bluuebunny/crossref_metadata_2025 huggingface dataset:
A mixed method study to assess behavioral and social predictors of parent/caregiver’s intention to vaccinate their children against COVID-19 disease in an Indian state marked by significant health disparities
Authors: Singh Tulika , Kumar Sanjay , Sinha Setu , Singh Varsha
Published: October 2023

Background

Parents/caregivers are the key decision-makers for child’s health care including vaccination. Vaccine hesitancy along with lagging full immunization coverage for childhood vaccination in India, affect child health outcome and will affect covid-19 vaccine uptake in children. It is important to understand behavioral and social factors surrounding childhood COVID-19 vaccination to design appropriate interventions to improve uptake.

Methods

A mixed-method approach combining quantitative and qualitative method was undertaken. A cross sectional survey of parents/caregivers of children aged less than 18 years residing in the state was carried out to find the prevalence and predictors of parent/ caregiver’s intention to vaccinate against COVID-19 disease. Semi-structured interviews were carried out to find facilitating and barrier factors for childhood COVID-19 vaccination.

Result

Out of 9904 study participants, 73.4% had intention to vaccinate. Parent/caregiver’s education and occupation, marital status, family type, family income, co-morbidity and previous COVID-19 infection in family, childhood vaccination under NIS, were found to be significantly associated. The likelihood of intention to vaccinate children against COVID-19 disease was greater among parents/caregivers aged 18-29 years (OR=2.631, 95% CI [1.733- 3.995], illiterate parents/caregivers (OR=3.037, 95% CI [2.319-3.977], prior COVID-19 infection in family (OR=1.595, 95% CI [1.432-1.821], and children’s prior vaccinations under NIS (OR=1.251, 95% CI [1.218-1.289]. In qualitative part, forty-five semi-structured interviews were conducted. The majority of intending parents gave vaccine effectiveness, increased immunity, high infection risk, herd immunity, and medical recommendations as reasons. Parents who refused mentioned inadequate data, adverse effects, beliefs, safety, and inconvenience as reasons. Effectiveness, and safety, long-term effects, and the short testing period were among the concerns of hesitant parents.

Conclusion

In order to promote COVID-19 vaccination among children, we need to address barriers, facilitators and behavioral determinants of parents/caregivers identified in this study and have targeted strategies for them.
Exome copy number variant detection, analysis and classification in a large cohort of families with undiagnosed rare genetic disease
Authors: Lemire Gabrielle , Sanchis-Juan Alba , Russell Kathryn , Baxter Samantha , Chao Katherine R. , Singer-Berk Moriel , Groopman Emily , Wong Isaac , England Eleina , Goodrich Julia , Pais Lynn , Austin-Tse Christina , DiTroia Stephanie , O’Heir Emily , Ganesh Vijay S. , Wojcik Monica H. , Evangelista Emily , Snow Hana , Osei-Owusu Ikeoluwa , Fu Jack , Singh Mugdha , Mostovoy Yulia , Huang Steve , Garimella Kiran , Kirkham Samantha L. , Neil Jennifer E. , Shao Diane D. , Walsh Christopher A. , Argili Emanuela , Le Carolyn , Sherr Elliott H. , Gleeson Joseph , Shril Shirlee , Schneider Ronen , Hildebrandt Friedhelm , Sankaran Vijay G. , Madden Jill A. , Genetti Casie A. , Beggs Alan H. , Agrawal Pankaj B. , Bujakowska Kinga M. , Place Emily , Pierce Eric A. , Donkervoort Sandra , Bönnemann Carsten G. , Gallacher Lyndon , Stark Zornitza , Tan Tiong , White Susan M. , Töpf Ana , Straub Volker , Fleming Mark D. , Pollak Martin R. , Õunap Katrin , Pajusalu Sander , Donald Kirsten A. , Bruwer Zandre , Ravenscroft Gianina , Laing Nigel G. , MacArthur Daniel G. , Rehm Heidi L. , Talkowski Michael E. , Brand Harrison , O’Donnell-Luria Anne
Published: October 2023

Copy number variants (CNVs) are significant contributors to the pathogenicity of rare genetic diseases and with new innovative methods can now reliably be identified from exome sequencing. Challenges still remain in accurate classification of CNV pathogenicity. CNV calling using GATK-gCNV was performed on exomes from a cohort of 6,633 families (15,759 individuals) with heterogeneous phenotypes and variable prior genetic testing collected at the Broad Institute Center for Mendelian Genomics of the GREGoR consortium. Each family’s CNV data was analyzed using theseqrplatform and candidate CNVs classified using the 2020 ACMG/ClinGen CNV interpretation standards. We developed additional evidence criteria to address situations not covered by the current standards. The addition of CNV calling to exome analysis identified causal CNVs for 173 families (2.6%). The estimated sizes of CNVs ranged from 293 bp to 80 Mb with estimates that 44% would not have been detected by standard chromosomal microarrays. The causal CNVs consisted of 141 deletions, 15 duplications, 4 suspected complex structural variants (SVs), 3 insertions and 10 complex SVs, the latter two groups being identified by orthogonal validation methods. We interpreted 153 CNVs as likely pathogenic/pathogenic and 20 CNVs as high interest variants of uncertain significance. Calling CNVs from existing exome data increases the diagnostic yield for individuals undiagnosed after standard testing approaches, providing a higher resolution alternative to arrays at a fraction of the cost of genome sequencing. Our improvements to the classification approach advances the systematic framework to assess the pathogenicity of CNVs.
Structural and molecular basis of choline uptake into the brain by FLVCR2
Authors: Cater Rosemary J. , Mukherjee Dibyanti , Iturbe Eva Gil , Erramilli Satchal K. , Chen Ting , Koo Katie , Grez Nicolás Santander , Reckers Andrew , Kloss Brian , Gawda Tomasz , Choy Brendon C. , Zheng Zhening , Clarke Oliver B. , Yee Sook Wah , Kossiakoff Anthony A. , Quick Matthias , Arnold Thomas , Mancia Filippo
Published: October 2023

