bluuebunny/crossref_metadata_2025 huggingface dataset:
LncRNA‐WAKMAR2 regulates expression of CLDN1 to affect skin barrier through recruiting c‐Fos
Authors: Tu Yunhua , Wang Li , Wang Xiaoli , Wu Wenjuan , Tu Ying , Zou Dandan , Deng Yuanyuan , Qi Jue , Cao Can , Xu Dan , Chai Yanjie , Zhu Yun , Zhang Juan , Sun Jun , Lai Fan , He Li
Published: December 2022

Background

Chronic actinic dermatitis (CAD) is an immune‐mediated photo‐allergic skin disease. In the clinic, the treatment of this disease is hampered by the lack of proper understanding of the skin barrier dysfunction mechanism.

Objective

To illuminate the mechanism of skin barrier dysfunction in CAD.

Methods

Transcriptome sequencing and protein profiling were used to detect skin barrier injury‐related genes. RNA pull down, a promoter‐reporter gene assay, and chromatin isolation by RNA purification‐sequencing were used to elucidate the effect of WAKMAR2 in skin barrier functionality.

Results

Transcriptome sequencing from patient's tissues showed a significantly decreased expression of WAKMAR2. Down‐regulation of WAKMAR2 destroyed the keratinocyte barrier. Moreover, WAKMAR2 can directly bind to the c‐Fos protein. This novel long non‐coding RNA (LncRNA)‐protein complexes were targeted to the CLDN1 promotor. Overexpression of WAKMAR2 enhanced the promoter activity of CLDN1, while the addition of AP‐1 inhibitor could reverse this phenomenon. Furthermore, our in vivo results suggested that expression of WAKMAR2 was required for the repair of skin damage in mice induced by ultraviolet irradiation.

Conclusions

We identified a crucial LncRNA (WAKMAR2) for the protection of the skin barrier in vitro and in vivo. Mechanically, it can specifically interact with c‐Fos protein for the regulation of CLDN1, a finding which could be applied for CAD treatment.
Development of a core descriptor set for Crohn's anal fistula
Authors:   The ENiGMA CODE collaborators
Published: December 2022

Aim

Crohn's anal fistula (CAF) is a complex condition, with no agreement on which patient characteristics should be routinely reported in studies. The aim of this study was to develop a core descriptor set of key patient characteristics for reporting in all CAF research.

Method

Candidate descriptors were generated from published literature and stakeholder suggestions. Colorectal surgeons, gastroenterologists and specialist nurses in inflammatory bowel disease took part in three rounds of an international modified Delphi process using nine‐point Likert scales to rank the importance of descriptors. Feedback was provided between rounds to allow refinement of the next ratings. Patterns in descriptor voting were assessed using principal component analysis (PCA). Resulting PCA groups were used to organize items in rounds two and three. Consensus descriptors were submitted to a patient panel for feedback. Items meeting predetermined thresholds were included in the final set and ratified at the consensus meeting.

Results

One hundred and thirty three respondents from 22 countries completed round one, of whom 67.0% completed round three. Ninety seven descriptors were rated across three rounds in 11 PCA‐based groups. Forty descriptors were shortlisted. The consensus meeting ratified a core descriptor set of 37 descriptors within six domains: fistula anatomy, current disease activity and phenotype, risk factors, medical interventions for CAF, surgical interventions for CAF, and patient symptoms and impact on quality of life.

Conclusion

The core descriptor set proposed for all future CAF research reflects characteristics important to gastroenterologists and surgeons. This might aid transparent reporting in future studies.
Implementation of a peri‐operative pain‐management algorithm reduces the use of opioid analgesia following pelvic exenteration surgery
Authors: Johnstone Charlotte S. , Koh Cherry E. , Britton Gregory J. , Solomon Michael J. , McLachlan Andrew J.
Published: December 2022

Aim

This study aimed to investigate the implementation and pain‐related outcomes of a peri‐operative pain‐management regimen for patients undergoing pelvic exenteration surgery at a university teaching hospital.

Method

This is a single‐site prospective observational cohort study involving 100 patients who underwent pelvic exenteration surgery between January 2017 and December 2018. A pain‐management algorithm regarding the use of opioid‐sparing multimodal analgesia was developed between the departments of anaesthesia, pain management and intensive care. The primary outcomes were: compliance with a pain‐treatment algorithm compared with a similar retrospective surgical patient cohort in 2013–2014; and requirements for regular doses of opioid analgesia at discharge, measured in oral morphine equivalent daily dose (oMEDD).

Results

Following the introduction of a pain‐management algorithm, regional anaesthesia techniques (spinal anaesthesia, transversus abdominus plane block, preperitoneal catheters or epidural analgesia) were used in 83/98 (84.7%) of the 2017–2018 cohort compared with 13/73 (17.8%) of the 2013–2014 cohort (p < 0.001). There was a reduction in the median dose of opioid analgesics (oMEDD) at time of discharge, from 150 mg (interquartile range [IQR]: 75.0–235.0 mg) in the 2013–2014 cohort to 10 mg (IQR: 0.00–45.0 mg) in the 2017–2018 cohort (p < 0.001). There was no change in pain intensity (assessed using the Verbal Numerical Rating Score) or oMEDD in the first 7 days following surgery.

