bluuebunny/crossref_metadata_2025 huggingface dataset:
Review article: The epidemiology and management of Clostridioides difficile infection—A clinical update
Authors: Clarke Lindsay M. , Allegretti Jessica R.
Published: March 2024

Background

Clostridioides difficile is the most common cause of healthcare‐associated infection, and severe cases can result in significant complications. While anti‐microbial therapy is central to infection management, adjunctive therapies may be utilised as preventative strategies.

Aim

This article aims to review updates in the epidemiology, diagnosis, and management, including treatment and prevention, of C. difficile infections.

Methods

A narrative review was performed to evaluate the current literature between 1986 and 2023.

Results

The incidence of C. difficile infection remains significantly high in both hospital and community settings, though with an overall decline in recent years and similar surveillance estimates globally. Vancomycin and fidaxomicin remain the first line antibiotics for treatment of non‐severe C. difficile infection, though due to lower recurrence rates, infectious disease society guidelines now favour use of fidaxomicin. Faecal microbiota transplantation should still be considered to prevent recurrent C. difficile infection. However, in the past year the field has had a significant advancement with the approval of the first two live biotherapeutic products—faecal microbiota spores‐live brpk, an oral capsule preparation, and faecal microbiota live‐jslm—both indicated for the prevention of recurrent C. difficile infection, with additional therapies on the horizon.

Conclusion

Although the prevalence of C. difficile infection remains high, there have been significant advances in the development of novel therapeutics and preventative measures following changes in recent practice guidelines, and will continue to evolve in the future.
Shame, Gaze and Voice: A Lacanian Perspective
Authors: Green Sharon R. , Vanheule Stijn
Published: March 2024

This paper proposes a Lacanian theory of shame linked to the era of Lacan's work starting with Seminar X and the invention of the object a. From a Lacanian perspective, shame is not evoked by the exposure of a deficit, but rather by the exposure and witnessing of the divided subject's constitutive lack. This paper proposes that the affect of shame is an index pointing to the divided subject's structural lack when it is exposed and witnessed by object a instantiated as the gaze of the scopic drive and the voice of the invocatory drive. Since shame can freeze speech as well as provoke flight from the analytic work, we suggest that it is helpful for the clinician to understand how the structure of shame manifests in the patient's speech and in the transference. Clinical examples are given throughout. The paper concludes with a case discussion of Lacanian analytic work with a female patient confronted with multiple existential dilemmas that evoked shame in relationship to her body, sexuality and death.
Impacts of tissue context on extracellular vesicles‐mediated cancer–host cell communications
Authors: Nishida‐Aoki Nao , Ochiya Takahiro
Published: March 2024

Tumor tissue is densely packed with cancer cells, non‐cancerous cells, and ECM, forming functional structures. Cancer cells transfer extracellular vesicles (EVs) to modify surrounding normal cells into cancer‐promoting cells, establishing a tumor‐favorable environment together with other signaling molecules and structural components. Such tissue environments largely affect cancer cell properties, and so as EV‐mediated cellular communications within tumor tissue. However, current research on EVs focuses on functional analysis of vesicles isolated from the liquid phase, including cell culture supernatants and blood draws, 2D‐cultured cell assays, or systemic analyses on animal models for biodistribution. Therefore, we have a limited understanding of local EV transfer within tumor tissues. In this review, we discuss the need to study EVs in a physiological tissue context by summarizing the current findings on the impacts of tumor tissue environment on cancer EV properties and transfer and the techniques required for the analysis. Tumor tissue environment is likely to alter EV properties, pose physical barriers, interactions, and interstitial flows for the dynamics, and introduce varieties in the cell types taken up. Utilizing physiological experimental settings and spatial analyses, we need to tackle the remaining questions on physiological EV‐mediated cancer–host cell interactions. Understanding cancer EV‐mediated cellular communications in physiological tumor tissues will lead to developing interaction‐targeting therapies and provide insight into EV‐mediated non‐cancerous cells and interspecies interactions.
Macroprolactin over time: Is there any point in rechecking it in people with a persistently elevated serum prolactin?
Authors: Livingston Mark , Hashmi Syeda F. , Ramachandran Sudarshan , Laing Ian , Heald Adrian
Published: March 2024

Objective and Design

Macroprolactinemia may influence the interpretation of serum prolactin levels—a recognised phenomenon since 1981. The degree of macroprolactinaemia over time is less well described. We determined how macroprolactin status (based on polyethylene glycol (PEG) precipitation) varied by analysing serial measurements in hyperprolactinaemic individuals over a period of 9 years.

Patients and Measurements

Results from 1810 individuals were included. All serum total prolactin results (measured using Roche Cobas 8000 analyser) were extracted from the laboratory information system for the period 1 January 2012 to 1 April 2021, along with relevant patient demographic/test data. Samples with a macroprolactin screening test performed (on samples with prolactin > 700 miu/L) were included in the main analysis.

