bluuebunny/crossref_metadata_2025 huggingface dataset:
From critical pedagogy to critical digital pedagogy: a prospective model for the EFL classrooms
Authors: Masood Marwa Mohammad , Haque Md. Mahmudul
Published: July 2021

Purpose

Critical digital pedagogy (CDP) is an emerging field in education. The basic tenet of CDP involves taking learners' experiences into account and engaging them in critical thinking about social oppression. With the outbreak of the unprecedented COVID-19 pandemic, CDP has got more currency and appropriacy in the current paradigm shift in learning and teaching.

Design/methodology/approach

This paper scrutinizes different aspects of CDP including its origins, theoretical underpinnings and its implementation in different contexts. It also critically reviews Freire's (1972) problem-posing education and Morris and Stommel's (2017) model of CDP.

Findings

The article proposes a CDP model based on the previous ones, which includes the core concepts and criteria of CDP and focuses on EFL classrooms.

Research limitations/implications

One of the limitations of CDP is gaining the learners' approval in creating an environment of co-constructing knowledge moving away from traditional practices. In addition to that, the use of new media in the classroom can be intimidating for students and stakeholders alike. The lack of logistic support in many rural, remote and underdeveloped contexts cannot be ignored either

Practical implications

The paper provides recommendations for future research in CDP.

Originality/value

Critical pedagogy (CP) is a teaching approach in which the oppressed are basically focused and teachers and learners construct knowledge together. Recently, with the outbreak of the COVID-19 pandemic, global education had to go online. Consequently, traditional teaching and learning had to undergo a paradigm shift. Along with other changes in traditional teaching and learning practices, there has been a significant change in teaching philosophy. This is how the CDP finds its currency in this emerging unprecedented teaching and learning situation.
The transition to adulthood for autistic young people with additional learning needs: the views and experiences of education professionals in special schools
Authors: Crane Laura , Davies Jade , Fritz Anne , O’Brien Sarah , Worsley Alison , Ashworth Maria , Remington Anna
Published: July 2021

Education professionals (n = 41) in special schools were interviewed about supporting their autistic pupils transitioning to adulthood following the introduction of the Children and Families Act 2014. Our participants explained how they lacked the time to fully implement knowledge gained from training, leading to growing reliance on experiential expertise. While our participants reported employing a variety of methods to elicit the voices of pupils, they were uncertain how effective and ethical these were. Further, a lack of available opportunities meant that participants felt they could not always support young people in achieving their goals. Based on these findings, we recommend greater investment in the implementation of staff training, more flexibility for schools to be able to meaningfully elicit and act on pupils' voices, and better vocational opportunities for autistic young people with additional learning needs. This would enable the principles of the Act, which have been widely lauded, to become a closer reality.
Sabre‐sheath trachea: An underused diagnostic weapon in the thoracic armoury
Authors: Brassil Colm , Srigandan Shrivuthsun , Murray Conor P
Published: July 2021

Introduction

A sabre‐sheath trachea is a highly specific sign for chronic obstructive pulmonary disease. It also correlates well with the degree of disease. We hypothesized that the term is vastly under‐utilized in radiologic reporting, despite its high diagnostic value.

Methods

We interrogated our multisite metropolitan‐wide radiology information system to find the number of CT reports containing the phrase ‘sabre‐sheath trachea’ and conceivable variants thereof, over the 10 years to present. We compared this with the entire number of CT chest reports in the same time period in order to estimate the utilization of the sign.

Results

The results confirmed our hypothesis that the sign is rarely invoked, likely around 1 in 41 times relative to opportunity.

Conclusions

This highly specific sign of chronic obstructive small airway disease should be reinforced in training and utilized by radiologists.
The need for improved patient reported outcome measures in patients with extremity sarcoma: a narrative review
Authors: Blight Thomas J. , Choong Peter F.M.
Published: July 2021

Background

Extremity sarcoma causes impairments to functionality and quality of life. Patient‐reported outcome measures (PROMS) assess patient perspectives relating to domains of health and quality of life.

Methods

To describe PROMs utilised in extremity sarcoma, the available literature was screened for studies that utilised PROMs to evaluate outcomes in extremity sarcoma following surgery.

Results

Seventy articles met eligibility criteria; six PROMs were identified. The Toronto Extremity Salvage Score, The Short‐Form 36, The EORTC QLQ‐C30, The Disabilities of the Arm, Shoulder and Hand questionnaire, the Reintegration to Normal Living index and the Patient‐Reported Outcomes Measurement Information System. Most sarcoma patients score well in these tools, with bone sarcoma, and extent of resection being predictors of poor outcomes.