Choline is an essential nutrient that the human body needs in vast quantities for cell membrane synthesis, epigenetic modification, and neurotransmission. The brain has a particularly high demand for choline, but how it enters the brain has eluded the field for over fifty years. The MFS transporter FLVCR1 was recently determined to be a choline transporter, and while this protein is not highly expressed at the blood-brain barrier (BBB), its relative FLVCR2 is. Previous studies have shown that mutations in humanFlvcr2cause cerebral vascular abnormalities, hydrocephalus, and embryonic lethality, but the physiological role of FLVCR2 is unknown. Here, we demonstrate bothin vivoandin vitrothat FLVCR2 is a BBB choline transporter and is responsible for the majority of choline uptake into the brain. We also determine the structures of choline-bound FLVCR2 in the inward- and outward-facing states using cryo-electron microscopy to 2.49 and 2.77 Å resolution, respectively. These results reveal how the brain obtains choline and provide molecular-level insights into how FLVCR2 binds choline in an aromatic cage and mediates its uptake. Our work could provide a novel framework for the targeted delivery of neurotherapeutics into the brain.
On the diffusion and implementation of trust-based management in Scandinavia: cross-country survey evidence
Authors: Siverbo Sven , Johansson-Berg Tobias , Øllgaard Bentzen Tina , Winsvold Marte
Published: October 2023

Purpose

This study aims to examine the diffusion and implementation of trust-based management (TBM) in Scandinavian countries (Denmark, Norway and Sweden). TBM is a novel “anti-New Public Management (NPM)” innovation within the realm of New Public Governance (NPG), which asserts that leadership and control in public sector organizations should be practiced and designed based on the assumption that civil servants and employees in general are trustworthy. The research questions are as follows: How has TBM been diffused and implemented in Scandinavia? To what extent can the institutional logics framework increase understanding of similarities and differences between the Scandinavian countries (Denmark, Norway and Sweden)?

Design/methodology/approach

The authors designed and submitted surveys to the municipal directors of the three Scandinavian municipal populations, thereby producing a unique cross-country dataset on TBM diffusion and implementation in Scandinavia (Denmark, Norway and Sweden).

Findings

The authors' study shows that TBM has diffused widely among Scandinavian municipalities and has developed into a municipal-level concept across policy fields and sectors. While Denmark stands out as an earlier and more decisive TBM reformer, the results show that similarities in the diffusion and implementation of TBM in Scandinavian countries are more apparent than the differences.

Originality/value

This study contributes to the public management literature and research on anti-NPM and NPG concepts by being the first wide-scale empirical study of TBM diffusion and implementation in the Scandinavian municipal sectors.
Modelling the inhibitors of integrated sustainable lean manufacturing system in the South Indian SMEs using fuzzy logic
Authors: Gopi Vivek , P.G. Saleeshya
Published: October 2023

Purpose

Small and medium-scale enterprises (SMEs) that operate with modest financial investments and commodities face numerous challenges to remain in business. One major philosophy used by SMEs these days is the implementation of lean manufacturing to get solutions for various issues they encounter. But is lean getting sustained over time? The purpose of this research is to design a Sustainable Lean Performance Index (SLPI) to assess the sustainability of lean systems and to pinpoint the variables that might be present as potential lean system inhibitors which hinder the sustainability of leanness.

Design/methodology/approach

A multi-level sustainable lean performance model is constructed and presented based on the literature research, field investigation and survey conducted by administering a questionnaire. Fuzzy logic approach is used to analyse the multi-level model.

Findings

SLPI for the SMEs is found using fuzzy logic approach. Additionally, the ranking score system is applied to categorise attributes into weak and strong categories. The performance of the current lean system is determined to be “fair” based on the Euclidean distance approach and the SLPI for SMEs.

Research limitations/implications

This work is concentrated only in South India because of the country’s vast geographical area and rich and wide diversity in industrial culture of the nation. Hence, more work can be done incorporating the other parts of the country and can analyse the lean behaviour in a comparative manner.

Practical implications

The generalised sustainable lean model analysed using fuzzy logic identifies the inhibitors and level of performance of SMEs in South India. This can be implemented to find out the level of performance in the SMEs after a deeper study and analysis around the SMEs of the country.

