bluuebunny/crossref_metadata_2025 huggingface dataset:
Commentary on “enhancing living skills in Dravet syndrome through precision teaching”: a component–composite approach with an environmental modification
Authors: Solomon Risca
Published: December 2024

Purpose

This paper is a commentary that aims to address themes arising from the paper by Vascelli and Iacomini (2024); including compassionate teaching, barriers to component teaching and interdisciplinary working.

Design/methodology/approach

This opinion piece explores broader considerations of this research, such as the importance of efficient and effective teaching, social validity and the value of interdisciplinary collaboration.

Findings

This commentary discusses areas to consider the importance of identifying effective reinforcing consequences to maximise effective teaching and considerations for ensuring that the skills are embedded into everyday life, alongside discussion on some of the barriers around teaching discrete and component skills in isolation.

Originality/value

This commentary discusses how vital it is to involve caregivers, analyse caregiver contingencies and assess social validity to remain focused on teaching applied, socially significant skills.
Continuous learning in SMES: the mediating role of resilient dynamic capabilities across the firm life cycle
Authors: Quansah Emmanuel , Solansky Stephanie , Wang Yuan , Moghaddam Kaveh
Published: December 2024

Purpose

Small and medium-sized enterprises (SMEs) are critical in the global business environment, yet they face significant challenges of survival. This study aims to investigate the role of continuous learning and resilience dynamic capabilities (RDC) on SME performance.

Design/methodology/approach

The authors conducted a quantitative survey of leaders from 290 SMEs to examine the relationship between continuous learning and performance. Structural equation modeling (SEM) is used to test the dependent relationships in this study. In addition, the Monte Carlo Method is used to test the mediating effect of RDC.

Findings

The results suggest that there is a direct effect of continuous learning on firm performance, as well as an indirect effect through RDC. In other words, the effect of continuous learning on firm performance was partially mediated through RDC.

Originality/value

The authors also explored whether firm life cycle stage matters regarding the role of continuous learning and RDC in SMEs. The mediating role of RDC becomes more pronounced (fully mediated) as SMEs transition from the growth stage to maturity stage of their life cycle.
Virtual relational capital for business development: a case study
Authors: Zamboni Francesco , Paoloni Paola , Cavazza Alberto , Dal Mas Francesca
Published: December 2024

Purpose

The study aims to investigate virtual relational capital (VRC) to evaluate to what extent virtual relations (VR), obtained by using new technologies, support the development of firms, also considering the increasing sustainability’s needs. The study addresses the literature gap on VRC dynamics through an empirical analysis.

Design/methodology/approach

The investigation focuses on a single case study in the lighting industry, deepening the case of a small Italian company. The case is analyzed through the lens of the CAOS framework model by Paoloni, nurtured through direct semi-structured interviews with the entrepreneur and some managers and consultants, and data collected via web scraping.

Findings

VRC, obtained by the use of new technological tools, contributes to developing and fostering the innovation ecosystem in which companies need to create new skills and synergic alliances with other stakeholders. Moreover, VR can improve commercial and sales performance, stakeholder engagement and sustainability, including alignment with the circular economy and waste management principles. VRC can support smaller companies with more limited resources to connect to a broader range of actors, raising their voices with policymakers and other relevant international institutions.

Originality/value

The study contributes to the theoretical understanding of VRC, especially in an era in which new technologies play a fundamental role for both businesses and people. It also provides practical insights into how companies, especially smaller ones, can maximize their sustainable impact by strategically adopting virtual interactions with meaningful stakeholders like customers, key executive partners, industrial associations and policymakers.
Evangelical and Ecumenical? Irish Presbyterianism in the United Kingdom, 1938–47
Authors: Houston Matthew
Published: December 2024

From 1938 to 1947, a period of escalating international tensions and armed conflict, Christian intellectuals in Great Britain formed and engaged in various discussion groups, debating responses to such challenges as totalitarianism, warfare, peacekeeping, international and domestic social order, and the place of the church in society. Although neglected in the historiography of such groups, Christians in Northern Ireland engaged in similar discussions, most notably through the “Davey commission,” a group of Presbyterians under the leadership of J. Ernest Davey. By examining the work and findings of that group, this article contextualises Northern Ireland in the historiography of British Christian thinking during the Second World War. Until recently, historians of twentieth‐century Protestantism in Northern Ireland have emphasised the region's disconnectedness from Christianity in Britain and interpreted its development in terms of binary opposition between evangelicals and ecumenists. The article evaluates recent scholarship which has suggested the limits of these earlier perspectives, showing that, at least in terms of Presbyterianism, mid‐twentieth century Protestantism in Northern Ireland was indeed closely connected to British Christianity and characterised by evangelical and ecumenical co‐operation. In so doing, the article also suggests new directions for the study of Christianity in mid‐twentieth century Northern Ireland.
Gains–loss asymmetry of jobs, income, and risk‐taking behaviors
Authors: Nguyen Holly , Slocum Lee Ann
Published: December 2024

