bluuebunny/crossref_metadata_2025 huggingface dataset:
I arrived at the sun! Developing an educational board game with the collaboration of pre‐service art and pre‐service science teachers
Authors: Küçükşen Öner Ferhunde , Cetin‐Dindar Ayla , Sarı Hazal
Published: March 2024

The aim of this study was to describe the design process of an educational board game, the Planet‐Dart. This board game design is based on the science curriculum and aims to enhance middle school students' basic concepts about solar system. The purpose of developing this educational game was to provide an entertaining way for learning science. A pre‐service art teacher designed the game with the support of two pre‐service science teachers. The pilot study was conducted with two middle school students, and with the feedback based on the pilot study the pre‐service art teacher made modifications to the game. Then, the main implementation of the game was conducted in a real‐classroom environment with 60 middle school students by one pre‐service science teacher and two science teachers. The qualitative results revealed that this game was an enjoyable and effective learning tool to play among middle school students. In addition, the pre‐ and in‐service science teachers emphasized that there was an entertaining learning environment during the play. Based on these findings, the developed educational board game could enhance students' learning outcomes and entertainment.
A biomedical engineering curriculum development: A qualitative study engaging four stakeholders
Authors: Prestigiacomo Rita , Chan Chun Chuen , Kark Lauren
Published: March 2024

Biomedical engineering is critical in improving people's lives through innovative solutions to biological and medical challenges. In the face of today's rapidly evolving climate, the field of biomedical engineering encounters numerous pressures that demand up‐to‐date skills and competencies. The (re‐)development of curricula aligning with industry and societal needs, students' expectations, and academics' expertise while outlining graduates' knowledge (that) and abilities (how) becomes indispensable despite the challenges and complexities presented by conflicting priorities, tight timelines, and scarce resources. This paper presents a qualitative study conducted by a biomedical engineering graduate school at an Australian university. The study engaged four key stakeholders—industry partners, recent graduates, current academics, and students—in a self‐auditing process of an existing biomedical engineering curriculum. This exercise aimed to identify priorities for the future development of the curriculum. The findings reveal the perspectives from the four stakeholder groups, with industry partners and recent graduates focusing on technical and transferable skills and current students and academic staff advocating for breadth and a more practice‐oriented curriculum, where transdisciplinarity should inform biomedical engineering education. We propose that this evidence‐based and bottom‐up approach with multiple stakeholders holds potential implications for fields beyond biomedical engineering education. It provides valuable guidance to educational institutions seeking to (re‐)develop their curricula to align with evolving industry and society demands.
Modelling the interplay between resilience, emotion regulation and psychological well‐being among Chinese English language teachers: The mediating role of self‐efficacy beliefs
Authors: Zhi Ran , Derakhshan Ali
Published: March 2024

With the rise of positive psychology (PP) in 1954 and its flowering in the last decade of the 20th century, the focus of psychological and educational studies has shifted from examining negative health‐related outcomes to their positive counterparts. In line with this new research agenda, several L2 researchers have studied different positive health‐related outcomes and their predictors among language teachers. Few language studies, however, have been dedicated to examining language teachers' psychological well‐being and its potential predictors. To bridge the lacuna, the current research tried to evaluate the role of emotion regulation and resilience in predicting Chinese EFL teachers' psychological well‐being. This research also strived to find out whether perceived self‐efficacy could mediate the interaction between psychological well‐being, emotion regulation and resilience. For this purpose, 430 English teachers recruited from Chinese EFL classes were asked to respond to four closed‐ended questionnaires. The analysis outcomes exhibited strong and positive associations between resilience, emotion regulation and psychological well‐being. The results also divulged that the psychological well‐being of English language teachers could be meaningfully predicted by their emotion regulation ability and resilience. Additionally, the results indicated that the association between Chinese English teachers' resilience, emotion regulation ability and psychological well‐being could be significantly mediated by their self‐efficacy beliefs. These outcomes may have some useful and instructive implications for educational principals and teacher trainers.
Somatic variants as a cause of drug‐resistant epilepsy including mesial temporal lobe epilepsy with hippocampal sclerosis
Authors: Carton Robert J. , Doyle Michael G. , Kearney Hugh , Steward Charles A. , Lench Nicholas J. , Rogers Anthony , Heinzen Erin L. , McDonald Seamus , Fay Joanna , Lacey Austin , Beausang Alan , Cryan Jane , Brett Francesca , El‐Naggar Hany , Widdess‐Walsh Peter , Costello Daniel , Kilbride Ronan , Doherty Colin P. , Sweeney Kieron J. , O'Brien Donncha F. , Henshall David C. , Delanty Norman , Cavalleri Gianpiero L. , Benson Katherine A.
Published: March 2024

Objective

The contribution of somatic variants to epilepsy has recently been demonstrated, particularly in the etiology of malformations of cortical development. The aim of this study was to determine the diagnostic yield of somatic variants in genes that have been previously associated with a somatic or germline epilepsy model, ascertained from resected brain tissue from patients with multidrug‐resistant focal epilepsy.

