bluuebunny/crossref_metadata_2025 huggingface dataset:
Still on the same page: A gender comparison of the top 100 picture books from the UK and China published 2011–2020
Authors: Li Yi , Terras Melissa , Li Yongning
Published: August 2023

As a primary source for the early ages, picture books guide preschool children's gender perception through stories and illustrations. However, previous studies have criticised an overall gender inequality in children's picture books. Compared to the increasing attention on gender diversity in the UK picture book industry, there has been little concern shown about gender diversity in the Chinese picture book market (which has only developed in the 21st Century). This article compares gender representation and gender stereotypes within 200 UK and Chinese bestselling picture books published between 2011 and 2020. It examines a range of aspects including authors' gender, and gendered aspects of book texts and illustrations via content analysis and text mining. Results show (1) there is male dominance in bestselling Chinese authorship, while titles from female authors are more prevalent in the UK list; (2) there is a predominance of male central characters in both bestselling UK and Chinese titles; (3) the narratives in bestselling picture books, especially in Chinese book texts, promote gender essentialism and gender biases in picture books from both markets; (4) that UK titles in translation, as well as other foreign titles, become an essential means of promoting gender equality in the mainstream Chinese picture book market. This study stresses that gender inequality is an international issue and aims to remind all parties in two different picture book industries to work on gender equality in future publishing practice, while showing that translation studies allow us to see how different markets intersect.
Sub‐dose anesthetics combined with chloride regulators protect the brain against chronic ischemia–hypoxia injury
Authors: Yang Chenyi , Wang Ye , Li Yun , Wang Xinyi , Hua Wei , Yang Zhuo , Wang Haiyun
Published: August 2023

Background

Cerebral ischemia–hypoxia leads to excitotoxicity‐mediated neuronal damage and cognitive dysfunction, especially in the elderly. Excessive intracellular [Cl−]i accumulation weakens γ‐aminobutyric acid (GABA) compensatory effects. Sub‐anesthetic dose of propofol protected the brain against ischemia–hypoxia, which was abolished by blocking Cl− efflux transporter K+/Cl− cotransporter 2 (KCC2). We aimed to determine whether low‐dose anesthetic combined with [Cl−]i regulators could restore the compensatory GABAergic system and improve cognitive function.

Methods

Chronic cerebral hypoxia (CCH) model was established by bilateral carotid artery ligation in aged rats. Sub‐dose of anesthetics (propofol and sevoflurane) with or without KCC2 agonist N‐ethylmaleimide (NEM) or Na+/K+/Cl− cotransporter 1 (NKCC1) antagonist bumetanide (BTN) was administered systemically 30 days post‐surgery. Primary rat hippocampal neuronal cultures were subjected to hypoxic injury with or without drug treatment. Memory function, hippocampal neuronal survival, GABAergic system functioning, and brain‐derived neurotrophic factor (BDNF) expressions were evaluated.

Results

Sub‐anesthetic dose of combined propofol (1.2 μg mL−1) and sevoflurane [0.7 MAC (minimum alveolar concentration)] did not aggravate the hypoxic brain injury in rats or cell damage in neuronal cultures. Adding either BTN or NEM protected against hypoxic injury, associated with improved cognitive function in vivo, less intracellular accumulation of [Cl−]i, reduced cell death, restored GABAergic compensation, and increased BDNF expression both in vivo and in vitro.

Conclusion

Sub‐anesthetic dose of propofol and sevoflurane is a recommended anesthesia regimen in at‐risk patients. Restoration of [Cl−]i homeostasis and GABAergic could further reduce the brain damage caused by ischemia–hypoxia.
Global analysis of iron metabolism‐related genes identifies potential mechanisms of gliomagenesis and reveals novel targets
Authors: Zhang Jiayue , Zhao Liang , Xuan Shurui , Liu Zhiyuan , Weng Zhenkun , Wang Yu , Dai Kexiang , Gu Aihua , Zhao Peng
Published: August 2023

Aims

This study aimed to investigate key regulators of aberrant iron metabolism in gliomas, and evaluate their effect on biological functions and clinical translational relevance.

Methods

We used transcriptomic data from multiple cross‐platform glioma cohorts to identify key iron metabolism‐related genes (IMRGs) based on a series of bioinformatic and machine learning methods. The associations between IMRGs and prognosis, mesenchymal phenotype, and genomic alterations were analyzed in silico. The performance of the IMRGs‐based signature in predicting temozolomide (TMZ) treatment sensitivity was evaluated. In vitro and in vivo experiments were used to explore the biological functions of these key IMRGs.

Results

HMOX1, LTF, and STEAP3 were identified as the most essential IMRGs in gliomas. The expression levels of these genes were strongly related to clinicopathological and molecular features. The robust IMRG‐based gene signature could be used for prognosis prediction. These genes facilitate mesenchymal transformation, driver gene mutations, and oncogenic alterations in gliomas. The gene signature was also associated with TMZ resistance. HMOX1, LTF, and STEAP3 knockdown in glioma cells significantly reduced cell proliferation, colony formation, migration, and malignant invasion.

