bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term postoperative opioid use in orthopaedic patients
Authors: Melis Eward J. , Vriezekolk Johanna E. , van der Laan Julian C. C. , Smolders José M. H. , van den Bemt Bart J. F. , Fenten Maaike G. E.
Published: December 2023

Background

The prevalence of long‐term opioid use after orthopaedic surgery varies from 1.4% to 24% and has mostly been studied with prescription data, making it difficult to estimate the size and impact of the problem. This study aims to assess the prevalence and predictors of long‐term postoperative opioid use in a high volume and tertiary orthopaedic centre by using online patient reported measures.

Methods

This Dutch prospective cohort study was conducted among adult patients who underwent any type of orthopaedic surgery from June to August 2021. Six months after surgery patients were invited to complete an online survey on current opioid use and patients' willingness to taper opioids. The demographics, clinical factors and preoperative opioid use were extracted from the patient file.

Results

In total, 607 patients (mean age 61.2 years, 63.4% female) completed the survey. Seventy‐six patients (12.5%) used opioids 6 months after surgery of which 20 (3.3%) did not use opioids before surgery. The median (Q1–Q3) postoperative daily dose after 6 months was 29.9 mg (10.0–76.1) morphine equivalents. Most of them (88.2%) wanted to taper opioids. Affected body region (OR's: 6.84–12.75) and pre‐operative opioid use (OR = 35.33) were significant predictors of long‐term opioid use.

Conclusion

The prevalence of long‐term postoperative opioid use was 12.5%; one in thirty patients became a new long‐term opioid user. Pre‐operative opioid use and affected body region were predictive for long‐term opioid use. These findings, together with the observation that long‐term opioid users want to taper opioids, emphasize the relevance of prevention, recognition and tapering support in the perioperative setting.

Level of Evidence

Level II.

Significance

Short‐term opioid use can unintentionally progress to long‐term opioid use. The prevalence of long‐term opioid use after orthopaedic surgery varies widely and is mostly prescription‐based, making it difficult to estimate the magnitude of the problem. This study assessed long‐term postoperative opioid use in a full breadth orthopaedic population using patient reported measures, making conclusions much more robust. The prevalence of long‐term postoperative opioid use in this study was 12.5%.
Autonomic nervous system function assessed by heart rate variability and the presence of symptoms affecting activities of daily living in community‐dwelling residents with chronic pain: The Hisayama Study
Authors: Nakamura Yuri , Shibata Mao , Morisaki Yukiko , Hirabayashi Naoki , Higashioka Mayu , Hata Jun , Hosoi Masako , Sudo Nobuyuki , Yamaura Ken , Ninomiya Toshiharu
Published: December 2023

Background

Autonomic nervous system dysfunction has been reported to be associated with impaired activities of daily living (ADL) among patients with chronic pain, but the association has not been fully addressed in general populations. This study cross‐sectionally investigated the association between autonomic nervous system function and the presence of subjective symptoms affecting ADL in community‐dwelling residents with chronic pain.

Methods

A total of 888 residents with chronic pain, aged 40–79 years, who underwent a health examination in 2017–2018 were included. Based on heart rate variability measured by fingertip pulse wave, the standard deviation of normal‐to‐normal intervals (SDNN), root mean square of successive RR interval differences (RMSSD), low frequency (LF) power, and high frequency (HF) power were calculated. Symptoms affecting ADL were defined as those scoring ≥1 on the modified Rankin Scale. Odds ratios (ORs) and their 95% confidence intervals (CIs) for symptoms affecting ADL were estimated using a logistic regression analysis.

Results

The overall prevalence of symptoms affecting ADL was 39.4%. The ORs for symptoms affecting ADL increased significantly per 1‐standard‐deviation decrement in log‐transformed SDNN (OR 1.23 [95% CI 1.06–1.44]), RMSSD (1.25 [1.08–1.45]), LF power (1.29 [1.11–1.52]), and HF power (1.29 [1.11–1.51]) after adjusting for age, sex, education, hypertension, diabetes, serum total cholesterol level, body mass index, past medical history, current smoking, current drinking, exercise, depressive symptoms, and pain intensity.

Conclusions

Decreased heart rate variability was associated with the presence of symptoms affecting ADL among individuals with chronic pain in a Japanese community.

Significance

Decrease in heart rate variability was associated with the presence of symptoms affecting ADL among individuals with chronic pain in a Japanese community. This article could help scientists understand the significance of autonomic nervous system dysfunction in the pathology of chronic pain. Approaches that target autonomic nervous system dysfunction may be an option to relieve or prevent symptoms affecting ADL for chronic pain sufferers.
Carbon leakage or carbon reduction? Carbon emission effect of the production relocation of metal smelting industry in China
Authors: Liu Hongguang , Wang Zhaoya , Guo Yanan , Chen Zhijun
Published: December 2023

The metal smelting industry (MSI) is one of the major carbon emission sectors in China, and it is of great significance to clarify the mechanism and truth of the carbon effect of production relocation (PR) of MSI for reducing national carbon emissions. Based on this thinking and previous studies, we proposed two concepts of relative carbon emission effect (RCE) and absolute carbon emission effect (ACE) of PR, then developed models to explore the impact of PR of MSI (PRM) on national carbon emission between 30 provincial administrative units in China from 2007 to 2017. The study demonstrates that the PRM and its ACE and RCE is divergent across provinces and regions. Overall, the PRM is beneficial to national carbon reduction under both relative and absolute scenarios. Specifically, the transfer‐in PRM of most provinces in central regions is beneficial to national carbon reduction, while the transfer‐out PRM of many provinces in coastal areas has worst carbon leakage effect.
Views of homecare staff and carers on oral needs and dental care for people living with dementia: A qualitative study
Authors: Soilemezi Dia , Wanyonyi Kristina , Hill Valerie , Manthorpe Jill
Published: December 2023

Objective

People living with dementia are at risk of mouth and dental problems. Many receive help with this aspect of personal care from family carers or homecare workers. We explored the views of homecare providers and carers on how this aspect of personal care is addressed and implemented.

