bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and efficacy of CO2 dot matrix laser combined with platelet‐rich plasma on depressed scar after acne vulgaris and influencing factors of its repair effect: A retrospective analysis
Authors: Guo Rong , Xuan Wenxia , He Xiao , Xu Kai
Published: January 2023

Background

Acne vulgaris (AV) is the most pervasive inflammatory disease of hair follicle and sebaceous gland in the dermatology department, and depressed scar (DS) is the most common and serious sequela of AV.

Aims

To explore the clinical value of CO2 dot matrix laser combined with platelet‐rich plasma (PRP)‐treated AV.

Methods

Total 81 patients with DS at the rear of AV from December 2018 to October 2019 were selected, randomly divided into observation group (OG, n = 39) and control group (CG, n = 42). Patients in the OG group were treated with CO2 dot matrix laser combined with PRP, and those in the CG group were treated with CO2 dot matrix laser. To observe clinical outcomes in both groups.

Results

According to experimental analysis, compared with the CG group, CO2 dot matrix laser combined with PRP can more strongly improve the clinical efficacy on patients, shorten the scar scabbing time and decrustation time, more effectively contributed to their scar repair, comfort, skin condition, psychological state and satisfaction, and reduced their pain. The subsequent follow‐up results also showed that patients in the OG group experienced better quality of life. Moreover, according to the logistic regression analysis, the course of disease, scar degree, and staying up late were independent risk factors for the repair effect, and the repair method of CO2 dot matrix laser combined with PRP was an independent protection factor.

Conclusion

To sum up, CO2 dot matrix laser combined with PRP can strongly enhance the scar repair effect, psychological state, and life quality of patients with DS after AV, so it is worth popularizing in clinical practice.
Tranexamic acid microinjections versus tranexamic acid mesoneedling in the treatment of facial melasma: A randomized assessor‐blind split‐face controlled trial
Authors: Poostiyan Nazila , Alizadeh Maryam , Shahmoradi Zabihollah , Fatemi Naeini Farahnaz
Published: January 2023

Background

Melasma is a hyperpigmentary disorder causing cosmetic disfigurement. We aimed to compare the efficacy and safety of tranexamic acid (TXA) microinjections with TXA mesoneedling for facial melasma.

Methods

This randomized assessor‐blind split‐face controlled trial included patients with symmetric facial melasma. One side of the face received TXA (100 mg/ml) mesoneedling and the other side intradermal TXA microinjections. The interventions were repeated three times with 4‐week intervals (weeks 0, 4, and 8). The primary outcome was improvement in modified Melasma Area and Severity Index (mMASI) 4 weeks after the final treatment session. Secondary outcomes were complications and patient satisfaction with the treatments evaluated by a visual analog scale (VAS).

Results

All 27 patients included in the study were female (mean age: 44.22 ± 8.39 years). Both groups were comparable in terms of mMASI scores before and after treatment (standardized mean difference [SMD] = 0.32, 95% confidence interval [CI] −0.22; 0.85, p = 0.248 and SMD = −0.13, 95% CI −0.66; 0.40, p = 0.633, respectively). The mMASI score change from baseline was not different (SMD = −0.39, 95% CI −0.93; 0.15, p = 0.157). However, patient satisfaction was significantly higher with TXA mesoneedling (SMD = 0.77, 95% CI 0.21; 1.32, p = 0.007). Post‐inflammatory hyperpigmentation occurred in one patient in the TXA mesoneedling group. Erythema, scaling, and edema were significantly higher with TXA mesoneedling (p < 0.001).

Conclusions

TXA mesoneedling was comparable with TXA microinjection in the treatment of facial melasma, while patient satisfaction was significantly higher with TXA mesoneedling; however, the high frequency of complications occurring with this treatment should be taken into account.
Claudin‐3 is a novel intestinal integrity marker in patients with alopecia areata: Correlation with the disease severity
Authors: Rafik Dina , Younis Ihab , Atef Rana , Eid Hanaa
Published: January 2023

Background

The development of alopecia areata is suggested to be influenced by intestinal permeability and gut dysbiosis. Claudin‐3, an essential component of tight junctions which may act as an indicator of intestinal barrier integrity.

Aims

The study's objective was to evaluate the plasma concentration level of Claudin‐3 in alopecia areata patients and its relationship to the severity of the condition.

Patients and Methods

In this case–control study, 50 alopecia areata patients and 30 healthy age and sex controls were involved. An enzyme‐linked immunosorbent assay was used to determine the concentration of claudin‐3 in the blood.

Results

Patients with alopecia areata had significantly higher plasma claudin‐3 concentrations than healthy controls [median (interquartile range), 7.73 ng/ml (4.49–33.7) vs. 6.14 ng/ml (4.45–15.6), p < 0.005]. Positive relations were found between claudin‐3 and SALT score (r = 0.675 & p‐value < 0.001).

Conclusions

Claudin‐3, a gut permeability biomarker, is elevated in alopecia areata and correlates with disease severity.
Microbotox injection versus its topical application following microneedling in the treatment of wide facial pores: A split face comparative study
Authors: Salem Rehab Mohammed , Salah Sarah Abd Elmordy , Ibrahim Samah Ezzat
Published: January 2023

Background

Enlarged facial pores and seborrhea are common cosmetic problems. Mesobotox has been proved to be effective safe therapeutic option.