Conclusion

TESS is the only sarcoma‐specific PROM, and though a valid assessment of functionality, it has difficulty differentiating patients with minor functional impairments. The absence of a disease‐specific measure of health is concerning, as generic tools do not account for the unique experiences sarcoma patients face and may impair their accuracy in analysing intervention effectiveness.
Randomised clinical trial: comparison of tegoprazan and placebo in non‐erosive reflux disease
Authors: Kim Seung Han , Cho Kwang Bum , Chun Hoon Jai , Lee Sang Woo , Kwon Joong Goo , Lee Dong Ho , Kim Sang Gyun , Jung Hwoon‐Yong , Kim Ji Won , Lee Joon Seong , Park Hyojin , Choi Suck Chei , Jee Sam Ryong , Kim Hyun‐Soo , Ko Kwang Hyun , Park Seun Ja , Lee Yong Chan , Park Soo Heon , Kim Ah Rong , Kim Eun Ji , Park Hyun Wook , Kim Bong Tae , Song Geun Seog
Published: July 2021

Background

Tegoprazan is a novel, fast‐ and long‐acting potassium‐competitive acid blocker that suppresses gastric acid secretion, which could benefit patients with non‐erosive reflux disease (NERD), a type of gastroesophageal reflux disease.

Aim

To evaluate the efficacy and safety profiles of tegoprazan compared with those of a placebo in Korean patients with NERD.

Methods

In this phase 3, double‐blind, placebo‐controlled, multicentre study, 324 Korean patients with NERD were randomised into three treatment groups: tegoprazan 50 mg, tegoprazan 100 mg and placebo. These drugs were provided once daily for 4 weeks. The primary endpoint was the proportion of patients with complete resolution of major symptoms (both heartburn and regurgitation) for the last 7 days of the 4‐week treatment period. Other outcomes related to efficacy, safety and tolerability were also evaluated.

Results

Among all, 42.5% (45/106), 48.5% (48/99) and 24.2% (24/99) of patients showed complete resolution of major symptoms at week 4 after receiving tegoprazan 50 mg, tegoprazan 100 mg, and placebo, respectively. Both doses of tegoprazan showed superior efficacy than the placebo (P = 0.0058 and P = 0.0004, respectively). The complete resolution rates of heartburn and proportions of heartburn‐free days (as other efficacy outcomes) were significantly higher in both tegoprazan groups than in the placebo group (P < 0.05 for all). No significant difference in the incidence of treatment‐emergent adverse events were noted.

Conclusions

Tegoprazan 50 and 100 mg showed superior therapeutic efficacy compared with the placebo, as well as a favourable safety profile in patients with NERD.

Registration number: ClinicalTrials.gov identifier NCT02556021.
Comparison of parenchymal volume loss assessed by three‐dimensional computed tomography volumetry and renal functional recovery between conventional and robot‐assisted laparoscopic partial nephrectomy
Authors: Kanda Sohei , Inoue Takamitsu , Nakajima Shiori , Sagehashi Ryuichiro , Nara Taketoshi , Numakura Kazuyuki , Saito Mitsuru , Narita Shintaro , Tsuchiya Norihiko , Habuchi Tomonori
Published: July 2021

Objectives

We retrospectively investigated if robot‐assisted laparoscopic partial nephrectomy (RAPN) contributes to a decrease in resected parenchymal volume (RPV), an increase in postoperative parenchymal volume (PPV), and an improvement of postoperative renal function when compared with conventional laparoscopic partial nephrectomy (LPN) using a three‐dimensional image analysis system.

Methods

Patients who underwent LPN (n = 37) and RAPN (n = 66) from November 2013 to November 2018 were included in this study. All patients had a tumor diameter of 4 cm or less. Patients with an anatomical or functional single kidney were excluded. RPV and PPV were measured using SYNAPSE VINCENT®. The surgical outcomes were compared between the two groups.

Results

Warm ischemic time in the RAPN group was significantly shorter than that in the LPN group (p < 0.001). The ratio of RPV to tumor volume (RPV/TV) in the RAPN group was significantly lower than that in the LPN group (p = 0.016). PPV in the RAPN group was significantly higher than that in the LPN group (p = 0.049). The decreased estimated glomerular filtration rate in the RAPN group was significantly lower than that in the LPN group on days 1, 7, 30, 90, and 180 after surgery.

Conclusions

Postoperative renal function in the RAPN group was significantly better than that in the LPN group in both the short and long term. In addition to a short warm ischemia time, the decreased RPV/TV and increased PPV may have contributed to the improvement of postoperative renal function.
Remote Working during the Pandemic: A Second Q&A with Gillian Isaacs Russell
Authors: Isaacs Russell Gillian
Published: July 2021

On the first anniversary of the beginning of the Covid‐19 pandemic lockdown, Gillian Isaacs Russell, author of the influential Screen Relations: The Limits of Computer‐Mediated Psychoanalysis and Psychotherapy, returns to respond to a second set of questions from the BJP. In this interview by email, she considers the challenges and issues that came up for clinicians and patients during the last year of working remotely. Looking back at the year as a whole, she explores the impact of ongoing trauma on the therapeutic couple. She discusses the creative ways that clinicians have found to navigate the losses and differences between co‐present and distance treatment, including holding an internal paradox of immersion in telepresence and the maintenance of a reflective distance, to be shared and explored with the patient. She examines the effects that differing hardware such as telephone or computer screen have on our intimate communication, how the intrusion of the personal environments of both clinician and patient may have affected the dynamics of the therapeutic couple, and the personal and global experience of loss and bereavement for both therapist and patient, particularly when it has to be processed remotely. Finally, the BJP asks her to give her thoughts on the future and whether the ‘new normal’ will include more hybrid forms of training and treatment.
Definitive radiotherapy for extracranial oligoprogressive metastatic renal cell carcinoma as a strategy to defer systemic therapy escalation
Authors: De Brian , Venkatesan Aradhana M. , Msaouel Pavlos , Ghia Amol J. , Li Jing , Yeboa Debra N. , Nguyen Quynh‐Nhu , Bishop Andrew J. , Jonasch Eric , Shah Amishi Y. , Campbell Matthew T. , Wang Jennifer , Zurita‐Saavedra Amado J. , Karam Jose A. , Wood Christopher G. , Matin Surena F. , Tannir Nizar M. , Tang Chad
Published: July 2021

