bluuebunny/crossref_metadata_2025 huggingface dataset:
Supporting self‐determination in mental health recovery: Strategies employed by occupational therapists
Authors: Fawor Jasmine , Hancock Nicola , Scanlan Justin Newton , Hamilton Debra Ellen
Published: October 2023

Introduction

Self‐determination is a core component of mental health recovery and a predictor of positive outcomes. The literature calls for occupational therapists to lead practice change to greater recovery‐orientation, including facilitating people's self‐determination. However, systemic challenges thwart translation of policy into practice and therapists report a lack of confidence in implementing recovery‐oriented principles. This study aimed to understand the strategies that mental health occupational therapists employ to support people's self‐determination.

Methods

Data were collected through an international on‐line questionnaire principally comprising two open‐ended questions designed to elicit deep reflective personal accounts. Participants were asked about an experience in which they supported a person's self‐determination and the factors that either facilitated or hindered this experience. Qualitative data were analysed using inductive thematic analysis, guided by constant comparative methods.

Findings

Thirty‐four therapists, predominantly from Australia (n = 30), participated. Therapists described supporting self‐determination as a multifaceted process that involved: (1) working on myself, (2) working with the person, and (3) working with others. They emphasised that the combined use of various strategies across these three areas of work was important to support people's self‐determination. Further, awareness of and addressing issues of power in their practice was key.

Conclusion

This study supports the translation of recovery‐oriented principles into practice by revealing the nuanced strategies implemented by occupational therapists striving to support self‐determination. Participants employed diverse strategies to empower people to take the ‘driver's seat’ in their mental health recovery journey. Insights from this study will support other occupational therapists to actualise recovery‐oriented principles and better support self‐determination in their practice. To effectively implement self‐determination strategies, therapists must reflect on and address existing power differentials within mental health services, particularly between themselves and the people they support.
Problem Directors and Corporate Risk‐Taking
Authors: Bhuiyan Md. Borhan Uddin , Liu Jia , Alam Ashraful
Published: October 2023

This study investigates the impact of a ‘problem director’ on the risk‐taking propensity of a firm and its consequences for firm value. Analysing a sample of US companies, we find that corporate risk‐taking propensity increases when a firm appoints a problem director. Our results are of economic significance, indicating that a one standard deviation increase in problem director's score leads to a 2.33% to 4.17% increase in corporate risk‐taking. Mediation analysis reveals that a problem director increases firm risk‐taking through reducing financial reporting quality. Further, a firm's risk‐taking increases when a new problem director joins the board, and the damaging effect persists even after the problem director has left. Moreover, if a chief executive officer (CEO) is a problem director, s/he displays a greater predisposition for risk‐taking. Moreover, when a problem director also sits on a board led by a problem CEO, we determine that the former will have an even greater propensity to take risks. Further analysis determines that the presence of problem directors damages long‐term firm value in the aftermath of risk‐taking behaviour. Overall, this study provides fresh evidence revealing a web of connections between a problem director, ineffective corporate governance and a decline in firm value.
Ghrelin delays premature aging in Hutchinson‐Gilford progeria syndrome
Authors: Ferreira‐Marques Marisa , Carvalho André , Franco Ana Catarina , Leal Ana , Botelho Mariana , Carmo‐Silva Sara , Águas Rodolfo , Cortes Luísa , Lucas Vasco , Real Ana Carolina , López‐Otín Carlos , Nissan Xavier , de Almeida Luís Pereira , Cavadas Cláudia , Aveleira Célia A.
Published: October 2023

Hutchinson‐Gilford progeria syndrome (HGPS) is a rare and fatal genetic condition that arises from a single nucleotide alteration in the LMNA gene, leading to the production of a defective lamin A protein known as progerin. The accumulation of progerin accelerates the onset of a dramatic premature aging phenotype in children with HGPS, characterized by low body weight, lipodystrophy, metabolic dysfunction, skin, and musculoskeletal age‐related dysfunctions. In most cases, these children die of age‐related cardiovascular dysfunction by their early teenage years. The absence of effective treatments for HGPS underscores the critical need to explore novel safe therapeutic strategies. In this study, we show that treatment with the hormone ghrelin increases autophagy, decreases progerin levels, and alleviates other cellular hallmarks of premature aging in human HGPS fibroblasts. Additionally, using a HGPS mouse model (LmnaG609G/G609G mice), we demonstrate that ghrelin administration effectively rescues molecular and histopathological progeroid features, prevents progressive weight loss in later stages, reverses the lipodystrophic phenotype, and extends lifespan of these short‐lived mice. Therefore, our findings uncover the potential of modulating ghrelin signaling offers new treatment targets and translational approaches that may improve outcomes and enhance the quality of life for patients with HGPS and other age‐related pathologies.
Findings from three methods to identify falls in hospitals: Results from the Ambient Intelligent Geriatric Management system fall prevention trial
Authors: Visvanathan R. , Lange K. , Selvam J. , Dollard J. , Boyle E. , Jones K. , Ingram K. , Shibu P. , Wilson A. , Ranasinghe D. C. , Karnon J. , Hill K. D
Published: October 2023

Objective

To (a) compare characteristics of patients who fall with those of patients who did not fall; and (b) characterise falls (time, injury severity and location) through three fall reporting methods (incident system reports, medical notes and clinician reports).

