bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating tensions when life‐sustaining treatment is withdrawn: A thematic synthesis of nurses' and physicians' experiences
Authors: Choi Hye Ri , Ho Mu‐hsing , Lin Chia‐Chin
Published: February 2024

Aim

To synthesise nurses' and physicians' experiences with withdrawing life‐sustaining treatment in an intensive care unit.

Design

The chosen methodology is thematic synthesis. The Preferred Reporting Items for Systematic Review and Meta‐Analyses and Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement.

Methods and Data Sources

A systematic search is conducted in APA PsycINFO, CINAHL Plus, EMBASE, PubMed and Web of Science following the inclusion and exclusion criteria in April 2023. Two reviewers independently screened and extracted the qualitative data. Subsequently, data analysis was conducted using thematic analysis of qualitative research. This study was not registered with any review registry due to the irrelevance of the data to health‐related outcomes.

Results

From the 16 articles, 267 quotes were extracted and analysed. The findings of the study revealed five analytical themes: (1) tensions between interdependent collaboration and hierarchical roles; (2) tensions between dignified dying or therapeutic perspectives; (3) family members' reflections of patient's wishes; (4) tensions in family members' positions; and (5) double‐sidedness of distress.

Conclusion

This study contributes to nursing knowledge by providing a more nuanced understanding of this complex phenomenon of withdrawing life‐sustaining treatment. The findings of this study have revealed significant variations globally in the practices surrounding the withdrawal of life‐sustaining treatment in intensive care units, emphasising the need for further research to inform clinical practices that cater to diverse contexts.

Reporting Method

Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement (ENTREQ statement).

Patient or Public Contribution

Since this study reported a potential collision between the patient's dignified dying and the family member's perceptions and interests, the family member's wishes should be carefully distinguished from the patient's quality of end of life in practice.
Interventions to address parenting stress among caregivers of children with chronic diseases: An umbrella review
Authors: Yang Jinrong , Gao Yuqin , Wang Weiren , Wang Junyan , Wang Yanjie , Yuan Lulu
Published: February 2024

Background

Caregivers of children with chronic diseases suffer from great parenting pressure, which directly affects the treatment and rehabilitation of children, reduces the quality of life of caregivers and damages family functioning. Existing reviews have not systematically summarized and evaluated interventions for parenting stress in caregivers of children with chronic diseases.

Data Sources

Embase, PubMed, Web of Science, OVID, CNKI, CBM, Wan Fang and Cochrane Library were searched for eligible reviews in November 2021 and October 2022.

Methods

Two reviewers independently screened titles and abstracts, reviewed full texts of articles for eligibility, and appraised the quality of reviews using JBI. The quality of the evidence was assessed using GRADE. Findings are reported in accordance with PRISMA checklist. Narrative summaries grouped findings by intervention types.

Results

Out of 2632 records, we included 21 systematic reviews for a synthesis. Interventions for parenting stress in children with chronic diseases were divided into seven categories. Cognitive behavioural interventions, psychosocial interventions, child behavioural and/or developmental parent interventions and synthesized interventions have shown high‐level evidence in reducing parenting stress for caregivers of children with chronic diseases. Furthermore, outcome measures and intervention protocols were highly heterogeneous across interventions.

Conclusions

This umbrella review suggest that reducing the parenting stress of caregivers of children with chronic diseases can directly target caregivers' parenting stress through cognitive behavioural interventions/psychosocial interventions and/or provide guidance to parents on the behavioural and developmental problems of children with chronic diseases. A more standardized approach to outcome measures is essential to assess efficacy and compare interventions across studies.

Relevance to Clinical Practice

The findings provide information and evidence for reducing parenting stress among caregivers of children with chronic diseases to guide the development of comprehensive intervention strategies.

Patient or Public Contribution

Patient or public contribution does not apply to this study.
Nurses' views on the presence of family members during invasive procedures in hospitalised children: A questionnaire survey
Authors: Ventura Expósito Laia , Arreciado Marañón Antonia , Gomà Tous Mireia , Ferrerons Sánchez Mercè , Zuriguel‐Pérez Esperanza
Published: February 2024

Aims and Objectives

(I) To identify the opinion and practices of nursing professionals regarding the presence of family members during invasive procedures in hospitalised children; (II) to determine the knowledge of nursing professionals about the patient‐and family‐centred care model.

Background

Family presence in invasive procedures benefits the patient and their relatives, but varied attitudes exist among healthcare personnel, with some being favourable and others unfavourable toward family presence.

Design

Observational, descriptive, cross‐sectional study.

Methods

Study population: Nurses from paediatric critical care services, emergency services, hospital wards, day hospitals and outpatient clinics at a Catalan tertiary hospital who participated voluntarily between September 2021 and July 2022. Data collection instrument: A questionnaire prepared by the researchers, based on the literature and reviewed by experts. REDCap link with access to the questionnaire was sent out to potential respondents through the institutional email. Bivariate analysis was performed with the R 4.2 program. The study was approved by the hospital's Clinical Research Committee and participants gave informed consent before responding to the questionnaire.

Results

A total of 172 nurses participated, and 155 valid responses were obtained. All respondents consider the family as a key element in paediatric care and report inviting family members to participate in the care given to their child. However, 12.0% of nurses do not invite the family to be present in invasive procedures. Almost all respondents note the need for training to acquire communication skills and improve the management of emotions.

