bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of equine sarcoids: A systematic review
Authors: Offer Katie S. , Dixon Claire E. , Sutton David G. M.
Published: March 2023

Background

The sarcoid is the most common equine cutaneous neoplasm. Evidence‐based treatment of this condition is often lacking, and selection of treatment modality based on clinical experience or anecdotal evidence.

Objectives

To assess the quality of the currently available best evidence regarding the treatment of the equine sarcoid.

Study design

Systematic review.

Methods

In compliance with PRISMA guidelines, literature searches were performed in PUBMED, Web of Science, CAB Abstracts, EMBASE (Ovid) and Scopus in April 2021. Included papers were required to describe an interventional study examining sarcoid treatment strategy, of level 4 evidence or greater. The case definition required confirmation of at least some included lesions on histopathology, and a minimum of 6 months of follow‐up was required on treated cases. Studies were assessed by two independent reviewers (KO, CD). Data extraction was performed manually, followed by risk of bias assessment. Methodological quality was assessed using the GRADE system.

Results

In total, 10 studies were included in the review. Case definition was confirmed via histopathology in all included lesions in 60% of papers. Time to follow‐up was variably reported. Overall risk of bias ranged from ‘some concerns’ to ‘critical’. Reported sarcoid regression rate ranged from 28% to 100% on an individual sarcoid level, and 9%–100% on a whole horse level. Transient local inflammation was reported following most treatment strategies, with further adverse events reported infrequently.

Main limitations

Review methodology excluded a large proportion of available literature regarding the equine sarcoid. Significant heterogeneity between included studies prevented quantitative synthesis and most included papers were at significant risk of bias, indirectness, and imprecision.

Conclusions

There is insufficient evidence currently available to recommend one sarcoid treatment over another. There is an urgent need for sufficiently powered, randomised, placebo‐controlled trials in order to allow more definitive comparison of the efficacy of different treatment strategies.
Biodiversity change under adaptive community dynamics
Authors: Carroll Tadhg , Cardou Françoise , Dornelas Maria , Thomas Chris D. , Vellend Mark
Published: March 2023

Compositional change is a ubiquitous response of ecological communities to environmental drivers of global change, but is often regarded as evidence of declining “biotic integrity” relative to historical baselines. Adaptive compositional change, however, is a foundational idea in evolutionary biology, whereby changes in gene frequencies within species boost population‐level fitness, allowing populations to persist as the environment changes. Here, we present an analogous idea for ecological communities based on core concepts of fitness and selection. Changes in community composition (i.e., frequencies of genetic differences among species) in response to environmental change should normally increase the average fitnessof community members. We refer to compositional changes that improve the functional match, or “fit,” between organisms' traits and their environment as adaptive community dynamics. Environmental change (e.g., land‐use change) commonly reduces the fit between antecedent communities and new environments. Subsequent change in community composition in response to environmental changes, however, should normally increase community‐level fit, as the success of at least some constituent species increases. We argue that adaptive community dynamics are likely to improve or maintain ecosystem function (e.g., by maintaining productivity). Adaptive community responses may simultaneously produce some changes that are considered societally desirable (e.g., increased carbon storage) and others that are undesirable (e.g., declines of certain species), just as evolutionary responses within species may be deemed desirable (e.g., evolutionary rescue of an endangered species) or undesirable (e.g., enhanced virulence of an agricultural pest). When assessing possible management interventions, it is important to distinguish between drivers of environmental change (e.g., undesired climate warming) and adaptive community responses, which may generate some desirable outcomes. Efforts to facilitate, accept, or resist ecological change require separate consideration of drivers and responses, and may highlight the need to reconsider preferences for historical baseline communities over communities that are better adapted to the new conditions.
Current situation, future vision and enablers of nursing home oral healthcare in Singapore: Dentists' perspectives
Authors: Tada Sayaka , Lee Gabriel Keng Yan , Koh Sarah Mun Yee , Wong Mun Loke
Published: March 2023

Objectives

To address the following research questions: (i) What is the current situation and future vision on oral healthcare service in nursing homes (NHs) in Singapore? (ii) What are the enablers to achieve the future vision? (iii) How do views differ between dentists with and without clinical experiences in NHs?

Background

Oral healthcare services in NHs need to reflect the perspectives of a diverse range of stakeholders and establish shared goals, however there is scarce evidence of in‐depth dentists’ insights.

Material and methods

Dentists were purposively recruited. Focus group discussions with 4–5 participants each were conducted via teleconferencing. Data were analysed thematically.

Results

The participants (n = 19, median 36.0 years) recognised the need of comprehensive reform of the oral healthcare paradigm in NHs: symptomatic care to preventive care, disease‐oriented care to person‐centred care and more active collaborative care. Overall, five domains of enabling factors emerged: (1) to improve general system of oral healthcare in NHs, (2) to increase the number of dentists engaging in NHs, (3) to improve the quality of dental practice, (4) to improve the quality of daily oral care and (5) to promote seniors' cooperative attitude to oral healthcare. There was a noticeable difference in the perception on how to encourage dentists to serve in NHs.

