bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic myeloid leukemia (CML) in children and adolescents—Clinicopathological findings
Authors: Nevejan Louis , Labarque Veerle , Boeckx Nancy
Published: November 2023

Background

Barely two per million Belgian children/adolescents are diagnosed with chronic myeloid leukemia (CML) annually. In this retrospective study, we aimed to investigate the diagnostic features, clinical and laboratory characteristics, and treatment outcome of this rare entity.

Methods

Medical records of all pediatric CML patients (age ≤ 17 years) diagnosed at the University Hospitals Leuven between 1986 and 2021 were reviewed.

Results

Fourteen patients (median age at diagnosis 12.5 years) were included, all presenting in chronic phase. Five patients were diagnosed before 2003; main therapy included hydroxyurea (n = 5/5), interferon‐alfa (n = 3/5) and allogeneic hematopoietic stem cell transplantation (allo‐Tx) (n = 3/5). Complete hematologic response (CHR), complete cytogenetic response (CCyR) and major molecular response (MMR) was reached in resp. 4/5, 4/5 and in 2/3 of evaluable patients. Three patients progressed to accelerated/blast phase (median time 19 months) and 1/5 is alive and disease‐free at last follow‐up. Nine patients were diagnosed after 2003 and were treated with first generation (1°G) tyrosine kinase inhibitors (TKI): 3/9 subsequently underwent an allo‐Tx, 4/9 were switched to 2°G TKI, one patient was additionally switched to 3°G TKI. CHR, CCyR and MMR was reached in 9/9, 9/9 and 8/9 of these patients. No progression to accelerated/blast phase was observed and none of these patients deceased. At last follow‐up, 7/9 patients were in MMR or disease free, the two remaining patients did not reach or lost MMR, both related to compliance issues.

Conclusion

Our study confirmed that TKI significantly improved the prognosis of pediatric CML. However, drug compliance poses a considerable challenge.
Effect of theanine on the hyperexcitability of trigeminal secondary nociceptive neurons following orofacial inflammation in rats
Authors: Watanuki Yui , Yajima Sora , Sashide Yukito , Takeda Mamoru
Published: November 2023

The present in vivo study investigated whether systemic administration of theanine attenuates the inflammation‐induced hyperexcitability of trigeminal spinal nucleus caudalis (SpVc) neurons associated with hyperalgesia. Complete Freund's adjuvant (CFA) was injected into the whisker pads of 24 rats to induce inflammation, and then mechanical stimulation was applied to the orofacial area to assess the threshold of escape. The mechanical threshold was statistically significantly lower in CFA‐inflamed rats compared to uninjected naïve rats, and this lowered threshold returned to control levels after 2 days of theanine administration. The mean discharge frequency of SpVc wide‐dynamic range (WDR) neurons to mechanical stimuli in anesthetized CFA‐inflamed rats was statistically significantly lower after two days of theanine administration. In addition, the increased mean spontaneous discharge of SpVc WDR neurons in CFA‐inflamed rats statistically significantly decreased after theanine administration. Similarly, theanine restored the expanded mean receptive field size in CFA‐inflamed rats to control levels. Taken together, these results suggest that administration of theanine attenuates inflammatory hyperalgesia associated with hyperexcitability of nociceptive SpVc WDR neurons. These findings support the potential of theanine as a therapeutic agent in complementary alternative medicine strategies to prevent inflammatory hyperalgesia.
Interaction of interictal epileptiform activity with sleep spindles is associated with cognitive deficits and adverse surgical outcome in pediatric focal epilepsy
Authors: Yu Han , Kim Woojoong , Park David K. , Phi Ji Hoon , Lim Byung Chan , Chae Jong‐Hee , Kim Seung‐Ki , Kim Ki Joong , Provenzano Frank A. , Khodagholy Dion , Gelinas Jennifer N.
Published: November 2023

Objective

Temporal coordination between oscillations enables intercortical communication and is implicated in cognition. Focal epileptic activity can affect distributed neural networks and interfere with these interactions. Refractory pediatric epilepsies are often accompanied by substantial cognitive comorbidity, but mechanisms and predictors remain mostly unknown. Here, we investigate oscillatory coupling across large‐scale networks in the developing brain.

Methods

We analyzed large‐scale intracranial electroencephalographic recordings in children with medically refractory epilepsy undergoing presurgical workup (n = 25, aged 3–21 years). Interictal epileptiform discharges (IEDs), pathologic high‐frequency oscillations (HFOs), and sleep spindles were detected. Spatiotemporal metrics of oscillatory coupling were determined and correlated with age, cognitive function, and postsurgical outcome.

Results

Children with epilepsy demonstrated significant temporal coupling of both IEDs and HFOs to sleep spindles in discrete brain regions. HFOs were associated with stronger coupling patterns than IEDs. These interactions involved tissue beyond the clinically identified epileptogenic zone and were ubiquitous across cortical regions. Increased spatial extent of coupling was most prominent in older children. Poor neurocognitive function was significantly correlated with high IED–spindle coupling strength and spatial extent; children with strong pathologic interactions additionally had decreased likelihood of postoperative seizure freedom.