Results

During the study period, 2782 macroprolactin checks were performed (12.5% of all prolactin tests) in 1810 individuals (599 males/2183 females, median‐age: 35, interquartile range: 25–47, range: 16–93 years). Multiple macroprolactin checks were carried out on 465 patients (1437 measurements) with 94 patients (141 measurements) screening positive (<60% recovery). Only 19 patients (18 female) had at least one result above and one below the 60% screening cut‐off, with 10 of these patients having results close to the 60% cut‐off; in 9 patients, results were clearly different between repeat samples. In seven cases, the adjusted monomeric prolactin showed a potentially clinically significant difference.

Conclusions

In this study, only 19/465 patients appeared to change macroprolactin status based on a 60% PEG recovery cut‐off. The majority of these 19 patients were on antipsychotic/antidepressant medication(s) or had a prolactinoma; in only 7 did monomeric prolactin change significantly. This suggests that once macroprolactin status has been determined, clinical decision making is rarely affected by repeating it.
Pre‐morbid sleep disturbance and its association with stroke severity: results from the international INTERSTROKE study
Authors: Mc Carthy Christine E. , Yusuf Salim , Judge Conor , Ferguson John , Hankey Graeme J. , Gharan Shahram Oveis , Damasceno Albertino , Iversen Helle Klingenberg , Rosengren Annika , Ogah Okechukwu , Avezum Luísa , Lopez‐Jaramillo Patricio , Xavier Denis , Wang Xingyu , Rangarajan Sumathy , O'Donnell Martin J.
Published: March 2024

Background and purpose

Whilst sleep disturbances are associated with stroke, their association with stroke severity is less certain. In the INTERSTROKE study, the association of pre‐morbid sleep disturbance with stroke severity and functional outcome following stroke was evaluated.

Methods

INTERSTROKE is an international case–control study of first acute stroke. This analysis included cases who completed a standardized questionnaire concerning nine symptoms of sleep disturbance (sleep onset latency, duration, quality, nocturnal awakening, napping duration, whether a nap was planned, snoring, snorting and breathing cessation) in the month prior to stroke (n = 2361). Two indices were derived representing sleep disturbance (range 0–9) and obstructive sleep apnoea (range 0–3) symptoms. Logistic regression was used to estimate the magnitude of association between symptoms and stroke severity defined by the modified Rankin Score.

Results

The mean age of participants was 62.9 years, and 42% were female. On multivariable analysis, there was a graded association between increasing number of sleep disturbance symptoms and initially severe stroke (2–3, odds ratio [OR] 1.44, 95% confidence interval [CI] 1.07–1.94; 4–5, OR 1.66, 95% CI 1.23–2.25; >5, OR 2.58, 95% CI 1.83–3.66). Having >5 sleep disturbance symptoms was associated with significantly increased odds of functional deterioration at 1 month (OR 1.54, 95% CI 1.01–2.34). A higher obstructive sleep apnoea score was also associated with significantly increased odds of initially severe stroke (2–3, OR 1.48; 95% CI 1.20–1.83) but not functional deterioration at 1 month (OR 1.19, 95% CI 0.93–1.52).

Conclusions

Sleep disturbance symptoms were common and associated with an increased odds of severe stroke and functional deterioration. Interventions to modify sleep disturbance may help prevent disabling stroke/improve functional outcomes and should be the subject of future research.
Frailty as a comprehensive health measure beyond seizure control in patients with epilepsy: A cross‐sectional study
Authors: Cerulli Irelli Emanuele , Borioni Maria S. , Morano Alessandra , Mazzeo Adolfo , Moro Pierludovico , Orlando Biagio , Salamone Enrico M. , Giordano Luca , Petrungaro Alessio , Toccaceli Blasi Marco , Giallonardo Anna T. , Canevelli Marco , Di Bonaventura Carlo
Published: March 2024

Objective

Due to the high clinical heterogeneity of epilepsy, there is a critical need for novel metrics aimed at capturing its biological and phenotypic complexity. Frailty is increasingly recognized in various medical disciplines as a useful construct to understand differences in susceptibility to adverse outcomes. Here, we develop a frailty index (FI) for patients with epilepsy (PwE) and explore its association with demographic and clinical features.

Methods

In this cross‐sectional study, we consecutively enrolled 153 PwE from an outpatient epilepsy clinic. Participants were assessed for various health deficits to calculate the FI. Associations between FI and demographic/clinical features, antiseizure medications (ASMs), and patient‐reported outcomes were analyzed using general linear models and Spearman correlation.

Results

The median age at the time of study visit was 47 years (interquartile range = 33–60), and 89 (58.2%) patients were females. Multiple linear regression revealed that the developed 33‐item FI showed an independent association with age, female sex, higher body mass index, family history of epilepsy, intellectual disability, and the number of ASMs used. A robust analysis of covariance showed higher FI levels in patients using cytochrome P450 3A4‐inducer ASMs. We found a moderate positive correlation between FI and psychological distress, lower quality of life, and physical frailty, measured by the Hospital Anxiety and Depression Scale, Quality of Life in Epilepsy Inventory‐10, and handgrip strength, respectively. Finally, a weak association was observed between higher FI scores and an increased number of epileptic falls.

