bluuebunny/crossref_metadata_2025 huggingface dataset:
Disentangled Lifespan Synthesis via Transformer‐Based Nonlinear Regression
Authors: Li Mingyuan , Guo Yingchun
Published: October 2024

Lifespan face age transformation aims to generate facial images that accurately depict an individual's appearance at different age stages. This task is highly challenging due to the need for reasonable changes in facial features while preserving identity characteristics. Existing methods tend to synthesize unsatisfactory results, such as entangled facial attributes and low identity preservation, especially when dealing with large age gaps. Furthermore, over‐manipulating the style vector may deviate it from the latent space and damage image quality. To address these issues, this paper introduces a novel nonlinear regression model‐Disentangled Lifespan face Aging (DL‐Aging) to achieve high‐quality age transformation images. Specifically, we propose an age modulation encoder to extract age‐related multi‐scale facial features as key and value, and use the reconstructed style vector of the image as the query. The multi‐head cross‐attention in the W+ space is utilized to update the query for aging image reconstruction iteratively. This nonlinear transformation enables the model to learn a more disentangled mode of transformation, which is crucial for alleviating facial attribute entanglement. Additionally, we introduce a W+ space age regularization term to prevent excessive manipulation of the style vector and ensure it remains within the W+ space during transformation, thereby improving generation quality and aging accuracy. Extensive qualitative and quantitative experiments demonstrate that the proposed DL‐Aging outperforms state‐of‐the‐art methods regarding aging accuracy, image quality, attribute disentanglement, and identity preservation, especially for large age gaps.
SOD‐diffusion: Salient Object Detection via Diffusion‐Based Image Generators
Authors: Zhang Shuo , Huang Jiaming , Chen Shizhe , Wu Yan , Hu Tao , Liu Jing
Published: October 2024

Salient Object Detection (SOD) is a challenging task that aims to precisely identify and segment the salient objects. However, existing SOD methods still face challenges in making explicit predictions near the edges and often lack end‐to‐end training capabilities. To alleviate these problems, we propose SOD‐diffusion, a novel framework that formulates salient object detection as a denoising diffusion process from noisy masks to object masks. Specifically, object masks diffuse from ground‐truth masks to random distribution in latent space, and the model learns to reverse this noising process to reconstruct object masks. To enhance the denoising learning process, we design an attention feature interaction module (AFIM) and a specific fine‐tuning protocol to integrate conditional semantic features from the input image with diffusion noise embedding. Extensive experiments on five widely used SOD benchmark datasets demonstrate that our proposed SOD‐diffusion achieves favorable performance compared to previous well‐established methods. Furthermore, leveraging the outstanding generalization capability of SOD‐diffusion, we applied it to publicly available images, generating high‐quality masks that serve as an additional SOD benchmark testset.
Deep‐Learning‐Based Facial Retargeting Using Local Patches
Authors: Choi Yeonsoo , Lee Inyup , Cha Sihun , Kim Seonghyeon , Jung Sunjin , Noh Junyong
Published: October 2024

In the era of digital animation, the quest to produce lifelike facial animations for virtual characters has led to the development of various retargeting methods. While the retargeting facial motion between models of similar shapes has been very successful, challenges arise when the retargeting is performed on stylized or exaggerated 3D characters that deviate significantly from human facial structures. In this scenario, it is important to consider the target character's facial structure and possible range of motion to preserve the semantics assumed by the original facial motions after the retargeting. To achieve this, we propose a local patch‐based retargeting method that transfers facial animations captured in a source performance video to a target stylized 3D character. Our method consists of three modules. The Automatic Patch Extraction Module extracts local patches from the source video frame. These patches are processed through the Reenactment Module to generate correspondingly re‐enacted target local patches. The Weight Estimation Module calculates the animation parameters for the target character at every frame for the creation of a complete facial animation sequence. Extensive experiments demonstrate that our method can successfully transfer the semantic meaning of source facial expressions to stylized characters with considerable variations in facial feature proportion.
The concept map as a tool for analyzing museum objects
Authors: Loureiro Maria Lucia de Niemeyer Matheus
Published: October 2024

This paper discusses using the concept map to study museum objects. The tool's original purpose, which was created in the 1970s by Joseph Novak, was to graphically represent the construction of knowledge of scientific topics by learners, particularly children. Concept maps start from the premise that new knowledge is always built on previous knowledge and allow the representation, organization, and relationship between concepts, which are seen as the primary elements of knowledge. Novak recognized that its potential is insufficiently explored and encouraged its application in different disciplines and fields that deal with concepts and their relationships. This incentive led the Museum of Astronomy and Related Sciences (Rio de Janeiro, Brazil) to adopt the concept map on an experimental basis to analyze objects in its collection. At first, the tool sought to emphasize the conceptual potential of museum objects and shed more light on their trajectory in time and space and the numerous possible connections with events, institutions, concepts, people, and other objects. In the initial experimental phase, the maps were included in papers presented at academic events and discussed with professionals dedicated to science and technology collections and other specialists in Museology and Information Science. In the second stage, maps began to be produced in greater numbers and on demand, focusing on objects selected for a temporary exhibition. Based on the assumption that museum objects are both unique and representative of a class of objects that share the same name and function, the maps constructed were based on Ingetraut Dahlberg's Theory of Concept, which distinguishes between general and individual objects and concepts.
Reducing the replication time for structural estimations: A successful replication of “An Anatomy of International Trade” using GPU computing
Authors: Zhong Jiatong
Published: October 2024