Methods

A substudy design within a stepped‐wedge clinical trial was used: 3239 trial participants were recruited from two inpatient Geriatric Evaluation and Management Units and one general medicine ward in two Australian states. To compare the characteristics of patients who had fallen with those who had not, descriptive tests were used. To characterise falls through three reporting methods, bivariate logistic regressions were used.

Results

Patients who had fallen were more likely than patients who had not fallen to be cognitively impaired (51% vs. 29%, p < 0.01), admitted with falls (38% vs. 28%, p = 0.01) and have poor health outcomes such as prolonged length of stay (24 [16–34] vs. 12 [8–19] days [IQR], p < 0.01) and less likely to be discharged directly to the community (62% vs. 47%, p < 0.01). Most falls were captured from medical notes (93%), with clinician (71%) and incident reports (68%) missing 21%–25% of falls. The proportion of injurious falls identified through incident reports was higher than medical records or clinician reports (40% vs. 34% vs. 37%).

Conclusions

This study reaffirms the need to improve reporting falls in incident systems and at clinical handover to the team leader. Research should continue to use more than one method of identifying falls, but include data from medical records. Many falls cause injury, resulting in poor health outcomes.
Hospitalisations before and after entry into a residential aged care facility: An interrupted time series analysis
Authors: Seaman Karla , Huang Guogui , Wabe Nasir , Nguyen Amy , Pinto Sonali , Westbrook Johanna
Published: October 2023

Objective

Hospitalisations are an important indicator of safety and quality of care in residential aged care facilities (RACFs). This study aimed to investigate changes in hospital use 12 months before and 12 months after RACF entry using routinely collected data from 25 Australian RACFs.

Methods

This was a retrospective longitudinal cohort study using linked aged care provider and hospital record data. The sample comprised 1029 residents living in an aged care facility between July 2014 and December 2019 who had stayed a minimum of 12 months in an RACF. The outcome measures were all‐cause hospitalisations and fall‐related hospitalisations. We applied an interrupted time series analysis using segmented regression to examine changes in both outcome measures over time. Stratified analyses were conducted by gender and dementia status.

Results

The rate of all‐cause hospitalisations increased dramatically over the 12 months before RACF entry, from 97 per 1000 residents per month 12 months prior to RACF admission to 303 per 1000 residents at the second month prior to RACF entry. All‐cause hospitalisations then decreased considerably to 55 per 1000 residents upon RACF admission and stabilised across the next 12 months. Such trajectories were also observed in fall‐related hospitalisations and were consistent for gender and dementia status.

Conclusions

In this study, hospitalisation rates decreased significantly after RACF entry, and such reductions were maintained for residents who stayed for 12 months in RACFs. Multiple hospital admissions are likely to precipitate entry into RACF. Additional investigation of how community‐based services can be successful in reducing the escalating hospitalisations is needed.
Computational fluid dynamics‐based design and in vitro characterization of a novel pediatric pump‐lung
Authors: Han Dong , Zhang Jiafeng , He Ge , Griffith Bartley P. , Wu Zhongjun J.
Published: October 2023

Background

Although extracorporeal membrane oxygenation (ECMO) has been used to provide temporary support for pediatric patients suffering severe respiratory or cardiac failure since 1970, ECMO systems specifically designed for pediatric patients, particularly for long‐term use, remain an unmet clinical need. We sought to develop a new pediatric ECMO system, that is, pediatric pump‐lung (PPL), consisting of a unique cylinder oxygenator with an outside‐in radial flow path and a centrifugal pump.

Methods

Computational fluid dynamics was used to analyze the blood fluid field for optimized biocompatible and gas exchange performances in terms of flow characteristics, hemolysis, and gas transfer efficiency. Ovine blood was used for in vitro hemolysis and gas transfer testing.

Results

Both the computational and experimental data showed that the pressure drop through the PPL's oxygenator is significantly low, even at a flow rate of more than 3.5 L/min. The PPL showed better hemolysis performance than a commercial ECMO circuit consisting of the Quadrox‐iD pediatric oxygenator and the Rotaflow pump at a 3.5 L/min flow rate and 250 mm Hg afterload pressure. The oxygen transfer rate of the PPL can reach over 200 mL/min at a flow rate of 3.5 L/min.

Conclusions

The PPL has the potential to provide adequate blood pumping and excellent respiratory support with minimal risk of hemolysis for a wide range of pediatric patients.
Economic policy uncertainty and geopolitical risk: evidence from China and Southeast Asia
Authors: Wang Kai‐Hua , Wang Zu‐Shan , Liu Hong‐Wen , Li Xin
Published: October 2023