Conclusion

Since implementation of a novel peri‐operative pain‐treatment algorithm, the use of opioid‐sparing regional techniques and preperitoneal catheters has increased. Additionally, the dose of opioids required at the time of discharge has reduced significantly.
Pre‐transplantation vitamin D deficiency increases acute graft‐versus‐host disease after hematopoietic stem cell transplantation in thalassemia major patients
Authors: Daloğlu Hayriye , Uygun Vedat , Öztürkmen Seda , Yalçın Koray , Karasu Gülsün , Yeşilipek Akif
Published: December 2022

Background

Although there are many studies on the role of vitamin D deficiency (VDD) in hematopoetic stem cell transplantation (HSCT), outcomes have often reported conflicting results because of the heterogeneity of the patients in the studies.

Methods

We investigated the association between VDD prior to HSCT and outcomes after HSCT in a relatively homogenous group of patients with thalassemia major (TM) who received identical treatment for TM before transplantation, and the same conditioning regimen and GVHD prophylaxis during and after transplantation. All patients, including the patients with normal vitamin D3 levels received 400 to 800 IU per day of vitamin D for the first 6 months after HSCT.

Results

Pre‐HSCT VDD increased the frequency of aGVHD after transplantation, particularly in HSCTs performed with PBSC for the stem cell source. Pre‐transplant low vitamin D3 levels had no association with transplant outcomes such as engraftment, viral infections, alloimmunization, chronic GvHD, total days of hospitalization, and success in terms of transfusion independence.

Conclusions

Low vitamin D3 levels before HSCT carry a significant risk for aGVHD. All patients with TM should be screened for VDD before HSCT, and every effort should be made to supplement vitamin D before the transplant in VDD patients.
Group chorusing as an intragroup signal in the greater ani, a communally breeding bird
Authors: Savagian Amanda , Riehl Christina
Published: December 2022

Group living often requires maintaining dynamic and varied relationships with fellow group members, while simultaneously monitoring and interacting with external competitors. Group members in many social species vocalize together to produce duets or choruses—coordinated, often conspicuous vocal displays—that may play a role in these interactions. Compared with male–female duets, however, relatively little research exists on the function and adaptive significance of group choruses, which involve three or more individuals. Here we investigate chorusing behavior in the greater ani (Crotophaga major), a communally breeding cuckoo that nests in stable social groups of four to eight unrelated individuals. Groups may remain together for several years on the same nesting territory, and groups occasionally destroy each other's clutches in conflicts over high‐quality territories. We asked whether the raucous, highly stereotyped choruses performed by ani groups are primarily used for intra‐ or intergroup communication, and whether they contain information about the identity of the social group and the number of birds vocalizing. Behavioral observations and acoustic recordings from three breeding seasons revealed that choruses typically occurred during social interactions within the group (78% of choruses) or in response to a predator or extra‐group individual (17%) and only rarely in intergroup interactions (4%). Consistent with this finding, choruses did not reliably reflect the number of birds vocalizing, and we found only limited evidence for group‐specific acoustic signatures (driven by a single group whose choruses were highly distinct). These results suggest that group choruses play an important role in intra‐group signaling, potentially in contexts such as group formation, reinforcement of social bonds within the group, and/or collective decision‐making, and they motivate new research questions about the role of collective signaling in social evolution.
Embodied modes in L2 French video reflections: Supporting metalinguistic awareness, organization, and community
Authors: Amgott Natalie , Gorham Julia A.
Published: December 2022

In recent years, research in multimodality has established the benefits of using multiple semiotic modes like image, sound, and text in digital second language (L2) communication. However, researchers have yet to investigate how L2 learners make meaning through embodied modes—or gestures and facial expressions. Grounded in the social semiotic theory of multimodality, this study leverages multimodal transcription and discourse analysis to describe how 126 college learners of L2 French used embodied modes in their video reflections. Findings reveal how gestures and facial expressions served to augment students’ metalinguistic awareness and organizational capacities in French. Further, embodied modes supported students in connecting to their audience. Because online language learning has increased during pandemic times, the findings shed light on the important role of embodied modes in designing L2 video assignments.
Predicting effects of multiple interacting global change drivers across trophic levels
Authors: van Moorsel Sofia J. , Thébault Elisa , Radchuk Viktoriia , Narwani Anita , Montoya José M. , Dakos Vasilis , Holmes Mark , De Laender Frederik , Pennekamp Frank
Published: December 2022