Significance

This study highlights the significance of frailty as a comprehensive health measure in epilepsy. It suggests that frailty in this specific population is not only a manifestation of aging but is inherently linked to epilepsy and treatment‐related factors. Future research is warranted to validate and refine the FI in diverse epilepsy populations and investigate its impact on specific adverse outcomes in longitudinal studies.
Culturally adapting relational savoring: A therapeutic approach to improve relationship quality
Authors: Borelli Jessica L. , Zhou Elayne , Russo Lyric N. , Li Frances H. , Tironi Marta , Yamashita Ken S. , Smiley Patricia A. , Campos Belinda
Published: March 2024

Relational savoring (RS) is a brief, strengths‐based approach to heightening attentional focus to moments of positive connectedness within relationships. RS can be administered preventatively or within an intervention context when a therapist aspires to foster more optimal relational functioning. Typically administered within a one‐on‐one therapy setting, RS has demonstrated efficacy in enhancing intra‐ and interpersonal outcomes. To increase access to mental health services, the developers of RS are committed to engaging in an iterative approach of enhancing the cultural congruence and accessibility of this intervention within various cultural contexts, beginning with Latine groups in Southern California. In this article, we describe relational savoring and its theoretical and empirical support, including the process of culturally adapting the intervention within the context of three major studies, each with a distinct focus on Latine groups, a community that is underserved in mental health care settings. We then provide a vision for future research to improve upon the intervention's compatibility for Latine families and other populations.
Foreign institutional investors’ certification and domestic minority shareholders’ mistrust
Authors: Cao Jerry , Li Yong , Liu Xiaojuan , Megginson William L.
Published: March 2024

Using hand‐collected data from China's split share structure reform (SSSR) program, we show that foreign institutional investors’ certification mitigates domestic minority shareholders’ mistrust of controlling shareholders’ reform plans and facilitates the implementation of the SSSR. Domestic minority shareholders cast fewer dissenting votes, complete the SSSR more quickly but with lower compensation, and achieve higher stock return reactions in reforming firms with higher foreign institutional ownership. Foreign institutional investors’ prestige is a key factor in aligning domestic minority shareholders toward seeking long‐term payoffs. Our work reveals the positive role of foreign institutional investors’ certification in a salient reform of corporate governance.
Unpunctual in diversity: The effect of stand species richness on spring phenology of deciduous tree stands varies among species and years
Authors: Heinecke Thilo , De Frenne Pieter , Verheyen Kris , Nijs Ivan , Matthysen Erik , Campioli Matteo
Published: March 2024

Climatic drivers alone do not adequately explain the regional variation in budburst timing in deciduous forests across Europe. Stand‐level factors, such as tree species richness, might affect budburst timing by creating different microclimates under the same site macroclimate. We assessed different phases of the spring phenology (start, midpoint, end, and overall duration of the budburst period) of four important European tree species (Betula pendula, Fagus sylvatica, Quercus robur and Tilia cordata) in monocultures and four‐species mixture stands of a common garden tree biodiversity experiment in Belgium (FORBIO) in 2021 and 2022. Microclimatic differences between the stands in terms of bud chilling, temperature forcing, and soil temperature were considerable, with four‐species mixtures being generally colder than monocultures in spring, but not in winter. In the colder spring of 2021, at the stand level, the end of the budburst period was advanced, and its overall duration shortened, in the four‐species mixtures. At species level, this response was significant for F. sylvatica. In the warmer spring of 2022, advances in spring phenology in four‐species stands were observed again in F. sylvatica and, less markedly, in B. pendula but without a general response at the stand level. Q. robur showed specific patterns with delayed budburst start in 2021 in the four‐species mixtures and very short budburst duration for all stands in 2022. Phenological differences between monocultures and four‐species mixtures were linked to microclimatic differences in light availability rather than in temperature as even comparatively colder microclimates showed an advanced phenology. Compared to weather conditions, tree species richness had a lower impact on budburst timing, but this impact can be of importance for key species like F. sylvatica and colder springs. These results indicate that forest biodiversity can affect budburst phenology, with wider implications, especially for forest‐ and land surface models.
Effects of conservation versus elimination of growing points on yield, C: N: P stoichiometry, and root morphology of Leymus chinensis
Authors: Zhao Chengzhen , Chang Xiao , Li Qiang , Zhong Rongzhen , Zhou Daowei
Published: March 2024

The conservation and elimination of the growing point of Leymus chinensis (Trin.) Tzvel. are two common contrasted scenarios during grazing. However, the biomass and nutrient allocation in L. chinensis, as well as their contribution to yield under these conditions are unclear. Therefore, a simulated grazing experiment was conducted using a factorial design that combined two defoliation heights (conservation versus elimination of growing points) and four plant heights (18, 24, 31, and 35 cm) during two growing seasons (2020 and 2021), resulting in eight treatments. Additionally, the experiment also included two identical control treatments with a single mowing in mid‐August. The results demonstrated that conservation treatments for the growing point increased the regeneration time of L. chinensis during the entire growing season in both years compared to elimination treatments for the growing point, due to the alteration in biomass allocation priority and C: N: P stoichiometric ratio between stems and leaves of L. chinensis, as well as root morphological traits. The growth strategy in the treatment with 17 cm defoliation height at 35 cm plant height demonstrated the optimal combination, resulting in stabling the accumulated DM yield of L. chinensis in both years. The findings emphasize the significance of comprehending the correlation between the growing point of L. chinensis and its yield, providing a pioneering approach to guide sustainable grazing practices for L. chinensis grassland.
Forage type and additive effects on fermentation quality and biorefinery performance of silages
Authors: Rinne M. , Stefański T. , Franco M. , Jalava T. , Kuoppala K.
Published: March 2024

