bluuebunny/crossref_metadata_2025 huggingface dataset:
BRalu Profile: the procurement strategy
Authors: Kaur Kulwinder , Bapat Gautam Surendra , Dua Gautam Gopal , P.T. Lincy , Reddy K. Nageswara
Published: October 2024

Learning outcomes

After completion of the case study, students will be able to understand BRalu Profile’s product range, customer base and historical developments; analyze how BRalu Profile’s procurement strategy evolved and its impact on business profitability; calculate and compare procurement costs and evaluate their role in decision-making for different suppliers; examine how market conditions (includes domestic and international dynamics) and pricing strategies influence procurement choices; assess the pros and cons of different procurement options and make informed recommendations based on supply chain principles; and identify potential procurement risks (e.g. currency exchange rates and supplier reliability) and propose strategies to mitigate them.

Case overview/synopsis

This case study explored the challenges faced by BRalu Profile, a prominent aluminum profile products company based in Ahmedabad, India. It focused on the critical task of supplier evaluation, selection and the complexities of maintaining relationships with existing suppliers. This case study delved into the intricate dynamics of procurement decisions within the supply chain and their direct impact on the firm’s overall performance. It also emphasized the supply chain’s susceptibility to disruptions and their consequences on company operations and supplier selection criteria. The protagonist, Dhaval Choladiya, had to navigate the complexities of cost-benefit analysis to identify the most suitable supplier, maximizing the firm’s net benefit while considering nonpricing parameters. This case study revealed the critical importance of maintaining strong supplier relationships in a competitive market and offered insights into the complexities of sourcing.

Complexity academic level

This case study is suitable for an undergraduate or graduate-level course on strategic sourcing or supply chain management or a risk management module in operations, strategy or finance course (e.g. how to deal with input cost fluctuations).

Supplementary materials

Teaching notes are available for educators only.

Subject code

CSS 11: Strategy.
Adoption of e-wallets: trust and perceived risk in Generation Z in Colombia
Authors: Gómez-Hurtado Catalina , Gálvez-Sánchez Francisco Jesús , Prados-Peña María Belén , Ortíz-Zamora Andrés Felipe
Published: October 2024

Purpose

This study aims to explore the development of trust in relation to security and privacy concerns, as well as the influence of perceived risk on the intention to use e-wallets. The research focused on the Colombian context because of its characterization as an underdeveloped financial system that has experienced considerable security and privacy violations in recent years. Additionally, this geographical area is relatively under-researched, and the target demographic for this investigation was Generation Z, given their pivotal role in driving the adoption of e-wallets.

Design/methodology/approach

Based on measurement scales that had already been tested in the academic literature on mobile payment systems, a questionnaire was developed and distributed electronically. A total of 424 responses were obtained from young Colombians. Structural equation modeling (SEM), specifically the PLS-SEM method, was used to process the data to study the explanatory and predictive power of the proposed model.

Findings

The findings revealed that security and privacy have a positive and significant effect on perceived trust, and that this at the same time has a positive and significant effect on attitude, perceived usefulness, perceived ease and intention to use, as well as a significant but negative effect on perceived risk. On the other hand, perceived risk showed an inverse, but not significant, relationship with intention to use.

Originality/value

This research explored the adoption of e-wallets by young people in Colombia, which has been widely claimed in the academic literature. In a turbulent context with a high distrust of financial institutions, as well as a change in digital money consumption patterns, it is critical to understand the factors that contribute to the adoption of mobile payment services. The findings, in addition to contributing to the academic debate, have important implications for e-wallet providers, as they offer information that allows designing strategies to attract and keep current and potential users. At the same time, the recommendations by the authors allow the design of tools, especially related to security and privacy, to improve their trust and build loyalty, thus contributing to the consolidation and development of the mobile payment system.
Engendering carcerality: An introduction
Authors: Boris Eileen , Butler Sara M. , Mireles Alex
Published: October 2024

Reflecting the carceral turn in scholarship, this introduction to a special issue on engendering carcerality explores the difference that gender makes in the history of the carceral in its various forms over time and space. It considers the multiple meanings and spaces of imprisonment, surveillance, and confinement; incarceration of mothers; confinement of sex workers; imprisoning of political prisoners, and reforming of youths, taking account of intersectional identities, sexuality and resistance. It looks forward by looking back, engaging in a dialogue with abolitionist movements and current global struggles to encourage critical gendered histories of incarceration and resistance.
Social order in Sweden's politicized and vulnerable neighborhoods – The perspective of residents
Authors: ESAIASSON PETER , SOHLBERG JACOB
Published: October 2024

This paper draws attention to a group of neighborhoods that are the object of heated elite discussions in many European countries. Using Sweden as our case, we demonstrate the feasibility of conducting high‐quality surveys with residents in neighborhoods where large shares have an immigrant background and low socioeconomic status. Moreover, we develop a measurement that allows us to assess what residents in two of Sweden's politicized and vulnerable neighborhoods think is needed to improve the social order of their local areas. We find that residents believe that neighborhood problems are generally about a lack of social control between people and that residents are not preoccupied with culture clash issues. Overall, beliefs about what contributes to social order are structured, largely homogenous and independent of elite discourse. Based on a comparison with a nationally representative sample, we conclude that residents in vulnerable neighborhoods and residents in other neighborhoods share a similar worldview and approach to daily life, but that the need for local social order is more keenly felt in the vulnerable neighborhoods.
A newly identified Y chromosome gene obp‐Y is required for sperm storage in female Zeugodacus tau (Diptera: Tephritidae)
Authors: Liu Peipei , Li Ziniu , Afzal Imran , Zhang Qiuyuan , Qiao Jiao , Wu Dong , Zhang Hongyu
Published: October 2024

