bluuebunny/crossref_metadata_2025 huggingface dataset:
A qualitative analysis of cancer‐related patient care in the emergency department
Authors: Lash Rebecca , Pettit Nick , Vachon Eric , Spackman Candice , Draucker Claire Burke
Published: February 2023

Objectives

Due to an increasing incidence of new cancer diagnoses in the United States and longer survivorship, a growing number of patients with cancer receive care in emergency departments (EDs). This trend places an increasing burden on already crowded EDs, and experts are concerned these patients do not receive optimal care. The purpose of this study was to describe the experiences of ED physicians and nurses who care for patients with cancer. This information can inform strategies to improve oncology care for patients in ED settings.

Methods

We used a qualitative descriptive design to summarize to the experiences of ED physicians and nurses (n = 23) caring for patients with cancer. We conducted individual, semistructured interviews to query participants about their perspectives on care for oncology patients in the ED.

Results

Physician and nurse participants identified 11 challenges and suggested three potential strategies to improve care. The challenges included the following: risk of infection, poor communication between ED staff and other providers, poor communication between oncology or primary care providers and patients, poor communication between ED providers and patients, difficult disposition decisions, new cancer diagnoses, complex pain management, allocation of limited resources, lack of cancer‐specific skills among providers, poor care coordination, and evolving end‐of‐life decisions. The solutions included the following: patient education, education for ED providers, and improved care coordination.

Conclusions

Physicians and nurses experience challenges stemming from three overarching types of factors: illness factors, communication factors, and system‐level factors. Solutions for the challenges of providing oncology care in the ED call for new strategies at the levels of the patient, provider, institution, and health care system.
Exchange‐traded fund ownership and underlying stock mispricing
Authors: Yang Joey W. , May Lewis , Gould John
Published: February 2023

In response to the increasing proliferation of exchange‐traded funds (ETFs), and a warning from the Wall Street hero Michael Burry that passive investing has put the stock market into ‘bubble’ territory, we examine the relation between stock ownership by ETFs and mispricing from 2002 to 2018. We find that increased ETF ownership induces overpricing in underlying stocks. We then identify three mechanisms for this relationship: the overpricing of stocks attributable to increased ETF ownership is stronger for stocks that experience an increase in passive ETF ownership; during periods characterised by high investor sentiment; and for illiquid stocks. Our results are robust to a battery of tests including alternative measures for all key variables and are not confounded by the global financial crisis. Additional analyses show that mispricing caused by ETF ownership change is not driven by firm fundamentals and does not exacerbate stocks' information environment around earnings announcement.
A critique of the Australian National Health and Medical Research Council CEO statement on electronic cigarettes
Authors: Mendelsohn Colin P. , Hall Wayne , Borland Ron , Wodak Alex , Beaglehole Robert , Benowitz Neal L. , Britton John , Bullen Chris , Etter Jean‐François , McNeill Ann , Rigotti Nancy A.
Published: February 2023

This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e‐cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping because it exaggerates the risks of vaping and fails to compare them to the far greater risks of smoking; it uncritically accepts evidence of harms from e‐cigarettes while adopting a highly sceptical attitude towards evidence of their benefits; it incorrectly claims that the association between adolescent vaping and subsequent smoking is causal; and it understates the evidence of the benefits of e‐cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect and misapplies the precautionary principle. Several sources of evidence supporting our assessment were published after the NHMRC Statement's publication and are also referenced. The NHMRC Statement on e‐cigarettes does not present a balanced assessment of the available scientific literature and fails to meet the standard expected of a leading national scientific body.
Cumulative family stress and externalizing problems: Secure base script knowledge as a protective factor
Authors: Houbrechts Melisse , Bijttebier Patricia , Calders Filip , Goossens Luc , Van Leeuwen Karla , Van Den Noortgate Wim , Bosmans Guy
Published: February 2023

The current study examined whether secure base script knowledge can buffer against higher concurrent externalizing problems and against relative increases in externalizing problems associated with cumulative family stress. We conducted a one‐year longitudinal study with two waves between 2017 and 2019 in which 272 Dutch‐speaking Western European children from Flanders (47.8% boys, ) participated. Secure base script knowledge was associated with lower concurrent externalizing problems (f2 = 0.03). High levels of secure base script knowledge also buffered against relative increases in externalizing problems associated with cumulative family risk (f2 = 0.02). These findings suggest that secure base script knowledge can mitigate the negative effects of a stressful family environment on externalizing problems.
Assessment of the content and quality of YouTube videos related zygomatic implants: A content–quality analysis
Authors: Yildirim Gulhan , Kocaelli Humeyra Arıkan
Published: February 2023

Introduction

This study aimed to evaluate the content and quality of YouTube videos of zygomatic implants.

Methods

According to Google Trends (2021), “zygomatic implant” was the most preferred keyword related to the topic. Therefore, in this study “zygomatic implant” was used as a keyword for the video search. Demographic characteristics such as the number of views, likes/dislikes, comments, video duration, number of days after upload, uploaders, and target audiences of the videos were evaluated. To evaluate the accuracy and content quality of videos (available from YouTube), the video information and quality index (VIQI) and global quality scale (GQS) were used. Statistical analyses were performed using the Kruskal–Wallis test, Mann–Whitney U test, chi‐square test, Fisher's exact chi‐square test, Yates continuity correction, and Spearman correlation analysis (p < 0.05).