Methods

Forty‐two patients were recruited across three categories: (1) malformations of cortical development, (2) mesial temporal lobe epilepsy with hippocampal sclerosis, and (3) nonlesional focal epilepsy. Participants were subdivided based on histopathology of the resected brain. Paired blood‐ and brain‐derived DNA samples were sequenced using high‐coverage targeted next generation sequencing to high depth (585× and 1360×, respectively). Variants were identified using Genome Analysis ToolKit (GATK4) MuTect‐2 and confirmed using high‐coverage Amplicon‐EZ sequencing.

Results

Sequence data on 41 patients passed quality control. Four somatic variants were validated following amplicon sequencing: within CBL, ALG13, MTOR, and FLNA. The diagnostic yield across 41 patients was 10%, 9% in mesial temporal lobe epilepsy with hippocampal sclerosis and 20% in malformations of cortical development.

Significance

This study provides novel insights into the etiology of mesial temporal lobe epilepsy with hippocampal sclerosis, highlighting a potential pathogenic role of somatic variants in CBL and ALG13. We also report candidate diagnostic somatic variants in FLNA in focal cortical dysplasia, while providing further insight into the importance of MTOR and related genes in focal cortical dysplasia. This work demonstrates the potential molecular diagnostic value of variants in both germline and somatic epilepsy genes.
Acquired diffuse palmoplantar erythema with keratoderma in Chinese patients with pustular psoriasis: A predictor for IL36 receptor antagonist c.115+6T>C mutation?
Authors: Hsu Francis Li‐Tien , Hsieh Chang‐Yu , Tsai Tsen‐Fang
Published: March 2024

Several studies have suggested that mutation of the interleukin 36 receptor antagonist gene (IL36RN) is related to generalized pustular psoriasis (GPP), and the presence of IL36RN mutation may affect the clinical manifestations and treatment responses. However, genetic testing is not routinely available in clinical practice for the diagnosis of GPP. Previously, GPP patients with acrodermatitis continua of Hallopeau (ACH) were found to have a high percentage of carrying IL36RN mutation. In this study, we reported six patients with pustular psoriasis presenting as diffuse palmoplantar erythema with keratoderma among 60 patients who carried IL36RN mutation. ACH was present in five patients and five patients had acute flare of GPP. This unique presentation may serve as a predictor for IL36RN mutation in patients with pustular psoriasis, similar to ACH.
Security and privacy protection protocol based on edge computing in smart campus
Authors: Liang Jing , Gong Yan
Published: March 2024

With the continuous emergence of modern Internet of Things, mobile Internet and other new generation of campus information technology and its extensive application in professional campus education, the development of college professional campus education information construction has entered a new stage of development. In view of higher requirements on data storage and network transmission delay of core business system in smart campus and more prominent wireless network security problems, this paper proposes a privacy protection protocol for smart campus based on chaotic mapping and edge computing. The protocol uses chaos mapping algorithm to protect user identity and negotiate session keys, and introduces edge computing to process authentication information on the edge server, which reduces the pressure of the core network and improves the authentication efficiency. This paper proves the security of the protocol by using BAN logic and Scyther, and verifies that the protocol can resist known attacks by analysing informal security. Through performance analysis and comparison, the proposed protocol has obvious advantages in computation and communication overhead.
The role of gender, stress, and social support in parents' pandemic well‐being: A cross‐national study
Authors: Thorsteinsen Kjærsti , Heijens Marie , Parks‐Stamm Elizabeth J. , Froehlich Laura , Martiny Sarah E.
Published: March 2024

Objective

The goal was to investigate whether and how the well‐being of mothers and fathers was differentially affected by the COVID‐19 pandemic in four European countries and whether differences in stress and social support explain observed gender differences.

Background

Previous research documents that the COVID‐19 pandemic had a significant impact on many people's lives and that some groups, such as women and parents, were affected more negatively than others. This study investigates potential underlying mechanisms and protective factors.

Method

In November 2020, 448 parents (218 fathers and 230 mothers, Mage = 41.18, SD = 8.47) from four European countries (Norway, Sweden, Germany, and the United Kingdom) completed an online questionnaire. Parents of elementary schoolchildren reported their stress, well‐being, and social support currently and retrospectively for the first lockdown (spring 2020).

Results

Mothers experienced lower well‐being than fathers during the pandemic, and parental well‐being differed between countries. In addition, the stress caused by the need to combine paid work and child care partly mediated the relationship between gender and well‐being, and social support played a protective role by buffering individuals from the negative impact of stress on well‐being.

Conclusion

The study allows a more differentiated perspective on the impact of the COVID‐19 pandemic on parental well‐being in Europe.

Implications

Results suggest in future health‐related crises, policymakers and practitioners working with families should focus on providing additional support to mothers of young children to maintain their well‐being.
Making family meals happen: Working mothers' work–family boundary management strategies in Singapore
Authors: Tan Hwee Boon Simone , Cho Eunae
Published: March 2024

Objective

We examined how working mothers, who often juggle paid work and family meal preparation, manage work–family boundaries to optimize their family meal practice.

Background

Despite the well‐established benefits of family meals, reconciliation of work demands with family meal preparation represents a challenge for many working mothers. A better understanding of malleable antecedents of family meals can be instrumental in enabling more families to have meals together.

Method

Full‐time working mothers of young children (aged below 12) in Singapore were individually interviewed (N = 34). In addition to the information about their typical family meal arrangements, we explored work and family factors that shape family meals and the strategies working mothers use to manage work–family boundaries. Data were analyzed using thematic analysis.

