bluuebunny/crossref_metadata_2025 huggingface dataset:
Targeting cellular senescence: A promising approach in respiratory diseases
Authors: Sugimoto Masataka
Published: August 2023

Cellular senescence serves as a significant tumor suppression mechanism in mammals. Cellular senescence is induced in response to various stressors and acts as a safeguard against the uncontrolled proliferation of damaged cells that could lead to malignant transformation. Senescent cells also exhibit a distinctive feature known as the senescence‐associated secretory phenotype (SASP), wherein they secrete a range of bioactive molecules, including pro‐inflammatory cytokines, growth factors, and proteases. These SASP components have both local and systemic effects, influencing the surrounding microenvironment and distant tissues, and have been implicated in the processes of tissue aging and the development of chronic diseases. Recent studies utilizing senolysis models have shed light on the potential therapeutic implications of targeting senescent cells. The targeting of senescent cell may alleviate the detrimental effects associated with cellular senescence and its SASP components. Senolytics have shown promise in preclinical studies for treating age‐related pathologies and chronic diseases, including cancer, cardiovascular disorders, and neurodegenerative conditions. Respiratory diseases have emerged as a significant global health concern, responsible for a considerable number of deaths worldwide. Extensive research conducted in both human subjects and animal models has demonstrated the involvement of cellular senescence in the pathogenesis of respiratory diseases. Chronic pulmonary conditions such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis have been linked to the accumulation of senescent cells. This review aims to present the findings from research on respiratory diseases that have utilized systems targeting senescent cells and to identify potential therapeutic strategies for the clinical management of these conditions. Geriatr Gerontol Int 2024; 24: 60–66.
The origins and consequences of administrative burdens in mass immunization programs: Experimental evidence based on the monkeypox outbreak
Authors: Zhang Youlang , Wang Huan
Published: August 2023

Studies in medicine, bioscience, psychology, sociology, and public health have provided various contextual, individual, and vaccine‐specific explanations for vaccine uptake. However, one significant yet often ignored fact is that vaccination could be viewed as a site of citizen‐state interaction in implementing public vaccination policy. This begs the questions: What barriers create administrative burdens in vaccination? How do the experiences of administrative burdens (i.e., the learning, psychological, and compliance costs in citizen‐state interactions) shape the public's willingness to vaccinate? According to theoretical insights drawn from the extant literature on administrative burden and vaccine uptake, this study uses a conjoint experiment design based on a representative sample of China to reveal the role of administrative burdens in shaping the public's willingness to vaccinate against the monkeypox outbreak, a ‘Public Health Emergency of International Concern’ from July 2022 to May 2023. The experimental results suggest that multiple salient barriers have distinct effects on the respondents' learning, psychological, and compliance costs, thus significantly influencing their vaccine uptake. These findings have important implications for both future research and efforts to promote mass immunization programs.
The burden of global outbreaks: Photos of the daily lives of children with congenital Zika syndrome during the COVID‐19 pandemic
Authors: de Lima Nascimento Coutinho Dinara Laiana , Feldner Heather , Coelho Monique L. G. , Monteiro Karolinne S. , Longo Egmar
Published: August 2023

Introduction

In Brazil, more than 3500 children with congenital Zika syndrome (CZS) face difficulties participating in activities of daily living, which may be aggravated by health emergencies, such as the COVID‐19 pandemic. Participation could be defined as the individual's involvement in daily life situations, and participation restrictions are problems that may arise in involvement in everyday situations.

Aim

To explore the daily lives of children with CZS during the COVID‐19 pandemic using photographic narratives captured by mothers and discuss possible strategies to improve participation results.

Methods

In this participatory action research, seven young Brazilian mothers acted as co‐researchers using photovoice to describe the experiences of their children with CZS (from 2 to 5 years old). Also, mothers contributed to validate the contents. The research was conducted online and included the following steps: pilot study, recruitment, individualized training, sociodemographic interview, photovoice training, photo taking, focus group for contextualization, data transcription and analysis and validation of analyses by the mothers.

Results

Content analysis revealed five categories that influenced the participation of the children: participation preferences, family relationships, access to healthcare, access to education and social isolation. Regarding participation preferences, mothers reported their children's desire to play with peers and family members and have autonomy. Mothers described the family environment as a happy, peaceful and safe place for the children. Lack of therapy was perceived to negatively impact the health of children; thus, treatments were considered essential for child development. Access to education included accessibility of remote education and a perceived lack of infrastructure and pedagogical preparation. Last, social isolation due to COVID‐19 directly affected the daily lives and behaviour of the children, interrupting therapies and medical appointments.

Conclusion

The photos and narratives captured several aspects of the daily lives of children with CZS impacted by the COVID‐19 pandemic, reinforcing the importance of considering the negative effects of social isolation and offering education and social assistance to promote participation and integral health.

