bluuebunny/crossref_metadata_2025 huggingface dataset:
Supporting reproductive health among birthing persons with chronic conditions in the United States: A qualitative multilevel study using systems thinking to inform action
Authors: Smith Cambray , Fatima Hiba , McClain Erin , Bryant Katherine , Verbiest Sarah , Hassmiller Lich Kristen
Published: January 2023

Objective (Study Question)

To use systems thinking with diverse system actors to (a) characterize current problems at the intersection of chronic conditions (CCs) and reproductive health (RH) care and their determinants, (b) determine necessary system actors for change, and (c) document cross‐system actions that can improve identified problems in the United States.

Data Sources/Study Setting

Data were collected from six groups of system actors via online focus groups.

Study Design

This is a qualitative multilevel study using the iceberg systems thinking framework.

Data Collection/Extraction Methods

Data were collected by note‐taking and recording six focus groups; analysis incorporated perspective triangulation using the systems thinking iceberg and system mapping to visualize interconnected system challenges, actors, and action ideas.

Principal Findings

Participants described eight necessary system actors: health care institutions, medical leaders, medical providers, patient advocates and foundations, patients and families, payors, policy makers, and research funders. Forty pain points were identified, spread across each of the four levels of the systems thinking iceberg: undesirable outcomes (6), concerning trends (9), system structure flaws (15), and problematic mental models (10). In response to these pain points, a set of 46 action ideas was generated by participants and mapped into nine action themes: (1) adjust QI metrics, incentives, and reimbursement, (2) bolster RH medical education and training, (3) break down medical silos, (4) enrich patient education, (5) expand the health care team, (6) improve holistic health care, (7) modify research and programmatic funding to prioritize RH and CC, (8) spur innovation for patient visits, and (9) support professional champions and leaders.

Conclusions

By embracing system complexity, creating visual maps, and pushing participants to identify actionable strategies for improvement, this study generates a set of specific actions that can be used to address pain points across the multiple system levels that make improving reproductive care for people with CCs so challenging.
Particle size influences decay rates of environmental DNA in aquatic systems
Authors: Brandão‐Dias Pedro F. P. , Hallack Daniel M. C. , Snyder Elise D. , Tank Jennifer L. , Bolster Diogo , Volponi Sabrina , Shogren Arial J. , Lamberti Gary A. , Bibby Kyle , Egan Scott P.
Published: January 2023

Environmental DNA (eDNA) analysis is a powerful tool for remote detection of target organisms. However, obtaining quantitative and longitudinal information from eDNA data is challenging, requiring a deep understanding of eDNA ecology. Notably, if the various size components of eDNA decay at different rates, and we can separate them within a sample, their changing proportions could be used to obtain longitudinal dynamics information on targets. To test this possibility, we conducted an aquatic mesocosm experiment in which we separated fish‐derived eDNA components using sequential filtration to evaluate the decay rate and changing proportion of various eDNA particle sizes over time. We then fit four alternative mathematical decay models to the data, building towards a predictive framework to interpret eDNA data from various particle sizes. We found that medium‐sized particles (1–10 μm) decayed more slowly than other size classes (i.e., <1 and > 10 μm), and thus made up an increasing proportion of eDNA particles over time. We also observed distinct eDNA particle size distribution (PSD) between our Common carp and Rainbow trout samples, suggesting that target‐specific assays are required to determine starting eDNA PSDs. Additionally, we found evidence that different sizes of eDNA particles do not decay independently, with particle size conversion replenishing smaller particles over time. Nonetheless, a parsimonious mathematical model where particle sizes decay independently best explained the data. Given these results, we suggest a framework to discern target distance and abundance with eDNA data by applying sequential filtration, which theoretically has both metabarcoding and single‐target applications.
Difficult diagnosis in the ICU: making the right call but beware uncertainty and bias
Authors: Pisciotta W. , Arina P. , Hofmaenner D. , Singer M.
Published: January 2023

Dealing with an uncertain or missed diagnosis is commonplace in the intensive care unit setting. Affected patients are subject to a potential decrease in quality of care and a greater risk of a poor outcome. The diagnostic process is a complex task that starts with information gathering, followed by integration and interpretation of data, hypothesis generation and, finally, confirmation of a (hopefully correct) diagnosis. This may be particularly challenging in the patient who is critically ill where a good history may not be forthcoming and/or clinical, laboratory and imaging features are non‐specific. The aim of this narrative review is to analyse and describe common causes of diagnostic error in the intensive care unit, highlighting the multiple types of cognitive bias, and to suggest a diagnostic framework. To inform this review, we performed a literature search to identify relevant articles, particularly those pertinent to unclear diagnoses in patients who are critically ill. Clinicians should be cognisant as to how they formulate diagnoses and utilise debiasing strategies. Multidisciplinary teamwork and more time spent with the patient, supported by effective and efficient use of electronic healthcare records and decision support resources, is likely to improve the quality of the diagnostic process, patient care and outcomes.
Targeting RNA with small molecules—A safety perspective
Authors: Lightfoot Helen L. , Smith Graham F.
Published: January 2023

