bluuebunny/crossref_metadata_2025 huggingface dataset:
Low‐temperature synthesis of mullite‐based ceramics from Moroccan naturally occurring andalusite and marble waste
Authors: Tabit Kamal , Borja Wafaa , Saâdi Latifa , Waqif Mohamed
Published: October 2021

The present work aims to prepare mullite‐based ceramics at low temperature mainly from andalusite and marble byproduct by a solid‐state interaction method. Marble powder byproduct was used, in the prospect of waste management, as a sintering aid. The influence of marble powder byproduct (5 wt.%) on the phase formation, microstructure‐temperature evolution, densification, and mechanical strength was evaluated by means of XRD, TGA‐DTA, and SEM. The results revealed that the andalusite remained present with mullite up to 1400°C, while the addition of 5 wt.% of marble byproduct involved its complete transformation into mullite and a trace of anorthite. The transformation of andalusite into mullite upon the heating in the range 1300–1400°C involved the densification of the matrix body and a significant increase in mechanical strength from 60 to 170 MPa, which promoted its application for refractory materials.
Microencapsulation of Bifidobacterium longum 51A cells by spray drying and its incorporation in acerola (Malpighia emarginata) pulp powder
Authors: Costa Karen , Silva Luana S. , Kobori Cintia N. , da Silva Andreia M. , Nicoli Jacques R.
Published: October 2021

Market of functional foods grows intensely, such as of fruit juice containing probiotics. However, the survival of the microorganism can be compromised by the low pH of such matrix, and the way of minimizing this acid stress is the use of microencapsulation techniques such as by spray drying. In this study, three formulations were tested for the encapsulation of Bifidobacterium longum 51A, and the viability was evaluated during storage after the atomization process and after addition in acerola pulp powder. All formulations offered equivalent protection of the bifidobacteria just after microencapsulation. When microencapsulated cells were incorporated to acerola pulp powder, a higher protection for B. longum 51A viability was observed when cellulose acetate phthalate was used after 30 days of storage both at room temperature and refrigeration. Concluding, acerola pulp matrix can be used as an alternative vehicle for probiotic administration, even when stored at room temperature.
Chemical characteristics and volatile compounds profiles in different muscle part of the farmed hybrid catfish (Clarias macrocephalus × Clarias gariepinus)
Authors: Phetsang Hatairad , Panpipat Worawan , Panya Atikorn , Phonsatta Natthaporn , Cheong Ling‐Zhi , Chaijan Manat
Published: October 2021

The chemical characteristics and volatile compounds profiles in distinct anatomical sites of a farm‐raised hybrid catfish (Clarias macrocephalus × Clarias gariepinus) were investigated. Total haem proteins, trimethylamine‐nitrogen, TBARS, n‐9 oleic acid, n‐6 linoleic acid and total concentration of all volatile compounds were all higher in the lateral line with the maximum redness index (p < 0.05). Dorsal muscle lipid contained more eicosapentaenoic acid and docosahexaenoic acid than the other two muscles (p < 0.05). Ventral muscle exhibited the highest fat content (p < 0.05) and was the only muscle discovered to have n‐3 linolenic acid. Geosmin and 2‐methylisoborneol (2‐MIB) were found in all three muscles. Despite the fact that 2‐MIB and geosmin are lipophilic compounds, their distribution was unaffected by fat content, with the highest levels in the lateral line (p < 0.05). Odour activity values (OAV) and sensory analyses revealed that not only 2‐MIB and geosmin but also (E)‐2‐nonenal and 1‐octen‐3‐ol, intensified the earthy and muddy odour in catfish muscles. The total off‐odour of catfish muscles was influenced by n‐9 oleic acid and n‐6 linoleic acid, according to the correlation analysis. The off‐odour compounds had a substantial negative connection with total n‐3 PUFA, as well as the irrelevance with fat content, according to this study.
Tax havens and international business: A conceptual framework of accountability‐avoiding foreign direct investment
Authors: Temouri Yama , Budhwar Pawan , Jones Chris , Ylönen Matti , Pereira Vijay , Cobham Alex
Published: October 2021

By taking an objective and scientific bibliometric analysis approach, this paper presents the first review of the extant knowledge base ontax havens. This analysis has guided us in developing an overarching theoretical framework that examines the determinants of the use of tax havens by multinational enterprises (MNEs). Based on our systematic review and theoretical framework, we were able to develop and introduce a new concept, calledaccountability‐avoiding FDI (foreign direct investment), which is distinct from the standard FDI motives identified in the international business (IB) literature. Our review also makes a contribution by explaining how various definitions, measurements, methodologies and categorizations of tax havens can lead to differing and mixed results. Given that the tax haven literature is of a cross‐disciplinary nature, we specifically make a case for how the IB community can make a stronger contribution to our understanding of tax haven activity and its ramifications. We conclude the paper with suggestions for the future research that IB and management scholars could pursue in order to contribute unique insights to the area of MNE strategy and the implications of tax haven investments for countries, various industries and the MNEs themselves.
Development and validation of the Professional Nursing Support Scale for Chinese patients with cancer
Authors: Song Yongxia , Wang Bingqing , Liu Shanshan , Tong Huanhuan , Hong Jingfang , Wang Wenru
Published: October 2021

Purpose

This study aimed to develop and test the psychometric properties of a Professional Nursing Support Scale for patients with cancer in mainland China.