Conclusion

There is a need for a comprehensive reform of the oral healthcare paradigm for seniors in NHs in Singapore. A multi‐tiered strategy using both top‐down and bottom‐up approaches is required.
Public sector workers' support for technocracy. Comparative evidence from 25 European countries
Authors: Migchelbrink Koen
Published: March 2023

Are public sector workers more supportive of technocracy than people not employed in the public sector? Public sector workers play an important role in the functioning and safeguarding of democracy. However, because of their training as neutral and competent policy workers and implementers, it is often claimed that they hold relatively strong technocratic attitudes. In this study, we compare the support for technocracy of 35,395 public sector and non‐public sector workers across 25 European countries. The results show that on average, public sector workers are not more supportive of technocracy than non‐public sector workers, and that the effect of public sector employment on support for technocracy differs across countries. Furthermore, we find that trust in representative institutions and satisfaction with government can reduce support for technocracy.
Participation in healthcare consultations: A qualitative study from the perspectives of persons diagnosed with hand osteoarthritis
Authors: Magnussen Hege Johanne , Kjeken Ingvild , Pinxsterhuis Irma , Sjøvold Trine Amalie , Hennig Toril , Thorsen Eva , Feiring Marte
Published: March 2023

Introduction

Scarce health resources and differing views between persons with hand osteoarthritis (OA) and health professionals concerning care preferences contribute to sustaining a gap between actual needs and existing clinical guidelines for hand OA. The aim of this study is to explore the experiences of persons diagnosed with hand OA in their encounters with health services and how those experiences influence negotiations and decision‐making in hand OA care.

Methods

Data from 21 qualitative interviews with persons diagnosed with hand OA were collected, transcribed verbatim and analysed using reflexive thematic analysis.

Results

Three main themes were developed: symptoms are perceived as ordinary ageing in everyday life, consultations are shaped by trust in healthcare and the responsibilities of prioritisation and self‐care govern interactions.

Conclusion

Ideas of ageing, professional knowledge and self‐management dominate hand OA health encounters and contribute to shaping illness perceptions, preferences and opportunities to negotiate decisions in consultations.

Patient or Public Contribution

Two patient research partners with hand OA are members of the study project group. One of them is also a co‐author of this manuscript.
Host–microbiome interactions in apical periodontitis: The endodontic microbiome in relation to circulatory immunologic markers
Authors: Georgiou Athina C. , van der Waal Suzette V. , Buijs Mark J. , Crielaard Wim , Zaura Egija , Brandt Bernd W.
Published: March 2023

Aim

To explore microbial differences in the endodontic infection of teeth with primary or secondary apical periodontitis (AP), with or without symptomatology. Additionally, to investigate if these differences are depicted in immunologic markers in blood.

Methodology

Twenty‐nine teeth with primary or secondary AP were extracted and cryo‐pulverized. Blood was drawn from the subjects at three different time‐points before and three time‐points after the extraction in a time period of four months. The V4 hypervariable region of the 16S rRNA gene was sequenced using Illumina MiSeq. The microbial profiles were ordinated using principal component analysis and tested for differences between groups with permutational multivariate analysis of variance using the Bray–Curtis distance. If significantly different, the microbial profiles were further analysed using the LDA effect size (LEfSe) biomarker discovery tool. A broad panel of inflammatory mediators in blood was examined longitudinally in all subjects during the six visits with mixed models. The Spearman correlation between these mediators and the zOTUs was calculated, and significant correlations (p < .05) were used as input for significant analysis of microarrays (SAM) using MeV.

Results

After subsampling, the 467 zOTUs were classified into 9 phyla and 99 genera or higher level taxa. The predominant genus in the entire sample set was Fusobacterium with a relative abundance of 12.3%, followed by Prevotella (9.9%), Actinomyces (7.7%) and Streptococcus (6.7%). The microbiomes of the endodontic infections were significantly associated with endodontic status (primary/secondary infection; p = .015) as well as with the presence or absence of pain (p = .011). There was also a difference in the concentration of inflammatory mediators, namely, C‐reactive protein, Interleukin (IL)‐8, IL‐10, IL‐12p70, RANKL and TNF‐α, depending on the existence of pain. In addition, the presence of specific bacteria (zOTUs) was correlated, positively or negatively, with the expression of several circulating inflammatory markers.

Conclusions

The microbial profiles and the concentration–time relationship of systemic inflammatory mediators of primary endodontic infection differed from those of secondary, and of symptomatic from those of asymptomatic cases. The fingerprint of associations between the immunological and microbiological profiles differed between asymptomatic and symptomatic patients.
Effects of carbothermal prereduction temperature and Co content on mechanical properties of WC–Co cemented carbides
Authors: Deng Xiao‐Chun , Kang Xiao‐Dong , Zhang Guo‐Hua
Published: March 2023

