bluuebunny/crossref_metadata_2025 huggingface dataset:
Impulse buying: A systematic literature review and future research directions
Authors: Redine Artem , Deshpande Sameer , Jebarajakirthy Charles , Surachartkumtonkun Jiraporn
Published: August 2022

This paper performs a comprehensive analysis of academic research on impulse buying following a systematic literature review approach. Drawing on the TCCM framework suggested by Paul and Rosado‐Serrano, we synthesize the impulse buying literature and develop a future research agenda. Accordingly, this review synthesizes impulse buying research in terms of theory development, context, characteristics, and methodologies to examine the development of the literature over time. This systematic review shows that impulse buying research is fragmented and still developing due to its transition from a traditional retail environment into different online channels. Furthermore, this paper proposes a conceptual framework based on the literature synthesis, presenting antecedents and mediators of impulse buying behaviour. Finally, this review identifies overlooked areas in impulse buying literature and provides insightful directions to advance research in the domain. Overall, this research effort makes a significant contribution to consumer behaviour literature, specifically to impulse buying literature.
Long‐term results after robot‐assisted radical prostatectomy of a simplified inguinal hernia prevention technique without artificial substance use
Authors: Shimbo Masaki , Endo Fumiyasu , Matsubara Taketo , Shimada Gen , Hattori Kazunori
Published: August 2022

Introduction

Durable techniques that prevent postoperative inguinal hernia (IH) after robot‐assisted radical prostatectomy (RARP) have not been established. This study evaluated the long‐term efficacy of a postoperative IH prevention technique that uses no artificial agents to assess the characteristics of IH occurrence after introducing this technique.

Patients and Methods

We retrospectively analyzed 201 consecutive patients who underwent RARP at our institution between September 2011 and February 2014. In total, 189 cases were eligible for the study. The non‐IH prevention and IH prevention groups comprised 72 and 117 cases, respectively. We compared the incidence of IH between the two groups using Kaplan–Meier curves. Risk factors for IH in the prevention group were determined via multivariable logistic regression analysis.

Results

The rate of IH occurrence was 20.8% (15 cases) in the nonprevention group and 8.5% (10 cases) in the prevention group, with median follow‐up periods of 99.5 and 89.9 months, respectively. The Kaplan–Meier curves indicated a significant difference between the two groups (p = 0.011). Only cutting of the vas deferens significantly contributed to reduced occurrence of IH in multivariable analysis (p = 0.047). After reviewing the intraoperative videos, insufficient separation of the vas deferens was considered the main cause of IH in the prevention group.

Conclusion

Our simple prevention technique with no artificial agents had a durable effect on IH prevention after RARP over a median follow‐up period of more than 7 years. Cutting the vas deferens effectively prevented IH after RARP.
Apolygus lucorum effector Al6 promotes insect feeding performance on soybean plants: RNAi analysis and feeding behaviour study with electrical penetration graph
Authors: Dong Yumei , Zhang Wendan , Jin Yan , Shen Danyu , Xia Ai
Published: August 2022

The mirid bug Apolygus lucorum, a dominant mirid species in northern China, is a notorious polyphagous pest with more than 200 hosts, including several major crops such as cotton and soybean, resulting in massive economic loss. Studies of insect salivary effectors may provide a novel control strategy for A. lucorum. An A. lucorum effector, that is, Al6, that inhibits plant immunity by using glutathione peroxidase to repress reactive oxidase accumulation was previously identified. In this study, we further explored the molecular functions of Al6 associated with feeding behaviour and insect survival on soybean, a major host of A. lucorum, using RNA interference and electrical penetration graph (EPG) techniques. We initially observed the injury symptom of this mirid bug and characterized feeding behaviour on soybean leaves using EPG. Our results revealed that A. lucorum preferred to feed on young plant organs such as tender leaves, shoots and buds. This mirid bug used cell rupture as a feeding strategy to ingest cell contents from plant tissues. Subsequently, we silenced the Al6 gene using RNAi and investigated the feeding behaviour, honeydew excretion, body weight, and survival rates of A. lucorum on soybean after Al6 knockdown. Our results demonstrated that silencing of Al6 significantly reduced feeding duration, amount of honeydew secretion, body weight, and survival rates of A. lucorum. Thus, our findings provide a novel molecular target of plant‐mediated RNAi for the control of A. lucorum.
Microstructural examination of interactions between chromia‐based refractory and nuclear glass in a melter
Authors: Smith‐Gray Natalie J. , Bussey John M. , McCloy John S.
Published: August 2022

