bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing in a different world: Remote area nursing as a specialist–generalist practice area
Authors: McCullough Kylie , Bayes Sara , Whitehead Lisa , Williams Anne , Cope Vicki
Published: June 2022

Objective

Remote area nurses provide primary health care services to isolated communities across Australia. They manage acute health issues, chronic illness, health promotion and emergency responses. This article discusses why their generalist scope of practice should be formally recognised as a specialist nursing practice area.

Design

Constructivist grounded theory, using telephone interviews (n = 24) with registered nurses and nurse practitioners.

Setting

Primary health care clinics, in communities of 150–1500 residents across Australia.

Participants

A total of 24 nurses participated in this study.

Results

Nurses' perceived their clinical knowledge and skill as insufficient for the advanced, generalist, scope of practice in the remote context, especially when working alone. Experience in other settings was inadequate preparation for working in remote areas. Knowledge and skill developed on the job, with formal learning, such as nurse practitioner studies, extending the individual nurse's scope of practice to meet the expectations of the role, including health promotion.

Conclusion

Remote area nursing requires different knowledge and skills from those found in any other nursing practice setting. This study supports the claim that remote area nursing is a specialist–generalist role and presents a compelling case for further examination of the generalist education and support needs of these nurses. Combined with multidisciplinary collaboration, developing clinical knowledge and skill across the primary health care spectrum increased the availability of health resources and subsequently improved access to care for remote communities. Further research is required to articulate the contemporary scope of practice of remote area nurses to differentiate their role from that of nurse practitioners.
The association between inflammatory bowel disease and mental ill health: a retrospective cohort study using data from UK primary care
Authors: Umar Nosheen , King Dominic , Chandan Joht Singh , Bhala Neeraj , Nirantharakumar Krish , Adderley Nicola , Zemedikun Dawit T. , Harvey Phil , Trudgill Nigel
Published: June 2022

Background

Patients with active inflammatory bowel disease (IBD) and mental illnesses experience worse IBD outcomes.

Aim

To describe the incidence of mental illnesses, including deliberate self‐harm, in IBD patients.

Methods

A population‐based retrospective cohort study using IQVIA medical research data of a primary care database covering the whole UK, between January 1995 and January 2021. IBD patients of all ages were matched 4:1 by demographics and primary care practice to unexposed controls. Following exclusion of patients with mental ill health at study entry, adjusted hazard ratios (HR) of developing depression, anxiety, deliberate self‐harm, severe mental illness and insomnia were calculated using a Cox proportional hazards model.

Results

We included 48,799 incident IBD patients: 28,352 with ulcerative colitis and 20,447 with Crohn's disease. Incidence rate ratios of mental illness were higher in IBD patients than controls (all p < 0.001): deliberate self‐harm 1.31 (95% CI 1.16–1.47), anxiety 1.17 (1.11–1.24), depression 1.36 (1.31–1.42) and insomnia 1.62 (1.54–1.69). Patients with Crohn's disease were more likely to develop deliberate self‐harm HR 1.51 (95% CI 1.28–1.78), anxiety 1.38 (1.16–1.65), depression 1.36 (1.26–1.47) and insomnia 1.74 (1.62–1.86). Patients with IBD are at increased risk of deliberate self‐harm (HR 1.20 [1.07–1.35]). The incidence rate ratios of mental illnesses were particularly high during the first year following IBD diagnosis: anxiety 1.28 (1.13–1.46), depression 1.62 (1.48–1.77) and insomnia 1.99 (1.78–2.21).

Conclusion

Deliberate self‐harm, depression, anxiety and insomnia were more frequent among patients with IBD. IBD is independently associated with an increased risk of deliberate self‐harm.
Paradoxical reactions and biologic agents: a French cohort study of 9303 patients
Authors: Bataille Pauline , Layese Richard , Claudepierre Pascal , Paris Nicolas , Dubiel Julien , Amiot Aurélien , Sbidian Emilie ,   on behalf of the AP-HP/Universities/Inserm COVID-19 research collaboration and on behalf of the ‘Entrepôt de Données de Santé’ AP-HP consortium
Published: June 2022

Background

Paradoxical reactions (PRs) are defined as the occurrence during biologic therapy of a pathological condition that usually responds to these drugs.

Objectives

To estimate the incidence of PRs and identify risk factors.

Methods

Multicentre study of the database for the Greater Paris University Hospitals, including biologic-naive patients receiving anti-tumour necrosis factor-α, anti-interleukin-12/23, anti-interleukin-17 or anti-α4β7-integrin agents for psoriasis, inflammatory rheumatism or inflammatory bowel disease (IBD). We used natural language processing algorithms to extract data. A cohort and a case–control study nested in the cohort with controls selected by incidence density sampling was used to identify risk factors.