Significance

Our findings identify pathologic large‐scale oscillatory coupling patterns in the immature brain. These results suggest that such intercortical interactions could predict risk for adverse neurocognitive and surgical outcomes, with the potential to serve as novel therapeutic targets to restore physiologic development.
Diagnostic approaches, aetiological agents and their associations with short‐term survival and laminitis in horses with acute diarrhoea admitted to referral institutions
Authors: Gomez Diego E. , Arroyo Luis G. , Schoster Angelika , Renaud David L. , Kopper Jamie J. , Dunkel Bettina , Byrne David ,   The MEDS group, Toribio Ramiro E.
Published: November 2023

Background

An international description of the diagnostic approaches used in different institutions to diagnose acute equine diarrhoea and the pathogens detected is lacking.

Objectives

To describe the diagnostic approach, aetiological agents, outcome, and development of laminitis for diarrhoeic horses worldwide.

Study design

Multicentre retrospective case series.

Methods

Information from horses with acute diarrhoea presenting to participating institutions between 2016 and 2020, including diagnostic approaches, pathogens detected and their associations with outcomes, were compared between institutions or geographic regions.

Results

One thousand four hundred and thirty‐eight horses from 26 participating institutions from 4 continents were included. Overall, aetiological testing was limited (44% for Salmonella spp., 42% for Neorickettsia risticii [only North America], 40% for Clostridiodes difficile, and 29% for ECoV); however, 13% (81/633) of horses tested positive for Salmonella, 13% (35/262) for N. risticii, 9% (37/422) for ECoV, and 5% (27/578) for C. difficile. C. difficile positive cases had greater odds of non‐survival than horses negative for C. difficile (OR: 2.69, 95%CI: 1.23–5.91). In addition, horses that were positive for N. risticii had greater odds of developing laminitis than negative horses (OR: 2.76, 95%CI: 1.12–6.81; p = 0.029).

Main limitations

Due to the study's retrospective nature, there are missing data.

Conclusions

This study highlighted limited diagnostic investigations in cases of acute equine diarrhoea. Detection rates of pathogens are similar to previous reports. Non‐survival and development of laminitis are related to certain detected pathogens.
In vitro stability study of 10 beta‐lactam antibiotics in human plasma samples
Authors: Brenkman Matthieu , Cartau Tom , Pape Elise , Kolodziej Allan , Charmillon Alexandre , Novy Emmanuel , Jouzeau Jean‐Yves , Gambier Nicolas , Scala‐Bertola Julien
Published: November 2023

Background and Objectives

Beta‐lactam antibiotics are reported for some of them to be subject to a rapid degradation in infusion solutions and in human blood samples. However, the current data of stability available in blood samples are limited to a few number of beta‐lactam antibiotics, and the methodology of the corresponding studies may be discussed. The objective of the present study is to evaluate the stability of 10 beta‐lactam antibiotics in human plasma samples.

Methods

Stability of amoxicillin, cefazolin, cefepime, cefotaxime, cefoxitin, ceftazidime, ceftriaxone, imipenem, meropenem, and piperacillin was evaluated at low and high concentrations at 20°C, 4°C, −20°C, and −80°C for 1, 7, 60, and 90 days, respectively.

Results

Amoxicillin, cefepime, meropenem, and piperacillin were the least stable antibiotics. The maximum durations allowing the stability for all the evaluated beta‐lactams at both tested concentrations were estimated at 3 h, 23 h, 10 days, and 35 days at 20°C, 4°C, −20°C, and −80°C, respectively.

Conclusion

We recommend to transport antibiotic plasma samples in ice at 4°C and even at −20°C if these samples come from external hospitals. Ideally, plasma samples should be stored at −80°C if possible; if not, the analysis of the samples should be performed as soon as possible in the limit of 10 days after a storage at −20°C.
An exploratory study of drug concentration and inhibitory effect of cetylpyridinium chloride buccal tablets on SARS‐CoV‐2 infection among 10 Chinese subjects
Authors: Li Yanting , Xie Zhenwei , Chen Liming , Liu Xiangxing , Li Shuang , Ye Shichun , Tang Hongyan , Lee Chongyou , Gu Qun , Men Fang , Zhang Jiaojiao , Hu Dingyuan , Jiang Yuanli , Wang Xiaochun , Wang Qian , Feng Yufei , Niu Suping , Liu Yan , Fang Yi
Published: November 2023

Background

It was evidenced that cetylpyridinium‐chloride (CPC) mouthwash could inhibit SARS‐COV‐2 activity and reduce salivary viral load, thus reducing SARS‐CoV‐2 transmission. However, due to insufficient residence time in the oral cavity, CPC‐containing mouthwashes have no prolonged antiviral effect. The duration of action of the CPC buccal tablet is expected to be longer than that of the mouthwash. However, there are currently no reports on the salivary drug concentration of CPC buccal tablets.

Objective

The study aimed to investigate the salivary drug concentration of CPC buccal tablets and the antiviral effect of CPC on SARS‐CoV‐2 in vitro.

Trial design

This is a single‐dose, single‐arm clinical trial, involving 10 Chinese healthy subjects who received 2‐mg CPC buccal tablet to collect saliva samples and to detect saliva concentration at different timepoints within 2 h (Clinical Trial Registration Number: NCT05802628, Registration Date: April 6, 2023).