RNA is a major player in cellular function, and consequently can drive a number of disease pathologies. Over the past several years, small molecule‐RNA targeting (smRNA targeting) has developed into a promising drug discovery approach. Numerous techniques, tools, and assays have been developed to support this field, and significant investments have been made by pharmaceutical and biotechnology companies. To date, the focus has been on identifying disease validated primary targets for smRNA drug development, yet RNA as a secondary (off) target for all small molecule drug programs largely has been unexplored. In this perspective, we discuss structure, target, and mechanism‐driven safety aspects of smRNAs and highlight how these parameters can be evaluated in drug discovery programs to produce potentially safer drugs.
Circular RNA ARHGAP5 inhibits cisplatin resistance in cervical squamous cell carcinoma by interacting with AUF1
Authors: Deng Sisi , Qian Lili , Liu Luwen , Liu Hanyuan , Xu Zhihao , Liu Yujie , Wang Yingying , Chen Liang , Zhou Ying
Published: January 2023

Cervical squamous cell carcinoma (CSCC) is one of the leading causes of cancer death in women worldwide. Patients with advanced cervical carcinoma always have a poor prognosis once resistant to cisplatin due to the lack of effective treatment. It is urgent to investigate the molecular mechanisms of cisplatin resistance. Circular RNAs (circRNAs) are known to exert their regulatory functions in a series of malignancies. However, their effects on CSCC remain to be elucidated. Here, we found that cytoplasmic circARHGAP5, derived from second and third exons of the ARHGAP5 gene, was downregulated in cisplatin‐resistant tissues compared with normal cervix tissues and untreated cervical cancer tissues. In addition, experiments from overexpression/knockdown cell lines revealed that circARHGAP5 could inhibit cisplatin‐mediated cell apoptosis in CSCC cells both in vitro and in vivo. Mechanistically, circARHGAP5 interacted with AU‐rich element RNA‐binding protein (AUF1) directly. Overexpression of AUF1 could also inhibit cell apoptosis mediated by cisplatin. Furthermore, we detected the potential targets of AUF1 related to the apoptotic pathway and found that bcl‐2‐like protein 11 (BIM) was not only negatively regulated by AUF1 but positively regulated by circARHGAP5, which indicated that BIM mRNA might be degraded by AUF1 and thereby inhibited tumor cell apoptosis. Collectively, our data indicated that circARHGAP5 directly bound to AUF1 and prevented AUF1 from interacting with BIM mRNA, thereby playing a pivotal role in cisplatin resistance in CSCC. Our study provides insights into overcoming cancer resistance to cisplatin treatment.
Exploration of caregiver experiences of reported first signs of autism
Authors: Smith Holly , Black Melissa H. , Thompson Craig , Falkmer Marita , Falkmer Torbjorn , Girdler Sonya , Milbourn Ben
Published: January 2023

Aim

This study explored caregiver‐reported first signs of autism and caregiver experiences of reporting these signs to health professionals using a multiple methods approach.

Background

Within the Australian context, children who have been diagnosed with autism represent a significant proportion of individuals requiring access to disability services. Due to the importance of accessing early intervention services to support future outcomes, it is vital that first signs are noticed, reported, and the diagnosis process begun as soon as possible.

Method

Phase 1 of the study included a secondary analysis of a survey of caregivers, while phase 2 consisted of focus groups of caregivers of children on the autism spectrum.

Results

Survey data indicated that most children were aged 12–18 months when first signs were noticed, with first signs noticed earlier in females than males. Children were age 2–6 years when caregivers sought advice and received a diagnosis. Uncertainty and a lack of information often left caregivers feeling frustrated and under‐supported when seeking advice and diagnosis. Despite first signs being recognised early by caregivers, barriers to information and seeking help and support resulted in significant delays in receiving a diagnosis.

Conclusions

The study provides valuable consideration of the caregiver perspective regarding reported first signs of autism and the additional challenges faced by caregivers living in regional and rural areas. By being more informed of what caregivers first notice, health professionals may also be able to provide better support and advice to caregivers in regard to access to diagnosis and early intervention services.
From Villages to Urban Neighborhoods: Urbanization and Health
Authors: Shen Yu , Sun Wenkai
Published: January 2023

With rapid urbanization, millions of rural villagers have become urban citizens in China. This paper estimates the effect of the in situ urbanization policy on an individual's health by employing the difference‐in‐differences framework and using panel survey data from the China Family Panel Studies. Our findings show that this program, unlike other kinds of urbanization, which have had negative impacts on mental health or made people smoke or drink more, increased people's self‐reported health status significantly. Further mechanism analysis reveals that the in situ urbanization policy affected health by increasing people's confidence in the future, their satisfaction with their current lives, and their medical insurance enrollment. This study highlights the importance of “the city comes to villagers” urbanization in China, and it can play an essential role in advancing the urbanization rate and avoiding the negative impacts of urbanization on health.
Paediatric eating disorders: Exploring virtual family therapy during a global pandemic
Authors: Pereira Jessica , Boachie Ahmed , Shipley Caitlin , McLeod Martha , Garfinkel Stephen , Dowdall Janet
Published: January 2023

Aim

Explore treatment response and effectiveness of virtual treatment for a paediatric eating disorder sample.

Methods

Twenty patients and their families who received either virtual or in‐person family therapy were included in the study. Family therapy was informed by family‐based treatment (FBT) principles. Patients' weight restoration at 1, 3, and 6 months after starting treatment was examined. Independent sample t tests assessed group differences and a Fisher exact test was used to evaluate the association between treatment group and weight restoration.

