bluuebunny/crossref_metadata_2025 huggingface dataset:
The dynamics of L2 teacher boredom and their link to creativity: A ban or boon for boredom
Authors: Elahi Shirvan Majid , Taherian Tahereh , Pawlak Mirosław , Kruk Mariusz
Published: August 2024

Research has revealed a prevalence of boredom among L2 teachers, despite efforts to mitigate this negative emotion. The interplay between teacher boredom and creativity, especially their concurrent development, has not been extensively studied longitudinally. Utilizing control‐value theory as its foundation, this study investigates the daily progression of boredom and creativity among L2 teachers, their mutual development, and how control‐value beliefs influence these dynamics. A 5‐day experience sampling method study involving 98 L2 teachers generated 423 observations. Dynamic structural equation modeling (DSEM) was employed at the individual (Level 1) and group (Level 2) levels. DSEM results revealed varied relationships between boredom and creativity changes over a week, influenced by teachers’ control and value beliefs. In innovators, with high perceived control and intrinsic value beliefs and moderate to high extrinsic value beliefs, previous experiences of boredom might positively influence the teacher's creativity the next day. This creativity might, in turn, decrease the teacher's boredom. This suggests a potential positive relationship between boredom and creativity in innovative language teachers. In adaptors, with moderate perceived control and intrinsic value beliefs and medium to low extrinsic value beliefs, previous experiences of boredom did not necessarily influence the teacher's creativity the next day. However, teacher creativity might still decrease teacher boredom. For traditionalists, with medium perceived control and intrinsic value beliefs and moderate to high extrinsic value beliefs, previous experiences of boredom might have decreased the teacher's creativity the next day, while teacher creativity might have decreased the teacher's boredom the same day. Finally, in dissatisfied teachers with low perceived control, intrinsic value, and extrinsic value beliefs, previous experiences of boredom might have decreased the teacher's creativity the next day, while teacher creativity might not necessarily predict the teacher's boredom. Results suggest a reciprocal relationship between boredom and creativity in adaptable and traditionalist teachers. Additionally, Level 2 analysis identified correlations between random effect parameters across four clusters.
A new species of Kannaphallus (Polyopisthocotylea: Heteraxinidae) parasitic on the twobar seabream Acanthopagrus bifasciatus (Sparidae, Teleostei) in Saudi Arabia
Authors: Alojayri Ghada , Abdel‐Gaber Rewaida , Mohammed Osama B. , Al‐Otaibi Tahani , Al‐Malki Esam S. , Al‐Hoshani Nawal , Almayouf Mina A. , Al‐Shaebi Esam , Al‐Quraishy Saleh
Published: August 2024

Monogeneans are highly host‐specific parasites infecting marine and freshwater fish. However, little information is available about the parasitic taxa within Heteraxinidae. An integrative study was performed to understand the taxonomic status of an unconfirmed heteraxinid marine species parasitizing the gill region of Acanthopagrus bifasciatus (Sparidae) from the Arabian Gulf (Saudi Arabia). Based on the morphological study, this parasite has all the generic features of the genus Kannaphallus (Heteraxinidae, Mazocraeidea). Distinct criteria that discriminated this species from other taxa of the same genus are the presence of genital spines (26–29), a short sclerotized duct in the male copulatory organ, the number of testes (mean 40, range 30–50), and clamps in the haptoral structure (45–50 in a long row and 19–22 in a short row). DNA of parasite species reported in the present study was amplified and sequenced for the nuclear large subunit of the ribosomal RNA (28S rRNA) gene and the mitochondrial cytochrome c oxidase subunit I (COI) gene. Results indicate that sequences obtained from both genes are unique and different from related sequences from the genus Kannaphallus. Morphological as well as molecular data indicate that our specimens are from a new species, and the name Kannaphallus acanthopagrusi n. sp. is suggested. This is the first report of a heteraxinid parasitizing marine sparid fish from Saudi Arabia, with unique morphological and molecular features.
Parent–adolescent family resilience and psychological adjustment in chronically ill adolescents: An actor–partner interdependence mediation model
Authors: Chen Meijia , Chen Xiuping , Jiang Hao , Wang Yuxin , Ren Liya , Zhang Liping , Dong Chaoqun
Published: August 2024

Aims

This study explored the relationships between family resilience, dyadic coping and psychological adjustment among adolescents with chronic illnesses and their parents. The actor–partner interdependence mediation model was used to validate the mediating role of dyadic coping in the relationship between family resilience and psychological adjustment.

Design

This is a cross‐sectional study.

Methods

A total of 318 parent–adolescents dyads were recruited from three paediatric hospitals in Wenzhou, Hangzhou, Shanghai city, China, between June 2022 and August 2023. The parents had a mean age of 41.62 years, and the adolescents had a mean age of 12.66 years. Participants independently completed a self‐report questionnaire assessed family resilience, dyadic coping and psychological adjustment. Data analysis was conducted using the actor–partner interdependence mediation model.