Methods

The study was conducted in two phases from January 2017 to January 2020. Phase I involved item generation and developing a preliminary version of Professional Nursing Support Scale through literature review, qualitative interviews, content validity evaluation and a pilot study. Phase II involved psychometric properties testing of the Professional Nursing Support Scale in 700 patients with cancer recruited from four public hospitals in Anhui Province, China.

Results

A 49‐item Professional Nursing Support Scale was finally developed. Exploratory factor analysis showed a four‐factor structure of the 49‐item Professional Nursing Support Scale, accounting for 56.95% of variance. Cronbach's α ranged from 0.91 to 0.94 for the four subscales. Confirmatory factor analysis further confirmed the best model fit of four‐factor structure of the Professional Nursing Support Scale. The Professional Nursing Support Scale also showed an acceptable concurrent validity with Supportive Care Needs Scale short form 34 (r = 0.75, p < 0.001) and Psychological Distress Thermometer (r = 0.39, p < 0.001).

Conclusions

The Professional Nursing Support Scale is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the care in Chinese patients with cancer.
Framing third places for universities' third mission – Field Configuring Events as collaborative learning and transfer formats
Authors: Lange Bastian
Published: October 2021

The paper uses the heuristics of a spatial perspective of so‐called Field Configuring Events (FCE) to investigate the question of how these new educational and project‐related transfer and collaboration courses in higher education context can capture the fundamentally changed institutional role – often called “third mission” or transfer competencies – fostering regional development. In doing so, the paper applies the concept FCE to an empirical case and aims at reconsidering the conceptual perspectives of this concept. The conceptual goal is to further refine the heuristic FCE and to align it more appropriately to understand dynamic knowledge production as an expression of new temporary (micro‐) geographies.
Qualitative study of nuclear medicine physicians' perceptions of positron emission tomography/computed tomography in pregnant patients with cancer
Authors: R Di Ciaccio Pietro , Emmett Louise , Hamad Nada
Published: October 2021

Staging using positron emission tomography/computed tomography (PET/CT) is standard of care in many cancers that occur most frequently in pregnancy, particularly lymphoma. While expert guidelines generally recommend against PET/CT in pregnant women, there is emerging evidence that likely absorbed foetal doses in pregnancy are relatively low, and as such in certain circumstances PET/CT may be acceptable when balancing benefit and risk. We conducted a qualitative survey of nuclear medicine physicians in Australia and New Zealand to assess practice and attitudes with respect to PET/CT in pregnancy women, finding that most respondents considered PET/CT in pregnancy may be an appropriate modality in carefully selected clinical contexts with appropriate modifications. It is important to continue to define the role of PET/CT in pregnancy into the future, particularly as this imaging modality has emerged as the standard of care in staging and response assessment for many cancers.
Reflections on pandemics and the 60th anniversary of the University of New South Wales Medical School
Authors: Isbister James P.
Published: October 2021

In March 1961 the University of New South Wales enrolled the first students into the new faculty of medicine that is now ranked 4th in Australia and 59th in the world. The author was fortunate to be a member of that pioneering group and looks back in gratitude to all the visionary and committed academics and mentors, who made this happen. Many of the foundation academics were fellows of the Royal Australasian College of Physicians, with two becoming University of New South Wales deans of medicine. One‐quarter of the foundation year's graduates became fellows of the college and the first PhD medical graduate, Professor John Chalmers AC, became president of the college.
Mental health nursing practice in rural and remote Canada: Insights from a national survey
Authors: MacLeod Martha L.P. , Penz Kelly L. , Banner Davina , Jahner Sharleen , Koren Irene , Thomlinson Alexandra , Moffitt Pertice , Labrecque Mary Ellen
Published: October 2021

Access to and delivery of quality mental health services remains challenging in rural and remote Canada. To improve access, services, and support providers, improved understanding is needed about nurses who identify mental health as an area of practice. The aim of this study is to explore the characteristics and context of practice of registered nurses (RNs), licensed practical nurses (LPNs), and registered psychiatric nurses (RPNs) in rural and remote Canada, who provide care to those experiencing mental health concerns. Data were from a pan‐Canadian cross‐sectional survey of 3822 regulated nurses in rural and remote areas. Individual and work community characteristics, practice responsibilities, and workplace factors were analysed, along with responses to open‐ended questions. Few nurses identified mental health as their sole area of practice, with the majority of those being RPNs employed in mental health or crisis centres, and general or psychiatric hospitals. Nurses who indicated that mental health was only one area of their practice were predominantly employed as generalists, often working in both hospital and primary care settings. Both groups experienced moderate levels of job resources and demands. Over half of the nurses, particularly LPNs, had recently experienced and/or witnessed violence. Persons with mental health concerns in rural and remote Canada often receive care from those for whom mental health nursing is only part of their everyday practice. Practice and education supports tailored for generalist nurses are, therefore, essential, especially to support nurses in smaller communities, those at risk of violence, and those distant from advanced referral centres.
Pregnancy in women with Brugada syndrome: Is there an increased arrhythmia risk? A case‐series report
Authors: van der Crabben Saskia N. , Kowsoleea Astra I. E. , Clur Sally‐Ann B. , Wilde Arthur A. M.
Published: October 2021

Introduction

In some rare arrhythmia syndromes, arrhythmia risk in female patients increases during pregnancy, necessitating extra controls. We wanted to evaluate if the increased risk for arrhythmia during pregnancy applies in women with Brugada syndrome and their potentially affected fetuses.