This paper investigates the connectedness between China's economic policy uncertainty (EPU) and the geopolitical risk (GPR) of the countries in the Association of Southeast Asian Nations (ASEAN) using quantile time‐varying parameter vector autoregression. The empirical results indicate that China's EPU becomes a net risk transmitter at the median quantile, demonstrating that ASEAN countries' GPR is vulnerable to China's economic shocks. Furthermore, extreme events such as COVID‐19 amplify the connection between EPU and GPR, leading to a higher total connectedness index value. Moreover, the pairwise spillover effect analysis reflects that the risk launcher effect of China's EPU is longer and more prominent for Thailand and the Philippines than for Malaysia and Indonesia, which enriches the hypothesis. The contributions are as follows. This paper selects emerging China as the research object and first discusses its economic influence on neighbouring countries. In addition, fully analysing the heterogeneous spillover effects of EPU on the GPR of different countries makes our suggestions diversified and practical. Therefore, improving recognisable ability and institutional quality will promote ASEAN countries to mitigate their vulnerability to China's EPU shocks. Meanwhile, China's government should quickly respond to external uncertainties, prudently adjust economic policies, and avoid large swings of EPU volatility.
Safety and short‐term outcomes of robotic‐assisted transabdominal preperitoneal repair for inguinal hernia in pioneering hospitals in Japan: A nationwide retrospective cohort study
Authors: Okamoto Nobuhiko , Misawa Takeyuki , Shimada Gen , Saito Takuya , Takiguchi Shuji , Imamura Kiyotaka , Ohuchi Masakazu , Tanida Tsukasa , Watanobe Ikuo , Fujii Tsutomu , Takemasa Ichiro , Mizutani Fumitoshi , Matsubara Taketo , Hayakawa Shunsuke , Watanabe Toru , Okuya Koichi , Takahashi Hideki , Horikawa Masahiro , Wakabayashi Go
Published: October 2023

Introduction

We aimed to evaluate the safety and short‐term outcomes of robotic‐assisted transabdominal preperitoneal repair for inguinal hernia in 12 pioneering hospitals in Japan.

Methods

Clinical data of patients who underwent robotic‐assisted transabdominal preperitoneal repair between September 1, 2016, and December 31, 2021 were collected. Primary outcome measures were intra‐operative adverse events and post‐operative complications, whereas secondary outcomes were surgical outcomes, including chronic pain, recurrence, and learning curve.

Results

In total, 307 patients were included. One case of inferior epigastric arterial injury was reported; no cases of bowel or bladder injury were reported. Thirty‐five seromas were observed, including four (1.3%) cases that required aspiration. The median operative time of a unilateral case was 108 minutes (interquartile range: 89.8–125.5), and post‐operative pain was rated 1 (interquartile range: 0–2) on the numerical rating scale. In complicated cases, such as recurrent inguinal hernias and robotic‐assisted radical prostatectomy‐associated hernias, dissection and suture were safely achieved, and no complications were observed, except for non‐symptomatic seroma. All patients underwent robotic procedures, and there was no chronic post‐operative inguinal pain, although one case of hernia recurrence was reported. Regarding the learning curve, plateau performance was achieved after 7–10 cases in terms of operative time (P < .001).

Conclusion

Robotic‐assisted transabdominal preperitoneal repair can be safely introduced in Japan. Regardless of the involvement of many surgeons, the mastery of robotic techniques was achieved relatively quickly. The advantage of robotic technology such as wristed instruments may expand the application of minimally invasive hernia repair for complicated cases.
Symbiotic acacia ants drive nesting behavior by birds in an African savanna
Authors: Lujan Ema , Nielsen Ryen , Short Zoe , Wicks Samuel , Watetu Wilson Nderitu , Khasoha Leo M. , Palmer Todd M. , Goheen Jacob R. , Alston Jesse M.
Published: October 2023

Mutualisms between plants and ants are common features of tropical ecosystems around the globe and can have cascading effects on interactions with the ecological communities in which they occur. In an African savanna, we assessed whether acacia ants influence nest site selection by tree‐nesting birds. Birds selected nest sites in trees inhabited by ant species that vigorously defend against browsing mammals. Future research could address the extent to which hatching and fledging rates depend on the species of ant symbiont, and why ants tolerate nesting birds but no other tree associates (especially insects).

Abstract in Swahili is available with online material.
Prognostic impact of cancer genomic profile testing for advanced or metastatic solid tumors in clinical practice
Authors: Fukada Ippei , Mori Seiichi , Hayashi Naomi , Hosonaga Mari , Xiaofei Wang , Yamazaki Masumi , Ueki Arisa , Kiyotani Kazuma , Tonooka Akiko , Takeuchi Kengo , Ueno Takayuki , Takahashi Shunji
Published: October 2023

Cancer genomic profile (CGP) testing, which is covered by the national health insurance system in Japan, has been introduced as a routine clinical practice. However, the effects of CGP testing on prognoses remain unclear. Drug accessibility rates and prognoses after CGP testing were retrospectively investigated in 713 patients who underwent CGP testing examined by our molecular tumor board between November 2019 and October 2022,. Overall survival (OS) was examined using the log‐rank test and the Kaplan–Meier method. The median age of patients (326 males and 387 females) was 58 years (12–85 years). CGP testing revealed one or more gene mutations in 681 cases (95.5%), among which actionable gene mutations were detected in 439 (61.6%). Although treatment options were recommended for 285 cases (40.0%) by the molecular tumor board, only 45 received treatment based on their gene mutations. During the median observation period of 8.6 months, 351 (49.2%) patients died of the exacerbation of existing diseases. No significant differences were observed in OS between patients treated with and without genomically matched therapy (p = 0.285). According to clinical responses to treatment based on gene mutations, median OS was significantly longer in patients who achieved partial response and stable disease (26.5 months; 95% CI 14.4–38.6) than in those with progressive disease and not evaluated (9.8 months; 95% CI 5.8–13.8, p = 0.013). Responses to treatment based on gene mutations may improve prognoses, and it is important to increase the drug accessibility rate after CGP testing.
Perception of parents and caregivers about the need for dental appointments for adolescents from a Brazilian birth cohort
Authors: Tillmann Thais Freitas Formozo , de Camargo Maria Beatriz Junqueira , Cascaes Andréia Morales , Barros Aluísio J. D. , Santos Iná S. , Corrêa Marcos Britto , Matijasevich Alicia , D'Ávila Otávio Pereira , Silva Alexandre Emidio Ribeiro
Published: October 2023

Objective

To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12–13 years and associated factors.

