bluuebunny/crossref_metadata_2025 huggingface dataset:
National burden and risk factors of diabetes mellitus in China from 1990 to 2021: Results from the Global Burden of Disease study 2021
Authors: Deng Wenzhen , Zhao Li , Chen Cheng , Ren Ziyu , Jing Yuanyuan , Qiu Jingwen , Liu Dongfang
Published: October 2024

Background

In recent years, the prevalence and mortality rates of diabetes have been rising continuously, posing a significant threat to public health and placing a heavy burden on the population. This study was conducted to describe and analyze the burden of diabetes in China from 1990 to 2021 and its attributable risk factors.

Methods

Utilizing data from the Global Burden of Disease Study 2021, we analyzed the incidence, prevalence, and disability‐adjusted life years (DALYs) of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in China from 1990 to 2021. We extracted sex‐ and age‐specific data on diabetes, focusing on DALYs, years lived with disability, and years of life lost. Bayesian meta‐regression and spatiotemporal Gaussian process regression were used to estimate disease parameters. Age‐standardized rates (ASRs) and estimated annual percentage changes (EAPC) were calculated using direct standardization and log‐linear regression. The population‐attributable fractions were also determined for each risk factor.

Results

In 2021, the absolute number of incident diabetes mellitus (DM) cases was estimated at 4003543.82, including 32 000 T1DM and 3971486.24 T2DM cases. The ASRs were 244.57 for DM, 2.67 for T1DM, and 241.9 for T2DM (per 100 000 population). The absolute number of prevalent DM cases was 117288553.93, including 1442775.09 T1DM and 115845778.84 T2DM cases. The ASRs were 6142.29 for DM, 86.78 for T1DM, and 6055.51 for T2DM (per 100 000 population). In 2021, there were 178475.73 deaths caused by DM, with an ASR of mortality of 8.98 per 100 000 population. The DALYs due to DM in 2021 were 11713613.86, with an ASR of 585.43 per 100 000 population and an EAPC of 0.57. This increase can be attributed to several factors, including high body mass index, air pollution, and dietary habits.

Conclusions

The burden of diabetes is considerable, with high prevalence and incidence rates, highlighting the urgent need for public health interventions. Addressing factors like high fasting plasma glucose, body mass index, air pollution, and dietary risks through effective interventions is critical.

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Governance and policy implications of the Inflation Reduction Act: A European perspective
Authors: Suárez‐Cuesta David , Latorre Maria C.
Published: October 2024

This paper examines the US 2022 Inflation Reduction Act (IRA) alongside the EU's Net‐Zero Industry Act (NZIA) and Critical Raw Materials Act (CRMA) of 2023. We analyze their differential approaches to accelerating investment in clean technology, enhancing energy security and fortifying supply chains. Both regions share the objective of diminishing reliance on Chinese dominance in clean industries. The US seeks to stimulate private investment primarily via uncapped tax credits from 2022 to 2031, some of them subject to stringent domestic content requirements. The EU has reacted to the potential violation of World Trade Organization's rules and a possible green investment shift to the US In doing so, the EU is relying heavily on a regulatory strategy, with emphasis on the simplification of procedures. However, the EU's public funding model is vague and leaves details to the discretion of member states, risking fragmentation within the single market. Through the application of a dynamic computable general equilibrium model, we show that a 50% increase in demand for the IRA's uncapped tax credits could nearly triple US GDP outcomes by 2027. We highlight the contrast between the IRA's immediate fiscal incentives and the NZIA's regulatory approach, emphasising that the former are more attractive for firms.
Senescent cell transplantation into the skin induces age‐related peripheral dysfunction and cognitive decline
Authors: Franco Ana Catarina , Martini Helene , Victorelli Stella , Lagnado Anthony B. , Wyles Saranya P. , Rowsey Jennifer L. , Pirius Nicholas , Woo Seung‐Hwa , Costa Daniela G. , Chaib Selim , Tullius Stefan G. , Tchkonia Tamar , Kirkland James L. , Khosla Sundeep , Jurk Diana , Cavadas Claudia , Passos João F.
Published: October 2024

Cellular senescence is an established cause of cell and tissue aging. Senescent cells have been shown to increase in multiple organs during aging, including the skin. Here we hypothesized that senescent cells residing in the skin can spread senescence to distant organs, thereby accelerating systemic aging processes. To explore this hypothesis, we initially observed an increase in several markers of senescence in the skin of aging mice. Subsequently, we conducted experiments wherein senescent fibroblasts were transplanted into the dermis of young mice and assessed various age‐associated parameters. Our findings reveal that the presence of senescent cells in the dermal layer of young mice leads to increased senescence in both proximal and distal host tissues, alongside increased frailty, and impaired musculoskeletal function. Additionally, there was a significant decline in cognitive function, concomitant with increased expression of senescence‐associated markers within the hippocampus brain area. These results support the concept that the accumulation of senescent cells in the skin can exert remote effects on other organs including the brain, potentially explaining links between skin and brain disorders and diseases and, contributing to physical and cognitive decline associated with aging.
Affective dynamics surrounding craving, non‐heavy alcohol use and binge drinking in female patients with alcohol use disorder and controls: An experience sampling method study
Authors: Leenaerts Nicolas , Vaessen Thomas , Sunaert Stefan , Ceccarini Jenny , Vrieze Elske
Published: October 2024

Background and Aims

Studies show that higher levels of positive affect (PA) and lower levels of negative affect (NA) are related to craving and alcohol consumption at a daily level in men, but little is known on these associations at a momentary level, and whether they are present in women. This study measured the dynamics of within‐person NA and PA surrounding craving, non‐heavy alcohol use and binge drinking in women with alcohol use disorder (AUD) and female controls without AUD.

