bluuebunny/crossref_metadata_2025 huggingface dataset:
Frontline managers’ experiences of practice leadership for when supporting autistic adults with complex support needs residing in community housing
Authors: Rickard Georgina , Deveau Roy
Published: July 2024

Purpose

This study aims to investigate the experiences of frontline managers supervising and developing staff to support autistic adults living in two types of residential housing in the community.

Design/methodology/approach

A qualitative approach used semi-structured interviews with 14 frontline managers. Audio-taped material was transcribed and analysed using thematic analysis.

Findings

Two main themes emerged. Theme 1 “autism in practice” illustrates commonalities observed to affect autistic adults with learning disabilities receiving staff support; whilst one sub-theme illustrated the diversity in how these commonalities may be experienced and expressed, another focused on participants’ experiences of staff concerns regarding behaviours described as challenging. Theme two, “what’s important in autism-informed support” reflected participants’ perceptions of the features of successful person-centred staff support for autistic service users.

Research limitations/implications

The “rich” experiences of these managers may not be readily generalised.

Practical implications

Features of good staff support for autistic adults who may show behaviours of concern included attending to individuals’ specific communication and sensory needs and for predictability within their environments. Developing staff skills and confidence to implement skilled approaches in the context of often high risk behaviour of concern took time and frontline managers “on site” to observe, coach, mentor and demonstrate good practice. More intellectually (verbally) able service-users were perceived as more “difficult” to support.

Social implications

Staff supporting autistic adults in ordinary housing need frontline managers to act as practice leaders rather than administrators.

Originality/value

This study is the first to report, to the best of the authors’ knowledge, on management for staff supporting autistic adults living in community housing.
The impact of fungi on soil protist communities in European cereal croplands
Authors: Degrune Florine , Dumack Kenneth , Ryo Masahiro , Garland Gina , Romdhane Sana , Saghaï Aurélien , Banerjee Samiran , Edlinger Anna , Herzog Chantal , Pescador David S. , García‐Palacios Pablo , Fiore‐Donno Anna Maria , Bonkowski Michael , Hallin Sara , van der Heijden Marcel G. A. , Maestre Fernando T. , Philippot Laurent , Glemnitz Michael , Sieling Klaus , Rillig Matthias C.
Published: July 2024

Protists, a crucial part of the soil food web, are increasingly acknowledged as significant influencers of nutrient cycling and plant performance in farmlands. While topographical and climatic factors are often considered to drive microbial communities on a continental scale, higher trophic levels like heterotrophic protists also rely on their food sources. In this context, bacterivores have received more attention than fungivores. Our study explored the connection between the community composition of protists (specifically Rhizaria and Cercozoa) and fungi across 156 cereal fields in Europe, spanning a latitudinal gradient of 3000 km. We employed a machine‐learning approach to measure the significance of fungal communities in comparison to bacterial communities, soil abiotic factors, and climate as determinants of the Cercozoa community composition. Our findings indicate that climatic variables and fungal communities are the primary drivers of cercozoan communities, accounting for 70% of their community composition. Structural equation modelling (SEM) unveiled indirect climatic effects on the cercozoan communities through a change in the composition of the fungal communities. Our data also imply that fungivory might be more prevalent among protists than generally believed. This study uncovers a hidden facet of the soil food web, suggesting that the benefits of microbial diversity could be more effectively integrated into sustainable agriculture practices.
Local co‐production in safety service provision: The case of Surf Life Saving in New South Wales
Authors: Hogan Owen , Dollery Brian , Kortt Michael A.
Published: July 2024

Beaches are iconic in Australian culture. However, coastal areas are intrinsically hazardous, given the nature of recreational beach activities. The need for beach regulation and safety services has spawned a vast network of voluntary life‐saving clubs across Australia that operate collaboratively with local government and volunteers. In this paper, we examine the operation of Surf Life Saving New South Wales (SLSNSW) through the analytical lens of local co‐production. We argue that the effectiveness of SLSNSW can be mainly ascribed to the efficacious manner in which SLSNSW, local councils and volunteers have been combined to generate beach safety services.
What can we learn from disability policy to advance our understanding of how to operationalise intersectionality in Australian policy frameworks?
Authors: Bates Shona , Kayess Rosemary , Katz Ilan
Published: July 2024

Intersectional theory recognises inequity is rarely the result of one social identity; social identities, and their interaction with context and power relations, offer some protective factors, while marginalises others. Taking an intersectional approach to social policy has the potential to provide deeper insights in terms of identifying and responding to needs, and understanding the impact of policies and specific interventions for diverse people. While Australian social policies, such as national strategies, are beginning to recognise inequity is likely to be higher for some social identities than others, a recent review of Australian policy and how it responds to people with disability suggests policies do not yet appear to take an intersectional approach. Drawing on this review, we discuss the challenges in operationalising intersectionality, explore how they may be overcome, and identify considerations for scholars and future research opportunities to advance our understanding of how to operationalise intersectionality in social policy in Australia. We suggest intersectionality requires a broader cultural shift across society and professions to recognise people have multiple identities, statuses, and life circumstances, and the way they interact with the context and power relations affects how they experience life.