Conclusions

The results show a favourable opinion towards the presence of family members and highlight the need to train nurses to develop communication skills.

Relevance to clinical practice

The data provided can favour the design of measures to improve and promote the presence of parents during invasive procedures, reinforcing the patient‐and family‐centred care model and improving the quality of care provided. One example is the creation of family care protocols where the inclusion of parents and the roles of each individual involved in the care process appears.
Content analysis of the nursing diagnosis of ineffective peripheral tissue perfusion in patients with diabetic foot
Authors: Fontenele Nascimento Lorrany , Maia Pascoal Lívia , de Oliveira Lopes Marcos Venícios , Santos Neto Marcelino , Arrais Sampaio Santos Francisca Aline , Pereira De Jesus Costa Ana Cristina , Stabnow Santos Floriacy
Published: February 2024

Aim

To analyse the content of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot.

Design

A methodological study with a quantitative approach was performed.

Methods

The analysis was performed between January and May 2021 by 34 nurses with clinical/theoretical/research experience with diabetes or nursing diagnoses. These nurses evaluated the relevance, clarity and precision of 12 diagnosis‐specific etiological factors, 22 clinical indicators and their conceptual and operational definitions.

Findings

All 12 etiological factors analysed were considered relevant to diagnostic identification. However, five showed inconsistencies regarding the clarity or precision of the operational definitions, requiring adjustments. Regarding the 22 clinical indicators evaluated, all of them presented a Content Validity Index (CVI) that was statistically significant. However, in the indicators, the colour does not return to lowered limb after 1 min of leg elevation, and cold foot had Content Validity Index (CVI) <0.9 regarding relevance and accuracy of operational definitions.

Conclusions

Twelve etiological factors and 22 clinical indicators were validated. Thus, this study revealed new and relevant aspects characterising peripheral perfusion in patients with diabetic foot that have not yet been clinically validated.

Implications for Nursing Practice

This study contributes to support the professional practice of nurses through the early identification of etiological factors and clinical indicators in persons with diabetic foot. As a proposal, we suggest the inclusion of new defining characteristics and related factors for the nursing diagnosis ineffective peripheral tissue perfusion in the NANDA‐I taxonomy.

Impact

The research highlights new and relevant aspects such as etiological factors and clinical indicators to characterise peripheral perfusion in patients with diabetic foot. Based on these findings, clinical validation is recommended to confirm the relevance of the proposed elements in the population studied for greater reliability and improved diagnostic assessment for the professional practice of nurses.

Reporting Method

EQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies.

Patient or Public Contribution

No patient or public contribution.
Epigenetics in the diagnosis and prognosis of head and neck cancer: A systematic review
Authors: Lim Isaac , Tan Jade , Alam Anneka , Idrees Majdy , Brenan Peter A. , Coletta Ricardo Della , Kujan Omar
Published: February 2024

Background

Aberrant epigenetic modifications significantly develop and progress human malignancies including head and neck squamous cell carcinoma (HNSCC). Taking into account issues of late diagnosis and poor prognosis associated with HNSCC, this systematic review is designed to provide an up‐to‐date insight of epigenetic changes in the management of HNSCC.

Methods

All studies that assessed the diagnostic and prognostic utilities of epigenetic changes (DNA methylation and histone modifications) among patients diagnosed with HNSCC or oral potentially malignant disorders (OPMDs) were considered for inclusion till June 2023. Pre‐defined Medical Subject Headings terms were used to search Web of Science, Pubmed, Scopus and Embase Ovid databases.

Results

Twenty‐five studies were deemed eligible for inclusion with a total number of 3790 samples (2123 HNSCCs, 334 OPMDs and 1333 as controls). DNA methylation was investigated in 18 studies while the role of histone modifications was assessed in seven studies. The most investigated biomarkers among the studies were H3, DAPK and TIMP3. The diagnostic accuracy of the epigenetic biomarkers in detecting HNSCC was assessed in eight studies where the following biomarkers showed the highest area under the curve values: TIPM3, DCC, DAPK, SEPT9, SHOX9, HOXA9 and TRH. None of the studies assessed the predictability of the epigenetic biomarkers in HNSCC and OPMDs.

Conclusion

Although initial promising results were seen using the epigenetic biomarkers in the early detection of HNSCC, the limited number of patients and the absence of well‐designed longitudinal studies limit the clinical applicability of the outcomes.
Multiperiod peer‐to‐peer risk sharing
Authors: Abdikerimova Samal , Boonen Tim J. , Feng Runhuan
Published: February 2024

Risk sharing has been practiced in various forms in the financial industry. This paper is the first to study both dynamic and static risk‐sharing mechanisms for a group of participants over multiple periods. The design of risk‐sharing strategies is based on the Pareto optimization of quadratic utilities of participants' reserves. Such a framework builds a connection between portfolio optimization in the finance literature and that for risk sharing in the insurance literature. Building on the most common form of reinsurance—pro rata treaties, we propose a peer‐to‐peer (P2P) network for risk sharing. Assuming independent multivariate losses over time, we find that the optimal risk‐sharing allocation exhibits a three‐component structure with the long‐term limit and two correction terms. This allows us to show convergence of the risk‐sharing solution and the ratios of long‐term reserves. Furthermore, we study the impact of actuarial fairness on various risk‐sharing strategies and their long‐term limits.
Dietary supplementation of water extract of Eucommia ulmoides bark improved caecal microbiota and parameters of health in white‐feathered broilers
Authors: Lu Min , Zhao Zhong‐Tao , Xin Ye , Chen Guoxun , Yang Fang
Published: February 2024