Objective

To compare the efficacy and longevity of intradermal mesobotox injection versus its topical application with microneedling for treatment of wide facial pores and seborrhea.

Materials and Methods

This split face study was conducted on 20 patients with enlarged facial pores and seborrhea. One side of the face was treated with intradermal injection of botulinum toxin, the other was treated with its topical application following microneedling. Patient evaluation was performed after 1 month then after 4 months.

Conclusion

Microbotox can effectively and safely minimize enlarged facial pores with no downtime. Intradermal injection showed more patient satisfaction on the basis of greater efficacy, longevity of treatment than its topical application following microneedling.
Mapping quality improvement education initiatives to Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines
Authors: Lamont Scott , Murray Andrew , Tetik Emine , Yeo Jiaming , Blair Bianca
Published: January 2023

Aims and Objectives

To explore the rigour of nurse‐led quality improvement projects involving education, training or continuing professional development, and examine evaluation frameworks contained within.

Background

Healthcare organisations invest significantly in quality improvement in the pursuit of cost‐effective, safe, evidence‐based and person‐centred care. Consequently, efforts to examine the success of investment in quality improvement activities are prominent, against a backdrop of rising healthcare expenditure, reforms, consumer expectations and feedback.

Design

A qualitative document analysis of quality improvement projects located in a local health district repository was undertaken.

Methods

N = 3004 projects were screened against inclusion criteria, with n = 160 projects remaining for analysis. Projects were mapped to an adapted version of the Standards for QUality Improvement Reporting Excellence (SQUIRE), specifically the education extension (SQUIRE‐EDU). Additionally, project evaluation frameworks were positioned within Kirkpatrick's four levels of training evaluation model. The SQUIRE checklist was also applied in line with EQUATOR guidelines.

Results

Of n = 60 completed projects assessed against four broad SQUIRE‐EDU categories and relevant criteria, n = 36 were assessed not to have met any categories, n = 14 projects met one category, n = 8 projects met two categories, and n = 2 projects met three categories. None of the completed projects met all four SQUIRE‐EDU categories. There was insufficient documentation relating to evaluation frameworks in n = 133 projects to position within Kirkpatrick's four levels of training evaluation.

Conclusions

Scientific rigour should underpin all quality improvement efforts. We recommend that SQUIRE international consensus guidelines (full or abridged) should guide both the design and reporting of all local quality improvement efforts.

Relevance to Clinical Practice

To be of value to the expansion of evidence‐based practice, quality improvement platforms should be designed to reflect the structural logic, rigour and reporting recommendations being advocated in consensus reporting guidelines. This may require investment in training and development programs, and identification of governance and support systems.

No Patient or Public Contribution, as the study was retrospective in nature and involved a health service repository of quality improvement projects accessible to health service staff only.
Assessment of maternal serum SERPINC1, E‐selectin, P‐selectin, and RBP4 levels in pregnancies with early‐ and late‐onset preeclampsia
Authors: Palalıoğlu Rabia Merve , Erbiyik Halil Ibrahim
Published: January 2023

Introduction

To investigate whether the SERPINC1, E‐selectin, P‐selectin, and RBP4 levels in first trimester maternal serum was associated with the presence of preeclampsia (PE).

Methods

This cross‐sectional study was conducted on 26 women with early‐onset preeclampsia (EO‐PE), 27 women with late‐onset preeclampsia (LO‐PE), and 27 women with uncomplicated pregnancies. Levels of serum SERPINC1, E‐selectin, P‐selectin, and RBP4 were measured with the use of an enzyme‐linked immunosorbent assay (ELISA) kit.

Results

E‐Selectin levels in patients with EO‐PE were higher than those with LO‐PE and control patients (pE‐L = 0.025; pE‐C = 0.000; p < 0.05). There was no significant intergroup difference in terms of P‐selectin and RBP4 levels (p > 0.05). SERPINC1 levels were lower in the patients in the with EO‐PE group than in those in the LO‐PE and the control groups (pE‐L = 0.000; pE‐C = 0.000; p < 0.05). In the PE group, there was a negative, moderate (41.7%) correlation between E‐selectin level and SERPINC1 (p = 0.002; p < 0.05). The receiver operating characteristic (ROC) curve showed that the best cut‐off values for E‐selectin were 23.14 ng/ml > with 100% sensitivity and 100% specificity. The ROC curve showed that the best cut‐off values for SERPINC1 were ≤87.76 ng/ml with 98.1% sensitivity and 96.3% specificity.

Discussion

Of the endothelial damage parameters, E‐selectin and SERPINC1 are especially associated with EO‐PE. Furthermore, they can be used as potential early diagnosis markers in the prediction of PE.
Relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during the COVID‐19 pandemic
Authors: Demirci Pınar Y. , Tunuğ Şule , Vurgeç Burcu A. , Sürücü Şule G.
Published: January 2023

Aim

The study aimed to determine the relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during COVID‐19.

