bluuebunny/crossref_metadata_2025 huggingface dataset:
BETWEEN DREAMS AND SURVIVAL: The (Dis)Embeddedness of Neoliberalism among Entrepreneurial Workers from São Paulo's Peripheries
Authors: Fontes Leonardo
Published: November 2023

Over the past few decades, the desire of residents on urban peripheries in Brazil to have their own businesses has grown. Consequently, several authors have critically pointed out the advance of neoliberal ideas among the urban popular classes. In this article I discuss the origins of this ‘entrepreneurial disposition’ and its relationship with neoliberal discourse that seeks to encourage ‘entrepreneurialism of oneself’. The analysis presented in this article is based on ethnographic research carried out among entrepreneurial workers on the outskirts of São Paulo through in‐depth interviews focusing on life histories and participant observation in strategic spaces (online and in person) during 2020 and 2021. I explore adherence and opposition to and resignification of neoliberal entrepreneurial ideology from different cultural and material backgrounds by retelling the history of five entrepreneurs from three different families. I argue that rather than neoliberal ideas being an ideological conviction, they are embedded in social practices that are quite common in the periphery of São Paulo. Therefore, they should be analysed in the light of these previously existing practices and moralities. From a peripheral point of view, ethnographic analysis also allows us to examine the limits of this embeddedness and shed light on possible forms of resistance.
SARS‐CoV‐2—Placental effects and association with stillbirth
Authors: Merriel Abi , Fitzgerald Brendan , O’Donoghue Keelin
Published: November 2023

SARS‐CoV‐2 has had a significant impact on pregnancy outcomes due to the effects of the virus and the altered healthcare environment. Stillbirth has been relatively hidden during the COVID‐19 pandemic, but a clear link between SARS‐CoV‐2 and poor fetal outcome emerged in the Alpha and Delta waves. A small minority of women/birthing people who contracted COVID‐19 developed SARS‐CoV‐2 placentitis. In many reported cases this was linked to intrauterine fetal death, although there are cases of delivery just before imminent fetal demise and we shall discuss how some cases are sub‐clinical. What is surprising, is that SARS‐CoV‐2 placentitis is often not associated with severe maternal COVID‐19 infection and this makes it difficult to predict. The worst outcomes seem to be with diffuse placental disease which occurs within 21 days of COVID‐19 diagnosis. Poor outcomes are often pre‐dated by reduced fetal movements but are not associated with ultrasound changes. In some cases, there has also been maternal thrombocytopenia, or coagulation abnormalities, which may provide a clue as to which pregnancies are at risk of fetal demise if a further variant of concern is to emerge. In future, multidisciplinary collaboration and cross‐boundary working must be prioritised, to identify quickly such a phenomenon and provide clinicians with clear guidance for reducing fetal death and associated poor outcomes. While we wait to see if COVID‐19 brings a future variant of concern, we must focus on appropriate future management of women who have had SARS‐CoV‐2 placentitis. As a placental condition with an infectious aetiology, SARS‐CoV‐placentitis is unlikely to recur in a subsequent pregnancy and thus a measured approach to subsequent pregnancy management is needed.
A Thriving Bioeconomy Needs Better Tools for Measuring and Monitoring
Authors: Carrez Dirk , Rupp Marco
Published: November 2023

Last year, the United States issued an Executive Order announcing the National Biotechnology and Biomanufacturing Initiative, a 2 billion dollar initiative supporting biotechnology and biomanufacturing innovations in health, climate change, energy, food security, agriculture and supply chain resilience. Together with their 2022 Inflation Reduction Act, investment for the commercial deployment of the whole bioeconomy across the entire supply chain is financially supported. The US is not alone – other countries are also developing their own initiatives.

If Europe wants to keep its competitive position in the bio‐based industries, it needs a better recognition in EU policy and more regulatory foresight to bring innovative products to the market. Bio‐based products and materials have to be recognised as an important Carbon Capture and Utilisation tool, lowering the use of fossil fuels, and contributing to climate mitigation. The European bioeconomy is well‐positioned for finding a greener way to build a more robust economic base, reduce strategic dependencies and reinforce the supply of critical materials. However, to realise this, access to finance should be made easier and there needs to be sufficient supply of renewable feedstock.

Although Europe has made good progress in recent years, more can and should be done to make the bio‐based industries a stronger part of a new sustainable growth and investment model. This article describes some possible recommendations.
Exploring pathways to food science careers in Southern California: A case study in food science career development
Authors: Hsu Jeremy L. , Ahles Sarah , Senger Lilian W. , Prakash Anuradha
Published: November 2023

Southern California is a diverse region that is home to a high concentration of food science companies, with an increasing demand for additional food scientists and technologists to join this workforce. Despite this abundance of food science companies and the high demand for jobs, there is currently a shortage in the number of qualified food scientists and technologists in the region. This shortage is also observed within higher education, with declining enrollments in the food science graduate and undergraduate programs across Southern California. Here, we conduct a case study to explore the factors that influence students from Southern California to pursue or not pursue careers in food science. We surveyed both undergraduate and graduate students currently enrolled in food science as well as industry professionals in the region to determine sources of knowledge about the discipline, and motivations and barriers for pursuing careers in food science. We also surveyed high school educators in the region to gain additional perspectives on how food science is being introduced at the secondary level, if at all. Our results demonstrate that many students and high school educators are not knowledgeable about career options within food science and that students who are pursuing food science largely report similar motivations for pursuing the discipline as those currently working in the food science industry. We conclude by discussing implications for the food science education community within Southern California and beyond.
Anatomic and morphometric examination of auditory ossicles in sheep
Authors: Kamaşak Arpaçay Burcu , Yağmur Berat , Uğuz Emre , Çömlekçi Elif , Öncü Ruken , Ulcay Tufan , Aycan Kenan
Published: November 2023