Methods

A comprehensive literature search was performed on PubMed (MeSH search terms “Brugada syndrome,” “pregnancy,” “parturition,” “labor,” “delivery,” “fetal death,” and “stillbirth”).

Results

Overall, six case reports with a total of six patients were identified. Of these six patients (three carriers of an SCN5A variant, three not tested), two women (both with unknown SCN5A status), developed severe cardiac events during pregnancy. The first patient, with a previous history of aborted sudden cardiac arrest at the age of 12 years, developed ventricular fibrillation (VF), while the other was diagnosed with Brugada syndrome postpartum because of nocturnal agonal respiration during pregnancy.

Conclusion

These (limited, heterogenous) cases suggest that women with Brugada syndrome (and their possibly affected fetuses), might have an overall low tendency to develop arrhythmias during pregnancy, but important data on risk factors (SCN5A status) are lacking. Arrhythmia risk during pregnancy seems to increase in probands and those who have previously experienced cardiac events. We suggest the use of risk stratification in these women to improve patient care, lower the emotional stress and physical burden for the pregnant mother, and lower health costs. Furthermore, we plead for SCN5A analysis in all these women for use of risk stratification and to enable cascade screening especially for specialized care in children carrying an SCN5A mutation.
Diagnosis of hypertension: Ambulatory pediatric American Heart Association/European Society of Hypertension versus blood pressure load thresholds
Authors: Sharma Ajay P. , Altamirano‐Diaz Luis , Mohamed Ali Mohamed , Stronks Katryna , Kirpalani Amrit , Filler Guido , Norozi Kambiz
Published: October 2021

The agreement between the traditionally‐used ambulatory blood pressure (ABP)‐load thresholds in children and recently‐recommended pediatric American Heart Association (AHA)/European Society of Hypertension (ESH) ABP thresholds for diagnosing ambulatory hypertension (AH), white coat hypertension (WCH), and masked hypertension (MH) has not been evaluated. In this cross‐sectional study on 450 outpatient participants, the authors evaluated the agreement between previously used ABP‐load 25%, 30%, 40%, 50% thresholds and the AHA/ESH thresholds for diagnosing AH, WCH, and MH. The American Academy of Pediatrics thresholds were used to diagnose office hypertension. The AHA threshold diagnosed ambulatory normotension/hypertension closest to ABP load 50% in 88% (95% CI 0.79, 0.96) participants (k 0.67, 95% CI 0.59, 0.75) and the ESH threshold diagnosed ambulatory normotension/hypertension closest to ABP load 40% in 86% (95% CI 0.77, 0.94) participants (k 0.66, 95% CI 0.59, 0.74). In contrast, the AHA/ESH thresholds had a relatively weaker agreement with ABP load 25%/30%. Therefore, the diagnosis of AH was closest between the AHA threshold and ABP load 50% (difference 3%, 95% CI ‐2.6%, 8.6%, p = .29) and between the ESH threshold and ABP load 40% (difference 4%, 95% CI ‐2.1%, 10.1%, p = .19) than between the AHA/ESH and ABP load 25%/30% thresholds. A similar agreement pattern persisted between the AHA/ESH and various ABP load thresholds for diagnosing WCH and MH. The AHA and ESH thresholds diagnosed AH, WCH, and MH closest to ABP load 40%/50% than ABP load 25%/30%. Future outcome‐based studies are needed to guide the optimal use of these ABP thresholds in clinical practice.
Live birth/parity number and the risk of incident hypertension among parous women during over 13 years of follow‐up
Authors: Moazzeni Seyyed Saeed , Asgari Samaneh , Azizi Fereidoun , Hadaegh Farzad
Published: October 2021

The effect of live birth/parity number on incident hypertension was investigated among Iranian parous women aged 30–70 years. The study population included 2188 normotensive women who were enrolled in 1999–2001. They were followed for incident hypertension (based on JNC 7 report) by 3‐year intervals up to April 2018. Multivariable Cox proportional hazard models, adjusted for a wide set of potential hypertension risk factors, reproductive factors, and pregnancy complications, were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the number of parity/live birth(s) for incident hypertension. Additionally, as a sensitivity analysis, age‐scale Cox regression was also done. During a median follow‐up of 13.5 years, 935 incident hypertension have occurred. Compared to those with two live births, the participants who had 3 and ≥4 live births were at higher risk of hypertension development by the HRs of 1.25 [95% CI: 1.02–1.55] and 1.39 [1.12–1.72], respectively, in the full‐adjusted model. Moreover, each additional live birth increased the risk of hypertension by a HR of 1.06 [95%CI: 1.02–1.11]. Results of parity number were also similar. Considering age as time scale also did not change the results generally. The authors found a significant interaction between live birth/parity number and age groups; the adverse effect of higher live birth/parity numbers on hypertension development was mainly found among those aged < 50 years. To sum up, compared to the live birth/parity number of two, Iranian women with ≥3 live birth/parity had a higher risk of incident hypertension; the issue was more prominent among younger mothers.
Assessment of the effects of a hair lotion in women with acute telogen effluvium: a randomized controlled study
Authors: Turlier V. , Darde M.‐S. , Loustau J. , Mengeaud V.
Published: October 2021

Background

Telogen effluvium is a hair loss disorder occurring about 3 months after a triggering event. The acute form impairs quality of life, but spontaneous recovery usually begins 3–6 months after identification and elimination of the cause, with complete recovery taking around 12 months.

