literature retrieval and factor score study, the research group successfully screened out a class of vegetable oils with the broadest industrial application potential, including yuzu, sesame, olive and so on. This project aims to provide new ideas about the design of green bio-based lubricants and to promote the development of vegetable oils in the industry. [ABSTRACT FROM AUTHOR]

The prevalence of substance use disorders (SUDs) is growing among older adults, and older adults in rural areas face disparities in access to SUD care. Rural older adults with SUDs commonly have comorbid chronic conditions that puts them at risk for frequent acute healthcare utilization. In rural areas, primary care for patients with SUDs are increasingly provided by nurse practitioners (NPs), and quality primary care services may decrease ED visits in this population. Yet, NP-delivered primary care for rural older adults with SUDs may be limited by work environment barriers, which include lack of support, autonomy, and visibility. This study assessed the relationship between the NP work environment and ED utilization among rural older adults with SUDs. This was a secondary analysis of cross-sectional data from a large survey of NPs in six U.S. states merged with Medicare claims. The study measured the NP work environment by the four subscales of the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ), which measure 1) independent practice and support, 2) NP-physician relations, 3) NP-administration, and 4) professional visibility. Multilevel logistic regression models, adjusted for practice and patient covariates, assess the relationship between the NP work environment and all-cause ED use. The sample included 1152 older adults with SUDs who received care at 126 rural NP primary care practices. NP independent practice and support at the practice was associated with 49 % lower odds of all-cause ED visits among older adults with SUDs. There were no relationships between the other NP-PCOCQ subscales and all-cause ED visits. Organizational support for NP independent practice is associated with lower odds of all-cause ED utilization among rural older adults with SUDs. Practice administrators should ensure that NPs have access to support and resources to enhance their ability to care for rural older adults with SUDs. Ultimately, these practice changes could reduce ED utilization and health disparities in this population. • Rural older adults with substance use disorders frequently use the emergency room. • Relations, teamwork, autonomy, and support may impact nurse practitioner (NP) care. • Support for NP independent practice associated with less emergency room use. • Organizational administrators should ensure NP autonomy and access to support. [ABSTRACT FROM AUTHOR]

[Display omitted] • HPN exhibits superior friction-reducing and anti-wear behaviors as additive. • HPN can adsorb and deposit at the friction interface due to the P-O-Ti bonds. • The tribofilm containing HPN can protect titanium alloy from severe wear. • The repulsive force between HPN and oil molecules is the key to friction reduction. In this work, a self-assembled hybrid phosphate nanoflower (HPN) containing Ba 3 (PO 4) 2 and NaBaPO 4 was synthesized via BaCO 3 primary crystals inducement. A ball-on-disc reciprocating tribometer was used to explore the tribological behavior of HPN as an additive for polyalphaolefin 8 (PAO8) on titanium alloy. Compared with the neat PAO8, after being lubricated with PAO8 containing HPN, the friction coefficient and wear rate decreased by 74.98% and 99.89%, respectively. The tribofilm at the friction interface was characterized and conformed by SEM, EDS, XPS, and cross-sectional TEM. As an additive to PAO8, HPN can participate in the formation of tribofilm and exhibit superior friction-reducing and anti-wear properties for titanium alloy. It was demonstrated that due to the P-O-Ti bonds, HPN can easily adsorb and deposit at the friction interface to form a tribofilm against wear. Besides, the simulation experiments showed that the repulsive force at the solid-liquid interface between HPN and oil molecules is the key to friction reduction and lubrication, and the comparative tribological experiments of different types of base oils were performed to verify the results of molecular dynamics. [ABSTRACT FROM AUTHOR]

Background: Prevalence of electronic health records (EHRs) has significantly increased, and EHRs are a known contributor to clinician burnout. However, it is unknown whether the use of multifunctional EHRs is associated with nurse practitioner (NP) burnout in primary care practices. This is a major gap in the literature because 69% of practicing NPs deliver primary care services to patients. Purpose: This study aimed to investigate whether the use of multifunctional EHRs is associated with primary care NP burnout. Method: This study is a secondary analysis of cross-sectional survey data collected from NPs in two states (Pennsylvania and New Jersey). Nurse practitioners completed surveys measuring burnout, use of multifunctional EHRs, demographics, and characteristics of their practice. Use of multifunctional EHRs was operationalized using two items—computerized capabilities and electronic reminder systems. Burnout was measured using a validated, single item asking NPs to self-report their feelings of burnout. A multilevel cox regression model was built to test for associations between the use of multifunctional EHRs and NP burnout. Results: Of 396 NPs included, 25.3% reported burnout. The use of multifunctional EHRs did not increase primary care NP burnout (risk ratio = 0.30, 95% confidence interval = 0.13–0.71, p =.01). Implications for practice: With 25.3% of NPs burned out, it is imperative to reduce NP burnout. However, computerized capabilities and electronic reminder systems did not contribute to feelings of NP burnout. Future research examining other EHR components is needed to understand which features of the EHR contribute to NP burnout. [ABSTRACT FROM AUTHOR]