WC–Co cemented carbides were prepared via an in situ synthesis method, including the carbothermal prereduction of WO3 and Co2O3 to remove all oxygen and a subsequent carbonization‐vacuum sintering process. The experimental results revealed that as the prereduction temperature increased from 1000 to 1200°C, the grain sizes of WC in WC–6Co and WC–12Co cemented carbides increased from .91 to 1.09 and .97 to 1.19 μm, respectively. Further, the fracture toughness of the sintered WC–6Co and WC–12Co cemented carbides increased from 9.97 to 10.83 and 11.11 to 18.30 MPa m1/2, respectively. In contrast, the hardness of the WC–6Co and WC–12Co cemented carbides decreased from 1477 to 1368 and 1351 to 1184 HV30, respectively. For a given prereduction temperature, an increase in Co content can improve the fracture toughness while lowering the hardness. In addition, an increase in the prereduction temperature or Co content led to an increase in the grain size of WC, which resulted in a transgranular fracture as the dominant mode.
3D printing of honeycomb Si3N4 ceramic
Authors: Ma Siqi , Fu Shuai , Wang Qikun , Yang Hualong , Li Wanlin , He Peigang , Wang Meirong , Cai Delong , Duan Xiaoming , Jia Dechang , Lin Hua‐Tay , Zhou Yu
Published: March 2023

In this paper, a honeycomb Si3N4 ceramic was fabricated by 3D printing with a well‐preserved structure. The effects of Si3N4 content on the rheological properties of Si3N4/sol–silica ink and the printing resolution of products were investigated. The microstructure, phase composition, liner shrinkage rate, and fracture behavior of printed samples before and after sintering were systematically characterized in detail. The results showed that the modified inks had the optimized rheological properties, and the stress–shear rate curves corresponding to each slurry could be well described by Bingham and Herschel–Bulkley fluid models. The corresponding slump rates of the printed samples with different Si3N4 to sol–silica mass ratios were all lower than 4%, and the linear shrinkage rate of all of the samples after sintering was below 20%. The fracture behavior under compressive loading of the honeycomb Si3N4 ceramics tended to be non‐catastrophic fractures both before and after sintering. The compressive strengths of all of the printed samples decreased with the increase of the Si3N4 content, and the highest compressive strength of the honeycomb ceramics could reach 131.2 MPa after sintering at 1600°C, which was about 366.9% higher than that of the samples in green state prior to the sintering.
Livin upregulation in keratinocytes of psoriasis patients to promote adhesion molecule expression
Authors: Che Delu , Hang Bing , Li Yazhuo , Li Kaili , Wang Kaijie , Wang Hao
Published: March 2023

Background

Activation of keratinocytes (KCs) is the main pathological feature of psoriasis. KCs recruit neutrophils by releasing various antimicrobial peptides and chemokines, which is also related to the expression of KC adhesion molecules. However, the regulatory mechanism governing their expression is still unclear. Livin, an inhibitor of the apoptosis protein family member involved in proliferation and metastasis of tumor cells, is significantly increased in psoriatic lesions.

Objectives

The aim of this study was to investigate the role of Livin in regulating adhesion molecule expression in KCs and release of chemokines that promote the activation and adhesion of neutrophils.

Methods

The expression of Livin in psoriasis patients, imiquimod mouse model, and the combination of IL‐17 alpha, IL‐22, IL‐1 alpha, OSM, and TNF‐α (Mix M5)‐treated HaCaT cells were detected by immunofluorescence staining, RT‐qPCR, and ELISA. Livin‐overexpression and knockdown in HaCaT cells transfected with HIV‐1‐based lentiviral vectors were used to study the function of Livin using RNA‐seq. Moreover, differences in the expression of HaCaT cell adhesion molecules after regulation of Livin expression and activation of neutrophils in the co‐culture model were verified.

Results

Livin was upregulated in the KCs of psoriasis patients, imiquimod mouse model and Mix M5‐treated HaCaT cells compared with the control groups. Livin in HaCaT cells might regulate the expression of adhesion molecules in KCs.

Conclusion

Thus, Livin may be a key effector molecule that regulates the expression of adhesion molecules in KCs and promotes the activation and adhesion of neutrophils.
How the agency contract fails in hybrid mode: agency fees and distribution sequences
Authors: Shu Wenjun , Xiao Zhongdong , Cao Yiyin
Published: March 2023

We consider a supplier selling substituted products to an e‐retailer through wholesale selling mode or mixed use of wholesale and agency selling mode (hybrid contracts). This paper explains the curious failure of the agency model and investigates the contract selection problem. We build the stylized models that consider consumer formats preferences and distribution sequence. We find that an excessively high agency fee can lead to failure but this is on the condition of substituted products simultaneously distributed. However, we find no failure phenomenon in sequential distribution scenarios. Because it is optimal to mark down the price of the delayed product that prevents inefficiency with a lower price in the agency model than in the wholesale model. Furthermore, in the e‐books industry, when consumers prefer digital (traditional) formats, the equilibrium strategy is that the e‐retailer claims a low agency fee, and the supplier chooses simultaneous (sequential) distribution through hybrid contracts. Besides, the equilibrium is robust.
Solving a multiobjective professional timetabling problem using evolutionary algorithms at Mandarine Academy
Authors: Hafsa Mounir , Wattebled Pamela , Jacques Julie , Jourdan Laetitia
Published: March 2023