Results

Weight restoration did not significantly differ between treatment groups (virtual vs. in‐person) at any time point and there was no association between group and remission weight at 6 months.

Conclusions

Study results are considered exploratory. Future research addressing study limitations is needed. Results suggest that paediatric eating disorder patients may benefit from family therapy delivered via a virtual platform.
Assessing place‐based identities in the early Middle Ages: a proposal for post‐Roman Iberia
Authors: Martínez Jiménez Javier , Tejerizo‐García Carlos
Published: January 2023

Sociological models of place‐based identity can be used to better understand the social dynamics of local communities and how they interact with their surroundings. This paper explores how these theoretical models of belonging to a place, in tandem with communal cognitive maps, can be applied to post‐Roman contexts, taking the Iberian Peninsula in the Visigothic period (sixth–eighth centuries) as a preliminary case study. We argue that this approach can give us not only a more complex understanding of community agencies but also allows us to reconsider the social context for past social interactions. Furthermore, it will open a new archaeological perspective for future work on the relations between groups and individuals with their built, social, and natural environments.
Analysis of co‐medication in people with dementia
Authors: Wurm Raphael , Parvizi Tandis , Goeschl Stella , Untersteiner Helena , Silvaieh Sara , Stamm Tanja , Cetin Hakan , Reichardt Berthold , Stögmann Elisabeth
Published: January 2023

Background and purpose

Dementia prevalence is increasing, with numbers projected to double by 2050. Risk factors for its development include age and cardiovascular comorbidities, which are found more often in patients with dementia and should be treated properly to improve outcomes. In this case–control study, we analysed a large population‐based prescription database to explore the patterns of co‐medication in patients with dementia.

Methods

Prescription claims covering >99% of the Austrian population from 2005 to 2016 were obtained. Patients who were treated with an approved antidementia drug (ADD) were included and co‐medication exposure was recorded. A group of people not taking ADDs was matched for age, sex and follow‐up duration as a control.

Results

We included 70,799 patients on ADDs who were exposed to a mean of 5.3 co‐medications while control patients were treated with a total of 5.2 co‐medications (p < 0.001). We found that patients on ADDs received less somatic (4.1 vs. 4.5) but more psychiatric medication (1.1 vs. 0.6;p < 0.001 for both). Patients on ADDs were less likely to be treated for pain, cardiovascular conditions or hyperlipidemia. More than 50% of patients on ADDs were treated with antidepressants or antipsychotics. Greater number of co‐medications was associated with markers of more intensive antidementia treatment.

Conclusion

Patients on ADDs received more medications overall but were less frequently treated for somatic conditions known to be more prevalent in this group. Together, our data suggest that management of comorbidities in dementia could be improved to optimize outcome and quality of life.
Evisceration in a Thoroughbred gelding following application of a topical chemotherapy agent for the treatment of sarcoids
Authors: Baldwin Alexandra J. , Mair Tim S. , Busschers Evita
Published: January 2023

This report describes the evisceration of the jejunum following acute dehiscence of the abdominal wall in an 18‐year‐old gelding, which had undergone treatment for suspected sarcoids on the ventral abdomen with a topical caustic/chemotherapy agent 6 weeks previously. The sarcoid lesions appeared to be responding appropriately to the topical therapy until the day of presentation. The jejunum was safely contained in an abdominal bandage and the horse underwent emergency referral before immediate anaesthesia and further assessment. The horse was euthanised at the owners' request following a guarded prognosis.
Eptinezumab improved patient‐reported outcomes in patients with migraine and medication‐overuse headache: Subgroup analysis of the randomized PROMISE‐2 trial
Authors: Starling Amaal J. , Cowan Robert P. , Buse Dawn C. , Diener Hans‐Christoph , Marmura Michael J. , Hirman Joe , Brevig Thomas , Cady Roger
Published: January 2023

Objective

To evaluate the effect of eptinezumab on patient‐reported outcomes in patients with chronic migraine (CM) and medication‐overuse headache (MOH).

Background

MOH is a secondary headache disorder commonly occurring in patients with CM and associated with functional and psychological impairments. Medication overuse and monthly headache and migraine days were reduced with eptinezumab compared with placebo as published previously; however, these outcomes do not fully capture the burden of migraine and treatment effect.

Methods

PROMISE‐2 was a phase 3, randomized, double‐blind, placebo‐controlled trial in adults with CM. Patients were randomized (1:1:1) to receive eptinezumab 100 mg, eptinezumab 300 mg, or placebo (up to 2 doses, 12 weeks apart). Patients completed the following patient‐reported outcomes: 6‐item Headache Impact Test (HIT‐6), Patient Global Impression of Change (PGIC), patient‐identified most bothersome symptom (PI‐MBS), and 36‐item Short‐Form Health Survey (SF‐36).

Results

A total of 431 CM patients (139, 147, and 145 patients in the eptinezumab 100 mg, eptinezumab 300 mg, and placebo groups, respectively) had MOH diagnosed at screening (40.2% of the total PROMISE‐2 population [n = 1072]). In CM with MOH patients, both doses of eptinezumab were associated with clinically meaningful improvements in mean HIT‐6 total scores by week 4 and remained improved throughout the 24‐week study. Responder rates for individual HIT‐6 items were greater with eptinezumab than with placebo at all time points. At week 12, almost twice as many eptinezumab‐treated patients indicated the PGIC was “much” or “very much” improved (58.5% [79/135, 100 mg] and 67.4% [95/147, 300 mg] vs. 35.8% [48/134, placebo]). Patients in the eptinezumab groups showed numerically greater improvements over placebo in the PI‐MBS and SF‐36 scores.

