bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosing patient flow issues in the emergency department: an Australasian hospital case study
Authors: Boehme Tillmann , Rylands Brogan , Fan Joshua Poh , Williams Sharon , Deakins Eric
Published: June 2024

Purpose

This study investigates how a hospital can increase the flow of patients through its emergency department by using benchmarking and process improvement techniques borrowed from the manufacturing sector.

Design/methodology/approach

An in-depth case study of an Australasian public hospital utilises rigorous, multi-method data collection procedures with systems thinking to benchmark an emergency department (ED) value stream and identify the performance inhibitors.

Findings

High levels of value stream uncertainty result from inefficient processes and weak controls. Reduced patient flow arises from senior management’s commitment to simplistic government targets, clinical staff that lack basic operations management skills, and fragmented information systems. High junior/senior staff ratios aggravate the lack of inter-functional integration and poor use of time and material resources, increasing the risk of a critical patient incident.

Research limitations/implications

This research is limited to a single case; hence, further research should assess value stream maturity and associated performance enablers and inhibitors in other emergency departments experiencing patient flow delays.

Practical implications

This study illustrates how hospital managers can use systems thinking and a context-free performance benchmarking measure to identify needed interventions and transferable best practices for achieving seamless patient flow.

Originality/value

This study is the first to operationalise the theoretical concept of the seamless healthcare system to acute care as defined by Parnaby and Towill (2008). It is also the first to use the uncertainty circle model in an Australasian public healthcare setting to objectively benchmark an emergency department's value stream maturity.
Relationship between innovation and firm performance and the role of strategic orientations
Authors: Ibarra-Cisneros Manuel-Alejandro , Vela-Reyna Juan Benito , Hernandez-Perlines Felipe
Published: June 2024

Purpose

The purpose of the present paper is to analyse the impact of entrepreneurial orientation (EO) and customer orientation (Co.) on innovation in the restaurant industry, as well as how innovation also positively influences financial and market performance. Likewise, it is analysed whether human capital (HC) and competitive strategy (CS) have a moderating effect between innovation and performance.

Design/methodology/approach

To reach the stated goals, a survey was applied to 129 entrepreneurs in the restaurant industry in Baja California, Mexico and using partial least squares structural equation modelling, the research hypotheses were verified.

Findings

Results indicate that EO and Co positively influence innovation, which also furthers better financial and market firm performance; however, no moderating effect was found for HC nor CS.

Practical implications

The findings allow contributing from a practical-entrepreneurial standpoint, as it raises awareness about the importance of developing strategies that allow efficiently gaining knowledge to encourage a culture in the restaurant industry focused on EO and Co, which, for their part, will boost the design and implementation of innovations.

Social implications

The paper contributes to understanding the behaviour of HC and CS, which may have an influence or not, depending on the role they have within a system.

Originality/value

This paper contributes to raising awareness of the importance of developing strategies that allow efficient knowledge to foster a culture in the restaurant industry focused on entrepreneurship and clientele.
Improving the quality of student assessment practices: a Saudi University case study
Authors: Mohamed Wessam , Almuqayteeb Taghreed , Abd El Sattar Ibrahim , Al-Ghamdi Taghreed , Alotaibi Ghazi
Published: June 2024

Purpose

This paper aims to explore the best practices to institutionalize the internal quality of student assessment (SA) when a gap emerges between quality conceptualization and practice work, using Imam Abdul Rahman bin Faisal University (IAU) as a case study.

Design/methodology/approach

A single-embedded case study research design chronologically presents key events of assuring and improving SA at IAU. It integrates quantitative and qualitative data to provide empirical evidence of changes in SA practices.

Findings

Over three years, evident improvements in SA practices resulted in more effective internal quality assurance strategies (e.g., faculty involvement) and the achievement of performance indicators.

Research limitations/implications

This study used data from informal observation and self-reports. Thus, it is suggested that future research should use in-depth (e.g. focus group) and diverse data sources from stakeholders (e.g. students) and use emerging global trends to assess SA quality.

Practical implications

Involving faculty as changing agents via accountability and training in assuring and improving SA quality leads to measurable improvements.

Social implications

A top-down approach alone is insufficient to assure and improve the quality of SA practices, so empowering faculty via involvement and training is inevitable.

Originality/value

The quality assurance of SA described in this practice-oriented case places IAU as a leading university in the region, contributes to the external quality assurance of SA, empowers Saudi graduates to compete in the labor market as aspired in Vision 2030 and adds to the literature on quality assurance of SA in a higher education context.
The effect of printing parameters on the mechanical properties of fiber-reinforced PA6 matrix composites in material extrusion-based additive manufacturing
Authors: Dogru Alperen , Seydibeyoglu M. Ozgur
Published: June 2024

Purpose

This study aims to understand the effect of the use of different proportions and types of fibers in the polyamide 6 (PA6) matrix during material extrusion-based additive manufacturing (MEX) and the effect of the manufacturing parameters on the mechanical properties. The mechanical, thermal and morphological properties of PA composites that are reinforced with carbon fiber (CF), glass fiber (GF) and as well as hybrid fiber (HF) were investigated.

Design/methodology/approach

In this study, the effect of nozzle temperature and layer thickness on the mechanical properties of composite samples was investigated in terms of their behavior under tensile, impact and compression loads, manufacturing parameters as well as fiber ratio and type. The results were also consolidated by scanning electron microscopy.

