bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation and properties of silica fume@polyure-thane urea cement composites
Authors: Feng Chao , Xu Dongdong , Cheng Hao , Yan Peihui , Wan Fei , Yan Wenwen
Published: January 2024

In this study, a new material was synthesized by compounding silica fume and polyurethane urea, which is used to evaculate the vibration reduction performance of concrete. The mechanical and damping properties of silica fume@ polyurethane urea (SF@PUU) reinforced cement paste were investigated. Also, FT-IR, XRD, TG analysis, and SEM are included. The results indicated that SF@PUU leads to the production of high damping ratio cement pastes. The damping capacities of SF@PUU cement composites, where the damping mechanism included internal, external, and multiphase friction within the cement matrix. Additionally, SF@PUU created a constrained-layer damping structure in cement paste to improve the damping properties. The review confirmed that SF@PUU subjected to proper treatments can be as the replacement to cement in concrete or as a damping filler. However, more investigation is required into the dimensional stability and durability of SF@PUU-based concrete.
An Age Study on Adopting Adult Hypertension Standards in Chinese Mature Children and Adolescents
Authors: Wang Xi , Gao Liwang , Wang Xia , Mi Jie
Published: January 2024

OBJECTIVE

To determine age cutoff values for the use of adult hypertension diagnostic criteria in children and adolescents, and to evaluate the consistency and screening effect of the adult criteria with the sex-, age-, and height-specific blood pressure reference (gold standard).

METHODS

A literature review and expert consultation were used to determine age cutoff value. In children above the cutoff age, the China Child and Adolescent Cardiovascular Health Survey was used to compare the consistency and screening effect between the adult criteria and the gold standard, and Beijing Blood Pressure Study was used to evaluate the predictive value of childhood hypertension diagnosed by adult criteria and gold criteria for hypertension and subclinical cardiovascular damage in adulthood.

RESULTS

(i) Adult criteria can be used to evaluate hypertension for children aged 16 and above. (ii) Among adolescents aged 16 and above, the adult standard has lower sensitivity (21.1%) but higher specificity (100.0%) compared with the gold standard, with a consensus rate of over 80.0%. And the predictive ability of the adult standard for subclinical cardiovascular health damage in adulthood is also similar to that of the gold standard.

CONCLUSIONS

Sixteen years can be used as a cutoff point for the adoption of adult hypertension diagnostic criteria in children, and it has a certain degree of simplicity and accuracy.
Rethinking the Mother–Daughter Plot: Female Polyphony in Najat El Hachmi’s Migration Trilogy
Authors: Codina Solà Núria
Published: January 2024

This article traces the various representations of motherhood in the fictional work of the Catalan-Amazigh writer Najat El Hachmi. By using a contrapuntal reading that retrieves the silenced female voices implicitly embedded in the texts, the article underlines the importance of attending to linguistic and narrative polyphony both in narratives of mothering and in texts in which the mother plays a secondary role. This multilingual and feminist approach to Edward Said’s strategy of contrapuntal reading provides new tools to revisit Marianne Hirsch’s conception of the mother–daughter plot, demonstrating that the mother’s voice is not necessarily absent in narratives of daughters, but rather unheard.
Posterior wall ablation by pulsed-field ablation: procedural safety, efficacy, and findings on redo procedures
Authors: Kueffer Thomas , Tanner Hildegard , Madaffari Antonio , Seiler Jens , Haeberlin Andreas , Maurhofer Jens , Noti Fabian , Herrera Claudia , Thalmann Gregor , Kozhuharov Nikola A , Reichlin Tobias , Roten Laurent
Published: January 2024

Aims

The left atrial posterior wall is a potential ablation target in patients with recurrent atrial fibrillation despite durable pulmonary vein isolation or in patients with roof-dependent atrial tachycardia (AT). Pulsed-field ablation (PFA) offers efficient and safe posterior wall ablation (PWA), but available data are scarce.

Methods and results

Consecutive patients undergoing PWA using PFA were included. Posterior wall ablation was performed using a pentaspline PFA catheter and verified by 3D-electroanatomical mapping. Follow-up was performed using 7-day Holter ECGs 3, 6, and 12 months after ablation. Recurrence of any atrial arrhythmia lasting more than 30 s was defined as failure. Lesion durability was assessed during redo procedures. Posterior wall ablation was performed in 215 patients (70% males, median age 70 [IQR 61–75] years, 67% redo procedures) and was successful in all patients (100%) by applying a median of 36 (IQR 32–44) PFA lesions. Severe adverse events were cardiac tamponade and vascular access complication in one patient each (0.9%). Median follow-up was 7.3 (IQR 5.0–11.8) months. One-year arrhythmia-free outcome in Kaplan–Meier analysis was 53%. A redo procedure was performed in 26 patients (12%) after a median of 6.9 (IQR 2.4–11) months and showed durable PWA in 22 patients (85%) with only minor lesion regression. Among four patients with posterior wall reconnection, three (75%) presented with roof-dependent AT.

Conclusion

Posterior wall ablation with this pentaspline PFA catheter can be safely and efficiently performed with a high durability observed during redo procedures. The added value of durable PWA for the treatment of atrial fibrillation remains to be evaluated.
Predictor of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia: a case-control study
Authors: Dufera Tadesse , Dheresa Merga , Dingeta Tariku , Legesse Mezgebu , Mesfin Sinetibeb , Balis Bikila , Balcha Tegenu
Published: January 2024

Background

Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia.