Despite extensive theorizing on the employment–crime link, little discussion has taken place on the mechanisms through which job gains and losses affect behavior. We draw on prospect theory and the loss aversion principle, which suggests people are more sensitive to losses than gains, to assess how individuals contend with transitions in employment and income. Using fixed‐effects and asymmetrical fixed‐effects models, we analyze 36 months of retrospective information for a sample of incarcerated males collected as part of the Second Nebraska Inmate Study. First, we assess whether job losses are more likely than job gains to generate financial stress and find support for the loss aversion principle. Second, we explore how people might compensate for changes in job and income status by engaging in risk‐taking behaviors (illegal earnings, gun carrying, and offending versatility). We find the positive relationship between job and income loss on the probability of reporting illegal earnings and crime versatility is stronger than the negative relationship between job and income gain and these behaviors. Financial stress, however, does not attenuate the relationship between losses and risk‐taking behaviors. We discuss the implications for theory and policy.
A Safaitic–Greek Graffito by a Shepherd in the Black Desert of Jordan
Authors: Hayajneh Hani , Harahsheh Rafe , Aliquot Julien
Published: December 2024

A newly discovered bilingual rock‐cut graffito from Qāʿ Raʿd is presented here. This Safaitic–Greek inscription recalls the stay of a shepherd and his flock in the basaltic desert of northeast Jordan. Although numerous documents have largely confirmed the presence of nomadic pastoralists in the same area, proven bilingual examples are exceptionally rare. This discovery once again raises questions about the role of the Greek language among the populations living on the outskirts of the Roman province of Arabia.
Phenotypic upregulation of hexocylceramides and ether‐linked phosphocholines as markers of human extreme longevity
Authors: Fernàndez‐Bernal Anna , Sol Joaquim , Galo‐Licona José Daniel , Mota‐Martorell Natàlia , Mas‐Bargues Cristina , Belenguer‐Varea Ángel , Obis Èlia , Viña José , Borrás Consuelo , Jové Mariona , Pamplona Reinald
Published: December 2024

Centenarians and their relatives possess a notable survival advantage, with higher longevity and reduced susceptibility to major age‐related diseases. To date, characteristic omics profiles of centenarians have been described, demonstrating that these individuals with exceptional longevity regulate their metabolism to adapt and incorporate more resilient biomolecules into their cells. Among these adaptations, the lipidomic profile stands out. However, it has not yet been determined whether this lipidomic profile is specific to centenarians or is the consequence of extreme longevity genetics and is also present in centenarians' offspring. This distinction is crucial for defining potential therapeutic targets that could help delay the aging process and associated pathologies. We applied mass‐spectrometry‐based techniques to quantify 569 lipid species in plasma samples from 39 centenarians, 63 centenarians' offspring, and 69 noncentenarians' offspring without familial connections. Based on this profile, we calculated different indexes to characterize the functional and structural properties of plasma lipidome. Our findings demonstrate that extreme longevity genetics (centenarians and centenarians' offspring) determines a specific lipidomic signature characterized by (i) an enrichment of hexosylceramides, (ii) a decrease of specific species of ceramides and sulfatides, (iii) a global increase of ether‐PC and ether‐LPC, and (iv) changes in the fluidity and diversity of specific lipid classes. We point out the conversion of ceramides to hexosylceramides and the maintenance of the levels of the ether‐linked PC as a phenotypic trait to guarantee extreme longevity. We propose that this molecular signature is the result of an intrinsic adaptive program that preserves protective mechanisms and cellular identity.
In vitro evaluation of the influence of ultrasonic activation on physicochemical properties of three endodontic repair materials
Authors: Frota Luciana Maria Arcanjo , Aguiar Bernardo Almeida , Luna‐Cruz Suyane Maria , Limoeiro Ana Grasiela , Alcalde Murilo Priori , Vivan Rodrigo Ricci , Duarte Marco Antonio Hungaro , de Vasconcelos Bruno Carvalho
Published: December 2024

The influence of ultrasonic activation (UA) on the physicochemical properties of setting time (n = 5), volumetric stability (n = 10), alkalizing activity/calcium ions release (pH/Ca2+) (n = 10) and calcium/phosphate‐rich substance formation in simulated body fluid (Hank's balanced salt solution; HBSS) of three cements was evaluated: white MTA‐Angelus (MTA), MTA Repair HP (MTAHP) and Biodentine (BIO). It was observed that UA influenced the setting times (min) distinctly, delaying the initial setting time of MTA (40.8/64.6) and accelerating that of BIO (35.6/22.4). The final setting time of MTAHP (154.4/114.6) and BIO (64.4/42.4) were also accelerated (p < 0.05). Volumetric reduction was observed in all groups, with MTA/UA being the most volumetrically stable (0.98%); UA did not influence volumetric stability (p > 0.05). All groups exhibited an alkaline pH, with a disadvantage for MTAHP and MTAHP/UA at 24 h, 72 h and 168 h (p < 0.05). All groups showed Ca2+ release. The tested cements exhibited a favourable Ca/P ratio on their surface after 28 days.
Hypothetical bias and cognitive ability: Farmers' preference for crop insurance products†
Authors: Veettil Prakashan Chellattan , Yashodha Yashodha , Vecci Joseph
Published: December 2024

