bluuebunny/crossref_metadata_2025 huggingface dataset:
Observed Versus Predicted Vaginal Birth After Cesarean for Patients of a Community Health Center
Authors: Ledbetter Ann , Wandtke Herrmann Tracy , Lupa Karen , Graupe Menachem
Published: September 2024

Introduction

The Maternal‐Fetal Medicine Units Network calculator for vaginal birth after cesarean (VBAC) probability was updated to exclude a race and ethnicity variable, but its impact on marginalized groups is unknown. We assessed the tool with attention to birth history and body mass index (BMI) in a predominately Hispanic cohort and examined the possible effect of discouraging labor after cesarean (LAC) with a low score.

Methods

We conducted a retrospective cohort study of LACs by patients who entered spontaneous or induced labor with a live, nonanomalous fetus in cephalic presentation between 2012 and 2022. Observed VBAC rates were compared with the mean predicted VBAC probability derived from the calculator. Areas under the curve (AUCs) were calculated for the entire cohort and for individuals with LAC with and without prior vaginal birth. A z‐test was used to determine the significance between VBAC rates in 4 BMI categories. The impact of discouraging LAC with VBAC probability below 70% was examined.

Results

A total of 400 people experienced 507 LACs, with 417 (82.2%) resulting in VBAC compared with a mean predicted probability of 71.2%. The AUC for all LACs was 0.76 (95% CI, 0.71‐0.81), whereas the AUC for LACs with prior vaginal birth was 0.70 (95% CI, 0.56‐0.85) and without was 0.60 (95% CI, 0.52‐0.67). Observed VBAC rates exceeded predicted rates for individuals with overweight and obese BMIs: <25 (79.6% vs 75.6%; P = .520), 25 to 30 (83.2% vs 71.9%; P = .007), 30 to 40 (82.7% vs 70.0%; P = .004), and ≥40 (82.8% vs 58.3%; P = .040). Discouraging LAC below 70% probability might have prevented 71 unsuccessful LACs, 160 initial VBACs, and 57 subsequent VBACs, decreasing the VBAC rate to 39.4% (200/507).

Discussion

In a predominately Hispanic cohort, the updated calculator underestimated VBAC potential for people with no vaginal birth history and/or an elevated BMI. Discouraging LAC based on low VBAC probability may prevent both initial and subsequent VBACs.
Safety of the Immediate Reconstitution of Poly‐l‐Lactic Acid for Facial and Body Treatment—A Multicenter Retrospective Study
Authors: Vasconcelos‐Berg Roberta , Real Julia , Wenz Franziska , Avelar Luiz Eduardo Toledo
Published: September 2024

Background

Poly‐l‐lactic acid (PLLA‐SCA; Sculptra) was approved in 1999 in Europe and 2004 in United States as a collagen biostimulator. It is a freeze‐dried preparation containing 150 mg PLLA‐SCA per vial and, since approval, has been recommended to be reconstituted 72 h before treatment, which can hinder its use in clinical practice. In 2021, the manufacturer authorized the reconstitution of PLLA‐SCA immediately before use.

Objective

To evaluate adverse events in patients treated with immediately reconstituted PLLA‐SCA on the face, body, and scars.

Method

This was a retrospective analysis of medical records of patients treated with immediately reconstituted PLLA‐SCA for aesthetic purposes from January 1, 2021, to December 31, 2021, at two medical centers.

Results

A total of 274 treatment sessions were conducted on 167 patients (ranging from 1 to 5 sessions per patient). Of these, 228 sessions (151 patients) targeted the face, 39 sessions (22 patients) addressed the body, and 7 sessions (5 patients) focused on scars. The mean final concentration of PLLA‐SCA was 15.30 mg/mL for the face, 8.35 mg/mL for the body, and 10.53 mg/mL for scars. The majority of injections were administered with a blunt cannula (face: 87.3%, body: 100%, scars: 57%), and in 6 out of 7 scar treatments, PLLA‐SCA was additionally applied topically after fractional treatment. One patient developed a PLLA‐SCA nodule 30 days after facial treatment, which resolved after two saline injections. The most common adverse events were bruising (face: 6.57%, body: 7.69%) and mild pain (face: 3.07%). No events required further intervention.

Conclusion

This study reports an adverse event profile with immediately reconstituted PLLA‐SCA, used on the face, body, and scars, similar to that reported with PLLA‐SCA reconstituted 72 h prior to use.

Trial Registration

This was a retrospective study of medical records at two medical centers, and trial registration was not required.
Nurses' acceptance of nursing information systems: A multi‐center cross‐sectional study in China
Authors: He Danni , Yao Jiani , Qi Wenhao , Cao Shihua , Chen Yanfei , Zhu Xiaohong , Lou Xiajing , Chen Xiaomin , Lin Xin , Feng Yaping , Fu Xiaoli , Ning Li , Wang Shuyuan , Liu Yan
Published: September 2024

Background

In China, nursing information systems (NIS) implementation can face numerous barriers to acceptance, including the attitudes of potential users. However, few studies have evaluated this acceptance.

Objective

The aim of this study was to explain the acceptance of NIS utilizing a survey based on unified theory of acceptance and use of technology.