Eaton, Kortum, and Kramarz (2011) (EKK) discovered empirical patterns from French manufacturing firms that a baseline firm heterogeneity model could not explain. The authors proposed and estimated a model that closely matches the patterns observed in French data. This paper successfully replicates their findings using author‐provided data, re‐implementing their algorithms in Python and leveraging graphics processing unit computing to significantly boost computational speed. Applying the model to Chinese manufacturing data, despite differences in context, showed that the model explains most observed patterns well.
A systematic review of the prevalence of post‐operative complications after general anaesthesia in adult horses (2000–2023)
Authors: Loomes Kate , de Grauw Janny , Gozalo‐Marcilla Miguel , Redondo José I , Bettschart‐Wolfensberger Regula
Published: October 2024

Background

Equine post‐operative morbidity represents a significant concern for both veterinary surgeons and horse owners.

Objectives

To estimate the prevalence of post‐operative complications in horses after elective/non‐abdominal surgery or colic surgery.

Study design

Systematic review.

Methods

A database search identified eligible studies which reported the prevalence of equine post‐operative complications published as a full paper in English in a peer‐reviewed journal between 2000 and 2023. Studies were evaluated using the JBI Critical Appraisal Checklist for Prevalence Studies and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. Data for the most commonly reported complications were analysed using Chi‐squared analysis of weighted means to answer 13 PICO (Population, Intervention, Comparator and Outcomes) questions.

Results

Sixty‐seven studies met inclusion criteria. Data for eight post‐operative morbidities (colic, surgical site complications, myopathy/neuropathy, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis, respiratory complications) were sufficient to allow statistical analyses. The weighted mean of the overall proportion of post‐operative complications after elective/non‐abdominal surgery is 17.48% (95% confidence interval [95% CI]: 13.20–22.92), significantly increasing to 55.62% (95% CI: 45.79–65.03) after colic surgery (odds ratio [OR] 6.63; 95% CI: 5.83–7.56; p < 0.001). The most commonly reported morbidity was post‐operative colic, with a weighted mean prevalence of 7.45% (95% CI: 4.83–11.76) after elective/non‐abdominal surgery, significantly rising to 26.46% (95% CI: 19.11–35.97) after colic surgery (OR 4.11; 95% CI: 3.60–4.71; p < 0.001). The weighted mean prevalence of surgical site complications, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis and respiratory complications were significantly higher after colic surgery compared with elective/non‐abdominal surgery. Myopathy/neuropathy was the only morbidity where prevalence was not different between groups (OR 1.86; 95% CI: 0.86–4.16; p = 0.16).

Main limitations

The majority of studies were retrospective. Morbidity definitions, data collection periods, follow‐up time and methods varied between studies.

Conclusions

Based on current evidence, the prevalence of post‐operative colic, surgical site complications, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis and respiratory complications is significantly higher after colic surgery compared with elective/non‐abdominal surgery under general anaesthesia.
Impact of a Case‐Based Sleep Apnoea Education on the Knowledge, Attitudes and Confidence of Dental Hygiene Students—A Multicentre Intervention Study
Authors: Kramer Ann‐Catrin André , Wright Bridget , Berggren Kristina , Lundsbakken Linda , Hopkins Karelle , Ahonen Hanna , Lindmark Ulrika
Published: October 2024

Objective

This pilot study aimed to explore knowledge, attitudes and confidence levels of Obstructive Sleep Apnoea (OSA) before and after case‐based education among dental hygiene students. Moreover, to give an international perspective, this study included students from the US and Scandinavia.

Methods

A longitudinal multicentre study assessed dental hygiene students' OSA knowledge, attitudes and confidence through a case‐based education model. Students from six dental hygiene programmes in the US, Norway and Sweden participated from 2021 to 2022. The intervention group (N = 89) received preview material, live synchronous OSA lecture, case‐based screening of fictitious patients and clinical practice using the STOP‐Bang screening tool. Controls (N = 70) followed the standard curriculum. The Obstructive Sleep Apnoea Knowledge and Attitudes (OSAKA) questionnaire, comprising 18 knowledge and five attitude/confidence questions, was used. Reliability was assessed and nonparametric tests determined OSAKA knowledge score differences among the baseline, 6 months and 12 months intervals.

Results

The intervention increased OSA knowledge with the largest increase in proportions of correct responses occurring between the baseline and 6 months and all single items showing a higher proportion of correct answers at 12 months compared to the baseline. Students' attitudes regarding the importance of OSAKA and confidence in managing patients increased from the baseline to both 6 months and 12 months.