Points for practitioners

Intersectionality recognises the interaction between social identities, context, and power relations.

The research note aims to advance our understanding of how to operationalise intersectionality in Australian social policy.

This note builds on a review of Australian policy frameworks and whether they take an intersectional approach to addressing disability.

The research note identifies considerations for researchers and research opportunities.

A broader cultural shift across society is required to recognise how different factors affect how people experience life.
The role of financial development, natural resources, and technology in determining green energy: New findings from the N‐11 countries
Authors: Tao Yi , Wang Weixin
Published: July 2024

In recent years, there has been a growing global emphasis on transitioning to renewable energy sources to mitigate the effects of climate change and promote sustainable development. The role of financial development, natural resources, and technology in determining the advancement of green energy has been a subject of ongoing research. This study examines the impact of financial development, natural resources, and technology on green energy development in N‐11 countries between 1990 and 2022, using economic growth and education as control variables. The empirical estimations are based on cross‐section dependence, testing for slope heterogeneity, second‐generation panel unit root tests, LM‐Bootstrap cointegration tests, fully modified ordinary least squares, and dynamic ordinary least squares. A 1% increase in natural resources is associated with a 0.0615% increase in the adoption of green energy. A 1% increase in education leads to a statistically significant increase of 1.0734% in the adoption of green energy financial development enables the deployment of renewable energy sources and access to financial resources. Natural resources determine the types of renewable energy technologies that are prioritized. Technological advancements drive the growth of renewable energy technologies and facilitate their integration into the energy mix. By analyzing the findings of recent studies on the N‐11 countries, we can gain valuable insights into the importance of these factors in advancing green energy and achieving sustainable energy development.
Temperature and pH‐dependent stability of fentanyl analogs: Degradation pathways and potential biomarkers
Authors: Schackmuth Madison , Kerrigan Sarah
Published: July 2024

The collection, storage, and transport of samples prior to and during analysis is of utmost importance, especially for highly potent analogs that may not be present in high concentrations and are susceptible to pH or thermally mediated degradation. An accelerated stability study was performed on 17 fentanyl analogs (fentalogs) over a wide range of pH (2–10) and temperature (20–60°C) conditions over 24 h. Dilute aqueous systems were used to investigate temperature and pH‐dependent kinetics using liquid chromatography–tandem mass spectrometry (LC–MS/MS). Liquid chromatography‐quadrupole/time‐of‐flight‐mass spectrometry (LC‐Q/TOF–MS) was used for structural elucidation of degradants. With the exception of remifentanil, all fentalogs evaluated were stable at pH 6 or lower. Fentalogs were generally unstable in strongly alkaline environments and at elevated temperatures. Remifentanil was the least stable drug and N‐dealkylated fentalogs were the most stable. Fentanyl degraded to acetylfentanyl, norfentanyl, fentanyl N‐oxide, and 1‐phenethylpyridinium salt (1‐PEP). A total of 26 unique breakdown products were observed for 15 of the fentanyl derivatives studied. Common degradation pathways involved N‐dealkylation, oxidation of the piperidine nitrogen, and β‐elimination of N‐phenylpropanamide followed by oxidation/dehydration of the piperidine ring. Ester and amide hydrolysis, demethylation at the propanamide, and O‐demethylation were observed for selected fentalogs only. The potential for analyte loss should be considered during the pre‐analytical phase (i.e., shipping and transport) where environmental conditions may not be controlled, as well as during the analysis itself.
Cytochrome b5 reductase 3 overexpression and dietary nicotinamide riboside supplementation promote distinctive mitochondrial alterations in distal convoluted tubules of mouse kidneys during aging
Authors: Pérez‐Rodríguez M. , García‐Verdugo A. , Sánchez‐Mendoza L. M. , Muñoz‐Martín A. , Bolaños N. , Pérez‐Sánchez C. , Moreno J. A. , Burón M. I. , de Cabo R. , González‐Reyes J. A. , Villalba J. M.
Published: July 2024

The kidney undergoes structural and physiological changes with age, predominantly studied in glomeruli and proximal tubules. However, limited knowledge is available about the impact of aging and anti‐aging interventions on distal tubules. In this study, we investigated the effects of cytochrome b5 reductase 3 (CYB5R3) overexpression and/or dietary nicotinamide riboside (NR) supplementation on distal tubule mitochondria. Initially, transcriptomic data were analyzed to evaluate key genes related with distal tubules, CYB5R3, and NAD+ metabolism, showing significant differences between males and females in adult and old mice. Subsequently, our emphasis focused on assessing how these interventions, that have demonstrated the anti‐aging potential, influenced structural parameters of distal tubule mitochondria, such as morphology and mass, as well as abundance, distance, and length of mitochondria‐endoplasmic reticulum contact sites, employing an electron microscopy approach. Our findings indicate that both interventions have differential effects depending on the age and sex of the mice. Aging resulted in an increase in mitochondrial size and a decrease in mitochondrial abundance in males, while a reduction in abundance, size, and mitochondrial mass was observed in old females when compared with their adult counterparts. Combining both the interventions, CYB5R3 overexpression and dietary NR supplementation mitigated age‐related changes; however, these effects were mainly accounted by NR in males and by transgenesis in females. In conclusion, the influence of CYB5R3 overexpression and dietary NR supplementation on distal tubule mitochondria depends on sex, genotype, and diet. This underscores the importance of incorporating these variables in subsequent studies to comprehensively address the multifaceted aspects of aging.
Family strategies: Labor migration, multigenerational households, and children's schooling in Nepal
Authors: Schafer Mark , Paudel Krishna P. , Upadhyaya Kamal
Published: July 2024

