Search

Background Intraoperative hypotension is a risk factor for perioperative adverse outcomes and is highly prevalent in older patients. Frailty has been associated with hemodynamic instability but its impact on postinduction hypotension is unclear. Therefore, we assessed the association between frailty and postinduction hypotension in older patients. Methods We retrospectively evaluated electronic medical records of patients aged ≥65 years who were assessed for preoperative frailty and underwent noncardiac surgery under general anesthesia. Reported Edmonton Frail Scale (REFS) scores were used to stratify patients into a nonfrail (REFS scores 0–5), prefrail (6–7), and frail (8–18) groups. Postinduction hypotension was defined as a mean blood pressure below 65 mmHg or 20% from baseline occurring within the first 20 minutes after anesthesia induction and evaluated using multivariate logistic regression analysis. Results Independent factors related to postinduction hypotension in our sample (421 patients) were status of frail (REFS score ≥8) compared to nonfrail (odds ratio [OR], 2.73; 95% confidence interval [CI], 1.44–5.18; p  = .002), lower baseline mean blood pressure in the operating room (OR, 0.98; 95% CI, 0.96–0.999; p  = .034) and at the presurgical center (OR, 0.96; 95% CI, 0.94–0.99; p  = .003), and orthopedic (compared to urologic) surgery (OR, 2.22; 95% CI, 1.14–4.30; p  = .019). Conclusion Preoperative frail status based on REFS scores is associated with postinduction hypotension. Frailty screening tool for older patients may enhance traditional risk calculators and improve patient selection for noncardiac surgery under general anesthesia. [ABSTRACT FROM AUTHOR]

Most employees proactively alter their jobs to improve their functioning at work. Such self-initiated behaviours, referred to as job crafting, are primarily intended to benefit the employees themselves. This study contrasts the self-serving nature of job crafting by hypothesizing its positive, reciprocal relationship with a form of work behaviour which primarily benefits organizations – innovative work behaviour (IWB). Drawing upon Conservation of Resources theory, we test a novel perspective suggesting that job crafting and IWB can perpetuate each other by forming gain cycles. Furthermore, we examine whether participative decision making (PDM) can instigate these gain cycles by enhancing subsequent job crafting and IWB. These research hypotheses were tested using three-wave survey data collected from employees (N = 404) within the Belgian higher education sector. The results demonstrate that not only does job crafting relate to subsequent increases in IWB, but also that IWB relates to subsequent increases in job crafting over three measurements occasions. In contrast, PDM did not predict subsequent changes in either form of work behaviour. We discuss these results in light of their contributions to advancing theoretical understanding of the job crafting-IWB relationship and practices intended to promote gain cycles beneficial to employees and employers alike. [ABSTRACT FROM AUTHOR]

Excessive production and accumulation of amyloid‐beta (Aβ) in the brain are one of the hallmarks of Alzheimer's disease (AD). Although oxidative stress is known to trigger and promote the progression of AD, the molecular relationship between oxidative stress and Aβ production is not yet fully understood. In this study, we demonstrate that microtubule acetylation induced by oxidative stress plays a critical role in Aβ production and secretion by altering the subcellular distribution of Aβ precursor protein (APP)‐containing lysosomal vesicles. Under oxidative stress, both H4‐APPSwe/Ind and HEK293T‐APPSwe/Ind cell lines showed increased microtubule acetylation and Aβ secretion. Knockdown (KD) of alpha‐tubulin N‐acetyltransferase 1 (ATAT1) by using a lentiviral shRNA not only inhibited the generation of intermediate APP fragments, such as β‐CTF and AICD, but also suppressed Aβ secretion. Oxidative stress promoted the dispersion of LAMP1‐positive vesicles to the periphery of the cell through microtubule acetylation, leading to the formation of neutralized lysosomal vesicles (NLVs), which was inhibited by ATAT1 KD. Treatment of the cells with the dynein ATPase inhibitor EHNA or downregulation of LIS1, a regulator of dynein‐mediated intracellular transport, increased the peripheral localization of NLVs and promoted Aβ secretion, whereas KD of ADP ribosylation factor like GTPase 8B showed the opposite result. ATAT1 KD in the hippocampal region of the 5×FAD AD mouse model also showed significant reductions in Aβ plaque accumulation and memory loss. Taken together, these findings suggest that oxidative stress–induced microtubule acetylation promotes the peripheral localization of lysosomal vesicles to form NLVs, thereby enhancing Aβ secretion. [ABSTRACT FROM AUTHOR]