bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of outliers on remote sensing‐assisted forest biomass estimation: A case study from the United States national forest inventory
Authors: Knott Jonathan A. , Liknes Greg C. , Giebink Courtney L. , Oh Sungchan , Domke Grant M. , McRoberts Ronald E. , Quirino Valquiria F. , Walters Brian F.
Published: March 2023

Large‐scale ecological sampling networks, such as national forest inventories (NFIs), collect in situ data to support biodiversity monitoring, forest management and planning, and greenhouse gas reporting. Data harmonization aims to link auxiliary remotely sensed data to field‐collected data to expand beyond field sampling plots, but outliers that arise in data harmonization—questionable observations because their values differ substantially from the rest—are rarely addressed.

In this paper, we review the sources of commonly occurring outliers, including random chance (statistical outliers), definitions and protocols set by sampling networks, and temporal and spatial mismatch between field‐collected and remotely sensed data. We illustrate different types of outliers and the effects they have on estimates of above‐ground biomass population parameters using a case study of 292 NFI plots paired with airborne laser scanning (ALS) and Sentinel‐2 data from Sawyer County, Wisconsin, United States.

Depending on the criteria used to identify outliers (sampling year, plot location error, nonresponse, presence of zeros and model residuals), as many as 53 of the 292 Forest Inventory and Analysis plot observations (18%) were identified as potential outliers using a single criterion and 111 plot observations (38%) if all criteria were used. Inclusion or removal of potential outliers led to substantial differences in estimates of mean and standard error of the estimate of biomass per unit area. The simple expansion estimator, which does not rely on ALS or other auxiliary data, was more sensitive to outliers than model‐assisted approaches that incorporated ALS and Sentinel‐2 data. Including Sentinel‐2 predictors showed minimal increases to the precision of our estimates relative to models with ALS predictors alone.

Outliers arise from many causes and can be pervasive in data harmonization workflows. Our review and case study serve as a note of caution to researchers and practitioners that the inclusion or removal of potential outliers can have unintended consequences on population parameter estimates. When used to inform large‐scale biomass mapping, carbon markets, greenhouse gas reporting and environmental policy, it is necessary to ensure the proper use of NFI and remotely sensed data in geospatial data harmonization.
Predicting severe pain after major surgery: a secondary analysis of the Peri‐operative Quality Improvement Programme (PQIP) dataset
Authors: Armstrong R. A. , Fayaz A. , Manning G. L. P. , Moonesinghe S. R. ,   the Peri‐operative Quality Improvement Programme (PQIP) delivery team, Oliver C. M. ,   for the PQIP collaborative
Published: March 2023

Acute postoperative pain is common, distressing and associated with increased morbidity. Targeted interventions can prevent its development. We aimed to develop and internally validate a predictive tool to pre‐emptively identify patients at risk of severe pain following major surgery. We analysed data from the UK Peri‐operative Quality Improvement Programme to develop and validate a logistic regression model to predict severe pain on the first postoperative day using pre‐operative variables. Secondary analyses included the use of peri‐operative variables. Data from 17,079 patients undergoing major surgery were included. Severe pain was reported by 3140 (18.4%) patients; this was more prevalent in females, patients with cancer or insulin‐dependent diabetes, current smokers and in those taking baseline opioids. Our final model included 25 pre‐operative predictors with an optimism‐corrected c‐statistic of 0.66 and good calibration (mean absolute error 0.005, p = 0.35). Decision‐curve analysis suggested an optimal cut‐off value of 20–30% predicted risk to identify high‐risk individuals. Potentially modifiable risk factors included smoking status and patient‐reported measures of psychological well‐being. Non‐modifiable factors included demographic and surgical factors. Discrimination was improved by the addition of intra‐operative variables (likelihood ratio χ2 496.5, p < 0.001) but not by the addition of baseline opioid data. On internal validation, our pre‐operative prediction model was well calibrated but discrimination was moderate. Performance was improved with the inclusion of peri‐operative covariates suggesting pre‐operative variables alone are not sufficient to adequately predict postoperative pain.
Am I being dehumanized? Development and validation of the experience of dehumanization measurement
Authors: Golossenko Artyom , Palumbo Helena , Mathai Mariya , Tran Hai‐Anh
Published: March 2023

Scholarly interest in the experience of dehumanization, the perception that one is being dehumanized, has increased significantly in recent years, yet the construct lacks a validated measurement. The purpose of this research is therefore to develop and validate a theoretically grounded experience of dehumanization measurement (EDHM) using item response theory. Evidence from five studies using data collected from participants in the United Kingdom (N = 2082) and Spain (N = 1427), shows that (a) a unidimensional structure replicates and fits well; (b) the measurement demonstrates high precision and reliability across a broad range of the latent trait; (c) the measurement demonstrates evidence for nomological and discriminant validity with constructs in the experience of dehumanization nomological network; (d) the measurement is invariant across gender and cultures; (e) the measurement demonstrates incremental validity in the prediction of important outcomes over and above conceptually overlapping constructs and prior measurements. Overall, our findings suggest the EDHM is a psychometrically sound measurement that can advance research relating to the experience of dehumanization.
Sexual orientation and self‐employment: New evidence
Authors: Pajovic Vesna , Waite Sean , Denier Nicole
Published: March 2023

