bluuebunny/crossref_metadata_2025 huggingface dataset:
Access and Use of Services by Caregivers of Older Adults: A Scoping Review of Cultural and Linguistic Diversity
Authors: Knipping Danielle , Garnett Anna , Jiang Bingfang Bianca
Published: March 2023

Westernized countries are home to an increasingly culturally and linguistically diverse (CLD) older adult population. Informal caregivers of CLD older adults face unique challenges accessing and using home- and community-based services (HCBS). This scoping review sought to identify facilitators and barriers to access and use of HCBS for informal caregivers of CLD older adults. Arksey and O’Malley’s framework guided a systematic search of five electronic databases. The search strategy retrieved 5979 unique articles. Forty-two studies met the inclusion criteria and informed this review. Facilitators and barriers were identified at three stages of using services: knowledge, access, and use of services. Findings concerning access to HCBS were subdivided into willingness and ability to access HCBS. Results emphasize the need for changes in healthcare systems, organizations, and providers to provide culturally appropriate care and improve the accessibility and acceptability of HCBS for informal caregivers of CLD older adults.
Lean, green, and smart manufacturing: An ingenious framework for enhancing the sustainability of operations management on the shop floor in industry 4.0
Authors: Tripathi Varun , Chattopadhyaya Somnath , Mukhopadhyay A K , Sharma Shubham , Kumar Vineet , Li Changhe , Singh Sunpreet
Published: March 2023

In the present competitive landscape industry, individuals have emphasized fulfilling the consumer needs in available resources and limited constraints. However, the industry individuals face several problems in achieving operational efficiency. These problems include ergonomics issues, environmental waste, work processes waste, inobservance on the shop floor, and workers’ apathy. The operations management teams use various approaches to improve operational excellence on the shop floor, including lean manufacturing, smart manufacturing, green manufacturing, and artificial neural network. These approaches are used to enhance productivity by eliminating problems in the operations management on the shop floor. The present research aims to develop a framework for improvement in operational excellence and sustainability in operations management on the shop floor in an industry 4.0 environment using lean, green, and smart manufacturing concepts. In the study, a strategic ergonomics assessment and environmental assessment have been used to assess working and operational performance on the shop floor. The adaptability of the developed framework has been investigated by implementing it in mining machinery manufacturing industry. The framework has been developed with insights gained from previous research, industry individuals, and brainstorming analysis on problems faced in operations management on the shop floor in industry 4.0 working environment. The novelty of the present study lies in the fact that no model has been developed for achieving operational excellence on the shop floor in industry 4.0 using the smart, lean green manufacturing concept. The developed framework significantly improved productivity by 85%, improved machinery utilization by 21%, reduced production time by 65%, reduced manufacturing defects by 96%, and production cost by 75%. The present research work strongly believe that the developed model would benefit industry individuals in enhancing sustainability in operational excellence on the shop floor in industry 4.0 environment by establishing a more competent and cleaner working environment with available resources.
The impact of curcumin supplementation on systemic lupus erythematosus and lupus nephritis: A systematic review
Authors: Ramessar Nina , Borad Abhilasha , Schlesinger Naomi
Published: March 2023

Objective

Curcumin is the active ingredient in the curry spice turmeric. It has anti-inflammatory properties due to the inhibition of transcription factors and inflammatory mediators such as nuclear factor- κβ (NF- κβ), cyclooxygenase-2 (COX2), lipoxygenase (LOX), tumor necrosis factoralpha (TNF-alpha), and interleukin-1 (IL-1) and 6 (IL-6). This review examines the literature regarding the efficacy of curcumin on systemic lupus erythematosus disease activity.

Methods

A search was conducted following guidelines in the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) using the PubMed, Google Scholar, Scopus, and MEDLINE electronic databases to retrieve relevant studies assessing the impact of curcumin supplementation on SLE.

Results

The initial search yielded three double-blind, placebo-controlled, randomized clinical trials, three human in vitro studies, and seven mouse-model studies. In human trials, curcumin decreased 24-h and spot proteinuria, but the trials were small, ranging from 14 to 39 patients, with varied curcumin doses and different study durations ranging from 4 to 12 weeks. There was no change in C3, dsDNA, or the Systemic Lupus Erythematosus Disease Activity (SLEDAI) scores even in the longer trials. The mouse-model trials yielded more data. NF- κβ activation was suppressed along with inducible nitric oxide synthase (NOS) species expression when 1 mg/kg/day of curcumin was administered for 14 weeks, leading to significant decreases in dsDNA, proteinuria, renal inflammation, and IgG subclasses. Another study suggested that curcumin reduced B cell-activating factor (BAFF) when used for up to 8 weeks at 50 mg/kg/day. A reduction in pro-inflammatory Th1 and Th17 percentages, IL-6 and anti-nuclear antibody (ANA) levels were reported. The doses used in the murine models were much higher than those used in human trials, with 12.5 mg–200 mg/kg/day used for over 16 weeks; highlighting that the optimal time for an immunological effect to be observed may require 12–16 weeks of curcumin use.

