bluuebunny/crossref_metadata_2025 huggingface dataset:
Partners Now Parents: Supporting Couples During the Journey to Parenthood
Authors: Savell Shannon M. , Breeden Lauren V. , Emery Robert E.
Published: January 2025

Becoming a parent is a highly anticipated milestone for many couples, yet previous research suggests that most couples experience a sharp decline in romantic satisfaction. However, there are few virtual, group‐based couples prevention programs for first‐time parents. The present study examined the feasibility and effectiveness of a newly developed prevention program for the journey to parenthood, the Partners Now Parents program. Sixty‐six racially and socioeconomically diverse expecting parents (33 couples) participated in this small, pilot examination. Seventeen couples were assigned to receive five teletherapy prevention program sessions over the course of the perinatal period, and 16 couples were assigned to an active control group receiving psychoeducation via email. We found a less steep decline in romantic satisfaction for those in the prevention program as compared to the active control group. The findings suggest that the prevention program is feasible, effective, and favorably received by participants. Prevention programs for expecting parents offer entry into mental health support with reduced mental health stigma when couples may be most open to change as they prepare for parenthood.
Are We Up to the Best Practises in Forage and Grassland Precision Harvest? A Review
Authors: Martelli Roberta , Ali Abid , Rondelli Valda , Barbanti Lorenzo
Published: January 2025

Grassland and forage crops are a domain where the application of precision agriculture techniques has been less intensive so far, compared to grain crops. This is especially evident in the case of variable yield assessment, the step that prompts the adoption of precision management techniques once farmers are faced by unexpectedly high yield spatial variation. Much work has been devoted to forage, grassland and pasture yield assessment since the early 2000's; evaluating the established achievements alongside the existing drawbacks and limitations is seen the best way to lay the foundation for future research work in this field. Self‐propelled forage harvesters received most attention in the quest for on‐the‐go yield assessment. Both volumetric flow (feedroll displacement sensing) and mass flow (impact force and torque sensing) assessments were tested prior to be developed into commercial applications. Nonetheless, their performances vary depending on harvested product characteristics (density, moisture, texture, etc.). Integrating multiple sensor technologies has emerged as the most effective solution to reduce this variability, despite the higher costs involved. Forage handling machines (mowers conditioners, waggon trailers and balers) were also largely addressed. Balers in the static weighing mode are one of the simplest and most reliable yield assessing platforms, although at the expenses of spatial discretization and positional lag of the yield data. Remote sensing based on spectral reflectance data from the standing crop is rapidly gaining interest, especially if performed from satellites. Multiple data sources (e.g., Landsat and MODIS images), sometimes processed through machine learning or neural network techniques, have demonstrated to provide more reliable yield assessments than single data sources. A cross cutting issue in all these techniques is the assessment of forage moisture. At the ground level, near infra‐red sensors are gaining popularity over capacitance sensors, thanks to their ability to determine also quality parameters of the harvested biomass. Overall, the need for calibration and maintenance of all sensor types represents a critical point that requires to be carefully evaluated before selecting an appropriate system.
An Ordovician Assemblage of Cool Water‐Adapted Paleotropical Ostracods Suggests an Early Psychrosphere
Authors: McGairy Anna , Nguyen Phong Duc , Williams Mark , Stocker Christopher P. , Harvey Thomas H. P. , Komatsu Toshifumi , Wong Hearing Thomas W. , Miller C. Giles , Marcilly Chloé M. , Pohl Alexandre
Published: January 2025

An ostracod assemblage from the Late Ordovician (Katian) Phu Ngu Formation of northern Vietnam, South China paleoplate, yields typical Baltic and Laurentian‐affinity genera together with some endemic forms. Detailed paleontological and sedimentary analysis of the Phu Ngu Formation suggests it was deposited in a deeper marine forearc setting, below storm wave base, but with (at least intermittently) oxygenated sea‐bottom conditions. Taphonomic assessment of the ostracod assemblage suggests it is in situ. The occurrence of globally widespread ostracod genera, including those from paleocontinents that were geographically remote from South China, is difficult to reconcile with the assumed limited dispersal capability of ostracods in shallow‐shelf settings—a characteristic that has often been used to refine Ordovician paleogeographical reconstructions. Here, we present the novel approach of using paleoclimate reconstructions to assess the environmental distributions of Paleozoic ostracod genera. We show that the deep‐marine depositional setting of our documented assemblage, together with general circulation model simulations of Ordovician ocean‐temperatures, suggests an early radiation of benthic ostracods into the deeper, colder, and thermally uniform ocean below the thermocline. The presence of a globally‐distributed psychrospheric (cool and deep marine) ostracod fauna would imply that our understanding of Ordovician ostracod dispersal is incomplete, and future paleobiogeographical studies should try to decouple the signal of shallow‐shelf benthic taxa, often endemic and probably limited by sea temperature, from those that are more cosmopolitan and tolerant of cooler, deeper waters.
Camellia saponin modulates oleic acid/linoleic acid‐induced lipogenesis in human sebocytes through lipophagy activation
Authors: Wan Kaibo , Li Jian , Ma Ling , Chen Timson , Chen Ya , Li Zhizhen , Zouboulis Christos C. , Wang Guang‐Li , Wang Jing
Published: January 2025

Background

Oily skin not only threatens people with aesthetic and hygienic discomfort but also confronts them with annoying skin problems. To explore new skin care ingredients from herbal or plant extracts and understand their underlying mechanism for sebum control would assist in the discovery of desirable sebosuppressive agents, though it is still a deserving and challenging task.