Results

A total of 151 videos were searched; 90 met all inclusion criteria. According to the video content score, 78.9% of the videos were identified as low content, 20% as moderate, and 1.1% as high content. There was no statistical difference between the groups in video demographic characteristics (p > 0.001). Conversely, information flow, accuracy of information, video quality and precision, and total VIQI scores were statistically different between the groups. The moderate‐content group had a higher GQS score than the low‐content group (p < 0.001). The videos were mainly uploaded (40%) from hospitals and universities. Most videos were targeted toward professionals (46.75%). Low‐content videos had higher ratings than the moderate‐ and high‐content videos.

Conclusions

Most YouTube videos on zygomatic implants showed low‐content quality. This implies that YouTube is not a reliable source of information on zygomatic implants. Dentists, prosthodontists, and oral and maxillofacial surgeons should be aware of the content of video‐sharing platforms and take responsibility for enriching video content.
Exponential growth bias in the prediction of COVID‐19 spread and economic expectation
Authors: Banerjee Ritwik , Majumdar Priyama
Published: February 2023

Exponential growth bias (EGB) is the pervasive tendency of people to perceive a growth process as linear when in fact it is exponential. We document that people exhibit EGB when asked to predict the number of COVID‐19 positive cases in the future. Using four experimental interventions, we examine the effect of EGB on expectations about future macroeconomic conditions, and investment choices in risky assets. In the first intervention (Step), participants make predictions in several short steps; in the second and third treatments (Feedback‐N and Feedback‐G), participants are given feedback about their prediction errors in the form of either numbers or graphs; and in the fourth treatment (Forecast), participants are offered a forecast range of the future number of cases, based on a statistical model. We find that Feedback‐N, Feedback‐G and Forecast significantly reduce EGB relative to Step. A reduction in the bias, through the interventions, also decreases risky investment and helps to moderate future economic expectations. The results suggest that nudges, such as behaviourally informed communication strategies, that correct EGB can also help to rationalize economic expectations.
Management as ideology: “New” managerialism and the corporate university in the period of Covid‐19
Authors: Al Mahameed Muhammad , Yates David , Gebreiter Florian
Published: February 2023

In this paper, we examine how Covid‐19 was utilized by the management of a university as a catalyst for ideological change, with the objective of transforming the ethos of a university management school and the role(s) of the academics employed within. Through new modes of working that maintained corporeal distance between university staff, market‐based ideology was mobilized to institute radical and lasting change within the roles of academics and operations of the institution. We focus on a singular case study: “Blue Management School” (BMS, pseudonym), based within an English mid‐tier research university which has historically embraced corporatization more readily than most of its peers. We conducted a qualitative analysis of management email communications and from interviews with nine academics (both current and former employees) who were working at BMS during the time concerned (March 2020 onward). We observe that Covid‐19 posed significant challenges to corporatized universities, and that university managers at BMS sought to address these challenges by undertaking further steps toward corporatization and mobilizing organizational change legitimized by the need to manage the Covid‐19 situation. This included hierarchical forms of accountability, with academics answering for module content to teaching convenors and the management team (“manager academics”). We draw attention to how management communications carried profound effects for the mobilization of ideological change within the institution, during this period. In addition, academic identity was affected, moving away from traditional research and teaching scholars toward revenue‐generating customer service workers, facilitating a power shift away from academics and further toward managers.
Feeling clumsy and curious. A collective reflection on experimenting with poetry as an unconventional method
Authors: van Amsterdam Noortje , van Eck Dide , Kjær Katrine Meldgaard , Leclair Margot , Theunissen Anne , Tremblay Maryse , Thomson Alistair , Lafaire Ana Paula , Brown Anna , Quental Camilla , De Coster Marjan , Pullen Alison
Published: February 2023

In this paper, we offer a collective, multi‐vocal reflection on using poetry for research purposes. These were reflections on an online sub‐plenary session organized as a workshop, which was held at the European Group for Organization Studies conference in 2021. During this workshop, the first three authors presented a step‐by‐step method for doing poetic inquiry and invited participants to apply it to their own empirical data or research praxis. The method was created in response to the marginalization of affect and embodiment in mainstream research in organization studies. Poetic inquiry aims to formulate specific practices of “writing differently” that assist researchers in their attempts to analyze and articulate their findings in embodied and affective ways. In this paper, we describe the method and bring together multi‐vocal reflections from the participants and organizers of the workshop on the affects of poetic inquiry and the (ethical) questions that it poses.
Landscape type affects the functional diversity of carabid beetles in agricultural landscapes
Authors: Deppe Franziska , Fischer Klaus
Published: February 2023

Agricultural intensification and expansion has been suggested to be a major driver of the loss of biodiversity and associated ecosystem services. Recent studies have shown that landscape‐level effects in addition to on‐site management are of significant importance for insect declines.