Patient/Public Contribution

Consistent with a participatory action research framework, Mothers acted as co‐researchers and participated in all stages of the research, especially in validating the data analysed by the researchers.
A virtuous cycle of co‐production: Reflections from a community priority‐setting exercise
Authors: Ikhile Deborah , Glass Devyn , Frere‐Smith Kat , Fraser Sam , Turner Keith , Ramji Hasu , Gremesty Georgie , Ford Elizabeth , van Marwijk Harm
Published: August 2023

Introduction

Co‐production is gaining increasing recognition as a good way of facilitating collaboration among different stakeholders, including members of the public. However, it remains an ambiguous concept as there is no definitive or universal model of co‐production or clarity on what constitutes a good co‐production approach. This paper draws on the reflections of the academic researchers, practitioners and public advisors involved in co‐producing a priority‐setting exercise. The exercise was conducted by the Primary and Community Health Services (PCHS) Theme of the National Institute for Health and Care Research Applied Research Collaboration for Kent, Surrey and Sussex (NIHR ARC KSS).

Methods

We collected data through written and verbal reflections from seven collaborators involved in the PCHS priority‐setting exercise. We used Gibbs' model of reflection to guide the data collection. We then analysed the data through an inductive, reflexive thematic analysis.

Results

A common thread through our reflections was the concept of ‘sharing’. Although co‐production is inherently shared, we used the virtuous cycle to illustrate a sequence of sharing concepts during the research cycle, which provides the underpinnings of positive co‐production outcomes. We identified six themes to denote the iterative process of a shared approach within the virtuous cycle: shared values, shared understanding, shared power, shared responsibilities, shared ownership and positive outcomes.

Conclusion

Our results present a virtuous cycle of co‐production, which furthers the conceptual underpinnings of co‐production. Through our reflections, we propose that positive co‐production outcomes require foundations of shared values and a shared understanding of co‐production as a concept. These foundations facilitate a process of shared power, shared responsibilities and shared ownership. We argue that when these elements are present in a co‐production exercise, there is a greater potential for implementable outcomes in the communities in which the research serves and the empowerment of collaborators involved in the co‐production process.

Public Members' Contributions

Three members of the public who are public advisors in the NIHR ARC KSS were involved in the priority‐setting exercise that informed this paper. The public advisors were involved in the design of the priority‐setting exercise and supported participants' recruitment. They also co‐facilitated the focus groups during data collection and were involved in the data analysis, interpretation and preparation of the priority‐setting report. For this current manuscript, two of them are co‐authors. They provided reflections and contributed to the writing and reviewing of this manuscript.
Restoring declining species through translocations: A test case using flightless grasshoppers in an urban setting
Authors: Yagui Hiromi , Kearney Michael R. , Hoffmann Ary A.
Published: August 2023

Population translocations are used increasingly as a conservation strategy for vertebrates. However, relatively few attempts have been made to translocate invertebrates despite their potential benefits for food webs, and despite the practicality of undertaking such translocations in small areas including urban environments where space is limited.

We conducted 36 translocations of 1851 individuals of the generalist flightless grasshopper Vandiemenella viatica across urban Melbourne, where 93% of its original habitat has been lost.

We aimed to understand characteristics essential for grasshopper persistence and to investigate detection, occupancy, dispersal and habitat suitability throughout its active period to improve insect translocation success in urban settings using revegetated sites and small remnant habitats. We also measured movement and detection probability after one week in short‐term trials.

The one‐week trial indicated that grasshopper sex and colour morph did not influence the probability of detection, and there was no evidence of directional movement by females and males.

One year after translocation, V. viatica were found in 28 out of 36 translocation sites. These surveys showed that detection probability changed across survey seasons and was influenced by soil temperature. Also, soil temperature positively affected detection in the winter surveys. Occupancy probability was influenced by graminoid cover, plant species richness and weed cover. We found no evidence of directional movement by females and males in the F1 generation. Abundance and presence/absence data were best explained by graminoid cover and plant species richness.

Our findings suggest that wingless grasshopper translocations are feasible in small urban patches of suitable habitat, helping to restore invertebrate biodiversity and ecological services.
Population control, technology, and economic growth
Authors: Chen Xianjuan , Zhou Yi
Published: August 2023

This paper examines the effects of China's population control policy on its economic transitions and long‐run equilibrium theoretically and quantitatively. The model‐predicted technological progress is assumed to be driven by population size and education level. With population control, the total number of children decreases; however, the average education level increases. Since the overall effect on technological progress is ambiguous, we performed a quantitative analysis of the model. The results demonstrate that population, technological progress, and income per capita move in endogenous cycles. The impact of China's population control policy depends on the timing of its implementation.
Review of paediatric obesity and non‐alcoholic fatty liver disease—A focus on emerging non‐pharmacologic treatment strategies
Authors: Piester Travis L. , Jagtap Nitin , Kalapala Rakesh
Published: August 2023