Results

Working mothers adopt various work–family boundary management strategies (temporal, behavioral, and communication) to achieve desired family meal frequency and quality of mealtime interactions. Mothers' broad views on work–family management and thoughts about family meals undergird their choice of specific strategies.

Conclusion

This research revealed working mothers' active management of work–family boundaries as a novel answer to the critical question of how working mothers of young children make family meals happen.

Implications

Our research has practical implications for working mothers' ability to facilitate family meals.
“I feel like I am betraying my child”: The socio‐politics of maternal guilt and shame
Authors: Rúdólfsdóttir Annadís Greta , Auðardóttir Auður Magndís
Published: March 2024

In this paper, we explore maternal shame and guilt as affective derivatives of social regulations of motherhood in Iceland, which is internationally perceived as a frontrunner in gender equality. We analyze 450 qualitative questionnaires completed by parents describing feelings of guilt and shame in connection to parenthood. We use 76 questionnaires completed by fathers to contrast and compare to answers from mothers to better understand the affective‐discursive workings of motherhood. The affective‐discursive analytical framework allows us to understand affective pulls, pushes, power dynamics and their social politics. The findings are contextualized in the Nordic welfare state, neoliberalism, the current ethos of intensive mothering. The recurrent thread running through the data is the idea of the ever‐present mother, and under this umbrella concept, we have developed two affective‐discursive themes: (i) the guilt of working (long hours) and having to arrange for childcare and (ii) failing to be 100% present for the child. We conclude that the emotions of guilt and shame are consistently present in mothers' lives, much more so than in fathers' lives, and that this gendered pattern is both caused by and serves to reinforce the age‐old cultural mandate that mothers are primarily responsible for child rearing. The marks of intensive mothering are evident in mothers' description of feeling guilty for everyday tasks such as working, cleaning, studying, arranging for daycare, sending their children to preschool, and attending to their own needs. This gendered pattern suggests that the gender equality cornerstone of the Nordic welfare state might be at risk as important institutions, such as preschools, are perceived as inferior to mothers' constant attention.
Creating competitive academic leadership by implementing alternative promotion tracks
Authors: Weinberger Yehudith
Published: March 2024

Staff members in academia are expected to meet a diverse range of simultaneous expectations: responding to students' scholastic needs, pursuing high‐quality, ongoing research and being involved in their institutions. Those who successfully bear this multifaceted burden are found worthy of promotion. This 5‐year study followed the activity of two parallel staff promotion committees in a large Israeli teachers' college: a researcher track and an ‘other’ track. The findings show two opposing trends, which continued until reaching an equilibrium: a decrease in portfolios presented and an increase of portfolios approved for promotion in the researcher track, and—in the ‘other’ track—an increase in the submitted and a decline in the approved. These tendencies signal a gradual establishment of the new ‘other’ track's status and speak to a distinctive added value for high‐quality academic innovation in the new era—lecturers' involvement in teamwork and partnership on the campus.
What really is nontokenistic fully inclusive patient and public involvement/engagement in research?
Authors: Hilton Andrea , Megson Molly , Aryankhesal Aidin , Blake Jessica , Rook George , Irvine Anne , Um Jinpil , Killett Anne , Maidment Ian , Loke Yoon , van Horik Jayden , Fox Chris ,   TIMES programme team
Published: March 2024

Patient and public involvement and engagement (PPIE) is critically important in healthcare research. A useful starting point for researchers to understand the scope of PPIE is to review the definition from the National Institute for Health and Care Research (NIHR) as, ‘research being carried out “with” or “by” members of the public rather than “to”, “about” or “for” them’. PPIE does not refer to participation in research, but to actively shaping its direction. The ‘Effectiveness of a decision support tool to optimise community‐based tailored management of sleep for people living with dementia or mild cognitive impairment (TIMES)’ study is funded through the NIHR programme grant for applied research. TIMES has thoroughly embraced PPIE by ensuring the person's voice is heard, understood, and valued. This editorial showcases how the TIMES project maximised inclusivity, and we share our experiences and top tips for other researchers. We base our reflections on the six key UK standards for public involvement; Inclusive Opportunities, Working Together, Support and Learning, Communications, Impact and Governance. We present our work, which had been co‐led by our PPIE leads, academics and partners including, together in dementia everyday, Innovations in Dementia, The UK Network of Dementia Voices (Dementia Engagement & Empowerment Project) and Liverpool Chinese Wellbeing. We have a Lived Experience Advisory Forum on Sleep, which includes people with dementia, family carers, representatives of the South Asian Community and the Chinese community.
Early HIV viral suppression associated with subsequent 12‐month treatment success among people living with HIV in South Africa
Authors: Violette Lauren R. , Thomas Katherine K. , Dorward Jienchi , Quame‐Amaglo Justice , Garrett Nigel , Drain Paul K.
Published: March 2024

Background

We analyzed the STREAM (Simplifying HIV TREAtment and Monitoring) study to determine risk factors associated with HIV viraemia and poor retention 18 months after initiation of antiretroviral therapy (ART).