In the organisms with XX/XY sex chromosomes, Y chromosome is unique to males and plays an important role in male reproductive development. The study of Y chromosome genes will contribute to the development of pest genetic prevention and control technology. In this study, we identified 9 Y chromosome genes in Zeugodacus tau (Diptera: Tephritidae), including gene 16222. Protein structure analysis showed that 16222 was highly similar to odorant binding protein, and thus gene 16222 was named obp‐Y. Obp‐Y knockout (KO) significantly reduced hatching rate of offspring. Sperm detection results showed that obp‐Y KO did not affect sperm number in the testes or sperm transfer during mating. We further examined the storage of sperms in females, and found that sperms in females mating with wild‐type males began to transfer from spermathecal ducts to the spermathecae at hour 0 after the end of mating (AEM), and at 0–24 h AEM, the sperm count in the spermathecae gradually increased. However, no sperms were observed in spermathecae of females mating with mutant males at hours 0, 4, 8, 24 and 48 AEM. In summary, this study revealed that Y chromosome gene obp‐Y was necessary for the storage of sperms in females. Our findings not only provide theoretical basis for elucidating the function of the Y chromosome, but also offer a molecular target for the genetic control over Z. tau.
Bluer in the city: urban male lizards exhibit more intense sexual coloration and lower parasite loads than non‐urban males
Authors: GONZÁLEZ‐MORALES Juan C. , RIVERA‐REA Jimena , SUÁREZ‐VARÓN Gabriel , BASTIAANS Elizabeth , ZARZA Heliot
Published: October 2024

Urbanization is a global phenomenon that involves the transformation of natural areas into urban spaces, thereby subjecting organisms to new selective pressures including a wide variety of pollutants and changes in intra‐ and interspecific interactions. Considering that projections indicate that by the year 2050, 65% of the human population will live in urban areas and that urbanization is a phenomenon with an upward pattern, identifying these phenotypic traits is vital to implementing conservation and management plans for urban fauna. The urban environment may exert different selective pressures on sexually selected traits than more pristine environments, a phenomenon which has been well studied in birds but is less understood in other vertebrates such as lizards, although they are common inhabitants of urban environments. Here, we compare sexual coloration, parasite load, and immune response in Sceloporus torquatus lizards in urban and non‐urban environments of Central Mexico. Our study shows that sexual coloration is more saturated (bluer) in male lizards from urban environments, while UV chroma was higher in non‐urban lizards. The average parasite load is lower in urban lizards than in non‐urban lizards, and we found a negative relationship between hemoparasite count and sexual coloration in male lizards from non‐urban environments but not in male lizards from urban environments. Additionally, non‐urban lizards exhibited a higher immune response. In female lizards, sexual coloration differed significantly between urban and non‐urban environments, but parasite load and immune response did not differ. These results may be useful to improve herpetofauna conservation plans in urbanized environments.
Effectiveness of combined botulinum toxin and fissurectomy on chronic anal fissures – a systematic review
Authors: Quinn Rakesh , Jamsari Giuleta , Low Gary KK , Albayati Sinan
Published: October 2024

Background

Anal fissures are a debilitating benign condition, thought to be due to the hypertonicity of the internal anal sphincter resulting in localized ischaemia inhibiting healing. There are several surgical and non‐surgical treatment options for chronic anal fissures. Clinical practice surveys report a trend toward sphincter‐sparing options, reserving the more successful treatment of lateral sphincterotomy, with an incontinence rate up to 10%, for refractory fissures.

Methods

A search of MEDLINE, Cochrane Database of Systematic Reviews and EMBASE for studies assessing sphincter‐sparing treatment with botulinum toxin and fissurectomy was performed following PRISMA guidelines. Outcomes assessed included healing rate, persistence, recurrence, re‐intervention and incontinence rates.

Results

Fifteen non‐randomized studies assessed 978 patients managed with botulinum toxin and fissurectomy. The mean age was 40.8 years with a female predominance of 58.9%. Healing rate was reported on 14 of the 15 studies, with a healing rate of 81% (95% CI:0.67, 0.90). Persistence rate was reported as 15% (95% CI:0.07, 0.28) and a recurrence rate of 6% (95% CI: 0.01, 0.19). Re‐intervention was required in 8% of patients with 55.1% requiring a repeat dose of botulinum toxin with or without fissurectomy. Incontinence appears to be transient with studies reporting a rate of 1% with median long‐term follow up 23 months (range: 5–60 months).