Findings

At 20 Wt.% CF reinforcement PA6 samples, a tensile strength value of 125 MPa was obtained with a 60% increase in tensile strength value compared to neatPA6. The HF-reinforced ones also measured a tensile strength value of 106.69 MPa. This corresponds to an increase of 38% compared to neatPA6. The results also show that HF reinforcement can be an important component for many composites and a suitable material for use under compression loading.

Originality/value

PA6, an engineering polymer, can be produced by MEX, which offers several advantages for complex geometries and customized designs. There are studies on different carbon and GF ratios in the PA6 matrix. Using these fibers together in a HF, the examination of their mechanical properties in the MEX method and the examination of the effect of GF reinforcement in the hybrid structure, which has a cost-reducing effect, has been an innovative approach. In this study, the results of the optimization of the parameters affecting the mechanical properties in the production of samples reinforced with different ratios and types of fibers in the PA6 matrix by the MEX method are presented.
Genome‐resolved metagenomics reveals the effect of nutrient availability on bacterial genomic properties across 44 European freshwater lakes
Authors: Shah Manan , Bornemann Till L. V. , Nuy Julia K. , Hahn Martin W. , Probst Alexander J. , Beisser Daniela , Boenigk Jens
Published: June 2024

Understanding intricate microbial interactions in the environment is crucial. This is especially true for the relationships between nutrients and bacteria, as phosphorus, nitrogen and organic carbon availability are known to influence bacterial population dynamics. It has been suggested that low nutrient conditions prompt the evolutionary process of genome streamlining. This process helps conserve scarce nutrients and allows for proliferation. Genome streamlining is associated with genomic properties such as %GC content, genes encoding sigma factors, percent coding regions, gene redundancy, and functional shifts in processes like cell motility and ATP binding cassette transporters, among others. The current study aims to unveil the impact of nutrition on the genome size, %GC content, and functional properties of pelagic freshwater bacteria. We do this at finer taxonomic resolutions for many metagenomically characterized communities. Our study confirms the interplay of trophic level and genomic properties. It also highlights that different nutrient types, particularly phosphorus and nitrogen, impact these properties differently. We observed a covariation of functional traits with genome size. Larger genomes exhibit enriched pathways for motility, environmental interaction, and regulatory genes. ABC transporter genes reflect the availability of nutrients in the environment, with small genomes presumably relying more on metabolites from other organisms. We also discuss the distinct strategies different phyla adopt to adapt to oligotrophic environments. The findings contribute to our understanding of genomic adaptations within complex microbial communities.
Identification and expression of MarCE, a marine carboxylesterase with synthetic ester‐degrading activity
Authors: Carr Clodagh M. , Göttsch Frederike , de Oliveira Bruno Francesco Rodrigues , Murcia Pedro A. Sánchez , Jackson Stephen A. , Wei Ren , Clarke David J. , Bornscheuer Uwe T. , Dobson Alan D. W.
Published: June 2024

Carboxylic ester hydrolases with the capacity to degrade polyesters are currently highly sought after for their potential use in the biological degradation of PET and other chemically synthesized polymers. Here, we describe MarCE, a carboxylesterase family protein identified via genome mining of a Maribacter sp. isolate from the marine sponge Stelligera stuposa. Based on phylogenetic analysis, MarCE and its closest relatives belong to marine‐associated genera from the Cytophaga–Flavobacterium–Bacteroides taxonomic group and appear evolutionarily distinct to any homologous carboxylesterases that have been studied to date in terms of structure or function. Molecular docking revealed putative binding of BHET, a short‐chain PET derivative, onto the predicted MarCE three‐dimensional structure. The synthetic ester‐degrading activity of MarCE was subsequently confirmed by MarCE‐mediated hydrolysis of 2 mM BHET substrate, indicated by the release of its breakdown products MHET and TPA, which were measured, respectively, as 1.28 and 0.12 mM following 2‐h incubation at 30°C. The findings of this study provide further insight into marine carboxylic ester hydrolases, which have the potential to display unique functional plasticity resulting from their adaptation to complex and fluctuating marine environmentsw.
Feasibility of adolescent contraceptive care in the pediatric emergency department: A pilot randomized controlled trial
Authors: Miller Melissa K. , Goggin Kathy , Stancil Stephani L. , Miller Elizabeth , Ketterer Tara , Staggs Vince , McNeill‐Johnson April D. , Adams Amber , Mollen Cynthia J.
Published: June 2024

Background

This study assessed feasibility constructs of adolescent contraceptive care in the pediatric emergency department (PED), including contraception initiation.

Methods

We conducted a randomized trial in two PEDs with pregnancy‐capable adolescents aged 15–18 years who were assigned to enhanced usual care (usual) or same‐day initiation (same day). All received counseling and clinic referral, but same‐day participants could also receive contraception in the PED. We trained PED clinicians in counseling and prescribing. Adolescents and clinicians rated feasibility using five Likert‐type items (1 = strongly disagree to 5 = strongly agree) after the session. We assessed PED medication initiation and appropriateness via medical record review and contraception use and side effects at 30 days via adolescent survey. To further explore feasibility, we conducted clinician interviews at study completion; these were audio‐recorded, transcribed, and analyzed. We hypothesized contraceptive care would be feasible (defined as average score ≥ 4 across five survey items).