Originality

The sustainable assessment of lean parameters in the SMEs of India is found to be very less in literature, and it lacks profundity. The model established in this study assesses the sustainability of the lean methodology adopted in SMEs by considering the lean and sustainability attributes along with enablers like technology, ethics, customer satisfaction and innovation with the aid of fuzzy logic.
Monetary impacts should be considered in biological invasion risk assessments
Authors: Soto Ismael , Haubrock Phillip J. , Cuthbert Ross N. , Renault David , Probert Anna F. , Tarkan Ali Serhan
Published: October 2023

Biological invasions pose a significant threat to biodiversity, planetary health and socio‐economies worldwide. Prioritizing invasive species for management is crucial, given the limited economic resources available.

While global invasive species risk scoring systems exist, they currently do not incorporate fully quantitative impact metrics. However, the emergence of monetary costs as a standardized measure of invasive species impact across contexts provides an opportunity to compare species in risk assessments.

Synthesis and applications: The economic impact of invasive species should now be considered in impact and risk assessments worldwide, given the growing availability and synthesis of cost data. This will allow for more informed decision‐making regarding the allocation of resources for invasive species management.
Cognitive assistance to support individuals with traumatic brain injury using a minimal and personalised approach: A conversion mixed methods study using video analysis
Authors: Gagnon‐Roy Mireille , Bier Nathalie , Le Dorze Guylaine , Boulé‐Riley Stéphanie , Paquette Guillaume , Couture Mélanie , Bottari Carolina
Published: October 2023

Introduction

Individuals with traumatic brain injury (TBI) frequently need assistance to manage complex everyday activities. However, little is known about the types of cognitive assistance that can be used to facilitate optimal independence. A conversion mixed method study using video analysis was conducted to describe assistance provided by trained occupational therapists during three everyday tasks carried out in the participants' homes and surrounding environments.

Methods

Forty‐five people with moderate and severe TBI were tested by three occupational therapists using the Instrumental Activities of Daily Living Profile, an observation‐based assessment that documents independence in complex everyday activities and the minimal assistance required to attain task goals. Using video analysis, difficulties experienced by the people with TBI during a meal preparation and grocery shopping task, and the cognitive assistance provided by the occupational therapists in response to these difficulties, were documented. Statistical analyses were also completed to identify the main difficulties and types of cognitive assistance provided during the evaluation, for the whole group and depending on their level of independence.

Results

Nine types of cognitive assistance were used by occupational therapists, including implicit (stimulating thought processes), and more explicit assistance (cueing), to facilitate task performance. When needed, motivational assistance, which consisted of encouraging participants to think for themselves, was also used. Stimulating thought processes was mostly used to support goal formulation and planning, whereas cueing was used in numerous instances. Participants with lower levels of independence received more assistance of almost all types to support them.

Conclusion

Using these findings, training could be developed for caregivers and occupational therapists to support them in providing minimal and personalised cognitive assistance. Further research is needed to examine the extent to which all types of cognitive assistance are effective in helping various cognitive profiles of people with TBI attain optimal independence.
Will the New UK Subsidy Control Regime Help ‘Level Up’ the Economy?
Authors: Stephan Andreas
Published: October 2023

There is an emerging political consensus in the UK that greater devolution of spending powers will bring benefits in terms of reducing economic disparities between regions, enhancing social cohesion, and improving the economy's prospects for productivity, growth and the transition to net zero. The Subsidy Control Act 2022 is thought to be key to achieving this by providing public authorities with greater flexibility in how they make spending decisions than was previously the case under EU State aid rules. This paper examines whether the new regime does indeed make it easier for awarding bodies to grant beneficial subsidies. It concludes that the regime risks placing obligations on public authorities that are considerably more onerous than EU State aid rules and there is a need to significantly increase the scope of streamlined routes which provide legal certainty to beneficial spending decisions.
Taking a chance on outcome standardisation: A cross‐sectional analysis assessing the uptake of the prevention of preterm birth core outcome set in randomised controlled trials
Authors: Bratten Chance , Tham Laura , Magana Kimberly , Ward Shaelyn , Magee Trevor , Modi Jay , Jones Garrett , Fitzgerald Kyle , Hughes Griffin , Ford Alicia Ito , Vassar Matt
Published: October 2023

Objective

Analyse uptake of the core outcome set (COS) within preterm birth (PTB) clinical trials.

Design

On 26 June 2023, we conducted a systematic search of phase III/IV trial registry entries regarding PTB interventions via ClinicalTrials.gov and the International Clinical Trial Registry Platform. These trials were analysed for the outcomes measured.

Setting

N/A.

Sample

After searching the two databases, 5257 randomised controlled trials (RCTs) were screened, resulting in 92 RCTs for analysis.

Methods

Inclusion criteria were the following: subjects were patients receiving an intervention for PTB, study enrolment began within 5 years prior to publication of PTB COS to 26 June 2023, and evaluated the efficacy of interventions. Authors screened and extracted data in masked, duplicate fashion, then performed an interrupted time series analysis, analysis of variance and correlation analysis.

Main outcome measures

We extracted outcomes measured by each clinical trial in our sample. Trials were analysed for the percentage of adopted outcomes from PTB COS.

Results

After COS publication, there was no significant change in percentage of COS outcomes measured. The most measured outcome was ‘offspring mortality’ (54.34%, 50/92) and the least measured outcome was ‘late neonatal neurodevelopment morbidity’ (3.26%, 3/92). Additionally, 22.83% (21/92) of trials measured zero outcomes related to the PTB COS.