Methods

The STREAM study was an open‐label randomized controlled trial in Durban, South Africa, that enrolled 390 people living with HIV presenting for their first HIV viral load measurement ~6 months after ART initiation. We used modified Poisson regression with robust standard errors to describe associations between baseline characteristics and three HIV outcomes 18 months after ART initiation: HIV viraemia (>50 copies/mL), poor retention in HIV care, and a composite outcome of poor retention in care and/or HIV viraemia.

Results

Approximately 18 months after ART initiation, 45 (11.5%) participants were no longer retained in care and 43 (11.8%) had viraemia. People with CD4 counts <200 and those with viraemia 6 months after ART initiation were significantly more likely to have viraemia 18 months after ART initiation (adjusted relative risk [aRR] 4.0; 95% confidence interval [CI] 2.1–7.5 and aRR 5.5; 95% CI 3.3–9.0, respectively). People who did not disclose their HIV status and had viraemia after ART initiation were more likely to not be retained in care 12 months later (aRR 2.6; 95% CI 1.1–6.1 and aRR 2.2; 95% CI 1.0–4.8). People with a CD4 count <200 and those with viraemia were more likely to not achieve the composite outcome 18 months after ART initiation.

Conclusions

Viraemia after ART initiation was the strongest predictor of subsequent viraemia and poor care retention. Understanding early indicators can help target our interventions to better engage people who may be more likely to experience persistent viraemia or disengage from HIV care.
Design, optimization, and verification of self‐lubricating ceramic tool microstructure by MC method
Authors: Zhu Hang , Zhang Guangfu , Chen Zhaoqiang , Huang Yajun , Tian Congfeng , Zhang Ruwei , Xu Chonghai
Published: March 2024

The computer‐aided analysis of microstructure evolution during the sintering process of self‐lubricating ceramic tools can unveil the underlying sintering mechanism and optimize experimental parameters. In this study, a novel self‐lubricating ceramic tool material, Al2O3/SiC/h‐BN@Al2O3, was fabricated with Al2O3 as the matrix, SiC as the reinforcement phase, and h‐BN@Al2O3 as the solid lubricant. The Monte Carlo (MC) method was employed to construct a model of self‐lubricating ceramic tool material, consisting of Al2O3/SiC/h‐BN@Al2O3. Subsequently, the sintering process was analyzed to investigate the influence of particle size and content of reinforced SiC, as well as the content of coated solid lubricant h‐BN@Al2O3, sintering pressure, and temperature on the microstructure of the tool. Optimal composition and sintering parameters were determined: 3 vol% for SiC additive amount with a particle size of 0.05 μm; 5 vol% for h‐BN@Al2O3 additive amount; and an optimal sintering temperature at 1650°C. The development of self‐lubricating ceramic tool materials, Al2O3/SiC/h‐BN@Al2O3, was realized through the employment of the aforementioned parameters. Their mechanical properties and microstructure were comprehensively characterized. The bending strength, fracture toughness, and Vickers hardness of the experimentally‐prepared Al2O3/3 vol%SiC/5 vol%h‐BN@Al2O3 self‐lubricating ceramic tool material were determined to be 722.42 MPa, 6.5 MPa·m1/2, and 20.65 GPa, respectively.
Innovative ceramic paste for stereolithography additive manufacturing alumina core applied in turbine blade casting
Authors: Ye Zhiwen , Hao Zongdong , Dou Rui , Wang Li , Tang Weizhe
Published: March 2024

Ceramic stereolithography 3D printing technology has demonstrated great potential in alumina core manufacturing for advanced turbine blade casting. However, there have been very few photosensitive material formulas specifically designed for alumina core fabrications. Herein, we present the design of a 3D printable ceramic paste based on bimodal particle size distributions for additive manufacturing of high‐quality alumina cores. The coarse particles in the paste remain in their original shape while the fine particles transform into platelet‐like particles during sintering. The effects of coarse particles, platelet‐like particles, and grain growth on maintaining porosity and limiting shrinkage rates are studied. Furthermore, the vacuum sintering process is found to be beneficial for core material properties. The physical properties tests verify that the newly designed alumina paste in this work can meet the application requirement, which is superior to the previous research.
Diagnostic insights from chemometric analysis of hemogram inflammatory indexes in male smokers with and without asthma or chronic obstructive pulmonary disease
Authors: Singh Brajesh , Dutta Vijay , Singh Smiti , Pundit Priyanka
Published: March 2024

Background

Diagnosis of asthma and chronic obstructive pulmonary disease (COPD) becomes difficult in a primary healthcare center due to ambiguous interpretation of spirometry and lack of facility to access established biomarkers. While routine hematological indices are easily available and accessible. The study aimed to evaluate the role of different hemogram indexes in males in COPD, asthma, and healthy smokers.

Materials and Methods

Lung function tests and complete blood count (CBC) were done for 50 male subjects each from asthma, COPD, and healthy smokers. Multivariate analysis (MVA) was performed on blood indices data set. Receiver operating characteristic (ROC) curve was plotted to observe the performance of indexes. Pearson correlation was used to establish association between the lung function and blood indices.