Methods

53 female patients with AUD and 75 female controls, all recruited in Belgium, were included in an experience sampling study where they reported on momentary NA, PA, craving and alcohol use in daily life over a period of 12 months. Assessments occurred eight times a day on Thursdays, Fridays and Saturdays in seven bursts of three weeks.

Results

Within‐person NA at a previous assessment (t−1) predicted craving at the current assessment (t0) in patients with AUD in a positive linear [β = 0.043; 95% confidence interval (CI) = 0.002, 0.057; P = 0.041] and quadratic fashion (β = 0.034; CI = 0.011, 0.057; P = 0.004). Within‐person PA at t−1 predicted craving at t0 in patients with AUD with a positive quadratic relation (β = 0.042; CI = 0.08, 0.065; P < 0.001). Within‐person NA at t−1 negatively predicted non‐heavy alcohol use at t0 in a linear fashion in controls (β = −0.495; CI = ‐0.677, ‐0.312; P < 0.001) and patients with AUD (β = −0.276; CI = ‐0.421, ‐0.132; P < 0.001). Within‐person PA at t−1 significantly predicted non‐heavy alcohol use at t0 with a positive linear term (β = 0.470; CI = 0.329, 0.610; P < 0.001) in controls, but with a positive linear term (β = 0.399; CI = 0.260, 0.454; P < 0.001) and a positive quadratic term (β = 0.203; CI = 0.060, 0.347; P = 0.003) in patients with AUD. Within‐person NA at t−1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (β = 0.236; CI = 0.060, 0.412; P = 0.008), but not for controls. Within‐person PA at t−1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (β = 0.378; CI = 0.215, 0.542; P < 0.001), and this was also the case for controls (β = 0.487; CI = 0.158, 0.770; P < 0.001). Non‐heavy alcohol use at t0 predicted lower levels of NA at t+1 in both patients with AUD (β = −0.161; SE = 0.044; CI = ‐0.248, 0.074; P = 0.001) and controls (β = −0.114; CI = ‐0.198, ‐0.029; P = 0.010). Non‐heavy alcohol use at t0 also predicted higher levels of PA at t+1 in both patients with AUD (β = 0.181; CI = 0.088, 0.274; P < 0.001) and controls (β = 0.189; CI = 0.101, 0.278; P < 0.001).

Conclusions

The momentary relation between affect and craving or alcohol use seems to be non‐linear in female patients with alcohol use disorder, whereby a worse mood predicts subsequent alcohol use, though more for binge drinking than for non‐heavy alcohol use.
The Careful Project: Evaluating the acceptability of local virtual reality experiences as a leisure activity for residents in aged care
Authors: Porock Davina , Cain Patricia , Young Christopher , Hilbers Julieanne , Bomm Maria , Ghosh Manonita , Stanley Mandy
Published: October 2024

Objectives

The aim of this project was to evaluate the feasibility and acceptability of virtual reality (VR) as a leisure activity for people living in residential aged care. Virtual reality experiences may offer alternatives for residents with limited mobility, or during times when older people are unable to leave residential care.

Methods

The intervention used VR videos delivered via a head‐mounted device. Video content was created by a local artist specifically for use with older Western Australian adults and used local content. VR sessions were videotaped for analysis. The evaluation included structured observation of video content to assess mood and engagement and post‐intervention interviews with participants.

Results

Mood and engagement scores indicated overall favourable mood and considerable positive engagement with the VR experience. Interview content analysis reflected the enjoyment participants took in visiting places they had once been and the surprising ways that the experience made them feel and act as though they were actually there. Videos featuring coastal visits were the most popular and videos featuring music were the most engaging. Some participants found the head‐mounted device uncomfortable. VR was considered potentially beneficial for residents with limited mobility or living with cognitive impairment.

Conclusions

Overall VR is a feasible and acceptable leisure activity for older people in residential care. The use of local content has the potential to prompt memories and generate new conversations. Future use of VR may consider different modes of video delivery and advancements in evaluation.
The epithelial barrier theory and its associated diseases
Authors: Sun Na , Ogulur Ismail , Mitamura Yasutaka , Yazici Duygu , Pat Yagiz , Bu Xiangting , Li Manru , Zhu Xueyi , Babayev Huseyn , Ardicli Sena , Ardicli Ozge , D'Avino Paolo , Kiykim Ayca , Sokolowska Milena , van de Veen Willem , Weidmann Lukas , Akdis Deniz , Ozdemir Banu Goker , Brüggen Marie Charlotte , Biedermann Luc , Straumann Alex , Kreienbühl Andrea , Guttman‐Yassky Emma , Santos Alexandra F. , Del Giacco Stefano , Traidl‐Hoffmann Claudia , Jackson David J. , Wang De‐Yun , Lauerma Antti , Breiteneder Heimo , Zhang Luo , O'Mahony Liam , Pfaar Oliver , O'Hehir Robyn , Eiwegger Thomas , Fokkens Wytske J. , Cabanillas Beatriz , Ozdemir Cevdet , Kistler Walter , Bayik Mahmut , Nadeau Kari C. , Torres Maria J. , Akdis Mübeccel , Jutel Marek , Agache Ioana , Akdis Cezmi A.
Published: October 2024