Conclusion

The study presented a comprehensive view of key regulators underpinning iron metabolism in gliomas and provided new insights into novel therapeutic approaches.
What we've learned: A research agenda for a museum, 7 years later
Authors: Hammerness Karen , MacPherson Anna , Gupta Preeti , Wallace Jamie , Chaffee Rachel , Jain Neeti
Published: August 2023

We have been learning about the learning of children and youth, teachers, and visitors over the course of 7 years as we developed and deepened a research agenda in education in our natural history museum. In 2016 in this journal, we detailed how we began this effort and the development and initial steps of an educational research agenda. Focusing on our work since then, our team of educational researchers describes how our research has revealed the considerable impact of out‐of‐school learning with youth, educators, and visitors and how we incorporate a focus upon equity across all areas of inquiry. We share main findings emerging from our research, early roadblocks and current challenges, and lessons about engaging in research on learning in a cultural institution with implications for both large and small settings.
Comparison of left atrial and left atrial appendage mechanics in the recurrence of atrial fibrillation after radiofrequency catheter ablation
Authors: Yang You , Liu Biaohu , Ji Wenyan , Ding Jing , Tao Shanqiang , Lian Feifei
Published: August 2023

Objectives

Although radiofrequency catheter ablation (RFCA) has become an important treatment strategy for paroxysmal or persistent atrial fibrillation (AF), AF recurrence after RFCA remains an important issue that plagues clinicians and patients. This study aimed to investigate the association of left atrial (LA) and left atrial appendage (LAA) mechanics with AF recurrence after RFCA and to compare their prognostic values in patients with AF undergoing RFCA.

Methods

A total of 160 patients with non‐valvular AF who underwent RFCA for the first time were included in this study. All patients underwent transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) before the procedure. All patients were followed up for one year after RFCA, and AF recurrence was recorded. Speckle‐tracking echocardiography was used to measure LA and LAA global longitudinal strain (GLS). LA and LAA mechanical dispersion (MD) were defined as the standard deviation of time to peak strain at each segment standardized by the R‐R interval. Logistic regression analysis was used to analyze independent contributors for AF recurrence after RFCA. The prediction efficiency of factors associated with the presence of AF recurrence was evaluated by the receiver operating characteristic (ROC) curve with area under curve (AUC).

Results

During 1‐year follow‐up, 45 (28%) patients had recurrence, and 115 (72%) patients had no recurrence. The age, CHA2DS2‐VASc score, NT‐proBNP, LA volume index (LAVI), LA MD, and LAA MD of patients in recurrence group were significantly higher than those in no recurrent group (p < .05). The LAA emptying fraction (LAAEF), LA GLS, and LAA GLS in recurrence group were significantly lower than those in no recurrent group (p < .05). Logistic regression analysis showed that LA and LAA GLS were independent contributors for AF recurrence (p < .05), providing incremental values. The AUCs of LA and LAA GLS in predicting AF recurrence were higher than that of other factors, and the LA GLS+LAA GLS joint model had higher prediction efficiency.

Conclusion

This study demonstrated the LA and LAA GLS were independent contributors for AF recurrence after RFCA and provided incremental values. LA and LAA GLS can be used as the predictor of AF recurrence after RFCA, and they may be beneficial for the risk stratification of AF recurrence.
Correlation of ex vivo cytokine secretion profiles with scoring indices in ulcerative colitis
Authors: Podolski Marija , Požgaj Lidija , Faraho Ivan , Petrinić Grba Adriana , Belamarić Daniela , Paravić Radičević Andrea , Bosnar Martina , Crnčević Urek Marija , Čubranić Aleksandar , Mustapić Sanda , Mijandrušić‐Sinčić Brankica , Banić Marko , Eraković Haber Vesna
Published: August 2023

Background

In ulcerative colitis, the complexity of mucosal cytokine secretion profiles and how they correlate with endoscopic and clinical scores is still unclear.

Methods

In this study, we collected fresh biopsies from UC patients to investigate which cytokines are produced in ex vivo culture conditions, a platform increasingly used for testing of novel drugs. Then, we correlated cytokine production with several scoring indices commonly used to assess the severity of the disease.

Results

Increased levels of IL‐1β, IL‐2, IL‐4, IL‐6, IL‐8, IL‐10, IL‐12, IL‐13, TNFα and IFNɣ were produced by biopsies of UC patients compared to non‐IBD controls. Our results show a better correlation of cytokine levels with Mayo Endoscopic Subscore (MES) and Mayo score, than the more complex Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Out of 10 measured cytokines, eight correlated with MES, six with Mayo score and only three with UCEIS, due to the partial increase in cytokine secretion observed in donors with UCEIS = 7–8. When we analysed individual subscores within the UCEIS, Vascular Network subscore showed a correlation similar to MES (7/10 cytokines), while Bleeding as well as Erosions and Ulcers subscores correlated with only 3/10 cytokines, similarly to the total UCEIS.

Conclusions

Our findings suggest that choosing biopsies from donors with MES = 2–3 and UCEIS = 2–6 from areas with no bleeding and no superficial and/or deep ulcers could enable a deeper insight into the cytokine profile of the inflamed tissue and represent a better tool for studying potential therapeutic targets and evaluation of novel therapies.
Safety, tolerability, and efficacy of adjunctive lacosamide in pediatric patients with epilepsy syndromes associated with generalized seizures: Phase 2, open‐label exploratory trial
Authors: Auvin Stéphane , Arzimanoglou Alexis , Beller Cynthia , Floricel Florin , Daniels Tony , Bozorg Ali
Published: August 2023

Objective

To evaluate the safety, tolerability, pharmacokinetics, and preliminary efficacy of lacosamide (LCM) (up to 12 mg/kg/day or 600 mg/day) as adjunctive therapy in pediatric patients with epilepsy syndromes associated with generalized seizures.