Aim

To explore the effect of Camellia saponin (CS) on modulating the lipogenesis of human sebocytes. Moreover, to explore the underlying mechanism of CS on oleic acid/linoleic acid (OL) mixture stimulated lipid accumulation.

Methods

The lipid accumulation model of cells was constructed by OL‐induction in vitro. The lipid synthesis in SZ95 sebocytes was detected by Oil Red O, Nile Red and BODIPY staining and the distribution of lipid droplets and autophagosomes were evaluated by transmission electron microscopy (TEM). Fluorescence staining, immunofluorescence and western blot (WB) were used to characterize the spatial localization of lipid droplets (LDs)/autophagosome/lysosome, the levels of LC3 and P62 proteins related to intracellular autophagy, as well as the pH of lysosome.

Results

CS treatment significantly relieved OL‐induced lipid accumulation in SZ95 sebocytes. Furthermore, CS maintained lysosomal acid environment to promote the fusion of autophagosome and lysosome, thus recovering the OL‐induced blockage of autophagy flow. We also found that CS activated AMPK, and down‐regulated mTOR in SZ95 sebocytes.

Conclusion

CS was able to relieve OL‐stimulated sebum accumulation in cultured human SZ95 sebocytes through lipophagy, in which process CS maintained lysosomal acid environment and activated the AMPK/mTOR pathway.
Generative AI and Its Potential Impact on Humanity
Authors: Nasr Rana Salah , El‐Deeb Sara
Published: January 2025

This study explores the evolving circumstances of generative artificial intelligence (AI) and its implications for humanity. A central question guides this exploration: “What is humanity in a world with human‐like machines?” as proposed by Suleyman (2023). Multiple streams of literature have been integrated to employ a holistic approach. This includes an extensive literature review and analysis of recent developments, incorporating insights from various sources and experts in key domains such as AI, AI singularity, ethics, digital transformation, human‐machine collaboration, and societal implications. While rapid advancements in generative AI have captured widespread attention, with a particular emphasis on its positive potential, it is equally vital to address its potential negative impacts, including human displacement, lower wages, and increased power and income inequality (Farina, Yu, and Lavazza 2024). Despite varying scholarly perspectives on the concept of generative AI, there is a consensus that it significantly impacts humans and society and requires careful consideration. The National Institute of Standards and Technology (NIST) and the European Parliament highlight the global significance of addressing its challenges. From a practical perspective, these insights have enormous implications for governments, business leaders, scholars, and society.
Breaking Barriers Transforming Primary Care to Serve the Physical Health Needs of Individuals With SMI in the NHS
Authors: Sheridan Emma , Bifarin Oladayo , Caves Maria , Higginbotham Karen , Harris Jane , Pinder Julie , Brame Peter
Published: January 2025

This critical review paper examines the health inequalities faced by individuals with Severe Mental Illness (SMI) in the United Kingdom; highlighting the disproportionate burden of physical health conditions such as respiratory disorders, cardiac illnesses, diabetes and stroke amongst this population. These conditions contribute to a significantly higher rate of premature mortality in individuals with SMI, with two‐thirds of these deaths deemed preventable. Despite the National Health Service (NHS) acknowledging the need to address these health inequalities, the mortality gap between those with and without SMI continues to widen. Additionally, there is limited engagement from service users in annual physical health checks, a concern that this paper addresses by identifying several barriers and providing recommendations to improve access and engagement in physical health checks. This review emphasises the focus on primary care systems as a critical point for addressing health disparities in individuals with SMI. Also, it highlights the need for primary care services to be more adaptive and integrated, playing a key role in managing the physical health of patients with SMI through regular health checks, flexible service delivery, and enhanced coordination with secondary care. Effectively supporting individuals with SMI requires tailored, integrated primary care interventions that address both psychological and physical health challenges, considering diverse demographic needs across the UK.
The Future of Artificial Intelligence in Mental Health Nursing Practice: An Integrative Review
Authors: Milasan Lucian H. , Scott‐Purdy Daniel
Published: January 2025

Artificial intelligence (AI) has been increasingly used in delivering mental healthcare worldwide. Within this context, the traditional role of mental health nurses has been changed and challenged by AI‐powered cutting‐edge technologies emerging in clinical practice. The aim of this integrative review is to identify and synthesise the evidence of AI‐based applications with relevance for, and potential to enhance, mental health nursing practice. Five electronic databases (CINAHL, PubMed, PsycINFO, Web of Science and Scopus) were systematically searched. Seventy‐eight studies were identified, critically appraised and synthesised following a comprehensive integrative approach. We found that AI applications with potential use in mental health nursing vary widely from machine learning algorithms to natural language processing, digital phenotyping, computer vision and conversational agents for assessing, diagnosing and treating mental health challenges. Five overarching themes were identified: assessment, identification, prediction, optimisation and perception reflecting the multiple levels of embedding AI‐driven technologies in mental health nursing practice, and how patients and staff perceive the use of AI in clinical settings. We concluded that AI‐driven technologies hold great potential for enhancing mental health nursing practice. However, humanistic approaches to mental healthcare may pose some challenges to effectively incorporating AI into mental health nursing. Meaningful conversations between mental health nurses, service users and AI developers should take place to shaping the co‐creation of AI technologies to enhance care in a way that promotes person‐centredness, empowerment and active participation.
Facile synthesis of rGO/DyMnO3 nanocomposite directly grown on nickel foam for supercapacitor applications
Authors: Fatima Rida , Sami Abdus , Haidar Zeshan , Ahmed Farooq , Junaid Ali , Qasim Bushra , Alfagham Alanoud T. , Khan Muhammad Shuaib , Elgorban Abdallah M. , Shah Syed Imran Abbas
Published: January 2025

