bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical history analysis of Japanese melanoma cases and characteristics of melanoma with childhood onset
Authors: Minagawa Akane , Uhara Hisashi , Ashida Atsuko , Koga Hiroshi , Okuyama Ryuhei
Published: August 2022

It remains debatable whether melanoma with a clinical history of early childhood onset truly arises from a nevus. To clarify the clinical and genetic characteristics of melanoma detected at birth or several years afterwards, 249 melanoma cases seen at Shinshu University Hospital between 2006 and 2015 were retrospectively analyzed. Ten (4.0%) cases (median age 39.5 years, range 19–70 years; male/female 2/8; lesion site, 6 extremities, 2 trunk, 1 head, 1 face; cumulative sun damage [CSD] skin, 9 low‐CSD, 1 high‐CSD; detection at birth 3) had recorded early childhood onset. Median Breslow's tumor thickness in those cases was 6.0 mm (range: 0.4–17.5 mm). The frequency of lesions detected at <20 years of age was significantly higher for low‐CSD melanoma (17.5%) than for high‐CSD (3.3%) and acral (0.8%) melanoma. Although melanoma with a history of early childhood onset is rare, the characteristics of such cases should be established since most have progressed to an advanced stage at the initial visit.
Nonstructural carbohydrates predict survival in saplings of temperate trees under carbon stress
Authors: Piper Frida I. , Moreno‐Meynard Paulo , Fajardo Alex
Published: August 2022

Nonstructural carbohydrates (NSCs) mediate plant survival when the plant's carbon (C) balance is negative, suggesting that NSCs could predict plant survival under C stress. To examine this possibility, we exposed saplings of six temperate tree species to diverse levels of C stress created by the combination of two light conditions (full light availability and deep shade) and two defoliation levels (severe defoliation and nondefoliation). We then measured survival, biomass and total NSCs and soluble sugars (SSs) concentrations in different organs of both dead and live saplings.

We estimated mean NSCs and SSs contents and concentrations per sapling and fitted logistic generalized mixed‐effects models to determine if NSCs and SSs predict survival. Using inverse prediction modelling, we also determined whether there is a common NSCs and SSs threshold across species at the time of sapling's death.

Defoliation and shade reduced the mean sapling's NSCs and SSs contents, indicating C stress. Mean sapling NSCs and SSs contents and concentrations predicted survival and the robustness of the models improved with the inclusion of species. At death, saplings of the exotic deciduous tree species Acer pseudoplatanus exhibited significantly lower mean NSCs and SSs contents than saplings of the evergreen conifer species Podocarpus nubigenus and lower stem NSCs and SSs concentrations than the broadleaf evergreen species Drimys winteri.

The energetic role that NSCs and SSs play in plants under C stress was evidenced by the capacity of these compounds to predict sapling survival under C stress. No common threshold of NSCs and SSs contents or concentrations for sapling survival amongst species was found, indicating that the level of these compounds may not be good proxies for interspecific comparisons of tolerance to C stress. Presumably, there are species‐specific limits for the mobilization and use of NSCs and SSs in metabolism.

Our results anticipate that the inclusion of NSCs and SSs in modelling will improve predictions regarding tree responses to ongoing climate change. Nonetheless, a better understanding of the many roles that carbohydrates play in plant survival under C stress is required to scale predictions up to the community level.

Read the free Plain Language Summary for this article on the Journal blog.
It’s never too late to prevent neonatal sepsis
Authors: Turrentine Mark
Published: August 2022

Linked article: This is a mini commentary on Chan et al., pp. 24–31. in this issue. To view this article visit https://doi.org/10.1111/1471‐0528.17279.
Impact of simulation training on the management of shoulder dystocia and incidence of permanent brachial plexus birth injury: An observational study
Authors: Kaijomaa Marja , Gissler Mika , Äyräs Outi , Sten Assi , Grahn Petra
Published: August 2022

Objective

To study the impact of shoulder dystocia (SD) simulation training on the management of SD and the incidence of permanent brachial plexus birth injury (BPBI).

Design

Retrospective observational study.

Setting

Helsinki University Women’s Hospital, Finland.

Sample

Deliveries with SD.

Methods

Multi‐professional, regular and systematic simulation training for obstetric emergencies began in 2015, and SD was one of the main themes. A study was conducted to assess changes in SD management and the incidence of permanent BPBI. The study period was from 2010 to 2019; years 2010–2014 were considered the pre‐training period and years 2015–2019 were considered the post‐training period.

Main outcome measures

The primary outcome measure was the incidence of permanent BPBI after the implementation of systematic simulation training. Changes in the management of SD were also analysed.

Results

During the study period, 113 085 vertex deliveries were recorded. The incidence of major SD risk factors (gestational diabetes, induction of labour, vacuum extraction) increased and was significantly higher for each of these factors during the post‐training period (p < 0.001). The incidence of SD also increased significantly (0.01% vs 0.3%, p < 0.001) during the study period, but the number of children with permanent BPBI decreased by 55% after the implementation of systematic simulation training (0.05% vs 0.02%, p < 0.001). The most significant change in the management of SD was the increased incidence of successful delivery of the posterior arm.