Early studies and theory suggest sexual minorities are drawn towards the relative independence of self‐employment to avoid discrimination in paid employment. However, recent evidence is mixed, suggesting that a higher propensity for self‐employment (relative to heterosexual people) is found only among lesbian women relative to heterosexual women. This study overcomes the data limitations of prior research by using data pooled from 2007–2017 cycles of the Canadian Community Health Survey (CCHS) and multivariate logistic regression to provide new evidence on LGB self‐employment. The results show that self‐employment is particularly high for bisexual people, especially bisexual women—but not for gay men or lesbian women. Overall, this study examines the enduring but nuanced relationship between self‐employment and sexual orientation and discusses countervailing factors related to socio‐economic resources, gender, and family structure.
Rapid detection of the MYD88 L265P mutation for pre‐ and intra‐operative diagnosis of primary central nervous system lymphoma
Authors: Yamaguchi Junya , Ohka Fumiharu , Kitano Yotaro , Maeda Sachi , Motomura Kazuya , Aoki Kosuke , Takeuchi Kazuhito , Nagata Yuichi , Hattori Hikaru , Tsujiuchi Takashi , Motomura Ayako , Nishikawa Tomohide , Kibe Yuji , Shinjo Keiko , Kondo Yutaka , Saito Ryuta
Published: March 2023

The myeloid differentiation primary response gene 88 (MYD88) L265P mutation is a disease‐specific mutation of primary central nervous system lymphoma (PCNSL) among the central nervous system tumors. Accordingly, this mutation is considered a reliable diagnostic molecular marker of PCNSL. As the intra‐operative diagnosis of PCNSL is sometimes difficult to achieve using histological examinations alone, intra‐operative detection of the MYD88 L265P mutation could be effective for the accurate diagnosis of PCNSL. Herein, we aimed to develop a novel rapid genotyping system (GeneSoC) using real‐time polymerase chain reaction (PCR) based on microfluidic thermal cycling technology. This real‐time PCR system shortened the analysis time, which enabled the detection of the MYD88 L265P mutation within 15 min. Rapid detection of the MYD88 L265P mutation was performed intra‐operatively using GeneSoC in 24 consecutive cases with suspected malignant brain tumors, including 10 cases with suspected PCNSL before surgery. The MYD88 L265P mutation was detected in eight cases in which tumors were pathologically diagnosed as PCNSL after the operation, while wild‐type MYD88 was detected in 16 cases. Although two of the 16 cases with wild‐type MYD88 were pathologically diagnosed as PCNSL after the operation, MYD88 L265P could be detected in all eight PCNSL cases harboring MYD88 L265P. The MYD88 L265P mutation could also be detected using cell‐free DNA derived from the cerebrospinal fluid of two PCNSL cases. Detection of the MYD88 L265P mutation using GeneSoC might not only improve the accuracy of intra‐operative diagnosis of PCNSL but also help the future pre‐operative diagnosis through liquid biopsy of cerebrospinal fluid.
An FBN1 deep intronic variant is associated with pseudoexon formation and a variable Marfan phenotype in a five generation family
Authors: Guo Dong‐chuan , Duan Xueyan , Mimnagh Kathleen , Cecchi Alana C. , Marin Isabella C. , Yu Yang , Velasco Walter V. , Lee Kwanghyuk , Zhu Xue , Murdock David R. , Leal Suzanne M. , Wheeler Marsha M. , Smith Josh , Bamshad Michael J. , Milewicz Dianna M.
Published: March 2023

Exome sequencing of genes associated with heritable thoracic aortic disease (HTAD) failed to identify a pathogenic variant in a large family with Marfan syndrome (MFS). A genome‐wide linkage analysis for thoracic aortic disease identified a peak at 15q21.1, and genome sequencing identified a novel deep intronic FBN1 variant that segregated with thoracic aortic disease in the family (LOD score 2.7) and was predicted to alter splicing. RT‐PCR and bulk RNA sequencing of RNA harvested from fibroblasts explanted from the affected proband revealed an insertion of a pseudoexon between exons 13 and 14 of the FBN1 transcript, predicted to lead to nonsense mediated decay (NMD). Treating the fibroblasts with an NMD inhibitor, cycloheximide, greatly improved the detection of the pseudoexon‐containing transcript. Family members with the FBN1 variant had later onset aortic events and fewer MFS systemic features than typical for individuals with haploinsufficiency of FBN1. Variable penetrance of the phenotype and negative genetic testing in MFS families should raise the possibility of deep intronic FBN1 variants and the need for additional molecular studies.
Learning to pause: Fidelity of and biases in the developmental acquisition of gaps in the communicative signals of a songbird
Authors: James Logan S. , Wang Angela S. , Bertolo Mila , Sakata Jon T.
Published: March 2023

The temporal organization of sounds used in social contexts can provide information about signal function and evoke varying responses in listeners (receivers). For example, music is a universal and learned human behavior that is characterized by different rhythms and tempos that can evoke disparate responses in listeners. Similarly, birdsong is a social behavior in songbirds that is learned during critical periods in development and used to evoke physiological and behavioral responses in receivers. Recent investigations have begun to reveal the breadth of universal patterns in birdsong and their similarities to common patterns in speech and music, but relatively little is known about the degree to which biological predispositions and developmental experiences interact to shape the temporal patterning of birdsong. Here, we investigated how biological predispositions modulate the acquisition and production of an important temporal feature of birdsong, namely the duration of silent pauses (“gaps”) between vocal elements (“syllables”). Through analyses of semi‐naturally raised and experimentally tutored zebra finches, we observed that juvenile zebra finches imitate the durations of the silent gaps in their tutor's song. Further, when juveniles were experimentally tutored with stimuli containing a wide range of gap durations, we observed biases in the prevalence and stereotypy of gap durations. Together, these studies demonstrate how biological predispositions and developmental experiences differently affect distinct temporal features of birdsong and highlight similarities in developmental plasticity across birdsong, speech, and music.