Objectives

To investigate the effectiveness and safety of a hair lotion containing creatine, acetyl tetrapeptide‐2 and B vitamins for reducing hair loss in acute telogen effluvium.

Methods

In this open, randomized, controlled study (NCT04652232), women with acute telogen effluvium from two clinical centres were randomly allocated to receive either the lotion and a mild shampoo (intervention group), or the mild shampoo alone (controls). Hair growth parameters and hair loss were measured from phototrichograms at weeks (W) 1, 4, 8 and 16, and through investigator assessments of standardized photographs at W1 and W16. The primary criterion was the change in anagen to telogen (A/T) ratio between W1 and W16.

Results

One hundred women (aged 19–50 years) were included (intervention group, N = 51; controls, N = 49). Compared to baseline, the A/T ratio was higher at W16 in both groups and was significantly higher at both W4 and W8 in the intervention group, compared to only at W8 in controls. Significant decreases in telogen hair density were seen at all time points in the intervention group, compared to only at W16 in controls, and the between‐group difference was significant at W8 (P = 0.0465). A larger reduction in the total number of hairs shed was observed at W8 in the intervention group (P = 0.0392). Investigator‐assessed scores showed improvements in hair density for the intervention group. Global tolerance of the lotion was excellent.

Conclusions

The lotion tested had a significant impact on hair loss in women with acute telogen effluvium and appeared to accelerate recovery from this condition.
Understanding the role of informal caregivers in postoperative care transitions for older patients
Authors: Sokas Claire M. , Hu Frances Y. , Dalton Michael K. , Jarman Molly P. , Bernacki Rachelle E. , Bader Angela , Rosenthal Ronnie A. , Cooper Zara
Published: October 2021

Background

Older adults may have new care needs and functional limitations after surgery. Many rely on informal caregivers (unpaid family or friends) after discharge but the extent of informal support is unknown. We sought to examine the role of informal postoperative caregiving on transitions of care for older adults undergoing routine surgical procedures.

Materials and methods

We performed a retrospective cohort study using ACS NSQIP Geriatric Pilot Project data, 2014–2018. Patients were ≥65 years and underwent an inpatient surgical procedure. Patients who lived at home alone were compared with those who lived with support from informal caregivers (family and/or friends). Primary outcomes were discharge destination (home vs. post‐acute care) and readmission within 30 days. Multivariable logistic regression was used to determine the association between support at home, discharge destination, and readmission.

Results

Of 18,494 patients, 25% lived alone before surgery. There was no difference in loss of independence (decline in functional status or new use of mobility aid) after surgery between patients who lived alone or with others (18.7% vs. 19.5%, p = 0.24). Nevertheless, twice as many patients who lived alone were discharged to a non‐home location (10.2% vs. 5.1%; OR: 2.24, CI: 1.93–2.56). Patients who lived alone and were discharged home with new informal caregivers had increased odds of readmission (OR: 1.43, CI: 1.09–1.86).

Conclusion

Living alone independently predicts discharge to post‐acute care, and patients who received new informal caregiver support at home have higher odds of readmission. These findings highlight opportunities to improve discharge planning and care.
Establishing Medicaid incentives for liberating nursing home patients from ventilators
Authors: Keohane Laura M. , Mart Matthew F. , Ely E. Wesley , Lai Pikki , Cheng Audrey , Makam Anil N. , Stevenson David G.
Published: October 2021

Background

Chronic ventilator use in Tennessee nursing homes surged following 2010 increases in respiratory care payment rates. Tennessee's Medicaid program implemented multiple policies between 2014 and 2017 to promote ventilator liberation in 11 nursing homes, including quality reporting, on‐site monitoring, and pay‐for‐performance incentives.

Methods

Using repeated cross‐sectional analysis of Medicare and Medicaid nursing home claims (2011–2017), hospital discharge records (2010–2017), and nursing home quality reports (2015–2017), we examined how service use changed as Tennessee implemented policies designed to promote ventilator liberation in nursing homes. We measured the annual number of nursing home patients with ventilator‐related service use; discharge destination of ventilated inpatients and percent of nursing home patients liberated from ventilators.

Results

Between 2011 and 2014, the number of Medicare SNF and Medicaid nursing home patients with ventilator use increased more than sixfold. Among inpatients with prolonged mechanical ventilation, discharges to home decreased as discharges to nursing homes increased.

As Tennessee implemented policy changes, ventilator‐related service use moderately declined in nursing homes from a peak of 198 ventilated Medicare SNF patients in 2014 to 125 in 2017 and from 182 Medicaid patients with chronic ventilator use in 2014 to 145 patients in 2017. Nursing home weaning rates peaked at 49%–52% in 2015 and 2016, but declined to 26% by late 2017. Median number of days from admission to wean declined from 81 to 37 days.