Conclusions

Systematic simulation‐based training of midwives and doctors can translate into improved individual and team performance and can significantly reduce the incidence of permanent BPBI.
Knowledge structure of emergy theory in the field of eco‐compensation research: A grounded theory approach
Authors: Xu Xiumei , Tan Yilan , Feng Chao
Published: August 2022

Although emergy theory has made progress in the field of eco‐compensation research, there is still a lack of review articles, summarizing the existing knowledge structure in this area of study. Accordingly, the objective of this paper is to provide a reference for researchers by characterizing the current status of emergy theory in the field of eco‐compensation and to establish the internal logic structure among existing studies, based upon a qualitative analysis of textual data. Inspired by the grounded theory, twelve concepts within five categories of emergy theory were extracted by open, axial, and selective coding of relevant literature. Concepts were extracted from the texts and categories were determined according to the inherent logical relationships among those concepts. The “knowledge structure model of emergy theory in the field of eco‐compensation” was constructed and the following five principal categories were identified: “emergy indicators system,” the “integration of methods and theories,” “research subjects,” “calculation of compensation standards,” and “research concerns.” Moreover, core and supporting genera were also identified from these five axial codes. Finally, the research focuses and hotspots were explored according to the theoretical frameworks as indicated by the core and supporting genera. The findings of this paper provide a reference for researchers to further promote innovation in the application of emergy theory in the field of eco‐compensation.
Analgesic benefits of the quadratus lumborum block in total hip arthroplasty: a systematic review and meta‐analysis
Authors: Hussain N. , Brull R. , Speer J. , Hu L.‐Q. , Sawyer T. , McCartney C. J. L. , Abdallah F. W.
Published: August 2022

The quadratus lumborum block (QLB) is reported to reduce pain and improve function following total hip arthroplasty; however, randomised controlled trials evaluating the benefits of adding this block to general or spinal anaesthesia in this population are conflicting. We performed a systematic review seeking randomised controlled trials investigating QLB benefits for total hip arthroplasty, stratifying comparisons regarding the addition of QLB to either general or spinal anaesthesia. The primary outcome was 24‐h area under the curve (AUC) pain score. Pain scores were interpreted in the context of a population‐specific minimal clinically important difference of 1.86 cm on a 10‐cm visual analogue scale, or an AUC pain score of 5.58 cm.h. Secondary outcomes included analgesic consumption, functional recovery and opioid‐related side‐effects. In all, 18 trials (1318 patients) were included. Adding QLB to general or spinal anaesthesia improved 24‐h AUC rest pain scores by a mean difference (95%CI) of −3.56 cm.h (−6.70 to −0.42; p = 0.034) and − 4.19 cm.h (−7.20 to −1.18; p = 0.014), respectively. These improvements failed to reach the pre‐determined minimal clinically important difference, as did the reduction in analgesic consumption. Quadratus lumborum block improved functional recovery for general, but not spinal, anaesthesia. Opioid‐related side‐effects were reduced with QLB regardless of anaesthetic modality. Low‐to‐moderate quality evidence suggests that the extent to which adding QLB to either general or spinal anaesthesia reduces postoperative pain and opioid consumption after total hip arthroplasty is statistically significant but may be clinically unimportant for most patients. However, adding QLB to general anaesthesia might enhance functional recovery. Taken together, our findings do not support the routine use of QLB as part of multimodal analgesic regimens for total hip arthroplasty.
The course of acute pancreatitis in children and potential simple laboratory markers of severity – A single Centre retrospective study
Authors: Kwiatek‐Średzińska Kamila , Kiryłowska Martyna , Uścinowicz Mirosława , Daniluk Urszula , Lebensztejn Dariusz
Published: August 2022

Aim

To evaluate the usefulness of routinely measured biochemical and complete blood count parameters as potential markers of the severity of paediatric acute pancreatitis (AP).

Methods

The retrospective study included children with AP hospitalised over a 3 years period. Demographic, clinical and laboratory data were collected.

Results

In total, 55 patients were enrolled in the study. Mild AP was diagnosed in 45 children (82%), moderately severe in 7 (13%), and severe in 3 patients (5%). Together 10 children (18%) were categorised into a single severe group. Children with severe AP had higher white blood cell and platelet counts on admission as well as a C‐reactive protein (CRP) concentration after 48 h. The CRP concentration after 48 h (cut‐off: 127.2 mg/L) and the white blood cell count on admission (cut‐off: 13.5x103/μl) were found to be statistically significant markers in predicting the severity of the disease. The CRP concentration after 48 h was demonstrated as an independent predictor.

Conclusion

Severe AP is observed in a quite significant percentage of children. The white blood cell count on admission and the CRP concentration after 48 h (as an independent predictor) may be potential simple laboratory markers of the severity of the disease.
Impact of similarity on recognition of faces of Black and White targets
Authors: Kawakami Kerry , Vingilis‐Jaremko Larissa , Friesen Justin P. , Meyers Chanel , Fang Xia
Published: August 2022