The prevalence of many chronic noncommunicable diseases has been steadily rising over the past six decades. During this time, over 350,000 new chemical substances have been introduced to the lives of humans. In recent years, the epithelial barrier theory came to light explaining the growing prevalence and exacerbations of these diseases worldwide. It attributes their onset to a functionally impaired epithelial barrier triggered by the toxicity of the exposed substances, associated with microbial dysbiosis, immune system activation, and inflammation. Diseases encompassed by the epithelial barrier theory share common features such as an increased prevalence after the 1960s or 2000s that cannot (solely) be accounted for by the emergence of improved diagnostic methods. Other common traits include epithelial barrier defects, microbial dysbiosis with loss of commensals and colonization of opportunistic pathogens, and circulating inflammatory cells and cytokines. In addition, practically unrelated diseases that fulfill these criteria have started to emerge as multimorbidities during the last decades. Here, we provide a comprehensive overview of diseases encompassed by the epithelial barrier theory and discuss evidence and similarities for their epidemiology, genetic susceptibility, epithelial barrier dysfunction, microbial dysbiosis, and tissue inflammation.
An anatomical analysis of liver volume and quality by ethnicity in a New Zealand population
Authors: Kim Hannah , McRedmond Liam , McFarlin Paul , Ritchie Darren , Heblij Pieter , Dunn Joel , Connor Saxon
Published: October 2024

Background

Post‐hepatectomy liver failure is a major cause of mortality, where future liver remnant (FLR) is the key controllable factor. Recommended minimum FLR is influenced by quality of liver parenchyma. Historical research has often failed to include Māori and Pacific Island (PI) populations despite worse health outcomes. Liver analysis by ethnicity is one such example of this. The aims were to determine digital FLR for various anatomical hepatectomies, investigate any correlations between computed tomography (CT) hepatic textural analysis and body mass index (BMI); and assess the variance of these relationships for different ethnicities.

Method

One hundred and fifty‐one patients who underwent abdominal CT scans at Burwood Hospital, Christchurch were retrospectively analysed. Māori and PI patients were selectively recruited to represent New Zealand's diversity. Liver volumetry, segmental ratio, and intra‐hepatic fat deposits (IHFD) per ethnicity were examined.

Results

Median age of the cohort was 66 (19–95) and 75 (50%) were males. 68%, 23% and 9% patients identified as being European, Māori/PI and Asian, respectively. No statistically significant difference in volume or segment/total volume ratio were noted across different ethnicities. Obese patients had higher IHFD compared with overweight and normal BMI groups. When stratified across ethnic groups, higher IHFD were observed in Asian compared with Māori/PI populations, despite lower BMI.

Conclusion

No significant variances in liver volumetry were found across different ethnic groups in New Zealand. However association between BMI and IHFD varied across different ethnic cohorts. Consequently, knowledge of liver volumetry is not enough; patient liver quality and ethnicity should considered for hepatic‐surgery planning.
Prevalence and characteristics of 11 potentially diarrhoeagenic microbes in asymptomatic individuals in Norway, 2015–2020
Authors: Weme Einar Tollaksen , Brandal Lin Thorstensen , Jenum Pål Arne , Wester Astrid Louise , Müller Fredrik
Published: October 2024

We aimed to estimate the prevalence of potentially diarrhoeagenic microbes (PDMs) in faecal samples from asymptomatic individuals in a high‐income country, identify risk factors for carriage and to identify microbial factors that differ between PDMs in asymptomatic versus symptomatic individuals. Samples from 1000 asymptomatic participants were collected, together with a questionnaire, between 2015 and 2020 and examined by PCR for 11 PDMs. Isolates were characterised and potential risk factors were registered. Atypical enteropathogenic Escherichia coli (aEPEC), Yersinia enterocolitica, Shiga toxin‐producing E. coli (STEC), enterotoxigenic E. coli (ETEC) and Campylobacter spp. were found in 163 (16%), 20 (2.0%), 17 (1.7%), 12 (1.2%) and 11 (1.1%) asymptomatic individuals, respectively. Other PDMs were rare. Only low virulent STEC, with stx1c, stx2b or stx2f, was detected. Travels outside Europe was a significant risk factor for detecting Campylobacter spp. (odds ratio (OR) 6.99; 95% CI 1.12–43.6) and ETEC (OR 11.4; 95% CI 1.26–102). Individuals ≥65 years of age had lower odds of carrying STEC (OR 0.11; 95% CI 0.02–0.57) or EPEC (OR 0.09; 95% CI 0.05–0.16) than individuals ≤5 years of age. The common finding of PDMs in asymptomatic individuals could have implications for the interpretation of positive findings in clinical samples and infection control measures.
Material hardship and use of social safety net programs among LGBT adults and their families
Authors: Henderson Emmett R. , Hotchkiss Maiya , Lin Clarisse A. , Blosnich John R.
Published: October 2024