Materials and methods

In this qualitative study we conducted semi‐structured interviews with carers (all family members), homecare workers and managers providing support to people living with dementia in their own homes. Interview questions focused on daily care practices, exploring barriers and facilitators to oral care. Interviews were recorded online or over the telephone, transcribed, and thematically analysed.

Results

Carers (n = 8), homecare workers (n = 9) and homecare managers (n = 15) were recruited from across England in 2021–2022. Across interviews, two main themes were identified: (i) Missed opportunities to address oral care, which is not always seen as a priority despite the importance and potential risk of neglect. (ii) Challenges in delivering oral care, including factors related to the person living with dementia (such as cognitive and physical decline) and factors related to the care infrastructure and policies such as training, perception of roles, allocated time, and consistency of care.

Discussion

More emphasis could be given to the training and skills of homecare providers to identify and prevent dental problems and to assist carers. Several strategies and tools (oral care checklists, greater detail around oral care in care assessments and care plans) could be used to enhance this aspect of personal care for people living with dementia.
An Investigation in the Comparability of the Exposure and Recommended Dose of Selected Pfizer Drugs in East Asian Countries: Is Mutual Usage of Clinical Data Among East Asian Countries Feasible?
Authors: Wang Diane D. , Yu Yanke , Fukuhara Kei , Liu Yuwang , Park So‐Young , Parivar Kourosh
Published: December 2023

The current regulatory path for new drug registration in East Asian countries has led to significant delay of the new medicines in these countries. A unified regulatory path and allowance of mutual usage of clinical data in East Asian countries would lead to cost saving in drug development and expedite the new drug registration in these countries. The objectives of the present analysis are to compare the approval dates of a selection of products developed by Pfizer in the United States and East Asian countries (China, Japan, Korea) and compare the pharmacokinetics and recommended doses of these products in East Asian countries. Eighteen products (20 drugs, 2 products with 2 combination drugs) with exposure data available in at least 2 of the 3 East Asian countries across different therapeutic areas were included in the analyses. The results showed that most products had delayed approval in East Asian countries (up to 8 years) after US or EU approval. No distinct differences were observed in the drug exposure and recommended doses for the selected products in East Asian countries. These results together with literature data of genetic similarity of the East Asian populations support the mutual usage of the clinical data in the East Asian countries for expedited regulatory submission and approval.
Cardiovascular effects of weight loss in old adults with overweight/obesity according to change in skeletal muscle mass
Authors: Cai Xiaojie , Liu Menghui , Xu Xingfeng , Zhang Shaozhao , Huang Rihua , Wang Peng , He Lixiang , Chen Zhuohui , Liu Zishan , Zhou Yi , Guo Yue , Zhuang Xiaodong , Liao Xinxue
Published: December 2023

Background

Patients with overweight/obesity and type 2 diabetes are encouraged to lose weight, but not all losing weight gain better cardiovascular health, especially old adults. The change in skeletal muscle mass (SMM) could be the key that explains the heterogenous cardiovascular effects of weight loss. This study aims to assess whether the cardiovascular effects of weight loss vary for those gaining skeletal muscle along with weight loss.

Methods

The old adults with overweight/obesity and type 2 diabetes in the Look AHEAD study having muscle measurement from dual‐energy X‐ray absorptiometry were included. Based on the weight change (WC) and SMM change (SMMC) between baseline and the 4‐year follow‐up, participants were allocated into three groups—weight gain (WG) group, weight loss with muscle loss (WL‐ML) group and weight loss with muscle gain (WL‐MG) group. Cox proportional hazards regression was performed to evaluate the cardiovascular risk of those gaining or losing SMM with weight loss compared with those gaining weight. Among the participants with weight loss, the ratio of SMMC/WC was calculated, and the association of SMMC/WC with primary cardiovascular outcome was assessed.

Results

A total of 491 participants were included in the study with an average age of 64.56 ± 3.81 years old. A total of 47.0% were male and 49.9% were from the intensive lifestyle intervention arm. Based on their WC and SMMC, 43 were assigned to the WG group, 373 to the WL‐ML group and 75 to the WL‐MG group. Over a follow‐up of almost 10 years, 97 participants encountered the primary endpoint. The WG group had the highest incidence of 25.59%, the WL‐MG group had the lowest incidence of 9.33% and the WL‐ML group had 21.18% (P = 0.040). In the fourth adjusted Cox model, the WL‐MG group achieved significantly decreased odds of the primary endpoint compared with the WG group (hazard ratio [HR] 0.33, 95% confidence interval [CI] [0.12, 0.87], P = 0.026), whilst the WL‐ML group did not (HR 0.91, 95% CI [0.47, 1.78], P = 0.670). Among the participants with weight loss, when SMMC/WC reached around 50%, this HR soared to approximately two‐fold.