Methods

Phase 2, multicenter, open‐label exploratory trial (SP0966; NCT01969851; 2012‐001446‐18) of oral LCM for epilepsy syndromes associated with generalized seizures in pediatric patients ≥1 month to <18 years of age taking one to three concomitant antiseizure medications. The trial comprised a 6‐week prospective baseline period, 6‐week flexible titration period, and 12‐week maintenance period.

Results

Fifty‐five patients (mean age: 9.2 years; 56.4% male) took at least one dose of LCM and had at least one post‐baseline efficacy‐related assessment. The median treatment duration was 127.0 days. There were no clinically significant mean or median changes or worsening from baseline to end of the titration period in the count of generalized spike–wave discharges per interpretable hour on 24‐h ambulatory electroencephalogram recordings, or from baseline to the maintenance period in mean and median days with any generalized or focal to bilateral tonic–clonic seizures per 28 days. Treatment‐emergent adverse events (TEAEs) were reported by 49 patients (89.1%), and three patients (5.5%) discontinued due to TEAEs. The median change and median percentage change in days with any generalized or focal to bilateral tonic–clonic seizures per 28 days from baseline to the maintenance period were both 0. Trends toward improvement (decrease) were observed in median change and median percentage change in days with each individual seizure type (absence, myoclonic, clonic, tonic, tonic–clonic, atonic, and focal to bilateral tonic–clonic) per 28 days.

Significance

Safety findings were consistent with the known safety profile of LCM and were as expected for the pediatric population. There was no worsening of generalized seizures with LCM. Limitations include the inability to correlate spike and wave data with clinical outcomes, and the lack of similar studies against which the results can be compared.
Economic evaluations of nonpharmacological treatments for drug‐resistant epilepsy: A systematic review
Authors: Chan Hoi Yau , Janssen Luca M. M. , Wijnen Ben F. M. , Hiligsmann Mickaël , Majoie Marian H. J. M. , Evers Silvia M. A. A.
Published: August 2023

This study was undertaken to systematically identify and critically appraise all published full economic evaluations assessing the cost‐effectiveness of nonpharmacological interventions for patients with drug‐resistant epilepsy. The Population, Intervention, Comparison, Outcome, Study criteria was used to design search strategies for the identification and selection of relevant studies. Literature search was performed using the MEDLINE (via PubMed), Embase, International Health Technology Assessment, National Institute for Health Research Economic Evaluation Database, and Cost‐Effectiveness Analysis Registry databases to identify articles published between January 2000 and May 2023. Web of Science was additionally used to perform forward and backward referencing. Title, abstract, and full‐text screening was performed by two independent researchers. The Consensus Health Economic Criteria (CHEC) checklist and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 were applied for quality assessment. A total of 4470 studies were identified, of which 18 met our inclusion criteria. Twelve of the studies conducted model‐based economic evaluation, and others were trial‐based. Three studies showed that epilepsy surgery was cost‐effective in adults, whereas this remained inconclusive for children (two positive, three negative). Three studies showed negative economic outcome for ketogenic diet in children. One of four studies showed positive results for self‐management. For vagus nerve stimulation, one study showed positive results in adults and another one negative results in children. One recent study showed cost‐effectiveness of responsive neurostimulation (RNS) in adults. Finally, one study showed promising but inconclusive results for deep brain stimulation (DBS). The mean scores for risk of bias assessment (based on CHEC) and for reporting quality (CHEERS 2022) were 95.8% and 80.5%, respectively. This review identified studies that assessed the cost‐effectiveness of nonpharmacological treatments in both adults and children with drug‐resistant epilepsy, suggesting that in adults, epilepsy surgery, vagus nerve stimulation, and RNS are cost‐effective, and that DBS and self‐management appear to be promising. In children, the cost‐effectiveness of epilepsy surgery remains inconclusive. Finally, the use of ketogenic diet was shown not to be cost‐effective. However, limited long‐term data were available for newer interventions (i.e., ketogenic diet, DBS, and RNS).
Surgical antimicrobial prophylaxis: Current standards of care
Authors: Southwood Louise L.
Published: August 2023

Antimicrobial drug resistance is a critical problem in human and veterinary medicine. Antimicrobial drug use and particularly overuse or misuse drive resistance. Surgical antimicrobial prophylaxis (SAP) is one area where misuse and overuse (particularly prolonged SAP) is documented to be at a high level. Infection‐related complications can be devastating to the patient, harm the client/patient–surgeon relationship and damage the reputation of the surgeon. Consequently, surgeons tend to be reluctant to change their antimicrobial prescribing behaviour. There is a plethora of data from human surgery and emerging data from veterinary surgery describing appropriate SAP and supporting the use of shorter duration of SAP. Antimicrobial stewardship programs (ASPs) have been developed and evaluated in human hospitals and this type of collaborative approach would likely have benefit in veterinary hospitals.
The effect of pre‐dosing with metformin on the insulin response to oral sugar in insulin‐dysregulated horses
Authors: Colmer Sarah F. , Adams Amanda A. , Adam Emma , Miller Rachel , Stefanovski Darko , Kulp Jeaneen C. , van Eps Andrew
Published: August 2023

Background

A single dose of metformin administered 1 h prior to oral glucose challenge was previously shown to reduce insulinaemic responses in horses with experimentally‐induced insulin dysregulation (ID). Targeted administration could be useful for controlling post‐prandial hyperinsulinaemia in horses with naturally‐occurring ID.