The concept of a green biorefinery has recently gained interest and can be defined as a process where green biomass is processed to a variety of products. Most green biorefineries rely on fresh green biomass as the feedstock, but using a stable ensiled biomass could provide benefits. We evaluated the effects of silage additive treatments on silage fermentation quality and performance in a laboratory scale liquid–solid separation to simulate the first step of a green biorefinery. In Experiment 1, red clover and fresh and wilted grass were ensiled without additive or treated with a lactic acid bacteria inoculant or a formic acid based additive. In Experiment 2, grass or red clover were treated with a fibrolytic enzyme, formic acid or a combination of them, and a control without additive was also included. Silage fermentation quality was improved by additive use. Biomass dry matter concentration was negatively related to liquid yield, but effects of additive treatments on the biorefinery performance were minor and inconsistent between different forages. Optimizing agronomic and feedstock conservation management plays an important role for the success and sustainability of the biorefinery process. Good silage management practices with minimal losses during storage should be targeted, but no clear patterns in biorefinery outputs were observed in the current study when different types of additives were used in grass and clover silage production.
The organization of the muscle system of the causative agent of dicrocoeliosis, Dicrocoelium dendriticum
Authors: Mochalova Natalia V. , Terenina Nadezhda B. , Movsesyan Sergei O. , Kreshchenko Natalia D.
Published: March 2024

The musculature of parasitic flatworms plays a central role in locomotory movement, attachment to the host, and in the function of the digestive, reproductive, and excretory systems. We examine for the first time the muscle system of the flatworm Dicrocoelium dendriticum, a causative agent of the parasitic disease dicrocoeliosis, by use of fluorescently labeled phalloidin and confocal laser scanning microscopy. Somatic musculature of D. dendriticum consists of the circular, longitudinal, and diagonal muscles. The distribution of the muscle fibers in the body wall differed among the anterior, middle, and posterior body regions of the worm. The musculature of the attachment organs, the oral and ventral suckers, includes several types of muscles: the external equatorial and meridional muscles, internal circular and semicircular muscles, and radial muscles. Inside of the ventral sucker the diagonally located muscles were revealed and the supplementary u‐shaped muscles were found adjoined to the base of the sucker from outside. The musculature of the internal organs composed of the excretory, reproductive, and digestive systems were characterized. Our results increase our knowledge of the morphology of trematodes and the arrangement of their muscle system.
Nonpharmacologic rate control of postoperative atrial fibrillation in the canine sterile pericarditis model
Authors: Lee Seungyup , Wallick Don , Khrestian Celeen , Juzbasich Dragan , Laurita Daniel , Rushing Gregory , Sahadevan Jayakumar
Published: March 2024

Introduction

Postoperative atrial fibrillation (POAF) is common following open heart surgery, and is associated with significant morbidity. Medications used for ventricular rate control of POAF may not be effective in controlling rapid ventricular rates during the postoperative period because of increased sympathetic tone. The purpose of this study was to develop nonpharmacologic rate control of POAF by atrioventricular node (AVN) fat pad stimulation using clinically available temporary pacing wires in the canine sterile pericarditis model.

Methods

We studied 10 sterile pericarditis dogs in the closed‐chest state on postoperative days 1−3. The AVN fat pad stimulation (amplitude 2–15 mA; frequency 20 Hz; pulse width 0.03–0.2 ms) was performed during sustained POAF (>5 min). We measured ventricular rate and inefficient ventricular contractions during sustained POAF and compared it with and without AVN fat pad stimulation. Also, the parameters of AVN fat pad stimulation to achieve a rate control of POAF were measured over the postoperative days.

Results

Eleven episodes of sustained POAF were induced in 5/10 sterile pericarditis dogs in the closed‐chest state on postoperative days 1−2. During POAF, the AVN fat pad stimulation decreased the ventricular rate from 178 ± 52 bpm to 100 ± 8 bpm in nine episodes. Nonpharmacologic rate control therapy successfully controlled the ventricular rate and eliminated inefficient ventricular contractions during POAF for the duration of the AVN fat pad stimulation. The AVN fat pad stimulation output remained relatively stable over the postoperative days.