We here compared carabid beetle (Coleoptera, Carabidae) assemblages of wet meadows among three pairs of highly fragmented ‘modern’ and less fragmented ‘traditional’ agricultural landscapes, using pitfall trapping.

Taxonomic diversity and abundance of Carabidae did not differ between modern and traditional landscapes, whereas the proportions of brachypterous, large‐bodied, and habitat specialist species were lower in modern compared to traditional landscapes.

These results suggest that landscape type affects functional rather than taxonomic carabid beetle diversity, based on species turnover.

To preserve functional diversity in agricultural landscapes, conservation strategies should consider the landscape level in addition to on‐site management, by securing connectivity between remnants of semi‐natural habitats.
Estimating inbreeding rate and effective population size in the Finnish Ayrshire population in the era of genomic selection
Authors: Sarviaho Katri , Uimari Pekka , Martikainen Katja
Published: February 2023

Genomic selection has been applied in dairy cattle breeding over the last decade. Using genomic information may speed up genetic gain as breeding values can be predicted reasonably accurately directly after birth. However, genetic diversity may decrease if the inbreeding rate per generation increases and the effective population size decreases. Despite many positive qualities of the Finnish Ayrshire, for example, high average protein yield and fertility, over time the breed has lost its place as the most common dairy breed in Finland. Thus, maintaining the genetic variability of the breed is becoming more important. The aim of our research was to estimate the impact of genomic selection on inbreeding rate and effective population size using both pedigree and genomic data. The genomic data included 46,914 imputed single nucleotide polymorphism (SNP) variants from 75,038 individuals, and the pedigree data included 2,770,025 individuals. All animals in the data were born between 2000 and 2020. Genomic inbreeding coefficients were estimated as the proportion of SNPs in runs of homozygosity (ROH) out of the total number of SNPs. The inbreeding rate was estimated by regressing the mean genomic inbreeding coefficients on birth years. Effective population size was then estimated based on the inbreeding rate. Additionally, effective population size was estimated from the mean increase in individual inbreeding using pedigree data. Introduction of genomic selection was assumed to have taken place gradually; years 2012–2014 were treated as a transition period from the traditional phenotype‐based breeding value estimation to genomic‐based estimation. The median length of the identified homozygous segments was 5.5 Mbp, and a slight increase in the proportion of segments over 10 Mbp was observed after 2010. The inbreeding rate decreased from 2000 to 2011 and subsequently increased slightly. The pedigree‐ and genomic‐based estimates of inbreeding rate were similar to each other. The estimates of effective population size based on the regression method were very sensitive to the number of years considered; thus, the estimates were not very reliable. The effective population size estimated from the mean increase in individual inbreeding reached its highest value of 160 in 2011 and decreased to 150 after that. In addition, the generation interval in the sire path has decreased from 5.5 years to 3.5 years after genomic selection was implemented. Based on our results, after the implementation of genomic selection, the proportion of long ROH stretches has increased, the generation interval in the sire path has decreased, the inbreeding rate has increased and the effective population size has decreased. However, the effective population size is still at a good level, allowing for an efficient selection scheme in the Finnish Ayrshire breed.
Tumescent local anaesthesia for the surgical therapy of congenital nevi in the first year of life
Authors: Kofler Katrin , Häfner Hans‐Martin , Kofler Lukas
Published: February 2023

Background

The indication for surgical treatment of congenital nevi must be made after individual consideration of the expected benefit and risk and requires careful information of the parents as well as interdisciplinary psychological support. In addition to suspected malignancy, a relevant indication is the risk of stigmatization depending on the size and localization of the nevus. Objective was to show which size reduction of the congenital nevus can be achieved by surgical therapy under tumescent local anaesthesia (TLA) in infancy and how often complications of anaesthesia or surgery occur.

Methods

All infants up to 12 months of age who underwent surgery for a congenital nevus under TLA at the University Dermatological Clinic Tuebingen between January 2015 and December 2021 were included; surgeries were performed using serial excisions (powerstretching technique), whereby the incisions were made inside the nevus and mobilization was strictly limited to the skin side without nevus.

Results

Overall, a cumulative total area of 38.65 cm2 could be removed on average within the first year of life (trunk: 67 cm2, head: 21.2 cm2, legs: 21.6 cm2, arms: 13.2 cm2). A cumulative maximum area reduction of 406.9 cm2 could be achieved. We evaluated 363 surgical sites (123 children) on all body regions. The median age of the children at the first surgery was 3.5 months (0.46–10.7 months). Complications occurred in 2.3% (seven procedures). All these complications were reversible in the course of the operation and did not lead to a prolonged hospital stay. No anaesthesia‐related complications occurred.