Results

Most of the 9303 included patients (median age 43·0, 53·8% women) presented an IBD (3773, 40·6%) or a chronic inflammatory rheumatic disease (3708, 39·9%), and 8489 (91·3%) received anti-TNF-α agents. A total of 297 (3·2%) had a PR. The global incidence rate was 7·6 per 1000 person-years [95% confidence interval (CI) 6·8–8·5]. The likelihood of PR was associated with IBD [adjusted odds ratio (aOR) 1·9, 95% CI 1·1–3·2, P = 0·021] and a combination of at least two inflammatory diseases (aOR 6·1, 95% CI 3·6–10·6, P < 0·001) and was reduced with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and corticosteroids (aOR 0·6, 95% CI 0·4–0·8, P = 0·002; and OR 0·4, 95% CI 0·2–0·6, P = 0·002, respectively).

Conclusions

The likelihood of PRs was associated with IBD or a combination of a least two inflammatory diseases. More studies are needed to assess the benefit of systematically adding csDMARDs for such high-risk patients.

What is already known about this topic?  Most published studies about paradoxical reactions concern paradoxical psoriasis in patients receiving anti-tumour necrosis factor-α agents.Few data are available for other paradoxical reactions and the most recent biologics.

What does this study add?  Risk of paradoxical reactions was increased with inflammatory bowel disease and a combination of at least two inflammatory diseases.Risk of paradoxical reactions was reduced with conventional synthetic disease-modifying antirheumatic drugs or corticosteroid therapy, which could be added for high-risk patients.
Rab27a‐dependent exosomes protect against cerebral ischemic injury by reducing endothelial oxidative stress and apoptosis
Authors: Ma Xiaotang , Zhao Jia , Li Suqing , Wang Yan , Liu Jinhua , Shi Yumeng , Liu Jiehong , Chen Yanyu , Chen Yanfang , Pan Qunwen
Published: June 2022

Introduction

Multicellular crosstalk within the brain tissue has been suggested to play a critical role in maintaining cerebral vascular homeostasis. Exosomes (EXs) mediated cell–cell communication, but its role in cerebral ischemic injury is largely unknown. Rab27a is one of the major genes controlling EX release. Here, we explored the role of Rab27a in regulating brain EXs secretion, and the effects of Rab27a‐mediated EXs on ischemia evoked cerebral vascular disruption and brain injury.

Methods

Cerebral ischemia was induced in Rab27a knockout (Rab27a−/−) and wide type (WT) mice by transient middle cerebral artery occlusion (tMCAO). Differential gene expression analysis was performed in ischemic brain tissue by using mRNA sequencing. EXs isolated from brain tissue of Rab27a−/− and WT mice (EXWT or EXRab27a−/−) were pre‐administrated into tMCAO operated Rab27a−/− mice or oxygen and glucose deprivation (OGD) treated primary brain vascular endothelial cells (ECs).

Results

We demonstrated that Rab27a expression in the peri‐infarct area of brain was significantly elevated, which was associated with local elevation in EXs secretion. Rab27a deficiency dramatically decreased the level of EXs in brain tissue of normal and tMCAO‐treated mice, and Rab27a−/− mice displayed an increase in infarct volume and NDS, and a decrease in cMVD and CBF following tMCAO. Pre‐infusion of EXWT increased the brain EXs levels in the tMCAO operated Rab27a−/− mice, accompanied with an increase in cMVD and CBF, and a decrease in infarct volume, NDS, ROS production, and apoptosis. The effects of EXRab27a−/− infusion were much diminished although in a dose‐dependent manner. In OGD‐treated ECs, EXRab27a−/− showed less effectivity than EXWT in decreasing ROS overproduction and apoptosis, paralleling with down‐regulated expression of NOX2 and cleaved caspase‐3.

Conclusion

Our study demonstrates that Rab27a controls brain EXs secretion and functions, contributing to cerebral vascular protection from ischemic insult by preventing oxidative stress and apoptosis via down‐regulating NOX2 and cleaved caspase‐3 expression.
Formation of donor‐specific antibodies depends on the epitope load of mismatched HLAs in lung transplant recipients: A retrospective single‐center study
Authors: Lobashevsky Andrew , Niemann Matthias , Kowinski Brenda , Higgins Nancy , Abdel‐Wareth Laila , Atrabulsi Basel , Roe David , Hage Chadi
Published: June 2022

The development of donor‐specific antibodies (DSA) has a significant impact on graft outcome in solid organ transplantation. Mismatched HLAs are recognized directly and indirectly by the recipient immune system. Both pathways occur in parallel and result in the generation of plasma cells, DSA, cytotoxic and T helper lymphocytes. Here, we present the results of an analysis of the epitope load of mismatched HLAs in a cohort of 220 lung transplant recipients using two in silico algorithms, HLAMatchmaker and PIRCHE‐II (Predicted Indirectly ReCognizable HLA Epitopes). De novo DSA (dnDSA) were detected by single antigen bead assays. The percentage of recipients who developed dnDSA was significantly higher in the group of patients who received lung transplants with a mismatching score above the detected threshold than in the group of patients who received lung transplants with a mismatching score below the threshold. In a multivariate Cox proportional hazard analysis, the PIRCHE‐II score appeared to be a superior predictor of dnDSA formation. In addition, PIRCHE‐II technology was shown to be useful in predicting separate dnDSA1 and dnDSA2 formation. We conclude that both algorithms can be used for the evaluation of the epitope load of mismatched HLAs and the prediction of DSA development in lung transplant recipients.
Influence of basic attributes and attitudes of nurses toward death on nurse turnover: A prospective study
Authors: Chang Wen‐Pei , Lin Yen‐Kuang
Published: June 2022

Background

Facing patient death is an unavoidable aspect of work for nurses working in healthcare settings. The attitudes of nurses toward death, however, can exert a negative psychological impact on themselves that can even cause them to quit this occupation.