One reason for the persistence of racial inequality may be anticipated dissimilarity with racial outgroups. In the present research, we explored the impact of perceived similarity with White and Black targets on facial identity recognition accuracy. In two studies, participants first completed an ostensible personality survey. Next, in a Learning Phase, Black and White faces were presented on one of three background colours. Participants were led to believe that these colours indicated similarities between them and the target person in the image. Specifically, they were informed that the background colours were associated with the extent to which responses by the target person on the personality survey and their own responses overlapped. In actual fact, faces were randomly assigned to colour. In both studies, non‐Black participants (Experiment 1) and White participants (Experiment 2) showed better recognition of White than Black faces. More importantly in the present context, a positive linear effect of similarity was found in both studies, with better recognition of increasingly similar Black and White targets. The independent effects for race of target and similarity, with no interaction, indicated that participants responded to Black and White faces according to category membership as well as on an interpersonal level related to similarity with specific targets. Together these findings suggest that while perceived similarity may enhance identity recognition accuracy for Black and White faces, it may not reduce differences in facial memory for these racial categories.
Of Course it's Political! A Critical Inquiry into Underemphasized Dimensions in Civic Text Visualization
Authors: Baumer Eric P. S. , Jasim Mahmood , Sarvghad Ali , Mahyar Narges
Published: August 2022

Recent developments in critical information visualization have brought the field's attention to political, feminist, ethical, and rhetorical aspects of data visualization. However, less work has explored the interplay between design decisions and political ramifications—structures of authority, means of representation, etc. In this paper, we build upon these critical perspectives and highlight the political aspect of civic text visualization especially in the context of democratic decision‐making. Based on a critical analysis of survey papers about text visualization in general, followed by a review on the status quo of text visualization in civics, we argue that civic text visualization inherits an exclusively analytic framing. This framing leads to a series of issues and challenges in the fundamentally political context of civics, such as misinterpretation of data, missing minority voices, and excluding the public from decision making processes. To span this gap between political context and analytic framing, we provide a series of two‐pole conceptual dimensions, such as from singular user to multiple relationships, and from complexity to inclusivity of visualization design. For each dimension, we discuss how the tensions between these poles can help surface the political ramifications of design decisions in civic text visualization. These dimensions can thus help visualization researchers, designers, and practitioners attend more intentionally to these political aspects and inspire their design choices. We conclude by suggesting that these dimensions may be useful for visualization design across a variety of application domains, beyond civic text visualization.
Competition and health‐care spending: Theory and application to Certificate of Need laws
Authors: Bailey James , Hamami Tom
Published: August 2022

Hospitals and other health‐care providers in 34 states must obtain a Certificate of Need (CON) from a state board before opening or expanding, leading to reduced competition. We develop a theoretical model of how market concentration affects health‐care spending. Our theoretical model shows that increases in concentration, such as those brought about by CON, can either increase or decrease spending. Our model predicts that CON is more likely to increase spending in markets in which costs are low and patients are sicker. We test our model using spending data from the Household Component of the Medical Expenditure Panel Survey (MEPS).
Training, Recruitment, and Outplacement as Endogenous Adverse Selection
Authors: Bar‐Isaac Heski , Leaver Clare
Published: August 2022

This paper presents a model of a competitive labour market where workers vary in firm‐specific and general skills, and firms choose the kind of information to disclose. We show that provision of general training, recruitment, and outplacement are linked. Disclosing general human capital information on bad matches but revealing nothing about good matches (information disclosure that resembles outplacement support in professional service firms) leads to an efficient allocation of workers and creates adverse selection that enables workers to pay for general training. It also implies that wages of released workers can be higher than wages of those who are retained.
Borderline personality features among individuals at clinical high risk for psychosis (CHR‐P): A brief report
Authors: West Michelle L. , Guest Ryan M. , Carmel Adam , Madigan Ryan , Yen Shirley
Published: August 2022

Aim

This exploratory study reports on borderline symptomatology within a sample of individuals at clinical high risk for psychosis (CHR‐P) through a validated, self‐report instrument, the short version of the Borderline Symptom List (BSL‐23).

Methods

The sample consisted of 44 help‐seeking CHR‐P youth (ages 14–29 years) who completed an initial evaluation at a specialized clinic for psychosis‐risk.

Results

The mean BSL‐23 score was 1.5 (SD = 1.0, range 0.1–4.0). Higher scores were strongly associated with greater reported depressive symptoms (r = 0.84, p < 0.001). Additionally, borderline symptoms associated with attenuated positive symptoms (r = 0.32, p = 0.034) and social anxiety (r = 0.34, p = 0.027). Borderline symptomatology was not associated with role or social functioning.

Conclusions

This study is one of the first examinations of borderline symptomatology within a CHR‐P sample through a validated self‐report measure. Future research replicating these results is required to determine their robustness.
Clonal haematopoiesis of indeterminate potential and impaired kidney function—A Danish general population study with 11 years follow‐up
Authors: Larsen Morten K. , Skov Vibe , Kjær Lasse , Møller‐Palacino Natascha A. , Pedersen Rasmus K. , Andersen Morten , Ottesen Johnny T. , Cordua Sabrina , Poulsen Henrik E. , Dahl Morten , Knudsen Trine A. , Eickhardt‐Dalbøge Christina Schjellerup , Koschmieder Steffen , Pedersen Kasper M. , Çolak Yunus , Bojesen Stig E. , Nordestgaard Børge G. , Stiehl Thomas , Hasselbalch Hans C. , Ellervik Christina
Published: August 2022