Conclusion

The case based educational intervention increased OSA knowledge and improved attitudes and confidence among dental hygiene students. The results also determined that the OSAKA questionnaire can be used in a setting with dental hygiene students to provide an overview of their knowledge, attitudes and confidence toward OSA. Current sleep medicine education in dental hygiene programmes is limited, suggesting the need for enhanced and sustained educational interventions to address this knowledge gap.
Survey on Patient Perception of At‐Home Bacterial Biofilm Control in Relation to Peri‐Implant Soft Tissue Health
Authors: Hoerler Sarah B. , Mueller Erin B. , Murray Whitnee R. , Zhou Miao Xian
Published: October 2024

Objective

Bacterial biofilm control around dental implants is critical for the health of the peri‐implant soft tissue and longevity of dental implants. The patient's role in regular biofilm removal around dental implants is just as important as that of the dental hygienist. The purpose of this study is to identify the relationship between at‐home dental implant care and patients' perceptions of peri‐implant soft tissue health.

Methods

A 15‐item paper survey was distributed to adult patients undergoing professional dental hygiene maintenance at a specialty dental practice within a 3‐month period and had at least one dental implant. Survey items included participant demographics, patient‐reported adjunctive aids for dental implants and patient perceptions of dental implant oral hygiene practices and peri‐implant soft tissue health.

Results

There was a statistical difference between time spent cleaning dental implants and peri‐implant soft tissue health. An association was found between patients who reported spending more time cleaning their dental implants and less bleeding (p = 0.046/54%), gingival inflammation (p = 0.026/58%) and gingival tissue redness (p = 0.036/53%). Additionally, patients who more frequently underwent professional dental hygiene maintenance perceived less gingival inflammation (p = 0.001/66%).

Conclusion

To promote peri‐implant soft tissue health and reduce oral biological complications, best practice guidelines should be implemented, including optimal at‐home dental implant care and regular professional dental hygiene maintenance.
Research on flame characteristics and coating growth process of titanium alloy in HVAF spraying
Authors: Li Chang , Li Siyu , Liu Pengfei , Tang Ping , Kong Shuai , Wang Cong
Published: October 2024

In this work, a flow field model of WC–12Co powder sprayed by high‐velocity air fuel (HVAF) was established based on the computational fluid dynamics (CFD) method. The macro–micro coupled thermodynamic model of coating multilayer growth process was established based on the birth and death element method. The temperature and velocity of the particles in the combustion flame were applied to the coating growth model, and the transient evolution of the coating temperature and thermal stress was revealed. The results show the temperature and thermal stress of coatings increase with the increasing the number of spraying layers, and their incremental gradient gradually decreases with the increasing the number of deposition layers. The peak temperature of the coating surface reaches 1494 K, and the peak thermal stress of the first coating reaches 2693 MPa. The maximum stress of spraying particles appears at the contact edge of particles. Further preparation of WC coating, through the hardness, friction, and wear, corrosion tests verify that WC–12Co coating can effectively provide the TC18 substrate performance. The microhardness of WC–12Co coating was approximately three times that of TC18 substrate. The average friction coefficient and corrosion rate of the coating are 0.15 and 0.06 mg/cm2/h lower than that of the substrate, respectively.
Glutathione as a skin‐lightening agent and in melasma: a systematic review
Authors: Sarkar Rashmi , Yadav Vidya , Yadav Twinkle , P Janaani , Mandal Irena
Published: October 2024

Hyperpigmentary disorders, including melasma, are challenging to treat. Glutathione has anti‐melanogenic and antioxidant properties, which led to its use as a skin‐lightening agent. Our objective was to review the published evidence and literature on the efficacy and safety of glutathione as a skin‐lightening agent and in the treatment of melasma. A literature search was done in the PubMed, Embase, and Cochrane library databases using the search terms “glutathione as a skin‐lightening agent” and “glutathione in melasma” for the past 10 years. The level of evidence, strength of recommendation, and risk of bias assessment were evaluated. Among various forms of topical glutathione, glutathione 0.5% was significantly more effective compared to glutathione 0.1% and placebo. For glutathione alone versus glutathione plus microneedling, more improvement was seen. Five randomized controlled trials and a single open‐arm clinical study on oral glutathione at doses of 250 mg once a day, 250 mg twice a day, and 500 mg once a day showed a significant reduction in the melanin index compared to placebo. The combination of topical 2% glutathione plus oral glutathione was superior to monotherapy alone. There was only one placebo‐controlled study on intravenous (IV) glutathione [6/16 (37.5%) vs. 3 (18.7%), (p0.054)]. The risk of bias assessment showed that almost an equal number of studies have low and high risk of bias. Topical versus oral glutathione both provide moderately efficacious skin‐lightening outcomes that are localized versus generalized and have minimal versus substantial adverse effects, but they are unsustainable, with variable costs. IV glutathione is contraindicated due to lack of efficacy and side effects. It may work more as an antioxidant in melasma.
Modeling of ternary ion exchange and stress evolution in lithium‐containing glass
Authors: Xu Junju , Zhang Yuzhou , Zhang Yajing , Lin Chen , Gao Ziyang , Ruan Haihui
Published: October 2024