Temporary migration to international destinations has many implications for the family members left behind. This paper discusses family economic theoretical perspectives and the family strategies that are adopted in Chitwan, Nepal. The family strategies include single united, split‐single generation, multigenerational, and split‐multigenerational households that are linked to the presence or absence of fathers and grandfathers. We examined how family strategies impact school outcomes, that is, school investment and school progress. We obtained three critical findings about family migration and structure strategies and school investment. First, multigenerational family strategies mitigated the negative association between siblings on educational investments. Second, split‐household strategies mitigated the negative associations between age and private school and between remittance dependency and top school fees. Third, family strategies shaped how ethnicity and caste influence educational investments as split‐household, multigenerational (and both) mitigated negative connection between the least powerful castes and ethnicities and school investment. Our findings did not show significant associations between family strategies and children's educational progress in Chitwan. Families in rural Nepal are responding to macrostructural changes, and there is a need for more research to better understand shifting family migration and household structure strategies, in all their complexities, and their implications for children in rural Nepal or other rural locations with a high temporary migration rate.
Genre‐style features of modern war diaries: An analysis of Ukrainian military literature
Authors: Kulinska Yanina , Gerasimenko Nina , Koval Olena , Kvitsynska Viktoriia
Published: July 2024

The relevance of this study stems from the need to examine diary discourse in modern Ukrainian military literature, highlighted by increased interest in new diary varieties, functions, and genre syncretism. The purpose of the study is to analyze diaries created after the Russian invasion on February 24, 2022, focusing on their nature, features, genre parameters, and how they differ from diaries written during the initial aggression in 2014. During the processing of diary texts, historical–biographical, comparative‐historical, and complex elements of hermeneutical, structural methods, textual, correlation, and discourse analyses were most often used. In addition, the method of comparing subject–object planes, and dimensions, was used for functional genre refinement. The paper presents a systematic analysis of the modern military diary, highlights its structural modifications, defines static and acquired functions, and describes the status and importance of the latest literary process among other genres. The results of the study can be used for the preparation of basic and special lecture courses on the theory and history of Ukrainian and world literature.
Time trends in the clinical management of cervical intraepithelial neoplasia grade 2: A Danish register‐based study
Authors: Eriksen Dina Overgaard , Randrup Tina Hovgaard , Lycke Kathrine Dyhr , Damgaard Rikke Kamp , Kahlert Johnny , Ostenfeld Eva Bjerre , Jensen Pernille Tine , Wentzensen Nicolas , Clarke Megan A. , Hammer Anne
Published: July 2024

Introduction

Active surveillance for cervical intraepithelial neoplasia grade 2 (CIN2) has been implemented recently in many countries, including the Nordic countries. In Denmark, the only eligibility criterion for active surveillance for CIN2 is that the woman should be of reproductive age. With this study, we aimed to evaluate clinical and socioeconomic characteristics in women with CIN2 managed by active surveillance or large loop excision of the transformation zone (LLETZ) and to evaluate temporal changes in the clinical management of CIN2.

Material and Methods

We conducted a Danish nationwide study using data from healthcare registries. All female residents aged 18–40 years, diagnosed with incident CIN2 from January 1, 1998, to February 29, 2020, were included. We collected data on age, index cytology result, year of CIN2 diagnosis, region of residence, civil status, HPV vaccination status, and socioeconomic position indicators. The variables were tabulated overall and by management group (active surveillance vs. LLETZ). To evaluate time trends, we used joinpoint regression to calculate the annual percentage change (APC), including 95% confidence intervals (CI).

Results

Of the 27 536 women with CIN2 included, 12 500 (45.4%) underwent active surveillance, and 15 036 (54.6%) underwent a LLETZ. Women undergoing active surveillance were younger, more often HPV‐vaccinated, and more likely to have a normal/low‐grade index cytology result than women undergoing LLETZ. Socioeconomic position indicators did not differ. Over time, the proportion of women undergoing active surveillance increased from 21.7% in 2004 to 73.6% in 2019 (APC 9.7, 95% CI 8.1–11.4). The proportion of women undergoing active surveillance aged <30 declined over time (APC −2.2, 95% CI −2.9 to −1.5). The proportion of women with normal/low‐grade index cytology increased slightly to 51.6% in 2019 (APC 0.8, 95% CI 0.4–1.3).