Materials and methods

CPC concentration in saliva was detected by liquid chromatography tandem mass spectrometry (LC–MS/MS), and pharmacokinetic parameters were calculated based on the non‐compartmental model. With an in vitro antiviral experiment, the activity of CPC buccal tablets against SARS‐CoV‐2 and its cellular toxicity was tested.

Results

Drug concentrations in saliva at 15 min, 30 min, 1 h, 1.5 h, and 2 h after administration were 8008.33 (1042.25, 41081.11), 2093.34 (373.15, 5759.83), 1016.58 (378.66, 3480.68), 891.77 (375.66, 6322.07), and 717.43 (197.87, 2152.71) ng/mL. PK parameters of saliva concentration: Cmax = 8008.33 (1042.25, 41081.11) ng/mL, AUC0‐t = 4172.37 (904.42, 13912.61) ng/mL * h, AUC0‐∞ = 6712.85 (1856.77, 19971.12) ng/mL * h, T1/2 = 1.22 (0.59, 2.83) h, Tmax = 0.25 (0.25, 0.25) h. As determined in in vitro experiment, CPC was active on SARS‐CoV‐2 with cytotoxic and inhibitory activity of CC50 = 35.75 μM (≈12155 ng/mL) and EC50 = 7.39 μM (≈2512.6 ng/mL).

Conclusions

The comparison between the salivary CPC concentration and EC50/CC50 values from in vitro antiviral experiments suggests that CPC buccal tablets may inhibit SARS‐CoV‐2 activity, and the inhibition may last for approximately 30 min without cytotoxicity.
Under the spotlight: The peer standard in CSR and the role of public attention
Authors: Nishi Hirofumi , Peabody S. Drew
Published: November 2023

As sustainability takes center stage in business strategies, firms lagging behind their peers on environmental initiatives are strongly motivated to bridge the gap. Analyzing the U.S. sectors primarily responsible for CO2 emissions, we show that environmentally lagging firms increase the efforts to reduce emissions and adopt eco‐friendly materials in the subsequent year. Interestingly, this phenomenon becomes significantly more pronounced among companies exposed to higher levels of consumer interest as measured by Google search volumes. Our finding suggests that lagging firms under greater public scrutiny recognize the need to address their sustainability deficiencies to maintain competitiveness and corporate reputation.
Congruence of water column, contemporary and pre‐industrial sediment cladoceran assemblages in 85 Canadian lakes of contrasting human impact levels
Authors: Paquette Cindy , Gregory‐Eaves Irene , Beisner Beatrix E.
Published: November 2023

Crustacean zooplankton occupy a key position as primary consumers within lake food webs, acting as early indicators of wider ecosystem shifts that can cascade to higher trophic levels. Their communities can be assessed via water column net hauls or via sediment samples containing preserved subfossil remnants from various time periods; the latter probably integrate multiple years of data, habitats within lakes, and seasonal patterns. The degree to which such samples do or do not correspond has never been assessed across a wide variety of lake types and gradients.

As part of a larger sampling of over 600 lakes across lake‐rich Canada, 85 lakes were selected along a gradient of human impact, according to contemporary catchment land use, to analyse cladoceran zooplankton assemblage relatedness among snapshot water column, contemporary and pre‐industrial sediment samples.

We used a combination of ordinations and matrix correlations (RV coefficients), along with partial redundancy analyses, to determine the degree to which the different sample types were comparable and whether they responded similarly to >30 environmental variables. We also compared conclusions obtained using the full cladoceran assemblages versus pelagic‐only taxa and whether our results varied according to degree of human impact.

Overall, while all sample types were correlated, congruence was highest between contemporary and pre‐industrial sediment sample types. This result could arise from the under‐representation of littoral taxa in water column samples relative to those from the sediment. In high impacted catchments, however, we observed greater similarity between water column and contemporary sediment samples, as water quality stressors potentially structure assemblages in parallel directions over time. In these modern‐day sample types and among measured variables, we identified lake depth and pH as the most important structuring variables across Canada.

In this first study comparing cladoceran assemblages in water column, contemporary and pre‐industrial sediments across many lakes, we conclude that water column and sediment samples respond similarly to environmental drivers but should not be considered entirely analogous or redundant.
Hypoxia stabilizes the H2O2‐producing oxidase Nox4 in cardiomyocytes via suppressing autophagy‐related lysosomal degradation
Authors: Matsunaga Shogo , Kohda Akira , Kamakura Sachiko , Hayase Junya , Miyano Kei , Shiose Akira , Sumimoto Hideki
Published: November 2023

The hydrogen peroxide (H2O2)‐producing NADPH oxidase Nox4, forming a heterodimer with p22phox, is expressed in a variety of cells including those in the heart to mediate adaptive responses to cellular stresses such as hypoxia. Since Nox4 is constitutively active, H2O2 production is controlled by its protein abundance. Hypoxia‐induced Nox4 expression is observed in various types of cells and generally thought to be regulated at the transcriptional level. Here we show that hypoxia upregulates the Nox4 protein level and Nox4‐catalyzed H2O2 production without increasing the Nox4 mRNA in rat H9c2 cardiomyocytes. In these cells, the Nox4 protein is stabilized under hypoxic conditions in a manner dependent on the presence of p22phox. Cell treatment with the proteasome inhibitor MG132 results in a marked decrease of the Nox4 protein under both normoxic and hypoxic conditions, indicating that the proteasome pathway does not play a major role in Nox4 degradation. The decrease is partially restored by the autophagy inhibitor 3‐methyladenine. Furthermore, the Nox4 protein level is upregulated by the lysosome inhibitors bafilomycin A1 and chloroquine. Thus, in cardiomyocytes, Nox4 appears to be degraded via an autophagy‐related pathway, and its suppression by hypoxia likely stabilizes Nox4, leading to upregulation of Nox4‐catalyzed H2O2 production.
Health‐related quality of life and physical activity in Nordic patients with moderate haemophilia A and B (the MoHem study)
Authors: Måseide Ragnhild J. , Berntorp Erik , Astermark Jan , Olsson Anna , Bruzelius Maria , Frisk Tony , Nummi Vuokko , Lassila Riitta , Tjønnfjord Geir E. , Holme Pål A.
Published: November 2023

