bluuebunny/crossref_metadata_2025 huggingface dataset:
A national questionnaire survey of Japanese urologists on treatment perspectives for elderly prostate cancer patients
Authors: Kato Takuma , Tohi Yoichiro , Honda Tomoko , Matsuda Iori , Osaki Yu , Naito Hirohito , Matsuoka Yuki , Okazoe Homare , Taoka Rikiya , Ueda Nobufumi , Sugimoto Mikio
Published: June 2023

Objective

This study conducted a national questionnaire survey of Japanese urologists from a treatment perspective for older patients with prostate cancer.

Methods

A questionnaire was distributed to 922 teaching hospitals of the Japanese Urological Association. Questionnaire items included years of urologist experience, gender, workplace, treatment equipment owned, daily specialty practice area, urological cancer specialty, treatment reference items for older adults, upper age limit for radical treatment, medication, and two hypothetical cases of Gleason grade group 2 prostate cancer with or without oligometastasis.

Results

In total, 1732 questionnaires were analyzed, with responses evenly distributed across all age groups. Workplaces included general hospitals (49.4%), university hospitals (40.3%), and cancer centers (4.2%). Performance status was the most frequently mentioned treatment‐related item, followed by comorbidities and cognitive function. In addition, geriatric assessment was used by only 13.3% of respondents. No upper age limit was found for total prostatectomy, brachytherapy, and external beam radiation. Anti‐androgens, androgen receptor‐axis‐targeted agents, chemotherapy, poly ADP ribose polymerase inhibitors, and immune‐checkpoint inhibitors were selected by 6.8%, 35.6%, 47.3%, 89%, 62.8%, 24.7%, 41.9%, and 41.7% of the respondents, respectively. Response rates for administration of hormone therapy for hypothetical cases of Gleason grade group 2 prostate cancer with or without oligometastases were 96.8% and 61.2%, respectively.

Conclusions

Less than 15% of urologists used geriatric assessments. Several responded that they would set age limits for highly invasive radical and systemic therapies.
Socio‐behavioural determinants associated with the first dental visit in Saudi children: A cross‐sectional study
Authors: Gudipaneni Ravi Kumar , Alsirhani Munahi Abdullah Rushdallah , Alruwaili Musab Redha S. , Alharbi Abdullah Khalaf K. , Alftaikhah Sultan Abdulkareem Ali , Almaeen Saud Hamdan , Manchery Nithin
Published: June 2023

Backgroud

Oral health is an integral component of overall well‐being, understanding the age at which children have their first dental visit (FDV) and the socio‐behavioural factors influencing these visits is essential for improving oral health outcomes in children.

Aim

This study aimed to determine the age at which Saudi children had their FDV and the socio‐behavioural predictors associated with these visits in Al Jouf Province, Kingdom of Saudi Arabia.

Design

This cross‐sectional study used a multistage stratified random sampling technique to invite 566 parents/guardians of schoolchildren aged 12 years or younger. Multinomial logistic regression analysis was used to identify socio‐behavioural variables that predict children's FDV. p < 0.05 was considered statistically significant.

Results

Most FDVs in children occurred between the ages of 6 and 10 years. More than half of the participants stated that FDVs occurred primarily because of dental pain. Furthermore, educated mothers reported a higher frequency of dental visits for their children. Children with a low family income were 63% (95% confidence interval 0.16–0.83; p = .015) less likely to visit a dentist between the ages of 1 and 5 years.

Conclusion

First dental visits in children in Al Jouf Province typically occurred between the ages of 6 and 10 years, with dental pain being the main reason. Parents' or caregiver's relationships with children, parental age and familial income were identified as predictors of the FDV.
RETRACTED: Platelet‐rich plasma influence on the sternal wounds healing: A meta‐analysis
Authors: Zhu Shenyu , Gao Jianfeng , Yu Wenbo , Xiong Jianxian
Published: June 2023

A meta‐analysis research was executed to appraise the effect of platelet‐rich plasma (PRP) on sternal wound healing (SWH). Inclusive literature research till April 2023 was done and 1098 interconnected researches were revised. The 11 picked researches, enclosed 8961 cardiac surgery (CS) persons were in the utilised researchers' starting point, 3663 of them were utilising PRP, and 5298 were control. Odds ratio (OR) and 95% confidence intervals (CIs) were utilised to appraise the effect of PRP on the SWH by the dichotomous approach and a fixed or random model. PRP had significantly lower sternal wound infection (SWI) (OR, 0.11; 95% CI, 0.03–0.34, p < 0.001), deep SWI (OR, 0.29; 95% CI, 0.16–0.51, p < 0.001), and superficial SWI (OR, 0.20; 95% CI, 0.13–0.33, p < 0.001), compared to control in CS persons. PRP had significantly lower SWI, deep SWI, and superficial SWI, compared to control in CS persons. However, caution must be taken when interacting with its values since there was a low sample size of some of the nominated research found for the comparisons in the meta‐analysis.
Alumina dissolution process to fabricate bimodal pore architecture alumina with superior green and sintered properties
Authors: Pandey Vaibhav , Panda Saroja Kanta , Singh Vinay Kumar
Published: June 2023