Methods

A multi‐center cross‐sectional study utilizing an online survey was conducted. SPSS AMOS was used to conduct a structural equation modelling analysis. This research followed the STROBE Checklist.

Results

A total of 3973 Nurses participated in the study between January 2023 and March 2023. The acceptance of NIS among nurses was overall moderate to high. The proposed model has been rigorously tested and validated using empirical data, ensuring its credibility and dependability. Performance expectancy (PE), social influence (SI), and attitude significantly and positively affected intentions to use NIS. Effort expectancy (EE) did not show any significant effects in the sample. Facilitating conditions (FCs) was found to have a negative relationship with the intention to use NIS. There was a statistically significant difference BI between the different age groups, working years, and computer training experience. The model demonstrates a good fit with the observed data.

Conclusions

This study identified PE, SI, and attitude as facilitators of nurses' intentions to use NIS. The findings about EE indicates that the ease of using NIS does not seem to be a concern among nurses. Moreover, high FC might be perceived as indicative of a complex system or extensive usage, that can lead to increased workload and reduced behavioural intention (BI). The significant differences in BI among various demographic groups highlight the need for more studies understanding the preferences and barriers faced by different, levels of experience and training backgrounds.

Patient or Public Contribution

No patient or public contribution.
Dementia‐Friendly Hospital—The Perspective of Professional Dementia Experts
Authors: Manietta Christina , Purwins Daniel , Pinkert Christiane , Fink Lisa , Rommerskirch‐Manietta Mike , Feige Melanie , Knecht Christiane , Roes Martina
Published: September 2024

Aim

To investigate the professional dementia experts' understanding of a dementia‐friendly hospital to identify its characteristics.

Design

We used a qualitative design embedded in a case study. A total of 16 semi‐structured expert interviews were conducted with 17 professional dementia experts. Using inductive content analysis, the interviews were analysed in a participatory manner involving a group of researchers and dementia experts.

Results

We identified six characteristics of dementia‐friendly hospitals: Proud to be dementia‐friendly—That's what we want; Seeing the human being—Taking care of everyone; Having everyone on board—It's a collective task; Being professional—It takes more than being nice and kind; Rethinking the ‘running’ system—We have to change, not them; and Being part of the community—Thinking beyond the hospital.

Conclusion

The concept of a dementia‐friendly hospital seems complex and requires a rethinking of the traditional hospital. For a conceptualisation, the involvement of people with dementia and their relatives is important to gain a comprehensive understanding.

Implications for the Profession and Patient Care

A dementia‐friendly hospital is characterised by professional care that comprises a safe, familiar and supportive environment, is prepared but also flexible, has everyone on board, and sees the human being. To become dementia‐friendly, individual interventions such as training courses can be a starting point. However, an overall concept is required that also includes components that contribute to successful implementation and a welcoming culture of people with dementia.

Impact

Our findings on the perspective of professional dementia experts contribute to the conceptualisation of dementia‐friendly hospitals.

Reporting Method

We reported our study according to the COREQ checklist.

Patient and Public Contribution

The investigation of the perspective of professional dementia experts is one part of a larger study. In this overall DEMfriendlyHospital study, we interviewed professional dementia experts, people with dementia and their relatives and also involved them in a participatory manner in various stages of the research process.
Exploring the Experiences and Perceptions of the Utilisation of Structured Clinical Handover Frameworks by Nurses Working in Acute Care Settings: A Scoping Review
Authors: Moyo Patience , Anderson Judith , Francis Karen , Biles Jessica
Published: September 2024

Background

There is increased interest in implementing structured clinical handover frameworks to improve clinical handover processes. Research postulates that structured clinical handover frameworks increase the quality of handovers; yet inconsistencies enacting these frameworks exist which has a potential to jeopardise the quality of communication during handovers thereby defeating the purpose of these frameworks.

Aim

This scoping review aims to analyse and synthesise what is currently known of the nurses' experiences and perceptions in implementing structured clinical handover frameworks and identify knowledge gaps in relation to this topic area.

Design

A scoping review guided by the PRISMA‐ScR checklist.

Methods

A systematic search of five electronic databases was undertaken to identify peer‐reviewed primary research studies which met the predetermined eligibility criteria. In total, 301 studies were imported into COVIDENCE, screened and assessed for eligibility resulting in 23 studies remaining. From the eligible studies, data was extracted, collated, appraised, summarised and interpreted.

Data Sources

MEDLINE, CINHAL, ProQuest, EMCARE, Web of Science and Informit.

Results

Twenty three studies were included in this review which yielded the following major themes: (1) quality and completeness of information transfer; (2) interprofessional collaboration; (3) challenges impacting the experience of implementing the structured clinical handover frameworks and (4) perceived impacts on quality, patient safety and health outcomes.

Conclusion

There are key benefits and issues experienced and perceived by nurses implementing structured clinical handover frameworks and this review identifies opportunities for further improvements. Future research should explore the perceived associations with patient outcomes.

Relevance to Clinical Practice

This review highlights the importance of structured clinical handover frameworks, the nurses' experiences in implementing these frameworks and strategies to improve the effectiveness of these frameworks.