Lesbian, gay, bisexual, and transgender (LGBT) people experience higher levels of economic insecurity and poverty compared to non‐LGBT people. Social safety net programs may reduce this disparity, but the uptake of these programs among LGBT adults has rarely been assessed. We conducted a secondary data analysis of the 2018–2020 Well‐Being and Basic Needs Survey to compare differences in material hardship and social safety net program utilization between LGBT and non‐LGBT adults in the United States. LGBT participants were more likely to report lack of an emergency fund, food insecurity, utilities hardship, medical hardship, and multiple material hardships. LGBT adults had higher odds compared to non‐LGBT adults of using SNAP, income‐ or disability‐based insurance, SSI or SSDI, and housing assistance. There were no differences in use of WIC, reduced‐price/free school lunch benefits, or charitable food. Future studies are needed to evaluate the efficacy of the social safety net programs for reducing material hardship.
Implicit associations with non‐suicidal self‐injury: Examination in a clinical sample by borderline personality symptomatology
Authors: Steele Stephanie Jarvi , Jaffe Nigel M. , Kelly Claire A. , Björgvinsson Thröstur , Swenson Lance P.
Published: October 2024

Objectives

We examine correlates and predictors for implicit associations with non‐suicidal self‐injury (NSSI) with the Self‐Injury Implicit Association Test (SI‐IAT) in a treatment‐seeking sample. We also examine group differences in the SI‐IAT among those with low/none, moderate and high/clinically significant borderline personality disorder (BPD) symptomatology in a treatment‐seeking sample.

Methods

Participants (N = 111; 58% female; 89% White; Mage = 30.25) completed the SI‐IAT and self‐report measures at two time points.

Results

Higher BPD symptom scores were significantly, positively correlated with implicit identification with NSSI, and predicted NSSI identity when controlling for depression indices, history of NSSI and other covariates. With Time 1 SI‐IAT scores entered as a covariate, BPD scores no longer significantly predicted Time 2 SI‐IAT scores. Individuals with moderate and high/clinically significant symptom counts of BPD had higher/stronger implicit associations with NSSI identity than those with no/low BPD symptoms.

Conclusions

Individuals with symptoms of BPD may implicitly identify with NSSI more than other clinical groups; examination of implicit assessments in BPD in future research is needed to further explore implicit identification with NSSI in this patient group to further understand both cross‐sectional and prospective relations.
Was Anna Freud a “friend of Dorothy”? A queer phenomenological historiography of Anna Freud and Dorothy Burlingham's personal and professional relationship
Authors: Mossop Harriet
Published: October 2024

The nature of Anna Freud and Dorothy Burlingham's 5‐decade‐long personal and professional relationship has always been subject to speculation. This paper considers the historiography of this important and enigmatic relationship from 1920s Vienna to today. Drawing on Sara Ahmed's Queer Phenomenology, which theorises sexual orientation and whiteness in spatial terms, I illustrate how the relationship was seen as deviating from the ‘straight lines’ of mid‐20th century heteronormative society. I extend this queer phenomenological approach to think about cultural orientations to the relationship through an examination of its depiction in biographies published in the 1980s, the collections at the Freud Museums in London and Vienna, and a fictionalised account of Anna Freud's life published in 2014. Extending Ahmed's queer phenomenological vocabulary, I identify examples of ‘straightening up’, ‘straightening devices’ and ‘straightening up by queering’. The possibility of finding ‘queer angles’ in Anna Freud's early clinical writings, in contrast to the normative tendencies of her later writing on ego psychology, is explored as a counterbalance to discussions about non‐normative sexuality and gender in psychotherapy which typically position these as something new. The relevance for clinical practice today is considered through the lens of an ethical imperative to find space for queer angles in the history of psychoanalysis.
Viviana A. Zelizer: Sociologist of the family and intimacy
Authors: Lazarus Jeanne , Pugliese Maude
Published: October 2024

This article is an introduction to the themed section titled, “Viviana A. Zelizer: Sociologist of the Family and Intimacy.” It first reviews the major works of Viviana Zelizer and their significance for the social studies of families and intimacy, underscoring how she has accounted for the interplay between family and economy through a series of objects: life insurance, the assessment of children's value, the social meaning of money, and, more recently, intimacy. The second part of the article describes extensions of Zelizer's work in the fields of family and intimacy studies and presents the four articles featured in the themed section.
Provider costs of treating opioid dependence with extended‐release buprenorphine in Australia
Authors: Settumba Stella , Shahbazi Jeyran , Byrne Marianne , Degenhardt Louisa , Grebely Jason , Larance Briony , Nielsen Suzanne , Lintzeris Nicholas , Ali Robert , Rodgers Craig , Blazey Alison , Weiss Robert , Dunlop Adrian , McDonough Michael , Cook Jon , Farrell Michael
Published: October 2024

Introduction

The costs of providing medication‐assisted treatment for opioid dependence can determine its scale of provision. To provide estimates of the costs of extended‐release buprenorphine (BUP‐XR), we performed a bottom‐up costing analysis of provider operational treatment costs.