Objectives

The objective was to compare the insulinaemic and glycaemic responses to oral sugar testing (OST) performed at different intervals after a single dose of metformin in horses with naturally‐occurring ID. We hypothesised that pre‐treatment with one dose of metformin would significantly decrease the insulinaemic response to OST.

Study design

Randomised cross‐over in vivo experiment.

Methods

Eight university‐owned adult horses with naturally‐occurring ID underwent OST 1, 2 and 6 h following a single oral dose of metformin (30 mg/kg) or 1 h after placebo (240 mL water) with a 7‐day washout between treatments over a period of 3 weeks. Plasma insulin, C‐peptide and glucose concentrations were measured at 0, 60 and 90 min after 0.45 mL/kg light corn syrup and the effect of treatment (and the interval since dosing) examined using a mixed effects linear regression model.

Results

Metformin treatment had no significant effect on plasma glucose, insulin or C‐peptide concentrations at any time point compared with placebo (p > 0.05). For OST 1 h post metformin, median (IQR) plasma insulin was 91.3 (62.4–114.9) μIU/mL at 60 min versus 76.2 (59.1–134.5) for placebo (p = 0.8) and 62.7 (31.4–109.7) at 90 min versus 51.8 (29.2–126.3) for placebo (p = 0.9).

Main limitations

Small sample size may limit identification of more subtle decreases in insulin concentration with metformin pre‐dosing. The results of this study are relevant only for one pre‐treatment dose (30 mg/kg) which limits extrapolation to predictions about the effects of longer‐term metformin administration on insulin and glucose dynamics in the horse.

Conclusions and clinical importance

The results do not support the use of targeted metformin treatment to reduce post‐prandial hyperinsulinaemia in horses with naturally‐occurring ID.
A netnographic study with social media comments for investigating service failures
Authors: Kim Haeok Liz , Park Seunghyun “Brian”
Published: August 2023

This study demonstrates a netnographic study to investigate airline service failure types and to test differences of linguistic patterns among complaint types on social media user comments. User comments in an airline's Facebook community were scraped and service failure types were systematically classified with the measurement developed by thematic coding and literature review. The results presented frequently occurring service failure categories in airline service operations. A T‐Test was conducted to confirm the significant differences in linguistic characteristics between complaint comments and non‐complaint comments. Word frequency analysis showed distinctive word themes between the two comment groups. Research and managerial implications were provided.
Effect of corrosion on the fatigue crack propagation properties of butt weld with G20Mn5QT cast steel and Q355D steel in 3.5‐wt% NaCl solution
Authors: Han Qinghua , Li Yang , Lu Yan , Wang Gexing
Published: August 2023

The corrosion fatigue crack propagation (FCP) of the butt weld with G20Mn5QT cast steel and Q355D steel in 3.5‐wt% NaCl solution was investigated experimentally. Considering the influences of stress ratio and loading frequency, the corrosion FCP rate curve was obtained. The results indicated that the corrosion FCP rate in the corrosion environment is three times that in air. Increasing the stress ratio or decreasing the loading frequency will increase the corrosion FCP rate. The fracture morphology of the specimens in the corrosion environment had more corrosion pits and intergranular characteristics due to anodic dissolution than that in air. Anodic dissolution and hydrogen embrittlement jointly promoted the corrosion FCP of butt weld in simulated seawater. The corrosion FCP rate model was established considering the effects of stress ratio and loading frequency.
Relational legacies and relative experiences: Austerity, inequality and access to special educational needs and disability (SEND) support in London, England
Authors: Warnock Rosalie
Published: August 2023

Through the lens of access to Special Educational Needs and Disability (SEND) support services in London, England, this paper highlights the relative legacies of state‐led austerity since 2010. Drawing on findings from a four‐month institutional ethnography with a London borough SEND support team and 43 repeat in‐depth narrative interviews with 15 parent carers with autistic children, this paper focuses in on two parents: Alice and Lucy. Comparing Alice and Lucy's experiences shows nuanced relational legacies of austerity: families with disabled and neurodiverse children have been disproportionately affected by austerity cuts. Additionally, however, their accounts show their relative experiences of accessing help: some more marginalised families with disabled children are finding it harder under these circumstances than others. Yet a neoliberal myth of meritocracy has emerged during this time which obscures the underlying structural and systemic reasons for widening relative inequality between families with disabled and neurodiverse children. This myth suggests that the parent carers who do manage to secure ever shrinking SEND resources have simply worked harder than others to get there. The result is that parent carers – including Alice and Lucy – have different experiences of trying to navigate and access the same SEND services, in the same place, at the same time. Bringing together geographical and sociological work on austerity, families, disability, and education, this paper extends understandings of how austerity is relational in its effects and shows how these legacies are still unfolding.
Altered resting‐state effective connectivity of trigeminal vascular system in migraine without aura: A spectral dynamic causal modeling study
Authors: Qin Zhaoxia , Qu Hang , Liang Huai‐Bin , Zhou Qichen , Wang Wei , Wang Min , Liu Jian‐Ren , Du Xiaoxia
Published: August 2023

Background

The trigeminal vascular system is an important part of the anatomical and physiological basis of migraine. The effective connectivity (EC) among the regions of interest (ROIs) in the trigeminal vascular system involved in migraine without aura (MWoA) remains unclear.