Obesity in paediatrics has become one of the most serious public health concerns worldwide. Paediatric obesity leads to increased adult obesity and is associated with several comorbidities, both physical and psychological. Within gastroenterology, non‐alcoholic fatty liver disease (NAFLD) is now the most common cause of paediatric liver disease and the most common cause of liver transplantation in young adults. Treatment for NAFLD largely focuses on treatment of obesity with weight loss strategies. Unfortunately, the traditional method of weight loss using multicomponent lifestyle modification (dietary changes, increased exercise and behavioural modification) has often led to disappointing results. In adult patients with obesity, treatment strategies have evolved to include bariatric surgery and, more recently, bariatric endoscopy. In paediatrics, the obesity and NAFLD epidemics will likely require this variety of treatment to address children in a personalized manner. Here, we present a review of paediatric obesity, paediatric NAFLD and the various treatment strategies to date. We focus on non‐pharmacologic and emerging therapies, including bariatric surgery and bariatric endoscopy‐based treatments. With such a large population of children and adolescents with obesity, further development of these treatments, including paediatric‐focused clinical trials, is essential for these emerging modalities.
Outcomes out to 12 months after sequential use of high‐dose tofacitinib following infliximab in acute severe ulcerative colitis
Authors: Eqbal Ali , Hilley Patrick , Choy Matthew , Srinivasan Ashish , de Cruz Peter
Published: August 2023

Acute severe colitis (ASUC) remains a significant cause of morbidity in up to 25% of patients with ulcerative colitis during their disease course. We present the outcomes out to 12 months following the use of high‐dose tofacitinib, 10 mg three times daily (TDS), in patients with steroid and infliximab refractory ASUC. A total of 11 patients with ASUC who were treated with high‐dose tofacitinib after failing sequential infliximab therapy between 2019 and 2021 were identified at an Australian tertiary centre. Ten of 11 patients demonstrated clinical and biochemical response to treatment during admission. Two of 11 patients required colectomy, one during the index admission and the other during re‐admission 10 days after the index presentation. Nine of the initial responders had a median Mayo score of 1 (IQR 0–4) at both 6 and 12 months, and all remained colectomy‐free out to 12 months. Neither venous thromboembolic events nor major infective complications were observed. Tofacitinib may be a safe and effective induction and maintenance agent in the treatment of steroid and infliximab refractory ASUC. Prospective studies with long‐term follow‐up are required to explore the use of tofacitinib in ASUC before it can be routinely recommended as salvage therapy.
The utility of rested prolactin sampling in the evaluation of hyperprolactinaemia
Authors: Wilkinson Tom , Li Bobby , Soule Steven , Hunt Penny
Published: August 2023

Background and Aims

Serum prolactin levels may be elevated by venepuncture stress. We investigated the utility of a rested prolactin sample, obtained through an indwelling venous cannula, in preventing the overdiagnosis of hyperprolactinaemia.

Methods

Patients at our institution undergo serial prolactin sampling, usually over 40 min, when investigating hyperprolactinaemia. We retrospectively reviewed all serial prolactin sampling performed during a 3‐year period. Patients with possible medication‐induced hyperprolactinaemia and macroprolactin interference were excluded. We assessed the effect of venepuncture‐associated stress on hyperprolactinaemia with the main outcome being normalisation of serum prolactin at the end of serial sampling.

Results

Ninety‐three patients with documented hyperprolactinaemia (range 360–1690 mU/L) were included in the analysis. Prolactin decreased during serial sampling in 73 patients (78%), suggesting a prevalent effect of venepuncture stress. The final prolactin sample was normal in 50 patients (54%), consistent with stress hyperprolactinaemia rather than pathological hyperprolactinaemia. Patients with a referral prolactin result greater than two times the upper reference limit (URL) were less likely (15%) to have a normal prolactin result on serial sampling. Measurement of a single rested prolactin sample from an indwelling cannula showed the same diagnostic utility as serial sampling.

Conclusion

Serum prolactin results are frequently elevated by the stress of venepuncture. Confirmation of pathological hyperprolactinaemia in a rested sample obtained from an indwelling venous cannula is recommended in patients with mild hyperprolactinaemia, particularly when the referral prolactin is less than two times the URL.
Immunogenic cell death (ICD) enhancers—Drugs that enhance the perception of ICD by dendritic cells
Authors: Liu Peng , Zhao Liwei , Zitvogel Laurence , Kepp Oliver , Kroemer Guido
Published: August 2023

The search for immunostimulatory drugs applicable to cancer immunotherapy may profit from target‐agnostic methods in which agents are screened for their functional impact on immune cells cultured in vitro without any preconceived idea on their mode of action. We have built a synthetic mini‐immune system in which stressed and dying cancer cells (derived from standardized cell lines) are confronted with dendritic cells (DCs, derived from immortalized precursors) and CD8+ T‐cell hybridoma cells expressing a defined T‐cell receptor. Using this system, we can identify three types of immunostimulatory drugs: (i) pharmacological agents that stimulate immunogenic cell death (ICD) of malignant cells; (ii) drugs that act on DCs to enhance their response to ICD; and (iii) drugs that act on T cells to increase their effector function. Here, we focus on strategies to develop drugs that enhance the perception of ICD by DCs and to which we refer as “ICD enhancers.” We discuss examples of ICD enhancers, including ligands of pattern recognition receptors (exemplified by TLR3 ligands that correct the deficient function of DCs lacking FPR1) and immunometabolic modifiers (exemplified by hexokinase‐2 inhibitors), as well as methods for target deconvolution applicable to the mechanistic characterization of ICD enhancers.
Personal strength use and job satisfaction in Chinese nurses: The mediating roles of basic psychological needs satisfaction and resilience
Authors: Bai Chengzhi , Bai Baoyu
Published: August 2023

Aim

This study aimed to investigate the association of personal strength use with job satisfaction among Chinese nurses and to examine the mediating roles of basic psychological needs satisfaction and resilience in this association.