Results

We enrolled 37 adolescents (12 in usual and 25 in same‐day), mean age was 16.6 years, 73% were Black, and 19% were Hispanic. We trained 27 clinicians. Average feasibility scores were 4.6 ± 0.4 (adolescents) and 4.1 ± 0.8 (clinicians). Eleven (44%) same‐day participants initiated contraception in the PED. One adolescent with migraines initially received estrogen‐containing pills; this was corrected after discharge. At 30 days, same‐day participants were more likely to report contraception use (78% vs. 13%; p = 0.007). One adolescent reported bloating as a side effect. Clinicians enjoyed delivering contraceptive care, found study resource materials useful, and identified staffing shortages as a barrier to care delivery.

Conclusions

We are among the first to report on PED‐based adolescent contraception initiation to prevent unintended pregnancy. Adolescents and clinicians reported that contraceptive care was feasible. Initiation was common and medications were largely appropriate and tolerated. Future efforts should explore integrating contraceptive care into routine PED care.
Causal inference with latent outcomes
Authors: Stoetzer Lukas F. , Zhou Xiang , Steenbergen Marco
Published: June 2024

While causal inference has become front and center in empirical political science, we know little about how to analyze causality with latent outcomes, such as political values, beliefs, and attitudes. In this article, we develop a framework for defining, identifying, and estimating the causal effect of an observed treatment on a latent outcome, which we call the latent treatment effect (LTE). We describe a set of assumptions that allow us to identify the LTE and propose a hierarchical item response model to estimate it. We highlight an often overlooked exclusion restriction assumption, which states that treatment status should not affect the observed indicators other than through the latent outcome. A simulation study shows that the hierarchical approach offers unbiased estimates of the LTE under the identification and modeling assumptions, whereas conventional two‐step approaches are biased. We illustrate our proposed methodology using data from two published experimental studies.
Nutritional status and cannula infections in pediatric patients on ventricular assist device support
Authors: Dezfouly Mostafa Abbasi , Jeewa Aamir , Maurich Andrea , Honjo Osami , Pidborochynski Tara , Buchholz Holger , Conway Jennifer
Published: June 2024

Background

Ventricular assist devices (VADs) are used to bridge pediatric patients to heart transplantation. Paracorporeal VADs require the placement of cannulas, which can create an environment for infections. We examined cannula infections in pediatric VAD patients and the role of nutritional status.

Methods

This retrospective study (2005–2021) included patients <20 years old on VAD support using Berlin Heart EXCOR® cannulas. Cannula infections were defined by a positive culture and need for antibiotic therapy. Malnutrition was defined using the American Society of Parenteral and Enteral Nutrition guidelines as well as the Michigan MTool.

Results

There were 76 patients with a median age at implant of 0.9 years (IQR 0.4, 3.6), 50% male, with 73.7% having non‐congenital heart disease. More than one‐quarter (26.3%) of patients developed a cannula infection. Higher pre‐implant weight (OR = 1.93, p = 0.05), creatinine (OR = 1.02, p = 0.044), and pre‐albumin (OR = 15.79, p = 0.025), as well as duration of VAD support (OR = 1.01; p = 0.003) were associated with increased odds of developing a cannula infection. There was no difference in the malnutrition parameters between those with and without an infection.

Conclusions

Further exploration in a larger cohort is needed to see whether these associations remain and if the incorporation of objective measures of nutritional status at the time of infection are predictive.
Effects of the phosphodiesterase 2 inhibitor BI 474121 on central nervous system cyclic guanosine monophosphate concentrations: Translational studies
Authors: van Kraaij Sebastiaan , Goeldner Rainer‐Georg , Rosenbrock Holger , Groeneveld Geert Jan , Kremer Philip , Schaible Jennifer , Zambori Janos , Schultheis Christian
Published: June 2024

Aims

Phosphodiesterase 2 (PDE2) regulates intracellular cyclic adenosine monophosphate and guanosine monophosphate (cAMP/cGMP) levels, which contribute to processes crucial for learning and memory. BI 474121, a potent and selective PDE2 inhibitor, is in development for treating cognitive impairment associated with schizophrenia.

Methods

The effects of BI 474121 on cGMP concentrations were first assessed in rat cerebrospinal fluid (CSF) to demonstrate central nervous system (CNS) and functional target engagement. Next, a Phase I study in healthy participants assessed the pharmacokinetics of BI 474121 in CSF vs. plasma, the pharmacodynamics of BI 474121 by measuring cGMP concentrations in the CSF, and the safety of BI 474121.

Results

In rats, BI 474121 was associated with a dose‐dependent increase (71% at the highest dose tested [3.0 mg kg−1]) in cGMP levels in the CSF relative to vehicle (P < 0.001). In healthy participants, the maximum‐measured concentration CSF‐to‐plasma ratio for BI 474121 exposure was similar following single oral doses of BI 474121 2.5, 10, 20 and 40 mg (dose‐adjusted geometric mean: 8.96% overall). BI 474121 2.5–40 mg administration in healthy participants also increased cGMP levels in CSF (maximum exposure‐related change from baseline ratio, BI 474121: 1.44–2.20 vs. placebo: 1.26). The most common treatment‐emergent adverse event (AE) was mild‐to‐moderate post‐lumbar puncture syndrome, which resolved with standard treatment. No AEs of special interest were observed.