Methods

In this cross‐sectional study, 48 patients (mean [SD] age 38.06 [10.35] years; male, 14/48 [29%]) with MWoA during the interictal phase and 48 healthy controls of similar age and sex (mean [SD] age 38.96 [10.96] years; male, 14/48 [29%]) underwent resting‐state functional magnetic resonance imaging (fMRI). Dynamic causal modeling analysis was conducted to investigate directional EC among ROIs in the trigeminal vascular system including the bilateral brainstem, the primary somatosensory cortex (S1), the thalamus, and the insula.

Results

Compared with the healthy control group, MWoA represented significantly reduced EC from the left brainstem (Brainstem.L) to the left insula (MWoA: mean [SD] −0.16 [0.36]; healthy controls: mean [SD] 0.11 [0.41]; Pcorrected = 0.021), reduced EC from the Brainstem.L to the right insula (MWoA: mean [SD] −0.15 [0.39]; healthy controls: mean [SD] 0.03 [0.35]; Pcorrected = 0.021), and decreased EC from the left thalamus (Thalamus.L) to the Brainstem.L (MWoA: mean [SD] −0.13 [0.56]; healthy controls: mean [SD] 0.10 [0.45]; Pcorrected = 0.021). Altered EC parameters were not significantly correlated with MWoA clinical data.

Conclusion

These results further provide increasing evidence that disturbed homeostasis of the trigeminovascular nociceptive pathway is involved in the pathophysiological mechanisms of migraine. Patients with MWoA exhibited a regional interaction distinct from healthy controls in the neural pathway of the Bilateral Insula–Brainstem.L–Thalamus.L, which may shed light on the future understanding of brain mechanisms for MWoA. Future brain‐based interventions are suggested to consider the dysregulation in the Bilateral Insula–Brainstem.L–Thalamus.L circuits.
Effect of ammonium chloride on the morphology of hexagonal boron nitride prepared by magnesium thermal reduction
Authors: Wu Xiaoming , Wang Longfei , Yang Zengchao , Li Jiangtao
Published: August 2023

Hexagonal boron nitride (h‐BN) crystals with cylindrical and nanoplate shape were prepared by the magnesium thermal reduction method. A simple and novel strategy successfully controlled the preferred growth direction of h‐BN crystal by adding a small amount of ammonium chloride to the reaction system, realized the transformation of the h‐BN crystal growth mode from cylindrical to nanoplate, and the thickness of h‐BN crystal nanoplates rapidly decreased from 2 μm to 40 nm. XRD results showed that the ammonium chloride content also significantly promoted the crystallinity of the synthesized h‐BN nanoplates, and the G.I. index decreased from 2.4 to 1.9. Raman and TEM results showed that the crystallinity of synthesized h‐BN was close to the properties of the single crystal.
Neonatal intensive care nurses' accounts of care for mothers/families with substance‐exposed pregnancies: A critical discourse analysis
Authors: Welborn Amber C. , Nichols Tracy , Gringle Meredith , Lewallen Lynne
Published: August 2023

Aims

To explore the effects of power dynamics and hospital organizational structure upon neonatal intensive care nurses' experiences caring for infants and families from a substance‐exposed pregnancy (SEP).

Design

This secondary data analysis further investigated the results of a primary study after the original analysis suggested differences in work environments may impact relationship‐building opportunities between nurses and mothers/families. Critical discourse analysis served as both the theoretical lens and analytic technique.

Method

Nine (9) nurses from the southeast region of the United States (U.S.) were interviewed in 2019. Fifty‐one (51) stories of caregiving experiences were analysed with a focus on narratives related to organizational structure and care delivery.

Results

Study findings revealed nurses experienced challenges providing high‐quality, family‐centered care for patients in the neonatal intensive care unit (NICU) affected by substances during pregnancy. Nurses described the central challenge of workload, exacerbated by power imbalances and structural constraints within the hospital's organizational structure. Findings suggest workload issues may endorse stigma by inhibiting opportunities to build relationships. Nurses report manageable workloads can support healthcare teams and recipients of care.

Conclusion

The study suggests power imbalances between nurses, families and adjacent healthcare professionals can inhibit the delivery of high‐quality care. Supporting healthcare teams and recipients of care while centering the role of organizational structure is critical. Questions emerged about workload demands impacting the potential production of stigma in clinical environments.

Impact

This study examines the intersection of nurses' care experiences and hospital organizational structure. It identifies how the unique needs of caring for infants and families from a SEP increase the complexity of power imbalances and organizational constraints to further increase workload demands. Findings have implications for global healthcare organization leaders who build and maintain the structural integrity of clinical environments and nurse leaders who advocate and guide clinical teams to provide high‐quality care in stressful healthcare environments.

Reporting Method

EQUATOR guidelines were followed, using the COREQ checklist.

Patient or Public Contribution

NICU nurses were interviewed about their care‐provision experiences. Interviews were analysed in the primary study and the current analysis of secondary data.
Attitudes and experiences related to the deaths of COVID‐19 patients among nursing staff: A qualitative evidence synthesis
Authors: Gómez‐Brufal‐Flores Manuel , Hueso‐Montoro César , Esteban‐Burgos Ana Alejandra , Montoya‐Juárez Rafael , Mota‐Romero Emilio , Capilla‐Díaz Concepción , Puente‐Fernández Daniel
Published: August 2023

Aim

To identify and synthesize the experiences and attitudes of nursing staff regarding the deaths of COVID‐19 patients.