Methods

The population of the study was women with gynecologic cancer who received chemotherapy in a university hospital. The study sample was calculated using G*Power 3.1.9.4 analysis program and completed with 64 patients who agreed to participate and met the research criteria. The personal information form, supportive care needs survey‐short form (SCNS‐SF29Tr), coronavirus anxiety scale (CAS), and death anxiety scale (DAS) were used for data collection.

Results

The participants' SCNS‐SF29Tr mean score was 105.7 ± 17.26, CAS mean score was 11.19 ± 3.96, and DAS mean score was 40.13 ± 15.5. There was a positive, very high‐level correlation between the health system and information and psychological needs subscales of SCNS‐SF29Tr and CAS (r = 0.809, r = 0.878, respectively; p < 0.05). In addition, a high‐level relationship was found between the daily life subscale of SCNS‐SF29Tr and CAS (r = 0.674; p < 0.001). A positive low‐level relationship was determined between the health system and information, daily life, and psychological needs (except for the sexuality) subscales of SCNS‐SF29Tr and DAS (r = 0.357, r = 0.252, r = 0.353 respectively; p < 0.05).

Conclusion

Gynecologic cancer participants had unmet supportive care needs in all subscales except for the sexuality. The participants had higher supportive care needs, high‐level coronavirus anxiety, and medium‐level death anxiety. In addition, the participants' all supportive care needs have increased as their coronavirus anxiety levels have increased. The participants' supportive care needs have increased, except for sexuality, as their death anxiety levels have increased.
Allometry of the pectoral flight muscles in birds: Flight style is related to variability in the mass of the supracoracoideus muscle
Authors: Deeming D. C.
Published: January 2023

Avian flight is powered by a downstroke force generated by the pectoralis (P) muscle and an upstroke force generated by the supracoracoideus (SC) muscle. Some taxa, notably penguins and hummingbirds, have very low P:SC ratios associated with larger masses of the supracoracoideus. Allometric relationships of these muscles are not reported relative to body mass and presumably the two muscles will exhibit isometry in volant birds. This study collated muscle masses for over 600 species representing 28 orders of birds and used phylogenetically controlled analysis of covariance to test for the effects of taxonomic grouping on the allometry of the flight muscles in birds. The P:SC ratio and the standardized residuals for the allometric relationships, were calculated for different orders. The pectoralis scaled isometrically with body mass but the supracoracoideus muscle exhibited a slight but significant negative allometry. Both muscles showed significant effects of taxonomic group but this effect was magnified for the supracoracoideus. Wing‐propelled divers and hovering hummingbirds had disproportionately high proportions of supracoracoideus muscles but tinamous, gamebirds and pigeons, which exhibit burst flight, also had low P:SC ratios. Many taxonomic groups had a ratio around 10:1 but values of 20:1, recorded for birds of prey and owls, were associated with relatively small masses of the supracoracoideus muscle. The P:SC ratio seems to reflect differing flight styles with the greater variability being more associated with the size of the supracoracoideus, the significance of which has not necessarily been fully appreciated in the morphology and flight action of birds.
Viral hepatitis elimination challenges in low‐ and middle‐income countries—Uzbekistan Hepatitis Elimination Program (UHEP)
Authors: Musabaev Erkin , Estes Chris , Sadirova Shakhlo , Bakieva Shokhista , Brigida Krestina , Dunn Rick , Kottilil Shyamasundaran , Mathur Poonam , Abutaleb Ameer , Razavi‐Shearer Kathryn , Anstiss Tim , Yusupaliev Bakhodir , Razavi Homie
Published: January 2023

Background & Aims

Chronic infection with hepatitis B and C viruses (HBV & HCV) is a major contributor to liver disease and liver‐related mortality in Uzbekistan. There is a need to demonstrate the feasibility of large‐scale simplified testing and treatment to implement a national viral hepatitis elimination program.

Methods

Thirteen polyclinics were utilized to screen, conduct follow‐up biochemical measures and treat chronic HBV and HCV infection in the general adult population. Task shifting and motivational interviewing training allowed nurses to provide rapid screening and general practitioners (GPs) to treat individuals on‐site. An electronic medical system tracked individuals through the cascade of care.

Results

The use of rapid tests allowed for screening of 60 769 people for HCV and HBV over 6 months and permitted outdoor testing during the COVID‐19 pandemic along with COVID testing. 13%–14% of individuals were lost to follow‐up after the rapid test, and another 62%–66% failed to come in for their consultation. One stop testing and treatment did not result in a statistically increase in retention and lack of patient awareness of viral hepatitis was identified as a key factor. Despite training, there were large differences between GPs and patients initiating treatment.