Research Highlights

The temporal organization of learned acoustic patterns can be similar across human cultures and across species, suggesting biological predispositions in acquisition.

We studied how biological predispositions and developmental experiences affect an important temporal feature of birdsong, namely the duration of silent intervals between vocal elements (“gaps”).

Semi‐naturally and experimentally tutored zebra finches imitated the durations of gaps in their tutor's song and displayed some biases in the learning and production of gap durations and in gap variability.

These findings in the zebra finch provide parallels with the acquisition of temporal features of speech and music in humans.
ccl19 and ccl21 affect cell movements and differentiation in early Xenopus development
Authors: Goto Toshiyasu , Michiue Tatsuo , Shibuya Hiroshi
Published: March 2023

We characterized Xenopus laevis C‐C motif chemokine ligand 19.L (ccl19.L) and C‐C motif chemokine ligand 21.L (ccl21.L) during early Xenopus embryogenesis. The temporal and spatial expression patterns of ccl19.L and ccl21.L tended to show an inverse correlation, except that the expression level was higher in the dorsal side at the gastrula stage. For example, even at the dorsal sector of the gastrulae, ccl19.L was expressed in the axial region and ccl21.L was expressed in the paraxial region. Dorsal overexpression of ccl19.L and ccl21.L and knockdown of Ccl19.L and Ccl21.L inhibited gastrulation, but their functions were different in cell behaviors during morphogenesis. Observation of Keller sandwich explants revealed that overexpression of both ccl19.L and ccl21.L and knockdown of Ccl21.L inhibited the convergent extension movements, while knockdown of Ccl19.L did not. ccl19.L‐overexpressing explants attracted cells at a distance and ccl21.L‐overexpressing explants attracted neighboring cells. Ventral overexpression of ccl19.L and ccl21.L induced secondary axis‐like structures and chrd.1 expression at the ventral side. Upregulation of chrd.1 was induced by ligand mRNAs through ccr7.S. Knockdown of Ccl19.L and Ccl21.L inhibited gastrulation and downregulated chrd.1 expression at the dorsal side. The collective findings indicate that ccl19.L and ccl21.L might play important roles in morphogenesis and dorsal–ventral patterning during early embryogenesis in Xenopus.
Temporal textures: Time, meaning, and the good life
Authors: Weber‐Guskar Eva
Published: March 2023

In the debate on meaning in life as part of a good human life, the role of time still needs to be worked out in greater detail. This paper argues that making the role of time in a specific sense explicit allows for the development of an account that leaves behind some of the objections with which current accounts are confronted. To show this, I will reconstruct two accounts of meaning in life and critically discuss them—the account of meaning by valuable activities and the account of meaning by intelligibility. The first one struggles with how to distinguish the value of meaning from the values of happiness and morality and neglects the common understanding of meaning in other contexts; the second one at least partly falls back into the older discussion about the meaning of life with undesired theoretical consequences. A new account, called the account of meaning by temporal textures, focuses on narrative intelligibility, showing that meaning in life builds on temporal relations between events. This time focused narrative account avoids some misleading associations and enables one to answer some pertinent questions concerning the relevance of meaning for the good life as a whole.
From basic sciences and engineering to epileptology: A translational approach
Authors: Bou Assi Elie , Schindler Kaspar , de Bézenac Christophe , Denison Timothy , Desai Sharanya , Keller Simon S. , Lemoine Émile , Rahimi Abbas , Shoaran Mahsa , Rummel Christian
Published: March 2023

Collaborative efforts between basic scientists, engineers, and clinicians are enabling translational epileptology. In this article, we summarize the recent advances presented at the International Conference for Technology and Analysis of Seizures (ICTALS 2022): (1) novel developments of structural magnetic resonance imaging; (2) latest electroencephalography signal‐processing applications; (3) big data for the development of clinical tools; (4) the emerging field of hyperdimensional computing; (5) the new generation of artificial intelligence (AI)–enabled neuroprostheses; and (6) the use of collaborative platforms to facilitate epilepsy research translation. We highlight the promise of AI reported in recent investigations and the need for multicenter data‐sharing initiatives.
Geographical approaches to religion in the past
Authors: Slatter Ruth
Published: March 2023