Conclusion

Our results demonstrated no significant change in outcome measurement before or after PTB COS publication. We recommend focusing on both the measurement of outcomes and the assessments that are used.
Neuroprotective effect of chitosan oligosaccharide on alcohol‐induced hippocampal injury using proteomic analysis
Authors: Wang Bin , Zhao Yuke , Qu Yufei , Lu Jingyu , Yan Hua , Gu Juan , Jiang Qiqing , Xu Yanshun , Xia Wenshui
Published: October 2023

Alcoholism is a serious public health problem, and the abuse of drinking seriously damages the health of people. Chitosan oligosaccharides (COSs) are small‐molecule oligosaccharides with amino groups that have many unique properties. The neuroprotective effect of COS on alcohol‐induced hippocampal injury in Sprague–Dawley (SD) rats was investigated. The discrimination ratio of the COS group in the Y‐maze experiment was 59.3% higher than that of the ETOH group. Meanwhile, the discrimination index was less than 0 in the ETOH group but greater than 0 in the COS group during the object recognition test. The cells in the COS group were more tightly arranged than those in the ETOH group. Proteomics was used to identify differentially expressed proteins in the hippocampus. There were 27 differentially expressed proteins in the COS and ETOH group for further bioinformatic analysis. There are three enriched pathway categories, namely, primary immunodeficiency, hedgehog signaling, and sulfur relay system. Next, sonic hedgehog signaling pathway‐related proteins were verified through western blotting. The protein expression level of β‐arrestin‐2 in the COS group was 2.85 times higher than that in the ETOH group. This work may contribute to understanding the underlying mechanism of the neuroprotective effect of COS against alcohol‐induced hippocampal injury in SD rats.
Identifying demographic and environmental drivers of population dynamics and viability in an endangered top predator using an integrated model
Authors: Warlick A. J. , Himes Boor G. K. , McGuire T. L. , Shelden K. E.W. , Jacobson E. K. , Boyd C. , Wade P. R. , Punt A. E. , Converse S. J.
Published: October 2023

Knowledge about the demographic and environmental factors underlying population dynamics is fundamental to designing effective conservation measures to recover depleted wildlife populations. However, sparse monitoring data or persistent knowledge gaps about threats make it difficult to identify the drivers of population dynamics. In situations where small, declining, or depleted populations show continued evidence of decline for unknown reasons, integrated population models can make efficient use of available data to improve our understanding of demography, provide fundamental insights into factors that may be limiting recovery, and support conservation decisions. We used mark‐resight and aerial survey data from 2004 to 2018 to build a Bayesian integrated population model for the Cook Inlet population of beluga whales (Delphinapterus leucas), which is listed as endangered under the U.S. Endangered Species Act. We examined the effects of prey availability and oceanographic conditions on beluga vital rates and conducted a population viability analysis to predict extinction risk across a range of hypothetical changes in beluga survival and reproduction. Our results indicated that while the survival of breeding females (0.97; 95% CI: 0.95–0.99) and young calves (0.92; 0.80–0.98) was relatively high, the survival of nonbreeders (0.94; 0.91–0.97) and fecundity (0.28; 0.22–0.36) may be depressed. Furthermore, our analysis indicates that the population will likely continue to decline, with a 17–32% probability of extinction in 150 years. Our model highlights the utility of integrated population modeling for maximizing the usefulness of available data and identifying factors contributing to the failure of protected populations to recover. This framework can be used to evaluate proposed conservation and recovery efforts for this and other endangered species.
Milk as diagnostic fluid for udder health management
Authors: Rowe S , House JK , Zadoks RN
Published: October 2023

Background

Mastitis is the major disease affecting milk production of dairy cattle, and milk is an obvious substrate for the detection of both the inflammation and its causative infectious agents at quarter, cow, or herd levels. In this review, we examine the use of milk to detect inflammation based on somatic cell count (SCC) and other biomarkers, and for the detection of mastitis pathogens through culture‐based and culture‐free methods.

Findings

The use of SCC at a cow or bulk milk level to guide udder health management in lactation is well‐established, and SCC is increasingly used to guide selective dry cow treatment. Other markers of inflammation include electrical conductivity, which is used commercially, and markers of disease severity such as acute phase proteins but are not pathogen‐specific. Some pathogen‐specific markers based on humoral immune responses are available, but their value in udder health management is largely untested. Commercial pathogen detection is based on culture or polymerase chain reaction, with other tests, for example, loop‐mediated isothermal amplification or 16S microbiome analysis still at the research or development stage. Matrix‐assisted laser desorption ionisation time of flight (MALDI‐ToF) is increasingly used for the identification of cultured organisms whilst application directly to milk needs further development. Details of test sensitivity, specificity, and use of the various technologies may differ between quarter, cow, and bulk milk applications.