This study shows the effects of nuclear waste glass production on Monofrax K‐3 refractory corrosion. A continuously fed research‐scale melter containing an Fe‐ and Ni‐rich simulated nuclear waste feed with borosilicate glass‐forming chemicals was cyclically melted at 1150°C and idled at 1050°C for a total of 11 weeks. Chemical maps using scanning electron microscopy show the interactions between the quenched melt and the refractory. Nanoscale X‐ray‐computed tomography was used for a three‐dimensional visualization of certain parts of the interface. Unreacted K‐3 consists of primarily corundum (Al,Cr)2O3 and spinel (Fe2+,Mg)(Al,Cr)2O4 interlocking crystalline phases. Some of the Cr from the refractory interacts with the Ni and Fe from the melt to form a reaction layer comprising (Ni,Fe2+)(Cr,Fe3+)2O4 spinel crystals. Simultaneously, melt components (Na,Si) infiltrate into the refractory. This interaction proceeds at the expense of the integrity of the refractory structure. Intact refractory grains (e.g., (Al,Cr)2O3) as well as the reaction layer itself can lose mechanical integrity and spall off into the melt, especially near the top of the melter. As the reaction layer can be a protective boundary for the refractory against further melt infiltration, a reduction in the reaction layer thickness allows an increase in refractory corrosion.
A tunable blue–cyan dual emission phosphor in Ca4−xLu2xHf1−xGe3O12:Bi3+ via forming segregation structure for WLEDs
Authors: Piao Siqi , Wang Yichao , Zhang Jinsu , Zhang Xizhen , Wu Danyang , Cao Yongze , Li Xiangping , Chen Baojiu
Published: August 2022

White light‐emitting diodes (WLEDs) are always fabricated by a combination of the near‐ultraviolet (n‐UV)‐emitting LED chip with tricolor emitting phosphors. However, improving the color rendering index (CRI) is limited due to the absence of cyan composition for common commercial combinations. Based on this, a series of blue–cyan dual‐peaks emission Ca4−xLu2xHf1−xGe3O12(CLHGO):Bi3+ phosphors with unique adjustability are developed by the solid solution design strategy. All the samples belong to the garnet structure with the Ia3d space group. Two relatively independent segregation structures [Ca4HfGe3O12] and [Ca3Lu2Ge3O12] are established in the samples. When Bi3+ ions enter into the highly symmetrical hexagon coordination environment, a special phenomenon appears that the emission peaks consist of two stabilized narrowband emission bands at 435 and 475 nm, their intensity ratio could change continuously with the increase of solid solubility. All these results are confirmed by means of excitation and emission spectra, first principles calculation and decay curves. The Ca3.4Lu1.2Hf0.4Ge3O12:Bi3+ sample, with a high efficiency around 84.1% and an excellent thermal stability (65.6%@150°C), is chosen as the optimal sample to improve the blue and cyan compositions for full spectrum emission. Using the Ca3.4Lu1.2Hf0.4Ge3O12:Bi3+, commercial green (Ba, Sr)2SiO4:Eu2+ phosphor, and commercial red CaAlSiN3:Eu2+ phosphor on a 360‐nm n‐UV LED chip to fabricate WLED, which successfully bridge the cyan gap and the CRI value of the as‐fabricated warm‐white LED reaches 90.2. The previous results confirmed that CLHGO:Bi3+ phosphors have promising application prospect in the development of n‐UV‐pumped warm‐white LEDs with high‐CRI values. The unique property performance originating from independent segregation structures provides more reference for the research on photoluminescence mechanism.
Fabrication of hierarchically porous silicon carbonitride monolith using branched polysilazane and freeze casting method without crosslinking step: Effect of polymer additive to aligned macropore structure
Authors: Huh Tae‐Hwan , Lee Taek Seung , Kwark Young‐Je
Published: August 2022

A hierarchically porous SiCN monolith with aligned macropores was prepared using a branch‐structured polysilazane, silsesquiazane (SSQZ), as a precursor and polymer additive, through the freeze casting method. As polymer additives, polystyrene (PS) and poly(methyl methacrylate), which have different compatibilities with SSQZ, were used to confirm the effect on the pore formation. In addition, the pore formability according to the molecular weight was investigated using PSs with different molecular weights. When the SSQZ and high‐molecular‐weight PS (HPS) were used, a porous SiCN with micro/meso/macropore structure could be fabricated because of the structural stability of the SSQZ and high molecular weight of HPS. The hierarchically porous SiCN monolith was successfully manufactured using SSQZ and HPS with 639 m2/g of specific surface area, 0.36 cm3/g of pore volume, and 2.1 nm of average pore size. The hierarchically porous SiCN monolith with high HPS content has improved dimensional stability to show its compressive fracture energy.
Antimicrobial effects of automobile screen washes against Legionella pneumophila
Authors: Hsiao Yun-Chung , Hung Yu-Hsin , Horng Yu-Ju , Chang Ching-Wen
Published: August 2022

Aims

Legionella pneumophila (Lp), a human pathogen, has been detected in windscreen wiper fluid reservoirs (WWFRs) where commercial screen washes (CSWs) are commonly added. Limited information is available on CSWs against planktonic Lp; however, responses of sessile Lp and planktonic Lp pre-acclimated in nutrient-limited water to CSWs remain unknown. This study thus investigates the antibacterial effects of CSWs on sessile and starved planktonic Lp, in comparison with unstarved Lp.

Methods and Results

Lp biofilms were produced on glass and WWFR materials of high-density polyethylene (HDPE) and polypropylene (PP). Planktonic Lp with and without acclimation in tap water were prepared. Log reductions in cell counts averaged 0.4–5.0 for 10 brands of CSWs against sessile Lp and 1.0–3.9 and 0.9–4.9, respectively, against starved and unstarved planktonic Lp for five CSWs. Both biofilm formation and acclimation in tap water enhanced Lp resistance to CSWs. Significantly different log-reduction values among CSW brands were observed for sessile Lp on HDPE and planktonic Lp regardless of acclimation (p < 0.05).

Conclusions

Biofilm formation, starvation acclimation and CSW brand are crucial factors influencing Lp response to CSWs.