The advancement of innovative energy storage electrode materials requires the immediate growth of redox‐active and sensible design of multifunctional electrochemical active materials. Supercapacitors are increasingly favored for the storage of energy owing to their large specific power, rapid charge/discharge times, and long‐term durability. The potential electrochemical energy storage using metal oxides motivated our research team to create DyMnO3 and their hybrid with reduced graphene oxide (rGO), via hydrothermal process in rGO/DyMnO3, as an electrocatalyst with comparatively high electrical conductivity and appropriate electrochemical active surface. This research was conducted utilizing a 2 M KOH as electrolyte within a possible window between −0.1 and 0.6 V. Impressively, our synthesized sample exhibited the remarkable specific capacitance of 1536.78 F g−1 on current density of 1 A g−1, attributed to quick charge storage and delayed discharging mechanism. The addition of rGO to porous spherical DyMnO3 enhances electrochemical performance, providing a specific surface area of 250 m2 g−1 and an electroactive surface area of 2675 cm−2. The created device displayed electrochemical activity with a high energy density of 149.40 Wh kg−1 at a power density of 719.86 W kg−1, respectively. Oxygen vacancy enhances results, indicating the rGO/DyMnO3 nanocomposite's potential for SCs and other electrochemical applications.
Piezoelectric and electromechanical synergic optimization in MnCO3‐modified lead magnesium niobate‐lead zirconate titanate ceramics for high‐power antenna
Authors: Li Ling , Chen Xiangjie , Lei Tianfu , Li Xiang , Li Jinglei , Li Fei , Wang Yaojin
Published: January 2025

Lead zirconate titanate (PZT)‐based piezoelectric ceramics are crucial components in high‐power magnetoelectric (ME) antenna devices, contributing to the miniaturization of very low frequency (VLF) communication systems. The piezoelectric coefficient (d33) and mechanical quality factor (Qm) determine the quality of the radiation performance of the antenna device and, therefore, play a pivotal role in antenna preparation and selection. However, achieving high values for both d33 and Qm simultaneously proves challenging, as these properties often tend to compete with each other. Herein, we address this challenge by introducing MnCO3‐modified lead magnesium niobate (PMN)‐PZT piezoelectric ceramics, leveraging elements doping to achieve a well‐balanced performance, where the d33 was optimized to 530 pC/N, while concurrently attaining a Qm of 624, being attributed to the synergistic contributions from the defect dipole and lead vacancies. Notably, the PMN‐PZT‐based antenna device exhibits a significantly enhanced converse ME coefficient αCME = 0.138 Oe·cm/V, which improves the antenna emission performance by about 25% compared to commercial PZT‐4 samples. These findings offer a promising theoretical foundation and a feasible technical pathway for the development and design of ME antennas in the future.
Emergency Department Crowding as Contributing Factor Related to Patient‐Initiated Violence Against Nurses—A Literature Review
Authors: Xie Renting , Timmins Fiona , Zhang Mengting , Zhao Jinbo , Hou Yongchao
Published: January 2025

Aim

To synthesise how ED crowding contributes to patient‐initiated violence against emergency nurses.

Design

Framework synthesis.

Data Sources

A systematic literature search was conducted in the PubMed, PsycINFO, CINAHL and Scopus databases, covering articles up to 21 March 2024.

Review Methods

A total of 25 articles were reviewed, evaluating study quality using the Crowe Critical Appraisal Tool and employing a framework synthesis approach to chart and synthesise data.

Results

The review identifies key factors linking emergency department crowding to patient‐initiated violence, focusing on crowding conditions, vulnerable populations and adverse outcomes. It emphasises the importance of multidimensional assessments, including input, throughput, output stages and staffing characteristics. Special attention is needed for patients with severe symptoms who are triaged into lower priority categories, as their perceptions of injustice and dissatisfaction may increase the risk of aggressive behaviour. However, limited information is available regarding the perspectives of patients' family members.

Conclusion

Accurate assessments of emergency department crowding and a thorough understanding of cognitive and emotional changes in high‐risk patients are essential to develop strategies to manage patient‐initiated violence effectively.

Impact

This review improves emergency nurses' understanding of the dynamics of patient‐initiated violence in crowded emergency departments, equipping them with knowledge to better anticipate and respond to such incidents. It also offers insights that are crucial for enhancing nursing practices and ensuring workplace safety, thereby supporting the development of future emergency safety strategies.