The myeloproliferative neoplasms are associated with chronic kidney disease but whether clonal haematopoiesis of indeterminate potential (CHIP) is associated with impaired kidney function is unknown. In the Danish General Suburban Population Study (N = 19 958) from 2010 to 2013, 645 individuals were positive for JAK2V617F (N = 613) or CALR (N = 32) mutations. Mutation‐positive individuals without haematological malignancy were defined as having CHIP (N = 629). We used multiple and inverse probability weighted (IPW)‐adjusted linear regression analysis to estimate adjusted mean (95% confidence interval) differences in estimated glomerular filtration rate (eGFR; ml/min/1.73 m2) by mutation status, variant allele frequency (VAF%), blood cell counts, and neutrophil‐to‐lymphocyte ratio (NLR). We performed 11‐year longitudinal follow‐up of eGFR in all individuals. Compared to CHIP‐negative individuals, the mean differences in eGFR were −5.6 (−10.3, −0.8, p = .02) for CALR, −11.9 (−21.4, −2.4, p = 0.01) for CALR type 2, and −10.1 (−18.1, −2.2, p = .01) for CALR with VAF ≥ 1%. The IPW‐adjusted linear regression analyses showed similar results. NLR was negatively associated with eGFR. Individuals with CALR type 2 had a worse 11‐year longitudinal follow‐up on eGFR compared to CHIP‐negative individuals (p = .004). In conclusion, individuals with CALR mutations, especially CALR type 2, had impaired kidney function compared to CHIP‐negative individuals as measured by a lower eGFR at baseline and during 11‐year follow‐up.
A method for introducing mode II dissipation energy into mixed fracture analyses
Authors: Blanco Sergio
Published: August 2022

This paper presents a methodology to consider the mode II fracture energy density in those analyses in which the phenomenon of mixed fracture occurs. The method consists of using a fracture energy density calculated as the weighted average of the fracture energy densities in mode I and mode II, the weighting factors being the relative importance of the mode I and II deformations with respect to the total deformation. This methodology has been implemented in local damage models using the smeared crack approximation but can be implemented in more complex models such as nonlocal damage models. Since there is no specific experimental test to measure the mode II fracture energy density, this method allows this parameter to be measured indirectly by adjusting its value so that the numerical equilibrium curve matches the experimental results.
Real‐time measurement of welding residual stress relaxation based on strain‐controlled fatigue test
Authors: Zhang Chunguo , Luan Shuai
Published: August 2022

Fatigue‐induced variation of residual stress (RS) in welded joints is inevitable and has significant influence on fatigue behavior. The widely used technologies (e.g., X‐ray diffraction) can only test surface RS of specimen at unloading or certain holding load condition. In this study, an approach of measuring equivalent RS in real time during fatigue cycling is proposed based on strain‐controlled fatigue with strain ratio of −1. Under applied waveform starting with tensile strain, tensile RS in a welded joint continuously relaxes with fatigue cycles, but compressive RS first increases then relaxes. Both tensile and compressive RSs rapidly change in the first few cycles and then gradually relax to a steady state in which accumulated plastic strain is linearly correlated to amount of RS relaxation during fatigue cycling.
In hot water? Patterns of macroinvertebrate abundance in Arctic thaw ponds and relationships with environmental variables
Authors: Gurney Kirsty E. B. , Koch Joshua C. , Schmutz Joel A. , Schmidt Joshua H. , Wipfli Mark S.
Published: August 2022

Ongoing environmental change across the Arctic is affecting many freshwater ecosystems, including small thaw ponds that support macroinvertebrates, thus potentially affecting important forage for fish and bird species. To accurately predict how fish and wildlife that depend on these macroinvertebrates will be affected by ecosystem change at high latitudes, understanding proximate factors that influence macroinvertebrate abundance is critical.

To better understand factors that affect spatial and seasonal (i.e. phenology) patterns in abundance, we collected macroinvertebrates throughout the growing season of a single year from 33 thaw ponds on the Arctic Coastal Plain in northern Alaska. We used hierarchical N‐mixture models to provide detection‐corrected estimates of abundance (of the population exposed to sampling) in relation to pond type and seasonal patterns in environmental variables (i.e., cumulative water temperature, nutrient levels) for five taxonomic groups representing key food items for birds and fish—Anostraca (Arthropoda: Branchiopoda), Chironomidae (Insecta: Diptera), Cladocera (Arthropoda: Branchiopoda), Limnephilidae (Insecta: Trichoptera), and Physidae (Mollusca: Gastropoda).

For three of five taxa (Anostraca, Cladocera, Limnephilidae), abundance varied across pond types and was lower in pond types where water temperatures increased more rapidly. Further, seasonal temperature profiles in ponds affected phenology, suggesting that seasonal patterns in abundance were influenced by changes in water temperature.