Conclusion

During sustained POAF, nonpharmacologic rate control by AVN fat pad stimulation effectively and safely controlled rapid ventricular rates throughout the postoperative period.
Hepatoprotective activity of Lactéol® forte and quercetin dihydrate against thioacetamide‐induced hepatic cirrhosis in male albino rats
Authors: Saad Hebatallah M. , Oda Samah S. , Alexiou Athanasios , Papadakis Marios , Mahmoud Mohamed H. , Batiha Gaber El‐Saber , Khalifa Eman
Published: March 2024

Liver cirrhosis is a silent disease in humans and is experimentally induced by many drugs and toxins as thioacetamide (TAA) in particular, which is the typical model for experimental induction of hepatic fibrosis. Thus, the objective of the present study was to elucidate the possible protective effects of lactéol® forte (LF) and quercetin dihydrate (QD) against TAA‐induced hepatic damage in male albino rats. Induction of hepatotoxicity was performed by TAA injection (200 mg/kg I/P, twice/ week) in rats. LF (1 × 109 CFU/rat 5 times/week) and QD (50 mg/kg 5 times/week) treated groups were administered concurrently with TAA injection (200 mg/kg I/P, twice/ week). The experimental treatments were conducted for 12 weeks. Hepatotoxicity was evaluated biochemically by measuring alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma‐glutamyl transferase (GGT) in the serum and histopathologically with the scoring of histopathological changes besides histochemical assessment of collagen by Masson's trichrome and immunohistochemical analysis for α‐smooth muscle actin (α‐SMA), Ki67 and caspase‐3 expression in liver sections. Our results indicated that LF and QD attenuated some biochemical changes and histochemical markers in TAA‐mediated hepatotoxicity in rats by amelioration of biochemical markers and collagen, α‐SMA, Ki67 and caspase3 Immunoexpression. Additionally, LF and QD supplementation downregulated the proliferative, necrotic, fibroblastic changes, eosinophilic intranuclear inclusions, hyaline globules and Mallory‐like bodies that were detected histopathologically in the TAA group. In conclusion, LF showed better hepatic protection than QD against TAA‐induced hepatotoxicity in rats by inhibiting inflammatory reactions with the improvement of some serum hepatic transaminases, histopathological picture and immunohistochemical markers.
Characterization of the visually impaired patients with diabetes mellitus in Japan
Authors: Sugihara Yuka , Takamura Yoshihiro , Yamada Yutaka , Morioka Masakazu , Gozawa Makoto , Kato Kumiko , Hirano Takao , Murao Fumiko , Shimizu Miho , Kusuhara Sentaro , Murakami Tomoya , Takenaka Yuki , Okabe Naoko , Jujo Tatsuya , Terasaki Hiroto , Nagasato Daisuke , Dong Zhenyu , Yoshida Shigeo , Ogura Shuntaro , Yasuda Kanako , Ishigooka Gaku , Sawada Osamu , Higashijima Fumiaki , Inatani Masaru
Published: March 2024

Aims/Introduction

To conduct a multicenter survey of visually impaired patients with diabetes mellitus (DM) and to identify the physical and ocular characteristics that lead to blindness in Japan.

Materials and Methods

Visually impaired patients with diabetes mellitus in Japan were divided into blind and low‐vision groups according to the World Health Organization classification. Data on parameters related to diabetes mellitus and ocular complications in the right and left eyes were collected from 19 highly advanced medical facilities and compared between the two groups.

Results

Among 408 visually impaired persons (blind group: 257, low‐vision group: 151), 72.1% were under 70 years of age. The rates of neovascular glaucoma (NVG) (right eye, P = 0.041; left eye, P = 0.0031) or proliferative diabetic retinopathy (PDR) (right eye: P = 0.014, left eye: P = 0.0047) and the rate of proliferative membrane beyond half of the retinal area (right eye: P = 0.0263, left eye: P = 0.037) were significantly higher in the blind group. The direct cause of visual impairment was retinal atrophy, common in both groups. Neovascular glaucoma and diabetic macular edema were equally prevalent in the blind and low‐vision groups, respectively.

Conclusions

In Japan, blind patients with diabetes mellitus are characterized by severe conditions such as neovascular glaucoma and progressive proliferative diabetic retinopathy upon their initial visit to an advanced care facility. These results highlight the importance of monitoring retinopathy through regular ophthalmological examinations, internal medicine, and appropriate therapeutic intervention.
Children's experiences of mask‐wearing: a systemic review and narrative synthesis
Authors: Preest Elin , Greenhalgh Trisha , Farrier Christian , van der Westhuizen Helene‐Mari
Published: March 2024

Rationale

Masks have been widely used as a preventative tool during the COVID‐19 pandemic. However, the use of masks by children has been controversial, with international guidelines recommending a risk‐based approach to national policymakers.

Aims and objectives

We aimed to conduct a systematic review that explores children's experiences of mask‐wearing, drawing on an evidence base that describes mask‐wearing in different contexts including air pollution, and to prevent the spread of infectious disease.

Methods

We searched MEDLINE, Embase and PsycINFO in June 2021, with repeat searches in August 2022 and January 2024, for primary research studies exploring children's experiences of masks. Included studies reported on participants between 4 and 14 years (inclusive), with no restrictions on language where an English translation was available. Two reviewers independently screened titles and abstracts and reviewed full texts, with discrepancies resolved by a third reviewer. We used the Mixed Methods Appraisal Tool for quality appraisal and narrative synthesis to identify key findings. We also conducted stakeholder consultation (Patient and Public Involvement (PPI)) with nine children, where they submitted annotated drawings of their preferred masks to complement our review findings.