Conclusion

Combination fissurectomy and botulinum toxin is a safe and viable sphincter sparing treatment option, with moderate success rate and negligible complications. Randomized controlled trials are required to further strengthen the evidence for its use in chronic anal fissures.
Ethical Ramifications of the Dark Side of Business Practices in the International Business Area
Authors: Davcik Nebojsa S. , Sharma Piyush , Markovic Stefan
Published: October 2024

The dark side of international business practices has attracted significant research attention recently. However, researchers are struggling to delve into the ethical ramifications of these practices because of a limited understanding of ethical and digital transformation issues in international business, which may be caused, inter alia, by sociocultural and market disparities, lack of regulatory frameworks, information asymmetries, data ubiquity, and power imbalance among key stakeholders. This paper addresses this important gap through four key themes—ethical considerations, data processing issues, legal considerations, and managerial contingencies. We discuss how to step forward in research on ethics in international business, assessing potential risks associated with privacy concerns, big data, cybersecurity, content analysis, stakeholder relationships, and discriminatory outcomes. Finally, we propose a research agenda and recommendations to address the ethical challenges and dilemmas international businesses face due to disruptive technologies (e.g., artificial intelligence) and cross‐market challenges (e.g., legal jurisdictions).
Clinical and radiographic changes following transcrestal sinus augmentation: A scoping review of the last 25 years
Authors: Decker Ann M. , Stuhr Sandra , Testori Tiziano , Wang Hom‐Lay
Published: October 2024

Introduction

Maxillary sinus floor elevation is a surgical procedure intended to increase the volume of the bone vertically to accommodate dental implant placement. This intervention is frequently required for implant installation in the posterior maxilla, where the bone may be insufficient for securing implants of necessary length and stability. Sinus floor elevation can be completed either through a direct approach with a “window” through the lateral wall of the alveolar ridge or an indirect “transcrestal/transalveolar” sinus floor elevation (TSFE), which accesses the sinus floor through the crest of the edentulous ridge. Our study aims to provide a comprehensive scoping review of research conducted over the past 25 years on TSFE, specifically.

Methods

A literature search aimed at identifying pertinent literature for the purpose of this PRISMA‐ScR‐compliant scoping review was conducted. Only randomized controlled trials, non‐randomized controlled trials, prospective cohort studies, and case series that met the eligibility criteria were selected. Relevant data from these studies were extracted. Primary outcome measures included radiographic bone levels and implant failure >5 years. Secondary outcome measures included implant stability at time of placement and complications. Interventions reported in the selected studies were grouped based on treatment modality, which were then compared with the control therapy (traditional osteotome technique) after a minimum of 12 months healing period.

Results

Our search yielded 633 records, and after deduplication, 574 of these were screened. Application of the eligibility criteria led to the inclusion of 37 articles in the final selection. Case selection for included studies enrolling subjects: Four different transcrestal sinus elevation treatment modalities were identified: (a) osteotome, (b) piezoelectric surgery, (c) osseodensification, and (d) hydraulic techniques. Due to the heterogeneity of the studies, no superior approach for TSFE could be identified. Overall, all techniques demonstrated high implant survival rates.

Conclusion

Comprehensive understanding of the patient's medical history, available armamentarium, and post‐operative complications/management strategies are all essential to the completion of a successful TSFE approach for implant placement in the posterior maxilla, regardless of the treatment modality used.
Retrospective study on the clinical and radiographic outcomes of 2.8 mm diameter implants supporting fixed prostheses up to 11 years
Authors: Xu Lianyi , Ma Yue , Du Xijin , Qing Ying , Cao Yingguang , Sun Xiaojuan , Jacobs Reinhilde , Song Ke
Published: October 2024

Objectives

This study aimed to report the clinical and radiographic results of 2.8 mm two‐piece narrow diameter implant (NDI) supporting fixed restorations.

Materials and Methods

Clinical and radiographic data of 54 NDIs in 32 patients were retrospectively assessed after 2 to 11 (mean 8.17) years of follow‐up. Clinical and radiographic measurements were taken. Survival rate, implant and prosthesis failure, pink aesthetic scores (PES), white aesthetic scores (WES), bleeding on probing (BOP), probing depth (PD), marginal bone loss (MBL), and mechanical and biological complications were evaluated.

Results

An implant failed during the follow‐up period, resulting in a cumulative survival rate of 98.15% at the implant level and 96.88% in the patient. The total mean values of PES and WES for 2.8 mm NDIs were 7.09 ± 1.15 (range: 3.33–9.00) and 7.42 ± 1.03 (range: 3.67–9.33). The prevalence of sites with positive BOP was 38.14 ± 29.77%. The mean PD value was 2.46 ± 0.62 mm. The average MBL was 1.15 ± 0.74 mm (range: 0.25–4.03 mm). No implant or abutment fracture was detected. A veneer chipping was present in one patient, and a loose crown appeared in another patient. Two implants (3.7%) and two patients (6.3%) were diagnosed with peri‐implantitis.

Conclusion

Within the limitation of the study, the results indicate that the use of two‐piece 2.8 mm NDI for the fixed prosthetic rehabilitation of edentulous regions with reduced interdental and/or buccal–lingual width is viable.
Analyzing the Burden of Midface Fractures Due to Road Traffic Accidents in Vietnam: An Epidemiological Approach
Authors: Nguyen Chon Thanh Ho , Hoang Hung Trong , Van Nguyen Tuan , Tran Cuong Minh , Dao Khai Quang
Published: October 2024

Background

Road traffic accidents have significantly impacted public health in Vietnam. This study investigated the patterns of midface fractures in Vietnam and their correlation with road traffic accidents in the country.

Methodology

This retrospective cross‐sectional study reviewed 2187 medical records of patients with midface fractures in Ho Chi Minh City. After applying exclusion criteria, the fractures were categorized. Statistical analyses, including chi‐squared and logistic regression, were conducted to identify associations and relationships among the types and causes of fractures.