Conclusions

The current study demonstrated the feasibility of large‐scale general population screening and task shifting in low‐ and middle‐income countries. However, such programs need to be proceeded by awareness campaign to minimize loss to follow up. In addition, multiple trainings are needed for GPs to bolster their skills to talk to patients about treatment.
Vision‐aided three‐dimensional damage quantification and finite element model geometric updating for reinforced concrete structures
Authors: Kong Qingzhao , Gu Jiaxuan , Xiong Bing , Yuan Cheng
Published: January 2023

This article presents a vision‐aided framework to achieve three‐dimensional (3D) concrete damage quantification and finite element (FE) model geometric updating for reinforced concrete structures. The framework can process images and point clouds to extract damage information and update it in an FE model. First, a mask region convolutional neural network was used to realize highly precise damage detection and segmentation based on images. Second, a 3D point cloud was adopted in conjunction with the processed images for 3D damage qualification. The model‐updating method enables an FE model to delete concrete elements to update the variations in volume caused by structural damage. This framework supports interaction with mainstream FE software for further analysis. To demonstrate the efficiency of the proposed framework, it was used in an experiment on a reinforced‐concrete shear wall.
Developing simulation games to advance public health nursing competence in baccalaureate education
Authors: Schofield Ruth , Chircop Andrea , Currie Genevieve , Foster Sue , Hamilton Julie , Kall Denise , Luctkar‐Flude Marian , Riselli Dawn Mercer , Oke Stacy , Ryan Maureen M. , Sanders Tanya , Tam Susan , Tyerman Jane
Published: January 2023

We describe the development of an innovative baccalaureate nursing education strategy for public health nursing. Virtual simulation pedagogy is known to be effective for acute care nursing practice while less known for public health nursing. Three Canadian nursing schools, the Canadian Association of Schools of Nursing (CASN), and the Canadian Alliance of Nurse Educators using Simulation (CAN‐Sim) partnered to develop three public health nursing virtual simulation games. Learners work through unfolding population health scenarios, simulating public health nursing practice focused on entry level public health nursing competencies. Each game fosters clinical reasoning and collaborative, community decision‐making to respond to population health issues during community assessment, evidence‐informed health promotion planning, and evaluation processes. A companion guide was developed to support best practices in implementing virtual simulation and promote optimum student learning using the public health nursing games.
Host responses against the fish parasitizing ciliateCryptocaryon irritans
Authors: Jiang Shuiqing , Huang Xiaohong
Published: January 2023

The parasitic ciliateCryptocaryon irritans, which infects almost all marine fish species occurring in both tropical and subtropical regions throughout the world. The disease, cryptocaryonosis, accounts for significant economic losses to the aquaculture industry. This review attempts to provide a comprehensive overview of the biology of the parasite, host–parasite interactions and both specific and non‐specific host defense mechanisms are responsible for the protection of fish against challenge infections with this ciliate. Also, this article reflects the current interest in this subject area and the quest to develop an available vaccine against the disease. Due to the high frequency of clinical fish cryptocaryonosis, the study of fish immune responses toC. irritansprovides an optimal experimental model for understanding immunity against extracellular protozoa.
Errors and complications in clinical periodontal practice due to methodologic bias and bad interpretation of the evidence
Authors: Chambrone Leandro , Garcia‐Valenzuela Francisco Salvador , Avila‐Ortiz Gustavo
Published: January 2023

Different types of errors and complications may arise during and after the execution of periodontal or implant‐related procedures. Some of the most relevant, although also controversial, and less commented, causative agents of errors and complications are methodological biases and bad interpretation of the evidence. Proper assessment of the literature requires of solid clinical knowledge combined with a systematic approach built on the recognition of common methodological biases and the avoidance of interpretive errors to critically retrieve, dissect, and judiciously apply available information for the promotion of periodontal and peri‐implant health. This review addresses common types of methodological bias and interpretive errors that can alter the reader's perceptions on the real effect and potential ramifications of the reported outcomes of a given therapeutic approach due to bad interpretation of the available evidence: (1) types of methodological biases; (2) spin and interpretive bias; (3) interpretation pitfalls when assessing the evidence (4) choice of relevant endpoints to answer the question(s) of interest; and (5) balance between statistical significance and clinical relevance.
Theta and alpha power track the acquisition and reversal of threat predictions and correlate with skin conductance response
Authors: Starita Francesca , Pirazzini Gabriele , Ricci Giulia , Garofalo Sara , Dalbagno Daniela , Degni Luigi A. E. , Di Pellegrino Giuseppe , Magosso Elisa , Ursino Mauro
Published: January 2023

The ability to flexibly adjust one's threat predictions to meet the current environmental contingencies is crucial to survival. Nevertheless, its neural oscillatory correlates remain elusive in humans. Here, we tested whether changes in theta and alpha brain oscillations mark the updating of threat predictions and correlate with response of the peripheral nervous system. To this end, electroencephalogram and electrodermal activity were recorded in a group of healthy adults, who completed a Pavlovian threat conditioning task that included an acquisition and a reversal phase. Both theta and alpha power discriminated between threat and safety, with each frequency band showing unique patterns of modulations during acquisition and reversal. While changes in midcingulate theta power may learn the timing of an upcoming danger, alpha power may reflect the preparation of the somato‐motor system. Additionally, ventromedial prefrontal cortex theta may play a role in the inhibition of previously acquired threat responses, when they are no longer appropriate. Finally, theta and alpha power correlated with skin conductance response, establishing a direct relationship between activation of the central and peripheral nervous systems. Taken together these results highlight the existence of multiple oscillatory systems that flexibly regulate their activity for the successful expression of threat responses in an ever‐changing environment.
Mathematical digital escape rooms
Authors: Stohlmann Micah S.
Published: January 2023

