•Product acceptance was consistent across the three methods of instruction used.•Panelists demonstrated a similar degree of sensory engagement in all methods.•Asynchronous testing methods proved to ...be more practical.
In the context of the COVID-19 pandemic, it has become challenging for sensory scientists to conduct in-person sensory tests, particularly large central location tests. Sensory literature comparing central location and home use tests shows no clear consensus about how each methodology affects sample ratings and panelist engagement. Research on instructional delivery suggests that the most effective method of increasing engagement involves interactive video conferencing. The objective of this study was to compare three methods of remote consumer testing regarding sample acceptance, sensory engagement, and method practicality. Eighty-four participants rated five chocolate-chip cookie products on a 9-pt hedonic scale in each of three methods: 1) a live (synchronous) Zoom session, 2) an asynchronous video-guided session, and 3) a fully written protocol session. Results showed no significant differences in sample liking pattern across the methods used. Engagement scores approached the limit of significance for the Active Involvement dimension, indicating panelists were least likely to feel distracted, zoned out or lose interest in the written protocol method. There were no significant differences in the time spent on the test by the panelists across the three methods. Asynchronous methods showed to be most suitable in terms of the convenience of the time of day at which the tests were completed, but showed no significant differences in other aspects of method practicality. Overall, a written protocol method of remote consumer testing is recommended, as it is less time-consuming for researchers while providing similar acceptance and engagement as other methods.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Estrogen receptor-positive (ER+) is the most common subtype of breast cancer. Endocrine therapy is the fundamental treatment against this entity, by directly or indirectly modifying estrogen ...production. Recent advances in novel compounds, such as cyclin-dependent kinase 4/6 inhibitors (CDK4/6i), or phosphoinositide 3-kinase (PI3K) inhibitors have improved progression-free survival and overall survival in these patients. However, some patients still develop endocrine resistance after or during endocrine treatment. Different underlying mechanisms have been identified as responsible for endocrine treatment resistance, where ESR1 gene mutations are one of the most studied, outstanding from others such as somatic alterations, microenvironment involvement and epigenetic changes. In this scenario, selective estrogen receptor degraders/downregulators (SERD) are one of the weapons currently in research and development against aromatase inhibitor- or tamoxifen-resistance. The first SERD to be developed and approved for ER+ breast cancer was fulvestrant, demonstrating also interesting activity in ESR1 mutated patients in the second line treatment setting. Recent investigational advances have allowed the development of new oral bioavailable SERDs. This review describes the evolution and ongoing studies in SERDs and new molecules against ER, with the hope that these novel drugs may improve our patients’ future landscape.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Enhancers are DNA sequences that enable complex temporal and tissue-specific regulation of genes in higher eukaryotes. Although it is not entirely clear how enhancer-promoter interactions can ...increase gene expression, this proximity has been observed in multiple systems at multiple loci and is thought to be essential for the maintenance of gene expression. Bromodomain and Extra-Terminal domain (BET) and Mediator proteins have been shown capable of forming phase condensates and are thought to be essential for super-enhancer function. Here, we show that targeting of cells with inhibitors of BET proteins or pharmacological degradation of BET protein Bromodomain-containing protein 4 (BRD4) has a strong impact on transcription but very little impact on enhancer-promoter interactions. Dissolving phase condensates reduces BRD4 and Mediator binding at enhancers and can also strongly affect gene transcription, without disrupting enhancer-promoter interactions. These results suggest that activation of transcription and maintenance of enhancer-promoter interactions are separable events. Our findings further indicate that enhancer-promoter interactions are not dependent on high levels of BRD4 and Mediator, and are likely maintained by a complex set of factors including additional activator complexes and, at some sites, CTCF and cohesin.