Results

The findings suggest that in the actor effects, family resilience directly influenced psychological adjustment, and family resilience is related to psychological adjustment through positive dyadic coping. In the partner effect, parents' family resilience influenced adolescents' psychological adjustment through the parents' positive dyadic coping. Similarly, adolescents' family resilience influenced parents' psychological adjustment through both parents' positive dyadic coping and adolescents' negative dyadic coping. Additionally, there was a partner effect between parents' family resilience and adolescents' psychological adjustment.

Conclusion

This study demonstrated the importance of developing effective dyadic interventions based on family resilience or positive dyadic coping strategies to improve the mental health of adolescents with chronic illnesses and their parents.

Impact

The mediating role of dyadic coping in the relationship between family resilience and psychological adjustment among adolescents with chronic illnesses and their parents was demonstrated. Future psychosocial interventions should focus on increasing parents' positive dyadic coping strategies and improving adolescents' negative dyadic coping strategies.

Patient or Public Contribution

No patient or public contribution.
Comparing effects of different goal type orders on collaborative simulation‐based inquiry in engineering problem solving: A process modelling approach
Authors: Sun Yanyan , Feng Chengjun , Peng Di , Wu Bian
Published: August 2024

Background

Both learning and problem solving are major goals of complex problem solving in engineering education. The order of knowledge construction and problem solving in learning through problem solving, however, has not been explained in current literature.

Objectives

To understand their relationships, this study compared the effects of different goal type orders on collaborative simulation‐based inquiry in engineering problem solving.

Methods

In the study, 24 engineering undergraduate students worked in pairs to solve a wind tunnel problem using a computer simulation application. Process mining and epistemic network analysis were used to model the inquiry process and identify inquiry patterns based on the log data and discussion discourse.

Results and Conclusions

The results showed the goal type of first assigned subtask influenced the inquiry strategies of medium‐performance learners most. In addition, the goal type of first assigned subtask had influence on learners' inquiry process. The learners assigned with a problem‐solving goal subtask first (Problem solving goal‐Learning goal condition) had more simulation trials and centered their inquiry discourse around clarification while the learners assigned with a learning goal subtask first (Learning goal‐Problem solving goal condition) connected reflection with other inquiry phases more often. The findings of this study suggested assigning a learning goal subtask first in simulated‐based complex engineering problem solving could be used as an idea‐centered scaffolding, especially for medium‐performance learners. However, low‐performance learners would experience a “situate knowledge paradox” and needs extra guidance. It is important to monitor the knowledge construction process in complex problem solving, even when seeking a solution is the major task.
Isoliquiritigenin diminishes invasiveness of human nasopharyngeal carcinoma cells associating with inhibition of MMP‐2 expression and STAT3 signalling
Authors: Lu Yen‐Ting , Hsin Chung‐Han , Kao Shao‐Hsuan , Ho Yu‐Ting , Yeh Fang‐Ling , Yang Shun‐Fa , Lin Chiao‐Wen
Published: August 2024

Nasopharyngeal carcinoma (NPC) is prevalent in Asia and exhibits highly metastatic characteristics, leading to uncontrolled disease progression. Isoliquiritigenin (ISL) have attracted attention due to their diverse biological and pharmacological properties, including anticancer activities. However, the impact of ISL on the invasive and migratory ability of NPC remains poorly understood. Hence, this study aimed to investigate the in vitro anti‐metastatic effects of ISL on NPC cells and elucidate the underlying signalling pathways. Human NPC cell NPC‐39 and NPC‐BM were utilized as cell models. Migratory and invasive capabilities were evaluated through wound healing and invasion assays, respectively. Gelatin zymography was employed to demonstrate matrix metalloproteinase‐2 (MMP‐2) activity, while western blotting was conducted to analyse protein expression levels and explore signalling cascades. Overexpression of signal transducer and activator of transcription 3 (STAT3) was carried out by transduction of STAT3‐expressing vector. Our findings revealed that ISL effectively suppressed the migration and invasion of NPC cells. Gelatin zymography and Western blotting assays demonstrated that ISL treatment led to a reduction in MMP‐2 enzyme activity and protein expression. Investigation of signalling cascades revealed that ISL treatment resulted in the inhibition of STAT3 phosphorylation. Moreover, overexpression of STAT3 restored the migratory ability of NPC cells in the presence of ISL. Collectively, these findings indicate that ISL inhibits the migration and invasion of NPC cells associating with MMP‐2 downregulation through suppressing STAT3 activation. This suggests that ISL has an anti‐metastatic effect on NPC cells and has potential therapeutic benefit for NPC treatment.
Effectiveness of digital interventions to reduce school‐age adolescent sexual risks: A systematic review
Authors: Aguilar‐Quesada Ana , Sierra‐Yagüe Alba , González‐Cano‐Caballero María , Zafra‐Egea José Antonio , Lima‐Serrano Marta
Published: August 2024

Introduction

The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital interventions are becoming increasingly relevant in sex education. We therefore posed the following research question: Are digital application interventions effective to prevent risky sexual behaviors in school adolescents?

Design

A systematic peer review was conducted between January and December 2023 in five databases (PubMed, Web of Science, Scopus, EMBASE, and PsycINFO) without restricting for language or year of publication.