The absence of an incentive‐compatible mechanism to reveal consumers' true willingness to pay in stated preference elicitation methods and the consequent hypothetical bias are an important concern in discrete choice experiments. Our study extends this discourse on hypothetical bias by examining how it varies with the heterogeneity in respondents' cognitive ability and familiarity with a good. This paper also adds to our understanding of the demand for agricultural insurance in developing countries by studying the willingness to pay for one of the world's largest agricultural insurance programs using a large state representative sample. Following a between‐subject design, we implemented a large scale randomized incentivized choice experiment and hypothetical choice experiment with real farmers who make decisions on the purchase of insurance. We find that demand for an insurance product is shaped by the subject's familiarity with and cognitive ability to understand the product. We show that the magnitude of the hypothetical bias is higher at a lower level of cognitive ability and that bias diminishes with an increase in cognitive ability. Finally, we examine key heterogeneity and test a number of possible mechanisms.
Leucine‐Rich Alpha‐2 Glycoprotein Is Associated With Transmural Inflammation Assessed by Intestinal Ultrasound in Patients With Crohn's Disease
Authors: Komatsu Moeko , Sagami Shintaro , Hojo Aya , Karashima Ryo , Maeda Masa , Yamana Yoko , Serizawa Kanade , Umeda Satoko , Asonuma Kunio , Nakano Masaru , Hibi Toshifumi , Matsuda Takahisa , Kobayashi Taku
Published: December 2024

Background

Intestinal ultrasound (IUS) is a non‐invasive tool for evaluating transmural inflammation in Crohn's disease (CD). However, its utility is constrained by operator dependency and limited accessibility.

Aims

To explore the feasibility of serum biomarkers—specifically leucine‐rich alpha‐2 glycoprotein (LRG)—as an alternative to IUS for assessing transmural inflammation.

Methods

This retrospective, single‐centre study included patients with CD who underwent IUS and measurements of LRG and C‐reactive protein (CRP). We assessed correlations between biomarkers and five IUS scores (Limberg score, Bowel Ultrasound Score (BUSS), International Bowel Ultrasound Segmental Activity Score (IBUS‐SAS), Simple Ultrasound Score (Simple‐US) and Simple Ultrasound Score for Crohn's Disease (SUS‐CD)) using receiver operator characteristic curve analysis and Spearman's rank correlation coefficient. We conducted subgroup analyses for patients in clinical remission.

Results

We analysed 213 IUS examinations performed on 97 patients; 170 (80%) IUS were during clinical remission. The area under the curve for LRG for each IUS score (0.76, 0.80, 0.77, 0.75 and 0.69, respectively) was superior to that of CRP and was statistically significant, particularly for LS, BUSS, IBUS‐SAS and Simple‐US (p < 0.001, p = 0.018, p < 0.001 and p < 0.001, respectively). Predictive values remained consistent among patients in remission. LRG demonstrated excellent correlation with IUS scores in both the overall patient population and those in remission.

Conclusion

LRG showed a robust correlation with IUS scores, suggesting its potential as a novel indicator for targeting transmural healing in patients with CD.
The Cultural, Social and Political Contexts of Diplomacy: Taiwan and Its Pacific Island Allies
Authors: Marinaccio Jess
Published: December 2024

Given Taiwan's limited formal diplomatic recognition, this paper examines interviews with diplomats/officials from one of Taiwan's Pacific allies, Tuvalu, as well as interviews with other Pacific diplomats in Taiwan and Taiwanese diplomats/officials, to outline diverging conceptions of diplomacy in Taiwan's official alliances. The paper first analyses interviews with Pacific diplomats in Taiwan, discussing how diplomats link meanings of diplomacy to socio‐cultural protocols in their home countries. Three themes that emerge in explanations of diplomacy are bartering/exchange, building/maintaining friendships and properly building/reinforcing inter‐island relationships. The paper next considers how interviews with Tuvaluan diplomats/officials focused on themes similar to those outlined by other Pacific diplomats but also revealed specific cultural mechanisms of diplomacy including the alofa, or ‘giving of gifts’. Subsequently, the article examines how Taiwanese diplomats/officials contemplate diplomacy, specifically how Taiwan's competition with China/the PRC has created negative conceptions of formal diplomacy. Taiwanese ideas of diplomacy often clash with Tuvaluan/Pacific conceptions because Taiwan sees diplomatic allies as always on the verge of severing ties and inherently disloyal. The conclusion discusses how cultural values and their influence on conceptions of diplomacy can engender tension in diplomatic relationships while also underscoring the importance of seeing diplomacy as both multifaceted and multiply understood.
The moderation effect of mental health services use on the relationship between exposures to adverse childhood experiences and mental health outcomes among US adolescents
Authors: Kim Lyoung Hee , Lee Seung Joo , Ahn So Young
Published: December 2024

Background

The prevailing exposure to Adverse Childhood Experiences (ACEs) among youth is associated with adolescents' mental health. However, few studies have examined whether receiving help from mental health services affects mental health outcomes among adolescents with ACEs. Therefore, this study examines the moderated effects of mental health services use on the relationship between exposures to ACEs and mental health outcomes among US adolescents.

Methods

The sample was restricted to adolescents aged 11–17 using data from the National Health Interview Survey (NHIS) from 2019, 2021, and 2022. Multivariate logistic regressions and descriptive analyses were performed to estimate the moderation effect of mental health services use.