Results

Most of the indices were elevated in COPD. Whereas, asthma patients showed a significant increase in eosinophil basophil ratio (EBR), lymphocyte‐monocyte ratio (LMR), and mean platelet volume‐platelet count ratio (MPR). Orthogonal (O)‐ Partial Least‐Squares Discriminant Analysis (PLSDA) and variable importance in projection (VIP) score established EBR, neutrophil‐lymphocyte ratio (NLR) and LMR, as discriminants for asthma. Whereas, Systemic Inflammatory Response Index (SIRI), NLR and EBR were the key variables for COPD. NLR (r = −0.73, p < 0.001) and SIRI (r = −0.71, p < 0.001) were found to be negatively correlated with forced expiratory volume in 1 s (FEV1) percentage of the predicted value (%pred) in asthma and COPD, respectively. EBR showed the sensitivity and specificity of 96% and 86% respectively in asthma. NLR was having sensitivity of 82% and 90% specificity in COPD.

Conclusion

Our study in males shows routine hematological indices as being cost‐effective, feasible, and seem to have tremendous potential as screening markers among chronic respiratory diseases in a primary healthcare center.
Optimal production and carbon reduction investment decision for manufacturers with leasing–selling strategies considering financing
Authors: Liu Biyu , Shi Yaling , Yang Haidong
Published: March 2024

For a capital‐constrained manufacturer, in the context of carbon reduction, whether products should be sold or leased and which financing mode is more beneficial are usually debated. By considering Carbon Emission Permits Repurchase Financing (CEPRF) and Green Credit Financing (GCF), the optimal decision‐making models with different strategies are presented. The Karush–Kuhn–Tucker theorem is applied and the results are compared. Meanwhile, the influence of initial capital and interest rates on the manufacturer's decision‐makings, profits, and environment are explored. The results show that: under the selling strategy, when the initial capital is small, GCF is better for the manufacturer; otherwise, CEPRF is better; under the leasing strategy, both optimal production and carbon reduction investment with CEPRF are lower than that with GCF, but their profits are higher. With CEPRF, the leasing strategy would bring more economic and environmental benefits to the manufacturer; with GCF, the selling strategy would result in more economic and environment benefits.
The impact of the COVID‐19 pandemic on longitudinal trends of surgical mortality and inpatient quality of care in Ontario, Canada
Authors: Habbous Steven , Ford Maggie , Bar‐Ziv Stacey , Donovan Terri , Hellsten Erik
Published: March 2024

Aims

Previous studies have shown the COVID‐19 pandemic was associated with reductions in volume across a spectrum of non‐SARS‐CoV‐2 hospitalizations. In the present study, we examine the impact of the pandemic on patient safety and quality of care.

Design

This is a retrospective population‐based study of discharge abstracts.

Methods

We applied a set of nationally validated indicators for measuring the quality of inpatient care to hospitalizations in Ontario, Canada between January 2010 and December 2022. We measured 90‐day mortality after selected types of higher risk admissions (such as cancer surgery and cardiovascular emergency) and the rate of patient harm events (such as delirium, pressure injuries and hospital‐acquired infections) occurring during the hospital stay.

Results

A total 13,876,377 hospitalization episodes were captured. Compared with the pre‐pandemic period, and independent of SARS‐CoV‐2 infection, the pandemic period was associated with higher rates of mortality after bladder cancer resection (adjusted risk ratio [aRR] 1.20 (1.07–1.34)) and open repair for abdominal aortic aneurysm (aRR 1.45 (1.06–1.99)). The pandemic was also associated with higher rates of delirium (adjusted odds ratio [aOR] 1.04 (1.02–1.06)), venous thromboembolism (aOR 1.10 (1.06–1.13)), pressure injuries (aOR 1.28 (1.24–1.33)), aspiration pneumonitis (aOR 1.15 (1.12–1.18)), urinary tract infections (aOR 1.02 (1.01–1.04)),Clostridiodes difficileinfection (aOR 1.05 (1.02–1.09)), pneumothorax (aOR 1.08 (1.03–1.13)), and use of restraints (aOR 1.12 (1.10–1.14)), but was associated with lower rates of viral gastroenteritis (aOR 0.22 (0.18–0.28)). During the pandemic, SARS‐CoV‐2‐positive admissions were associated with a higher likelihood of various harm events.

Conclusion

The COVID‐19 pandemic was associated with higher rates of patient harm for a wide range of non‐SARS‐CoV‐2 inpatient populations.

Impact

Understanding which quality measures are improving or deteriorating can help health systems prioritize quality improvement initiatives.

Patient or Public Contribution

No patient or public contribution.
Spiritual coping within medical professions: A psychometric analysis of the Numinous Motivations Inventory short form
Authors: Williamson Elizabeth , Piedmont Ralph L. , Fox Jesse , Rowe Megan , Robinson Diane
Published: March 2024

Aim

To examine the psychometric properties of a short form version of the Numinous Motivation Inventory (NMI) for use with healthcare providers in measuring their existential engagement with life and to assess its relationship with spiritual coping and emotional dysphoria.

Design

Correlational and psychometric study.

Method

Data were collected from June to December 2022. Participants included 102 physicians, recruited from across the United States. Qualtrics was utilized to collect data, and they were evaluated with the NMI short form, Spiritual Coping Questionnaire and Depression, Anxiety, and Stress scale (DASS‐21).