Purpose: Few clinical indicators of a poor outcome have been defined in acute cardioembolic stroke (CES) patients. We would like to explore practical clinical factors that can predict poor outcomes of CES in the early stage. Patients and Methods: In this single-center, retrospective, observational study, 251 consecutive patients with acute CES who did not undergo reperfusion therapy were evaluated. On the basis of the modified Rankin Scale (mRS) score at 3 months, patients were divided into the good functional outcome group (mRS ≤ 2) and the poor functional outcome group (mRS ≥ 3). Risk factors were analyzed and the independent indicators for a poor outcome were identified using a binary logistic regression model. Results: One hundred (39.8%) patients had a poor outcome. Patients in the poor outcome group were significantly older (P = 0.002) and had significantly higher baseline National Institutes of Health Stroke Scale (NIHSS) score compared with those with a good outcome (P < 0.001). After adjusting for potential confounders, the baseline NIHSS score (P < 0.001), moderate to severe leukoaraiosis (P = 0.011), non-symptomatic intracranial hemorrhage (P = 0.019), stroke-associated pneumonia (P = 0.001), and fasting glucose (P = 0.040) were independent risk factors for a poor outcome. Conclusion: The short-term outcome in acute CES patients without reperfusion therapy can be predicted by using five practical clinical factors. These indicators should attract more attention. [ABSTRACT FROM AUTHOR]

Research Objective: The growing nurse practitioner (NP) workforce can play a critical role in meeting the demand for health care services especially in primary care. Yet, many policy and organizational barriers affect this workforce and their ability to deliver high quality care. State‐level scope of practice (SOP) regulations have received substantial attention due to their impact on access and quality of care. Yet, little is known how these state‐level polices also affect organizations employing NPs and potentially NPs' ability to deliver care. This study investigated the relationship between SOP policies governing NP practice and organizational‐level work environment in primary care practices. Study Design: We collected survey data from primary care NPs about their work environments from six states (Arizona, Washington, New Jersey, Pennsylvania, California, and Texas) in 2018–2019. All NPs in Arizona and New Jersey, a 75% random sample of NPs in Pennsylvania, and a 50% random sample of NPs for California and Texas were sampled. NPs completed a validated work environment tool, the Nurse Practitioner‐Primary Care Organizational Climate Questionnaire, which measures four domains of work environment: NP Administration Relations (NP‐AR), NP‐Physician Relations (NP‐PR), Independent Practice and Support (IPS), and Professional Visibility (PV). Regression models were used to assess the relationship between state level‐SOP and organizational‐level work environment domains. The models were controlled for demographic and work characteristics. Population Studied: Data were collected from 1244 NPs in 1109 practices. Arizona and Washington were characterized as having full SOP for NPs‐NPs independently deliver care. New Jersey and Pennsylvania had reduced SOP‐physician collaboration is required for care delivery; and California and Texas had restricted SOP‐physician supervision required. Principal Findings: NP practices from full SOP states were more likely to have higher PV scores compared to practices within reduced (B = 0.16; P‐value = 0.005) and restricted (B = 0.12; P‐value = 0.02) SOP states. Practices from full SOP states were more likely to have higher NP‐AR scores compared to practices from reduced (B:0.22; P‐value = 0.0003) and restricted (B = 0.15; P‐value = 0.009) SOP states. In addition, practices from full SOP states were more likely to have higher IPS score compared to practices from reduced (B:0.14; P‐value = 0.0003) and restricted (B = 0.09; P‐value = 0.01) SOP states. There was no relationship between SOP type and practice‐level NP‐PR score. Conclusions: Findings show that state‐level policies indeed affect organizational‐level work environment. NP work environment is more favorable in states with more favorable policy environment which does not require physician supervision or collaboration for NP care delivery. NPs practicing in full SOP states have better relationships with administration, report more visibility in NP role, and more support within their organizations for independent NP practice. Implications for Policy or Practice: NPs play a critical role in the U.S. health care system and creating optimal state‐ and organizational‐ level policies will help to optimally utilize NPs and maximize their contributions to patient care and the overall health care system. Full SOP regulations should be the gold‐standard, and policy makers in reduced and restricted SOP states should invest efforts to remove unnecessary restrictions. Practice administrators should create favorable work environments for NPs. Primary Funding Source: National Institutes of Health. [ABSTRACT FROM AUTHOR]