No Patient or Public Contribution

As this is a systematic review and framework synthesis, there was no direct patient or public involvement.
Decision Regret About Treatment Amongst Women With Early Breast Cancer: An Integrative Review
Authors: Liu Jing , Hunter Sharyn , Lee Regina Lai Tong , Zhu Jiemin , Chan Sally Wai‐Chi
Published: January 2025

Aims

To synthesise evidence on decision regret about treatment amongst women with early breast cancer, including (1) the type of treatment related to decision regret, (2) the level of decision regret, and (3) factors associated with decision regret.

Design

Integrative review.

Methods

Studies published between January 2000 and December 2023 were searched from five online databases to provide up‐to‐date evidence. The Joanna Briggs Institute critical appraisal tools were used to evaluate the quality of the studies. The constant comparison strategy was employed for data analysis.

Results

A total of 26 studies were included. Breast cancer surgery was the most frequently studied treatment in relation to decision regret amongst women with early breast cancer, while adjuvant therapies were less studied. Most studies reported low levels of decision regret, while several studies found high levels. The proportion of women reporting decision regret varied considerably from 2.5% to 69% across the included studies. Factors associated with decision regret included various socio‐demographic and clinical characteristics (age, ethnicity, employment, education, health literacy, cancer stage, and treatment types), decision‐making experiences (patient involvement, patient preference, accessing information, and the use of decision support tools), and mental health.

Conclusion

Decision regret occurs in women with early breast cancer after surgery and adjuvant therapies. A variety of factors should be considered during the treatment decision‐making process to minimise decision regret. More robust studies are needed to disaggregate decision regret by treatment type and to evaluate the effectiveness of decision support tools in reducing decision regret in women with early breast cancer.

Impact

Nurses and other healthcare professionals should be aware of the potential for decision regret related to surgery and adjuvant therapies in women with early breast cancer. The findings can help nurses and other healthcare professionals identify women at higher risk of experiencing decision regret and provide support during the treatment decision‐making process to mitigate it.

Reporting Method

PRISMA 2020 Statement.

Patient or Public Contribution

No patient or public contribution to this review.
Long‐term safety and efficacy of ritlecitinib in adults and adolescents with alopecia areata and at least 25% scalp hair loss: Results from the ALLEGRO‐LT phase 3, open‐label study
Authors: Tziotzios C. , Sinclair R. , Lesiak A. , Mehlis S. , Kinoshita‐Ise M. , Tsianakas A. , Luo X. , Law E. H. , Ishowo‐Adejumo R. , Wolk R. , Sadrarhami M. , Lejeune A.
Published: January 2025

Background

ALLEGRO‐LT is an ongoing, long‐term, open‐label, multicentre, phase 3 study of ritlecitinib in adults and adolescents with alopecia areata (AA).

Objectives

To evaluate ritlecitinib safety and efficacy through Month 24 in patients with AA and ≥25% scalp hair loss.

Methods

ALLEGRO‐LT enrolled rollover patients who previously received study intervention in either ALLEGRO phase 2a or 2b/3 studies and de novo patients who had not received treatment in either study. The de novo cohort results are reported here. Patients aged ≥12 years with AA and ≥25% scalp hair loss received a daily, 4‐week 200‐mg ritlecitinib loading dose, followed by daily 50‐mg ritlecitinib. Analyses are based on data up to the cut‐off (December 2022). Efficacy outcomes included proportions of patients achieving Severity of Alopecia Tool (SALT) scores ≤20 and ≤10, Patient Global Impression of Change (PGI‐C) score of ‘moderately improved’ or ‘greatly improved’ and eyebrow assessment (EBA) and eyelash assessment (ELA) response (≥2‐grade improvement from baseline or normal score in patients with abnormal baseline EBA/ELA).

Results

Mean (SD) ritlecitinib exposure among the 449 de novo patients enrolled was 728.7 (273.81) days. At Month 24 (as observed), 73.5% and 66.4% of patients achieved SALT score ≤20 and ≤10; 82.4% had PGI‐C response; 60.8% and 65.7% had EBA and ELA response. 86.1% of patients reported treatment‐emergent adverse events (AEs); most were mild or moderate in severity, with the most frequent being positive SARS‐CoV‐2 test (24.2%), headache (20.8%) and pyrexia (13.0%). Rates of serious AEs, severe AEs and treatment discontinuations were 4.9%, 6.0% and 6.5%, respectively. Herpes zoster infection occurred in six patients, serious infections in four, malignancies (excluding nonmelanoma skin cancer) in three and major adverse cardiovascular events in three.

Conclusions

In patients with AA and ≥25% scalp hair loss, ritlecitinib demonstrated clinical efficacy and had an acceptable safety profile with long‐term treatment.

Clinical Trial Registration

ClinicalTrials.gov NCT04006457.
Nurses' Knowledge, Attitude and Practice in Nutrition Management of Hospitalised Adults: A Mixed‐Methods Study
Authors: Ang Wei Lin Sandy , Zhang Di , Cai Huimei , Chew Han Shi Jocelyn
Published: January 2025

Aim(s)

To examine nurses' knowledge, attitude and practice regarding nutrition management in hospitalised adults and explore their views on it.