Introduction Measuring the impact of care complexity on health outcomes, based on psychosocial, biological and environmental circumstances, is important in order to detect predictors of early ...deterioration of inpatients. We aimed to identify care complexity individual factors associated with selected adverse events and in-hospital mortality. Methods A multicenter, case-control study was carried out at eight public hospitals in Catalonia, Spain, from January 1, 2016 to December 31, 2017. All adult patients admitted to a ward or a step-down unit were evaluated. Patients were divided into the following groups based on the presence or absence of three adverse events (pressure ulcers, falls or aspiration pneumonia) and in-hospital mortality. The 28 care complexity individual factors were classified in five domains (developmental, mental-cognitive, psycho-emotional, sociocultural and comorbidity/complications). Adverse events and complexity factors were retrospectively reviewed by consulting patients’ electronic health records. Multivariate logistic analysis was performed to identify factors associated with an adverse event and in-hospital mortality. Results A total of 183,677 adult admissions were studied. Of these, 3,973 (2.2%) patients experienced an adverse event during hospitalization (1,673 0.9% pressure ulcers; 1,217 0.7% falls and 1,236 0.7% aspiration pneumonia). In-hospital mortality was recorded in 3,996 patients (2.2%). After adjustment for potential confounders, the risk factors independently associated with both adverse events and in-hospital mortality were: mental status impairments, impaired adaptation, lack of caregiver support, old age, major chronic disease, hemodynamic instability, communication disorders, urinary or fecal incontinence, vascular fragility, extreme weight, uncontrolled pain, male sex, length of stay and admission to a medical ward. High-tech hospital admission was associated with an increased risk of adverse events and a reduced risk of in-hospital mortality. The area under the ROC curve for both outcomes was > 0.75 (95% IC: 0.78–0.83). Conclusions Several care complexity individual factors were associated with adverse events and in-hospital mortality. Prior identification of complexity factors may have an important effect on the early detection of acute deterioration and on the prevention of poor outcomes.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Recent findings show that approximately 87% of the U.S. population fail to meet the vegetable intake recommendations, with unpleasant taste of vegetables being listed as the primary reason for this ...shortfall. In this study, spice and herb seasoning was used to enhance palatability of vegetables, in order to increase consumer acceptance. In total, 749 panelists were screened and recruited as specific vegetable likers of the vegetable being tested or general vegetable likers. Four sessions were designed to evaluate the effect of seasoning within each type of vegetable, including broccoli, cauliflower, carrot, and green bean. Each panelist was only allowed to participate in one test session to evaluate only one vegetable type, so as to mitigate potential learning effect. Overall, the results showed that seasoned vegetables were significantly preferred over unseasoned vegetables (P < 0.001), indicating the sensory properties were significantly improved with seasoning. When general vegetable likers and specific vegetable likers were compared in terms of their preference between seasoned and unseasoned vegetables, the pattern varied across different vegetables; however, general trend of seasoned vegetable being preferred remained. The findings from this study demonstrate the effect of seasoning in enhancing consumer liking of vegetables, which may lead to increased consumption to be assessed in future studies.
Practical Application
To improve the sensory properties of vegetables, masking the bitter taste of vegetables using spice and herb seasoning are gaining increasing attention. Our findings suggest that the overall liking of vegetables could be improved by incorporating spice and herb seasonings that are specifically formulated for each vegetable. Ultimately, developing and commercializing spice and herb seasonings may aid to increase vegetable consumption, as well as expanding the vegetable seasoning market.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Aim
To compare the patient acuity, nurse staffing and workforce, missed nursing care and patient outcomes among hospital unit‐clusters.
Background
Relationships among acuity, nurse staffing and ...workforce, missed nursing care and patient outcomes are not completely understood.
Method
Descriptive design with data from four unit‐clusters: medical, surgical, combined and step‐down units. Descriptive statistics were used to compare acuity, nurse staffing coverage, education and expertise, missed nursing care and selected nurse‐sensitive outcomes.
Results
Patient acuity in general (medical, surgical and combined) floors is similar to step‐down units, with an average of 5.6 required RN hours per patient day. In general wards, available RN hours per patient day reach only 50% of required RN hours to meet patient needs. Workforce measures are comparable among unit‐clusters, and average missed nursing care is 21%. Patient outcomes vary among unit‐clusters.
Conclusion
Patient acuity is similar among unit‐clusters, while nurse staffing coverage is halved in general wards. While RN education, expertise and missed care are comparable among unit‐clusters, mortality, skin injuries and risk of family compassion fatigue rates are higher in general wards.
Implications for Nursing Management
Nurse managers play a pivotal role in hustling policymakers to address structural understaffing in general wards, to maximize patient safety outcomes.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Aim
To assess the ability of the patient main problem to predict acuity in adults admitted to hospital wards and step‐down units.
Background
Acuity refers to the categorization of patients based on ...their required nursing intensity. The relationship between acuity and nurses' clinical judgment on the patient problems, including their prioritization, is an underexplored issue.
Method
Cross‐sectional, multi‐centre study in a sample of 200,000 adults. Multivariate analysis of main problems potentially associated with acuity levels higher than acute was performed. Distribution of patients and outcome differences among acuity clusters were evaluated.
Results
The main problems identified are strongly associated with patient acuity. The model exhibits remarkable ability to predict acuity (AUC, 0.814; 95% CI, 0.81–0.816). Most patients (64.8%) match higher than acute categories. Significant differences in terms of mortality, hospital readmission and other outcomes are observed (p < .005).
Conclusion
The patient main problem predicts acuity. Most inpatients require more intensive than acute nursing care and their outcomes are adversely affected.