Conclusion

We were able to show that a reduction of large areas of congenital nevi is possible in the first year of life with the combination of serial excisions using powerstretching technique, TLA, and intracutaneous butterfly sutures.
Effect of ultrasound pretreatment and microwave vacuum drying in the production of dried poniol fruit
Authors: Dash K. K. , Boro Sibo , Bhagya Raj G. V. S.
Published: February 2023

This study suggested a combination of microwave and vacuum drying to meet the requirements of preserving the nutritional content of fresh poniol fruit, consuming lower energy, and having a faster drying rate. In this study, the influence of microwave power, vacuum level, and citric acid pretreatment level on the product quality of dried poniol was analyzed. The citric acid pretreatment was conducted in an ultrasonicator bath. The pretreated was dried by changing the microwave power () from 400 to 800 W and the vacuum level () from 300 to 600 mmHg. The quality of the dried product was analyzed in terms of total phenolic content (), antioxidant activity (), total change in color (), and rehydration ratio () of dried poniol fruit. The response range in the sequence was between 22.219–38.361 mg GAE/g, 69.037–92.578 %DPPH inhibition, 23.451–40.148, and 1.38–3.81, respectively, at various combinations of independent variables. The optimal combination of independent variables for maximal recovery of total phenolic content, antioxidant activity, rehydration ratio, and minimal color changes was obtained at 440 W power level, 600 mmHg vacuum, and pretreated with citric acid of concentration .8%. Under the optimum combination of independent variables, the total phenolic content, antioxidant activity, rehydration ratio, and total color change values were 37.904 mg GAE/g, 92.973%, 23.906, and 3.307, respectively. Because of the low temperature in the vacuum process combined with the rapid heating time of microwaves, the results indicate that microwave vacuum drying might be a viable alternative method for improving the quality of dried food products.

Practical Applications

Microwave vacuum drying is a technology that uses microwave radiation to generate heat in the absolute pressure range between the triple point of water and atmospheric pressure. Heat is generated in microwave vacuum drying by directly converting electromagnetic energy into kinetic molecular energy. Hence, heat is generated deep inside the product being dried. Because interior temperatures are greater than exterior temperatures, evaporating water is driven to the surface, resulting in higher partial pressure. As a result, the moisture evaporating within the product is released through the pore structure of the macro‐capillary system of the solid material, resulting in a faster drying rate. Since the superficial layer does not dry out completely, the surfaces remain porous. This method results in a superior end product that is also very nutritious with enhanced sensory properties. As a result, this approach is used in the chemical, pharmaceutical, and food industries.
Application of sentinel lymph node mapping in endometrial cancer: A survey among Chinese gynecological oncologists
Authors: Song Nan , Zheng Hong , Gao Yunong , Gao Min
Published: February 2023

Aim

To gain a better understanding of the use of sentinel lymph node mapping by Chinese oncologists for endometrial cancer staging and analyze factors influencing its application.

Methods

Questionnaires were collected online before and by phone after the symposium to evaluate the general characteristics of oncologists who participated in the endometrial cancer seminar and factors associated with the application of sentinel lymph node mapping in endometrial cancer patients.

Results

Gynecologic oncologists from 142 medical centers participated in the survey. 35.4% of doctors employed sentinel lymph node mapping for endometrial cancer staging, 57.3% chose indocyanine green as the tracer. Multivariate analysis revealed that cancer research center (odds ratio = 4.229, 95% CI 1.747–10.237), physician familiarity with sentinel lymph node mapping (odds ratio = 126.188, 95% confidence interval 43.220–368.425) and the use of ultrastaging (odds ratio = 2.657, 95% confidence interval 1.085–6.506) were related to the doctors' selection of sentinel lymph node mapping. There was a significant difference in the surgical procedure for early endometrial cancer, the number of removed sentinel lymph node, and the reason for not adopting sentinel lymph node mapping before and after the symposium.

Conclusions

The theoretical knowledge of sentinel lymph node mapping, the use of ultrastaging, and cancer research center are related to a higher acceptance of sentinel lymph node mapping. Distance learning is conducive to the promotion of this technology.
A Tapestry of Edgelands: Defining Carceral Edgeland(s) in Masafer Yatta (Firing Zone 918)
Authors: Gandolfo Luisa
Published: February 2023

The carceral edgeland occupies a unique position. At times, it is acknowledged; at others, it remains unseen by those outside its boundaries. In cases where the edgeland is architectural, such as a prison or a detention center, it can prompt viewers to consider the power dynamics exercised within. This article, however, is concerned with the possibilities for the edgeland to be moveable and embodied. Focusing on the transformation of the area of Masafer Yatta in the occupied West Bank into a military training zone, the article shifts the discourse from the connection between the edgeland and the symbolic power of carceral architecture to suggest alternative carceral edgelands: the occupying edgeland, wherein the moveable and embodied converge to form a tapestry of edgelands. The Israeli military presence varies in intensity, yet the result is the realization of Achille Mbembe's ‘infrastructural warfare’ (2003) that manifests through the moveable edgeland, and second, the embodied edgeland that is enacted by the military personnel who symbolize the state. In Masafer Yatta, the army's long‐term presence has had an impact on the communities that evokes Lauren Berlant's ‘political depression’ (2011). Building on Paul Farley and Michael Symmons Roberts' recognition of multitudinous edgelands (2012), this article suggests that there can be multiple carceral edgelands at one site, all of which facilitate exclusion and political depression through enclosure, whether through fences, walls, or moveable checkpoints.
Neuroimaging features of FOXR2‐activated CNS neuroblastoma: A case series and systematic review
Authors: Shimazaki Kenichiro , Kurokawa Ryo , Franson Andrea , Kurokawa Mariko , Baba Akira , Bou‐Maroun Laura , Kim John , Moritani Toshio
Published: February 2023

Background and Purpose

CNS neuroblastoma, FOXR2‐activated (CNS NB‐FOXR2) is a newly recognized tumor type in the 2021 World Health Organization classification of central nervous system (CNS) tumors. We aimed to investigate the clinical and neuroimaging findings of CNS NB‐FOXR2 and systematically review previous publications and three new cases.