Review Methods

A qualitative evidence synthesis was carried out, using Noblit and Hare's meta‐ethnographic approach. The review protocol was listed in PROSPERO (CRD42022330928). Studies published from January 2020 to January 2022 that met the criteria were searched in PubMed, Web of Science, Scopus, CINAHL, CUIDEN and PsycInfo. A total of 12 articles were included.

Results

Thirty‐three metaphors emerged, which were grouped into three main themes: Determining factors of care, Feelings about death and Strategies for coping with death. Nurses reported the high emotional toll, the absence of family and the lack of staff, protocol and training as determining factors. Furthermore, staff had doubts about the quality of care that COVID‐19 patients received. As coping strategies, nurses developed avoidance behaviours towards COVID‐19 patients, selective memories, resilience, and/or leaving the profession.

Conclusions

The difficulty in providing adequate nursing care and the high number of deaths has increased anxiety and stress among nurses. These factors, alongside their lived experiences of seeing patients suffering, many dying alone without family members, have had psychological repercussions on nursing staff.

Implications for the Profession and/or Patient Care

The results demonstrate a high emotional toll and doubts surrounding their caregiving role caused by the lack of professional training needed to face a pandemic. This research shows what has been learned for future pandemics and highlights basic components that could provide a foundation for coping interventions for healthcare professionals.

Impact

What Problem did the Study Address?

The challenges posed by COVID‐19 patient deaths for nursing staff around the world and also by the pandemic circumstances in which those deaths occurred.

What were the Main Findings?

The high number of deceased patients who were isolated from family members, communication with family members and doubts surrounding care given during the pandemic have created feelings of fear, stress and anxiety, as well as obsessive thoughts that have changed nursing staff's perception of death due to COVID‐19.

Where and on whom will the Research have an Impact?

Results will be useful for preparing for future pandemics, and for policymakers and health staff in supporting healthcare professionals by creating programmes to help them cope with the emotional toll they have felt after dealing with death in such unprecedented circumstances.

Reporting Method

The authors have adhered to the PRISMA guidelines and the eMERGe Reporting Guidance.

Patient or Public Contribution

No patient or public contribution.
Morphological and molecular characterization of a new member of the phylum Rhodelphidia
Authors: Prokina Kristina I. , Tikhonenkov Denis V. , López‐García Purificación , Moreira David
Published: August 2023

Rhodelphidia is a recently discovered phylum within the supergroup Archaeplastida, comprising only two known representatives (Rhodelphis marinus and Rhodelphis limneticus). Despite its close phylogenetic relatedness to red algae, Rhodelphidia differ markedly by being nonphotosynthetic eukaryotrophic flagellates with gene‐ and intron‐rich genomes. Here, we describe a new freshwater Rhodelphidia species, Rhodelphis mylnikovi sp. n., strain Rhod‐M. It shows clear morphological differences with the two other Rhodelphis species, including larger cell body size, presence of two contractile vacuoles, short and blunt pseudopodia, absence of cysts, and tendency to cannibalism. 18S rRNA‐based phylogenetic analysis placed it sister to the freshwater species R. limneticus.
A recently evolved BAHD acetyltransferase, responsible for bitter soyasaponin A production, is indispensable for soybean seed germination
Authors: Yuan Jia , Ma Liya , Wang Yan , Xu Xindan , Zhang Rui , Wang Chengyuan , Meng Wenxiang , Tian Zhixi , Zhou Yihua , Wang Guodong
Published: August 2023

Soyasaponins are major small molecules that accumulate in soybean (Glycine max) seeds. Among them, type‐A soyasaponins, fully acetylated at the terminal sugar of their C22 sugar chain, are responsible for the bitter taste of soybean‐derived foods. However, the molecular basis for the acetylation of type‐A soyasaponins remains unclear. Here, we identify and characterize GmSSAcT1, encoding a BADH‐type soyasaponin acetyltransferase that catalyzes three or four consecutive acetylations on type‐A soyasaponins in vitro and in planta. Phylogenetic analysis and biochemical assays suggest that GmSSAcT1 likely evolved from acyltransferases present in leguminous plants involved in isoflavonoid acylation. Loss‐of‐function mutants of GmSSAcT1 exhibited impaired seed germination, which attribute to the excessive accumulation of null‐acetylated type‐A soyasaponins. We conclude that GmSSAcT1 not only functions as a detoxification gene for high accumulation of type‐A soyasaponins in soybean seeds but is also a promising target for breeding new soybean varieties with lower bitter soyasaponin content.
Reflections from the frontline of nursing on acute patient deterioration
Authors: Dresser Susan , Teel Cynthia , Peltzer Jill
Published: August 2023

Aims

To describe medical‐surgical nurses' reflections on their experiences with patient deterioration.

Background

An extensive body of knowledge exists regarding optimal responses to acute patient deterioration within a hospital environment. Much less attention has focused on the profound psychological and emotional impact these experiences of unexpected deterioration can have on nurses who provided the supportive or rescue care. A triggering event, such as patient deterioration, or direct questioning about these experiences, can lead nurses to reflect further on the situation. Engaging in reflection is believed to enhance learning and improve clinical judgement when future complex situations arise. Findings related to nurses' reflective practice when recalling previous situations with deteriorating patients are limited. This gap in the literature provided the basis for the current project.