Conclusions

This subgroup analysis in patients with CM/MOH at baseline suggests that eptinezumab treatment is associated with early, sustained, and clinically meaningful improvements in patient‐reported outcomes.
Online demand disruption in the presence of constrained capacity
Authors: Chen Yujing , Zha Yong , Wang Dong , Bi Gongbing
Published: January 2023

Demand disruptions are common during emergencies and are typically accompanied by capacity constraints. Using a model in which a firm sells products through an online platform channel and an offline direct channel, we study the effect of demand disruptions on the firm and the online platform in the presence of constrained capacity. Our analysis reveals that prices in both channels are all subject to markup due to constrained capacity in the absence of demand disruptions. When the demand disruption is sufficiently mild, the firm adopts the constant online allocation strategy with sufficient capacity and the constant allocation strategy with limited capacity. When demand fluctuates substantially, the firm chooses a flexible allocation strategy or allocation‐shifting strategy according to whether the capacity is sufficient or constrained. Different from prior studies, the boundary of the firm's optimal strategies depends on the capacity constraint. Furthermore, we find that when the capacity is low relative to some threshold, increasing capacity harms the firm's profits. Finally, we impart insights and provide guidance for the firm in determining optimal pricing and product allocation strategies when facing demand disruptions in other related emergency scenarios.
Phase stability and tensorial thermal expansion properties of single to high‐entropy rare‐earth disilicates
Authors: Salanova Alejandro , Brummel Ian A. , Yakovenko Andrey A. , Opila Elizabeth J. , Ihlefeld Jon F.
Published: January 2023

Temperature limitations in nickel‐base superalloys have resulted in the emergence of SiC‐based ceramic matrix composites as a viable replacement for gas turbine components in aviation applications. Higher operating temperatures allow for reduced fuel consumption but present a materials design challenge related to environmental degradation. Rare‐earth disilicates (RE2Si2O7) have been identified as coatings that can function as environmental barriers and minimize hot component degradation. In this work, single‐ and multiple‐component rare‐earth disilicate powders were synthesized via a sol‐gel method with compositions selected to exist in the monoclinic C 2/m phase (β phase). Phase stability in multiple cation compositions was shown to follow a rule of mixtures and the C 2/m phase could be realized for compositions that contained up to 25% dysprosium, which typically only exists in a triclinic, P , phase. All compositions exhibited phase stability from room temperature to 1200°C as assessed by X‐ray diffraction. The thermal expansion tensors for each composition were determined from high‐temperature synchrotron X‐ray diffraction and accompanying Rietveld refinements. It was observed that ytterbium‐containing compositions had larger changes in the α31 shear component with increasing temperature that led to a rotation of the principal axes. Principal axes rotation of up to 47° were observed for ytterbium disilicate. The results suggest that microstructure design and crystallographic texture may be essential future avenues of investigation to ensure thermo‐mechanical robustness of rare‐earth disilicate environmental barrier coatings.
Estimates of genetic and phenotypic parameters for feeding behaviour and feed efficiency‐related traits in Nelore cattle
Authors: Kava Rafaela , Peripolli Elisa , Brunes Ludmilla C. , Espigolan Rafael , Mendes Egleu D. M. , da Silva Neto João Barbosa , Londoño‐Gil Marisol , Sainz Roberto D. , Lobo Raysildo B. , Baldi Fernando
Published: January 2023

The objective of this study was to obtain (co)variance components, heritability, and genetic and phenotypic correlation estimates for feed efficiency and feed behaviour‐related indicator traits. Further, it aimed to predict the direct and correlated responses for feed efficiency traits when selection was applied for feeding behaviour‐related traits in Nelore cattle. Phenotypic records (n = 4840) from 125 feed efficiency tests (RFI: Residual feed intake and DMI: Dry matter intake) carried out between 2011 and 2018 were considered in this study. Animals belonged to five farms located in two Brazilian geographical regions (Midwest and Southeast). Animals under similar management and environmental conditions in the feedlot were evaluated when they attained an average of 13.5 ± 4.15 months of age. Feed behaviour‐related traits were also obtained, including meal criteria (MC), meal frequency (MF), average meal duration (AMD), meal duration (MD), average consumption per meal (ACM), and consumption rate (CR) through the GrowSafe System® electronic bunk system. The contemporary groups for all traits were composed of farm, management group, feed efficiency test, sex, and birth year. The (co)variance components were estimated using the restricted maximum likelihood method considering a multi‐trait (n = 8) animal model. The heritability estimates for RFI (0.23 ± 0.02), DMI (0.31 ± 0.02), MF (0.65 ± 0.02), AMD (0.29 ± 0.02), ACM (0.24 ± 0.02), MD (0.41 ± 0.02), MC (0.48 ± 0.02), and CR (0.42 ± 0.02) were moderate to high. The highest genetic correlation was obtained between CR and MD (−0.91 ± 0.04), MD and AMD (0.73 ± 0.03), CR and AMD (−0.68 ± 0.04), and RFI and DMI (0.81 ± 0.02). The highest phenotypic correlation was between ACM and AMD (0.76 ± 0.02), DMI and MD (0.77 ± 0.02), and DMI and RFI (0.77 ± 0.02). Genetic improvement for feed efficiency and feeding behaviour‐related traits is feasible and the results obtained herein provided valuable information regarding the genetic background of Nelore feeding behaviour‐related traits. The genetic association between feeding behaviour and feed efficiency‐related traits suggested that animals spending less time feeding at a low feeding rate also had lower DMI and higher feed efficiency (RFI), and likely had lower energy maintenance requirements. The relative efficiency of selection showed that feeding behaviour‐related traits were not adequate indicator traits to improve RFI and DMI. The DMI might be an effective selection criterion to improve RFI and reduce the herd's maintenance requirements.
Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta‐analysis of epidemiological studies
Authors: Trindade Diogo , Carvalho Rui , Machado Vanessa , Chambrone Leandro , Mendes José João , Botelho João
Published: January 2023