Methods

Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers. Demographic and economic exposure variables were obtained from the first (2004) and sixth general follow‐up (2015), respectively. The exposure variables ‘previous history of dental pain’, ‘self‐rated oral health’, clinical variables and the outcome variable were obtained from the second oral health follow‐up (2017). Unadjusted and adjusted multivariate Poisson regression analyses provided prevalence ratios (PR) and respective 95% confidence intervals (CI).

Results

At the first oral health follow‐up (2009), 1303 five‐year‐old children were recruited, 996 of whom were reassessed and underwent oral health examinations at 12 and 13 years of age (response rate: 76.4%). The findings showed that 72.4% of parents/caregivers perceived that the adolescents needed dental appointments. No associations were found between the outcome and sociodemographic or economic variables. After adjustments, the outcome remained positively associated with previous history of toothache (PR 1.22; 95% CI 1.14–1.32), self‐rated oral health as fair or poor (PR 1.26; 95% CI 1.15–1.39), the presence of dental caries (PR 1.27; 95% CI 1.20–1.38) and severe or disabling malocclusion (PR 1.14; 95% CI 1.05–1.25).

Conclusions

The perception of parents/caregivers regarding the need for dental appointments on the part of their adolescent sons and daughters was associated with oral health problems, and these findings can serve as the basis for creating and improving oral health programmes that seek a better understanding on the part of parents and caregivers regarding the importance of integral care for their adolescent children.
Impact of levothyroxine therapy for maternal subclinical and overt hypothyroidism on early child neurodevelopment: A prospective cohort study
Authors: Zhao Zhekun , Zhao Huanqiang , Xiong Yu , Zhou Qiongjie , Li Xiaotian
Published: October 2023

Objective

Treatment indication of maternal subclinical hypothyroidism (SCH) is undetermined, despite the wide administration of levothyroxine for maternal overt hypothyroidism (OH). This study aimed to evaluate the therapeutic effect of levothyroxine for maternal SCH and OH in real‐world practice, with a focus on early child neurodevelopment.

Design

Prospective cohort study.

Patients and Measurements

Pregnant women diagnosed with SCH at the first antenatal visit were enroled and compared to those diagnosed with OH. Thyroid follow‐ups were conducted during pregnancy. Early child neurodevelopment was assessed using the Gesell Development Diagnosis Scale (GDDS) at 1, 3, 6, 12 and 24 months of age.

Results

From January 2012 to December 2013, a total of 442 pregnant women were included in final analysis, among whom 194 and 248 were assigned to the SCH and OH groups, respectively. The percentage of levothyroxine therapy at the first antenatal visit was significantly lower in the SCH group than that in the OH group (91.24% vs. 97.58%, p < .01), with a similar treatment rate at delivery (99.4% vs. 100%, p > .05). Notably, GDDS scores were lower in the SCH group than those in the OH group at 6 months to 2 years of age, which was confirmed by subgroup analyses and sensitivity analyses.

Conclusions

Children born with maternal SCH demonstrated slightly lower neuropsychological scores at 6 months to 2 years of age compared to those with maternal OH in the clinical practice. The therapeutic effect of maternal SCH on the child neurodevelopment requires further exploration.
Meta‐analysis of multi‐modality therapies in sinonasal undifferentiated carcinoma—A timely update
Authors: See Alicia Su Yun , Chu Clarisse , Lim Isis Claire Zhen Yu , Tan Benjamin Kye Jyn , Ang Sheryl Xiu Qi , Xu Shuhui , Teo Neville Wei Yang , Charn Tze Choong
Published: October 2023

Objectives

Sinonasal undifferentiated carcinoma (SNUC) is a rare but aggressive tumour with very poor prognosis. There are currently no well‐established clinical trials to guide therapy and the impact of various treatment modalities on survival is not well defined. We aim to provide an updated systematic review on current treatment modalities on survival outcomes.

Design and Setting

Individual patient data were extracted, and survival data pooled in a one‐stage meta‐analysis. Descriptive statistics were analysed using the Kaplan–Meier method. Patient‐level comparisons stratified by treatment modalities, adjusted for demographics, were conducted using shared‐frailty Cox regression.

Participants and Main outcome measures

Participants include all patients diagnosed with SNUC based on histological evidence. We looked at the overall cumulative survival outcome for different treatment modalities and overall survival by treatment modality in low versus high stage SNUC patients.