Introduction

The impact of moderate haemophilia on health‐related quality of life (HRQoL) and physical activity (PA) is not well known. In previous studies, persons with factor VIII/factor IX activity (FVIII/FIX:C) below 3 IU/dL were associated with a more severe bleeding phenotype than predicted.

Aim

To explore HRQoL and PA in patients with moderate haemophilia A (MHA) and B (MHB).

Methods

A cross‐sectional, multicentre study covering patients with MHA and MHB in Sweden, Finland, and Norway. HRQoL was assessed with the EuroQoL 5‐Dimensions (EQ‐5D) form and PA with the International Physical Activity Questionnaire among participants aged ≥15 years.

Results

We report on 104 patients aged 15–84 years from the MoHem study. Overall, EQ‐5D utility was .85 (median) (Q1–Q3 0.73–1.0) with corresponding visual analogue scale (VAS) 80 (70–90), which were similar regardless of treatment modality, FVIII/FIX:C, and MHA or MHB. Pain and mobility were most frequently affected dimensions. Utility (r = ‐.54), VAS (r = ‐.42), and PA (r = ‐.32) correlated negatively with arthropathy (HJHS). Only patients aged 41–50 years displayed lower utility (p = .02) and VAS (p < .01) than the Norwegian population norm. Patients on prophylaxis aged 35–54 years reported higher PA than those treated on‐demand (p = .01).

Conclusion

Haemophilic arthropathy had negative impact on HRQoL and PA in Nordic patients with moderate haemophilia. Middle‐aged patients captured lower utility and VAS than observed in the general population. Tailored prophylaxis and improved joint health may influence positively on HRQoL and PA also in moderate haemophilia.
Cost‐effectiveness analysis of adult living‐donor liver transplantation in Japan
Authors: Tajima Tetsuya , Shin Jung‐Ho , Kunisawa Susumu , Sasaki Noriko , Hata Koichiro , Fushimi Kiyohide , Hatano Etsuro , Imanaka Yuichi
Published: November 2023

Aim

Living‐donor liver transplantation (LDLT) is a highly effective life‐saving procedure; however, it requires substantial medical resources, and the cost‐effectiveness of LDLT versus conservative management (CM) for adult patients with end‐stage liver disease (ESLD) remains unclear in Japan.

Methods

We performed a cost‐effectiveness analysis using the Diagnostic Procedure Combination (DPC) data from the nationwide database of the DPC research group. We selected adult patients (18 years or older) who were admitted or discharged between 2010 and 2021 with a diagnosis of ESLD with Child–Pugh class C or B. A decision tree and Markov model were constructed, and all event probabilities were computed in 3‐month cycles over a 10‐year period. The willingness‐to‐pay per quality‐adjusted life‐year (QALY) was set at 5 million Japanese yen (JPY) (49,801 US dollars [USD]) from the perspective of the public health‐care payer.

Results

After propensity score matching, we identified 1297 and 111,849 patients in the LDLT and CM groups, respectively. The incremental cost‐effectiveness ratio for LDLT versus CM for Child–Pugh classes C and B was 2.08 million JPY/QALY (20,708 USD/QALY) and 5.24 million JPY/QALY (52,153 USD/QALY), respectively. The cost‐effectiveness acceptability curves showed the probabilities of being below the willingness‐to‐pay of 49,801 USD/QALY as 95.4% in class C and 48.5% in class B. Tornado diagrams revealed all variables in class C were below 49,801 USD/QALY while their ranges included or exceeded 49,801 USD/QALY in class B.

Conclusions

Living‐donor liver transplantation for adult patients with Child–Pugh class C was cost‐effective compared with CM, whereas LDLT versus CM for class B patients was not cost‐effective in Japan.
Adolescents, parents, and providers' experiences of triadic encounters in paediatric diabetes clinics: A qualitative study
Authors: Coyne Imelda , Pembroke Sinead , Sleath Betsy , Brenner Maria , Roche Edna F. , Hilliard Carol , Cody Declan
Published: November 2023

Introduction

Adolescents with Type 1 diabetes are a cohort whose self‐management of their diabetes care often declines during adolescence which can lead to adverse health outcomes. Research indicates that providers find it challenging to engage adolescents in communication exchanges during triadic encounters in diabetes clinics. Our study aimed to explore adolescents, parents, and providers' experiences of clinic encounters.