A computational model of ternary ion exchange (IOX) for strengthening glass is proposed to predict the cation concentration and residual stress distributions in glass after ternary IOX. The comparison between theoretical predictions and experimental results indicated the validates the model. Additionally, it provides a method to determine ion diffusivity and volume expansion through ternary IOX experiments. Simulations of K–Na–Li ternary IOX were conducted using the parameters calibrated based on experimental results from a thick silicate glass. Then the process parameters were changed to clarify their influences. Key findings reveal that for thick glass (where lateral expansion is negligible), the optimum ratio of K+ and Na+ concentrations in a molten salt is 2:1. We further consolidate the effects of process parameters by training a neural network (NN) and demonstrate that the NN can be a surrogate model to replace the time‐consuming simulations, which could be more adaptable by the glass industry.
Capturing Potential Interventions for the Empowerment of Older People and Informal Caregivers in Transitional Care Decision‐Making: A Qualitative Study Using Focus Groups
Authors: Kraun Lotan , De Vliegher Kristel , Keldermans Elise , Ellen Moriah E , van Achterberg Theo
Published: October 2024

Aim

To capture older people's, informal caregivers' and health professionals' ideas on potential interventions for empowering older people and informal caregivers in transitional care decision‐making.

Design

A descriptive qualitative design was adopted.

Methods

The study was conducted between February and May 2022 in the region of Flanders, Belgium, as part of the TRANS‐SENIOR consortium's collaborative research. Data were collected using focus groups, including older people, informal caregivers and healthcare professionals involved in any physical relocation of the older person across home, hospital or nursing home settings. Thematic data analysis was performed based on Braun and Clarke's six‐step method.

Results

A total of 40 people participated in the focus groups. Four main themes were identified, which describe ideas on how to empower older people and informal caregivers in transitional care: Providing clear and timely information, preparing people for what is to come, person‐centredness and providing professional and peer support for informal caregivers.

Conclusions

Healthcare (professionals) should facilitate older people's and informal caregivers' empowerment in transitional care decision‐making by setting them at the core and inception of the decision‐making process. While informal caregivers support their loved ones in decision‐making processes, they should also be supported and monitored for burdensome issues.

Implications to Patient Care

Multicomponent, well‐planned and personalised interventions are needed to empower older people and informal caregivers in transitional care decision‐making. The ideas raised by all stakeholders who participated in this study can inform these interventions.

Reporting Method

Adhered to consolidated criteria for reporting qualitative research checklist.

Patient or Public Contribution

Organisations advocating for the interests of older people and informal caregivers played a pivotal role in shaping the TRANS SENIOR project. Furthermore, the study benefitted from the collaborative input of AGE Platform Europe, which amplified the voices and representation of older people during the project design phase.
Examining systemic inflammation as a pathway linking peer victimization to depressive symptoms in adolescence
Authors: Lorenz Tamara , Michels Nathalie , Slavich George M. , Giletta Matteo
Published: October 2024

Background

Adolescents exposed to victimization are at an increased risk for a variety of adverse mental health outcomes, including depressive symptoms. Yet, the biological pathways underlying these associations remain poorly understood. Focusing on within‐person processes, we examined whether low‐grade systemic inflammation mediated the longitudinal associations between peer victimization and depressive symptoms in adolescence.

Methods

207 adolescents (at baseline Mage = 12.69 years; SD = 0.49; 43.5% female) participated in a multi‐wave longitudinal study, with assessments repeated every 6 months over 1.5 years. At each assessment wave, participants self‐reported their peer victimization experiences and depressive symptoms. Dried blood spots were collected at each wave using a finger prick procedure to assay a key marker of low‐grade systemic inflammation, interkeukin‐6 (IL‐6). Data were analyzed using random‐intercept cross‐lagged panel models.

Results

The cross‐lagged paths from IL‐6 to depressive symptoms were significant across all models and waves (β12 = .13; β23 = .12; β34 = .08), indicating that when adolescents' levels of low‐grade systemic inflammation were above their person‐specific average, they reported increased levels of depressive symptoms in the subsequent months. However, no significant cross‐lagged within‐person associations emerged between peer victimization and either IL‐6 or depressive symptoms.

Conclusions

The findings provide no evidence for the hypothesized mediating role of inflammation in the within‐person associations between peer victimization and depressive symptoms. Nevertheless, they extend prior research by indicating that elevated levels of low‐grade systemic inflammation predict the development of depressive symptoms in adolescence.
Short‐Term Grasslands in Agriculture Support Both Natural Enemy and Phytophagous Arthropod Populations
Authors: Tsuruda Matthew , Clausen Martina , Bondar Drew , Kremen Claire , Carrillo Juli
Published: October 2024