Research Objective: The growing nurse practitioner (NP) workforce can play a critical role in meeting the demand for health care services especially in primary care. Yet, many policy and organizational barriers affect this workforce and their ability to deliver high quality care. State‐level scope of practice (SOP) regulations have received substantial attention due to their impact on access and quality of care. Yet, little is known how these state‐level polices also affect organizations employing NPs and potentially NPs' ability to deliver care. This study investigated the relationship between SOP policies governing NP practice and organizational‐level work environment in primary care practices. Study Design: We collected survey data from primary care NPs about their work environments from six states (Arizona, Washington, New Jersey, Pennsylvania, California, and Texas) in 2018–2019. All NPs in Arizona and New Jersey, a 75% random sample of NPs in Pennsylvania, and a 50% random sample of NPs for California and Texas were sampled. NPs completed a validated work environment tool, the Nurse Practitioner‐Primary Care Organizational Climate Questionnaire, which measures four domains of work environment: NP Administration Relations (NP‐AR), NP‐Physician Relations (NP‐PR), Independent Practice and Support (IPS), and Professional Visibility (PV). Regression models were used to assess the relationship between state level‐SOP and organizational‐level work environment domains. The models were controlled for demographic and work characteristics. Population Studied: Data were collected from 1244 NPs in 1109 practices. Arizona and Washington were characterized as having full SOP for NPs‐NPs independently deliver care. New Jersey and Pennsylvania had reduced SOP‐physician collaboration is required for care delivery; and California and Texas had restricted SOP‐physician supervision required. Principal Findings: NP practices from full SOP states were more likely to have higher PV scores compared to practices within reduced (B = 0.16; P‐value = 0.005) and restricted (B = 0.12; P‐value = 0.02) SOP states. Practices from full SOP states were more likely to have higher NP‐AR scores compared to practices from reduced (B:0.22; P‐value = 0.0003) and restricted (B = 0.15; P‐value = 0.009) SOP states. In addition, practices from full SOP states were more likely to have higher IPS score compared to practices from reduced (B:0.14; P‐value = 0.0003) and restricted (B = 0.09; P‐value = 0.01) SOP states. There was no relationship between SOP type and practice‐level NP‐PR score. Conclusions: Findings show that state‐level policies indeed affect organizational‐level work environment. NP work environment is more favorable in states with more favorable policy environment which does not require physician supervision or collaboration for NP care delivery. NPs practicing in full SOP states have better relationships with administration, report more visibility in NP role, and more support within their organizations for independent NP practice. Implications for Policy or Practice: NPs play a critical role in the U.S. health care system and creating optimal state‐ and organizational‐ level policies will help to optimally utilize NPs and maximize their contributions to patient care and the overall health care system. Full SOP regulations should be the gold‐standard, and policy makers in reduced and restricted SOP states should invest efforts to remove unnecessary restrictions. Practice administrators should create favorable work environments for NPs. Primary Funding Source: National Institutes of Health. [ABSTRACT FROM AUTHOR]