Methods

Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association.

Result

The common determinants for anemia in pregnant mothers were: rural residency (AOR = 2.25, 95% CI: 1.14–4.8), no formal education (AOR = 4.4, 95% CI: 1.94–9.9), inter-pregnancy interval (AOR = 2.7, 95% CI: 1.24–5.8), and mid-upper arm circumference (AOR = 5.0, 95% CI: 2.0–12.7).

Conclusion

In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended.
Deciphering the hidden structures of HH 216 and Pillar IV in M16: results from JWST and HST
Authors: Dewangan L K , Jadhav O R , Maity A K , Bhadari N K , Sharma Saurabh , Padovani M , Baug T , Mayya Y D , Pandey Rakesh
Published: January 2024

To probe the star formation process, we present an observational investigation of the Pillar IV and an ionized knot HH 216 in the Eagle Nebula (M16). Pillar IV is known to host a Class I protostar that drives a bipolar outflow. The outflow has produced the bow shock, HH 216, which is associated with the red-shifted outflow lobe. The JWST near- and mid-infrared images (resolution ∼0${_{.}^{\prime\prime}}$07–0${_{.}^{\prime\prime}}$7) reveal the protostar as a single, isolated object (below 1000 au). The outer boundary of Pillar IV is depicted with the 3.3 $\mu$m Polycyclic aromatic hydrocarbon (PAH) emission. HH 216 is traced with the 4.05 $\mu$m Brα and the radio continuum emission; however, it is undetected with 4.693 $\mu$m H2 emission. HH 216 seems to be associated with both thermal and non-thermal radio emissions. High-resolution images reveal entangled ionized structures (below 3000 au) of HH 216, which appear to be located towards termination shocks. New knots in 4.693 $\mu$m H2 emission are detected and are mainly found on Pillar IV’s northern side. This particular result supports the previously proposed episodic accretion in the powering source of HH 216. One part of the ionized jet (extent ∼0.16 pc) is discovered on the southern side of the driving source. Using the 12CO(J  = 1–0), 12CO(J  = 3–2), and 13CO(J  = 1–0) emission, observational signposts of cloud-cloud collision (or interacting clouds) towards Pillar IV are investigated. Overall, our results suggest that the interaction of molecular cloud components around 23 and 26 km s−1 might have influenced star formation activity in Pillar IV.
Analysis of Differences in Characteristics of High-Risk Endemic Areas for Contracting Japanese Spotted Fever, Tsutsugamushi Disease, and Severe Fever With Thrombocytopenia Syndrome
Authors: Ogawa Takahisa , Tsuzuki Shinya , Ohbe Hiroyuki , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo , Kutsuna Satoshi
Published: January 2024

Background

Tick-borne infections, including tsutsugamushi disease, Japanese spotted fever, and severe fever with thrombocytopenia syndrome (SFTS), are prevalent in East Asia with varying geographic distribution and seasonality. This study aimed to investigate the differences in the characteristics among endemic areas for contracting each infection.

Methods

We conducted an ecologic study in Japan, using data from a nationwide inpatient database and publicly available geospatial data. We identified 4493 patients who were hospitalized for tick-borne infections between July 2010 and March 2021. Mixed-effects modified Poisson regression analysis was used to identify factors associated with a higher risk of contracting each tick-borne disease (Tsutsugamushi, Japanese spotted fever, and SFTS).

Results

Mixed-effects modified Poisson regression analysis revealed that environmental factors, such as temperature, sunlight duration, elevation, precipitation, and vegetation, were associated with the risk of contracting these diseases. Tsutsugamushi disease was positively associated with higher temperatures, farms, and forests, whereas Japanese spotted fever and SFTS were positively associated with higher solar radiation and forests.

Conclusions

Our findings from this ecologic study indicate that different environmental factors play a significant role in the risk of transmission of tick-borne infections. Understanding the differences can aid in identifying high-risk areas and developing public health strategies for infection prevention. Further research is needed to address causal relationships.
An altered expression of miR‐376a‐3p and miR‐20a‐5p in peripheral blood exosomes regulates the autophagy and inflammatory systemic substrates, and relates to the smoking habit and age in Crohn's disease
Authors: Caparrós Esther , García‐Martinez Irma , Pedro Zapater  , Lucía Madero  , Valverde Ángela M. , Ana Gutiérrez  , Francés Rubén
Published: January 2024