Methods

We searched PubMed, SCOPUS, and Embase databases for patients with pathologically proven CNS NB‐FOXR2 with sufficient information for preoperative CT and MRI findings. Two board‐certified radiologists reviewed the studies and imaging data.

Results

Thirty‐one patients from six previous publications and 3 patients from our hospital comprised the study population (median age, 4.2 [range: 1.4‐16] years; 19 girls). Clinically, CNS NB‐FOXR2 mainly affected children between 2 and 6 years (24/34, 67.6%). Nausea/vomiting and seizures were reported as the main presenting symptoms (100% in total). The tumors frequently showed hyperdensity compared to the cortex on nonenhanced CT (4/5, 80%) with calcification along the inner rim of the tumor (4/5, 80%). More than half of patients showed susceptibility artifacts indicating intratumoral hemorrhage and/or calcification (15/28, 53.6%) on T2*‐ and/or susceptibility‐weighted imaging. Elevated relative cerebral blood volume and flow and percentile signal recovery were observed in one case with dynamic susceptibility contrast MRI.

Conclusions

Characteristic imaging features including hyperdense attenuation of the solid components and calcification along the inner rim on CT and susceptibility‐weighted imaging may assist with preoperative diagnosis of CNS NB‐FOXR2 in pediatric patients.
The Way to Spend a Workday Matters in School Principals' Somatic and Psychological Discomfort
Authors: Ning Bo , Li Jiayang , Vandecandelaere Machteld , Liu Hongqiang
Published: February 2023

BACKGROUND

School principals usually have to sacrifice health and family obligations to obtain sufficient work time. This study investigates school principals' somatic and psychological discomfort related to their time allocation to diverse work contexts and life domains, so as to test the optimal allocation of time to each context and domain.

METHODS

This study is based on survey data of 347 school principals, from the preexisting 2021 Survey of School Teachers' Living Conditions in Shanghai. Generalized linear regression modeling was adopted to analyze the data according to the research purpose.

RESULTS

This study finds that school principals' daily time spent on work at home, sleep, breakfast, exercise, and family obligations significantly predict their somatic or psychological discomfort. However, their time spent on work at school, daytime napping, lunch, and dinner are not of significance.

CONCLUSIONS

This study reveals several unhealthy ways of working and lifestyle habits among school principals from a perspective of time allocation, such as extended periods working at home, sleep deficits, hurried breakfast, lack exercise, and failure to meet familial obligations.
Paternal sleep deprivation induces metabolic perturbations in male offspring via altered LRP5 DNA methylation of pancreatic islets
Authors: Zeng Yi , Zhang Zhen , Liang SiTing , Chang XinMiao , Qin RuiJie , Chen Hong , Guo LiXin
Published: February 2023

Diabetes and metabolic perturbation are global health challenges. Sleep insufficiency may trigger metabolic dysregulation leading to diabetes. However, the intergenerational transmission of this environmental information is not clearly understood. The research objective was to determine the possible effect of paternal sleep deprivation on the metabolic phenotype of the offspring and to investigate the underlying mechanism of epigenetic inheritance. Male offspring of sleep‐deprived fathers exhibit glucose intolerance, insulin resistance, and impaired insulin secretion. In these SD‐F1 offspring, a reduction in beta cell mass and proliferation of beta cells were observed. Mechanistically, in pancreatic islets of SD‐F1 offspring, we identified alterations in DNA methylation at the promoter region of the LRP5 (LDL receptor related protein 5) gene, a coreceptor of Wnt signaling, resulting in downregulation of downstream effectors cyclin D1, cyclin D2, and Ctnnb1. Restoration of Lrp5 in the pancreas of SD‐F1 male mice could improve impaired glucose tolerance and expression of cyclin D1, cyclin D2, and Ctnnb1. This study might significantly contribute to our understanding of the effects of sleeplessness on health and metabolic disease risk from the perspective of the heritable epigenome.
Associations between actigraphy‐derived rest–activity rhythm characteristics and hypertension in United States adults
Authors: Yeung Chris Ho Ching , Bauer Cici , Xiao Qian
Published: February 2023