Global change encompasses many co‐occurring anthropogenic drivers, which can act synergistically or antagonistically on ecological systems. Predicting how different global change drivers simultaneously contribute to observed biodiversity change is a key challenge for ecology and conservation. However, we lack the mechanistic understanding of how multiple global change drivers influence the vital rates of multiple interacting species. We propose that reaction norms, the relationships between a driver and vital rates like growth, mortality, and consumption, provide insights to the underlying mechanisms of community responses to multiple drivers. Understanding how multiple drivers interact to affect demographic rates using a reaction‐norm perspective can improve our ability to make predictions of interactions at higher levels of organization—that is, community and food web. Building on the framework of consumer–resource interactions and widely studied thermal performance curves, we illustrate how joint driver impacts can be scaled up from the population to the community level. A simple proof‐of‐concept model demonstrates how reaction norms of vital rates predict the prevalence of driver interactions at the community level. A literature search suggests that our proposed approach is not yet used in multiple driver research. We outline how realistic response surfaces (i.e., multidimensional reaction norms) can be inferred by parametric and nonparametric approaches. Response surfaces have the potential to strengthen our understanding of how multiple drivers affect communities as well as improve our ability to predict when interactive effects emerge, two of the major challenges of ecology today.
Cropland intensification mediates the radiative balance of greenhouse gas emissions and soil carbon sequestration in maize systems of sub‐Saharan Africa
Authors: Zheng Jinsen , Canarini Alberto , Fujii Kazumichi , Mmari William N. , Kilasara Method M. , Funakawa Shinya
Published: December 2022

Sub‐Saharan Africa (SSA) must undertake proper cropland intensification for higher crop yields while minimizing climate impacts. Unfortunately, no studies have simultaneously quantified greenhouse gas (GHG; CO2, CH4, and N2O) emissions and soil organic carbon (SOC) change in SSA croplands, leaving it a blind spot in the accounting of global warming potential (GWP). Here, based on 2‐year field monitoring of soil emissions of CO2, CH4, and N2O, as well as SOC changes in two contrasting soil types (sandy vs. clayey), we provided the first, full accounting of GWP for maize systems in response to cropland intensifications (increasing nitrogen rates and in combination with crop residue return) in SSA. To corroborate our field observations on SOC change (i.e., 2‐year, a short duration), we implemented a process‐oriented model parameterized with field data to simulate SOC dynamic over time. We further tested the generality of our findings by including a literature synthesis of SOC change across maize‐based systems in SSA. We found that nitrogen application reduced SOC loss, likely through increased biomass yield and consequently belowground carbon allocation. Residue return switched the direction of SOC change from loss to gain; such a benefit (SOC sequestration) was not compromised by CH4 emissions (negligible) nor outweighed by the amplified N2O emissions, and contributed to negative net GWP. Overall, we show encouraging results that, combining residue and fertilizer‐nitrogen input allowed for sequestering 82–284 kg of CO2‐eq per Mg of maize grain produced across two soils. All analyses pointed to an advantage of sandy over clayey soils in achieving higher SOC sequestration targets, and thus call for a re‐evaluation on the potential of sandy soils in SOC sequestration across SSA croplands. Our findings carry important implications for developing viable intensification practices for SSA croplands in mitigating climate change while securing food production.
Emergency calls concerning older patients: Are the appropriate questions asked?
Authors: Jomard Nathalie , Vincent Adélaïde , Chammem Rita , Gilbert Thomas , Rouze Heloïse , Comte Brigitte , Haesebaert Julie , Schott Anne‐Marie
Published: December 2022

Aim

In the present study, we evaluated the triage process particularly for older patients after calls to Emergency Medical Call Centers (ECC), according to the geriatric assessment tool.

Methods

In this observational population‐based cross‐sectional study in the Rhône (France), we analyzed the audiotapes of all calls received by ECC concerning patients aged ≥75 years, during seven randomly selected days, over a period of 1 year. We analyzed whether information about seven key items, predefined by a panel of experts as essential for quality telephone triage of seniors, was actually collected.

Results

Among 4168 calls, 712 (17.1%) concerned patients >75 years (mean ± SD, age 84.6 ± 5.6 years). The mean duration of calls was 3 min 28 s. Information about living arrangements (alone or not), dependency, multiple pathologies, polymedication, ability to walk independently or with help, and hospitalization in the previous 3 months was not collected in 20%, 42%, 40%, 45%, 58% and 61% of calls, respectively. All seven geriatric items were collected for only 54 (7.8%) calls, and only three criteria collected for 277 (40%) calls. Nurse‐managed calls were significantly associated with the collection of less geriatric items compared with physician‐managed calls.

Conclusion

Key information is particularly important to guide the orientation, and further management of older patients may be lacking during the telephone triage of patients in ECCs. This may represent an important level of improvement of the triage process, to address the needs of older patients better and avoid inappropriate emergency department visits. Geriatr Gerontol Int 2023; 23: 54–59.
Alignment of patient‐centredness definitions with real‐life patient and clinician experiences: A qualitative study
Authors: Babione Julie , Panjwani Dilshaan , Murphy Sydney , Kelly Jenny , Van Dyke Jessica , Santana Maria , Kaufman Jaime , Sargious Peter , Rabi Doreen
Published: December 2022

Introduction

Patient‐centred care (PCC) has come to the forefront for many institutions, funding agencies and clinicians, and is integrated into care. Does a disconnect in understanding still exist between patients, healthcare organizations and clinicians in what PCC means and how outstanding issues might be addressed?

Methods

We conducted interviews and focus groups with self‐reported chronic care patients and clinicians providing care to these patients exploring PCC experiences, expectations and practices. These data were initially analysed using inductive thematic analysis. This paper reports on the findings of a secondary analysis examining the alignment between patients and clinicians on five key predetermined dimensions of PCC.