Patient or Public Contributions

No Patient or Public Contributions as this study is a review of published primary evidence.
Placental growth factor alleviates hyperglycemia‐induced trophoblast pyroptosis by regulating mitophagy
Authors: Tao Jun , Rao Yuzhu , Wang Jingjing , Tan Shiming , Zhao Jinli , Cao Zitong , He Lu , Meng Jun , Wu Peng , Wang Zuo
Published: September 2024

Introduction

Hyperglycemia is closely related to trophoblast dysfunction during pregnancy and results in suppressed invasion, migration, and pro‐inflammatory cell death of trophoblasts. Hyperglycemia is a dependent risk factor for gestational hypertension accompanied by decreased placental growth factor (PLGF), which is important for maternal and fetal development. However, there is currently a lack of evidence to support whether PLGF can alleviate trophoblast cell dysfunction caused by high blood sugar. Here, we aim to clarify the effect of hyperglycemia on trophoblast dysfunction and determine how PLGF affects this process.

Methods

The changes in placental tissue histomorphology from gestational diabetes mellitus (GDM) patients were compared with those of normal placentas. HTR8/SVneo cells were cultured in different amounts of glucose to examine cellular pyroptosis, migration, and invasion as well as PLGF levels. Furthermore, the levels of pyroptosis‐related proteins (NLRP3, pro‐caspase1, caspase1, IL‐1β, and Gasdermin D [GSDMD]) as well as autophagy‐related proteins (LC3‐II, Beclin1, and p62) were examined by Western blotting. The GFP‐mRFP‐LC3‐II system and transmission electron microscopy were used to detect mitophagy levels, and small interfering RNAs targeting BCL2 Interacting Protein 3 (siBNIP3) and PTEN‐induced kinase 1 (siPINK1) were used to determine the role of mitophagy in pyroptotic death of HTR‐8/SVneo cells.

Results

Our results show that hyperglycemia upregulates NLRP3, pro‐caspase1, caspase1, IL‐1β at the protein level in GDM patients. High glucose (HG, 25 mM) inhibits viability, invasion, and migration of trophoblast cells while suppressing superoxide dismutase levels and promoting malondialdehyde production, thus leading to a senescence associated beta‐gal‐positive cell burst. PLGF levels in nucleus and the cytosol are also inhibited by HG, whereas PLGF treatment inhibited pyroptosis‐related protein levels of NLRP3, pro‐caspase1, caspase1, IL‐1β, and GSDMD, Gasdermin D N‐terminal domain (GSDMD‐N). HG‐induced mitochondrial dysfunction and BNIP3 and PINK1/Parkin expression. Knocking down BINP3 and PINK1 abolished the protective role of PLGF by preventing mitophagy.

Conclusion

PLGF inhibited hyperglycemia, while PLGF reversed hyperglycemic injury by promoting mitophagy via the BNIP3/PINK1/Parkin pathway. Altogether, these results suggest that PLGF may protect against trophoblast dysfunction in diabetes.
The Association Between the Central Sensitisation Inventory and Temporomandibular Disorders Is Confounded by Migraine, Depression, Widespread Pain and Parafunction. A Cross‐Sectional Telehealth Study
Authors: Calixtre Letícia Bojikian , van der Meer Hedwig Aleida , Visscher Corine Mirjam , de Oliveira Ana Beatriz , de Godoi Gonçalves Daniela Aparecida
Published: September 2024

Background

Temporomandibular disorders (TMDs) are conditions that involve the temporomandibular joints, masticatory muscles, and associated tissues, causing orofacial pain. Central sensitisation (CS) is a relevant part of the TMD pathophysiology. Migraine, psychological aspects, parafunctional oral habits and widespread pain are commonly associated with both TMD and CS and could confound the association between them.

Objectives

To investigate the association between painful TMD and the Central Sensitisation Inventory (CSI) score, and to assess the presence of confounders in this association.

Methods

Cross‐sectional study that assessed women with and without orofacial pain complaints using telehealth. The TMD Pain Screener and an online physical examination determined the presence of painful TMD. The following questionnaires were applied: CSI, Headache Screening Questionnaire, Generalized Anxiety Disorder‐7, Patient Health Questionnaire‐9, Oral Behavior Checklist, Jaw Functional Limitation Scale and the Nordic musculoskeletal questionnaire. A single regression investigated the association between the CSI score and TMD, and a multiple regression investigated the effect of the other outcomes as possible confounders. Confounding was considered present when the association between TMD and the CSI score changed more than 10% after adding a possible confounder to the regression model.

Results

Forty‐two women with painful TMD and 53 without TMD were included. There was a significant association between the CSI score and the presence of painful TMD (R2 = 0.639; p < 0.001). This association changed when the following outcomes were added to the model: presence of migraine, symptoms of depression, widespread pain and parafunctional oral habits.

Conclusion

The positive association between TMD and the CSI score was confounded by migraine, symptoms of depression, widespread pain and parafunctional oral habits.
Exploring the Relationship Between Somatisation, Facial Pain and Psychological Distress in East Asian Temporomandibular Disorder Patients
Authors: Yap Adrian Ujin , Kim Sunghae , Jo Jung Hwan , Lee Byeong‐min , Park Ji Woon
Published: September 2024

Objectives

The relationship of somatisation with facial pain duration/intensity, pain‐related interference/disability and psychological distress was investigated in East Asian temporomandibular disorder (TMD) patients. Correlations between somatisation, facial pain and psychological characteristics were also explored alongside the demographic/physical factors associated with moderate‐to‐severe depression and anxiety.