Escape rooms have been receiving more attention for use in education. Escape rooms are games in which teams solve multiple puzzles and challenges using clues, hints, and strategy to determine how to escape from a locked room. The implementation of escape rooms has the potential for increasing students' mathematical understanding and engagement. They also enable students to develop teamwork and communication skills which are essential for work, everyday life, and being a productive citizen. The importance of technology for use in education has also received more attention of late. Technology can be utilized with escape rooms for the development of digital escape rooms. This article describes a mathematical digital escape room that was implemented with a class of middle school students. Important principles for developing escape rooms are described and how they were integrated with the digital escape room entitled, Blanca's Building.
Functional analysis of PsbS transmembrane domains through base editing in Physcomitrium patens
Authors: Beraldo Claudia , Guyon‐Debast Anouchka , Alboresi Alessandro , Nogué Fabien , Morosinotto Tomas
Published: January 2023

Plants exposed to light fluctuations are protected from photodamage by non‐photochemical quenching (NPQ), a reversible mechanism that enables dissipation of excess absorbed energy as heat, which is essential for plant fitness and crop productivity. In plants NPQ requires the presence of the membrane protein PsbS, which upon activation interacts with antenna proteins, inducing their dissipative conformation. Here, we exploited base editing (BE) in the moss Physcomitrium patens to introduce specific amino acid changes in vivo and assess their impact on PsbS activity, targeting transmembrane regions to investigate their role in essential protein–protein interactions. This approach enabled the recognition of residues essential for protein stability and the identification of a hydrophobic cluster of amino acids impacting PsbS activity. This work provides new information on the molecular mechanism of PsbS while also demonstrating the potential of BE approaches for in planta gene function analysis.
Effectiveness of interventions for academic burnout among nursing students: A systematic review
Authors: Tating Dan Louie Renz P. , Tamayo Reiner Lorenzo J. , Melendres Julia Czen N. , Chin Isabel K. , Gilo Ericka Louise C. , Nassereddine Ghiwa
Published: January 2023

Background

Nursing students experience higher stress and burnout compared to students in other health professions, with a prevalence rate of as high as 20%. More recently, they have been affected by changes in nursing education due to the COVID‐19 pandemic, such as requirements for social isolation and distance learning. Although there are existing studies on interventions that address academic burnout among nursing students, there is no synthesis of randomized trials on this topic.

Aim

This study aimed to systematically synthesize studies of interventions for academic burnout among nursing students.

Methods

A systematic search for randomized controlled trials was performed in PubMed, CINAHL, CENTRAL, Web of Science, and Scopus. Eligibility criteria were based on study directness in relation to the Patient, Intervention, Comparison, and Outcome (PICO) question. Two review authors independently screened articles for inclusion, collected data from the included studies, and performed risk of bias assessments using the Cochrane Risk of Bias Tool 2.0. A narrative synthesis was performed. This review was registered a priori in PROSPERO (CRD42022350196).

Results

Six papers were included in this review. Various interventions were studied: Qigong exercises, progressive muscle relaxation, autogenic therapy and laughter therapy, didactic behavioral sessions focusing on personal and professional development, and coping skills enhancement. The effects of these interventions on academic burnout, depression, and stress among nursing students were short term and their benefits over time remain uncertain.

Linking Evidence to Action

Progressive muscle relaxation and cognitive behavioral interventions demonstrated short‐term positive effects on academic burnout, depression, and stress among nursing students. These findings may support the development of individual‐level and organizational‐level initiatives for nursing students aimed to lessen or prevent academic burnout. Large‐scale, high‐quality studies on the effect of interventions on academic burden in various settings and cultures are needed.
Mode coupling in a coastal wedge due to quasi-crossing of range-dependent modal eigenvalues
Authors: Jiang Yanyu , Zhang Qianchu , Katsnelson Boris
Published: January 2023

A specific mechanism of mode coupling in a waveguide propagation is studied when two range-dependent eigenvalues approach each other. This phenomenon is analogous to the so-called quasi-crossing of states in atomic physics (Landau–Zener theory). It is considered for the sound wave propagation in a coastal wedge in the presence of a sound-speed profile. The change in mode composition and the corresponding spatial variability of the sound field are analyzed by using modes coupling equations and the parabolic equation with a field decomposition over adiabatic modes, respectively.
Origins of Mesoamerican astronomy and calendar: Evidence from the Olmec and Maya regions
Authors: Šprajc Ivan , Inomata Takeshi , Aveni Anthony F.
Published: January 2023

Archaeoastronomical studies have demonstrated that the important civic and ceremonial buildings in Mesoamerica were largely oriented to sunrises or sunsets on specific dates, but the origin and spread of orientation practices were not clear. Using aerial laser scanning (lidar) data, we analyzed orientations of a large number of ceremonial complexes in the area along the southern Gulf Coast, including many recently identified Formative sites dating to 1100 BCE to 250 CE. The distribution pattern of dates marked by solar alignments indicates their subsistence-related ritual significance. The orientations of complexes built between 1100 and 750 BCE, in particular, represent the earliest evidence of the use of the 260-day calendar, centuries earlier than its previously known use in textual records.
Association of nurse staffing and unit occupancy with mortality and morbidity among very preterm infants: a multicentre study
Authors: Beltempo Marc , Patel Sharina , Platt Robert W , Julien Anne-Sophie , Blais Régis , Bertelle Valerie , Lapointe Anie , Lacroix Guy , Gravel Sophie , Cabot Michèle , Piedboeuf Bruno
Published: January 2023

Objective

In a healthcare system with finite resources, hospital organisational factors may contribute to patient outcomes. We aimed to assess the association of nurse staffing and neonatal intensive care unit (NICU) occupancy with outcomes of preterm infants born <33 weeks’ gestation.