Significance and Impact of Study

This study advances the knowledge of Lp reaction in anthropogenic water systems with CSWs.
Organizational contexts, implementation processes, and capacity outcomes of multicultural, multilingual Home‐Based Programs in public initiatives: A Mixed‐Methods study
Authors: Kim Eunjung , Boutain Doris M. , Lim Sungwon , Parker Sanithia , Wang Di , Maldonado Nofziger Rebekah , Weiner Byran J.
Published: August 2022

Aims

The study aim was to examine the impact of a home‐based programme intervention on organizational contexts, implementation processes and organizational capacity outcomes from multicultural, multilingual participants working at community‐based organizations.

Design

This was a sequential exploratory, mixed‐methods longitudinal study using community‐based participatory research principles.

Sample

Twenty participants from nine multicultural, multilingual community‐based organizations were in this public health initiative's intervention to develop community‐designed, home‐based programmes.

Methods

Capacity building providers delivered the intervention selected by the funders. Workshop outcomes were descriptively measured in April/May 2019. In April/May and November 2019, participants completed surveys about organizational contexts, implementation processes and organizational capacity outcomes, which were analysed with t‐tests using the organization as the unit of analysis. Qualitative data were analysed using content analysis.

Results

Seven programmes were new and two were modified. As workshop outcomes, 59% of participants reported increased overall implementation knowledge and 74% reported capacity building providers as the most helpful resource. After 6 to 7 months, no statistically significant changes were noted in organizational contexts, implementation processes or organizational capacity outcomes. Participants benefited from capacity building because they had programmes developed, formed partnerships with capacity building providers, gained implementation knowledge, and engaged in networking.

Conclusion

Participants reported excellent individual and organizational strengths. Many Initiative factors contributed to no statistical changes. Namely, there was no opportunity for baseline data; limited community‐based organization engagement in the intervention model selection, timeline and processes; the Initiative's timeline did not fit participants' timeline; insufficient time to develop culturally and linguistically appropriate programmes; late literature review abstracts; lack of adequate, planful and paid capacity building time; and a contract requirement to have the programme due when it was not implementable. These Initiative design factors, as reported by participants, limited the Initiative's home‐based programme development.

Impact

This study highlights the strengths of participants, community‐based organizations and capacity building providers. Model selection, timeline and budget were identified as key factors for equitable implementation in multicultural, multilingual organizations.
Scoping review: Diagnostic reasoning as a component of clinical reasoning in the U.S. primary care nurse practitioner education
Authors: Smith Sheila K. , Benbenek Mary M. , Bakker Caitlin J. , Bockwoldt Denise
Published: August 2022

Aims

Diagnostic Reasoning (DR) is an essential competency requiring mastery for safe, independent Nurse Practitioner (NP) practice, but little is known about DR content included in NP education programs. The aims of this study were to identify whether and how the concept of DR is addressed in NP education.

Design

We conducted a scoping review on DR‐related content and teaching innovations in U.S. primary care NP education programs, with implications for NP education programs worldwide. Concepts and principles with global applicability include: conducting focused and hypothesis‐directed histories and exams, generating the problem statement, formulating the differential diagnosis, appropriate and relevant diagnostic testing, determining the working diagnosis and developing evidence‐based, patient‐centred management plans.

Data sources

N = 1115 articles retrieved from Medline, Embase, PsycINFO, and CINAHL for the period 2005–2021. Forty‐one scholarly articles met inclusion/exclusion criteria.

Review methods

Data were extracted, synthesized and grouped by theoretical frameworks, content included, educational interventions and assessment measures.

Results

Most articles provided descriptions of approaches for teaching NP clinical or diagnostic reasoning. Ten papers directly referenced the current science and theory of DR.

Conclusion

The US NP education literature addressing DR is limited and demonstrates a lack of shared conceptualizations of DR. Whilst numerous components of DR are identifiable in the literature, a robust teaching/learning scholarship for DR has not yet been established in the US NP education literature.

Impact

Whilst primary care NP education programs are beginning to incorporate DR education into their curricula, little research has been conducted to demonstrate the effectiveness of educational outcomes. Increased integration of DR content into NP education is needed, including increased educational research on teaching DR competencies.

Patient or public contribution

No patient or public contribution was included in this review, as the public is generally not familiar with DR or its teaching approaches.
‘Doing the best we can’: Registered Nurses' experiences and perceptions of patient safety in intensive care during COVID‐19
Authors: Stayt Louise Caroline , Merriman Clair , Bench Suzanne , M. Price Ann , Vollam Sarah , Walthall Helen , Credland Nicki , Gerber Karin , Calovski Vid
Published: August 2022

Aims

To explore registered nurses' experiences of patient safety in intensive care during COVID‐19.

Design

A qualitative interview study informed by constructivism.

Method

Semi‐structured interviews were conducted and audio‐recorded with 19 registered nurses who worked in intensive care during COVID‐19 between May and July 2021. Interviews were transcribed verbatim and thematically analysed utilizing framework.

Results

Two key themes were identified. ‘On a war footing’—an unprecedented situation which describes the situation nurses faced, and the actions are taken to prepare for the safe delivery of care. ‘Doing the best we can’—Safe Delivery of Care which describes the ramifications of the actions taken on short‐ and long‐term patient safety including organization of care, missed and suboptimal care and communication. Both themes were embedded in the landscape of Staff Well‐being and Peer Support.