Methods

Anonymised data were acquired from records of consecutive ‘first‐time’ patients seeking TMD care at a tertiary oral medicine clinic. Axis I physical TMD diagnoses were established utilising the diagnostic criteria for TMDs (DC/TMD) protocol and patients with TMD pain were stratified into those with pain‐related (PT) and combined (CT) conditions. Axis II measures administered encompassed the Patient Health Questionnaire‐15 (PHQ‐15), Graded Chronic Pain Scale (GCPS), Patient Health Questionnaire‐9 (PHQ‐9) and General Anxiety Disorder Scale‐7 (GAD‐7). Individuals with PT and CT were further categorised into those without (Pain − Som/Comb − Som) and with somatisation (Pain + Som/Comb + Som). Statistical evaluations were performed with nonparametric and logistic regression analyses (α = 0.05).

Results

The final sample comprised 473 patients (mean age 36.2 ± 14.8 years; 68.9% women), of which 52.0% had concomitant somatisation. Significant differences in pain duration (Comb + Som > Pain − Som), pain‐related interference/disability (Comb + Som > Comb − Som) and depression/anxiety (Pain + Som, Comb + Som > Pain − Som, Comb − Som) were discerned. Depression/anxiety was moderately correlated with somatisation (rs = 0.64/0.52) but not facial pain characteristics. Multivariate modelling revealed that somatisation was significantly associated with the prospects of moderate‐to‐severe depression (OR 1.35) and anxiety (OR 1.24).

Conclusion

Somatisation exhibited a strong association with psychological distress when contrasted with facial pain in East Asian TMD patients.
Risk of depression in patients with atopic dermatitis: An updated systematic review and meta‐analysis of children, adolescent and adult groups
Authors: Cao Lihua , Su Jiangwei , Tian Fang , Zhou Yang , Liu Songchun , Lou Fanglu
Published: September 2024

Aim

Atopic dermatitis is a popular allergy disease among children, adolescents and adults. The risk of depression in patients with atopic dermatitis can be evaluated using an updated systemic review and meta‐analysis of observational and cross‐sectional studies.

Methods

The log odds ratio (OR) was transformed using the OR and 95% confidence interval (CI) to assess the risk of depression in patients with atopic dermatitis across the children, adolescent and adult groups. After a restricted selection, 39 studies of 234 306 patients with atopic dermatitis and 10 935 459 reference individuals were enrolled. The focused outcome was the OR and 95% CI of depression risk in each included study, assigned according to the age for the children, adolescent and adult groups.

Results

In adult patients with atopic dermatitis, a significantly higher risk of depression was observed. In addition, the similar significantly higher risk of depression was observed in children and adolescent patients with atopic dermatitis, respectively. However, the significantly high heterogeneity was observed across children, adolescent and adult groups.

Conclusions

In the current meta‐analysis, the patients with atopic dermatitis had a higher risk of depression across the children, adolescent and adult groups, respectively. However, substantial heterogeneity should be considered during the interpretation of our meta‐analysis results.
The 70 years since the discovery of rapid eye movement sleep: history, electroencephalographic features and unsolved issues
Authors: Parrino Liborio , Rausa Francesco , Balella Giulia , Bottignole Dario , Rosenzweig Ivana , Mutti Carlotta
Published: September 2024

This article aims at providing a comprehensive review of the historical discovery and following research on rapid eye movement (REM) sleep, highlighting its manifold nature as a behavioural, electrophysiological and dreaming state. Pioneering works conducted by Aserinsky, Kleitman, Dement and Jouvet established the foundational understanding of REM sleep recurrence, brainstem mechanisms, and the paradoxical coexistence of electroencephalographic activation and muscle atonia. We focus on REM sleep homeostasis, emphasising its role in emotional recovery and the consequences of REM deprivation, such as the REM rebound effect. We also analyse the periodicity of REM sleep, its ultradian rhythm, and the physiological mechanisms underlying its regulation. Additionally, the article discusses the entangled relationship between arousals, sleep, and consciousness, pointing out the distinction between non‐REM and REM sleep‐related arousals, and the similarities between REM sleep and wakefulness.
Evaluation of the efficacy of a live Escherichia coli biotherapeutic product (asymptomatic bacteriuriaE. coli 212)
Authors: Segev Gilad , Chen Hilla , Dear Jonathan D. , Martínez López Beatriz , Pires Jully , Klumpp David J. , Schaeffer Anthony J. , Westropp Jodi L.
Published: September 2024

Background

Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed.

Hypothesis/Objective

Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs.

Animals

Thirty‐four dogs with >1 UTI in the 12 months before presentation.

Methods

All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture.

Results

Clinical cure rates for ASB E. coli 212–treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non‐inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline.

Conclusions and Clinical Importance

These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.
An analysis of the burden of liver cirrhosis: Differences between the global, China, the United States and India
Authors: Lu Keqiang , Sui Juanjuan , Yu Wenhui , Chen Yan , Hou Zhiyong , Li Pengyan , Sun Yuli
Published: September 2024

Background

Cirrhosis continues to be the most common cause of chronic liver disease‐related deaths globally, which puts significant strain on global health. This report aims to investigate the patterns of cirrhosis in China, the United States, India and worldwide from 1990 to 2019 through an epidemiological analysis of the disease utilizing data from the Global Burden of Disease Study (GBD) 2019 database.

