bluuebunny/crossref_metadata_2025 huggingface dataset:
A Women's Health Issue?: Framing Post‐Abortion Syndrome in the 1980s
Authors: Moran Rachel Louise
Published: August 2021

In the 1980s, a subset of anti‐abortion activists in the US claimed the existence of ‘post‐abortion syndrome’ (PAS), a mental illness resulting from the trauma of abortion. Appropriating vocabulary from 1970s feminist health activism, these anti‐abortion activists argued against the main goal of that movement, reproductive justice. Instead, conservative and essentialist PAS activists argued ‘aborted women’ needed to take control of their health by telling their stories of victimisation. Using interviews, congressional hearings and contemporary texts, this article uses PAS to discuss tensions over women's mental health amid the 1980s' backlash.
Kidney Transplantation and South African Medical Hierarchies: Nursing Innovations and Inequities, 1960s–1990s
Authors: Horwitz Simonne
Published: August 2021

This article focuses on female kidney transplant nurses, whose contributions, while often overlooked and underappreciated, were critical to the success of transplantation. It reveals that white and, from the 1980s onwards, Black kidney transplant nurses made two central contributions. First, they developed specialised skills in dialysis that were vital to transplant success. Second, through countless hours of close observation of post‐transplant patients, nurses gained confidence and knowledge that enabled them to improve medical and care procedures initially established by medical doctors. At the same time, this article recognises that nurses's contributions were powerfully shaped by inequities of gender, race and language.
Residues of glyphosate in food and dietary exposure
Authors: Vicini John L. , Jensen Pamela K. , Young Bruce M. , Swarthout John T.
Published: August 2021

Glyphosate is the active ingredient in Roundup® brand nonselective herbicides, and residue testing for food has been conducted as part of the normal regulatory processes. Additional testing has been conducted by university researchers and nongovernmental agencies. Presence of residues needs to be put into the context of safety standards. Furthermore, to appropriately interpret residue data, analytical assays must be validated for each food sample matrix. Regulatory agency surveys indicate that 99% of glyphosate residues in food are below the European maximum residue limits (MRLs) or U.S. Environmental Protection Agency tolerances. These data support the conclusion that overall residues are not elevated above MRLs/tolerances due to agricultural practices or usage on genetically modified (GM) crops. However, it is important to understand that MRLs and tolerances are limits for legal pesticide usage. MRLs only provide health information when the sum of MRLs of all foods is compared to limits established by toxicology studies, such as the acceptable daily intake (ADI). Conclusions from dietary modeling that use actual food residues, or MRLs themselves, combined with consumption data indicate that dietary exposures to glyphosate are within established safe limits. Measurements of glyphosate in urine can also be used to estimate ingested glyphosate exposure, and studies indicate that exposure is <3% of the current European ADI for glyphosate, which is 0.5 mg glyphosate/kg body weight. Conclusions of risk assessments, based on dietary modeling or urine data, are that exposures to glyphosate from food are well below the amount that can be ingested daily over a lifetime with a reasonable certainty of no harm.
Ultrasound‐assisted foreign body extraction (U‐SAFE): Review of technique and technical pearls
Authors: White Roland Z , Rezaian Pouria , Parasuramar Amaran , Sampson Matthew J
Published: August 2021

Introduction

Soft tissue foreign bodies are a common presentation to emergency departments and primary care. They have variable presentations and associated morbidity depending on their acuity, location, functional impairment and neurovascular involvement. Traditional removal has utilised blind technique or surgical exploration. Their removal can be difficult secondary to induration, inflammation, granulation and scar tissue. Ultrasonography has emerged as a minimally invasive and inexpensive method of examination and retrieval. This article entails ultrasound‐guided foreign body extraction with associated pearls of experience.

Methods

From March 2017 to August 2020, a fellowship trained interventional radiologist and a fellowship trained musculoskeletal radiologist performed 52 foreign body extractions under ultrasound guidance at a single institution.

Results

52 foreign body extractions occurred over 3‐year time period with a 95% success rate. The most common location of foreign body was the finger (62%) and feet/toes (17%). Foreign bodies identified include wood (31%), plant‐based material (29%), metal (17%), glass (17%) and synthetic material (6%). Two unsuccessful cases were secondary to delayed presentation with significant foreign body reaction and the 2nd due to patient psychiatric issues. There were no identified complications.

Conclusion

Ultrasonography‐guided foreign body extraction is a minimally invasive, efficient and targeted technique for foreign body removal.
Auditing Non‐GAAP Measures: Signaling More Than Intended*
Authors: Anderson Spencer B. , Hobson Jessen L. , Sommerfeldt Ryan D.
Published: August 2021