In this paper, we propose a method for solving a real‐world timetabling problem at Mandarine Academy. The primary motivation for this work is to provide an automated professional course scheduling tool to replace the time‐consuming task of manually creating timetables that are constantly incorrect. Following a review of both scientific literature and company requirements, a mathematical model of the problem is provided, which includes 18 constraints (hard/soft) and five objectives, two of which are competing. We test a handful of multi‐objective evolutionary algorithms (MOEA's) starting with the non‐dominated sorting genetic algorithm (NSGA II and NSGA III), the multi‐objective evolutionary algorithm based on decomposition (MOEA/D), the indicator‐based evolutionary algorithm and finally the strength Pareto evolutionary algorithm . Two custom genetic operators (mutation and crossover) are proposed and compared to conventional operators (PMX and swap mutation). To obtain elite configurations, a tuning phase involving all of the aforementioned algorithms is carried out. Experiments were divided by problem size, with three to five objectives tested. Experiments include the use of real‐world data from the company's catalog. This dataset was made available to the scientific community to serve as a testing ground for professional course scheduling, an underexploited field of scheduling. We discuss findings, including a comparison of each algorithm's performance using various metrics, as well as convergence graphs and population evolution.
ParallelChain: a scalable healthcare framework with low‐energy consumption using blockchain
Authors: Pawar Vijayant , Sachdeva Shelly
Published: March 2023

The blockchain‐enabled healthcare system assists in tackling the inherent issues of centralized healthcare systems, such as data stewardship, single point of failure, and data integrity. However, existing blockchain‐enabled healthcare systems suffer from high‐energy consumption, low transaction throughput, and poor scalability. This work proposes the healthcare framework ParallelChain to tackle the low scalability and high‐energy consumption issue. ParallelChain divides the network into clusters, enabling linear scalability of nodes. The parallel execution of transactions in each cluster improves the throughput. The leader selection process of ParallelChain does not require solving computer‐intensive puzzles, making it more energy efficient than proof‐of‐work. The performance of ParallelChain is validated using metrics such as data transfer, processing time, consensus delay, block congestion, and message exchange. It shows that the amount of data transmitted is 4.6 times more in Bitcoin than ParallelChain with varying nodes. The number of messages exchanged is reduced by 48%, and the processing time is reduced by 2.17 and 1.7 times for varying nodes and block sizes, respectively.
Diversity and genetic connectivity of heteropod (Pterotracheoidea) gastropods in the Tropical Eastern Pacific
Authors: Collin Rachel , Madrid Maycol , Venera‐Pontón Dagoberto E. , Macdonald Kenneth S. , De León Alexandra , Vrdoljak Dubravka , Boyle Michael J. , Bryant Peter , Arehart Tim , Driskell Amy C.
Published: March 2023

Previous research focusing on pelagic gastropods in the open ocean has demonstrated that many morphospecies comprise multiple distinct clades or cryptic species that can be distinguished with DNA sequence data. To date, the genetic diversity of the pelagic gastropod fauna of the tropical East Pacific, especially in shallow coastal waters, remains largely unexplored. To document the diversity of pterotracheoids (formerly heteropods) from the coastal waters of the Bay of Panama, we collected, photographed and sequenced fragments of mitochondrial cytochrome c oxidase subunit I (COI) and 16S ribosomal DNA for 60 atlantids, 3 carinariids and 6 pterotracheids. In addition to the COI barcode, our results include the first published 16S sequences for these groups. We found 11 operational taxonomic units (OTUs): 9 in the genus Atlanta, 1 Carinaria and 1 Firoloida. We report the presence of Atlanta oligogyra (Clades A and B), Atlanta turriculata, Atlanta lesueurii, Atlanta helicinoidea (Clade B), Atlanta plana, Atlanta echinogyra, Atlanta inflata and Atlanta frontieri through comparisons of our sequences with previously published sequences. We did not find Atlanta gaudichaudi, Atlanta inclinata, Atlanta tokiokai, Atlanta gibbosa, Atlanta peronii, or Oxygyrus inflatus, which have previously been reported from the region. Haplotype networks and estimates of ΦST illustrate how some species show population differentiation across the tropical Indo‐Pacific region, whereas others show little apparent population structure. For example, the most common haplotypes of A. inflata and of A. turriculata occur in the Indian Ocean, the Central and West Pacific and the tropical East Pacific, whereas individuals of A. frontieri from the Indian Ocean do not share haplotypes with individuals of A. frontieri from the Pacific Ocean. Analyses were limited by sample sizes, but these data suggest that population genetics approaches may be useful for reconstructing population histories of these important, but overlooked, components of the plankton.
Effects of calreticulin mutations on cell transformation and immunity
Authors: Desikan Harini , Kaur Amanpreet , Pogozheva Irina D. , Raghavan Malini
Published: March 2023