It is important to know the morphometry of the auditory ossicles for middle ear surgical applications. The present study aims to investigate the morphometric measurements of sheep auditory ossicles and the relationship between these ossicles. In this study, 100 malleus, incus and stapes of 50 Akkaraman sheep were examined using at trinocular stereo microscope and a total of 19 morphometric measurements were taken. The mean values of the morphometric measurements were obtained, and correlation analysis was performed between each part of each auditory ossicle. Similarities were found between the measurements of the lengths of the malleus, manubrium mallei and incus, and the width of the base of the stapes with morphometric measurements in human auditory ossicles. A significant positive correlation was found between the length of the malleus with the length of the manubrium mallei, between the length of the incus with the lengths of the long crus and corpus incudis, between the length of the stapes with the lengths of the rostral crus, caudal crus, caput stapedis, and the length and width of the intercrural foramen. Due to the anatomic similarities between sheep and human auditory ossicles, it was concluded that the auditory ossicles of sheep are suitable for use in the training of human ear surgery applications.
Surgeons versus radiologists: do we care what they think?
Authors: Thomas Jeff , Jerome Ashly , Marr Georgia , De Boo Diederick Willem , Gani Jon
Published: November 2023

Backgrounds

Acute surgical care nowadays usually involves access to urgent imaging. There is a paucity of data on how often the images or radiologist reports of these images are used by the surgical team. We aimed to identify the rates and timeliness of radiology images and report viewing for acute surgical admissions in an Australian tertiary university teaching hospital.

Methods

We utilized a data set comprising radiological studies completed at our institute during a one‐month period. Investigations were classified by modality and whether images or reports were available ‘in‐hours’ or ‘after‐hours’. The time taken from imaging to reports available for viewing by the surgical team was calculated using timestamps derived from electronic hospital systems. Spearman's rho test was used to assess correlation between the Study Ascribable Time and time to view an image or report.

Results

Of 40 042 investigations, 1156 (3%) satisfied study criteria. Both images and reports were viewed in 82% (n = 950/1156) of cases. CT scans had the shortest median time for image (14 min, IQR 4–47 min) and report (25 min, IQR 8–68 min) viewing. CT (95%, n = 410/430) and MRI (95%, n = 38/40) scans had the highest proportion of both images and reports viewed, regardless of whether the scan was completed ‘in‐hours’ or ‘after‐hours’. X‐ray reports were viewed least often (73%).

Conclusion

This study demonstrates a high level of viewing of acute surgical radiological imaging and reports by surgical teams. The ‘simpler’ the study the less likely the radiology report will be viewed.
When Broken Worlds Churn: The Anti‐Caste Fabulations of Du Saraswathi
Authors: Sreenath Shreyas
Published: November 2023

How can literary fabulation prompt a reflection on caste, colonial, and capitalist lifeworlds? Engaging with two short stories by the Dalit feminist thinker Du Saraswathi, this article considers the role of fabulation in sparking anti‐caste praxis, decolonial thought, and a reflection on ecological interdependence. Bacchisu (“Tip”) and Honnahelu (“Shit and Gold”) are penned in the context of the sanitation workers’ movement in Karnataka, India and the ongoing struggles of waste workers to assert the dignity of their labour and their ancestral relations. Both stories capture the intimate worlds of solid waste and sewage workers, overwhelmingly from Dalit (ex‐untouchable) communities, as they navigate capitalist debris and the brokenness of caste society. They archive relations between caste overseers and contractual workers, the police and local bureaucracy, and peri‐urban ecologies. Saraswathi's writings explore such political concerns in ways that exceed the circumscribed realism of caste society—mingling Dalit culinary practices, embodied desires, rhythms of collective protest, rapturous encounters with spiritual beings, colonial legacies, and reproductive futures. In a context where Dalit testimonies are doubly silenced by the evidentiary procedures of postcolonial law and retributive violence, how can fabulation bear witness to an anti‐caste reality that integrates spiritual, ecological, and political struggles?
Psychological need fulfillment as a source of resilience: Its protective role in concerns and symptoms of anxiety and depression during the COVID‐19 pandemic
Authors: Waterschoot Joachim , Morbée Sofie , Soenens Bart , Van den Bergh Omer , Raemdonck Eveline , Brisbois Marie , Schmitz Mathias , Klein Olivier , Luminet Olivier , Van Oost Pascaline , Yzerbyt Vincent , Vansteenkiste Maarten
Published: November 2023