miRNAs are short single‐stranded noncoding RNAs that participate as epigenetic regulators in inflammatory bowel disease. Most miRNAs detectable in serum are concentrated in exosomes, with relevant cargo for immunobiological processes. We set to evaluate the exosomes miRNAs content in the serum of patients with Crohn's disease (CD) and run a prospective observational study on CD patients on biological monotherapy and healthy controls. miRNA cargo was evaluated in peripheral blood‐derived exosomes. Serum autophagy and inflammatory substrates were measured. Patients were followed for 6 months. Patients (n = 28) showed an overexpression of miR‐376a‐3p and a downregulation of miR‐20a‐5p compared to controls (n = 10), without significant differences between patients according to biologics. Serum autophagy substrates ATG4C (r = .57; p = .001) and ACRV1C (r = .66; p = .001) inversely correlated with miR‐376a‐3p expression, whereas IGF1R correlated with miR‐20a‐5p expression (r = .42; p = .02). Th1‐related cytokines correlated with miR‐376a‐3p expression, whereas the Th17‐associated cytokines inversely correlated with miR‐20a‐5p expression. Smoking (β = −2.301 CI 95% −3.790/−0.811, p = .004) remained as independent factor related to the overexpression of miR‐376a‐3p, whereas diagnosis before 16 years of age (β = 2.044 CI 95% 0.934/3.154, p = .001) and a younger age of patients (β = −.720 CI 95% −0.108/−0.035, p = .001) were related to decreased miR‐20a‐5p expression. Seven patients (25%) had a flare in the 6‐month follow‐up. Patients with overexpression of miR‐376a‐3p at the baseline showed an increased risk of flare during this period (OR 0.475 [0.237–0.950], p = .035). Finally, a comparative miRNA signature between biologic monotherapies was also explored. Targeting miR‐376a‐3p and miR‐20a‐5p epigenetic regulators may yield homeostatic effects on relevant biological processes related to disease progression in CD patients.
Relationship Between the Clinical Learning Environment and Caring Behaviors Among Baccalaureate Nursing Students During the COVID-19 Pandemic
Authors: Inocian Ergie P. , Kelly Susan H. , Paragas Emmanuel D. , Felicilda-Reynaldo Rhea Faye D. , Turk Melanie T.
Published: January 2024

Caring is a fundamental professional nursing value. This study examined the effect of the clinical learning environment (CLE) on nursing students’ caring behaviors during the COVID-19 pandemic. Valuing nursing work in the CLE increased the knowledge and skills aspect of caring behavior. Higher CLE scores in affordances and engagement and student centeredness increased the respectful deference of others and positive connectedness aspects of caring behaviors. These results may inform efforts to promote aspects of nursing students’ caring behaviors during global health emergencies by enhancing the value of nursing work, engagement, and student-focused qualities of the CLE.
Aesthetic Expression as a Means to Nurture “Self” in a Basic Nursing Care Practicum
Authors: Betriana Feni , Promnoi Chantra , Nilmanat Kittikorn
Published: January 2024

Nursing students develop their professional “self” through clinical placement experiences. Aesthetic expression can be used as a means to reflect students’ personal knowing and to convey self as nurtured during their clinical journey. In a postconference session of the Basic Nursing Care Practicum course, six students were asked to draw pictures reflecting their clinical experience and then share their stories. It appeared that nursing students learned the meaning of nursing and caring, and through these meanings, their actual self as nurses was also developed.
Integrating Experiential Informatics and Quality Improvement in Baccalaureate Education
Authors: Brunel Mallory , Allert Jenny
Published: January 2024

Current education for prelicensure students addresses informatics, typically focusing on theory, terminology, and an overview of systems. This leaves health partners with the burden of teaching “bedside” informatics skills. Utilizing an innovative new model, a course was developed to bridge the gap between theory and practical application. Students join mock clinical practice councils and perform chart audits to understand the important role of informatics in quality improvement. By using practical bedside informatics tools and applications, students learn to improve patient outcomes and safe care environments in alignment with current expectations.
A Qualitative Study of Rehabilitation Professionals' Practices to Define the Presence of Arm Morbidity After Breast Cancer Surgery
Authors: Francisco Beatrice A. , Zadravec Kendra , Edwards Amy N. , Warren Alora , Johnson Katherine A. , Dau Catalina , Rafn Bolette S. , Campbell Kristin L.
Published: January 2024

Background:

Rehabilitation professionals (RPs) play a major role in identifying, managing, and treating upper-body issues in individuals following breast cancer surgery. Varying definitions of postoperative arm morbidity in the literature have hampered development of standardized surveillance programs for people undergoing breast cancer surgery within clinical care. Our objective was to explore RPs' practices in defining the presence of arm morbidity after breast cancer surgery.

Methods:

This qualitative study used semistructured focus group interviews with 29 RPs from 5 health authorities in British Columbia, Canada. Transcripts were analyzed using content analysis.

Results:

Two categories captured RPs' overarching lack of consensus in defining the presence of postoperative arm morbidity: (1)Complex concerns, complex considerations; and (2)Many ways of measuring arm morbidity. Varying perspectives exist as to which upper-body issues and functional criteria constitute arm morbidity, as well as which characteristics to consider in identifying who is at risk of developing arm morbidity. In tandem, there is currently no gold standard outcome measure or standardized assessment to identify arm morbidity.

Conclusion:

Because of the complex interaction between different breast cancer treatments and various environmental and personal factors, there is currently a lack of consensus among RPs about how to define and assess arm morbidity. Our findings demonstrate the presence of arm morbidity is challenging to characterize, given its multifaceted presentation, inconsistent approaches to risk stratification across clinical settings and geographical regions the RPs worked, and numerous ways of measuring arm morbidity.
Naltrexone Compared With Buprenorphine or Methadone in Pregnancy
Authors: Atluru Sreevalli , Bruehlman Alyssa K. , Vaughn Porcia , Schauberger Charles W. , Smid Marcela C.
Published: January 2024

OBJECTIVE:

Although naltrexone is an evidence-based medication for opioid use disorder (MOUD), few data are available with use in pregnancy. Our objective was to assess outcomes of pregnant individuals with opioid use disorder (OUD) taking naltrexone compared with those taking methadone or buprenorphine.