Methods

A qualitative study was conducted with a convenience sample of 13 adolescents with Type 1 diabetes (aged 11–17), 14 parents, and seven providers. Participants were recruited from two outpatient diabetes clinics in two urban children's hospitals, Ireland. Data were obtained using a combination of interviews and focus groups. Data were analysed thematically.

Results

Adolescents and their parents appeared to hold both positive and negative experiences of diabetes clinic encounters. Providers reported challenges associated with engaging adolescents in communication exchanges. The structure, focus and style of clinic encounters created barriers that potentially led to suboptimal adolescent participation and impaired provider–adolescent communication during clinic visits.

Conclusions

The findings provide insights into the challenges associated with adolescents' engagement in communication encounters in diabetes clinics. Healthcare providers could encourage adolescents to be more actively involved in their diabetes management, by taking an adolescent‐centred approach and creating a nonjudgemental milieu. Focusing on adolescent's agenda could lead to more meaningful and relevant discussions between providers and adolescents and ensure more tailored education in the time available. Adolescence is a risky period for nonadherence and adverse health complications; therefore, it is critical that providers make every contact count in diabetes clinic encounters.

Patient or Public Involvement

The study's design and delivery were guided by two advisory groups, comprising (1) five adolescents living with Type 1 diabetes (T1D) and (2) five parents of an adolescent with T1D.
Reference intervals and biological variation in parameters of the thrombin generation test in healthy individuals
Authors: Olga Melnichnikova , Yuliya Zhilenkova , Vitaly Lukinov , Ekaterina Zolotova , Konstantin Pishchulov , Svetlana Evgina , Maria Simakova , Tatyana Vavilova
Published: November 2023

Introduction

Establish the referenceintervals (RIs) and analyze biological variability (BV) to introduce the thrombin generation test (TGT) into clinical practice.

Methods

To determine the RIs parameters of TGT, we analyzed platelet‐poor plasma (PPP) (n = 123), rich (PRP) (n = 76), and microparticle‐mediated TGT (MP‐TGT) (n = 32) in healthy participants. For the BV study, we collected samples from five participants over 5 weeks. A nested analysis of variance (ANOVA) was performed to evaluate the BV results.

Results

The between‐individual variation (CVG), within‐individual variation (CVI), analytical variation (CVA) for TGT on PPP for all parameters were from 5.5% to 17.3%, 5.4% to 17.7%, and 2.6% to 5.3%, respectively. For PRP, the CVG, CVI, and CVA were ranged from 3.0% to 23.7%, 8.4% to 23.0%, and 4.1% to 6.9%, respectively. The index of individuality (II) ranged from 0.3 to 3.1 for PPP and from 0.3 to 4.5 for PRP. The reference change value (RCV) for PPP was from 19.8% to 50.1%, while for PRP, it was 27.2% to 66.5%. We recommend using the RIs for the parameters ETP (nM/min): 1101.6–2332.1 and Peak (nM): 163.5–381.3 for PPP and ETP (nM/min): 1088.5–2634.9; Peak (nM): 72.6–210.7 for PRP. The resulting MP‐TGT are highly dependent on age require a larger sample.

Conclusion

For TGT on PPP and PRP the RIs developed on our population for Peak and ETP parameters can be used. Time parameters: Lagtime and ttPeak, min with II < 0.6, require monitoring over time with RCV calculation.
A tactile approach to introduce the skin autoimmune disease psoriasis to the general public and the vision‐impaired community
Authors: Song Runqiu , Ye Jingran , Chung Shanzou , Meyer C Chris , Déchelette Corinne , Purcell Anthony W , Braun Asolina
Published: November 2023

Scientific outreach activities play an important role in disseminating knowledge, connecting the general public to research and breaking down scientific skepticism barriers. However, the vision‐impaired community is often disadvantaged when the most common audio–visual approach of scientific communication is applied. Here we integrated tactile clues in the scientific communication of immune processes involved in the autoimmune skin disease psoriasis. We fostered the involvement of the vision‐impaired community through interactive experiences, including tactile scientific origami art, a haptic poster and wood‐carved molecular models. Readily accessible science communication that engages a number of senses is a critical step toward making science more inclusive and engaging for individuals with a wide range of sensory abilities. The approach of the 2023 Monash Sensory Science exhibition aligns with the principles of equity, diversity and inclusion and helps to empower a more informed and scientifically literate public.
Effects of grit, calling, and resilience on the retention intention of general hospital nurses
Authors: Lee Gi Ran , Lee Imsun , Chung Mihee , Ha Jiyeon
Published: November 2023

Aim

This study aimed to determine the influence of personal factors such as grit, calling, and resilience on nurses’ retention intention in South Korean general hospitals.

Background

The global shortage and high turnover rate of nurses have become significant concerns with no clear solutions for increasing retention.

Introduction

Determining the factors related to the f general hospital nurses and retention intention is important for solving the problem of inadequate nursing personnel and improving the quality of nursing services.

Methods

This study was a descriptive survey of 221 nurses working at a general hospital in South Korea from July 2021 to February 2022. Data were collected using self‐reported online questionnaires, with measurement tools focusing on grit, calling, resilience, and retention intention. The STROBE checklist was used for reporting this study.

Results

The average retention intention score was 5.35 ± 1.52 out of 8 points. Significant correlations were found between retention intention and grit, calling, and resilience. The factors influencing retention intention were job satisfaction, calling, marital status, and total career length, explaining 31.9% of the variance.