Results and Conclusion

Seventeen studies were identified, comprising 208 patients from 1993 to 2020. There was no significant difference in cumulative overall survival in low versus high stage patients, and no significant difference in outcomes by treatment modality. The overall cumulative survival of SNUC is 30% at 95 months. Among patients treated with various combinations of treatment modalities, patients with chemoradiotherapy had the highest cumulative survival of 42% at 40 months. Definitive chemoradiotherapy was associated with improved disease survival rate. Regardless of tumour stage, patients should be treated early and aggressively, with no superiority of one treatment regimen over another. Trimodality treatment does not confer survival advantage over bimodality treatment.
Nevus lipomatosus superficialis: A series of six cases
Authors: AbdullGaffar Badr , Keloth Tasnim
Published: October 2023

Nevus lipomatosus still imposes diagnostic, categorization, and etiologic challenges. Even though an intradermal adipose tissue is a histopathologic prerequisite, the lesions are clinically divided into classic multiple forms and a solitary variant, which some consider a separate so‐called lipofibroma clinicopathologic entity. This further complicates the true prevalence, classification and etiopathogenesis of nevus lipomatosus. Case reports and series studies have reflected either consistent or variable and sometimes conflicting clinicopathologic findings. A few have reported electron microscopic findings. Immunohistochemistry is lacking. We report two multiple and four solitary forms of nevus lipomatosus in six patients, highlighting their salient histopathologic features and immunohistochemical profile. Both forms showed intradermal groups of perivascular S100+ lipogenic and CD34+ mesenchymal cells intermixed with scattered CD1a+ and FXIIIa+ dendrocytes, CD3 lymphocytic and CD117 mast cells in a fibromyxoid milieu. Epidermal nevoid and comedonal follicular alterations, attenuated dermal connective tissue and adnexal structures were variably present in both forms. We compared our findings with seven series of studies reporting classic and solitary forms. Both forms showed similar histopathologic findings, comparable clinicopathologic features, predominantly pelvic, and shoulder girdle distribution patterns in bimodal age onsets. Even though some lipomatous skin lesions clinically and histopathologically overlap with nevus lipomatosus, certain findings are helpful distinguishing features. Small intradermal islands of lipocytic fibroplasia have characteristic perivascular milieu that may function as a niche of preadipose CD34 mesenchymal stem cells. They are most likely represented in the dermis of the pelvic and shoulder areas in certain individuals prone to maintain these embryonic reservoirs, which are clinically manifested at different ages. Some may have unifocal or multifocal residues reflecting multiple and solitary forms.
Treatment responses to basal insulin glargine 300 U/ml and glargine 100 U/ml in newly defined subphenotypes of type 2 diabetes: A post hoc analysis of the EDITION 3 randomized clinical trial
Authors: Landgraf Wolfgang , Owens David R. , Frier Brian M. , Bolli Geremia B.
Published: October 2023

Introduction

To compare responses to basal insulin glargine 300 U/ml (IGlar‐300) and 100 U/ml (IGlar‐100) in newly defined subphenotypes of type 2 diabetes.

Methods

Insulin‐naive participants (n = 858) from the EDITION 3 trial were assigned to subphenotypes ‘Mild Age‐Related Diabetes (MARD)’, ‘Mild Obesity Diabetes (MOD)’, ‘Severe Insulin Resistant Diabetes (SIRD)’ and ‘Severe Insulin Deficient Diabetes (SIDD)’. Key variables were analysed at baseline and 26 weeks.

Results

Participants were comprised of MOD 56.1% (n = 481), SIDD 22.1% (n = 190), MARD 18.2% (n = 156) and SIRD 3.0% (n = 26). After 26 weeks a similar decrease in glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) of 16‐19 mmol/mol and 1.4‐1.7 mmol/L, respectively, occurred in MARD and MOD with both insulins. SIDD had the most elevated HbA1c and FPG (80‐83 mmol/mol/11.1‐11.4 mmol/L) and reduction in both HbA1c and FPG was greater with IGlar‐100 than with IGlar‐300 (−18 vs. −15 mmol/mol and −1.6 vs. −1.3 mmol/L, respectively; each p = .03). In SIDD, despite receiving the highest basal insulin doses, HbA1c decline (57‐60 mmol/mol/7.3‐7.6%) was suboptimal at week 26. In MOD and SIDD lower incidences with IGlar‐300 were found for level 1 nocturnal hypoglycaemia [odds ratio (OR) 0.59, 95% confidence intervals (CI) 0.36‐0.97; OR 0.49, 95% CI 0.24‐0.99]. In addition, fewer level 2 hypoglycaemia episodes occurred at any time with IGlar‐300 in SIDD (OR 0.31, 95% CI 0.13‐0.77).

Conclusion

Both insulins produce comparable outcomes in type 2 diabetes subphenotypes, but in SIDD, add‐on treatment to basal insulin is required to achieve glycaemic targets.
A collection of no authority: canon law and the Collectio 91 capitulorum
Authors: Meeder Sven
Published: October 2023

Normative texts need to be authoritative to be effective in communicating norms and rules. Recent scholarship has shown a renewed interest in the authoritative status of the texts within early medieval works of canon law and the ways in which authority is reflected in the practice of attribution, promulgation, or organization. A small canonical collection known as the Collectio 91 capitulorum appears to flout the received knowledge. The current article presents this modest collection. It explores the relationship between ‘authority’ and canon law in general, and examines the negotiation of authority within this collection in particular.
A new perspective for nucleation and nanocrystallization from interfacial energy and nanoscale composition fluctuations in glasses
Authors: Komatsu Takayuki , Honma Tsuyoshi
Published: October 2023

