bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the influence of perceived humanization of service encounters on value creation of chatbot-assisted services
Authors: Khan Md Irfanuzzaman , Fatima Johra Kayeser , Bahmannia Somayeh , Chatrath Sarvjeet Kaur , Dale Naomi F. , Johns Raechel
Published: October 2024

Purpose

While prior research has examined customer acceptance of humanized chatbots, the mechanisms through which they influence customer value creation remain unclear. This study aims to investigate the emerging concept of Perceived Humanization (PH), examining how hedonic motivation, social influence and anthropomorphism influence value creation through the serial mediation of PH and trust. The moderating roles of rapport and social presence are also explored.

Design/methodology/approach

Based on data from an online survey involving 257 respondents, this study employs Partial Least Squares Structural Equation Modeling utilizing SmartPLS3 software.

Findings

Hedonic motivation leads to value creation via two routes: PH and affective trust; and PH and cognitive trust. Social influence and anthropomorphism also positively impact value creation through similar pathways. Rapport moderates the impact of social influence on PH, while social presence moderates the relationship between PH and both affective and cognitive trust. A cross-cultural analysis of China, India and New Zealand highlights varying cultural dimensions influencing PH and its effects on value creation.

Practical implications

For practitioners in the tourism industry, the findings highlight the strategic importance of enhancing PH in chatbot interactions. By understanding and optimizing these elements, businesses can significantly improve their customer value-creation process.

Originality/value

This study contributes to the service marketing literature by generating a comprehensive framework for the comprehension and application of PH. Its cross-cultural perspective provides rich insights, offering valuable information for service marketers aiming to thrive in the dynamic and competitive tourism industry.
Evaluation of real estate investment performance of insurance companies by NHF Act in curbing housing deficit in Nigeria
Authors: Inuwa Mohammed Danlami , Said Rosli
Published: October 2024

Purpose

The purpose of this study is to evaluate the real estate investment performance portfolio decision-making of the insurance firms by the National Housing Fund (NHF) Act in reducing the housing deficit in Nigeria. The insurance companies' gross premium, real estate investment and return on investment trends for the period 2014–2019 were evaluated, to determine the extent of their investment in real estate in Nigeria, this ought to have reduced the shortfall in housing.

Design/methodology/approach

Both primary and secondary sources were used. Cronbach’s alpha was used for testing the reliability. The Friedman mean rank with Chi-square was used for different types of real estate investment properties and for reasons for investing in real estate by insurance companies in Nigeria. The test for normality was conducted using the Shapiro–Wilk and Spearman correlation for the significance. The percentage and the data envelopment analysis frontier model were used for measuring performance and efficiency.

Findings

The results showed that the majority of real estate investments made by insurance companies were in commercial and land buying and reselling and that their performance was below average. However, their motivation for investing is not toward the NHF Act but rather for diversification and increasing their capital.

Originality/value

To the best of the authors’ knowledge, this is one of the first studies in Nigeria that looked at how well insurance firms have performed investing in real estate as required by the NHF Act. However, the new Act, the National Housing Fund (Establishment) Act of 2018 which was put on hold due to flaws, affected data availability beyond 2019.
Pollination‐related plant traits under environmental changes: Seasonal and daily mismatches produce temporal constraints
Authors: Leclerc Mathieu A. J. , Gibernau Marc , Pincebourde Sylvain
Published: October 2024

Pollination is a key tenet of ecosystem sustainability and food security, but it is threatened by climate change. While many studies investigated the response of plant‐pollination traits to temperature, few attempted multifactorial and integrative approaches with multiple floral traits.

We determined which plant‐pollination traits were disrupted by environmental changes and the consequence for plant fitness. We focused on the thermogenic plant, Arum italicum, which relies on floral scent and heat production to attract its pollinators with a deceptive strategy. In a field mesocosm, we measured the response of floral phenology, thermogenesis traits, scent and plant fitness to experimental changes in shade level, water supply and soil temperature. In the laboratory, we exposed plants to extreme heat to determine the thermoregulation ability at high temperatures.

Plant fitness decreased dramatically in response to soil warming and the level of shade. While both factors caused a lower number of inflorescences, soil warming was mostly responsible for the crash in number of fruits.

The plant traits related to thermogenesis and scent were relatively resilient to the environmental changes in the mesocosm and were unlikely to produce the observed decrease in plant fitness. First, environmental changes only weakly modified the scent composition. Second, the appendix regulated its maximal temperature almost perfectly, while stamen regulated imperfectly. In the laboratory experiment, the appendix maintained a thermal gradient supposedly to improve scent emission while stamen became cooler than ambient air, possibly preventing the pollinators from overheating within the floral chamber.

By contrast, the phenology of flowering was drastically modified. Flowers appeared earlier in the season in response to soil warming (by 39 days) or absence of shade (by 19 days). At the daily scale, flowering hour did not change across the season resulting in plants flowering before sunset late in the season and before the pollinator activity window (mostly nocturnal). The strong shift observed in the flowering period may induce a temporal mismatch with this pollinator both early and late in the season when the insects may not be active so early in the spring and during daytime, respectively, thereby altering plant fitness.

