bluuebunny/crossref_metadata_2025 huggingface dataset:
First-line managers’ experiences of and reflections on structural conditions for management practice in hospital settings
Authors: Lundin Karin , Skytt Bernice , Silén Marit , Engström Maria , Strömberg Annika
Published: December 2024

Purpose

The purpose of this paper is to describe first-line managers’ (FLMs’) experiences and reflections on structural conditions for management practice within hospital settings using Kanter’s theory of structural empowerment.

Design/methodology/approach

A qualitative deductive approach with a descriptive design was used. Interviews were conducted with 11 FLMs in charge of medical or surgical hospital units spread across Sweden. Data were analyzed using a directed content analysis, based on Kanter’s theory of structural empowerment, encompassing such as access to necessary and sufficient resources, information, support and opportunities to learn and develop.

Findings

Findings of this study from the FLMs’ descriptions and reflections shed light on the impact of power dynamics on the structural conditions for management practice. The availability of nursing staff was a fundamental resource in the FLMs’ work performance, ensuring delivery of care to patients and a sound work environment for staff. Additionally, the other structural elements outlined in Kanter’s theory were evident in the findings, as the FLMs wished for structured information flow, identified potential and challenged opportunities for development and emphasized the importance of receiving support from people with a genuine understanding of their work situation.

Originality/value

The results of this study contribute to the understanding of FLMs’ structural conditions for management practice in hospital settings. The paper’s originality stems from the use of a deductive approach, providing a structured lens with the potential to inform future research and practice in the field of health-care management.
Do renewable energies moderate the effect of climate vulnerability on women’s socio-economic well-being? Evidence from African countries
Authors: Asaloko Prince P. , Asongu Simplice , Kalemasi Cédrick M. , Niyonzima Thomas G.
Published: December 2024

Purpose

The purpose of this study is to assess the role of renewable energy as a means of promoting women’s economic participation and improving their health by mitigating climate vulnerability.

Design/methodology/approach

To shed light on this relationship, the authors assess the capacity of renewable energy to reduce the negative impact of climate vulnerability on women’s economic empowerment and health, using the generalized method of moments estimator for 36 African countries over the period 1990–2021.

Findings

The empirical results show that climate vulnerability reduces economic empowerment and climate vulnerability increases child mortality. These results are mitigated by the use of renewable energy. The use of renewable energy mitigates the negative impact of climate vulnerability on women’s economic empowerment. Renewable energy use also reduces the pressure of climate vulnerability on child mortality. In addition, the authors take into account regional heterogeneities and find distinct effects. The results remain stable after further robustness testing.

Originality/value

Renewable energy thresholds are provided at which climate vulnerability no longer reduces women’s socio-economic well-being.
ESG footprint and investment-cash flow sensitivity: the role group affiliation
Authors: Dash Sakti Ranjan , Sethi Maheswar
Published: December 2024

Purpose

This study aims to examine the investment-cash flow sensitivity (ICFS) and the impact of environmental, social and governance (ESG) on ICFS of manufacturing firms in India. Furthermore, it explores the role of group affiliation in such ESG–ICFS nexus.

Design/methodology/approach

The paper uses the generalized method of moments regression to analyze the data with a sample of 222 manufacturing firms from 2012 to 2022.

Findings

The paper reveals that Indian manufacturing firms mainly depend on internal cash flow for their investment decision, and ESG footprint reduces such sensitivity of investment-cash flow. Furthermore, group-affiliated firms have greater ICFS, and the impact of ESG on ICFS is more noticeable in group-affiliated firms than in standalone counterparts.

Originality/value

This paper provides valuable insights into current literature, with implications that extend to economies, firms, managers and investors. To the authors’ knowledge, this paper examining the impact of ESG on ICFS amidst group affiliation is first-of-its-kind.
An introduction to bee and pesticide research
Authors: Straw Edward A. , Stanley Dara A.
Published: December 2024

Bees and pesticides is a topic which attracts a considerable amount of research and media attention. It is also an applied topic, with experimental results informing policy. Policy decisions have‐real world consequences for food production and need to be made using the best available evidence.

This article aims to be an entry point for the increasing number of researchers now studying the topic, who may not have worked with pesticides beforehand. We have assumed a general knowledge of bee ecology, but no knowledge of pesticides.

We build up the knowledge base throughout the article, introducing concepts one‐by‐one and building on those concepts to tackle the more complex ideas later in the article.