Myeloproliferative neoplasms (MPNs) are cancers involving dysregulated production and function of myeloid lineage hematopoietic cells. Among MPNs, Essential thrombocythemia (ET), Polycythemia Vera (PV) and Myelofibrosis (MF), are driven by mutations that activate the JAK–STAT signalling pathway. Somatic mutations of calreticulin (CRT), an endoplasmic reticulum (ER)‐localized lectin chaperone, are driver mutations in approximately 25% of ET and 35% of MF patients. The MPN‐linked mutant CRT proteins have novel frameshifted carboxy‐domain sequences and lack an ER retention motif, resulting in their secretion. Wild type CRT is a regulator of ER calcium homeostasis and plays a key role in the assembly of major histocompatibility complex (MHC) class I molecules, which are the ligands for antigen receptors of CD8+ T cells. Mutant CRT‐linked oncogenesis results from the dysregulation of calcium signalling in cells and the formation of stable complexes of mutant CRT with myeloproliferative leukemia (MPL) protein, followed by downstream activation of the JAK–STAT signalling pathway. The intricate participation of CRT in ER protein folding, calcium homeostasis and immunity suggests the involvement of multiple mechanisms of mutant CRT‐linked oncogenesis. In this review, we highlight recent findings related to the role of MPN‐linked CRT mutations in the dysregulation of calcium homeostasis, MPL activation and immunity.
Modelling the effectiveness of land‐based natural flood management in a large, permeable catchment
Authors: Collins Sarah L. , Verhoef Anne , Mansour Majdi , Jackson Christopher R. , Short Chris , Macdonald David M. J.
Published: March 2023

In the United Kingdom, woodland planting and soil and crop management are being promoted as approaches to tackling flooding. Although evidence is limited, it is thought tree planting and regenerative agriculture practices such as crop–herbal ley pasture rotations increase infiltration, soil water storage and evapotranspiration, potentially reducing flooding. A process‐based soil–water–vegetation model was coupled with a semi‐distributed groundwater model to explore the impact of these interventions on peak and low flows in a large, groundwater‐dominated catchment. Land use change and management were found to have limited potential to reduce flooding in this setting. Herbal ley–crop rotations produced a <1% reduction in flow for return periods >2 years, and levels of woodland planting judged to be the realistic maximum produced reductions of 0.2%–2.6%, depending on tree species. Broadscale spruce planting was the only scenario to produce significant reductions in peak flow (16.0%–24.7% at return periods 1–15 years); however, the level of spruce planting required to achieve these reductions was estimated to reduce Q95 flow by ~39%, which would likely have negative implications for water security and ecological river flows. The impact of land‐based natural flood management interventions for flood prevention in large, permeable catchments should not be overstated.
Prevalence of unpaid caregiving, pain, and depression in older seriously ill patients undergoing elective surgery
Authors: Hu Frances Y. , Wang Yihan , Abbas Muhammad , Bollens‐Lund Evan , Reich Amanda J. , Lipsitz Stuart R. , Gray Tamryn F. , Kim Dae , Ritchie Christine , Kelley Amy S. , Cooper Zara
Published: March 2023

Introduction

Serious illness is a life‐limiting condition negatively impacting daily function, quality of life, or excessively straining caregivers. Over 1 million older seriously ill adults undergo major surgery annually, and national guidelines recommend that palliative care be available to all seriously ill patients. However, the palliative care needs of elective surgical patients are incompletely described. Understanding baseline caregiving needs and symptom burden among seriously ill older surgical patients could inform interventions to improve outcomes.

Methods

Using Health and Retirement Study data (2008–2018) linked to Medicare claims, we identified patients ≥66 years who met an established serious illness definition from administrative data and underwent major elective surgery using Agency for Healthcare Research and Quality (AHRQ) criteria. Descriptive analyses were performed for preoperative patient characteristics, including: unpaid caregiving (no or yes); pain (none/mild or moderate/severe); and depression (no, CES‐D < 3, or yes, CES‐D ≥ 3). Multivariable regression was performed to examine the association between unpaid caregiving, pain, depression, and in‐hospital outcomes, including hospital days (days admitted between discharge date and one‐year post‐discharge), in‐hospital complications (no or yes), and discharge destination (home or non‐home).

Results

Of the 1343 patients, 55.0% were female and 81.6% were non‐Hispanic White. Mean age was 78.0 (SD 6.8); 86.9% had ≥2 comorbidities. Before admission, 27.3% of patients received unpaid caregiving. Pre‐admission pain and depression were 42.6% and 32.8%, respectively. Baseline depression was significantly associated with non‐home discharge (OR 1.6, 95% CI 1.2–2.1, p = 0.003), while baseline pain and unpaid caregiving needs were not associated with in‐hospital or post‐acute outcomes in multivariable analysis.

Conclusions

Prior to elective surgery, older adults with serious illnesses have high unpaid caregiving needs and a prevalence of pain and depression. Baseline depression alone was associated with discharge destinations. These findings highlight opportunities for targeted palliative care interventions throughout the surgical encounter.
Unique fiber phenotype composition and metabolic properties of the stapedius and tensor tympani muscles in the human middle ear
Authors: Rönnblom Anton , Thornell Lars‐Eric , Shah Farhan , Tano Krister , Stål Per
Published: March 2023