DATA SOURCES:

We undertook a systematic review using electronic database search (PubMed, CINAHL, EMBASE, PsycInfo), conference proceedings, and trial registries including ClinicalTrials.gov.

METHODS OF STUDY SELECTION:

We conducted an electronic search of research articles through May 2023 for randomized controlled trials, prospective cohort, and retrospective cohort studies of naltrexone (oral, implant, or extended release) compared with methadone or buprenorphine (sublingual or extended release) among pregnant individuals with OUD. After double review of all articles, we abstracted obstetric (primary outcome: gestational age at delivery), neonatal (primary outcome: neonatal abstinence syndrome [NAS]), and substance use outcomes.

TABULATION, INTEGRATION, AND RESULTS:

Five studies met eligibility criteria; four were retrospective cohort studies, and one was a prospective cohort study. Four studies included data on gestational age at delivery (weeks) with no difference detected between the two groups in any study (mean difference ranging −0.20, 95% CI, −1.49–1.09 to 0.8, 95% CI, −0.15 to 1.75). Three studies included data on NAS with all studies detecting a lower risk in the naltrexone group compared with methadone or buprenorphine (relative risk ranging from 0.08, 95% CI, 0.01–1.16 to 0.15, 95% CI, 0.06–0.36). Most studies (four of five) had a moderate or high potential for selection bias primarily driven by small sample size and lack of controlling for confounders.

CONCLUSION:

Although the evidence base is limited, available data suggest that naltrexone use in pregnancy is a reasonable MOUD option with reassuring perinatal outcomes. To enhance confidence in this conclusion and to assess substance use outcomes, further comparative studies of pregnant people with OUD taking naltrexone and other MOUD types are needed.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, 42017074249.
Characteristics of Elderly-Onset Rheumatoid Arthritis Patients With COVID-19
Authors: Xiao Lanlan , Ma Xinlei , Wu Jinzhi , Liang Junyu , Chen Weiqian , Lin Jin
Published: January 2024

This study aimed to investigate the clinical characteristics of elderly-onset rheumatoid arthritis (EORA) patients with COVID-19. We retrospectively enrolled EORA patients diagnosed with COVID-19 from December 2022 through February 2023 and followed them up. Demographic characteristics of the patients and clinical data on COVID-19 were collected, and EORA-related data at the onset of rheumatoid arthritis and during COVID-19 episodes were evaluated. A total of 102 EORA outpatients were enrolled and stratified into the COVID-19 group (n = 60) and the non–COVID-19 group (n = 42). In the COVID-19 group, 56 (93.3%) had symptoms, 8 (13.3%) had viral pneumonia, and 4 (6.7%) developed severe COVID-19. Multivariate logistic regression analysis showed that lack of COVID-19 vaccination (P = 0.016 and P = 0.030, respectively) and having interstitial lung disease (P = 0.013 and P = 0.001, respectively) were independent risk factors for viral pneumonia and severe COVID-19. Compared with the general population, EORA patients did not show significantly higher susceptibility to COVID-19 or a higher risk of severe COVID-19. However, EORA patients with interstitial lung disease require special consideration during COVID-19 episodes.
Time to Pivot: A Guide to Holistic Admissions
Authors: Snyder Jennifer , Alexander Lisa Mustone , Statler Michel , Straker Howard , Bowser Jonathan , Caruthers Kara , Murray Donna , Alesbury Elizabeth
Published: January 2024

As an ever-increasing number of physician assistant (PA) programs moves toward holistic admissions, a better understanding of how to achieve their stated admission goals becomes more important. With the June 2023 US Supreme Court decision effectively ending affirmative action in higher education, navigating holistic admissions is now an even greater challenge. In this article, the PA Education Association's Presidents Commission offers a guide for programs to use in implementing holistic admissions at their institutions and key considerations. Is the process mission-driven? Does it follow principles of quality improvement and incorporate ongoing assessment of that process? Using data can be a constructive and insightful way to inform the process. The authors hope that tools, resources, and recommendations offered in this article will serve as valuable resources for any program attempting to institute or improve its holistic admissions process.
Workload of the Director of Clinical Education in Doctor of Physical Therapy Programs
Authors: Lewis Michele (Shelly) , Folkins Eric
Published: January 2024

Introduction.

Directors of clinical education (DCEs) have complex roles in Doctor of Physical Therapy (DPT) programs. Workload imbalances affect the DCEs' ability to perform tasks efficiently and effectively. In this study, our purpose was to examine the DCEs' formal and actual workload, and factors that influence workload.

Review of Literature.

Variations in DCE workload exist among DPT programs. The DCEs' day-to-day workload often differs from their formal workload. Programmatic and individual factors may influence workload. We did not find any large-scale studies that compared the DCEs' actual and formal workloads.

Subjects.

We examined data from 143 DCEs for DPT programs in the United States.

Methods.

Subjects were recruited using email and Listserv to take a novel online survey. In this quantitative, nonexperimental study, we examined data through descriptive statistics, Wilcoxon signed-rank tests, and multiple regressions.

Results.