Design

A qualitative descriptive design.

Methods

Twenty medical‐surgical nurses were interviewed in 2018. The nurses were recruited through purposive sampling. Semi‐structured telephone interviews explored nurses' experiences of a patient deterioration. Conventional content analysis with iterative coding and categorising and theme development was used for data analysis.

Findings

Three themes emerged as participants reflected on their experiences. The themes were, Enduring frustration and regret, Feeling deeply responsible for and to the patient and Making sense of what happened.

Conclusions

Medical‐surgical nurses who care for acutely deteriorating patients can experience lasting emotional, psychological and physical concerns that often go unrecognised and untreated. Furthermore, nurses with this background commonly reported their perceived increased risk for workplace distress.

Relevance to Clinical Practice

Findings from this study are important for nurses, healthcare administrators and leaders, and patients. Participating in a rescue attempt often has a negative impact on nurses' perception of workplace stress and on persistent concerns about nurses' mental and physical health. The findings can be useful in informing additional studies about the phenomenon. Findings also can inform the exploration of workplace design. Organisations should assess for factors influencing workplace stress, develop strategies to mitigate the presence of workplace stress and foster nurses' well‐being so they can respond to future scenarios of patient deterioration, while maintaining their physical and mental health.

Patient or Public Contribution

This study did not include any patient or public input.
Dexamethasone solution and dexamethasone in Mucolox™ for the treatment of oral inflammatory ulcerative diseases: A phase II randomized clinical trial
Authors: Lodolo Michele , Thanasuwat Burinrutt , Veluppillai Piri , Bassani Gus , Villa Alessandro
Published: August 2023

Background

Mucolox™ is a mucosal drug delivery system that prolongs the contact time between the oral mucosa and topical corticosteroids, potentially reducing the need for multiple applications daily. This study aimed to assess the clinical efficacy and tolerability of dexamethasone 0.5 mg/5 mL solution in Mucolox™ for the management of oral inflammatory ulcerative diseases.

Methods

Participants were randomly assigned to receive dexamethasone 0.5 mg/5 mL in Mucolox™ (Mucolox™ arm) or dexamethasone 0.5 mg/5 mL solution (standard arm) and instructed to swish/gargle for 5 min three times daily. Changes from pre‐ to posttreatment patient's sensitivity score (0–10 on a visual analog scale), reticulation/erythema/ulceration score, and oral health‐related quality of life were evaluated at baseline and at the end of the study period.

Results

Twenty nine patients (75% females) with a median age of 58 years (range 18–79) were enrolled and randomly allocated to the Mucolox™ or standard arm. One subject was excluded. Although statistically significant in both arms, the pre‐ to posttreatment sensitivity score reduction was higher in the Mucolox™ arm (6.3 vs. 4.4‐point reduction). Both arms showed a decrease in the reticulation/erythema/ulceration score between the two visits (7.2 vs. 4.7 [Mucolox™ arm]; 8.0 vs. 4.8 [standard arm]; p > 0.05). Mucolox™ in dexamethasone 0.5 mg/5 mL solution was better tolerated when taste and level of comfort were considered.

Conclusions

Both treatments were effective in the management of oral inflammatory ulcerative diseases. Dexamethasone 0.5 mg/5 mL in Mucolox™ was better tolerated and was slightly better in controlling patients' oral sensitivity. Larger studies are needed to confirm these findings in oral inflammatory ulcerative diseases patients.

Trial Registration: ClinicalTrials.gov Identifier: NCT04540133.
Can High and Consistent School‐Related Protective Factors Prevent Cannabis Use Among American Indian Middle School Students?
Authors: Henry Kimberly L. , Stanley Linda R. , Swaim Randall C.
Published: August 2023

BACKGROUND

High cannabis use rates among American Indian (AI) adolescents necessitate the identification of factors that protect against early cannabis initiation.

METHODS

Data collected from 279 AI middle school students attending reservation‐based schools in 2018 and 2019 were analyzed. Three waves of data, with approximately 6 months between each, were used. A repeated measures latent class analysis examined a school‐related protective factor index over three waves. The predictive power of lifetime cannabis use on school protection class membership was estimated, along with differences in past month cannabis use at follow‐up 2 across school protection classes while holding baseline use constant.

RESULTS

Four school protection classes were identified: high, moderate, low, and declining protection. Abstinence at baseline was associated with an increased odds of membership in the high protection class compared to the moderate and low protection classes. Students with consistent and high school protection throughout middle school were significantly less likely to report past month cannabis use at follow‐up 2 compared to other classes.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Maintaining a high level of school protection throughout middle school substantially lowers the odds of cannabis use among AI adolescents.

CONCLUSIONS

Interventions to promote school‐related protective factors in this population are essential and should be designed and tested.
Evaluation of real‐time polymerase chain reaction for the diagnosis of protozoal myeloencephalitis in horses using cerebrospinal fluid
Authors: Enriquez Carla Katherine , Morrow Jennifer K. , Graves Amy , Johnson Amy
Published: August 2023

Background

Equine protozoal myeloencephalitis (EPM) caused bySarcocystis neuronaremains an antemortem diagnostic challenge in some horses. Recent work suggested the use of real‐time PCR (rtPCR) on cerebrospinal fluid (CSF) as a promising diagnostic tool.