People with disrupted circadian rhythms, such as shift workers, have shown a higher risk of hypertension. However, it is unclear whether more subtle differences in diurnal rest–activity rhythms in the population are associated with hypertension. Clarifying the association between the rest–activity rhythm, a modifiable behavioural factor, and hypertension could provide insight into preventing hypertension and possibly cardiovascular diseases. In this study, we investigated the association between rest–activity rhythm characteristics and hypertension in a large representative sample of United States adults. Cross‐sectional data were obtained from the National Health and Nutrition Examination Survey 2011–2014 (N = 6726; mean [range] age 49 [20–79] years; 52% women). Five rest–activity rhythm parameters (i.e., pseudo F statistic, amplitude, mesor, amplitude:mesor ratio, and acrophase) were derived from 24‐h actigraphy data using the extended cosine model. We performed multiple logistic regression to assess the associations between the rest–activity rhythm parameters and hypertension. Subgroup analysis stratified by age, gender, race/ethnicity, body mass index and diabetes status was also conducted. A weakened overall rest–activity rhythm, characterised by a lower F statistic, was associated with higher odds of hypertension (odds ratio quintile 1 versus quintile 5 [OR Q1vs.Q5 ] 1.61, 95% confidence interval [CI] 1.26–2.05; p trend < 0.001). Similar results were found for lower amplitude (OR Q1vs.Q5 1.51, 95% CI 1.13–2.03; p trend = 0.01) and amplitude:mesor ratio (OR Q1vs.Q5 1.34, 95% CI 1.01–1.78; p trend = 0.03). The results were robust to the adjustment of confounders, individual behaviours including physical activity levels and sleep duration and appeared consistent across subgroups. Possible interaction between the rest–activity rhythm and body mass index was found. Our results support an association between weakened rest–activity rhythms and higher odds of hypertension.
Susceptibility to hepatitis B virus infection in adults living in Spain
Authors: Soriano Vicente , Aguilera Antonio , Benito Rafael , González‐Díez Rocío , Miró Elisenda , Liendo Paloma , Rodríguez‐Diaz Juan Carlos , Cabezas Teresa , Richart Alberto , Ramos José Manuel , Barea Luisa , Álvarez Carmen , Treviño Ana , Gómez‐Gallego Félix , Corral Octavio , de Mendoza Carmen
Published: February 2023

Background

A protective hepatitis B virus (HBV) vaccine has been available for four decades. Universal HBV vaccination of infants is recommended by the WHO since the 1990s. Furthermore, HBV immunization is advised for all adults with high‐risk behaviours and no seroprotection. However, HBV vaccine coverage remains globally suboptimal. The advent of new more efficacious trivalent HBV vaccines has renewed the interest in HBV vaccination. At present, the extent of current HBV susceptibility in adults remains unknown in Spain.

Methods

HBV serological markers were assessed on a large and representative sample of adults in Spain, including blood donors and individuals belonging to high‐risk groups. Serum HBsAg, anti‐HBc and anti‐HBs were tested in specimens collected during the last couple of years.

Results

From 13 859 consecutive adults tested at seven cities across the Spanish geography, overall 166 (1.2%) had positive HBsAg. Past HBV infection was recognized in 14% and prior vaccine immunization in 24%. Unexpectedly, 37% of blood donors and 63% of persons belonging to high‐risk groups had no serum HBV markers and therefore were potentially HBV susceptible.

Conclusion

Roughly 60% of adults living in Spain seem to be HBV susceptible. Waning immunity might be more common than expected. Hence, HBV serological testing should be performed at least once in all adults regardless of risk exposures. HBV vaccine full courses or boosters should be administered to all adults lacking serological evidence of HBV protection.
Breastfeeding sick children in hospital: Exploring the experiences of mothers in UK paediatric wards
Authors: Hookway Lyndsey , Brown Amy , Grant Aimee
Published: February 2023

There is a paucity of literature exploring the challenges of breastfeeding sick children in hospital. Previous research has focused on single conditions and hospitals which limits understanding of the challenges in this population. Although evidence suggests that current lactation training in paediatrics is often inadequate, it is unclear where the specific training gaps are. This qualitative interview study of UK mothers aimed to explore the challenges of breastfeeding sick infants and children on a paediatric ward or paediatric intensive care unit. From 504 eligible respondents, a sample of 30 mothers of children aged 2–36 months with various conditions and demographic backgrounds was purposively chosen, and a reflexive thematic analysis undertaken. The study identified previously unreported impacts such as complex fluid needs, iatrogenic withdrawal, neurological irritability and changes to breastfeeding behaviour. Mothers described breastfeeding as emotionally and immunologically meaningful. There were many complex psychological challenges such as guilt, disempowerment, and trauma. Wider struggles such as staff resistance to bedsharing, inaccurate breastfeeding information, lack of food and inadequate breast pump provision made breastfeeding more challenging. There are numerous challenges related to breastfeeding and responsively parenting sick children in paediatrics, and these also impacted maternal mental health. Staff skill and knowledge gaps were widespread, and the clinical environment was not always conducive to supporting breastfeeding. This study highlights strengths in clinical care and provides insight into what measures are perceived as supportive by mothers. It also highlights areas for improvement, which may inform more nuanced paediatric breastfeeding standards and training.
Secondary invasive fungal infection in hospitalised patients with COVID‐19 in the United States
Authors: Thompson George R. , Miceli Marisa H. , Jiang Jeanette , Shortridge Emily F. , Davies Kalatu , Gurumoorthy Giridharan , Kimura Tomomi
Published: February 2023

Background

Invasive fungal infections (IFIs) have been identified as a complication in patients with Coronavirus disease 2019 (COVID‐19). To date, there are few US studies examining the excess humanistic and economic burden of IFIs on hospitalised COVID‐19 patients.