These findings suggest that increases in water temperature in northern areas could alter macroinvertebrate phenology, possibly with consequences for upper level predators if availability of macroinvertebrate prey is reduced or shifted seasonally. Our results will facilitate improved predictions of how changing abiotic conditions could affect inland waters in northern areas, a critical need for conservation of Arctic wildlife and ecosystems.
Spatiotemporal influences of climate and humans on muskox range dynamics over multiple millennia
Authors: Canteri Elisabetta , Brown Stuart C. , Schmidt Niels Martin , Heller Rasmus , Nogués‐Bravo David , Fordham Damien A.
Published: August 2022

Processes leading to range contractions and population declines of Arctic megafauna during the late Pleistocene and early Holocene are uncertain, with intense debate on the roles of human hunting, climatic change, and their synergy. Obstacles to a resolution have included an overreliance on correlative rather than process‐explicit approaches for inferring drivers of distributional and demographic change. Here, we disentangle the ecological mechanisms and threats that were integral in the decline and extinction of the muskox (Ovibos moschatus) in Eurasia and in its expansion in North America using process‐explicit macroecological models. The approach integrates modern and fossil occurrence records, ancient DNA, spatiotemporal reconstructions of past climatic change, species‐specific population ecology, and the growth and spread of anatomically modern humans. We show that accurately reconstructing inferences of past demographic changes for muskox over the last 21,000 years require high dispersal abilities, large maximum densities, and a small Allee effect. Analyses of validated process‐explicit projections indicate that climatic change was the primary driver of muskox distribution shifts and demographic changes across its previously extensive (circumpolar) range, with populations responding negatively to rapid warming events. Regional analyses show that the range collapse and extinction of the muskox in Europe (~13,000 years ago) was likely caused by humans operating in synergy with climatic warming. In Canada and Greenland, climatic change and human activities probably combined to drive recent population sizes. The impact of past climatic change on the range and extinction dynamics of muskox during the Pleistocene–Holocene transition signals a vulnerability of this species to future increased warming. By better establishing the ecological processes that shaped the distribution of the muskox through space and time, we show that process‐explicit macroecological models have important applications for the future conservation and management of this iconic species in a warming Arctic.
Temperature and not landscape composition shapes wild bee communities in an urban environment
Authors: Geppert Costanza , Cappellari Andree , Corcos Daria , Caruso Valerio , Cerretti Pierfilippo , Mei Maurizio , Marini Lorenzo
Published: August 2022

More than half of the world's population lives in urban areas, a proportion that is expected to increase. Even if urbanisation is widely regarded as a major threat to global biodiversity, recent research highlighted the potential ecological importance of cities for pollinators. Key determinants of cities' ability to sustain pollinators are the presence of green areas and the connectivity between them. However, also temperature is expected to be of primary importance for pollinator activities.

Here, we aimed at disentangling the effects of temperature, open habitat cover, and distance from the city centre on wild bee communities in the city of Rome (Italy). We selected 36 sites along two statistically independent gradients of temperature and open habitat cover, and we sampled wild bee communities using pan‐traps for 4 months. Then, we measured functional traits of wild bee species, that is, body size, social behaviour, nesting strategy, and diet breadth.

Temperature emerged as the main driver of wild bee communities, with communities richer in species and individuals at warmer temperatures. We found little species replacement between cold and warm sites. In addition, with increasing temperatures, bee communities were dominated by polylectic and small‐bodied species.

Here, we showed that in a highly urbanised environment, temperature shapes pollinator communities irrespective of other landscape metrics. Even if warming seemed beneficial for urban pollinator abundance and richness, it might strongly homogenise bee communities by selecting for those traits that make species more easily adaptable.
High‐resolution HLA class II sequencing of Swedish multiple sclerosis patients
Authors: Akel Omar , Zhao Lue Ping , Geraghty Daniel E , Lind Alexander
Published: August 2022

Multiple sclerosis (MS) is a chronic neurological disease believed to be caused by autoimmune pathogenesis. The aetiology is likely explained by a complex interplay between inherited and environmental factors. Genetic investigations into MS have been conducted for over 50 years, yielding >100 associations to date. Globally, the strongest linkage is with the human leukocyte antigen (HLA) HLA‐DRB5*01:01:01‐DRB1*15:01:01‐DQA1*01:02:01‐DQB1*06:02:01 haplotype.

Here, high‐resolution sequencing of HLA was used to determine the alleles of DRB3, DRB4, DRB5, DRB1, DQA1, DQB1, DPA1 and DPB1 as well as their extended haplotypes and genotypes in 100 Swedish MS patients. Results were compared to 636 population controls.

The heterogeneity in HLA associations with MS was demonstrated; among 100 patients, 69 extended HLA‐DR‐DQ genotypes were found. Three extended HLA‐DR‐DQ genotypes were found to be correlated to MS; HLA‐DRB5*01:01:01‐DRB1*15:01:01‐DQA1*01:02:01‐DQB1*06:02:01 haplotype together with

(A) HLA‐DRB4*01:01:01//DRB4*01:01:01:01‐DRB1*07:01:01‐DQA1*02:01//02:01:01‐DQB1*02:02:01,

(B) HLA‐DRBX*null‐DRB1*08:01:01‐DQA1*04:01:01‐DQB1*04:02:01, and

(C) HLA‐DRB3*01:01:02‐DRB1*03:01:01‐DQA1*05:01:01‐DQB1*02:01:01.

At the allelic level, HLA‐DRB3*01:01:02 was considered protective against MS. However, when combined with HLA‐DRB3*01:01:02‐DRB1*03:01:01‐DQA1*05:01:01‐DQB1*02:01:01, this extended haplotype was considered a predisposing risk factor. This highlights the limitations as included with investigations of single alleles relative to those of extended haplotypes/genotypes.