Method

We included randomized control trials or quasi‐experimental studies that measured the effectiveness of interventions targeting young people aged 10–19 years or their parents and developed in a school setting. Interventions aimed at young people with intellectual disabilities, learning difficulties, or any disease requiring a specific intervention were excluded.

Results

The search ultimately yielded 27 studies covering a total of 18 digital interventions that demonstrated positive effects, not maintained over time, on knowledge, attitudes, and behaviors, although the latter to a lesser extent.

Discussion

We have found very interesting digital interventions with effects, among others, on knowledge, attitudes, and contraceptive use in adolescents. In general, digital interventions have positive effects on knowledge and attitudes, but it is more difficult to modify behaviors with strictly digital interventions or combined with complementary face‐to‐face sessions or group class activities.

Conclusion

We thus believe that digital interventions are adequate to reduce adolescent sexual risk behaviors, and our systematic review facilitates the implementation of these interventions by sharing existing digital interventions that have had positive effects, as well as the main characteristics a digital intervention should possess to reduce sexually risky behaviors in adolescents.

Clinical relevance

Digital interventions with adolescents improve sexual behaviors and can be a valuable resource in education on this topic due to their accessibility and confidentiality, two key points for young people.
A multi‐nudge‐based behavioural insight into ward nurses' respiratory rate measurement: An observational study
Authors: Takaki Shunsuke , Hara Koji , Motoyama Ayana , Kawana Yuki , Kuroki Makoto , Sasaki Shusaku
Published: August 2024

Aim

This study observed changes in respiratory rate measurement (RRM) and identified barriers and challenges in clinical practice that influence healthcare worker behaviour, aiming to improve RRM in a hospital setting.

Design

An observational study was conducted.

Methods

We observed and analysed changes in the behaviour of healthcare workers at a hospital where multi‐nudges were introduced to improve RRM.

Results

We checked respiration rate using electronic data and discovered that the original measurement rates were low. Measurement rates rapidly increased after posters were added. Barriers such as time constraints and measurement equipment were also noted.

Conclusion

RRM was found to be effective in promoting behavioural economics in medical settings. The results show that incorporating behavioural science principles into medical interventions has the potential to positively change behaviour.

Implications for the Profession and/or Patient Care

By increasing nurses' awareness of respiratory rate measurement and addressing barriers to it, the measurement rate of respiratory rate can also increase, leading to more accurate patient evaluations and triage.

Impact

What problem did the study address?

The proportion of respiratory rate measurements leading to rapid response system (RRS) calls was low.

What were the main findings?

The study observed that a multi‐nudge approach effectively changes the behaviour of ward nurses, resulting in enhanced quality of medical care.

Where and on whom will the research have an impact?

This research can serve as a valuable reference for leaders promoting healthcare quality projects, by offering a method to encourage behavioural change.

Reporting Method

This study complied with the EQUATOR guidelines and its reporting adheres to the STROBE checklist.

Patient or Public Contribution

No patient or public contribution.
Business News and Business Cycles
Authors: BYBEE LELAND , KELLY BRYAN , MANELA ASAF , XIU DACHENG
Published: August 2024

We propose an approach to measuring the state of the economy via textual analysis of business news. From the full text of 800,000 Wall Street Journal articles for 1984 to 2017, we estimate a topic model that summarizes business news into interpretable topical themes and quantifies the proportion of news attention allocated to each theme over time. News attention closely tracks a wide range of economic activities and can forecast aggregate stock market returns. A text‐augmented vector autoregression demonstrates the large incremental role of news text in forecasting macroeconomic dynamics. We retrieve the narratives that underlie these improvements in market and business cycle forecasts.
Examining dental providers counseling on human papillomavirus vaccine: Insights from parents and dental professionals
Authors: Barrientos Luis , Shortall Sarah , Williams Joshua , Hamilton Scott , Jack Jessica
Published: August 2024

Objectives

To (1) assess perceptions of parents of patients ages 9–17 years regarding human papillomavirus (HPV) vaccine counseling and a same‐day HPV vaccine program, and (2) assess perceptions among dental staff who actively participated in the same administration program.

Methods

We conducted a post‐evaluation, convenience survey of parents of patients aged 9–17 and dental staff at a large‐urban federally qualified healthcare center (FQHC) from July 25, 2022, to August 26, 2022. Parent and staff perceptions were assessed using validated instruments whenever possible. Data were analyzed descriptively.

Results

Overall, 101 parents participated (response rate: 89%). Overall, 80 parents (74.3%) reported wanting to discuss diseases prevented by the HPV vaccine with their dental provider. Twenty parents (20%) reported receiving counseling on the HPV vaccine by their dentist; 95% (n = 19) of those parents reported it did not change their comfort with their provider and 60% (n = 12) reported their child received the vaccine that day.

Overall, 44 dental staff members (32% DDS/DMD, 14% RDH‐BS‐Dental Hygiene, 55% Other) completed surveys (response rate: 100%). Of these, 39 (88.6%) were willing to recommend the HPV vaccine and participate in a referral program. Nearly all dentists and hygienists (95%) reported discussing the vaccine was within their scope of practice, and most (65%) agreed vaccine administration should be within their scope.