Synthesis and applications. Our article is a starting point for those entering bee and pesticide research, and can help introduce the complex concepts and terminology of the field. We point to some further reading and resources throughout and offer some advice on best practice within the field. We hope this will ultimately help new researchers to quickly design high‐quality experiments, which can better inform pesticide policy and usage.
Gut Mycobiota of Three Rhinopithecus Species Provide New Insights Into the Association Between Diet and Environment
Authors: Yang Xuanyi , Wang Xiaochen , Zhang Mingyi , Shen Ying , Teng Yang , Li Ming , Pan Huijuan
Published: December 2024

Gut mycobiota are part of the gut microbiome, typically derived from the host diet and living environment. In this study, we examined the gut mycobiota of three snub‐nosed monkeys: Rhinopithecus roxellana, R. bieti, and R. strykeri using next‐generation amplicon sequencing targeting the fungal internal transcribed spacer. The alpha diversity indexes of gut mycobiota in R. bieti were significantly higher than R. roxellana and R. strykeri, the beta diversity indicated that R. roxellana and R. bieti had more similar feeding habits. Core mycobiota demonstrated commonalities among the three species and potentially associated with feeding habits. Mycobiota displaying significant differences exhibited the respective characteristics of the host, likely associated with the hosts’ living environment. Among them, animal and plant pathogenic fungi and lichen parasites are potential threats to the survival of snub‐nosed monkeys for their pathogenicity to both monkeys and their food plants. Functionally, fungal trophic modes and functional guilds revealed a strong association between gut mycobiota and host diet. We found a higher abundance and more significant correlations with lichen parasitic fungi in R. strykeri than the other two species, indicating potential threats to their foods. Accordingly, this study revealed the basic structures of gut mycobiota of three wild Rhinopithecus species and highlighted the associations between gut mycobiota and their feeding habits and living environments. Furthermore, due to the close connection between fungi and the environment, animals could ingest fungi from their diet; thus, we speculate that gut mycobiota may serve a role in environmental monitoring for wildlife.
Common institutional ownership and commonality in liquidity: Evidence from China
Authors: Chen Xiaoyu
Published: December 2024

This study investigates the impact of common institutional ownership on commonality in liquidity. We find that common institutional ownership reduces commonality in liquidity through synergistic governance, which is driven by the economy of scale and externality of common ownership. However, the negative relationship is weakened by exit threats of common ownership, emphasising the important role of active investor monitoring. We show that information transparency is the primary channel through which common institutional ownership reduces liquidity commonality. Moreover, the impacts are more pronounced for large‐cap stocks, and firms with high institutional ownership stability and high stock pricing efficiency.
Carcass Density, Size and Visibility Do Not Significantly Differ Between Areas With and Without Spotted‐Hyaenas (Crocuta crocuta), With Implications for Threatened Vultures
Authors: Fester Karl Sebastian Moritz , Luskin Matthew Scott , Maron Martine
Published: December 2024

Changes in predator guild composition can affect obligate scavengers through facilitation and competition dynamics. In Namibia, declines of spotted‐hyaenas (Crocuta crocuta) may influence threatened vultures, either positively, via provisioning carcasses, or negatively, as dominant scavengers competing for carcasses. To examine potential mechanisms of influence of spotted‐hyaenas on vultures, we compared carcass densities, carcass size (live weight estimated by species, age class and sex), and potential visibility of carcasses to vultures between sites with and without spotted‐hyaenas across Namibia. We sampled thirteen private protected areas (PPAs), six with spotted‐hyaenas present and seven where they were absent. Carcass densities were estimated for each PPA using line‐transect sampling, recording a total of fifty‐four carcasses. There were no significant differences in carcass density, carcass size or carcass distance to cover, as a proxy for visibility, between areas with and without spotted‐hyaenas. These results do not indicate mechanisms of either strong facilitation or strong competition with vultures, suggesting that spotted‐hyaena activity on these Namibian reserves is not detrimental to vultures, but equally may not result in increased carcass availability.
Effects of social mistreatment, academic alienation, and developmental challenge on university students' well‐being through coping strategies: A longitudinal study
Authors: Jiang Jingwen , Kwok Sylvia Y. C. L. , Deng Xi
Published: December 2024

Background

Few studies have concurrently examined how different types of stressors influence university students' well‐being through their use of coping strategies. Exploring such effects should enrich our understanding of how individuals develop strategies for coping with specific stressful situations and provide insights into the mechanisms by which different stressors impact students' well‐being in higher education contexts.

Aims

This study investigated the effects of social mistreatment, academic alienation, and developmental challenge on emotional and psychological well‐being via approach and avoidance coping strategies.

Sample

The participants were 293 university students in Hong Kong (mean age = 21 years).

Methods

We collected three waves of data through longitudinal student self‐reports and analysed them using structural equation modelling.

Results

Social mistreatment can lead to greater use of avoidance coping. Academic alienation can lead not only to a greater reliance on avoidance coping but also less use of approach coping. Developmental challenge can increase the use of approach coping. The effects of social mistreatment on emotional and psychological well‐being were mediated by the use of avoidance coping strategies. Moreover, the effects of academic alienation on emotional and psychological well‐being were mediated by the use of approach and avoidance coping strategies.