Eucommia ulmoides has been used as a food and medicine homologue for a long time in China. We hypothesize that Eucommia ulmoides achieves its health‐promoting effects via altering gut microbiota. Here, we investigated the effects of water extract of Eucommia ulmoides bark on caecal microbiota and growth performance, antioxidant activity, and immunity in white‐feathered broilers treated for 42 days. A total of 108 one‐day‐old Cobb white‐feathered broilers were randomly assigned to three treatment groups: control diet, 0.75% Eucommia ulmoides diet (EU Ⅰ) and 1.5% Eucommia ulmoides diet (EU Ⅱ). The results showed that EU Ⅱ treatment improved average body weight (ABW), thigh muscle quality and total length of intestines, and decreased the serum total triglycerides and total cholesterol (TC) (p < 0.05). Eucommia ulmoides supplementation increased serum superoxide dismutase (SOD), glutathione peroxidase (GSH‐Px), total antioxidant activities and content of immunoglobulins, and reduced levels of malondialdehyde and tumour necrosis factor‐α (TNF‐α) (p < 0.05). Moreover, the supplementation increased the diversity of caecal microbiota and reduced the pathogenic genera Escherichia Shigella and Helicobacter. The genera Ochrobactrum, Odoribater, Klebsiella, Enterobacter, Georgenia and Bifidobacterium were positively associated with the ABW, total intestinal length, serum levels of GSH‐Px, SOD and immunoglobulins (p < 0.001) and negatively associated with the TC and TNF‐α (p < 0.01), suggesting an association of the changes of gut microbiota and improvement of broiler health. Meanwhile, Eucommia ulmoides supplementation enriched the Kyoto Encyclopedia of Genes and Genomes pathway of exocrine secretion from the pancreas, circadian entrainment and inhibited lipopolysaccharide biosynthesis. In conclusion, Eucommia ulmoides water extract can be used as a feed additive to improve poultry industry production.
Effect of paprika extracts on growth performance, haemolymph chemistry, intestinal microbiota and antioxidant enzyme activities of white‐leg shrimp (Litopenaeus vannamei)
Authors: Erfanifar Elnaz , Khoei Zahra Amini , Abolfathi Marzieh , Erfanifar Elahe , Tamadoni Jahromi Saeid , Taee Hadis Mansouri , Pourmozaffar Sajjad
Published: February 2024

This study aims to evaluate the effects of paprika extract on the survival rate, growth performance and stimulation of the innate immune system of Litopenaeus vannamei. In this experiment, 240 healthy shrimp (3.22 ± 0.12 g) were randomly divided into four groups. The shrimp were fed diets with different concentrations of paprika oil extracts (0%, 0.5%, 1% and 2%) for 8 weeks. The results showed that growth performance, urea, uric acid, creatinine, cholesterol levels, aspartate aminotransferase and alkaline phosphatase activities were not significantly affected by adding paprika extract to the shrimp diet (p > 0.05). Diets containing 1% and 0.5% paprika extract showed the highest levels of total protein and triglyceride, respectively (p < 0.05). There was a significant decrease in haemolymph glucose concentration in shrimp‐fed diets containing 1% and 2% paprika extract (p < 0.05). Moreover, a diet containing 0.5% paprika extract resulted in the highest levels of total heamocyte count, hyaline cells and large‐granular cells in shrimp (p < 0.05). Higher catalase and superoxide dismutase activities were also exhibited in the paprika groups (p < 0.05). Vibrio sp. bacteria were not significantly reduced by paprika extract in the intestines of L. vannamei (p > 0.05). A significant decrease in heterotrophic bacteria was observed with increasing extract concentrations (p < 0.05). The shrimp culture industry can utilize paprika extract as a cost‐effective, efficient and environmentally friendly immune stimulant at a concentration of 0.5%.
The global status of human milk banking
Authors: Israel‐Ballard Kiersten , LaRose Emily , Mansen Kimberly
Published: February 2024

Human milk provides essential nutrition for infants and holds many health benefits for infants and mothers. When a mother's own milk is not available for her infant, the World Health Organization recommends feeding donor human milk (DHM) from a human milk banking facility. DHM is human milk produced, collected then donated to a human milk bank (HMB). HMBs serve many vital functions, including screening donor mothers, then collecting, processing, storing, and allocating DHM to recipients. The first HMB opened in 1909, and today there are more than 700 HMBs globally. Unfortunately, HMB facilities are not present in all locales, with notable gaps in South Asia and Africa. Additionally, there are no global standards to guide HMB operational procedures. Even though most HMBs attempt to employ quality control systems to provide safe DHM, differences in community needs, resource availability, and a range of methods and policies to execute processes result in significant variations in DHM quality and HMB operations. Robust and collaborative systems that ensure safe and equitable access to DHM are needed. In this paper, we present a global snapshot of current human milk banking practices; review an interdisciplinary framework to guide and support HMB activities as an integrated part of health and newborn care systems; discuss factors that contribute to HMB sustainability; outline barriers to scaling HMBs worldwide; and highlight knowledge, policy, and research gaps. Developing global HMB guidance and rigorous, adaptable standards would strengthen efforts to improve newborn health.
Virtual‐real‐fusion simulation framework for evaluating and optimizing small‐spatial‐scale placement of cooperative roadside sensing units
Authors: Ma Y. , Zheng Y. B. , Wang S. Y. , Wong Y. D. , Easa S. M.
Published: February 2024