Herein, a straightforward, adaptable, and cost‐effective approach has been proposed to realize the concept of dissolution of alumina in acidic aqueous media to fabricate porous alumina showing exceptional green machining properties and exhibiting good thermomechanical properties through in situ generated blowing agents and thermo‐foaming process. The process involves dissolving alumina in concentrated sulfuric acid to generate aluminum hydroxide and aluminum sulfate, which act as blowing agents to produce pores in the final structure through a decomposition process at elevated temperatures. By varying the concentration of deionized water and acidification using sulfuric acid, different alumina slurries are prepared. Sintering shrinkage is well countered through simultaneous consolidation and decomposition process during the heat treatment, and a minimum shrinkage of 0.88% is achieved. In addition to its pore‐forming properties, aluminum sulfate also provides strong binding effects to green bodies, contributing to their exceptional green machining properties. The resulting porous alumina exhibits a green flexural strength of up to 17 MPa, making it capable of bearing loads and forces during green machining. The sintered porous alumina fabricated in the study has a porosity range of 34.43%–59.24% and a flexural strength of 27.84–53.21 MPa. The prepared porous alumina also exhibits satisfactory thermal resistivity, with a minimum thermal conductivity of 1.23 W/m K, and has intra/intergranular space in the nano range. The coexistence of a combination of bimodal pores in a single monolithic matrix makes it exceptionally porous and suitable for an extensive spectrum of applications.
Novel B‐site scheelite structure ceramic Bi(Ge0.5Mo0.5)O4 and its dielectric properties
Authors: Xu Diming , Zhang Haowei , Pang Lixia , Hussain Fayaz , Zhou Tao , Sun Shi‐Kuan , Chen Zhijiao , Zhou Di
Published: June 2023

Scheelite structure phase inorganic oxides show their irreplaceable role in numerous application areas due to their clear structure and superior properties, especially in dielectrics. Scheelite structure phase BiVO4 has been permanently studied but substitutions, modifications, and explorations of novel phases persist hitherto and inspire more interest. In this work, we report a novel Scheelite structure phase of Bi(Ge0.5Mo0.5)O4 and a detailed study of both structural analysis and dielectric properties investigation. Bi(Ge0.5Mo0.5)O4 adopts the monoclinic Scheelite structure, identical to BiVO4, with a dielectric permittivity of ∼ 35, Qf value of ∼20 000 GHz, and TCF value of ‒46 ppm/°C. No secondary ferroelastic transition was seen in Bi(Ge0.5Mo0.5)O4 till 600°C, close to its synthetical temperature. The results indicate the success of discovering a new Scheelite structure phase and its prior engineering potential in modifying and substituting BiVO4 over the dielectric area, photocatalyst, ion conductor, and so forth.
Focal atrial tachycardia arising from left superior pulmonary vein in a pediatric patient, safely treated by pulsed‐field ablation
Authors: Rossillo Antonio , Borio Gianluca , Vittadello Sabina , Spadaro Gian Luca , Bonanno Carlo , Raviele Antonio , Caprioglio Francesco
Published: June 2023

Introduction

We describe the first case of the use of pulsed‐field ablation (PFA) to treat focal atrial tachycardia (FAT) in a pediatric patient.

Methods

An 11‐year‐old girl with obesity was referred to our center for ablation of incessant atrial tachycardia. The earliest atrial activation was shown to be present in the left superior pulmonary vein. Radiofrequency ablation of FAT seems to be associated with a lower success rate and, especially, with a higher complication rate than in adult patients.

Results

We performed ablation by means of a novel nonthermal energy source (PFA) that is able to reduce the risk of complications due to injury to anatomic structures surrounding the heart. After the first application, stable sinus rhythm was restored.

Conclusions

PFA can be used to treat FAT arising from pulmonary veins in young children as a good alternative to RFA ablation, thereby reducing the risk of potential procedure‐related complications.
The tree shrew as a new animal model for the study of periodontitis
Authors: Ma Liya , Chen Rui , Zhang Yelin , Dai Zichao , Huang Guobin , Yang Rongqiang , Yang Hefeng
Published: June 2023

Aim

Periodontitis is an inflammatory, infectious disease of polymicrobial origin that can damage tooth‐supporting bone and tissue. Tree shrews, evolutionarily closer to humans than commonly used rodent models, have been increasingly used as biomedical models. However, a tree shrew periodontitis model has not yet been established.

Materials and Methods

Periodontitis was induced in male tree shrews/Sprague–Dawley rats by nylon thread ligature placement around the lower first molars. Thereafter, morphometric and histological analyses were performed. The distance from the cemento‐enamel junction to the alveolar bone crest was measured using micro‐computed tomography. Periodontal pathological tissue damage, inflammation and osteoclastogenesis were assessed using haematoxylin and eosin staining and quantitative immunohistochemistry, respectively.

Results

Post‐operatively, gingival swelling, redness and spontaneous bleeding were observed in tree shrews but not in rats. After peaking, bone resorption decreased gradually until plateauing in tree shrews. Contrastingly, rapid and near‐complete bone loss was observed in rats. Inflammatory infiltrates were observed 1 week post operation in both models. However, only the tree shrew model transitioned from acute to chronic inflammation.