This review assesses (anglophone) cross‐disciplinary research that has used geographical methodologies to study religion in the past. It identifies three prominent themes within the existing literature: the spatalisation of religion, the intersections between religion and built environments, and the relationships between religion and physical landscapes. It argues that the application of geographical approaches to the study of religion in the past has made important contributions to feminist and postcolonial attempts to de‐centre religious leaders and social elites. However, it also demonstrates that the existing literature has been fundamentally informed by inherently modern and western definitions of religion. Primarily, it identifies how the existing literature has prioritised the study of institutionalised Abrahamic religions, emphasised the analysis of sacred‐secular dichotomies, and assumed that religious affiliation involves personal belief and spiritual encounter. In response, this paper calls for geographical approaches to religion in the past to engage with a more diverse range of subjects and use network or assemblage approaches to challenge modern and western assumptions about religious practices and experiences.
A simple, rapid, and efficient method for generating multigene‐knockout culture cells by the CRISPR/Cas9 system
Authors: Fujii Toshihiro , Inoue Naomi , Nobeyama Takanobu , Inoue Junko , Ogasawara Shin , Otani Yuhei , Fujii Shinobu , Ito Chihiro , Fukunaga Rikiro
Published: March 2023

We evaluated the efficacy of simultaneous multiple‐gene knockout in human culture cells. By simple co‐transfection of HeLa cells with a mixture of pX330‐based targeting plasmids together with a puromycin resistance plasmid, followed by transient selection of puromycin‐resistant cells, Cas9/single‐guide RNA (sgRNA)‐transduced polyclonal cell populations were selected and grown. Western blot analyses revealed co‐transfection of up to seven targeting plasmids for p38α, p38β, JNK1, JNK2, Mnk1, ERK1, and mLST8 genes, drastically reduced protein expression of these genes in the polyclonal population. Analyses of a randomly isolated group of 25 clones revealed knockout efficiencies for the seven targeted genes ranging between 68% and 100%, and in six clones (24%), all targeted genes were disrupted. Deep sequencing analyses of the individual target sites revealed that, in most cases, Cas9/sgRNA‐induced nonhomologous end joining resulted in deletion or insertion of only a few base pairs at the break points. These results demonstrate that simple co‐transfection‐based simultaneous targeting offers an easy, rapid, and efficient method to generate multiplex gene‐knockout cell lines.
Emergency department utilization among patients who receive outpatient specialty care for headache: A retrospective cohort study analysis
Authors: Phelan Michael P. , Thompson Nicolas R. , Ahmed Zubair , Lapin Brittany , Udeh Belinda , Anderson Eric , Katzan Irene , Walker Laura E.
Published: March 2023

Objectives

To compare clinical characteristics among outpatient headache clinic patients who do and do not self‐report visiting the emergency department for headache.

Background

Headache is the fourth most common reason for emergency department visits, compromising 1%–3% of visits. Limited data exist about patients who are seen in an outpatient headache clinic but still opt to frequent the emergency department. Clinical characteristics may differ between patients who self‐report emergency department use and those who do not. Understanding these differences may help identify which patients are at greatest risk for emergency department overutilization.

Methods

This observational cohort study included adults treated at the Cleveland Clinic Headache Center between October 12, 2015 and September 11, 2019, who completed self‐reported questionnaires. Associations between self‐reported emergency department utilization and demographics, clinical characteristics, and patient‐reported outcome measures (PROMs: Headache Impact Test [HIT‐6], headache days per month, current headache/face pain, Patient Health Questionnaire‐9 [PHQ‐9], Patient‐Reported Outcomes Measurement Information System [PROMIS] Global Health [GH]) were evaluated.

Results

Of the 10,073 patients (mean age 44.7 ± 14.9, 78.1% [7872/10,073] female, 80.3% [8087/10,073] White patients) included in the study, 34.5% (3478/10,073) reported visiting the emergency department at least once during the study period. Characteristics significantly associated with self‐reported emergency department utilization included younger age (odds ratio = 0.81 [95% CI = 0.78–0.85] per decade), Black patients (vs. White patients) (1.47 [1.26–1.71]), Medicaid (vs. private insurance) (1.50 [1.29–1.74]), and worse area deprivation index (1.04 [1.02–1.07]). Additionally, worse PROMs were associated with greater odds of emergency department utilization: higher (worse) HIT‐6 (1.35 [1.30–1.41] per 5‐point increase), higher (worse) PHQ‐9 (1.14 [1.09–1.20] per 5‐point increase), and lower (worse) PROMIS‐GH Physical Health T‐scores (0.93 [0.88–0.97]) per 5‐point increase.

Conclusion

Our study identified several characteristics associated with self‐reported emergency department utilization for headache. Worse PROM scores may be helpful in identifying which patients are at greater risk for utilizing the emergency department.
Understanding the emergence of females as leaders in academia: The intersections of gender stereotypes, status and emotion
Authors: Gaus Nurdiana , Larada Nasrullah , Jamaluddin Syakir , Paramma Muhammad Azwar , Karim Abdul
Published: March 2023