Objective

To study whether delivering definitive radiotherapy (RT) to sites of oligoprogression in metastatic renal cell carcinoma (mRCC) enabled deferral of systemic therapy (ST) changes without compromising disease control or survival.

Patients and Methods

We identified patients with mRCC who received RT to three or fewer sites of extracranial progressive disease between 2014 and 2019 at a large tertiary cancer centre. Inclusion criteria were: (1) controlled disease for ≥3 months before oligoprogression, (2) all oligoprogression sites treated with a biologically effective dose of ≥100 Gy, and (3) availability of follow‐up imaging. Time‐to‐event end‐points were calculated from the start of RT.

Results

A total of 72 patients were identified (median follow‐up 22 months, 95% confidence interval [CI] 19–32 months), with oligoprogressive lesions in lung/mediastinum (n = 35), spine (n = 30), and non‐spine bone (n = 5). The most common systemic therapies before oligoprogression were none (n = 33), tyrosine kinase inhibitor (n = 23), and immunotherapy (n = 13). At 1 year, the local control rate was 96% (95% CI 87–99%); progression‐free survival (PFS), 52% (95% CI 40–63%); and overall survival, 91% (95% CI 82–96%). At oligoprogression, ST was escalated (n = 16), maintained (n = 49), or discontinued (n = 7), with corresponding median (95% CI) PFS intervals of 19.7 (8.2–27.2) months, 10.1 (6.9–13.2) months, and 9.8 (2.4–28.9) months, respectively. Of the 49 patients maintained on the same ST at oligoprogression, 21 did not subsequently have ST escalation.

Conclusion

Patients with oligoprogressive mRCC treated with RT had comparable PFS regardless of ST strategy, suggesting that RT may be a viable approach for delaying ST escalation. Randomised controlled trials comparing treatment of oligoprogression with RT vs ST alone are needed.
Bifurcation in the evolution of certainty in a small decision‐making group by consensus
Authors: Gheondea‐Eladi Alexandra , Gheondea Aurelian
Published: July 2021

In a previous paper, the evolution of certainty measured during a consensus‐based small‐group decision process was shown to oscillate to an equilibrium value for about two‐thirds of the participants in the experiment. Starting from the observation that experimental participants are split into two groups, those for whom the evolution of certainty oscillates and those for whom it does not, in this paper we perform an analysis of this bifurcation with a more accurate model and answer two main questions: what is the meaning of this bifurcation, and is this bifurcation amenable to the approximation method or numerical procedure? Firstly, we have to refine the mathematical model of the evolution of certainty to a function explicitly represented in terms of the model parameters and to verify its robustness to the variation of parameters, both analytically and by computer simulation. Then, using the previous group decision experimental data, and the model proposed in this paper, we run the curve‐fitting software on the experimental data. We also review a series of interpretations of the bifurcated behaviour. We obtain a refined mathematical model and show that the empirical results are not skewed by the initial conditions, when the proposed model is used. Thus, we reveal the analytical and empirical existence of the observed bifurcation. We then propose that sensitivity to the absolute value of certainty and to its rate of change are considered as potential interpretations of this split in behaviour, along with certainty/uncertainty orientation, uncertainty interpretation, and uncertainty/certainty‐related intuition and affect.
Boys Write About Boys: Androcentrism in Children’s Reading Experience and Its Emergence in Children’s Own Writing
Authors: Hsiao Yaling , Banerji Nilanjana , Nation Kate
Published: July 2021

Gender bias exists in our language environment. We investigated personal name usage in two large corpora of language written for and by U.K. children aged 5–13. Study 1 found an overrepresentation of male names in children’s books, largely attributable to male authors. In stories written by over 100,000 children, Study 2 found an overall male bias that interacted with age. Younger children wrote more about their own gender. With age, girls became more balanced yet boys continued to show a strong male bias. Our findings demonstrate a male‐centered bias in both children’s books and their own writing. We consider the power of written language to both shape and be shaped by cultural stereotypes via systematic biases in gender associations.
Istradefylline, an adenosine A2a receptor antagonist, ameliorates neutrophilic airway inflammation and psoriasis in mice
Authors: Tokano Mieko , Kawano Masaaki , Takagi Rie , Matsushita Sho
Published: July 2021

Objective

Extracellular adenosine is produced from secreted adenosine triphosphate by cluster of differentiation (CD)39 and CD73. Both are critical nucleotide metabolizing enzymes of the adenosine generating pathway and are secreted by neuronal or immune cells. Adenosine plays a role in energy processes, neurotransmission and endogenous regulation of inflammatory responses. Istradefylline is a selective adenosine A2a receptor antagonist used for the treatment of Parkinson's disease. We have reported that adenosine primes hypersecretion of interleukin (IL)‐17A through the adenosine A2a receptor. Istradefylline, as well as an inhibitor of CD39 (ARL67156) and an inhibitor of CD73 (AMP‐CP), suppressed IL‐17A production, and the administration of istradefylline to mice with experimental autoimmune encephalomyelitis led to the marked amelioration of the disease. These previous results suggest that adenosine is an endogenous modulator of neutrophilic inflammation. We investigated the effect of istradefylline, ARL67156 and AMP‐CP on other mouse models of neutrophilic inflammation.