Roadside sensing units’ (RSUs) perception capability may be substantially impaired by occlusion issue even they work cooperatively. However, the joint influence of static and dynamic occlusions in real‐life situations remains inadequately considered in optimizing RSUs’ placement. This study proposes a virtual‐real‐fusion simulation (VRFS) framework that combines traffic simulation and point clouds of real‐world road environment to optimize RSUs’ deployment. Point clouds and triangular meshes are used to model static and dynamic obstacles, respectively. A structure‐retained spherical projection method is developed to efficiently emulate RSUs’ data collection. Based on the developed VRFS, the probabilistic occupancy maps (POM) are created to represent traffic scenarios. The POM‐based cross entropy (CE) is proposed as the surrogate metric for evaluating the detection performance of cooperative RSUs. The Bayesian optimizer is applied to optimize the RSUs’ placement parameters (decision variables) by minimizing CE. Test results show that it is viable to use the POM‐based CE as a proxy for evaluating cooperative RSUs’ sensing performance. Considering the occlusion effect adds to the efficacy of POM‐based CE as a surrogate metric. Compared with traffic volume, the adverse effect of the proportion of large vehicles on RSUs’ detection performance is more significant. There are no significant patterns regarding how the optimized RSU positions vary with traffic parameters. The comparisons with existing methods further verify the importance of considering both static and dynamic occlusions in optimizing RSUs’ placement. Besides, the proposed method can yield better optimization results more efficiently than existing approaches.
Changes in the locus coeruleus during the course of Alzheimer's disease and their relationship to cortical pathology
Authors: Beardmore Rebecca , Durkin Matthew , Zayee‐Mellick Faizan , Lau Laurie C. , Nicoll James A. R. , Holmes Clive , Boche Delphine
Published: February 2024

Aims

In Alzheimer's disease (AD), the locus coeruleus (LC) undergoes early and extensive neuronal loss, preceded by abnormal intracellular tau aggregation, decades before the onset of clinical disease. Neuromelanin‐sensitive MRI has been proposed as a method to image these changes during life. Surprisingly, human post‐mortem studies have not examined how changes in LC during the course of the disease relate to cerebral pathology following the loss of the LC projection to the cortex.

Methods

Immunohistochemistry was used to examine markers for 4G8 (pan‐Aβ) and AT8 (ptau), LC integrity (neuromelanin, dopamine β‐hydroxylase [DβH], tyrosine hydroxylase [TH]) and microglia (Iba1, CD68, HLA‐DR) in the LC and related temporal lobe pathology of 59 post‐mortem brains grouped by disease severity determined by Braak stage (0‐II, III‐IV and V‐VI). The inflammatory environment was assessed using multiplex assays.

Results

Changes in the LC with increasing Braak stage included increased neuronal loss (p < 0.001) and microglial Iba1 (p = 0.005) together with a reduction in neuromelanin (p < 0.001), DβH (p = 0.002) and TH (p = 0.041). Interestingly in LC, increased ptau and loss of neuromelanin were detected from Braak stage III‐IV (p = 0.001). At Braak stage V/VI, the inflammatory environment was different in the LC vs TL, highlighting the anatomical heterogeneity of the inflammatory response.

Conclusions

Here, we report the first quantification of neuromelanin during the course of AD and its relationship to AD pathology and neuroinflammation in the TL. Our findings of neuromelanin loss early in AD and before the neuroinflammatory reaction support the use of neuromelanin‐MRI as a sensitive technique to identify early changes in AD.
The bHLH transcription factor OsPRI1 activates the Setaria viridis PEPC1 promoter in rice
Authors: Carvalho Pedro , Gomes Célia , Gonçalves Ivan , Lourenço Tiago F. , Vlad Daniela , Langdale Jane A. , Saibo Nelson J. M.
Published: February 2024

Photosynthetic efficiency is reduced by the dual role of Rubisco, which acts either as a carboxylase or as an oxygenase, the latter leading to photorespiration. C4 photosynthesis evolved as a carbon‐concentrating mechanism to reduce photorespiration. To engineer C4 into a C3 plant, it is essential to understand how C4 genes, such as phosphoenolpyruvate carboxylase (PEPC1), are regulated to be expressed at high levels and in a cell‐specific manner.

Yeast one‐hybrid screening was used to show that OsPRI1, a rice bHLH transcription factor involved in iron homeostasis, binds to the Setaria viridis PEPC1 promoter. This promoter drives mesophyll‐specific gene expression in rice. The role of OsPRI1 in planta was characterized using a rice line harbouring SvPEPC1pro::GUS.