In conclusion, with 69 genotypes presented among 100 patients, high‐resolution sequencing was conducted to underscore the wide polymorphisms present among MS patients. Additional studies in larger cohorts will be of importance to define MS among the patient group not associated with HLA‐DRB5*01:01:01‐DRB1*15:01:01‐DQA1*01:02:01‐DQB1*06:02:01.
Issues commonly faced by nurses caring for international patients: A qualitative study
Authors: Kume Ayami , Lau Yukiko , Kume Miyoko
Published: August 2022

Aim

To identify common challenges nurses face when caring for international patients, irrespective of specialty, medical facility, or nursing experience.

Background

Internationalization in medical facilities is progressing worldwide, and the number of international patients is increasing, as is evident in Japan.

Introduction

Delivering high‐quality nursing care to international patients can be challenging owing to language and socio‐cultural barriers. Research examining the challenges faced by nurses in these situations is limited. It is necessary to clarify and analyze the current situation when interacting with international patients.

Methods

This study employed a qualitative design. Semistructured interviews were conducted with 11 registered nurses experienced in caring for non‐Japanese patients. Qualitative content analysis was performed following Mayring's approach.

Results

We identified 56 subcategories, 23 categories, and 8 core categories for challenges faced by nurses interacting with international patients: language, religion or culture, medical culture, financial status, treatment continuity, care support, hospital protocols, and addressing requests or requirements for international patients.

Discussion

This study analyzed the religious, lifestyle, and cultural differences (along with the various language and communication barriers) faced by nurses who treat international patients. It also discussed the need for accessible, cross‐cultural information in hospitals that have limited accommodations for international patients.

Conclusion

Nurses could be more accommodating of patients’ religions, lifestyles, and cultures by familiarizing themselves with relevant background information beforehand.

Implications for nursing policy

Differences in health care cultures across countries can lead to malpractice, as dealing with cultural differences is difficult for nurses who interact with international patients and they may not be fully informed about the challenges posed by such differences. It is important for nurses to share their experiences in dealing with international patients and prepare for the increasing number of international patients in the future.
The subtle tine: Asymptomatic Micra perforation incidentally discovered during cardiac surgery
Authors: Tan Nicholas Y. , Madhavan Malini , Greason Kevin L. , Cha Yong‐Mei
Published: August 2022

A 70‐year‐old woman with longstanding persistent atrial fibrillation underwent Micra leadless pacemaker implantation and atrioventricular nodal ablation. No postprocedural complications were noted. She subsequently underwent surgical mitral valve replacement 4 years later. During the surgery, Micra tine perforation of the right ventricular free wall was seen. No device revision was performed due to her asymptomatic status and stable pacemaker position/function. Pericardial effusion is a known complication of Micra implantation. The incidence of tine perforation is unknown as many patients may be asymptomatic. The clinical consequences regarding adverse events, device functionality, and explantation/extraction risk profile remain to be determined.
Systolic blood pressure and recurrent stroke in patients with different lesion patterns on diffusion weighted imaging
Authors: Chen Pan , Wu Qiong , Xie Xuewei , Jing Jing , Gu Hongqiu , Wang Xianwei , Meng Xia , Liu Liping , Wang Yilong , Wang Yongjun ,   the CHANCE Investigators
Published: August 2022

Little is known about the relationship between baseline systolic blood pressure (SBP) and subsequent clinical events in patients with different lesion patterns on diffusion weighted imaging (DWI). We analyzed the Acute Non‐disabling Cerebrovascular Events (CHANCE) trial dataset. Patients were categorized into negative DW imaging (no detectable lesions), lacunar infarction (single lesion ≤15 mm) and non‐lacunar infarction (single lesion >15 mm or multiple lesions) based on lesion patterns on DWI. The primary outcome was recurrent stroke within 90 days. Cox proportional hazards models were used to assess the association between SBP levels and stroke outcomes in patients with different lesion patterns. A total of 1089 patients were analyzed. We found 258 cases (23.7%) with negative DW imaging, 392 (36.0%) with lacunar infarction and 439 (40.3%) with non‐lacunar infarction. Patients with non‐lacunar infarction had the highest incidence of stroke at 90‐day (P < .001). In non‐lacunar infarction group, compared with SBP < 160 mmHg, patients with SBP ≥ 160 mmHg had significantly higher risk of 90‐day recurrent stroke (20.3% vs. 10.7%; adjusted hazard ratio 1.81, 95% confidence interval 1.09–3.00). No significant association was found between SBP and clinical outcomes in patients with negative DWI and lacunar stroke groups. The result at 1 year was similar as at 90‐day. Therefore, non‐lacunar infarction, the most common lesion pattern in CHANCE study, had the highest risk of recurrent stroke and combined vascular events both in 90 days and 1 year. High baseline SBP was significantly associated with increased risk of short‐ and long‐term recurrent strokes in patients with non‐lacunar infarction.
Feeling the heat? Fear of failure and performance
Authors: Chong Alberto , Chong Marco Z.
Published: August 2022