Conclusion

Nurses reported an increase in patient safety risks which they attributed to the dilution of skill mix and fragmentation of care. Nurses demonstrated an understanding of the holistic and long‐term impacts on patient safety and recovery from critical illness.

Impact

This study explored the perceived impact of COVID‐19 on patient safety in intensive care from a nursing perspective. Dilution of skill mix, where specialist critical care registered nurses were diluted with registered nurses with no critical care experience, and the fragmentation of care was perceived to lead to reduced quality of care and increased adverse events and risk of harm which were not consistently formally reported. Furthermore, nurses demonstrated a holistic and long‐term appreciation of patient safety. These findings should be considered as part of future nursing workforce modelling and patient safety strategies by intensive care leaders and managers. No public or patient contribution to this study. The study aims and objectives were developed in collaboration with health care professionals.
Sexually dimorphic effects of estrogen receptor 2 deletion in the dorsal raphe nucleus on emotional behaviors
Authors: He Jing , Yan Jing‐Jing , Zha Xi , Ding Xiao‐Jing , Zhang Yan‐li , Lu Zheng , Xu Xiao‐Hong
Published: August 2022

Sex differences in emotional behaviors and affective disorders have been widely noted, of which sexually dimorphic secretion of gonadal steroid hormones such as estrogen is suspected to play a role. However, the underlying neural mechanisms remain poorly understood. We noted that the expression of estrogen receptor 2 (Esr2, or ERβ), a key mediator of estrogen signaling in the brain, was enriched in the dorsal raphe nucleus (DRN), a region involved in emotion regulation. To investigate whether DRN Esr2 expression confers sex‐specific susceptibility or vulnerability in emotional behaviors, we generated a conditional allele of Esr2 that allowed for site‐specific deletion of Esr2 in the DRN via local injection of Cre‐expressing viruses. DRN‐specific Esr2 deletion mildly increased anxiety behaviors in females, as shown by decreased time spent in the center zone of an open field in knockout females. By contrast, DRN Esr2 deletion had no effects on anxiety levels in males, as demonstrated by knockout males spending comparable time in the center zone of an open field and open arms of an elevated‐plus maze. Furthermore, in the tail suspension test, DRN Esr2 deletion reduced immobility, a depression‐like behavior, in a male‐biased manner. Together, these results reveal sex‐specific functions of DRN Esr2 in regulating emotional behaviors and suggest targeted manipulation of DRN Esr2 signaling as a potential therapeutic strategy to treat sex‐biased affective disorders.
Which factors are associated with cannabis use among adolescents in Andalusia? An application of the I‐Change model
Authors: Torrejón‐Guirado María‐Carmen , Lima‐Serrano Marta , Mercken Liesbeth , de Vries Hein
Published: August 2022

Background

Cannabis use is increasing among Andalusian adolescents, causing health, social and financial problems. School nurses visit schools and provide health promotion to adolescents in Andalusia. In order to better tailor health promotion programs, it is important to understand the sociodemographic and motivational factors related to cannabis use in Andalusian adolescents.

Design/Methods

In this cross‐sectional study, 369 students (aged 15–18 years) from secondary schools in Andalusia were involved. An anonymous questionnaire based on the I‐Change Model was self‐administered during school hours. Cannabis users were compared with non‐cannabis users regarding sociodemographic and motivational factors. Contingency tables, mean comparison tests, and logistic regression analyses were conducted.

Results

The prevalence of cannabis use in the last year was 21.6%. Non‐cannabis users had a few positive beliefs toward cannabis use (e.g. the ability to relax or medical benefits), as well as users. Users recognized some disadvantages of cannabis use but played down their importance and mentioned more advantages. Moreover, social influence, especially from peers, plays a critical role in cannabis use. Specific social situations and moods seemed to be special risk factors for cannabis use, such as being at a celebration or feeling good. Results of regression analysis showed that cannabis use is mainly associated with age, low family function, low family affluence, high pocket money, perceiving few disadvantages of cannabis use, much social modeling of cannabis use, social norm and pressure favoring cannabis, low self‐efficacy to resist using cannabis and positive intentions to use cannabis.

Conclusions

Based on our results, prevention programmes lead by nurses can be tailored to the factors important to prevent cannabis use, focusing on outlining the disadvantages of cannabis use, alternatives for using cannabis when feeling good, increasing salience of healthy social influences and reinforcing self‐efficacy to resist temptations to use cannabis are recommended.