We show that OsPRI1 activates the S. viridis PEPC1 promoter by binding to an N‐box in the proximal promoter, and that GUS activity is highly reduced in SvPEPC1pro::GUS lines when OsPRI1 is mutated. Cross‐species comparisons showed that the SvPRI1 homolog binds to the SvPEPC1 promoter but the maize ZmPRI1 does not bind to the ZmPEPC1 promoter.

Our results suggest that elements of the iron homeostasis pathway were co‐opted to regulate PEPC1 gene expression during the evolution of some but not all C4 species.
Perceptual representations mediate effects of stimulus properties on liking for music
Authors: Clemente Ana , Kaplan Thomas M. , Pearce Marcus T.
Published: February 2024

Perceptual pleasure and its concomitant hedonic value play an essential role in everyday life, motivating behavior and thus influencing how individuals choose to spend their time and resources. However, how pleasure arises from perception of sensory information remains relatively poorly understood. In particular, research has neglected the question of how perceptual representations mediate the relationships between stimulus properties and liking (e.g., stimulus symmetry can only affect liking if it is perceived). The present research addresses this gap for the first time, analyzing perceptual and liking ratings of 96 nonmusicians (power of 0.99) and finding that perceptual representations mediate effects of feature‐based and information‐based stimulus properties on liking for a novel set of melodies varying in balance, contour, symmetry, or complexity. Moreover, variability due to individual differences and stimuli accounts for most of the variance in liking. These results have broad implications for psychological research on sensory valuation, advocating a more explicit account of random variability and the mediating role of perceptual representations of stimulus properties.
Effects of Grandmothers' Proximity on Mothers' Labour Force Participation*
Authors: Akyol Pelin , Yılmaz Zeynep
Published: February 2024

This paper investigates the causal effects of grandmothers' geographical proximity on labour supply decisions of married women with young children by leveraging a novel data set from Turkey. We deal with the reverse causality and endogeneity problems arising from mothers' and grandmothers' joint location and labour supply decisions by implementing a two‐stage least squares estimation method using the number of alive grandmothers as an instrument. We argue that grandmothers' proximity can increase mothers' labour supply through their free and flexible childcare services. On the other hand, geographically close grandmothers can reduce mothers' labour supply by imposing the traditional gender norms prevalent in Turkey or requiring them to take on elderly caregiving duties. The overall effect depends on the relative size of these opposing factors. Our findings suggest that living in the same neighbourhood as grandmothers increases the probability of labour force participation and the employment rates of women with young children by 18.2 ppt and 16.4 ppt, respectively. These results are mostly driven by the non‐village sample. The ‘traditional gender norm’ channel explains the insignificant impact of grandmothers' proximity on the labour market outcomes of mothers who have been raised in villages.
Older individuals' perspectives on the prerequisites for living at home: A mixed‐methods systematic review
Authors: Ylönen Minna , Stolt Minna , Kohanová Dominika , Suhonen Riitta
Published: February 2024

Introduction

Living at home for as long as possible is a central ageing policy goal. Older individuals usually expect to stay at home, if possible, and their goals regarding living at home generally include holistic wellness, prevention and treatment of ageing effects and the retention of satisfaction. Previous research on older individuals living at home has mostly focused on their physical performance, usually evaluated by healthcare professionals. However, there is limited research on older individuals' identification of the prerequisites for living at home.

Methods

The aim was to identify older individuals' views on the prerequisites for living at home. We conducted a mixed‐methods systematic review with a data‐based convergent design. We carried out a computerized search in MEDLINE (1966 to the end of August 2021) and CINAHL (1982 to the end of August 2021). All types of study designs were included. We evaluated the methodological quality of the included articles.

Results

Of the 1052 articles identified, 28 were eligible. The prerequisites for older individuals to be able to live at home include lifestyle and self‐care capability and physical, psychosocial, environmental and socio‐economic components.

Conclusion

The review provided knowledge that can be used to inform measures for supporting independent at‐home living. Older individuals' perspectives on prerequisites for at‐home living are unique and individually specific. A checklist can be developed to detect individuals' singularity and the strengths and limitations impacting independent living. Therefore, assessments of each older individual's own perspective are needed to better identify the prerequisites for at‐home living.
Revision for Solid‐Body Breakage of the 3D‐Printed Implant Following Joint‐Sparing Surgery: A Technical Note
Authors: Li Zhuangzhuang , Lu Minxun , Gong Taojun , Zhou Yong , Min Li , Luo Yi , Tu Chongqi
Published: February 2024

Background

The advent of three‐dimensional (3D)‐printed custom‐made implants has revolutionized orthopaedic surgery, particularly in limb‐ and joint‐sparing surgeries. However, clinical experience in the revision for 3D‐printed implant breakage is lacking, and the revision surgery remains challenging. This study reported the revision of proximal tibial prosthetic reconstruction necessitated by solid‐body breakage of a 3D‐printed implant, aiming to detail the surgical techniques and evaluate postoperative outcomes.