Conclusions

The results of this longitudinal study indicate the need to improve teaching practices or learning environments to reduce interpersonal and academic stressors due to their negative impact on coping and well‐being. The results also have implications for helping students to adopt better coping strategies and promote their well‐being.
Resan: A Residual Dual‐Attention Network for Abnormal Cardiac Activity Detection
Authors: Wang Xuhui , Zhu Yuanyuan , Wu Fei , Gao Long , Qi Datun , Jing Xiaoyuan , Luo Chong
Published: December 2024

Cardiovascular disease is one of the leading causes of death worldwide. Early and accurate detection of abnormal cardiac activity can be an effective way to prevent serious cardiovascular events. Electrocardiogram (ECG) and phonocardiogram (PCG) signals provide an objective evaluation of the heart's electrical and acoustic functions, enabling medical professionals to make an accurate diagnosis. Therefore, the cardiologists often use them to make a preliminary diagnosis of abnormal cardiac activity in clinical practice. For this reason, many diagnostic models have been proposed. However, these models fail to utilize the interaction information within and between the signals to aid the diagnosis of disease. To address this issue, we designed a residual dual‐attention network (ResAN) for the detection of abnormal cardiac activity using synchronized ECG and PCG signals. First, ResAN uses a feature learning module with two parallel residual networks, for example, ECG‐ResNet and PCG‐ResNet to automatically learn the deep modal‐specific features from the ECG and PCG sequences, respectively. Second, to fully utilize the available information of different modal signals, ResAN uses a dual‐attention fusion module to capture the salient features of the integrated ECG and PCG features learned by the feature learning module, as well as the alternating features between them based on the attention mechanisms. Finally, these fused features are merged and fed to the classification module to detect abnormal cardiac activity. Our model achieves an accuracy of 96.1%, surpassing the performances of comparison models by 1.0% to 9.9% when using synchronized ECG and PCG signals. Furthermore, the ablation study confirmed the efficacy of the components in ResAN and also showed that ResAN performs better with synchronized ECG and PCG signals compared to using single‐modal signals. Overall, ResAN provides a valid solution for the early detection of abnormal cardiac activity using ECG and PCG signals.
Model‐based impact analysis of climate change and land‐use intensification on trophic networks
Authors: Neumann Christian , Sritongchuay Tuanjit , Seppelt Ralf
Published: December 2024

There is well‐established evidence that land use is the main driver of terrestrial biodiversity loss. In contrast, the combined effects of land‐use and climate changes on food webs, particularly on terrestrial trophic networks, are understudied. In this study, we investigate the combined effects of climate change (temperature, precipitation) and land‐use intensification on food webs using a process‐based general mechanistic ecosystem model (‘MadingleyR'). We simulated the ecosystem dynamics of four regions in different climatic zones (Brazil, Namibia, Finland and France) according to trait‐based functional groups of species (ectothermic and endothermic herbivores, carnivores and omnivores). The simulation results were consistent across the selected regions, with land‐use intensification negatively affecting endotherms, whereas ectotherms were under increased pressure from rising temperatures. Land‐use intensification led to the downsizing of endotherms, and thus, to smaller organisms in the food web. In combination with climate change, land‐use intensification had the greatest effect on higher trophic levels, culminating in the extinction of endothermic carnivores in Namibia and Finland and endothermic omnivores in Namibia. Arid and tropical regions showed a slightly higher response of total biomass to climate change under a high‐emissions scenario with rising temperatures, whereas areas with low net primary productivity showed the most negative response to land‐use intensification. Our results suggest that 1) further land‐use intensification will significantly affect larger organisms and predators, leading to a major restructuring of global food webs. 2) Arid low‐productivity regions will experience significant changes in community composition due to global change. 3) Climate changes appear to have slightly greater effects in tropical and arid climates, whereas land‐use intensification tends to affect less productive environments. This paper shows how general ecosystem models deepen our understanding of multitrophic interactions and how climate change or land‐use drivers affect ecosystems in different biomes.
Predictive factors for arteriovenous fistula maturation: A prospective study
Authors: Correia Ana Luisa , Silva Ana Rita , Mira Filipe , Pinto Rui , Ferreira Emanuel , Guedes Marques Maria , Romãozinho Catarina , Alves Rui
Published: December 2024

Introduction

Arteriovenous fistula (AVF) maturation failure remains common despite preoperative ultrasound mapping. Identifying predictive biomarkers can help anticipate primary failure and reducing invasive procedures. Our study aimed to identify clinical and analytical risk factors for primary AVF failure or delay.

Methods

A prospective study (October 2022–March 2023) included adult patients scheduled for AVF creation. In all patients, a preoperative ultrasound mapping was conducted and AVF maturation assessed at least 6 weeks post‐surgery. Clinical, analytical, and demographic data were collected.

Findings

Eighty patients were included, 62.5% male, and mean age 66.3 years. For distal anastomosis, preoperative vein (3.8 ± 1.2 vs. 2.8 ± 0.6 mm; p 0.002) and supply artery (2.5 ± 0.4 vs. 2.0 ± 0.3 mm; p 0.001) diameters were significant factors impacting primary failure. Also, for proximal anastomosis, the artery diameter (2.4 ± 0.4 vs. 2.0 ± 0.4 mm; p 0.01) had an impact on AVF maturation. ROC curves established for distal AVF a vein diameter cutoff of 3.25 mm (AUC 77.2%) and artery cut‐off of 2.35 mm (AUC 74.6%) and for proximal AVF an artery cutoff of 2.25 mm (AUC 76.5%). Distal AVF creation correlated with higher primary failure risk (p < 0.001). No correlation was found between the primary failure rate and the presence of central venous catheter or serum results. In a sub analysis, we found that patients with central venous catheter had higher levels of inflammatory markers.

