bluuebunny/crossref_metadata_2025 huggingface dataset:
Biobehavioral Efficacy of the Elevated Side‐Lying Position for Feeding Preterm Infants: Study Protocol
Authors: Park Jinhee , Thoyre Suzanne , Smallcomb Jane , Mcternan Melissa , Kneeland Tondi
Published: September 2024

Aim

Present a study protocol investigating the biobehavioral efficacy of side‐lying vs. supine positions on physiologic and behavioural responses of preterm infants during their transition from tube to full oral feeding, and identify associated infant characteristics.

Design

Within‐subject cross‐over design.

Methods

Sixty preterm infants born at ≤35 weeks gestational age (GA) from a level 3 NICU are observed during their transition to full oral feeding. Each undergoes two feedings within 24 h: One in the supine position and one in the side‐lying position. Continuous physiologic and video data are collected 30 min before and after feeding. Physiologic measures include heart rate, respiratory rate, oxygen saturation, and autonomic nervous system regulation (heart rate variability and splanchnic‐cerebral oxygen ratio). Behavioural responses are assessed via microanalysis of the sucking and breathing waveforms and videotaped feedings (Suck‐breathe coordination and Early Feeding Skills assessment tool). Data are analysed using linear mixed‐effects models. IRB was obtained in September 2021, with funding awarded by the National Institute of Nursing Research in July 2021.

Conclusion

This study will enhance our understanding of the effects of the side‐lying position on preterm infant feeding, providing guidance for its clinical use as a feeding strategy.

Implications

Provides vital knowledge to guide evidence‐based practices in enhancing oral feeding in preterm infants and inform future pivotal efficacy trials.

Impact

If effective, this intervention could significantly enhance the management of feeding challenges in preterm infants across neonatal care settings.

Reporting Method

Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013.

Patient or Public Contribution

While direct parent involvement was not documented in our protocol, informal feedback on data collection procedures from parents was incorporated. Additionally, extensive engagement with healthcare professionals during study design addressed patient safety, logistical challenges, and ethical standards in NICU settings.

Trial Registration: ClinicalTrials.gov identifier: NCT04942106; registered on 28 June 2021. Available at: https://clinicaltrials.gov/ct2/show/NCT04942106.
Sense of coherence on the relationship between COVID‐19‐related stress and sleep quality among nurses
Authors: Ishitsuka Mami , Muroi Kei , Hachisuka Tomoko , Shibata Itsuka , Hori Daisuke , Doki Shotaro , Takahashi Tsukasa , Sasahara Shinichiro , Matsuzaki Ichiyo
Published: September 2024

Aim

We aimed to examine the mediating effects of the Sense of Coherence (SOC) on the relationship between stress and sleep in nurses during the coronavirus disease 2019 (COVID‐19) pandemic.

Methods

A cross‐sectional survey targeting nurses in Chiba and Tokyo during the summer of 2021 was conducted using Google Forms. Responses were obtained using the Pittsburgh Sleep Quality Index (PSQI), the 13‐item version of the SOC scale (SOC‐13), and questions regarding COVID‐19‐related stress. Structural equation modeling (SEM) was performed to investigate relevant relationships.

Results

A total of 181 valid responses were obtained from 400 surveyed nurses. SEM analysis showed that COVID‐19 stress was indirectly related to PSQI via its effect on SOC‐13, with higher SOC‐13 negatively correlated with PSQI.

Conclusions

Our findings suggest the need for interventions designed to promote SOC for nurses working under stressful conditions.
Controlled comparison evaluation of the soothing effect of 3 cosmetic products on skin discomfort induced by an irritant chemical agent (capsaicin)
Authors: Vitale Maria , López Ana , Truchuelo Maria Teresa , Nobile Vincenzo , Milani Massimo , Gómez‐Sánchez María José
Published: September 2024

Background

Sensitive skin is a highly prevalent problem. The objective of the study was to assess whether the tested products are effective and safe in terms of improving the symptoms of sensitive skin.

Methods

A clinical randomized split‐face study was carried out on 24 healthy female subjects. Three cosmetic combinations were tested versus vehicle: product A (Solía Thermal Spring Water–TSW–from Cantabria, Spain + diatom algae–P. tricornutum–extract), product B (Solía TSW + diatom algae extract + Annona cherimola Fruit Extract) and product C (Solía TSW + diatom algae extract + Annona cherimola Fruit Extract + niacinamide). Prior to each application of the study Product (A, B, or C)/vehicle, 10% of aqueous solution of capsaicin to induce skin irritation was applied, mimicking the symptoms of sensitive skin. Stinging and burning sensations were evaluated at different time points.

Results

All three tested products A, B, and C showed to act better in calming the symptoms induced by capsaicin when compared to the vehicle.

Conclusions

The tested products would be an interesting option for treating stinging and burning sensations in sensitive skin patients.
Diagnosis of abnormal uterine bleeding based on the FIGO classification: A systematic review and expert opinions
Authors: Kitahara Yoshikazu , Hiraike Osamu , Ishikawa Hiroshi , Kugu Koji , Takai Yasushi , Yoshino Osamu , Ono Masanori , Maekawa Ryo , Ota Ikuko , Iwase Akira ,   Subcommittee “Standardization of diagnosis for menstrual disorders” in Reproductive Endocrinology Committee, Japan Society of Obstetrics and Gynecology, 2018‐2022
Published: September 2024

Aim

To present evidence‐ and consensus‐based recommendations for the diagnosis abnormal uterine bleeding.