Conclusions

Our study revealed that a ligature‐induced tree shrew model of periodontitis partly reproduced the pathological features of human periodontitis and provided theoretical support for using tree shrews as a potential model for human periodontitis.
The challenges of using ranks to estimate sales
Authors: Liebowitz Stan J. , Zentner Alejandro
Published: June 2023

Researchers have frequently used data on product ranks to estimate nonpublic sales quantities, believing that there is a power‐law‐induced linear relationship between logged sales ranks and logged sales. Using essentially complete data on book sales, the most commonly used product in this literature, we find that the (double‐logged) relationship between sales ranks and quantity sold is not linear, but robustly concave. We demonstrate that this concavity is likely to cause very poor sales predictions in many instances. We provide two concrete examples where applying this linear method to the concave relationship has led to serious errors in sales estimates. First, in the claim that the Internet's greater product variety in books has a large positive impact on social welfare, and second, in a claim about relative sales levels in top 20 and top 50 music “charts.” We also explore the use of nonlinear specifications as an alternative method to predict sales from ranks and find a simple specification that provides much better sales estimates. Finally, we examine the possibility that a particular type of biased sample might allow reasonable linear estimates of industry sales and conclude that it is possible but quite unlikely.
Managerial characteristics and performance of eurozone mutual funds
Authors: Tolikas Konstantinos , Callonnec Marc
Published: June 2023

We investigate the relation between observable managerial characteristics (i.e., gender, age, tenure, professional qualifications, and advanced education) and performance in diversified equity mutual funds domiciled in the eurozone. We find that differences in the fund alphas are statistically significant only in groups based on age, tenure, and professional qualifications (i.e., chartered financial analyst [CFA]). We also find a significant positive relation for age and CFA certification with a fund's risk‐adjusted performance and a significant negative relation for tenure. However, we find no significant effect for gender and advanced education (i.e., master of business administration [MBA]). The differences in risk taking are significantly related only with age and tenure; the former has a negative and the latter a positive relation with risk taking.
Real‐time detection of Fusarium infection in moving corn grains using YOLOv5 object detection algorithm
Authors: Thangaraj Sundaramurthy Rathna Priya , Balasubramanian Yogameena , Annamalai Manickavasagan
Published: June 2023

Real‐time inspection and removal of individual Fusarium head blight (FHB) infected corn grains from the processing lines has been a challenging issue due to the bulk handling and smaller kernel size. In this study, four different variants (small(s), medium(m), nano(n), and large(l)) of You Only Look Once (YOLO) version 5 object detection technique were trained for the detection of Fusarium infection in a moving monolayer of touching and non‐touching corn grains. The YOLOv5 object detection models were evaluated for their performance in detecting FHB infection in individual corn grains. A heterogeneous dataset containing images and video frames of healthy and FHB infected corn grains in different illuminations was utilized. The mean average precision calculated at Intersection over Union threshold of .5 (mAP@50) was 99%, 98%, 95%, and 96% for YOLOv5‐s, YOLOv5‐m, YOLOv5‐n, and YOLOv5‐l models, respectively. The detection speed in videos was 3.9, 1.6, 9.8, and .8 frames per second for YOLOv5‐s, m, n, and l models, respectively. For non‐touching grains, all four variants of the YOLOv5 model showed 100% precision, but for touching grains, all variants showed false negatives in detection of FHB infection, especially on overlapping kernels. The recall values were found to be 98%, 99%, 96%, and 97% for YOLOv5‐s, m, n, and l models, respectively. The best combination of mAP, detection speed, and lower false negatives was achieved by the YOLOv5‐m model. YOLOv5‐m has the potential for use in real‐time detection of Fusarium infection in corn grains apart from lag time in videos.

Practical Application

The developed video analysis technique based on YOLOv5 object detection method will be beneficial for the accurate identification of Fusarium infected corn grains in bulk handling facilities. The individual FHB infected grains could be detected on processing lines and could be used for real‐time inspection replacing the random sampling techniques currently used, thereby preventing the entry of Fusarium mycotoxins in the food chain. For non touching corn grains, all the YOLOv5 model variants showed a 100% precision in identifying the healthy and FHB infected grains. For touching grains, YOLOv5‐m model showed the best combination of mAP, detection speed, and lower false negatives proving appropriate for inspection on moving conveyor belts. The nano model with the lightweight architecture installed in portable devices can be used for immediate detection of FHB infection without lag time.
Biomarkers for monitoring alcohol sobriety after liver transplantation for alcoholic liver disease
Authors: Liu Jiang , Man Kwan
Published: June 2023

Alcoholic liver disease (ALD) has become the most common indication for liver transplantation in Western countries, and its incidence is rapidly increasing in East Asia. Alcohol abstinence remains the standard of care for promoting liver transplantation for ALD and for preventing posttransplant graft loss. However, efficient monitoring methods are still being developed due to the limitations of traditional biomarkers, interviews, and questionnaires. The development of alcohol biomarkers has shifted from detecting alcohol and methanol to indirect byproducts, and to current mid‐term and long‐term direct alcohol metabolites, which provide higher accuracy and cover almost all types of alcohol relapse detection. However, in most clinical studies, biomarkers are used and validated in healthy individuals and alcohol use disorder (AUD) patients and for pretransplant evaluations. The evidence for their use in posttransplant abstinence monitoring is still lacking, but it is crucial for early detection of alcohol relapse and initiating intervention. This review aims to summarize the current evidence of the use of biomarkers for monitoring sobriety and alcohol relapse after liver transplantation, as well as to cover the diagnostic accuracy, detection window, and optimal multidisciplinary strategies.
Countercyclical Capital Buffers: A Cautionary Tale
Authors: KOCH CHRISTOFFER , RICHARDSON GARY , HORN PATRICK VAN
Published: June 2023