Background

The topic of nurses’ job satisfaction has been extensively studied worldwide because of its significant effects on nurse turnover, recruitment, and quality of care.

Methods

A sample of 417 nurses completed a multi‐section questionnaire that included established scales to measure personal strength use, basic psychological needs satisfaction, resilience, and job satisfaction.

Results

The results revealed that personal strength use was positively linked to nurses’ job satisfaction. Additionally, basic psychological needs satisfaction and resilience mediated the association of personal strength use with job satisfaction both independently and serially.

Conclusion

Personal strength use increases nurses’ job satisfaction by satisfying their basic psychological needs and improving their resilience.

Implications for nursing and health policy

Creating a culture that supports the use of personal strengths among nurses is a promising strategy that hospital managers could consider to enhance nurses’ job satisfaction. Furthermore, implementing programs and interventions to improve nurses’ basic psychological needs satisfaction and resilience could further boost their job satisfaction.
Structural and psychological empowerment and burnout among nurses: A systematic review and meta‐analysis
Authors: Şenol Çelik Sevilay , Sariköse Seda , Çelik Yusuf
Published: August 2023

Aim

This study aims to review available evidence about the relationship between structural and psychological empowerment and burnout among nurses.

Background

Nurses are key healthcare providers, who experience higher levels of burnout due to uncertainty and role conflicts about nursing roles and responsibilities and poor management. Nurse empowerment is an effective approach to reduce nurse burnout and enhance patient care quality.

Introduction

Positive working conditions along with positive attitudes and perceptions for nurses are crucial in the workplace. Nurse empowerment in the workplace results in quality improvements in work life and the provision of healthcare.

Method

We conducted a systematic review in accordance with the recommendations of the Joanna Briggs Institute and the PRISMA guideline. Relevant studies published between 2007 and 2022 were identified via PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE (R), Science Direct and Turkish scientific literature databases. Studies that reported correlation coefficients were pooled to conduct a meta‐analysis.

Results

Random‐effects meta‐analyses showed a negative association between structural and psychological empowerment and emotional exhaustion. The overall findings showed a moderate and negative association between the six dimensions of structural empowerment and depersonalization. There was a positive association between structural empowerment and personal accomplishment.

Discussion

There is a relationship between decreased burnout levels and nurse empowerment. The causal relationship between empowerment and burnout levels needs to be investigated in various healthcare settings in several countries.

Conclusion

The relationship between structural and psychological empowerment and burnout levels emphasizes that empowerment can reduce nurse burnout. Nurse empowerment is a critical management strategy for improving the quality of life for nurses, increasing the quality and effectiveness of patient care and achieving positive outcomes.

Implications for nursing and health policy

The encouragement and empowerment of nurses for prompt decision‐making and effective resource utilization, reduces nurse burnout, enhancing nurses’ job commitment, productivity, satisfaction and competence along with increased quality of care. The encouragement of nurses as empowered managers at the macro, meso and institutional levels not only improves the overall quality of health services but also helps to find solutions for the issues concerning healthcare service users and the health system environment.
The price of the slow lane: Traffic congestion and stock block trading premium
Authors: Cao Tingqiu , Qian Xianhang , Zhang Le
Published: August 2023

Using data on city‐level daily traffic congestion and stock block trading, we investigate the impact of trader cities' traffic congestion on the stock block trading price. We find that higher level of traffic congestion in the traders' cities is associated with lower stock block trading premium, particularly when the information asymmetry between the trading parties is high. We also find that the buyers have more bargaining power in determining the price premium of block trading. Moreover, we employ a multi‐pronged approach to address the identification issue and find confirming evidence for the causal link.
Sternal wound infections following internal mammary artery grafts for a coronary bypass: A meta‐analysis
Authors: Li Mingmei , Yu Zhenxing , Chen Qiong , Zhao Qian , Chen Xiang , Lei Changjiang , Wang Xiaohui , Yang Rui
Published: August 2023