Methods

Data were collected in a single‐arm open label trial of BUP‐XR injections conducted in specialist public drug treatment services and primary care private practices in three Australian states (the CoLAB study). The unit costs of resources used for each activity were combined with quantities used at each participating facility to arrive at the average annual cost per client.

Results

One hundred participants across the six health facility sites received monthly subcutaneous BUP‐XR injections administered by a health‐care practitioner. The average cost of providing 1 year of treatment per participant was $6656 ($6026–$8326). Screening cost (initial assessment and medical history) was $282 while monthly follow‐up appointments cost $531 per client. The main cost driver was the monthly treatment costs accounting for 79% of the average annual client cost, with medication costs comprising 95% of this cost.

Discussion and Conclusion

With medication costs making up the largest proportion of treatment costs, treatment using BUP‐XR has the potential to free up other health system resources, for example, staff time. The costs reported in this study can be used in an economic evaluation to estimate the net benefit or cost‐effectiveness of BUP‐XR especially when compared to other opioid agonist treatments.
Mobilized Resilience and Development under Sanctions in Iran
Authors: Kalb Zep
Published: October 2024

How do states maintain economic development in the face of sanctions? Recent studies have examined economic resilience as a property of a system preceding a shock, leaving unanswered questions about how sanctioned states discipline employers and limit predatory behaviour. Using the case of Iran, this article aims to fill this gap by presenting a model of Mobilized resilience, describing how bottom‐up and top‐down mobilizations can create demand for institutional capacity. Integrating unique qualitative and quantitative material, the author argues that Iran's political elites responded to sanctions by launching top‐down campaigns that appealed to workers, promoted capital–labour unity, and demanded state commitment to development. These campaigns facilitated widespread labour protests that further empowered the state to block capital flight and steer firms onto more profitable, growth‐oriented routes. Labour ‘resistance’ thus unexpectedly helped to realize the Supreme Leader's calls for a ‘resistance economy’. These findings suggest that political support for worker mobilization in the context of sanctions can result in economic benefits, with significant consequences for our understanding of economic statecraft, development and labour movements.
Clinical genetic approaches to the management of patients with myotonic dystrophy type 1 and their families
Authors: Nakamura Katsuya
Published: October 2024

This commentary is on the original article by Trucco et al. on pages 365–373 of this issue.
Spatial Nonstationarity in Phenological Responses of Nearctic Birds to Climate Variability
Authors: Tonelli Benjamin A. , Youngflesh Casey , Cox Tyler , Neate‐Clegg Montague H. C. , Cohen Emily B. , Tingley Morgan W.
Published: October 2024

Climate change is shifting the phenology of migratory animals earlier; yet an understanding of how climate change leads to variable shifts across populations, species and communities remains hampered by limited spatial and taxonomic sampling. In this study, we used a hierarchical Bayesian model to analyse 88,965 site‐specific arrival dates from 222 bird species over 21 years to investigate the role of temperature, snowpack, precipitation, the El‐Niño/Southern Oscillation and the North Atlantic Oscillation on the spring arrival timing of Nearctic birds. Interannual variation in bird arrival on breeding grounds was most strongly explained by temperature and snowpack, and less strongly by precipitation and climate oscillations. Sensitivity of arrival timing to climatic variation exhibited spatial nonstationarity, being highly variable within and across species. A high degree of heterogeneity in phenological sensitivity suggests diverging responses to ongoing climatic changes at the population, species and community scale, with potentially negative demographic and ecological consequences.
The effectiveness of cryotherapy and cooled topical anesthesia compared with conventional topical anesthesia in alleviating intraoral injection pain: A systematic review and meta‐analysis
Authors: Saeedi Pooya , Sarraf Shirazi Alireza , Ghorbani Mahsa
Published: October 2024

Background

Injection pain remains a significant concern in dental procedures, often leading to patient anxiety and reluctance to seek necessary care.

Aim

This study aimed to assess the effectiveness of cryotherapy in reducing injection pain compared with topical anesthesia during intraoral local anesthesia.

Design

MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL databases were searched up to November 2023. Inclusion criteria involved randomized clinical trials aligned with the PICO question. Study selection, data extraction, and risk of bias assessment using the ROB‐2 tool were performed. The results were synthesized through a random‐effects inverse variance meta‐analysis. The primary outcomes assessed were the Visual Analogue Scale (VAS) and Sound Eye Motor (SEM). Subgroup analysis was conducted for children and adults.

Results

In the meta‐analysis, 31 RCTs involving 2470 subjects were included. Twenty‐seven studies demonstrated cryotherapy's significant superiority over topical anesthesia in reducing injection pain via VAS in adults (p = .01), children (p = .01), and combined age groups (p < .001). Additionally, cryotherapy significantly outperformed topical anesthesia in reducing pain via SEM in children (p = .04) and combined age groups (p = .03) across 13 studies, with no significant difference in adults (p = .51). Furthermore, cooled topical anesthesia also outperformed room temperature topical anesthesia (p < .001). The certainty of the results, however, is of very low quality.