Drawing on the expectation state theory, this paper seeks to analyse the social cognitive process of the impacts of gender stereotypes along with their culturally derived schemas of status belief, status characteristics and emotion at the early stage of women's endeavour to emerge as leaders in academia. Employing a convenience sampling and interviews held with five women academic participants from three public and private universities in the western region of Indonesia, this research reveals that two social cognitive practices affect women's endeavour to emerge as leaders; (1) the incongruities of cultural and cognitive expected status belief and status characteristics about females with the expected performance of leadership. The pervasive effect of these can be mitigated when women adopt a strategy of neglection, coupled with a strategy of networking both via their own networks and their husband's networks; (2) the incongruities of cultural and cognitive expected ways of emotional expression on women with the expected performance of leadership. This impacts the status conferral that shapes the worthiness of females to emerge as leaders, leading female leaders in our study to build a protective shield of emotion display to keep them perceived as worthy individuals for leadership roles.
Mesonephric‐like adenocarcinoma of the female genital tract: novel observations and detailed molecular characterisation of mixed tumours and mesonephric‐like carcinosarcomas
Authors: Mirkovic Jelena , Olkhov‐Mitsel Ekaterina , Amemiya Yutaka , Al‐Hussaini Maysa , Nofech‐Mozes Sharon , Djordjevic Bojana , Kupets Rachel , Seth Arun , McCluggage W Glenn
Published: March 2023

Aims

To report novel observations in five mesonephric‐like adenocarcinomas (MLAs) of the female genital tract.

Methods and results

We report two endometrial MLAs in association with endometrioid carcinoma and atypical hyperplasia and three (one endometrial, two ovarian) cases with a sarcomatoid component (mesonephric‐like carcinosarcoma). Pathogenic KRAS mutations, which are characteristic of MLA, were identified in all cases although interestingly, in one of the mixed carcinomas, this was confined to the endometrioid component. The concurrent MLA, endometrioid carcinoma and atypical hyperplasia components in one case harboured identical EGFR, PTEN and CCNE1 mutations, suggesting that the atypical hyperplasia gave rise to a Müllerian carcinoma with both endometrioid and mesonephric‐like components. The carcinosarcomas all contained a component of MLA and a sarcomatous component with chondroid elements. In the ovarian carcinosarcomas, the coexisting epithelial and sarcomatous components shared some mutations including KRAS and CREBBP, suggesting that they are clonally related. Furthermore, in one case CREBBP and KRAS mutations detected in the MLA and sarcomatous components were also detected in an associated undifferentiated carcinoma component, suggesting that it was clonally related to the MLA and sarcomatous components.

Conclusions

Our observations provide additional evidence that MLAs have a Müllerian origin and characterise mesonephric‐like carcinosarcomas in which chondroid elements appear to be characteristic. In reporting these findings, we provide recommendations for distinction between a mesonephric‐like carcinosarcoma and a MLA with a spindle cell component.
A method for resolving organisation‐enterprise system misfits: An action research study in a pluralistic organisation
Authors: Morquin David , Ologeanu‐Taddei Roxana , Paré Guy , Wagner Gerit
Published: March 2023

Although off‐the‐shelf enterprise systems (ES) have been widely adopted in organisations, the extant literature repeatedly documents ES failures caused by misfits between organisational processes and the ES. Although some misfits can be identified early in the ES lifecycle, others emerge in the onward and upward phase (i.e., after the implementation) and, hence, must be resolved reactively. Prior research on misfits and resolution strategies has primarily focused on the implementation phase, often assuming that close‐to‐perfect information on the misfit's nature and characteristics is available. However, no study has examined how to effectively complete a shared diagnosis and resolution of misfits when diverging individual user perceptions are taken as the starting point. Such situations may be particularly pronounced in pluralistic organisations, where a variety of interdependent processes and potentially competing perceptions of processes are prevalent. The main objective of this study is to address this gap. To this end, we propose a pragmatic method for the diagnosis and resolution of misfits between organisational processes and enterprise systems, which builds on an actionable conceptualization of misfits. This method builds on theoretical concepts of affordances, affordance actualization, user participation, and change agentry. To demonstrate the feasibility and effectiveness of the proposed method, we conducted an action research study in a university hospital. Our analysis focused on a specific misfit involving the hospital's ES‐supported clinical processes. The findings suggest that the method effectively diagnoses and resolves misfits and optimises the resources required for their resolution through efficient management of user participation. We conclude with a discussion of the theoretical and practical contributions of our work.
Barriers to nurses performing physical assessments in rehabilitation care units: An observational study
Authors: Da Veiga Gonçalves Lorena , Latanioti Maria , Latif Sabah , Verloo Henk , Pereira Filipa
Published: March 2023

Aims

To describe the perceived barriers to nurses performing physical assessments of patients in rehabilitation wards. Secondarily, to investigate how sociodemographic and professional characteristics influence the use and frequency of physical assessments by nurses and their perceptions of barriers to their practice.

Design

A multicentre, cross‐sectional, observational study.

Methods

Data were collected from September to November 2020 among nurses working with inpatients in eight rehabilitation care institutions in French‐speaking Switzerland. Instruments included the Barriers to Nurses' use of Physical Assessment Scale.

Results

Almost half of the 112 nurses who responded reported performing physical assessments regularly. The predominant perceived barriers to performing physical assessments were ‘specialty area’, ‘lack of nursing role models’ and ‘lack of time and interruptions’. Greater clinical nursing experience in rehabilitation wards and more senior nurse specialist positions were associated with significantly lower use of physical assessment procedures by nurses.

Conclusion

The present study revealed heterogeneity in the use of physical assessment by nurses practicing in rehabilitation units and highlighted their perceived barriers to this.