Conclusions

BI 474121 crosses the blood–brain barrier to inhibit PDE2, supporting cGMP as a translational marker to monitor CNS target engagement. These findings promote further clinical development of BI 474121.

ClinicalTrials.gov number (NCT04672954).
Association of 3'UTR variations of EGFR and KRAS oncogenes with clinical parameters in lung cancer tumours
Authors: Bagci Ozkan
Published: June 2024

Bacground Information

Lung cancer is one of the leading types of cancer deaths worldwide, with approximately 2 million people diagnosed with lung cancer each year. In this study, we aimed to determine the exonic and 3′UTR sequences of EGFR, PIK3CA and KRAS genes in 39 sporadic lung cancer tumors and to reveal the changes in the miRNA binding profile of tumors with somatic variation in the 3'UTR region and to examine the relationship of these changes with clinical parameters.

Results

A statistically significant correlation was found between the presence of miRNA that could not bind to the 3′UTR region due to variation in at least one of the EGFR or KRAS genes and the presence of metastasis in the tumor. At the same time, Kaplan‐Meier analysis between those with and without alterations in the miRNA profile due to somatic variation in the 3′UTR region showed that survival was lower in those with miRNA alterations and this was statistically significant.

Conclusions

In our study, it was shown that variations in the 3′UTR regions of EGFR and KRAS oncogenes may cause increased expression of these oncogenes by preventing the binding of miRNAs, and it was suggested that this may be related to metastasis, survival and drug resistance mechanism.

Significance

In this study, we show that hsa‐miR‐124‐3p, hsa‐miR‐506‐3p, hsa‐miR‐1290 and hsa‐miR‐6514‐3p are particularly prominent in lung carcinoma in relation to these biological pathways and the roles that variations in the 3′UTR regions of oncogenes may play in the carcinogenesis process.
Paroxysmal events in glucose transporter type 1 deficiency syndrome: Early identification of their true nature is important
Authors: Korff Christian M.
Published: June 2024

This commentary is on the original article by Ito et al. on pages 1466–1475 of this issue.
Unravelling the metabolic landscape of cutaneous melanoma: Insights from single‐cell sequencing analysis and machine learning for prognostic assessment of lactate metabolism
Authors: Xie Jiaheng , Zhang Pengpeng , Ma Chenfeng , Tang Qikai , Zhou Xinxin , Xu Xiaolong , Zhang Min , Zhao Songyun , Zhou Liping , Qi Min
Published: June 2024

This manuscript presents a comprehensive investigation into the role of lactate metabolism‐related genes as potential prognostic markers in skin cutaneous melanoma (SKCM). Bulk‐transcriptome data from The Cancer Genome Atlas (TCGA) and GSE19234, GSE22153, and GSE65904 cohorts from GEO database were processed and harmonized to mitigate batch effects. Lactate metabolism scores were assigned to individual cells using the ‘AUCell’ package. Weighted Co‐expression Network Analysis (WGCNA) was employed to identify gene modules correlated with lactate metabolism. Machine learning algorithms were applied to construct a prognostic model, and its performance was evaluated in multiple cohorts. Immune correlation, mutation analysis, and enrichment analysis were conducted to further characterize the prognostic model's biological implications. Finally, the function of key gene NDUFS7 was verified by cell experiments. Machine learning resulted in an optimal prognostic model, demonstrating significant prognostic value across various cohorts. In the different cohorts, the high‐risk group showed a poor prognosis. Immune analysis indicated differences in immune cell infiltration and checkpoint gene expression between risk groups. Mutation analysis identified genes with high mutation loads in SKCM. Enrichment analysis unveiled enriched pathways and biological processes in high‐risk SKCM patients. NDUFS7 was found to be a hub gene in the protein–protein interaction network. After the expression of NDUFS7 was reduced by siRNA knockdown, CCK‐8, colony formation, transwell and wound healing tests showed that the activity, proliferation and migration of A375 and WM115 cell lines were significantly decreased. This study offers insights into the prognostic significance of lactate metabolism‐related genes in SKCM.
Dealing with couple infidelity in romantic relationships: A group intervention feasibility study
Authors: Ripoll‐Núñez Karen , Gordon Kristina Coop
Published: June 2024