Read the free Plain Language Summary for this article on the Journal blog.
A simple model of internal and external balance for resource‐rich developing countries
Authors: Davies M. H. , Schröder M.
Published: October 2024

We present a simple model of internal and external balance that incorporates key features of resource‐rich developing countries (RRDCs). The main result is that ‘government take’—the ratio of fiscal resource revenue to resource output—is a key determinant of the equilibrium real exchange rate (ERER) in these countries. Examining the case of Papua New Guinea, which has grappled with foreign exchange restrictions since 2015, we find that about half of the RER overvaluation estimated at 26% in 2019 would disappear if the current low level of government take was to be lifted to its long‐term average. The analysis has two key takeaways for RRDCs. First, changes in the government take require adjustments to the RER and fiscal policy to maintain internal and external balance. Second, economic adjustments to falls in the take are difficult; therefore, policies seeking to stabilise the take over time to promote macroeconomic stability are recommended.
Nutrient content and ultra‐performance liquid chromatography tandem mass spectrometry metabolomic comparative analysis of Lithocarpus corneus and Lithocarpus pachylepis
Authors: Deng Jinqing , Yin Xiufang , Shen Hongjian , Liu Biting , Ye Jiarong , Hu Yufan , Li Junren , Liao Boyong
Published: October 2024

China possesses abundant species resources in genus Lithocarpus Blume, commonly known as “acorns.” These nuts are traditional foods in China, holding significant potential for local specialty food and rural economic development. To explore their edible value, we compared the nutritional components and metabolites between the fruits of Lithocarpus corneus (YD) and Lithocarpus pachylepis (HL), which are cultivated widely in south of China. Non‐targeted metabolomics analysis of YD and HL was performed using ultra‐performance liquid chromatography tandem mass spectrometry technology. A total of eight classes of differential metabolites (DAMs) were detected: alkaloids, amino acids and peptides, carbohydrates, fatty acids, polyketides, shikimates and phenylpropanoids, terpenoids, and other metabolites. In the positive ion mode, 225 DAMs were identified, whereas in the negative ion mode, 116 DAMs were identified. KEGG pathway enrichment analysis showed that the differentially abundant metabolites were generally enriched in three pathways: aminoacyl‐tRNA biosynthesis, alanine, aspartate, and glutamate metabolism, and ABC transporters. The nutritional content of YD has higher moisture, fructose, and total flavonoid levels, but lower starch, protein, fat, glucose, sucrose, and total sugar content than HL. Additionally, YD contains more Ca, K, P, and Fe, but less Mg and Zn compared to HL. Analyses indicate that YD is nutrient‐rich and beneficial, making it suitable for further development. Two species of Lithocarpus contain nandrolone, suggesting a new direction for specialty food development. The unique chemical composition and rich nutritional content of Lithocarpus fruits provide a theoretical basis for their development and application as food resources.

Practical Application

L. corneus and L. pachylepis are traditional Chinese nuts, rich in starch, minerals, and flavonoids, making them suitable for consumption or use as food constituents. Their fruits contain various unique natural chemical compounds, indicating high application value and development potential.
Predictors of emergency medical transport refusal following opioid overdose in Washington, DC
Authors: Turley Ben , Zamore Kenan , Holman Robert P.
Published: October 2024

Background and Aims

Patient initiated transport refusal during Emergency Medical Service (EMS) opioid overdose encounters has become an endemic problem. This study aimed to quantify circumstantial and environmental factors which predict refusal of further care.

Design

In this cross‐sectional analysis, a case definition for opioid overdose was applied retrospectively to EMS encounters. Selected cases had sociodemographic and situational/incident variables extracted using patient information and free text searches of case narratives. 50 unique binary variables were used to build a logistic model.

Setting

Prehospital EMS overdose encounters in Washington, DC, USA, from July 2017 to July 2023.

Participants

Of EMS encounters in the study timeframe, 14 587 cases were selected as opioid overdoses.

Measurements

Predicted probability for covariates was the outcome variable. Model performance was assessed using Stratified K‐Fold Cross‐Validation and scored with positive predictive value, sensitivity and F1. Prediction accuracy and McFadden's pseudo‐R squared are also determined.

Findings

The model achieved a predictive accuracy of 78% with a high positive predictive value (0.83) and moderate sensitivity (0.68). Bystander type influenced the refusal outcome, with decreased refusal probability associated with family (nondescript) (−28%) and parents (−16%), while presence of a girlfriend increased it (+28%). Negative situational factors like noted physical trauma (−62%), poor weather (−14%) and lack of housing (−14%) decreased refusal probability. Characteristics of the emergency response team, like a prior crew member encounter (+20%) or crew experience <1 year (−36%), had a variable association with transport.