The essential role of the psychological needs for autonomy, competence, and relatedness in well‐being has been demonstrated convincingly. Yet whether their fulfillment also serves as a source of resilience in the face of adversity has received limited attention. A longitudinal sample of Belgian citizens (N = 1869; Mage = 56.23, 68% female) completed an online questionnaire on 13 occasions between April 2020 and April 2022 during the COVID‐19 crisis. Multilevel analyses showed that need fulfillment, both at the between‐ and within‐person level, related negatively to concerns, even after controlling for exposure to personal risks. Further, the association between concerns and changes in symptoms of depression and anxiety was dampened when people reported higher need fulfillment compared with others (i.e. between‐person level) or when they reported periodically more need fulfillment than usual (i.e. within‐person level). This moderation effect occurred on top of the systematic negative main effect of need fulfillment on symptoms of anxiety and depression. Psychological need fulfillment serves as a resilience factor (a) by reducing concerns in the face of adverse events (i.e. an appraisal effect) and (b) by mobilizing resources that help individuals to deal better with concerns (i.e. a coping effect). Theoretical and practical implications of the resilience effect of need fulfillment are discussed.
Drug–drug interactions and the risk of adverse drug reaction‐related hospital admissions in the older population
Authors: Hughes John E. , Moriarty Frank , Bennett Kathleen E. , Cahir Caitriona
Published: November 2023

Aims

The aims of this study were to estimate potentially clinically important drug–drug interaction (DDI) prevalence, and the average causal effect of DDI exposure on adverse drug reaction (ADR)‐related hospital admission, and to examine differences in health‐related quality of life (HRQoL) and length of stay (LOS) per DDI exposure in an older (≥65 years) population acutely hospitalized.

Methods

This was a cross‐sectional study conducted among 798 older individuals acutely admitted to hospital in Ireland between 2016 and 2017. Medication (current/recently discontinued/over‐the‐counter) and clinical data (e.g., creatinine clearance) were available. DDIs were identified using the British National Formulary (BNF) and Stockley's Drug Interactions. Causal inference models for DDI exposure on ADR‐related hospital admission were developed using directed acyclic graphs. Multivariable logistic regression was used to estimate the average causal effect. Differences in HRQoL (EQ‐5D) and LOS per DDI exposure were examined non‐parametrically. DDI prevalence, adjusted odds ratios (aOR), and 95% confidence intervals (CIs) are reported.

Results

A total of 782 (98.0%) individuals using two or more drugs were included. Mean age was 80.9 (SD ± 7.5) years (range: 66–105); 52.2% were female; and 45.1% (n = 353) had an ADR‐related admission. At admission, 316 (40.4% [95% CI: 37.0–43.9]) patients had at least one DDI. The average causal effect of DDI exposure on ADR‐related hospital admission was aOR = 1.21 [95% CI: 0.89–1.64]. This was significantly increased by exposure to: DDIs which increase bleeding risk (aOR = 2.00 [1.26–3.12]); aspirin‐warfarin (aOR = 2.78 [1.37–5.65]); and esomeprazole‐escitalopram (aOR = 3.22 [1.13–10.25]. DDI‐exposed patients had lower HRQoL (mean EQ‐5D = 0.49 [±0.39]) compared those non‐DDI‐exposed (mean EQ‐5D = 0.57 [±0.41]), (P = .03); and greater median LOS in hospital (8 [IQR5–16]days) compared those non‐DDI‐exposed (7 [IQR 4–14] days),(P = .04).

Conclusions

Potentially clinically important DDIs carry an increased average causal effect on ADR‐related admission, significantly (two‐fold) by exposure to DDIs that increase bleeding risk, which should be targeted for medicine optimization.
A study of the clinical and demographic characteristics of adults with an intellectual disability who remain in learning disability assessment and treatment units despite being clinically ready for discharge
Authors: Williams Jonathan , Pender Fiona , Shahzad Saman , Woodrow Ceri , Dar Rimsha , Humphreys Matthew , Evans‐Stone Joanne , Nall‐Evans Sharleen , Wilson Peter
Published: November 2023

Background

This study investigated differences in the clinical and demographic characteristics of individuals with intellectual disabilities delayed in assessment and treatment hospitals versus individuals who were not delayed. The study further investigated the clinical outcomes of the individuals whose discharge from the hospital was delayed.

Method

This was a cohort study using secondary data collected from patient records. Variables included age, ethnicity, levels of deprivation, areas of origin, diagnoses, and the provision of a care and treatment review. A comparison was made between individuals who became delayed despite being clinically ready for discharge and those who were discharged on time.

Findings

Individuals with severe intellectual disabilities were more likely to experience delayed discharge from hospital (p = 0.001). Similarly, people who were admitted to hospitals away from their home areas were also more likely to experience delayed discharge (p < 0.001). There were no significant differences between the delayed and nondelayed groups for other factors such as age, deprivation or ethnicity. Individuals who experienced a delay in discharge did not experience an increased rate of adverse incidents compared to the period of active treatment and clinical improvements were maintained during the period of delay. There were low rates of completion of care and treatment reviews before admission, although people who were delayed were more likely to have received a review during admission (78.8% vs. 27.1%).