Many companies regularly disclose non‐GAAP performance measures to communicate firm‐specific information that does not fit within the mold of GAAP reporting. However, these non‐GAAP measures may have low information content or even be misleading to investors. Thus, the question arises of whether auditors should play a larger role in the reporting of non‐GAAP measures, which currently are not audited. We run an experiment to provide ex ante evidence on the effect of auditing non‐GAAP measures. Specifically, we present investor‐participants with a non‐GAAP measure that should be used when making investment judgments (more informative) or should not be used when making investment judgments (less informative) and is either audited or is not audited. As predicted, we find that, when participants view a non‐GAAP measure that is more informative, they appropriately use the non‐GAAP measure in their investment‐related judgments, regardless of whether the measure is audited. However, also as predicted, we find that, while participants appropriately do not use a less informative non‐GAAP measure when it is not audited, participants inappropriately do use the less informative non‐GAAP measure in their investment‐related judgments when it is audited. Mediation results provide evidence consistent with audits affecting investors' reliance on non‐GAAP measures. Specifically, our results are consistent with audits of non‐GAAP measures signaling more than is intended, evidenced by investors perceiving an audited non‐GAAP measure as being useful in their investment decisions when the measure is less informative to them. Our findings suggest that regulators should exercise caution when it comes to prescribing assurance over non‐GAAP measures.
The influence of retinal oxygen saturation and choroidal volume on postoperative outcomes in patients with epiretinal membrane
Authors: Weigert Günther , Georgopoulos Michael , Buehl Wolf , Maccora Katia , Aliyeva Leyla , Steiner Irene , Schmidt‐Erfurth Ursula , Sacu Stefan
Published: August 2021

Purpose

To investigate the effects of vitrectomy (Vy) with or without same time cataract surgery and membrane plus internal limiting membrane peeling (MP+ILMP) on retinal oxygenation and choroidal volume and their role on postoperative outcome.

Methods

Thirty‐two eyes were included in this prospective clinical study. All patients received 23 gauge Vy+MP+ILMP without endotamponade. Additional cataract surgery was performed in 14 patients. Follow‐up visits were scheduled at day 1, week 1, month 1 and month 3. At each visit, best corrected visual acuity (BCVA) using ETDRS charts (except at day 1), oxygenation of retinal vessels using the Oxymap T1, and optical coherence tomography (OCT, Heidelberg Spectralis) was performed.

Results

Mean BCVA increased significantly from 73 ± 11 letters to 77 ± 7 letters at month 3 (p = 0.02). Mean central retinal thickness (CRT) decreased from 456 ± 84 µm at baseline to 418±58µm (p = 0.01 baseline versus month 3). In the cataract surgery group, CRT was higher at month 3 than in the group without (400 ± 58 µm versus 441 ± 51 µm; p = 0.007). There was no statistically significant difference in choroidal volume or oxygenation of retinal vessels between groups (additional cataract surgery versus vitrectomy alone). Oxygenation of retinal arteries tended to decrease at day 1 followed by an increase, but the changes did not reach the level of significance (p = 0.29 baseline versus month 3). Oxygenation of retinal veins increased significantly (p = 0.02 baseline versus month 1; p = 0.04 baseline versus month 3, accordingly). There was a significant negative correlation (Spearman correlation coefficient rs = −0.35, p = 0.047) between visual acuity and oxygenation of retinal veins at month 3. No statistically significant correlation was found between CRT and oxygenation of neither retinal arteries nor veins. Choroidal volume (CV) of the central mm did not change significantly during the study period (baseline: 0.203 ± 0.04 mm3, median: 0.206, month 3: 0.205 ± 0.04 mm3, p = 0.54). There was no statistically significant effect of choroidal volume at baseline on postoperative clinical outcomes (change in BCVA estimate [95% CI]: 7 [−76; 90], p = 0.86; change in CRT: 147 [−577; 871], p = 0.68).

Conclusion

Oxygen saturation may affect the visual acuity outcome but not the CRT in patients after vitrectomy for epiretinal membrane. Choroidal thickness had no statistically significant influence on the study outcomes. Further studies are needed to evaluate if the measurement of retinal oxygenation may be helpful in the decision for surgery.
Taspine is a natural product that suppresses P2X4 receptor activity via phosphoinositide 3‐kinase inhibition
Authors: Nadzirin Izzuddin Bin , Fortuny‐Gomez Anna , Ngum Neville , Richards David , Ali Seema , Searcey Mark , Fountain Samuel J.
Published: August 2021

Background and Purpose

P2X4 is a ligand‐gated cation channel activated by extracellular ATP involved in neuropathic pain, inflammation and arterial tone.

Experimental Approach

Natural products were screened against human or mouse P2X4 activity using fura‐2 loaded 1321N1 cells for measurement of intracellular Ca2+ responses. Whole‐cell currents were measured by patch clamp. Human primary macrophage chemokine release was used to assess effect of taspine on inflammatory cell function. An enzymatic assay was performed to assess the effect of taspine on recombinant PI3‐kinase.

Key Results

A natural product screen identified taspine as an inhibitor of human P2X4 activity. Taspine inhibits human and mouse P2X4‐mediated Ca2+ influx in 1321N1 cells expressing receptors but lacked activity at human P2X2, P2X3, P2X2/3 and P2X7 receptors. Taspine inhibited the maximal response at human and mouse P2X4 but effective on ATP potency. Taspine has a slow onset rate (~15 min for half‐maximal inhibition), irreversible over 30 min of washout. Taspine inhibits P2X4‐mediated Ca2+ signalling in mouse BV‐2 microglia cells and human primary macrophage. Taspine inhibited P2X4‐mediated CXCL5 secretion in human primary macrophage. Taspine reversed ivermectin‐induced potentiation of P2X4 currents in 1321N1 stably expressing cells. The PI3‐kinase inhibitor LY294002 mimicked the properties of taspine on P2X4‐mediated Ca2+ influx and whole‐cell currents. Taspine directly inhibited the enzymatic activity of recombinant PI3‐kinase in a competitive manner.