Conclusions

Refusal of emergency transport for opioid overdose cases in Washington, DC, USA, has expanded by 43.8% since 2017. Several social, environmental and systematic factors can predict this refusal. Logistic regression models can be used to quantify broad categories of behavior in surveillance medical research.
‘Transmission Tracker – Dirofilaria’– a public dashboard to assess in real‐time the temperature‐bounded transmissibility of canine heartworm across Australia
Authors: Atkinson PJ , Stevenson M , O'Handley R , Nielsen T , Caraguel C
Published: October 2024

The causative agent of canine heartworm disease, Dirofilaria immitis, requires specific temperature conditions to mature within its mosquito vector, and therefore (re‐)infect a canid host. Suitable temperature conditions are not continuously met for locations where most (>97%) Australians and their pet dogs live. The length of the disruption in the transmissibility of D. immitis varies greatly across Australia, and to some degree, between years. We developed an online dashboard ‘Transmission Tracker – Dirofilaria’ that processes near real‐time temperature records across Australia and allows users to enquire about historical and current weather suitability for canine heartworm transmission at any Australian postcode of their interest. This information allows veterinarians to access when, and for how long, heartworm may be transmitted at a specific location, assess the associated risk of infection and advise on a patient‐dependent dirofilariosis prevention plan for their canine patients and guardians. Our dashboard is publicly accessible at: https://heartworm-mapping.adelaide.edu.au/shiny/.
Application of otolith morphometrics in delineating population structure of Aphaniops stoliczkanus (Teleostei: Aphaniidae) in southern Iranian waters
Authors: Iranmanesh Mahdi , Askari Hesni Majid
Published: October 2024

Widely distributed Species in different geological and ecological environments often exhibit great intraspecific diversity. Aphaniops stoliczkanus (Day, 1872) is an endemic species of Middle East occurring over a vast geographic range in different basins. This species has been observed in freshwater, brackish water and hot sulphur springs; therefore, its populations are known to exhibit considerable morphological variation. In the present study, we have investigated the poorly studied populations of A. stoliczkanus of the Hormuz and Makran basins of Iran in terms of otolith morphology and morphometrics. According to the results, these populations can be divided into two distinct groups including east and west of the Strait of Hormuz. Our results also provide evidence that there is a relationship between otolith morphology and the environment, serving as environmental factors that may influence the formation of specific regions in the otolith shape. Despite the remarkable morphological similarities among otoliths in geographically close populations of Charak and Chiruyeh, our data purposed that geographically these populations have different dorsal tip shapes in their otolith. In comparison to the data from other studies, the otoliths of Qeshm Island appear to resemble the overall shape of otolith found in Oman very closely. However, it is believed that Qeshm Island population was separated from the Hormuz basin populations during the Holocene Sea level rise. Also, the outcomes of this study provide insights into the potential role of environmental factors in shaping intraspecific diversity and the migration patterns of this species within the Persian Gulf.
Scanning electron microscopy comparison of an abnormal and normal otoliths of the Anguilla anguilla collected from the Bafa Lake in Western Anatolia
Authors: Jawad Laith A. , Güçlü Salim Serkan , Koca Habil Uğur , Cilbiz Mehmet
Published: October 2024

Aberrations in the otolith can harmfully influence the imperative actions of the fish species. The chief drive of the current investigation is to describe the deformities in the otoliths of the European eel Anguilla anguilla. Out of 76 Anguilla anguilla individuals collected from Bafa Lake in Western Anatolia, Türkiye, four female specimens exhibited abnormal otoliths. Scanning electron microscope was used to determine the deformed otoliths examined. The outcomes of the abnormality analyses in A. anguilla otoliths, deformities were noticed such as numerous prominence structures and bumps of different sizes on the surface of the otolith produced by buildup of the different crystal structures in some parts of the otolith. These deformities were found in the left and/or right otoliths of the female individuals of different total lengths. The percentage of individuals with abnormal otoliths of A. anguilla is calculated as 5.3%. The current study presents for the first‐time abnormal otolith information on left and right otoliths in female A. anguilla. Deformities in the otoliths of European eels are believed to result from a combination of genetic predisposition and stress caused by various environmental factors, such as water pollution, changes in salinity, temperature fluctuations and nutritional imbalances.
Pairwise likelihood estimation and limited‐information goodness‐of‐fit test statistics for binary factor analysis models under complex survey sampling
Authors: Jamil Haziq , Moustaki Irini , Skinner Chris
Published: October 2024

This paper discusses estimation and limited‐information goodness‐of‐fit test statistics in factor models for binary data using pairwise likelihood estimation and sampling weights. The paper extends the applicability of pairwise likelihood estimation for factor models with binary data to accommodate complex sampling designs. Additionally, it introduces two key limited‐information test statistics: the Pearson chi‐squared test and the Wald test. To enhance computational efficiency, the paper introduces modifications to both test statistics. The performance of the estimation and the proposed test statistics under simple random sampling and unequal probability sampling is evaluated using simulated data.
‘Being a Social Worker … It's in My DNA’ Retaining Experienced Child and Family Social Workers: The Role of Professional Identity
Authors: Cook Laura L. , Carder Sara , Zschomler Danny
Published: October 2024

The retention of experienced child and family social workers is a significant issue in the United Kingdom, the United States and Europe. Failure to retain experienced practitioners has serious implications for the protection and support of vulnerable children. Existing research and workforce interventions have focused on the support of early‐career social workers to prevent exit. Relatively few studies have examined what can be learned from experienced social workers who have remained in the profession long‐term. This study captures the voices of experienced stayers. Data consist of interviews with social workers (n = 58) across 11 local authorities in England who have remained in practice for ≥8 years. Findings suggest that a strong sense of professional identity (PI) sustains social workers and promotes retention. For experienced social workers, staying in the profession long‐term involves navigating a series of identity challenges over the course of their career, conceptualized here as Critical Career Episodes (CCEs). Based on these findings, we suggest that retaining experienced social workers involves support to navigate CCEs alongside meaningful opportunities for learning and development. We identify three key factors that support and sustain ongoing PI development and support retention: generativity, specialism and mobility. The article concludes with recommendations to support workforce retention.
PathVar: A Customisable NGS Variant Calling Algorithm Implicates Novel Candidate Genes and Pathways in Hemiplegic Migraine
Authors: Alfayyadh Mohammed M. , Maksemous Neven , Sutherland Heidi G. , Lea Rodney A. , Griffiths Lyn R.
Published: October 2024