Conclusion

It is important for clinicians and service development leads to be aware that people who are admitted away from their home area and people with severe intellectual disabilities may be at higher risk of experiencing significantly delayed discharge from the hospital. More broadly, many people remained in hospital for a substantial length of time after being assessed as clinically ready for discharge. Due to the low rates of completion before admission, the expansion of community‐based care and treatment reviews should also be explored. While people did not suffer increased rates of adverse incidents during their extended stay, their liberty was still restricted, hence there should be a focus on effective community provision. The current model of relying on the willingness of independent providers to support the care of complex individuals requires significant reform.
Complement‐mediated thrombotic microangiopathy treated with anticomplement protein 5 therapy, a retrospective study
Authors: Laber Damian A. , Patel Parth C. , Logothetis Constantine N. , Patel Ankita K. , Jaglal Michael , Haider Mintallah , Visweshwar Nathan , Rajasekaran‐Rathnakumar Geetha , Eatrides Jennifer
Published: November 2023

Background

Complement‐mediated thrombotic microangiopathy (CM‐TMA), also called atypical hemolytic uremic syndrome (aHUS), is a difficult‐to‐diagnose rare disease that carries severe morbidity and mortality. Anti‐C5 monoclonal antibodies (aC5‐mab) are standard treatments, but large studies and long‐term data are scarce. Here, we report our single institution experience to augment the knowledge of CM‐TMA treated with aC5‐mab therapy.

Methods

We aimed to assess the short and long‐term effects of aC5‐mab in patients diagnosed with CM‐TMA treated outside of a clinical trial. This was a retrospective study. We included all patients diagnosed with CM‐TMA and treated with aC5‐mab at our institution. There were no exclusion criteria. Endpoints included complete TMA response (CR) defined as normalization of hematological parameters and ≥25% improvement in serum creatinine (Cr) from baseline in patients with renal disease, relapse defined as losing the previously achieved CR, morbidity, adverse events, and survival.

Results

We found 28 patients with CM‐TMA treated with aC5‐mab. The median age was 50 years. Baseline laboratories: platelet counts 93 × 109/L, hemoglobin 8.6 g/dL, lactate dehydrogenase 1326 U/L, serum Cr 4.7 mg/dL, and estimated glomerular filtration rate 19 mL/min. One individual was on renal replacement therapy (RRT) and 10 initiated RRT within 5 days of the first dose of aC5‐mab. Genetic variants associated with CM‐TMA included mutations in C3, CFB, CFH, CFHR1/3, CFI, and MCP. The mean duration of hospitalization was 24 days. The median time to initiation of aC5‐mab was 10 days. Sixteen subjects received RRT. At the time of hospital discharge, 27 were alive, 14 remained on RRT, and 4 had a CR. At 6 months, 23 patients were alive, 18 continued aC5‐mab, 8 remained on RRT, and 9 had a CR. At the last follow‐up visit past 6 months, 20 were alive, 14 continued aC5‐mab, 5 remained on RRT, 12 had a CR, and 1 was lost to follow‐up.

Conclusions

Our study provides real‐world experience and insight into the long‐term outcomes of CM‐TMA treated with aC5‐mab. Our findings validate that CM‐TMA is an aggressive disease with significant morbidity and mortality, and confirm that aC5‐mab is a relatively effective therapy for CM‐TMA. Our study adds practical, real‐world experience to the literature, but future research remains imperative.
“Quem pode ser a dona?”: Afro‐Brazilian women entrepreneurs and gendered racism
Authors: Murphy Demetrius Miles
Published: November 2023

In 2013, the number of Black entrepreneurs surpassed the number of White entrepreneurs in Brazil. Of those Black entrepreneurs, 30 percent were women. In Brazil, gendered racism often stereotypes Black women as domestic servants or hypersexual. Despite the robust literature on Afro‐Brazilians generally and Afro‐Brazilian women particularly, Afro‐Brazilian women entrepreneurs, their experiences, and their strategies for competing in the market and resisting gendered racism remain under‐theorized. I use semi‐structured interviews with Black women entrepreneurs to explain the relationship between gendered racism and Black entrepreneurship. My findings show that Afro‐Brazilian women entrepreneurs actively defy and redefine the standard images of entrepreneurs and Black women in Brazil. They contest the treatment of Black women as objects of the market by situating themselves as agentic players by challenging gendered racism through two entrepreneurial cultural strategies: (1) engaging in dignity work and (2) employing a women‐first imperative. By centering the experience of Afro‐Brazilian women, I contribute to the entrepreneurship literature, Africana Studies, and Latin American Studies.
Impact of Type and Shape of Microplastics on the Transport in Column Experiments
Authors: Schenkel Cheyanne A. , Brown Megan R.M. , Lenczewski Melissa E.
Published: November 2023

The pervasive nature of plastic and the longevity of plastics leaves a legacy of microplastics (MPs) that contaminate our environment, including drinking water sources. Although MPs have been documented in every environmental setting, a paucity of research has focused on the transport and fate of MPs in groundwater. Previous field and laboratory studies have shown that MPs can migrate through aquifer material and are influenced by environmental factors. This study used controlled column experiments to investigate the influence of polymer type (polyamide, polyethylene, polypropylene, and polyester) and particle shape (fragment, fiber, and sphere) on MP retardation and retention. The results showed that all individual MP types investigated were retarded compared to the NaCl tracer, with a retardation factor ranging from 1.53 to 1.75. While hypothesized that presence of multiple types and shapes could change mobility, the results indicate that this hypothesis is not correct for the conditions tested. This study provides new insights into MP transport in groundwater systems based on the characteristics of MP particles. In addition, this study demonstrates the need for further research on types of MPs and under more conditions, especially in the presence of a mixture of types and shapes of MPs to gauge what is occurring in natural systems where many MPs are present together.
The impact of the COVID‐19 pandemic on hepatocellular carcinoma diagnosis and treatment in Japan: A multicenter collaborative observational study
Authors: Murai Kazuhiro , Hikita Hayato , Kodama Takahiro , Kaibori Masaki , Nishimura Yuki , Tatsumi Tomohide , Yamada Tomomi , Kanto Tatsuya , Mochida Satoshi , Takehara Tetsuo
Published: November 2023

Aim

Coronavirus disease 2019 emerged in December 2019 and spread worldwide. This study aimed to clarify the impact of the coronavirus disease 2019 pandemic on the diagnosis and treatment of hepatocellular carcinoma (HCC) in Japan.