Conclusions

Our results indicate that cryotherapy significantly reduces injection pain compared with topical anesthesia, especially in children and combined age groups, but is less effective in adults. Additionally, cooled topical anesthesia is more effective than room temperature topical anesthesia. Thus, cryotherapy is a and potentially superior alternative to topical anesthesia, particularly for children.
Risk Factors for Disease Aggravation in Older Patients With Non‐communicable Diseases: Interpretive Structural and Hierarchical Holographic Modelling
Authors: Sun Yuanqiu , Qu Xiaoyan , Hu Bo , Liu Man , Zhu Xiuli
Published: October 2024

Aims

This study aimed to analyse and determine the risk factors of disease aggravation faced by older patients with non‐communicable diseases (NCDs) and their interwoven correlations.

Design

We employed a descriptive and cross‐sectional study, which followed the STROBE guidelines for reporting.

Methods

We conducted a semi‐structured in‐depth interview with 26 older patients with NCDs from a hospital in Qingdao, China between July and August 2022 on the basis of the literature review. Then, we analysed data using the directed content analysis and determined risk factors through a focus group discussion and the Delphi consultation. Afterward, we combined interpretive structural modelling and hierarchical holographic modelling to construct a hierarchical structure model and drew relationship framework diagrams to exhibit diversified risk factors and complex interwoven correlations.

Results

We identified 30 risk factors from individual, interpersonal, organisational, community and policy levels. The hierarchical structure model constructed by interpretive structural modelling demonstrated a four‐layer structure, and the individual and interpersonal levels were at the highest layer. The relationship framework diagrams demonstrated the identification process of risk factors and interwoven correlations at individual and organisational levels.

Conclusions

Risk factors causing disease aggravation amongst older patients with NCDs are diverse. To delay the progression of NCDs, we should comprehensively explore risk factors, interpret the root causes and effects of risks from multiple perspectives and consider the interaction amongst multi‐level risk factors to develop precise measures related to risk control.

Impact

Controlling risk factors is an effective measure to postpone disease aggravation. Through this study, we provide a scientific and comprehensive basis for clinical risk screening so that healthcare providers can sense potential risk factors for disease aggravation in older patients' surroundings and formulate targeted nursing measures according to the risk factors faced by different patients.

Patient or Public Contribution

Patients participated in interviews to supplement risk factors included in our study. Experts provided opinions on the inclusion, exclusion and modification of risk factors.
What Determines Healthcare Workers to Seek Professional Psychological Support? A Cross‐Sectional Study
Authors: Wang Hui , Hu Yinhuan , Li Jiayi , Liu Sha , Feng Xiandong
Published: October 2024

Aim

Although healthcare workers often experience significant mental health challenges, their willingness to seek professional psychological help remains relatively low. However, the factors associated with healthcare workers' psychological help‐seeking remain unclear. This study aims to identify the determinants of professional psychological help‐seeking intention among healthcare workers based on the theory of planned behaviour.

Design

Cross‐sectional study.

Methods

A questionnaire, incorporating demographic information and latent variable items, was developed and employed on 403 healthcare workers through online and offline surveys from December 2022 to January 2023 using convenience sampling. Structural equation modelling was applied to test the research hypotheses.

Results

The model explained 46.9% of the variance in help‐seeking intention. Subjective norm had the strongest total association with help‐seeking intention. Attitude towards help‐seeking behaviour, subjective norm and perceived behavioural control were directly positively related to help‐seeking intention. Moreover, self‐stigma, public stigma, perceived barriers and perceived risk were indirectly associated with help‐seeking intention mediated by attitude towards the behaviour and perceived behavioural control. Of the four constructs, public stigma showed the most significant indirect relation to behavioural intention.

Conclusion

Healthcare workers' intention to seek psychological support is associated with multiple interacting factors, particularly subjective norm and public stigma. Targeted interventions addressing individual and systemic barriers are essential to create a supportive environment for healthcare workers to access mental health services.

Impact

This study identified key barriers and facilitators to healthcare workers seeking psychological support, which can assist authorities in enhancing mental health services and implementing tailored intervention strategies, thereby promoting help‐seeking behaviour among healthcare workers. Moreover, our research reinforces the applicability of the theory of planned behaviour in explaining healthcare workers' intention to seek professional psychological support.

Patient or Public Contribution

No patient or public contribution.
(Not) Going Out and Barriers to Leaving the House for People With Intellectual Disabilities Through the COVID‐19 Pandemic in the UK
Authors: Caton Sue , Hatton Chris , Bradshaw Jill , Jahoda Andrew , Kelly Rosemary , Maguire Roseann , Oloidi Edward , Taggart Laurence , Todd Stuart , Hastings Richard P. ,   the Coronavirus and People with Learning Disabilities Study Team
Published: October 2024

Background

People with intellectual disabilities commonly experience multiple barriers to ‘going out’.

Aims

This paper explores what barriers prevented people from going out, and if the extent and nature of going out changed over time for people with intellectual disabilities as the COVID‐19 pandemic progressed.

Methods

Data are drawn from a wider study that explored, at four time points, the experiences of people with intellectual disabilities through the COVID‐19 pandemic in the United Kingdom.

Findings

The number of people leaving the house for almost all reasons increased over time through the pandemic, except for some outdoor participation and exercise. However, there was a significant decrease in outdoor exercise at the final time point of the study. Reliance on other people and a lack of availability of support were identified as barriers.