Conclusions

This value‐based approach demonstrates the importance of designing payment models that target key patient outcomes like ventilator liberation.
Analytics and Lean Health Care to Address Nurse Care Management Challenges for Inpatients in Emerging Economies
Authors: Moreno‐Fergusson María Elisa , Guerrero Rueda William Javier , Ortiz Basto Germán A. , Arevalo Sandoval Indira Alba Lucia , Sanchez–Herrera Beatriz
Published: October 2021

Purpose

Prescriptive and predictive analytics and artificial intelligence (AI) provide tools to analyze data with objectivity. In this paper, we provide an overview of how these techniques can improve nursing care, and we detail a quantitative model to afford managerial insights about care management in a Hospital in Colombia. Our main purpose is to provide tools to improve key performance indicators for the care management of inpatients which includes the nurse workload.

Methods

The optimal nurse‐to‐patient assignment problem is addressed using analytics, lean health care, and AI. Also, we propose a new mathematical model to optimize the nurse‐to‐patient assignment decisions considering several variables about the patient state such as the Barthel index, their risks, the complexity of the care, and the mental state.

Findings

Our results show that there are several processes inherent to compassionate nursing care that can be improved using technology. By using data analytics, we can also provide insights about the high variability of the care requirements and, by using models, find nurse‐to‐patient assignments that are nearly perfectly balanced.

Conclusions

We illustrated this improvement with a pilot test that makes the equitable distribution of nursing workload the functionality of this strategy. The findings can be useful in highly complex hospitals in Latin America.

Clinical Relevance

The proposed model presents an opportunity to make near perfectly balanced nurse‐to‐patient assignments according to the number of patients and their health conditions using technology.
Effects of topical application of different molecular weight marine fish skin collagen oligopeptides on UVB‐induced photoaging rat skin
Authors: Qin Xiu‐Yuan , Xu Yaguang , Wei Ying , Zhang Rui‐Xue , Fang Lei , Zhang Hai‐Xin , Bi Yuan , Gu Rui‐Zeng
Published: October 2021

Objective

The objective of this work was to develop a peptide production process of the exact molecular weight propitious to topical application for cosmetics and to investigate the effects of enzymolysis‐derived peptide on UVB‐induced photoaging rat skin.

Methods

The chum salmon fish skins were hydrolyzed by alkaline protease and neutral protease and spray‐dried at different conditions, and three kinds of molecular weight peptide (MFSOP) were obtained. A total of 66 ICR rats (female, 20 ± 1 g) were randomly divided into eleven groups, including the normal, model, and experimental groups. The three kinds of MFSOP were dissolved at different dosages (5‰, 2.5%, and 5%) and then applied on the ICR hairless back skins prior to exposing UVB irradiation of 3000mJ/cm2 to them 4 h later. After 8 weeks, the rats were killed and the hair‐shaved skins were tested for skin moisture, hyaluronic acid, hydroxyproline, antioxidant activity, and RNA expression.

Results

Three kinds of MFSOP were obtained, with the average molecular weights of 495.16, 1194.00, and 2032.46 Dalton, respectively. The MFSOPs, especially the MFSOP of average molecular weight of 1194.00 Dalton, played an important role in the recovery of the UVB‐injured skin tissue in lock in moisture, in antioxidant activity and in promotion in collagen and elastin protein to some extent.

Conclusion

MFSOPs, especially MFSOP of average molecular weight of 1194.00 Dalton, derived from enzymolysis are potential materials to apply in cosmetics for the UVB9‐induced anti‐photoaging activity (lock in moisture, antioxidant activity, and promotion in collagen and elastin protein).
Evaluating efficacy and safety of the topical silicone gel containing onion extract in the treatment of post‐cesarean surgical scars
Authors: Napavichayanun Supamas , Vasuratna Apichai , Santibenchakul Somsook , Cherdchom Sarocha , Aramwit Pornanong
Published: October 2021

Background

Cesarean section scars are post‐surgical problems in women. Many active ingredients have been found to diminish scar formation. Clinical investigations on the onion extract have gained more attention due to its properties, such as improvement of scar appearance and texture. However, published studies evaluating the usefulness of the onion extract in the treatment of scars are controversial.

Methods

The three‐month study period followed a prospective, randomized, and double‐blinded design. Each enrolled subject's post‐cesarean completely sealed wounds were divided into two halves along the closure axis. Each half was randomly assigned to the treatment with either silicone gel containing 5% onion extract or the silicone gel containing vitamin C. All subjects were respectively evaluated at the one, two, and three months of the treatment.

Results

After the three‐month follow‐up, there was a statistically significant difference in scar improvement between before and after treatment. None of statistically significant difference in the Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS) scores and melanin value was found between silicone gel containing 5% onion extract and the control silicone gel. However, the improvement of scar erythema by treatment with the silicone gel containing 5% onion extract was significantly greater than in the control group. No adverse effects were reported in either group.
Quality of life in young adults with acne: Results of a cross‐sectional study
Authors: Singh Inder Pal , Poonia Kavita , Bajaj Kanika
Published: October 2021

Background

The impact of acne on quality of life (QoL) may vary between patients from different age groups. There are limited data in the literature on QoL of young adults with acne and acne scars.

Objectives

To assess the QoL of young adults (age 18 to 25) with acne by using dermatology life quality index (DLQI) and Cardiff acne disability index (CADI), to assess the scores of individual items on DLQI and CADI, and to compare the two scales.

Methods

In this cross‐sectional questionnaire study of 1392 subjects with acne, each subject completed two questionnaires: DLQI and CADI. Mean values of DLQI and CADI, and those of individual items on DLQI and CADI were calculated; t‐test was used for testing mean values and Spearman’s rho coefficient for correlation between two questionnaires.