Conclusions

The participants gaining SMM along with weight loss achieved the lowest odds of adverse cardiovascular events, whilst those who lost SMM along with weight loss had comparable cardiovascular risk with those gaining weight. The more muscle lost during weight loss, the greater the harm. The cardiovascular effects of weight loss were modulated by whether the participants gained SMM meanwhile losing weight.
Positive correlation between measures of habitual responding and motivated responding in mice
Authors: Bryant Kathleen G. , Barker Jacqueline M.
Published: December 2023

Habit and motivation are thought to be separate processes, with motivated behavior often considered to be goal directed, whereas habits are defined by the absence of goal‐directed control over behavior. However, there has been increasing interrogation of the binary nature of habitual versus goal‐directed behavior. Furthermore, although drug and alcohol exposure can promote the formation of habits, drug seeking itself can also be highly flexible, pointing toward the need for complex consideration of the parallel processes that drive behavior. The goal of the current study was to determine whether there was a relation between motivation—as measured by progressive ratio—and habit—as measured by contingency degradation—and whether this relation was affected by ethanol exposure history and sex. The results showed that these measures were positively correlated such that greater contingency insensitivity was associated with achieving higher break points on the progressive‐ratio task. However, this relation depended on reinforcement schedule history, ethanol exposure history, and sex. These point to potential relations between measures of habit and motivation and stress the importance of carefully parsing behavioral findings and assays. These findings are also expected to inform future substance use research, as drug history may affect these relations.
Software‐assisted automated detection and identification of “unknown” fentanyl analogues
Authors: Drug Eyal , Marder Dana , Binyamin Iris , Yeffet Dina , Gershonov Eytan , Dagan Shai
Published: December 2023

Fentanyl and its non‐pharmaceutical analogues (NPFs) are potent synthetic opioids, traditionally used for pain management, with ever‐increasing illicit uses. Tightening the regulation for known fentanyls leads to new synthetic analogues in the opioid market. Furthermore, the Organization for the Prohibition of Chemical Weapons (OPCW) has recently issued a decision regarding aerosolized use of central nervous system (CNS)‐acting agents, such as fentanyl and its analogues, under the concern that these materials could be misused for terror or war purposes. The ever‐increasing development of new fentanyl analogues makes the task of detection and identification of these new, unknown analogues crucial. In this work, we introduce an automated tool for the detection and putative identification of “unknown” fentanyl analogues, using liquid chromatography–mass spectrometry (LC–MS) (high‐resolution mass spectrometry [HRMS]) analysis, subsequently followed by data processing using the “Compound Discoverer” software. This software, in our modified use, enabled the automatic detection of various fentanyl analogues, by “digging” out components and comparing them to pre‐calculated theoretical molecular ions of possible modifications or transformations on the fentanyl backbone structure (no library or database used). Subsequently, structural elucidation for the proposed component of interest is carried out by automated MS/MS data interpretation, as performed by the software. This method was explored on 12 fentanyl‐based “unknown” analogues used as model examples, including chemical modifications such as fluorination and methylation. In all tested compounds, automatic detection and identification were achieved, even at concentrations as low as 1 ng/mL in an environmental soil matrix extract.
Identification and characterization of Sofosbuvir‐resistant mutations of hepatitis C virus genotype 3a replicon
Authors: Ngari Jackline Wangu , Leumi Steve , Han Lin , Liu Chaolun , Tong Yimin , Zhong Jin
Published: December 2023

Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide. Among its 8 genotypes (GT), GT3 has a relatively lower sustained virological response to highly effective direct‐acting antiviral agents (DAA). Sofosbuvir (SOF), an anti‐NS5B polymerase inhibitor, is a core component of many anti‐HCV DAA cocktail regimens, and its resistant mutations are rare in clinics because these mutations usually severely impair the NS5B polymerase activity, including a mutation S282T in NS5B, the most frequently reported SOF‐resistant mutation. In this study, we selected SOF‐resistant variants of a previously developed GT3 subgenomic replicon (PR87A7). Two mutations were identified in the viral genome of SOF‐resistant PR87A7 variants, Q606R in nontargeted NS3 and S282T in targeted N5SB. We demonstrated that Q606R could rescue the replication defect of S282T in PR87A7, and the resulting double mutant confers the SOF resistance. Finally, we showed that NS3‐606R could not compensate for the replication defect of S282T in other GTs. In conclusion, we identified a novel GT3‐specific combination of two mutations that confers SOF resistance. Our result calls for attention to potential mutations that may arise in nontargeted viral proteins during the SOF‐based DAA treatment of chronic HCV.
Role of peripheral and tissue eosinophils and eosinophil cationic protein in pediatric inflammatory bowel disease
Authors: Kim You Ie , Yang Hye Ran
Published: December 2023

Objectives

Inflammatory bowel disease (IBD), eosinophilic gastrointestinal disease (EGID), and functional abdominal pain disorder (FAPD) present with nonspecific gastrointestinal (GI) symptoms clinically and also have some similarities in pathogeneses associated with eosinophils. Therefore, we aimed to evaluate the role of eosinophils in IBD compared to EGID and FAPD by investigating eosinophils in peripheral blood and GI tissue and eosinophil cationic protein (ECP).