Design

Retrospective cohort study.

Setting

Four level III NICUs.

Patients

Infants born 23–32 weeks’ gestation 2015–2018.

Main outcome measures

Nursing provision ratios (nursing hours worked/recommended nursing hours based on patient acuity categories) and unit occupancy rates were averaged for the first shift, 24 hours and 7 days of admission of each infant. Primary outcome was mortality/morbidity (bronchopulmonary dysplasia, severe neurological injury, retinopathy of prematurity, necrotising enterocolitis and nosocomial infection). ORs for association of exposure with outcomes were estimated using generalised linear mixed models adjusted for confounders.

Results

Among 1870 included infants, 823 (44%) had mortality/morbidity. Median nursing provision ratio was 1.03 (IQR 0.89–1.22) and median unit occupancy was 89% (IQR 82–94). In the first 24 hours of admission, higher nursing provision ratio was associated with lower odds of mortality/morbidity (OR 0.93, 95% CI 0.89 to 0.98), and higher unit occupancy was associated with higher odds of mortality/morbidity (OR 1.19, 95% CI 1.04 to 1.36). In causal mediation analysis, nursing provision ratios mediated 47% of the association between occupancy and outcomes.

Conclusions

NICU occupancy is associated with mortality/morbidity among very preterm infants and may reflect lack of adequate resources in periods of high activity. Interventions aimed at reducing occupancy and maintaining adequate resources need to be considered as strategies to improve patient outcomes.
Unusual presentation of non-inflamed glandular odontogenic cyst presenting with cholesterol clefts
Authors: Juneja Manish , George Jiji
Published: January 2023

Glandular odontogenic cysts (GOCs) are relatively rare among odontogenic cysts but are widely discussed owing to their multifaceted nature. We present a case of a women in her late 30s with a large radiolucency of right posterior ramus area and an associated impacted third molar. Histopathology confirmed GOC; although it presented with unusual presence of cholesterol clefts in absence of inflammation. This report emphasises the novelty and significance of the aforementioned finding.
Microsurgical replantation of a traumatic total scalp avulsion
Authors: Madsen Christoffer Bing , Poulsen Lotte , Bakholdt Vivi , Sørensen Jens Ahm
Published: January 2023

We present a rare case of microsurgical replantation of a total scalp avulsion. A woman in her mid-60s was renovating a tractor when her hair was caught in a column drill resulting in traumatic scalp avulsion. The avulsed scalp involved the eyebrows and the entire hair-covered part of the scalp. The prehospital management and the conservation packing of the scalp was very effective. Microsurgical replantation was achieved with anastomoses of the left superficial temporal artery and one temporal vein on each side. The combination of the prehospital treatment and our university hospital setup made it possible to reattach the scalp with an ischaemia time of approximately 5 hours. A functional and aesthetically pleasing outcome was achieved, and the patient was discharged 6 days postoperatively with a vital scalp and no complaints. Five months postoperatively, she has no sign of alopecia and is regaining sensation and function of the scalp.

A woman in her mid-60s was renovating a tractor when her hair was caught in a column drill resulting in traumatic scalp avulsion. The avulsed scalp involved the eyebrows and the entire hair-covered part of the scalp. The prehospital management and the conservation packing of the scalp was very effective.
Football-specific extension of the IOC consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020
Authors: Waldén Markus , Mountjoy Margo , McCall Alan , Serner Andreas , Massey Andrew , Tol Johannes L , Bahr Roald , D'Hooghe Michel , Bittencourt Natália , Della Villa Francesco , Dohi Michiko , Dupont Gregory , Fulcher Mark , Janse van Rensburg Dina Christina (Christa) , Lu Donna , Andersen Thor Einar
Published: January 2023

Several sports have published consensus statements on methods and reporting of epidemiological studies concerning injuries and illnesses with football (soccer) producing one of the first guidelines. This football-specific consensus statement was published in 2006 and required an update to align with scientific developments in the field. The International Olympic Committee (IOC) recently released a sports-generic consensus statement outlining methods for recording and reporting epidemiological data on injury and illness in sport and encouraged the development of sport-specific extensions.