Results

Mean DLQI (4.50) and CADI (3.60) scores were low. However, scores were significantly higher in females and in those with acne scars. “Feelings of embarrassment” and “interference with social activities” scored significantly higher for females across both questionnaires. There was no correlation between severity (as well as duration) of acne and HRQoL scores. Spearman’s rho coefficient of correlation between DLQI and CADI was 0.71.

Conclusions

Acne impaired the QoL of young adults, acne scars more so. Females felt worse about their appearance with greater embarrassment and impaired social activities. QoL scores seem to depend on patients’ perceptions, which may depend on factors other than objective severity of acne. We found good correlation between the two scales.
The long‐term ICU patient: Which definition?
Authors: Minton Claire , Batten Lesley , Best Amy
Published: October 2021

Aims and objectives

To offer a review of the differing terminologies used by clinicians and researchers to describe the long‐term intensive care unit (ICU) patient and the underlying propositions that align with this terminology.

Background

Ongoing medical and technological advances in emergency and intensive care have resulted in improved survival of critically ill patients in recent decades. In addition, these advancements have also resulted in improved survival of complex critically ill patients who progress to a trajectory of prolonged critical illness, having protracted stays in the ICU. There is great variability in terminology used to define the long‐term ICU patient. This lack of a common definition for long‐term ICU patients is problematic, increasing their vulnerability and risk of care not being centred about their unique needs.

Design

In this discursive article, we explore the terminology used to define the long‐term ICU patient. An initial broad search of the literature across four electronic databases was conducted to identify common terminology used to define the long‐term ICU patient. From here, seven definitions were identified and chosen for inclusion in the review as they meet inclusion criteria and clearly described a group of patients who have an extended ICU stay. The seven selected terms are as follows: prolonged mechanical ventilation; failure to wean; insertion of tracheostomy; chronically critically ill; persistent critical illness; persistent inflammatory‐immunosuppressive and catabolic syndrome; and frailty. Following this a focused review of the literature with the selected terms was conducted to explore in greater detail the terminology.

Discussion

The lack of clear definition for this patient group can potentiate their care needs being unmet. Acknowledgement of the need to clearly define this patient group is the first step to improve outcomes. Nursing is well positioned to recognise the different terminologies use to describe this group of patients and implement care to suit their unique clinical characteristics.

Conclusion and Relevance to Clinical Practice

Recognition and standardisation of these terms are an important priority to pave the way to improve care pathways and outcomes for this group of patients and their family.
Kidney injury molecule‐1 and urinary gamma‐glutamyl transferase as biomarkers of acute kidney injury in cats
Authors: Xavier Júnior F. A. F. , Morais G. B. , Silveira J. A. M. , Sampaio T. L. , Martins A. M. C. , Silva I. N. G. , Viana D. A. , Evangelista J. S. A. M.
Published: October 2021

Objectives

To evaluate the concentration of kidney injury molecule‐1 and activity of urinary gamma‐glutamyl transferase in cats with urethral obstruction and healthy cats.

Materials and Methods

Blood and urine samples were collected from a group of 15 healthy cats (control group) and a group of 20 cats with urethral obstruction at presentation, and 24 hours and 7 days after unblocking the obstruction. The serum creatinine, urinary creatinine and urinary gamma‐glutamyl transferase were measured by spectrophotometry and kidney injury molecule‐1 by the sandwich enzyme‐linked immunosorbent assay.

Results

On presentation, cats with obstruction had serum creatinine concentration and urinary gamma‐glutamyl transferase index higher than healthy cats (mean difference 544 μmol/L, 95% confidence intervals 222 to 865 μmol/L, and 0.0022 U/μmol‐uCre, 0.00043 to 0.0039 U/μmol‐uCre, respectively), urine creatinine concentration lower (mean difference 25,624 µmol/L, 17,329 to 33,919 µmol/L), and no significant difference in the kidney injury molecule‐1/urinary creatinine ratio (mean difference 13 pg/μmol‐uCre, −33 to 59 pg/μmol‐uCre). In the group of cats with urinary obstruction, over time serum creatinine decreased, urine creatinine increased, urinary gamma‐glutamyl transferase index did not change significantly, and kidney injury molecule‐1/urinary creatinine ratio increased.

Clinical Significance

Cats with post‐renal obstruction and potential intrinsic renal damage had higher urinary gamma‐glutamyl transferase index than healthy cats at the time of presentation and showed increase in kidney injury molecule‐1/urinary creatinine ratio over time.
From Person to Life: An Anthropological Examination of Primary Health Care Approach to Depression in Rio de Janeiro
Authors: Wenceslau Leandro David , Ortega Francisco
Published: October 2021

Mental illness approaches in public health have resulted in controversies around the adequacy of interpretative and therapeutic models. These controversies engage polarized debates amid understandings of mental illnesses either as brain disorders or as socioculturally determined entities. Aiming to investigate how mental health care is implemented in a Latin American metropolis, we conducted an ethnographic study of the approach to depression in a primary care unit in Rio de Janeiro between 2016 and 2017. “Life” emerged from our fieldwork as the main local category for understanding the experiences of patients with depressive symptoms and the work of reengagement performed by family physicians. With this investigation, we seek to provide insights into an approach to mental illness in primary health care that moves away from polarized interpretive frameworks and remains open to the singularities of patients’ experiences of suffering.
Post release monitoring of rehabilitated gray seal pups over large temporal and spatial scales
Authors: Sayer Sue , Allen Rebecca , Bellman Katie , Beaulieu Marion , Cooper Tamara , Dyer Natalie , Hockin Kirsten , Hockley Kate , Jarvis Dan , Jones Grace , Oaten Paul , Waddington Natalie , Witt Matthew J. , Hawkes Lucy
Published: October 2021