Conclusion

Despite the wide use of curcumin in everyday life, its molecular and anti-inflammatory use has only been partially explored. Current data show a potential benefit on disease activity. Still, no uniform dose can be advised because long-duration, large-scale randomized trials using defined dosing are needed in different subsets of SLE, including lupus nephritis patients.
Ending the doctor–patient relationship
Authors: Lehman Kirk , Edirisinghe Vinuri
Published: March 2023

Objective

Terminating a therapeutic relationship can be particularly challenging and onerous for the treating medical practitioner. There are multiple reasons why a practitioner may desire to terminate the relationship, ranging from inappropriate behaviour and assault through to threatened or actual litigation. This paper provides psychiatrists as well as all doctors and support staff who work alongside them with a simple, step-by-step visual guide to terminating a therapeutic relationship, giving due consideration to their professional and legal obligations in line with common recommendations by medical indemnity organisations.

Conclusions

If a practitioner’s ability to manage the patient is inadequate or compromised due to an emotional, financial, or legal circumstance, it is reasonable to consider termination of the relationship. Practical steps such as taking contemporaneous notes, writing to the patient and their primary care doctor, ensuring continuity of healthcare, and communicating with authorities where appropriate have been identified as components commonly recommended by medical indemnity insurance organisations.
A stress-state-dependent damage criterion for metals with plastic anisotropy
Authors: Brünig Michael , Koirala Sanjeev , Gerke Steffen
Published: March 2023

The paper discusses the effect of stress state and of loading direction on the onset and evolution of damage in anisotropic ductile metals. A series of experiments with uniaxially and biaxially loaded specimens covering a wide range of stress states and different loading directions is used in combination with corresponding numerical simulations to develop damage criteria. The underlying continuum damage model is based on kinematic definition of damage tensors. The strain rate tensor is additively decomposed into elastic, plastic and damage parts. The anisotropic plastic behavior of the investigated aluminum alloy sheets is governed by the Hoffman yield condition taking into account the strength-differential effect revealed by uniaxial tension and compression tests. Based on this yield criterion generalized anisotropic stress invariants as well as the generalized stress triaxiality and the generalized Lode parameter are defined characterizing the stress state in the anisotropic ductile metal. A damage criterion formulated in terms of these anisotropic stress invariants is proposed and damage mode parameters allow adequate consideration and combination of different damage processes on the micro-level. At the onset of damage the anisotropic stress parameters are determined. With these experimental-numerical data the damage mode parameters are identified depending on stress state and loading direction.
A Process Perspective on Adaptive Performance: Research Insights and New Directions
Authors: Jundt Dustin K. , Shoss Mindy K.
Published: March 2023

Given its acceptance and value as an important facet of workplace behavior, research has primarily attempted to understand adaptive performance by way of examining its antecedents. Although useful, these findings provide little insight into the in-situ, intra-individual processes that occur during adaptive performance (i.e., How do people adapt to change? What determines the speed at which people adapt? How do failures to adapt occur?). The current paper develops and presents a process model of adaptation in order to provide a framework for organizing, understanding, and investigating the in-situ process involved when individuals adapt to changes in job demands. In particular, we suggest that in order to successfully adapt to a changing task environment, individuals must go through a series of processes in order to detect the nature of a change, diagnose its cause, develop or refine strategies, learn additional knowledge or skills, and enact appropriate performance behaviors. At the same time, dynamic emotional, cognitive, motivational, and situational factors serve as proximal inputs and outputs of these processes. In doing so, they shape the success and speed with which people adapt and suggest a broadened set of outcomes of adaptive performance. We describe how this model can be leveraged to stimulate dynamic adaptive performance research and to promote adaptive performance in applied settings.
Student stories of resilience after campus sexual assault
Authors: Driessen Molly C
Published: March 2023

Undergraduate students who experience campus sexual assault (CSA) are faced with a wide array of potentially detrimental mental health and educational outcomes that may significantly impact their sense of wellbeing. Many researchers have focused on documenting these consequences of CSA, but there is a dearth of research on students’ post-assault experiences. Specifically, there is a lack of scholarship exploring students’ lived experiences of navigating their post-assault lives in their campus environment through the lens of resilience. The purpose of this study was to explore the phenomenon of resilience among undergraduate students who have experienced CSA, through a qualitative phenomenological inquiry. This study used critical conceptual understandings of resilience, including socio-ecological and intersectional feminist theoretical perspectives and social work discourses of resilience, to further complicate how the phenomenon is often described in scholarship. The findings revealed four key themes of the phenomenon to include resilience within the context of agency, coping, connection, and hope. Recommendations and implications across social work research, policy, and practice are presented, specifically those identified by the participants as recommendations for change in addressing CSA and supporting student experiences of resilience.
Meanings of being a change agent in implementing a new organisational culture in home care services: A phenomenological hermeneutic study
Authors: Ericson Lidman Eva , Strandberg Gunilla
Published: March 2023