Aim

The aim of the study was to evaluate the prevalence of periodontitis in dentate people between 2011 and 2020.

Materials and Methods

PUBMED, Web of Science, and LILACS were searched up to and including December 2021. Epidemiological studies reporting the prevalence of periodontitis conducted between 2011 and 2020 were eligible for inclusion in this review. Studies were grouped according to the case definition of confidence as confident (Centers for Disease Control [CDC] AAP 2012; CDC/AAP 2007; and Armitage 1999) and non‐confident (community periodontal index of 3 or 4, periodontal pocket depth >4 mm, and clinical attachment level ≥1 mm). Random effects meta‐analyses with double arcsine transformation were conducted. Sensitivity subgroup and meta‐regression analyses explored the effect of confounding variables on the overall estimates.

Results

A total 55 studies were included. The results showed a significant difference, with confident case definitions (61.6%) reporting nearly twice the prevalence as non‐confident classifications (38.5%). Estimates using confident periodontal case definitions showed a pooled prevalence of periodontitis of 61.6%, comprising 17 different countries. Estimates reporting using the CDC/AAP 2012 case definition presented the highest estimate (68.1%) and the CDC/AAP 2007 presented the lowest (48.8%). Age was a relevant confounding variable, as older participants (≥65 years) had the highest pooled estimate (79.3%).

Conclusion

Between 2011 and 2020, periodontitis in dentate adults was estimated to be around 62% and severe periodontitis 23.6%. These results show an unusually high prevalence of periodontitis compared to the previous estimates from 1990 to 2010.
Data simulation to forecast the outcomes of the FAVOR III China trial
Authors: Wang Yang , Song Lei , Guan Changdong , Zhao Yanyan , Chen Ge , Li Wei , Tu Shengxian , Qiao Shubin , Kirtane Ajay J. , Xu Bo
Published: January 2023

Background

FAVOR III China (F3C) is a large‐scale randomized trial comparing QFR‐guided and angiography‐guided percutaneous coronary intervention (PCI) strategies. The aim of current study was to assess the feasibility of predicting the 1‐year outcomes of the F3C trial using simulation of retrospectively assessed quantitative flow ratio (QFR) data obtained from the all‐comers PANDA III trial.

Methods

Among 2348 subjects from the PANDA III trial, angiography from 1391 patients was able to be analyzed with QFR. Each subject from the F3C was matched to a PANDA III patient according to the five baseline characteristics (age, sex, diabetes, multivessel disease, and existence of any vessel with diameter stenosis % >90% and thrombolysis in myocardial infarction flow <3) through a bootstrapping sampling process. Outcome predictions were based on these blinded baseline data. The primary endpoint was a composite of death, myocardial infarction, or revascularization at 1 year.

Results

Among the patients with analyzable QFR, 814 patients were able to be matched to F3C patients undergoing a QFR‐guided treatment strategy. After 10,000 simulations, the patients in the QFR‐guided group were simulated to have a 1.9% (95% predictive intervals: –3.5% to –0.3%) absolute reduction of the occurrence of the primary study endpoint compared with the angiography‐guided group. In total, 72.7% (7266/10,000) simulated point estimates fell within the actual 95% CI of F3C (–4.7% to –1.4%).

Conclusions

Using a simulation process based on a comparison to an existing trial cohort, the primary results of a prospectively conducted randomized controlled trial could be predicted with reasonable precision.
Copy–paste concept: Full digital approach in the management of gingival emergence profiles
Authors: Agnini Alessandro , Romeo Davide , Giulia Benedetti , Tommaso Weinstein , Christian Coachman , Agnini Andrea
Published: January 2023

Objective

Obtaining a perfect integration of a prosthetic rehabilitation on natural teeth and implantys in the esthetic zone requires a deep knowledge of the biological processes and a clear understanding of the characteristics of the restorative materials. Once the soft tissue profile has been created with the placement of a temporary prosthesis, the ability to accurately transfer information about the tissue profile and the contour of the restoration for the fabrication of the definitive crowns can be challenging.

Clinical Significance

This paper illustrate the copy paste full digital workflow, a simple protocol that allows to create definitive restorations by making an exact copy of the temporary prosthesis that has been placed in function in the patient's mouth.
Smart care for dealing with nurses' alarm fatigue in the intensive care unit
Authors: Movahedi Ali , Sadooghiasl Afsaneh , Ahmadi Fazlollah , Vaismoradi Mojtaba
Published: January 2023

Background

Alarm fatigue is a condition in which a person experiences sensory overload or desensitization in exposure to frequent non‐actionable alarms. Nurses are the main users of alarms in health care and their behaviors for alarm management influence the occurrence of alarm fatigue.