Methods

A literature search for the diagnosis of abnormal uterine bleeding was systematically conducted in PubMed from its inception to May 2024 to identify meta‐analyses, reviews, randomized controlled trials, and clinical trials, followed by an additional systematic search using keywords. Based on this evidence, an expert panel developed background, clinical, and future research questions.

Results

Based on a systematic search and the collected evidence, we developed five background questions, three clinical questions, and one future research question, with recommendations and/or statements. Evidence and recommendations are provided for clinical questions. Additionally, we developed a flowchart for diagnosis showing the steps of the examinations to be performed.

Conclusion

The flowchart and nine recommendations/statements specify an efficient diagnostic procedure to differentiate abnormal causative diseases of uterine bleeding optimized for actual Japanese situations.
Influence of CAD‐CAM manufacturing methods on the accuracy and mechanical properties of implant‐supported prostheses: A systematic review
Authors: Ellakany Passent , Madi Marwa , Elwan Amira H. , Alshehri Turki , Aljubran Hussain , Aly Nourhan M.
Published: September 2024

Purpose

This systematic review aimed to provide comprehensive insights on the accuracy, fit, and mechanical characteristics of implant‐supported computer‐aided design and computer‐aided manufacturing (CAD‐CAM) prostheses, with a focus on milled and 3D‐printed approaches.

Methods

The research question focused on implant‐supported dental prostheses, comparing different manufacturing techniques (conventional, milled, and 3D‐printed) to determine the different factors affecting the mechanical properties and fit of the CAD‐CAM implant‐supported prosthesis. The eligibility criteria encompassed studies involving implant‐supported restorations, clear reporting of manufacturing techniques, and English‐language publications from the last decade. The search was conducted across three main databases, MEDLINE, Scopus, and Web of Science in September 2023. Publication details, study characteristics, and methodological details of each included study were described.

Results

Of the initial 1964 articles, 581 met the inclusion criteria, and 104 studies were included in the final qualitative analysis. The majority of studies were conducted in the United States, Turkey, and Brazil. Fourteen studies evaluated accuracy parameters, while four studies focused on mechanical characteristics. The studies revealed variability in mechanical properties and marginal and internal fit, with fabrication methods impacting the structural integrity and stress distribution of the prostheses.

Conclusions

The findings suggest that digital manufacturing workflows, both milling and 3D printing, yield acceptable properties for implant‐supported restorations with minimal variations in fit and accuracy. Notably, 3D printing and hybrid techniques demonstrate advantages in specific aspects like marginal fit and stress distribution. However, the milled prosthesis provided superior results in flexural strength and fracture resistance compared to conventional methods. Further research is needed to confirm these findings in clinical settings.
Recurrent aphthous stomatitis in a child successfully treated with apremilast
Authors: March‐Rodríguez Alvaro , Lobato‐Berezo Alejandro , Pujol Ramon M.
Published: September 2024

A 13‐year‐old male presented with a 2‐year history of recurrent aphthous stomatitis. The patient had undergone several unsuccessful treatments, leading to the decision to initiate apremilast. He showed a good clinical response with reduction in outbreaks, and no adverse effects were observed. This is the first report, to our knowledge, of a pediatric patient treated with apremilast for this indication.
Experiences of nursing students providing support in disaster areas: A qualitative study
Authors: Yildirim Maksude , Bozdağ Fatma , Başdaş Öznur
Published: September 2024

This study was conducted as a qualitative inquiry to deeply explore the thoughts and experiences of nursing students involved in support activities in disaster areas. It was conducted as a qualitative study. Data for the study were collected through face‐to‐face interviews or video conferencing using a Personal Information Form and a Semi‐Structured Interview Form created by the researcher. Data analysis was conducted using the MAXQDA software.

The population of this qualitative study consisted of nursing students actively involved in support activities in 11 provinces affected by the magnitude of 7.7 earthquake centered in Kahramanmaraş/Turkey. The sample of the study comprised nursing students who responded to our call shared with nursing student groups and met the inclusion criteria.

Through qualitative analysis, three themes were identified: initial emotions experienced during the earthquake, difficulties faced during the earthquake process, and emotions following the earthquake experience.

Students participating in support activities in the earthquake‐affected region provided explanations regarding their emotions, encountered ethical dilemmas, infrastructure issues, as well as deficiencies in organization and education.
Impact of low‐performance signals on employee fraud in public organizations: Evidence from a pay‐for‐performance context
Authors: Kim Taek Kyu
Published: September 2024

Employee fraud, defined as the misuse of organizational resources for personal financial gain, has long been a serious issue in public organizations, risking deteriorated performance outcomes. Although previous public administration research has discussed organizational cheating related to organizational performance, we need to inquire further about employee fraudulent behaviors across public organizations and other scenarios that cause those behaviors. This study focuses on whether performance outcomes affect employee fraud in the context of high‐stakes performance management. To test this relationship, this study links data from performance evaluation and integrity assessment for South Korean government corporations. A regression discontinuity design (RDD) was employed to estimate the impact of performance shortfalls on employee fraud. The results show that employees in poor‐performing public corporations are more likely to abuse operating expenses, benefit allowance, and project expenses than employees in relatively high‐performing organizations.
Practising Resilience: Lived Experience, Agency and Responses to the Cost‐of‐Living Crisis
Authors: Hewlett Kirstie , Dacombe Rod , Haggar Tianne , Piggott Hannah , Wojciechowska Marta , Hall Suzanne
Published: September 2024