Conclusion and Implications

Taspine is a novel natural product P2X4 receptor inhibitor, mediating its effect through PI3‐kinase inhibition rather than receptor antagonism. Taspine can inhibit the pro‐inflammatory signalling by P2X4 in human primary macrophage.
The flavonoid Astragalin shows anti‐tumor activity and inhibits PI3K/AKT signaling in gastric cancer
Authors: Wang Zhongqing , Lv Jian , Li Xiufang , Lin Qing
Published: August 2021

Gastric cancer is a common malignant cancer, which is one of the most affected cancers by PI3K/AKT signaling. Here, we investigated the anti‐tumor role of Astragalin, a natural flavonoid compound, in gastric cancer and explored the underlying molecular mechanism. Three well‐established gastric cancer cell lines and xenograft mouse model were used to examine the anti‐tumor effect of Astragalin by using CCK‐8, transwell assays, and Western blot. Tumor burden of xenograft mice with Astragalin administration was monitored and determined during and at end of the experiments. Astragalin could effectively inhibit cell viability of gastric cancer cells and possessed good anti‐tumor activity in xenograft mice. In addition, astragalin induced the expression of apoptotic signaling proteins, suppressed the migration and invasion cancer cells, and inhibited the PI3K/AKT signaling pathway significantly. In contrast, epidermal growth factor stimulation was able to block the anti‐tumor activity of Astragalin. In conclusion, astragalin exerts its anticancer activities through inhibiting PI3K/AKT signaling, which highlights its potential for the treatment of gastric cancer.
Nonthrombotic internal jugular venous stenosis may facilitate cerebral venous thrombosis
Authors: Wu Xiaoqin , Ya Jingyuan , Zhou Da , Ding Yuchuan , Ji Xunming , Meng Ran
Published: August 2021

Aims

To explore the effect of nonthrombotic internal jugular venous stenosis (IJVS) exerted on cerebral venous thrombosis (CVT).

Methods

Patients with imaging confirmed CVT were enrolled into this real‐world case–control study consecutively from January 2018 through April 2021, and were divided into CVT and IJVS‐CVT groups, according to whether or not with non‐thrombotic IJVS. Chi‐square and logistic regression models were utilized for between‐group comparison of thrombotic factors.

Results

A total of 199 eligible patients entered into final analysis, including 92 cases of CVT and 107 cases of IJVS‐CVT. Chi‐square revealed that thrombophilic conditions were found in majority of CVT, while only minority in the IJVS‐CVT group (83.7% vs. 20.6%, p < 0.001). Multivariate logistic regression indicated that most identified thrombophilia were negatively related to IJVS‐CVT (all p < 0.05), including oral contraceptive use (β = −1.38), hyperhomocysteinemia (β = −1.58), hematology (β = −2.05), protein C/S deficiency (β = −2.28), connective tissue disease (β = −1.18) and infection (β = −2.77). All recruited patients underwent standard anticoagulation, 10 cases in IJVS‐CVT group also received jugular angioplasty for IJVS correction. Most participants obtained alleviations during 1‐year follow‐up. However, both clinical and imaging outcomes in IJVS‐CVT group were not as good as those in CVT group (both p < 0.05). Moreover, 8 cases with CVT and 7 cases with IJVS‐CVT were rehospitalized for CVT recurrences and underwent customized treatment.

Conclusion

Nonthrombotic IJVS may be one of the risk factors of CVT. Anticoagulation might need to be suggested for IJVS patients.
Mismatch between bird species sensitivity and the protection of intact habitats across the Americas
Authors: Cazalis Victor , Barnes Megan D. , Johnston Alison , Watson James E. M. , Şekercioğlu Cagan H. , Rodrigues Ana S. L.
Published: August 2021

Protected areas are highly heterogeneous in their effectiveness at buffering human pressure, which may hamper their ability to conserve species highly sensitive to human activities. Here, we use 60 million bird observations from eBird to estimate the sensitivity to human pressure of each bird species breeding in the Americas. Concerningly, we find that ecoregions hosting large proportions of high‐sensitivity species, concentrated in tropical biomes, do not have more intact protected habitat. Moreover, 266 high‐sensitivity species have little or no intact protected habitat within their distributions. Finally, we show that protected area intactness is decreasing faster where high‐sensitivity species concentrate. Our results highlight a major mismatch between species conservation needs and the coverage of intact protected habitats, which likely hampers the long‐term effectiveness of protected areas at retaining species. We highlight ecoregions where protection and management of intact habitats, complemented by restoration, is urgently needed.
Efficient detection of Parkinson's disease using deep learning techniques over medical data
Authors: Sahu Lipsita , Sharma Rohit , Sahu Ipsita , Das Manoja , Sahu Bandita , Kumar Raghvendra
Published: August 2021