The exponential growth of next‐generation sequencing (NGS) data requires innovative bioinformatics approaches to unravel the genetic underpinnings of diseases. Hemiplegic migraine (HM), a debilitating neurological disorder with a genetic basis, is one such condition that warrants further investigation. Notably, the genetic heterogeneity of HM is underscored by the fact that approximately two‐thirds of patients lack pathogenic variants in the known causal ion channel genes. In this context, we have developed PathVar, a novel bioinformatics algorithm that harnesses publicly available tools and software for pathogenic variant discovery in NGS data. PathVar integrates a suite of tools, including HaplotypeCaller from the Genome Analysis Toolkit (GATK) for variant calling, Variant Effect Predictor (VEP) and ANNOVAR for variant annotation, and TAPES for assigning the American College of Medical Genetics and Genomics (ACMG) pathogenicity labels. Applying PathVar to whole exome sequencing data from 184 HM patients, we detected 648 variants that are probably pathogenic in multiple patients. Moreover, we have identified several candidate genes for HM, many of which cluster around the Rho GTPases pathway. Future research can leverage PathVar to generate high quality, candidate pathogenic variants, which may enhance our understanding of HM and other complex diseases.
A Systematic Review and Meta‐Analysis of the Efficacy of Antimicrobial Chemoprophylaxis for Recurrent Acute Otitis Media in Children
Authors: Davies Timothy , Peng Xicheng , Salem Joseph , Elcioglu Zeynep C. , Kremneva Anna , Gruber Mei‐yin , Milinis Kristijonas , Mather Michael W. , Powell Jason , Sharma Sunil
Published: October 2024

Objectives

Acute otitis media (AOM) is a common childhood infection. Recurrent AOM affects a subset of children, resulting in an adverse impact on quality of life, socioeconomic disadvantage, and risk of long‐term sequelae. Antimicrobial chemoprophylaxis is used in some settings but is increasingly controversial due to an awareness of adverse long‐term effects and contribution to global antibiotic resistance.

Design and Setting

A comprehensive literature search was undertaken using Medline (1946–October 2023) and Embase (1974–October 2023). The primary aim was to assess the efficacy of antimicrobial chemoprophylaxis on AOM episodes in children < 18 years of age. Bias and quality assessment was performed. Dichotomous data were analysed using risk ratio with 95% confidence intervals. Meta‐analysis was carried out using random‐effects models for pooled analysis, independent of heterogeneity. Heterogeneity was assessed using the I
2 statistic.

Main Outcome Measures

The effect of antimicrobial chemoprophylaxis in children with rAOM on the number of individual AOM episodes. Secondary outcomes: assessment of antimicrobial agents and outcomes in children with risk factors.

Results

Assessment of qualitative data was performed on 20 studies (n = 2210). No controlled trials were identified post‐multivalent pneumococcal conjugate vaccine (PCV) introduction, restricting current generalisability. Quantitative meta‐analysis on nine pre‐PCV studies (n = 1087) demonstrated antimicrobial chemoprophylaxis reduced any episode of AOM with a risk ratio 0.59 (95% CI 0.45–0.77).

Conclusion

Families and clinicians must balance marginal short‐medium term benefit (based on pre‐PCV data), and the potential for adverse effects to that individual, and the societal risk of antimicrobial resistance with prolonged antibiotic use.
Hunting for Early Melanomas With a Maximum Clinical Surface Diameter up to 6 mm: A Prospective Study of Reflectance Confocal Microscopy Features in 68 Consecutive Cases
Authors: Pyne J. , MacDonald S. , Beale S. , Myint E. , Clark S. , Trang A.
Published: October 2024

Background

Early diagnosis of melanoma and prompt effective therapy optimizes prognosis. Reflectance confocal microscopy (RCM) facilitates diagnosis by providing immediate 3D single cell resolution down into the papillary dermis.

Methods

Consecutive cases were examined using a Vivascope 1500 confocal microscope at a single referral medical practice in Sydney, Australia 2019–2023. Melanoma clinical surface diameters were recorded by 0.1 mm increments up to 6.0 mm. The RCM features recorded were: pagetoid single cells or nests, pleomorphic cell shape, atypical dendritic cells, non‐edged papillae, variation in melanocyte size and confluent sheets of cells. All cases required diagnostic agreement by two dermatohistopathologists using hematoxylin and eosin staining followed by SOX 10 and/or PRAME stains if required.