Discussion

Our study highlights the importance of preoperative evaluation, ultrasound mapping, and careful AVF site selection. Recognizing vein and artery diameter thresholds for optimal outcomes is crucial. Avoiding central venous catheters in suitable patients can positively impact AVF results.
The Role of Community Social Capital and Collective Action in the Development of Sustainable Tourism
Authors: Auliah Aidha , Prayitno Gunawan , Ari Ismu Rini Dwi , Adrianto Dimas Wisnu , Subagiyo Aris , Biloshkurska N. V. , Ismaili Hairi
Published: December 2024

Bangelan Tourism Village in Indonesia holds significant potential as a tourist destination that delivers both economic and social benefits to the local community. This study focuses on the role of social capital as a key factor in the success of sustainable tourism development. The theoretical framework of this research centres on social capital, which includes trust, social networks and norms as essential elements that facilitate collective action between communities and the government to achieve sustainable tourism. Social capital, in its connection to sustainable tourism, enables coordination and collaboration among local stakeholders to pursue common goals. Uniquely, this study demonstrates that community‐driven collective action, supported by social capital, is more effective than government‐initiated programmes in advancing sustainable tourism in rural Indonesia, filling a gap in the existing literature. Data were collected via questionnaires from 261 heads of households in Bangelan Tourism Village and analysed using the structural equation modelling (SEM) partial least square (PLS) method. The results indicate that social capital, represented by trust, social networks and norms, has a strong positive influence on collective action. In turn, collective action has an even stronger impact on achieving sustainable tourism. The practical implications underscore the importance of strengthening social capital to promote active community participation in tourism management, through strategies such as community training and policies that foster mutual cooperation. This research provides a significant contribution to the literature on the relationship between social capital, collective action and sustainable tourism development, offering valuable insights for policymakers seeking to strengthen social capital in support of sustainable rural tourism.
DExD‐Box Helicase 21 Enhances Myometrial Contractions Through Thrombospondin‐1‐Mediated Increase in Cell Adhesion
Authors: Chen Lina , Jiang Yanmin , Wang Xiaodi , Wang Lele , Bao Junjie , Lv Zi , Sha Xiaoyan , Zheng Zheng , Chen Yunshan , Ji Kaiyuan , Liu Huishu
Published: December 2024

During labour, the myometrium transitions from a quiescent to an actively contracting state, governed by changes in gene expression. Identifying the pivotal transcription regulators involved in these gene expression alterations offers a useful strategy for addressing abnormal myometrial contractions. This study determined that the transcriptional regulator DExD‐Box Helicase 21 (DDX21) is upregulated in human myometrial tissues and myometrial smooth muscle cells (hMSMCs) during labour. DDX21 enhances hMSMC contractility through a mechanism that involves binding to thrombospondin 1 (THBS1) mRNA, a cell adhesion molecule, and promoting its transcription and subsequent protein expression. This upregulation of THBS1 increases cellular adhesion, which is crucial for effective myometrial contraction and for contractile function. Consequently, the DDX21‐THBS1 pathway could be a potential target for modulating key functions required for effective myometrial contraction.
Do meaningful dimensions of childhood adversity exist? Data‐driven evidence from two prospective cohort studies
Authors: Chow Athena R.W. , Baldwin Jessie R. , Bowes Lucy
Published: December 2024

Background

There is not yet a consensus on the best way to conceptualise adverse childhood experiences (ACEs). We used data‐driven methods across two populations to examine (a) if there were meaningful dimensions underlying ACEs and (b) whether dimensions were differentially associated with increased risk of adolescent psychopathology.

Methods

Participants were 18,539 British children from the UK Millennium Cohort Study (MCS) and 11,876 American children from the US Adolescent Brain Cognitive Development Study (ABCD). A wide range of ACEs (e.g., abuse, neglect, parental psychopathology, peer victimisation) were measured prospectively from infancy to mid‐adolescence using interviews and questionnaires. Internalising and externalising symptoms were assessed with child and/or parent reports during adolescence.

Results

Our preregistered exploratory factor analysis revealed four latent dimensions in the MCS (parental threat, deprivation, victimisation, and parental discipline) and ABCD (parental threat, deprivation, victimisation, and traumatic events). All dimensions except deprivation were associated with increased risk for internalising and externalising symptoms. Over and above the other dimensions, victimisation was more strongly associated with internalising (MCS β = .34, 95% CI 0.33–0.36; ABCD β = .11, 95% CI 0.10–0.13) and externalising (MCS β = .31, 95% CI 0.30–0.33; ABCD β = .13, 95% CI 0.11–0.15) symptoms.