The meta‐analysis aims to evaluate and compare the sternal wound infections following internal mammary artery grafts for a coronary bypass. Examinations comparing bilateral internal mammary artery to single internal mammary artery for coronary artery bypass grafting were among the meta‐analyses from various languages that met the inclusion criteria. Using dichotomous random‐ or fixed‐effect models, the results of these investigations were examined, and the Odd Ratio (OR) with 95% confidence intervals (CIs) was computed. A total of 31 examinations from 2001 to 2023 were recruited for the current analysis including 181 503 personals with coronary artery bypass grafting. Bilateral internal mammary artery had significantly higher sternal wound infection (OR, 1.51; 95% CI, 1.37–1.68, p < 0.001), superficial sternal wound infection (OR, 1.72; 95% CI, 1.16–2.56, p = 0.007), deep sternal wound infection (OR, 1.62; 95% CI, 1.41–1.86, p < 0.001), sternal wound infection in diabetics (OR, 1.48; 95% CI, 1.16–1.90, p = 0.002), sternal wound infection in elderly (OR, 1.38; 95% CI, 1.22–1.57, p < 0.001), sternal wound infection in pedicled preparation (OR, 1.70; 95% CI, 1.30–2.23, p < 0.001) and sternal wound infection in skeletonized preparation (OR, 1.40; 95% CI, 1.09–1.81, p = 0.009) compared to single internal mammary artery in personals with coronary artery bypass grafting. Bilateral internal mammary artery grafting is linked to a higher risk of impaired wound healing, particularly in diabetic individuals, elderly, pedicled preparation, and skeletonized preparation. Nevertheless, caution should be exercised while interacting with its values since examinations were performed by different surgeons with different skills on different types of personals.
WKYMVm ameliorates obesity by improving lipid metabolism and leptin signalling
Authors: Kang Ji Hyeon , Kim Hyung Sik , Park Seon Hyang , Kim Ye Seon , Bae Yoe‐Sik
Published: August 2023

Obesity is a metabolic disorder that results from an imbalance of energy intake and consumption. As low‐grade chronic inflammation caused by obesity can lead to various complications, it is important to develop effective treatments against obesity. In this study, we investigate the effects of WKYMVm, a strong anti‐inflammatory agent, against obesity. Administration of WKYMVm into high fat diet (HFD)‐induced obese mice significantly attenuated body weight gain, food intake and increased insulin sensitivity. HFD‐induced hepatic steatosis and adipose tissue hypertrophy were also markedly ameliorated by WKYMVm. During the maturation of adipocytes, WKYMVm improves lipid metabolism by increasing lipolysis, adipogenesis, mitochondrial biogenesis and fat browning. WKYMVm administration also elicited a decrease in leptin levels, but an increase in leptin sensitivity via regulation of hypothalamic endoplasmic reticulum stress and the leptin receptor cascade. Taken together, our results show that WKYMVm ameliorates obesity by improving lipid metabolism and leptin signalling, suggesting that WKYMVm can be a useful molecule for the development of anti‐obesity agents.
Editorial Perspective: Adapting western psychological interventions for children and adolescents in LMICs: lessons from Nepal
Authors: Pacini Adele , Shrestha Prithvi
Published: August 2023

Nepal is a low‐middle income country which is considered to be a collectivist culture and has a significant mental health treatment gap for young people. The dominant approach in the global mental health literature has been to import western treatments with varying degrees of cultural adaptation. We argue that this approach is at best cost‐ineffective, and at worst harmful, particularly where young people receive interventions outside of their community. The existing literature suggests that the type of intervention delivered, is of less importance than the situating of it within a young person's community, and that leveraging existing cultural resources for resilience within a community, may ultimately be of more benefit than the translating and delivering western ones.
Vitiligo patient population and disease burden in France: VIOLIN study results from the CONSTANCES cohort
Authors: Ezzedine Khaled , Seneschal Julien , Da Silva Audrey , Préaubert Nathalie , Lamblin Anne , Delattre Carine , Emery Corinne , Nevoret Camille , Finzi Jonathan , Bouée Stéphane , Passeron Thierry
Published: August 2023

Background

Vitiligo is a chronic autoimmune disease resulting in skin depigmentation.

Objectives

This study assessed the prevalence, disease burden and treatment of vitiligo in France.

Methods

VIOLIN was a cross‐sectional study nested in the national CONSTANCES cohort, which consists of randomly selected adults aged 18–69 years in France. In VIOLIN, longitudinal data were collected prospectively from 158,898 participants during 2012–2018 and linked to the National Health Data System (SNDS), a healthcare utilization database. Patients with physician‐diagnosed vitiligo were matched (1:3) with control participants based on age, sex, geographic region, year of inclusion and skin phototype. Patients completed a questionnaire in 2022 to collect disease characteristics, disease burden and quality‐of‐life (QoL) data.

Results

Vitiligo prevalence was 0.71% (681/95,597) in 2018. The mean age in the vitiligo population was 51.2 years; 51.4% were women. Most patients (63%) were diagnosed before age 30 years, mainly by dermatologists (83.5%). Most patients (81.1%) had visible lesions (i.e. on face, hands). Vitiligo was limited to <10% of the body surface area (BSA) in 85.8% of patients. Comorbidities including thyroid disease (18.0% vs. 9.0%), psoriasis (13.7% vs. 9.7%), atopic dermatitis (12.4% vs. 10.3%), depression (18.2% vs. 14.6%) and alopecia areata (4.3% vs. 2.4%) were significantly more common in patients with vitiligo versus matched controls (n = 2043). QoL was significantly impaired in patients with >5% BSA involvement or visible lesions, particularly with ≥10% facial involvement. Vitiligo‐specific instruments (i.e. Vitiligo Impact Patient scale and Vitiligo‐specific QoL instrument) were more sensitive to QoL differences among subgroups versus general skin instruments, and generic instruments were least sensitive. Most patients (83.8%) did not receive any prescribed treatment.