Conclusion

A combination of factors restricted the extent to which people were going out even after COVID‐19 protections were lifted.
Hospital 4Ms: Documentation and association with patient characteristics
Authors: Welch Sarah A. , Archer Kristin R. , Hymel Alicia M. , Pennings Jacquelyn S. , Schwartz Andrea Wershof , Kang Christy , Qian Edward T. , Duggan Maria C. , Roumie Christianne L.
Published: October 2024

Background

For the thousands of health systems recognized as Age‐Friendly, considerable progress has been made to integrate 4Ms into clinical care. This study evaluated associations between 4Ms documentation and patient characteristics in an inpatient setting.

Methods

In this prospective cohort, hospitalizations included were from patients in an Acute Care for Elders (ACE) unit where the 4Ms were adopted and implemented. Each M (What Matters, Medication, Mentation, and Mobility) was stratified into three categories (not documented, partly documented, and fully documented) reflecting “assessment” and “action” clinical care processes. Electronic health records were reviewed for patient and hospitalization characteristics. Descriptive statistics evaluated these characteristics across categories of each M.

Results

There were 620 hospital encounters (573 patients) included in the cohort. Patients had a median age of 80 years [IQR 76, 86] and 85% were White. Of all 4Ms, What Matters had the lowest documentation with 413 (67%) of encounters falling into the not documented group. Medication had the highest documentation with 453 (73%) of encounters in the fully documented group. Significant differences in documentation were associated with age and partly versus fully documented Mobility (80 [76, 86] and 82 [77, 88] (p = 0.019)). Hospital length of stay was differentially associated with documentation of all 4M categories. Initial mobility scores were associated with not versus partly documented Medication (6 [2, 7] and 2 [2, 6] (p = 0.041)).

Conclusions

We developed a structured way to categorize “assessment” and “action” 4Ms care processes reflective of three documentation categories in the hospital (not, partly, and fully) and identified important patient and hospital characteristics associated with each. These results offer opportunities for future improvement efforts and insight to which characteristics may be important to measure with wider 4Ms adoption and uptake.
Therapeutic Performance of Needle Injection Versus Needle‐Free Jet Injector System for Polynucleotide Filler in Skin Rejuvenation
Authors: Hong Ji Yeon , Lee Yoon Hwan , Kim Hyun‐Jo , Park Kui Young
Published: October 2024

Background

Polynucleotide (PN) filler often causes pain and can lead to delivery inaccuracies when applied via intradermal injection using a traditional needle.

Aims

To evaluate the efficacy of treatment and the pain during the procedure using conventional needle injection versus a needle‐free jet system for intradermal PN filler application.

Methods

In this split‐face clinical trial, 10 Korean subjects were enrolled. Each subject received an intradermal injection of PN filler on one side of the face and a needle‐free jet injection using CureJet on the other side. Assessments included global and 3D skin imaging at each visit. Pain intensity was evaluated using visual analogue scale (VAS) scores during the injection. Additionally, patient satisfaction and adverse events were documented.

Results

Findings revealed that Global Aesthetic Improvement Scale scores and patient satisfaction were significantly higher with the CureJet compared to the needle injection method. VAS scores were notably lower on the CureJet side. Improvements in both pore and wrinkle indices were observed from baseline, with a more pronounced improvement rate on the CureJet side compared to the needle injection side.

Conclusions

Needle‐free injection of PN for aging skin was found to be effective in enhancing pore and wrinkle improvement, while reducing associated discomfort.
Experiences and Perceptions of Medication Management Communication During Transitions of Care for Residents in Aged Care Homes and Their Caregivers: A Qualitative Meta‐Synthesis
Authors: Dowling Alison , Garratt Stephanie , Manias Elizabeth
Published: October 2024

Aim

To explore the experiences and perceptions of communication about managing medication across transitions of care for residents living in aged care homes and their family caregivers.

Background

Effective medication communication across transitions of care involves exchanging information, resident, and family caregiver's participation in decision‐making, and shared responsibility.

Design

A qualitative meta‐synthesis.

Method

This review was conducted in accordance with the PRISMA 2020 guidelines and the accompanying 27‐item checklist. A systematic search of seven electronic databases (Embase, PsycINFO, Medline Ovid, Scopus, CINAHL, EmCare and Web of Science) was performed from inception to December 2023. Studies eligible for inclusion in this review were required to be published in peer‐reviewed English journals and focus on medication communication among healthcare providers, residents and family caregivers during transitions of care for aged care residents. The JBI Critical Appraisal Checklist for Qualitative Research was employed for the critical appraisal of the studies, and the COREQ checklist was used to evaluate their quality.

Results

Of the 2610 studies identified, 12 met the inclusion criteria. No study was excluded based on quality. Two main themes were generated: (1) Medication information exchange involving residents and families, and (2) resident and family factors influencing medication communication engagement. The findings revealed a lack of supportive structure for effective communication and collaboration among residents, family caregivers and healthcare providers during transitions of care, marked by one‐way interactions and limited evidence of shared decision‐making or family caregiver engagement in medication management communication, despite varying individual needs and preferences.