Case Presentation

A patient diagnosed with osteosarcoma underwent joint‐sparing surgery with a 3D‐printed implant, but implant breakage occurred during subsequent follow‐up. The initial implant was broken into two parts: the proximal implant breakage part (IBP) integrated with the host bone and the distal IBP left in the prosthetic component. Four revision protocols were devised, each based on one of the four hypothesis results of taking out the initial implant. A new custom‐made implant and a series of assistance devices (“positioning devices,” “drill devices,” “tap devices,” and “separator devices”) were specifically prepared for revision surgery. The proximal IBP was taken out from the host bone, but the distal IBP was not taken out from the initial prosthetic component. The patient received the new custom‐made implant for reconstruction, with the knee joint preserved. The patient recovered uneventfully after revision surgery and achieved satisfactory function. The Musculoskeletal Tumor Society was 28 at the last follow‐up. No complications were detected during the follow‐up period.

Conclusion

Comprehensive preoperative planning and preparation, enabling the surgeon to effectively address intraoperative challenges, are crucial for the successful revision of 3D‐printed implant breakage. It is feasible to re‐implant a 3D‐printed custom‐made implant, demonstrating satisfactory clinical and functional results.
A guide to photosynthetic gas exchange measurements: Fundamental principles, best practice and potential pitfalls
Authors: Busch Florian A. , Ainsworth Elizabeth A. , Amtmann Anna , Cavanagh Amanda P. , Driever Steven M. , Ferguson John N. , Kromdijk Johannes , Lawson Tracy , Leakey Andrew D. B. , Matthews Jack S. A. , Meacham‐Hensold Katherine , Vath Richard L. , Vialet‐Chabrand Silvere , Walker Berkley J. , Papanatsiou Maria
Published: February 2024

Gas exchange measurements enable mechanistic insights into the processes that underpin carbon and water fluxes in plant leaves which in turn inform understanding of related processes at a range of scales from individual cells to entire ecosytems. Given the importance of photosynthesis for the global climate discussion it is important to (a) foster a basic understanding of the fundamental principles underpinning the experimental methods used by the broad community, and (b) ensure best practice and correct data interpretation within the research community. In this review, we outline the biochemical and biophysical parameters of photosynthesis that can be investigated with gas exchange measurements and we provide step‐by‐step guidance on how to reliably measure them. We advise on best practices for using gas exchange equipment and highlight potential pitfalls in experimental design and data interpretation. The Supporting Information contains exemplary data sets, experimental protocols and data‐modelling routines. This review is a community effort to equip both the experimental researcher and the data modeller with a solid understanding of the theoretical basis of gas‐exchange measurements, the rationale behind different experimental protocols and the approaches to data interpretation.
Diverging cell wall strategies for drought adaptation in two maize inbreds with contrasting lodging resistance
Authors: Calderone Silvia , Mauri Nuria , Manga‐Robles Alba , Fornalé Silvia , García‐Mir Lluís , Centeno María‐Luz , Sánchez‐Retuerta Camila , Ursache Robertas , Acebes José‐Luis , Campos Narciso , García‐Angulo Penélope , Encina Antonio , Caparrós‐Ruiz David
Published: February 2024

The plant cell wall is a plastic structure of variable composition that constitutes the first line of defence against environmental challenges. Lodging and drought are two stressful conditions that severely impact maize yield. In a previous work, we characterised the cell walls of two maize inbreds, EA2024 (susceptible) and B73 (resistant) to stalk lodging. Here, we show that drought induces distinct phenotypical, physiological, cell wall, and transcriptional changes in the two inbreds, with B73 exhibiting lower tolerance to this stress than EA2024. In control conditions, EA2024 stalks had higher levels of cellulose, uronic acids and p‐coumarate than B73. However, upon drought EA2024 displayed increased levels of arabinose‐enriched polymers, such as pectin‐arabinans and arabinogalactan proteins, and a decreased lignin content. By contrast, B73 displayed a deeper rearrangement of cell walls upon drought, including modifications in lignin composition (increased S subunits and S/G ratio; decreased H subunits) and an increase of uronic acids. Drought induced more substantial changes in gene expression in B73 compared to EA2024, particularly in cell wall‐related genes, that were modulated in an inbred‐specific manner. Transcription factor enrichment assays unveiled inbred‐specific regulatory networks coordinating cell wall genes expression. Altogether, these findings reveal that B73 and EA2024 inbreds, with opposite stalk‐lodging phenotypes, undertake different cell wall modification strategies in response to drought. We propose that the specific cell wall composition conferring lodging resistance to B73, compromises its cell wall plasticity, and renders this inbred more susceptible to drought.
MrERF039 transcription factor plays an active role in the cold response of Medicago ruthenica as a sugar molecular switch
Authors: Fu Jiabin , Zhao Yanyun , Zhou Yan , Wang Yu , Fei Zhimin , Wang Waner , Wu Jiaming , Zhang Feng , Zhao Yan , Li Jiayu , Hao Jinfeng , Niu Yiding
Published: February 2024