The middle ear muscles have vital roles, yet their precise function in hearing and protection remains unclear. To better understand the function of these muscles in humans, the morphology, fiber composition, and metabolic properties of nine tensor tympani and eight stapedius muscles were analyzed with immunohistochemical, enzyme‐histochemical, biochemical, and morphometric techniques. Human orofacial, jaw, extraocular, and limb muscles were used as references. The immunohistochemical analysis showed that the stapedius and tensor tympani muscles were markedly dominated by fibers expressing fast contracting myosin heavy chain MyHC‐2A and MyHC‐2X (79 ± 6% vs. 86 ± 9%, respectively, p = 0.04). In fact, the middle ear muscles had one of the highest proportions of MyHC‐2 fibers ever reported for human muscles. Interestingly, the biochemical analysis revealed a MyHC isoform of unknown identity in both the stapedius and tensor tympani muscles. Muscle fibers containing two or more MyHC isoforms were relatively frequently observed in both muscles. A proportion of these hybrid fibers expressed a developmental MyHC isoform that is normally absent in adult human limb muscles. The middle ear muscles differed from orofacial, jaw, and limb muscles by having significantly smaller fibers (220 vs. 360 μm2, respectively) and significantly higher variability in fiber size, capillarization per fiber area, mitochondrial oxidative activity, and density of nerve fascicles. Muscle spindles were observed in the tensor tympani muscle but not in the stapedius muscle. We conclude that the middle ear muscles have a highly specialized muscle morphology, fiber composition, and metabolic properties that generally showed more similarities to orofacial than jaw and limb muscles. Although the muscle fiber characteristics in the tensor tympani and stapedius muscles suggest a capacity for fast, fine‐tuned, and sustainable contractions, their difference in proprioceptive control reflects different functions in hearing and protection of the inner ear.
Developing nurse‐sensitive outcomes in acute inpatient mental health settings—A systematic review
Authors: Ngune Irene , Myers Helen , Cole Amanda , Palamara Peter , Redknap Robina , Roche Michael , Twigg Diane
Published: March 2023

Background

While nurse‐sensitive outcomes (NSOs) are well established in numerous health settings, to date there is no indicator suite of NSOs for inpatient mental health settings.

Aim

To assess the relationship between nursing variables and patient outcomes in acute inpatient mental health settings to determine which outcomes can be used as indicators of the quality of nursing care.

Methods

Databases accessed were CINAHL, MEDLINE, PsycINFO and EMBASE, last searched in May 2022. The review followed the 2020 PRISMA checklist for systematic reviews. Papers published between 1995 and 2022, conducted in acute mental health care units were included. The quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool. A meta‐analysis was not possible because of the large number of variables and measurement inconsistencies.

Results

A total of 57 studies were reviewed. Studies were categorised according to whether they found a significant or non‐significant relationship between nurse variables and patient outcomes. Seven outcomes—aggression, seclusion, restraint, absconding, pro‐re‐nata medications, special observations and self‐harm—were identified. For each outcome, there were significant findings for several nurse variables indicating that all included outcomes could be used as NSOs. However, evidence for aggression, seclusion and restraint use as suitable NSOs was more robust than the evidence for self‐harm, absconding, pro‐re‐nata medications and special observations.

Conclusion

All the seven outcomes can all be used to develop an NSO indicator suite in mental health inpatient settings. More work is needed to establish high‐quality studies to clearly demonstrate the relationship between these outcome measures and changes in nurse variables such as nurse staffing, skill mix, work environment, nurse education and nurse experience.

Patient and Public Contribution

Patient or public contribution was not possible because of the type of the variables being explored.
Impact of personal protective equipment attached powered air‐purifying respirator on nursing‐skill performance and psychosocial stress of intensive care unit COVID‐19 nurses: A cross‐sectional study
Authors: Jun Yiwha , Lee Ogcheol , Kim Sunghee
Published: March 2023

Aim

To investigate how personal protective equipment with an attached powered air‐purifying respirator worn by intensive care unit nurses caring for COVID‐19 patients in Korea impacts nursing‐skill performance and psychosocial stress.

Design

A cross‐sectional descriptive study was designed using purposive sampling.

Review Methods

Online data collection was conducted from 3 March 2021–20 March 2021on 181 nurses who had worked for more than 1 month in COVID‐19 critical care settings wearing personal protective equipment with a powered air‐purifying respirator. A structured questionnaire was used to gather data on sociodemographic characteristics, attitude toward personal protective equipment, nursing‐skill performance wearing personal protective equipment and psychosocial stress.

Data Sources

Data was sourced from structured questionnaire responses.

Results

Nursing skill performance decreased to 63.4%, compared with normal performance. Subjects' perceptions and attitudes related to PPE scored 3.56 out of 5; 44.7% of subjects reported severe psychosocial stress, which was significantly affected by attitude toward personal protective equipment usage, nursing performance, experience caring for COVID‐19 patients and length of personal protective equipment usage per shift.

Conclusion

Greater negative attitude toward usage of personal protective equipment with a powered air‐purifying respirator, results in lower nursing‐skill performance and higher the psychosocial stress of nurses responding to COVID‐19 outbreaks.

Implications for the profession and/or patient care

High negative attitude toward PPE and low nursing‐skill performance due to PPE with an attached PAPR results in significant and debilitating psychosocial stress in ICU nurses responding to COVID‐19 outbreaks. To respond effectively to future infectious disease outbreaks and improve nursing performance, minimising the inconvenience and restrictions experienced by nurses wearing personal protective equipment is critical.

Reporting Method

We adhered to relevant EQUATOR guidelines to report.