Results

The study found that 89.3% of midface fractures stemmed from road traffic accidents, with 55.2% and 14.4% zygomatic complex fractures and Le Fort type II fractures, respectively. Adults aged 19–39 accounted for 65.1% of patients, with males at 80.5%. Traffic accidents were significantly associated with an 18.7 times higher risk of concomitant mandibular fractures and a 10.5 times higher risk of Le Fort type II fractures, irrespective of age and gender.

Conclusion

This study underscores the need for targeted prevention strategies to decrease the incidence of maxillofacial injuries resulting from road traffic accidents in Vietnam, particularly among high‐risk groups such as males and young adults.
Effect of lateral extent of pulp tissue removal on the outcome of partial pulpotomy for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis: A randomized clinical trial
Authors: Ramani A. , Sangwan P. , Duhan J. , Popat S. , Sangwan A.
Published: October 2024

Aim

The aim of this study is to compare the outcomes of restricted partial pulpotomy (R‐PP) versus extended partial pulpotomy (E‐PP) for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis (SIP).

Methodology

This double‐arm, parallel designed randomized clinical trial was registered at clinicaltrials.gov (registration number: NCT05406557). Following random allocation, 43 participants of each group received the designated intervention. In the R‐PP group, 2–3 mm of superficial pulp tissue was removed only from the exposure site, while chamber was completely de‐roofed and 2–3 mm of superficial pulp tissue from entire chamber was removed in the E‐PP group. Haemostasis was achieved using 3% sodium hypochlorite‐soaked cotton pellets. Upon haemostasis, ProRoot mineral trioxide aggregate (ProRoot MTA) was placed over the pulpal wound, overlaid with a resin‐modified glass ionomer liner, and restored with composite resin in the same visit. Outcome measures included clinical and radiographic success evaluation at 6 and 12 months, and pain assessment using the visual analogue scale pre‐operatively and daily for 7 post‐operative days. Nonparametric tests were used for variables including patient's age, pain intensities, mean analgesic consumption, and haemostasis time. Categorical variables including gender, caries type, analgesic intake, hard tissue barrier formation, clinical and radiographic success, and pulp sensibility responses were assessed using Chi‐square or Fisher's exact test. Tooth survival was analysed using Kaplan–Meier analysis.

Results

A total of 81 cases were analysed at 12 months follow‐up. Comparable success was observed in both groups (97.6% in E‐PP & 97.5% in R‐PP; p > .05). The R‐PP group reported significantly lower pain scores on the 1st and 2nd post‐operative days than E‐PP (p < .05) and required significantly less analgesic intake (p < .05). Hard tissue barrier formation was significantly lower in the R‐PP group (p < .05). No significant differences were observed between groups regarding haemostasis time, pulp sensibility responses, and tooth survival (p > .05).

Conclusions

Both the PP approaches exhibited comparable success for managing cariously exposed mature permanent molars with SIP. Given the conservative nature of R‐PP, it may be used as preferred PP approach for managing such cases. Being the first study of this kind, further work is necessary to draw definitive conclusions.
Synthesis and characterization of cerium monazite phosphate glass‐ceramic for immobilization of nuclear waste salt
Authors: Liu Xueyang , Duan Xilei , Li Lin , Zhang Qiang , Qian Zhenghua , Qiao Yanbo
Published: October 2024

A phosphate glass‐ceramic wasteform incorporating cerium monazite was synthesized through a two‐step solid phase sintering methodology, aimed at immobilizing waste salts derived from the pyrochemical reprocessing of spent nuclear fuel. The initial phase involved the synthesis of cerium monazite powder, employing a stoichiometric mixture of CeF3 and NH4H2PO4 in a molar ratio of mol(Ce:PO4) = 1:1.4, which was subjected to a thermal treatment at 900°C. Subsequently, the glass‐ceramic matrix was fabricated by sintering a composite mixture of the synthesized cerium monazite and iron phosphate glass (IPG) powder at a temperature of 1000°C for a duration of 2 h, resulting in a cerium incorporation exceeding 36.5 wt%. Microstructural analysis and structural characterization of the glass‐ceramic sample elucidated the presence of monazite crystallites (CePO4) with dimensions ranging from .2 to 5.5 µm. The chemical durability of the wasteform was assessed through modified ASTM C1308 tests conducted in deionized water over a period of 28 days, revealing a total elemental leaching rate of 2.58 × 10−7 g m−2 min−1.
Fracture resistance of pottery laminates with intentionally introduced defects
Authors: Sawada Takeyuki , Maki Yuto , Ikari Shunsuke , Yamamoto Keisuke , Kawai Shuji , Nakao Wataru
Published: October 2024