Objectives

This qualitative research aimed to explore strategies used by nurses in dealing with nurses' alarm fatigue in the intensive care unit (ICU).

Design

Qualitative research was carried out. Eighteen nurses working in ICUs were selected purposefully and were invited to take part in individual semi‐structured interviews. Collected data were analyzed using content analysis for developing categories and subcategories.

Setting

Twelve ICUs in ten hospitals in four urban areas of Iran.

Results

The research's main category was “smart care” consisting of two categories of “technologic actions” and “non‐technologic actions.” Also, six subcategories were developed: “identifying the cause and taking timely actions”, “personalized alarm settings”, “reducing the number of unnecessary alarms”, “effective teamwork”, “improving the physical environment and ward arrangement”, and “self‐calmness”.

Conclusion

Smart care by nurses included a set of active and proactive interventions developed through thinking and reflection and the use of information, skills, and experiences in order to manage exposure to alarm fatigue. Strategies used by nurses to prevent alarm fatigue can reduce the physical and psychological burden caused by frequent exposure to alarms in the ICU and consequently can have direct impacts on the quality and safety of nursing care.

Clinical Relevance

Nurses in the healthcare process often experience alarm fatigue that is influenced by the cultural‐contextual aspect of care and the care environment. Smart care in terms of technologic and non‐technologic actions helps with the prevention of alarm fatigue.
Current state of management of struma ovarii and preoperative imaging features: A retrospective case series study of 18 patients at a single institution
Authors: Tamura Nami , Murakami Keisuke , Ozaki Rie , Takeuchi Shiori , Ochiai Asako , Kawasaki Yu , Okada Yukiko , Kitade Mari , Itakura Atsuo
Published: January 2023

Aim

Even though 95% of struma ovarii are benign, it is often overtreated because of the difficulty to distinguish it from malignancy. In this study, our aim was to evaluate the current state of the preoperative diagnosis and the selection of the surgical procedure, and to improve preoperative diagnostic accuracy by retrospectively reviewing imaging findings.

Methods

We retrospectively reviewed the clinical course and imaging characteristics of 18 patients who were diagnosed postoperatively with struma ovarii, pathologically, at our institution between 2015 and 2021.

Results

The preoperative diagnoses included benign ovarian tumor in eight cases, borderline in four cases, and malignant in six cases. None of the cases were diagnosed as struma ovarii preoperatively. Of the seven patients who had confirmed a desire for future childbearing, four patients were suspected for borderline or malignant tumor preoperatively, and underwent abdominal adnexectomy. In patients without a desire for childbearing, laparoscopic surgery was performed in only 45% of the patients whose preoperative diagnosis was benign. On magnetic resonance imaging (MRI), 54% of the cases showed enhanced solid components, which is characteristic of malignant tumors, but diffusion restriction was observed in only 11%. On computed tomography (CT), 78% of the cases showed a high attenuation lesion reflecting thyroid tissue.

Conclusions

Struma ovarii is difficult to distinguish from malignancy preoperatively, making the choice of surgical approach complicated. A comprehensive evaluation of diffusion‐weighted MRI and CT findings may improve the accuracy of preoperative diagnosis of struma ovarii.
Effect of acupressure applied to L4 point on the severity of fistula needle pain in patients: A randomised control trial
Authors: Çevik Banu , Turgay Gülay , Inanoğlu Işılay , Kaya Semiha , Sayin Cihat Burak
Published: January 2023

Background

Patients usually feel pain when a needle is inserted into the fistula. This acute pain can be relieved by acupressure, which is a nonpharmacological application method.

Objective

This study was designed to explore the effect of acupressure application to the Hegu point on the severity of acute pain caused by fistula needle insertion in patients with antecubital arteriovenous fistula.

Design

It is a randomised control study.

Participants

The study was conducted with 32 intervention and 32 control patients, recruited from a dialysis centre of a foundation university in Turkey between October 2021 and January 2022.

Measurements

Acupressure was applied 3 min before needle placement in the fistula area of the patients in the experimental group.

Result

While there was no decrease in the severity of acute pain during fistula needle insertion in the patients in the control group, there was a significant decrease in the mean acute pain severity scores experienced by the patients in the experimental group, whose Hegu point acupressure was applied.

Conclusion

The results of this study support the effectiveness of Hegu point acupressure as an effective and low‐cost way to reduce the acute pain of needle insertion put on dialysis patients with a fistula. In addition, the results provide a practical reference for acute pain management for dialysis nurses.
Phylogenomic insights into the reticulate evolution of Camellia sect. Paracamellia Sealy (Theaceae)
Authors: Qin Sheng‐Yuan , Chen Kai , Zhang Wen‐Ju , Xiang Xiao‐Guo , Zuo Zheng‐Yu , Guo Cen , Zhao Yao , Li Lin‐Feng , Wang Yu‐Guo , Song Zhi‐Ping , Yang Ji , Yang Xiao‐Qiang , Zhang Jian , Jin Wei‐Tao , Wen Qiang , Zhao Song‐Zi , Chen Jia‐Kuan , Li De‐Zhu , Rong Jun
Published: January 2023