Conclusion

In a single site convenience survey within an urban, federally qualified health care system, most parents, and dental staff perceived HPV vaccine counseling and administration favorably and clinically appropriate during routine dental visits.
Relationship Between Melatonin Receptor Agonists and Parkinson's Disease
Authors: Noguchi Yoshihiro , Masuda Rikuto , Aizawa Haruka , Yoshimura Tomoaki
Published: August 2024

Parkinson's disease affects millions of people worldwide, and without significant progress in disease prevention and treatment, its incidence and prevalence could increase by more than 30% by 2030. Researchers have focused on targeting sleep and the circadian system as a novel treatment strategy for Parkinson's disease. This study investigated the association between melatonin receptor agonists and Parkinson's disease, using the Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS). The target drugs were melatonin receptor agonists including ramelteon, tasimelteon, and agomelatine. Parkinson's disease cases were defined according to the Medical Dictionary for Regulatory Activities (MedDRA) 25.0; Standardized MedDRA Query (SMQ) using both the “narrow” and “broad” preferred terms (PTs) associated with Parkinson's disease. The association between melatonin receptor agonists (ramelteon, tasimelteon, and agomelatine) and Parkinson's disease was evaluated by the reporting odds ratio. Upon analyzing the data from all patients registered in the FAERS, ramelteon (ROR: 0.66, 95% confidence interval [95% CI]: 0.51–0.84) and tasimelteon (ROR: 0.49, 95% CI: 0.38–0.62) showed negative correlations with Parkinson's disease. Conversely, only agomelatine was positively correlated with Parkinson's disease (ROR: 2.63, 95% CI: 2.04–3.40). These results suggest that among the melatonin receptor agonists, ramelteon and tasimelteon are negatively correlated with Parkinson's disease. In contrast, agomelatine was shown to be positively correlated with Parkinson's disease. These results should be used in research to develop drugs for the treatment of Parkinson's disease, fully considering the limitations of the spontaneous reporting system.
Development of a Japanese Version of the Creative Mindset Scale (CMS) Using Item Response Theory
Authors: Ishiguro Chiaki , Matsumoto Kazuki , Agata Takumitsu , Noguchi Hiroyuki , Okada Takeshi
Published: August 2024

The purpose of this study was to develop the Japanese version of the Creative Mindset Scale (CMS‐J) and examine its psychometric properties using classical test theory (CTT) and item response theory (IRT). Three surveys were conducted to examine the psychometric properties. Study 1 (n = 700) confirmed the conceptual structure of the CMS‐J. Confirmatory factor analyses of the CMS‐J suggested a two‐factor structure, as in the original scale. The test–retest reliability was examined based on data from 143 participants who responded to the CMS‐J questionnaire after a 7‐week interval. Study 2 (n = 1,114) confirmed the convergent and discriminant validities, as well as the internal consistency, of the CMS‐J. Finally, Study 3 (n = 1,300) confirmed the effective measurement of growth and fixed mindset of the CMS‐J using IRT analyses. The present findings suggest that the CMS‐J has a fundamental psychometric property.
Pharmacokinetics, safety, and efficacy of daridorexant in Japanese subjects: Results from phase 1 and 2 studies
Authors: Uchiyama Makoto , Mishima Kazuo , Yagi Tomoko , Yoshihara Tatsuya , Eto Takashi , Muehlan Clemens , Togo Osamu , Inoue Yuichi
Published: August 2024

Daridorexant is a dual orexin receptor antagonist for the treatment of insomnia. We report results from the first two randomised, double‐blind clinical studies of daridorexant in Japanese subjects. In the Phase 1 study, daridorexant (10, 25, 50 mg) or placebo were administered in the morning for 4 days in 24 young (mean age 26.9 years) and 24 older (mean age 69.7 years) healthy Japanese adults. Daridorexant reached a peak plasma concentration within 1.0 h across every dose and age group. For all doses, the mean plasma concentration of daridorexant showed a similar change between the age groups. Exposure parameters increased dose‐dependently with minimal/no accumulation upon repeated dosing. The terminal half‐life was ~8 h. In the Phase 2, four‐period, four‐way crossover study, 47 Japanese subjects (mean age 50.4 years) with insomnia disorder were randomised to receive four treatments (daridorexant 10, 25, 50 mg, placebo) during four treatment periods, each consisting of two treatment nights (5–12 day washout between treatment periods). Subjects continued their fourth treatment for 12 further days. A statistically significant dose–response relationship (multiple‐comparison procedure‐modelling, p < 0.0001) was found in the reduction of polysomnography‐measured wake after sleep onset (WASO; primary endpoint) and latency to persistent sleep (secondary endpoint) from baseline to days 1/2. Statistically significant dose–response relationships were also observed for secondary subjective endpoints from baseline to days 1/2 (sWASO, latency to sleep onset). All daridorexant doses were well tolerated, with no treatment discontinuations and no next‐morning residual effects. These results supported further investigation of daridorexant in Japanese patients with insomnia disorder.
A ribonuclease T2 protein FocRnt2 contributes to the virulence of Fusarium oxysporum f. sp. cubense tropical race 4
Authors: He Yanqiu , Li Pengfei , Zhou Xiaoshu , Ali Shaukat , Zhu Jie , Ma Yini , Li Jieling , Zhang Nan , Li Huaping , Li Yunfeng , Nie Yanfang
Published: August 2024