Conclusions

Across two distinct populations, we found that ACEs can be captured by common underlying dimensions of parental threat, deprivation, and victimisation, as well as additional sample‐specific dimensions. Our findings expand dimensional theories of childhood adversity by suggesting that in addition to threat and deprivation, victimisation is a distinct dimension of adversity that has the strongest associations with adolescent psychopathology.
How smart is smart money? Evidence from mutual funds' exposure on corporate misconduct
Authors: Kong Dongmin , Zhao Zhao
Published: December 2024

We examine how mutual funds' trading and performance respond to corporate misconduct. We exploit a combined dataset of corporate misconduct and holding information of mutual funds and find that mutual funds tend to not only sell but also buy more stocks of corporations with misconduct. Moreover, the exposure to misconduct stocks is negatively related to mutual funds' future performance. The top quintile portfolio of funds with the highest level of misconduct exposure underperforms the bottom quintile by 1.57% to 1.97% on an annualized basis. This performance gap is wider when it is easier for fund managers to gain information advantages.
Clinical Significance of Lymphatic Involvement in Intramucosal (pT1a) Gastric Cancer Resected by Endoscopic Submucosal Dissection
Authors: Matsueda Katsunori , Kono Yoshiyasu , Miyahara Koji , Nakagawa Masahiro , Mouri Hirokazu , Matsueda Kazuhiro , Hamada Kenta , Iwamuro Masaya , Kawano Seiji , Kawahara Yoshiro , Tanaka Takehiro , Otsuka Motoyuki
Published: December 2024

Background and Aim

Lymphatic involvement is sometimes detected during routine examination of intramucosal (pT1a) gastric cancer resected endoscopically. However, its clinical significance and association with the risk of metastasis remain unknown.

Methods

This was a retrospective cohort study of 6797 consecutive patients with pT1a gastric cancers treated by endoscopic submucosal dissection (ESD) at three institutions in Japan from January 2005 to August 2023. Patients with 49 uncommon‐type gastric cancer types were excluded. The risk of metastasis for pT1a cancers with lymphatic involvement was quantified by comparing lymph node metastasis and/or metastatic recurrence in patient groups who underwent additional surgery post‐ESD or did not undergo surgery but were followed up for > 3 years.

Results

Among the 6748 pT1a cancers treated by ESD, 41 lesions (0.6%) had histologically confirmed lymphatic involvement. Among the 41 patients, 1 was excluded from the analysis of metastasis risk because the follow‐up period after ESD without additional surgery was ≤ 3 years. Metastasis was identified in 1 of 40 patients analyzed (2.5%; 95% confidence interval [CI] 0.4%–12.9%), and was not detected in any of the 25 patients with pure differentiated‐type lesions (0.0%; 95% CI 0.0%–13.7%).

Conclusions

The low prevalence of metastasis after ESD for pT1a gastric cancer with lymphatic involvement, particularly in patients with pure differentiated‐type lesions, suggests a low risk of metastatic recurrence.
Associations between multimorbidity and kidney function decline in old age: A population‐based cohort study
Authors: Beridze Giorgi , Dai Lu , Carrero Juan‐Jesús , Marengoni Alessandra , Vetrano Davide L. , Calderón‐Larrañaga Amaia
Published: December 2024

Background

Individual chronic conditions have been linked to kidney function decline; however, the role of multimorbidity (the presence of ≥2 conditions) and multimorbidity patterns remains unclear.

Methods

A total of 3094 individuals from the Swedish National study on Aging and Care in Kungsholmen (SNAC‐K) were followed for 15 years. Multimorbidity was operationalized as the number of chronic conditions and multimorbidity patterns identified using latent class analysis (LCA). Joint models and Cox regression models were used to explore the associations between multimorbidity, and subsequent absolute and relative (≥25% decline from baseline) changes, respectively, in the estimated glomerular filtration rate (eGFR) calculated using the creatinine‐based Berlin Initiative Study equation.

Results

Mean age of the sample was 73.9, and 87% had multimorbidity. There was an independent dose–response relationship between the number of chronic conditions, and absolute (β [95% confidence interval, CI] = −0.05 [−0.07; −0.03]) and relative (hazard ratio, HR [95% CI] = 1.23 [1.17; 1.29]) declines in eGFR. Five patterns of multimorbidity were identified. The Unspecific, low burden pattern had the lowest morbidity burden and was used as the reference category. The Unspecific, high burden, and Cardiometabolic patterns showed accelerated absolute (β [95% CI] = −0.15 [−0.26; −0.05] and −0.77 [−0.98; −0.55], respectively) and relative (HR [95% CI] = 1.45 [1.09; 1.92] and 3.45 [2.27; 5.23], respectively) declines. Additionally, the Cognitive and Sensory pattern showed accelerated relative decline (HR [95% CI] = 1.53 [1.02; 2.31]). No associations were found for the Psychiatric and Respiratory pattern.