Results

We screened 982 titles and abstracts and reviewed 94 full texts. 45 studies were included in the synthesis. Children's experiences of mask‐wearing were influenced by their perceived necessity, social norms around their use and parental attitudes. Challenges related to mask‐wearing were described, including difficulty reading facial expressions and physical discomfort. Children found it easier to wear masks when sitting and in cooler environments, and they benefited from unmasking during outdoor break time at school. As part of the PPI consultation, children highlighted the importance of mask design and the environmental impact of masks.

Conclusion

Children's experiences of mask‐wearing were varied and context‐dependent, with several mask‐design challenges raised. Future policy on mask‐wearing needs to consider the context in which mask‐wearing would be most beneficial, and how local adaptations to policy can respond to children's needs.
Diamond Gymnura natalensis and duckbill Aetomylaeus bovinus rays undertake nationwide coastal migrations
Authors: Elston Chantel , Murray Taryn S. , Rogers Toby , Parkinson Matthew C. , Mann Bruce Q. , Daly Ryan , Filmalter John D. , Cowley Paul D.
Published: March 2024

Migration is a critical aspect of ocean ecosystems, and understanding this phenomenon answers ecological and management questions. Given the difficulty in tracking ocean animals across large distances, the extent to which different ray species perform long‐distance movements, such as migrations, remains unknown. This study used passive acoustic telemetry to track the movements of endemic diamond Gymnura natalensis and critically endangered duckbill Aetomylaeus bovinus rays along the South African coastline using a collaborative nationwide network of coastal acoustic receivers for up to 7 years. Duckbill rays were detected significantly more frequently than diamond rays, but both species moved between the south and east coasts of South Africa (traveling up to 1167 km). Tagged individuals were detected significantly more often in their tagging locations during summer months but traveled significantly further distances during winter months. Furthermore, movement models fitted to individual duckbill rays' annual net‐squared displacement identified most individual annual movements as migratory. This evidence suggests that both diamond and duckbill rays make eastward winter migrations and return to specific areas along the coastline during the summer months. The exceptions to this were diamond rays tagged on the east coast that were not found to migrate seasonally, which supports previous research that there is intraspecific variability in migrations for ray species. These findings have implications for understanding ray migration not only on a global scale but also locally for spatial management interventions and population delineation.
Effect of a plant protein‐rich diet on postprandial phosphate metabolism in healthy adult men: a randomised controlled trial
Authors: Uenishi Kozue , Kawasaki Nozomi , Iseki Haruka , Nogata Misato , Kawabata Yuki , Kido Shinsuke
Published: March 2024

Background

This study examined the effects of animal protein‐ and plant protein‐rich diets on postprandial phosphorus metabolism in healthy male subjects.

Methods

The study was conducted by randomised parallel‐group comparison of healthy men aged 21–24 years. In Study 1, participants were divided into two groups and consumed either a 70% animal protein diet (AD, n = 6) or a 70% plant protein diet (PD, n = 6). In Study 2, participants were divided into three groups and consumed either AD (n = 10), PD (n = 10) or AD + DF, a 70% animal protein diet loaded with the same amount of fibre as PD (n = 9). The phosphorus contents of the diets used in this study were nearly equivalent (AD, 710.1 mg; PD, 709.7 mg; AD + DF, 708.9 mg). Blood and urine samples were collected before, and 2 and 4 h after the meal to measure phosphorus and calcium levels.

Results

In Study 1, PD consumption resulted in lower blood and urinary phosphorus concentrations 2 h postprandially compared with AD (p < 0.05). In Study 2, blood phosphorus levels in AD + DF after the diet remained lower, but not significantly so compared with AD, and urinary phosphorus levels were significantly lower 2 h postprandially (p < 0.05).

Conclusions

A plant protein‐rich diet reduced rapid postprandial increases in blood and urinary phosphorus concentrations compared with the animal protein‐rich diets, suggesting that dietary fibre may play a partial role in the postprandial decreases in blood and urinary phosphorus concentrations.
The role of social media in the professional sphere of Finnish registered dietitians
Authors: Liikkanen Jade , Virtanen Heli E.K. , Mikkonen Santtu , Laitinen Aija L.
Published: March 2024

Background

With the widespread use of social media, understanding how healthcare professionals, such as dietitians, utilise these platforms for their work has gained interest. The aim of the current study was to describe how Finnish registered dietitians utilise various social media channels for professional purposes. The study also investigated the perceived social media skills of dietitians.

Methods

A cross‐sectional study was conducted using an online survey administered between December 2022 and February 2023. The participants were 107 Finnish registered dietitians who held a master's degree suitable for the profession. The Fisher's exact test was employed for categorical variables, whereas the Kruskal–Wallis test was used for ordinal variables with multiple groups.

Results

Out of the 107 participants, 62 (58%) reported using social media for professional purposes. The primary purposes across various social media channels were interaction with colleagues (80%) on Facebook, networking with professionals from other fields (86%) on LinkedIn and general monitoring of the field on Instagram (91%), Twitter (77%) and YouTube (58%). Dietitians' perceived social media skills were found to have a statistically significant relationship with age (p < 0.05) for all channels, except Twitter.