• Cholesteryl ester(CE) generated from the mitochondria associated membrane (MAM). • MAM-resident ACAT controls the Esterification of Cholesterol. • Progesterone suppressed CE level, CE / FC ratio and the length of MAM. • Progesterone decreased ACAT1 expression through the PGRMC1 receptor. • The ERK1/2 pathway maybe involved in the progesterone mediated regulation of ACAT1. Cholesteryl ester(CE), generated from the mitochondria associated membrane (MAM), is involved in the pathogenesis of Alzheimer's Disease (AD). In theory, the different neuroprotective effects of progesterone in AD are all linked to MAM, yet the effect on cholesterol esterification has not been reported. Therefore, this study was aimed to investigate the regulation of progesterone on intracerebral CE in AD models and the underlying mechanism. APP/PS1 mice and AD cell model induced by Aβ 25-35 were selected as the research objects. APP/PS1 mice were daily administrated intragastrically with progesterone and The Morris Water Maze test was performed to detect the learning and memory abilities. Intracellular cholesterol was measured by Cholesterol/Cholesteryl Ester Quantitation Assay. The structure of MAMs were observed with transmission electron microscopy. The expression of acyl-CoA: cholesterol acyltransferase 1 (ACAT1), ERK1/2 and p-ERK1/2 were detected with western blotting, immunohistochemistry or immunofluorescence. Progesterone suppressed the accumulation of intracellular CE, shortened the length of abnormally prolonged MAM in cortex of APP/PS1 mice. Progesterone decreased the expression of ACAT1, which could be blocked by progesterone receptor membrane component 1 (PGRMC1) inhibitor AG205. The ERK1/2 pathway maybe involved in the progesterone mediated regulation of ACAT1 in AD models, rather than the PI3K/Akt and the P38 MEPK pathways. The results supported a line of evidence that progesterone regulates CE level and the structure of MAM in neurons of AD models, providing a promising treatment against AD on the dysfunction of cholesterol metabolism. [ABSTRACT FROM AUTHOR]

Objectives: To review the clinical and imaging data of spinal giant cell tumour of the tendon sheath (GCTTS) to improve our understanding of the disease. Methods: The imaging findings, clinicopathological features and clinical outcomes of 14 patients with pathologically confirmed spinal GCTTS were analysed retrospectively. Results: All 14 patients had a single spinal lesion, including ten cervical vertebra lesions and four thoracic vertebra lesions. CT scan findings: The lesions showed osteolytic bone destruction and were centred on the facet joint, eroding the surrounding bone with a paravertebral soft tissue mass. MRI scan findings: all the lesions manifested predominantly as isointense or hypointense on T1-weighted imaging (T1WI). On T2-weighted imaging (T2WI), eight lesions were hypointense, and four were isointense. The remaining two lesions showed slight hyperintensity. The enhanced scans of eight lesions showed moderate to marked homogeneous or heterogeneous enhancement. PET/CT findings: Among the five patients who underwent PET/CT, three presented lesions with well-defined, sclerotic borders, and the uptake of 18F-FDG was markedly increased. One lesion showed an ill-defined border and an uneven increase in 18F-FDG uptake with an SUVmax value of 8.9. A recurrent lesion was only found on PET/CT 45 months after surgery and the SUVmax was 5.1. Conclusions: Spinal GCTTS is extremely rare. Osteolytic bone destruction in the area of the facet joint with a soft tissue mass and hypointensity on T2WI images are indicative of the spinal GCTTS. GCTTS shows high uptake of 18F-FDG, and PET/CT is helpful in detecting recurrent lesions. [ABSTRACT FROM AUTHOR]

Background: Burnout threatens patient care and clinicians are experiencing challenges within the practice environment. Little is known about nurse practitioner (NP) perceptions of burnout and its relationship to care quality and practice environment. We investigate the relationship between primary care NP burnout on perceptions of care quality and if the practice environment moderates the relationship between burnout and care quality. Methods: This is a secondary analysis of cross‐sectional survey data from 396 NPs. Burnout and care quality were measured using a single item, but the practice environment was measured using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. Multi‐level proportional odds cumulative logit models were built to test for associations between burnout and care quality and for moderation. Results: Total, 25.3% of NPs reported burnout. Odds of perceiving higher quality of care was 85% less for NPs experiencing burnout compared to those not experiencing burnout. Practice environment did not moderate the relationship between burnout and care quality, but with a one unit increase in the practice environment subscales, the odds of NPs perceiving higher care quality increased anywhere from 3.83 to 7.57 times. Conclusion: Burnout is related to lower perceptions of care quality but favorable environments were related to higher perceptions of quality. [ABSTRACT FROM AUTHOR]