Countercyclical capital buffers (CCyBs) are an old idea recently resurrected. They compel systemically important banks to accumulate capital during expansions to sustain operations during downturns. We compare banks before the Great Depression, when CCyBs existed, and Great Recession, when they did not. Pre‐Depression systemically important banks built capital buffers between 3% and 5% of total assets during booms, nearly twice the maximum modern CCyB, while also reducing risky lending and building cash reserves. These buffers enabled banks at the core of the financial system to continue operations during severe crises while the rest of the financial system collapsed. This analogy indicates that modern countercyclical buffers may achieve their goals of protecting core banks during crises but raises questions about whether they will contribute to overall financial stability.
Associations Between State Practice Regulations and Access to Midwifery Care
Authors: Herndon Acacia , Vanderlaan Jennifer
Published: June 2023

Introduction

This study aimed to identify associations between state policies and access to midwifery care. Identifying policies that facilitate increased access to midwives will help policymakers determine the best methods for increasing access to midwives in their states.

Methods

This cross‐sectional study was conducted at the county level as a secondary analysis of National Vital Statistics data from the Natality online database. The unit of analysis was counties with populations of at least 100,000, and the outcome was the proportion of births attended by midwives in 2019. The potential predictors of increased access to midwifery care were independent midwife licensure, independent midwife prescribing, midwife access to hospital medical staff membership, and midwife Medicaid parity. Medicaid provider resources and state statutes verified Medicaid reimbursement rates and eligibility for hospital medical staff privileges. Each state was categorized as an independent or restricted licensure state according to data from the American College of Nurse‐Midwives. Data for the control variable, the presence of a midwifery education program, were gathered from the Accreditation Commission for Midwifery Education. The analysis was conducted as a Poisson regression.

Results

There was no association between independent licensing and increased access among all states. Stratifying the analysis by independent licensing law revealed that all but one policy was related to higher rates of midwife attendance at birth. Maximum Medicaid reimbursement correlated with greater access regardless of licensing status. The rate of midwife‐attended births in independent licensing states grew as the number of potential predictors in a county increased.

Discussion

Regulatory policies beyond independent licensing are associated with women's access to midwifery services. In independent licensing states, adopting additional policies favorable to midwives may strengthen access to midwifery. Policymakers and regulators can use these findings to identify strategies for accelerating the expansion of midwifery access in their states.
Mitophagy suppresses motor neuron necroptotic mitochondrial damage and alleviates necroptosis that converges to SARM1 in acrylamide‐induced dying‐back neuropathy
Authors: Wang Shuai , Yang Yiyu , Yu Zhigang , Song Mingxue , Liu Zhidan , Shan Shulin , Yong Hui , Ni Wenting , Qiang Yalong , Zhang Cuiqin , Wang Shu’e , Zhao Xiulan , Song Fuyong
Published: June 2023

Acrylamide (ACR), a common industrial ingredient that is also found in many foodstuffs, induces dying‐back neuropathy in humans and animals. However, the mechanisms remain poorly understood. Sterile alpha and toll/interleukin 1 receptor motif‐containing protein 1 (SARM1) is the central determinant of axonal degeneration and has crosstalk with different cell death programs to determine neuronal survival. Herein, we illustrated the role of SARM1 in ACR‐induced dying‐back neuropathy. We further demonstrated the upstream programmed cell death mechanism of this SARM1‐dependent process. Spinal cord motor neurons that were induced to overexpress SARM1 underwent necroptosis rather than apoptosis in ACR neuropathy. Mechanically, non‐canonical necroptotic pathways mediated mitochondrial permeability transition pore (mPTP) opening, reactive oxygen species (ROS) production, and mitochondrial fission. What's more, the final executioner of necroptosis, phosphorylation‐activated mixed lineage kinase domain‐like protein (MLKL), aggregated in mitochondrial fractions. Rapamycin intervention removed the impaired mitochondria, inhibited necroptosis for axon maintenance and neuronal survival, and alleviated ACR neuropathy. Our work clarified the functional links among mitophagy, necroptosis, and SARM1‐dependent axonal destruction during ACR intoxication, providing novel therapeutic targets for dying‐back neuropathies.

image
Sub‐second timing irregularities in a simple motor task in autism spectrum disorder: Preliminary effects of intermittent light stimulation
Authors: Carmo Joana C. , Filipe Carlos N.
Published: June 2023