Conclusions

Patients with vitiligo in France have a high disease burden, particularly those with visible lesions or higher BSA involvement. Most patients are not receiving treatment, highlighting the need for new effective treatments and patient/physician education.
Abnormal bolus reflux on impedance‐pH testing independently predicts 3‐year pulmonary outcome and mortality in pulmonary fibrosis
Authors: Bailey Mariel E , Borges Lawrence F , Goldberg Hilary J , Hathorn Kelly E , Gavini Sravanya , Lo Wai‐Kit , Chan Walter W
Published: August 2023

Background and Aim

Gastroesophageal reflux has been associated with idiopathic pulmonary fibrosis (IPF), although the directionality of the relationship has been debated. Data on the value of objective reflux measures in predicting IPF disease progression and mortality remain limited. We aimed to evaluate the association between multichannel intraluminal impedance and pH testing (MII‐pH) and 3‐year pulmonary outcomes in IPF patients.

Methods

This was a retrospective cohort study of adults with IPF who underwent pre‐lung transplant MII‐pH off acid suppression at a tertiary center. Patients were followed for 3 years after MII‐pH for poor pulmonary outcomes (hospitalization for respiratory exacerbation or death). A secondary analysis was performed using mortality as outcome of interest. Time‐to‐event analyses using Kaplan–Meier and Cox regression were performed to evaluate associations between MII‐pH and poor outcomes.

Results

One hundred twenty‐four subjects (mean age = 61.7 ± 8 years, 62% male) were included. Increased bolus exposure time (BET) on MII‐pH was associated with decreased time to poor pulmonary outcomes and death (log‐ranked P‐value = 0.017 and 0.031, respectively). On multivariable Cox regression analyses controlling for potential confounders including age, sex, smoking history, body mass index, proton pump inhibitor use, baseline pulmonary function, and anti‐fibrotic therapy, increased BET was an independent predictor for poor pulmonary outcomes [hazard ratio 3.18 (95% confidence interval: 1.25–8.09), P = 0.015] and mortality [hazard ratio 11.3 (95% confidence interval: 1.37–63.9), P = 0.025] over 3 years.

Conclusions

Increased BET on MII‐pH is an independent predictor of poor pulmonary outcomes and mortality over 3 years in IPF patients. These findings also support a role for gastroesophageal reflux in IPF disease progression and the potential impact of routine reflux testing and treatment.
The Nutritional Online sUrvey for pRegnancy Induced Sickness & Hyperemesis (NOURISH) study: results from the first trimester
Authors: Maslin Kate , Dean Caitlin , Shawe Jill
Published: August 2023

Background

Hyperemesis gravidarum (HG) is severe pregnancy sickness, often leading to dehydration, weight loss and electrolyte disturbances. Little is known about nutritional intake and its consequences in those affected. The aim of this study was to explore the first trimester nutritional intake and clinical characteristics in those with severe sickness.

Method

Recruitment was via the social media accounts of national pregnancy charities. The eligibility criteria were as follows: between 6 and 11 weeks pregnant, age ≥18 years and residing in the UK. Participants completed a self‐report online questionnaire including the Pregnancy Unique Quantification of Emesis 24 (PUQE24) score and a 3‐day online diet diary. Groups were compared by PUQE24 categories. Nutritional intakes were compared to dietary reference values.

Results

One hundred sixty‐six participants took part in the study: 36 categorised with mild, 109 with moderate and 21 with severe symptoms at a median gestation of 8.1 (interquartile range [IQR] 3) weeks. Those in the severe category had significantly higher weight loss (3.0 kg, IQR 3.5) than the mild category (0.0 kg, IQR 0.9). In those who completed the diet diary (n = 70), intakes of energy, carbohydrate, protein, fat, fibre, calcium, iron, zinc, thiamine, riboflavin, folate and vitamin C were all significantly lower in the severe category (p < 0.05). The severe group consumed only 39.5% and 41.6% of energy and protein needs, respectively, and were more likely to stop taking micronutrient supplements (p < 0.05).

Conclusion

Nutritional and supplement intake in those with severe pregnancy sickness was poor; however, intake across all participants was suboptimal. Future research should investigate how to improve nutritional intake across all categories of pregnancy sickness.
Social supermarkets, nutritional implications and healthy eating: exploration of members and their views
Authors: Mulrooney Hilda M. , Ranta Ronald , Nancheva Nevena , Bhakta Dee , Lake Stef
Published: August 2023

Background

The Covid‐19 pandemic has increased the need for food support but simultaneously enabled substantial innovation in food support provision, including the evolution of social supermarkets (SSM). These allow consumers to choose from a range of low‐cost products, minimise stigma and reduce food waste. Data from members of two Sussex SSM were gathered for their perspectives and experiences, as well as potential nutritional implications of the SSM.

Methods

Questionnaires administered face‐to‐face during site visits and optional telephone interviews were used. Data were collected during three site visits; 111 participants completed questionnaires, and an additional 25 detailed interviews with members of the SSM were completed. All data were gathered between December 2021 and May 2022.