Banana Fusarium wilt, caused by Fusarium oxysporum f. sp. cubense tropical race 4 (Foc TR4), is a major disease of banana plants worldwide. Effector proteins play critical roles in banana–Foc TR4 interaction. Our previous studies highlighted a ribonuclease protein belonging to the T2 family (named as FocRnt2) in the Foc TR4 secretome, which was predicted to be an effector. However, its biological function in Foc TR4 infection is still unclear. Herein, we observed significant expression of FocRnt2 during the early stage of fungal infection in planta. A yeast signal sequence trap assay showed that FocRnt2 contained a functional signal peptide for secretion. FocRnt2 possessed ribonuclease activity that could degrade the banana total RNA in vitro. Subcellular localization showed that FocRnt2 was localized in the nucleus and cytoplasm of Nicotiana benthamiana leaves. Transient expression of FocRnt2 suppressed the expression of salicylic acid‐ and jasmonic acid‐signalling marker genes, reactive oxygen species accumulation, and BAX‐mediated cell death in N. benthamiana. FocRnt2 deletion limited fungal penetration, reduced fusaric acid biosynthesis in Foc TR4, and attenuated fungal virulence against banana plants, but had little effect on Foc TR4 growth and sensitivity to various stresses. Furthermore, FocRnt2 deletion mutants induced higher expression of the defence‐related genes in banana plants. These results suggest that FocRnt2 plays an important role in full virulence of Foc TR4, further improving our understanding of effector‐mediated Foc TR4 pathogenesis.
The molecular mechanisms that underlie IGHMBP2‐related diseases
Authors: Rzepnikowska Weronika , Kaminska Joanna , Kochański Andrzej
Published: August 2024

Immunoglobulin Mu‐binding protein 2 (IGHMBP2) pathogenic variants result in the fatal, neurodegenerative disease spinal muscular atrophy with respiratory distress type 1 (SMARD1) and the milder, Charcot–Marie‐Tooth (CMT) type 2S (CMT2S) neuropathy. More than 20 years after the link between IGHMBP2 and SMARD1 was revealed, and 10 years after the discovery of the association between IGHMBP2 and CMT2S, the pathogenic mechanism of these diseases is still not well defined. The discovery that IGHMBP2 functions as an RNA/DNA helicase was an important step, but it did not reveal the pathogenic mechanism. Helicases are enzymes that use ATP hydrolysis to catalyse the separation of nucleic acid strands. They are involved in numerous cellular processes, including DNA repair and transcription; RNA splicing, transport, editing and degradation; ribosome biogenesis; translation; telomere maintenance; and homologous recombination. IGHMBP2 appears to be a multifunctional factor involved in several cellular processes that regulate gene expression. It is difficult to determine which processes, when dysregulated, lead to pathology. Here, we summarise our current knowledge of the clinical presentation of IGHMBP2‐related diseases. We also overview the available models, including yeast, mice and cells, which are used to study the function of IGHMBP2 and the pathogenesis of the related diseases. Further, we discuss the structure of the IGHMBP2 protein and its postulated roles in cellular functioning. Finally, we present potential anomalies that may result in the neurodegeneration observed in IGHMBP2‐related disease and highlight the most prominent ones.
Delirium care burden of intensive care nurses caring for patients undergoing open‐heart surgery: A mixed‐method research
Authors: Ulus Meltem , Durmaz Edeer Aylin
Published: August 2024

Background

Delirium is an acute confusional state characterized by inattention, cognitive dysfunction and an altered level of consciousness. Delirium causes negative outcomes in patients, and patients with delirium increase the workload of nurses. Therefore, it is important to recognize the challenges and burdens experienced by nurses caring for patients with delirium.

Aim

To determine the subjective burden experienced by intensive care nurses caring for patients who have undergone open‐heart surgery.

Study Design

A mixed‐method sequential explanatory design. A non‐probability purposive sampling method was used for the quantitative stage. Using OpenEpi, we employed the method of sample calculation with an unknown universe. The sample size of the quantitive study comprised 130 nurses. Quantitative data were collected with Google survey. For gathering qualitative data, online video interviews were conducted with 10 nurses, an interpretive phenomenological approach was used and content analysis was performed.

Results

In the quantitative phase, we found that the subjective burden was high. In the qualitative phase, five main themes emerged: difficulty in recognizing delirium, physical burden, emotional burden, burden in care management of patients with delirium and the effect of patients with delirium on other patients. The nurses experienced physical and emotional burden in delirium management and felt lonely while caring for patients with delirium.

Conclusions

Because nurses play a key role in the care of patients with delirium, reducing the burden nurses experience when caring for patients with delirium should be considered important in ensuring that this patient population receives adequate care.