Results

Obtained fit statistics from structural equation modelling analysis indicated close fit of the NMI short form with the original model. Multiple regression analyses demonstrated the value of the NMI as a predictor of negative affect independent of spiritual coping. The NMI did not interact with Spiritual Coping, which was independent of negative affect.

Conclusions

The Numinous represents an important aspect of physicians' coping. The constructs can be utilized in training and clinical settings as a valuable and easy‐to‐use metric for promoting and assessing wellness. The implications of these findings and the value of the NMI were discussed.

Impact

An understanding of existential drivers can equip one to cope with the stressors of healthcare. The NMI short form has the capability to explore an individual's existential drivers through the understanding of three domains.

Reporting Method

Adhered to proper EQUATOR guidelines (GRRAS).

Public Contribution

No patient or public contribution.
Joint association and interaction of birth weight and lifestyle with hypertension: A cohort study in UK Biobank
Authors: Zhang Ziyi , Liu Xiaowen , Huang Ninghao , Jin Ming , Zhuang Zhenhuang , Yang Zeping , Liu Xiaojing , Huang Tao , Li Nan
Published: March 2024

Low birth weight and unhealthy lifestyle are both associated with an increased risk of hypertension. The authors aimed to assess the joint association and interaction of birth weight and lifestyle with incident hypertension. The authors included 205 522 participants free of hypertension at baseline from UK Biobank. A healthy lifestyle score was constructed using information on body mass index, physical activity, diet, smoking status and alcohol intake. Cox proportional hazard models were used to investigate the impact of birth weight, healthy lifestyle score and their joint effect on hypertension. The authors documented 13 548 (6.59%) incident hypertension cases during a median of 8.6 years of follow‐up. The multivariate adjusted hazard ratios and 95% confidence intervals were 1.12 (1.09, 1.15) per kg lower birth weight and 0.76 (0.75, 0.77) per score increment in healthy lifestyle score. Healthy lifestyle reduced the risk of hypertension in any category of different birth weight groups. The preventive effect of healthy lifestyle on hypertension was the most pronounced at lower birth weight with <2500 g and 2500–2999 g, respectively. Addictive interaction between birth weight and healthy lifestyle score was observed with the relative excess risk due to interaction of 0.04 (0.03, 0.05). Our findings emphasized the importance of healthy lifestyle for hypertension prevention, especially among the high‐risk population with lower birth weight.
Comparative safety and effectiveness of angiotensin converting enzyme inhibitors and thiazides and thiazide‐like diuretics under strict monotherapy
Authors: Anand Tara V. , Bu Fan , Schuemie Martijn J. , Suchard Marc A. , Hripcsak George
Published: March 2024

Previous work comparing safety and effectiveness outcomes for new initiators of angiotensin converting‐enzyme inhibitors (ACEi) and thiazides demonstrated more favorable outcomes for thiazides, although cohort definitions allowed for addition of a second antihypertensive medication after a week of monotherapy. Here, we modify the monotherapy definition, imposing exit from cohorts upon addition of another antihypertensive medication. We determine hazard ratios (HR) for 55 safety and effectiveness outcomes over six databases and compare results to earlier findings. We find, for all primary outcomes, statistically significant differences in effectiveness between ACEi and thiazides were not replicated (HRs: 1.11, 1.06, 1.12 for acute myocardial infarction, hospitalization with heart failure and stroke, respectively). While statistical significance is similarly lost for several safety outcomes, the safety profile of thiazides remains more favorable. Our results indicate a less striking difference in effectiveness of thiazides compared to ACEi and reflect some sensitivity to the monotherapy cohort definition modification.
Association of postexercise blood pressure with cardiovascular outcomes and mortality: The CARDIA study
Authors: Wang Jia‐Jie , Zheng Zhichao , Zhang Ying
Published: March 2024

Postexercise blood pressure (BP) may be a better predictor of cardiovascular risk than office BP, but there is a lack of data supporting this claim. We hypothesized that postexercise BP may be an important prognostic marker. Our aim was to evaluate the association of postexercise BP with major adverse cardiovascular events (MACE) and all‐cause mortality. A total of 2581 participants (median age, 46 years; 55.9% women) from the Coronary Artery Risk Development in Young Adults study at year 20 (2005–2006) who underwent a graded exercise treadmill test using a modified Balke graded protocol were included. Postexercise BP was measured at baseline. Cox models were used to estimate the associations of postexercise BP with MACE and all‐cause mortality. Participants were followed up until December 31, 2021. In the entire population, postexercise systolic BP showed no significant association with MACE or all‐cause mortality, while postexercise diastolic BP was associated with MACE (hazard ratios [HR], 1.27 [95% CI, 1.06–1.52], per 10 mmHg increase) and all‐cause mortality (HR, 1.26 [95% CI, 1.05–1.51], per 10 mmHg increase). In the normal BP group, postexercise systolic BP was not significantly associated with MACE or all‐cause mortality, and postexercise diastolic BP was strongly associated with MACE (HR, 1.57 [95% CI, 1.18–2.09], per 10 mmHg increase). In this population‐based cohort study, postexercise diastolic BP was significantly associated with the risk of MACE and all‐cause mortality. Among individuals with normal BP, postexercise diastolic BP could identify those at a higher risk of cardiovascular events.
LncRNAs expression profile in a family household cluster of COVID‐19 patients
Authors: Iancu Iulia Virginia , Diaconu Carmen Cristina , Plesa Adriana , Fudulu Alina , Albulescu Adrian , Neagu Ana Iulia , Pitica Ioana Madalina , Dragu Laura Denisa , Bleotu Coralia , Chivu‐Economescu Mihaela , Matei Lilia , Mambet Cristina , Nedeianu Saviana , Popescu Corneliu Petru , Sultana Camelia , Ruta Simona Maria , Botezatu Anca
Published: March 2024