Results

Total cases were 68: 38 males (mean age 57) and 30 females (mean age 64). Melanoma in situ (n = 65) compared to invasive melanoma (n = 3), all males, invasion depth (0.4–0.5 mm). Most frequent RCM features found in 50% or more of cases within all diameter increments were: pagetoid single cells n = 64/68 (94%), pleomorphic cell shape n = 63/68 (93%), epidermal disarray n = 58/68 (85%), and atypical dendritic cells n = 45/68 (66%). Non‐edged dermal papillae were n = 42/68 (62%).

Conclusion

Melanoma RCM features were found throughout the diameter ranges. Confocal examination may facilitate early melanoma recognition in these ranges.
How do licensing boards provide oversight? An Idaho case study
Authors: Norris Conor , Adams Alex , Timmons Edward
Published: October 2024

Occupational licensing laws are designed to improve service quality and protect consumers from harm by establishing entry requirements and oversight of practising professionals. Evidence on the effects of licensing is mixed. The quality of services is difficult to measure objectively, complicating attempts to compare costs and benefits of regulation. A 2017 executive order in the US state of Idaho required licensing boards to report disciplinary actions against professionals. This new source of data provides some insight into the type of enforcement undertaken by licensing boards. We find that disciplinary actions directly related to quality are rare. Between 0.01 and 0.38 per cent of licensees are disciplined for quality‐related issues; 36 to 53 per cent of total disciplinary actions are directly related to quality, with the rest covering technical breaches.
A minor masterpiece? Reconsidering De ponderibus et mensuris by Juan de Mariana
Authors: Patriarca Giovanni
Published: October 2024

The article investigates a little‐known work titled De ponderibus et mensuris [On Weights and Measures] written by Juan de Mariana in 1599. It contains the embryo of his future monetary theories, and has other interesting aspects, not only juridical and historical but also epistemological. Significant points of convergence with the early modern mathematics and abacus tradition make it unique. Apart from its stylistic, pedagogical and technical originality, this work also appears as a watershed for the evolution of economic science, its language and methodology.
Belgian recommendations for managing psoriasis in a changing treatment landscape
Authors: Speeckaert R. , Nikkels A. F. , Lambert J. , Benhadou F. , Reynaert V. , Ghislain P. D. , Hillary T. , Lambert J. L. W.
Published: October 2024

Targeted biologic drugs and small molecules have transformed the psoriasis treatment landscape in recent years. The Belgian healthcare system, in common with many others across Europe, must balance the burgeoning use of these transformative, yet expensive, drugs with the sustainable use of limited resources. Drawing on recent updates to the EuroGuiDerm and the German S2 psoriasis guidelines, eight Belgian dermatologists experienced in treating patients with psoriasis undertook a quasi‐Delphi initiative to provide perspectives on the current opportunities and challenges in psoriasis. This update focuses on responsible ways to rationalize the use of innovative treatments (e.g. biologics and small molecules). Inherently, this required viewpoints on the International Psoriasis Council's new definition of severe psoriasis, defining psoriasis severity and the concept of treating to target. It discusses the appropriateness of using older biologics classes, biosimilars and personalized dosing and lastly, how teledermatology may play a role in providing sustainable, patient‐centric psoriasis care. In addition, this manuscript includes the updated Belgian evidence‐based treatment advice in psoriasis (BETA‐PSO) to reflect recent data and drug approvals. The recommendations reflect the best practices for clinicians when using systemic and biologic therapies to treat patients with psoriasis and offer guidance on how they may prescribe these drugs sustainably and efficiently.
Simulating Upper Eyelid Ptosis During Neuromodulator Injections—An Exploratory Injection and Dissection Study
Authors: Paternostro Ferdinando , Hong Wei‐Jin , Zhu Guo‐Sheng , Green Jeremy B. , Milisavljevic Milan , Cotofana Mikaela V. , Alfertshofer Michael , Hendrickx S. Benoit , Cotofana Sebastian
Published: October 2024

Background

Aesthetic neuromodulator injections of the upper face are frequently performed to temporarily block muscular actions of the periorbital muscles to ultimately reduce skin rhytids. However, the adverse event rate in the literature for toxin‐induced blepharoptosis ranges from 0.51% to 5.4%.

Objective

To identify access pathways by which injected neuromodulator product can travel from extra‐ to intra‐orbital and therefore affect the levator palpebrae superioris muscle.

Methods

Nine non‐embalmed human body donors were investigated in this study with a mean age at death of 72.8 (16.1) years. The 18 supraorbital regions were injected in 28 times (14 for supratrochlear and 14 for supraorbital) with 0.5 cc, whereas eight cases (four for supratrochlear and four supraorbital) were injected with 0.1 cc of colored product. Anatomic dissections were conducted to identify structures stained by the injected color.

Results

The results of this injection‐ and dissection‐based study revealed that both the supratrochlear and the supraorbital neurovascular bundles are access pathways for injected neuromodulator products to reach the intra‐orbital space and affect the levator palpebrea superioris muscle. Out of 36 conducted injection passes, seven (19.44%) resulted in affection of the sole elevator of the eyelid of which 100% occurred only at an injection volume of 0.5 cc and not at 0.1 cc.