Aim

The objective of this study was to explore the attitudes of nurses toward death, the factors influencing said attitudes, and whether nurses basic attributes and attitudes toward death were associated with their future turnover behavior.

Method

A prospective study design was adopted. The recruitment period ran from October 2017 to March 2018. A total of 323 nurses completed a basic attributes survey as well as the Death Attitude Profile‐Revised questionnaire and were followed until May 30, 2021. The factors influencing turnover were then analyzed using the Cox proportional hazard model. The STROBE checklist was used for reporting in this study.

Results

Age was found to be significantly associated with fear of death and death avoidance. Compared with nurses with no religion, nurses who were Buddhists/Taoists were more inclined toward neutral acceptance in their attitude toward death, whereas those who were Christians/Catholics were more inclined toward escape acceptance. Nurses with less than three years of work experience were more likely to resign earlier than those with more than 3 years of work experience. Fear of death and approach acceptance could be used to predict turnover.

Conclusions

Younger nurses were more likely to exhibit fear of death and escape behavior, and those with less work experience or a greater fear of death were more likely to resign. Nurses with religious beliefs could accept patient death more positively, whereas those who faced death with positive approach acceptance displayed reductions in turnover.

Implication for nursing and health policy

Younger nurses should receive more education regarding death early in their training. Hospitals should also offer more education from a religious aspect in order to reduce turnover.
Public and dental professionals' use of social media to discuss amelogenesis imperfecta
Authors: Henrick Victoria , Marks Samantha , Balmer Richard , Barber Sophy
Published: June 2022

Background

Amelogenesis imperfecta (AI) is an inherited disorder of enamel development that is challenging to treat and often associated with negative patient and parental outcomes. Social media provides a valuable perspective on patients' and dental professionals' experience of AI and dental care.

Aim

To explore how the public and dental professionals use social media to discuss AI.

Design

A cross‐sectional study involving a systemic search of eight social media platforms using the search term ‘amelogenesis imperfecta’. Relevant posts were selected using predefined eligibility criteria. Word content of eligible posts was qualitatively analysed using a thematic framework approach.

Results

A total of 555 posts were identified, of which 144 were eligible for analysis. For dental professionals, the posts included case reports and seeking and sharing of information. For the public, the posts were related to individuals' experience of AI, dental treatment and outcome of treatment.

Conclusions

Posts from individuals affected by AI suggest a need for better distribution of reliable information and greater support. Case reports indicate that dental professionals find it challenging to recognise AI and determine appropriate treatment options. Social media could potentially be used to inform and support people with AI and allow dental professionals to share information and learning with peers.
Dental caries as a source of Helicobacter pylori infection in children: An RT‐PCR study
Authors: Sruthi Maria Anthonet , Mani Geo , Ramakrishnan Mahesh , Selvaraj Jayaraman
Published: June 2022

Background

Findings on the presence of Helicobacter pylori in the oral cavity are conflicting. This bacterium can occur either transiently in the oral cavity or, in some situations, pose a threat to oral/gastric tissues.

Aim

We investigated the presence of H. pylori in deep carious lesions of children and assessed its association with dental status and caries severity.

Design

This cross‐sectional study involved 20 children aged 3–6 years attending the paediatric outpatient clinic. Demographic and oral hygiene‐related data were obtained from parents/caregivers. Caries status and severity were assessed using the DMFT and ICDAS II indices respectively. Dentine samples were collected and stored in phosphate‐buffered saline solution. These samples were assessed for H. pylori using reverse transcription polymerase chain reaction. DMFT and ICDAS II scores were compared between children with and without H. pylori.

Results and conclusion

H. pylori was detected in 70% of children with severe carious lesions (95% confidence interval: 46%–88%). The mean DMFT score was significantly higher in the group with H. pylori than in the group without (p = .001). The prevalence of H. pylori was greater in those with ICDAS II code 6 than in those with ICDAS II code 5 caries. Cavitated carious lesions can serve as a reservoir for H. pylori. Its presence was associated with higher caries status and caries severity (ICDAS II code 6). The presence of H. pylori in such cavities may tip the balance of plaque ecosystem in favour of Streptococcus mutans, the main bacterial source in dental caries.
Prevalence of antibodies against SARS‐CoV‐2 in the Norwegian population, August 2021
Authors: Tunheim Gro , Rø Gunnar Øyvind Isaksson , Chopra Adity , Aase Audun , Kran Anne‐Marte Bakken , Vaage John Torgils , Lund‐Johansen Fridtjof , Hungnes Olav
Published: June 2022

Background

One year into the COVID‐19 pandemic, the cumulative number of confirmed COVID‐19 cases in Norway was still low. In January 2021, when the Norwegian COVID‐19 vaccination campaign started, the national seroprevalence estimate of SARS‐CoV‐2 antibodies was 3.2%. We have conducted a nationwide cross‐sectional study in August 2021 to investigate the overall prevalence of SARS‐CoV‐2 antibodies in Norway after 8 months of COVID‐19 mass vaccination and a third wave of SARS‐CoV‐2 infection.