The cost of living in the United Kingdom has risen to unprecedented levels, leaving people experiencing intensifying hardship. However, there is a tension between the ways in which the cost‐of‐living crisis has been framed in public discourse and the experiences of the public, who focus less on coping with short‐term shocks and more on the erosion of personal resilience over the long term. To explore how resilience has been practised during the crisis and the types of policy change people want to see, this article draws on findings from a mixed‐methods study, taking in a longitudinal survey fielded in Britain in 2022–2023, alongside findings from deliberative workshops and peer research conducted in three London boroughs. Our contribution is both theoretical, connecting lived experience to the existing literature on resilience, and empirical, through the application of novel methods to policy responses to hardship. Using Item Response Theory, supported by insights from peer research and deliberative workshops, we identify the differential nature of the strategies people are taking to cope with rising costs. We then consider the types of policy changes people would like to see, finding far greater appetite for long‐term, ambitious systemic reform to rebuild resilience, not short‐term measures to weather the peaks of inflation. Our findings suggest a distrust in those with the power to enact change as well as stigma around accessing support, while also highlighting the need for engaging the most vulnerable in the process.
Cost of Living/Cost of Smoking: A Demonstration Study of Cooperative Action Learning to Understand and Address Smoking in Deprived Communities Within the Cost‐of‐Living Crisis
Authors: D'Ambruoso Lucia , Stephen Amanda , Cowan Eilidh , Innocent Wendy , Marathia Effie , Littlejohn Chris , Duffy Sheila ,   Cost of Living/Cost of Smoking Learning Partnership
Published: September 2024

Smoking is responsible for over 8 million deaths globally per annum. While socially disadvantaged communities are disproportionately affected, few interventions effectively reach these groups. We progressed a participatory action research (PAR) study on smoking‐related health inequalities in the context of the current UK cost‐of‐living crisis. We worked with people living in deprived neighbourhoods in rural northeast Scotland. The objective was to engage affected communities together with the health authority in cooperative action learning. Community‐based participants (n = 9) engaged in a series of workshops (n = 8) adopting roles as co‐researchers, collecting and arranging new data and evidence. We then connected with service providers in a series of additional workshops (n = 3) to analyse and interpret the data, appraise local action and reflect on the process. Community partners identified a convergence between increased stress owing to the crisis, and increased availability, affordability and acceptability of tobacco‐related products, namely e‐cigarettes. The situation was compounded by lack of awareness of available cessation services. A shared action agenda was developed prioritising: (a) the stress‐related root causes of smoking, (b) inclusive access to cessation support, (c) incentivised cessation with locally framed messaging and (d) deliberative dialogue between communities and service providers. There was a high level of engagement, openness and honesty and the strategic relevance of the process was acknowledged. The study provides holistic understandings of health and hardship and demonstrates that existing services can be enhanced with community intelligence. We provide practical methods to support policy commitments to community health emphasising mutual empowerment between service users and providers.
Assessment of current practices and perceived effectiveness of injectable polynucleotide for enlarged facial pores among cosmetic physicians: A survey‐based evaluation
Authors: Lee Dagyeong , Choi Hosung , Yoo Kyounghun , Park Young Jin , Park Hyun Jun , Oh Seung Min , Ji Gun Hyon , Rah Gong Chan , Shin Dong Wook
Published: September 2024

Background

Polynucleotides stimulate collagen formation and are used clinically to enhance elasticity. In this study, we investigated current practices and perceived effectiveness of polynucleotide injection treatment for enlarged facial pores among cosmetic physicians.

Materials and Methods

A survey was developed to investigate clinicians’ use and effectiveness of polynucleotides in the treatment of enlarged facial pores. This survey was distributed to clinicians at the Korean Aesthetic Surgery & Laser Society Autumn Symposium.

Results

A total of 407 physicians who used polynucleotides for enlarged facial pores were enrolled in the survey. Polynucleotides were used by 75.7%, 87.7%, and 72.2% of physicians for enlarged facial pores caused by excessive sebum production, reduced elasticity, and acne, respectively. Among those users, 81.4%, 83.8%, and 76.8% in those same categories, respectively, responded that polynucleotides were “very effective” or “effective.” Furthermore, most clinicians combined polynucleotides with microneedle radiofrequency as energy‐based devices and with botulinum toxin as injection therapy.

Conclusion

This study highlights the widespread use and perceived efficacy of polynucleotide injection among cosmetic physicians in the Republic of Korea for enlarged facial pores due to excessive sebum production, reduced elasticity, and acne. Positive feedback from practitioners supports the benefits of using polynucleotides in enlarged facial pore treatment.
Ex vivo comparison of one‐layer versus two‐layer closures in end‐to‐end anastomoses in normal equine descending colon
Authors: St. Blanc Michael P. , Mirza Mustajab H. , Riggs Laura M. , Leise Britta S.
Published: September 2024

Objective

The aim of the study was to evaluate time to closure, bursting pressures and luminal diameters of a single and double‐layer end‐to‐end anastomoses in normal equine descending colon.