Conclusion

Clinically, the results indicate that a low injection volume, a superficial injection for the supraorbital location, and angling the needle tip away from the supratrochlear foramen (toward the contralateral temple) when targeting the corrugator supercilii muscles, can increase the safety profile of an aesthetic toxin glabellar treatment.
Effectiveness of Integrated Care for Older Pepole (ICOPE) in Improving Intrinsic Capacity in Older Adults: A Systematic Review and Meta‐Analysis
Authors: Liu Wei , Qin Rixin , Zhang Xueyan , Li Guichen , Qiu Yiming , Zhang Guangwei , Chen Li
Published: October 2024

Objective

Conduct a systematic review of existing studies on intrinsic capacity (IC) and a meta‐analysis of studies to assess the overall effectiveness of ICOPE in improving IC in older adults.

Methods

Ten databases were systematically searched from inception to November 8, 2023, and the search was last updated on January 2, 2024. Randomised controlled trials (RCTs) were included. The main outcomes were IC (cognition, psychological, sensory, vitality and locomotion).

Results

The results showed ICOPE had a significant effect in improving cognitive function (SMD = 0.36; 95% CI, 0.17 to 0.56, p < 0.001, 12 RCTs, 7926 participants) and depressive symptoms (SMD = −0.70; 95% CI, −0.96 to −0.43, p < 0.001, 26 RCTs, 11,034 participants), but there was no statistically significant difference in improving locomotion (SMD = 0.16; 95% CI, −0.03 to 0.34, p = 0.098, 3 RCTs, 1580 participants). Meta‐regression analysis shows that intervention duration should be paid attention to when the source of heterogeneity is discussed on the cognition.

Conclusion

The results suggest that ICOPE may be a potentially effective approach to help improve the IC in older adults, showing significant potential for improving cognitive function and reducing depressive symptoms in particular.

Implications for the Profession and/or Patient Care

ICOPE is expected to provide effective strategies to enhance issues such as IC and may be an innovative way to improve the overall health of older adults. This result provides strong support for geriatric nursing practice and encourages the adoption of ICOPE as a viable nursing approach to promote healthy ageing.
Assessing the Risk of Delirium and Death in Sepsis Using the Braden Score: A Retrospective Study
Authors: Li Xinya , Tang Yonglan , Bai Zihong , Liang Xin , Huang Xiaxuan , Chen Jianguang , Cheng Hongtao , Lyu Jun , Wang Yu
Published: October 2024

Aims and Objectives

To provide a viable tool for the early clinical identification of high‐risk populations in patients with sepsis.

Background

Sepsis‐associated delirium (SAD) has the potential to significantly impact the short‐ and long‐term prognosis of patients. However, accurately predicting and effectively managing SAD remains a significant challenge.

Methods

This study employed a retrospective analysis of adult sepsis patients admitted to the intensive care unit (ICU) for the first time. Patients were divided into two groups based on their initial Braden score upon admission to the ICU: a high‐risk group (≤ 15 points) and a low‐risk group (> 15 points). The relationship between Braden score and delirium was assessed using logistic regression and restricted cubic splines, while restricted mean survival time was employed to analyse the relationship between Braden scores and patients' 90‐ and 180‐day mortality.

Results

Of the 28,312 patients included in the study, those in the high‐risk group exhibited a significantly elevated risk of delirium (44.8% vs. 29.7%) and higher 90‐day (28.7% vs. 19.4%) and 180‐day (33.2% vs. 24.1%) mortality rates (all p < 0.001). After adjusting for confounding variables, logistic regression demonstrated that the risk of delirium was 1.54 times higher in the high‐risk group (95% CI = 1.45–1.64, p < 0.001). Following propensity score matching, the difference in survival was statistically significant at both time points, with the high‐risk group having a reduced survival rate of 7.50 days (95% CI = −8.24, −6.75; p < 0.001) and 15.74 days (95% CI = −17.40, −14.08; p < 0.001) at 90 days and 180 days, respectively.

Conclusions

The Braden score is a simple and effective tool for the early identification of patients at increased risk of adverse outcomes in sepsis.

Design

Retrospective study.

Relevance to Clinical Practice

The Braden score can be employed by clinical nurses for the purpose of early identification of poor prognostic risk in patients with sepsis.

Reporting Method

This study was conducted according to the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.

Patient or Public Contribution

Patients were involved in the sample of the study.
Symptom Clusters in Breast Cancer Patients Receiving Adjuvant Chemotherapy: A Systematic Review
Authors: Qi Yishu , Li Huiyuan , Guo Yao , Cao Ying , Wong Cho Lee
Published: October 2024

Background

Breast cancer patients experience various adverse symptoms during adjuvant chemotherapy. These adverse symptoms often form symptom clusters and have a negative impact on patients.

Aims

To summarise common symptom clusters in different dimensions and their longitudinal changes among breast cancer patients receiving adjuvant chemotherapy.

Design

A systematic review.

Data Sources

Ten electronic databases were searched from 2001 to January 2024, and the search was last updated on 16 August 2024.

Methods

Two reviewers independently assessed the eligibility of each study and extracted data. The Standard Quality Assessment Criteria for Evaluating Primary Research Papers was used to evaluate the quality of included studies. The findings were synthesised narratively. This systematic review has been registered (CRD42022370210).

Results

Nine studies with a total of 1454 participants were included. The common symptom clusters in breast cancer patients receiving adjuvant chemotherapy were the gastrointestinal symptom cluster (nausea‐lack of appetite), the fatigue‐pain‐sleep disturbance symptom cluster and the psychological symptom cluster (worry‐sadness‐nervousness‐distress‐feeling irritable‐difficult concentrating). The severity dimension was the most frequently utilised in identifying symptom clusters, with the number and concurrence of symptom clusters showing variation over time.