The extent to which group therapy benefits individuals who have experienced couple infidelity remains unexamined. In this study, a brief group intervention for individuals who experienced couple infidelity was designed, and the feasibility of the intervention was evaluated (i.e., acceptability; implementation; measurements’ performance and, limited‐efficacy testing). The final sample was composed of 20 women and 4 men (M = 29.95 years, SD = 12.3). Twenty‐four completed pre and post assessments and 20 of these completed the follow‐up assessment. At pre, post, and follow‐up, participants responded to a questionnaire packet that included measures of depression, anxiety and PTSD symptoms, relationship self‐efficacy, centrality of event, cognitive fusion, and decision to forgive. Also, follow‐up interviews were conducted. The closed group intervention consisted of eight 90‐min weekly sessions. The group therapy process component was based on solution‐focused therapy. Psychoeducation component included mindfulness, reflection on personal values, factors that contribute to infidelity, and forgiveness. Session rating scores indicated an overall high acceptance of the intervention, its contents, and goals. Interview reports showed that dealing with thoughts and emotions, understanding infidelity, and forgiveness were the most helpful contents. Group support and processes were also positively valued. Repeated‐measures MANOVA results indicated statistically significant decrease in symptoms, cognitive fusion, and importance of the event, as well as an increase in self‐efficacy. Measurement instruments showed adequate reliability. These results indicate that a group treatment may be an alternative format to help individuals deal with psychological consequences of couple infidelity, when couple therapy is not possible.
Diagnostic guide for immune checkpoint inhibitor‐induced liver injury
Authors: Ito Takanori , Takeuchi Yasuto , Mizuno Kazuyuki , Imai Michitaka , Yoshimaru Yoko , Abe Kazumichi , Abe Masanori , Matsuura Takanori , Yokode Masataka , Shiokawa Masahiro , Kodama Yuzo , Komuta Mina , Harada Kenichi , Tanaka Atsushi
Published: June 2024

With the widespread use of immune checkpoint inhibitors (ICIs), liver injury (ICI‐induced liver injury) as an immune‐related adverse event has become a major concern in clinical practice. Because severe cases of liver injury require administration of corticosteroids, a comprehensive evaluation is crucial, including clinical course, blood and imaging tests, and if necessary, pathological examination through liver biopsy. As with liver injury induced by other drugs, classification of injury type by R‐value is useful in deciding treatment strategies for ICI‐induced liver injury. Histologically, the most representative feature is an acute hepatitis‐like hepatocellular injury, characterized by diffuse lobular inflammation accompanied by CD8‐positive T lymphocytes. Another condition that can cause liver injury during ICI treatment is cholangitis accompanied by non‐obstructive bile duct dilatation and bile duct wall thickening. Many cases of ICI‐induced cholangitis are classified as non‐hepatocellular injury type, and they have been reported to respond poorly to corticosteroids. It is essential that gastroenterologists/hepatologists and doctors in various departments work in cooperation to develop a system that achieves early diagnosis and appropriate treatment of ICI‐induced liver injury.
Mindfulness‐based intervention as a symptom management strategy in patients with end‐stage renal disease: A controlled clinical trial
Authors: Alhawatmeh Hossam , Najadat Ishraq A. , Hweidi Issa M.
Published: June 2024

Aim

The study's purpose was to examine the effect of mindfulness‐based intervention (MBI) on physical and psychological symptoms in patients with end‐stage renal disease (ESRD) in Jordan.

Methods

A repeated‐measure randomized control study was conducted in a haemodialysis unit in Jordan between April 2023 and July 2023. Participants (N = 61) were selected using convenience sampling and then randomly assigned into experimental and control groups. The experimental group performed 30‐min MBI, three times a week for 8 weeks during haemodialysis sessions. The Depression, Anxiety and Stress Scale‐21 and the Patient Health Questionnaire‐15 were used to measure the outcomes at baseline, after 5 weeks of the intervention and at the end of the intervention.

Results

Mixed‐model repeated‐measure ANOVAs revealed that the experimental group showed significantly lower levels of stress, depression and physical symptoms than the control group over time. Within‐subject repeated‐measure ANOVAs revealed that, in the experimental group, physical symptoms improve significantly over the three points of time. However, significant reductions in psychological symptoms occurred 5 weeks after initiating the intervention, but there was no further significant improvement at the end of the intervention.

Conclusion

The study supports the integration of MBI as a symptom management strategy into nursing care plans of patients with ESRD.

Trial Registration

Clinical trial.gov; registration ID: NCT06064708.
Anti‐aging trends in Australia
Authors: Yip Leona
Published: June 2024

Anti‐aging trends in Australia have changed considerably since the country emerged from the lockdowns associated with the SARS‐Cov2 pandemic. People now rely on social media influencers for skin care advice and skin care products, including professional skin care treatments that can be purchased on Internet platforms. The quest for the perfect ‘zoom face’ led to a 300% rise in cosmetic procedures across Australia in the year to April 2021. People now want to use less products on their skin, while looking healthy and natural (termed ‘skin minimalism’). The popularity of retinoid derivatives for preventing wrinkles has been superseded by non‐irritating actives like hyaluronic acid (HA) and niacinamide that provide skin barrier protection, skin hydration, plumping and anti‐inflammatory effects. Botulinum toxin injections remain the most popular non‐surgical cosmetic procedure, followed by HA fillers, and biostimulators that promote the synthesis of collagen and give longer lasting but more gradual results than HA fillers. Laser resurfacing is widely used for epidermal resurfacing and skin tightening, as well as non‐ablative lasers, intense pulsed light and radiofrequency or ultrasound skin tightening devices. Superficial chemical peels are still popular because they are relatively gentle, inexpensive, and require no downtime, whereas medium‐to‐deep chemical peels have largely been superseded by laser technology. However, the most efficient approach to prevent skin aging is adopting a healthy lifestyle and taking action against all factors of the skin aging exposome.
Asset versus equity acquisitions by financial institutions
Authors: Brodmann Jennifer , Danso Charles Armah , Jory Surendranath Rakesh , Ngo Thanh
Published: June 2024