Parkinson's disease is a degenerative disease that leads to brain disorder and nonfunctioning of different body parts. Deep learning tools like artificial neural network (ANN), convolution neural network (CNN), regression Analysis (RA), and so on, has been considered to a great extent in recent days. Several data sets based on the motor and nonmotor symptoms are applied to different classifier for correct identification of Parkinson's patient from healthy people. In this paper, hybridization of two deep learning tools such as, RA and ANN are done for effective diagnosis of the disease by probability estimation. The communal merits of individual approaches of the existing approaches are realized in this context for accurate probability estimation. Data preprocessing and probability estimation of preprocessed data is done in RA. The second existing approach is used to identify the PD patient by comparing with a predefined threshold value of a neuron. The estimation is performed on the data set of speech recognition, iron content, and pulse rate among a group of people. The proposed approach is compared with the existing approaches like, SVM and k‐NN classifier. The computed result reveals the superiority of the proposed algorithm with 93.46% accuracy.
Fishing for health: Do the world’s national policies for fisheries and aquaculture align with those for nutrition?
Authors: Koehn John Zachary , Allison Edward H , Villeda Karen , Chen Zelin , Nixon Marisa , Crigler Emily , Zhao Lily , Chow Michelle , Vaitla Bapu , Thilsted Shakuntala H , Scholtens Joeri , Hicks Christina C , Andrew Neil
Published: August 2021

Aquatic foods are rich in micronutrients essential to human health, and fisheries and aquaculture are increasingly recognized for their capacity to contribute to reducing global micronutrient deficiencies and diet‐based health risks. Whether fisheries and aquaculture sector and public health nutrition policies align to meet this goal, however, is unclear. Do fisheries and aquaculture policies have explicit nutrition and public health objectives? Do public health nutrition policies recognize the contribution of aquatic foods? Using content analysis, we assessed the alignment of objectives in national fisheries and public health nutrition policies. We further determined conditions associated with varying levels of cohesion among policies in these sectors or domains. We found that 77 of 158 national fisheries policies identified nutrition as a key objective in the sector, and 68 of 165 public health nutrition policies identified the importance of fish and shellfish consumption as key objectives. More recent policies were associated with improved coherence among sectors. International organization presence in policy development was also associated with greater coherence. Countries with higher overweight prevalence had fisheries and public health nutrition policies that were not aligned. There has been a promising recent trend for improved alignment of objectives between fisheries and public health nutrition policies, but more targeted and systematic policy approaches are needed to realize the potential contribution of nutrient‐rich fish and shellfish to healthier food systems.
Soil pH determines bacterial distribution and assembly processes in natural mountain forests of eastern China
Authors: Ni Yingying , Yang Teng , Ma Yuying , Zhang Kaoping , Soltis Pamela S. , Soltis Douglas E. , Gilbert Jack A. , Zhao Yunpeng , Fu Chengxin , Chu Haiyan
Published: August 2021

Aim

There have been numerous studies of forest‐soil microbial biogeography, but an integrated view of edaphic factors, plant, climatic factors, and geographic distance in determining the variation of bacterial community and assembly processes remains unclear at large spatial scales. Here, we analysed the factors affecting the biogeographic pattern and assembly processes of soil bacterial communities under 58 tree species in five natural mountain forests.

Location

Eastern China.

Major taxa studied

Bacterial communities.

Methods

Hierarchical partitioning analysis and distance decay models were performed to evaluate the relative contributions of plant phylogeny, environmental, and spatial variables to the composition of bacterial communities. We applied the nearest taxon index (NTI), β‐nearest taxon index (βNTI), and the modified Raup–Crick metric to reveal the mechanisms of bacterial assembly processes.

Results

We found that plant phylogeny accounted for a significant, but minor, fraction (0.7%) of the variation in composition of bacterial communities. In contrast, soil pH was the primary determinant of bacterial diversity and community composition, independently explaining 68.6 and 69.9% of the variation, respectively. Based on the NTI analysis, bacterial community assembly was more phylogenetically clustered with increasing soil pH. Variable selection was the predominant process explaining bacterial community assembly when differences in soil pH were ≥ 0.83, whereas homogenizing dispersal dominated when differences in soil pH were <0.83. However, there was no significant relationship between plant phylogenetic distance and βNTI.

Main conclusions

Our findings provide strong evidence that soil pH predominantly determines bacterial distribution and mediates the relative impact of stochasticity and determinism in soil bacterial community assembly. This suggests that climate‐change associated forest soil acidification could have a dramatic impact on soil bacterial diversity, composition, and function.
The common good and academic freedom in Poland
Authors: Szadkowski Krystian , Krzeski Jakub
Published: August 2021

This article addresses the inadequacy of the universal approach to academic freedom, which fails to account for the extent to which academic freedom can be exercised. Instead of considering the fixed meaning of academic freedom, the article proposes a relational approach. One that focuses on the relation between academic freedom and the common good, as particular articulations of academic freedom are legitimized through reference to the quasi‐universal concept of the common good. To ground this argument, the article examines different historical meanings of the idea of the common good in the relations between the state and the university sector in Poland, and the effect they had on the content and extent of academic freedom. In doing so, it contributes to the discussion on the cultural and national specificities of both academic freedom and the common good.
Hypertension among Mongolian adults in China: A cross‐sectional study of prevalence, awareness, treatment, control, and related factors
Authors: Yu Peiyao , Ning Yuzhen , Gao Yumin , Zhao Yanping , Tie Lin , Wu Lijitu , Zhang Lili , Zhang Ru , Cui Meng , Pang Hui , Wu Qian , Wang Zhidi , Chen Le , Zhao Lingyan
Published: August 2021