Results

Eighteen patients participated, representing a range of chronic conditions. Thirty‐eight clinicians participated. One thousand and three hundred patient and 1800 clinician codes were identified and grouped into 5 main topics with 140 unique themes (patients) and 9 main topics with 54 unique themes (clinicians). A total of 166 quotes (patient = 93, clinician = 73) were identified for this PCC definition alignment analysis. Partial or complete alignment of patient and clinician perspectives was seen on most dimensions. Key disconnects were observed in patient involvement, patient empowerment and clinician–patient communication. Only 18% of patients reported experiencing patient‐centred communication, whereas 57% of clinicians reported using patient‐focused communication approaches.

Conclusion

Overall, study patients and clinicians endorse that many PCC elements occur. This study highlights key differences between patients and clinicians, suggesting persistent challenges. Clinician participants relayed their PCC approaches of informing and educating patients; however, patients often perceive these approaches as didactic, role‐diminishing and noncollaborative. Collaborative approaches, such as shared decision‐making, hold promise to bridge persistent PCC gaps and should be integrated into medical education programmes.

Patient or Public Contribution

This project was conceived and executed with a co‐design approach wherein patients with chronic conditions who are trained in research (i.e., see descriptions of Patient and Community Engagement Research in the text) were involved in all stages of the research project alongside other researchers on the project team. Healthcare providers were involved as participants and as principal investigators in the project.
Call rate as an index of nest count in wading bird colonies
Authors: Larson Rachel C. , Gawlik Dale E.
Published: December 2022

Traditional monitoring methods for colonial waterbirds, such as nest counts, can be expensive, time‐intensive, disruptive to nesting birds and limited by colony accessibility. Our study tested the use of acoustic sampling as a colony monitoring technique for three species of colonially nesting herons (Ardeidae) by quantifying the relationship between chick call rate and nest count in colonies. Because acoustic detection can be influenced by soundscape variables, we measured day since colony initiation, body condition index of small heron chicks, nest height, vegetation density and wind speed and evaluated their effects on call rate detection. Generalized linear mixed‐effects models showed that call rate detection increased with daily nest count for all species. Snowy Egret Egretta thula and Tricoloured Heron Egretta tricolour detected call rate was also dependent on environmental, temporal and physiological variables, whereas Great Egret Ardea alba call detection was affected by vegetation density around nests and wind speed. Our study showed that wading bird nest counts can be estimated using acoustic sampling, reducing the need for manual colony surveys, and facilitating long‐term monitoring of wading bird nesting trends, which are important measures of wetland restoration worldwide.
‘They'd beat us with whatever is available to them’: Exploitation and abuse of Ghanaian domestic workers in the Middle East
Authors: Kandilige Leander , Teye Joseph Kofi , Setrana Mary , Badasu Delali Margaret
Published: December 2022

Generic accounts of pervasive cases of exploitation and abuse against migrant domestic workers in the Middle East exist in the extant literature. However, very little is known about the breadth, depth and gendered nature of abuses experienced by female migrants from especially the sub‐Saharan African region. Abuses of the rights of sub‐Saharan Africans are under‐represented and under‐theorised. This paper interrogates the question what is the nature, extent and severity of exploitation and abuse against female Ghanaian domestic workers in the Middle East? Using data from mixed‐methods research, this paper adopts the framework of structural, symbolic and interpersonal violence to examine the range of abuses against domestic workers and the context within which these abuses take place.
The impact of COVID‐19 on the mental health workforce: A rapid review
Authors: Crocker Kaitlyn M. , Gnatt Inge , Haywood Darren , Butterfield Ingrid , Bhat Ravi , Lalitha Anoop Raveendran Nair , Jenkins Zoe M. , Castle David J.
Published: December 2022

The COVID‐19 pandemic led to significant adaptations to healthcare. Provision of mental healthcare in a changing environment presented healthcare workers with unique challenges and demands, including changes in workload and expectations. To inform current and future healthcare service responses, and adaptations, the current review aimed to collate and examine the impact of the pandemic on mental healthcare workers (MHWs). We conducted a rapid systematic review to examine the overall impact of the COVID‐19 pandemic on MHWs. Searches were conducted in Ovid Medline and PsycInfo and restricted to articles published from 2020. Inclusion criteria specified articles written in English, published in peer‐reviewed journals, and that examined any outcome of the impact of COVID‐19 on MHWs; 55 articles fulfilled these criteria. Outcomes were categorized into ‘work‐related outcomes’ and ‘personal outcomes’. Mental healthcare workers worldwide experienced a range of work‐related and personal adversities during the pandemic. Key work‐related outcomes included increased workload, changed roles, burnout, decreased job satisfaction, telehealth challenges, difficulties with work‐life balance, altered job performance, vicarious trauma and increased workplace violence. Personal outcomes included decreased well‐being, increased psychological distress and psychosocial difficulties. These outcomes differed between inpatient, outpatient and remote settings. The COVID‐19 pandemic significantly altered the delivery of mental healthcare and MHWs experienced both work‐related and personal adversities during the COVID‐19 pandemic. With the continuation of changes introduced to healthcare in the initial stages of the pandemic, it will be important to maintain efforts to monitor negative outcomes and ensure supports for MHWs, going forward.
Extracorporeal shockwave therapy compared with standard care for diabetic foot ulcer healing: An updated systematic review
Authors: Hitchman Louise , Totty Joshua , Smith George E. , Carradice Daniel , Twiddy Maureen , Iglesias Cynthia , Russell David , Chetter Ian C.
Published: December 2022