Conclusions

This study summarised common symptom clusters in breast cancer patients receiving adjuvant chemotherapy and revealed their changes from symptom dimensions and the chemotherapy process. These findings support further exploration of symptom cluster changes and underlying mechanisms, facilitating the design of targeted management strategies, including appropriate interventions and measurement dimensions in clinical nursing, to ultimately reduce patients' symptom burden.

Impact

Common symptom clusters have been identified in breast cancer patients receiving adjuvant chemotherapy. Clinical nursing in oncology can prioritise these symptom clusters and provide patients with targeted management strategies.

Reporting Methods

PRISMA guidelines and SWiM guidelines.

Patient or Public Contribution

No patient or public contribution.
Travel burden and bypassing closest site for surgical cancer treatment for urban and rural oncology patients
Authors: Onega Tracy , Ramkumar Niveditta , Brooks Gabriel A. , Loehrer Andrew P. , Kapadia Nirav S. , O'Malley A. James , Fraze Taressa K. , Smith Rebecca E. , Wang Qianfei , Wong Sandra L. , Tosteson Anna N. A.
Published: October 2024

Purpose

We examined the relationship between travel burden for surgical cancer care and rurality, geographic bypass of the nearest surgical facility, cancer type, and mortality outcomes.

Methods

Using Medicare claims and enrollment data (2016–2018) from beneficiaries with cancer of the colon, rectum, lung, or pancreas, we measured travel times to: the nearest surgical facility and facility used. For those who bypassed the nearest, we examined travel time and rurality in relation to surgical rates. Using multivariable regression modeling, we estimated associations of bypass with 90‐day postoperative‐ and one‐year mortality; rurality was examined as an effect modifier.

Findings

Among 211,025 beneficiaries with cancer, 25.5% resided in non‐metropolitan areas. About 66% of metropolitan/micropolitan, and 78% of small town/rural patients bypassed their closest facility. Increasing rurality was significantly associated with increased likelihood of bypass (Referent = metropolitan, OR; 95%CI: micropolitan 1.10; 1.04–1.16, small town/rural 2.08; 1.96–2.20. Bypassing the nearest facility was associated with decreased likelihood of both 90‐day postoperative mortality (OR = 0.79; 95%CI 0.74–0.85) and 1‐year mortality (OR = 0.81; 95%CI 0.77–0.86). The greatest decrement in 1‐year mortality was for pancreatic cancer across all rural‐urban categories (OR; 95%CI: metropolitan 0.63; 0.53–0.76; micropolitan 0.53; 0.29–0.97); small town/rural 0.46; 0.25–0.86).

Conclusions

Most Medicare beneficiaries with lung, colon, rectal, or pancreatic cancer bypassed the closest facility providing surgical cancer care, especially rural patients. Bypassing was associated with a lower likelihood of 90‐day postoperative, and 1‐year mortality. Understanding determinants of bypassing, particularly among rural patients, may reveal potential mechanisms to improve cancer outcomes and reduce rural cancer disparities.
Role ofPNPLA3in Hepatic Stellate Cells and Hepatic Cellular Crosstalk
Authors: Castanho Martins Maria , Dixon Emmanuel Dauda , Lupo Giulia , Claudel Thierry , Trauner Michael , Rombouts Krista
Published: October 2024

Aims

Since its discovery, the patatin‐like phospholipase domain containing 3 (PNPLA3) (rs738409 C>G p.I148M) variant has been studied extensively to unravel its molecular function. Although several studies proved a causal relationship between the PNPLA3 I148M variant and MASLD development and particularly fibrosis, the pathological mechanisms promoting this phenotype have not yet been fully clarified.

Methods

We summarise the latest data regarding the PNPLA3 I148M variant in hepatic stellate cells (HSCs) activation and macrophage biology or the path to inflammation‐induced fibrosis.

Results

Elegant but contradictory studies have ascribed PNPLA3 a hydrolase or an acyltransferase function. The PNPLA3 I148M results in hepatic lipid accumulation, which predisposes the hepatocyte to lipotoxicity and lipo‐apoptosis, producing DAMPs, cytokines and chemokines leading to recruitment and activation of macrophages and HSCs, propagating fibrosis. Recent studies showed that the PNPLA3 I148M variant alters HSCs biology via attenuation of PPARγ, AP‐1, LXRα and TGFβ activity and signalling.

Conclusions

The advent of refined techniques in isolating HSCs has made PNPLA3's direct role in HSCs for liver fibrosis development more apparent. However, many other mechanisms still need detailed investigations.
Posterior Circulation Ischemic Stroke From Atlantoaxial Instability and Lateral Dislocation due to Os Odontoideum: Case Report and Review of Literature
Authors: Wang Xianghe , Li Yao , Shao Minghao , Liang Jingjuan , Tang Weijun , Lin Jixian , Ma Xiaosheng , Wang Hongli , Han Xiang
Published: October 2024

Background

Strokes in young individuals often stem from unusual causes. Posterior circulation ischemic stroke caused by vertebral artery insufficiency due to atlantoaxial instability or dislocation is rare. We present a case of posterior circulation ischemic stroke due to an unstable os odontoideum and review the current literature. The clinical features and imaging manifestations are described to promote awareness of etiology, early diagnosis, and assessment.