Methods

Download the GBD database's statistics on liver cirrhosis deaths and Disability‐Adjusted Life Years for the years 1990–2019 worldwide as well as for China, the United States and India. Utilize techniques like age–period–cohort interaction, decomposition analysis, study of health inequities, Joinpoint model and Bayesian Average Annual Percentage Change model to process the data.

Results

The main age group affected by cirrhosis disease, according to the results, is 50–69 years old. According to the Joinpoint model, there has been a negative worldwide Average Annual Percent Change (AAPC) in the burden of cirrhosis between 1990 and 2019. Only the USA's AAPC is positive out of the three nations that were evaluated (albeit its 95% confidence interval spans 0). These are China, India and the United States. Forecasting models indicate that the prevalence of cirrhosis will keep rising in the absence of government action. According to decomposition analysis, the main factors contributing to the rising burden of cirrhosis are population ageing and size, whereas changes in the disease's epidemiology slow the disease's growth. Research on health disparities indicates that, between 1990 and 2019, there was a downward trend in health disparities between various locations.

Conclusion

Health organizations across different areas should take aggressive measures to address the worrisome prevalence of cirrhosis.
The origins of centralized agenda control at Westminster: Consensus or controversy?
Authors: Fleming Thomas G. , Hix Simon , Zubek Radoslaw
Published: September 2024

Centralized agenda control is a feature of many parliaments, with important consequences for the conduct and outcomes of legislative politics. Much previous work has thus sought to understand the emergence of centralized agenda‐setting rules. We extend this literature by studying the “Balfour reforms”, which centralized agenda control in the early twentieth century UK House of Commons. Our aim is to probe a conventional claim in the existing literature: that the opposition supported these reforms. This is a counter‐intuitive claim, which rests on relatively little direct evidence. We analyze historical roll‐call data from 1902 to assess how far the opposition supported agenda centralization. We complement this analysis by examining attempted amendments and speech contributions to parliamentary debates. Contrary to the standard view, we find that the primary opposition party consistently resisted these reforms. This evidence of controversy rather than consensus revises our understanding of a key milestone in the development of the Westminster parliament, and contributes to the wider literature on the choice of agenda‐setting procedures.
Comparative efficacy of non‐pharmacological interventions for anxiety in adult intensive care unit patients: A systematic review and network meta‐analysis
Authors: Ma Yanfei , Yang Xiuru , Wang Chunyan , Li Yeping , Zhang Yaqing , Wang Lihui , Hu Rong , Li Xixi
Published: September 2024

Background

The primary goal of the intensive care unit is to the anxiety of conscious patients is often ignored in the care unit.

Aim

The purpose of this study was to assess the efficacy of various non‐pharmacological therapies for anxiety disorders in adult patients in the intensive care unit, in order to enhance humanistic care in the intensive care unit and to promote the patients' physical and mental recovery together.

Study Design

We conducted a systematic and comprehensive search of the literature in five databases (including the Cochrane Library, PubMed, EBSCO, Web of Science, and Embase) covering nearly a decade for randomized controlled trials of non‐pharmacological therapies to reduce anxiety in adult intensive care unit patients. Two researchers independently assessed the quality of the literature, collected and condensed the data, and used STATA software to perform a network meta‐analysis. The ranking probabilities for each intervention were calculated using the Surface under the Cumulative Ranking (SUCRA) method. The study protocol was registered with PROSPERO.

Results

This study ultimately included 26 randomized controlled trials involving 2791 adult ICU patients. Non‐pharmacological interventions for anxiety in adult ICU patients included music therapy, aromatherapy, ICU diary, virtual reality, massage therapy, monitoring room diary, and health education. when compared to the control group (usual care), aromatherapy + music therapy [MD = −2.65, 95% CI (−4.76, −0.54)] (P = 0.0137) and music therapy [MD = −1.77, 95% CI (−3.40, −0.13)] (P = 0.0338) were superior in reducing anxiety in adult ICU patients. The results of the network meta‐analysis showed that aromatherapy combined with music therapy significantly alleviated anxiety in adult ICU patients (SUCRA: 99.8%).

Conclusions

Music therapy combined with aromatherapy has demonstrated superior effectiveness compared to other non‐pharmacological interventions for reducing anxiety in awake adults in the ICU. However, the underlying mechanisms of this combined therapy require further exploration.

Relevance to Clinical Practice

Future research on the use of music therapy combined with aromatherapy in the care unit may help reduce anxiety in patients while fostering their physical and mental healing; however, individual variances and unique clinical circumstances must be considered.
The effect of eye mask on sleep quality and pain in patients undergoing coronary artery bypass graft surgery: A double‐blind randomized controlled trial
Authors: Dagcan Sahin Necibe , Nal Burcu , Gurol Arslan Gulsah , Astarcioglu Mehmet Ali , Parlar Ali İhsan
Published: September 2024

Background

Pain is one of the common postoperative issues that impair recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. It leads to prolonged recovery and sleep disturbances in patients.