Methods

First, we collected the monthly numbers of HCC‐related general medical practices from January 2019 to December 2021 at liver disease‐specific medical institutions in Japan. Next, we collected individual clinical information from patients with newly diagnosed HCC during this period.

Results

There was a decrease in the number of HCC‐related medical practices, including referrals, enhanced abdominal ultrasonography and radiofrequency ablation, in Japan's first state of emergency (SOE; April–May 2020) compared with 2019. Fewer patients were diagnosed with new HCC during the first SOE than before or after it. There was no difference in tumor diameter, number of tumors or Barcelona Clinic Liver Cancer stage between patients diagnosed before the first SOE and those diagnosed during or after the first SOE. The median waiting times for treatment of patients diagnosed during and after the first SOE were 31 and 37 days, which were significantly shorter and not longer than that of patients diagnosed before the first SOE (36 days), respectively.

Conclusion

The number of HCC‐related general medical practices decreased during the first SOE. However, the coronavirus disease 2019 pandemic did not lead to HCC progression by diagnostic delays or cause HCC treatment delays in Japan.
The effect of different anions on the crystallization course of α‐Al2O3 powder in hydrothermal method
Authors: Zhang Fengze , Ouyang Ruifeng , Zhou Tianxiang , Xiong Chengrong , Shi Wei , Su Xiaoli , Zeng Tao , Chen Yunxia , Dong Gang
Published: November 2023

α‐Al2O3 powder with excellent sintering properties plays an irreplaceable role in advanced ceramics. However, the preparation of α‐Al2O3 at low temperature still remains a grand challenge. Herein, aluminum sulfate, aluminum nitrate, and aluminum chloride are used as raw materials for α‐Al2O3 synthesis. In general, the Al3+ will be hydrolyzed to form AlOOH during the hydrothermal process. But SO42− reacted with Al3+ and OH− to form Al4(OH)10SO4 during the hydrothermal process. During the calcining process, the transition temperatures from AlOOH to α‐Al2O3 were 1100°C, which can be summarized as follows: AlOOH → γ‐Al2O3 → θ‐Al2O3 → α‐Al2O3. Meanwhile, Al4(OH)10SO4 converted into pure α‐Al2O3 at only 1050°C, due to the direct conversion from γ‐Al2O3 to α‐Al2O3. This spherical α‐Al2O3 was made up by completely uniformed small particles of about 10–20 nm. Finally, an Al2O3 ceramic with 98.07% of theoretical density and .01% water absorption rate was obtained at a temperature of 1600°C. This work offers an intriguing solution toward the development of Al2O3‐based advanced ceramics.
Interventions to reduce burnout and improve the mental health of nurses during the COVID‐19 pandemic: A systematic review of randomised controlled trials with meta‐analysis
Authors: Wong Kang Wei , Wu Xinyao , Dong Yanhong
Published: November 2023

This systematic review aims to investigate and determine the effectiveness of interventions on improving mental health (anxiety, depression, stress or mental well‐being) and/or reducing burnout of nurses working in hospitals during the COVID‐19 pandemic. A search was conducted on studies from conception to December 2022 in databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Scopus and Web of Science and in ProQuest Thesis & Dissertations Global Database, Google Scholar and ClinicalTrials.gov. A total of 17 randomised controlled trials that evaluated different interventions were included. The outcomes were anxiety (n = 11), depression (n = 5), stress (n = 13) mental well‐being (n = 7) and burnout (n = 7). Not all interventions led to positive outcomes. Grading of Recommendations Assessment, Development and Evaluation (GRADE) appraisal and risk of bias assessment using the Cochrane tool for randomised controlled trials (RoB 2.0) revealed poor quality of currently available literature, with low to very low certainty. Meta‐analysis showed high heterogeneity among the five different outcomes, with subgroup analysis showing greater success in interventions conducted on nurses involved in the care of COVID‐19 patients. More well‐designed trials are necessary to reinforce current evidence to improve the mental health of nurses, to not only protect their quality of life but also to ensure the quality of patient care.
The multiobjective traveling salesman–repairman problem with profits: design and implementation of a variable neighborhood descent algorithm for a real scenario
Authors: Morante‐González R. , López‐Sánchez A. D. , Sánchez‐Oro J. , Hernández‐Díaz A. G.
Published: November 2023