Conclusions

To enhance nurses’ intention to remain at general hospitals, their job satisfaction and sense of a calling should be improved. Further research should be conducted to identify factors that influence retention intention, particularly among groups with low job retention, with consideration of individual characteristics that might affect retention intention.

Implications for nursing and health policy

Increasing nurses’ retention intention would alleviate the nursing shortage, help hospitals retain competent nurses, reduce turnover‐related costs, and improve organizational efficiency. Resolving the nursing shortage is critical for improving patient safety and nursing service quality at general hospitals.
Do the clinical practice guidelines for paediatric dentistry meet the quality standards? A meta‐research and quality appraisal using the AGREE II tool
Authors: Elagami Rokaia Ahmed , Laux Caroline Mariano , Gallegos Claudia López , Tedesco Tamara Kerber , Cóvos Thais Gimenez , Braga Mariana Minatel , Mendes Fausto Medeiros , Cenci Maximiliano Sérgio , Raggio Daniela Prócida
Published: November 2023

Background

Clinical practice guidelines (CPGs) enhance health care and aid clinicians' decisions.

Aim

To evaluate the quality of clinical guidelines in paediatric dentistry using the AGREE II tool.

Design

PubMed, EMBASE, Scopus, LIVIVO, Lilacs, international guidelines websites, scientific societies, and gray literature were searched until September 2021. We included paediatric dental clinical guidelines and excluded drafts or guidelines for patients with special needs. Two independent reviewers performed quality assessment using the APPRAISAL OF GUIDELINES FOR RESEARCH & EVALUATION II (AGREE II) instrument. We calculated the mean overall domain scores (95% confidence interval) for each guideline. We used regression analysis to correlate the score of overall assessment and the six domains of AGREE II with guideline characteristics.

Results

Forty‐four guidelines were included in this study. Highest mean score was for Domain 4 (Clarity of Presentation; 58%, 95% CI: 50.8–64.9), whereas the lowest was for Domain 5 (Applicability; 16%, 95% CI: 10.8–21.4). The reporting quality was improved in Domains 1–5 with reporting checklists (p < .001), whereas that of Domain 6 was improved by decreasing years since publication (p = .047).

Conclusion

Paediatric dental guidelines do not comply with the methodological quality standard, especially in Domain 5 (Applicability). The AGREE reporting checklist should be implemented with a system to evaluate the certainty of evidence for future guidelines.
Comparing the traditional and emerging therapies for enhancing wound healing in diabetic patients: A pivotal examination
Authors: Liao Chunfen , Zhu Mingjie , Ding Hongchen , Li Yanli , Sun Qianshu , Li Xueqin
Published: November 2023

Chronic non‐healing ulcers are common among diabetic patients, posing significant therapeutic challenges. This study compared traditional therapies (TT) and emerging therapies (ET) for enhancing diabetic patients' wound healing. A total of 150 diabetic patients with chronic ulcers, ages 30–65, were randomly assigned to one of two groups: TT (n = 75) or ET (n = 75). ET included growth factors, bioengineered skin substitutes, and hyperbaric oxygen therapy, while TT for wound healing predominantly included debridement, saline‐moistened dressings, and off‐loading techniques. The primary outcome was the percentage of lesions that healed within 12 weeks, which was assessed at intervals. Secondary outcomes included time to wound recovery, pain using Visual Analogue Scale (VAS), and life quality via Wound‐QoL questionnaire. By the 12th week, the ET group had a repair rate of 81.33% compared to 57.33% in TT group (p < 0.05). ET exhibited superior pain reduction (VAS score: 4.7 ± 1.6 for ET vs. 6.2 ± 1.4 for TT, p < 0.05) and improved life quality (Wound‐QoL score: 61.8 ± 9.1 for ET vs. 44.3 ± 10.3 for TT, p < 0.05). However, there were slightly more cases of cutaneous irritation and hematomas among ET patients. ET have demonstrated significant efficacy in accelerating wound healing in diabetic patients, surpassing traditional methods, with additional advantages in pain management and life quality. Due to the observed minor complications, however, caution is required.
Environmental conical nozzle levitator equipped with dual wavelength lasers
Authors: Thorpe Fox , Li Trevor , Weber Richard , McCormack Scott J.
Published: November 2023

The environmental conical nozzle levitator (E‐CNL) with dual‐wavelength lasers is an extreme environment materials characterization system that was designed to investigate ultra‐high‐temperature materials: refractory metals, oxides, carbides, and borides above 3000 K in a controlled atmosphere. This article details the characterizations using this system to establish its high‐temperature capabilities and to outline ongoing work on materials under extreme conditions. The system has been used to measure the melting point of several oxide materials (TiO2, Tm = 2091 ± 3 K; Al2O3, Tm = 2310 3 K; ZrO2, Tm = 2984 31 K; and HfO2, Tm = 3199 ± 45 K) and several air‐sensitive refractory metals (Ni, Tm = 1740 K; Ti, Tm = 1983 K; Nb, Tm = 2701 K; and Ta, Tm = 3368 K—note: mean ± standard deviation) during levitation which matched literature values within 0.17–2.43 % demonstrating high accuracy and precision. This containerless measurement approach is critical for probing properties without container‐derived contamination, and dual‐wavelength laser heating is essential to heat both relatively poor electrical conductors (some refractory metals and carbides) and insulators (oxides). The highest temperature achieved utilizing both lasers in these experiments was ∼4250 ± 34 K on a 76.6 mg, molten HfO2 sample using a normal spectral emissivity of 0.91. Stable levitation was demonstrated on spherical samples (yttria‐stabilized zirconia) while adjusting levitation gas composition from pure oxygen to pure argon, verifying atmospheric control up to 3173 K on solid or molten samples. These successes demonstrate the viability of in situ high‐temperature environmentally controlled studies potentially up to 4000 K on all classes of ultra‐high‐temperature materials in one system. These measurements highlight the E‐CNL system will be essential for the development of next‐generation ultra‐high‐temperature materials for hypersonic platforms, nuclear fission and fusion, and space exploration.
Developing a model of neonatal nurse‐controlled analgesia: A Delphi study
Authors: Muirhead Renee , Kynoch Kathryn , Peacock Ann , Birch Pita , Lewis Peter A.
Published: November 2023