Methods

Pediatric patients with chronic GI symptoms who underwent endoscopic biopsies were enrolled. Complete blood cell counts, inflammatory markers, immunoglobulin E (IgE), serum ECP levels, and endoscopic and histopathologic findings were retrospectively reviewed.

Results

A total of 387 patients were included: 179 with EGID, 107 with IBDs, and 82 with FAPD. Peripheral absolute eosinophil count (AEC), total IgE, and serum ECP were significantly higher in both IBD and EGID than in FAPD (all p < 0.05). Statistically significant differences were noted among the three groups in tissue eosinophil counts in each segment of GI tract except for the esophagus (p < 0.05). Significant differences were observed in tissue eosinophil counts in the ascending, sigmoid colon, and rectum between EGID and IBD (p < 0.05). Peripheral and tissue eosinophils in the stomach and duodenum revealed positive correlation in both EGID and IBD (both p < 0.001).

Conclusion

Elevated eosinophil‐related markers, as well as increased tissue eosinophilic infiltration in the affected areas of the GI tract in both IBD and EGID compared to FAPD, suggest that eosinophils might play a common important role in the pathogeneses of both diseases.
Synthesis of Poly[N‐(2‐((3‐Morpholino‐3‐Oxopropyl)Thio)Ethyl)Methacrylamide]: A New Thermoresponsive Polymer with Tunable LCST‐ and UCST‐Type Phase Transition in Aqueous and Alcoholic Solutions
Authors: Liu Dan , Liang Hui , Lu Jiang
Published: December 2023

A novel monomer, N‐(2‐((3‐morpholine‐3‐isopropyl)thio)ethyl)methacrylamide (MTMA), is synthesized and polymerized by reversible addition‐fragmentation chain transfer (RAFT) polymerization to give a thermoresponsive polymer poly[N‐(2‐((3‐morpholino‐3‐oxopropyl)thio)ethyl)methacrylamide] (PMTMA). PMTMA exhibits reversible thermoresponsive phase transitions of the lower critical solution temperature (LCST) type in water and the upper critical solution temperature (UCST) type in ethanol and methanol. The degree of polymerization and concentration of PMTMA, and solvent type have a significant influence on the transition temperature. PMTMA shows complicated thermoresponse in water–alcohol mixtures. In water–ethanol mixtures, the phase diagram of PMTMA can be divided into three regions according to ethanol volume percentages, φ: 0 ≤ φ < 15% for an LCST region; 15% ≤ φ < 91.5% for a complete dissolution region; 91.5% ≤ φ ≤ 100% for a UCST region. At high water content, the LCST increases with increasing ethanol content; and at high ethanol content, the UCST decreases with increasing water content. In water–methanol mixtures, PMTMA shows more complex thermoresponse. In the range of 0–50 °C, the phase diagram can be divided into five regions, depending on the methanol volume percentages φ: 0 ≤ φ < 15% for LCST region; 15% ≤ φ < 25% for immiscible region; 25% ≤ φ < 85% for UCST region; 85% ≤ φ < 95% for fully dissolved region; 95% ≤ φ ≤ 100% for another UCST region.
Electron‐Assisted Deposition‐Polymerization in Vacuum of Polymethines with Terminal Allyl Group
Authors: Grytsenko Kostyantyn , Doroshenko Tamara , Kolomzarov Yurii , Lytvyn Petro , Slominskii Yurii
Published: December 2023

Polymethines containing an allyl group have been synthesized. Their films are produced by physical vapor deposition (PVD) on glass, silicon (Si), gold (Au), polytetrafluoroethylene (PTFE), and nanostructured plastic substrates. Optical spectra recorded during the deposition showed no decomposition of molecules. The influence of dye structure and substrate on the morphology of the deposits is studied using atomic force microscopy (AFM). Depending on the dye structure and the substrate material, various nanostructures are grown. Dichroic nanowires (NWs) are formed by self‐assembly on Au and Si substrates. On the Si surface, NWs grow between the edges of neighboring Au stripes. Several methods are used for the selective opening of the allyl group. Smooth films are produced with optical spectra similar to those deposited by PVD. The morphology of the films is dependent on the activation conditions. The thermal stability of the films exceeds the stability of those deposited via PVD.
Dynamic serum testosterone concentration may predict in vitro fertilization yield during ovarian stimulation by a gonadotrophin‐releasing hormone agonist long protocol in women with normal ovarian reserve
Authors: Zhao Yang , Jiao Xuedan , Xu Jiawen , Chu Chu , Cao Yacong , Xu Huiyu , Xu Wenming , Zhao Xiaomiao
Published: December 2023

Objective

To determine whether dynamic changes in serum total testosterone (TT) levels during controlled ovarian stimulation (COS) by a GnRH‐a (gonadotrophin‐releasing hormone agonist) long protocol may predict pregnancy in women with normal ovarian reserve in in vitro fertilization.

Methods

The TT measurements were added to routine hormone tests during COS. The TT dynamic changes, clinical pregnancy rate, and quality of oocytes and embryos of 109 patients were analyzed.