Methods

We tested the effect of istradefylline, ARL67156 and AMP‐CP on ovalbumin‐induced neutrophilic airway inflammation or imiquimod‐induced psoriasis in mice. The two mice models received these drugs orally or percutaneously, respectively. The production of IL‐17A in the lung and ear thickness were used as an index of the effects.

Results

We show that istradefylline, ARL67156 and AMP‐CP suppressed the ovalbumin‐induced IL‐17A production in the lung and imiquimod‐induced psoriasis.

Conclusion

These results show that adenosine‐mediated IL‐17A production plays a role in neutrophilic inflammation models, and furthermore, istradefylline, ARL67156 and AMP‐CP are effective in animal models of neutrophilic inflammation. Some clinical relevancies in coronavirus disease 2019 are discussed.
Timing and localization of myasthenia gravis‐related gene expression
Authors: Vergoossen Dana L. E. , Keo Arlin , Mahfouz Ahmed , Huijbers Maartje G.
Published: July 2021

Myasthenia gravis (MG) is an acquired autoimmune disorder caused by autoantibodies binding acetylcholine receptors (AChR), muscle‐specific kinase (MuSK), agrin or low‐density lipoprotein receptor‐related protein 4 (Lrp4). These autoantibodies inhibit neuromuscular transmission by blocking the function of these proteins and thereby cause fluctuating skeletal muscle weakness. Several reports suggest that these autoantibodies might also affect the central nervous system (CNS) in MG patients. A comprehensive overview of the timing and localization of the expression of MG‐related antigens in other organs is currently lacking. To investigate the spatio‐temporal expression of MG‐related genes outside skeletal muscle, we used in silico tools to assess public expression databases. Acetylcholine esterase, nicotinic AChR α1 subunit, agrin, collagen Q, downstream of kinase‐7, Lrp4, MuSK and rapsyn were included as MG‐related genes because of their well‐known involvement in either congenital or autoimmune MG. We investigated expression of MG‐related genes in (1) all human tissues using GTEx data, (2) specific brain regions, (3) neurodevelopmental stages, and (4) cell types using datasets from the Allen Institute for Brain Sciences. MG‐related genes show heterogenous spatio‐temporal expression patterns in the human body as well as in the CNS. For each of these genes, several (new) tissues, brain areas and cortical cell types with (relatively) high expression were identified suggesting a potential role for these genes outside skeletal muscle. The possible presence of MG‐related antigens outside skeletal muscle suggests that autoimmune MG, congenital MG or treatments targeting the same proteins may affect MG‐related protein function in other organs.
Regulation of redox signaling in HIF‐1‐dependent tumor angiogenesis
Authors: Manuelli Valeria , Pecorari Chiara , Filomeni Giuseppe , Zito Ester
Published: July 2021

Angiogenesis is the process of blood vessel growth. The angiogenic switch consists of new blood vessel formation that, in carcinogenesis, can lead to the transition from a harmless cluster of dormant cells to a large tumorigenic mass with metastatic potential. Hypoxia, that is, the scarcity of oxygen, is a hallmark of solid tumors to which they adapt by activating hypoxia‐inducible factor‐1 (HIF‐1), a transcription factor triggering de novo angiogenesis. HIF‐1 and the angiogenic molecules that are expressed upon its activation are modulated by redox status. Modulations of the redox environment can influence the angiogenesis signaling at different levels, thereby impinging on the angiogenic switch. This review provides a molecular overview of the redox‐sensitive steps in angiogenic signaling, the main molecular players involved, and their crosstalk with the unfolded protein response. New classes of inhibitors of these modulators which might act as antiangiogenic drugs in cancer are also discussed.
Patterns of post‐drought recovery are strongly influenced by drought duration, frequency, post‐drought wetness, and bioclimatic setting
Authors: Jiao Tong , Williams Christopher A. , De Kauwe Martin G. , Schwalm Christopher R. , Medlyn Belinda E.
Published: July 2021