Simplified agricultural land with high chemical input is increasingly replacing natural habitats in many parts of the world. This loss and fragmentation of natural areas may have profound impacts on an array of wildlife, including predatory arthropods that provide natural biocontrol of agricultural pests. There is increasing interest in utilising short‐term seminatural habitat restoration in agricultural systems to support populations of beneficial organisms. We assessed the impact of two types of short‐term set‐asides on the diversity and abundance/activity density of phytophagous and predatory arthropods. We found that flower‐enhanced set‐asides supported higher abundances of both phytophagous and predatory arthropods compared to control crop fields. In addition, we found that both set‐aside types (flower enhanced and traditional) supported a more active and diverse community of beneficial predatory carabid beetles, with particularly strong trends in set‐asides supplemented with flowering plants. These results suggest that small‐scale, temporary, seminatural habitats in agricultural systems provide support for a diverse and abundant community of both beneficial and phytophagous arthropods.
Haplotype‐resolved genome of a heterozygous wild peach reveals the PdaWRKY4‐PdaCYP716A1 module mediates resistance to aphids by regulating betulin biosynthesis
Authors: Wang Jun‐Xiu , Li Yong , Wang Xin‐Wei , Cao Ke , Chen Chang‐Wen , Wu Jin‐Long , Fang Wei‐Chao , Zhu Geng‐Rui , Chen Xue‐Jia , Guo Dan‐Dan , Wang Jiao , Zhao Ya‐Lin , Fan Jia‐Qi , Liu Su‐Ning , Li Wen‐Qing , Bie Hang‐Ling , Xu Qiang , Wang Li‐Rong
Published: October 2024

Wild species of domesticated crops provide valuable genetic resources for resistance breeding. Prunus davidiana, a wild relative of peach with high heterozygosity and diverse stress tolerance, exhibits high resistance against aphids. However, the highly heterozygous genome of P. davidiana makes determining the underlying factors influencing resistance traits challenging. Here, we present the 501.7 Mb haplotype‐resolved genome assembly of P. davidiana. Genomic comparisons of the two haplotypes revealed 18,152 structural variations, 2,699 Pda_hap1‐specific and 2,702 Pda_hap2‐specific genes, and 1,118 allele‐specific expressed genes. Genome composition indicated 4.1% of the P. davidiana genome was non‐peach origin, out of which 94.5% was derived from almond. Based on the haplotype genome, the aphid resistance quantitative trait locus (QTL) was mapped at the end of Pda03. From the aphid resistance QTL, PdaWRKY4 was identified as the major dominant gene, with a 9‐bp deletion in its promoter of the resistant phenotype. Specifically, PdaWRKY4 regulates aphid resistance by promoting PdaCYP716A1‐mediated anti‐aphid metabolite betulin biosynthesis. Moreover, we employed a genome design to develop a breeding workflow for rapidly and precisely producing aphid‐resistant peaches. In conclusion, this study identifies a novel aphid resistance gene and provides insights into genome design for the development of resistant fruit cultivars.
The Relationship Between Dyadic Coping and Mental Health in Stroke Survivors and Their Spouse Caregivers: An Actor‐Partner Interdependence Model
Authors: Song Wangtao , Zhang Xinyue , Ge Song , Zhai Qinghua , Shan Qiuju , Li Xin , Mei Yongxia , Zhang Zhenxiang
Published: October 2024

Aim

To investigate the relationship among dyadic coping, mental health and the individual and mutual influences on stroke survivors and their spouse caregivers.

Design

A cross‐sectional descriptive study was conducted in China from November 2019 to August 2020. The STROBE checklist was used to report the present study.

Methods

The analysis included 224 dyads of stroke survivors and their spouse caregivers in China. Data on stroke survivors and their spouse caregivers were collected using the Dyadic Coping Inventory (DCI), the Patient Health Questionnaire nine‐item scale (PHQ‐9) and the Generalised Anxiety Disorder seven‐item scale (GAD‐7). The dyadic analysis was conducted based on the Actor‐Partner Interdependence Model (APIM).

Results

Regarding actor effects, spouse caregivers' dyadic coping and perceived dyadic coping had a negative predictive effect on their own anxiety and depression. Stroke survivors' perceived dyadic coping had a negative effect on their own depression. Regarding partner effects, spouse caregivers' perceived dyadic coping also had a negative predictive effect on the depression of the patients. In contrast, stroke survivors' perceived dyadic coping was positively associated with spouse caregivers' anxiety and depression. These findings suggested that mental health of stroke survivors and their spouse caregivers was affected by various dyadic coping dimensions.

Conclusions

Our research has the potential to contribute to the understanding dyadic coping and mental health of stroke survivor‐spouse caregiver dyads. The findings reveal that the coping strategies employed by stroke couples are closely related to the mental health of both partners.

Impact

This study provides evidence for the significant impact of dyadic coping on the psychological well‐being of stroke survivors and their spouse caregivers. Therefore, dyadic interventions aiming at strengthening dyadic coping may have positive effects on their mental health.

Patient or Public Contribution

This study directly involved the patients and family caregivers in hospital settings.
Correlation Between Symptom Clusters and Self‐Management Among Maintenance Haemodialysis Patients: A Cross‐Sectional Study
Authors: Zhang Na , Tu Hui , Xiong Xiaoyun , Guo Ting , Zhang Xiaoxue , Cheng Ting , Peng Ying , Li Wenxin , Chen Yihui
Published: October 2024

Aims and Objectives

The purpose of this study was to explore the relationship between symptom clusters and self‐management among maintenance haemodialysis (MHD) patients.