Methods

Residual sera were collected from laboratories across Norway in August 2021. In IgG antibodies against the spike protein, the spike receptor binding domain (RBD) and the nucleocapsid protein of SARS‐CoV‐2 were measured by a bead‐based flow cytometric assay.

Results

In total, 1926 residual sera were collected from individuals aged 0–98 years; 55.1% were from women. The overall national estimated seroprevalence from vaccination and/or infection was 62.6% (credible interval [CrI] 60.1%–65.2%) based on having antibodies against both spike and RBD. Estimated seroprevalence increased with age. Among all samples, 11.7% had antibodies against nucleocapsid. For unvaccinated children <12 years, the seroprevalence estimate due to SARS‐CoV‐2 infection was 12.5% (95% CrI 9.3%–16.1%). Of seropositive samples from the unvaccinated children, 31.9% lacked anti‐nucleocapsid antibodies.

Conclusions

The high overall SARS‐CoV‐2 seroprevalence estimates are in line with Norwegian registry data. Vaccination, not infection, contributed the most to the high seroprevalence in August 2021. Lack of antibodies against nucleocapsid should not automatically be interpreted as absence of previous infection as this could lead to underestimation of COVID‐19 cases in seroprevalence studies.
Re‐Framing Anni Albers and Bauhaus
Authors: Kim Hyunsoo
Published: June 2022

At this time when interdisciplinary education in higher education is in trend, the Bauhaus is in its prime again as it celebrates 100th anniversary. Anni Albers, a seminal figure in textiles, art education and modern art in America, was one of the few artists who were present in both of the experimental art colleges of the century‐ Bauhaus in Germany and Black Mountain College in the United States. Many versions of her story exist to date, however this article focuses on the version of her own story, which has not been highlighted either in media or academia. It has been widely accepted that 1) gender inequality existed in Bauhaus, 2) the shift of Albers’ medium derived from wanting recognition from the art world, and 3) a structured curriculum educated many of the artists graduated from Bauhaus. However, in this study, two oral interviews of Anni Albers, seventeen years apart, were compared with public perception, which has dominated understanding of the artist and Bauhaus for centuries. The interviews change our perspective, particularly on gender equity, craft, fine art, and curriculum at Bauhaus in the life of Anni Albers.
Protection by hydroxychloroquine prevents placental injury in obstetric antiphospholipid syndrome
Authors: Liu Jing , Zhang Liting , Tian Yijia , Wan Shuting , Hu Min , Song Shasha , Zhang Meihua , Zhou Qian , Xia Yu , Wang Xietong
Published: June 2022

Obstetric antiphospholipid syndrome (OAPS) is mediated by antiphospholipid antibodies (aPLs, and anti‐β2 glycoprotein I antibody is the main pathogenic antibody), and recurrent abortion, preeclampsia, foetal growth restriction and other placental diseases are the main clinical characteristics of placental pathological pregnancy. It is a disease that seriously threatens the health of pregnant women. Hydroxychloroquine (HCQ) was originally used as an anti‐malaria drug and has now shown benefit in refractory OAPS where conventional treatment has failed, with the expectation of providing protective clinical benefits for both the mother and foetus. However, its efficacy and mechanism of action are still unclear. After clinical data were collected to determine the therapeutic effect, human trophoblast cells in early pregnancy were prepared and treated with aPL. After the addition of HCQ, the proliferation, invasion, migration and tubule formation of the trophoblast cells were observed so that the therapeutic mechanism of HCQ on trophoblast cells could be determined. By establishing an obstetric APS mouse model similar to the clinical situation, we were able to detect the therapeutic effect of HCQ on pathological pregnancy. The normal function of trophoblast cells is affected by aPL. Antibodies reduce the ability of trophoblast cells to invade and migrate and can impair tubule formation, which are closely related to placental insufficiency. HCQ can partially reverse these side effects. In the OAPS mouse model, we found that HCQ prevented foetal death and reduced the incidence of pathological pregnancy. Therefore, HCQ can improve pregnancy outcomes and reverse the aPL inhibition of trophoblast disease. In OAPS, the use of HCQ needs to be seriously considered.
The association of specific types of vegetables consumption with 10‐year type II diabetes risk: Findings from the ATTICA cohort study
Authors: Kosti Rena I. , Tsiampalis Thomas , Kouvari Matina , Chrysohoou Christina , Georgousopoulou Ekavi , Pitsavos Christos S. , Panagiotakos Demosthenes B.
Published: June 2022

Background

The present study aimed to investigate the association between vegetable consumption, in total as well as per type/category, and 10‐year type‐2 diabetes mellitus (T2DM) incidence.