Emerging evidence suggests that extracorporeal shockwave therapy (ESWT) may improve time to DFU healing. The aim of this review was to appraise the evidence on role of ESWT in DFU healing and impact of different ESWT doses. Databases were searched for trials comparing ESWT plus standard care to standard care alone in participants with DFUs. Search results were reviewed by two independent reviewers. The Cochrane Risk of Bias 2 tool and GRADE approach was used to assess bias and certainty. The primary outcome was time to healing. The search identified 345 papers after duplicates removed. Six trials consisting of 471 participants were included. There was unclear or high risk of bias across all domains. Time to ulcer healing was probably shorter in patients treated with ESWT compared with standard ulcer care alone (GRADE: low certainty). Patients treated with ESWT were more likely to heal at 20 weeks post‐ESWT compared with those treated with standard ulcer care alone (GRADE: low certainty). There was significant heterogeneity. ESWT remains a promising new treatment but the translation into routine clinical practice is still limited by the low certainty of evidence surrounding its effectiveness, case selection and optimum dose.
Investigation of the chemical versatility in high‐entropy pyrochlores
Authors: Vayer Florianne , Decorse Claudia , Bérardan David , Dragoe Diana , Dragoe Nita
Published: December 2022

This article reports on the exploration of the chemical versatility of entropy‐stabilized pyrochlores (A2B2O7) with large chemical disorder introduced on the B site, as well as the study of isovalent and aliovalent substitution on the B site and of Ca2+‐doping on the A site. Among all the 20 new compounds obtained in this study, 8 are entropy‐stabilized: RE2(TiZrHfGeSn)2 (with RE = Gd–Ho and Y), Pr2(TiZrHfScNb)2O7, and RE2(TiGeSnAlNb)2O7 (with RE = Er and Y). Moreover, some physical properties (magnetic, electrical, thermal, and optical properties) of these high‐entropy pyrochlores have been screened, and some of them could be potentially interesting for applications. For example, we observed low thermal diffusivity values (between 0.4 and 0.7 m2 s−1) making them interesting for thermal barrier coating or tunable optical bandgaps in the visible region that could make them appealing as photocatalysts or in optical applications. Furthermore, single‐phased compounds were obtained for almost all the rare earths (REs) on the A site. Therefore, when five nonmagnetic cations are used for the B site, it enables to study the magnetic properties and, more specifically, the influence of the local chemical and structural disorder on the exotic ground states observed in monocationic RE pyrochlores.
Microstructure of rapidly‐quenched ZrO2‐SiO2 glass‐ceramics fabricated by container‐less aerodynamic levitation technology
Authors: Fu Le , Wang Bohan , Sathyanath Sharath Kumar Manjeshwar , Chang Jiang , Yu Jianding , Leifer Klaus , Engqvist Håkan , Li Qin , Xia Wei
Published: December 2022

In this work, an aerodynamic levitation technology (ALT) was utilized to prepare ZrO2‐SiO2 glass‐ceramics with two different ZrO2 contents, that is, 35 mol% and 50 mol%. The glass‐ceramics were partially melted at ∼2000°C or fully melted at ∼3000°C by ALT, followed by rapid quenching to obtain spherical glass‐ceramic beads. The phase compositions and microstructures of the glass‐ceramics were characterized. Crystallization of ZrO2 occurred during the solidification process and ZrO2 content, processing temperature, and the addition of yttrium (3 mol%) affected the crystalline phase of ZrO2. No ZrSiO4 or crystalline SiO2 were formed during the solidification process and the glass‐ceramics were away from thermodynamic equilibrium due to rapid quenching. The glass‐ceramics showed a microstructure of irregular‐shaped ZrO2 micro‐aggregates embedded in an amorphous SiO2 matrix, with lamellar twins and lattice defects formed within ZrO2 crystals. For samples prepared at ∼3000°C, a liquid‐liquid phase separation occurred in the melt, which eventually resulted in the formation of large and irregular‐shaped ZrO2 aggregates. In comparison, for samples prepared at ∼2000°C, pre‐existed ZrO2 crystals formed during heating acted as nucleation sites during the cooling process, followed by grain growth to form large ZrO2 aggregates. Solidification and microstructure formation mechanisms were proposed to elucidate the solidification process during rapid cooling and the microstructure of the glass‐ceramics obtained.
The European Summit: A Critical Space for the Development of British‐Irish Intergovernmentalism
Authors: Litter Darren
Published: December 2022