Background

MHD patients experience disease progression and multiple symptom burdens that severely impact quality of life, and self‐management of symptoms may significantly improve patient‐reported outcomes.

Design

A cross‐sectional study.

Methods

This cross‐sectional descriptive study included 194 patients undergoing MHD. The patients were assessed using the Dialysis Symptom Index (DSI) and the Haemodialysis Self‐Management Instrument (HD‐SMI). We used descriptive analysis, exploratory factor analysis, Pearson's correlation analysis and linear regression analysis to examine (1) the level of individual self‐management, (2) the presence of symptom clusters by symptom severity and (3) the correlation between symptom clusters and self‐management behaviours. This study was conducted in accordance with the STROBE checklist.

Results

The top five most severe symptoms among the patients were itching, feeling tired or lack of energy, difficulty sleeping, dry mouth and dry skin. We identified five groups of symptoms: (1) poor sleep, (2) neuromuscular, (3) gastrointestinal, (4) skin irritation and (5) psychological. In the present study, MHD patients reported low to moderate levels of self‐management behaviours (50.84 ± 10.56), and low self‐management ability was correlated with greater severity of the five symptom clusters (p < 0.01). Linear regression analysis revealed that all five symptom clusters were included in the regression equation, explaining 30% of the total variance in self‐management skills among MHD patients.

Conclusion

Enhanced awareness of symptom clusters and comprehensive symptom management are necessary to improve patients' quality of life.

Clinical Relevance

Nursing practices should incorporate comprehensive symptom assessments to help patients develop effective self‐management strategies to improve quality of life.
Contextual Factors Influencing Intensive Care Patients’ Discharge Processes: A Multicentre Prospective Observational Study
Authors: Lin Frances Fengzhi , Peet Jacqueline , Murray Lauren , Yin Huahua , Ramanan Mahesh , Jacobs Kylie , Brailsford Jane , Osmond Amelia , Kajevu Moreblessing , Prichard Roslyn , Garrett Peter , Tabah Alexis , Mock Carol , Mehdi Ahmed , Chen Yingyan
Published: October 2024

Aims

To compare contextual factors influencing discharge practices in three intensive care units (ICUs).

Design

A prospective observational study.

Methods

Data were collected using a discharge process report form (DPRF) between May and September 2023. Descriptive statistics were performed to analyse demographic and clinical data. One‐way analysis of variance (ANOVA) was used to test the time interval differences among the three sites.

Results

Overall, 69 patients' discharge processes were observed. Among them, 41 (59%) experienced discharge delay, and 1 in 5 patients experienced after‐hours discharge. There were statistically significant differences in mean hours in various time intervals during the discharge processes among the three sites. Patients in Hospital C waited the longest time (mean = 31.9 h) for the ward bed to be ready after the bed was requested and for being eventually discharged after ICU nurses to get them ready for discharge (mean = 26.7 h) compared to Hospital A and Hospital B.

Conclusions

We found that discharge delay and after‐hours discharge were common and there were significant differences in mean hours of various time intervals during the discharge processes occurred among the three sites. The influence of contextual factors in different hospitals/ICU needs to be considered to improve the ICU discharge process.

Implications for the Profession and/or Patient Care

Researchers and clinicians should consider targeted context‐specific interventions and strategies to optimise patient discharge process from ICUs.

Impact

The study findings will inform the development of tailored interventions to reduce the discharge delay and after‐hours discharge and, in turn, improve the quality and safety of patient care and health service efficiency.

Reporting Method

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Patient or Public Contribution

Patients' discharge processes were observed, and consumer representatives were involved in the study design.
The Impact of Lockdown in Cyberbullying in Primary Education: Transitions of Cyberbullying and Bullying
Authors: Llorent Vicente J. , Seade‐Mejía Carolina , Vélez‐Calvo Ximena , Nasaescu Elena
Published: October 2024

BACKGROUND

The COVID‐19 pandemic triggered a worldwide socio‐sanitary crisis, continuing to impact societies worldwide. With many school systems shifted to online education, the current study presents a unique opportunity to investigate relevant phenomena related to serious health issues during the schooling and later in life, cyberbullying and bullying. This study began just before the COVID‐19 lockdown was declared and resumed 5 months later allowing to explore 2 main objectives: first, to explore whether cyberbullying increased during the lockdown, and second, to analyze transitions from to time of bullying and cyberbullying.

METHODS

The participants included 792 students from sixth and seventh years of Primary Education (Meanage = 10.81, SD = 0.85) in Ecuador. This is a quantitative longitudinal study. Cyberbullying and bullying scales were used for data collection before the lockdown in January and February 2020 (T1), and after 5 months of lockdown, at the end of the same academic year in July 2020 (T2). Descriptive, comparative and predictive analyses, a latent transition analysis was used to identify latent status of cyberbullying and bullying behavior at T1 and T2.

RESULTS

The results revealed a significant increase of cyberbullying after 5 months of the lockdown. Interestingly, only a small percentage of students who were uninvolved in cyberbullying and bullying in T1 remained uninvolved in T2.