Nanomaterials are widely used as promising additives in tribology. In this study, large cadmium-based phosphate (CdP) microspheres assembled from nanosheets were synthesized, and the tribological performance and anti-wear mechanism of the CdPs as additives in lubricating oils were investigated using a reciprocating ball-on-disc tribometer and surface characterization techniques. Oxygen-free oil with CdP significantly reduced the friction coefficient (COF) and wear rate (WR) of TA5 titanium alloys. Compared with pure polyalphaolefin 8 (PAO8), lubrication with PAO8 containing 25 wt% CdP reduced the average COF and WR by 70.03 % and 99.56 %, respectively. The extraordinary anti-wear property was attributed to the adsorption and deposition of CdP on the titanium alloy surface through P–O–Ti bonds, which resulted in a smooth tribofilm containing CdP. This tribofilm can prevent the adhesion of debris from the titanium alloy on the worn surface of the alloy and reduce adhesive and abrasive wear. However, the adsorption of CdP on the titanium alloy was compromised when an oxygen-containing oil was used as the base oil because the oxygen-containing oil molecules can bind to the titanium alloys and block the positions occupied by CdP. Based on the experimental results, it is concluded that CdP is an excellent anti-wear additive for titanium alloys. [Display omitted] • CdP microspheres exhibit superior anti-wear behavior as oil-based additives for titanium alloy. • CdP can effectively reduce the adhesive wear and abrasive wear as lubricant additives. • The adsorption layer formed by CdP on the worn surface is the key to anti-wear. • The P–O–Ti bonds contribute to the adsorption and deposition of CdP on titanium alloy. [ABSTRACT FROM AUTHOR]

[Display omitted] Recent studies have shown that neutrophils play an important role in the development and progression of heart failure. Developmental endothelial locus-1 (DEL-1) is an anti-inflammatory glycoprotein that has been found to have protective effects in various cardiovascular diseases. However, the role of DEL-1 in chronic heart failure is not well understood. In a mouse model of pressure overload-induced non-ischemic cardiac failure, we found that neutrophil infiltration in the heart increased and DEL-1 levels decreased in the early stages of heart failure. DEL-1 deficiency worsened pressure overload-induced cardiac dysfunction and remodeling in mice. Mechanistically, DEL-1 deficiency promotes neutrophil infiltration and the formation of neutrophil extracellular traps (NETs) through the regulation of P38 signaling. In vitro experiments showed that DEL-1 can inhibit P38 signaling and NETs formation in mouse neutrophils in a MAC-1-dependent manner. Depleting neutrophils, inhibiting NETs formation, and inhibiting P38 signaling all reduced the exacerbation of heart failure caused by DEL-1 deletion. Overall, our findings suggest that DEL-1 deficiency worsens pressure overload-induced heart failure by promoting neutrophil infiltration and NETs formation. [ABSTRACT FROM AUTHOR]

Recently, nanomaterial lubricant additives have attracted the attention of tribologists. Herein, a novel cobalt phosphate octahydrates (CoP) nanoflower was synthesized, and as an oil-base additive, CoP exhibited extraordinary tribological performance for titanium alloy. Compared with the pure PAO8, the friction coefficient (COF) and wear rate (W R) has been reduced by 69.77% and 99.27% at a concentration of 10 wt% CoP. Besides, SEM, EDS, and XPS characterization confirmed that CoP could fill and repair the surface of titanium alloy to make the worn surface smoother, and be deposited on the surface to form a deposition layer to protect the titanium alloy from severe wear. The low shear force between CoP nanosheets in the deposition layer promotes lubrication, achieving low COF. [ABSTRACT FROM AUTHOR]

[Display omitted] Transient receptor potential ankyrin 1 (TRPA1) has been linked to the development of various cardiovascular diseases, but its role in diabetic cardiomyopathy is not well understood. This study aimed to investigate the protective effects of TRPA1 deficiency on diabetic cardiomyopathy in rats with streptozotocin-induced diabetes and in neonatal rat cardiac fibroblasts (CFs) exposed to high glucose (HG). Cardiac TRPA1 expression levels were measured in diabetic rats. Cardiac function, remodeling, and fibrosis were analyzed in Sprague-Dawley (SD) rats and TRPA1-deficient rats with diabetic cardiomyopathy. In vitro, fibrosis was measured in CFs exposed to HG. Additionally, 1,8-cineole, a natural inhibitor of TRPA1, was used to treat SD rats with diabetic cardiomyopathy. TRPA1 expression was increased in the heart tissue of diabetic rats and in CFs treated with HG. TRPA1 deficiency significantly improved cardiac function in diabetic rats, as evidenced by improved echocardiography and reduced cardiac hypertrophy and fibrosis. In vitro, TRPA1 deficiency suppressed the transformation of HG-induced CFs into myofibroblasts. The cardioprotective effect of TRPA1 deficiency was found to inhibit cardiac fibrosis by regulating GRK5/NFAT signaling. Furthermore, inhibition of GRK5/NFAT signaling abolished the promotion of CF transformation into myofibroblasts by TRPA1 activation. Inhibition of TRPA1 activation by 1,8-cineole reduced cardiac dysfunction and remodeling in diabetic rats by regulating GRK5/NFAT signaling. TRPA1 deficiency reduced cardiac fibrosis in diabetic rats and inhibited HG-induced CF activation in vitro by regulating GRK5/NFAT signaling. The TRPA1 inhibitor 1,8-cineole may serve as a novel therapeutic agent for the treatment of diabetic cardiomyopathy. [ABSTRACT FROM AUTHOR]