Clinical Relevance

Nurses need to know the sociodemographic factors and motivations associated with the use of cannabis in adolescents in order to establish effective preventive interventions at school.
In vivo and ex vivo range of motion in the fire salamander Salamandra salamandra
Authors: Herbst Eva C. , Eberhard Enrico A. , Richards Christopher T. , Hutchinson John R.
Published: August 2022

Joint range of motion (RoM) analyses are fundamental to our understanding of how an animal moves throughout its ecosystem. Recent technological advances allow for more detailed quantification of this RoM (e.g. including interaction of degrees of freedom) both in ex vivo joints and in vivo experiments. Both types of data have been used to draw comparisons with fossils to reconstruct locomotion. Salamanders are often used as analogues for early tetrapod locomotion; testing such hypotheses requires an in‐depth analysis of salamander joint RoM. Here, we provide a detailed dataset of the ex vivo ligamentous rotational joint RoM in the hindlimb of the fire salamander Salamandra salamandra, using a new method for collecting and visualising joint RoM. We also characterise in vivo joint RoM used during walking, via scientific rotoscoping and compare the in vivo and ex vivo data. In summary, we provide (1) a new method for joint RoM data experiments and (2) a detailed analysis of both in vivo and ex vivo data of salamander hindlimbs, which can be used for comparative studies.
Transvaginal natural orifice transluminal endoscopic surgery in gynecological procedure: Experience of a Women's and Children's Medical Center from China
Authors: Huang Lu , Feng Dan , Gu Ding‐Xian , Lin Yong‐Hong , Gong Zhao‐Lin , Liu Dan‐Dan , Zhang Qiang , Li Yan , Huang Li‐Qiong , He Li
Published: August 2022

Objective

To review of our hospital's experiences in transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and challenges we encountered in performance of the procedure, so as to provide help to medical institutions who are preparing to carry out vNOTES.

Methods

We retrospectively analyzed the data of all patients receiving vNOTES in our hospital from April 2018 to May 2021. Data we collected cover the general characteristics, perioperative outcomes, and complications of the patients.

Results

A total of 1147 patients underwent vNOTES in the past 3 years at our hospital. The total numbers of adnexal surgery, myomectomy, hysterectomy, pelvic floor reconstruction surgery, and malignant tumor surgery performed via vNOTES were 902, 98, 82, 51, and 14, respectively. Eighteen patients were converted to transabdominal laparoscopic surgery. A total of 38 patients had complications according to Clavien‐Dindo classification, and the total complication rate was 3.31%. Among these cases of complications, 27 were Grade I, 4 were Grade II, and 7 were Grade III. No complications of Grade IV or V were reported.

Conclusion

The application of vNOTES is safe and feasible for most gynecological surgeries. Moreover, hospitals with traditional laparoscopic equipment are advised to try this technique as there is no need to purchase additional expensive equipment. However, since vNOTES represents a novel approach, the long‐term complications and efficacy associated with this technique are pending to be verified through large‐scale prospective multicenter randomized controlled studies.
Addressing Health Disparities in LGBTQ Youth Through Professional Development of Middle School Staff
Authors: Owens Melissa , Mattheus Deborah
Published: August 2022

BACKGROUND

Significant health disparities exist for sexual minority youth (SMY). While supportive adults in schools have been shown to improve mental wellbeing and academic outcomes for students, most teachers do not receive training specific to lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) students.

METHODS

The project aimed at providing staff from a Hawaii middle school with “Safe Space” professional training to increase knowledge and comfort in supporting SMY. Pre‐ and post‐training surveys were used to measure knowledge of LGBTQ issues and comfort in supporting LGBTQ students and a 2‐week and 3‐month survey assessed staff's application of newly learned material.

RESULTS

Sixty‐four staff participated in the first of 2 training sessions with 59 completing both sessions. Results from the pre‐ and post‐survey showed a 34.9% increase in knowledge of LGBTQ issues (effect size = 1.22) and a 5.5% increase in self‐rated comfort level in supporting LGBTQ students (effect size = 0.22). A 3‐month follow‐up indicated that 52.9% of the respondents were actively applying knowledge learned within their school setting.

CONCLUSIONS

The project results demonstrate the value of the training not only in the short term but also staff's ability to apply the knowledge they learned. Given the success of implementation, expansion to other schools could facilitate ally‐building attitudes and behaviors as a protective factor for SMY throughout the state.
Follow‐up of infants with colic into childhood: Do they develop behavioural problems?
Authors: Zeevenhooven Judith , de Bruin Françoise E , Schappin Renske , Vlieger Arine M , van der Lee Johanna H , Haverman Lotte , van Sleuwen Bregje E , L'Hoir Monique P , Benninga Marc A
Published: August 2022

Aim

To assess whether infants with colic (IC) demonstrate persisting developmental dysregulation into childhood, manifested as behavioural problems, and to determine if these behavioural problems are associated with parenting factors.

Methods

Preschool children with a history of IC at the age of 0–3 months, as defined by the Wessel criteria, were invited to participate in an observational follow‐up study, in which their caregivers completed the Child Behaviour Checklist (CBCL). Raw scores and clinical‐range scores on the internalising, externalising and total behavioural problems scales were compared with a Dutch normative sample using independent t‐tests and Chi‐square tests. For the clinical‐range scores, multivariable logistic regressions (odds ratios [99% confidence interval, CI]) were used to adjust for confounders and to identify variables associated with behavioural problems.

Results

Two hundred and fifty‐eight children with a history of IC (median age 5.1 (interquartile range, IQR 4.6–5.5) years, 51.9% boys) were included. The cases had a significantly higher adjusted risk (adjusted odds ratios (aORs) [99% CI]) of scoring in the clinical range of the emotionally reactive, internalising and total problems scale (2.96 [1.24–7.06]; 2.50 [1.35–4.62]; 2.98 [1.46‐6.07], respectively). Internalising (P < 0.001), externalising (P < 0.001) and total (P < 0.001) behavioural problems in children with a history of IC were associated with higher parenting stress scores.