Conclusions

There is a growing array of diagnostic assays that can be used to detect markers of inflammation or infection in milk. The value of some of these methods in on‐farm udder health improvement programs is yet to be demonstrated whilst methods with proven value may be underutilised.
Adaptive functioning and academic achievement in pediatric survivors of acute lymphoblastic leukemia: Associations with executive functioning, socioeconomic status, and academic support
Authors: Seghatol‐Eslami Victoria C. , Cook Edwin W. , Sharafeldin Noha , Wolfson Julie , Murdaugh Donna L.
Published: October 2023

Objectives

This study examines associations of functional outcomes (adaptive functioning and academic achievement) with executive functioning (EF), socioeconomic status (SES), and academic support in pediatric acute lymphoblastic leukemia (ALL) survivors.

Methods

Fifty survivors of B‐lineage ALL treated with chemotherapy‐only (42% female, 76% NHW, ages 6–19) were evaluated on performance‐based EF and academic achievement, and parent‐rated EF and adaptive functioning. Area deprivation and child opportunity (i.e., SES) were extracted using census blocks and tracts. Academic support data were extracted from chart review.

Results

Compared to population norms, pediatric ALL survivors demonstrated significantly lower overall adaptive skills and performance in word reading and math calculation (all p ≤ .011). Frequencies of impairment were significantly elevated on all adaptive scales and in math calculation compared to the population (all p ≤ .002). Parent‐rated EF significantly predicted overall adaptive skills (p < .001), while performance‐based EF significantly predicted word reading and math calculation (all p < .05). Adaptive functioning was not associated with neighborhood‐specific variables or academic support. However, academic support predicted word reading (p < .001), while area deprivation and academic support predicted performance‐based EF (all p ≤ .02).

Conclusions

Screening of functional outcomes, targeted intervention, and neuropsychological monitoring are necessary to support pediatric ALL survivors' neurocognitive and psychosocial development.
Repurposing consumer sunscreen habits and practices survey data to guide the development of UV filter environmental exposure models and risk assessments
Authors: Carrao Andrea M. , Schmitt Celine N. , Dyer Scott D.
Published: October 2023

Objective

A key factor that is deficient in most environmental emissions assessments for UV filters is a keen understanding of consumer habits and practices that can inform realistic exposure assessments. This study utilized a large volunteer survey (>11 000 persons) that captured many factors that affect consumer‐based loadings to aquatic environments. The purpose of this study was to utilize this large survey to identify factors that affect the amount of sunscreen products used by consumers.

Methods

Correlations among more than 20 variables were used to provide an understanding of the overall dataset and identify factors that may be related to the amount of sunscreen product applied to the body (i.e., application thickness). Forward multiple linear regressions were used to identify the relative importance of each of these factors alone and in combination with others in predicting the amount of applied sunscreen.

Results

The proportion of body surface area (BSA) covered by sunscreen was the primary factor related to application thickness, followed by body surface area of the survey participant, seasonal usage, Fitzpatrick skin type and the sun protection factor, respectively. Each of the five regression models examined was statistically highly significant.

Conclusions

Comparisons to recommendations from the National Academies of Science, Engineering and Medicine parameters illustrated sufficient differences so as to encourage the development of future consumer habits and practice surveys that include factors beyond the scope of this study (e.g., activities, time of day, year, location, etc.) that can lead to improved exposure and risk assessments.
Exploring factors associated with hypertension self‐care in primary care: The role of nurse education levels and patient‐related factors
Authors: Suwanno Jom , Phonphet Chennet , Mayurapak Chidchanog , Ninla‐aesong Putrada , Thaimwong Ladda
Published: October 2023

Aim

To explore the association between nurse education levels and patient‐related factors with hypertension self‐care.

Background

Although self‐care development is recognized as a healthcare provider–patient encounter, the attribution of nurse education level to hypertension self‐care is not well addressed.

Design

A cross‐sectional study.

Methods

Hypertensive patients from 15 primary care facilities were sampled, and self‐care was assessed using the Self‐Care of Hypertension Inventory version 2.0, with standardized scores ≥70 indicating adequate self‐care. Data on patient‐related factors were obtained from electronic health records, self‐reports and laboratory tests, while nurse education levels were categorized as standard (baccalaureate‐prepared) or higher (post‐baccalaureate specialty).

Results

A total of 1493 participants were included in this study, with a median age of 66 years and 77.7% being female. Approximately 10% of participants had adequate self‐care, and 66% received care from higher educated nurses. The study showed the relation between nurse education levels and the self‐care of the patients. Adequate hypertension self‐care was significantly associated with higher educated nurse providers and patient‐related factors, including intermediate to higher education, non‐overweight/obese and the absence of age‐related comorbidities.

Conclusions

Hypertensive patients who had been provided care by higher educated nurses and their favourable sociodemographic, lower cardiometabolic risk and no concomitant disease were more likely to demonstrate adequate self‐care.
The efficacy of Tai Chi for essential hypertension: A systematic review and meta‐analysis
Authors: Zhang Pengchao , Zhang Dan , Lu Deyi
Published: October 2023

Aim

We aimed to assess the impact of Tai Chi interventions on individuals with essential hypertension and to compare the effects of Tai Chi versus control in this population.

Background

Tai Chi has been extensively utilized in the prevention of essential hypertension. Nevertheless, there is a lack of consensus regarding its benefits for treating essential hypertension.

Design

A systematic review and meta‐analysis was conducted.

Data Sources

We conducted a systematic literature search of the Medline, Scholar, Elsevier, Wiley Online Library, Chinese Academic Journal (CNKI) and Wanfang databases from January 2003 to August 2023.