Conclusion

Multimorbidity is strongly associated with accelerated kidney function decline in older age. Individuals with cardiometabolic multimorbidity exhibit a particularly increased risk. Increased monitoring and timely interventions may preserve kidney function and reduce cardiovascular risks in individuals presenting with conditions that are characteristic of high‐risk multimorbidity patterns.
Perceptions of Coping With Breastfeeding Pain: A Secondary Analysis
Authors: Russell Megan , Lucas Ruth , Bernier Carney Katherine
Published: December 2024

Introduction

Although there are many known benefits of providing human milk to infants, breastfeeding‐related pain is a significant reason for breastfeeding cessation. Breastfeeding‐related pain is a unique experience due to breastfeeding's goal‐directed purpose, repetitive nature, and socio‐emotional reflections of successful parenting. Understanding how lactating parents cope with breastfeeding‐related pain will inform clinical practice to encourage individuals to meet their lactation goals. The aim of this study was to evaluate how lactating parents view coping with breastfeeding‐related pain to be different from coping with other types of pain.

Methods

We conducted a secondary analysis of a pilot randomized control study of a breastfeeding pain self‐management intervention. Data from 57 participants who breastfed and completed self‐report surveys at 1, 2, and 6 weeks postpartum were included. We employed Boyatzis’ thematic analysis method to evaluate affirmative responses to “Is coping with breastfeeding pain different than coping with other pain?” We evaluated correlations between responses to coping with breastfeeding pain and pain severity scores.

Results

We identified 3 main themes: (1) uncharted waters, (2) light at the end of the tunnel, and (3) parental role and responsibility. No significant differences were detected between the pain scores of individuals who viewed coping with breastfeeding to be different and those who did not.

Discussion

Lactating parents reported an array of psychological coping strategies in response to breastfeeding‐related pain. Coping processes were influenced by personal goals, parental role evaluations, and a desire to meet their infant's needs. Interventions during prenatal and postpartum care that incorporate individualized coping strategies could support breastfeeding goal attainment.
Stigmatization and Psychosocial Burden in Acne Patients
Authors: Tunca Mustafa , Balik Zeynep Büşra , Uncu Hüma Beliz , Botsali Ayşenur
Published: December 2024

Background

Acne vulgaris, a common dermatological condition, has physical manifestations and significant emotional and social implications for those affected. This study aims to assess the stigma experienced by acne vulgaris patients and identify relevant physical, social, and psychological factors.

Methods

The research involved individuals aged 12–45 diagnosed with acne vulgaris. The authors recorded each patient's demographic information, global acne severity, and acne scar severity. Additionally, each patient completed the Dermatologic Life Quality Index, Beck Depression Inventory, Liebowitz Social Anxiety Scale, and 6‐item stigmatization scale. Using the scale scores, the authors categorized the severity into subgroups and compared the results within these subgroups.

Results

The severity of acne was positively correlated with DLQI scores (r = 0.196, p = 0.004) and stigmatization scores (r = 0.156, p = 0.024). Higher stigmatization scores were associated with increased levels of depression (r = 0.461, p < 0.001) and anxiety (r = 0.336, p < 0.001), as well as a significant impact on quality of life (r = 0.472, p < 0.001). Upon stratification of patients into three age groups (adolescence, late adolescence, and adulthood), the comparisons between these groups did not reach statistical significance.

Conclusion

The results of the current study reveal a clear connection between the severity of acne and psychosocial disturbances, irrespective of age. The authors advise incorporating psychosocial screening, especially for severe acne vulgaris patients of all ages.
Factors influencing confidence in tracheal intubation among neonatal trainees: A questionnaire‐based study
Authors: Rao Vishwas , Balachander Bharathi , Dubey Pragya , Rao PN Suman
Published: December 2024

Aim

Tracheal intubation (TI) is pivotal in managing critically ill neonates. This study aims to investigate the disparities in exposure and training techniques that affect self‐perceived confidence in neonatal fellows concerning TI.

Methods

A comprehensive, structured questionnaire‐based survey was conducted among neonatal trainees from October to November 2022. Self‐perceived confidence in TI was evaluated using a Likert scale, ranging from 1 to 10. The trainees who scored below seven were categorised as under‐confident, while those who scored seven or more were considered confident in TI. An analysis was done to assess the differences in exposure, training and clinical policies related to TI in both groups. A P‐value <0.05 was considered significant.

Results

The final dataset consisted of 93 trainees. Confidence was higher among those who had independently performed TI on more than 30 neonates during their postgraduate training (relative risk (RR) 1.5 (1.03–2.1), P = 0.02) and super‐specialty training (RR 1.5 (1.20–1.93), P = 0.0004). Confidence was also significantly associated with training programmes that incorporated written checklists for intubation instruments and policies (RR 1.4 (1.1–1.8), P = 0.006), conducted debriefing sessions after each TI attempt (RR 1.3 (1.03–1.6), P = 0.005), and implemented regular simulation programmes (RR 1.4 (1.1–1.8), P = 0.0006).