Relevance to Clinical Practice

Delirium patients create a care burden for intensive care nurses. To reduce this burden of care, in‐service training in patient management and bedside teaching support should be provided to nurses. Furthermore, the use of a valid scale to diagnose delirium should be integrated into health policies. Nurses should not be left alone in the management of delirium. Managing delirium patients with a team including physicians, nurses and professionals from other health disciplines will ensure that patients receive high‐quality care, thereby reducing the care burden of nurses.
Autonomic assessment at the intersection of psychosocial and gastrointestinal health
Authors: Kolacz Jacek
Published: August 2024

Background

Wearable technology is increasingly used in clinical practice and research to monitor functional gastrointestinal symptoms and mental health.

Aims

This article explores the potential of wearable sensors to enhance the understanding of the autonomic nervous system (ANS), particularly its role in linking psychological and gastrointestinal function. The ANS, facilitates brain‐gut communication and is responsive to psychosocial conditions. It is implicated in disorders related to psychological stress and gut‐brain interaction. Wearable technology enables tracking of the ANS in daily life, offering complementary and alternative methods from traditional lab‐based measures. This review places focus on autonomic metrics such as respiratory sinus arrhythmia, vagal efficiency, and electrodermal activity as well as self‐reports of autonomic symptoms.

Discussion

Potential applications include use of wearable sensors for tracking autonomic activity in disorder of gut‐brain interaction such as cyclic vomiting syndrome, in which ANS dysregulation may be triggered by psychosocial factors. Considerations for data interpretation and contextualization are addressed, acknowledging challenges such as situational confounders of ANS activity and accuracy of wearable devices.
Unsupervised machine learning highlights the challenges of subtyping disorders of gut‐brain interaction
Authors: Dowrick Jarrah M. , Roy Nicole C. , Bayer Simone , Frampton Chris M. A. , Talley Nicholas J. , Gearry Richard B. , Angeli‐Gordon Timothy R.
Published: August 2024

Background

Unsupervised machine learning describes a collection of powerful techniques that seek to identify hidden patterns in unlabeled data. These techniques can be broadly categorized into dimension reduction, which transforms and combines the original set of measurements to simplify data, and cluster analysis, which seeks to group subjects based on some measure of similarity. Unsupervised machine learning can be used to explore alternative subtyping of disorders of gut‐brain interaction (DGBI) compared to the existing gastrointestinal symptom‐based definitions of Rome IV.

Purpose

This present review aims to familiarize the reader with fundamental concepts of unsupervised machine learning using accessible definitions and provide a critical summary of their application to the evaluation of DGBI subtyping. By considering the overlap between Rome IV clinical definitions and identified clusters, along with clinical and physiological insights, this paper speculates on the possible implications for DGBI. Also considered are algorithmic developments in the unsupervised machine learning community that may help leverage increasingly available omics data to explore biologically informed definitions. Unsupervised machine learning challenges the modern subtyping of DGBI and, with the necessary clinical validation, has the potential to enhance future iterations of the Rome criteria to identify more homogeneous, diagnosable, and treatable patient populations.
Tourniquet Effect on Patients Undergoing Total Knee Arthroplasty: A Single‐Blind, Randomized Controlled Trial
Authors: Dong Ziyang , Li Yang , Xue Heng , Tao Liyuan , Tian Hua
Published: August 2024

Background

Tourniquet is applied in Total Knee Arthroplasty (TKA) to reduce intraoperative blood loss and improve view of surgical field. However, tourniquet use in TKA is still in dispute. Some researchers find that tourniquet may lead to extra side effects such as aggravated pain and limb swelling, while others consider that tourniquet has no significant adverse impact on clinical outcomes of TKA patients. This trial is conducted to evaluate tourniquet effect on TKA patients.

Methods

A prospective, single‐blind, randomized controlled trail is adopted with a sample size of 130 knees from August 2020 to February 2023. Patients undergoing TKA are randomly allocated to tourniquet group and non‐tourniquet group. Outcomes including quadriceps thickness and stiffness, operation time, total blood loss, intraoperative blood loss, postoperative blood loss, transfusion rate, thigh circumference, knee and thigh VAS, D‐Dimer and CRP level, knee function score, patient satisfaction, and complications are evaluated in this trial. Student's t‐test, Mann–Whitney U test, Pearson's chi‐square test, and Fisher's exact test are used in this study.

Results

No significant difference in demographic information and baseline outcomes were found (p > 0.05). Participants in the tourniquet group had significantly less total blood loss and intraoperative blood loss, more postoperative blood loss, and higher D‐Dimer level on postoperative day 3 when compared with non‐tourniquet group (p < 0.05). Other outcomes including quadriceps thickness and stiffness, operation time, postoperative blood loss, transfusion rate, thigh circumference, knee and thigh VAS, D‐Dimer level on postoperative day 1, CRP level, knee function score, patient satisfaction, and complications showed no significant difference (p > 0.05).