This paper introduces a problem that can be seen as a combination of the traveling salesman problem with profits and the traveling repairman problem with profits, coined as the multi‐objective traveling salesman–repairman problem with profits (Mo‐TSRPP). The objective of the Mo‐TSRPP is to simultaneously optimize three objectives: the total cost, total latency, and total profit. Indirectly, the number of nodes visited is also considered although not as an objective itself since it is determined by the size of every efficient solution in the Pareto front. The Mo‐TSRPP emerges as a real‐world problem in which a freelancer, which repairs appliances, wants to plan the daily route. Moreover, the daily plan does not require to visit all customers. To solve the problem, first, a greedy randomized adaptive procedure is designed to generate a set of high‐quality nondominated solutions and then, a variable neighborhood descent algorithm is applied for further improving the initial set. This procedure allows us to attain a good approximation of the Pareto front. To prove the performance of the proposal a comparison is done against three well‐known evolutionary algorithms: NSGA‐II, SPEA‐2, and MOEA/D. Finally, a realistic problem is shown and solved to illustrate the potential of the algorithm.
Religion as a Determinant of Relationship Stability
Authors: Boulis Christopher , Torgler Benno
Published: November 2023

There is a burgeoning literature that investigates the effects of religion on relationship dissolution. This study is distinguished from prior scholarship in three broad areas: The investigation estimates the effect of religion on relationship stability using multiple measures of religious affiliation and religious observance; it is based on information of the respondent and their partner for both cohabiting and marital relationships; and it is performed using multiple waves of a large‐scale nationally representative panel data set, the Household Income and Labour Dynamics in Australia Survey. It addresses key limitations, such as: the use of a single measure of religion, a tendency to only use married individual data, and an overreliance on cross‐sectional data. The results indicate that intrafaith couples tend to have a higher degree of relationship stability than other couple types; although, once other factors are controlled for, this effect is no longer statistically significant. We also find religiosity, in particular, religious attendance has a large positive effect on stability in intrafaith couples but can lower stability in interfaith and mixed couples.
Health workforce under pressure—How do we sustain our future?
Authors: McCormack Joanna , Noble Christy , Mattick Karen
Published: November 2023

McCormack, Noble and Mattick explore the seemingly unsustainable workload placed on the health workforce. Interrelations between multiple lenses of sustainability are discussed and a possible pathway towards sustainability is provided.
Contemplating the future of competency assessment
Authors: Born Marise Ph. , Stegers‐Jager Karen M.
Published: November 2023

Health education's competency models are evolving to balance universal skills with those that are job‐ and organization‐specific. These authors argue that a three‐layer framework emphasizing person‐organization fit will create better outcomes.
Erdoğan's Bid to Re‐Establish Dominance After His Pyrrhic Victory
Authors: Özcan Nihat Ali , İpek Pınar
Published: November 2023

This article examines President Recep Tayyip Erdoğan's actions since he barely survived the May 2023 election. It argues that although Erdoğan's authoritarian personality and conservative Islamist ideology drive his foreign policy, his pyrrhic victory and Turkey's economic problems have forced him to rebalance the country's regional and bilateral relations with Arab and Western states. The analysis first explains Erdoğan's re‐election strategy to demonstrate his authoritarian personality and desire to retain power. It then shows how the election results and Turkey's economic challenges have shaped Erdoğan's pragmatic U‐turns in foreign policy since the campaign. From there, the article assesses the president's near‐term strategies for municipal elections and other challenges in domestic politics. It concludes that Erdoğan's overconfidence is constrained by Turkish economic stresses, though the direction of foreign policy remains unclear.
LIPUS can promote osteogenesis of hPDLCs and inhibit the periodontal inflammatory response via TLR5
Authors: Li Ping , Zhang Zhipeng , Liu Jingjing , Xue Hui
Published: November 2023

In this study, we isolated human periodontal ligament cells (hPDLCs) to find the optimal time of LIPUS stimulation and to explore how LIPUS affects inflammatory and osteogenic responses in hPDLCs in an inflammatory environment. The target molecules of LIPUS were identified by high‐throughput sequencing. RT–qPCR and WB were used to detect how LIPUS affected the expression of related genes in TNFα‐induced inflammation. The expression of ROS and inflammatory factors was detected by flow cytometry. Immunohistochemistry was used to further verify gene expression in rats. hPDLCs were isolated successfully. The optimal LIPUS stimulation condition was 45 mW/cm2 for 30 min and continued for 3 days, and this intensity significantly promoted the osteogenesis and mineralization of hPDLCs. LIPUS significantly inhibited the upregulation of IL‐6 and ROS, increased the percentage of cells in the G2 phase, inhibited cell apoptosis, and inhibited the upregulation of TLR5 expression in an inflammatory environment. LIPUS can effectively restrain the inflammation and oxidative stress response of hPDLCs and promote osteogenesis in an inflammatory environment. LIPUS inhibited the periodontal inflammatory response through TLR5 in hPDLCs and dental pulp.
Liaw's Ellipse Anteversion Method for Distinguishing Acetabular Component Retroversion from Anteversion on Plain Radiographs
Authors: Lin Chun‐Hao , Chen Wei‐Cheng , Weng Pei‐Wei , Huang Yu‐min , Liaw Chen‐Kun
Published: November 2023