We examine the impact of asset versus equity acquisitions in generating firm value for financial institutions. We find that acquirers experience statistically and economically significantly higher cumulative abnormal returns in asset acquisitions compared to equity acquisitions. We analyze the announcement‐period returns and find that investors' reaction to asset acquisitions by financial institutions is met more favorably than are equity acquisitions. When employing the difference‐in‐differences approach, we find that asset acquisitions entail improved operating performance.
Applying material and energy flow analysis to assess urban metabolism in the context of the circular economy
Authors: Papageorgiou Asterios , Björklund Anna , Sinha Rajib
Published: June 2024

With the circular economy (CE) gaining more traction worldwide, local authorities are engaging in efforts to develop circular strategies at the urban level. Developing and monitoring such strategies require detailed quantitative information on material and energy flows, which can be obtained through an urban metabolism (UM) analysis. This study demonstrates a bottom‐up approach to analyze UM at the sectoral level based on material and energy flow analysis (MEFA), aiming to examine its utility within the context of the CE. The analysis is performed for Umeå urban area (Sweden) with a 5‐year timeframe (2017–2021). The application of MEFA provides a detailed quantitative description of material and energy flows per sector, indicating the critical sectors in terms of resource consumption and waste generation and the most significant flows. More specifically, it reveals that the construction sector and households are key sectors within Umeå’s UM and that construction materials, food products, fossil fuels, and drinking water are significant metabolic flows. Furthermore, the application of MEFA with a multi‐year timeframe uncovers trends in consumption rates of materials and generation rates of waste and emissions, revealing, for example, the correlation of material consumption and waste generation with the level of construction activity. Overall, by illustrating the potential of MEFA to provide a detailed quantitative analysis of material and energy flows, this study emphasizes its utility in supporting the design and monitoring of circular strategies at the urban level. At the same time, it highlights limitations of the method and suggests areas for future research.
Psychometric properties of the Turkish version of the Cervical Cancer Knowledge Scale
Authors: Ergöz Aksoy Selcan Zeynep , Bilgiç Dilek
Published: June 2024

Aim

This study aimed to investigate the psychometric properties of the Turkish adaptation of The Cervical Cancer Knowledge Scale (CCKS‐T). This scale was designed for the assessment of cervical cancer knowledge levels among women in the screening period.

Methods

Research was conducted with 307 women aged 21–65 years, who satisfied the eligibility criteria and agreed to participate. Data were collected via an online survey conducted during July and August 2023, utilizing both a Descriptive Information Form and the CCKS‐T. To confirm the validity of the scale, language and content validity assessments were conducted, in addition to confirmatory factor analysis. The scale's reliability was evaluated using Cronbach's alpha, item‐total correlation analysis, and a test–retest analysis. The scale consisted of eight items.

Results

The content validity index of the scale items was found to be 1.0 with excellent sensitivity. Confirmatory factor analysis showed that the item factor loadings varied between 0.31 and 0.81 and the model had a good fit (x2/df = 2.200; GFI = 0.96; CFI = 0.96; RMSEA = 0.063). Cronbach's alpha of the Turkish version of the scale was found to be 0.80.

Conclusion

The CCKS‐T demonstrates both validity and reliability as an instrument for the assessment of Turkish women's knowledge about cervical cancer.
Within‐group sex ratios predict growth of social mole‐rats
Authors: Bensch H. M. , Thorley J. , Finn K. T. , Zöttl M.
Published: June 2024

Groups of wild animals can vary considerably in their composition, including in the proportion of group members who are male or female, that is the within‐group sex ratio. Variation in within‐group sex ratios can arise from active adjustment of litter sex ratios by mothers, from sex differences in mortality, dispersal and immigration, or from stochastic variation in recruitment. Variation in the within‐group sex ratio can have consequences for within‐group competition and can affect individual life histories throughout development. In this paper, we explore which processes may generate variation in within‐group sex ratios in wild Damaraland mole‐rats (Fukomys damarensis), a singular cooperative breeder. We investigate whether within‐group sex ratios predict the growth, body condition and philopatry of individuals. We show that although the population‐level sex ratio is balanced, skewed within‐group sex ratios are common, particularly among small groups. Our data suggests that stochastic variation in the sex of recruits explains natural variation in the sex ratio of wild groups. Non‐breeding individuals in groups with a sex ratio biased towards their own sex grow more slowly than individuals in groups biased towards the opposite sex, suggesting that intra‐sexual competition may decrease growth rates. We suggest that the costs of competition may contribute to the large variation in growth observed in social mole‐rat groups.
Tinea faciei clinical characteristics, causative agents, treatments and outcomes; a retrospective study in Thailand
Authors: Khiewplueang Kritsada , Leeyaphan Charussri , Bunyaratavej Sumanas , Jirawattanadon Pattriya , Saengthong‐aram Phuwakorn , Matthapan Lalita , Prasong Waranyoo , Panyawong Chatisa , Plengpanich Akkarapong
Published: June 2024

Background

Tinea faciei is a relatively uncommon dermatophyte infection. The studies, which included clinical forms, and isolated species of dermatophytes, are limited.

Materials and Methods

This retrospective study aims to determine the causative organism, clinical characteristics, treatments and outcomes of patients with tinea faciei attending the dermatologic clinic, Siriraj Hospital, from 1 January 2017 to 30 September 2021. Demographic data, clinical presentations, isolated dermatophyte species, treatments and outcomes were collected and analysed.