The Fédération Internationale de Football Association Medical Scientific Advisory Board established a panel of 16 football medicine and/or science experts, two players and one coach. With a foundation in the IOC consensus statement, the panel performed literature reviews on each included subtopic and performed two rounds of voting prior to and during a 2-day consensus meeting. The panel agreed on 40 of 75 pre-meeting and 21 of 44 meeting voting statements, respectively. The methodology and definitions presented in this comprehensive football-specific extension should ensure more consistent study designs, data collection procedures and use of nomenclature in future epidemiological studies of football injuries and illnesses regardless of setting. It should facilitate comparisons across studies and pooling of data.
Toxocarosis in humans: how much of a problem is it in the UK?
Authors: Patterson Jacoby
Published: January 2023

Toxocara canis(from dogs) is recognised as a potential cause of human toxocarosis, butToxocara cati(from cats) and other species (eg,Toxascaris leoninafound in foxes) are also possible causes. Most colonisation withToxocaraspecies does not lead to symptomatic infection in well-cared for adult animals; young and debilitated animals are at greater risk. Humans can acquire infection from infected animals, for example, via soil contaminated with faeces; however, most human infections are asymptomatic, with symptomatic infection being very rare in the UK. The risk of human infection is reduced by measures such as hand washing and responsible disposal of dog faeces. Some organisations recommend regular prophylactic treatment of pet dogs and cats. However, there are concerns that some parasiticides are contaminating the environment. As an example of a One-Health problem there is a potential conflict between the needs of animal health, human health and the health of the wider ecosystem. Also, considering that only about 5% of non-juvenile household dogs shedToxocaraeggs at a given time, it has been questioned whether it is worthwhile to invest in frequent blind treatments. British veterinary organisations have suggested less frequent treatment may be more appropriate and should be based on individual risk assessment and faecal examinations for worms rather than blanket regular prophylactic treatment, which could reduce the impact of parasiticides on the environment without greatly increasing the risks to animal or human health.
‘How is it possible that at times we can be physicians and at times assistants in suicide?’ Attitudes and experiences of palliative care physicians in respect of the current legal situation of suicide assistance in Switzerland
Authors: Tomczyk Martyna , Andorno Roberto , Jox Ralf J
Published: January 2023

Introduction

Switzerland lacks specific legal regulation of assistance in suicide. The practice has, however, developed since the 1980s as a consequence of a gap in the Swiss Criminal Code and is performed by private right-to-die organisations. Traditionally, assistance in suicide is considered contrary to the philosophy of palliative care. Nonetheless, Swiss palliative care physicians regularly receive patient requests for suicide assistance. Their attitudes towards the legal regulations of this practice and their experience in this context remain unclear.

Objectives

Our study aimed to explore and describe the attitudes and experiences of Swiss palliative care physicians concerning the legal situation of suicide assistance.

Methods

In 2019, we performed an exploratory interview study with 12 Swiss palliative care physicians on palliative sedation as an alternative to assisted suicide. In this paper, we present the results that emerged from a thematic subanalysis of the data.

Results

Participants stated that assistance in suicide and palliative care are based on opposing philosophies, but they admitted a shift in paradigm over the last years in the sense that one practice does not necessarily exclude the other. They reported various roles in suicide assistance and considered that the current activities of Swiss right-to-die organisations were problematic and needed to be regulated by law.

Discussion and conclusion

These results could enrich national and international reflection on suicide assistance in the context of palliative care by reducing confusion between the two practices and strengthening the confidence of patients and their relatives.
Using Explainable Artificial Intelligence in the Clock Drawing Test to Reveal the Cognitive Impairment Pattern
Authors: Jiménez-Mesa Carmen , Arco Juan E. , Valentí-Soler Meritxell , Frades-Payo Belén , Zea-Sevilla María A. , Ortiz Andrés , Ávila-Villanueva Marina , Castillo-Barnes Diego , Ramírez Javier , Del Ser-Quijano Teodoro , Carnero-Pardo Cristóbal , Górriz Juan M.
Published: January 2023

The prevalence of dementia is currently increasing worldwide. This syndrome produces a deterioration in cognitive function that cannot be reverted. However, an early diagnosis can be crucial for slowing its progress. The Clock Drawing Test (CDT) is a widely used paper-and-pencil test for cognitive assessment in which an individual has to manually draw a clock on a paper. There are a lot of scoring systems for this test and most of them depend on the subjective assessment of the expert. This study proposes a computer-aided diagnosis (CAD) system based on artificial intelligence (AI) methods to analyze the CDT and obtain an automatic diagnosis of cognitive impairment (CI). This system employs a preprocessing pipeline in which the clock is detected, centered and binarized to decrease the computational burden. Then, the resulting image is fed into a Convolutional Neural Network (CNN) to identify the informative patterns within the CDT drawings that are relevant for the assessment of the patient’s cognitive status. Performance is evaluated in a real context where patients with CI and controls have been classified by clinical experts in a balanced sample size of [Formula: see text] drawings. The proposed method provides an accuracy of [Formula: see text] in the binary case-control classification task, with an AUC of [Formula: see text]. These results are indeed relevant considering the use of the classic version of the CDT. The large size of the sample suggests that the method proposed has a high reliability to be used in clinical contexts and demonstrates the suitability of CAD systems in the CDT assessment process. Explainable artificial intelligence (XAI) methods are applied to identify the most relevant regions during classification. Finding these patterns is extremely helpful to understand the brain damage caused by CI. A validation method using resubstitution with upper bound correction in a machine learning approach is also discussed.
Intersection numbers of twisted homology and cohomology groups associated to the Riemann–Wirtinger integral
Authors: Goto Yoshiaki
Published: January 2023