Laminated ceramics containing layers of pottery materials with high and low Young's moduli were developed to mimic the nacre structure of abalone shells with high resistances against dynamic fractures. The layers with the low Young's modulus moderated crack deflection and impact, thereby exhibiting a high fracture resistance. The ceramic pores were formed by the CO2 gas generated through the oxidation of SiC during firing. The dynamic fracture resistance was enhanced by elastic wave scattering owing to the difference between the Young's moduli of the dense and porous layers. The effect of lamination on the dynamic fracture resistance was observed because the elastic waves were scattered owing to the difference in the elastic modulus between the porous and dense layers, and their propagation to the back sample surface was suppressed. The fracture energy of the 5‐layer laminate was determined to be about four times larger than that of the dense monolayer, which indicates that the introduction of intentional defects is effective in improving the dynamic fracture resistance of the pottery ceramics.
Risk factors in bone marrow transplant recipients with leukaemia. Increased relapse risk in patients treated with ciprofloxacin for gut decontamination
Authors: Carlens Stefan , Ringdén Olle , Aschan Johan , Hägglund Hans , Ljungman Per , Mattsson Jonas , Remberger Mats
Published: October 2024

Three hundred and six patients with lowand intermediaterisk leukaemias undergoing allogeneic BMT between 1980 and March 1996 were studied regarding transplantation‐related mortality (TRM), relapse, and leukaemia‐free survival (LFS). Among the patients were 262 recipients of marrow from HLA‐identical siblings and 44 patients receiving marrow from HLA‐A, B, and ‐DR identical unrelated donors. Between 1986 and 1993, 153 adult patients received ciprofloxacin continuously during Cy conditioning, but since November 1993 ciprofloxacin has not been given until after Cy treatment. TRM at 5 yr showed an incidence of 30%. Significant risk factors in Cox regression multivariate analysis comprised acute GVHD grades II‐IV (p < 0.0001), seropositivity for 3‐4 herpes viruses prior to BMT (p = 0.002), intermediate risk disease (p = 0.008), female donor to male recipient (p = 0.015), and a donor age over 17 yr (p = 0.025). The risk of relapse was studied from 90 d after BMT, and the overall 5‐yr incidence was 32%. Significant risk factors comprised acute leukaemia, as compared to CML (p = 0.003), total body irradiation (TBI) compared to busulphan treatment (p = 0.011), gram‐negative prophylaxis with ciprofloxacin during cyclophosphamide (Cy) conditioning (p = 0.024), GVHD prophylaxis using a combination of methotrexate (MTX) and cyclosporine (CSA), compared to monotherapy (p = 0.037) and absence of chronic GVHD (p=0.050). The 5‐yr probability of relapse in patients receiving ciprofloxacin prophylaxis during Cy conditioning was 40%, compared to 24% in patients not receiving this treatment (p = 0.01). Overall, LFS at 5 yr was 49%. LFS was evaluated from day 30 after BMT until relapse or death of the patient. We found no difference in TRM, relapse or LFS between recipients of HLA‐identical sibling or unrelated bone marrow, risk factors significantly associated with an inferior LFS included acute GVHD grades II‐IV (p = 0.0002), intermediate risk disease (p = 0.003), donor seropositivity for 3‐4 herpes viruses (p = 0.046), and TBI conditioning (p = 0.048).
Patterns of acute rejection in portal‐enteric versus systemic‐bladder pancreas‐kidney transplantation
Authors: Nymann Trine , Hathaway Donna K , Shokouh‐Amiri M Hosein , Gaber Lillian W , Abu‐El‐Ella Khaled , Abdulkarim A Bashar , Gabera A Osama
Published: October 2024

Portal‐enteric (PE) transplantation of the pancreas allograft provides maintained physiologic drainage, and theoretically the portal delivery of transplantation antigens may have beneficial effects on the graft acceptance leading to improved graft survival. To determine whether the technique of pancreas placement affects the incidence of acute rejection we reviewed our experience in technically successful PE and systemic‐bladder (SB) drained simultaneous pancreas and kidney (SPK) transplants performed between 1989 and 1994. Forty‐seven recipients were included (SB= 30, PE = 17). All patients received cyclosporine based quadruple immunosuppression and survived at least 1 month. The two groups were comparable in HLA mismatches, cold ischemia time and level of immunosuppression at time of rejection. In the SB group the incidence of rejection was 1.04 kidney rejection/patient and 0.90 pancreas rejection/patient whereas the PE group experienced 0.53 kidney rejection/patient and 0.47 pancreas rejection/patient. The two groups were compared using incidence density statistics due to great variation in follow‐up time. The SB group had a significant higher density of both kidney and pancreas rejections (p ≤ 0.037 for kidney rejection and 0.058 for pancreas rejection). In addition, while 6 of 30 (20%) pancreas grafts and 4 of 30 (13%) kidney grafts were lost to irreversible rejection in the SB group, only 1 of 17 (6%) pancreas graft and 1 of 17 (6%) kidney graft were lost in the PE group. These data demonstrate, that the PE placement of pancreas allograft affects the rates of acute rejection and graft loss, and imply that there exist Some important immunological advantages when the pancreas graft is drained into the portal circulation.
Explaining the Family‐Centred Care of Young People With Depressive Disorders and Suicidal Ideations: A Grounded Theory Study
Authors: Sun Fan‐Ko , Long Ann , Wang Liang‐Jen , Tsai Ching‐Shu , Li Chia‐Jung , Chiang Chun‐Ying
Published: October 2024

Aim

This study aimed to develop a theory to guide family members caring for young people with depressive disorders and suicidal ideations.

Design

Strauss and Corbin's Grounded Theory.

Methods

Theoretical sampling was used to recruit primary family caregivers (aged 22–60) of young people experiencing depressive disorders and suicidal ideations from hospitals and psychiatric clinics in Taiwan. Data were collected using interviews (n = 23) in 2023. Data were analysed using Corbin & Strauss' analytical framework, including open, axial and selective coding until theoretical saturation was reached.