Results

A total of 151 tinea faciei cases were observed. Trichophyton rubrum (48.6%), Trichophyton mentagrophytes complex (22.2%) and Microsporum canis (18.1%) were common causative agents. Tinea faciei was commonly detected in females (64.9%) with a history of pets (54.6%). Clinical presentations often involved plaques and scales on the cheeks. Among patients with lesions on the cheek, mycological cure was observed significantly less often compared to those without cheek lesions. Patients with other concurrent skin or nail infections, a history of topical steroids and a history of previous fungal infection had a slightly longer duration of mycological cure than those without factors. Recurrent infection was found in 33.3%. Male, history of previous fungal infection, and lesions on the cheeks were significantly associated with recurrent infection.

Conclusions

Fungal infection of the face was commonly found in women and patients with pets. The most common pathogen that caused tinea faciei was T. rubrum. Topical antifungal treatments could be used with favourable outcomes. The history of past infection and lesion on the cheeks should be carefully assessed to be vigilant for recurrent infection.
A further involuntary contribution to naturalising nationalism
Authors: Duchesne Sophie
Published: June 2024

Robert Schertzer and Eric Taylor Woods' book analyses tweets posted by Donald Trump, Marine Le Pen and Brexit supporters in 2017 from a historical perspective in order to reveal the deep roots of white ethnic nationalism. This commentary questions the explanatory nature of the analysis, and highlights how the book inadvertently contributes to the ongoing naturalisation of nationalism, particularly in Western countries.
The efficacy of orthokeratology lenses with smaller back optic zone diameter in myopia control. A meta‐analysis
Authors: Zhou Yongli , Li Huan , Hao Jiangdong , Pan Wei , Yang Zhikuan , Lan Weizhong
Published: June 2024

Purpose

This study was conducted to determine whether orthokeratology (OK) lenses with a smaller back optic zone diameter (BOZD) could exhibit stronger myopia control effects.

Method

A meta‐analysis was registered in PROSPERO (CRD42023408184). A comprehensive systematic database search was conducted, encompassing PubMed, Cochrane Library, EMBASE, MEDLINE, Web of Science, Ovid, CNKI and CBM, to identify relevant studies up to 25 March 2023. The primary inclusion criteria for this meta‐analysis were studies that investigated the myopia control effect of OK lenses with a small optical treatment area (≤5 mm). To assess the quality of the retrieved articles, two researchers evaluated them using the Cochrane bias risk assessment criteria. The primary outcome measures were the changes in axial length (AL) and refractive error, using the weighted mean differences (WMD) and 95% confidence intervals (CI) to assess differences between small and traditional back optical treatment zone groups in terms of these outcomes.

Results

The analysis encompassed five eligible studies, with a 1 year duration. The average difference in AL between the groups was 0.12 mm (WMD = −0.12, 95% CI [−0.16, −0.09], p < 0.00001). Likewise, the average difference in refractive error between the two groups was 0.44 D (WMD = 0.44, 95% CI [0.30, 0.57], p < 0.00001). None of the studies reported severe adverse events.

Conclusions

Current evidence suggests that OK lenses with smaller back optical treatment zone are more effective in preventing myopia progression than traditional lenses. However, a longer‐term evaluation is warranted.
Key influences of VDD (DX) ICD selection: Results from a prospective, national survey
Authors: Vamos Mate , Nemeth Marianna , Kesoi Bence , Papp Roland , Polgar Balazs , Ruppert Mihaly , Mikler Csaba , Liptak Attila , Selley Torda , Balazs Tibor , Szili‐Torok Tamas , Zima Endre , Zoltan Duray Gabor ,   investigators of the Hungarian DX Survey
Published: June 2024

Background

To preserve the benefit of atrial sensing without the implantation of an additional lead, a single‐lead ICD system with a floating atrial dipole (DX ICD) has been developed. The purpose of this nationwide survey was to provide an overview of the current key influences of device selection focusing on DX ICD and to test the applicability of a previously published decision‐making flowchart of ICD‐type selection.

Methods

An online questionnaire was sent to all implanting centers in Hungary. Eleven centers reported data from 361 DX ICD and 10 CRT‐DX systems implantations between February 2021 and May 2023.

Results

The most important influencing clinical factors indicated by the participating doctors were elevated risk of atrial fibrillation (AF)/stroke (56%), risk of sinus/supraventricular tachycardias (SVT) (42%), and a potential need for CRT upgrade in the future (36%). The DX ICD was considered in the majority of cases instead of the VVI system (87%), and only in a small proportion instead of a DDD ICD (13%). 60% of the patients with DX ICDs were also included into remote monitoring‐based follow‐up. In 83% of the cases, good (>2 mV) or excellent (>5) atrial signal amplitude was recorded within 6 weeks after the implantation.