Conclusions

The findings suggest that Finnish dietitians predominantly utilise social media for passive monitoring of the field, rather than actively sharing content with the public. Professional communication tends to take place within their own professional groups. Incorporating social media use into the official job description could serve as an encouraging factor to enhance the professional utilisation of social media among dietitians.
Optimization of the end‐of‐life tire repartition within the European treatment system to minimize its environmental impacts
Authors: Duval Lisa , Majeau‐Bettez Guillaume , Saunier François , Maréchal François , Margni Manuele
Published: March 2024

This study contrasts two different approaches to inform European‐scale decision‐making to mitigate the environmental impacts of the end‐of‐life tires (ELT) management system. The first analysis is a traditional life cycle assessment (LCA) that compares the environmental performances of the 12 main available European end‐of‐life (EOL) technologies in ELT processing while restricting the boundaries to the EOL stage. The second analysis has a broader scope, addressing the optimization of the ELT distribution within the 12 considered pathways to minimize the environmental impacts of the total tire use in Europe under present capacity and constraints. The results of the traditional LCA show that, except for landfill, all the tested EOL routes present environmental benefits. Material recovery pathways bring the most environmental credits, whereas civil engineering pathways are the least promising. The LCA results that emerged from the optimization of ELT management technologies yield two optimal technological mixes that maximize the quantity of ELT recycled in molded objects production: such results represent a hypothetical case with no constraints. When considering constraints, that is, limitations on maximum quantities of ELT that can undergo retreading, pyrolysis, or recycling in synthetic turfs, in molded objects and in production, the number of optimal technology mixes increases to five. The type of technologies favored depends on the minimized impact categories (climate change, fossil and nuclear energy use, human health, and ecosystem quality). A comparison between constrained and unconstrained scenarios shows that achieving the best environmental performances is conditional to the accessibility of the EOL technologies as well as their individual environmental impacts.
Nursing students' attitudes towards mental illness: A multi‐national comparison
Authors: Moxham Lorna , Tapsell Amy , Perlman Dana , Al Mutair Abbas , AL‐Sagarat Ahmad Yahya , Alsaraireh Faris A. , Chung Min‐Huey , Jose Tessy Treesa , Kuo Shu‐Yu , Liu Megan F. , Nayak Asha K. , Shamsan Abbas , Sudhakar Christopher , Tsai Hsiu‐Ting , Velayudhan Binil , Yang Chyn‐Yng , Roberts Michelle M. , Yeh Pi‐Ming , Patterson Christopher
Published: March 2024

Accessible Summary

What is known on the subject

Health professionals, including nurses, are shown to have stigmatizing attitudes towards mental illness.

For nursing students who are in their formative years of professional development, mental illness stigma can severely impact the care they provide.

Little research has investigated multi‐national comparisons of nursing students' attitudes towards mental illness.

What this paper adds to existing knowledge

This study shows that between countries, there were substantial differences amongst nursing students in stigmatizing attitudes towards mental illness.

Cultural perspectives may explain some of these differences.

What are the implications for practice

Regardless of location, stigmatizing attitudes are present at varying levels. Each nation can take steps to reduce these by acknowledging the presence of stigmatizing attitudes amongst nurses, educating nurses regarding the negative impacts of stigma on patient outcomes, and decrease stigmatizing attitudes by facilitating opportunities for nurses (particularly student nurses) to have direct contact with people with lived experiences of mental illness.

Introduction

Stigmatizing attitudes perpetuated by nursing professionals are a pervasive problem for people experiencing mental health issues. This global issue has detrimental consequences; inhibiting one's life chances and help‐seeking behaviours. To date, few studies have compared nursing students' attitudes towards mental illness from a multi‐national perspective.

Aim

To compare undergraduate nursing students' attitudes towards mental illness across six countries: Australia, India, Jordan, Saudi Arabia, Taiwan and USA.

Method

In a cross‐sectional design, data were collected from undergraduate nursing students (N = 426) using the Social Distance Scale. A one‐way analysis of variance was used to compare differences between countries.

Results

Nursing students' attitudes to mental illness differed between countries. Social Distance Scores were highest amongst nursing students from Jordan and Saudi Arabia. Students from Taiwan and India possessed moderate stigma scores. Social Distance Scores from the USA and Australia were lowest.

Discussion

Clear differences in stigmatizing attitudes emerged between countries; these are discussed in relation to possible cultural influences.

Implications for Practice

It is suggested that educating nurses, combined with direct contact with people with lived experiences of mental illness, can reduce stigmatizing attitudes regardless of country, location or educational institution.
Utility of focused cardiac ultrasonography training in veterinary students to differentiate stages of subclinical myxomatous mitral valve disease in dogs
Authors: Huh Terry , Achilles Erin J. , Massey Laura K. , Loughran Kerry A. , Larouche‐Lebel Éva , Convey Victoria , McKaba Victoria F. , Crooks Alexandra , Kraus Marc S. , Gelzer Anna R. , Oyama Mark A.
Published: March 2024

Background

Differentiation of the subclinical phases of myxomatous mitral valve disease (MMVD) in dogs relies heavily on echocardiography. Focused cardiac ultrasonography (FCU) is a point‐of‐care technique that can assess heart size.