Objectives

This study investigated the incidence, risk factors, clinical and economic burden of IFIs in patients hospitalised with COVID‐19 in the United States.

Patients/Methods

Data from adult patients hospitalised with COVID‐19 during 01 April 2020–31 March 2021 were extracted retrospectively from the Premier Healthcare Database. IFI was defined either by diagnosis or microbiology findings plus systemic antifungal use. Disease burden attributable to IFI was estimated using time‐dependent propensity score matching.

Results

Overall, 515,391 COVID‐19 patients were included (male 51.7%, median age: 66 years); IFI incidence was 0.35/1000 patient‐days. Most patients did not have traditional host factors for IFI such as hematologic malignancies; COVID‐19 treatments including mechanical ventilation and systemic corticosteroid use were identified as risk factors. Excess mortality attributable to IFI was estimated at 18.4%, and attributable excess hospital costs were $16,100.

Conclusions

Invasive fungal infection incidence was lower than previously reported, possibly due to a conservative definition of IFI. Typical COVID‐19 treatments were among the risk factors identified. Furthermore, diagnosis of IFIs in COVID‐19 patients may be complicated because of the several non‐specific shared symptoms, leading to underestimation of the true incidence rate. The healthcare burden of IFIs was significant among COVID‐19 patients, including higher mortality and greater cost.
Phylogenetic structure of the extinction and biotic factors explaining differential survival of terrestrial notosuchians at the Cretaceous–Palaeogene crisis
Authors: Aubier Paul , Jouve Stéphane , Schnyder Johann , Cubo Jorge
Published: February 2023

Although the clade Crocodylomorpha is represented by few extant species (Crocodylia), it has a rich fossil record. Hundreds of species, adapted to terrestrial, semi‐aquatic and marine environments, have existed over more than 200 million years. Numerous studies have attempted to characterize the factors driving the diversification and extinction events of Crocodylomorpha, resulting in ambiguous and even contradictory conclusions, which points to the need for phylogenetically and temporally smaller‐scaled studies. Here, we focus on differential survival at the Cretaceous–Palaeogene (K–Pg) crisis of Notosuchia, a diverse clade of mostly terrestrial Crocodylomorpha that achieved great diversity during the Cretaceous. More precisely, we tested the effect of body size and palaeotemperatures on notosuchian survival probability during the K–Pg crisis as well as the effect of diet on the evolution of their body size. We find that Notosuchia showed an evolutionary trend towards larger body sizes through time, associated with a shift from an omnivorous to a carnivorous diet. This may explain why sebecids were the only notosuchians to survive the K–Pg crisis. We also corroborate the conclusions of previous studies that detected a Lagerstätten effect occurring in the Adamantina Formation (Upper Cretaceous, Brazil, Bauru Group). This work confirms the value of more finely‐scaled macroevolutionary studies for understanding the history of a rich and complex group such as Crocodylomorpha.
Baby boomers in Europe: demography, socioeconomic and health status, and oral health needs
Authors: Kossioni Anastassia E.
Published: February 2023

The European countries are aging fast. Baby boomers in Europe constitute a diverse population group with several differences in life events and living conditions. The fiscal effects of the aging of European population have led to changes in policies and legislation that largely affect the lives of baby boomers necessitating an increase in their working lives. Furthermore, reforms are planned in the existing health and long‐term care systems.

Although some baby boomers in Europe face chronic medical conditions, the majority perceive their general health as good or very good. However, approximately one quarter have reported unmet needs for medical care, mainly due to cost or long waiting lists with large variability among different countries.

The oral health of baby boomers has improved compared to previous generations particularly related to tooth loss. However, older groups in many countries face an increase in dental caries and periodontal disease. Some baby boomers may enter very old age with many natural teeth, functional impairment, limited ability to perform oral hygiene and an increased demand for more complex dental care as well as domiciliary care. However, in contrast to medical care, dental expenses in Europe are mainly financed with out‐of‐pocket payments while domiciliary dental care is rarely provided leading to unmet dental care needs for the most vulnerable individuals.