Conclusion

Tourniquet application can effectively reduce intraoperative blood loss and total blood loss, without significant side effects. Hence, we advocate the regular use of tourniquet in primary TKA.
Age‐related Differences in Volumetric Bone Mineral Density, Structure, and Bone Strength of Surgical Neck of Humerus in Postmenopausal Women
Authors: Wang Yeming , Li Jian , Men Yutao , Wei Wanfu
Published: August 2024

Objective

Postmenopausal changes in bone mass and structure compromise the mechanical properties of proximal humerus, predisposing it to low‐energy fractures with complex morphology. The aim of the study is to investigate associations of bone quality and estimated bone strength of the surgical neck with age after menopause.

Methods

A total of 122 healthy postmenopausal women were recruited from December 2016 to December 2022 and assigned to three groups: the 50–59 years group, the 60–69 years group, and the older than 70 years group. Bone properties of the surgical neck, including volumetric bone mineral density (vBMD), cortical thickness (CTh), the periosteal and medullary size, and estimated indices of bone strength were evaluated by quantitative computed tomography.

Results

Compared to the 50–59 years group, postmenopausal women aged over 70 years were characterized by lower cortical thickness (13.9%) and vBMD (6.65%), as well as reduced strength indices including the minimum and maximum section modulus (Zmin 18.11%, Zmax 21.71%), polar section modulus (Zpol 20.21%), and the minimum and maximum second moments of area (Imax 21.01%, Imin 21.43%). Meanwhile, the difference in periosteal diameter and perimeter, total area in three groups did not reach statistical significance. Both cortical thickness and vBMD value were inversely associated with age, showing 10.56% and 23.92% decline. Imax showed the greatest age‐related decrease between age of 54 and 86 years (39.08%), followed by Zmax (−35.77%), Imin (−35.73%), Zpol (−34.90%) and Imin (−23.92%).The strength indices had stronger correlations with cortical thickness than with bone size or density.

Conclusion

In postmenopausal women, aging is associated with a significant decline in cortical bone thickness and mechanical strength of the proximal humerus, especially over the age of 70 years.
Biomechanical Effects of Multi‐segment Fixation on Lumbar Spine and Sacroiliac Joints: A Finite Element Analysis
Authors: Zhao Geng , Wang Lianlei , Wang Hongwei , Li Chao , Yuan Suomao , Sun Junyuan , Tian Yonghao , Liu Xinyu
Published: August 2024

Objective

Spine fixation surgery affects the biomechanical environment in the sacroiliac joint (SIJ), which may lead to the SIJ pain or degeneration after surgery. The purpose of this study is to determine the impact of the number and position of fixed segments on the SIJs and provide references for surgeons to plan fixation levels and enhance surgical outcomes.

Methods

The intact lumbar‐pelvis finite element (FE) models and 11 fixation FE models with different number and position of fixed segments were developed based on CT images. A 400N follower load and 10° range of motion (ROM) of the spine were applied to the superior endplate of L1 to simulate the flexion, extension, bending and torsion motion after surgery. The peak stress on the SIJs, lumbar intervertebral discs, screws and rods were calculated to evaluate the biomechanical effects of fixation procedures.

Results

With the lowermost instrumented vertebra (LIV) of L5 or S1, the peak stress on SIJs increased with the number of fixed segments increasing. The flexion motion led to the greater von Mises stress on SIJ compared with other load conditions. Compared with the intact model, peak stress on all fixed intervertebral discs was reduced in the models with less than three fixed segments, and it increased in the models with more than three fixed segments. The stress on the SIJ was extremely high in the models with all segments from L1 to L5 fixed, including L1‐L5, L1‐S1 and L1‐S2 fixation models. The stress on the segment adjacent to the fixed segments was significant higher compared to that in the intact model. The peak stress on rods and screws also increased with the number of fixed segments increasing in the flexion, extension and bending motion, and the bending and flexion motions led to the greater von Mises stress on SIJs.

Conclusion

Short‐term fixation (≤2 segments) did not increase the stress on the SIJs significantly, while long‐term segment fixation (≥4 segments) led to greater stress on the SIJs especially when all the L1‐L5 segments were fixed. Unfixed lumbar segments compensated the ROM loss of the fixed segments, and the preservation of lumbar spine mobility would reduce the risks of SIJ degeneration.
FHL1: A novel diagnostic marker for papillary thyroid carcinoma
Authors: Zeng Yeting , Zeng Dehua , Qi Xingfeng , Wang Hanxi , Wang Xuzhou , Dai Xiaodong , Qu Lijuan
Published: August 2024

Although there are clear morphologic criteria for the diagnosis of papillary thyroid carcinoma (PTC), when the morphology is untypical or overlaps, accurate diagnostic indicators are necessary. Since few studies investigated the role of down‐regulated genes in PTC, this article aims to further explore the molecular markers associated with PTC. We conducted bioinformatics analysis of gene microarrays of PTC and normal adjacent tissues. Besides, quantitative real‐time quantitative polymerase chain reaction array and immunohistochemical staining were used to investigate the expression of the major down‐regulated genes. The results indicated that several important down‐regulated genes, including TLE1, BCL2, FHL1, GHR, KIT, and PPARGC1A were involved in the process of PTC. Compared to normal adjacent tissues, the mRNA expression of the major genes was down‐regulated in PTC (p＜0.05). Immunohistochemically, FHL1 shows negative or low expression in PTC tissues (p＜0.05). BCL2 did not show a significant difference between PTC and normal thyroid tissues (p > 0.05). TLE1, KIT, PPARGC1A and GHR showed negative expression in both tumor and normal tissues. These results suggested that FHL1 could serve as a novel tumor marker for precise diagnosis of PTC.
Non‐pharmacological management of wandering in persons with dementia: an integrative review
Authors: Park Sojung , Lee Yaelim
Published: August 2024