Hypothesis/Objectives

Veterinary students trained in FCU can differentiate dogs with subclinical MMVD based on left ventricular (LV) and left atrial (LA) dimensions.

Animals

Forty‐eight dogs with subclinical MMVD.

Methods

Veterinary students were trained to measure LV dimension and LA‐to‐aortic root dimension ratio (LA : Ao) using FCU. Dogs were categorized into 2 cohorts based on whether or not the LV normalized internal diastolic dimension was ≥1.7 and LA : Ao was ≥1.6. Agreement between FCU and echocardiographic studies performed by cardiologists was evaluated.

Results

One‐hundred and forty‐six FCU examinations were performed by 58 veterinary students on 48 dogs. Overall agreement between students and cardiologists was moderate (Fleiss' kappa, 0.54; 95% confidence interval [CI], 0.39‐0.69; P < .001). Percentage accuracy in observations with heart dimensions less than the cutoffs (86/89, 97%) was significantly higher than in observations in with larger hearts (31/57, 54%; P < .001). Agreement increased from moderate to good as heart sizes became more extreme. Degree of confidence by students in performing FCU was significantly higher at the end vs start of the study.

Conclusions and Clinical Importance

Categorization of dogs with subclinical MMVD by veterinary students using FCU was associated with moderate to good agreement with echocardiography. Focused cardiac ultrasonography is a point‐of‐care method that can help assess clinical stage in dogs with subclinical MMVD.
Island medicine longitudinal cohort study: Rapid rise in chronic kidney disease in rural and remote communities
Authors: Jose Matthew D. , Cuthbertson Laura , Burgess James , Jose Kim , Saunder Timothy , Kitsos Alex , Radford Jan , Raj Rajesh
Published: March 2024

Aim

To determine the change in incidence and prevalence of chronic kidney disease (CKD) in rural and remote communities over the last decade.

Methods

We examined the change in age‐standardized incidence and prevalence in Tasmania between 2010 and 2020, using a linked dataset that included any adult with a creatinine test taken in a community laboratory during the study period (n = 581 513; 87.8% of the state's adult population). We defined CKD as two measures of eGFR <60 mL/min per 1.73 m2, at least 3 months apart.

Results

State‐wide age‐standardized prevalence of CKD increased by 28% in the decade to 2020, from 516 to 659 per 10 000 population. Prevalence in men increased 31.3% and women 24.8%. The greatest increase in age‐standardized prevalence was seen in rural or remote communities with an increase of 36.6% overall, but with considerable variation by community (range + 0.4% to +88.3%). The increase in the actual number of people with CKD in the decade to 2020 was 67%, with the number of women increasing by 58% and men by 79%.

Conclusion

The age‐standardized prevalence of CKD in rural and remote regions has increased considerably over the past decade, likely compounded by limited access to primary and secondary healthcare. These findings highlight the need to ensure healthcare resources are directed to areas of greatest need.
How much do we know about nursing care delivery models in a hospital setting? A mapping review
Authors: Geltmeyer Klara , Eeckloo Kristof , Dehennin Laurence , De Meester Emma , De Meyer Sigrid , Pape Eva , Vanmeenen Margot , Duprez Veerle , Malfait Simon
Published: March 2024

To deal with the upcoming challenges and complexity of the nursing profession, it is deemed important to reflect on our current organization of care. However, before starting to rethink the organization of nursing care, an overview of important elements concerning nursing care organization, more specifically nursing models, is necessary. The aim of this study was to conduct a mapping review, accompanied by an evidence map to map the existing literature, to map the field of knowledge on a meta‐level and to identify current research gaps concerning nursing models in a hospital setting. Next to nursing models, two other organizational correlates seem to be of importance when looking at the organization of nursing care: nurse staffing and skill mix. Although it seems that in recent research, the theoretical focus on the organization of nursing care has been left behind, the increasingly complex healthcare environment might gain from the use of nursing theory, or in this case, care delivery models. As almost no fundamental studies have been done toward the combination of care delivery models, nurse staffing, and skill mix, those elements should be taken into account to fully capture the organization of nursing care in future research.
From plaster casts to picket lines: Public support for industrial action in the National Health Service in England
Authors: Hansen Martin Ejnar , Pickering Steven David
Published: March 2024

This paper explores public sentiment towards strike action among healthcare workers, as a result of their perceived inadequate pay. By analysing survey data collected in England between 2022 and 2023, the study focuses on NHS nurses and junior doctors, due to their critical role in delivering essential public services. Results indicate higher public support for strikes by nurses and junior doctors compared to other professions such as postal workers, teachers, rail workers, airport workers, civil servants and university lecturers. However, variation in support for strikes by healthcare workers is observed across societal segments. Significant disparities in support are linked to individual political affiliations, left–right ideological positions and trust in the NHS. In short, nonconservative voters, individuals leaning towards left‐wing politics and those with greater trust in the NHS demonstrate higher likelihoods of supporting strikes by health workers. These findings carry implications for future strike decisions and highlight specific target groups for enhanced communication efforts to garner increased public support.