Results

Using mental health services buffered the associations between ACEs and severe anxiety and depressive symptoms. Receiving counseling/therapy moderated the impact of ever living with an individual who had severe anxiety (Adjusted Odds Ratio, AOR: 0.58, p < .05) and depressive symptoms (AOR: 0.38, p < .01) among adolescents. Furthermore, counseling/therapy moderated the effect of ever living with an individual with a history of alcohol or drug abuse on severe depressive symptoms (AOR: 0.49, p < .05) and the effect of being a victim or witness of violence on severe anxiety symptoms (AOR: 0.45, p < .01). In addition, taking prescription medication moderated the effect of the experience of incarcerated family members on severe anxiety symptoms (AOR: 0.41, p < .05).

Conclusion

Our findings suggest that policy and practice need to encourage access to mental health care for vulnerable adolescents with ACEs to reduce the detrimental effect of their experiences on their mental health problems.
Food Allergy in Children in China
Authors: Leung Agnes Sze‐Yin , Jie Shao , Gu Yanjun , Wong Gary Wing‐Kin
Published: December 2024

The prevalence of food allergies in China seems to be increasing, but there are limited studies describing the pattern of food allergies across the country. This review highlights regional variations observed across China, with data indicating a higher prevalence in the more economically developed eastern and southern coastal regions compared to inland areas. Egg and milk are the most common allergies among children under 3 years old; for children above 3 years old, specific food allergens also show regional differences, with shellfish allergies being more common in southern and eastern coastal areas, while wheat and fruit allergies are more prevalent in northern regions. Emerging peanut and tree nut allergies have also been observed in China's megacities, although the prevalence remains relatively low compared to Western countries. These geographic and environmental influences highlight the complexity of the food allergy landscape in China and the need for a more nuanced understanding of the underlying drivers. Despite the growing burden of food allergies, significant gaps exist in effectively managing these conditions in China. Lack of standardised diagnostic tools, limited access to oral food challenges and a shortage of trained allergists pose major challenges. Another critical gap is the limited availability and affordability of epinephrine autoinjectors, essential for managing life‐threatening anaphylactic reactions. Addressing these systemic deficiencies in China's food allergy management infrastructure will require concerted efforts from policymakers, healthcare systems and pharmaceutical companies. Investing in the development of standardised diagnostics, expanding the allergy speciality workforce and ensuring equitable access to emergency care and treatment options are crucial steps towards improving health outcomes for the millions of individuals affected by food allergies in China.
Pattern of Ophthalmic Injuries in Patients With Maxillofacial Fractures at a Tertiary Care Centre in Central India
Authors: Khan Tauseef Ahmed , Tripathi Geeta Mishra , Mishra Ambrish , Sharma Divashree , Dwivedi Anamika
Published: December 2024

Introduction

Maxillofacial injuries are usually associated with ophthalmic injuries that may be mild to severe, and may even result in loss of integrity of the orbital skeleton and impairment of the visual apparatus.

Aim

To evaluate the pattern of ophthalmic injuries associated with maxillofacial fractures in patients who reported to a tertiary care hospital, associated with a medical college in M.P, India.

Material and Methods

The records of patients who sustained ophthalmic injuries with maxillofacial trauma from 1st January 2012 to 31st January 2024 and reported to the Department of Dentistry of a tertiary care hospital were evaluated. The data related to demographic characteristics, aetiology of trauma, type of maxillofacial fractures and pattern of ophthalmic injuries were gathered and analysed.

Results

A total of 1575 patients with maxillofacial trauma reported to the institute during the study duration. The study sample comprised 1046 (66.41%) maxillofacial trauma patients who sustained ophthalmic injuries. Males were more commonly involved (85.85%) than females (14.15%). The commonly involved age group was 21–30 years with 34.32% of patients belonging to the age group. The most common aetiology was road traffic accidents, reported in 71.89% of patients. Zygomaticomaxillary complex (ZMC) fractures were evident in 73.52%, mandibular fractures in 50.19%, naso‐orbito‐ethmoidal (NOE) fractures in 19.41% and frontal bone fractures in 18.74% patients. Subconjunctival haemorrhage was seen in 79.83%, periorbital ecchymosis in 72.94% and periorbital oedema in 60.32% of cases. Retrobulbar haemorrhage was seen in 2.58%, traumatic optic neuropathy in 2.01% and retinal detachment in 0.86% of cases.

Conclusion

Ophthalmic injuries were seen frequently in 66.41% of cases with maxillofacial trauma, particularly in zygomatic complex fractures (73.52%). The findings emphasise that the competency of maxillofacial surgeons plays a vital role in comprehending the severity and management of post‐traumatic ophthalmic consequences in maxillofacial injuries. Also, ophthalmological evaluation in maxillofacial trauma, particularly involving the midface should be considered mandatory.
Neuronal HIF‐1α expression in mediobasal hypothalamus affects glycolipid metabolism and body weight in mice fed with high‐fat diet
Authors: Ma Lijuan , Rozjan Azmat , Duolikun Dilihumaier , Guo Hai , Yao Qiaoling
Published: December 2024