Review Methods

Using the methods of the Cochrane Collaboration Handbook, a meta‐analysis was conducted to assess the collective impact of Tai Chi exercise in controlling hypertension. The primary outcomes measured included blood pressure and nitric oxide levels.

Results

The participants consisted of adults with an average age of 57.1 years who had hypertension (mean ± standard deviation systolic blood pressure at 148.2 ± 12.1 mmHg and diastolic blood pressure at 89.2 ± 8.3 mmHg). Individuals who practiced Tai Chi experienced reductions in systolic blood pressure of 10.6 mmHg, diastolic blood pressure of 4.7 mmHg and an increase in nitric oxide levels.

Conclusions

Tai Chi can be a viable lifestyle intervention for managing hypertension. Greater promotion of Tai Chi by medical professionals could extend these benefits to a larger patient population.
Risk stratification and management of non‐muscle‐invasive bladder cancer: A physician survey in six Asia‐Pacific territories
Authors: Ku Ja Hyeon , Lee Lui Shiong , Lin Tzu‐Ping , Kikuchi Eiji , Kitamura Hiroshi , Ng Chi‐Fai , Ng Junice Yi Siu , Poon Darren Ming‐Chun , Kanesvaran Ravindran , Seo Ho Kyung , Spiteri Carmel , Tan Ee Min , Tran Ben , Tsai Yuh‐Shyan , Nishiyama Hiroyuki
Published: October 2023

Objectives

Multiple clinical practice guidelines, conflicting evidence, and physician perceptions result in variations in risk stratification among patients with non‐muscle‐invasive bladder cancer (NMIBC). This study aims to describe the extent of this variation and its impact on management approaches in the Asia‐Pacific region.

Methods

We conducted a cross‐sectional survey involving 32 urologists and seven medical oncologists with ≥8 years of experience managing early‐stage bladder cancer patients across Australia, Hong Kong, Japan, South Korea, Singapore, and Taiwan. The physicians completed an anonymous questionnaire that assessed their risk stratification and respective management approaches, based on 19 NMIBC characteristics. For each NMIBC characteristic, they were required to select one risk group, and their most preferred management approach.

Results

Our results demonstrated a higher consensus on risk classification versus management approaches. More than 50% of the respondents agreed on the risk classification of all NMIBC characteristics, but 42% or fewer chose the same treatment option as their preferred choice for all but two characteristics—existence of variant histology (55%) and persistent high‐grade T1 disease on repeat resection (52%). Across territories, there was the greatest variation in preferred treatment options (i.e., no treatment, intravesical chemotherapy, or Bacillus Calmette‐Guérin [BCG] treatment) for intermediate‐risk patients and the highest consensus on the treatment of very high‐risk patients, namely radical cystectomy.

Conclusions

Our study revealed considerable variation in risk stratification and management of NMIBC in the region. It is critical to develop practical algorithms to facilitate the recognition of NMIBC and standardize the treatment of NMIBC patients.
Editorial: Salutogenic mental health science—A phoenix rising from the pathogenic ashes of psychiatry?
Authors: Fisher Helen L.
Published: October 2023

As highlighted by several of the papers featured in this current issue of the Journal, psychiatric research and practice is dominated by a pathogenic focus on understanding the origins of mental ill‐health and developing interventions to prevent or treat psychopathology. The World Health Organization has called for a paradigm shift to move away from the almost exclusive focus on the absence of illness towards the promotion of mental, physical and social well‐being among those with or at risk of psychiatric disorders. Adoption of a salutogenic approach, which focuses on factors and interventions that promote positive health and improve quality of life, has been heralded as the transformation psychiatry requires to achieve this ambitious aim. Looking forward, salutogenic mental health science should harness the power of longitudinal data and analytical techniques, centre lived experience expertise, and take heed of the cautionary tales of its pathogenic predecessor.
The influence of ultrasound homogenization on recrystallization during the storage of vegan ice cream
Authors: Kot Anna , Kamińska‐Dwórznicka Anna
Published: October 2023

This article investigated the influence of ultrasound homogenization and stabilizers (iota carrageenan and its hydrolysates) in the production of vegan ice cream. The cryoscopic temperature, osmotic pressure, overrun, melting time, and microstructure analysis were investigated. Vegan ice cream were stored at −18°C and the recrystallization process was analyzed based on images taken after 24 h, 1 month, and 3 months. According to the results, it was noted that ultrasound homogenization contributed to obtaining smaller ice crystals in ice cream, in comparison to the samples after traditional homogenization. The average diameter of ice crystals in the sample US pretreated, after 3 months of storage was less than 21 μm. The overrun value ranged from 9.22% to 32.36% and the melting time for samples did not exceed 34 min. The analysis of the cryoscopic temperature and osmotic pressure showed that ultrasound contributed to increasing the cryoscopic temperature and lowering the osmotic pressure.