Design

A mixed‐method approach combining cross‐sectional and descriptive qualitative methods.

Methods

379 enrolled/registered nurses working in acute or intensive units of a tertiary hospital were recruited between 24th August 2023 and 3rd December 2023. Participants completed a questionnaire on their sociodemographic profile, knowledge, attitude and practice (KAP) regarding nutrition management. Data analysis was conducted using R software, reporting levels of KAP and its associations with sociodemographic factors. Mann–Whitney U and Kruskal–Wallis tests were used for non‐normally distributed knowledge and practice scores (reported as median and interquartile range). Two‐sample t‐tests and ANOVA were used for normally distributed attitude scores (reported as mean and standard deviation). 21 of the participants from the quantitative study were either purposively sampled or snowballed from the quantitative study to undergo semi‐structured interviews (physically or virtually face‐to‐face), which were transcribed verbatim and analysed using content analysis.

Results

The mean scores on KAP were 61.6, 19.4 and 22.8, respectively. Knowledge varied significantly by educational level (p < 0.001), while attitudes also differed based on education (p = 0.001) and years of employment (p = 0.019). Practice scores showed differences based on subspeciality (p = 0.032), nursing rank (p < 0.001) and years of employment (p = 0.004). Findings identified barriers to effective nutrition management, including prioritisation issues, varying professional roles, limited autonomy and resource shortages. It also emphasises nurses' roles in nutrition management and strategies such as nurses' autonomy and family members involvement to improve nutrition management.

Conclusion

Sociodemographic factors significantly influence nurses' KAP in nutrition management, revealing knowledge deficits, low prioritisation and time constraints. Tailored education and training, increased autonomy, resource expansion and greater family involvement can enhance nurses' KAP in nutrition management.
Three‐Dimensional (3D) Printing in Non‐Industrial Spaces: A Summary of Emissions Evaluations in 11 School Settings
Authors: Li Jessica F. , Glassford Eric K.
Published: January 2025

Background

Additive manufacturing or 3‐dimensional (3D) printing is an emerging technology with increasing prevalence in non‐industrial settings such as university and school settings. However, printers are often located in spaces not designed for this purpose.

Methods

3D‐printer use in 11 university and K‐12 schools was evaluated by identifying emissions using area air sampling for volatile organic compounds (VOCs) and particle counting instruments (PCIs) measuring ultrafine particulate (UFP) and evaluating controls to reduce potential exposure. Ventilation in printer locations was also characterized.

Results

VOCs and UFP were identified during 3D printing. Best‐practice recommendations were provided to school health and safety staff to protect users, including workers and students. Recommendations included installing and implementing engineering controls, administrative controls, and personal protective equipment (PPE) to minimize exposure to 3D printer emissions.

Implications

School health and safety staff can translate findings and recommendations for these 11 evaluations to identify 3D‐printing areas on their campuses and use principles of industrial hygiene to protect workers and students and prevent the movement of emissions.

Conclusions

VOCs and UFP were detected during 3D printing. There were opportunities to improve health and safety practices and reduce potential exposure when using 3D printing technologies.
Impact of COVID‐19 on Antimicrobial Stewardship Activities in Hospitalised Children: A Scoping Review
Authors: Mohammed Zabiuddin Ahad , Grant Gary , Irwin Adam D. , Hattingh Laetitia , Kalwaje Eshwara Vandana , Okonkwo Rose I. , Khan Sohil
Published: January 2025

Aim

COVID‐19 has brought unprecedented challenges to the healthcare system. The rapid spread of the virus, laboratory burn‐out, exhausted staff, diagnostic uncertainty and lack of guidelines cumulatively disrupted hospital antimicrobial stewardship (AMS) programs. This scoping review evaluated how the COVID‐19 pandemic has impacted the implementation of AMS, particularly within the context of clinical audits.

Methods

An initial trend analysis was performed using a database search from 2000 to 2022. This review was developed following PRISMA‐Scr guidelines. Databases such as Medline, Embase, Cochrane Library and CINAHL were searched using Medical Subject Headings and free text for ‘Children’, ‘antimicrobial stewardship’ and ‘COVID‐19’. Primary studies that reported data on antimicrobial use among hospitalised children during COVID‐19 from December 2019 to December 2022 were considered.

Results

Paediatric AMS‐related research output changed annually by −4.94% in 2022 compared to 14.44% in 2019. Of 677 articles, 15 were included, with 3 added through snowballing technique. All the studies were observational and from countries of all income levels. A quantitative measure of antibiotic use was the commonly assessed sub‐category of AMS, while three studies performed the audit for a reason for antibiotic use, microbiological cultures, and surgical prophylaxis. Most studies reported antimicrobial use as prevalence, while two reported the days of therapy, and two used the AWaRe classification and the antibiotic spectrum index (ASI).

Conclusions

Paediatric AMS activities were disrupted during the COVID‐19 pandemic. A basic quantitative measure of antibiotic use was the only measure of assessment, with other AMS components unreported. A robust paediatric‐focused AMS resilient to future pandemics and evidence‐informed stewardship approach is needed.
Antibiotic Prescription Trends in Dentistry: A Descriptive Study Using Japan's National Database
Authors: Hirayama Kaho , Kanda Naoki , Hashimoto Hideki , Yoshimoto Hiromasa , Goda Kazuo , Mitsutake Naohiro , Hatakeyama Shuji
Published: January 2025

Objectives

Antibiotic prescription trends in dentistry in Japan remain underexplored. This study aimed to describe these trends and evaluate the impact of the national antimicrobial stewardship program launched in 2016.