Methods

The ATTICA study was conducted during 2001–2012 in 3042 apparently healthy adults living in Athens area, Greece. A detailed biochemical, clinical, and lifestyle evaluation was performed; vegetable consumption (total, per type) was evaluated through a validated semi‐quantitative food frequency questionnaire. After excluding those with no complete information of diabetes status or those lost at the 10‐year follow‐up, data from 1485 participants were used for the current analysis.

Results

After adjusting for several participants' characteristics, including overall dietary habits, it was observed that participants consuming at least 4 servings/day of vegetables had a 0.42‐times lower risk of developing T2DM (hazard ratio [HR] = 0.42; 95% confidence interval [CI] = 0.29–0.61); the benefits of consumption were greater in women (HR = 0.29; 95% CI = 0.16–0.53) compared to men (HR = 0.56; 95% CI = 0.34–0.92). Only 33% of the sample consumed vegetables 4 servings/day. The most significant associations were observed for allium vegetables in women and for red/orange/yellow vegetables, as well as for legumes in men.

Conclusions

The intake of at least 4 servings/day of vegetables was associated with a considerably reduced risk of T2DM, independently of other dietary habits; underlying the need for further elaboration of current dietary recommendations at the population level.
Sex is associated with differences in oxidative stress and susceptibility to severe hepatic encephalopathy in bile‐duct ligated rats
Authors: Macedo de Oliveira Mariana , Monnet‐Aimard Alexis , Bosoi Cristina R. , Tremblay Mélanie , Rose Christopher F.
Published: June 2022

Hepatic encephalopathy (HE) is a debilitating neurological complication of chronic liver disease (CLD). Hyperammonemia plays an important role in HE's pathogenesis, acting synergistically with systemic oxidative stress. During CLD, muscle plays a compensatory role in detoxifying ammonia, and therefore muscle loss leads to an increase in the risk of developing HE. With most animal studies involving males, sex's impact on the development of CLD and associated complications such as HE and muscle loss remains unknown. Therefore, we aimed to identify the impact of sex on CLD, HE, and muscle mass loss in a rodent model of CLD. Liver injury markers, hyperammonemia, oxidative stress, muscle mass, and ammonia clearance were measured in female and male bile‐duct ligated (BDL) rats. In addition, covert HE was assessed in females while ammonia‐precipitated severe HE was assessed in female and male BDL rats, and male BDL rats treated with allopurinol (100 mg/kg), an antioxidant (xanthine oxidase inhibitor). Female BDL developed CLD and HE (impaired motor coordination and night activity) compared to respective SHAM. Hyperammonemia and muscle ammonia clearance were similar between female and male BDL. However, only female BDL rats did not develop muscle loss, brain edema, and short‐term memory impairment (vs. female SHAM) and systemic oxidative stress and decreased albumin levels (vs. male BDL). Furthermore, both female BDL and allopurinol‐treated male BDL rats were protected against ammonia‐induced overt HE. In conclusion, female and male BDL rats develop distinct features of CLD and HE, with systemic oxidative stress playing a pivotal role in the susceptibility to ammonia‐precipitated overt HE.

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Hair loss treatment and restoration: Online interest trends and video‐based social media content
Authors: Gupta Aditya K. , Hall Deanna C.
Published: June 2022

Background

Public interest in hair loss topics and treatments can be observed by examining online trends, such as those monitored by Google Trends. Social media has also gained the interest of the dermatology community. Video‐based social media sites are being used to provide the public with informational content related to hair loss and treatments, but it may not always be unbiased or reliable.

Aims

This research examined the interest in hair loss and treatment related trends in recent years through Google Trends, as well as examined what videos from YouTube and TikTok that the average person may encounter when performing searches related to hair loss and treatments.

Results

Google Trends showed that the COVID‐19 pandemic had an initial negative impact on interests of hair loss and treatment related topics, both worldwide and in the United States. External events, such as a celebrity receiving a hair transplant, can influence the interests of the general public with the topic. The social media sites showed that there was a high level of interest in the topics, approximately 25% of videos involved a medical professional, and many involved personal experiences or natural remedies.

Conclusions

Interest in hair loss and treatments continues to grow. Clinicians should do their best to follow the current public interests and be aware of where patients may be obtaining information. Being aware of general interest trends online can benefit clinicians by allowing them to prepare their clinics for potential influxes.
Types of periocular wrinkles based on anatomical and contractile characteristics of participating periocular muscles: A modified classification method and personalized injection technique
Authors: Li Yilin , Cai Lei , Zhang Xinyu , Yin Bo , Gong Xi , Li Facheng , Han Xuefeng
Published: June 2022

Background

Clinical classification methods for periocular wrinkles based on participating muscle behavior are lacking, and traditional treatment lacks detailed and individualized methods.

Aims

This study aimed to propose a modified classification system and individualized treatment for periocular wrinkles based on the participating muscles.

Patients/Methods

Periocular wrinkles were classified into types I.I, I.II, I.III, II, and III. A personalized treatment pattern with a multipoint, low‐dose technique was developed based on wrinkle classification and severity. Standard photographs were taken and assessments made at follow‐up to evaluate wrinkle severity.