Understanding vegetation recovery after drought is critical for projecting vegetation dynamics in future climates. From 1997 to 2009, Australia experienced a long‐lasting drought known as the Millennium Drought (MD), which led to widespread reductions in vegetation productivity. However, vegetation recovery post‐drought and its determinants remain unclear. This study leverages remote sensing products from different sources—fraction of absorbed photosynthetically active radiation (FPAR), based on optical data, and canopy density, derived from microwave data—and random forest algorithms to assess drought recovery over Australian natural vegetation during a 20‐year period centered on the MD. Post‐drought recovery was prevalent across the continent, with 6 out of 10 drought events seeing full recovery within about 6 months. Canopy density was slower to recover than leaf area seen in FPAR. The probability of full recovery was most strongly controlled by drought return interval, post‐drought hydrological condition, and drought length. Full recovery was seldom observed when drought events occurred at intervals of 3 months or less, and moderately dry (standardized water balance anomaly [SWBA] within [−1, −0.76]) post‐drought conditions resulted in less complete recovery than wet (SWBA > 0.3) post‐drought conditions. Press droughts, which are long term but not extreme, delayed recovery more than pulse droughts (short term but extreme) and led to a higher frequency of persistent decline. Following press droughts, the frequency of persistent decline differed little among biome types but peaked in semi‐arid regions across aridity levels. Forests and savanna required the longest recovery times for press drought, while grasslands were the slowest to recover for pulse drought. This study provides quantitative thresholds that could be used to improve the modeling of ecosystem dynamics post‐drought.
Agglomeration externalities and the non‐linear performance of environmental regulation: Evidence from China
Authors: Pang Rui , Zheng Dan , Shi Minjun
Published: July 2021

The pollution abatement effect of environmental regulation changes periodically in terms of local economic agglomeration levels, because of agglomeration externalities could influence firms' regulatory response by changing the compliance cost. Based on a panel dataset of 30 provinces in China from 1999 to 2017, this paper engages in threshold model and mediation analysis to examine the thresholds of economic agglomeration for environmental regulation to take effect and the influencing paths of environmental regulation at different agglomeration levels. The economic agglomeration degree is measured by the economic density of the built‐up area. The threshold test recognizes two thresholds of economic density, which are 0.3 CNY billion/km2 and 1.7 CNY/km2. Only when economic density exceeds the thresholds, can environmental regulation significantly reduce industrial emission intensity and emission density, respectively. At the first threshold, environmental regulation takes effect mainly through improving local industrial structure; at the second threshold, environmental regulation takes effect mainly through downsizing the scale of polluting industries. The policy enlightenment provided by this article is to formulate differentiated environmental governance strategies according to local conditions and the characteristics of the development stage of each region.
Does experience matter? The relationship between nephrologist characteristics and end stage kidney disease patient outcomes
Authors: Reule Scott , Foley Robert , Shaughnessy Daniel , Drawz Paul , Ishani Areef , Rosenberg Mark
Published: July 2021

Background

Nephrology offers the unique opportunity to directly link patients to providers, allowing the study of patient outcomes at the provider level. The purpose of this analysis was to determine whether nephrologist experience, defined as years in nephrology practice, was associated with clinical outcomes.

Design

Physician data contained within the American Medical Association (AMA) Physician Masterfile was combined with patient and Medicare claims data from the United States Renal Data System (USRDS) for the calendar year 2012, with follow up extending through June 30, 2014. Associations with important healthcare outcomes including mortality in patients receiving maintenance renal replacement therapy (RRT), waitlisting for kidney transplantation, and receipt of a kidney transplant were determined with broad adjustment for both patient and provider level variables, with attention on tertile of provider time in practice.

Results

We identified 256,324 patients on maintenance RRT cared for by 6193 nephrologists. Nephrologists with the least experience were more likely to be female, reside in a region with ≥1,000,000 people, have a Doctor of Osteopathic Medicine degree, and have a listed maintenance of certification status as “yes.” Overall, 30.2% of the cohort died at a mean follow up of 1.99 years. Compared to those with the 0–10 years of experience, receipt of care from nephrologists with more experience was associated with lower mortality (AHR 0.97 CI 0.94–0.99 for nephrologists with 11–20 years) and increased listing for kidney transplantation (AHR 1.10; CI 1.01–1.21 for nephrologists with >21 years experience). Experience level did not result in a difference in kidney transplantation rates.

Conclusions

Receipt of maintenance RRT from nephrologists with greater experience was associated with decreased mortality and increased listing for kidney transplantation, an effect that remained significant after multiple adjustments for important patient and nephrologist variables.
Stuff you think you can handle as a parent and stuff you can’t’. Understanding parental health‐seeking behaviour when accessing unscheduled care: A qualitative study
Authors: Conlon Ciara , Nicholson Emma , De Brún Aoife , McDonnell Therese , McAuliffe Eilish
Published: July 2021

Background

Unscheduled health care constitutes a significant proportion of health‐care utilization. Parental decision making when accessing unscheduled care for their children is multifaceted and must be better understood to inform policy and practice.

Design

Nineteen semi‐structured interviews and one focus group (n = 4) with parents of children younger than twelve in Ireland were conducted. Participants had accessed unscheduled care for their children in the past. Data were thematically analysed.

Results

Parents accessed unscheduled care for their children after reaching capacity to manage the child's health themselves. This was informed by factors such as parental experience, perceived urgency and need for reassurance. Parents considered the necessity to access care and situated their health‐seeking behaviour within a framework of ‘appropriateness’. Where parents sought unscheduled care was largely determined by timely access, and inability to secure a general practitioner (GP) appointment often led parents to access other services. Parents expressed a need for more support in navigating unscheduled care options.