Results

Overall, the SSMs were valued by their members. Social, economic and nutritional benefits were identified. SSM increased consumer choice and reduced stigma. Most members visited regularly, using SSM to supplement other food purchases. They valued the opportunity to choose their own foods and opportunities to socialise, in addition to the range of food and household items offered. The majority agreed that healthy eating was important but time and cost were barriers especially for younger members. SSM introduced members to novel foods and dishes, potentially diversifying dietary intakes. Challenges included restrictions on the amounts of food available, depending on the timing of visits. This was a greater challenge for those more reliant on SSM for household needs.

Conclusions

SSM represent an innovative and less stigmatising model of food support. Greater variety of food offered suggests their potential to diversify and improve dietary intakes. Challenges include ensuring stability of food supply and reducing stigma further.
Fundamental neurochemistry review: Glutamatergic dysfunction as a central mechanism underlying flavivirus‐induced neurological damage
Authors: Nogueira Clara O. , Rocha Tamires , Messor Daniel F. , Souza Isis N. O. , Clarke Julia R.
Published: August 2023

The Flaviviridae family comprises positive‐sense single‐strand RNA viruses mainly transmitted by arthropods. Many of these pathogens are especially deleterious to the nervous system, and a myriad of neurological symptoms have been associated with infections by Zika virus (ZIKV), West Nile virus (WNV), and Japanese encephalitis virus (JEV) in humans. Studies suggest that viral replication in neural cells and the massive release of pro‐inflammatory mediators lead to morphological alterations of synaptic spine structure and changes in the balance of excitatory/inhibitory neurotransmitters and receptors. Glutamate is the predominant excitatory neurotransmitter in the brain, and studies propose that either enhanced release or impaired uptake of this amino acid contributes to brain damage in several conditions. Here, we review existing evidence suggesting that glutamatergic dysfunction‐induced by flaviviruses is a central mechanism for neurological damage and clinical outcomes of infection. We also discuss current data suggesting that pharmacological approaches that counteract glutamatergic dysfunction show benefits in animal models of such viral diseases.

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Insights into acne and the skin barrier: Optimizing treatment regimens with ceramide‐containing skincare
Authors: Schachner Lawrence A. , Alexis Andrew F. , Andriessen Anneke , Berson Diane , Gold Michael , Goldberg David J. , Hu Shasa , Keri Jonette , Kircik Leon , Woolery‐Lloyd Heather
Published: August 2023

Introduction

Acne is a common, complex, multifactorial inflammatory skin disease associated with epidermal barrier dysfunction. Beginning in childhood, acne affects many adolescents and adults. Acne is associated with lower self‐esteem, anxiety, and depression and may cause scars and pigmentary sequelae. The review explores the relationships between acne and the skin barrier function and discusses nuances in the prevention, treatment, and maintenance of acne and its impact on the skin barrier.

Methods

The advisors' previous publications addressed prescription and nonprescription pediatric acne treatment and skincare using cleansers, moisturizers, and a practical algorithm for treatment and maintenance, including skincare recommendations for pediatric acne patients and an algorithm for skin of color patients with acne.

Before the meeting, literature was culled on the relationship between the skin barrier and acne and current best practices in acne, addressing prescription and nonprescription acne products and skincare as monotherapy, adjunctive, and maintenance treatment.

Results

After discussing 13 draft statements, the advisors applied the selected literature and drew from their clinical knowledge and experience, and agreed on five statements. The follicular epithelial barrier is directly involved with changes that occur during both comedogenesis and in stages of inflammation, especially with follicular rupture compromising the barrier's integrity. In acne‐affected skin, sebaceous glands are larger, sebum excretion and filaggrin expression higher, and stratum corneum lipids are reduced.

Educating patients and clinicians about inflammation's central role in acne and measures to reduce inflammation is essential. Skin irritation and xerosis from acne and treatments lead to poor treatment adherence. A skincare regimen should be included in the acne prevention, treatment, and maintenance care regimen and should be ongoing. Maintenance treatment with topical agents and skincare using gentle ceramide‐containing cleansers and moisturizers is a recommended strategy after successfully controlling the disease.

Conclusions

Epidermal barrier dysfunction contributes to acne exacerbation. Using the appropriate treatment and skincare helps to minimize irritation and inflammation, enhance treatment adherence, and improve patient outcomes.
Rosehip extract and wound healing: A review
Authors: Belkhelladi Malachy , Bougrine Amina
Published: August 2023

Background

Each year, over 100 million patients are afflicted with new scars from medical procedures worldwide. Natural compounds have shown promise in the treatment of scars and skin disorders. Rosehip oil (RO), produced from the pressed fruit of the rosehip (Rosa canina L.) plant, is used in the pharmaceutical, cosmetic, and food industries. The use of this plant in the treatment of scars has yet to be reviewed.

Aims

This review aims to analyze the current findings on the use of RO in the treatment of postsurgical scars.