Results

Compared with the non‐pregnancy group, in the pregnancy group the TT level on Gn initial day (TTinitial‐d) increased sharply when the dominant follicle reached a diameter 10–12 mm [TTfΦ (10–12)‐d] and on human chorionic gonadotrophin (HCG) day (TTHCG‐d), also the ratios of TTfΦ (10–12)‐d to TTinitial‐d (1.23 ± 0.37 vs. 1.10 ± 0.58, p = 0.040) and TTHCG‐d to TTinitial‐d (2.32 ± 1.26 vs. 2.00 ± 1.43, p = 0.019) increased notably. Of the 2 TT ratios, the first tertile limit was regarded as the threshold of high TT ratios (1.00, 1.45). High tertiles had higher pregnancy rates than low tertiles (82.86% vs. 42.11%, p = 0.006; 71.43% vs. 44.83%, p = 0.040). The 2 TT ratios were positively associated with the number of metaphase II oocytes and good‐quality embryos.

Conclusion

Of COS in a long GnRH‐a protocol with optimized outcome, serum TT kinetics appears to be characterized by sharp rises at the early and late stages of follicle growth. The ratios of TTΦ (10–12)‐d to TTinitial‐d and TTHCG‐d to TTinitial‐d may be predictors for pregnancy and qualitative outcomes of oocytes and embryos.
From consumption to withdrawal: A broad synopsis of the effects of alcohol
Authors: Zhu Jun , Liu Qi , Kong Bin , Shuai Wei , Xiao Zheng , Dai Chang , Huang He
Published: December 2023

The consumption of alcohol reflects both societal norms and personal choices and has major clinical implications. Long‐term excess alcohol consumption leads to a domino effect of pathological outcomes and onset of chronic illness. However, the risks of alcohol consumption extend beyond long‐term health issues. Because habitual alcohol drinkers reach a state of systemic homeostasis, when they attempt withdrawal, they experience many negative physiological effects and may develop alcohol withdrawal syndrome. The complex interplay between alcohol consumption and withdrawal does not result solely in behavioral issues. Rather, a substantial number of important physiological adaptations and potential problems underly habitual drinking. Addressing these issues requires comprehensive medical observation and intervention. Here, we summarize the pathophysiological mechanisms, clinical diseases, and related treatment methods of alcohol consumption and withdrawal. The aim was to provide a reference to improve understanding of alcohol use and promote an informed approach to alcohol withdrawal.
How to work together for engineering materials!
Authors: Iwata Shuichi
Published: December 2023

To share and utilize data effectively for collaborative work, a common understanding of the knowledge behind the data, including its context and meaning, is a fundamental requirement. This paper focuses on the gaps that hinder common understanding between the real world and the data space, acting as barriers between systems, organizations, data spaces, and disciplines. To understand the core reasons and devise strategies for bridging the gap, the author has endeavored to synthesize a case study of material data activities from two perspectives: diachronic and synchronic, which is framed into a two‐step process, involving the establishment of intersubjectivity among experts and interobjectivity among materials/substances data. As a result, the author has formulated an action plan for the digitization of engineering materials, encompassing tacit knowledge, know‐how, and intellectual property rights to establish a foundation for their use with traceability, interoperability, and reusability. In order to create a conceptual framework that enhances a productive ecosystem facilitated by networked materials and substance databases, this plan is conclusively based on two key steps: fostering interactions among experts rooted in substances and materials and standardizing digitized data related to substances/materials based on their geospatial structural information.
Parenteral nutrition insecurity: ASPEN survey to assess the extent and severity of parenteral nutrition access and reimbursement issues
Authors: Mirtallo Jay M. , Blackmer Allison , Hennessy Kathryn , Allen Penny , Nawaya Alaa D.
Published: December 2023

Background

Parenteral nutrition (PN) shortages and lack of qualified professional staff to manage PN impact safe, efficacious care and costs of PN. This American Society for Parenteral and Enteral Nutrition (ASPEN)–sponsored survey assessed the frequency and extent to which PN access affects PN delivery to patients.

Methods

Healthcare professionals involved with PN were surveyed. Questions were developed to characterize the respondent population and determine the extent and severity of PN access issues to components, devices, and healthcare professionals, as well as their effects on discharge and transfer issues. Reimbursement issues included cost, adequacy of therapy, and healthcare professional reimbursement. Burdens were types and frequency of errors, adverse events, and nutrition problems resulting from PN access issues. Impact on professionals and organizations was determined.

Results

Respondents (N = 350) worked in hospitals (75%) and home infusion (25%). Per day, clinicians cared for <15 patients receiving PN. All age populations were represented. Respondents reported shortages of macronutrients (72%, 233 of 324) and micronutrients (91%, 297 of 324). Issues with access to healthcare workers were observed. PN access issues contribute to increased costs of PN, and knowledge regarding the current rate of PN reimbursement is limited. Respondents (75%, 197 of 261) observed an error due to PN access issues. Adverse events (57%, 149 of 259) were observed leading to temporary or permanent harm (24%, 61 of 259) as well as near death (4%, 9 of 259) and death (1%, 2 of 259). Providers reported time away from other job responsibilities and workplace stress.