Patient or Public Contribution

No patient or public contribution.
Immigration Policing as Holey War: Rings of Connection, Deadly Gaps, and State Loopholes in the Struggle for Asylum
Authors: Crosson J. Brent
Published: March 2023

This article uses the concept of holes rather than borders to articulate the space that US immigration policing engenders. In contradistinction to borders—lines or zones that can be mapped, walled, or policed to delimit sovereign bodies—holes are strategic exceptions to mappable sovereignties. Rather than fixed, mappable boundaries, holes are mutable and in flux, thriving on the shifting potential to appear or disappear and to make people disappear as legal subjects. If US immigration policing operates, to a large extent, through holes distributed across borders and long‐distance spaces, then any mapping of this power that centers national borders or bounded nation‐states alone is insufficient. I show how the policing of Venezuelan migration centers the distribution of holes from South and Central America to spaces within the US that are far from “the border.” Against a discursive focus on “the border” and the border wall in US rhetoric on immigration, I argue that the actual practices of impeding flows of immigration or channeling them through spaces of death have increasingly operated through holey space. If holy space has been defined in studies of religion as a sacred space set apart from mundane rules, then the hol(e)y spaces of immigration are set apart from fixed conceptions of “the rule of law.” A focus on holes shows how the legal order of immigration depends more on exceptions, personalized or arbitrary power, and the instability of interim extra‐legal executive orders than a dichotomy of legal/illegal. Despite their necropolitical power, holes do not create an entirely striated, hierarchical space. Holes are also rings of connection and passageways, highlighting the creativity and agency of asylum seekers in forging dignity under extremely difficult conditions.
Technique to restore the midline space of central incisors using a two‐in‐one template: A clinical report
Authors: Wu Jiacheng , Zhu Jiakang , Yang Xin , Gao Jing , Yu Haiyang
Published: March 2023

Using composite resin restoration of full‐coverage crowns to obtain a completely symmetrical esthetic restoration of individual central incisors remains difficult. Freehand direct composite resin restoration is challenging even for highly skilled dentists. This clinical report describes a digital protocol for achieving symmetrical restoration of two central incisors using a custom‐designed, two‐in‐one template.
School Nurse Perspectives on Collaboration With Primary Care Providers
Authors: Goldberg Lauren , Rankine Jacquelin , Devlin Bridgetta , Miller Elizabeth , Ray Kristin N.
Published: March 2023

BACKGROUND

School nurses are rarely integrated into primary care teams to their full potential. We aimed to characterize school nurses' perceptions related to current and optimal collaboration with primary care providers (PCPs) and identify actionable solutions to improve efficiency, quality, and coordination of pediatric care.

METHODS

We conducted and qualitatively analyzed interviews with school nurses to characterize structures, processes, and perceived benefits of optimized school nurse‐PCP collaboration.

RESULTS

School nurse interviewees (n = 23) identified factors important to school nurse‐PCP collaboration within 2 domains: information sharing and relationship building. Information sharing themes included health information sharing laws, data sharing systems, and technology‐based communication systems. Relationship building themes included health care sector understanding of the school nurse role, PCP knowledge of school health requirements, shared professional development opportunities, and time and personnel. Perceived benefits of optimized PCP‐school nurse collaboration were identified for children, PCPs, school nurses, and parents.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Needs assessments and action plans guided by the domains of information sharing and relationship building can inform local improvements to optimize school nurse‐PCP collaboration.

CONCLUSIONS

School nurses highlighted cross‐sector solutions to enhance school nurse‐PCP collaboration including integrated information sharing systems and intentional relationship building.
What makes an international institution work for labor activists? Shaping international law through strategic litigation
Authors: Kahraman Filiz
Published: March 2023

Studies on international legal mobilization often analyze the mobilization efforts of activists at a single international court. Yet we know little about how activists choose among multiple international institutions to advance social justice claims. Drawing on comparative case studies of Turkish and British trade union activists' legal mobilization efforts and case law analysis, I show that activists, guided by their lawyers, probe multiple avenues to identify the legal institution with the highest judicial authority and is most responsive to activists' claims. Once they identify their target institution, the iterative process between a responsive court and activists' strategic litigation can build a court's jurisprudence in a new issue area, even if the court provides limited de jure rights protections. Activists primarily use international litigation strategy to leverage structural reforms at the domestic level and to set new international norms through precedents.
Enlargement of opisthenar microcirculatory area predicts impaired heart function in severe acute coronary syndrome patients
Authors: Chen Chen , Zhu Bai Lin , Zheng Wei Da , Guo Zhen Yi , Jin Xin , Zhao Zai Hao , Lin Mei Hua , Cui Lan , Zhang Yin Hua
Published: March 2023

Background

Impaired microcirculation in acute coronary syndrome (ACS) patients manifests inadequate recovery and adverse clinical outcome. Here, we analyzed correlations between peripheral microcirculation and heart function in ACS patients.

Methods

Opisthenar microvessel area (OMA) were measured with optical coherence tomography angiography (OCTA), cardiac functional indexes (echocardiograph) were assessed 48–72 h after therapeutic interventions.