Conclusions

The use of active surveillance for CIN2 has increased over the past two decades in Denmark. Observed differences in characteristics between women undergoing active surveillance vs LLETZ are likely related to indications for clinical management.
Letter: Risks of proton pump inhibitor treatment in cirrhotic patients—Authors' reply
Authors: Yoon Jun Sik , Lee Jeong‐Hoon
Published: July 2024

LINKED CONTENT

This article is linked to Yoon et al papers. To view these articles, visit https://doi.org/10.1111/apt.17909 and https://doi.org/10.1111/apt.17954
Hybrid rangeland governance: Connecting policies with practices in pastoral China
Authors: Tsering Palden
Published: July 2024

The issue of rangeland governance and tenure in pastoral China has sparked significant controversy and discussion. Several models have been suggested, encompassing private, state and common property systems. However, what does the practical implementation of rangeland governance entail? A review of the history of rangeland governance and policy in Amdo, Tibet tells how land governance is constructed by pastoralists adapting existing norms, formulating rules in various contexts, and negotiating with various groups such as the monastery, religious organisations, and governmental authorities. The governance of rangeland in Amdo, Tibet is characterised by constant negotiations and contestations, including resistance from below, and is shaped by various processes in the real‐world context. Through the notion of assemblage, which involves bringing together an array of agents and objectives to intervene in social processes to produce desired outcomes and avert undesired ones, this paper adds to the existing body of research on land governance by examining how institutions are formed in the case of a hydroelectric dam on the land of the pastoralists. Consequently, the question arises: What does this mean for policy and practice for the rangelands of China? If hybrid rangeland governance is to be considered the prevailing practice, then what implications would this have for the framing of policies and their implementation?
Connectome gradient dysfunction contributes to white matter hyperintensity‐related cognitive decline
Authors: Yang Dan , Tan Yi , Zhou ZhiXin , Ke Zhihong , Huang Lili , Mo Yuting , Tang Limoran , Mao ChengLu , Hu Zheqi , Cheng Yue , Shao Pengfei , Zhang Bing , Zhu Xiaolei , Xu Yun
Published: July 2024

Background

Although white matter hyperintensity (WMH) is closely associated with cognitive decline, the precise neurobiological mechanisms underlying this relationship are not fully elucidated. Connectome studies have identified a primary‐to‐transmodal gradient in functional brain networks that support the spectrum from sensation to cognition. However, whether connectome gradient structure is altered as WMH progresses and how this alteration is associated with WMH‐related cognitive decline remain unknown.

Methods

A total of 758 WMH individuals completed cognitive assessment and resting‐state functional MRI (rs‐fMRI). The functional connectome gradient was reconstructed based on rs‐fMRI by using a gradient decomposition framework. Interrelations among the spatial distribution of WMH, functional gradient measures, and specific cognitive domains were explored.

Results

As the WMH volume increased, the executive function (r = −0.135, p = 0.001) and information‐processing speed (r = −0.224, p = 0.001) became poorer, the gradient range (r = −0.099, p = 0.006), and variance (r = −0.121, p < 0.001) of the primary‐to‐transmodal gradient reduced. A narrower gradient range (r = 0.131, p = 0.001) and a smaller gradient variance (r = 0.136, p = 0.001) corresponded to a poorer executive function. In particular, the relationship between the frontal/occipital WMH and executive function was partly mediated by gradient range/variance of the primary‐to‐transmodal gradient.

Conclusions

These findings indicated that WMH volume, the primary‐to‐transmodal gradient, and cognition were interrelated. The detrimental effect of the frontal/occipital WMH on executive function was partly mediated by the decreased differentiation of the connectivity pattern between the primary and transmodal areas.
Accuracy of ultrasound‐guided fine‐needle aspiration cytology in evaluation of thyroid nodules using different ultrasonographic and cytological features
Authors: Al‐Yousofy Fayed , Hamood Mukhtar , Almatary Abdullah M. , Mothanna Abdullatif , Al‐Wageeh Saleh , Nasher Saeed T. , Alselwi Ammar , Hassan Huda , Al‐Yousofy Anwer , Ahmad Radwan H.
Published: July 2024

Background

Fine‐needle aspiration cytology (FNAC) is a reliable method for preoperative evaluation of thyroid nodules particularly if ultrasound‐guided (USG‐FNAC). The main purpose of this study is to evaluate the efficacy of USG‐FNAC and its accuracy.

Methods

We retrospectively studied 212 thyroidectomy cases with preoperative ultrasonography and FNAC data during the period 2015–2022 using TI‐RADS for final ultrasound diagnosis and Bethesda system for cytological diagnosis.

Results

The studied cases were 200 females and 12 males. Thyroid cancer was more prevalent under 20 years old (78.5%). Papillary thyroid carcinoma comprises 84% of all cancer cases. Significant ultrasound features (p‐value <0.05) favour malignancy were hypoechogenicity (66%), mixed echogenicity (84%), irregular border (61%), microcalcification (68%) and rim halo (63.6%). Malignancy was found in 21% of TI‐RADS‐2, 65% of TI‐RADS‐4 and 100% of TI‐RADS‐5. There is a significant difference between different categories of Bethesda system. All cases in Cat‐VI were malignant (100%). Malignancy was also found in 81% of Cat‐V, 20% of Cat‐IV, 33% of Cat‐III, 16% of Cat‐II and 43% of Cat‐I. Cytological features consistent with malignancy were as follows: grooving (94%), nuclear irregularities (89%), nuclear pseudoinclusion (89%) and little colloid (82%). In our study, USG‐FNAC sensitivity was 83%, specificity 85%, PPV 85%, NPV 83% and accuracy 84%.