Respondents worked significantly more hours than they were expected to work. A significant difference existed between the percentage of time formally designated and the time actually spent performing administrative, scholarship, and teaching tasks. Respondents reported lacking time in all workload categories. Collective programmatic and DCE characteristics statistically significantly affected the DCEs' scholarship and service workloads. The number of clinical education experiences independently significantly affected the DCEs' administrative and service workloads. The amount of training a DCE received independently significantly affected the DCEs' administrative, scholarship, and service workloads.

Discussion and Conclusion.

A consistent method of calculating DCE workload should be developed that considers DCE and program characteristics. More time is needed for DCEs to perform their roles effectively. If workload imbalances, program variations, and time constraints are not addressed, DCEs may become dissatisfied with their jobs and leave the position.
The Role of Endoscopic Ultrasound-guided Fine-needle Aspiration of Pelvic Lesions
Authors: Su Tong , Zhang Xiaohua , Wang Ruixia , Wang Jing , Xu Hongwei , Xu Changqin , Zhao Shulei
Published: January 2024

Background and Aims:

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a potentially valuable tool for the diagnosis of pelvic lesions. The aim of this meta‑analysis was to evaluate the efficacy and feasibility of EUS-FNA in the diagnosis of pelvic lesions.

Methods:

We performed a computerized search of PubMed, EMBASE, Cochrane Library, and Science Citation Index, through March 2023. The main outcome measures examined in the meta-analysis were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy.

Results:

We evaluated 22 trials that used surgical pathology or imaging follow-up results as the reference standard. The studies comprised 844 patients. The cumulative sensitivity, specificity, PPV, NPV, and accuracy were 94%, 100%, 100%, 89%, and 96%, respectively. In the subgroup analysis, the prospective studies revealed the cumulative sensitivity, specificity, PPV, NPV, and accuracy were 91%, 100%, 100%, 85%, and 93%, respectively.

Conclusions:

In conclusion, we provide evidence that EUS-FNA is a qualitative diagnostic technique with high sensitivity, specificity, PPV, and accuracy. However, its NPV is slightly low, which does not exclude the risk of a missed diagnosis, and more randomized controlled trials or prospective studies are still needed in the future. EUS-FNA is effective and feasible for pelvic space-occupying lesions. This technique has high clinical application value for pelvic lesions.
Coming to Terms
Authors: Varilek Brandon M. , Isaacson Mary J.
Published: January 2024

Female veteran populations are growing internationally and are more likely than men to develop certain serious illnesses, including some cancers. In the United States, fewer than 50% of eligible female veterans sought care at Veteran Affairs facilities. In addition, female veterans are not well represented within palliative care research, and little research exists that explores the female veteran experience of living with a serious illness. The purpose of this study was to explore female veterans' experiences of living with a serious illness. This study reports the qualitative findings from a multimethod study using qualitative inquiry to explore female veterans' experiences of living with a serious illness. Participants completed individual, semistructured interviews. Braun and Clarke's method of reflexive thematic analysis guided the analysis. Ten participants shared their experiences, and 3 themes emerged: “You call this quality of life?”, coming to terms, and “it” dictates everything. This study highlights the impaired quality of life of female veterans. Palliative care can serve to improve quality of life and return a sense of control back to female veterans. Nurses at all levels can have a positive impact in improving palliative care delivery for the female veteran population in both civilian and government health care sectors.
Effects of a Discourse Intervention on End-of-Life Knowledge and Attitudes of Bachelor of Science in Nursing Students
Authors: Haynes Jayme G. , Dingley Catherine
Published: January 2024

Several challenges exist to providing effective, formalized end-of-life education for undergraduate nursing students. The purpose of this study was to determine whether the addition of a discourse intervention to the End-of-Life Nursing Education Consortium Undergraduate Nursing Modules effectively improved junior-level prelicensure bachelor of science in nursing students' knowledge and attitudes toward end-of-life care. This quasi-experimental 2-group comparison, pretest/posttest design consisted of a sample of 135 enrolled in a medical-surgical nursing class. Applying Mezirow's transformational learning theory, a 2-hour discourse intervention that included a self-reflective journal, an unfolding case study focused on loss, and a discussion with question-and-answer session was implemented at the completion of the Undergraduate Nursing Modules for the intervention group. Knowledge and attitude toward end-of-life care were measured before and after the intervention with the Palliative Care Quiz for Nurses and the Frommelt Attitude Toward Care of the Dying.

The findings indicated increased knowledge and positive attitude changes. This study supports the value of theory-based educational interventions, like a discourse intervention, to enhance effective pedagogy when addressing emotionally laden content such as end-of-life care. This study may have also given a glimpse of how a global pandemic may affect end-of-life knowledge and attitudes.
A Road Map for the Development of a Decisional Authority Framework for Professional Governance Using Accountability Grids
Authors: Wisner Kirsten , Collins Aubree , Porter-O'Grady Tim
Published: January 2024

Although resources are available to guide structures and processes for professional governance, limited information exists about defining and legitimizing the decisional authority needed to support direct care nurses' ownership of clinical practice as well as the role of nursing leaders. This article presents a road map for creating and implementing clinical nurse, nurse leader, and nurse executive accountability grids with clearly delineated authority to provide a decisional authority framework for professional governance in one organization.
The Essential Parallels Between Clinical Practice and the Scientific Method
Authors: Preskorn Sheldon H.
Published: January 2024