Cold stress severely restricts plant development, causing significant agricultural losses. We found a critical transcription factor network in Medicago ruthenica was involved in plant adaptation to low‐temperature. APETALA2/ethylene responsive factor (AP2/ERF) transcription factor MrERF039 was transcriptionally induced by cold stress in M. ruthenica. Overexpression of MrERF039 significantly increased the glucose and maltose content, thereby improving the tolerance of M. ruthenica. MrERF039 could bind to the DRE cis‐acting element in the MrCAS15A promoter. Additionally, the methyl group of the 14th amino acid in MrERF039 was required for binding. Transcriptome analysis showed that MrERF039 acted as a sugar molecular switch, regulating numerous sugar transporters and sugar metabolism‐related genes. In addition, we found that MrERF039 could directly regulate β‐amylase gene, UDP glycosyltransferase gene, and C2H2 zinc finger protein gene expression. In conclusion, these findings suggest that high expression of MrERF039 can significantly improve the cold tolerance of M. ruthenica root tissues during cold acclimation. Our results provide a new theoretical basis and candidate genes for breeding new legume forage varieties with high resistance.
Atypical brain responses to 40‐Hz click trains in girls with Rett syndrome: Auditory steady‐state response and sustained wave
Authors: Neklyudova Anastasia , Kuramagomedova Rabiat , Voinova Victoria , Sysoeva Olga
Published: February 2024

Aim

The current study aimed to infer neurophysiological mechanisms of auditory processing in children with Rett syndrome (RTT)—rare neurodevelopmental disorders caused by MECP2 mutations. We examined two brain responses elicited by 40‐Hz click trains: auditory steady‐state response (ASSR), which reflects fine temporal analysis of auditory input, and sustained wave (SW), which is associated with integral processing of the auditory signal.

Methods

We recorded electroencephalogram findings in 43 patients with RTT (aged 2.92–17.1 years) and 43 typically developing children of the same age during 40‐Hz click train auditory stimulation, which lasted for 500 ms and was presented with interstimulus intervals of 500 to 800 ms. Mixed‐model ancova with age as a covariate was used to compare amplitude of ASSR and SW between groups, taking into account the temporal dynamics and topography of the responses.

Results

Amplitude of SW was atypically small in children with RTT starting from early childhood, with the difference from typically developing children decreasing with age. ASSR showed a different pattern of developmental changes: the between‐group difference was negligible in early childhood but increased with age as ASSR increased in the typically developing group, but not in those with RTT. Moreover, ASSR was associated with expressive speech development in patients, so that children who could use words had more pronounced ASSR.

Conclusion

ASSR and SW show promise as noninvasive electrophysiological biomarkers of auditory processing that have clinical relevance and can shed light onto the link between genetic impairment and the RTT phenotype.
Coping target checklist for home‐based older adults living with disabilities and their spousal caregivers
Authors: Lin Xiaolu , Ou Jiexia , Wang Yanfang , Wu Yanni , Yang Lingli , Zhang Mi , Zhou Chunlan
Published: February 2024

Background

The substantial rise in the population of older adults living with disabilities is a prominent concern, presenting a profound challenge for healthcare and social welfare systems. Community‐based home care is seen as an effective approach to meet the care needs of older adults living with disabilities.

Objective

To construct a coping target checklist for home‐based older adults living with disabilities and their spousal caregivers.

Methods

The initial draft was developed based on a comprehensive literature review, followed by two rounds of Delphi correspondence final version.

Results

A comprehensive literature review resulted in the development of 7 modules, 20 topics. After round 1, 3 items were removed, 3 sections, 1 topic and 1 objective were new additions, 16 items were modified, split or combined. Four sections, 3 sections (Individual coping target for spousal caregivers, Individual coping target for older adults living with disabilities, and Shared coping target), 7 modules, 18 topics and 49 objectives were finally identified in round 2. The content of the list tool is derived from three perspectives: self‐management strategies for older adults living with disabilities, caregiving strategies for spousal caregivers, and combined.

Conclusions

The coping target checklist was intended to be evidence‐based and reflective of a practical direction for home‐based older adults living with disabilities and their spousal caregivers living at home.
Transcriptome analysis in mouse skin after exposure to ultraviolet radiation from a canopy sunbed
Authors: Qutob Sami S. , Roesch Samantha P. M. , Smiley Sandy , Bellier Pascale , Williams Andrew , Cook Kate B. , Meier Matthew J. , Rowan‐Carroll Andrea , Yauk Carole L. , McNamee James P.
Published: February 2024

Exposure to ultraviolet radiation (UV‐R), from both natural and artificial tanning, heightens the risk of skin cancer by inducing molecular changes in cells and tissues. Despite established transcriptional alterations at a molecular level due to UV‐R exposure, uncertainties persist regarding UV radiation characterization and subsequent genomic changes. Our study aimed to mechanistically explore dose‐ and time‐dependent gene expression changes, that may drive short‐term (e.g., sunburn) and long‐term actinic (e.g., skin cancer) consequences. Using C57BL/6N mouse skin, we analyzed transcriptomic expression following exposure to five erythemally weighted UV‐R doses (0, 5, 10, 20, and 40 mJ/cm2) emitted by a UV‐R tanning device. At 96 h post‐exposure, 5 mJ/cm2 induced 116 statistically significant differentially expressed genes (DEGs) associated with structural changes from UV‐R damage. The highest number of significant gene expression changes occurred at 6 and 48 h post‐exposure in the 20 and 40 mJ/cm2 dose groups. Notably, at 40 mJ/cm2, 13 DEGs related to skin barrier homeostasis were consistently perturbed across all timepoints. UV‐R exposure activated pathways involving oxidative stress, P53 signaling, inflammation, biotransformation, skin barrier maintenance, and innate immunity. This in vivo study's transcriptional data offers mechanistic insights into both short‐term and potential non‐threshold‐dependent long‐term health effects of UV‐R tanning.
Causal modeling in multilevel settings: A new proposal
Authors: Blanchard Thomas , Hüttemann Andreas
Published: February 2024