The Riemann–Wirtinger integral is an analogue of the hypergeometric integral, which is defined on a one-dimensional complex torus. We study the intersection forms on the twisted homology and cohomology groups associated with the Riemann–Wirtinger integral. We derive explicit formulas of some intersection numbers, and apply them to studies of the monodromy representation, connection problems, and contiguity relations.
Application of a Distributionally Robust Optimization Approach for Single-Period Stochastic Inventory Problems with Different Carbon Policies
Authors: Bai Qingguo , Wang Guihao , Liu Di , Zhang Zhenning
Published: January 2023

While single-period stochastic inventory problems have been studied in academia and industry, the impacts of both carbon emissions reduction and partial distribution information have not been investigated. In this paper, we consider carbon emission reduction in a single-period inventory problem where both product price and demand are stochastic. When only partial information on the first and second moments of the two stochastic elements is specified, we use the max–min criterion to construct two optimization models under cap-and-trade and carbon tax policies. For each model, we prove the existence of the optimal robust decisions on production quantity and cleaning equipment investment. By comparing the profit and carbon emission between these two models, we identify certain conditions that improve the economic and environmental performance of the manufacturer. Finally, we conduct a numerical study to test the robustness of the optimal operational decisions under each carbon policy.
Finite size effect on the thermodynamics of a hot and magnetized hadron resonance gas
Authors: Atta Debasis , Chaudhuri Nilanjan , Ghosh Snigdha
Published: January 2023

The thermodynamic properties of a non-interacting ideal hadron resonance gas (HRG) of finite volume have been studied in the presence of an external magnetic field. The inclusion of background magnetic field in the calculation of thermodynamic potential is done by the modification of the dispersion relations of the charged hadrons in terms of Landau quantization. The generalized Matsubara prescription has been employed to take into account the finite size effects in which a periodic (anti-periodic) boundary conditions is considered for the mesons (baryons). We find significant effects of the magnetic field as well as system size on the temperature dependence of energy density, longitudinal and transverse pressure especially in low temperature regions. The HRG is found to exhibit diamagnetism (paramagnetism) in the low (high) temperature region whereas the finite size effect is seen to strengthen the diamagnetic behavior of the medium.
Use of Journey Maps and Personas in Software Requirements Elicitation
Authors: Canedo Edna Dias , Calazans Angelica Toffano Seidel , Silva Geovana Ramos Sousa , Costa Pedro Henrique Teixeira , Masson Eloisa Toffano Seidel
Published: January 2023

Requirements elicitation is a fundamental step in a software development process since it is at this stage that the software begins to be designed. In some situations, the problems related to the failure of the software development project are due to an incomplete requirements elicitation, resulting in solutions that do not understand all the necessary functionalities or do not incorporate innovation. Despite the various techniques offered by Requirements Engineering, situations such as the growing application market and the need for innovation further increase the importance of understanding the user’s different needs. In this paper, we investigated how the journey map and personas techniques are being used in requirements elicitation in both the literature and the industry, along with the advantages, disadvantages and challenges of using these techniques. We conducted systematic literature review to identify the personas and journey map techniques used in requirements elicitation in the literature and industry. In addition, we conducted a survey with 52 practitioners (software developers, users and managers) to investigate their perceptions of the use of journey maps and personas techniques in the requirements elicitation phase. Twenty-four primary studies were identified that address journey map and personas techniques in software requirements elicitation. In addition, most respondents stated that using these techniques facilitates understanding the requirements, providing better integration, collaboration and leveling of knowledge among the members of the software development teams. Our findings allow us to conclude that most of the software developers, users and managers that participated in the survey consider that the journey map and personas techniques are effective in helping understand the software requirements to be developed by the development teams.
Shadow behaviors of rotating Ayón–Beato–García black holes in four-dimensional Einstein Gauss–Bonnet gravity
Authors: Belhaj A. , Hassouni Y. , Oualaid M. , Sekhmani Y.
Published: January 2023

By applying the Newman–Janis Algorithm, we investigate optical behaviors of rotating Ayón–Beato–García black holes in four-dimensional Einstein Gauss–Bonnet Gravity. Exploiting the Hamilton–Jacobi mechanism, we first obtain the needed null geodesic equations of motion. We then provide analytic and numerical methods to study the associated optical aspect for certain regions of the involved moduli space. Concretely, we analyze and examine the shadow behaviors in terms of one-dimensional real closed curves. Particularly, we find various shapes including the D-ones. After that, we study graphically the corresponding astronomical observables. We compute and discuss the energy emission rate. We observe that the rotating parameter and the Gauss–Bonnet coupling have a relevant influence on the shadow geometric configurations and the energy emission rate. Moreover, we find that the nonlinear electrodynamic charge does not affect such optical behaviors. Finally, we provide a possible link with the event horizon telescope activities by imposing certain conditions on the involved black hole parameters in the [Formula: see text] imaging aspect.