Conclusion

PN access issues result in “PN insecurity” that negatively impacts patients and healthcare providers and leads to adverse events including death in patients receiving PN.
An efficient parallel solution scheme for the phase field approach to dynamic fracture based on a domain decomposition method
Authors: Hao Shourong , Shen Yongxing
Published: December 2023

The phase field approach to fracture becomes popular for complicated fracture problems in recent years. However, its widespread application is hindered by its high computational cost. In this article, we propose an efficient parallel explicit‐implicit solution scheme for the phase field approach to dynamic fracture based on a domain decomposition method, specifically, the dual‐primal finite element tearing and interconnecting (FETI‐DP) method. In this scheme, the displacement field is updated by an explicit algorithm in parallel, and the phase field is implicitly solved by the FETI‐DP method. In particular, Lagrange multipliers are introduced to ensure the interface continuity of the phase field. In the computational process, the information exchange among subdomains merely exists in a few substeps, which renders the cost for communication very small. Moreover, the size of equations to be solved is proportional to the total area of subdomain interfaces, which is significantly reduced compared with a typical single‐domain solution procedure. The solution scheme is able to perform phase field simulations with a million of degrees of freedom using only 0.034 core hours per load step, and has flexible extensibility for existing phase field codes. Several numerical examples demonstrate the accuracy and efficiency of the proposed scheme.
Correlation of health literacy, health management self‐efficacy, and attitude in elderly patients with schizophrenia: A cross‐sectional study
Authors: Liao Su‐Jung , Wang Lin‐Jie
Published: December 2023

Aim

The study investigated the relationship between chronic diseases and health problems, emotional health status, health literacy, health self‐management attitude, and health management self‐efficacy in older patients with schizophrenia. It is expected to provide multiple health perspectives in the care of older patients with schizophrenia and improve their health literacy and self‐management.

Design

A cross‐sectional study.

Methods

Data collection from 2020/09 to 2021/10, the study of older patients with schizophrenia who were diagnosed with schizophrenia and were over 50 years, live in residential mental rehabilitation institutions in eastern Taiwan as older people. Data were collected on demographic variables, chronic diseases, health problems, health literacy, healthy management self‐efficacy, and attitudes.

Results

The study results show 61.49 years (SD = 6.57), the gender, health literacy, and health management self‐efficacy can effectively explain the variance of health self‐management state by 18.5% (F(3,116) = 10.01, p < 0.000), in which health literacy (β = 0.28, t = 3.07, p = 0.003) and health management self‐efficacy (β = 0.19, t = 2.03, p = 0.04) that in the analysis of predictors, emotional health status, and health literacy not only have significant explanatory power on health management self‐efficacy and the performance of physical functions but are also important factors affecting the quality of life among the elderly; the important influencing factor of health management self‐efficacy and health self‐management behaviour is health literacy. Therefore, health literacy is crucial to the health attitudes of older patients with schizophrenia.

Conclusion

This study found that increased health literacy among older patients with schizophrenia can enhance their attitude and ability to manage their health.

Implications for the Profession and No Patient or Public Contribution

Nursing can provide nursing measures related to individual health literacy to help patients improve their health literacy, maintain the health of chronic older patients with schizophrenia, reduce elderly schizophrenia disability, enhance patients' ability to manage their self‐efficacy and health self‐management attitude, and improving the health and quality of life of patients.
An analysis on the optimal control and approximate controllability for Hilfer fractional neutral integro‐differential systems with finite delay
Authors: Ma Yong‐Ki , Kavitha K. , Shukla Anurag , Vijayakumar V. , Nisar Kottakkaran Sooppy
Published: December 2023

The existence and uniqueness of solutions to Hilfer fractional neutral delay integro‐differential equations subject to nonlocal conditions are discussed in this study. The main results of this study are based in part on the fixed point techniques of Banach contraction and Krasnoselskii's fixed point theorem from calculus theory. First, we determine whether or not the fractional system has a mild solution. The uniqueness of the mild solution is further illustrated by expanding our results. The optimal control problems are governed by a new class of neutral delay integro‐differential equations in Banach spaces, and we also develop sufficient conditions for the approximate controllability of a nonlinear fractional system. An example is given at the end to strengthen the compatibility of the results.
Downregulated BMP–Smad1/5/8 signaling causes emphysema via dysfunction of alveolar type II epithelial cells
Authors: Zheng Xi , Chen Xiaoying , Hu Xiaoxiao , Chen Lidan , Mi Nana , Zhong Qianqian , Wang Linfang , Lin Chensheng , Chen YiPing , Lai Fancai , Hu Xuefeng , Zhang Yanding
Published: December 2023

Bone morphogenetic protein (BMP)–Smad1/5/8 signaling plays a crucial regulatory role in lung development and adult lung homeostasis. However, it remains elusive whether BMP–Smad1/5/8 signaling is involved in the pathogenesis of emphysema. In this study, we downregulated BMP–Smad1/5/8 signaling by overexpressing its antagonist Noggin in adult mouse alveolar type II epithelial cells (AT2s), resulting in an emphysematous phenotype mimicking the typical pathological features of human emphysema, including distal airspace enlargement, pulmonary inflammation, extracellular matrix remodeling, and impaired lung function. Dysregulation of BMP–Smad1/5/8 signaling in AT2s leads to inflammatory destruction dominated by macrophage infiltration, associated with reduced secretion of surfactant proteins and inhibition of AT2 proliferation and differentiation. Reactivation of BMP–Smad1/5/8 signaling by genetics or chemotherapy significantly attenuated the morphology and pathophysiology of emphysema and improved the lung function in Noggin‐overexpressing lungs. We also found that BMP–Smad1/5/8 signaling was downregulated in cigarette smoke‐induced emphysema, and that enhancing its activity in AT2s prevented or even reversed emphysema in the mouse model. Our data suggest that BMP–Smad1/5/8 signaling, located at the top of the signaling cascade that regulates lung homeostasis, represents a key molecular regulator of alveolar stem cell secretory and regenerative function, and could serve as a potential target for future prevention and treatment of pulmonary emphysema. © 2023 The Pathological Society of Great Britain and Ireland.
Effect of grain boundaries, cure, and temperature on the thermomechanical properties of epoxy/graphene composites
Authors: Ding Qiuyue , Ding Ning , Chen Xiangfeng , Guo Wenyue , Zaïri Fahmi
Published: December 2023