An important question for the causal modeling approach is how to integrate non‐causal dependence relations such as asymmetric supervenience into the approach. The most prominent proposal to that effect (due to Gebharter) is to treat those dependence relationships as formally analogous to causal relationships. We argue that this proposal neglects some crucial differences between causal and non‐causal dependencies, and that in the context of causal modeling non‐causal dependence relationships should be represented as mutual dependence relationships. We develop a new kind of model – “hybrid models” ‐ based on this suggestion, and formulate a set of axioms for those models. Our formalism has important implications for Kim's exclusion problem: whereas Gebharter's framework vindicates Kim's causal exclusion objection against nonreductive physicalism, our framework has no such implication, and can help non‐reductive physicalists vindicate the efficacy of high‐level properties. A further benefit of our formalism is that it yields a natural and plausible way of thinking about interventions in multi‐level contexts.
Investigating the longstanding mystery of stigma length differences between morphs of distylous plants
Authors: Trevizan R. , Oliveira P. E. , Cardoso J. C. F.
Published: February 2024

Longer stigmas in short‐styled morphs of distylous plants have been considered an adaptive characteristic that increases intermorph pollen deposition. The greater pollen deposition in short‐styled stigmas may be a by‐product of their longer length, making deposition effectiveness comparison between morphs unfeasible. Thus, investigating which morph has the relatively most efficient stigma (i.e., pollen deposition per unit length) can boost our understanding of the adaptive significance of longer stigmas.

Here, we compared pollen deposition between morphs relative to stigma length and assessed whether short‐styled stigmas are more, less, or equally effective in receiving pollen grains per unit length. We reviewed the literature to characterize the extent of sigma length differences between morphs using the two most speciose distylous genera as model systems: Palicourea and Psychotria (Rubiaceae). Then, we conducted a between‐morph comparison of raw and relative pollen depositions in a Palicourea rigida population.

We confirmed that short‐styled stigmas were longer than long‐styled stigmas in both Palicourea (194.31% longer) and Psychotria (52.59% longer) flowers. Furthermore, in the focal Pal. rigida, although short‐styled stigmas were 268.04% longer and received 97.04% more pollen grains than long‐styled stigmas, the relative pollen deposition had a reverse pattern, with short‐styled stigmas being two‐times less efficient in receiving pollen.

Our results indicate that the longer length of the short‐styled stigmas may have a compensatory effect, increasing the chances of pollen grains reaching the stigma and probably maintaining disassortative intermorph pollination in distylous plants.
Interoception as a function of hypnotizability during rest and a heartbeat counting task
Authors: Giusti Gioia , Zelič Žan , Callara Alejandro Luis , Sebastiani Laura , Santarcangelo Enrica L.
Published: February 2024

The hypnotizability‐related differences in morpho‐functional characteristics of the insula could at least partially account for the differences in interoceptive accuracy (IA) observed between high and low hypnotizable individuals (highs, lows). Our aim was to investigate interoceptive processing in highs, lows, and medium hypnotizable individuals (mediums), who represent most of the population, during a 10‐minute open eyes relaxation condition (Part 1) and three repetitions of consecutive 2‐minute open eyes, closed eyes, and heartbeat counting conditions, followed by a 2‐minute post‐counting condition (Part 2). Electrocardiogram and electroencephalogram were recorded in 14 highs, 14 mediums, and 18 lows, classified according to the Stanford Hypnotic Susceptibility Scale: Form A. Heartbeat‐evoked cortical potentials (HEP) were extracted throughout the entire session, and IA index was obtained for the heartbeat counting task (HCT). In Part 1, significant hypnotizability‐related differences were observed in the right central region in both early and late HEP components, with lows showing positive amplitudes and highs/mediums showing negative amplitudes. In Part 2, the same group differences were limited to the early component. Moreover, in the left frontal regions, only mediums modified their HEP during the counting task with respect to the open/closed eyes conditions, whereas highs displayed HEP differences between counting and post‐counting rest. HCT did not show significant group differences. In conclusion, highs and mediums seem to be more similar than mediums and lows regarding HEP, despite the absence of significant differences in HCT. Nonetheless, a negative correlation between hypnotizability scores and HEP amplitudes was observed in the regions showing group differences.
Bureaucratic overload and organizational policy triage: A comparative study of implementation agencies in five European countries
Authors: Zink Dionys , Knill Christoph , Steinebach Yves
Published: February 2024

Research on policy implementation traditionally has focused on understanding the success or failure of individual policies within specific contexts. Little attention has been given to the challenges that emerge from the cumulative growth of policy portfolios over time. This paper is addressing this research gap by examining the phenomenon of organizational policy triage, which occurs when implementation organizations face overload and are forced to make trade‐off decisions between the implementation of the different policies in their portfolios. We investigate empirical patterns of policy triage across 16 social and environmental implementation agencies in five European countries (Denmark, Germany, Ireland, Italy, and UK). We show that variation in policy triage can be explained by the combination of three central factors: blame‐shifting opportunities, the mobilization of external resources, and the commitment to compensate for overload by implementation authorities.