Several authors have contributed extensively to the neurocognitive understanding of timing. In Autism Spectrum Disorder (ASD) on the contrary, internal timing and its functioning is not well understood. In this study, we have adapted a simple finger‐tapping motor task, with a timing component, as we aim at understanding whether the processing of time is preserved in this population. We have tested a group of people on the autism spectrum without intellectual disabilities and a control sample recruited from the general population, matched for age, sex, schooling and general cognitive abilities on this task with a learning and testing phase. In the testing phase, we have added two exploratory conditions where participants were exposed to intermittent light stimulation of 4 and 8 Hz. Results show that both in the learning and testing phase, besides troubles in the motor component encountered by the people on the spectrum, their timing component performance was also problematic. This reveals to be especially true for time intervals below the 1 s range, as hypothesized, whereas performance in longer intervals is clearly preserved. It was also observed that the exposure to intermittent light stimulation specifically overcomes the difficulties observed in the autistic group, at the timing components at this millisecond time range. The observed timing difficulties in this group seem to be restricted to the system responsible for the processing of time intervals in the milliseconds range, which helps accommodate disparate findings in the literature.
Casual association between childhood body mass index and risk of psoriasis: A Mendelian randomization study
Authors: Li Yuan , Zhang Wei , Chen Gaihe , Zhao Peng , Wu Chuyan , Bao Yunlei , Jiang Feng , Zeng Ni , Ding Yan
Published: June 2023

Background

Observational studies have suggested that childhood body mass index (BMI) is associated with the risk of psoriasis. However, their causal relationship remains unclear. In this investigation, we aimed to determine whether an association exists between childhood BMI and psoriasis.

Methods

Using summary statistics for childhood BMI of European descent from publicly available GWAS meta‐analyses (n = 39 620), we conducted Mendelian randomization (MR) research using the inverse variance weighting (IVW), weighted median, and MR‐Egger regression techniques. The outcome was a genome‐wide association studies (GWAS) for the self‐reported non‐cancer disease classification psoriasis in the UK Biobank population (total n = 337 159; case = 3871; control = 333 288).

Results

We selected instrumental variables from 16 single‐molecule polymorphisms that attained genome‐wide significance in GWAS on childhood BMI. Using the IVW method, our findings supported a causal relationship between childhood BMI and psoriasis (beta = 0.003, standard error [SE] = 0.001, p = 0.006). Using MR‐Egger regression analysis, we evaluated the potential for directional pleiotropy to bias our results (intercept = 0.00039, p‐value = 0.247) and found no causal relationship between childhood BMI and psoriasis (beta = −0.002, SE = 0.004, p = 0.625). The weighted median method, however, provided proof of a causal relationship (beta = 0.003, SE = 0.001, p = 0.029). Cochran's Q test and the funnel plot revealed little proof of heterogeneity or asymmetry, indicating the lack of directional pleiotropy.

Conclusion

According to the findings of the MR analysis, an increased childhood BMI may be linked to a higher likelihood of psoriasis.
Whitening and moisturizing enhancing effects of three‐dimensional human adipose‐derived mesenchymal stem cell‐conditioned medium‐containing cream
Authors: Kim Kyung Hye , Lee Sunray , Bae Seunghee
Published: June 2023

Background

High‐functional cosmetic products combined with the concept of “treatment” cosmetics are being introduced to the market. Cosmetic products containing a skin‐derived microbiome, a three‐dimensional (3D) stem cell culture medium, and low‐molecular‐weight collagen are being introduced, and these products are leading the cosmeceutical market. We aimed to confirm the potential of a 3D stem cell culture medium‐containing cream as a skin‐whitening and moisturizing product.

Aim

To determine the enhancing effects of a cream containing 3D adipose tissue‐derived mesenchymal stem cell‐conditioned media (3D ADMSC‐CM) on whitening and moisturization.

Methods

The inhibitory activities of tyrosinase (TYR) and melanin were confirmed using 3D ADMSC‐CM. Furthermore, hyaluronic acid expression in 3D ADMSC‐CM was verified. The clinical efficacy of the cream containing 3D ADMSC‐CM was established by evaluating its antioxidant properties and effects on skin tone, radiance, freckles, and moisturization.

Results

The use of 3D ADMSC‐CM suppressed the inhibitory effects of TYR and melanin by approximately 24% and 33%, respectively, and increased the expression of hyaluronic acid synthase. A significant difference was observed after 4 weeks of using 3D ADMSC‐CM in the skin antioxidant evaluation. After 2 and 4 weeks of use, skin tone and radiance increased and skin freckles decreased significantly. Under extremely cold and dry weather conditions, the use of the cream increased skin moisturization.

Conclusions

The 3D ADMSC‐CM cream evaluated in an environment similar to the human body was found to enhance skin whitening and moisturization and can therefore be used in the skin care and cosmetic industries as a biocosmetic product.
Person‐centred oral hydration care for older people with dementia admitted to acute hospital wards: Empirical research qualitative
Authors: Higgins Shanlee , Baillie Lesley , Moorley Calvin , Nolan Fiona
Published: June 2023

Aims and Objectives

To conduct an in‐depth exploration of oral hydration care provided to people living with dementia in acute hospital wards, using a person‐centred care framework.

Background

Oral hydration care is an important, yet rarely explored aspect of fundamental care for people with dementia admitted to acute hospitals. Using person‐centred care as a conceptual framework we investigated how oral hydration care is delivered for people living with dementia in acute hospital wards.

Design

A qualitative, multiple‐case study. The cases were three acute wards in one hospital.