This column presents a way of conceptualizing the clinical practice of medicine including psychiatry within the framework of the scientific method. The goal is to aid practicing clinicians as well as trainees. This conceptual framework will improve the care of patients as it applies a discipline relative to giving time-limited trials of the various treatments available and then an assessment of whether the treatment worked adequately or not and what to do in the latter case. In this way, this approach should decrease the risk of excessive multiple medication use to treat a specific patient. Incorporating this conceptual framework early in the training of mental health care prescribers would be desirable.
Scam Susceptibility: Thoughts on How to Initially Approach and Manage Patients in a Geriatric Psychiatry Setting
Authors: Huang Weijiao , Carlew Anne , Vas Collin , De Abreu Izabella
Published: January 2024

Recent studies have demonstrated that older adults are more vulnerable to scams because of social isolation, economic affluence, mental disorders, struggles with technology, and cognitive impairments. In this report, we present the case of a 73-year-old man who fell victim to multiple scams over 8 years, leading to a loss of more than $100,000. We also discuss approaches to managing such patients in the outpatient setting. Susceptibility to scams is considered an increasing threat to the well-being of aging societies. The complexity of the problem and the scarcity of available studies make the management of such cases challenging for clinicians.
Complications of major lower limb amputations before prosthetic provision at a tertiary care rehabilitation facility
Authors: Atallah Huthaifa , Qureshi Ahmad Zaheer , Nawaz Shah , Wani Tariq
Published: January 2024

Background:

Although postoperative complications of lower limb amputations and complications related to prosthetics are well known, complications before prosthetic fitting are less often emphasized in literature. There are no Saudi studies documenting the complications before prosthetic fitting where there is high rise in dysvascular amputation, and early prosthetic provision remains a challenge.

Objectives:

To investigate the complications following major lower limb amputations (MLLAs).

Study design:

Retrospective study.

Methods:

One hundred thirty-six electronic files for individuals with major lower limb amputations were reviewed. Individuals visiting the primary limb loss clinic for the first time, who have not been fitted with a prosthesis before, were included.

Results:

Muscle weakness was the most common complication (55.1%), followed by edema (52.9%), while infection was found to be the least frequent (5.1%). Age was significantly associated with etiology (p value < 0.001), usage of assistive device (p value = 0.002), and complications (p value = 0.013). Complications were also significantly associated with time since amputation (p value = 0.001). In addition, etiology was significantly associated with the usage of assistive device (p value = 0.012).

Conclusions:

Muscle weakness and edema were the most common complications after MLLA in a cohort of patients with median onset of 8.5 ± 6.8 months since amputation. Presence of various complications in MLLAs before prosthetic evaluation reflect gaps of care including delayed prosthetic evaluation. National strategies need to be introduced to promote early rehabilitation interventions, prevent complications, and improve quality of life of individuals with MLLAs.
Comparison of HIV prevalence, incidence, and viral load suppression in Zambia population-based HIV impact assessments from 2016 and 2021
Authors: Mulenga Lloyd B. , Hines Jonas Z. , Stafford Kristen A. , Dzekedzeke Kumbutso , Sivile Suilanji , Lindsay Brianna , Chola Mumbi , Ussery Faith , Patel Hetal K. , Abimiku Alash’le , Birhanu Sehin , Minchella Peter A. , Stevens Thomas , Hanunka Brave , Chisenga Tina , Shibemba Aaron , Fwoloshi Sombo , Siame Mwiche , Mutukwa John , Chirwa Lameck , Siwingwa Mpanji , Mulundu Gina , Agbakwuru Chinedu , Mapondera Prichard , Detorio Mervi , Agolory Simon G. , Monze Mwaka , Bronson Megan , Charurat Man E. ,   for the ZAMPHIA 2021 Study Group†
Published: January 2024

Background:

The Zambian government has implemented a public health response to control the HIV epidemic in the country. Zambia conducted a population-based HIV impact assessment (ZAMPHIA) survey in 2021 to assess the status of the HIV epidemic to guide its public health programs.

Methods:

ZAMPHIA 2021 was a cross-sectional two-stage cluster sample household survey among persons aged ≥15 years conducted in Zambia across all 10 provinces. Consenting participants were administered a standardized questionnaire and whole blood was tested for HIV according to national guidelines. HIV-1 viral load (VL), recent HIV infection, and antiretroviral medications were tested for in HIV-seropositive samples. Viral load suppression (VLS) was defined as <1000 copies/ml. ZAMPHIA 2021 results were compared to ZAMPHIA 2016 for persons aged 15–59 years (i.e., the overlapping age ranges). All estimates were weighted to account for nonresponse and survey design.

Results:

During ZAMPHIA 2021, of 25 483 eligible persons aged ≥15 years, 18 804 (73.8%) were interviewed and tested for HIV. HIV prevalence was 11.0% and VLS prevalence was 86.2% overall, but was <80% among people living with HIV aged 15–24 years and in certain provinces. Among persons aged 15–59 years, from 2016 to 2021, HIV incidence declined from 0.6% to 0.3% (P-value: 0.07) and VLS prevalence increased from 59.2% to 85.7% (P-value: <0.01).