In this study, molecular dynamics (MD) method was used to systematically investigate the effects of grain boundaries (GBs), degree of cure and temperature on the mechanical properties and thermal stability of epoxy/graphene composites. Uniaxial tensile simulations were performed for pristine graphene and graphene containing GBs reinforced epoxy composites with different degrees of cure. Results show that the yield strength and Young's modulus of epoxy/graphene composites increase with the degree of cure. The behind mechanisms can be attributed to the stronger bonding interaction between epoxy chains. The mechanical properties of epoxy/graphene composites with high degree of cure are more sensitive to GB types. The glass transition temperature (Tg) of pristine graphene and graphene containing GBs reinforced epoxy composites presents an increasing trend with the degree of cure. The introduction of GBs can enhance the Tg of epoxy/graphene composites because of the appropriate wrinkles of GBs in graphene sheets helping to block the slippage of epoxy chains. The MD predicted results of Tg are in good agreement with existing experimental data and the DiBenedetto relationship can be applied using the MD parameters. Both yield strength and Young's modulus of epoxy/graphene composites decrease with temperature, which is mainly due to the weak interface interactions at high temperature and the sufficient energy of atoms at high temperature to overcome the energy barrier. GBs present diverse effects on the yield strength and Young's modulus at different temperatures. This work provides a theoretical basis for the application of epoxy composites reinforced with graphene containing GBs under different conditions.

Highlights

The thermomechanical properties of epoxy/graphene composites are studied.

The coupling effects of GBs, cure degree, and temperature are evidenced.

The existence of GBs can improve the Tg of epoxy/graphene composites.

MD predicted Tg agrees well with experimental data using the WLF relationship.
Experimental investigation on triglycidyl isocyanurate‐based tribologically functional composites
Authors: Liu Changxin , Wang Hai , Qi Xiaowen , Fan Bingli , Yang Xiao , Dong Yu
Published: December 2023

The aim of this study is to prepare epoxy/polytetrafluoroethylene (PTFE)/glass fiber (GF) composites (EPGs) with the unique characteristics of low friction and high wear resistance based on triglycidyl isocyanurate (TGIC). The tribological properties of composites with different filler ratios under different working conditions were systematically studied. At the maximum filler content of 40 wt% PTFE, the minimum coefficient of friction (COF) and wear rate reached 0.079 and 0.45 × 10−6 mm3/N·m. The hardness decreased by 44.2% and the density increased by 18.3%. The worn surfaces and transfer films were observed and analyzed by scanning electron microscopy (SEM) and x‐ray photoelectron spectroscopy (XPS). The increasing tendency of velocity and amplitude is beneficial to reduce the carbon‐rich region and further enhance the formation of transfer films. It is proved that the tribological properties of TGIC‐based epoxy composites are higher than those of other types of epoxy composites. This study offers great insight into the tribological applications of TGIC‐based epoxy composites.

Highlights

Epoxy/PTFE/GF composites (EPGs) were prepared using TGIC as the base material.

EPGs have good mechanical and tribological properties.

The COF of EPG3 reaches 0.079 and the wear rate becomes 0.45 × 10−6 mm3/(N·m).

The increasing tendency of velocity and amplitude is beneficial to reduce the carbon‐rich region and further enhance the formation of transfer films.
Serine protease mediates Ovomermis sinensis‐inhibited host immune responses by inducing apoptosis: implications for successful parasitism and host mortality
Authors: Jiao Zhenlong , Chen Mingming , Zhao Wenjing , Wu Yuanming , Guo Guo
Published: December 2023

BACKGROUND

Mermithid nematodes are entomopathogens that parasitize and kill insect hosts and are used for biological control. It is widely believed that mermithid nematodes kill their host upon nematode emergence, unlike other parasites that depend on virulence factors. In this study, we disproved this theory by demonstrating that the mermithid nematode Ovomermis sinensis mediates host mortality by serine protease‐induced apoptosis.

RESULTS

Successful parasitism of O. sinensis increased with the infection rate, and the inhibition of host immunity by O. sinensis increased with the parasitic load. A serine protease was identified from the host hemolymph. This protease belongs to the trypsin‐like serine protease family, which is an apoptosis‐inducing serine protease. Specifically, Os‐sp was highly expressed only during the parasitic stage and could be induced by host hemocytes and the fat body. Importantly, host immune effectors (melanization, phenoloxidase activity, and encapsulation) were suppressed by the recombinant protein rOs‐sp that induced apoptosis of hemocytes and fat body in a dose‐dependent manner, which contributes to host death.