Case Presentation

A 24‐year‐old male presented with recurrent right‐sided limb numbness and weakness and cerebellar ataxia due to posterior circulation ischemic stroke. The work‐up revealed thrombosis reformation in the tortuous left vertebral artery. It is noteworthy that the patient developed compression and chronic damage of the vertebral artery secondary to atlantoaxial instability and lateral dislocation due to an os odontoideum. He underwent antiplatelet and anticoagulant therapy, cervical traction, and posterior atlantoaxial screw fixation and fusion with iliac crest autograft. The postoperative course was uneventful. At 6‐month follow‐up, the patient had a solid fusion mass and rigid stability of the atlantoaxial joint without neurologic deficits or ischemic sequelae.

Conclusions

For unexplained posterior circulation ischemic stroke, it is important to consider unstable os odontoideum as a potential etiology, especially in pediatric and young adult male patients. Atlantoaxial instability and dislocation with os odontoideum, especially when occurring laterally, may cause insufficiency of the vertebral artery and subsequent posterior circulation ischemic strokes. The significance of lateral atlantoaxial dislocation in the genesis of vertebral artery injury and the necessity for specific positional imaging are emphasized.
Experts – Part I: What They Are and How to Identify Them
Authors: Croce Michel , Baghramian Maria
Published: October 2024

This paper investigates the topic of expertise in cognitive domains from a socio‐epistemological perspective. In particular, two central questions in the epistemology of expertise are discussed: what an expert is according to extant theories on the market; and how ordinary people can identify an expert in domains in which they have no competence of their own.
THE NOTION OF SEQUENTIALITY IN LANGUAGE: AN INVESTIGATION IN COGNITIVE SEMANTICS
Authors: Hamawand Zeki
Published: October 2024

This research aims to clarify the concept of sequentiality in language: the case in which a number of things occur one after the other, as seen in phrases like a queue of customers, a strand of programs and a fleet of cars. Utilizing Langacker's theory of Cognitive Semantics, the study seeks to substantiate two claims. The first is that the meaning of a linguistic expression is understood in terms of the domain in which it is embedded. The second is that the meaning of a linguistic expression is the outcome of the specific construal imposed on its content. The paper proposes that the choice of a sequential phrase is influenced by how the speaker perceives and describe a situation. The study intends to demonstrate that each sequential phrase carries a unique meaning that sets it apart from others. When two or more sequential phrases modify a noun, they indicate semantic contrast, with each phrase offering a different perspective. The findings show that sequential phrases have distinct functions and are distinguishable in their usage through examples provided.
SlMYB72 interacts with SlTAGL1 to regulate the cuticle formation in tomato fruit
Authors: Wu Mengbo , Zhou Yuanyi , Ma Haifeng , Xu Xin , Liu Mingchun , Deng Wei
Published: October 2024

The cuticle is the first physical barrier covering the surface of tomatoes and plays an important role in multiple stress responses. But the molecular regulatory networks of cuticle formation are not fully understood. In this study, we found that SlMYB72 can interact with SlTAGL1 to regulate the formation of fruit cuticle in tomato. Downregulating the expression of SlMYB72 inhibits the formation of fruit cuticle, resulting in a reduced fruit cuticle thickness, accelerated postharvest water loss, and increased susceptibility to Botrytis cinerea. RNA sequencing analysis showed that downregulation of the SlMYB72 gene decreased the expression levels of genes related to fatty acid and cuticle metabolism. SlMYB72 regulates the cuticle formation by directly binding to the promoter of long‐chain acyl‐coA synthetases (SlLACS1) and medium‐chain alkane hydroxylase (SlMAH1). Moreover, SlMYB72 interacts with SlTAGL1, which can enhance the transcriptional activation of SlMYB72 on the SlMAH1 promoter. Overall, our study expands our understanding of the regulation of cuticle formation by SlMYB72 and provides new insights into fruit shelf life extension via manipulation of cuticle content.
Third eyelid cartilage eversion in an adult mare
Authors: D'Agostino Albert L. , Giuliano Elizabeth A. , Kuroki Keiichi , Martin Lynn M.
Published: October 2024

Purpose

To describe the first report of third eyelid cartilage eversion in an adult American Quarter Horse mare.

Case Presentation

A 22‐year‐old American Quarter Horse mare presented to the University of Missouri Veterinary Health Center Equine Hospital for a 2‐week history of a third eyelid cartilage abnormality of the left eye with no known recent trauma. Complete ophthalmic examination revealed third eyelid cartilage eversion of the left nictitans. The abnormal scrolled cartilage was surgically excised using a handheld cautery unit and submitted for histopathologic evaluation.

Results

Histopathologic findings displayed normal third eyelid cartilage, without evidence of neoplasia or inflammation. Mucosal hyperplasia and increased vascularity of the submucosa were observed. The horse healed well after electrocautery excision and normal third eyelid conformation was restored.

Conclusion

To the authors' knowledge, this is the first report of an acquired, presumed spontaneous, third eyelid cartilage eversion in a horse.