Ammonia (NH 3) plays a significant role in fertilizer production to support the ever-increasing population and serves as a renewable energy carrier as well as a zero-carbon emission fuel. Currently, NH 3 is produced by a non-sustainable and highly energy-intensive process. Among the available alternatives, the electrochemical nitrogen reduction reactions (NRR) has attracted attention due to the compact and on-site electrolytic cells that can operate from solar or wind power under ambient conditions but still suffer from relatively low Faraday efficiency and NH 3 yields. For the commercialization of electrocatalytic NRR, a catalytic material demonstrating a FE ∼50% and an NH 3 yield rate of ∼10−6 mol s−1 cm−2 is suggested. Various strategies, including amorphization, structural engineering, catalyst-support interactions and hydrogen evolution suppression over catalytic materials, have been presented to enhance the electrocatalytic NRR. In this review, the current progress of various identified NRR electrocatalysts (including metal carbides, nitrides, oxides, phosphides, sulfides, selenides, borides, bimetallic materials, metal-organic frameworks, and metal-free materials) is summarized by collectively focusing on both theoretical analysis and experimental investigations. For further development of rational catalysts, a collaboration of theoretical and experimental studies, advanced characterization techniques, understanding of the electrocatalytic mechanism, efficient screening systems, and precise detection methods are needed. Specially designed electrocatalysts can improve NRR activity by regulating the cathodic reactions. The challenges and future perspectives have been described with special emphasis on various transition metal-based electrocatalysts for N 2 fixation. • Ambient electrochemical ammonia synthesis is an energy-saving approach. • Electrochemical NH 3 synthesis is still in the basic scientific investigation stage. • For NRR commercialization FE ∼50% and an NH 3 yield ∼10−6 mol s−1 cm−2 are advised. • To date, Mo-based compounds have demonstrated high ambient NRR performances. [ABSTRACT FROM AUTHOR]

[Display omitted] Several interleukins (ILs) have been demonstrated to participate in cardiac injury. This study aimed to investigate whether IL-27p28 plays a regulatory role in doxorubicin (DOX)-induced cardiac injury by regulating inflammation and oxidative stress. Dox was used to establish a mouse cardiac injury model, and IL-27p28 was knocked out to observe its role in cardiac injury. In addition, monocytes were adoptively transferred to clarify whether monocyte-macrophages mediate the regulatory role of IL-27p28 in DOX-induced cardiac injury. IL-27p28 knockout significantly aggravated DOX-induced cardiac injury and cardiac dysfunction. IL-27p28 knockout also upregulated the phosphorylation levels of p65 and STAT1 and promoted M1 macrophage polarization in DOX-treated mice, which increased cardiac inflammation and oxidative stress. Moreover, IL-27p28-knockout mice that were adoptively transferred WT monocytes exhibited worse cardiac injury and cardiac dysfunction and higher cardiac inflammation and oxidative stress. IL-27p28 knockdown aggravates DOX-induced cardiac injury by worsening the M1 macrophage/M2 macrophage imbalance and its associated inflammatory response and oxidative stress. [ABSTRACT FROM AUTHOR]