Aim

To develop a nurse‐led model of analgesia to manage post‐operative pain in the surgical neonate.

Design

A four‐round e‐Delphi study was conducted from March to December 2022.

Methods

An e‐Delphi method was used seeking a consensus of 70% or greater. Fifty‐one experts were invited to join the panel. Members consisted of multi‐disciplinary healthcare professionals who work in areas associated with neonatal care. In round 1, 49 statements relative to neonatal pain assessment and management were distributed to the panel. Panel members were asked to rate their level of agreeance on a Likert scale from 1 to 5 (1 = strongly disagree to 5 = strongly agree). Ratings equal to or greater than 4 represented agreement, 3 indicated uncertainty and 2 or less disagreement with the proposed statement. An opportunity for free‐text responses after each statement was provided. This iterative process continued for three rounds. In the fourth and final round, the completed model of neonatal nurse‐controlled analgesia was presented along with a further opportunity to provide feedback on the final version.

Results

Four rounds of statements and voting were required to reach consensus on a model of neonatal nurse‐controlled analgesia. The model consists of criteria for use, over‐arching guidelines and three separate pathways based on an individual baby's pain assessment scores, need for pain relieving interventions and time‐lapsed post‐surgical procedure.

Conclusion

A comprehensive model of neonatal nurse‐controlled analgesia, applicable to the Australasian context, was developed in collaboration with a group of neonatal experts.

Impact

This study provides a multi‐modal family‐integrated model to manage neonatal post‐operative pain. By providing nurses with increased autonomy to assess and manage acute pain, this model has the potential to not only provide a more responsive and individualized approach to alleviate discomfort, but highlights the integral role of parent partnerships in the neonatal intensive care.

Reporting Method

This study was reported in line with the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies.

Patient or Public Contribution

No patient or public contribution was utilized for this study.
Just keep swimming? Observations of resting behavior in gray reef sharks Carcharhinus amblyrhynchos (Bleeker, 1856)
Authors: Bullock Robert W. , Foster Craig , Lea James S. E.
Published: November 2023

Understanding the respiratory modes of sharks has important implications for studying the metabolism, energetics, and behavioral strategies of different species. Here we provide the first reported observations of resting behavior in the gray reef shark Carcharhinus amblyrhynchos, a species typically considered an obligate ram ventilator. Observations were made at several locations in the Republic of Seychelles, where sharks were found resting under reef ledges and were unresponsive to the presence of divers. These findings update our understanding of the respiratory mode of this species and have implications for future research.
The physical and psychosocial impact of a school‐based running programme for adolescents with disabilities
Authors: Campagna J. , Czyszczon K. , Little J. , Selby C. , Wick L. , Ferreira D. , Oriel K.
Published: November 2023

Background

Adolescents with disabilities have fewer opportunities to participate in community‐based fitness programmes. The purpose of this study was to examine the impact of a school‐based running programme at a local middle school in Lebanon, Pennsylvania, on fitness and quality of life (QoL) in children with physical and cognitive disabilities in a life‐skills classroom.

Methods

Nineteen adolescents with diagnosed disabilities including intellectual disability (ID), autism spectrum disorder and Down syndrome were recruited from three life‐skills classrooms to participate in a school‐based running programme. The programme was designed to be implemented two times/week for 6 weeks by classroom teachers/aides. Physical therapy faculty and students developed the programme and assisted with implementation. Each session lasted 30 min, consisting of a warm‐up and cooldown, relay races, games and timed runs. Pre‐ and post‐test measures included physiological cost index (PCI) and Paediatric Quality of Life Inventory™ (PedsQL™). Pre‐ and post‐test data were compared using Wilcoxon signed rank tests. Each week participants also completed a training log to reflect on the activity for the day.

Results

Participants demonstrated significant improvements in PCI (P = 0.028) and the PedsQL™ (P = 0.008) following the running programme.

Conclusions

Results of this study suggest that participation in a 6‐week school‐based running programme may improve fitness and QoL in adolescents with disabilities.
Midwifery Practice Leaders’ Experiences of Practice Changes Early in the COVID‐19 Pandemic: A Qualitative Exploration
Authors: Chapman Meredith , Evans Emily Cowley , Long Maryann H.
Published: November 2023

Introduction

The coronavirus disease 2019 (COVID‐19) pandemic generated considerable upheaval in all sectors of the US health care system, including maternity care. We focused this inquiry on midwifery practice leaders’ experiences and perspectives on changes that occurred in their practices early in the pandemic.