More than 3 years after the start of SARS‐CoV‐2 pandemic, the molecular mechanisms behind the viral pathogenesis are still not completely understood. Long non‐coding RNAs (lncRNAs), well‐known players in viral infections, can represent prime candidates for patients' risk stratification. The purpose of the current study was to investigate the lncRNA profile in a family cluster of COVID‐19 cases with different disease progression, during the initial wave of the pandemic and to evaluate their potential as biomarkers for COVID‐19 evolution. LncRNA expression was investigated in nasopharyngeal swabs routinely collected for diagnosis. Distinct expression patterns of five lncRNAs (HOTAIR, HOTAIRM1, TMEVPG1, NDM29 and snaR) were identified in all the investigated cases, and they were associated with disease severity. Additionally, a significant increase in the expression of GAS5‐family and ZFAS1 lncRNAs, which target factors involved in the inflammatory response, was observed in the sample collected from the patient with the most severe disease progression. An lncRNA prognostic signature was defined, opening up novel research avenues in understanding the interactions between lncRNAs and SARS‐CoV‐2.
On color adjustment potential and color blending threshold of dental composite resins
Authors: Kovacs‐Vajna Zs. M. , Manauta J. , Tosco V. , Faccoli M. , Torricelli F. , Colalongo L. , Richelli A. , Autran F. , Devoto W. , Putignano A.
Published: March 2024

Objective

Color Adjustment Potential evaluates the color blending of dental Composite Resins. While Color Adjustment Potential is simple, its clinical relevance is unclear. This research aims to understand it better and to create an index for Composite Resins with meaningful clinical interpretation.

Materials and Methods

Single and double shade composite disks of various diameters and opacities were created to test the indices. Color measurements used a dental colorimeter, avoiding subjective assessments. Color Adjustment Potential analysis of each material revealed insights, leading to the creation of a new Color Blending Threshold, providing a clinically relevant numerical value for Composite Resins.

Results

Color Adjustment Potential's numerical significance was clarified and introduced a new index for clinical applications. Color adaptation of each test shade to all Vita shades was also calculated, useful for single‐shade restorations in open and closed cavity types.

Conclusions

The proposed Color Blending Threshold defines the open/closed cavity dimension that can be adequately restored with a single shade of resin composite.

Clinical Significance

Understanding how dental materials adapt to surrounding tooth colors enhances esthetic restorations, simplifies shade matching, and optimizes resin composite production. The proposed Color Blending Threshold is a parameter that directly relates to the clinical significance of a material's true color blending ability. It defines the cavity dimension that can be adequately restored with a single shade of resin composite while ensuring that the resulting color difference falls below a predetermined threshold, meeting the clinical requirements for an esthetic restoration.
Can denticle morphology help identify southeastern Australian elasmobranchs?
Authors: Appleby Mariah , Raoult Vincent , Broadhurst Matt K. , Gaston Troy
Published: March 2024

Elasmobranchs are covered in scale‐like structures called dermal denticles, comprising dentine and enameloid. These structures vary across the body of an individual and between species, and are frequently shed and preserved in marine sediments. With a good understanding of denticle morphology, current and historical elasmobranch diversity and abundance might be assessed from sediment samples. Here, replicate samples of denticles from the bodies of several known (deceased) shark species were collected and characterized for morphology before being assigned morphotypes. These data were used to expand the established literature describing denticles and to investigate intra‐ and interspecific variability, with the aim of increasing the viability of using sediment samples to assess elasmobranch diversity and abundance. Denticle morphology was influenced more by life‐history traits than by species, where demersal species were largely characterized by generalized function and defense denticles, whereas pelagic and benthopelagic species were characterized by drag‐reduction denticles. Almost all species possessed abrasion strength or defense denticles on the snout, precluding their utility for separating species. In a separate manipulative experiment, samples of denticles were collected from sediments in two aquaria with known elasmobranchs to determine their utility for reliably separating species. Visual examination of denticles, morphometric measurements, scaled photographs, and reference collections allowed for some precise identification, but not always to the species level. Ongoing work to develop denticle reference collections could help to identify past and present families and, in some cases, species.
Enterolith with a bonefish spine nidus in a Brazilian cownose ray Rhinoptera brasiliensis (Müller & Henle) (Myliobatiformes: Rhinopteridae)
Authors: Camilo L. O. , Maganhe B. L. , Gallo Neto H. , Sanches E. G.
Published: March 2024