We use new individual‐level data from MasterChef, a television show in the United States in order to objectively capture situations of fear of failure. We codify situations in which the contestants are on the verge of being eliminated from competition and situations where they explicitly express fear of failing. These new data have the distinct advantage of being purely objective. We cover ten seasons, from 2010 to 2020 and include nearly 200 observations to study the role of fear of failure on performance. Using ordinary least squares, we show that extreme fear of failure is associated with an increase of two to four positions in the final placement of the cooking competition. This positive link between fear of failure and performance tends to contradict the conventional wisdom in both psychology and behavioral economics that such a link tends to be negative. Our findings are robust to broad changes in specification.
Disrupting language of instruction policy at a classroom level: oracy examples from South Africa and Zambia
Authors: Chamberlain Liz , Rodriguez‐Leon Lucy , Woodward Clare
Published: August 2022

Education policy in the Global South often focuses on two areas: learner‐centred education (LCE) and language of instruction (LoI). For over a decade, LCE has been promoted throughout sub‐Saharan Africa and has been referred to as a ‘policy panacea’. The basic premise of LCE is that it offers learners substantial control over what and how they learn through active engagement. Pair and group work involving talk are key aspects of LCE; however, in contexts where teachers and students are not proficient in the official LoI, the efficacy of this pedagogic approach is brought into question. Drawing on vignettes based on observational data of early years and primary classroom practice in South Africa and Zambia, this paper offers a discursive exploration of how valuing oracy and legitimising multilingualism alter classroom dynamics and interactions between teachers and children. Encouraging translanguaging as a pedagogical approach enables more effective meaning‐making through talk and supports pedagogic shifts to more learner‐centred classrooms. Exploring the potential of professional development to inspire change, we critically draw out some of the observable shifts in practice, alongside the challenges, for practitioners moving to a more multilingual classroom whilst simultaneously operating within the LoI policy.
Genomics reveal population structure, evolutionary history, and signatures of selection in the northern bottlenose whale, Hyperoodon ampullatus
Authors: de Greef Evelien , Einfeldt Anthony L. , Miller Patrick J. O. , Ferguson Steven H. , Garroway Colin J. , Lefort Kyle J. , Paterson Ian G. , Bentzen Paul , Feyrer Laura J.
Published: August 2022

Information on wildlife population structure, demographic history, and adaptations are fundamental to understanding species evolution and informing conservation strategies. To study this ecological context for a cetacean of conservation concern, we conducted the first genomic assessment of the northern bottlenose whale, Hyperoodon ampullatus, using whole‐genome resequencing data (n = 37) from five regions across the North Atlantic Ocean. We found a range‐wide pattern of isolation‐by‐distance with a genetic subdivision distinguishing three subgroups: the Scotian Shelf, western North Atlantic, and Jan Mayen regions. Signals of elevated levels of inbreeding in the Endangered Scotian Shelf population indicate this population may be more vulnerable than the other two subgroups. In addition to signatures of inbreeding, evidence of local adaptation in the Scotian Shelf was detected across the genome. We found a long‐term decline in effective population size for the species, which poses risks to their genetic diversity and may be exacerbated by the isolating effects of population subdivision. Protecting important habitat and migratory corridors should be prioritized to rebuild population sizes that were diminished by commercial whaling, strengthen gene flow, and ensure animals can move across regions in response to environmental changes.
Cultural historical activity and the complexity of health professions education
Authors: Gladman Tehmina , Grainger Rebecca
Published: August 2022

Commenting on Hu et al., Grainger and Gladman comment on how the purpose of student‐led community learning can change focus from the development of technical and professional skills to the aspirations and goals of the community in which students work.
Subjective and objective analysis of orthodontic expert consensus on the assessment of orthodontic treatment outcomes
Authors: Chen Huanhuan , Song Guangying , Li Weiran , Jiang Ruoping , Zhang Xiaoyun , Chen Si , Chen Gui , Liu Siqi , Dai Fanfan , Teng Fei , Han Bing , Xu Tianmin
Published: August 2022

Objective

The objective of the study was to explore and validate the consensus of orthodontic experts on the assessment of orthodontic treatment outcomes based on subjective and objective analysis.

Materials and Methods

The research consisted of two parts: the exploration and verification of expert consensus. First, a sample of 108 cases randomly selected from six dental schools in China were evaluated by 69 orthodontic experts and measured by researchers based on post‐treatment study casts and lateral cephalograms, respectively. Then, through statistical analysis, the objective indicators significantly correlated with experts' subjective evaluations were selected, their weights were determined, and the critical values of satisfactory, acceptable and unacceptable grades were screened. Subsequently, another sample of 72 cases were evaluated by another 36 orthodontic experts, and the subjective evaluation results were compared with the objective measurement results.

Results

There were six model indicators and seven cephalometric indicators being significantly correlated with the experts' subjective evaluations, including occlusal contact, overjet, midline, interproximal contact, alignment, occlusal relationship, L1/NB, ANB, SN/OP, U1/SN, LL‐EP, Cm‐Sn‐UL and Ns‐Prn‐Pos, with a cumulative R2 of 0.704. In the verification part, the correlation coefficient between the 36 experts' subjective scores and objective regression scores was 0.716 (P < .001); the correlation coefficient between the 36 experts' subjective grades and objective grades was 0.757 (P < .001).