Results

A paradigm model was used to link the 13 categories and develop a substantive theory to help guide family members in the care of their young persons with depressive disorders and suicidal ideations. The core category that emerged was ‘Struggling to contain the young person's life by adjusting, assisting, and protecting them from diving into depression’. Other key categories interconnected with this core category were—creating a nurturing environment, adjusting to changes, protecting the young person's safety and assisting with their medical treatment.

Conclusion

Family caregivers could use this theory as a guide to enhance the care of young persons experiencing depressive disorders and suicidal ideations and accompany them alongside the healing process.

Implications for the Profession

Nursing professionals could provide psychoeducation to family caregivers on how to hold the young person gently and acquire compassion for the young persons' lived experience, thoughts and emotions, by creating a nurturing environment, adjusting to changes, protecting their safety and assisting with their medical treatment.

Impact

This theory provides valuable guidance for future intervention research aimed at improving family caregivers' ability to care for young persons with depressive disorders and suicidal ideations.

Reporting Method

The COREQ guidelines were utilised.

Patient or Public Contribution

No patient or public contribution.
Navigating the Complexities of Nursing Documentation When Patients Have Access to the Content: A Qualitative Study
Authors: Lerbæk Birgitte , Kusk Kathrine Hoffmann , Jørgensen Lone , Laugesen Britt
Published: October 2024

Aim

To explore how Danish registered nurses (RNs) in hospitals experience documenting nursing care in electronic patient records when the content is accessible to patients.

Methods

In a qualitative research design, data were generated in six focus groups conducted in late 2022 and early 2023, comprising 31 RNs employed in inpatient wards at a university hospital in Denmark. Subsequently, qualitative content analysis was applied to the gathered data.

Results

The findings include three themes: (1) weighing one's words, (2) building trust or triggering conflicts and (3) risking loss of knowledge. Together, these three themes illustrate the complexities that RNs navigate when patients have access to the content of nursing documentation.

Conclusion

Patients' access to nursing documentation requires RNs to navigate a complex interplay of factors, including awareness of language‐use, influence on the nurse–patient–relative relationships, and the risk of losing essential knowledge. Therefore, although patients' access to nursing documentation can induce a positive change in terms of strengthening the professional focus on documentation, it can also result in changes in documentation practices in ways that may compromise nursing documentation as a working tool.

Implications for the Profession and Patient Care

The findings emphasize an urgent need to explore and discuss how sensitive nursing observations can be shared in a safe and appropriate way when patients have access to the documentation. Furthermore, to prevent misunderstandings and conflicts with patients, it is essential to focus on and prioritize patient involvement in nursing documentation.

Impact

RNs navigate complex practices when patients have direct online access to nursing documentation content. It is crucial to clarify which content nursing documentation should entail and how sensitive nursing observations can be shared in a safe and appropriate way.

Reporting

The COREQ checklist was used for reporting.
Long‐term remission of Hailey–Hailey disease by Er:YAG ablative laser therapy
Authors: Debeuf Marie‐Eline P. H. , Knoops Kèvin , López‐Iglesias Carmen , Lookermans Eline , Nelemans Patty J. , Abdul Hamid Myrurgia , van Geel Michel , Gostynski Antoni H. , Steijlen Peter M. , Bolling Marieke C. , Verstraeten Valerie L. R. M.
Published: October 2024

Background

Hailey–Hailey disease (HHD) is a rare genetic therapy‐resistant blistering disease with great disease burden. Treatment is currently focused on symptomatic relief. Er:YAG ablative laser therapy is a therapeutic modality with promising results, though evidence is currently scarce.

Objective

To analyse the effect of Er:YAG ablative laser therapy on clinical remission of erosive plaques in HHD and on patient's quality of life (QoL).

Methods

In this observational study eight patients were included and 77 erosive plaques were treated once only by Er:YAG laser and assessed for clinical remission. QoL was evaluated by obtaining Skindex‐29 and DLQI questionnaires before laser therapy, 6 weeks and 3 years after laser therapy. Skin biopsies were taken to evaluate the depth of laser ablation. The intercellular distance between keratinocytes, the number of desmosomes and intermediate filament distribution were studied by electron microscopy before and after laser therapy and in clinically uninvolved skin and were compared to subjects without HHD.

Results

One single Er:YAG laser ablation to mid‐dermis resulted in complete remission of 97.4% of HHD plaques (75/77) after median 38 months (range 7–63 months) and significantly improved QoL. Laser therapy restored the number of desmosomes, decreased intercellular distance and diminished perinuclear retraction of keratin filaments to a level comparable to the patient's clinically uninvolved skin. After laser ablation, the skin showed significantly fewer ultrastructural aberrations compared to the patient's clinically uninvolved skin and rather resembled the skin of healthy control individuals.