Study design

Experimental study.

Sample population

Eight adult horses.

Methods

Four segments of descending colon from each horse were randomly assigned to a control (n = 8, CON), one‐layer (n = 12, group 1; continuous Lembert pattern), or two‐layer group (n = 12, group 2; simple continuous oversewn with Cushing pattern). Anastomoses were performed, and time to closure and luminal diameter were measured. Bursting pressures were determined, and location of failure was recorded. Mixed analysis of variance (ANOVA) was employed.

Results

Mean time to completion was decreased (p = .003) in group 1 (18.6 min ± 22.8 s) compared with group 2 (21.35 min ± 22.8 s). Luminal diameter was reduced (p < .0001) in group 2 (47 ± 2.46 mm) compared to group 1 (65 ± 2.77 mm). Location of failure was remote to the anastomosis in all but one segment; therefore, differences in anastomotic bursting pressures could not be determined.

Conclusion

Two‐layer closures resulted in significant luminal reduction and took longer to complete than one‐layer anastomoses.

Clinical significance

Use of one‐layer closures may be advantageous primarily with respect to luminal diameter.
Modelling neurocardiac physiology and diseases using human pluripotent stem cells: current progress and future prospects
Authors: Wu Hsueh‐Fu , Hamilton Charlotte , Porritt Harrison , Winbo Annika , Zeltner Nadja
Published: September 2024

Throughout our lifetime the heart executes cycles of contraction and relaxation to meet the body's ever‐changing metabolic needs. This vital function is continuously regulated by the autonomic nervous system. Cardiovascular dysfunction and autonomic dysregulation are also closely associated; however, the degrees of cause and effect are not always readily discernible. Thus, to better understand cardiovascular disorders, it is crucial to develop model systems that can be used to study the neurocardiac interaction in healthy and diseased states. Human pluripotent stem cell (hiPSC) technology offers a unique human‐based modelling system that allows for studies of disease effects on the cells of the heart and autonomic neurons as well as of their interaction. In this review, we summarize current understanding of the embryonic development of the autonomic, cardiac and neurocardiac systems, their regulation, as well as recent progress of in vitro modelling systems based on hiPSCs. We further discuss the advantages and limitations of hiPSC‐based models in neurocardiac research.

image
Emotional contagion builds resilience
Authors: Metzger Martin , Donato Jose
Published: September 2024

Mice that witness cage mates in distress withstand future negative emotions better
Grazing intensity alters network complexity and predator–prey relationships in the soil microbiome
Authors: Camuy-Vélez Lennel A. , Banerjee Samiran , Sedivec Kevin
Published: September 2024

Grasslands are recognized as important reservoirs of soil biodiversity. Livestock grazing is implemented as a grassland management strategy to improve soil quality and enhance plant diversity. Soil microbial communities play a pivotal role in grassland ecosystems, so it is important to examine whether grazing practices affect the soil microbiome. Previous studies on grazing have primarily focused on bacteria and fungi, overlooking an important group—protists. Protists are vital in soil microbiomes as they drive nutrient availability and trophic interactions. Determining the impact of grazing on protists and their relationships with bacterial and fungal communities is important for understanding soil microbiome dynamics in grazed ecosystems. In this study, we investigated soil bacterial, fungal, and protist communities under four grazing levels: no grazing, moderate-use grazing, full-use grazing, and heavy-use grazing. Our results showed that heavy grazing led to a greater diversity of protists with specific groups, such as Discoba and Conosa, increasing in abundance. We also found strong associations between protist and bacterial/fungal members, indicating their intricate relationships within the soil microbiome. For example, the abundance of predatory protists increased under grazing while arbuscular mycorrhizal fungi decreased. Notably, arbuscular mycorrhizae were negatively associated with predatory groups. Furthermore, we observed that microbial network complexity increased with grazing intensity, with fungal members playing an important role in the network. Overall, our study reports the impact of temporal grazing intensity on soil microbial dynamics and highlights the importance of considering protist ecology when evaluating the effects of grazing on belowground communities in grassland ecosystems.

IMPORTANCE

The significance of this study lies in its exploration of the effects of temporal grazing intensity on the dynamics of the soil microbiome, specifically focusing on the often-neglected role of protists. Our findings provide insights into the complex relationships between protists, bacteria, and fungi, emphasizing their impact on trophic interactions in the soil. Gaining a better understanding of these dynamics is essential for developing effective strategies for grassland management and conservation, underscoring the importance of incorporating protist ecology into microbiome studies in grasslands.
Characterization of a
Bifidobacterium animalis
subsp.
lactis
reference strain based on ecology and transcriptomics
Authors: Lugli Gabriele Andrea , Argentini Chiara , Tarracchini Chiara , Mancabelli Leonardo , Viappiani Alice , Anzalone Rosaria , Angelini Leonora , Alessandri Giulia , Longhi Giulia , Bianchi Massimiliano G. , Taurino Giuseppe , Bussolati Ovidio , Milani Christian , Turroni Francesca , Ventura Marco
Published: September 2024