Educational interventions for all healthcare professionals, as well as formal and informal carers and the public are required, and appropriate policies and legislations are needed to promote the oral health of the aging European population.
Health literacy and uptake of annual physical checkups among emerging adults in the United States: Findings from the Behavioral Risk Factor Surveillance System
Authors: Alawode Oluwatobi A. , Nicholson Harvey L.
Published: February 2023

Public health literature is replete with evidence on the determinants of preventive healthcare utilization. However, gap exists in the relationship between health literacy, a key social determinant of health, and annual physical checkups, especially among younger adults in the United States. This age group is one of the least likely to utilize such services for screening and prevention of diseases, which can have a significant impact on their long‐term health as they progress through the life course. Using the Andersen Healthcare Utilization framework, this study investigated the association between health literacy, an enabling factor, and uptake of annual physical checkups among emerging adults aged 18–29. A binary logistic regression model was employed to achieve the study objective using data from the 2016 Behavioral Risk Factor Surveillance System data (N = 9515). Findings showed that 61% of young adults had physical checkups in the past year. After adjusting for predisposing, need, and other enabling factors, experiencing difficulties with oral and written health literacy and having difficulties obtaining medical information and advice were significantly associated with lower odds of physical checkups in the past year. These findings provide evidence for strategies like Healthy People 2030 that aim to increase preventive healthcare service utilization among emerging adults.
The consumption of ritual and the changing values of filial piety in ancestor worship
Authors: Cao Meng
Published: February 2023

Ancestor worship is regarded as the key element of the Han people's belief system across most of China. However, the rituals pertaining to death, such as in funerals and annual ancestor worship, vary from place to place. For decades, the state has made tremendous efforts to reform and standardise funerals consistent with its path to modernization by insisting on more socialist practices rather than those that are perceived as ‘superstitious’ and ‘irrational’, such as burning paper and incense or performing rituals. I argue that despite regulating the use of funeral materials or memorial types, the state has failed to reform the essence of death rituals, that is, the duty of filial piety and people's conception of the afterlife. In addition, funerals and other rituals related to death contribute to individual's social reputation.
Using trends and outliers in managing delayed transfusions
Authors: Bahar Burak , Gehrie Eric A. , Mo Yunchuan D. , Jacquot Cyril , Delaney Meghan
Published: February 2023

Objectives

To investigate if time to initiate a blood transfusion after an informative laboratory test could feasibly be used by the transfusion medicine service as a metric to monitor for transfusion delays.

Background

Delayed transfusions may result in patient morbidity and mortality, but no standards for timely transfusion have been developed. Information technology tools could be implemented to identify gaps in provision of blood and to recognise areas of improvement.

Materials and Methods

Data obtained from a children's hospital's data science platform and time from the release of laboratory results to the initiation of transfusions were calculated and weekly medians were used for trend analyses. Outlier events were obtained using locally estimated scatterplot smoothing and generalised extreme studentized deviate test.

Results

Overall, the number of outlier events on the timing of transfusions based on patients' haemoglobin level and platelet count were small (n = 1 and n = 0 for 139 weeks, respectively). Investigation of these events for adverse clinical outcomes was non‐significant.

Conclusions

Herein, we propose that the trends and outlier events could be further investigated and used to make decisions and implement protocols to improve patient care.
Polymorphism of glutathione S‐transferase P1 of dogs with mammary tumours
Authors: Fedets Oleh M. , Dmytruk Kostyantyn V. , Adaszek Lukasz , Kurlyak Iryna M. , Dmytruk Olena V. , Lisiecka Urszula , Winiarczyk Stanislaw
Published: February 2023

Mammary tumours constitute more than half of neoplasms in female dogs from different countries. Genome sequences are associated with cancer susceptibility but there is little information available about genetic polymorphisms of glutathione S‐transferase P1 (GSTP1) in canine cancers. The aim of this study was to find single nucleotide polymorphisms (SNPs) in GSTP1 of dogs (Canis lupus familiaris) with mammary tumours compared to healthy dogs and to determine the association between GSTP1 polymorphisms and the occurrence of these tumours. The study population included 36 client‐owned female dogs with mammary tumours and 12 healthy female dogs, with no previous diagnosis of cancer. DNA was extracted from blood and amplified by PCR assay. PCR‐products were sequenced by Sanger method and analysed manually. The 33 polymorphisms were found in GSTP1: 1 coding SNP (exon 4), 24 non‐coding SNPs (9 in exon 1), 7 deletions and 1 insertion. The 17 polymorphisms have been found in introns 1, 4, 5 and 6. The dogs with mammary tumours have significant difference from healthy in SNPs I4 c.1018 + 123 T > C (OR 13.412, 95%CI 1.574–114.267, P = .001), I5 c.1487 + 27 T > C (OR 10.737, 95%CI 1.260–91.477, P = .004), I5 c.1487 + 842 G > C (OR 4.714, 95% CI 1.086–20.472, P = .046) and I6 c.2481 + 50 A > G (OR 12.000, 95% CI 1.409–102.207, P = .002). SNP E5 c.1487 T > C and I5 c.1487 + 829 delG also differed significantly (P = .03) but not to the confidence interval. The study, for the first time, showed a positive association of SNPs in GSTP1 with mammary tumours of dogs, that can possibly be used to predict the occurrence of this pathology.
Novel Insights into the Molecular Mechanisms Underlying Robustness and Stability in Probiotic Bifidobacteria
Authors: Schöpping Marie , Goel Anisha , Jensen Kristian , Faria Ricardo Almeida , Franzén Carl Johan , Zeidan Ahmad A.
Published: February 2023

Probiotics are industrially and clinically important microorganisms. To exert their health-promoting effects, probiotic microorganisms must be administered at high counts, while maintaining their viability at the time of consumption.