Conclusions

Trainees with increased opportunities for intubation and training programmes featuring regular simulations and debriefing sessions tend to possess higher self‐perceived confidence in TI.
Enterobacter mori Causing Leaf Spot and Soft Rot in Three New Ornamental Hosts
Authors: Bolhasani Fatemeh , Falahi Charkhabi Nargues
Published: December 2024

Leaf spot and soft rot of ornamental plants were observed in the Alborz and Markazi provinces during the summer and autumn of 2022. Eighteen samples were collected from symptomatic ornamental plants in Karaj and Arak cities. Necrotic leaf spots surrounded by a broad yellow halo were observed in the affected pothos (Epipremnum aureum) and compact dragon (Dracaena compacta) plants. On the severely affected, leaves of compact dragon with a yellow margin were observed. Soft rot symptoms which turned dark brown areas were observed on the diseased jade plants (Crassula ovata). The colonies of bacterial strains were cream‐coloured, round, convex, smooth and with entire margins on nutrient agar. In the pathogenicity of 35 recovered strains, the five strains isolated from pothos caused water‐soaking 2 days after inoculation, which finally turned into necrotic lesions surrounded by chlorotic halos. Eight strains isolated from compact dragon produced necrotic spots on the inoculated plants. Five strains originated from jade plants induced soft rot 4–5 days post‐inoculation. All 18 pathogenic strains were negative in Gram and oxidase reactions. The gyrB and infB gene sequences of eight representative strains were partially amplified and sequenced. In the maximum‐likelihood phylogenetic tree created based on the concatenated sequences of gyrB and infB genes, the strains clustered with Enterobacter mori LMG 25706T supported with bootstrap value of 100%. To the best of our knowledge, this is the first report of pothos and compact dragon leaf spot and jade plant soft rot caused by E. mori.
Recent advancements in aquaponics with special emphasis on its sustainability
Authors: Nair Chythra Somanathan , Manoharan Ramya , Nishanth Drishya , Subramanian Radhakrishnan , Neumann Elke , Jaleel Abdul
Published: December 2024

An aquaponic system which is an integration of hydroponics with aquaculture is sustainable, ecologically friendly, and uses non‐renewable resources with very high efficacy. The increasing trend in aquaponics research demonstrates a growing recognition of its potential to address critical global issues such as food security, water conservation, and sustainable agriculture, particularly in regions vulnerable to climate change and resource limitations. It has witnessed remarkable advancements in recent years, with various methods and variations emerging to enhance its functionality and productivity. The purpose of this review is to unify fragmented research on aquaponics and provide a comprehensive resource that emphasizes its potential for broad adoption and successful implementation in varied environments. This review focuses on recent innovations in aquaponic system designs for various climates and examines key advancements in critical areas, including microbial communities, biofiltration, feed management, water quality, and nutrient cycling, emphasizing the interdisciplinary nature of aquaponics. Coupled systems suit moderate climates with high resource efficiency, while decoupled systems offer flexibility across diverse climates by allowing independent control of each component. Innovations such as sandponics, algaeponics, and saline aquaponics address challenges like water scarcity and nutrient efficiency. Smart technologies like IoT and AI are integrated into aquaponics, automating monitoring and nutrient management for better productivity. Emerging areas, including vermi‐aquaponics and flocponics, offer new solutions for nutrient cycling, making aquaponics more efficient, adaptable, and resource‐conserving globally. This paper also examines the sustainability aspects of aquaponics, emphasizing its economic, social, and environmental dimensions. Despite high setup costs and nutrient complexities, aquaponics offers significant potential for sustainable food production by minimizing water use and reducing synthetic fertilizers. Its scalability in both urban and rural areas, along with innovations like vertical systems, presents promising solutions for enhancing agriculture and food security across diverse environments.
Cognitive Reappraisal Reduces Academic Anxiety in University Students With Dyslexia
Authors: Coates McDowall Holly , Rimfeld Kaili , Krishnan Saloni
Published: December 2024

University students with dyslexia have greater anxiety than their peers without dyslexia, especially related to their academic studies. Most universities focus on mitigating the learning needs of these students, for example, providing more time during exams. Relatively little attention is paid to the psychological impact of having dyslexia. In this preregistered study, we investigated whether cognitive reappraisal reduced academic anxiety in university students with dyslexia. We codesigned negative and neutral scenarios about academic life with university students with dyslexia. We presented university students (54 students with dyslexia and 51 neurotypical students) with these scenarios about academic life and asked them to rate their anxiety. As hypothesized, we observed that students with dyslexia had higher academic anxiety than those without dyslexia (d = 0.43). When instructed to use cognitive reappraisal, all students, irrespective of having dyslexia or not, benefitted from an anxiety reduction (d = 0.87). Our experimental research indicates cognitive reappraisal may be a valuable tool to support students. Furthermore, it may help those with dyslexia to manage the heightened emotional demands of academia. Intervention trials that assess the real‐world implementation of cognitive reappraisal are now warranted.
Breaking the Hybrid Myth of Paphiopedilum wenshanense: Double Bifurcated Divergence Followed by Adaptive Introgression Formed a Morphological Intermediate
Authors: Jiang Hong , Chang Jui‐Tse , Liao Pei‐Chun , Lee Yung‐I
Published: December 2024