Conclusions

Children with a history of IC demonstrated significantly more internalising behavioural problems at preschool age compared to the norm sample. Specific advice and support need to be available for parents to understand and regulate the behaviour of their child, from infancy to childhood.
Is slide‐based or video‐based eLearning better at achieving behavioural change in bronchiolitis management? A cluster‐based randomised control trial
Authors: Talati Rutty , Fonseca Bob , Mallitt Kylie‐ann , Mackenzie John
Published: August 2022

Aim

This cluster‐based randomised control trial examines the comparative efficacy of two eLearning programs that teach clinicians evidence‐based bronchiolitis management for children less than 12 months of age.

Methods

Six hospitals, matched for size, were randomly allocated to either video‐based (arm A) or slide‐based (arm B) eLearning programs. To assess behavioural change, participants (doctors and nurses) were asked to declare how they would manage a video scenario of an infant with bronchiolitis, before and after either eLearning method. Measured outcomes included the number of investigations and treatments ordered, admissions to hospital and discharge planning. Confidence scores and change in understanding for bronchiolitis management were also measured.

Results

Both methods of eLearning instruction resulted in reductions in unnecessary investigations and treatments performed, as well as improved confidence and understanding of bronchiolitis management on the video scenario. Video‐based eLearning instruction additionally demonstrated a significant reduction in unnecessary hospital admissions and better discharge planning, based on learners' declarations to the video scenario, relative to slide‐based learning.

Conclusion

Slide‐based and video‐based eLearning both demonstrate improvements in reported bronchiolitis management. However, video‐based eLearning may yield more significant practice changes, improved clinician confidence in management, as well as improved patient experience.
Implications for paediatric training and workforce from pandemic disruptions: A view from a tertiary hospital
Authors: Gard Jye , Cisternino Angela , Polley Clare , Gray Amy
Published: August 2022

Aim

To understand the lived experience of paediatric trainees in relation to their educational opportunities, workforce roles and the interplay between them, during pandemic disruptions.

Methods

Twenty paediatric trainees working at Australian paediatric hospitals during the time of COVID‐19 restrictions were interviewed between July and November 2020. Based on a phenomenological approach, the interviews examined junior doctors' experiences in relation to medical education, adaptive education modes, learning opportunities and their workforce roles during the pandemic. Qualitative inductive thematic data analysis was used to develop a cohort narrative.

Results

Four overarching themes were identified regarding trainee perceptions of the impact of COVID‐19 restrictions on learning opportunities, both positive and negative. These were: impaired rapport building, altered team role, altered care and education affordances versus access. Participants felt ill‐equipped to provide optimal clinical care during virtual and stifled in‐person consultations, detached from the multidisciplinary team, that changed work roles diminished their professional self‐worth, and that online learnings were advantageous if rostering afforded opportunities to engage with them.

Conclusion

To equip paediatric trainees for the next steps in their careers, we suggest the following areas of focus: the use of new tools of rapport, smart investment in clinical moments, reconnection of multidisciplinary teams and learning, the support of online learning infrastructure with protected education time and roadmaps for learning, and teaching on how to triage information sources and alongside clinical visit types.
Melatonin drives apoptosis in head and neck cancer by increasing mitochondrial ROS generated via reverse electron transport
Authors: Florido Javier , Martinez‐Ruiz Laura , Rodriguez‐Santana César , López‐Rodríguez Alba , Hidalgo‐Gutiérrez Agustín , Cottet‐Rousselle Cécile , Lamarche Frédéric , Schlattner Uwe , Guerra‐Librero Ana , Aranda‐Martínez Paula , Acuña‐Castroviejo Darío , López Luis C. , Escames Germaine
Published: August 2022

The oncostatic effects of melatonin correlate with increased reactive oxygen species (ROS) levels, but how melatonin induces this ROS generation is unknown. In the present study, we aimed to elucidate the two seemingly opposing actions of melatonin regarding its relationship with free radicals. We analyzed the effects of melatonin on head and neck squamous cell carcinoma cell lines (Cal‐27 and SCC‐9), which were treated with 0.5 or 1 mM melatonin. We further examined the potential effects of melatonin to induce ROS and apoptosis in Cal‐27 xenograft mice. Here we report that melatonin mediates apoptosis in head and neck cancer by driving mitochondrial reverse electron transport (RET) to induce ROS production. Melatonin‐induced changes in tumoral metabolism led to increased mitochondrial activity, which, in turn, induced ROS‐dependent mitochondrial uncoupling. Interestingly, mitochondrial complex inhibitors, including rotenone, abolished the ROS elevation indicating that melatonin increased ROS generation via RET. Melatonin also increased membrane potential and CoQ10H2/CoQ10 ratio to elevate mitochondrial ROS production, which are essential conditions for RET. We found that genetic manipulation of cancer cells with alternative oxidase, which transfers electrons from QH2 to oxygen, inhibited melatonin‐induced ROS generation, and apoptosis. RET restored the melatonin‐induced oncostatic effect, highlighting the importance of RET as the site of ROS production. These results illustrate that RET and ROS production are crucial factors in melatonin's effects in cancer cells and establish the dual effect of melatonin in protecting normal cells and inducing apoptosis in cancer cells.
Is the urgency message encoded in heterospecific alarm calls perceived by domestic chickens?
Authors: Dutour M. , Ridley A. R. , Randler C.
Published: August 2022