Results

Wrinkle severity was reduced at 1 and 3 months after periorbital botulinum toxin injection, and no serious adverse events were recorded.

Conclusions

Periorbital wrinkles were classified according to participating muscles. The modified injection pattern was individualized, effective, and safe for the treatment of periorbital wrinkles.
Children living with long‐term conditions and their experiences of partnership in nursing care: An integrative systematic review
Authors: Barratt Macey , Bail Kasia , Paterson Catherine
Published: June 2022

Aims and Objective

To describe the experiences of nursing care and partnership nursing as expressed by children living with long‐term conditions.

Background

Children with long‐term conditions have higher rates of hospitalisations and adverse events in hospital, yet little is known about their experiences of nursing care. How children perceive partnership in care with their families and nurses is of interest in the achievement of safe and effective care

Design

An integrative review following Joanna Briggs Institute protocols for systematic reviews.

Method

An integrative review was chosen following Joanna Briggs Institute protocols for systematic reviews. A total of 5150 articles were screened, with 251 full‐text publications reviewed. A total of 21 studies were included, three mixed‐method studies and 18 qualitative studies. This review has been reported as per Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.

Results

Four integrated findings were identified: “Children are aware of their surroundings and needs,” “Children value positive communication,” “Children want to be recognised as an individual in the triadic relationship, and this can be done through nurses using tailored play;” and “Children seek a shared decision‐making process.”

Discussion

Children wanted to be seen as an individual in Children and Young People's nursing as well as a child who craves security, fun and comfort, both from their families and nursing staff. Children described observing partnership between nursing staff and parents but felt uninvolved, with some children craving more knowledge and power to better understand their long‐term condition.

Relevance to Clinical Practice

Further research is required on how Children and Young People's nursing staff can better support children and empower them to be active members in the shared decision‐making process if the child wishes to be involved.
Key features of adolescent inpatient units and development of a checklist to improve consistency in reporting of settings
Authors: Hayes Claire , Simmons Magenta , Palmer Victoria , Hamilton Bridget , Simons Christine , Hopwood Malcolm
Published: June 2022

Accessible summary

What is known on the subject?

Little is known about adolescent inpatient units, key features which define them, and how these essential services operate and deliver care.

What the paper adds to existing knowledge?

Adolescent inpatient unit studies are limited in their descriptions of settings in terms of how they operate and key features.

The proposed preliminary checklist is a practical tool to assist clinicians, policy makers, and researchers when reporting to ensure comprehensive descriptions of adolescent inpatient settings.

What are the implications for practice?

This could be used to inform service design processes for inpatient and other mental health service models which is of critical importance in the context of reforms and implementation of these in Australia currently.

Greater attention to operational models, services, and philosophies of practice will improve reporting and allow for the advancement of knowledge, comparison of study results, and a clearer direction for mental health nursing clinicians and researchers.

Introduction

Adolescent inpatient units care for vulnerable population groups; however, little is known about how these essential services operate and deliver care.

Aims

To examine the descriptions of adolescent mental health inpatient units in Australian and international research publications and to identify key features which were used to define them. A secondary aim was to develop a checklist to improve consistency when reporting on the operations and services delivered within adolescent mental health inpatient units (both public and private).

Methods

Five electronic databases (CINAHL, MEDLINE, ERIC, EMBASE, and PsycINFO) were systematically searched. We included studies that provided descriptions of operations and services within adolescent inpatient units where participants had a mean age between 12 and 25. Narrative synthesis was used to explore the similarities and differences between descriptions of settings.

Results

Twenty‐eight studies were identified, which varied in their descriptions of adolescent inpatient units, providing inconsistent information to inform best practice.

Discussion

Studies lack consistency and comprehensive detail when describing the operational models within inpatient units, making interpretation challenging. Consequently, a preliminary checklist is proposed to improve reporting of adolescent inpatient units.
Evolution of woody plants to the land‐sea interface – The atypical genomic features of mangroves with atypical phenotypic adaptation
Authors: Xie Wei , Guo Zixiao , Wang Jiayan , He Ziwen , Li Yulong , Feng Xiao , Zhong Cairong , Shi Suhua
Published: June 2022

How plants adapt and diverge in extreme environments is a key question of plant evolution and ecology. Mangrove invasion of intertidal environments is facilitated by adaptive phenotypes such as aerial roots, salt‐secreting leaf, and viviparity, and genomic mechanisms including whole genome duplication and transposable element number reduction. However, a number of mangroves lack these typical phenotypes. The question we ask is whether these phenotypically atypical mangroves also have distinct genomic features? The sibling mangrove species Lumnitzera littorea and Lumnitzera racemosa provide a model to study this question. We sequenced and assembled their genomes to chromosome level, together with a closely related species Combretum micranthum. While most mangroves have small genomes, the genomes of both Lumnitzera species are large (1443 and 1317 Mb) and carry a high proportion of repeat sequences (~75%). Moreover, Lumnitzera species have not undergone post‐gamma whole‐genome duplications. Their genome size increased mainly due to the expansion of repeat sequences in their ancestors. However, Lumnitzera genomes have reduced transposable elements by constraining the proliferation of new LTR‐RTs. Meanwhile, the two species have more gene families contracted than expanded, and some gene families with reversed size change may underlie their differentiation in root morphology and local distribution. We identified 86 chromosomal inversions, five of which are measured between 6.5 and 12.8 megabases. A number of genes located in these inversions function in pigment biosynthesis, a process likely involved in flower colour differentiation between the Lumnitzera species. We conclude that the mangroves with atypical phenotypes also have atypical genomic evolution.
Deliberate reflection and clinical reasoning: Founding ideas and empirical findings
Authors: Mamede Sílvia , Schmidt Henk G.
Published: June 2022