Bifidobacteria are recognized as health-promoting bacteria that reside in the human gut, helping in the digestion of fiber, preventing infections, and producing essential compounds like vitamins. To date,
Bifidobacterium animalis
subsp.
lactis
, together with
Bifidobacterium adolescentis
,
Bifidobacterium bifidum
,
Bifidobacterium breve,
and
Bifidobacterium longum
, represents one of the species that are used as probiotic bacteria. Despite the extensive and detailed scientific research conducted on this microbial taxon, the molecular mechanisms by which
B. animalis
subsp.
lactis
exerts health benefits to its host are still largely unknown. Thus, we dissected the genetic repertoire and phylogenetic relationship of 162 strains of
B. animalis
subsp.
lactis
to select a representative reference strain of this taxon suitable for investigating its interaction with the host. The
B. animalis
subsp.
lactis
PRL2013 strain, which was isolated by a mucosal sample of a healthy adult, was chosen as the reference of the monophyletic cluster of human origin and revealed a greater adhesion index than that observed for another
B. animalis
subsp.
lactis
strain used in the industry as a probiotic supplement. Transcriptomics analyses of PRL2013 strain, when exposed to human cell monolayers, revealed 291 significantly upregulated genes, among which were found genes predicted to encode extracellular structures that may directly interact with human cells, such as extracellular polymeric substances, wall teichoic acids, and pili.

IMPORTANCE

To date, many
Bifidobacterium animalis
subsp.
lactis
strains have been isolated from human fecal samples. However, their presence in these samples does not necessarily suggest an ability to colonize the human gut. Furthermore, probiotics of non-human origin may not effectively interact with the gut epithelium, resulting in transient bacteria of the gut microbiota. In vitro experiments with human cells revealed that
B. animalis
subsp.
lactis
PRL2013, an autochthonous member of the human gut, shows colonization capability, leading to future applications in functional foods.
Opportunities for guiding development: insights from first-year life science majors’ use of metacognition
Authors: Stanton Julie Dangremond , Halmo Stephanie M. , Carter Rayna J. , Yamini Kira A. , Ososanya Deborah
Published: September 2024

Students with strong metacognitive skills are positioned to learn and achieve more than peers who are still developing their metacognition. Yet, many students come to college without well-developed metacognitive skills. As part of a longitudinal study on metacognitive development, we asked when, why, and how first-year life science majors use metacognitive skills of planning, monitoring, and evaluating. Guided by the metacognition framework, we collected data from 52 undergraduates at three institutions using semi-structured interviews. We found that first-year students seek study recommendations from instructors, peers, and online resources when they plan their study strategies. First-year students struggle to accurately monitor their understanding and benefit when instructors help them confront what they do not yet know. First-year students evaluate the effectiveness of their study plans at two specific points: immediately after taking an exam and/or after receiving their grade on an exam. While first-year students may be particularly open to suggestions on how to learn, they may need help debunking myths about learning. First-year students acknowledge they are still learning to monitor and welcome formative assessments that help them improve the accuracy of their monitoring. First-year students may be primed to receive guidance on their metacognition at the points when they are most likely to evaluate the effectiveness of their study strategies and plans. Based on our results, we offer suggestions for instructors who want to support first-year students to further develop their metacognition.
Evaluating the efficacy of endotracheal and intranasal epinephrine administration in severely asphyxic bradycardic newborn lambs: a randomised preclinical study
Authors: de Jager Justine , Pothof Romy , Crossley Kelly J , Schmölzer Georg M , te Pas Arjan B , Galinsky Robert , Tran Nhi T , Songstad Nils Thomas , Klingenberg Claus , Hooper Stuart B , Polglase Graeme R , Roberts Calum T
Published: September 2024

Objective

Intravenous epinephrine administration is preferred during neonatal resuscitation, but may not always be rapidly administered due to lack of equipment or trained staff. We aimed to compare the time to return of spontaneous circulation (ROSC) and post-ROSC haemodynamics between intravenous, endotracheal (ET) and intranasal (IN) epinephrine in severely asphyxic, bradycardic newborn lambs.

Methods

After instrumentation, severe asphyxia (heart rate <60 bpm, blood pressure ~10 mm Hg) was induced by clamping the cord in near-term lambs. Resuscitation was initiated with ventilation followed by chest compressions. Lambs were randomly assigned to receive intravenous (0.02 mg/kg), ET (0.1 mg/kg) or IN (0.1 mg/kg) epinephrine. If ROSC was not achieved after three allocated treatment doses, rescue intravenous epinephrine was administered. After ROSC, lambs were ventilated for 60 min.

Results

ROSC in response to allocated treatment occurred in 8/8 (100%) intravenous lambs, 4/7 (57%) ET lambs and 5/7 (71%) IN lambs. Mean (SD) time to ROSC was 173 (32) seconds in the intravenous group, 360 (211) seconds in the ET group and 401 (175) seconds in the IN group (p<0.05 intravenous vs IN). Blood pressure and cerebral oxygen delivery were highest in the intravenous group immediately post-ROSC (p<0.05), whereas the ET group sustained the highest blood pressure over the 60-min observation (p<0.05).