Impact statement

Most nurses working in rehabilitation care units did not routinely perform physical assessments as part of their daily clinical practice. These results should raise stakeholders' awareness of this fact. Effective interventions to increase the use of physical assessments in nursing practice are to be recommended, including continuing education or hiring enough highly qualified nurses as role models in wards. This will promote quality of care and patient safety in rehabilitation care units.

Public and patient engagement and involvement

There was no patient or public involvement in the present study.
Fleas and lesions in armadillo osteoderms
Authors: Boyde Alan , Mills David , Abba Agustin Manuel , Ezquiaga María Cecilia
Published: March 2023

Armadillos are bitten by several species of flea. Females of the genus Tunga penetrate the epidermis and when in place are fertilised by males, after which the abdomen swells enormously to form a ‘neosome’. Within the penetrans group, T. perforans, makes lesions that perforate the osteoderms within the integument to form ~3 mm diameter cavities occupied by a discoid neosome. We examined these lesions in carapace material from animals which had died in the wild to see whether we could recruit evidence as to how they may be generated, either by the insect or by the host. We studied one species without such lesions, the nine‐banded armadillo Dasypus novemcinctus, and two species with, the greater hairy armadillo Chaetophractus villosus and the southern three‐banded armadillo Tolypeutes matacus, both showing the characteristic ‘flea bite’ holes in the external surfaces of the osteoderms. Samples were studied by three‐dimensional backscattered electron mode scanning electron microscopy and X‐ray microtomography. Both methods showed resorption pit complexes in the external surfaces of the osteoderms characteristic of those made by osteoclasts in active bone resorption. Lesions involved both the syndesmoses (sutures) between adjacent bones and the central regions of the osteoderms. Many lesions showed extensive repair by infilling with new bone. We conclude that the T. perforans neosome creates a local host response which causes bone resorption, creating the space in which it can grow.
Beauty from within: Improvement of skin health and appearance with Lycomato a tomato‐derived oral supplement
Authors: Tarshish Elizabeth , Hermoni Karin
Published: March 2023

Backround

Healthy and a youthful appearance is a common desire of the aging population. “Beauty from within” involves using nutrition and nutraceuticals to support skin function for reducing and reversing signs of aging such as wrinkles, pigmentary changes, skin laxity, and dullness. Carotenoids possess strong antioxidant and anti‐inflammatory activities and are effective in improving skin barrier and could thereby stimulate “beauty from within” by providing endogenous support to reduce the expressions of aging.

Aim

This study was designed to determine whether 3‐month supplementation with Lycomato would improve skin condition.

Method

A panel of 50 female subjects used Lycomato capsules as nutritional supplements for 3 months. Skin status was observed via questionnaires for the assessment of skin condition and expert visual grading of facial markers such as wrinkles, tonality, roughness, laxity, and pore size. Skin barrier was assessed using transepidermal water loss (TEWL). Measurements were obtained before treatment and after 4 and 12 weeks of use.

Results

Results indicated a statistically significant improvement (p < 0.05) in skin barrier as measured by TEWL after 12 weeks of consuming the supplement. There was also a significant improvement in skin tonality, lines and wrinkles, pore size, and skin firmness as observed by expert evaluation as well as subject self‐assessment.

Conclusion

Based on the confines and conditions of this study, oral supplementation with Lycomato resulted in significant improvement in skin barrier. Visual appearance of lines and wrinkles, skin tonality, pores, smoothness, and firmness were considerably improved, and these improvements were found to be substantially discernible by the subjects.
Overweight in childhood and young adulthood increases the risk for adult thromboembolic events
Authors: Lilja Lina , Bygdell Maria , Martikainen Jari , Rosengren Annika , Kindblom Jenny M. , Ohlsson Claes
Published: March 2023

Background

Approximately one third of thromboembolic (TE) events are related to obesity, but to which extent elevated body mass index (BMI) during the distinct periods of childhood and puberty contributes is not known. We aimed to evaluate the impact of high BMI during childhood and puberty for the risk of adult venous and arterial thromboembolic events (VTE, ATE, respectively) in men.

Methods

We included 37,672 men from the BMI Epidemiology Study (BEST) Gothenburg with data on weight and height in childhood, young adult age, and on pubertal BMI change. Information on outcomes (VTE [n = 1683], ATE [n = 144], or any first TE event [VTE or ATE; n = 1780]) was retrieved from Swedish national registers. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regressions.

Results

Both BMI at 8 years of age and the pubertal BMI change were associated with VTE, independently of each other (BMI at 8: HR 1.06 per standard deviation [SD] increase, 95% CI, 1.01;1.11; pubertal BMI change: HR 1.11 per SD increase, 95% CI, 1.06;1.16). Individuals with normal weight during childhood followed by young adult overweight (HR 1.40, 95% CI, 1.15;1.72), and individuals with overweight at both childhood and young adult age (HR 1.48, 95% CI, 1.14;1.92), had a significantly increased risk of VTE in adult life, compared with the normal weight reference group. Individuals with overweight in childhood and in young adult age had increased risk of ATE and TE.

Conclusion

Young adult overweight was a strong determinant, and childhood overweight a moderate determinant, of the risk of VTE in adult men.
Validation of a cage‐side agglutination card for Dal blood typing in dogs
Authors: Véran Emilie , Blais Marie‐Claude
Published: March 2023

Background

Although 98% of the canine population is Dal‐positive, Dal‐negative dogs are more common in some breeds such as Doberman Pinschers (42.4%) and Dalmatians (11.7%), and finding compatible blood for these breeds may be challenging, given limited access to Dal blood typing.