Background

Wandering behaviour affects a significant portion of dementia patients, ranging from 15% to 80%, presenting a serious safety concern and adding to caregivers' burden. Recent studies emphasise the effectiveness of non‐pharmacological interventions over pharmacological ones due to their minimal side effects. Consequently, in current literature there has been a surge of interest in exploring non‐pharmacological methods for managing wandering.

Purpose

This integrative literature review aims to deepen comprehension of wandering behaviour, presents recent studies on non‐pharmacological approaches, and inspires further research in this field.

Methods

Electronic data collection spanned from 2019 to 2024, sourcing 20 relevant articles from PubMed and Scopus databases using search terms such as ‘dementia’, ‘Alzheimer's disease’, ‘wandering’, and ‘management’. A thematic analysis methodology was employed to identify non‐pharmacological treatment themes for managing wandering. This approach involves scrutinising and synthesising themes within the dataset. Qualitative data analysis focused on significant phrases and keywords, grouping them to derive relevant themes.

Results

Recent literature extensively explores non‐pharmacological methods for managing wandering. These include understanding behaviours, identifying and targeting high‐risk groups, facilitating safe wandering, addressing environmental factors, promoting exercise and activity, and offering caregiver support.

Conclusions

This study significantly advances understanding of wandering behaviour and highlights recent research on non‐pharmacological interventions. The findings suggest the potential for providing safe and effective treatment to wandering dementia patients, thereby alleviating stress for both patients and caregivers.
The cofradías’ role within the Fisheries Local Action Groups system: Implications for small‐scale fisheries in Galicia (Spain)
Authors: García‐Lorenzo Iria , Piñeiro‐Antelo María Ángeles , Villasante Sebastián , Pita Pablo
Published: August 2024

Structural funds for fisheries have a long history in the European Union, but the use of public funds for the sustainable development of fisheries‐dependent areas is a relatively recent practice. This approach is based on the concept of sustainable fisheries management and focuses on increasing the importance of the involvement of local communities in conservation and management. Fisheries Local Action Groups (FLAGs), created to harmonise social development in a broad sense with the specific, sectoral development of fishing, have become key players in this process in some European countries. In Galicia (NW Spain), FLAGs started to be created in 2008, and soon they were deeply integrated into the small‐scale fisheries (SSF) sector, which was already highly organised. Thus, synergies have been established between cofradías—fisheries organisations with a key role and strong responsibilities in the management of fisheries resources‐ and FLAGs. This article studies the interdependencies between cofradías and FLAGs and how these relationships can influence the development of SSF and their communities. Galician FLAGs and cofradías have created in general positive relationships that contributed to the development of the SSF sector. On the other hand, bureaucratic obligations are concentrated funding in larger cofradías, while the needs of the most vulnerable fishing stakeholders are less covered.
Interleukin‐33 links asthma to alopecia areata: Mendelian randomization and mediation analysis
Authors: Wu Pingfan , Tian Kai , Gao Suyue , Jia Zou , Xu Wushuang , Wang Xiaoyun , Wu Lijun
Published: August 2024

Objective

The objective of this study is to elucidate the causal association between asthma and alopecia areata (AA) through the application of Mendelian randomization (MR) analysis, leveraging summary data from genome‐wide association studies (GWAS). Additionally, it explores potential mediating factors.

Materials and Methods

Mendelian randomization (MR) analysis was employed to investigate the causal relationship between asthma and AA using genetic instrumental variables (IVs) for asthma, 91 circulating inflammatory proteins, and AA extracted from large‐scale GWAS. The primary analytical approach utilized the inverse‐variance weighted (IVW) method, supplemented by weighted median and MR‐Egger methods to assess robustness. Tests for heterogeneity and pleiotropy were conducted to ensure result reliability. Furthermore, the study examined the mediating role of circulating inflammatory proteins in the asthma‐AA relationship.

Results

The findings revealed an increased risk of AA among asthma patients (odds ratio (OR) = 14.070; 95% confidence interval (CI) = 1.410–140.435; P = 0.024). Interleukin‐33 (IL‐33) emerged as a significant mediator in the asthma‐AA relationship, explaining 13.1% of the mediation effect. Bidirectional Mendelian randomization analyses did not establish a causal effect of AA on asthma occurrence.

Conclusion

This study, utilizing Mendelian Randomization, elucidates the causal link between asthma and AA, highlighting the mediating role of IL‐33. These findings underscore the importance of considering AA risk in asthma management and offer insights for potential therapeutic strategies targeting IL‐33. Future research should explore additional biomarkers and mediating mechanisms between asthma and AA to enhance treatment approaches and patient quality of life.