Context

The idea that reflection improves reasoning and learning, since long present in other fields, emerged in the 90s in the medical education literature. Since then, the number of publications on reflection as a means to improve diagnostic learning and clinical problem‐solving has increased steeply. Recently, concerns with diagnostic errors have raised further interest in reflection. Several approaches based on reflection have been proposed to reduce clinicians' errors during diagnostic reasoning. What reflection entails varies substantially, and most approaches still require empirical examination.

Purpose

The present essay aims to help clarify the role of deliberate reflection in diagnostic reasoning. Deliberate reflection is an approach whose effects on diagnostic reasoning and learning have been empirically studied over the past 15 years. The philosophical roots of the approach will be briefly examined, and the theory and practice of deliberate reflection, particularly its effectiveness, will be reviewed. Lessons learned and unresolved issues will be discussed.

Discussion

The deliberate reflection approach originated from a conceptualization of the nature of reflection practice in medicine informed by Dewey's and Schön's work. The approach guides physicians through systematically reviewing the grounds of their initial diagnosis and considering alternatives. Experimental evidence has supported the effectiveness of deliberate reflection in increasing physicians' diagnostic performance, particularly in nonstraightforward diagnostic tasks. Deliberate reflection has also proved helpful to improve students' diagnostic learning and to facilitate learning of new information. The mechanisms behind the effects of deliberate reflection remain unclear. Tentative explanations focus on the activation/reorganisation of prior knowledge induced by deliberate reflection. Its usefulness depends therefore on the difficulty of the problem relative to the clinician's knowledge. Further research should examine variations in instructions on how to reflect upon a case, the value of further guidance while learning from deliberate reflection, and its benefits in real practice.
Physical activity and health: Findings from Finnish monozygotic twin pairs discordant for physical activity
Authors: Kujala Urho M. , Leskinen Tuija , Rottensteiner Mirva , Aaltonen Sari , Ala‐Korpela Mika , Waller Katja , Kaprio Jaakko
Published: June 2022

Genetic and early environmental differences including early health habits associate with future health. To provide insight on the causal nature of these associations, monozygotic (MZ) twin pairs discordant for health habits provide an interesting natural experiment. Twin pairs discordant for leisure‐time physical activity (LTPA) in early adult life is thus a powerful study design to investigate the associations between long‐term LTPA and indicators of health and wellbeing. We have identified 17 LTPA discordant twin pairs from two Finnish twin cohorts and summarize key findings of these studies in this paper. The carefully characterized rare long‐term LTPA discordant MZ twin pairs have participated in multi‐dimensional clinical examinations. Key findings highlight that compared with less active twins in such MZ twin pairs, the twins with higher long‐term LTPA have higher physical fitness, reduced body fat, reduced visceral fat, reduced liver fat, increased lumen diameters of conduit arteries to the lower limbs, increased bone mineral density in loaded bone areas, and an increased number of large high‐density lipoprotein particles. The findings increase our understanding on the possible site‐specific and system‐level effects of long‐term LTPA.
From coping strategy to hopeful everyday practice: Changing interpretations of food self‐provisioning
Authors: Daněk Petr , Sovová Lucie , Jehlička Petr , Vávra Jan , Lapka Miloslav
Published: June 2022

While alternative food networks (AFNs) have become the leading conceptualisation of sustainable food systems, vibrant scholarship on food self‐provisioning (FSP) in Central and Eastern Europe has remained confined to the geopolitical region it investigates. This article brings these two bodies of thought closer together in two steps. First, we trace four framings of FSP deployed over the last three decades—coping strategy, cultural practice, hobby and source of good food and reading FSP as transformative practice—to demonstrate its progressive affinity with AFNs. Second, we follow the most recent framing in highlighting the material reality of local food production as a feature shared by both FSP and AFNs. From this perspective, FSP can be understood as a more radical variant of AFNs given its more substantial environmental and social impact (FSP is more widespread and socially inclusive and less dependent on market transactions). By uncovering the epistemological underpinnings of these different framings of FSP and exploring their implications for food practices on the ground, this article draws general lessons for scholarship aiming to advance food system transformation.
Multicenter evaluation of the IL‐3‐pSTAT5 assay to assess the potency of cryopreserved stem cells from cord blood units: The BEST Collaborative study
Authors: Trépanier Patrick , Fournier Diane , Simard Carl , Fontaine Magali J. , Stroncek David , Takanashi Minoko , McKenna David , Schwartz Joseph , Tanhehco Yvette C. , Reems Jo‐Anna , Torrents Silvia , Kogler Gesine , Liedtke Stefanie , Giroux Martin , Holovati Jelena L. , Louis Isabelle , Prasath Arun , Pineault Nicolas , Bazin Renée ,   The Biomedical Excellence for Safer Transfusion Collaborative
Published: June 2022

Background

The IL‐3‐pSTAT5 assay, a new, rapid, and standardized flow‐cytometry‐based assay may compensate for several limitations of the colony‐forming unit (CFU) assay typically used for stem cell potency assessments of cord blood units (CBU). We performed an inter‐laboratory evaluation of the performance of this new assay.