Conclusion

One single Er:YAG laser treatment resulted in long‐term remission of HHD and significantly improved QoL. Our findings support a greater role for ablative laser surgery in the management of this recalcitrant disorder.
Midlife is good for more than a crisis: Exercise for dementia prevention
Authors: Fenton Laura , Pa Judy
Published: October 2024

This editorial comments on the article by Wei et al. in this issue.
Hospital‐acquired malnutrition: point prevalence, risk identifiers and utility of a digital Dashboard to identify high‐risk, long‐stay patients in five Australian facilities
Authors: Palmer Michelle , Hosking Breanne , Naumann Fiona , Courtice Sally , Henderson Amanda , Stoney Rachel M. , Ross Lynda J. , Vivanti Angela
Published: October 2024

Background

There are limited hospital‐acquired malnutrition (HAM) studies among the plethora of malnutrition literature, and a few studies utilise electronic medical records to assist with malnutrition care. This study therefore aimed to determine the point prevalence of HAM in long‐stay adult patients across five facilities, whether any descriptors could assist in identifying these patients and whether a digital Dashboard accurately reflected ‘real‐time’ patient nutritional status.

Methods

HAM was defined as malnutrition first diagnosed >14 days after hospital admission. Eligible patients were consenting adult (≥18 years) inpatients with a length of stay (LOS) >14 days. Palliative, mental health and intensive care patients were excluded. Descriptive, clinical and nutritional data were collected, including nutritional status, and whether a patient had hospital‐acquired malnutrition to determine point prevalence. Descriptive Fisher's exact and analysis of variance (ANOVA) tests were used.

Results

Eligible patients (n = 134) were aged 68 ± 16 years, 52% were female and 92% were acute admissions. HAM and malnutrition point prevalence were 4.5% (n = 6/134) and 19% (n = 26/134), respectively. Patients with HAM had 72 days greater LOS than those with malnutrition present on admission (p < 0.001). A high proportion of HAM patients were inpatients at a tertiary facility and longer‐stay wards. The Dashboard correctly reflected recent ward dietitian assessments in 94% of patients at one facility (n = 29/31).

Conclusions

HAM point prevalence was 4.5% among adult long‐stay patients. Several descriptors may be suitable to screen for at‐risk patients in future studies. Digital Dashboards have the potential to explore factors related to HAM.
Bridging Gaps in Shared Decision‐Making for Anxiety Disorders: A Commentary on Villena et al.
Authors: Chen Chia‐Wei , Wei Lien‐Chung , Chiu Hsien‐Jane
Published: October 2024

This commentary reflects on the recent study by Villena et al., which addresses the need for enhanced shared decision‐making (SDM) for individuals with anxiety disorders. As a psychiatrist with expertise in anxiety management, I commend the study's emphasis on patient involvement and its alignment with real‐world clinical challenges. The findings, particularly regarding patients' preferences for psychological interventions and the current trend towards pharmacological treatments, highlight the need to better align treatment approaches with evidence‐based guidelines. Additionally, the study underscores the importance of psychoeducation and active coping strategies like exposure techniques. These insights offer valuable contributions towards improving patient‐centred care and SDM in anxiety disorder treatment.
Revisiting the effects of state anesthesia policy interventions: A comprehensive look at certified registered nurse anesthetist service provision in U.S. hospitals from 2010 to 2021
Authors: Feyereisen Scott , McConnell William , Puro Neeraj
Published: October 2024

Aims

Rural hospitals in the United States often rely on nonphysician providers such as advanced practice nurses to care for their patients. One important role that is served by advanced practice nurses is that of anesthesia provider (certified registered nurse anesthetist or CRNA). In 2001, Centers for Medicare & Medicaid Services (CMS) passed an opt‐out law affording state governors the right to loosen physician supervision requirements on CRNAs in their respective states, thus potentially improving access in targeted areas. Since then, 24 states have adopted these opt‐out provisions. We aim to understand the extent to which the CMS opt‐out law has resulted in increased CRNA service provision in hospitals, especially in rural areas.

Design

The study used a longitudinal design. We compiled 2010‐2021 American Hospital Association data, which includes 4,464 unique U.S. hospitals observed an average of 8 times annually (35,863 total hospital‐year observations).

Methods

We model CRNA services provision at the hospital level using longitudinal mixed effects generalized linear models that incorporate state, county, and hospital control variables.

Results

Using descriptive statistics and mixed effects generalized linear models, we discovered that adopting opt‐out provisions does not universally result in increased CRNA service provision in U.S. hospitals. Notably, opt‐out provisions do not improve access in rural counties. However, in supplemental analysis, we discover some of the conditions under which the likelihood of CRNA service provision is influenced.

Conclusions

Hospitals often utilize CRNAs to staff their hospitals. However, many hospitals use both CRNAs and physician anesthesiologists; this can be a potential source of contention and confusion, given the lack of uniformity in the scope of practice policies. We offer some suggestions with regard to the effects of state interventions into the field, and how they might impact this dispute. Lastly, policymakers should consider additional measures to address rural access limitations, as the opt‐out policy does not seem to be working as intended.
Effects of visit restriction in the COVID‐19 pandemic: Experiences and perceptions of intensive care nurses
Authors: Aydın Er Rahime , Delihasanoğlu Ayşegül
Published: October 2024

Background

The visit restrictions imposed as a result of COVID‐19 precluded the entrance of the patient's family into the confines of the intensive care unit.

Aim

This study evaluated the experiences of intensive care nurses (ICNs) regarding COVID‐19 visit restrictions and their opinions on these restrictions.