Discussion:

Zambia has made substantial progress toward controlling the HIV epidemic from 2016 to 2021. Continued implementation of a test-and-treat strategy, with attention to groups with lower VLS in the ZAMPHIA 2021, could support reductions in HIV incidence and improve overall VLS in Zambia.
Establishing Shock Index, Pediatric Age-Adjusted (SIPA) Cut Points in Trauma Patients Under 1 Year of Age
Authors: Marlor Derek , Flint Jennifer , Noel-MacDonnell Janelle R. , Cruz-Centeno Nelimar , Stewart Shai , Elman Meredith , Juang David
Published: January 2024

Purpose

Shock Index (SI) is used to predict injury severity and adverse outcomes in trauma patients, but age-adjusted shock index (SIPA) has superior performance in pediatric patients over the age of 1 year. SIPA scores under the age of 1 have not been well studied. This project aimed to establish and evaluate SIPAcut pointdata points for patients under 1 year of age.

Methods

Using age-based vital signs, we developedcut pointvalues for patients under 1 year old using our institutional trauma data. All trauma patients under the age of 12 months were included, and clinical outcomes were recorded. SIPAcut pointswere defined using age specific vital sign limits (SIPA-VS) and tested against optimalcut pointsdefined by ROC analysis (SIPA-ROC) and acut pointof 1.2 (SIPA-Nordin), which is used for patients ages 1-4 years. Student's t-test, chi-square tests, ANOVA, and test characteristics were used to analyze groups.

Results

A total of 609 pediatric trauma patients under the age of 12 months were identified from 2018 to 2022. SIPA scores were calculated for 483 patients. There were 406 patients with blunt trauma and 17 with penetrating. SIPA-Nordin was elevated in 81.6% (n = 397) of patients, compared to SIPA-VS 21% (n = 101) and SIPA-ROC 31% (n = 150). In comparison to SIPA-Nordin, both SIPA-VS and SIPA-ROC score exhibited superior specificity and negative predictive values (NPV) for multiple outcomes. Elevated SIPA-ROC scores had statistically significant associations with ICU admission, mechanical ventilation, severe anemia, transfusion during hospital admission, and in-hospital mortality.

Conclusion

SIPA is a useful tool in identifying patients at risk for several complications of severe traumatic injury. SIPAcut pointshad high NPV and specificity for many outcomes. This study proposescut pointvalues that may aid in clinical decision-making for trauma patients under 1 year of age.

Level of Evidence: Level IV Retrospective Review
Presenilin Gene Mutation-associated Psychosis
Authors: Colijn Mark A. , Ismail Zahinoor
Published: January 2024

Although psychotic symptoms have been described in association with rare presenilin (PSEN) gene mutations underlying early-onset Alzheimer disease (AD), no contemporary reviews on this topic exist. The purpose of this review is to characterize the psychiatric phenotype (specifically with respect to psychosis) of PSEN1 and PSEN2 variant-associated AD. A PubMed search was completed in July 2023. Only articles that described individuals harboring a PSEN1 or PSEN2 mutation who experienced symptoms of psychosis were included in the review. Thirty-three articles describing 52 individuals were included in the review, as well as one other study that provided limited information pertaining to an additional 21 cases. While visual hallucinations were the most common psychotic symptom, followed by persecutory delusions, auditory hallucinations occurred in ~17% of individuals. In ~33% of the reviewed cases psychotic symptoms were present at or near disease onset, and 9 of these individuals experienced auditory hallucinations and/or delusions in the absence of visual hallucinations (~17% of all cases). In many cases, symptoms developed at a relatively young age. As presenilin gene variant-associated psychosis may resemble a primary psychotic disorder, clinicians should be vigilant with respect to screening for signs/symptoms suggestive of neurodegeneration in first-episode psychosis.
The influence of a soil amendment on the abundance and interaction of arbuscular mycorrhizal fungi with arable soils and host winter wheat
Authors: Wilkes Thomas I.
Published: January 2024

Arbuscular mycorrhizal (AM) fungi have been shown to be associated with an estimated 70 % of vascular terrestrial plants. Such relationships have been shown to be sensitive to soil disturbance, for example, tillage in the preparation of a seed bed. From the application of arable soil management, AM fungal populations have been shown to be negatively impacted in abundance and diversity, reducing plant growth and development. The present study aims to utilise two sources (multipurpose compost and a commercial inocula) of mycorrhizal fungi for the amendment of arable soils supporting Zulu winter wheat under controlled conditions and quantify plant growth responses. A total of nine fields across three participating farms were sampled, each farm practicing either conventional, reduced, or zero tillage soil management exclusively. Soil textures were assessed for each sampled soil. Via the employment of AM fungal symbiosis quantification methods, AM fungi were compared between soil amendments and their effects on crop growth and development. The present study was able to quantify a mean 6 cm increase to crop height (P<0.001), 10 cm reduction to root length corresponding with a 2.45-fold increase in AM fungal arbuscular structures (P<0.001), a 1.15-fold increase in soil glomalin concentration corresponding to a 1.26-fold increase in soil carbon, and a 1.32-fold increase in the relative abundance of molecular identified AM fungal sequences for compost amended soils compared to control samples. Mycorrhizal inocula, however, saw no change to crop height or root length, AM fungal arbuscules were reduced by 1.43-fold, soil glomalin was additionally reduced by 1.55-fold corresponding to a reduction in soil carbon by 1.31-fold, and a reduction to relative AM fungal species abundance by 1.26-fold. The present study can conclude the addition of compost as an arable soil amendment is more beneficial for the restoration of AM fungi beneficial to wheat production and soil carbon compared to the addition of a commercial mycorrhizal inocula.
Tepidibacter aestuarii sp. nov., isolated from the Bach Dang Estuary, Haiphong, Vietnam
Authors: Pradel Nathalie , Chifflet Sandrine , Beavogui Angelina , Bartoli Manon , Chu Van Thuoc , Aouane Aicha , Bui Van Vuong , Mari Xavier , Pham The Thu , Oliveira Pedro H. , Cayol Jean-Luc
Published: January 2024