Improper acetabulum component position is a significant risk factor for postoperative dislocation after total hip arthroplasty. Several radiographic two‐dimensional methods exist for measuring acetabulum component anteversion, but they cannot distinguish between anteversion and retroversion. “Liaw's version,” initially proposed as a simple mathematical standardized two‐dimensional method, was modified to the computerized ellipse method, proving superior accuracy to traditional two‐dimensional methods. In this article, we demonstrated its application in detecting and measuring retroverted acetabulum component. We obtained anteroposterior pelvis radiographs from a patient undergoing total hip arthroplasty on the day of surgery and 2 weeks postoperatively. The computerized ellipse method was used to measure the acetabulum component orientation. Upon comparison, the difference between θ assigned to be retroverted (9.52–8.56 = 0.96) is much smaller than the difference between θ assigned to be anteverted (23.81–18.86 = 4.95), leading us to determine retroversion. This was further confirmed by computed tomography at the 6‐week follow‐up. We propose that using the computerized ellipse method to measure Liaw's version can be a valuable tool in identifying acetabulum component retroversion on anteroposterior radiographs during routine postoperative follow‐up and retrospective assessments of total hip arthroplasty patients.
Uncovering epigenetic and transcriptional regulation of growth in Douglas‐fir: identification of differential methylation regions in mega‐sized introns
Authors: Vu Giang Thi Ha , Cao Hieu Xuan , Hofmann Martin , Steiner Wilfried , Gailing Oliver
Published: November 2023

Tree growth performance can be partly explained by genetics, while a large proportion of growth variation is thought to be controlled by environmental factors. However, to what extent DNA methylation, a stable epigenetic modification, contributes to phenotypic plasticity in the growth performance of long‐lived trees remains unclear. In this study, a comparative analysis of targeted DNA genotyping, DNA methylation and mRNAseq profiling for needles of 44‐year‐old Douglas‐fir trees (Pseudotsuga menziesii (Mirb.) Franco) having contrasting growth characteristics was performed. In total, we identified 195 differentially expressed genes (DEGs) and 115 differentially methylated loci (DML) that are associated with genes involved in fitness‐related processes such as growth, stress management, plant development and energy resources. Interestingly, all four intronic DML were identified in mega‐sized (between 100 and 180 kbp in length) and highly expressed genes, suggesting specialized regulation mechanisms of these long intron genes in gymnosperms. DNA repetitive sequences mainly comprising long‐terminal repeats of retroelements are involved in growth‐associated DNA methylation regulation (both hyper‐ and hypomethylation) of 99 DML (86.1% of total DML). Furthermore, nearly 14% of the DML was not tagged by single nucleotide polymorphisms, suggesting a unique contribution of the epigenetic variation in tree growth.
Genome‐wide identification of Avicennia marina aquaporins reveals their role in adaptation to intertidal habitats and their relevance to salt secretion and vivipary
Authors: Guo Zejun , Wei Mingyue , Xu Chaoqun , Wang Lu , Li Jing , Liu Jingwen , Zhong Youhui , Chi Bingjie , Song Shiwei , Zhang Ludan , Song Lingyu , Ma Dongna , Zheng Hai‐Lei
Published: November 2023

Aquaporins (AQPs) regulate the transport of water and other substrates, aiding plants in adapting to stressful environments. However, the knowledge of AQPs in salt‐secreting and viviparous Avicennia marina is limited. In this study, 46 AmAQPs were identified in A. marina genome, and their subcellular localisation and function in transporting H2O2 and boron were assessed through bioinformatics analysis and yeast transformation. Through analysing their expression patterns via RNAseq and real‐time quantitative polymerase chain reaction, we found that most AmAQPs were downregulated in response to salt and tidal flooding. AmPIP (1;1, 1;7, 2;8, 2;9) and AmTIP (1;5, 1;6) as salt‐tolerant candidate genes may contribute to salt secretion together with Na+/H+ antiporters. AmPIP2;1 and AmTIP1;5 were upregulated during tidal flooding and may be regulated by anaerobic‐responsive element and ethylene‐responsive element cis‐elements, aiding in adaptation to tidal inundation. Additionally, we found that the loss of the seed desiccation and dormancy‐related TIP3 gene, and the loss of the seed dormancy regulator DOG1 gene, or DOG1 protein lack heme‐binding capacity, may be genetic factors contributing to vivipary. Our findings shed light on the role of AQPs in A. marina adaptation to intertidal environments and their relevance to salt secretion and vivipary.
Penile keloid formation post‐circumcision: A case series and review of literature
Authors: Tam Idy , Sun Lillian , Patel Anish , Woo Lynn , Weaver John , Shah Sonal D.
Published: November 2023

The formation of penile keloid after circumcision is an uncommon complication. Herein, we report two pediatric cases of large circumferential keloids that developed post‐circumcision and were successfully treated by surgical excision and intralesional triamcinolone injections. In addition, we provide a comprehensive review of the reported cases of penile keloids that developed after circumcision in the literature to highlight the various presentations, treatment options, and outcomes for this condition.
Swedish stakeholders' views of the preparatory work needed before introducing the nurse practitioner role in municipal healthcare–A focus group study
Authors: Ljungbeck Birgitta , Carlson Elisabeth , Forss Katarina Sjögren
Published: November 2023

Background

The nurse practitioner role has become important globally in handling the growing healthcare needs of older adults with chronic diseases. Nevertheless, research shows that introducing the role is a complex process, and more studies are needed to prepare for its introduction into different healthcare contexts, such as municipal healthcare.

Aim

The aim is to investigate what Swedish stakeholders identify as the preparatory work needed before introducing the nurse practitioner role into municipal healthcare.