Conclusion

Our study supports neonatal resuscitation guidelines, highlighting intravenous administration as the most effective route for epinephrine. ET and IN epinephrine should only be considered when intravenous access is delayed or not feasible.
Hepatic sarcoid resembling lymphoma
Authors: Rao Vikram , Lucas Sarah , Segal Jonathan P
Published: September 2024

Sarcoidosis is an inflammatory disease characterised by non-caseating granulomas that can affect any organ, although lung involvement is the most common. It is rare to find sarcoidosis isolated to extrapulmonary organs. We describe a case of extrapulmonary sarcoidosis with involvement of the liver in a man in his late 40s. His initial clinical history and investigations were more consistent with a diagnosis of lymphoma until a liver biopsy was performed revealing non-caseating granulomas more suggestive of a diagnosis of sarcoidosis. This patient had a history of young-onset ischaemic heart disease (IHD). We discuss the possible links between sarcoidosis, an inflammatory condition, and IHD, as well as the challenges to treating such patients with concurrent metabolic syndrome. This case also highlights the heterogeneous nature of sarcoidosis, with the diagnosis being important as prompt treatment can prevent complications of end-stage liver disease, including portal hypertension and cirrhosis.
Carbon dioxide laser excision as a novel treatment for large xanthelasma palpebrarum: long-term efficacy and safety
Authors: Wang Dingqiao , Mao Zhen , Li Zuohong , Gao Wuyou , Qu Yixin , Li Xingyi , Jiang Yuzhen , Lin Xianchai
Published: September 2024

Aims

This study evaluates the long-term efficacy and safety of carbon dioxide (CO₂) laser excision as a novel treatment for large xanthelasma palpebrarum.

Methods

The study included 295 patients diagnosed with xanthelasma palpebrarum, categorised as 246 patients with grade I, 16 with grade II, 22 patients with grade III and 11 with grade IV lesions. All underwent CO₂ laser excision and were followed up for a 12-month period. Treatment efficacy was assessed through clearance and recurrence rates, evaluated using digital photography and complications were recorded.

Results

The participant group consisted of 66 males and 229 females, with an average age of 41.7±11.6 years. Clearance rates exceeded 99% for grades I–III and were around 95% for grade IV lesions. The recurrence rate was 6.8%, with higher recurrence rates observed in lesions over 2 mm in height compared with those under 2 mm (p<0.001). The main complications over the 12-month follow-up were scarring (4.4%), hyperpigmentation (8.1%) and hypopigmentation (8.5%), with no severe complications reported.

Conclusion

CO₂ laser excision emerges as a precise, minimally invasive and effective modality for treating xanthelasma palpebrarum, marking a significant advancement in treatment modalities. Further research is required to reinforce these results and refine treatment protocols.
Cryotherapy for treating soft tissue injuries in sport medicine: a critical review
Authors: Racinais Sebastien , Dablainville Valentin , Rousse Yohan , Ihsan Mohammed , Grant Marie-Elaine , Schobersberger Wolfgang , Budgett Richard , Engebretsen Lars
Published: September 2024

Sports medicine physicians and physiotherapists commonly use cryotherapy (eg, ice application) postinjury to decrease tissue temperature with the objective of reducing pain, limiting secondary injury and inflammation, and supporting healing. However, besides the analgesic effect of cryotherapy, a literature search revealed no evidence from human studies that cryotherapy limits secondary injury or has positive effects on tissue regeneration. Thus, our current understanding of the potential mechanisms and applications of cryotherapy largely relies on the results from animal studies. Importantly, treatment should not aim at obliterating the inflammatory and regeneration processes but instead aim to restore an adapted/normal regulation of these processes to improve function and recovery. However, some animal studies suggest that cryotherapy may delay or impair tissue regeneration. With the translation of laboratory animal studies to human sport medicine being limited by different injury and muscle characteristics, the effect of cryotherapy in patients with musculoskeletal injuries is uncertain. Thus, pending the results of human studies, cryotherapy may be recommended in the first 6 hours following an injury to reduce pain (and possibly haematoma), but it should be used with caution beyond 12 hours postinjury as animal studies suggest it may interfere with tissue healing and regeneration.
One year cumulative incidence and risk factors associated with workplace violence within the ambulance service in a Swedish region: a prospective cohort study
Authors: Viking Magnus , Hugelius Karin , Höglund Erik , Kurland Lisa
Published: September 2024

Objective

To measure the 1 year cumulative incidence of and analyse the risk factors associated with workplace violence directed towards the ambulance service in a Swedish region.

Design

Prospective cohort study.

Setting

The ambulance services in Örebro County Council (Sweden) contain approximately 300 000 inhabitants.

Participants

All ambulance missions during the period of 12 months (n=28 640) were assessed.

Primary and secondary outcome measures

The primary outcome measure was workplace violence together with the associated risk factors.

Results

The 1 year cumulative incidence of workplace violence within the ambulance service was 0.7%. Non-physical violence was most common. There was an increased odds for violence when the patient was under the influence of alcohol or drugs or suffering from mental illness. There was an association between the dispatch categories intoxication, unconsciousness or mental health problems and workplace violence against ambulance personnel. The offenders were mostly men aged 18–29 and workplace violence was more likely to occur in public places.