A mesophilic, anaerobic, endospore-forming, fermentative bacterium designated strain 8C15bT was isolated from bank sediment of the Bach Dang Estuary, Haiphong, Vietnam. The Bach Dang Estuary, where Haiphong harbour is located, is subject to strong anthropogenic influence, resulting in high concentrations of black carbon and heavy metals. Strain 8C15bT grew optimally at 30 °C, pH 7.5 and with 2.5 % (w/v) NaCl. The main cellular fatty acids consisted of iso-C15 : 0 (51 %), iso-C15:1 ω7c (32 %) and iso-C13 : 0 (5 %). Genomic considerations of strain 8C15bT and comparisons with the phylogenetically closest strains of the genus

Tepidibacter

provide evidence that

Tepidibacter thalassicus

SC562T (=DSM 15285T),

Tepidibacter formicigenes

DV1184T (=DSM 15518T),

Tepidibacter mesophilus

B1T (=JCM 16806T) and strain 8C15bT could be differentiated at the species level. We propose the name Tepidibacter aestuarii sp. nov. for the type strain 8C15bT (=JCM 35983T=KCTC 25692T). Finally, the nickel-tolerance properties of strain 8C15bT are highlighted in this study.
Mining genomic repositories to further our knowledge of the extent of SARS-CoV-2 co-infections
Authors: Peñas-Utrilla Daniel , Muñóz Patricia , Pérez-Lago Laura , García de Viedma Darío
Published: January 2024

Recombination events between Delta and Omicron SARS-CoV-2 lineages highlight the need for co-infection research. Existing studies focus on late-phase co-infections, with few examining earlier pandemic stages. This new study aims to globally identify and characterize co-infections using a bioinformatic pipeline to analyse genomic data from diverse locations and pandemic phases. Among 26988 high-quality SARS-CoV-2 isolates from 11 diverse project databases, we identified 141 potential co-infection cases (0.52%), surpassing previous prevalence estimates. These co-infections were observed throughout the pandemic timeline, with an increase noted after the emergence of the Omicron variant. Co-infections involving the Omicron variant were the most prevalent, potentially influenced by the high level of diversity within this lineage and its impact on the viral landscape. Additionally, we found co-infections involving the pre-Alpha/Alpha lineages, which have been rarely described, raising possibilities of contributing to new lineage emergence through recombination events. The analysis revealed co-infection cases involving both different and the same lineages/sublineages. Our study showcases the potential of our pipeline to leverage valuable information stored in global sequence repositories, advancing our understanding of SARS-CoV-2 co-infections. The prevalence of co-infections highlights the importance of monitoring viral diversity and its potential implications on disease dynamics. Integrating clinical data with genomic findings can further shed light on the clinical implications and outcomes of co-infections.
Personal Mastery Attenuates the Association between Greater Perceived Discrimination and Lower Amygdala and Anterior Hippocampal Volume in a Diverse Sample of Older Adults
Authors: Rosario Michael A. , Alotaibi Razan , Espinal-Martinez Alan O. , Ayoub Amara , Baumann Aletha , Clark Uraina , Cozier Yvette , Schon Karin
Published: January 2024

There is limited research investigating whether perceived discrimination influences brain structures that subserve episodic memory, namely the hippocampus and amygdala. Our rationale for examining these regions build on their known sensitivity to stress and functional differences along the long-axis of the hippocampus, with the anterior hippocampus and amygdala implicated in emotional and stress regulation. We defined perceived discrimination as the unfair treatment of one group by a dominant social group without the agency to respond to the event. A potential moderator of perceived discrimination is personal mastery, which we operationally defined as personal agency. Our primary goals were to determine whether perceived discrimination correlated with amygdala and anterior hippocampal volume, and if personal mastery moderated these relationships. Using FreeSurfer 7.1.0, we processed T1-weighted images to extract bilateral amygdala and hippocampal volumes. Discrimination and personal mastery were assessed via self-report (using the Experiences of Discrimination and Sense of Control questionnaires, respectively). Using multiple regression, greater perceived discrimination correlated with lower bilateral amygdala and anterior hippocampal volume, controlling for current stress, sex, education, age, and intracranial volume. Exploratory subfield analyses showed these associations were localized to the anterior hippocampal CA1 and subiculum. As predicted, using a moderation analysis, personal mastery attenuated the relationship between perceived discrimination and amygdala and anterior hippocampal volume. Here, we extend our knowledge on perceived discrimination as a salient psychosocial stressor with a neurobiological impact on brain systems implicated in stress, memory, and emotional regulation, and provide evidence for personal mastery as a moderating factor of these relationships.