Polyploids are common in Camellia sect. Paracamellia, which contain many important oil crop species. However, their complex evolutionary history is largely unclear. In this study, 22 transcriptomes and 19 plastomes of related species of Camellia were sequenced and assembled, providing the most completed taxa sampling of Camellia sect. Oleifera and C. sect. Paracamellia. Phylogenetic trees were reconstructed with predicted single‐copy nuclear genes and plastomes. Phylogenetic trees with nuclear genes demonstrated that C. sect. Oleifera should be merged into C. sect. Paracamellia. Cytonuclear discordance and network analyses suggested hybridizations among polyploid species and relatives. The divergence of major clades in C. sect. Paracamellia was dated to be during the middle to late Miocene from the ancestral Lingnan region, and a rapid diversification during the Quaternary was found, probably through hybridization and polyploidization. The tetraploid Camellia meiocarpa Hu may have originated from hybridization between closely related diploid species. The hexaploid Camellia oleifera C. Abel probably originated from hybridization between closely related diploid and tetraploid (e.g., C. meiocarpa) species. The octoploid Camellia vietnamensis T. C. Huang ex Hu could have originated from hybridization between hexaploid C. oleifera and the closely related diploid species. Hybridization and polyploidization played an important role in generating the rich variation of important fruit traits, especially increased fruit size in polyploid species.
Calcineurin B‐like interacting protein kinase 31 confers resistance to sheath blight via modulation of ROS homeostasis in rice
Authors: Chen Huan , Lin Qiujun , Li Zhuo , Chu Jin , Dong Hai , Mei Qiong , Xuan Yuanhu
Published: January 2023

Sheath blight (ShB) severely threatens rice cultivation and production; however, the molecular mechanism of rice defence against ShB remains unclear. Screening of transposon Ds insertion mutants identified that Calcineurin B‐like protein‐interacting protein kinase 31 (CIPK31) mutants were more susceptible to ShB, while CIPK31 overexpressors (OX) were less susceptible. Sequence analysis indicated two haplotypes of CIPK31: Hap_1, with significantly higher CIPK31 expression, was less sensitive to ShB than the Hap_2 lines. Further analyses showed that the NAF domain of CIPK31 interacted with the EF‐hand motif of respiratory burst oxidase homologue (RBOHA) to inhibit RBOHA‐induced H2O2 production, and RBOHA RNAi plants were more susceptible to ShB. These data suggested that the CIPK31‐mediated increase in resistance is not associated with RBOHA. Interestingly, the study also found that CIPK31 interacted with catalase C (CatC); cipk31 mutants accumulated less H2O2 while CIPK31 OX accumulated more H2O2 compared to the wild‐type control. Further analysis showed the interaction of the catalase domain of CatC with the NAF domain of CIPK31 by which CIPK31 inhibits CatC activity to accumulate more H2O2.
PhAAT1, encoding an anthocyanin acyltransferase, is transcriptionally regulated byPhAN2in petunia
Authors: Chen Zeyu , Yuan Junwei , Yao Yi , Cao Jiahao , Yang Wenjie , Long Yu , Liu Juanxu , Yang Weiyuan
Published: January 2023

Anthocyanins widely exist in plants and they are important pigments for color of petals and fruits. They are produced through a multi‐step pathway controlled by transcription factor complexes. The anthocyanin skeleton modification is the last reaction in the anthocyanin synthesis pathway, which improves the stability of anthocyanins. Acylation modification is an important modification of anthocyanins. However, the identification and function of anthocyanin acyltransferase genes and their expression regulation are rarely reported. In this study, we identified the petunia anthocyanin acyltransferase gene,PhAAT1. PhAAT1 is located in the cytoplasm andPhAAT1silencing changed flower color and reduced the stability of anthocyanin. Metabolomics analysis showed thatPhAAT1silencing led to the reduction of p‐coumaroylated and caffeoylated anthocyanins. In addition,PhAAT1was positively regulated by the MYB transcription factor, PhAN2, which directly interacts with the promoter ofPhAAT1.
Agricultural wastes for brine shrimp Artemia production: A review
Authors: Ogburn Nepheronia Jumalon , Duan Luchun , Subashchandrabose Suresh Ramraj , Sorgeloos Patrick , O'Connor Wayne , Megharaj Mallavarapu , Naidu Ravi
Published: January 2023

An increasing global population has meant aquaculture, one of the fastest growing food industry sectors, faces significant sustainability challenges as it tries to address the rising global protein demand. In many sectors, production is underpinned by fishmeal as dietary ingredient, but this is a finite resource with competing users from the poultry and livestock industries. Alternatively, some (planktonic) aquatic species, especially brine shrimp Artemia, can be produced using agricultural waste to provide food or biomass to support increasing aquaculture demand. This review investigates research and production of Artemia using agricultural waste. Various systems used for Artemia production in inoculated ponds are analysed and discussed to provide options for environmentally sustainable food systems that can be applied from either an artisanal level in developing countries with a considerable labour force, or in intensive systems in countries with large volumes of under‐utilised resources, for example, sugar/alcohol‐based waste and inland saline areas. Using agricultural waste, single cell protein production in a separate aerobic digester can be a simple, continuous food source for Artemia to enable daily biomass harvest. This could then be used as a fishmeal replacement or possibly for human consumption to promote a circular economy by remediating waste to produce protein, like a food production mine.
Cell‐free next‐generation sequencing impacts diagnosis and antimicrobial therapy in immunocompromised hosts: A retrospective study
Authors: Vissichelli Nicole C. , Morales Megan K. , Kolipakkam Bharadhwaj , Bryson Alexandra , Sabo Roy T. , Toor Amir A.
Published: January 2023

Background

Cell‐free next‐generation sequencing (cfNGS) may have a unique role in the diagnosis of infectious complications in immunocompromised hosts. The rapid turnaround time and non‐invasive nature make it a promising supplement to standard of care.