Practical Applications

The presented study shows an alternative to dairy products for the vegan ice cream market. Changing mechanical homogenization to ultrasound homogenization in vegan ice cream production might be an effective step for ice cream producers. Owing to the fact that the use of ultrasound during production may reduce the impact of using stabilizers on the recipe of vegan ice cream. Finally, such changes will not result in additional steps in ice cream production which may not generate additional costs.
Addition of community paramedics to a physician home‐visit program: A prospective cohort study
Authors: Ulintz Alexander J. , Podolsky Seth R. , Lapin Brittany , Wyllie Robert R.
Published: October 2023

Background

Home‐based primary care promotes aging in place but is not immediately responsive to urgent needs. Community paramedicine leverages emergency medical services clinicians to expedite in‐home care, though limited evidence supports this model. We evaluated the primary care and acute care use of older adults evaluated urgently by a community paramedic with telemedicine physician compared to a physician home visit model.

Methods

This prospective cohort study enrolled older adults in home‐based primary care who requested an urgent evaluation. We allocated participants to the physician home visit model or physician home visit plus community paramedic model by ZIP code. We observed primary care and acute care use for 6 months following enrollment. The primary outcome was the median number of primary care and acute care visits per participant. Secondary outcomes included 30‐day readmission rates, median wait times, and physician productivity. Data analysis included descriptive statistics, comparison of means and proportions, and negative binomial regression modeling reported as incidence rate ratios (IRR).

Results

We screened 255 participants, determined 203 eligible, allocated 199, and completed observation for 167 (84 community paramedicine, 83 physician home visit). Participants were mostly female, age 76–86 years, with 3–5 comorbidities, living in a home/apartment. Community paramedic participants had 29% more primary care visits (IRR 1.29, 95% confidence interval [CI] 1.06–1.57) and shorter wait times for urgent evaluations (1 vs. 5 days, p < 0.001) without increasing acute care use (IRR 0.75, 95% CI 0.48–1.18) or 30‐day readmissions (IRR 1.32, 95% CI 0.49–3.55). Physician productivity increased 81% (40 vs. 22 visits/week, p < 0.001).

Conclusion

Older adults evaluated by a community paramedic for urgent needs were seen sooner, used acute care similarly to patients evaluated by a physician home visit, and nearly doubled physician efficiency. This suggests that older adults may benefit from combining emergency medical services and primary care resources for urgent evaluations.
The potential influences of professional identity for undergraduate nursing students during the COVID‐19 pandemic: A cross‐sectional study
Authors: Hu Xiao , Chen Xiaoju , Ouyang Qian , Li Gang , Wade Gail Holland , Chen Yidi
Published: October 2023

Aim

We aimed to investigate the level of undergraduate nursing students' professional identity (PI) during the COVID‐19 pandemic and its potential influences.

Methods

This cross‐sectional study included 742 undergraduate nursing students from Chengdu Medical College. Basic demographics, personal characteristics and PI score were collected. Chi‐squared test, one‐way analysis of variance, and multivariable logistic regression analysis were used to analyze the data.

Results

In the classes of 2019, 2020, and 2021, the PI score was 96.85 ± 18.26, 105.37 ± 17.46, 106.67 ± 22.08 (P < .001). PI score was the independent predictive factor for both “want to be a nurse” and “willingness to serve during COVID‐19 or other pandemics”.

Conclusions

PI contributes greatly to nursing students' willingness to be a nurse and overcome pandemics. The challenge of culturing PI during COVID‐19 pandemic revealed the necessity of developing individual management strategies for nursing education.
Re‐evaluating the importance of threatened species in maintaining global phytoregions
Authors: Brown Matilda J. M. , Walker Barnaby E. , Budden Andrew P. , Nic Lughadha Eimear
Published: October 2023

Anthropogenic introductions are known to be changing the structure of global phytogeographical regions (phytoregions), but previous studies have been limited by incomplete or biased data sets that are likely to underestimate the importance of threatened species. In this work, we analyse a comprehensive data set of all known species and their occurrences (at botanical country resolution) to quantify the impact of potential future extinction scenarios.

We used Infomap, a network‐based community detection algorithm, to generate phytoregional delineations for six species‐distribution scenarios (native, introduced and extinctions of species that are either documented as threatened or likely to be threatened, as well as combinations thereof). We compared the numbers and sizes of phytoregions to characterise the amount and spatial distribution of changes in global phytoregions under each scenario.

Extinctions of species that are predicted to be threatened had a greater homogenising effect on phytoregions than introductions, and there was some evidence that introductions may even mitigate the homogenisation caused by extinctions, though this interaction is complex.

This research provides the first evidence that the loss of threatened species would have significant ramifications for global phytoregions and demonstrates the need to consider extinction processes in studies of anthropogenic effects on biodiversity patterns.
Exploring clinical evaluation indicators for predicting coagulation in the extracorporeal circulation circuit in hemodialysis patients receiving individualized regional citrate anticoagulation—A single‐center, retrospective clinical study
Authors: Zou Menglin , Wu Feifei , Fan Yanna , Gong Yanyan , Hu Zhen , Jiang Tin , Gan Chenfu , Luo Laimin
Published: October 2023

Background

Citrate anticoagulation is an important anticoagulation method in hemodialysis (HD) but cannot completely prevent the occurrence of coagulation in the extracorporeal circulation (ECC) circuit, and the clinical coagulation status can significantly affect the effect of citrate anticoagulation. In this study, the relationships between clinical coagulation status indicators and coagulation in the ECC circuit in HD patients receiving individualized citrate anticoagulant were studied to explore indicators that may predict coagulation in the ECC circuit.