Methods

Using Japan's national administrative claims database from fiscal year (FY) 2015 to FY 2020, this cross‐sectional study comprehensively analyzed trends in antibiotic prescription by dentists. Prescription rates were computed per 1000 inhabitants yearly and standardized to the FY 2015 national population. Changes in prescription rates were evaluated using Poisson regression analysis.

Results

In FY 2020, the total number of antibiotic prescriptions was 134.4 per 1000 inhabitants per year, showing a 6% decline over the 6‐year period (95% confidence interval, 6%–6%). Third‐generation cephalosporins constituted 52.3% of dental antibiotic prescriptions in FY 2020, though the proportion had slightly decreased. In hospitals, prescriptions of third‐generation cephalosporins decreased from 64.9% in 2015 to 20.3% in 2020, being replaced by penicillin (from 15.0% to 64.0%). However, in clinics, the magnitude of the change was small (third‐generation cephalosporins, 60.5%–53.1%; penicillin, 10.2%–22.2%).

Conclusions

Third‐generation cephalosporins continue to dominate dental antibiotic prescriptions. The increase in penicillin use was much more pronounced in hospitals than in clinics. Strengthening antimicrobial stewardship, particularly in clinics where the majority of dental care is provided, is crucial.
Effects of the Transcutaneous Electrical Stimulation System on Heartburn, Regurgitation and Esophageal Acid Exposure in GERD Patients—An Uncontrolled Feasibility Study
Authors: Dickman Ram , Brun Rita , Levy Sigal , Ron Yishai , Rainis Tova , Naftali Timna , Hazani‐Pauker Maor , Boltin Doron , Perets Tsachi Tsadok , Fass Ronnie , Gingold‐Belfer Rachel
Published: January 2025

Background

Proton pump inhibitors (PPI) for gastroesophageal reflux disease (GERD) are associated with a high failure rate. Our uncontrolled feasibility study aimed determining the effect of a transcutaneous electrical stimulation system (TESS) on GERD symptoms and acid exposure time (AET).

Methods

Recruited patients with heartburn and regurgitation. During the first phase (one‐week, run‐in period, off‐PPI's), patients completed symptom diaries and demographic questionnaires. Thereafter, all patients underwent gastroscopy with subsequent placement of a wireless esophageal pH capsule, off‐PPI. Based on pH analysis in the first 24 h, only those with increased AET (percent total time pH < 4 above 6%) continued to the next phase. During that phase, patients were treated for up to 3 weeks with TESS and documented their symptoms. The Primary endpoint was the magnitude of reduction in GERD‐related symptoms. The secondary endpoints were the magnitude of reduction of AET and DeMeester score, as compared with their baseline values.

Results

Included 31 patients and of those, 26 patients (42% females, aged 49 ± 15 years, mean BMI 25 ± 3 kg/m2) completed the first two phases of the study.

At baseline, mean number of daily heartburn and regurgitation episodes was 2.55 ± 1.79 and 1.40 ± 1.73, respectively. Following TESS, mean number of daily heartburn and regurgitation episodes dropped to 0.77 ± 0.75 and 0.36 ± 0.8, respectively (p < 0.001). At base line, mean AET and DeMeester score were 12.4 ± 5.6 and 32.1 ± 12.7, respectively. Following TESS mean AET dropped to 6.0 ± 3.5 and DeMeester score dropped to 16.2 ± 8.2 (p < 0.001).

Conclusions

TESS is effective in reducing both symptoms and esophageal AET in GERD patients.
Osteoradionecrosis Incidence in the Site of Pre‐Radiotherapy Tooth Extraction
Authors: Eaton James J. , Hodgson Alexander , Richards Jessica A. , Collins Timothy , Godden Daryl R. P. , Beech Andrea N.
Published: January 2025

Aims

To identify the incidence of osteoradionecrosis (ORN) in the site of extraction in patients who had pre‐radiotherapy extractions over a 10‐year period and the important predictive patient and treatment factors.

Material and Methods

A retrospective review was performed on all patients who were prescribed pre‐radiotherapy extractions over 10 years in the oral and maxillofacial surgery department of a UK district general hospital. Notes were examined for predictive factors, whether ORN developed or not, and if ORN did develop to what extent and what treatment, if any, was required. The number of patients receiving one or more extractions was 140 from 2009 to 2019.

Results

The incidence of ORN was higher than expected in the site of a pre‐radiotherapy extraction. ORN developed relatively quickly, and in some cases within 12 months after completion of radiotherapy. Important risk factors were radiation dose, anatomical site of the primary tumour and social factors, namely, smoking and high alcohol intake. The number of pre‐radiotherapy extractions prescribed overall gradually reduced over the 10‐year period.