Methods

Direct observation of care for 13 people with dementia (132 h), semistructured interviews with ward staff (n = 28), ward leaders (n = 4), organisational leaders (n = 5), people with dementia (n = 6), their relatives (n = 5), documentary analysis of clinical inpatient records (n = 26) and relevant hospital policies. Data were analysed using framework analysis.

Results

Four themes were identified: (1) The acute hospital: oral hydration is obscured and not prioritised (2) Overshadowing of oral hydration at ward level (3) Siloed nature of hydration roles (4) Strategies for, and barriers to, delivering person‐centred oral hydration care.

Conclusions

This study combines the concept of person‐centred care and oral hydration care for people living with dementia admitted to acute hospital wards, demonstrating that person‐centred hydration care was complex and not prioritised.

Relevance to Clinical Practice

Nurses should consider means of improving prioritisation and cohesive delivery of person‐centred hydration care in acute hospital wards.
High‐grade vaginal intraepithelial neoplasia after hysterectomy for high‐grade cervical intraepithelial neoplasia: Is hysterectomy a “definitive” treatment compared to conization?
Authors: Tanaka Miyu , Yamanoi Koji , Taki Mana , Kitamura Sachiko , Sunada Masumi , Chigusa Yoshitsugu , Horie Akihito , Yamaguchi Ken , Hamanishi Junzo , Mandai Masaki
Published: June 2023

Aim

We investigated the frequency of early recurrence of vaginal intraepithelial neoplasia grade 2/3 (VaIN 2/3) (within 2 years) after hysterectomy for cervical intraepithelial neoplasia grade 3 (CIN3). The characteristics of the clinicopathological factors common to them were explored including different surgical methods.

Methods

As a retrospective observational study, a total of 647 CIN3 patients were divided into a conization and hysterectomy group (C group, n = 492; H group, n = 155), and HSIL (CIN2/3 or VaIN2/3) recurrence within 2 years after surgery was evaluated. A stratified analyses was performed. Surgical methods were divided into trans‐abdominal, trans‐vaginal, and laparoscopic.

Results

The recurrence of VaIN3 was detected in four cases (2.6%) in the H group, which was similar to that of CIN2/3 in the C group, 12 out of 491 patients (2.4%). The patients who developed VaIN3 were significantly older than those who did not (median, VaIN3: 71.0; VaIN1 and less: 48.0; p < 0.0001). All VaIN3 cases were detected within 5 months, although majority of cases were negative in the margin (3/4 cases; margin negative). The method of hysterectomy was not related to the VaIN3 recurrence.

Conclusion

For CIN3 patients for whom hysterectomy is the main treatment, VaIN3 can develop in 2.6% within very shortly after operation even if surgical margin was negative. The elder the age, the higher the risk of early recurrence could be. Laparoscopic surgery is considered to be acceptable methods of hysterectomy.
Evaluation of fetal adrenal artery Doppler velocimetry and fetal adrenal gland size in pregnancies after recovery from COVID‐19
Authors: Uyan Hendem Derya , Oluklu Deniz , Menekse Beser Dilek , Yildirim Muradiye , Sakcak Bedri , Turgut Ezgi , Sahin Dilek
Published: June 2023

Aim

Assessment of the fetal adrenal gland (FAG) size and middle adrenal artery (MAA) Doppler parameters in pregnancy recovered from Coronavirus Disease (COVID‐19) and comparison of the values with the healthy control group.

Methods

Thirty‐eight pregnant women who had recovered from COVID‐19 infection and 76 healthy control group between 33 and 35 weeks of gestation were involved in this case–control study. Fetuses were examined for fetal biometry, fetal well‐being, adrenal gland dimensions, and Doppler parameters 4–6 weeks after the diagnosis of COVID 19 infection. FAG dimensions were measured in two planes and MAA blood flow velocity was evaluated with pulsed Doppler. Pregnant women with COVID‐19 infection were grouped according to the National Institutes of Health for the severity of the disease, and those with mild and moderate infections were examined in the study.

Results

The total adrenal gland (TAG) height, fetal zone (FZ) length and width, and MAA‐Peak Systolic Velocity (MAA‐PSV) were significantly higher, and the MAA‐Pulsatility Index (MAA‐PI) was significantly lower in the COVID‐19 group (p < 0.05). The lower in MAA‐PI and the higher in MAA‐PSV, the width of the FZ, and width of the TAG were found to be significant in the moderate group compared to the mild groups (p < 0.05).

Conclusion

COVID‐19 pregnancies might cause early maturation of the FAG and its vasculature depends on the intrauterine stress due to the hyper‐inflammation, so fetuses exposed to maternal COVID‐19 suggested to have an increase in blood flow to the adrenal gland and fetal adrenal size.
The role of MRI in the prognosis of Wernicke's encephalopathy
Authors: Kitaguchi Tomoaki , Ota Yoshiaki , Liao Eric , Moritani Toshio , Shah Gaurang , Yamada Kei , Srinivasan Ashok
Published: June 2023

Background and Purpose

Wernicke's encephalopathy (WE) is a severe acute disorder related to thiamine deficiency. This study was aimed at revealing the relationship between clinical and imaging findings and WE recovery.

Methods

We retrospectively reviewed 34 cases of WE diagnosed between 2003 and 2020 (median age: 57 years, 14 females) at two academic institutions. WE cases were divided into two groups with symptomatic recovery within 4 weeks (group 1) or later (group 2). The lesion sites were divided into typical and atypical sites (total sites defined as when either typical or atypical sites were involved). Clinical and MRI features were compared between them as appropriate.