The objectives of the study were to comprehend the prevalence of hypertension (HTN) and prehypertension (PHT), awareness, treatment, and control of HTN and its distribution in urban, agricultural, pastoral, and semi‐agricultural/semi‐pastoral areas, and to explore the related factors of HTN among Mongolian adults in China. From August 2018 to August 2020, a multi‐stage stratified cluster random sampling method was conducted to investigate the prevalence of HTN among Mongolian adults aged ≥18 years living in China (n = 2558). Inclusion criteria for HTN were systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg and/or had hypertensive history and/or taking antihypertensive drugs for HTN. The prevalence rates of HTN and PHT were 44.77% and 32.03%, respectively. The prevalence rates of PHT in urban, agricultural, pastoral, and semi‐agricultural/semi‐pastoral areas were 34.93%, 34.73%, 26.03%, and 33.44%, respectively, and the prevalence rates of HTN were 35.97%, 40.15%, 49.68%, and 48.07%, respectively. The awareness, treatment and control rates of HTN were 66.48%, 58.93%, and 16.48%, respectively. In this survey, the overweight, obesity, and central obesity rates were 34.30%, 30.67%, and 58.08%, respectively. Compared with Chinese adults ≥18 years, the prevalence rate of HTN among Mongolian adults in China aged ≥ 18 years was relatively high; the prevalence rate of PHT and HTN awareness, treatment, and control rates were similar. The prevalence of HTN and the rates of obesity and central obesity were higher in pastoral regions than in the other three types of regions, and the rate of overweight was highest in agricultural regions.
Seasonal differences in hypothalamic thyroid‐stimulating hormone β, gonadotropin‐releasing hormone‐I and deiodinase expression between migrant and resident subspecies of white‐crowned sparrow (Zonotrichia leucophrys)
Authors: Pérez Jonathan H. , Krause Jesse S. , Bishop Valerie R. , Reid Angus M. A. , Sia Michael , Wingfield John C. , Meddle Simone L.
Published: August 2021

Across taxa, the seasonal transition between non‐breeding and breeding states is controlled by localised thyroid hormone signalling in the deep brain via reciprocal switching of deiodinase enzyme expression from type 3 (DIO3) to type 2 (DIO2). This reciprocal switch is considered to be mediated by increasing thyroid‐stimulating hormone β (TSHβ) release from the pars tuberalis, which occurs in response to a change in photoperiod. Although well characterised in a handful of model organisms in controlled laboratory settings, this pathway remains largely unexplored in free‐living animals under natural environmental conditions. In this comparative gene expression study, we investigated hypothalamic thyroid hormone signalling in two seasonally breeding subspecies of white‐crowned sparrow (Zonotrichia leucophrys), across the entirety of their annual cycles. The migratory Gambel's (Z.l.gambelii) and resident Nuttall's (Z.l.nuttalii) subspecies differ with respect to timing of reproduction, as well as life history stage and migratory strategies. Although DIO3 mRNA expression was elevated and DIO2 mRNA expression was reduced in the wintering period in both subspecies, DIO2 peaked in both subspecies prior to the onset of reproduction. However, there was differential timing between subspecies in peak DIO2 expression. Intriguingly, seasonal modulation of TSHβ mRNA was only observed in migrants, where expression was elevated at the start of breeding, consistent with observations from other highly photoperiodic species. There was no correlation between TSHβ, DIO2 and gonadotropin‐releasing hormone‐I mRNA or reproductive metrics in residents. Based on these observed differences, we discuss potential implications for our understanding of how changes in medial basal hypothalamic gene expression mediates initiation of seasonal reproduction.
Effectiveness of mHealth–Safe Kids Hospital for the prevention of hospitalized children safety incidents: A randomized controlled trial
Authors: Park Il Tae , Oh Won‐Oak , Jang Gwang‐Cheon , Han Jihee
Published: August 2021

Background

Preschool‐age children in hospitals are at a high risk of unexpected incidents. Safety incidents in hospitals can cause serious damage to the children.

Objective

To determine the effectiveness of the mobile‐type mHealth Safe Kids Hospital (SKH) application (app) for the prevention of hospitalized child safety incidents.

Design

This study used a three‐group, randomized controlled trial pre‐post design.

Setting(s)

This study was conducted in the pediatric ward of three general hospitals in Korea.

Participants

A total of 124 eligible hospitalized children and their caregivers were enrolled in the study from June to December 2018. Of these, 116 finally participated in the study, and 8 were excluded because they were discharged before the intervention.

Methods

Hospitalized preschool‐age children and their caregivers were randomly allocated into three groups: experimental group I (n = 39), experimental group II (n = 39), and the control group (n = 38). Experimental group I received the SKH app intervention, the experimental group II received a paper‐based intervention, whereas the control group received the usual intervention. Participants’ outcomes of awareness, knowledge, and behavior related to hospital safety, were assessed at two time points: baseline and 24 h after the intervention.