Conclusions

Communication about medication management during transitions of care focused on sharing details rather than active engagement. Residents and their family caregivers have individual needs and perspectives regarding communication about medication management, which are not well addressed by healthcare providers during transitions of care. Healthcare providers' communication remains limited, and family caregivers are underutilised.
The Relationship Between Discomfort Intolerance And the Fear Of Self‐Injection And Testing In Patients With Diabetes Using Insulin: A Cross‐Sectional Study
Authors: Töyer Şahin Nilhan , Ek Hülya , Pehlivan Seda
Published: October 2024

Background

Diabetes is a global problem. Diabetes nurses, in particular, take great responsibility in reducing and controlling the fears of individuals using insulin and increasing their capacity to tolerate discomfort.

Aim

This study was conducted to examine the effects of the capacity to tolerate discomfort on the fear of self‐injection and the status of testing blood glucose levels in patients with type 1 and type 2 diabetes using insulin.

Methods

This cross‐sectional study was conducted between December 2022 and February 2023 with 320 adult patients with type 1 and type 2 diabetes using insulin who were followed up in the Endocrinology and Internal Medicine Clinics of a university hospital in Turkey. The data analysis process included analyses of the frequency, independent‐samples t‐tests, one‐way ANOVA, the Kruskal–Wallis H test, and Pearson's correlation analysis. Data were analysed using the IBM SPSS v27.0 software, considering alpha as 0.05.

Results

The mean total Discomfort Intolerance Scale score of the patients was 22.78 ± 6.74, and the mean Fear of Self‐Injecting and self‐testing was 21.1 ± 6.7. A negative significant correlation was found between the discomfort intolerance levels of the patients and their levels of fear of self‐injection and self‐testing (p < 0.05).

Conclusion

Individuals with a higher capacity to tolerate discomfort have lower levels of fear of self‐testing and self‐injection. Therefore, the fear of self‐testing and self‐injection in patients using insulin injections may affect diabetes self‐management.

Relevance to Clinical Practice

Individuals with low tolerance for discomfort should be identified, interventions to increase tolerance in individuals at risk should be planned, and diabetes self‐management should be better supported.

Reporting Method

The reporting of the results of the study adhered to the STROBE guidelines.
Pharmaco‐Economic Assessment of Screening Strategies for High‐Risk MASLD in Primary Care
Authors: Younossi Zobair M. , Paik James M. , Henry Linda , Stepanova Maria , Nader Fatema
Published: October 2024

Background and Aims

Several scientific associations recommend a sequential combination of non‐invasive tests (NITs) to identify high‐risk MASLD patients but their cost‐effectiveness is unknown.

Methods

A cost‐utility model was developed to assess the incremental cost‐effectiveness ratio (ICER) of recommended screening strategies for patients with clinically suspected MASLD, specifically those with type 2 diabetes (T2D) and obesity with multiple cardiometabolic risk factors which will be initiated in primary care. Six screening strategies were assessed, using either vibration‐controlled transient elastography (VCTE) or the enhanced liver fibrosis (ELF) test as a second‐line test following an initial Fibrosis‐4 (FIB‐4) assessment as the first line NIT. The model included treatment effects of resmetirom for metabolic dysfunction‐associated steatohepatitis (MASH) patients with F2 or F3 fibrosis.

Results

All screening strategies for high‐risk MASLD in US incurred additional costs compared to no screening, ranging from $13 587 to $14 730 per patient with T2D and $14 274 to $15 661 per patient with obesity. However, screening reduced long‐term costs, ranging from $22 150 to $22 279 per patient with T2D and $13 704 to $13 705 per patient with obesity, compared to $24 221 and $14 956 for no screening, respectively. ICERs ranged from $26 913 to $27 884 per QALY for T2D patients and $23 265 to $24  992 per QALY for patients with obesity. While ICERs were influenced by VCTE availability, they remained cost‐effective when using ELF as the second‐line test. Our findings remain robust across a range of key parameters.

Conclusions

Screening for high‐risk MASLD is cost‐effective according to recent guidelines. Implementing these screening strategies in primary care should be considered.
Global Epidemiological Impact of PNPLA3 I148M on Liver Disease
Authors: Kozlitina Julia , Sookoian Silvia
Published: October 2024

The prevalence of metabolic dysfunction‐associated steatotic liver disease (MASLD) has increased exponentially over the past three decades, in parallel with the global rise in obesity and type 2 diabetes. It is currently the most common cause of liver‐related morbidity and mortality. Although obesity has been identified as a key factor in the increased prevalence of MASLD, individual differences in susceptibility are significantly influenced by genetic factors. PNPLA3 I148M (rs738409 C>G) is the variant with the greatest impact on the risk of developing progressive MASLD and likely other forms of steatotic liver disease. This variant is prevalent across the globe, with the risk allele (G) frequency exhibiting considerable variation. Here, we review the contribution of PNPLA3 I148M to global burden and regional differences in MASLD prevalence, focusing on recent evidence emerging from population‐based sequencing studies and prevalence assessments. We calculated the population attributable fraction (PAF) as a means of quantifying the impact of the variant on MASLD. Furthermore, we employ quantitative trait locus (QTL) analysis to ascertain the associations between rs738409 and a range of phenotypic traits. This analysis suggests that these QTLs may underpin pleiotropic effects on extrahepatic traits. Finally, we outline potential avenues for further research and identify key areas for investigation in future studies.