Geometric variables and surface chemistry of nanomaterials as lubricant additives both affect the details on the interacting frictional surface. Herein, copper phosphate nanosheets (CPNs) were synthesized by a simple and facile method, which exhibited extraordinary tribological properties as the novel lubricating oil nanoadditives. Compared with the base oil, the friction coefficient (COF) has been reduced by 77% by CPNs at a concentration of 20 wt%, which could also protect the titanium alloy surface from any measurable wear. But as the CPNs content increased to 25 wt%, the shear jamming caused by hydrogen bonding between crystal water in CPNs may interfere with lubrication. Besides, it is significantly effective in preventing the adhesions of titanium alloy on the surface of counterface at a suitable concentration. The extraordinary tribological performance is contributed to the nanosheets of copper phosphate but not the nanoparticles. Moreover, in the presence of CPNs, the tribo-film containing CPNs is formed during sliding contact, but this tribo-film can't hold for a long time without CPNs, indicating that CPNs can well retain the tribo-film. However, the dominant factor for friction reduction and antiwear is not this tribo-film but the solid-liquid interface lubrication between nanosheets and lubricating oil. The Stribeck curves were used to explain how CPNs play a role in boundary lubrication and mixed lubrication. [ABSTRACT FROM AUTHOR]

It has been proposed that the intrinsic property of nucleosome arrays to undergo liquid-liquid phase separation (LLPS) in vitro is responsible for chromatin domain organization in vivo. However, understanding nucleosomal LLPS has been hindered by the challenge to characterize the structure of the resulting heterogeneous condensates. We used cryo-electron tomography and deep-learning-based 3D reconstruction/segmentation to determine the molecular organization of condensates at various stages of LLPS. We show that nucleosomal LLPS involves a two-step process: a spinodal decomposition process yielding irregular condensates, followed by their unfavorable conversion into more compact, spherical nuclei that grow into larger spherical aggregates through accretion of spinodal materials or by fusion with other spherical condensates. Histone H1 catalyzes more than 10-fold the spinodal-to-spherical conversion. We propose that this transition involves exposure of nucleosome hydrophobic surfaces causing modified inter-nucleosome interactions. These results suggest a physical mechanism by which chromatin may transition from interphase to metaphase structures. [Display omitted] • Tetranucleosome phase separation involves a two-step condensation process • Spinodal decomposition causes the initial formation of loosely packed irregular condensates • Nuclei formation within spinodal condensates gives raise to denser spherical condensates • Histone H1 catalyzes more than 10-fold the spinodal-to-spherical condensate conversion Zhang et al. demonstrate that liquid-liquid phase separation of tetranucleosome arrays occurs in two steps: a spinodal decomposition involving formation of loosely arranged irregular condensates, followed by the emergence of tightly packed spherical nuclei. The structure of nucleosome condensates by cryo-ET suggests a physical mechanism of chromatin compaction in vivo. [ABSTRACT FROM AUTHOR]

[Display omitted] • 1.MCC950 treatment reverses cardiac dysfunction in mice after TAC surgery. • 2.MCC950 attenuates cardiac hypertrophy and fibrosis induced by pressure overload. • 3.MCC950 attenuates pressure overload-induced myocardial inflammation. • 4.MCC950 reduces the infiltration of both M1 and M2 macrophages after TAC surgery. Activation of the NLRP3 inflammasome promotes pathological cardiac remodeling induced by pressure overload. However, the therapeutic effects of NLRP3 inhibition after cardiac remodeling remain unknown. The present study aimed to investigate whether the selective NLRP3 inhibitor, MCC950, could reverse transverse aortic constriction (TAC)-induced cardiac remodeling. Mice were divided into four groups based on the treatment given: sham, sham + MCC950, TAC, and TAC + MCC950. MCC950 (10 mg/kg, intraperitoneal injection, once per day) was administered from two weeks after TAC or sham surgery for four weeks. Echocardiography, histological analysis, RT-PCR, and Western blotting were performed to explore the function of MCC950 after TAC. We found that MCC950 reversed cardiac dysfunction after TAC. MCC950 attenuated cardiac hypertrophy by down-regulating calcineurin expression and inhibiting MAPK activation. Further, it also alleviated cardiac fibrosis post-TAC by inhibiting the TGF-β/Smad4 pathway, and reduced cardiac inflammation and macrophage infiltration post-TAC, including both M1 and M2 macrophages. Taken together, MCC950 can attenuate cardiac remodeling due to pressure overload by inhibiting hypertrophy, fibrosis, and inflammation. Our study provides a basis for the clinical application of NLRP3 inhibitors in the treatment of non-ischemic heart failure. [ABSTRACT FROM AUTHOR]