Objectives

To validate a cage‐side agglutination card for Dal blood typing and determine the lowest packed cell volume (PCV threshold) at which interpretation remains accurate.

Animals

One‐hundred fifty dogs, including 38 blood donors, 52 Doberman Pinschers, 23 Dalmatians and 37 anemic dogs. Three additional Dal‐positive canine blood donors were included to establish the PCV threshold.

Methods

Dal blood typing was performed on blood samples preserved in ethylenediaminetetraacetic acid (EDTA) <48 hours using the cage‐side agglutination card and a gel column technique (gold standard). The PCV threshold was determined using plasma‐diluted blood samples. All results were read by 2 observers, blinded to each other's interpretation and to the sample's origin.

Results

Interobserver agreement was 98% and 100% using the card and gel column assays, respectively. Overall, the sensitivity and specificity of the cards were 86%‐87.6% and 96.6%‐100%, respectively, depending on the observer. However, 18 samples were mistyped using the agglutination cards (15/18 by both observers): 1 false‐positive (Doberman Pinscher), and 17 false‐negative samples including 13 anemic dogs (PCV range, 5%‐24%; median, 13%). The PCV threshold allowing reliable interpretation was determined to be >20%.

Conclusions and Clinical Importance

Dal agglutination cards are reliable as a cage‐side test, but results should be interpreted cautiously in severely anemic patients.
Australian soil microbiome: A first sightseeing regional prediction driven by cycles of soil temperature and pedogenic variations
Authors: Pino Vanessa , Fajardo Mario , McBratney Alex , Minasny Budiman , Wilson Neil , Baldock Chris
Published: March 2023

Declines in soil multifunctionality (e.gsoil capacity to provide food and energy) are closely related to changes in the soil microbiome (e.g., diversity) Determining ecological drivers promoting such microbiome changes is critical knowledge for protecting soil functions. However, soil‐microbe interactions are highly variable within environmental gradients and may not be consistent across studies. Here we propose that analysis of community dissimilarity (β‐diversity) is a valuable tool for overviewing soil microbiome spatiotemporal changes. Indeed, β‐diversity studies at larger scales (modelling and mapping) simplify complex multivariate interactions and refine our understanding of ecological drivers by also giving the possibility of expanding the environmental scenarios. This study represents the first spatial investigation of β‐diversity in the soil microbiome of New South Wales (800,642 km2), Australia. We used metabarcoding soil data (16S rRNA and ITS genes) as exact sequence variants (ASVs) and UMAP (Uniform Manifold Approximation and Projection) as the distance metric. β‐Diversity maps (1000‐m resolution)—concordance correlations of 0.91–0.96 and 0.91–0.95 for bacteria and fungi, respectively—showed soil biome dissimilarities driven primarily by soil chemistry—pH and effective cation exchange capacity (ECEC)—and cycles of soil temperature—land surface temperature (LST‐phase and LST‐amplitude). Regionally, the spatial patterns of microbes parallel the distribution of soil classes (e.g., Vertosols) beyond spatial distances and rainfall, for example. Soil classes can be valuable discriminants for monitoring approaches, for example pedogenons and pedophenons. Ultimately, cultivated soils exhibited lower richness due to declines in rare microbes which might compromise soil functions over time.
Does allowing access to electronic differential diagnosis support threaten the reliability of a licensing exam?
Authors: Sibbald Matthew , Pugh Debra , Sherbino Jonathan , Morin Maxim , Norman Geoffrey R. , Monteiro Sandra
Published: March 2023

Introduction

Newer electronic differential diagnosis supports (EDSs) are efficient and effective at improving diagnostic skill. Although these supports are encouraged in practice, they are prohibited in medical licensing examinations. The purpose of this study is to determine how using an EDS impacts examinees' results when answering clinical diagnosis questions.

Method

The authors recruited 100 medical students from McMaster University (Hamilton, Ontario) to answer 40 clinical diagnosis questions in a simulated examination in 2021. Of these, 50 were first‐year students and 50 were final‐year students. Participants from each year of study were randomised into one of two groups. During the survey, half of the students had access to Isabel (an EDS) and half did not. Differences were explored using analysis of variance (ANOVA), and reliability estimates were compared for each group.

Results

Test scores were higher for final‐year versus first‐year students (53 ± 13% versus 29 ± 10, p < 0.001) and higher with the use of EDS (44 ± 28% versus 36 ± 26%, p < 0.001). Students using the EDS took longer to complete the test (p < 0.001). Internal consistency reliability (Cronbach's alpha) increased with EDS use among final‐year students but was reduced among first‐year students, although the effect was not significant. A similar pattern was noted in item discrimination, which was significant.