Conclusions

The 1 year cumulative incidence of workplace violence within the regional ambulance service was low in comparison to that of previous research. The overall regression model had low explanatory power, indicating that the phenomenon is complex and that additional variables need to be taken into account when trying to predict when workplace violence will occur. Additional research is needed to fully understand why workplace violence within the ambulance service occurs and how to mitigate such situations.
Demographic and surgical characteristics in patients who do not achieve minimal important change in the KOOS Sport/Rec and QoL after ACL reconstruction: a comparative study from the Swedish National Knee Ligament Registry
Authors: Simonsson Rebecca , Bittar Judy , Kaarre Janina , Zsidai Bálint , Sansone Mikael , Piussi Ramana , Musahl Volker , Irrgang James , Samuelsson Kristian , Senorski Eric Hamrin
Published: September 2024

Objectives

This study aimed to compare demographic and surgical characteristics between patients who do and do not achieve minimal important change (MIC) in the Knee injury and Osteoarthritis Outcome Score (KOOS) Sports and Recreation (Sport/Rec) and Quality of Life (QoL) subscales 1 year after anterior cruciate ligament reconstruction.

Design

Comparative cross-sectional.

Setting

The MIC for the KOOS Sport/Rec subscale was ≥12.1 and ≥18.3 for the KOOS QoL subscale from before surgery to 1-year follow-up using data from the Swedish National Knee Ligament Registry.

Participants

In total 16 131 patients were included: 11 172 (69%) with no MIC for the Sport/Rec scale, and 10 641 (66%) for the QoL.

Results

Patients with no MIC for Sport/Rec and QoL had a higher body mass index (BMI) (24.8±3.5 vs 24.6±3.3 and 24.7±3.5 vs 24.6±3.2, respectively, p<0.0001), were younger (years) at time of surgery (28.5±10.3 vs 29.1±10.8 and 27.4±9.8 vs 29.7±11.0, respectively, p=0.0002 and <0.0001), had longer time from injury to surgery (months) (Sports/Rec 22.0±38.5 vs 19.3±36.6, respectively, p=0.0002), and greater rates of concomitant cartilage injuries especially to the lateral femoral condyle (22.7% vs 19.4% and 23.3% vs 19.0%, respectively, p=0.001 and p=0.005) compared with patients who achieved the MIC. A smaller proportion of patients treated with a hamstring tendon autograft had no MIC (91.4%) compared with patients with MIC (94.1%).

Conclusions

Patients with no MIC for KOOS Sport/Rec and QoL subscales had a higher BMI, longer time from injury to surgery and were younger at the time of surgery compared with patients who did achieve MIC. Although differences were small, they may reframe management strategies with patients who have these characteristics.
Nurses’ perceptions of patient safety culture and adverse events in Hail City, Saudi Arabia: a cross-sectional approach to improving healthcare safety
Authors: Alrasheeday Awatif M , Alkubati Sameer A , Alqalah Talal Ali Hussein , Alrubaiee Gamil Ghaleb , Pasay-An Eddieson , Alshammari Bushra , Abdullah Saleh O , Loutfy Ahmed
Published: September 2024

Objective

This study aimed to assess nurses’ perceptions of patient safety culture (PSC) and its relationship with adverse events in Hail City, Saudi Arabia.

Design

A cross-sectional study was conducted between 1 August 2023 and the end of November 2023 at 4 governmental hospitals and 28 primary healthcare centres.

Setting

Hail City, Saudi Arabia.

Participants

Data were collected from 336 nurses using 3 instruments: demographic and work-related questions, PSC and adverse events.

Results

Nurses had positive responses in the dimensions of ‘teamwork within units’ (76.86%) and ‘frequency of events reported’ (77.87%) but negative responses in the dimensions of ‘handoffs and transitions’ (18.75%), ‘staffing’ (20.90%), ‘non-punitive response to errors’ (31.83%), ‘teamwork across units’ (34.15%), ‘supervisor/manager expectations’ (43.22%) and ‘overall perception of patient safety’ (43.23%). Significant associations were found between nationality, experience, current position and total safety culture, with p values of 0.015, 0.046 and 0.027, respectively. Nurses with high-ranking perceptions of PSC in ‘handoffs and transitions,’ ‘staffing’ and ‘teamwork across hospital units’ reported a lower incidence of adverse events than those with low-ranking perceptions, particularly in reporting pressure ulcers (OR 0.86, 95% CI 0.78 to 0.94, OR 0.82, 95% CI 0.71 to 0.94 and OR 0.83, 95% CI 0.70 to 0.99, respectively) (p<0.05). Nurses with high-ranking perceptions of PSC in UK ‘handoffs and transitions’ reported a lower incidence of patient falls. Similarly, those with high-ranking perceptions in both ‘handoffs and transitions’ and ‘overall perception of patient safety reported a lower incidence of adverse events compared with those with low-ranking perceptions, especially in reporting adverse drug events (OR 0.83, 95% CI 0.76 to 0.91 and OR 0.75, 95% CI 0.61 to 0.92, respectively) (p<0.05).

Conclusion

From a nursing perspective, hospital PSCs have both strengths and weaknesses. Examples include low trust in leadership, staffing, error-reporting and handoffs. Therefore, to improve staffing, communication, handoffs, teamwork, and leadership, interventions should focus on weak areas of low confidence and high rates of adverse events.
Finding linkages between the Sustainable Development Goals in Uganda: a key to attain health and well-being for all
Authors: Wanyana Irene , Helldén Daniel , Ndejjo Rawlance , Murzabekov Marat , Alfven Tobias , Wanyenze Rhoda K , Viberg Nina
Published: September 2024

Introduction

While Uganda has made significant strides towards the 2030 Agenda, several development challenges persist, including a high disease burden, poverty and the effects of climate change. Multisectoral collaboration is critical in achieving Uganda’s Sustainable Development Goals (SDGs); however, most sectors in the country still operate in isolation. Understanding the linkages between the goals in Uganda is critical for accelerating progress on health and the SDGs. This study aimed at taking initial steps in investigating the linkages between health and other SDGs in Uganda.