Nucleation behaviors in glasses/supercooled liquids (SCLs) such as lithium disilicate Li2O–2SiO2, cordierite Mg2Al4Si5O18, fresnoite Ba2TiSi2O8, and K2O–Nb2O5–GeO2/TeO2 glasses were analyzed and discussed from the interfacial energy γ at SCL–nucleus interfaces and nanoscale composition fluctuations. Based on the fragility concept for SCLs and the intrinsic origin of γ, the magnitude order of γ(fragile SCL) < γ(strong SCL) was proposed to be a crucial guide for an understanding of high homogeneous nucleation rates and prominent nanocrystallization. The role of nucleating agent TiO2/ZrO2 in accelerating the nucleation rate in cordierite‐based and β‐spodumene‐type Li2O–Al2O3–SiO2‐based glasses was discussed from the new perspective of γ(homoepitaxial‐like nucleation) < γ(heteroepitaxial‐like nucleation). Ferroelectric nanocrystals such as SrxBa1–xNb2O6 in borate glasses and fluoride nanocrystals such as CaF2 are also well understood from the proposed guidelines. The present article provides a new perspective for nucleation in glasses/SCLs, contributing to the comprehensive composition design of new innovative glass‐ceramics.
Effect of phage and rhamnolipid on Salmonella Infantis biofilm removal and biological control of phage on food deterioration
Authors: Erol Hilal Basak , Kaskatepe Banu
Published: October 2023

Bacteria adherence to the surface and the resulting biofilm have serious harmful effects in food. Biofilm formation in foods can lead to food deterioration and disease transfer easily. Some alternative applications are being tried to remove biofilms. Among these, biosurfactants and bacteriophages are promising owing to their low toxicity, easy availability, and high activity. In our study, the action of phage and rhamnolipid, a biosurfactant, on the biofilm of Salmonella Infantis, which is an important pathogen in food, was examined. Additionally, the efficacy of phages in the biocontrol of foods was tested. It is observed that the phage significantly reduces the bacterial concentration in milk in the first 4 h at 4 °C and 25 °C and maintains its effect for 24 h at 4 °C. The p_S3 phage, rhamnolipid (RML), and p_S3 phage + RML mixture on the 48‐h biofilm decreased the biofilm mass by 44.9–81.8%, 20.8–81.1%, and 12–60%, respectively. On a 1‐week‐old biofilm, the p_S3 phage, RML, and p_S3 phage + RML mixture decreased the biofilm mass by 43–60%, 55–72%, and 49.7–61.7%, respectively. It is seen that the p_S3 phage and RML co‐administration on biofilm can be a biosafe application in food production facilities where it is a more effective application in removing the biofilm in long‐term exposure.
Mycoprotein as a meat substitute: production, functional properties, and current challenges‐a review
Authors: Khan Rahim , Brishti Fatema Hossain , Arulrajah Brisha , Goh Yong Meng , Abd Rahim Muhamad Hafiz , Karim Roselina , Hajar‐Azhari Siti , Kin Kit Sam , Anwar Farooq , Saari Nazamid
Published: October 2023

Meat has historically been an essential source of animal‐based protein. However, due to population growth, health problems linked to the consumption of red meat, and concerns over environmental challenges, there is an increased need for alternative protein sources. Various plant‐based meat alternatives have recently been explored, with ongoing advancements in industrial‐scale production. Mycoprotein has been proposed as a sustainable alternative to meat due to its distinctive functional food properties and fibrous structure. However, some challenges still prevail related to large‐scale production, texture, sustainability, and acceptability of mycoprotein products. This review paper provides a comprehensive overview of scientific research on mycoprotein, focusing on nutritional composition, functional properties, production technology, and health benefits. This study also examines the current challenges related to product safety, environmental impact, and prospects of this innovative food.
Well‐being, turnover intention, and stigma attitudes of mental health transition‐to‐practice nurses: A cross‐sectional study
Authors: Foster Kim , Steele Michael , Metcalfe James , Toomey Nigel , Alexander Louise
Published: October 2023

There is global recognition that mental health nursing can be stressful and have detrimental effects on nurses' well‐being and retention. With substantial nursing shortages, there is an urgent need to attract and retain nurses to sustain this workforce and provide effective mental healthcare. Mental health transition programs provide vital recruitment pathways and support novice registered nurses, enrolled nurses and experienced registered generalist nurses moving into this field. There is little evidence, however, on the well‐being, resilience, and retention of nurses transitioning into mental health. The primary aims for this cross‐sectional study were to describe demographic characteristics, perceived stress, well‐being, resilience, mental illness stigma attitudes, work satisfaction, and turnover intention of four nurse cohorts entering mental health transition programs: generalist registered nurses, graduate and post‐graduate registered nurses, and enrolled nurses; to explore relationships between these variables; and explore differences between these four nurse cohorts. Findings (n = 87) included overall moderate perceived stress, moderate well‐being and resilience, high work satisfaction, low stigma, and low turnover intention. Higher turnover intention was associated with lower age and work satisfaction, and higher perceived stress. Generalist RNs had significantly higher stress and stigmatizing attitudes than Enrolled Nurses. Secondary analysis of well‐being scores identified 14 nurses with scores indicating depression, with significantly lower resilience and work satisfaction, and significantly higher stress than the rest of the sample. To help prevent attrition, it is vital that mental health services provide tailored well‐being initiatives during transition and intervene early to provide support for nurses with mental distress.
Investigating the developmental onset of regenerative potential in the annelid Capitella teleta
Authors: Boyd Alicia A. , Seaver Elaine C.
Published: October 2023