Objective

To evaluate the sensitivity and specificity ofS. neuronartPCR on CSF for EPM diagnosis using horses with EPM andS. neurona‐seropositive horses with other neurologic conditions.

Animals

Ninety‐nine horses with neurologic disease that underwent complete neurologic examination, CSF collection, and, if euthanized, necropsy including the central nervous system (CNS).

Methods

Retrospective case‐control study using banked CSF samples. Samples from horses with neurologic abnormalities and necropsy‐confirmed EPM diagnosis, presumptive EPM diagnosis using strict criteria (SnSAG2/4/3 ELISA serum:CSF titer ratios <50) and horses diagnosed with other neurologic diseases were used.

Results

Fifty‐two horses had EPM; 23 were confirmed on necropsy, and 29 were presumptive clinical diagnoses. The other 47 horses all had necropsy‐confirmed diagnoses. Four of the 47 horses had normal neurologic findings on necropsy and the remaining 43 horses had neurologic diseases including equine degenerative myeloencephalopathy (EDM), cervical vertebral stenotic myelopathy, trauma, and other miscellaneous conditions. One CSF sample was weakly positive forS. neuronaby rtPCR, this sample was obtained from a horse with confirmed EDM. Samples from the other 98 horses were negative forS. neuronaby rtPCR.

Conclusions and Clinical Importance

Our study contradicts previous conclusions thatS. neuronartPCR is potentially useful for EPM diagnosis, because our results indicate that the assay has a low sensitivity (0%) for EPM.
A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma
Authors: Pazzi Paolo , Fosgate Geoffrey T. , Rixon Anouska , Hanekom Josef , Kristensen Annemarie T. , Goddard Amelia
Published: August 2023

Background

Knowledge of the prevalence of thromboemboli and the associated hemostatic status in dogs with carcinoma or sarcoma is unknown and might allow earlier intervention.

Objectives

Estimate prevalence of thromboemboli and their association with hemostatic changes in dogs with carcinomas or sarcomas; estimate predictive values of hemostatic variables for thromboembolic disease in tumor‐bearing dogs.

Animals

Thirty‐two dogs with sarcoma, 30 with carcinoma, 20 healthy age‐controlled dogs.

Methods

Prospective cross‐sectional study. A hemostasis panel (platelet concentration, thromboelastography, fibrinogen and D‐dimer concentration, factor X, VII and antithrombin activity) was performed in all dogs. Tumor‐bearing dogs underwent complete post mortem and histopathological evaluation. Comparisons between healthy dogs and tumor‐bearing dogs with and without intracavitary hemorrhage; and tumor‐bearing dogs with and without microthrombi were analyzed.

Results

Thromboembolic disease was identified in 32/62 (52%, 95% CI: 39%‐65%) tumor‐bearing dogs. Microthrombi were identified in 31/62 (50%, 95% CI: 37%‐63%) dogs, 21/31 (68%, 95% CI: 49%‐83%) had exclusively intra‐tumoral microthrombi, 10/31 (32%, 95% CI: 17%‐51%) had distant microthrombi. Macrothrombi were identified in 3 tumor‐bearing dogs. Hemostatic changes potentially consistent with overt and non‐overt disseminated intravascular coagulation were identified in some tumor‐bearing dogs. D‐dimer concentrations were significantly higher (P = .02) and platelet concentration significantly lower (P = .03) in tumor‐bearing dogs with microthrombi compared to tumor‐bearing dogs without microthrombi. D‐dimer concentration above 500 ng/mL was 80% sensitive and 41% specific for the prediction of microthrombi presence.

Conclusion

The high microthrombi prevalence and concomitant hemostatic dysfunction in dogs with carcinomas or sarcomas has not previously been reported, though the clinical importance is unknown. Increased D‐dimer concentration might increase suspicion of microthrombi.
Seasonal and diel patterns in Pacific white‐sided dolphin (Lagenorhynchus obliquidens) pulsed calls near Barkley Canyon
Authors: Kanes K. S. Jasper , Dosso Stan E. , Insua Tania Lado , Mouy Xavier , Bateman Andrew
Published: August 2023

Evaluation of temporal patterns in offshore marine mammal activity through visual data collection can be impaired by light and weather conditions and the cost of ship time. The conditions‐independence and cost‐efficacy of acoustic data collection make it popular for researching the temporal patterns of wild dolphins. However, Pacific white‐sided dolphins (PWSDs) north of Southern California remain under‐researched. This study evaluates diel and seasonal patterns in PWSD communication signals detected in 480 days of near‐continuous passive acoustic data collected over 20 months from the Barkley Canyon node of Ocean Networks Canada's NEPTUNE observatory, offshore Vancouver Island, British Columbia, Canada. In this study, a random forest classifier is used to identify PWSD pulsed calls and false positives are manually removed. The resulting acoustic presence‐absence data set is evaluated for seasonal and diel patterns using generalized additive mixed models, considering masking effects from ambient noise. PWSDs are found to be vocally active during all diel periods year‐round, with high summer and low spring activity. Seasonally dependent diel patterns are identified, with PWSD pulsed calls exhibiting no diel pattern in spring, a slight increase in vocal activity during dusk and night in fall and winter, and a notable increase during night and dawn in summer.