Conclusions

There is little information in the available literature to indicate the material risk of ORN in the region of a pre‐radiotherapy extraction site after oncological treatment. With our results, we are able to warn patients more appropriately about their risk of ORN to allow them to give informed consent for pre‐radiotherapy extractions.
Characteristics of Resection Parameters in Robot‐Assisted Total Knee Arthroplasty With the Ligament Balancing Workflow
Authors: Wei Qing‐Da , An Hao‐Ming , Gu Wang , Sun Wei , Li Rui , Chai Wei
Published: January 2025

Objective

Robotic‐assisted total knee arthroplasty (TKA) is a novel orthopedic technique. The workflow of robotic‐assisted TKA is quite different from that of traditional manual TKA and may result incompletely different resection parameters. Understanding these parameters may help surgeons better perform robotic‐assisted TKA. This study aims to analyze the specific resection parameters of robotic‐assisted TKA.

Methods

We retrospectively reviewed 85 MAKO‐assisted TKA surgeries performed by three surgeons at our institution between May 2021 and November 2023. All patients had unilateral primary knee arthritis, and a Triathlon PS (Stryker) knee prosthesis was used. Intraoperative resection plan, radiological outcomes, and clinical outcomes were collected among them. The angle between the transepicondylar axis (TEA) and the femoral prosthesis axis was defined as rTEA, the angle between the posterior condylar axis (PCA) and the femoral prosthesis axis was defined as rPCA. The t‐test and the Chi‐square test (or Fisher's exact probability test) were used to determine differences in categorical variables.

Results

rTEA averaged 2.7° (range, 0°–6.7°), and rPCA averaged 4.9° (range, 0.2°–9.6°). The mean resection of the medial distal femur was 7.7 mm (range, 3.0–12.5), that of the lateral tibial plateau was 6.4 mm (range, 1.5–13.0), and that of the medial posterior condyle of the femur was 10.6 mm (range, 6.5–17.5), whereas that of the lateral posterior condyle of the femur was 6.7 mm (range, 2.0–13.0).

Conclusion

Robotic‐assisted TKA using the ligament balancing workflow generally resulted in greater external rotation than reported reference values for conventional manual TKA within the existing literature, with reference to both the TEA and PCA. In addition, tibial resection was generally less, and the joint line was generally shifted upwards.
Morphological Characteristics of Inferior Pole Patellar Fractures and a Finite‐Element Analysis Combined With a Retrospective Clinical Study of Anchor Suture and Titanium Cable Cerclage Treatment
Authors: Hu Zhenghui , Sun Chen , Heng Hongquan , Li Jian , Chen Hainan , Chen Fuchao , Su Peng , Wang Dengfeng
Published: January 2025

Objective

Inferior pole patellar fractures (IPPFs) pose a significant challenge due to their complex fracture patterns and high risk of complications associated with current treatment methods. This study aims to (1) characterize the fracture patterns of IPPFs using fracture mapping and (2) compare the biomechanical stability and clinical outcomes of treatment with anchor suture with patellar cerclage versus Kirschner‐wire tension band combined with patellar cerclage.

Methods

(1) A retrospective analysis was conducted on 61 patients with IPPF. For each case, fracture reduction was manually simulated, with fracture lines and fragments overlaid onto a complete patella template to identify fracture patterns. (2) Finite‐element models were used to analyze the mechanical properties of anchor suture and titanium cable cerclage treatment and Kirschner‐wire tension band combined with patellar cerclage in treating IPPFs. Additionally, a retrospective analysis of clinical data was performed on 57 patients with IPPF (AO/OTA 34 A1) treated at our institution between January 1, 2023, and December 25, 2023. Of these, 18 patients underwent anchor suture and titanium cable cerclage (Group A), and 39 underwent Kirschner‐wire tension band combined with patellar cerclage (Group B). We compared operative time, final knee range of motion, incidence of secondary surgery, postoperative complications, and functional recovery between the two groups based on medical records and follow‐up results.

Results

(1) IPPFs were predominantly comminuted, with fracture lines on the anterior view concentrated laterally and near the superior surface of the inferior pole. Fracture lines became more sparse as they approached the distal patella. The posterior view was similar to the anterior, with the majority of fractures near the superior surface of the inferior pole. (2) Finite‐element analysis revealed no significant differences between the two groups in terms of displacement and stress. Operative time was similar between the groups (p > 0.05), as were final knee range of motion (p > 0.05) and postoperative Bostman scores (p > 0.05). Group A had no postoperative complications or readmissions, while Group B had two cases of hardware irritation and one case of knee joint infection.

Conclusion

The fracture lines of IPPF are varied, often comminuted, and correlate with the mechanism of injury. Biomechanical and clinical outcomes suggest that anchor suture with patellar cerclage is a viable option for stabilizing IPPF.

Trial Registration: ClinicalTrials.gov identifier: NCT06736639
The Association Between Gestational Age and Type 1 Diabetes Mellitus in Children and Adolescents: A Systematic Review and Network Meta‐Analysis
Authors: Zhai Yiman , Gou Hao , Sun Xiangjuan
Published: January 2025

Background

With genetics thought to explain a portion of the overall risk of type 1 diabetes mellitus (T1DM), environmental risk factors in early life have been proposed. Previous studies on the incidence of T1DM in children or adolescents by gestational age at birth have yielded inconsistent results.