An animal's ability to regrow lost tissues or structures can vary greatly during its life cycle. The annelid Capitella teleta exhibits posterior, but not anterior, regeneration as juveniles and adults. In contrast, embryos display only limited replacement of specific tissues. To investigate when during development individuals of C. teleta become capable of regeneration, we assessed the extent to which larvae can regenerate. We hypothesized that larvae exhibit intermediate regeneration potential and demonstrate some features of juvenile regeneration, but do not successfully replace all lost structures. Both anterior and posterior regeneration potential of larvae were evaluated following amputation. We used several methods to analyze wound sites: EdU incorporation to assess cell proliferation; in situ hybridization to assess stem cell and differentiation marker expression; immunohistochemistry and phalloidin staining to determine presence of neurites and muscle fibers, respectively; and observation to assess re‐epithelialization and determine regrowth of structures. Wound healing occurred within 6 h of amputation for both anterior and posterior amputations. Cell proliferation at both wound sites was observed for up to 7 days following amputation. In addition, the stem cell marker vasa was expressed at anterior and posterior wound sites. However, growth of new tissue was observed only in posterior amputations. Neurites from the ventral nerve cord were also observed at posterior wound sites. De novo ash expression in the ectoderm of anterior wound sites indicated neuronal cell specification, although the absence of elav expression indicated an inability to progress to neuronal differentiation. In rare instances, cilia and eyes re‐formed. Both amputations induced expanded expression of the myogenesis gene MyoD in preexisting tissues. Our results indicate that amputated larvae complete early, but not late, stages of regeneration, which indicates a gradual acquisition of regenerative ability in C. teleta. Furthermore, amputated larvae can metamorphose into burrowing juveniles, including those missing brain and anterior sensory structures. To our knowledge, this is the first study to assess regenerative potential of annelid larvae.
Chemically Crosslinked Lactate Dehydrogenase: Stability and Reconstitution After Glutaraldehyde Fixation
Authors: Gottschalk N. , Jaenicke R.
Published: October 2023

Lactate dehydrogenase (LDH) from pig heart was stabilized in its tetrameric state by crosslinking with glutaraldehyde. The product (containing 82% tetramers, 9% dimers, 6% monomers, and 3% aggregates) retained up to approximately equal to 60% of its original activity without detectable changes in the spectral and catalytic properties of the enzyme. Fixation of the native quaternary structure enhances the stability of the enzyme: the equilibrium transitions of heat and guanidine deactivation are shifted from 60 to 65 degrees C and CG.HCl = 0.3 to 1.0 M, respectively. Deactivation and denaturation of the crosslinked enzyme do not coincide: the equilibrium transition of fluorescence emission at CG.HCl approximately equal to 3.5 M is paralleled by a significant decrease in cooperativity. The kinetics of thermal denaturation allow structural transitions within a partially crosslinked, native‐like species (less than or equal to 10%) to be separated from the unfolding of the fully crosslinked enzyme. The corresponding first‐order rate constants at CLDH = 10 micrograms/ml and 60 degrees C are 4.5 × 10(‐4) and 2.7 × 10(‐5)s‐1, respectively. The yield of reconstitution of the crosslinked enzyme after acid denaturation does not exceed 30%; the rate of reactivation is fast due to the significant residual structure of the acid‐denatured enzyme. Rate‐determining association (which dominates the reconstitution of the unmodified enzyme) does not contribute to the kinetic mechanism. After complete randomization in 6 M guanidinium chloride, incorrect near‐neighbor interactions between the crosslinked subunits essentially block the reconstitution of the native structure and function.
Hepatic or Splenic Targeting of Carrier Erythrocytes: A Murine Model
Authors: Zocchi E. , Guida L. , Benatti U. , Canepa M. , Borgiani L. , Zanin T. , de Flora A.
Published: October 2023

Carrier mouse erythrocytes, i.e., red cells, subjected to a dialysis technique involving transient hypotonic hemolysis and isotonic resealing were treated in vitro in three different ways: (a) energy depletion by exposure for 90 min at 42 degrees C; (b) desialylation by incubation with neuroaminidase; and (c) oxidative stress by incubation with H2O2 and NaN3. Procedure (c) afforded maximal damage, as shown by analysis of biochemical properties of the treated erythrocytes. Reinfusion in mice of the variously manipulated erythrocytes following their 51Cr labeling showed extensive fragilization as indicated by rapid clearance of radioactivity from the circulation. Moreover, both the energy‐depleted and the neuraminidase‐treated erythrocytes showed a preferential liver uptake, reaching 50 and 75%, respectively, within 2 h. On the other hand, exposure of erythrocytes to the oxidant stress triggered a largely splenic removal, accounting for almost 40% of the reinjected cells within 4 h. Transmission electron microscopy of liver from mice receiving energy‐depleted erythrocytes demonstrated remarkable erythrocyte congestion within the sinusoids, followed by hyperactivity of Kupffer cells and by subsequent thickening of the perisinusoidal Disse space. Concomitantly, levels of serum transaminase activities were moderately increased. Each of the three procedures of manipulation of carrier erythrocytes may prove applicable under conditions where selective targeting of erythrocyte‐encapsulated chemicals and drugs to either the liver or the spleen has to be achieved.
Generation and epitope analysis of thyroid stimulating hormone‐specific monoclonal antibodies for enzyme immunoassays
Authors: Chow SN , Chen KW , Su SL , Tung J. , Lee CY
Published: October 2023