Conclusion

Ultrasound features in favour of malignancy in thyroid nodules are hypoechoic or complex echogenicity, irregular border, punctuate calcification and presence of rim halo. Cytological features in favour of malignancy are grooving, nuclear irregularities, nuclear pseudoinclusion and little or absent colloid.
Children's living arrangements and labor market outcomes of divorced mothers in Wisconsin
Authors: Chanda Trisha
Published: July 2024

Objective

This paper examines the way divorced mothers' long‐run employment, long‐run earnings, and subjective experiences of work–family conflict differ by children's postdivorce living arrangements.

Background

Children's living arrangements are an important—and somewhat overlooked—determinant of mothers' postdivorce economic outcomes. Parenting commitments and resource availability tied to the amount of time children spend in residence can impact mothers' experiences of work–family conflict and consequent employment.

Method

The paper uses linked administrative and survey data for divorced parents in Wisconsin. It applies a mixed‐methods approach, first using multivariate regression models to control for baseline characteristics in exploring mothers' labor market outcomes and experiences of work–family conflict, and subsequently performing content analysis on open‐ended survey responses to enhance the findings from the quantitative analysis.

Results

Mothers with shared physical custody are 5% more likely to report being employed in the long run, experience 6% less work–family conflict, and show larger increases in long‐term earnings than mothers who have sole physical custody of their children. However, the higher long‐term earnings of shared placement mothers cannot be attributed to lower work–family conflict.

Conclusion

Shared placement mothers enjoy a labor market advantage in the long term after divorce, but more research is needed to understand the mechanisms behind this relationship.

Implications

Public policy encouraging shared placement can be beneficial for divorced mothers' economic outcomes.
Colonization ability and uniformity of resources and environmental factors determine biological homogenization of soil protists in human land‐use systems
Authors: Li Zhi‐Peng , Shangguan Hua‐Yuan , Yao Haifeng , Yang Xiao‐Ru , Mazei Yuri , Zhu Biao , Scheu Stefan , Sun Xin
Published: July 2024

Humans have substantially transformed the global land surface, resulting in the decline in variation in biotic communities across scales, a phenomenon known as “biological homogenization.” However, different biota are affected by biological homogenization to varying degrees, but this variation and the underlying mechanisms remain little studied, particularly in soil systems. To address this topic, we used metabarcoding to investigate the biogeography of soil protists and their prey/hosts (prokaryotes, fungi, and meso‐ and macrofauna) in three human land‐use ecosystem types (farmlands, residential areas, and parks) and natural forest ecosystems across subtropical and temperate regions in China. Our results showed that the degree of community homogenization largely differed between taxa and functional groups of soil protists, and was strongly and positively linked to their colonization ability of human land‐use systems. Removal analysis showed that the introduction of widespread, generalist taxa (OTUs, operational taxonomic units) rather than the loss of narrow‐ranged, specialist OTUs was the major cause of biological homogenization. This increase in generalist OTUs seemingly alleviated the negative impact of land use on specialist taxa, but carried the risk of losing functional diversity. Finally, homogenization of prey/host biota and environmental conditions were also important drivers of biological homogenization in human land‐use systems, with their importance being more pronounced in phagotrophic than parasitic and phototrophic protists. Overall, our study showed that the variation in biological homogenization strongly depends on the colonization ability of taxa in human land‐use systems, but is also affected by the homogenization of resources and environmental conditions. Importantly, biological homogenization is not the major cause of the decline in the diversity of soil protists, and conservation and study efforts should target at taxa highly sensitive to local extinction, such as parasites.
Short‐term efficacy of tildrakizumab on difficult‐to‐treat areas: a real‐world experience
Authors: Cacciapuoti Sara , Potestio Luca , Gallo Lucia , Musumeci Maria Letizia , Caldarola Giacomo , D'Amico Domenico , Caudullo Francesco , Papaianni Valeria , De Simone Clara , Peris Ketty , Megna Matteo
Published: July 2024

Background

Novel biologics targeting the IL23/T‐17 axis, such as tildrakizumab, have been developed to treat psoriasis. There is limited evidence on the use of tildrakizumab for the treatment of psoriasis in difficult‐to‐treat areas.

Objective

Our aim was to evaluate the short‐term efficacy and safety of tildrakizumab in patients with moderate‐to‐severe psoriasis and with the involvement of difficult‐to‐treat areas.

Methods

A multicentric retrospective study was conducted on patients who initiated tildrakizumab between July 2022 and July 2023. Psoriasis Area and Severity Index (PASI), Psoriasis Scalp Severity Index (PSSI), Palmoplantar Psoriasis Area and Severity Index (ppPASI), and Nail Psoriasis Severity Index (NAPSI) were measured at baseline and after 16 weeks. The percentages of achieving a PASI75, PASI90, or PASI100 response were assessed. Dermatology Life Quality Index (DLQI) and Itch Visual Analog Scale (VAS) were measured simultaneously. Data about potential safety issues and adverse events were collected.