This study aimed to explore the interaction between the expression of neuronal HIF‐1α in the mediobasal hypothalamus and food intake, glycolipid metabolism and body weight (BW) in mice consuming high‐fat diet (HFD). In HIF‐1αflox/flox mice, AAV‐hSyn‐GFP (NC group) or AAV‐hSyn‐cre‐GFP (KD group) virus was injected into medial base of the hypothalamus. Frozen brain tissue sections confirmed the presence of the virus within the hypothalamus of mice after 28 days of AAV injection, including reporter signals within the arcuate nucleus, dorsomedial hypothalamic nucleus (DMH) and ventromedial hypothalamus (VMH). Consistently, the levels of HIF‐1α mRNA in the ventral hypothalamus were significantly lower in the KD group compared to the NC group. These KD mice also demonstrated significantly increased food intake, body weight (BW), total cholesterol (TC), high‐density lipoprotein (HDL), low‐density lipoprotein (LDL) and serum insulin, combined with higher blood glucose, compared to NC animals. However, the levels of triglycerides and FFA were similar in both groups. Significant differences in p‐Akt levels were not observed in the skeletal muscle, liver or epididymal fat in KD mice after insulin injection. In conclusion, the knockdown of HIF‐1α within the neurons of mediobasal hypothalamus results in an increase in the appetite of mice fed with HFD, which in turn leads to a significant dysregulation of lipid and glucose metabolism and a corresponding increase in weight. Therefore, the neuronal HIF‐1α expression in the mediobasal hypothalamus may be a critical regulator of glycolipid metabolism and body weight control when a high‐fat diet is consumed.
Identification of Potential Biomarkers and Pathways in Acute Myeloid Leukemia: Correlation Between the Calcineurin Signaling Pathway and Vascular Brittleness in Acute Myeloid Leukemia
Authors: Alharbi Homood , Ahmad Mohammad , Cui Zhong , Meng Dong , Xin Ying , Yan Xues
Published: December 2024

Objective

In this study, clinical bioinformatics analysis was used to identify potential biomarkers of acute myeloid leukemia (AML) occurrence and development, drug resistance, and poor prognosis to provide a theoretical basis for the treatment of AML.

Methods

On the basis of the TCGA, GEO, and GTEx databases, an AML secondary database was established, and differential expression analysis and WGCNA were carried out to identify genes related to the prognosis of AML patients. Survival analysis was carried out for internal verification of key genes, and GEO data were used for external verification to obtain core genes related to prognosis. For differentially expressed genes, the EpiMed platform independently developed by the team was used for drug prediction.

Results

A total of 36 overlapping genes were obtained via difference analysis and WGCNA. Enrichment analysis revealed that the overlapping genes were associated with neutrophil activation, transcription dysregulation, AML, apoptosis, and other biological indicators. A protein interaction network was constructed for NCOA4, ACSL4, DPP4, ATL1, MT1G, ALOX15, and SLC7A11, which are key genes. Survival analysis revealed that NCOA4, ACSL4, DPP4, and ATL1 significantly affected the survival of patients with AML. The GSE142698 dataset verified that MPO, BCL2A1, and STMN1 had a statistically significant impact on the survival of AML patients.

Conclusion

NCOA4, ACSL4, DPP4, and ATL1 may be potential biomarkers related to the survival and prognosis of patients with AML, and the calcineurin signaling pathway is associated with the risk of vascular fragility in AML patients, which can provide a reference for further research and optimization of treatment regimens.
Paternal Physical Punishment and Neglect: Does It Increase the Odds of Toothache in Children and Adolescents?
Authors: de Aquino Goulart Mariél , Possebon Müller Letícia , Oliva Vinholes Anelisa , Mello dos Santos Camila , Celeste Roger Keller
Published: December 2024

Background

Physical punishment by caregivers affects approximately 60% of children between the ages of 2 and 14 worldwide.

Aim

To evaluate the association between physical punishment and paternal neglect of children and adolescents and toothache.

Design

This cross‐sectional study included all schoolchildren between the ages of 9 and 19 from a small Brazilian town in 2016 (n = 329). Toothache was assessed through a structured questionnaire using the question: “In the last six months, have you experienced a toothache?” (yes/no). The main exposures consisted of six validated questions about negligence and six about physical punishment, both with three potential answers: Always (2 points), sometimes (1 point) or never (0 points). Logistic regression models were fitted to estimate the association between paternal physical punishment/neglect and toothache, adjusted for sex, age, family equivalent income and parents' level of education.

Results

Thirty‐seven percent of the children reported no physical punishment, while 19% reported no negligence. The odds ratio (OR) of toothache for every 1 point increase on the abuse or negligence scale was OR = 1.27 (95% Confidence Intervals (CI) = 1.08–1.50) and OR = 1.10 (95% CI = 0.96–1.26), respectively. If the child's mother had started and/or finished university, the OR of toothache is lower.

Conclusions

Paternal physical punishment is associated with toothache.
The Role of Nurse Implementation Scientists in Leading Health System Transformation in Atlantic Canada and Beyond: A Discussion Paper
Authors: Campbell Alyson , Cassidy Christine
Published: December 2024

Aim

To discuss and provide examples of how nurse implementation scientists can support health system transformation.

Design

Discussion paper.

Methods

Using Prince Edward Island's health system strategic plan as a case exemplar, selected key priorities in the strategic plan were mapped with examples and discussion of how nurse implementation scientists can support health system transformation on Prince Edward Island and beyond.