Conclusions

Orthodontic experts had good consistency in the subjective evaluation of the combined records of post‐treatment study casts and lateral cephalograms. The objective indicators selected from subjective and objective analysis had good reliability and validity and could further improve the existing occlusal indices.
Clinical Results of Utilizing the Satellite Rod Technique in Treating Ankylosing Spondylitis Kyphosis
Authors: Liu Chao , Hu Fanqi , Hu Wenhao , Zhang Zhen , Zheng Guoquan , Song Kai , Li Fangcai , Zhang Xuesong
Published: August 2022

Objective

According to the literature, there are no clinical reports documenting the use of the satellite rod technique in the treatment of ankylosing spondylitis kyphosis. The purpose of this retrospective study was to compare the clinical outcome of patients with ankylosing spondylitis kyphosis who adopted satellite rods versus those who did not.

Methods

Patients with ankylosing spondylitis kyphosis who underwent one or two‐level pedicle subtraction osteotomy (PSO) were reviewed, and total of 119 patients (112 males and seven females, average age 39.89 ± 6.61 years) were eligible and included in this present study. Anterior–posterior and lateral full‐length spine X‐ray films were performed preoperatively and at the two‐year follow‐up visit. Global kyphosis (GK), lumbar lordosis (LL), thoracolumbar kyphosis (TLK), thoracic kyphosis (TK), and osteotomy angle (OA) were measured. The complications of every group of patients were collected. Pre‐ and postoperative health‐related quality of life instruments, including the Bath Ankylosing Spondylitis Functional Index (Basfi) and Scoliosis Research Society outcomes instrument‐22 (SRS‐22), were recorded. The patients were divided into three groups based on features of their osteotomy including PSO levels and whether the satellite rod technique was applied. Patients who underwent one‐level PSO without the satellite rod technique were categorized in the one‐level group. Patients who underwent one‐level PSO with the satellite rod technique were classified in the satellite rod group. Patients who underwent two‐level PSO without the satellite rod technique were included in the two‐level group. The paired sample t test was used to compare pre‐ and postoperative parameters. One‐way ANOVA was performed for multiple group comparisons.

Results

The average follow‐up time is 29.31 ± 3.66 months. The patients' GK were significantly improved from 46.84 ± 20.37 degree to 3.31 ± 15.09 degree. OS achieved through each osteotomy segment of one‐level group (39.78 ± 12.29 degree) and satellite rods group (42.23 ± 9.82 degree), was larger than that of two‐level group (34.73 ± 7.54 and 28.85 ± 7.26 degree). There was no significant difference between the one‐level group and the satellite rod group in achieving the OS. Thirteen patients experienced different complications (10.92%). Three patients experienced rod fracture in the one‐level group. There was no rod fracture or screw failure in the satellite rod group or the two‐level group.

Conclusion

The satellite rod technique is also recommended for patients who undergo PSO osteotomy to correct ankylosing spondylitis kyphosis deformities.
Using eye movement desensitisation and reprocessing (EMDR) with autistic individuals: A qualitative interview study with EMDR therapists
Authors: Fisher Naomi , Patel Henna , van Diest Caroline , Spain Debbie
Published: August 2022

Objectives

Eye Movement Desensitisation and Reprocessing (EMDR) is an evidence‐based psychological therapy that targets distress associated with trauma and affective disturbance. Few studies have examined EMDR for autistic individuals who have co‐occurring mental health conditions, but there is preliminary evidence of effectiveness. The current study explored EMDR therapists' experiences of working with autistic individuals, and adaptations incorporated into clinical practice to make this more accessible and effective.

Design

A qualitative interview design was used. Data were thematically analysed.

Method

Twenty‐three UK‐based EMDR therapists attended one‐off semi‐structured qualitative interviews.

Results

Four main themes emerged: (1) the experience of being autistic; (2) factors around accessing EMDR; (3) adapting EMDR; and (4) supervision and support for EMDR therapists. Participants described offering a nuanced and tailored approach; one that retained the integral components of the eight phases of EMDR, while also being flexible and responsive to each client.

Conclusions

Findings reinforce the importance of offering formulation‐based psychological therapy that flexes in an evidence‐informed way, according to the preferences and needs of autistic individuals. Further research should establish factors influencing accessibility and effectiveness of EMDR for autistic individuals, and the impact of autism‐relevant training on the knowledge, skills and confidence of EMDR therapists and clinical supervisors working with this client group.
A survey of stochastic inventory models with fixed costs: Optimality of (s, S) and (s, S)‐type policies—Continuous‐time case
Authors: Perera Sandun C. , Sethi Suresh P.
Published: August 2022

Fixed costs of ordering items or setting up a production process arise in many real‐life scenarios. In their presence, the most widely used ordering policy in the stochastic inventory literature is the [Formula: see text] policy. Optimality of [Formula: see text] policies and [Formula: see text]‐type policies have been examined for various inventory models, including those with the inventory level being reviewed in every period or continuously, finite and infinite horizons, discounted‐cost and average‐cost criteria, backlogging and lost‐sales practices, standard and generalized demands and/or costs, deterministic and stochastic lead times, single‐product and multi‐product settings, and coordinated pricing‐inventory decisions. We comprehensively survey the vast literature accumulated over seven decades in two papers. This paper is devoted to continuous‐time models, and the companion paper, also published in this journal issue, reviews discrete‐time models. We go over model specifications, proof techniques, specific results, and limitations of the articles published in the literature. We conclude each paper by providing corresponding suggestions for extensions and directions for future research.