Methods

This retrospective, observational single‐center study at a tertiary care medical center in Virginia investigated the use of cfNGS in clinical practice. Patients over age 18 years with cfNGS performed for any indication were included. The primary outcome was detection of bacteria and/or fungi on cfNGS. The secondary outcomes were concordance, and abundance of fungal and bacterial organism concentration detected over time from symptom onset, and clinical impact.

Results

Thirty‐six patients (92% immunosuppressed) were identified and included. Twenty‐one (58%) tests detected one to five organisms (14/21 bacteria, 8/21 fungi, and 6/21 viruses). The clinical impact of cfNGS was positive in 52.8% of cases, negative in 2.8%, and negligible in 44.4%. Positive tests prompted therapy changes in 12 of 21 patients; six of 20 bacteria and seven of eight fungi identified were considered clinically pathogenic. Three bacteria identifications and six fungi identifications prompted targeted treatment. When fungal species were not identified by cNFGS, antifungal de‐escalation occurred in seven patients.

Conclusion

cfNGS assisted in critical management changes, including initiation of treatment for identified organisms and antimicrobial de‐escalation. Its non‐invasive nature and rapid turnaround time make this an important adjunct to standard of care testing that may assist in providing earlier, targeted therapy, especially when opportunistic pathogens remain high on the differential diagnosis.

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«Es como estar entre dos mundos»: Las experiencias de estudiantes wayuu en centros educativos de La Guajira y Santander (Colombia)
Authors: Lores Masip Fernando , Romero Rodríguez María Cristina
Published: January 2023

Este artículo plantea una descripción y análisis de las prácticas y representaciones en torno a los procesos (etno)educativos de jóvenes wayuu en centros de educación básica, media y superior en La Guajira y Santander (Colombia). Basándonos en nuestra experiencia etnográfica sobre el terreno reflexionamos acerca del papel que las políticas (etno)educativas del Estado colombiano juegan en la conformación de las disposiciones escolares de las/os jóvenes estudiantes wayuu, de sus expectativas laborales, así como en las rupturas y continuidades con las prácticas culturales en el interior de sus familias y comunidades wayuu de origen. En nuestro análisis exploramos tres ámbitos de experiencia diferenciados (cultura wayuu, educación y empleo), que interpretamos desde la perspectiva de los distintos agentes implicados: estudiantes, docentes, familias y comunidades wayuu. A partir de nuestros resultados podemos concluir que, en el contexto de estas políticas de etnoeducación, la escolarización continuada en estos centros transforma decisivamente las cosmovisiones de los/as estudiantes, sus esquemas de autocomprensión y de relación con su comunidad. Concretamente, pensamos que se están produciendo profundos cambios colectivos y personales en las jóvenes generaciones wayuu, principalmente, en cuanto a la subjetivación de las relaciones de clase, raza y género, las estructuras familiares y la conformación de sus expectativas académicas y laborales.
Sacrificio, enriquecimiento y robo de cuerpos en Mozambique: Namakakattha
Authors: Sesma Gracia Ane , Vieitez Cerdeño Soledad , Manzanera Ruiz Roser
Published: January 2023

Las muertes de personas y la desaparición de cuerpos o partes de ellos se relacionan con el namakakattha, el enriquecimiento monetario, la producción (y creciente circulación) de manufacturas y la fuerza de trabajo en el norte de Mozambique. Este artículo aborda la cosmovisión macua en cuanto a la concepción del sacrificio y su relación con la fuerza de trabajo, en conexión con la energía vital y el enriquecimiento. La metodología es cualitativa (observaciones participantes, entrevistas semiestructuradas y diario de campo). Los resultados muestran que los cambios económicos estructurales han incidido en las interpretaciones socioculturales sobre sacrificio y enriquecimiento. Esta investigación es novedosa en cuanto al análisis de las muertes en relación con el sacrificio, el trabajo y la producción fabril.
Transmission loss and directivity of sound transmitted through a slit on ground
Authors: Wang Shuping , Yang Ziyi , Tao Jiancheng , Qiu Xiaojun , Burnett Ian S.
Published: January 2023

An analytical model is proposed for sound transmission through a slit on a rigid ground based on the modal superposition method to investigate the transmission loss (TL). A simple formula is derived for estimation of the TL for plane waves with and without the ground, which gives a more precise prediction than existing approaches. It is found that a larger slit height generally decreases the TL, except at the resonant frequencies of the slit. The slit width has little effect on the TL at high frequencies, and the slit depth affects the resonant frequencies significantly even though it has little effect on the overall TL. Compared with the same size slit in the free field, the rigid ground reduces the TL at most frequencies, and that reduction is a constant between 3 and 9 dB in the low frequency range. It is also found that the sound transmitted through the slit is almost omnidirectional at low frequencies, while most of the sound energy at high frequencies falls within the range where the long side of the slit is located. The experimental results demonstrate the validity of the analytical model and the findings in numerical simulations.