Objectives

To clarify the association between gestational age at birth and T1DM in childhood/adolescence and to offer evidence‐based support for the prevention or screening of T1DM.

Data Sources

PubMed, Embase, Web of Science, and the Cochrane Library were searched from the inception of the databases to February 7, 2024.

Study Selection and Data Extraction

Data were extracted using a standardised form created a priori, and quality was assessed using the Newcastle‐Ottawa Scale (NOS).

Synthesis

Due to the diversity of gestational age groups in the original studies, a Bayesian network meta‐analysis was performed to discuss the association of different gestational ages with the risk of T1DM in childhood/adolescence.

Results

A total of 13 studies on children/adolescents with T1DM were included. Compared with the gestational age of 39–40 weeks, gestational ages of < 37 weeks (odds ratio [OR] 1.35, 95% credible interval [CrI] 1.19, 1.53), 33–36 weeks (OR 1.19, 95% CrI 1.11, 1.27), and 37–38 weeks (OR 1.26, 95% CrI 1.21, 1.30) were correlated with an increased risk of T1DM, whereas gestational ages of < 32 weeks (OR 0.61, 95% CrI 0.43, 0.88) and < 33 weeks (OR 0.72, 95% CrI 0.59, 0.87) were correlated with a lower risk.

Conclusions

A higher risk of T1DM was observed in infants born early term or preterm compared to full‐term infants. However, the results of this network meta‐analysis indicate that extremely or very preterm infants were less likely to develop T1DM. Further studies are needed to validate this in the future.
Carbonates and microbialites record a dynamic lake basin evolution in the Late Cretaceous to Eocene Sheep Pass Formation, Nevada, USA
Authors: Olsen‐Valdez Juliana , Widlansky Sarah , Trower Elizabeth , Snell Kathryn , Clyde William
Published: January 2025

Ancient terrestrial sediments provide critical information about the responses of continental environments to global scale climate and tectonic perturbations, which are vastly understudied relative to marine archives. The >1 km thick Sheep Pass Formation type section in east‐central Nevada preserves non‐marine carbonates, including microbialites, and lesser siliciclastics, deposited in a tectonically active, high‐elevation basin during the latest Cretaceous through to middle Eocene time, an interval spanning major global greenhouse climate states and warming events. This study combines outcrop and hand‐sample observations, thin section petrography and X‐ray diffraction mineralogical analyses to create a facies framework and interpreted environmental evolution for the Sheep Pass Basin. Together, these observations portray the Sheep Pass Formation type section as a dynamic and highly sensitive basin due to its small size. The dominance of thrombolite boundstones compared to metazoan fossils, which sets the Sheep Pass Formation type section apart from other Palaeogene‐aged lake basins in the western United States, reflects the resilience of microbial mats compared to metazoans in this dynamic setting. The major lacustrine phase of the Sheep Pass Basin records three intervals: a shallow lake with few microbialites, followed by abundant microbialites, before the transition to a marginal setting with evaporative conditions, marking the culmination of this major lacustrine phase. The transition to a microbialite‐dominated interval was likely driven by physicochemical conditions (for example, higher alkalinity), paired with lower competition from metazoan grazers. Although the Sheep Pass Formation type section preserves environmental change in response to both tectonics and climate, similar trends in facies, mineralogy and invertebrate abundance compared to other sedimentary basins from this time suggest that global climate influenced distinct environmental shifts in the Sheep Pass Basin. This work provides a detailed sedimentological framework for a new, high‐elevation palaeoclimate record during a pivotal geological climate interval.
Red blood cell utilization in patients with sickle cell disease: A Canadian single‐center experience
Authors: Uminski Kelsey , Perelman Iris , Mack Johnathan , Tinmouth Alan
Published: January 2025

Background

Red blood cell (RBC) utilization in patients with sickle cell disease (SCD) in Canada is poorly defined. This study describes RBC utilization in an SCD cohort at a single Canadian center.

Study Design and Methods

All adults with SCD who received care at the Ottawa Hospital between January 2006 and May 2019 were included, and followed until December 2021. Data on hospital encounters and RBC transfusions were obtained from hospital databases.

Results

Overall, 273 patients were included (median age: 25 years; 53.8% female; median follow‐up: 8.1 years). During the study period, there were 23,127 hospital encounters (median: 45 [interquartile range (IQR) 18, 100] per patient), with 165 patients (60.4% of cohort) receiving 22,538 RBC units. Most RBC units (86.5%) were transfused in the outpatient setting. Although only 2.9% of patients had O‐negative blood type, O‐negative RBC units accounted for 29.1% of units transfused. One hundred forty‐seven patients received 2205 RBC units (9.8% of total) as simple transfusions (median: 5 [IQR 3, 13] per patient), and 88 patients received 20,333 RBC units (90.2% of total) during 2702 red cell exchange (RCE) sessions (median: 14.5 (IQR 1, 47.5) RCE per transfused patient). A median of 7 RBC units (IQR 6, 9) were transfused per RCE session, with a median of 30 days (IQR 28, 40) between sessions.

Discussion

Patients with SCD at our center frequently received O‐negative units, and large RBC volumes were used for RCE. These results provide a utilization baseline for future education and quality improvement initiatives to optimize RBC stewardship.