Results

A total of 76 patients were included, and 59 (77.6%) were affected by psoriasis localized to the scalp (n = 32), palmoplantar locations (n = 13), or nails (n = 14). The mean PASI score decreased from 16.5 ± 9.8 at baseline to 1.9 ± 1.6 after 16 weeks. Tildrakizumab treatment resulted in the improvement of PSSI (19.9 ± 10.7 to 2.7 ± 4.2), ppPASI (15.4 ± 6.9 to 1.9 ± 2.3), and NAPSI (20.3 ± 16.9 to 7.6 ± 10.8) from baseline to 16 weeks, respectively. DLQI and Itch VAS also showed marked improvement.

Conclusions

Tildrakizumab is a valuable option for treating difficult‐to‐treat psoriasis and pruritus, with rapid onset of action.
Service pricing and charging strategy for video platforms considering consumer preferences
Authors: Liu Xuwang , Zhou Biying , Qi Wei , Wang Junwei
Published: July 2024

Heterogeneity of consumer preferences is a crucial feature of the platform economy, and service price and charging strategies crucially influence customer choice behavior. To enhance consumer experience and boost product value, video platforms offer value‐added services, also known as premium membership features. For instance, Youku's benefits of value‐added service include seamless video playback, high‐definition picture quality, and exclusive episodes. This study constructs a two‐stage Hotelling model from monopoly to duopoly competition. Considering the heterogeneity of consumer preferences for product quality and platform usage costs, we analyze the impact mechanism of the customer preferences heterogeneity and the service pricing of video platform enterprises. In addition, we analyze the Nash equilibrium strategies of competing enterprises in the competition scenario, and we consider two charging strategies: freemium and bundled sales. The results indicate that the consumer sensitivity factors significantly impact the optimal pricing of services and the profits of enterprises and that this impact varies with the heterogeneity of customer composition and the type of charging strategies. For the optimal solutions in a competition scenario, the proportion of quality‐sensitive customers is positive for the freemium model, whereas it is negative for the bundled sales model. Furthermore, we analyze the impact of heterogeneous customer composition on the choice of charging strategy utilizing numerical analysis. This study provides a theoretical basis and decision support for product development and value‐added service pricing that can be applied to video platform enterprises and other media platforms.
Factor IX Antibody and Immune Tolerance
Authors: Warrier Indira
Published: July 2024

Prevalence of FIX inhibitor is ten times lower than factor VIII inhibitor. FIX inhibitor patients pose major challenges for treatment because of the simultaneous occurrence of severe allergy to FIX at the time of inhibitor development. Immune tolerance induction in haemophilia B inhibitor patients with allergy to FIX is complicated due to the development of nephrotic syndrome. Moreover, response to ITI usually is poor.
Factor Xa and Prothrombin: Mechanism of Action of FEIBA
Authors: Turecek Peter L. , Varadi Katalin , Gritsch Herbert , Auer Wilfried , Pichler Ludwig , Eder Gerald , Schwarz Hans Peter
Published: July 2024

A complex consisting of activated factor X (FX) (enzyme) and prothrombin (substrate), both highly purified from human plasma and virus inactivated, was formulated, characterised biochemically as well as in animal studies, and given the name Partial Prothrombinase (PPT). In vitro, PPT shortened the clotting time of a high‐titre human factor VIII (FVIII) inhibitor plasma in a manner similar to that of the activated prothrombin complex concentrate FEIBA and triggered coagulation in plasma samples in which factor V (FV) is present. In vivo, the ability of PPT to activate coagulation in both chimpanzees and baboons was equivalent to that of FEIBA. PPT also triggered coagulation in a von Willebrand factor(vWF)‐deficient dog and controlled bleeding in rabbits with antibody‐induced haemophilia A. Thus, studying the mechanism of action of PPT also explains the therapeutic principle of FEIBA.
Degradation Products of Factor VIII Which Can Lead to Increased Immunogenicity
Authors: Josić Djuro , Buchacher Andrea , Kannicht Christoph , Lim Yow‐Pin , Löster Klemens , Pock Katharina , Robinson Stephen , Schwinn Horst , Stadler Monika
Published: July 2024