Results

WE patients were divided into group 1 (19 cases, median age: 57 years, 10 females) and group 2 (15 cases, median age: 57 years, four females). Regarding clinical features, only cerebellar ataxia was more often observed in group 1 than in group 2. Regarding MRI features, signal abnormality on T2‐weighted image (WI)/fluid‐attenuated inversion recovery (FLAIR) was more often observed in atypical sites between groups 1 and 2 (1/19 vs. 7/15; p = .01). There were significant differences between groups 1 and 2 regarding the presence of both vasogenic edema and cytotoxic edema in total sites (4/11 vs. 11/15, p = .005; 1/19 vs. 6/15, p = .03), with a significant difference in the presence of vasogenic edema in typical sites (4/19 vs. 10/15, p = .01).

Conclusion

The early recovered group showed a lower incidence of T2WI/FLAIR abnormality in atypical sites and diffusion signal abnormality in total or typical sites with a lower incidence of cerebellar ataxia.
Mental health nurses' attitudes towards risk assessment: An integrative systematic review
Authors: Dickens Geoffrey L. , Al Maqbali Mohammed , Hallett Nutmeg , Ion Robin , Kemp Caroline , Schoultz Mariyana , Watson Fiona
Published: June 2023

Accessible Summary

What is known on the subject?

Risk assessment and risk management are considered to be important practices carried out by mental health nurses.

Risk assessment can help keep mental health service users' safe, but some nurses see it as a ‘tick the box’ exercise.

Some studies have looked at nurses' attitudes to risk assessment but no one has systematically described all the studies.

What the article adds to existing knowledge?

Mental health nurses' attitudes towards risk assessment are diverse with regard to its legitimacy, conduct and value.

This study provides an organised framework to help understand the areas in which these different attitudes occur.

What are the implications for practice?

Since attitudes can influence clinical practice, nurses need to reflect on how they view risk assessment. Further research is required to investigate whether particular attitudes are positive or negative and whether attitudes can be changed.

Introduction

Understanding nurses' attitudes towards risk assessment could inform education and practice improvements.

Aim/Question

To explore mental health nurses' attitudes towards risk assessment.

Method

An integrative systematic review (PROSPERO: CRD42023398287). Multiple databases (PubMed, CINAHL, MEDLINE, EMBASE and PsycINFO) were searched for primary studies of mental health nurses' attitudes towards risk assessment. Qualitative studies were subject to inductive coding and thematic analysis; quantitative data were integrated with emerging themes.

Results

Eighteen articles were included. Qualitative studies commonly lacked rigorous analyses. Four themes emerged: underlying purpose and legitimacy of risk assessment (philosophical orientation); use of structured approaches (technical orientation); value of intuition (intuitive orientation); and service user involvement (relationships orientation). There were contradictory study findings in each thematic category indicating different attitudes among mental health nurses.

Discussion

Mental health nurses' attitudes towards risk assessment vary in four key domains. Survey studies suggest they are more approving of structured approaches to risk assessment than many qualitative studies suggest. There is a need to develop a valid measure of attitudes to risk assessment.

Implications for Practice

This review could help health organisations to develop strategies to improve their risk assessment policies and practice. There is a need to develop structured training and education programmes.
Certified Child Life Specialist role in implementation of individualized coping plans for children receiving botulinum toxin injections
Authors: Mikuluk Brittany , Guttoo Parishma , Anderson Avery , Skeens Micah
Published: June 2023

Purpose

The purpose of this paper is to describe the implementation of evidence‐based, individualized coping plans and to compare the rates of child anxiety, child cooperation, and parent anxiety before and after implementation of these coping plans for children receiving recurring BoNT‐A injections emphasizing the role of Certified Child Life Specialists (CCLSs) within the interdisciplinary team approach.

Design and Methods

A retrospective chart review was conducted for children receiving BoNT‐A injections at a Physical Medicine clinic pre‐ and post‐implementation of the coping plan. Descriptive statistics were used to evaluate care plan implementation, child cooperation, child anxiety, and parent anxiety.

Results

Post‐implementation of coping care plans, children experienced improved cooperation during BoNT‐A injections. Parental anxiety decreased once coping plans were implemented. Documentation improved after the implementation of coping plans specific to areas involving cooperation, child's anxiety and distress, and parental anxiety and distress. It was also noted that there was an increase in child anxiety assessments within documentation.