Results

Results showed that OMA normalized with heart rate (OMA‐HR) were significantly greater in ACS patients with percutaneous intervention (ACS‐PCI, n = 25, stenosis >80%) compared to those with pharmacological intervention (ACS‐PI, n = 23, stenosis <50%, p = .02). Ejection fraction (EF) and fractional shortening (FS), which were not different between two groups, showed negative correlations with OMA‐HR in ACS‐PCI (EF: r = −0.512, p = .009; FS: r = −0.594, p = .002). Cardiac output (CO) inversely correlated with OMA‐HR in both groups (r = −0.697, p < .0001; r = −0.527, p = .01). Neutrophil to lymphocyte ratio (NLR) on admission was greater in ACS‐PCI group. NLR, which was negatively associated with EF or FS, was positively associated with OMA‐HR in all patients. The area under the curve (AUC) for OMA‐HR was 0.683 (specificity 0.696 and sensitivity 0.72, p = .02). OMA‐HR at >376.5 μm2 predicts reduced FS and CO (p = .002, p = .005, respectively). Summary OMA‐HR predicts inadequate recovery of the heart in severe ACS patients post‐PCI.
A salivary secretory protein from Riptortus pedestris facilitates pest infestation and soybean staygreen syndrome
Authors: Shan Shiqi , Huang Yue , Guo Chunyun , Hu Biao , Zhang Hehong , Li Yanjun , Chen Jianping , Wei Zhongyan , Sun Zongtao
Published: March 2023

The bean bug (Riptortus pedestris), one of the most important pests of soybean, causes staygreen syndrome, delaying plant maturation and affecting pod development, resulting in severe crop yield loss. However, little is known about the underlying mechanism of this pest. In this study, we found that a salivary secretory protein, Rp614, induced cell death in nonhost Nicotiana benthamiana leaves. NbSGT1 and NbNDR1 are involved in Rp614‐induced cell death. Tissue specificity analysis showed that Rp614 is mainly present in salivary glands and is highly induced during pest feeding. RNA interference experiments showed that staygreen syndrome caused by R. pedestris was significantly attenuated when Rp614 was silenced. Together, our results indicate that Rp614 plays an essential role in R. pedestris infestation and provide a promising RNA interference target for pest control.
Pelvic Reduction Frame Facilitating Percutaneous Fixation to Pelvic Fractures
Authors: Anglen Jeffrey Owen
Published: March 2023

This article is a retrospective report of the outcome of 43 unilateral unstable, vertically displaced pelvic ring injuries using a reduction frame which is attached to the OR table, along with special instruments allowing “unlocking” of the fracture to facilitate reduction. The frame utilized by the authors is a modification of the Starr Frame® (Starr Frame, LLC, Richardson), which has been refined to be lower profile, more accessible, and more versatile in pin placement. They have also reported a new attachment for the frame to apply lateral traction to the fractured hemipelvis. The authors provide a detailed description of the techniques involved in securing the patient to the frame and table, and then the stepwise application of multiplanar tractions to the fractured hemipelvis. Their technique of unlocking closed reduction (UCRT) involved controlled application of lateral distraction to disimpact the compressed or overlapping fractured bone surfaces, followed by distal and anterior traction through a femoral supracondylar pin, and direct manipulation of the hemipelvis through a supracetabular “LC‐2” half pin. Reduction is followed by percutaneous fixation using 7.3‐mm cannulated screws across the posterior ring and either external fixation or subcutaneous supra‐acetabular pedicle screw internal fixation device (INFIX) anteriorly.
Permanent His bundle pacing in patients with right atriomegaly: The value of different dedicated delivery sheaths
Authors: Marinaccio Leonardo , Putorti Francesco , Rocchetto Eros , Giacopelli Daniele
Published: March 2023

Background

An enlarged right atrium (RA) is a challenging anatomy that can limit the successful use of His bundle pacing (HBP). It is unknown whether new implantation tools could help overcome these challenges.

Methods

Consecutive patients with RA volume index >25 mL/m2 in men and >21 mL/m2 in women underwent permanent HBP. We used a stylet‐driven lead (SDL) with an extendable helix delivered via a dedicated delivery sheath (Selectra 3D, Biotronik) as a first attempt. In case of failure, a second attempt was performed with the same lead but with a different delivery curve. Finally, a lumen‐less lead (LLL) was also available as a third attempt.

Results

The study cohort included 24 patients (median age 75.7 years [interquartile range, 70.9–79.0], 88% men) with a RA volume of 49 mL/m2 (45–54). Using SDL, HBP was achieved with a single sheath curve in 17 patients (71%). The second attempt with the same lead but a different sheath was successful in four more patients (SDL success 87%). The fluoroscopy time increased significantly when the second attempt was necessary (8 min [6–11] vs. 15 min [13–17], p < .001). In the remaining three patients, HBP was further attempted with a LLL leading to a final procedural success of 96%. No lead dislodgment nor significant increase in pacing threshold was observed at 1‐month (1.2 [0.7–1.7] V@1.0 ms vs. 1.1 [0.8–1.7] V@1.0 ms, p = .939).

Conclusion

The availability of different dedicated delivery systems for HBP can improve procedural outcomes even in challenging circumstances, such as in patients with right atriomegaly.