By using an improved hybridoma technique with a semisolid medium of methylcellulose for initial cloning, numerous high affinity monoclonal antibodies against human thyroid stimulating hormone (TSH) were generated. These antibodies were characterized with respect to their subunit and epitope specificity. Epitope analysis of antibodies specific to the beta‐subunit of TSH was performed by a sandwich pairing procedure. Based on the results of this analysis, it was concluded that there are four distinct TSH‐specific epitopes on the beta‐subunit of TSH; these are designated a, b, c, and ab. The five antibodies binding to epitopes a, b, and c are not mutually exclusive. However, the antibody binding to epitope ab prevents further binding of other antibodies to epitope a or b, but not to epitope c. This epitope analysis enabled us to combine three high affinity monoclonal antibodies, each of which reacts with epitopes a, b, and c, respectively, in a typical sandwich enzyme immunoassay. One was immobilized on polystyrene beads and the other two were conjugated with horseradish peroxidase and served as the second antibodies. This enzyme immunoassay can be performed within 90 min and with a minimum sensitivity of 0.2‐0.3 microIU/ml.
The relationship between urban greenspace perception and use within the adolescent population: A focused ethnography
Authors: Lyons Rachel , Colbert Alison , Browning Matthew , Jakub Karen
Published: October 2023

Introduction

Greenspace is beneficial for improving adolescent mental health, yet healthcare professionals still do not understand the connection between the built environment and subjective mental well‐being. We also need to understand how this population uses greenspace and how they feel when in it.

Aim

The aim of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace and to explore how they feel when they are in greenspace.

Design

Focused ethnography.

Methods

Data were collected between June 2022 and August 2022 using participant observation, photo elicitation and semi‐structured interviews. Braun and Clarke's (2006) six phases of thematic analysis were used to guide data collection and analysis.

Results

A total of 11 adolescents between ages 12 and 18 who resided in and around Newark, NJ, were recruited. Three themes were identified from the data: (1) A tranquil space in an unsafe place; (2) Park means family connection with burgeoning independence; and (3) My park: Sense of ownership and responsibility.

Conclusions

This study deepens the understanding between subjective mental well‐being and urban greenspace exposure. Adolescents accepted responsibility for maintaining “my park”, which strengthens community cohesion, detailing the importance of youth input during urban planning.

Implications for Practice

Implications from this study suggest that environmental interventions may help ameliorate an ongoing mental health care crisis among adolescents. Healthcare providers should consider the built environment as another approach to promoting mental health.

Patient or Public Contribution

None other than research participants.
Peer functioning difficulties may exacerbate symptoms of attention‐deficit/hyperactivity disorder and irritability over time: a temporal network analysis
Authors: Bellaert Nellia , Morreale Kristina , Tseng Wan‐Ling
Published: October 2023

Background

Children with attention‐deficit/hyperactivity disorder (ADHD) have been consistently found to experience impairments in peer functioning. Irritability is highly prevalent in children with ADHD and may worsen social impairments given the frequent temper outbursts and low frustration tolerance characterizing irritability. However, it is still unclear how ADHD and irritability symptoms interact with peer functioning difficulties over time. Assessing these temporal dynamics using a novel longitudinal approach (i.e., temporal network analysis) may reveal precise targets for intervention.

Methods

This study investigates the dynamic associations between ADHD symptoms, irritability, and peer functioning in a community sample of 739 children (ages 8–11 years, Mage = 10.06 [SD = 0.59], 47.77% females) assessed at three timepoints, 6 months apart, in a school‐based study. Parents reported their child's ADHD symptoms using the Swanson, Nolan, and Pelham Rating Scale (SNAP‐IV), and irritability symptoms using the Child Behavior Checklist (CBCL) irritability items. Children's peer functioning (i.e., peer acceptance, peer rejection, number of friendships, and victimization) was measured via peer nomination. To estimate the longitudinal associations between the variables, we built a graphical vector autoregression model for panel data.

Results

The longitudinal network highlighted that poor peer functioning contributed to increases in symptoms over time. Specifically, (1) physical victimization predicted increases in inattention, hyperactivity, and irritability; (2) peer rejection predicted increases in inattention, which in turn predicted increases in irritability; (3) peer acceptance predicted decreases in inattention and irritability; and (4) higher numbers of mutual friendships increased inattention.

Conclusions

These results suggest that a negative social environment involving physical bullying and rejection may aggravate ADHD and irritability symptoms. Conversely, positive social interactions, such as being liked by peers, may improve inattention and irritability symptoms. Fostering social–emotional skills and positive social interactions and environments in children with ADHD and irritability may be a promising target for future interventions to reduce symptoms.