Methods

Data were collected through four focus group interviews conducted virtually on the TEAMS digital platform, with three to six participants in each group and 18 participants total. The transcribed interviews were analysed using a six‐step thematic approach: familiarisation with the data, coding the data, generating initial themes, reviewing themes, defining and naming the themes and producing the report.

Findings

The findings are divided into two main themes, each with two sub‐themes. In the first, clarifying why the nurse practitioner role is needed, participants stressed the importance of having a clear intention for introducing the role. The second, ensure a national framework to bolster the introduction at the local level, demonstrates the need for collaboration among national actors to clarify the role's mandate and authority before its introduction.

Conclusions

Adding the nurse practitioner role to municipal healthcare can help increase the supply of nursing competence and the quality of patient care, but preparation for introducing the role requires extensive work. The development of the nurse practitioner role requires decision‐makers and leaders to take primary responsibility for its introduction. This study can support countries in the early phase of developing the nurse practitioner role by identifying both best practices and pitfalls.
Evolution from shallow‐water deltas to fluvial fans in lacustrine basins: A case study from the Middle Jurassic Shaximiao Formation in the central Sichuan Basin, China
Authors: Yang Tian , Li Xiaofang , Yang Yu , Wen Long , Cao Zhenglin , Wang Xiaojuan , Zhang Shaomin , Liang Qiangshao
Published: November 2023

Distinguishing between shallow‐water delta and fluvial fan deposits in the subsurface of lacustrine basins is challenging due to their similar depositional characteristics and distribution patterns. This study focuses on the Middle Jurassic Shaximiao Formation in the central Sichuan Basin using core observations, seismic analyses, petrology analyses, zircon analyses, palaeoclimate indicators and palaeocurrent analyses to address this issue. Fifteen sedimentary lithofacies and eight lithofacies associations were established, corresponding to channelized fluvial deposits, non‐channelized fluvial deposits and shallow‐water delta deposits. Shallow‐water deltas are dominated by channels and mouth‐bar complexes with grey, red and green interbedded mudstone. Shingled seismic reflection, green mud clasts, small burrows and wave ripples are common with occasional palaeosols. Fluvial fans are dominated by channels and crevasse‐splays with pink colour and accompanied by red coloured floodplain deposits. Bright spot seismic reflection, red mud clasts, big burrows, current ripples and palaeosols are common. The increased uplift of the Dabashan Mountains controls the palaeocurrent direction, promoting the evolution from a shallow‐water delta in relatively humid environments to a fluvial fan in relatively arid environments. The channel widths in shallow‐water deltas are wider than those in fluvial fans, whereas the opposite applies for the channel amalgamation rate. Highly frequent channel‐width variations are controlled by short‐cycle climate fluctuation, corresponding to chemical index of alteration value fluctuations in different sandstone groups. The channel width in the relatively humid environments is wider than that in arid environments for both shallow‐water deltas and fluvial fans. It is likely that the sedimentary evolution from shallow‐water deltas to fluvial fans is relatively common in lacustrine basins in relatively arid environments with wide and gentle slope landforms.
Differences in toll‐like receptor ligand‐induced cytokine concentrations before and after solid organ transplantation: A prospective, observational cohort study in a clinical setting
Authors: Møller Dina Leth , Sørensen Søren Schwartz , Perch Michael , Gustafsson Finn , Hald Annemette , Knudsen Andreas Delhbæk , Abdulovski Ranya , Arentoft Nicoline Stender , Lundgren Jens , Rasmussen Allan , Ostrowski Sisse Rye , Nielsen Susanne Dam
Published: November 2023

Reliable methods to assess immune function after solid organ transplantation (SOT) are needed to guide dosing of immunosuppression. We hypothesized that toll‐like receptor ligand‐induced cytokine concentrations would decrease post‐transplantation due to the use of immunosuppressive medication. Furthermore, we hypothesized that induced cytokine concentrations pre‐transplantation would be higher in recipients with episodes of acute rejection post‐transplantation due to underlying immunological dispositions. We aimed to investigate toll‐like receptor ligand‐induced cytokine concentrations by TruCulture©, a standardized immunoassay, in SOT recipients before and 3 months after SOT and explored associations with methylprednisolone‐treated acute rejections. We conducted a prospective, observational cohort study including 123 participants (67 liver, 32 kidney and 24 lung transplant recipients). Whole blood was stimulated for 22 h with: (A) Lipopolysaccharide (LPS), (B) Resiquimod, (C) Polyinosinic:polycytidylic acid (Poly I:C) and (D) a blank control. Cytokine concentrations (TNF‐α, IL‐1β, IL‐6, IL‐8, IL‐10, IL‐12p40, IL‐17A, IFN‐α and IFN‐γ) were measured by Luminex. 30 participants developed methylprednisolone‐treated acute rejection at a median of 9 days (IQR 5–17) post‐SOT. We found that all induced cytokine concentrations decreased post‐SOT except from LPS‐induced and Poly I:C‐induced IL‐10. The induced cytokine concentration pre‐transplantation did not differ in recipients with or without acute rejection. In conclusion, the induced cytokine concentrations decreased for all stimuli post‐SOT, except the anti‐inflammatory cytokine IL‐10. Importantly, recipients developing early acute rejection did not differ in induced cytokine concentrations pre‐SOT. Thus, the use of a standardized assay in SOT is feasible in a clinical setting and may provide important information on the immune function post‐SOT.