Study design and methods

This Biomedical Excellence for Safer Transfusion (BEST) Collaborative multicenter, international study included 15 participants from public cord blood banks (CBBs), CBB‐supporting research laboratories, and stem cell laboratories. To perform the IL‐3‐pSTAT5 assay, participating centers received reagents, instructions, and 10 blind CBU samples, including eight normal samples and two samples exposed to a transient warming event. We measured inter‐laboratory agreement qualitatively (proportion of correctly classified samples) and quantitatively (coefficient of variation [CV], correlation coefficients, receiver operating characteristics (ROC) curve, and intraclass correlation coefficient [ICC]).

Results

The qualitative agreement was 97.3% (i.e., 107/110; Fleiss' kappa = 0.835). The average CV on a per‐sample basis was 11.57% among all samples, 8.99% among normal samples, and on a per‐center basis was 9.42% among normal samples. In a correlation matrix that compared results across centers, the mean Pearson's correlation coefficient was 0.88 (standard deviation = 0.04). The ICC was 0.83 (95% confidence interval = 0.68–0.95). The area under the curve (AUC) from the ROC curve was 0.9974.

Discussion

Excellent qualitative and quantitative agreement was exhibited across laboratories. The IL‐3‐pSTAT5 assay may therefore be implemented in flow cytometry laboratories to rapidly and reliably provide standardized measures of stem cell potency in CBUs.
Evaluation of Phase Transformation Strain and Its Influence on Residual Stress Generation in Laser Welded Ti–6Al–4V Alloy
Authors: Kumar Bikash , Bag Swarup , Ruhul Amin M.
Published: June 2022

The assessment of welding-induced residual stress is always of significant interest due to its adverse effect on the structural stability and mechanical performance of the welded structure. Incorporation of intricate phenomena, in particular, thermal gradient, phase development, volumetric dilation, and phase transformation strain during FE modelling, not only acts as a reliable method for residual stress calculation but also serves as a directive to reduce tensile residual stress in a weldment which is sensitive to the selection of materials. In order to investigate the same for continuous and pulse laser-welded Ti–6Al–4V alloy, the sequentially coupled thermal–metallurgical–mechanical models are established. The internal state-dependent variables (SDVs) are implemented to capture the growth of phase evolved during diffusionless β → α′ transformation using Koistinen–Marburger (K–M) theory in the cooling cycle. The role played by a phase transformation induced strain on the generation of residual stress is systematically investigated. The volumetric dilation and associated phase fraction form the basis for the estimation of phase transformation strain in the present study. The accomplishment of highest martensitic fraction (∼95%) produced a phase transformation strain of 7.95 × 10−3 in pulse mode of operation. As a result, reversal of residual stress from tensile to compressive is perceived for pulse laser-welded specimen. Similarly, a sign of enriched martensitic transformation is noticed that puts the weld surface into a compression state and mitigates the overall tensile residual stress. The assumption of diffusional phase transformation during heating cycle and non-diffusional transformation during cooling phase in laser welding is more appropriate to predict the residual stress using thermal–metallurgical–mechanical model.
Thermal Model of a Parabolic Trough Solar Field With a Closed-Loop Operation During Sunrise Period
Authors: Lekhal R. , Ait-Ali M. A. , Ahmed Zaid T.
Published: June 2022

This work presents a numerical simulation of a thermal model for a solar loop with parabolic trough collectors (PTCs) considering fluid recirculation at closed-loop (CL) operation during sunrise. At the beginning of the day, the heat transfer fluid (HTF) is recirculated in a CL to obtain the inlet loop operating temperature without resorting to additional preheating energy. Energy balances are carried out on the HTF, the absorber tube, and the glass envelope as a function of optical and thermo-physical parameters of the heat collector element (HCE). A system of second-order differential equations was established, and mathematical model was resolved by finite difference and Newton–Raphson methods for solution. This model has been well validated by comparing the results with the existing experimental and numerical data. Three typical days of winter, spring, and summer were simulated for the solar loop operation considering a CL fluid recirculation at start-up conditions. Results show a more flexible CL operation at relatively large flowrates compared to the open-loop (OL) operation, which requires substantial preheating energy at the same conditions; the start-up solar field using the CL strategy allows us both operational autonomy and significant energy savings. Solar loop thermal and optical powers gained and lost are plotted for the typical days considered; we observe that maximum thermal efficiency of 66.53% is achieved at 2.27 p.m. for the summer day.