CONCLUSION

Serine protease mediates O. sinensis‐inhibited host immune responses by inducing apoptosis that is lethal to the insect host. Our findings have broader implications for understanding the mechanism of successful parasitism and killing of host by nematodes. © 2023 Society of Chemical Industry.
LP formulation of stochastic Bayesian two‐player zero‐sum games with long horizon
Authors: Orpa Nabiha Nasir , Li Lichun
Published: December 2023

This article studies two‐player zero‐sum stochastic Bayesian games where each player has its own dynamic state that is unknown to the other. To compute the optimal strategy for the players, prior work uses sequence form to construct linear programming formulation, whose size grows exponentially with respect to the time horizon of the game. The exponential computational complexity restricts us in games with short horizon. While window‐by‐window or receding horizon methods can be used to extend the horizon, how to update the initial parameters in each window is still unknown. Based on the existing results about dual games, this article proposes LP formulations to update the initial parameters in each window. A window‐by‐window method is given with performance analysis. The main results are demonstrated in a security problem of underwater sensor networks.
A Doping‐Induced SrCo0.4Fe0.6O3/CoFe2O4 Nanocomposite for Efficient Oxygen Evolution in Alkaline Media
Authors: Liu Heng , Wang Yuan , Tan Pengfei , dos Santos Egon C. , Holmes Stuart M. , Li Hao , Pan Jun , D'Agostino Carmine
Published: December 2023

Perovskite and spinel oxides are promising alternatives to noble metal‐based electrocatalysts for oxygen evolution reaction (OER). Herein, a novel perovskite/spinel nanocomposite comprised of SrCo0.4Fe0.6O3 and CoFe2O4 (SCF/CF) is prepared through a simple one‐step method that incorporates iron doping into a SrCoO3‐δ matrix, circumventing complex fabrication processes typical of these materials. At a Fe dopant content of 60%, the CoFe2O4 spinel phase is directly precipitated from the parent SrCo0.4Fe0.6O3 perovskite phase and the number of active B‐site metals (Co/Fe) in the parent SCF can be maximized. This nanocomposite exhibits a remarkable OER activity in alkaline media with a small overpotentional of 294 mV at 10 mA cm−2. According to surface states analysis, the parent SCF perovskite remains in its pristine form under alkaline OER conditions, serving as a stable substrate, while the second spinel CF is covered by 5/8 monolayer (ML) O*, exhibiting considerable affinity toward the oxygen species involved in the OER. Analysis based on advanced OER microkinetic volcano model indicates that a 5/8 ML O* covered‐CF is the origin for the remarkable activity of this nanocomposite. The results reported here significantly advance knowledge in OER and can boost application, scale‐up and commercialisation of electrocatalytic technologies toward clean energy devices.
Enhancing the Conductivity of PEDOT:PSS Films by the Confinement of Ice Crystals
Authors: Chen Lie , Shen Peijie , Zhao Tianyi , Liu Mingjie
Published: December 2023

Rapid developments in organic electronics demand highly conductive and freestanding (PEDOT:PSS) films. However, the synthesis of highly conductive PEDOT:PSS films requires toxic reagents, such as high‐concentration acids and bases. Herein, an eco‐friendly and cost‐effective strategy is reported for improving the conductivity of PEDOT:PSS films through the confinement of ice crystals. The crystallization of water swelled by the film facilitated the phase separation of PEDOT and PSS, and the excess PSS in the skin layer is effectively removed. Moreover, under the confinement effect, the carrier mobility of the film is enhanced through the formation of a well‐crystallized PEDOT molecular morphology. A detailed elucidation of aggregate structure evolution in PEDOT:PSS films during annealing, solvent post‐treatment, and subsequent confined crystallization is presented herein. After multiple water crystallization cycles, the conductivity of the PEDOT:PSS film increased by over 85%, achieving a maximum of 2564 ± 142 S cm−1. Finally, compared to post‐treatment with dimethyl sulfoxide (DMSO), the current strategy can improve the Seebeck coefficient by 5.6% and the power factor by 139%.
miR‐9 promotes canine endothelial‐like cell migration by targeting COL15A1
Authors: Jiang Heng , Liu Mengmeng , Qin Yao , Zhang Hong
Published: December 2023

Background

Endothelial cell migration is the initial stage of angiogenesis. In previous studies, miR‐9 has been found to regulate angiogenesis and cell migration in human medicine.

Objectives

This study aimed to reveal the regulatory effect of miR‐9 on canine endothelial cell migration.

Methods

Embryonic canine ventricle myocardium tissues were collected and induced to differentiate into endothelial‐like cells (ELCs). A transwell and invasion assay were used to evaluate the impact of miR‐9 on the migration capacity of ELCs, after which a luciferase reporter assay, western blotting, RNA sequencing and reverse transcription‐polymerase chain reaction were conducted to explore the regulatory mechanism.

Results

Our results showed that we successfully induced the primary cells derived from canine cardiac embryo tissues into ELCs. MiR‐9 also promoted the migration and invasion of canine ELCs, and inhibited the expression of collagen XV, an angiogenic inhibitor, at the translational level by targeting the 3′ untranslated region of COL15A1 gene. Furthermore, RNA sequencing showed that overexpression of miR‐9 impacted several signalling pathways and eight genes involved in angiogenesis and cell migration in canine ELCs.

Conclusions

These findings suggest that miR‐9 enhances the migration of canine ELCs and may serve as a potential diagnostic and therapeutic target for canine diseases involved in endothelial cells migration and angiogenesis, but more further studies are needed.