Wildlife rescue and rehabilitation is used globally to aid the conservation and welfare of marine species, however, postrelease monitoring is challenging. Here, long‐term, regional postrelease monitoring provides feedback for rehabilitation centers for gray seals (Halichoerus grypus). Data from 1,094 rehabilitated gray seals over 19 years across the southwest UK were examined to assess postrelease survivorship and the impact of release site on movements and range. Using flipper tags combined with photo identification, 391 rehabilitated seals (35.7%) were resighted, including 188 seals (17.2%) that were traced back to a specific rehabilitated individual with release data. The maximum monitoring duration for a single rehabilitated seal was 17 years, although the majority (151/188; 80%) were sighted for less than 5 years and 80/188 (43%) were resighted for less than a year. Almost all 188 traced rehabilitated seals (n = 176, 93.6%) visited the St Ives Bay Wild Site, yet only half had been released at the adjacent St Ives Bay Release Site. Rehabilitated seals had similar dispersal patterns to their wild conspecifics but over a smaller area. Once released, rehabilitated animals face the same threats as their wild counterparts.
Adverse events in trials of licensed drugs for irritable bowel syndrome with constipation or diarrhea: Systematic review and meta‐analysis
Authors: Barberio Brigida , Savarino Edoardo V. , Black Christopher J. , Ford Alexander C.
Published: October 2021

Background

Nocebo effects occurring in patients receiving placebo frequently impact on adverse events reported in randomized controlled trials (RCTs) in irritable bowel syndrome (IBS). Therefore, we conducted a systematic review and meta‐analysis to assess the proportion of patients randomized to placebo or active drug experiencing any adverse event in trials of licensed drugs for IBS with constipation (IBS‐C) or diarrhea (IBS‐D), and to estimate the risk of developing adverse events among patients randomized to placebo.

Methods

We searched MEDLINE, EMBASE CLASSIC and EMBASE, and the Cochrane central register of controlled trials (through June 2021) to identify RCTs comparing licensed drugs with placebo in adults with IBS‐C or IBS‐D. We generated Forest plots of pooled adverse event rates in both active drug and placebo arms and pooled risk differences (RDs) with 95% confidence intervals (CIs).

Key results

There were 21 RCTs of licensed drugs versus placebo in IBS‐C (5953 patients placebo) and 17 in IBS‐D (3854 patients placebo). Overall, 34.9% and 46.9% of placebo patients in IBS‐C and IBS‐D trials, respectively, developed at least one adverse event, with a statistically significantly higher risk of any adverse event and withdrawal due to an adverse event with active drug. In IBS‐C and IBS‐D trials, rates of each individual adverse event were generally higher with active drug. However, in IBS‐C trials, only diarrhea or headache was significantly more common with active drug (RD 0.066 (95% CI 0.043–0.088) and RD 0.011 (95% CI 0.002–0.021), respectively), and in IBS‐D trials only constipation, nausea, or abdominal pain (RD 0.096 (95% CI 0.054–0.138), 0.014 (95% CI 0.002–0.027), and 0.018 (95% CI 0.002–0.034), respectively).

Conclusions & Inferences

Patients with IBS randomized to placebo have a high risk of reporting adverse events, which might relate to both nocebo and non‐nocebo factors. Although patients’ expectations and psychosocial factors may be involved, further understanding of the mechanisms are important to control or optimize these effects in RCTs, as well as in clinical practice.
Facilitation at early growth stages results in spatial associations and stable coexistence in late growth stages of two long‐lived, dominant shrubs
Authors: Schlau Benjamin , Huxman Travis , Mooney Kailen , Pratt Jessica
Published: October 2021

While models of species coexistence largely focus on how competition defines biological communities, over recent decades, a number of studies show positive plant–plant species interactions (facilitation) can also promote stable coexistence. The long‐lived, co‐dominant shrubs California buckwheatEriogonum fasciculatumand California sagebrushArtemisia californicashare a well‐documented positive association at the habitat level in their native California coastal sage scrub ecosystem, but mechanisms underlying their interactions remain unclear at finer spatial scales. Here, a hypothesis thatE. fasciculatumacidifies CSS's alkaline soils and facilitatesA. californicathrough amelioration of alkalinity stress is tested in a greenhouse experiment and association tests in the field. Greenhouse results demonstrate facilitation at early growth stages. In late growth stages, water competition is known to determine the shrubs' interactions with each other, but here, field observations of the shrubs in late growth stages show positive associations betweenA. californicaandE. fasciculatumthat have a positive linear relationship to increasing soil pH. These results highlight the importance of understanding lifecycle‐long interactions among species in evaluating facilitation's impacts on community structure.
Efficacy and Safety of Postoperative Intravenous Tranexamic Acid in Total Knee Arthroplasty: A Prospective Randomized Controlled Study
Authors: Xue Chen‐xi , Yao Yun‐feng , Lv Hao , Cheng Li , Jing Jue‐hua
Published: October 2021

Objective

To assess the efficacy and safety of postoperative intravenous tranexamic acid (TXA) in patients undergoing total knee arthroplasty (TKA).