CONCLUSIONS

The discussion explores the dynamics of cyberbullying involvement and examines changes in the roles and groups of bullying and cyberbullying after 5 months of lockdown. The political‐ and school‐related implications of these findings are thoroughly discussed.
The evolution and disintegration of innovation narratives during scaling in science‐based ventures
Authors: Schou Peter Kalum
Published: October 2024

Science‐based ventures (SBVs) are crucial vehicles that bring new technologies from the lab and to the mainstream market. During this journey, innovation narratives play a crucial role in coordinating innovation. Innovation narratives are linguistic representations that actors use to make sense of innovation activities, events and actions. In other words, they are stories that drive sensemaking, which is a critical element in avoiding conflicts in product innovation process and securing coordinated activities between diverse actors. However, as SBVs shift markets and undergo radical changes, they may have to update narratives to fit these changes. Yet, little is known about how innovation narratives and coordination evolve during this journey. To improve knowledge on this matter, I conducted a 24‐month study of a science‐based venture crossing over to a commercial market. I find that during this transition, innovation narratives shift from being shaped by progressive storytelling, where the benefits of becoming commercial and hiring nonacademics is highlighted, to being shaped by retrogressive storytelling, where incumbents and newcomers use their respective pasts to develop divergent narratives, and finally to appearing as disintegrated storytelling, where narratives compete and hinder coordination in innovation processes. Building on these findings, I construct a process model of how innovation narratives evolve and disintegrate as SBVs scale. This article contributes to knowledge on innovation management by illustrating how innovation narratives affect coordination in innovation processes, as well as how they may evolve during organizational change. Furthermore, this article illuminates the challenges that SBVs face to their innovation processes when scaling.
Wasting coexisting with underweight and stunting among children aged 6‒59 months hospitalised in Garissa County Referral Hospital, Kenya
Authors: Wambua Mutuvi , Kariuki Symon M. , Abdullahi Hassan , Abdullahi Osman A. , Ngari Moses M.
Published: October 2024

Management of undernourished children depends only on wasting yet it can coexist with underweight and/or stunting. Among children admitted to hospital with acute illness, we determined the proportion with wasting coexisting with underweight and/or stunting and their risk factors. A retrospective review of hospital records of children 6‒59 months old admitted at Garissa County referral hospital, Kenya, from January 2017 to December 2019 was conducted. Using World Health Organization 2006 growth standards, undernutrition were defined: wasting as Weight‐for‐height Z‐score < −2, stunting Height‐for‐age Z‐score < −2 and underweight Weight‐for‐age Z‐score < −2. We studied wasting coexisting with underweight and/or stunting. Among 624 children recruited, 347 (56%) were males and 511 (82%) <24 months old. Diarrhoea 210 (34%) and pallor/anaemia 310 (50%) were the most frequent admission diagnosis. HIV infection was present among 8 (1.3%) children. Wasting, underweight and stunting were present among 595 (95%), 518 (83%) and 176 (28%) children respectively. 161 (26%), 506 (81%) and 161 (26%) children had wasting coexisting with stunting, underweight and both stunting and underweight respectively. In the multivariable regression, diarrhoea was positively associated with wasting coexisting with stunting (adjusted risk ratio [aRR = 2.96] [95% CI = 2.06‒4.23]) and anaemia with wasting coexisting with underweight (aRR = 1.23) (95% CI = 1.03‒1.47). Overall, 343 (55%) children were discharged alive, 67 (11%) absconded from the wards, 164 (26%) were transferred to another hospital and 50 (8.0%) died before discharge. The risk of inpatient death was 10.3%, 7.9%, 8.4% and 6.8% among children not wasted, wasted only, wasted & underweight, and wasted and underweight and stunted respectively (Chi‐square p = 0.60). The study reports an unacceptably high levels of undernourishment, including coexisting forms of undernutrition among hospitalised children. This highlights a public health priority for current nutrition therapeutic care and need of continuity of care among those children discharged alive in the community‐based management of acute malnutrition programmes.
Dynamic change and risk factors of intense thirst in patients admitted to neuro‐intensive care unit: An observational study
Authors: Zhao Peng , Luo Yansi , Xiang Lijun , Cao Meng , Song Xuemei , Liao Lin , Yan Mingyu , Cheng Lei , Zhu Zhihui , Zhang Xiaomei
Published: October 2024

Background

Thirst is a clinical discomfort symptom reported by most patients admitted to intensive care unit (ICU). Little is known about the dynamic change and risk factors of intense thirst in neuro‐intensive care unit (Neuro‐ICU).

Aim

The objective of this study was to explore the dynamic change and determine the risk factors of intense thirst in patients admitted to Neuro‐ICU, providing reference for personalized interventions of intense thirst.

Study design

The study design is a prospective observational study. Demographic and disease‐related, treatment, physiological and biochemical data were collected for 230 patients from Neuro‐ICU of a hospital from May 2023 to November 2023. We assessed thirst intensity on numeric rating scale (NRS) of 0–10 (10 = worst possible thirst) at eight time points: 7:00, 9:00, 11:00, 13:00, 15:00, 17:00, 19:00 and 21:00 and a self‐designed general information questionnaire based on safety protocol for thirst management to analyse the risk factors of intense thirst in Neuro‐ICU patients. If thirst scores were more than 7, we defined it as intense thirst. This study followed the STROBE checklist for cross‐sectional studies.