The biochemical and immunochemical aspects of the development of inhibitors with a plasma‐derived, double‐virus inactivated factor VIII (FVIII) concentrate (marketed as Octavi SDPlus in Germany and Bisinact in Belgium) are described. A total of 12 cases of inhibitor formation (predominantly type II) were reported in Germany, 8 in Belgium but none in Portugal. Initially, the only difference between the non‐pasteurised, SD virus‐inactivated product Octavi and the pasteurised product Octavi SDPlus appeared to be pasteurisation, though subsequently, the quality of source material for the product was found to differ in different countries. Separation studies revealed the presence of a 40 kDa peptide fragment in some batches. It was subsequently shown that there was a strong correlation between inhibitor development and batches containing the 40 kDa marker, and a relationship between elevated markers of coagulation activation (FPA in particular) and the occurrence of the 40 kDa marker. Further work revealed that analytical methods commonly used for quality control were not suitable to highlight batch‐to‐batch differences. It was concluded that inhibitor potential (neoantigenicity) in Octavi SDPlus arose due to two effects; degradation of FVIII already present in source material; and heating of unstable FVIII degradation products. In this case, inhibitors were not caused by the overall production process, nor by GMP failures. The problem of inhibitor potential can be avoided if appropriate preventive measures are taken. Further work is needed to prove non‐neoantigenicity and to reinforce the scientific findings, and to characterise pilot batches.
Comparative efficacy and tolerability of fusidic acid/hydrocortisone cream (Fucidin® H cream) and miconazole/hydrocortisone cream (Daktacort® cream) in infected eczema
Authors: Poyner T.F. , Dass B.K.
Published: July 2024

Aim

To study the efficacy, tolerability and acceptability of 2% fusidic acid and 1% hydrocortisone with 2% miconazole and 1% hydrocortisone.

Subject

Atopic dermatitis and topical therapy with antibacterial/antiinflammatory or antifungal/antiinflammatory remedies.

Methods

A randomised, open, parallel group comparison.

Results

207 patients with clinically infected eczema were included in a trial with either 2% fusidic acid and 1% hydrocortisone or 2% miconazole and 1% hydrocortisone. At the end of treatment, there was no statistically significant difference between treatments in the preparations of patients “cleared” or “markedly improved” (fusidic acid 69.5%, miconazole 68.6%).

After 1 week treatment, there was a statistically significant difference in the overall treatment response in favour of fusidic acid/hydrocortisone cream (P = 0.04). Fusidic acid/hydrocortisone cream was significantly more effective than miconazole/hydrocortisone cream at 1 week in reducing the total sign score (P = 0.001), erythema (P = 0.002), induration (P = 0.001), dryness/scaling (P = 0.02). and cracking/fissuring (P = 0.01). Fusidic acid/hydrocortisone cream was significantly more effective bacleriologically than miconazole/hydrocortisone cream (P = 0.04), Patients considered that treatment‐related irritation was significantly more common with fusidic acid/hydrocortisone cream (P = 0.03).

Adverse events were recorded in 7 (7.3%) patients given fusidic acid/hydrocortisone and in 8 (7.5%) patients given miconazole/hydrocortisone cream and contributed to treatment withdrawal in 1 (1.0%) patient given fusidic acid/hydrocortisone cream and in 3 (2.8%) patients given miconazole/hydrocortisone cream.

Conclusion

Fusidic acid/hydrocortisone cream and miconazole/hydrocortisone cream were equally effective in treating clinically infected eczema. However, fusidic acid/hydrocortisone cream produced a significantly more rapid clinical improvement and was more effective bacteriologically. Both treatments were well tolerated.
Mechanisms of the influence of proactive personality on nurses' sense of social responsibility: A structural equation modelling study
Authors: Yan Dexiu , Chen Lan , Li Mengyao , Zhang Yuanyuan , Zhang Yaqing , Zhang Yili , Chang Jian
Published: July 2024

Aim

To explore the mechanism of proactive personality influence on nurses' sense of social responsibility through a serial multiple mediation model of volunteering motivation and self‐efficacy.

Design

Further analysis of a cross‐sectional and survey‐based study.

Methods

In June 2023, a study was conducted with 722 Chinese nurses from four hospitals. Data were collected using the Proactive Personality Scale, the Self‐Efficacy Scale, the Motivation to Volunteer Scale and the Nurses' Sense of Social Responsibility Scale. Structural equation modelling was used to analyse the relationship between nurses' sense of social responsibility and its correlative factors.

Results

Structural equation modelling showed a good model fit. Proactive personality, self‐efficacy and motivation to volunteer can directly influence nurses' sense of social responsibility (β = .12, β = .04, β = .50, p < .05). According to the test of chained mediation effects, proactive personality was significant through a single mediation path of self‐efficacy (Z = 2.33, p < .05) and motivation to volunteer (Z = 7.32, p < .05) and through successive mediation paths of both variables (Z = 3.33, p < .05).

Conclusion

A proactive personality can motivate nurses' social responsibility. Therefore, prompting nurses to be more proactive can effectively enhance nurses' sense of social responsibility.

Reporting Method

This study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies.