The European summit is where the national representatives of European Union (EU) member states have their say on policy issues. It has also been posited, however, that its ‘margins’ are advantageous to the achievement of bilateral as well as EU consensus. This article uses the British‐Irish relationship and the insights of British and Irish elite interviewees like Bertie Ahern, Sir John Holmes and Lord Robin Butler to demonstrate this function. Using a novel intergovernmental lens, it shows that not only was the European summit beneficial to this relationship but also it was integral to its transformation, in addition to the key 1985–1998 negotiation phases. The article is relevant to the Brexit context, substantiating the view that it will cause a deficit in the British‐Irish relationship. It also serves as a basis for expanded study of the European summit space, and its dynamic contribution to strengthened relationships amongst EU member states.
Evidence for the Predator Attraction Hypothesis in an amphibian predator–prey system
Authors: Crane Adam L. , Bryshun Reid , McCormack Megan , Achtymichuk Gabrielle H. , Rivera‐Hernández Ita A. E. , Ferrari Maud C. O.
Published: December 2022

Many species possess damage‐released chemical alarm cues that function in alerting nearby individuals to a predator attack. One hypothesis for the evolution and/or maintenance of such cues is the Predator Attraction Hypothesis, where predators, rather than prey, are the “intended” recipients of these cues. If a predator attack attracts additional predators, these secondary predators might interfere with the predation event, providing the prey with a better chance to escape. In this study, we conducted two experiments to explore this hypothesis in an amphibian predator/prey system. In Experiment 1, we found that tiger salamanders (Ambystoma mavortium) showed a foraging attraction to chemical cues from wood frog (Lithobates sylvaticus) tadpoles. Salamanders that were experienced with tadpole prey, in particular, were strongly attracted to tadpole alarm cues. In Experiment 2, we observed experimental encounters between a tadpole and either one or two salamanders. The presence of the second predator caused salamanders to increase attack speed at the cost of decreased attack accuracy (i.e., increasing the probability that the tadpole would escape attacks). We also found that the mere presence of visual and chemical cues from a second predator did not affect this speed/accuracy trade‐off but did cause enough of a distraction to increase tadpole survival. Thus, our findings are consistent with the Predator Attraction Hypothesis for the evolution and/or maintenance of alarm cues.
Association between postural tremor and risk of disability in community‐dwelling older people
Authors: Xu Xitong , Chen Jie , Ji Shaozhen , Gu Zhuqin , Chen Meijie , Chhetri Jagadish Kumar , Chan Piu
Published: December 2022

Background

The prevalence of postural tremor increases with age and the tremor has been found to be associated with aging‐related physiological decline. However, whether postural tremor in older adults is associated with adverse outcomes such as disability is unclear. This study investigated the association between postural tremor and the risk of disability in activities of daily living (ADL) among community‐dwelling older people.

Methods

Data were derived from a population‐based study of Chinese adults aged ≥55 years. Postural tremor was assessed at baseline using a two‐step method (i.e., tremor screening followed by examination of positive cases). ADL disability was determined using an 8‐item questionnaire, which covered the mobility and self‐care domains of ADL. Participants free of ADL disability at baseline were followed for up to 4 years.

Results

The prospective analyses included 5868 participants. Participants with postural tremor were at greater risk of incident ADL disability, particularly disability in the mobility domain of ADL. After multivariate adjustment, postural tremor was not significantly associated with incident ADL disability (multivariate‐adjusted relative risk [RR] = 1.05, 95% confidence interval [CI] = 0.77–1.43), and was marginally associated with incident disability in the mobility domain of ADL (multivariate‐adjusted RR = 1.36, 95% CI = 0.98–1.88). The risk of mobility‐related ADL disability was significantly increased among men, but not women, with postural tremor (multivariate‐adjusted RR = 1.84, 95% CI = 1.11–3.05). Older age and an increased number of chronic comorbidities mainly explained the higher risk of ADL disability in older people with postural tremor.

Conclusions

Postural tremor in older adults is associated with greater incidence of ADL disability, particularly mobility‐related ADL disability. The association is largely due to older age and a higher prevalence of chronic comorbidities in older people with postural tremor. Postural tremor is not a strong independent predictor of ADL disability in older people.
Reviving the anatomic past: Breathing new life into historic anatomical teaching tools
Authors: Cullinane Dearbhla P. , Franklin Callum , Barry Denis S.
Published: December 2022

The last two decades have seen a shift in the way anatomy education is delivered. With the introduction of blended learning, cadaveric dissection is no longer the be all and end all and, in many cases, the continuing role of anatomical teaching artefacts has declined after decades of prominence. While some institutions have abandoned their archaic anatomical collections and medical museums completely, others have invested in their technological enhancement. We describe the integration of historical teaching artefacts into contemporary anatomy education through the development of an interactive online e‐platform and shed light on the enduring pedagogic value of past anatomical teaching specimen.
Predictors of preconception health knowledge among Canadian women: A nationwide cross‐sectional study
Authors: Dennis Cindy‐Lee , Prioreschi Alessandra , Birken Catherine S. , Brennenstuhl Sarah , Brown Hilary K. , Bell Rhonda C. , Marini Flavia , Wrottesley Stephanie V.
Published: December 2022

Background

Optimising preconception health—that is the health of women and men prior to a potential pregnancy—is increasingly recognised as fundamental to improving maternal and infant health outcomes. To date, limited research has been conducted examining preconception knowledge and studies focusing on preconception health behaviours have targeted certain behaviours, while overlooking others, with limited attention given to the interconception period and differences between multiparous and primiparous/nulliparous women.