Methods

A 2-day workshop with 29 multisectoral stakeholders was conducted to explore the nature of linkages between the SDGs nationally in Uganda. Results were analysed using the SDG synergies approach and presented using a cross-impact matrix to show the nature and strength of linkages between the goals.

Results

Overall, there were more positive linkages between the SDGs than negative ones. Progress on SDG 10 (reduced inequalities) was considered to have the most positive influence on the 2030 Agenda. SDG 3 (good health and well-being) was the goal that was perceived to be most positively affected if progress was made on other goals. The economic goals, SDG 8 (decent work and economic growth) and SDG 9 (industry, innovation and infrastructure) were the goals that promoted other goals the least. Negative linkages were perceived between SDG 13 (climate action) and the economic goals (SDG 8; SDG 9).

Conclusion

The findings reveal that promoting linkages were perceived to be the majority, but some restricting linkages between the SDGs also exist. The promoting linkages suggest a need for integrated approaches in attaining SDG 3 and other SDGs in Uganda. Further addressing inequalities in their different forms, policy reforms, local community engagements and continuous monitoring are critical for sustainable development in Uganda.
Challenges faced by migrant populations in complying with public health measures during the COVID-19 pandemic in Malaysia: A qualitative study
Authors: Loganathan Tharani , Zaini Amirah Zafirah , Kunpeuk Watinee , Suphanchaimat Rapeepong , Yi Huso , Farwin Aysha , Abdul Majid Hazreen
Published: September 2024

Introduction

The COVID-19 pandemic adversely impacted migrants in Malaysia, raising concerns about the effectiveness of public health measures. This study aims to investigate challenges faced by migrant populations in complying with public health measures during the pandemic.

Methods

We conducted 29 in-depth interviews with stakeholders between April 2022 and February 2023. Thematic analysis was conducted, and results were organised by major COVID-19 public health measures: (1) movement restrictions, (2) non-pharmaceutical interventions, (3) COVID-19 screening and testing and (4) quarantine, isolation and hospitalisations.

Results

Migrants encountered difficulties complying with the movement control orders due to livelihood crises and a lack of understanding of regulations. Financial constraints hindered migrants’ ability to purchase quality face masks, and they lacked the comprehension of the importance of non-pharmaceutical interventions for disease prevention. In the absence of government intervention, non-governmental organisations and international organisations played an important role in providing essential food aid, health information, face masks and hygiene products, and other services to migrants. Despite encouragement to seek testing and treatment, migrants were deterred by fear of immigration enforcement and unaffordable fees. Overcrowded living conditions made physical distancing, isolation and quarantine challenging. Many avoided government-designated quarantine centres due to financial constraints and fear of arrest. Delayed medical treatment may have resulted in high COVID-19 mortality among migrants.

Conclusions

The COVID-19 pandemic highlighted significant health disparities experienced by migrants in Malaysia, including the double health and livelihood crises, and limited access to essential health information, resources, healthcare and social protection. Urgent reforms are needed to ensure migrant-inclusive health policies, enhance outbreak preparedness and prevent unnecessary suffering and deaths among migrants during both pandemic and non-pandemic periods.
Tanner’s target height formula underestimates final adult height in Korean adolescents and young adults: reassessment of target height based on the Korean National Health and Nutrition Examination Survey 2010–2019
Authors: Kim Sejin , Yoo Jae Ho , Chueh Hee Won
Published: September 2024

Objective

Estimating children’s target height (TH) plays an important role in diagnosing, evaluating and treating many paediatric endocrinological diseases. However, in many countries, employing Tanner’s formula to predict children’s final adult height (FAH) is considered misleading. Therefore, this study aimed to re-evaluate the validity of Tanner’s formula for predicting the TH of Korean adolescents and young adults and develop a new formula suitable for Korean children.

Design/setting

Data were derived from the Korean National Health and Nutrition Examination Survey 2010–2019.

Patients

A total of 2586 participants (1266 men, 1320 women) were included, excluding participants for whom Tanner’s formula could not be calculated because of missing parental height data.

Main outcome measures

Tanner-based TH was compared with the FAH.

Results

The difference between Tanner-based TH and FAH was 4.86±0.178 cm for men and 4.81±0.150 cm for women. Sex-specific univariable and multivariable analyses were conducted to determine variables influencing positive height gap (greater than estimated TH). Both men and women with higher education levels were more likely to exhibit a positive height gap. Those with a history of chronic illness were less likely to exhibit a positive height gap, particularly in women. Using a new formula derived using linear regression analysis, the sum of parental heights explained 27.6% and 30.6% of the variance in sons’ and daughters’ heights, respectively.

Conclusions

Tanner’s formula for calculating TH tended to underestimate FAH; hence, our new formula may offer a better alternative for estimating TH and evaluating growth in Korean children and adolescents.