Species with intermediate phenotypes are usually hypothesised to have originated from hybrid speciation. However, other mechanisms, such as double bifurcated speciation with introgression may create the same phenotypes. Clarifying the underlying process generating the observed intermediate morphology is important for conservation efforts, as it provides insights into the species' evolutionary background and adaptability. Here, we utilised genome‐wide single nucleotide polymorphism data to test evolutionary history models for Paphiopedilum wenshanense Z. J. Liu & J. Yong Zhang, an orchid species that is widely considered to be a hybrid with intermediate morphology of other two closely related species, P. concolor Pfitzer and P. bellatulum Pfitzer, distributed in Indochina. Our results rejected the hybrid speciation hypothesis and ascribed the intermediate floral phenotypes of P. wenshanese to introgression from P. concolor after it diverged from P. bellatulum during the last glacial maximum. Excluding the geographic covariate, the current genetic mixing rate of P. wenshanense from P. concolor is stronger in the south part of its range and is associated with precipitation in the early summer, indicating that population divergence in P. wenshanense is being driven by adaptive introgression. These genetic patterns also correspond to the observed floral variation across P. wenshaense populations. The introgression from P. concolor, along with the intermediate and varying floral morphologies, may expand the ecological opportunities for P. wenshanense, providing an explanation for why high genetic diversity has been maintained despite a high level of inbreeding and small census population size. Our study provides a framework for future research to investigate the characteristics and underlying mechanisms of intermediate morphologies in general.
Digital Healthy Diet and Health Literacy as Determinants of Physical Activity Level in Adults: A Descriptive Correlational Study
Authors: Selçuk Tosun Alime , Duran Büşra , Akgül Gündoğdu Nurcan , Lök Neslihan
Published: December 2024

Objective

This study was conducted to determine the level of health literacy, digital healthy diet literacy, and physical activity of adult individuals to evaluate the relationship of physical activity with health literacy and digital healthy diet literacy and to examine the determinants of physical activity level.

Design and Method

It is a descriptive and correlational study. The sample of the study consists of 404 individuals aged 18–65. Personal Information Form, International Physical Activity Questionnaire—Short Form, Health Literacy Scale—Short Form, and Digital Healthy Diet Literacy Scale were used to collect the study data. Number, percentage, mean and standard deviation, t test in independent groups, one‐way analysis of variance, and multiple regression analysis were used in the analysis of the study data.

Results

Participants' gender (β = 0.572, p = 0.000), educational status (β = 0.630, p = 0.000), employment status (β = 0.573, p = 0.000), perceived economic situation (β = 0.774, p = 0.000), cohabitants (β = 0.609, p = 0.000), perceived health (β = 0.580, p = 0.000), smoking status (β = 0.639, p = 0.045), health literacy total score (β = 0.603, p = 0.000), and digital health literacy (β = 0.782, p = 0.000) were found to be predictors of physical activity level (p < 0.001). It was determined that these determinants explained 57.3% (adjusted R2 = 0.573) of the change in physical activity level.

Conclusion

The mean scores of the participants' physical activity level were at a medium level. Increasing the participants' awareness of health literacy and digital healthy diet literacy may be effective in increasing the level of physical activity.
Unexpected sounds induce a rapid inhibition of eye‐movement responses
Authors: Vasilev Martin R. , Ozkan Zeynep G. , Kirkby Julie A. , Nuthmann Antje , Parmentier Fabrice B. R.
Published: December 2024

Unexpected sounds have been shown to trigger a global and transient inhibition of motor responses. Recent evidence suggests that eye movements may also be inhibited in a similar way, but it is not clear how quickly unexpected sounds can affect eye‐movement responses. Additionally, little is known about whether they affect only voluntary saccades or also reflexive saccades. In this study, participants performed a pro‐saccade and an anti‐saccade task while the timing of sounds relative to stimulus onset was manipulated. Pro‐saccades are generally reflexive and stimulus‐driven, whereas anti‐saccades require the generation of a voluntary saccade in the opposite direction of a peripheral stimulus. Unexpected novel sounds inhibited the execution of both pro‐ and anti‐saccades compared to standard sounds, but the inhibition was stronger for anti‐saccades. Novel sounds affected response latencies as early as 150 ms before the peripheral cue to make a saccade, all the way to 25 ms after the cue to make a saccade. Interestingly, unexpected sounds also reduced anti‐saccade task errors, indicating that they aided inhibitory control. Overall, these results suggest that unexpected sounds yield a global and rapid inhibition of eye‐movement responses. This inhibition also helps suppress reflexive eye‐movement responses in favor of more voluntarily generated ones.
Sanan rai wisdom in Atauro's tourism transformation
Authors: Oliveira Ana Carolina Ramos
Published: December 2024

This paper examines the history and activities of the Timorese NGO Empreza Di'ak, focusing on its role in revitalising traditional pottery (sanan rai in Tetum) on Atauro Island. Traditionally a form of women's knowledge, pottery has been reimagined in the post‐independence era as cultural heritage at risk of extinction, now transformed into commodities primarily targeting the tourist market. The paper explores the interplay of social, economic, and generational factors driving the revival of sanan rai production within the broader context of positioning Atauro as an international tourism destination. It delves into the complexities, challenges, and subjectivities that arise, alongside the unexpected situations and evolving expectations of local communities as they navigate this process of (re)engaging with and revaluing a nearly lost tradition.