Patient or Public Contribution

This study explored the mechanisms influencing nurses' sense of social responsibility at the end of the epidemic. The results may inform the maintenance of high levels of long‐term effects of nurses' social responsibility and shed light on building a standing workforce for public health emergencies.
Diploid and triploid Chinook salmon (Oncorhynchus tshawytscha) exhibit differential immunological responses to acute thermal stress
Authors: Rogozynski Noah P. , Cadonic Ivan G. , Soto‐Dávila Manuel , Wong‐Benito Valentina , Rodriguez‐Ramos Tania , Craig Paul , Dixon Brian
Published: July 2024

Exposure to temperatures outside of a fish's optimal range results in suppression of the immune system, ultimately leaving aquaculture stocks susceptible to disease outbreaks. This effect is exacerbated in triploid fishes, which demonstrate greater susceptibility to stress than their diploid counterparts. This study investigates the impacts of acute heat stress on the abundance of immune transcripts and proteins in diploid and triploid Chinook salmon (Oncorhynchus tshawytscha), an important finfish crop. This study also demonstrates that acute heat stress induces significant increases in the abundance hsp70, hsp90 and il1b transcripts in the head kidneys, gills and heart ventricles of both diploid and triploid Chinook salmon. Widespread dysregulation of antigen‐presentation transcripts was also observed in fish of both ploidies. These results suggest that acute heat stress activates acute‐phase responses in Chinook salmon and dysregulates antigen presentation, potentially leaving fish more susceptible to infection. At the protein level, IL‐1β was differentially expressed in the head kidney and ventricles of diploid and triploid salmon following heat shock. Differential expression of two tapasin‐like proteins in diploid and triploid salmon subjected to heat shock was also observed. Altogether, these data indicate that diploid and triploid Chinook salmon respond differently to acute thermal stressors.
The association between social risks and days at home for older veterans
Authors: Jacobs Josephine C. , Greene Liberty , Rao Mayuree , Smith Valerie A. , Van Houtven Courtney H. , Maciejewski Matthew L. , Zulman Donna M.
Published: July 2024

Background

Many health systems are trying to support the ability of older adults to remain in their homes for as long as possible. Little is known about the relationship between patient‐reported social risks and length of time spent at home. We assessed how social risks were associated with days at home for a cohort of older Veterans at high risk for hospitalization and mortality.

Methods

A prospective cross‐sectional study using a 2018 survey of 3479 high‐risk Veterans aged ≥65 linked to Veterans Health Administration data. Social risks included measures of social resources (i.e., no partner present, low social support), material resources (i.e., not employed, financial strain, medication insecurity, food insecurity, and transportation barriers), and personal resources (i.e., low medical literacy and less than high school education). We estimated how social risks were associated with days at home, defined as the number of days spent outside inpatient, long‐term care, observation, or emergency department settings over a 12‐month period, using a negative binomial regression model.

Results

Not having a partner, not being employed, experiencing transportation barriers, and low medical literacy were respectively associated with 2.57, 3.18, 3.39, and 6.14 fewer days at home (i.e., 27% more facility days, 95% confidence interval [CI] 8%–50%; 42% more facility days, 95% CI 7%–89%; 34% more facility days, 95% CI 7%–68%; and 63% more facility days, 95% CI 27%–109%). Experiencing food insecurity was associated with 2.62 more days at home (i.e., 24% fewer facility days, 95% CI 3%–59%).

Conclusions

Findings suggest that screening older Veterans at high risk of community exit for social risks (i.e., social support, material resources, and medical literacy) may help identify patients likely to benefit from home‐ and community‐based health and social services that facilitate remaining in home settings. Future research should focus on understanding the mechanisms by which these associations occur.
Pain management inequities by demographic and geriatric‐related variables in older adult inpatients
Authors: Rambachan Aksharananda , Neilands Torsten B. , Karliner Leah , Covinsky Kenneth , Fang Margaret , Nguyen Tung
Published: July 2024

Background

Pain is ubiquitous, yet understudied. The objective of this study was to analyze inequities in pain assessment and management for hospitalized older adults focusing on demographic and geriatric‐related variables.

Methods

This was a retrospective cohort study from January 2013 through September 2021 of all adults 65 years or older on the general medicine service at UCSF Medical Center. Primary exposures included (1) demographic variables including race/ethnicity and limited English proficiency (LEP) status and (2) geriatric‐related variables including age, dementia or mild cognitive impairment diagnosis, hearing or visual impairment, end‐of‐life care, and geriatrics consult involvement. Primary outcomes included (1) adjusted odds of numeric pain assessment versus other assessments and (2) adjusted opioids administered, measured by morphine milligram equivalents (MME).

Results

A total of 15,809 patients were included across 27,857 hospitalizations with 1,378,215 pain assessments, with a mean age of 77.8 years old. Patients were 47.4% White, 26.3% with LEP, 49.6% male, and 50.4% female. Asian (OR 0.75, 95% CI 0.70–0.80), Latinx (OR 0.90, 95% CI 0.83–0.99), and Native Hawaiian or Pacific Islander (OR 0.77, 95% CI 0.64–0.93) patients had lower odds of a numeric assessment, compared with White patients. Patients with LEP (OR 0.70, 95% CI 0.66–0.74) had lower odds of a numeric assessment, compared with English‐speaking patients. Patients with dementia, hearing impairment, patients 75+, and at end‐of‐life were all less likely to receive a numeric assessment. Compared with White patients (86 MME, 95% CI 77–96), Asian patients (55 MME, 95% CI 46–65) received fewer opioids. Patients with LEP, dementia, hearing impairment and those 75+ years old also received significantly fewer opioids.

Conclusion

Older, hospitalized, general medicine patients from minoritized groups and with geriatric‐related conditions are uniquely vulnerable to inequitable pain assessment and management. These findings raise concerns for pain underassessment and undertreatment.