Conclusions

Better resources to educate and support parents are required, and structural issues, such as accessibility to GPs, need to be addressed to enable parents to better navigate the unscheduled health system and manage their children's health. The discourse around ‘appropriate’ and ‘inappropriate’ access to health care has permeated parental decision making when accessing unscheduled health care for their children. What constitutes appropriate access should be examined, and a shift away from this framing of health‐seeking behaviour may be warranted.

Patient or Public Contribution

There was no explicit patient or public involvement. All authors hold experience as users of the health system.
Effect of CO2 nanobubbles incorporation on the viscosity reduction of fruit juice concentrate and vegetable oil
Authors: Phan Khanh , Truong Tuyen , Wang Yong , Bhandari Bhesh
Published: July 2021

Viscosity is one of key parameters to handle liquid food during processing and transport. In this work, viscosities of apple juice concentrate (APJC) and canola oil (CANO) injected with CO2 nanobubbles (NBs), having size ranged approximately from 50 to 850 nm, were investigated. A significant (P ≤ 0.05) viscosity reduction was observed by up to 18% and 10% in APJC and CANO, respectively, after the NBs injection. When being stored at ambient (23 °C) and refrigerated (4 °C) temperatures for 7 days, the reduction effect on viscosities of samples treated with NBs tended to diminish in accordance with the growth of NBs’ size and the decrease of dissolved CO2 concentration. Besides, the suspension of CO2 NBs insignificantly affected pH, total soluble solid content of APJC, as well as densities of APJC and CANO. These findings suggested that utilisation of NBs can be a feasible mean to reduce viscosity and enhance processing efficiency of food fluids.
Violation and lack of awareness of employment rights in the United Kingdom's hotel industry: Isolation, fragmentation and barriers to labour enforcement
Authors: Papadopoulos Orestis , Lopez‐Andreu Marti , Jamalian Mandi
Published: July 2021

The article examines the extent of labour violation in the UK hotel industry and identifies the challenges and difficulties that workers face to defend their employment rights. Drawing on interview material and documents, the article identifies the factors that weaken workers' capacities to bring forward complaints and discusses the organisational, institutional and individual factors making silence dominant in the sector. This multifaceted analysis demonstrates different layers of vulnerability that create a very unfavourable environment for the promotion of employment rights in a context of heightened levels of fear. We contribute to the existing studies by demonstrating that for precarious and insecure workers in particular, the UK model of individual employment rights has ‘no substance’. Our findings highlight that it jeopardises not only the enforcement of rights but also workers' ability to acquire comprehensive knowledge and awareness of them.
Identifying suitable benchmarks in the way toward achieving targets using data envelopment analysis
Authors: Ruiz José L. , Sirvent Inmaculada
Published: July 2021

It was earlier claimed by the authors that the data envelopment analysis (DEA) models commonly used only implement objectives concerned with target setting, while peer identification, which is a key issue for the benchmarking, is actually a by‐product. For this reason, they developed some bi‐objective DEA benchmarking models that pay special attention to the selection of benchmarks among peers, in addition to setting the closest targets. Following an analogous approach, we here continue that research and propose new models that provide a response to the question of whom to emulate to achieve the targets that have been set for a given organization. Thus, the proposed approach now aims to relate the setting of targets and the identification of peers, specifically identifying peers that may serve as benchmarks for improving performance in the direction established by the targets set. As a result, the models identify the so‐called leading benchmark, which is the one whose performance is most aligned with the targets. Eventually, a series of targets and peers are generated by varying the importance attached to the two objectives considered, which offer decision‐makers alternatives for the selection of a course of action when planning improvements.
Did rest breaks help with acute fatigue among nursing staff on 12‐h shifts during the COVID‐19 pandemic? A cross‐sectional study
Authors: Sagherian Knar , McNeely Clea A. , Steege Linsey M.
Published: July 2021

Aim

This study aimed to explore whether 30‐min rest breaks were as effective at lowering acute fatigue among 12‐h shift hospital nursing staff who cared for patients with COVID‐19 as among those who did not.

Design

The study was cross‐sectional in design.

Methods

Data from the SAFE‐CARE study collected online between May and June 2020 were used. A subsample (N = 338) comprised of nursing staff who reported working 12‐h shifts, and providing direct patient care in hospitals was used in this study. Data on socio‐demographics, work and rest breaks, and subjective measures of fatigue, psychological distress, sleep and health were used. Hierarchical multiple linear regression followed by stratified analyses was conducted to explore the relationships between rest breaks and acute fatigue among nursing staff groups with and without COVID‐19 patient care.

Results

The sample, on average, had high acute fatigue. Around 72% reported providing care to patients with COVID‐19, and 71% reported taking rest breaks ‘sometimes’, ‘often’ or ‘always’. In the group that cared for patients with COVID‐19, there was no significant relationship between rest breaks and acute fatigue (p = .507). In the group that cared for patients hospitalized for other reasons, rest breaks were associated with lower acute fatigue (p = .010).

Conclusion

Our findings showed both the importance and inadequacy of rest breaks in reducing acute fatigue. The process of within‐work recovery is complex, and routine rest breaks should be facilitated by nursing management on hospital units during and after the COVID‐19 pandemic.