Aim

This study was conducted to examine the effect of eye mask use on sleep quality and pain in patients undergoing CABG surgery.

Study Design

A double‐blind randomized trial design was employed. The study included 60 patients undergoing CABG surgery. They were divided into intervention and control groups through block randomization. Data were collected using a ‘Demographic Characteristics Form’, the ‘Richards‐Campbell Sleep Questionnaire (RCSQ)’ and a ‘Visual Analogue Scale’ (VAS) through face‐to‐face interviews. While patients in the control group received standard care throughout the night, patients in the intervention group received standard care and used eye mask. All patients were followed up for three nights. The CONSORT was used to report the study.

Results

The main outcome of the study, the RCSQ score, was higher in the intervention group at baseline. The intervention group had higher RCSQ scores than the control group at time 1 and time 2. There were no differences between the groups in the secondary outcome, pain levels. The control group had higher pain scores at time 1 and time 2 than the intervention group.

Conclusion

The use of an eye mask after CABG surgery is an effective, safe and simple nursing intervention to improve sleep quality and control pain.

Relevance to Clinical Practice

Because the use of an eye mask is an independent and unique nursing intervention, nurses should be supported and allowed to practise it.
Thermal acclimation of ecosystem processes to climate warming
Authors: Wang Jinsong , Niu Shuli
Published: September 2024

This article is a Commentary on Lu et al. (2025), 245: 523–533.
Oral squamous cell carcinoma identification by FTIR spectroscopy of oral biofluids
Authors: Lapa Teresa , Páscoa Ricardo N. M. J. , Coimbra Filipe , Medeiros Luís , Gomes Pedro S.
Published: September 2024

Objectives

This case study evaluated the efficacy of mid‐infrared spectroscopy on the identification of oral squamous cell carcinoma, following the assessment of unstimulated whole saliva.

Study Design and Methods

The trial follows a matched case–control design. Saliva samples were characterized through mid‐infrared spectroscopy, and chemometric tools were applied to distinguish between case and control participants, further identifying the spectral regions that played a pivotal role in the successful identification of oral squamous cell carcinoma.

Results

Mid‐infrared spectroscopy was capable to discriminate between cancer patients and matched controls with 100% of correct predictions. Additionally, the spectral regions mostly contributing to the successful prediction were identified and found to be potentially associated with significant molecular changes crucial to the carcinogenic process.

Conclusion

The application of mid‐infrared spectroscopy in saliva analysis may be regarded as an innovative, noninvasive, low cost, and sensitive technique contributing to the identification of oral squamous cell carcionma.
CAF‐secreted COL5A2 activates the PI3K/AKT pathway to mediate erlotinib resistance in head and neck squamous cell carcinoma
Authors: Guo Yibo , Chen Mingtao , Yang Jie , Zhou Wenkai , Feng Guanying , Wang Yang , Ji Tong , Zhang Yu , Liu Zheqi
Published: September 2024

Objective

To investigate the mechanisms behind acquired resistance to erlotinib in head and neck squamous cell carcinoma (HNSCC) with a focus on the role of cancer‐associated fibroblasts (CAFs) and the PI3K/AKT signaling pathway.

Materials and Methods

This study analyzed gene expression profiles of erlotinib‐sensitive and ‐resistant HNSCC cell lines using datasets from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. It included microarray and RNA‐sequencing data, differentially expressed genes (DEGs) analysis, and pathway enrichment. In vitro experiments assessed the functional role of CAFs and the impact of the extracellular matrix component COL5A2 on erlotinib resistance.

Results

We identified 124 DEGs associated with erlotinib resistance, with key genes like COL5A2 significantly upregulated. CAFs were found to highly express COL5A2, enhancing erlotinib resistance by activating the PI3K/AKT pathway. Higher erlotinib resistance scores correlated with increased infiltration of CAFs.

Conclusions

Erlotinib resistance in HNSCC is significantly influenced by the tumor microenvironment (TME), particularly through CAFs and the PI3K/AKT pathway. Targeting these mechanisms may offer new therapeutic strategies to overcome resistance in HNSCC patients.
Comparison of the effects of acupuncture methods on the temporomandibular disorder: A network meta‐analysis
Authors: Yan Qiuying , Bu He , Xu Guixing , Jia Min , Li Dehua
Published: September 2024

Objectives

A network meta‐analysis (NMA) was applied to compare the therapeutic effect of different acupuncture methods on temporomandibular disorder (TMD).

Materials and Methods

A computer retrieval was carried out in the English databases of Cochrane, PubMed, Embase and Web of Science, as well as the Chinese databases of CNKI, Wanfang and VIP for randomized controlled trials on the effect of acupuncture on TMD, with a retrieval deadline of January 21, 2024. Data analysis was conducted using R software and Bayesian method. The pain score served as the primary outcome measure, with the mouth opening as the secondary outcome measure.

Results

Thirty‐five articles were included in the analysis, involving 1937 TMD patients. The NMA results suggested that DN‐PT had the best effect on relieving pain and improving mouth opening. (Description of all abbreviations in Supplementary Material S3).