Methods

This literature search considered published journal articles (clinical trials or literature reviews). Studies were identified by searching electronic databases (PubMed and MEDLINE) and reference lists of respective articles. Additional articles were identified through Google Scholar. Only articles available in English were included in this review.

Results

There is a scarcity of high‐quality studies assessing the therapeutic potential of RO. From the two human clinical trials using RO, there is some evidence to suggest its potential as an active ingredient in topical formulations for the treatment of wounds. Topical treatments containing RO extract may reduce the size and erythema of postsurgical scars through the polarization of macrophages and the inhibition of inflammatory cytokines.

Conclusions

Some evidence suggests that RO may improve postsurgical scars. At present, there is insufficient evidence to recommend the use of RO for the treatment of wounds. Further investigation is required to establish its therapeutic effects on human skin and its potential use as an ingredient in topical formulations.
Safety considerations for treating the parotid and submandibular glands with neuromodulators for facial slimming
Authors: Gelezhe Pavel , Frank Konstantin , Casabona Gabriela , Kaye Kai O. , Kassirer Samuel , Moelhoff Nicholas , Freytag David L. , Gotkin Robert H. , Alfertshofer Michael , Cotofana Sebastian
Published: August 2023

Background

Neuromodulators have predominantly been used for the treatment of upper facial lines, but their use has expanded to include lower face and neck treatments. However, the injection sites for these treatments are based on skin surface landmarks, which may pose risks to nearby structures and result in undesired outcomes.

Objective

To investigate the spatial relationship between the FDA‐approved skin surface landmarks for neuromodulator injections in the parotid and submandibular glands and the topographical anatomy of critical facial structures such as the facial artery, facial vein, external carotid artery, and retromandibular vein.

Materials and methods

A cross‐sectional retrospective analysis was conducted on contrast‐enhanced cranial CT scans. The scans were analyzed for the morphology and location of the parotid and submandibular glands. Measurements were taken for gland volume, craniocaudal extent, anterior–posterior extent, and distances between the skin surface and gland capsule or nearby structures such as arteries.

Results

The study sample consisted of 53 subjects, including 7 males and 46 females, with a mean age of 36.91 years and a mean BMI of 23.28 kg/m2. The mean volume of the parotid gland was 31.9 ± 3.0 cc in males and 28.5 ± 3.6 cc in females with p < 0.001, while the mean volume of the submandibular gland was 18.2 ± 2.0 cc in males and 14.5 ± 3.4 cc in females with p < 0.001. The mean distances between skin surface and the gland capsule were 5.98 ± 2.2 and 8.84 ± 4.0 mm for the parotid and submandibular gland, respectively. This distance increased with higher age and higher BMI values in a statistically significant manner with p < 0.001.

Conclusion

The distances between FDA‐approved skin surface landmarks and the parotid and submandibular glands varied significantly depending on gender, age, and BMI. Optimal injection depth and location for neuromodulator treatments cannot be generalized based on these landmarks alone, emphasizing the need for real‐time ultrasound imaging guidance.
Cognitive bias during clinical decision‐making and its influence on patient outcomes in the emergency department: A scoping review
Authors: Jala Sheila , Fry Margaret , Elliott Rosalind
Published: August 2023

Background

An integral part of clinical practice is decision‐making. Yet there is widespread acceptance that there is evidence of cognitive bias within clinical practice among nurses and physicians. However, how cognitive bias among emergency nurses and physicians' decision‐making influences patient outcomes remains unclear.

Aim

The aim of this review was to systematically synthesise research exploring the emergency nurses' and physicians' cognitive bias in decision‐making and its influence on patient outcomes.

Methods

This scoping review was guided by the PRISMA Extension for Scoping Reviews. The databases searched included CINAHL, MEDLINE, Web of Science and PubMed. No date limits were applied. The Patterns, Advances, Gaps, Evidence for practice and Research recommendation (PAGER) framework was used to guide the discussion.

Results

The review included 18 articles, consisting of 10 primary studies (nine quantitative and one qualitative) and eight literature reviews. Of the 18 articles, nine investigated physicians, five articles examined nurses, and four both physicians and nurses with sample sizes ranging from 13 to 3547. Six primary studies were cross‐sectional and five used hypothetical scenarios, and one real‐world assessment. Three were experimental studies. Twenty‐nine cognitive biases were identified with Implicit bias (n = 12) most frequently explored, followed by outcome bias (n = 4). Results were inconclusive regarding the influence of biases on treatment decisions and patient outcomes.

Four key themes were identified; (i) cognitive biases among emergency clinicians; (ii) measurement of cognitive bias; (iii) influence of cognitive bias on clinical decision‐making; and (iv) association between emergency clinicians' cognitive bias and patient outcomes.

Conclusions

This review identified that cognitive biases were present among emergency nurses and physicians during clinical decision‐making, but it remains unclear how cognitive bias influences patient outcomes. Further research examining emergency clinicians' cognitive bias is required.

Relevance to Clinical Practice

Awareness of emergency clinicians' own cognitive biases may result to the provision of equity in care.

No Patient or Public Contribution in this review

We intend to disseminate the results through publication in a peer‐reviewed journals and conference presentations.