Vertebrate alarm calls can signal danger, and often encode information about predator proximity. Some species of birds alter the number of notes of their alarm calls to reflect urgency, with high‐urgency alarm calls having more notes than low‐urgency calls. Not only do individuals perceive the urgency message encoded in the alarm calls of conspecifics, but also in the alarm calls given by heterospecifics (sympatric and allopatric species). Yet, although well studied in wild species, the capacity to use heterospecific graded alarm call systems has not been investigated in domestic animals. Domestication may have altered the perceptual and communicative abilities of domestic species because they are less threatened by predators. Using playbacks conducted on domestic naked neck chickens (Gallus gallus domesticus) in France, we tested whether this species is able to decode information about urgency in alarm calls produced by a sympatric species; the common chaffinch (Fringilla coelebs), and by an allopatric species; the Australian magpie (Cracticus tibicen). We found the latency to resume foraging behaviour was higher after the high‐urgency call playbacks than the low‐urgency call playbacks, suggesting that the urgency encoded in heterospecific calls was perceived by chickens. However, results seem to indicate that the chickens are not able to discriminate between alarm and control (songs) sounds, but simply respond to specific sound characteristics of each playback stimulus. Our results raise some questions about how animals perceive and attend to information provided by heterospecific alarms. We hope this study will encourage future work with domesticated and nondomesticated animals.
Genetic heterogeneity and predominance of blaCTX-M-15 in cefotaxime-resistant Enterobacteriaceae isolates colonizing hospitalized children in Tunisia
Authors: Harbaoui S. , Ferjani S. , Abbassi M.S. , Saidani M. , Gargueh T. , Ferjani M. , Hammi Y. , Boutiba-Ben Boubaker I.
Published: August 2022

Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae have emerged as important nosocomial pathogens. Community infections by these organisms have been also reported and were associated with previous intestinal colonization. We aimed to characterize cefotaxime-resistant Enterobacteriaceae (CTX-R-En) isolated from hospitalized children in a Tunisian paediatric ward. Seventy CTX-R-En isolates were collected from 227 rectal swabs from hospitalized children in a paediatric ward. Antimicrobial susceptibility testing was determined according to the EUCAST guidelines. Isolates were characterized by polymerase chain reaction (PCR, genes encoding: ESBLs, pAmpC, carbapenemases, plasmid-mediated quinolone resistance, virulence factors in Escherichia coli and Klebsiella pneumoniae isolates, occurrence of classes 1 and 2 integrons, phylogenetic groups of E. coli isolates, ERIC-PCR and PCR-based replicon typing) and conjugal transfer experiments. In total, 65 out of 227 (28·6%) hospitalized children were colonized with CTX-M-R-En, and 70 isolates were identified. Isolates were 59 ESBL-, 7 plasmidic-AmpC (pAmpC)-, 3 ESBL+pAmpC-, and one ESBL+carbapenemase producers. The following bla genes were identified: blaCTX-M-15 (n = 54), blaCTX-M-1 (n = 5), blaCTX-M-9 (n = 2), blaCTX-M-13 (n = 1) and blaCTX-M-14 (n = 1), blaCMY-2 (n = 5), blaCMY-4 (n = 4), blaACC-1 (n = 1) and blaOXA-48 (n = 1). Our results showed that hospitalized children were colonized with various CTX-R-En-producing several beta-lactamase enzymes.
Reviving Jewish Theology: From A Soft Maimonidean to a Practical Biblical Metaphysics
Authors: Kepnes Steven
Published: August 2022

This essay is my contribution to the project of reviving Jewish theology as an enterprise in which language and thought make positive statements about God. This project is necessitated by what I see as the failures of the negative or “apophatic theologies” of postmodernism to generate and support a vibrant Jewish religious life. My strategy is to retrieve from medieval philosophy what I call a “soft metaphysics” as a framework and series of axioms for thought and practice rather than the demonstration of universal propositions of truth. I then turn to the Hebrew Bible for a textual hermeneutics and a “practical metaphysics” in which theology is tasked with attending to the needs of the human spiritual life.
Osteohistology and taphonomy support social aggregation in the early ornithischian dinosaur Lesothosaurus diagnosticus
Authors: Botha Jennifer , Choiniere Jonah N. , Barrett Paul M.
Published: August 2022

Lesothosaurus diagnosticus is a small ornithischian dinosaur from the Lower Jurassic Massospondylus Assemblage Zone of the upper Elliot Formation of the Karoo Basin of South Africa and Lesotho. The Early Jurassic age, comparatively large sample size, and multiple growth stages of Lesothosaurus make it an excellent taxon for investigating the plesiomorphic condition of ornithischian growth. Here, we examine the osteohistology of an ontogenetic series of Lesothosaurus diagnosticus using multiple limb elements to assess the maximum body size, life history, growth dynamics and potential for sociality in one of the earliest‐branching ornithischian dinosaurs. We found that Lesothosaurus grew rapidly during early and mid‐ontogeny (as shown by its highly vascularized woven‐parallel complex) with its growth rate decreasing between 2–4 years of age, possibly indicating the onset of reproductive maturity. However, an external fundamental system, indicating a cessation in growth, could not be confirmed in any of the individuals studied, suggesting that at 6 years of age, this taxon was still not fully grown. The presence of multiple individuals of varying ontogenetic stages in a monodominant bone bed strongly suggests that it lived in multigenerational herds, indicating that, along with the Venezuelan Laquintasaura venezuelae, social behaviour developed very early in ornithischian evolutionary history.
Magnetic resonance imaging study of the sciatic nerve variation in the pediatric gluteal region: Implications for the posterior approach of the sciatic nerve blockade
Authors: Byun Sarang , Morris Sarah , Pather Nalini
Published: August 2022