Conclusion

Accelerating the development and delivery of evidence‐informed services that support health system transformation is needed. Nurse implementation scientists are ideally positioned to lead these efforts. Appropriate resourcing and compensation are essential to fully embrace nurse implementation scientist roles, collaboration, and buy‐in from health system leaders.

Implications for Nursing

Practical examples of how nurse implementation scientists can lead health system transformation in a rigorous, evidence‐informed way are identified.

Impact

Literature providing examples of how nurse implementation scientists can make meaningful impacts within health systems, particularly in rural contexts, is limited. Nurse implementation scientists are ideally positioned to collaborate with and lead health system transformation by virtue of their knowledge, skills, qualifications and experience. Implications of this work extend beyond nursing to other health disciplines, health organisations, government leaders, researchers and populations. The discussion and examples provided may be applicable to similar contexts.

Patient or Public Contribution

No patient or public contribution.
Impact of Atopic Dermatitis on Adolescents and Families: A Mixed‐Method Systematic Review
Authors: Vicho‐de‐la‐Fuente Noelia , Martinez‐Santos Alba‐Elena , Rodríguez‐González Raquel , Florez Ángeles , Sheaf Greg , Coyne Imelda
Published: December 2024

Aims

To summarise the evidence regarding the impact of atopic dermatitis on adolescents and their families as well as their healthcare needs and to propose a nursing care plan based on the findings.

Design

Mixed‐method systematic review.

Methods

Twenty‐four studies were included, of which 19 were quantitative and 5 were qualitative. The quality of the studies was assessed using the Mixed Methods Assessment Tool. The synthesis method used was data‐driven convergent synthesis design.

Data Sources

A systematic search was carried out in CINAHL, Embase, MEDLINE, PsycInfo and Web of Science without language restrictions from 1 January 2013 to 30 April 2023.

Results

The quality of life of adolescents with atopic dermatitis and their families are impaired. The more the severity of the condition, the greater the impact for them and their families. Atopic dermatitis impacts adolescents' sleep (due to itching), behaviour, mental well‐being, social and school life. Likewise, parents' sleep, free time, interpersonal relationships and work life are affected by caring for their adolescents.

Conclusion

Adolescents and their families encounter numerous challenges managing and living with atopic dermatitis on a daily basis. The condition has a widespread impact on adolescents and parents' quality of life across home, work and school settings. In the family, there was also an alteration in the functioning and relationships between its members.

Implications for the Profession and/or Patient Care

This review reveals the burden of atopic dermatitis for adolescents and families and the need for comprehensive support. Greater awareness among healthcare professionals of the impacts may help promote an evidence‐based approach that supports the whole family. Based on these findings, we propose a nursing care plan based on the NANDA taxonomy to promote better healthcare provision for adolescents and families.

Reporting Method

This review adheres to PRISMA guidelines.

Patient or Public Contribution

No patient or public contribution.

Review Registration (PROSPERO According to JAN Guidelines)

CRD42023435352.
Evaluating the benefits and risks of puberty blockers and gender‐affirming hormones for transgender adolescents
Authors: Wright Daniel , Pang Ken C , Giordano Simona , Gillam Lynn
Published: December 2024

The use of puberty blockers and gender‐affirming hormones by transgender adolescents is the subject of an ongoing public debate. In this paper, we address one central ethical aspect of the debate – the question of what sort of benefits these treatments provide and how to evaluate the significance of these benefits in relation to risks. We argue that the intended benefit of these treatments is best understood as appearance congruence, namely, to create or maintain alignment of physical appearance with one's gender identity. The common focus on the mental health benefits associated with these treatments may obscure a range of experiential benefits sought by young people, such as positive gender experiences and being treated by others as one's identified gender. We also address concern about the risk that young people may revert to their assigned gender (de‐transition) and experience regret. We distinguish between de‐transition and regret, highlighting that regret appears to occur in a minority of instances of de‐transition or discontinuation of hormone treatment.
Exploring the Utility of a Machine Learning Approach with Mobile‐Based Cognitive Function Tasks for Detecting Depression
Authors: Takeshige Momoka , Oka Taiki , Ohwan Mai , Hirai Kei
Published: December 2024

Self‐report questionnaires, used for detecting major depressive disorder (MDD) in daily life, may incur biases stemming from social desirability and repetitive answers. Though detection based on mobile sensing was being developed recently, it cannot sufficiently promote self‐help action due to the characteristics of passive feedback. Thus, an active self‐monitoring and feedback system is crucial for individuals to recognize and address their malfunctions. In this study, we proposed to predict changes in MDD severity using cognitive tasks monitored on mobile devices. An online survey was conducted to evaluate the severity, incorporating cognitive tasks such as Navon task, Go/No‐go task, and n‐back task, along with the Quick Inventory of Depressive Symptomatology. Participants completed the survey three times on their mobile devices. The analysis included data from 75 participants, including 21 participants whose MDD score increased by at least one point during the second and third surveys; the first survey was excluded to avoid confounding effects. A random forest classifier was employed for classifying participants whose depression has and has not worsened. The learned model achieved modest accuracy (68.3%) with a significant mean area under the curve of 0.59 (t(9) = 2.98, p = .016, dz = 0.94), suggesting the potential to predict depressive states based on cognitive domains. Moreover, working memory and attentional inhibition functions contributed to predicting the severity change mostly. Though improvements are required to reduce false negatives for practical applications, our result suggests that MDD aggravation could be assessed by mobile cognitive tasks.
Gynoecial diversity in the Annonaceae and the evolution of functional traits that overcome the limitations of apocarpy
Authors: Chen Yanwen , Chen Junhao , Xue Bine , Yang Bin , Thomas Daniel C. , Saunders Richard M. K.
Published: December 2024