Practice Implications

CCLS were able to utilize their expertise to collaboratively create individualized coping care plans to increase child's cooperation and decrease parental anxiety during BoNT‐A injections.
Micro‐XCT chondrule classification for subsequent isotope analysis
Authors: Jäggi Noah , Roth Antoine S. G. , Rüfenacht Miriam , Schönbächler Maria , Galli André
Published: June 2023

Chondrules are microscopic, recrystallized melt droplets found in chondritic meteorites. High‐resolution isotope analyses of minor elements require large enough element quantities which are obtained by dissolving entire chondrules. This work emphasizes the importance of X‐ray computed tomography (XCT) to detect features that can significantly affect the bulk chondrule isotope composition. It thereby expands on other works by looking into chondrules from a wide range of chondrites including CR, CV, CB, CM, L, and EL samples before turning toward complex and time‐consuming chemical processing. The features considered are metal and igneous rims, compound chondrules, matrix remnants, and metal contents. In addition to the identification of these features, computed tomography prevents the inclusion of non‐chondrule samples (pure matrix or metal) as well as samples where two different chondrule fragments with potentially different isotope compositions are held together by matrix. Matrix surrounding chondrules is also easily detected and the affected chondrules can be omitted or reprocessed. The results strongly encourage to perform XCT before dissolution of chondrules for isotope analysis as a non‐invasive method.
The pursuit of clinical recognition: Aesthetics, care, and music therapy in North American hospitals
Authors: Evans Meredith
Published: June 2023

This article examines the making of clinical care by tracing how music therapists integrate their work within North American hospitals. Situated on the margins of the clinic, music therapists are in pursuit of clinical recognition—to be perceived and understood as valuable to biomedicine. The pursuit of clinical recognition illustrates how the configuration of care is an aesthetic concern, negotiated not only through processes of reasoning and rationalization but also through sensory‐affective experiences. Music therapists cultivate a clinical aesthetic to their care by demonstrating clinical efficacy to their medical colleagues and self‐fashioning clinical subjectivities through participation in medical rounds and charting. While clinical recognition creates conditions of possibility for music therapists to provide care in biomedical institutions, recognition is perpetually elusive for hospital music therapists. By cultivating sonic atmospheres and connections, music therapists disrupt and exceed a normative clinical aesthetic, illustrating ways of caring in the clinic beyond biomedical scripts.
An emerging view of coevolution in the legume–rhizobium mutualism
Authors: Carlson Christopher , Frederickson Megan E.
Published: June 2023

Mutualisms are often framed as ‘delicately balanced antagonisms’ (Bronstein, 1994), with the net fitness benefits to both partners potentially masking underlying conflicts of interest. How commonly symbionts evolve to ‘cheat’ their hosts and hosts evolve to ‘sanction’ or ‘control’ uncooperative symbionts is the subject of debate, especially in legume–rhizobium interactions (Frederickson, 2013; Kiers et al., 2003). This kind of antagonistic coevolution should result in either arms‐race dynamics characterized by repeated selective sweeps or fluctuating selection dynamics that leave signatures of balancing selection in host and symbiont genomes (Frederickson, 2013; Kortright et al., 2022; O'Brien et al., 2021). In a From the Cover article in this issue of Molecular Ecology, Epstein et al. (2022) combine GWAS and population genomic analyses to assess the evidence for positive or balancing selection consistent with ongoing, antagonistic coevolution between legumes and rhizobia. They found few genomic signatures of fitness conflicts between mutualistic partners, suggesting that legume and rhizobium fitness interests are largely aligned and symbiotic traits are mostly under stabilizing selection. In combination with other recent work (e.g. Batstone et al., 2020), the results of Epstein et al. (2022) indicate that there is little ongoing fitness conflict between legumes and rhizobia that shapes host and symbiont genomes in this system. It may be time to move beyond symbiont ‘cheating’ and host ‘control’ as the dominant paradigm for understanding how partners in mutualism coevolve.
Rortyan therapists, pragmatist engineers, and white nationalist egotists: A response to Huckerby, Huetter‐Almerigi, and Showler
Authors: Llanera Tracy
Published: June 2023

This essay is a reply to commentaries by Elin Danielsen Huckerby, Yvonne Huetter‐Almerigi, and Paul Showler on Tracy Llanera's Richard Rorty: Outgrowing Modern Nihilism (2020).
Robust nonlinear decision mapping approach for online bus speed control under uncertainty
Authors: Zheng Liang , Liu Pengjie
Published: June 2023

The degradation of bus system attractiveness is primarily caused by low‐level service quality and reliability. As an essential technology for bus operation management, online bus speed control has proven to be a flexible and effective solution to mitigate bus bunching and enhance the service level of bus operation systems. In this study, we propose a robust nonlinear decision mapping (RNDM) approach that uses real‐time key bus system states to control bus speeds and accounts for uncertainties associated with passenger demands at stations and traffic speeds of interstation links. We develop this approach through a design process that involves learning the input–output mapping relation of a nonlinear programming simulation‐based optimization (NLPSO) method using regression tree with AdaBoost. Critical parameters of the fitted regression tree with AdaBoost are then optimized offline using a distributionally robust simulation‐based optimization (DRSO) model that is solved by a simulation‐based optimization (SO) algorithm. The resulting RNDM method effectively handles two types of uncertainties, expressed by two ambiguity sets of probability distributions, and ensures good bus operation performance even under worst‐case uncertainty levels. Numerical experiments reveal that the RNDM, NLPSO, and integer programming SO (IPSO) methods successfully mitigate bus bunching and improve service efficiency and robustness, compared to the no‐control scenario. Furthermore, the RNDM method outperforms NLPSO and IPSO in terms of comprehensive performance under uncertainties and demonstrates practical operability. In conclusion, this study presents an innovative general framework that uses a nonlinear decision mapping optimized offline by an SO approach to address online simulation‐based optimal decision‐making problems under uncertainties, which can be applied to solve similar problems.