Results

Hospital safety awareness had a higher increase after intervention in experimental groups I and II than in the control group. Among the four subdomains of hospital safety awareness, there was a significant increase in the scores of experimental group I on three subdomains after the intervention: falls (F = 8.19, p < 0.001), burns (F = 6.73, p = 0.002), and medical devices (F = 6.81, p = 0.002). In hospital safety knowledge and safety behavior, experimental group I had the highest average score after the intervention compared with experimental group II and the control group; however, there was no statistically significant difference in the average score of the three groups.

Conclusions

Using the SKH app is easy to attract the interest of preschool‐age children and is also easy for nurses to use in clinical trials; thus, it is considered to be a useful educational intervention to prevent safety incidents in clinical fields in future.

Clinical Relevance

It is thought to contribute to the prevention of preschool‐age children's safety incidents in pediatric wards.
Influencing factors of resource utilisation in haemodialysis patients—Based on socioecological pyramid model
Authors: Yao Xiao‐Yue , Wang Yan , Liu Zhun‐Ji , Li Yu‐Qin , Fan Xiao‐Li
Published: August 2021

Aims and objectives

To describe the current situation and analyse influencing factors of resource utilisation in maintenance haemodialysis patients.

Background

The self‐management level of patients undergoing maintenance haemodialysis in China is low. The applicability of the Chronic Illness Resources Survey in Chinese maintenance haemodialysis patients has been validated, and this survey can be used to assess the utilisation of self‐management support resources among haemodialysis patients. Determining the influencing factors of resource utilisation can help improve the self‐management behaviour of haemodialysis patients and control the progression of the disease.

Design

A descriptive study design was chosen.

Methods

A convenience sample of 314 patients undergoing haemodialysis was recruited from dialysis centres in three hospitals in western Xinjiang from June 2018–April 2019. SPSS19.0 software was used to describe the current situation of resource utilisation. Moreover, t test, analysis of variance and multivariate linear regression were applied to explore the influencing factors of patients’ resource utilisation. Standards for observational studies STROBE Statement checklist‐v4 were chosen on reporting the study process.

Results

The average score of the total resource utilisation was 2.95 ± 0.51. The average item score of seven dimensions from high to low was 3.46 for medical staff, 3.32 for personal, 3.22 for family and friends, 3.16 for work‐related, 3.12 for media policy, 2.55 for neighbourhood/community and 2.23 for organisation. Multiple linear regression showed that there have six main factors, which explained 65.4% of the variance of haemodialysis patients’ resource utilisation.

Conclusions

The personal, family and friends, work and media and policy subscales were rated the highest, with support from neighbourhood/community and organisation rated the lowest. In general, participants perceived moderate levels of support. Government and healthcare team should pay more attention on haemodialysis patients who had low level of education, poor economic conditions and poor mental condition.

Relevance to clinical practice

ESRD has caused a burden on healthcare expenditure and has become a critical public health problem worldwide. Self‐management is particularly important for dialysis patients which have attracted extensive interest. In the future research, we can use this questionnaire to evaluate the related resources of disease management of dialysis patients, encourage patients to make full use of the resources around them and focus on those patients with low education and monthly income level and bad mental state.
Genetic variants of HOTAIR are associated with susceptibility to recurrent spontaneous abortion: A preliminary case–control study
Authors: Salimi Saeedeh , Sargazi Saman , Heidari Nia Milad , Mirani Sargazi Fariba , Ghasemi Marzieh
Published: August 2021

Aim

To investigate the association between Hox transcript antisenses RNA (HOTAIR) polymorphisms, rs12826786 C/T, rs920778 T/C, rs4759314 A/G, and rs1899663 G/T, with recurrent spontaneous abortion (RSA) susceptibility in the Iranian women.

Methods

We enrolled 161 patients diagnosed with RSA and 177 healthy women with at least one live birth without a history of abortion. Genotyping of HOTAIR polymorphisms was carried out using both restriction fragment length polymorphism‐polymerase chain reaction and amplification refractory mutation system‐polymerase chain reaction methods. Odds ratios (ORs) with 95% confidence intervals (CIs) were assessed to estimate the strength of association.

Results

Different inheritance models of rs12826786 C/T, rs920778 T/C, and rs1899663 G/T polymorphisms significantly enhanced the risk of RSA (p < 0.05), whereas the rs4759314 A/G polymorphism was correlated with diminished risk of developing RSA under recessive AA versus GA + GG (OR 0.42 [95% CI = 0.19–0.91]), log‐additive GG versus GA vs. GG (OR 0.67 [95% CI = 0.48–0.93]), and allelic A versus G (OR 0.65 [95% CI = 0.47–0.92]) models. Moreover, the TGTC, TTCT, TTTC, CGTC, CGTT, CTCC, CTCT, CTTC, and CTTT haplotypes of rs920778/rs1899663/rs12826786/ significantly increased the risk of RSA. The studied variants were not in strong linkage disequilibrium.

Conclusions

Our results indicated that variations in the HOTAIR gene might serve as beneficial biomarkers for determining susceptibility to RSA. To confirm these findings, replication studies with a larger population and different races are needed.
Elementary School Personnel and Cultural Factors Affecting Health Education Implementation in the High‐Stakes Testing Era*
Authors: Boguslawski Melissa K. , Lohrmann David K. , Sherwood‐Laughlin Catherine , Eckes Suzanne , Chomistek Andrea K. , Applegate Trent
Published: August 2021

BACKGROUND

Despite proven health and learning benefits, health education implementation in elementary schools is not optimal. This study investigated learning environment, leadership, and training factors that may influence elementary‐level health education implementation in the current standardized testing‐saturated environment.