Conclusions

Based on the available evidence, the results of the NMA suggest that DN‐PT is most effective in relieving TMD pain and increasing mouth opening. However, due to the fact that some acupuncture therapies are only reported in a small number of research reports, this may lead to an increase in the randomness of the results and a decrease in the reliability.
OSR1 suppresses oral squamous cell carcinoma proliferation and migration via the AXIN2/β‐catenin pathway
Authors: Guo Xintong , Du Xinyi , Zhao Gaoye , Liu Chongshen , Gao Jing , Huang Zunzhi , Dong Wei
Published: September 2024

Objectives

The odd‐skipped related transcription factor 1 (OSR1) gene exerts distinct regulatory effects on tumorigenesis and development in various cancer types. However, the precise role of OSR1 in oral squamous cell carcinoma (OSCC) remains to be elucidated.

Methods

GEPIA 2 and TCGA databases were utilized to analyze the OSR1 expression in head and neck squamous cell carcinoma (HNSC) patients and its impact on prognosis. Hematoxylin–eosin staining, immunohistochemistry, immunofluorescence, western blotting, and RT‐qPCR were employed to detect the OSR1 expression in OSCC tissues and cells. Lentivirus transfection was utilized for overexpression and downexpression of OSR1 in OSCC. CCK8 cell proliferation assay, colony formation and cell scratch assay were conducted to investigate the effects of OSR1 on biological behavior of OSCC cells. Western blotting and RT‐qPCR were applied to investigate the regulatory mechanism of OSR1 on AXIN2/β‐catenin signaling pathway.

Results

OSR1 expression was significantly decreased in HNSC patients, OSCC tissues and cells, leading to a decrease in 5‐year survival rate. OSR1 overexpression inhibited the proliferation and migration of OSCC cells, and the AXIN2/β‐catenin signaling pathway was inhibited. Silencing OSR1 had the opposite effect.

Conclusions

OSR1 functioned as a tumor suppressor gene in OSCC proliferation and migration by regulating the AXIN2/β‐catenin signaling pathway.
Exploring the macroevolutionary impact of ecosystem engineers using an individual‐based eco‐evolutionary simulation
Authors: Smith Thomas J. , Parry Luke A. , Dunn Frances S. , Garwood Russell J.
Published: September 2024

Ecosystem engineers can radically reshape ecosystems by modulating the availability of resources to other organisms through modifying either physical or biological aspects of the environment. The introduction or removal of ecosystem engineers from otherwise stable ecosystems can impact the diversity of co‐occurring species, such as driving local extinctions of native taxa. While these impacts are well established over ecological timescales for a wealth of taxa, the macroevolutionary implications of the onset of ecosystem engineering behaviours are less clear. Despite this uncertainty, ecosystem engineering has been implicated in several major transitions in Earth history including the appearance of extensive bioturbation during the Cambrian substrate revolution and associated Ediacaran–Cambrian turnover, and the Great Oxygenation Event. Whether ecosystem engineers are frequently associated with turnover and extinction in deep time is not known. Here we investigate this with an eco‐evolutionary simulation framework in which we assign lineages the ability to impact the fitness of co‐occurring taxa through phenotype–environment feedback. We explore numerous conditions, including how frequently such feedback occurs, and whether ecosystem engineers modify or create niches. We show that there is no general expected outcome from the introduction of ecosystem engineers. In a minority of runs, ecosystem engineering lineages completely dominate, rendering all others extinct, but in others they persist (but do not dominate), or die out. We suggest that ecosystem engineers have complex impacts, but possess the capacity to profoundly shape diversity, and it is appropriate to consider them alongside other exogenous extinction drivers in deep time.
The Transcription Factor ZmMYB56 Regulates High CO2‐Induced Stomatal Closure in Maize Seedlings by Regulating ZmHLT1 Expression
Authors: Baozhu Li , Runan Liu , Hui Zhang , Jiong Liu , Yanan Tian , Pengtao Wang , Zuliang Li , Tingting Chen , Fuhang Jiao , Jiaxing Li , Tengfei Jia , Qingzeng Li , Yingxue Li , Xiangyu Zhang , Han Li , Zhao Xiang
Published: September 2024

Stomata are channels through which plants exchange H2O and CO2 with the external environment. The regulation of stomatal movement has significant impacts on plant growth, development and stress adaptation. Here, we present a maize R2R3−MYB transcription factor, ZmMYB56, which regulates high CO2‐induced stomatal closure in maize seedlings. ZmMYB56 is highly expressed in stomatal guard cells and is negatively regulated by CO2 and HCO3−. Loss of ZmMYB56 function leads to insensitivity to high CO2. As a transcription factor, ZmMYB56 binds to a cis‐acting element in the ZmHLT1 promoter and regulates its expression. ZmHLT1 plays a key role in CO2‐ induced maize stomatal movement, and its absence causes a severe weakening of maize's response to ambient CO2. ZmHLT1 expression is negatively regulated by bicarbonate, which does not occur in Zmmyb56 mutants, highlighting the significance of this regulatory relationship in plant responses to CO2 and HCO3−. Taken together, these results show that ZmMYB56‐regulated ZmHLT1 expression is important for high CO2‐induced stomatal closure in maize. Our findings provide insight into genetic pathways that could be manipulated to improve maize growth and stress tolerance, especially under increasing atmospheric CO2 concentrations.
Development and psychometric properties of an instrument to evaluate missed nursing care in home care: A validation study
Authors: Di Nitto Marco , Zaghini Francesco , Caponnetto Valeria , Ferraiuolo Fabio , Napolitano Francesca , Alvaro Rosaria , Lancia Loreto , Manara Duilio Fiorenzo , Rasero Laura , Rocco Gennaro , Mazzoleni Beatrice , Sasso Loredana , Bagnasco Annamaria
Published: September 2024

Objective

To develop and validate a questionnaire to evaluate missed nursing care (MNC) in a home care setting.