Aims

To determine predictors of preconception health knowledge among Canadian women and to examine whether parity modified the effect of predictors on preconception knowledge.

Materials and Methods

A cross‐sectional study reported according to STROBE was undertaken from May to June 2019 in Canada with 928 women. An online questionnaire was used including the Preconception Health Knowledge Questionnaire, demographic characteristics, current health status, previous pregnancy outcomes and use of preconception care services. Ordinary least squares regression was used to model knowledge scores. Predictors were entered using theoretically driven hierarchical entry.

Results

Mean age of women was 34 years and one in five were immigrants. In the final model, household income (b = .17, SE = .07; p = .009), being born outside Canada (b = −.75, SE = .25; p = .003), miscarriage/stillbirth history (b = .47, SE = .21; p = .027) and previous use of preconception care (b = .97, SE = .20, p ⟩ .001) were predictive of preconception health knowledge. Effect modification by parity was not statistically significant in the final model (f = 1.22, p = .19).

Discussion

Women at higher risk of poor preconception knowledge, and who therefore stand to gain from preconception knowledge interventions may include those who (1) are socially and economically disadvantaged; (2) have not engaged in preconception care previously and (3) were not born in Canada. Ensuring national promotion of and access to preconception care is an important strategy to prevent adverse pregnancy outcomes and optimise maternal and infant health.

Conclusion

This study highlights the need for national promotion of and access to preconception health care for all pregnancy‐planning families in order to improve perinatal outcomes.

Relevance for clinical practice

When evaluating preconception health efforts, preconception health knowledge must be considered within the context of social determinants of health and individuals’ abilities to act on their knowledge.
Fall rates by specialties and risk factors for falls in acute hospital: A retrospective study
Authors: Heikkilä Anniina , Lehtonen Lasse , Junttila Kristiina
Published: December 2022

Background

Falls are common adverse events in acute care hospitals, and about 25–50% of fallers suffer injuries. In acute care, fall rates range from 0.4–9 falls per 1000 patient days, varying among unit types, patient characteristics, and diseases. Several risk factors have been identified, including recent falls, age, reduced mobility, cognitive ability and polypharmacy. Several countries have become an aging society in which an increasing number of older patients need acute care. Therefore, the prevention of falls has become one of the most important aspects of patient safety.

Aim and Design

This retrospective study aimed to explore adults' inpatient falls in a Finnish university hospital with several specialties. The objectives were to draw an overall picture of fall rates in Finnish acute care, and to model risk factors for falls including secondary diagnoses.

Methods

The study was conducted in a large university hospital in Finland. The data consisted of patients' electronic health records from 2014–2016 and included a total of 114,951 adult patients. Univariable and multivariable binary logistic regression model analysis was used to identify risk factors for falls and multiple imputation was used to missing data. The study reporting followed the STROBE guidelines.

Results

A total of 841 falls were recorded, totalling 1.5 falls per 1000 patient days, and the rate of falls with injury was 0.4 per 1000 patient days. The regression model included the following risk factors: increasing old age, prolonged hospital stays, specialty of neurology, mode of arrival (emergency care and hospital transfer), no operation during hospital stays and secondary diagnoses such as dementia, pneumonia and alcohol abuse.

Conclusions

In acute care, falls occur most in patients with neurological diagnoses and least in surgical patients. Risk factors for falls include increasing age, emergency arrival, hospital transfer and prolonged hospital stay.

Relevance to Clinical Practice

Educational interventions to improve healthcare professionals' competence and preventive interventions to avoid inpatient falls need to be prioritized in medical specialties with high fall rates.
Clostridium difficile and other adverse events from overprescribed antibiotics for acute upper respiratory infection
Authors: Carmichael Harris , Asch Steven M. , Bendavid Eran
Published: December 2022

Background

Guidelines widely recommend avoiding antibiotics for many acute upper respiratory infections (aURIs) to avert adverse events in the absence of likely benefit. However, the extent of harm from these antibiotics remains a subject of debate and could inform patient‐centered decision‐making. Prior estimates finding a number needed to harm (NNH) between 8 and 10 rely on patient‐reported adverse events of any severity. In this analysis, we sought to estimate adverse events by only measuring comparatively severe events that require subsequent clinical evaluation.

Methods

We constructed a retrospective cohort, including 51 million patient encounters. Using logistic regression models, we determined the adjusted odds ratio (aOR) of clinically detectable adverse events following antibiotic use compared with events among unexposed individuals with aURIs. Our outcomes included candidiasis, diarrhea, Clostridium difficile infection (CDI), and a composite outcome.