Most species in the early divergent angiosperm family Annonaceae are apocarpous, with very diverse gynoecial morphologies. Although several Annonaceae genera with apocarpous flowers are known to possess an extragynoecial compitum (EGC) that enables intercarpellary pollen‐tube growth to enhance fertilization success, the occurrence of EGC across the whole family remains obscure. Twenty Annonaceae species from all four subfamilies (Anaxagoreoideae, Ambavioideae, Annonoideae, and Malmeoideae) are examined here, with anatomical evidence revealing the occurrence of stigmatic exudate‐mediated suprastylar EGC in all four subfamilies. Histological and ontogenetic studies furthermore indicate that trichomes in Cananga and Drepananthus form a confluent zone that connects adjacent stigmas, providing a structural premise for suprastylar EGC. Infrastylar EGC are reported in the Annonaceae for the first time in several genera, including Artabotrys, Annona, and Miliusa, associated with the opening on the ovary ventral groove and/or basal placentation. In addition to the sister genera Isolona and Monodora that are clearly syncarpous, flowers of the distantly related genus Cyathocalyx with a unicarpellate gynoecium have also been hypothesized to be syncarpous. Evidence of carpel vasculature and primordium development does not support that the solitary Cyathocalyx carpel is originated from carpel fusion, however, although the increased number of ovules renders it functionally similar to syncarpy. Gynoecial features, including the extensive occurrence of EGC and the increased number of ovules per carpel (consonant with reduction to a solitary carpel) in Cyathocalyx, may have evolved to overcome limitations associated with apocarpy and possibly contribute to the reproductive success and diversification of the family.
Genomic‐Guided Conservation Actions to Restore the Most Endangered Conifer in the Mediterranean Basin
Authors: del Valle José Carlos , Arista Montserrat , Benítez‐Benítez Carmen , Ortiz Pedro Luis , Jiménez‐López Francisco J. , Terrab Anass , Balao Francisco
Published: December 2024

Species with extremely small population sizes are critically endangered because of reduced genetic diversity, increased inbreeding and hybridisation threats. Genomic tools significantly advance conservation by revealing genetic insights into endangered species, notably in monitoring frameworks. Sicilian fir (Abies nebrodensis) is the most endangered conifer in Europe with only 30 adult trees in an 84‐ha area. Using 20,824 SNPs from RAD‐seq, employing genome assembly and a custom 120 SNP‐array, we evaluated genetic diversity, mating patterns, and effective population size in adult trees, 118 natural seedlings, and 2064 nursery seedlings from past conservation actions. We assessed introgression from neighbouring non‐native fir plantations (~6%) and established an intra‐population assisted gene flow (AGF) program selecting the most genetically dissimilar individuals and investigating the outcome through simulations. Genomic analysis unveiled significant genetic diversity among adult Sicilian firs, comparable to non‐endangered Mediterranean firs with larger populations. However, the genetic diversity of the forthcoming generation declined due to high self‐fertilisation, leading to marked inbreeding (FIS = 0.38) and an alarmingly low effective population size (Ne = 6). Nursery seedling monitoring revealed similar selfing rates and introgression (~2%) from non‐native firs. Although intra‐population AGF could help to mitigate genetic loss, it may not alleviate the species vulnerability to imminent environmental challenges, perpetuating the risk of an extinction vortex. Hence, investigating the impact of Sicilian fir population decline and selfing on inbreeding depression, along with exploring the potential of hybrids for genetic load alleviation and future adaptation, is crucial for effective conservation strategies.
An Evaluation of London's Intermediate Minor Oral Surgery Service
Authors: Savla Adesh , Gupta Rashi , Koshal Sonita
Published: December 2024

Background

Oral surgery as a speciality has traditionally experienced significant demands, representing one of the largest volume and cost of referrals from primary to secondary care. The IMOS service was created with the objective to increase the efficiency and accessibility of oral surgery services to the public, as well as reduce pressures within hospital settings.

Aims

To assess:

The quality of the service provided.

The waiting times.

If the service met needs.

Patient‐reported outcome and experience measures.

Method

A random sample of patients referred to London Tier 2 IMOS providers were selected, 10 from each provider, totalling 180. They were evaluated to ascertain waiting times, treatment delivered, quality of documentation and level of complexity, level 1, 2, and 3. Patient‐Reported Experience Measures (PREMs) and Patient Reported Outcome Measures (PROMs) were also carried out to assess satisfaction.

Results

38.3% of referrals were classed as Level 1 and the remaining Level 2 and Level 3 were 60% and 1.67%, respectively. 37.2% of patients were seen within 0–49 days, and 72.3% of patients were seen and treated within 18 weeks. 90.8% of these cases were non‐surgical, 17.9% involved mandibular 3rd molar extractions, of which 46.6% were surgical.