Methods

This was a qualitative descriptive study using thematic analysis. The data were responses to an open‐ended question in a survey of pandemic‐related employment and clinical practice changes. Findings are presented from a constructivist perspective, describing the experiences and perspectives of a group of US midwifery practice leaders during the initial phase of the COVID‐19 pandemic.

Results

Two main themes emerged from the analysis: demands on midwives and driving forces. Demands on midwives were 3‐fold: clients’ needs, modification of care, and midwives’ needs. These encompassed the psychological, physical, and emotional toll that caring for women during the pandemic placed on midwives. Driving forces were those entities that spurred and directed change and included regulations, institutions, financial logistics, and team dynamics. Survey respondents in community (home and birth center) practices reported substantial increases in inquiries and client volume, and many respondents expressed concern about withdrawal of students from clinical placements.

Discussion

Midwifery practices experienced profound changes in their work environments during the COVID‐19 pandemic, with both positive and negative characteristics. These challenges in providing birth care were similar to those reported in other countries. Results indicated existing guidance for maternity care during emergencies did not meet clients’ needs. Coordinated planning for maternity care in future prolonged health emergencies should incorporate best practices and include midwives in the process.
Innovation of the protocol for the application of cryolipolysis: Effects and mechanisms of action
Authors: Palauro Christiane Rodrigues Tofoli , Meyer Patrícia Froes , Soares Ciro Dantas , de Morais Carreiro Eneida , de Paiva Dumaresq Flávio , de Oliveira Fernando Cesar Camara , de Andrade Ana Laura Martins , da S P S Daumas Priscila
Published: November 2023

Background

In recent years, aesthetic procedures aiming at body remodeling and have grown exponentially. Cryolipolysis (CLL) has stood out as a noninvasive resource that acts directly on the subcutaneous adipose tissue promoting a significant reduction of adipose tissue through of cooling that could lead to the crystallization cytoplasmic lipids, loss of cellular integrity, apoptosis/necrosis of adipocytes, and local inflammation, producing selective loss of adipose tissue. Thus, the objective of the present study was to evaluate the effects of a specific technique of CLL application on the inflammatory reactions of the target tissue in different post‐application times.

Methods

This is a randomized, blind clinical study that evaluated the tissue sample of six patients after 45, 60, and 90 days of an innovative protocol for the application of CLL, with samples collected through abdominoplasty surgeries. The samples were evaluated by immunohistochemical analyses of several markers.

Results

A significantly greater increase in fibroblasts was observed at 45 days and greater phagocytic action at 60 days.

Regarding the apoptosis process, the expression of caspase 3 and cleaved caspase 3 markers varied at different times, with cleaved caspase 3 being higher at 45 and 90 days after CLL application.

Conclusion

The protocol of the CLL presented in this study was able to induce inflammatory responses in addition to confirming the selective apoptotic action at the different times studied.
Fox eyes lift—A new protocol for eyebrow elevation with laser Fotona
Authors: Burmann Tiana G. , Duarte Fernando B. , Akaishi Patrícia M. S.
Published: November 2023

Background

The eyelids play an important role in our appearance and are usually the first to show signs of age. The Fotona SP Spectro Systems consist of a range of noninvasive laser treatments that work together synergistically to tighten the collagen in four dimensions and provide long‐lasting firmness to the face. The Fotona SP Spectro combines two wavelengths: Er:YAG (2940 nm) and Nd:YAG (1064 nm) with four distinct treatments: SmoothLiftingTM, FRAC3®, PIANO®, and SupErficialTM, allowing safe, painless, noninvasive, and no downtime rejuvenation.

Aims

To present a new protocol of treatment with Fotona SP Spectro for eyebrow elevation, which we call fox eyes lift (FEL), and compare it to the standard SmoothEye® (SE) protocol.

Methods

This is a prospective, interventional, split‐face study. The sample consisted of 21 subjects (19 women) with a mean age of 50.1 ± 7.9 years who underwent two different protocols, that is, SE on one side and FEL on the other. The protocol used on each side was selected by drawing lots. Three sessions were held at 1‐month intervals. Standardized photographic documentation was obtained before and 30 days after the end of treatment. Eyebrow position before and after complete treatment was quantified using ImageJ software.

Results

Statistical analysis by ANOVA showed a significant improvement in eyebrow position after treatment with both protocols, with a significantly greater effect of FEL (p = 0.0003 d = 0.95).

Conclusion

Fox eyes lift is an efficient and safe technique providing significant improvement in the position of the eyebrow.
Redefining sexual health after gynaecological cancer: Lived experiences from Gynea, a digital rehabilitation programme
Authors: Breistig Sigrund , Thorkildsen Kari Marie , Werner Henrica Maria Johanna , Nordgreen Tine , Sekse Ragnhild Johanne Tveit
Published: November 2023

Background

Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to enhance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea.

Methodology

This is a phenomenological hermeneutic study. Individual, in‐depth semi‐structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method.

Findings

Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships.

Conclusion

Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and communicate these with their partners.

Implications for Patient Care

Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not necessarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment.

Patient or Public Contribution

Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in Gynea.