Study Design

From May 2023 to July 2023, semi‐structured interviews with 15 ICNs from intensive care units in a tertiary public hospital in Türkiye were conducted. Data were analysed using qualitative content analysis with an inductive approach. Reporting of the study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Results

The analysis revealed two main themes, ‘widespread negative impacts of visit restrictions’ and ‘adaptive strategies to the visitation ban’, and seven sub‐themes supporting the main themes. Nurses perceived that the visit restrictions imposed during the COVID‐19 pandemic had a severe negative effect on patients, their relatives, themselves and the care environment. They also did not support visit restriction in future pandemics.

Conclusions

The COVID‐19 visitation policy weakened the involvement of family members in patient care and created serious challenges in the intensive care setting. The study revealed an urgent need for patient‐centred, family‐sensitive and consistently applied protocols in future pandemics.

Relevance to Clinical Practice

In future pandemics, strategies such as the benefit–benefit ratio of the visit, the provision and use of adequate personal protective equipment, and vaccination requirements should be considered in visiting decisions of patients hospitalized because of infection. Participation of nurses responsible for patient care in decisions regarding visitor practices should be supported.
Taxonomy, anatomy and palynology of Paepalanthus fonsecae (Eriocaulaceae), a new species from central Brazil
Authors: Trovó Marcelo , Picanço Leite Wellerson , Sayuri Tajima Aline , de Mathias Tessari Gabriela , Ramos Renato , Gonçalves‐Esteves Vania , Ike Coan Alessandra
Published: October 2024

The new species, Paepalanthus fonsecae (Eriocaulaceae), is described and illustrated. It is placed in P. sect. Conodiscus due to its dimerous flowers, subcylindrical receptacles, and a gynoecium with the nectariferous branches of the style inserted below the level of the short stigmas on the fused portion of the style. The new species is compared with similar congeners, especially P. echinoides, from which it is mainly distinguished by having an elongated aerial stem covered by membranaceous and flat leaves, and the inflorescences consisting of usually fewer but longer scapes, each subtending a wider capitulum with elliptic involucral bracts. Paepalanthus fonsecae is known from two collections from central Brazil in the municipalities of Alto Paraíso de Goiás and Cavalcante and, according to IUCN criterion B, it should be treated as critically endangered (CR). Detailed comments on the species' distribution and morphology, along with new anatomical and palynological data, are provided.
What determines transfer of carbon from plants to mycorrhizal fungi?
Authors: Bunn Rebecca A. , Corrêa Ana , Joshi Jaya , Kaiser Christina , Lekberg Ylva , Prescott Cindy E. , Sala Anna , Karst Justine
Published: October 2024

Biological Market Models are common evolutionary frameworks to understand the maintenance of mutualism in mycorrhizas. ‘Surplus C’ hypotheses provide an alternative framework where stoichiometry and source–sink dynamics govern mycorrhizal function. A critical difference between these frameworks is whether carbon transfer from plants is regulated by nutrient transfer from fungi or through source–sink dynamics. In this review, we: provide a historical perspective; summarize studies that asked whether plants transfer more carbon to fungi that transfer more nutrients; conduct a meta‐analysis to assess whether mycorrhizal plant growth suppressions are related to carbon transfer; and review literature on cellular mechanisms for carbon transfer. In sum, current knowledge does not indicate that carbon transfer from plants is directly regulated by nutrient delivery from fungi. Further, mycorrhizal plant growth responses were linked to nutrient uptake rather than carbon transfer. These findings are more consistent with ‘Surplus C’ hypotheses than Biological Market Models. However, we also identify research gaps, and future research may uncover a mechanism directly linking carbon and nutrient transfer. Until then, we urge caution when applying economic terminology to describe mycorrhizas. We present a synthesis of ideas, consider knowledge gaps, and suggest experiments to advance the field.
Biofortifying multiple micronutrients and decreasing arsenic accumulation in rice grain simultaneously by expressing a mutant allele of OAS‐TL gene
Authors: Xu Xuejie , Sun Sheng‐Kai , Gao Axiang , Huang Xin‐Yuan , Wirtz Markus , Hell Rüdiger , Zhao Fang‐Jie
Published: October 2024

Rice grains typically contain relatively high levels of toxic arsenic (As) but low levels of essential micronutrients. Biofortification of essential micronutrients while decreasing As accumulation in rice would benefit human nutrition and health.

We generated transgenic rice expressing a gain‐of‐function mutant allele astol1 driven by the OsGPX1 promoter. astol1 encodes a plastid‐localized O‐acetylserine (thiol) lyase (OAS‐TL) with Ser189Asn substitution (OsASTOL1S189N), which enhances cysteine biosynthesis by forming an indissociable cysteine synthase complex with its partner serine acetyltransferase (SAT). The effects on growth, As tolerance, and nutrient and As accumulation in rice grain were evaluated in hydroponic, pot and field experiments.

The expression of OsASTOL1S189N in pOsGPX1::astol1 transgenic lines enhanced SAT activity, sulphate uptake, biosynthesis of cysteine, glutathione, phytochelatins and nicotianamine, and enhanced tolerance to As. The expression of OsASTOL1S189N decreased As accumulation while increased the accumulation of multiple macronutrients (especially sulphur, nitrogen and potassium) and micronutrients (especially zinc and selenium) in rice grain in a pot experiment and two field experiments, and had little effect on plant growth and grain yield.

Our study provides a new strategy to genetically engineer rice to biofortify multiple essential nutrients, reducing As accumulation in rice grain and enhancing As tolerance simultaneously.