313 PREMs and 321 PROMs were collected, the experience survey revealed over 98.7% of patients felt anxiety and pain were managed well, with any concerns addressed. PROMs showed that 94.3% of patients did not require further calls or assistance post‐treatment. 72.4% of patients felt recovery was completed within 3 days of the treatment. 1.87% of patients required further assistance such as for dry socket and infection.

Conclusion

The London IMOS service is an economical, safe and effective environment to provide minor oral surgery to the vast majority of patients, who would have otherwise been seen in secondary care. Development of pan London triage and communication pathways will further enhance the service and ensure smooth and efficient patient journeys.
Early Hospital Readmission After Pediatric Liver Transplant: A Retrospective Analysis of the Society of Pediatric Liver Transplantation (SPLIT) Database
Authors: Price Matthew D. , Ruck Jessica M. , Dilwali Natasha , Thomas Ananda , Zhou Alice , Gorijavolu Rahul , King Elizabeth A. ,   Society of Pediatric Liver Transplantation
Published: December 2024

Introduction

Incidence of and risk factors for early hospital readmission (EHR) are poorly defined in pediatric liver transplant recipients. Therefore, we evaluated EHR incidence and risk factors for pediatric liver recipients in a nationally representative sample.

Methods

Using the Society of Pediatric Liver Transplantation database, we retrospectively analyzed 2808 pediatric liver‐only recipients transplanted 2011–2022. Recipient‐, donor‐, and center‐level characteristics were evaluated as possible risk factors for EHR within 30 days of hospital discharge using multivariable modified Poisson regression.

Results

Overall, 23% (N = 642) of pediatric recipients experienced EHR. Independent risk factors for EHR include diabetes (adjusted relative risk [aRR] 2.33, 95% CI: 1.41–3.86, p = 0.001), history of malignancy (aRR 1.59, 95% CI: 1.19–2.11, p = 0.002), and shorter length of transplant hospitalization. Recipients in the shortest length of stay quartile (median [IQR] 8 [7–9] days) had a ninefold increased risk for EHR compared with recipients in the longest length of stay quartile (34 [28–48] days) (aRR 8.86, 95% CI: 5.68–13.81, p < 0.001). Incidence of EHR did not vary by transplant center and was not associated with other characteristics of the donor (DCD vs. not DCD), recipient (age, race, sex, and diagnosis), procedure (whole vs. split liver, ischemic time), or transplant center.

Conclusion

We found the 30‐day readmission rate for pediatric liver transplant recipients was 23%. Shorter hospital stays were a major risk factor for EHR, highlighting that longer initial transplant hospital stays may be beneficial for predischarge optimization and coordination of their complex care.
Bridging the Gap: A Review of Pediatric to Adult Transition of Care in Liver Transplantation
Authors: Kosmach‐Park Beverly , Coyne Bethany , Gupta Nitika , Mazariegos George
Published: December 2024

Background

With improvements in long‐term graft function and survival, an increasing population of pediatric liver transplant (LT) recipients now require adult care. A process to successfully transition young adults to adult LT centers is supported in the literature with discussions on the rationale for health care transition (HCT), barriers to transition, stakeholder perspectives, and transfer readiness (TR). Results of outcomes studies are difficult to generalize and there remains no standard of care for HCT in LT. Of concern is that the youth's increasing independence occurs during a period of developmental vulnerability, with a threat to graft function due to risk‐taking behaviors, specifically nonadherence, that may lead to rejection, graft loss, and death.

Objectives/Method

The purpose of this comprehensive literature review is to discuss current knowledge, practices, and outcomes of HCT for LT recipients with additional support from literature in solid organ transplant (SOT) and pediatric‐onset chronic conditions literature.

Results

Recent position statements in LT and SOT express a greater awareness of the importance of HCT with broad agreement that reflects a similarity in approach in endorsing HCT as an essential process that should be initiated in early adolescence with TR as a primary determinant of transfer; however, standardization with consistent outcomes measurement is lacking. The literature supports transition as an esential component of care that should be initated in early adolescence with programs that address knowlege, skill‐development, and advocacy. The engagement of all stakeholders in LT is essential to program development.

Conclusions

There is increasing awareness among the multidisciplinary team of the importance and role of the adult provider in extending transitional care into the adult setting as executive functioning skills mature. Outcome measures need to be clearly defined and standardized. Regulatory agency involvement to validate and support the need for TOC programs is crucial and should promote outcomes research for best practice program standardization.
Can reducing learning costs improve public support for means‐tested benefit programs?
Authors: Porumbescu Gregory , Walsh Stephanie , Hetling Andrea
Published: December 2024

This study investigates how efforts to reduce learning costs of means‐tested public benefit programs impact public support of these programs and perceived deservingness of program beneficiaries. Focusing on the Supplemental Nutrition Assistance Program (SNAP) in the United States, a well‐known means‐tested public benefit program, we integrate research from educational psychology with policy feedback theory, predicting that the structure of information about SNAP's application process and eligibility requirements affects learning costs and public attitudes toward this program and its beneficiaries. Testing these predictions through a preregistered dose–response survey experiment, participants are randomly assigned to control or one of three treatment groups, which incrementally alters the structure of SNAP information participants are exposed to. Our findings demonstrate that enhancing the SNAP information structure lowers learning costs and indirectly improves public support and perceived deservingness of beneficiaries. We discuss implications for theory and practice.