An adult female Brazilian cownose ray (Rhinoptera brasiliensis), housed in Ubatuba Aquarium died after loss of appetite period. During necropsy, an enterolith was discovered partially obstructing the intestinal lumen. Examination of the enterolith revealed a bonefish spine nidus. Enterolithiasis has been linked to multiple factors including diet, genetics, alkaline intestinal environments and, as in this particular case, the ingestion and retention of foreign bodies. The composition of this enterolith from a cownose ray was primarily monohydrocalcite. This short communication, apparently the first to report enterolithiasis in stingrays, emphasizes the need for post‐mortem examinations of carcasses on macroscopic and microscopic levels.
Intraday variation in trading costs: Evidence from the TSPP
Authors: Cox Justin , Van Ness Bonnie , Van Ness Robert
Published: March 2024

We examine changes in the intraday pattern of trading costs between pilot and control stocks during the US Securities and Exchange Commission tick size pilot program (TSPP). We find that intraday trading costs are relatively unchanged between pilot and control stocks in pre‐ and post‐TSPP periods. We find that differences in trading costs between pilot and control stocks during the TSPP are lower in the morning and greater toward the close. We also find that intraday differences in quoted depth between pilot and control stocks during the TSPP is lower at the beginning of the day, increases during the day, and falls toward the close of trading.
An age‐friendly approach to primary care in an academic health system
Authors: Wismann Andrea , Kleszynski Keith , Jelinek Dawn , Hand Rachel , Lich Brian , Wickersham Elizabeth , Jennings Lee A.
Published: March 2024

Background

Age‐friendly care, addressing what matters most, medications, mentation, and mobility, is a successful model for improving older adult care. We describe the initial outcomes of age‐friendly care implementation in five primary care clinics in an academic health system.

Methods

In partnership with a regional quality improvement (QI) organization, we used practice facilitation to implement age‐friendly care from July 2020 to June 2023. Clinic workflows and electronic health record (EHR) templates were modified to capture six QI measures for patients ≥65 years:

Documenting what matters most to patients

Advance care planning (ACP)

Annual cognitive screening

Caregiver referral to dementia community resources

Fall‐risk screening

Co‐prescription of opioid and sedative‐hypnotic drugs

Providers were alerted if patients had positive screens and given support tools for clinical decision‐making. QI measures from January–June 2023 were compared to the year prior to implementation. Providers and staff were interviewed about implementation barriers and facilitators.

Results

All six measures improved in Geriatrics and and other clinics showed improvement in ACP and cognitive screening. All clinics had high fall‐risk screening rates (≥85%). The least improved measure was co‐prescription of opioids and sedative‐hypnotics with co‐prescription rates ranging from 7% to 39%. Implementation hinged on leadership prioritization, practice facilitator guidance, clinical team buy‐in, EHR functionality, and clinical performance review. Three clinics received Age‐Friendly Health System recognition.

Conclusions

A QI approach using practice facilitation and EHR templates improved some but not all age‐friendly care measures. Future interventions will focus on training in high‐risk medication tapering and elicitation of health goals.
Pharmacist‐led telehealth deprescribing for people living with dementia and polypharmacy in primary care: A pilot study
Authors: Green Ariel R. , Quiles Rosalphie , Daddato Andrea E. , Merrey Jessica , Weffald Linda , Gleason Kathy , Xue Qian‐Li , Swarthout Meghan , Feeser Scott , Boyd Cynthia M. , Wolff Jennifer L. , Blinka Marcela D. , Libby Anne M. , Boxer Rebecca S.
Published: March 2024

Background

People living with dementia (PLWD) have complex medication regimens, exposing them to increased risk of harm. Pragmatic deprescribing strategies that align with patient‐care partner goals are needed.

Methods

A pilot study of a pharmacist‐led intervention to optimize medications with patient‐care partner priorities, ran May 2021–2022 at two health systems. PLWD with ≥7 medications in primary care and a care partner were enrolled. After an introductory mailing, dyads were randomized to a pharmacist telehealth intervention immediately (intervention) or delayed by 3 months (control). Feasibility outcomes were enrollment, intervention completion, pharmacist time, and primary care provider (PCP) acceptance of recommendations. To refine pragmatic data collection protocols, we assessed the Medication Regimen Complexity Index (MRCI; primary efficacy outcome) and the Family Caregiver Medication Administration Hassles Scale (FCMAHS).

Results

69 dyads enrolled; 27 of 34 (79%) randomized to intervention and 28 of 35 (80%) randomized to control completed the intervention. Most visits (93%) took more than 20 min and required multiple follow‐up interactions (62%). PCPs responded to 82% of the pharmacists' first messages and agreed with 98% of recommendations. At 3 months, 22 (81%) patients in the intervention and 14 (50%) in the control had ≥1 medication discontinued; 21 (78%) and 12 (43%), respectively, had ≥1 new medication added. The mean number of medications decreased by 0.6 (3.4) in the intervention and 0.2 (1.7) in the control, reflecting a non‐clinically meaningful 1.0 (±12.4) point reduction in the MRCI among intervention patients and a 1.2 (±12.9) point increase among control. FCMAHS scores decreased by 3.3 (±18.8) points in the intervention and 2.5 (±14.4) points in the control.

Conclusion

Though complex, pharmacist‐led telehealth deprescribing is feasible and may reduce medication burden in PLWD. To align with patient‐care partner goals, pharmacists recommended deprescribing and prescribing. If scalable, such interventions may optimize goal‐concordant care for PLWD.