METHODS

Survey data were collected from principals of 8 Michigan elementary schools and, via focus groups, 30 teachers in their schools. Teacher groups were separated into 2 categories based on principals' understanding of state health education policies. Grounded theory analysis was used.

RESULTS

Despite all 30 teachers' positive attitudes toward health education, numerous consistent implementation barriers were identified; competition for instructional time with tested subjects was most critical. Teachers with principals who indicated a greater understanding of state policies reported more: consistent instruction; availability of resources, and encouragement to teach select topics, especially mental health.

CONCLUSION

That these findings were produced in a state with strong CSHE polices, proven curricula, and expansive support systems are disheartening and accentuate the profound impact of standardized testing on elementary‐level health education implementation. More promising, principals' understanding of applicable state‐level policies appeared to generate stronger health education implementation. Future research should focus on the possible impact of time devoted to health instruction on standardized test scores.
Rationalised premedication practice for blood product transfusions: A single‐centre quality initiative
Authors: Grant Andrew M , Wright Felicity A , O'Brien Tracey A
Published: August 2021

Aim

Blood and platelets are scarce resources that are an essential part of the supportive care for paediatric cancer patients. There are many inherent risks involved with transfusions including acute transfusion reactions (ATRs). Following an initial ATR, prophylactic medications are commonly given prior to subsequent transfusions. However, there are risks with medication administration as well as negative implications for the health system. Our aim was to prevent the automatic prescribing of premedications prior to blood and platelet transfusions for ATRs. We hypothesised this would not increase the risk of harm.

Methods

Our intervention was to eliminate automatic prescribing of intravenous corticosteroids and intravenous promethazine prior to a transfusion. This was approached through a behaviour change model and the implementation of recommended prescribing guidelines. Three Plan Do Study Act (PDSA) cycles refined the guidelines to align with clinicians' needs and build support through co‐design. Data gathered on individual patients receiving transfusions and reaction rates during the trial were compared to international data.

Results

A total of 100 patients received a transfusion during the trial. Eleven patients either had a previous reaction or experienced their first reaction during this time. All patients followed the guidelines and had either no premedication or an oral antihistamine premedication. There were no breakthrough reactions using oral antihistamines. The overall reaction rate was 1.33%, which aligns with the reported data on ATRs internationally.

Conclusion

A restricted prescribing approach to pharmaceutical cover prior to blood and platelet transfusions can be implemented effectively in a paediatric cancer population, without an increase in the risk of harm to the patients.
Can the concept of nutrient density be useful in helping consumers make informed and healthier food choices? A mixed‐method exploratory approach
Authors: Spiro Ayela , Wood Victoria
Published: August 2021

Poor dietary patterns are major risk factors for chronic diseases and pose a challenge to public health. Strategies to achieve dietary improvement are likely to be complex and multifactorial, but of interest is whether the concept of nutrient density, paying attention to intakes of multiple essential nutrients within appropriate energy balance, could be a worthwhile approach, and whether this could help in the communication of healthier dietary patterns to consumers. In order to explore the concept further, a mixed‐methods market research approach was undertaken, using in‐depth interviews and surveys with consumers and nutrition professionals. This produced some rich insights into the way consumers perceive the nutrient quality of their diets. There was a notable desire amongst both groups to support a move away from concentrating on single nutrients and calories to a broader, more holistic approach that incorporates some of the positive nutritional aspects of foods. Overall, the concept of nutrient density was recognised as a helpful tool in describing healthier foods and nutritional quality. However, the actual term ‘nutrient density’ is unfamiliar to consumers, and communicating nutrient density to consumers who have different understandings, beliefs and motivations may be challenging. Further research is needed to identify how to best frame the concept in a way that resonates with consumers and facilitates dietary behaviour change.
Medical Research Council Hot Topic workshop report: Planning a UK Nutrition and Healthy Life Expectancy Trial
Authors: Carter Jennifer , Mathers John , Fairweather‐Tait Susan , Jebb Susan , Sattar Naveed , Jennings Amy , Minihane Anne‐Marie
Published: August 2021

There is a drive in the UK to harness findings from novel fundamental and efficacy nutritional research and, through inter‐disciplinary and multi‐agency collaborations, to improve eating behaviour for the benefit of population health. This report summarises the progress made during the Medical Research Council‐funded Hot Topic workshop on the planning for a potential UK‐wide nutrition primary prevention randomised controlled trial with incident disease as the study endpoint: the UKNutrition and HealthyLifeExpectancy (NuLifE)Trial. Through two workshops, along with online discussions and a systematic evidence synthesis, over 40 experts from a range of disciplines came together over 6 months. The workshop reached a consensus and delivered a three‐stage plan with the ultimate ambitious aim of providing effective eating behaviour change strategies to address the growing inequalities in the UK and contribute to both a reduced risk of prevalent diet‐related chronic disease and an increase in healthy life expectancy.
Nursing violent patients: Vulnerability and the limits of the duty to provide care
Authors: Dunsford Jennifer
Published: August 2021