Methods

This study was a single‐center, retrospective clinical study, and clinical data and laboratory tests related to the coagulation status of HD patients receiving individualized regional citrate anticoagulation (RCA) were collected. The relationships between indicators commonly used in clinical practice to evaluate clinical coagulation status and coagulation in the ECC circuit were statistically analyzed to find indicators that can predict the occurrence of coagulation in the ECC circuit.

Results

The individualized RCA had a good anticoagulation effect, and the actual citrate infusion rate in nearly 80% of the patients was within ±10% of the theoretical infusion rate. The combined diseases or conditions that affect the coagulation status in vivo may increase the incidence of coagulation in the ECC circuit. The clinical D‐dimer level is an independent risk factor that affects and can predict coagulation in the ECC circuit, with a cutoff value of 2.03 mg/L, sensitivity of 59%, and specificity of 78%.

Conclusion

Individualized RCA can meet the needs of most HD treatments. Abnormal coagulation status in HD patients may increase the incidence of coagulation in the ECC circuit during individualized RCA for HD, and the D‐dimer level can predict the occurrence of coagulation in the ECC circuit during this treatment.
Cyborg farmers: Embodied understandings of precision agriculture
Authors: Velden Daniel van der , Klerkx Laurens , Dessein Joost , Debruyne Lies
Published: October 2023

Precision agriculture is often seen as disembodied and placeless, promised to either bring about a fourth agricultural revolution or as the start of dystopian rural futures, where farmers and their knowledge will be replaced by machines. A growing body of literature shows more nuanced ways of working with precision agriculture. This illustrates the need to investigate how, and under which conditions, precision agriculture is integrated and internalised by farmers. Based on 25 in‐depth interviews with male Dutch crop farmers, contractors, researchers, and ag‐tech developers, we develop the concept of the cyborg farmer, who embodies the use of precision technology while maintaining an intimate relationship with agro‐ecological context. This approach challenges the mind–body dichotomy in that the cognitive is not understood as primary, as emotions and the materiality of the body are taken seriously. This perspective emphasises the importance of embodied knowledge in how farmers interpret precision agriculture data. Our findings highlight the productive tension between data‐driven elements of precision agriculture and the embodied and intuitive understanding of agro‐ecological context. This productive tension consists of the successful integration of different forms of knowledge by the cyborg farmer, where embodied sense‐making and precision agriculture data are integrated into the formation of useable knowledge. The cyborg farmer maintains farmer agency and resists the dominance of algorithmic rationality over other forms of knowledge
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Safety behaviors were associated with greater anxious symptoms during the first year of the COVID‐19 pandemic
Authors: Stallman Jane K. , Bains Williams Kirsten N. , Goodson Jason T. , Haeffel Gerald J.
Published: October 2023

Research shows that people who use safety behaviors are at greater risk factor for anxiety than people who do not use safety behaviors. However, the perception of some safety behaviors changed during the COVID‐19 pandemic; behaviors that were once considered unnecessary or excessive were now commonplace (e.g., monitoring bodily symptoms, avoiding crowds). The purpose of this study was to determine the degree to which the pandemic changed the status of health‐related safety behaviors as a risk factor for symptoms of anxiety. To this end, we tested the effect of safety behavior use on anxious symptoms during the first year of the pandemic using a longitudinal design with 8 time points and participants (n = 233) from over 20 countries. Despite possible changes in their perception, those engaging in high levels of safety behaviors reported the greatest levels of anxious symptoms throughout the pandemic year. However, the outcomes for safety behavior users were not all negative. Safety behavior use at baseline was the only predictor of participants' willingness to receive the COVID‐19 vaccine (measured one year later).
A novel allele of FUT2 gene containing a deletion of nine bases (c.461_469delGGACCTTCT) in a Chinese Han blood donor
Authors: Zhou Shihang , Wang Liying , Song Wenqian , Xia Yuexin , Shao Linnan , Liang Xiaohua
Published: October 2023

Background and Objectives

The FUT2 gene is responsible for the synthesis of the H antigen in body secretions. It is highly polymorphic and population specific. We investigated the FUT2 gene polymorphism in Chinese blood donors and found a novel deletion mutation in one non‐secretor individual. This study aimed to identify mutation(s) responsible for a non‐secretor phenotype.

Materials and Methods

The Lewis blood group of a Chinese Han blood donor was typed using the standard serological technique and the FUT2 gene of the sample was analysed by Sanger sequencing. Clone sequencing was performed for determining the haplotype of the FUT2 gene. Bioinformatics tools were used for predicting the effect of the deletion on the FUT2 gene.

Results

A novel nine‐base deletion (c.461_469delGGACCTTCT) in the FUT2 gene was identified in a Chinese Han blood donor. Two haplotypes Se390,418 and se204,249,461_469del,772,993 were determined by clone sequencing. According to the prediction of bioinformatics tools, the mutation at c.461_469delGGACCTTCT might not influence the activity of the Se enzyme.

Conclusion

We identified a new FUT2 mutation, the deletion of nine bases (c.461_469delGGACCTTCT), in a Chinese Han blood donor. This deletion was reported for the first time.