Conclusion

In the current national survey, the most important influencing factors indicated by the implanters for selecting a DX ICD were the elevated risk of stroke or sinus/SVT and a potential need for CRT upgrade in the future. These findings support the use of a previously published decision‐making flowchart.
Musculocontractural type of Ehlers–Danlos syndrome with novel CHST14 pathogenic variant in two siblings
Authors: KS Aswanth , Sarkar Namrata , Bhatia Riti , Singh Vivek , Sharma Shruti , Verma Prashant Kumar
Published: June 2024

Musculocontractural Ehlers–Danlos syndrome (MC‐EDS) is a rare entity worldwide with underlying pathogenic variant in the carbohydrate sulfotransferase 14 (CHST14) gene. Previous reports of the same entity from India were of two unrelated cases. Ours is the first report of two siblings in an Indian family with craniofacial dysmorphism and distal arthrogryposis with a clinical diagnosis of EDS, where an underlying pathogenic variant in CHST14 was detected by exome sequencing.
Child healthcare nurses’ experience of communication with 4‐year‐old children during their visit to the child health care center
Authors: Lind Britt‐Marie , Wigert Helena , Jenholt Nolbris Margaretha , Patriksson Katarina
Published: June 2024

Objective

To illuminate child healthcare nurses’ experiences of communication with 4‐year‐old children during their visit to the child healthcare center.

Design

A qualitative method, using data collected from individual interviews.

Sample

Fifteen semistructured interviews with nurses working in a child healthcare center.

Measurements

The results were analyzed using reflexive thematic analysis.

Results

The analysis resulted in three themes and eight subthemes: Adapting to the child in the conversation, based on the subthemes Preparing for the visit, Listening in and observing, and Creating a welcoming environment; Combining strategies for the conversation, based on the subthemes Engaging the child, Using visual tools, and Parental involvement; and Challenges due to language barriers, based on the subthemes Using an interpreter and Parent acts as interpreter.

Conclusion

Child healthcare nurses focus on the child when communicating and strive to create joy and a welcoming environment. The communication strategies employed during the visit include engaging the child directly, involving parents in the conversation, and balancing the parental involvement. Communication challenges related to language barriers are addressed, particularly during interpreter‐assisted conversations. The study indicates a need for tailored strategies, collaboration, and sensitivity to ensure a child‐centered approach.
Postcolonial experiences of Chinese aid: Encountering and welcoming South–South aid from the middle
Authors: Sou Gemma , Day Jennifer
Published: June 2024

This paper explores how public servants in aid‐recipient countries perceive and encounter the development structures and normative discourses of South–South partnerships. The paper draws on interviews with senior public servants in the Antigua and Barbuda government who interface directly with Chinese aid delivery. The public servants perceive that ‘Northern’ development models have largely failed and that ‘Southern’ donors can facilitate alternative development pathways. They understand that South–South partnerships give aid‐recipient countries greater control over their development futures, invoking some of the original radicalism of South–South partnerships. The public servants also perceive that Western critiques of Chinese aid are underpinned by orientalism, and they reject notions that they are being passively integrated into the Chinese government's global vision. Yet, they do not passively internalise the normative discourses on South–South partnerships. This paper advances a multi‐scalar postcolonial geographical analysis of South–South partnerships and will be of interest to those exploring how aid‐recipient countries navigate the politics and power relations of the contemporary global aid landscape. The paper also advances debates on how subaltern geopolitics play out in the context of increasing South–South partnerships. Finally, with its focus on South–South partnerships, the paper contributes to the aid ethnographies literature.
Impact of a single blood donation on hemoglobin mass, iron stores, and maximum oxygen uptake in pre‐menopausal women—A pilot study
Authors: Wachsmuth Nadine B. , Haupt Sandra , Bauer Philipp , Schierbauer Janis R. , Treff Gunnar , Steinacker Jürgen M. , Rilstone Sian , Schmidt Walter F. J.
Published: June 2024

Background

During whole blood donation (BD), 500 mL of blood is drawn. The time interval between two BDs is at least 8–12 weeks. This period might be insufficient for restoring hemoglobin mass (Hbmass) and iron especially in women, who generally have lower Hbmass and iron availability. Since both variables influence physical performance, this pilot study aimed to monitor Hbmass, iron status, and maximum oxygen uptake (V̇O2max) recovery in women after a single BD.

Study Design and Methods

In 10 women (24.7 ± 1.7 years), Hbmass, hemoglobin concentration [Hb], iron status, and V̇O2max were assessed before and up to 12 weeks after a single BD.

Results

BD reduced Hbmass from 562 ± 70 g to 499 ± 64 g (p < .001). Although after 8 weeks no significant mean difference was detected, 7 women had not returned to baseline after 12 weeks. [Hb] did not return to initial values (13.4 ± 0.7 g/dL) after 12 weeks (12.9 ± 0.7 g/dL, p < .01). Ferritin decreased from baseline until week 6 (40.9 ± 34.2 ng/mL vs. 12.1 ± 6.9 ng/mL, p < .05) and was not restored after 12 weeks (18.4 ± 12.7 ng/mL, p < .05), with 6 out of 10 women exhibiting iron deficiency (ferritin <15 ng/mL). V̇O2max was reduced by 213 ± 47 mL/min (7.2 ± 1.2%; p < .001) and remained below baseline after 12 weeks (3.2 ± 1.4%, p < .01).

Discussion

For most pre‐menopausal women, 12 weeks were not sufficient to recover from BD and achieve baseline Hbmass and iron stores resulting in prolonged reduction of aerobic capacity. A subsequent BD might lead to a severe anemia.