Results

A total of 230 Neuro‐ICU patients were observed. The dynamic analysis results showed an overall downward trend in thirst intensity, with the highest NRS thirst scores at 07:00 (6.13 ± 2.14) and the lowest at 21:00 (4.02 ± 2.72). The investigation of the current situation showed that the incidence of intense thirst in Neuro‐ICU patients was 47.4%. Intense thirst in Neuro‐ICU patients was predicted by dysphagia (odds ratio [OR] = 1.436, 95% confidence interval [CI]:1.063–1.941), open mouth breathing (OR = 2.201, 95% CI:1.041–4.656), high glucose (OR = 2.584, 95% CI:1.097–6.087), xerostomia (OR = 3.049, 95% CI:1.950–4.767) (all p < .05).

Conclusion

The intensity of thirst was dynamically changing and the incidence of intense thirst in Neuro‐ICU patients was relatively high. Timely assessment of Neuro‐ICU patients' thirst severity and identification of those at high risk can ensure the implementation of effective interventions based on patients' characteristics.

Relevance to Clinical Practice

Thirst is a pervasive distressing symptom often reported by critically ill patients. This study revealed that the clinical nurses need to enhance their focus on dynamic change of thirst, which is helpful for improving the efficiency of bundled thirst interventions at the suitable time.
Disorders of secondary peristalsis are associated with the development of esophagitis
Authors: Berger Tal David , Kung Jasmine , Chalmers Christopher , Nemec Grace , Wen Anna , Nurko Samuel , Rosen Rachel
Published: October 2024

Background

Disorders of primary peristalsis are associated with a higher percent time pH <4 in the esophagus suggesting poor acid clearance. However, there are no studies of secondary peristalsis and its relationship to microscopic or erosive esophagitis. The goal of this study was to determine the relationship between secondary peristalsis using functional luminal imaging probes (EndoFLIP) and the presence or absence of esophagitis.

Methods

We reviewed the endoscopic and EndoFLIP 2.0 tracings for 103 consecutive patients including those with a history of upper gastrointestinal surgery undergoing upper endoscopy. Esophagogastric junction (EGJ) distensibility and diameter, repetitive antegrade contraction (RACs) presence and frequency, and occlusive diameters were measured. Measurements were then compared between patients with and without microscopic and/or erosive esophagitis. Means were compared using t‐tests. Proportions were compared using Chi‐Squared analyses.

Key Results

One hundred and three patients were included (mean age: 14.4 + 6.4 years). Ten patients had erosive esophagitis and 28 patients had microscopic esophagitis. Erosive and microscopic esophagitis were associated with abnormal or absent of RACs (p < 0.001). Occlusive diameters were higher in patients with esophagitis compared to those without (p < 0.001). There was no relationship between EGJ distensibility and the presence of erosive or microscopic esophagitis (p = 0.4). The absence of RACs was the only independent predictor of esophagitis (erosive and microscopic), after controlling for age, proton pump inhibitors (PPI) use and EGJ distensibility (p < 0.001).

Conclusions & Inferences

Abnormal secondary peristalsis is associated with microscopic and gross esophagitis, suggesting that EndoFLIP should be part of the diagnostic algorithm for esophagitis.
Subfamily C7 Raf‐like kinases MRK1, RAF26, and RAF39 regulate immune homeostasis and stomatal opening in Arabidopsis thaliana
Authors: Gonçalves Dias Márcia , Doss Bassem , Rawat Anamika , Siegel Kristen R. , Mahathanthrige Tharika , Sklenar Jan , Rodriguez Gallo Maria Camila , Derbyshire Paul , Dharmasena Thakshila , Cameron Emma , Uhrig R. Glen , Zipfel Cyril , Menke Frank L. H. , Monaghan Jacqueline
Published: October 2024

The calcium‐dependent protein kinase CPK28 regulates several stress pathways in multiple plant species. Here, we aimed to discover CPK28‐associated proteins in Arabidopsis thaliana.

We used affinity‐based proteomics and identified several potential CPK28 binding partners, including the C7 Raf‐like kinases MRK1, RAF26, and RAF39. We used biochemistry, genetics, and physiological assays to gain insight into their function.

We define redundant roles for these kinases in stomatal opening, immune‐triggered reactive oxygen species (ROS) production, and resistance to a bacterial pathogen. We report that CPK28 associates with and trans‐phosphorylates RAF26 and RAF39, and that MRK1, RAF26, and RAF39 are active kinases that localize to endomembranes. Although Raf‐like kinases share some features with mitogen‐activated protein kinase kinase kinases (MKKKs), we found that MRK1, RAF26, and RAF39 are unable to trans‐phosphorylate any of the 10 Arabidopsis mitogen‐activated protein kinase kinases (MKKs).

Overall, our study suggests that C7 Raf‐like kinases associate with and are phosphorylated by CPK28, function redundantly in stomatal opening and immunity, and possess substrate specificities distinct from canonical MKKKs.