Implications for nursing management
Prospective measurement of acuity, considering nurses' clinical judgments on the patient main problem, is feasible and may contribute to support nurse management workforce planning and staffing decision‐making, and to optimize patients, nurses and organizational outcomes.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Objective
To identify and classify the barriers and facilitators of the individualisation process of the standardised care plan in hospitalisation wards.
Background
The administration of ...individualised care is one of the features of the nursing process. Care plans are the structured record of the diagnosis, planning and evaluation stages of the nursing process. Although the creation of standardised care plan has made recording easier, it is still necessary to record the individualisation of the care. It is important to study the elements that influence the individualisation process from the nurses' perspective.
Design
Qualitative study with the grounded theory approach developed by Strauss and Corbin.
Methods
Thirty‐nine nurses from three hospitals participated by way of theoretical sampling. In‐depth interviews were conducted, as well as participant observation, document analysis and focus group discussion. The analysis consisted of open, axial and selective coding until data saturation was reached. EQUATOR guidelines for qualitative research (COREQ) were applied.
Results
For both barriers and facilitators, three thematic categories emerged related to organisational, professional and individual aspects. The identified barriers included routines acquired in the wards, the tradition of narrative records, lack of knowledge and limited interest in individualisation. The identified facilitators included holding clinical care sessions, use of standardised care plan and an interface terminology, the nurse's expertise and willingness to individualise.
Conclusion
The individualisation process of the standardised care plan involves multiple barriers and facilitators, which influence its degree of accuracy.
Relevance to clinical practice
Implementing strategies at an organisational level, professional level and individual level to improve the way the process is carried out would encourage individualising the standardised care plan in a manner that is consistent with the needs of the patient and family; it would improve the quality of care and patient satisfaction.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Understanding the underlying molecular mechanisms of defined cancers is crucial for effective personalized therapies. Translocations of the mixed-lineage leukemia (MLL) gene produce fusion proteins ...such as MLL-AF4 that disrupt epigenetic pathways and cause poor-prognosis leukemias. Here, we find that at a subset of gene targets, MLL-AF4 binding spreads into the gene body and is associated with the spreading of Menin binding, increased transcription, increased H3K79 methylation (H3K79me2/3), a disruption of normal H3K36me3 patterns, and unmethylated CpG regions in the gene body. Compared to other H3K79me2/3 marked genes, MLL-AF4 spreading gene expression is downregulated by inhibitors of the H3K79 methyltransferase DOT1L. This sensitivity mediates synergistic interactions with additional targeted drug treatments. Therefore, epigenetic spreading and enhanced susceptibility to epidrugs provides a potential marker for better understanding combination therapies in humans.
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•MLL-AF4 binding requires an unmethylated CpG (uCpG) island and Menin•MLL-AF4 and Menin can spread into the gene body of some targets•Spreading targets are highly transcribed and have an aberrant chromatin signature•Spreading of MLL-AF4 is a predictor of sensitivity to DOT1L inhibitors
Translocations of the MLL gene produce fusion proteins such as MLL-AF4 that cause poor-prognosis leukemias. Kerry et al. show that MLL-AF4 can spread into the gene body of some target genes. Spreading targets have an aberrant chromatin signature and are sensitive to DOT1L inhibitors.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Treatment for the HER2+ breast cancer subtype is still unsatisfactory, despite breakthroughs in research. The discovery of various new molecular mechanisms of transcription factors may help to make ...treatment regimens more effective. The transcription factor SALL4 has been related to aggressiveness and resistance therapy in cancer. Its molecular mechanisms and involvement in various signaling pathways are unknown in the HER2+ breast cancer subtype. In this study, we have evaluated the implication of SALL4 in the HER2+ subtype through its expression in patients’ samples and gain and loss of function in HER2+ cell lines. We found higher SALL4 expression in breast cancer tissues compared to healthy tissue. Interestingly, high SALL4 expression was associated with disease relapse and poor patient survival. In HER2+ cell lines, transient overexpression of SALL4 modulates PI3K/AKT signaling through regulating PTEN expression and BCL2, which increases cell survival and proliferation while reducing the efficacy of trastuzumab. SALL4 has also been observed to regulate the epithelial–mesenchymal transition and stemness features. SALL4 overexpression significantly reduced the epithelial markers E-cadherin, while it increased the mesenchymal markers β-catenin, vimentin and fibronectin. Furthermore, it has been also observed an increased expression of MYC, an essential transcription factor for regulating epithelial-mesenchymal transition and/or cancer stem cells. Our study demonstrates, for the first time, the importance of SALL4 in the HER2+ subtype and partial regulation of trastuzumab sensitivity. It provides a viable molecular mechanism-driven therapeutic strategy for an important subset of HER2-overexpressing patients whose malignancies are mediated by SALL4 expression.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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