Conclusion

EDS use during diagnostic licensing style questions was associated with modest improvements in performance, increased discrimination in senior students and increased testing time. Given that clinicians have access to EDS in routine clinical practice, allowing EDS use for diagnostic questions would maintain ecological validity of testing while preserving important psychometric test characteristics.
Vividness and content
Authors: Fazekas Peter
Published: March 2023

The notion of subjective vividness plays a fundamental role in comparing different conscious experiences, yet it is poorly understood and lacks proper definition. Philosophical reflection on this topic is especially scarce. This article proposes a novel account of vividness arguing that its standard operationalisation in psychology conflates two major modality‐general dimensions along which experiences vary—subjective intensity and subjective specificity—which themselves are determined by further modality‐specific factors. The article identifies the neural underpinnings of these factors in the visual domain, demonstrates the unificatory power of the account, and argues that vividness is part of the content of perception.
Risk factors for progression of chronic kidney disease: An investigation in prepubertal children
Authors: van Biljon Gertruida , Meintjes Cornelius J. , Becker Piet J. , Karusseit Victor O. L.
Published: March 2023

Aim

Previous studies on progression of chronic kidney disease (CKD) in children have included older post‐pubertal subjects. This study attempted to evaluate risk factors for progression of CKD in pre‐pubertal children.

Methods

An observational study of children aged 2–10 years with an eGFR within the limits of >30 and <75 mL/min/1.73 m2 was performed. Presenting clinical and biochemical risk factors, as well as diagnosis, were analysed for their association with progression to kidney failure, time to kidney failure and for the rate of decline of kidney function.

Results

One hundred and twenty‐five children were studied of whom 42 (34%) had progressed to CKD stage 5 during the median period of follow up of 3.1 (IQR = 1.8–6) years. Hypertension, anaemia and acidosis at entry were associated with progression but they did not predict reaching the end point. Only glomerular disease, proteinuria and stage 4 kidney disease were independent predictors of kidney failure and the time to kidney failure. The rate of kidney function decline was greater in patients with glomerular than non‐glomerular disease.

Conclusions

Common modifiable risk factors, when present at initial evaluation, were not independently associated with CKD progression to kidney failure in prepubertal children. Only non‐modifiable risk factors and proteinuria predicted eventual stage 5 disease. The physiological changes of puberty may be the major precipitator of kidney failure during adolescence.
Physical intradialytic patient‐reported outcome measures in haemodialysis and haemodiafiltration: A cross‐over study
Authors: Wijngaarden Gertrude , Rootjes Paul A. , Nubé Menso J. , de Roij van Zuijdewijn Camiel L. M. , Grooteman Muriel P. C.
Published: March 2023

Aim

Standard haemodialysis (sHD) is associated with a poor survival and marked adverse intradialytic patient‐reported outcome measures (ID‐PROMs). Whereas physical ID‐PROMs (PID‐PROMs) are alleviated by cool dialysate (cHD), survival is prolonged by haemodiafiltration (HDF). So far, PID‐PROMs are not prospectively compared between HD and HDF.

Methods

To assess whether PID‐PROMs and thermal perception differ between sHD, cHD, low volume HDF (lvHDF) and high volume HDF (hvHDF), 40 patients were cross‐over randomized to each modality for 2 weeks. Dialysate temperature (Td) was 36.5°C, except in cHD (Td 35.5°C). Target convection volumes were 15 L in lvHDF and ≥ 23 L in hvHDF. PID‐PROMs were evaluated with a modified Dialysis Symptom Index (mDSI) and thermal perception with the Visual Analogue Scale Thermal Perception (VAS‐TP). Tb and room temperature were measured as well.

Results

Except for the item ‘feeling cold’ during cHD (p = .01), PID‐PROMs did not differ between modalities, but varied markedly between patients (11/13 items, p < .05). Tb increased in sHD, lvHDF, and hvHDF (+0.30, 0.35, 0.38°C, respectively, all p < .0005), but remained stable in cHD (+0.04°C, p = .43). Thermal perception remained unaltered in sHD and both HDF modalities, but shifted towards cold in cHD (p = .007).

Conclusion

(1) PID‐PROMs did not differ between modalities, but varied markedly between patients. Hence, PID‐PROMs are largely patient‐dependent. (2) While Tb increased in sHD, lvHDF and hvHDF, thermal perception did not change. Yet, whereas Tb remained unaltered in cHD, cold perception emerged. Hence, as for bothersome cold sensations, cHD should be avoided in perceptive individuals.
A false decrease in the automatically measured atrial pacing threshold when using the automatic pacing threshold adjustment algorithm
Authors: Ishihara Yu , Noma Takahisa , Takeuchi Masaki , Shimokawa Kohei , Shiraishi Yoji , Inoue Tomoko , Ohara Minako , Ishikawa Kaori , Minamino Tetsuo
Published: March 2023

Automatic pacing threshold adjustment algorithms and remote monitoring are widely used to improve the utility of pacemakers and ensure patient safety. However, healthcare providers involved in the management of permanent pacemakers should know the potential pitfalls of these functions. In this report, we present a case of atrial pacing failure induced by the automatic pacing threshold adjustment algorithm that went unnoticed even under remote monitoring.
Critical PDT Theory VII: Preclinical Translation
Authors: Kessel David
Published: March 2023

The translation of photodynamic effects into clinical practice is a complex process that involves the pharmacokinetics of photosensitizing agents, light dosimetry and oxygenation levels. But even the ‘translation’ of basic photobiology into meaningful preclinical information can be challenging. Some thoughts on directions for progress in clinical trials are suggested.