Impact

Rest breaks may present an effective strategy in lowering fatigue. Although rest breaks were not associated with less fatigue among staff caring for patients with COVID‐19, other co‐workers experienced some fatigue recovery. For frontline nursing staff, routine rest breaks are encouraged, and a systematic evaluation pertaining the sufficiency of rest breaks during high work demands in future research is needed.
Moderating effects of task interdependence on interaction behaviours and creativity for nursing students on interdisciplinary teams
Authors: Liu Hsing‐Yuan
Published: July 2021

Aims

Nursing students in Taiwan often study in interdisciplinary teams that must create healthcare products. Creativity is imperative for the students’ success, but studies have not explored the relational precursors to team creativity in nursing education. Therefore, the relationship was examined between task interdependence, interaction behaviours (constructive controversy, helping behaviours and spontaneous communication) and creativity for nursing students on interdisciplinary teams in Taiwan to investigate whether high task interdependence moderates the correlations between interaction behaviours and creativity.

Design

Descriptive, cross‐sectional, quantitative study.

Methods

Participants were nursing students (N = 99) attending interdisciplinary capstone courses in 2‐ or 4‐year nursing programmes at a university for science and technology in Taiwan. Self‐report questionnaires were used to collect the students’ demographics and perceptions of their teams’ task interdependence, interaction behaviours and creativity between January 2018 and January 2019. Pearson's correlation coefficient revealed variable associations. SPSS PROCESS macro displayed moderating effects.

Results

Task interdependence had significant positive correlations with all three interaction behaviours and team creativity. Each interaction behaviour also had significant positive correlations with team creativity. High task interdependence negatively moderated the relationships between team creativity and (a) constructive controversy, and (b) spontaneous communication, but not (c) helping behaviours.

Conclusion

The empirically validated moderation model and study results suggest that nursing educators can foster creativity in their students by encouraging task interdependence and helping behaviours, and teaching students to build constructive controversy and spontaneous communication into their collaborative plans.

Impact

In Taiwan, nursing students must demonstrate creativity in interdisciplinary capstone courses. Their ability to do so requires them to cooperate with students in other disciplines who have unique skills or knowledge. This study provides insights into the relational factors that may improve creativity for nursing students on interdisciplinary teams.
Intralesional Candida antigen versus intralesional vitamin D3 in the treatment of recalcitrant multiple common warts
Authors: Abdel Razik Lamis Hosny , Obaid Zakaria Mahran , Fouda Ibrahim
Published: July 2021

Background

There are various therapies available for recalcitrant common warts; however no specific therapy has been established as entirely effective.

Aims

To assess the efficacy and safety of intralesional Candida antigen injection of vs. intralesional vitamin D3 injection in the treatment of multiple recalcitrant common warts.

Patients and methods

A total of 80 adult patients with multiple common warts were randomly assigned to one of three groups in this study. Thirty patients were assigned to Group I, who received a 0.3 ml intralesional injection of Candida antigen. Thirty patients were assigned to Group II, who received a 0.6‐ml (60 000 IU) intralesional injection of vitamin D3. Twenty patients were in Group‐III, who received 0.3 ml of normal saline as a control. Each agent was injected at the base of largest wart every 3 weeks until full clearance has been obtained, or for a maximum of four sessions.

Results

In the Candida antigen, vitamin D3, and saline groups, complete wart clearance was observed in 76.7 percent, 20%, and 0.0 percent, respectively. The side effects were negligible and transient, and there was no recurrence of the lesions.

Conclusion

Intralesional injection of Candida antigen is as a safe, simple, cost‐effective treatment modality for multiple recalcitrant common warts and it outperforms intralesional vitamin D3.
Approaches of male nurses for degendering nursing and becoming visible: A metasynthesis
Authors: Younas Ahtisham , Ali Nizar , Sundus Amara , Sommer Jacoline
Published: July 2021

Introduction

Patient, nurse and public discrimination against male nurses is well‐documented. Male nurses encounter challenges in degendering nursing and becoming more visible nursing professionals. However, little is known about male nurses' decisions and strategies to address issues concerning gender‐based discrimination and professional visibility.

Aims

To develop a comprehensive understanding of the approaches of male nurses to degender nursing and become more visible in the profession.

Methods

A metasynthesis using the PRISMA guidelines. A comprehensive literature search was performed PubMed, CINAHL, Web of Science and Scopus databases. The search terms included ‘lived experiences’, ‘male nurses’, ‘clinical practice’, ‘male educators’ and ‘male nurse managers’. In total, 16 qualitative studies published from January 2005 to November 2020 were critically appraised and synthesised. Two authors independently extracted data using summary tables. Data were synthesised using thematic synthesis which entails generation of codes and development of descriptive and analytical themes.

Results

Male nurses used intrapersonal, interpersonal and strategic adaptation to degender nursing and becoming visible as a nursing professional. These approaches entailed goal‐directed behaviours, relationship‐building strategies and positive and negative manipulation of resources.

Discussion

The approaches to degender nursing enabled men to prove their worth as competent nursing professionals, lessen the gendered stigmatisation and receive autonomy and respect.