Design

A new instrument was developed and tested performing a preliminary analysis of a multicenter cross‐sectional study in Italy. Reporting was performed according to COnsensus‐based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines.

Sample

Eight hundred out of a total of 2549 home care nurses enrolled in AIDOMUS‐IT were considered for the validation of the Missed Nursing Care in Home Care (MNC_HC).

Measurements

The MNC_HC instrument was developed by a panel of experts and underwent content and face validation. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted.

Results

EFA revealed a one‐factor solution, explaining 56% of the total variance for MNC_HC. CFA confirmed excellent structural validity, with a one‐factor model showing an exceptional fit (χ2 (27) = 141.39, p < .001, RMSEA = 0.04, SRMR = 0.04, CFI = 0.99, TLI = 0.99, factor loadings > 0.5). MNC_HC also demonstrated high reliability (Cronbach's α = 0.92). The activity with the highest rate of missed care was the documentation of nursing care (77%), while activities related to nursing techniques (e.g., injections, dressings, etc.) were reported to be missed less (33.63%).

Conclusions

MNC_HC is a quick‐filling, valid, reliable, and psychometrically sound instrument for measuring MNC in home care useful for future research.
Attention as selection for action defended
Authors: Wu Wayne
Published: September 2024

Attention has become an important focal point of recent work in ethics and epistemology, yet philosophers continue to be noncommittal about what attention is. In this paper, I defend attention as selection for action in a weak form, namely that selection for action is sufficient for attention. I show that selection for action in this conception captures how we, the folk, experience it and how the cognitive scientist studies it. That is, selection for action pulls empirical and folk‐psychology together. Accordingly, philosophers who take seriously either source have reason to work with selection for action as their starting conception of attention. This conception provides a way to bridge empirical and philosophical concerns where attention is central. The theoretical advantages of selection for action have been obscured by the common opinion that it is easily refuted. I defend the position against many of the published objections and then deploy it to provide a foundation for the intuitive, but inchoate, idea of attention being gradable, something of which there can be more or less. An analysis of the gradability of attention is then applied to consider recent work on the harms due to a surplus of attention.
Justification, normalcy and randomness
Authors: Smith Martin
Published: September 2024

Some random processes, like a series of coin flips, can produce outcomes that seem particularly remarkable or striking. This paper explores an epistemic puzzle that arises when thinking about these outcomes and asking what, if anything, we can justifiably believe about them. The puzzle has no obvious solution, and any theory of epistemic justification will need to contend with it sooner or later. The puzzle proves especially useful for bringing out the differences between three prominent theories; the probabilist theory, the normic theory and a theory recently defended by Goodman and Salow.
Understanding abortion legality and trimester of abortion care in Ohio, West Virginia and Kentucky, three abortion‐restrictive states
Authors: Beckmeyer Annamarie L. , Brenner‐Levoy Jeremy A. , Hill B. Jessie , Odum Tamika C. , Turner Abigail Norris , Norris Alison H. , Bessett Danielle , Rivlin Katherine L.
Published: September 2024

Introduction

In the era of Dobbs, legality of abortion care in the United States depends upon state law. Even before Dobbs, while abortion remained legal mounting restrictions and debate surrounding legal abortion could have led to confusion about abortion legality and discouraged patients from accessing legal abortion. We hypothesized an association between believing abortion is illegal or uncertainty about legality with later timing of abortion care.

Methods

We surveyed patients seeking abortion care in Ohio, West Virginia, and Kentucky from April 2020 to April 2021. We asked about their understanding of abortion legality at the time they were first deciding to have an abortion. Using unconditional logistic regression models, we examined associations between beliefs about abortion legality (measured as belief that abortion is legal or sometimes legal versus. illegal or unsure) and timing of abortion care (measured as trimester of abortion).

Results

Over half (57%) of the 1,479 patients who met eligibility criteria and completed the survey believed abortion was always legal, 21% thought abortion was sometimes legal, 12% believed abortion was illegal, and 10% did not know. Most (92%) had a first trimester abortion (<14 weeks gestation). Belief that abortion was illegal, or uncertainty about abortion legality, was not significantly associated with second trimester abortion care (unadjusted odds ratio [uOR]: 0.78, 95% confidence interval [CI]: 0.50–1.20). This association did not change meaningfully after adjusting for demographic and clinical variables (adjusted OR [aOR]: 0.83, 95% CI: 0.51–1.33).

Discussion

More than one in five patients presenting for abortion care in three abortion‐restrictive states prior to Dobbs erroneously believed that abortion was illegal or were unsure. Understanding of legality was not significantly associated with timing of abortion care. These misunderstandings could escalate under Dobbs.