Findings

From our analysis, 62.4% of the population received antibiotics in an aURI encounter. Observed adverse events in the antibiotic‐exposed group were 54,279 and 46,936 for diarrhea and candidiasis, respectively, yielding an aOR of 1.24 and 1.61, and an NNH of 3,126 and 1,975. Observed events of CDI in the exposed group were 30,133, and aORs of isolated CDI and combined adverse events were 1.07 and 1.30, resulting in an NNH of 17,695 and 1,150, respectively. Females were more likely to be diagnosed with any adverse event. Overall antibiotics were found to result in 5.7 additional cases of CDI per 100,000 outpatient prescriptions following an upper respiratory tract infection.

Interpretation

Despite higher NNH than previous methods of analysis, we find substantial iatrogenic harm associated with prescribing antibiotics in aURIs.
Strategic Practice Drift: How Open Strategy Infiltrates the Strategy Process
Authors: Stjerne Iben , Geraldi Joana , Wenzel Matthias
Published: December 2022

This paper builds theory on the process of open‐strategy infiltration through an ethnographic study investigating how open strategy entered a financial services firm's strategy process behind the backs of top managers. Based on our analysis, we show how open strategy infiltrates the strategy process through a ‘strategic practice drift’, i.e., a gradual and partly unnoticed shift towards open strategy that occurs through ‘accommodating’ and ‘legitimizing’ the performance of transparency and inclusion in the strategy process. We show how the ‘goal‐based ambiguity’ and ‘procedural certainty’ of initiatives that latently imply the performance of transparency and inclusion in the strategy process enable open‐strategy infiltration. Furthermore, we show how top managers' ‘goal‐based rationalization’ and ‘procedural renegotiation’ of practising transparency and inclusion contribute to the eventual reproduction of open strategy in the strategy process. Our model generates an understanding of how and why open strategy can enter the strategy process behind the backs of top managers and adds nuance to extant understandings of the role of top managers in this process. In addition, our findings contribute to research on strategy as practice by theorizing ‘strategic practice drifts’ and extending our understanding of the role of ambiguity therein.
Problem Solving or Responsibility Avoidance? The Role of CEO Internal Attribution Tendency in Shaping Corporate Downsizing in Response to Performance Shortfalls
Authors: Shi Wei , Chen Guoli , Li Boshuo
Published: December 2022

This study examines how CEOs' internal attribution tendency – to attribute an observed outcome to internal factors – shapes the extent to which corporate downsizing activities are driven by performance shortfalls. Despite the known effectiveness of downsizing in creating leaner organizations and enhancing firm performance, CEOs often avoid it as it runs counter to their own interests. Applying the awareness‐motivation‐capability (AMC) framework, we argue that CEOs' internal attribution tendency influences their awareness of responsibility for performance shortfalls, and ultimately whether they engage in downsizing actions in response to such shortfalls. This effect becomes more salient when CEOs have the motivation (e.g., scrutiny from financial analysts) or capability (e.g., the existence of an unfavourable external environment) to avoid taking such responsibility. Using a sample of 2424 US firms, we find support for our arguments. Our study highlights the importance of CEO internal attribution tendency in explaining whether firms resort to downsizing actions to address performance shortfalls.
Towards Stronger Causal Claims in Management Research: Causal Triangulation Instead of Causal Identification
Authors: Cornelissen Joep , Kaandorp Mariëtte
Published: December 2022

This article addresses widespread concerns about the reliability and strength of many causal claims made in management research. We first critically review the three prevalent forms of theorizing used to identify causal relationships in this field, i.e., propositional, configurational, and process approaches to causation. Highlighting the strengths and limitations of these approaches, we show that while no single approach is sufficient by itself as the basis for robust causal claims, researchers can nonetheless enhance and strengthen claims significantly by combining approaches and thus subjecting them to multiple criteria for drawing robust inferences. We emphasize the risks of continuing with narrow monolithic approaches, using examples of weak claims to show how these could have been strengthened (or abandoned) if the researchers had followed our proposed model of causal triangulation. Finally, we elucidate the practical benefits for management researchers and stakeholders in society of adopting this theoretically pluralistic approach to causation.
So you think you are an ally? Effects of (in)congruence between men's self‐perceptions and women's perceptions of men's values and allyship on women's inclusion and vitality
Authors: Warren Meg A. , Schwam Allison
Published: December 2022

As public consciousness of sexism is increasing in the workplace (e.g., #MeToo movement), labelling oneself as an ally (e.g., UN HeforShe campaign) is becoming more socially desirable for men. However, do women agree with such men in their assessments of being allies? Importantly, how does women's agreement (or not) with men's self‐assessments of allyship affect women's inclusion‐relevant outcomes? Using a multi‐informant design and data from 101 men–women colleague pairs, this study considered men's self‐perceptions and women's other‐reports of men's key allyship‐relevant characteristics—justice, moral courage, civility and allyship. Polynomial regression and response surface analyses revealed differential impacts of (in)congruence between men's and women's perceptions on women's sense of inclusion and vitality. Simply, when women perceived men as higher (or the same) in justice, moral courage and civility than men reported themselves, it positively predicted women's outcomes. This suggests that humble self‐presentation by men on characteristics that are parallel to allyship (but not allyship) may be ideal. Yet, both under‐ and overestimation by men on allyship itself predicted poorer outcomes for women, suggesting that the ideal is for men to have an accurate assessment of their own strengths and weaknesses as an ally.