Conclusions

Degendering the gendered stigmatisation of nursing and becoming a visible nursing professional is essential for male nurses to promote diversity in the profession. Male nurses used both negative and positive approaches to gain recognition, respect and autonomy. They continued their struggles to promote the role of men as nurses.

Relevance to Clinical Practice

Nursing institutions and regulatory bodies could use the findings to develop conducive environments to degender nursing and increase male nurses' visibility. Future male nurses could use the identified positive approaches and tailor them to meet their needs to become more visible and competent nursing professionals.
Adjuvant carboplatin for treatment of splenic hemangiosarcoma in dogs: Retrospective evaluation of 18 cases (2011‐2016) and comparison with doxorubicin‐based chemotherapy
Authors: Faulhaber Erica A. , Janik Emily , Thamm Douglas H.
Published: July 2021

Background

Doxorubicin‐based chemotherapy after splenectomy remains the standard of care for hemangiosarcoma in dogs, but prognosis is generally poor.

Hypothesis/objectives

To determine clinical outcome with carboplatin chemotherapy after splenectomy compared to doxorubicin‐based protocols. A secondary objective was to determine if peripheral monocyte count was associated with prognosis.

Animals

Medical data from 40 dogs with histopathologically confirmed stage I or II hemangiosarcoma treated with splenectomy and carboplatin (n = 18) or doxorubicin‐based protocols (n = 22) were evaluated.

Methods

Retrospective study. Statistical associations were assessed using the Kaplan‐Meier method for survival times and log rank analysis for differences in survival time. Demographic information and survival times were obtained via medical records. Blood monocyte counts before and after surgery were documented.

Results

Median survival times were 160 days (48 to >559) and 139 days (54‐975), for dogs in the carboplatin (n = 18) and doxorubicin (n = 22) groups respectively (P = .82, hazards ratio [HR] [95% CI] = 1.075 [0.56‐2.07]). The median survival time for dogs whose monocyte counts decreased between splenectomy and chemotherapy initiation was 265 days, compared to 66 days for dogs with increased monocytes (P = .002, HR [95% CI] = 4.17 [1.21‐14.39]).

Conclusions and Clinical Importance

Carboplatin could be considered as an alternative in cases where doxorubicin might be contraindicated. Increasing postoperative peripheral monocyte counts might be associated with a poorer prognosis.
Congenital dyserythropoiesis and polymyopathy without cardiac disease in male Labrador retriever littermates
Authors: Thomas‐Hollands Alison , Shelton G. Diane , Guo Ling T. , Loughran Kerry , Kaiman Gregory , A. Hutton Tabitha , Walsh Koranda A.
Published: July 2021

Background

Two Labrador retriever littermates were identified based on incidentally noted marked microcytosis and inappropriate metarubricytosis. Muscle atrophy was noted and associated with distinctive pathological findings in biopsy samples from 1 dog studied. The disorder represents a rare clinical entity of suspected congenital dyserythropoiesis and polymyopathy. Clinicopathologic changes were similar to a previously reported syndrome of congenital dyserythropoiesis, congenital polymyopathy, and cardiac disease in 3 related English Springer Spaniel (ESS) dogs, but the dogs reported here did not have apparent cardiac disease.

Interventions

Bone marrow aspiration, electromyography, muscle biopsies, and an echocardiogram were performed on dog 1. Results supported dyserythropoiesis and congenital polymyopathy similar to reports in ESS dogs, but did not identify obvious cardiac disease.

Conclusion

The clinicopathologic changes of dyserythropoiesis and polymyopathy provide an easily recognizable phenotype for what appears to be a low morbidity syndrome. Early recognition may decrease unnecessary testing or euthanasia.
The time is ripe for functional genomics: Can epigenetic changes mediate reproductive timing?
Authors: Heckwolf Melanie J. , Meyer Britta S.
Published: July 2021

Populations are under strong selection to match reproductive timing with favourable environmental conditions. This becomes particularly important and challenging with increasing interannual environmental variability. Adjusting reproductive timing requires the ability to sense and interpret relevant environmental cues, while responding flexibly to their interannual variation. For instance, in seasonal species, reproductive timing is often dependent on photoperiod and temperature. Although many genes influencing the timing of reproduction have been identified, far less attention has been paid to the gene‐regulatory cascades orchestrating these complex gene‐environment interactions. In a From the Cover article in this issue of Molecular Ecology, Lindner, Laine, et al. (2021) addressed this knowledge gap by investigating the role of DNA methylation in mediating reproductive timing in the seasonally breeding great tit (Parus major). Using a clever blood sampling design, they investigated genome‐wide DNA methylation changes following individual female birds across multiple reproductive stages. This approach revealed 10 candidate genes with a strong correlation between promoter methylation and reproductive status. Some of these genes are known to be involved in reproductive timing (e.g., MYLK‐like or NR5A1), yet for others this function was previously unknown (Figure 1). Interestingly, NR5A1 is a key transcription factor, which may affect other genes that are part of the same regulatory network. The findings of Lindner, Laine, et al. (2021) provide a strong case for studying DNA methylation to uncover how gene‐environment interactions influence important life‐history traits, such as reproductive timing.