The duty to provide care is foundational to the nursing profession and the work of nurses. Unfortunately, violence against nurses at the hands of recipients of care is increasingly common. While employers, labor unions, and professional associations decry the phenomenon, the decision to withdraw care, even from someone who is violent or abusive, is never easy. The scant guidance that exists suggests that the duty to care continues until the risk of harm to the nurse is unreasonable, however, “reasonableness” remains undefined in the literature. In this paper, I suggest that reasonable risk, and the resulting strength of the duty to provide care in situations where violence is present, hinge on the vulnerability of both nurse and recipient of care. For the recipient, vulnerability increases with the level of dependency and incapacity. For the nurse, vulnerability is related to the risk and implications of injury. The complex interplay of contextual vulnerabilities determines whether the risk a nurse faces at the hands of a violent patient is reasonable or unreasonable. This examination will enhance our understanding of professional responsibilities and can help to clarify the strengths and limitations of the nurse's duty to care.
Auxin and its role in plant development: structure, signalling, regulation and response mechanisms
Authors: Gomes G. L. B. , Scortecci K. C.
Published: August 2021

Auxins are plant hormones that play a central role in controlling plant growth and development across different environmental conditions. Even at low concentrations, auxins can regulate gene expression through specific transcription factors and proteins that are modulated to environmental responses in the signalling cascade. Auxins are synthesized in tissues with high cell division activity and distributed by specific transmembrane proteins that regulate efflux and influx. This review presents recent advances in understanding the biosynthetic pathways, both dependent and independent of tryptophan, highlighting the intermediate indole compounds (indole‐3‐acetamide, indole‐3‐acetaldoxime, indole‐3‐pyruvic acid and tryptamine) and the key enzymes for auxin biosynthesis, such as YUCs and TAAs. In relation to the signalling cascade, it has been shown that auxins influence gene expression regulation by the connection between synthesis and distribution. Moreover, the molecular action of the auxin response factors and auxin/indole‐3‐acetic acid transcription factors with the F‐box TIR1/AFB auxin receptors regulates gene expression. In addition, the importance of microRNAs in the auxin signalling pathway and their influence on plant plasticity to environmental fluctuations is also demonstrated. Finally, this review describes the chemical and biological processes involving auxins in plants.
Effects of zinc application on the growth and photosynthetic characteristics of pecan at the seedling stage
Authors: Liu J.‐P , Deng Q.‐J. , Shang Y.‐J. , Yao X.‐W. , Wang H.‐K. , Tang Y.‐J. , Peng F.‐R. , Tan P.‐P.
Published: August 2021

Pecan (Carya illinoinensis) is sensitive to Zn, which is involved in basic physiological and biochemical processes.

To explore the growth and physiology of pecan in response to Zn application, we used 1‐year‐old annual grafted seedlings (Pawnee) and applied four concentrations of Zn fertilizer (0.05, 0.10, 0.20 and 0.40 g·plant−1); a control (CK; no Zn fertilization) was also included. The growth characteristics, anatomical structure of the leaves and photosynthesis were assessed.

Compared with the CK, photosynthesis and chlorophyll (Chl) fluorescence parameters, leaf area and leaf structure significantly increased at Zn concentrations of 0.05 and 0.10 g·plant−1. In addition, growth of pecan at the seedling stage increased in response to moderate Zn application. In contrast, treatment with 0.20 and 0.40 g·Zn·plant−1 dramatically decreased these physiological indices and inhibited pecan growth.

The results show that moderate soil Zn application promotes pecan growth and development by increasing photosynthesis. However excess Zn concentrations were not conducive to seedling growth. The concentration of 0.1 g·Zn·plant−1 was best when considering long‐term soil Zn applications, providing a theoretical foundation for microelement management of pecan.
Inter‐morph pollen flow and reproductive success in a self‐compatible species with stigma‐height dimorphism: the influence of herkogamy and reciprocity
Authors: Ganguly S. , Barua D.
Published: August 2021

Inter‐morph pollen transfer and its dependence on herkogamy and reciprocity are not completely understood in species with stigma‐height dimorphism. We asked whether total stigmatic pollen loads, inter‐morph fraction of pollen load and reproductive success differed between morphs in Jasminum malabaricum, a species exhibiting stigma‐height dimorphism. We tested whether higher herkogamy and reciprocity resulted in higher inter‐morph pollen deposition and reproductive success.

We quantified individual‐level estimates of herkogamy, reciprocity, total stigmatic pollen load, inter‐morph stigmatic pollen fraction and fruit set for both morphs in naturally occurring populations of J. malabaricum.

Total pollen load was higher in the long‐styled morph, inter‐morph pollen fraction was higher in the short‐styled morph, but fruit set did not differ between morphs. Higher herkogamy resulted in a higher inter‐morph fraction of pollen load and fruit set in the long‐styled morph of one population. In the other population, only reciprocity was found to be related to inter‐morph pollen deposition.

This study is the first to quantify and report natural inter‐morph stigmatic pollen load in a species with stigma‐height dimorphism. Morph‐specific differences in pollen load were similar to patterns commonly observed in heterostylous species. The results highlight the importance of both herkogamy and reciprocity in facilitating inter‐morph pollen transfer. Population‐specific patterns indicate that local environmental factors determine the relative functional importance of herkogamy and reciprocity.