Introduction

In pediatric patients, the sciatic nerve is one of the most commonly blocked peripheral nerves during orthopedic procedures of the lower limb. Ultrasound guidance is the current standard for a successful localization of the sciatic nerve in the gluteal region. Relevant anatomical landmarks are also used to determine the nerve location when ultrasound is not available or inadequate. However, reports have demonstrated paucity of information regarding the sciatic nerve location and variation in the hip throughout pediatric development. This imaging study aimed to document and analyze the relative morphometric relationship of the sciatic nerve in the pediatric gluteal region throughout development.

Methods

The location of the sciatic nerve in relation to bony landmarks was measured in 84 pediatric magnetic resonance imaging of patients aged 0.7–15.8 years.

Results

The sciatic nerve was identified medial to the most lateral point of greater trochanter at the level of ischial spine and the tip of coccyx. The strong positive correlation between sciatic nerve to landmark distances and age and stature demonstrated linear variation between sciatic nerve location with age and growth of children. To predict the nerve location in the gluteal region, regression equations using patient age were created, having implications for the posterior approach of the sciatic nerve blockade in children. Clinically significant differences were found between sexes, specifically in the older age group.

Conclusion

Despite the small sample size of younger age group, this study is the first to document the morphometric changes of the sciatic nerve in the gluteal region across pediatric development and may be useful for providing confirmatory guidelines for nerve location when ultrasound is not accessible or cannot be utilized for practice.
Identification of vacuolar phosphate influx transporters in Brassica napus
Authors: Han Bei , Wang Chuang , Wu Tao , Yan Junjun , Jiang Aosheng , Liu Yu , Luo Yu , Cai Hongmei , Ding Guangda , Dong Xu , White Philip J. , Xu Fangsen , Wang Sheliang , Shi Lei
Published: August 2022

Recent progress has shown that vacuolar Pi transporters (VPTs) are important for cellular Pi homoeostasis in Arabidopsis thaliana and Oryza sativa under fluctuating external Pi supply, but the identity and involvement of VPTs in cellular Pi homoeostasis in Brassica napus is poorly understood. Here, we identified two vacuolar Pi influx transporters B. napus, BnA09PHT5;1b and BnCnPHT5;1b, and uncovered their necessity for cellular Pi homoeostasis through functional analysis. Both Brassica proteins are homologs of Arabidopsis AtPHT5;1 with a similar sequence, structure, tonoplast localization, and VPT activity. Brassica pht5;1b double mutants had smaller shoots and larger shoot cellular Pi concentrations than wild‐type B. napus, which contrasts with a previous study of the Arabidopsis pht5;1 mutant, suggesting that PHT5;1‐VPTs play different roles in cellular Pi homoeostasis in seedlings of B. napus and A. thaliana. Disruption of BnPHT5;1b genes also caused Pi toxicity in floral organs, reduced seed yield and impacted seed traits, consistent with the proposed role of AtPHT5;1 in floral Pi homoeostasis in Arabidopsis. Taken together, our studies identified two vacuolar Pi influx transporters in B. napus and revealed the distinct and conserved roles of BnPHT5;1bs in cellular Pi homoeostasis in this plant species.
Neutropenia in pediatric solid organ transplant
Authors: Harshman Lyndsay A. , Williams Robin , Engen Rachel M.
Published: August 2022

Neutropenia is generally defined as an absolute neutrophil count in the circulation of less than 1500/mm3and occurs in up to 25%–30% of pediatric solid organ transplant recipients (SOT) within the first year after transplantation. In the SOT population, neutropenia is most often a result of drug‐induced bone marrow suppression but can also be secondary to viral infection, nutritional deficiencies, lymphoproliferative infiltrate, and inherited causes. Outcomes for patients with neutropenia vary by degree of neutropenia and type of solid organ transplant. Management of neutropenia should begin by addressing the underlying cause, including reducing or removing medications when appropriate, treating infections, and addressing nutrient deficiencies; however, consultation with an experienced pediatric hematologist and use of granulocyte colony‐stimulating factor (G‐CSF) may be helpful in some cases. Overall, data on clinical outcomes for G‐CSF use remain limited, but observational studies may support its use in patients with infections or severe neutropenia.
Conceptual engineering: A road map to practice
Authors: Isaac Manuel Gustavo , Koch Steffen , Nefdt Ryan
Published: August 2022

This paper discusses the logical space of alternative conceptual engineering projects, with a specific focus on (1) the processes, (2) the targets and goals, and (3) the methods of such projects. We present an overview of how these three aspects interact in the contemporary literature and discuss those alternative projects that have yet to be explored based on our suggested typology. We show how choices about each element in a conceptual engineering project constrain the possibilities for the others, thereby giving rise to distinct groupings of possible projects under the banner of conceptual engineering. We conclude with a critical reflection on the potential ethical issues that arise as a result of effectively putting conceptual engineering into practice.