Methods

From March 2020 to August 2020, all patients undergoing primary unilateral TKA in our hospital were considered in prospective randomized controlled study. Included patients were randomized into three groups to receive either two doses of 15 mg/kg intravenous TXA postoperatively, at 2 and 24 h after closing the incision (group A), or a single dose of 15 mg/kg intravenous TXA 2 h postoperatively (group B), or placebo (group C). The calculated total blood loss (TBL) and hidden blood loss (HBL), incidence of venous thromboembolism (VTE), and transfusion rate were compared among groups. The levels of prothrombotic state parameters including thrombomodulin (TM), thrombin‐anti‐thrombin complex (TAT), plasmin‐anti‐plasmin complex (PIC), and tissue‐type plasminogen activator‐plasminogen activator inhibitor complex (t‐PAI·C) in plasma were measured during the perioperative period. Patients were compared depending on the Kellgren‐Lawrence classification (K‐L types III and IV).

Results

All patients were followed up for at least 4 weeks. The mean TBL and HBL in group C (1,182.45 ± 160.50; and 965.47 ± 139.61 mL, respectively) were significantly higher than those in groups A (944.34 ± 130.88 mL, P < 0.05; and 712.45 ± 129.82mL, P < 0.05, respectively) or B (995.20 ± 154.00 mL, P < 0.05; and 757.20 ± 134.39 mL, P < 0.05, respectively), but no significant differences were found between groups A and B (P > 0.05 and P > 0.05, respectively). None of the patients of three groups received blood transfusion, so there were no significant differences in blood transfusion rate among groups. Similar results were obtained with subgroups of patients who had the K‐L types III and IV. The DVT frequencies were four, three, and three in groups A, B, and C, respectively, with no significant differences after comparison (P > 0.05). There were no significant differences in the levels of prothrombotic state parameters (TM, TAT, PIC, t‐PAI·C) or incidence of VTE among groups (P > 0.05). Wound leakage was observed in five patients during the hospital stay (two patients in group A, one patient in group B, and two patients in group C), and no statistical difference was found in wound leakage or other complications among groups (P > 0.05).

Conclusions

Short‐term application of postoperative intravenous TXA in TKAs resulted in reduced HBL without a measured increase in the actual incidence of VTE or the potential risk of thrombosis, but administration of TXA after the first 24 h had no significant effect.
Microfracture of Acetabular Rim After Segmental Labral Resection to Restore the Morphology and Function of Labrum: A Retrospective Study of More than 2 Years Follow‐up
Authors: Su Tiao , Li Jing , Yang Liu , Chen Guang‐xing
Published: October 2021

Objective

To report on the clinical outcome of patients undergoing combined arthroscopic treatment of labral resection and microfracture at the rim of acetabulum at a minimum 2‐year follow‐up.

Methods

The retrospective study included 38 patients undergoing hip arthroscopy for irreparable labral injury from 24 February 2014 to 26 February 2018. Thirteen patients were excluded owing to patient refusal of participation and concomitant diseases like synovial chondromatosis and dysplasia hip. The study group consisted of patients undergoing combined arthroscopic labral resection and microfracture at the rim of acetabulum (MICRO Group: 20 patients), arthroscopic labral resection alone (RESEC Group: five patients). Postoperative three‐dimensional (3D) double‐echo steady‐state (DESS) sequence with radial imaging at 3 Tesla were obtained and fluoroscopic image of the involved hip under distraction were used to observe the restoration of vacuum effect. Patient‐reported outcome scores (PROs) including the Harris Hip Score (HHS), Visual Analogue Score (VAS), Hip Outcome Score Activities of Daily Living Subscale (HOS‐ADL), Hip Outcome Score Sport‐Specific Subscale (HOS‐SSS) were collected and compared between two groups.

Results

All patients were followed up for at least 6 months. The follow‐up time of RESEC group is longer than MICRO group (46.6 months vs 23.9 months, P < 0.05). The 3D DESS imaging demonstrated intermediate signal intensity at the relative area where the labrum resected followed by microfracture at the acetabular rim in MICRO group. Meanwhile, regrowth of labrum‐like tissue was not observed in MRI imaging of the RESEC group. Furthermore, vacuum effect was more apparent in MICRO group compared with RESEC group. All PROs in both groups showed a statistically significant improvement at follow‐up compared with preoperative levels. RESEC group: HHS (73.0 vs 93.8, P < 0.05); HOS‐ADL (51.5 vs 89.1, P < 0.05); HOS‐SSS (47.8 vs 88.3, P < 0.05); VAS (6.4 vs 2.0, P < 0.05). MICRO group: HHS (70.5 vs 91.5, P < 0.05); HOS‐ADL (52.4 vs 87.0, P < 0.05); HOS‐SSS (48.1 vs 86.5, P < 0.05); VAS (6.3 vs 1.6, P < 0.05). One patient of MICRO group had transient neurapraxias of the pudendal nerve that resolved completely by 3 months. There showed no statistically significant difference between groups regarding the preoperative and postoperative PROs.

Conclusion

Compared to labral resection, combined arthroscopic labral resection and microfracture at the rim of acetabulum is able to fulfill the labral defect area with the potential to restore the seal effect of labrum as an effective and safe option for irreparable segmental labral tears.