Culture change is common in healthcare organisations worldwide today, and change agents are key persons in the process of change. It is therefore of vital importance to deepen the knowledge about change agents’ experiences. The aim of the study was to illuminate meanings of being a change agent to improve home care services. Ten change agents were interviewed individually using open-ended questions. The interviews were analysed with phenomenological hermeneutics. The design of the study followed the COREQ guidelines. Three themes were revealed in the analysis: ‘Being confirmed by the opportunity to make quality improvements’; ‘Pushing oneself to transfer the message’; and ‘Being strengthened by achievements but wishing for better conditions’. In order to prepare co-workers, change agents need training before their mission begins and during the change process.
What Color is a Golden Boy? The Glorification and Disparagement of Male Superstar Athletes in Sports Illustrated
Authors: Woods Joshua , Hartwell Matthew
Published: March 2023

This study examined media representations of male superstar athletes over more than three decades. Some journalists portrayed their subjects as smart, physically attractive young men at the top of their games. Other writers emphasized their flaws and told stories of tarnished heroes. Based on an analysis of 140 references to sports stars in Sports Illustrated magazine articles, the results showed that favorable and unfavorable framing of athletes depended on their race/ethnicity, the dominance of their sport, and the historical context in which they played. Compared to white sports stars, racial minority athletes were more often portrayed with unfavorable frames, such as unintelligent, immoral, or lacking charm. Athletes from lesser-known sports were also more likely to be described with unfavorable frames than athletes from the four most dominant sports in the US (football, basketball, baseball, and hockey). Both favorable and unfavorable frames were more common in articles published in the most recent period (2013–2021) than in earlier decades (1987–2012), signaling an increasing interest among journalists in the personal qualities of sports stars. The study provides new empirical and theoretical insight on the relationships between three social antecedents—racism, hegemonic sport culture, and technological change—and the framing of superstar athletes.
Alzheimer’s Disease is a Disorder of Consciousness
Authors: Yokoi Teruo
Published: March 2023

The diagnostic criteria for Alzheimer’s disease (AD) described in DSM-5-TR, require a decline in memory and learning and in at least one other cognitive domain among six cognitive domains, and also interference with the activities of daily living (ADL) because of decline in these cognitive functions; as such, DSM-5-TR positions memory impairment as the core symptom of AD. DSM-5-TR shows the following examples of symptoms or observations regarding impairments in everyday activities in terms of learning and memory involving the six cognitive domains. Mild: Has difficulty recalling recent events, and relies increasingly on list making or calendar. Major: Repeats self in conversation, often within the same conversation. These examples of symptoms/observations demonstrate difficulties in recall, or difficulties in bringing memories into the consciousness. In the article, it is proposed that considering AD as a disorder of consciousness could promote a better understanding of the symptoms experienced by AD patients and contribute to devising methods to provide improved care to these patients.
Embodied geographies of environmental justice: Toward the sovereign right to wholly inhabit oneself
Authors: Gay-Antaki Miriam
Published: March 2023

I introduce insights from Latin America and across disciplines to advance our understanding of environmental injustices as written on women's bodies. This paper will entice environmental justice scholarship into conversation with geography to stress how embodied geographies of environmental justice are necessary to understand the geographical, gendered, sexualized, and racialized arrangement of environmental injustices. Expanding Environmental Justice to incorporate the body through Segato's understanding of cuerpo-territorio, a concept that blends geography, territory, and the body, we blur the lines between public and private—emphasizing the role of the state and global capitalism in the subjugation of women and people of color. By asking who reproduces, what is reproduced, and where, in environmental justice work, we underscore that environmental matters are reproductive, and the disproportionate embodied consequences of environmental injustices on sexualized, gendered, and racialized bodies. This violence against feminized bodies is explained as the unintended consequences of global capital accumulation, but decolonial, queer, Black, and feminist geographical insights show how these are central for capital accumulation. Attending to the body as an important geopolitical site allows us to articulate mundane, everyday instances of environmental justice and reproductive justice as geopolitically important. I propose that Embodied Geographies of Environmental Justice that center the concept of cuerpo-territorio underscore that the physical territory of both environmental justice and reproductive justice struggles is in racialized and feminized bodies. By bringing in feminist, Marxist, and postcolonial understandings of production and reproduction, I provide a framework that allows for a global and nuanced understanding of gendered geographies of violence, environmental, and reproductive justice. A reading of a Moraga poem toward the end of the paper, demands that we attend to women of color theorizing their own experiences in radical and innovative terms that resist and transform oppressive relations offering possibilities for renewal, regeneration, and healing.
Cytokine receptor IL27RA is an NF-κB–responsive gene involved in CD38 upregulation in multiple myeloma
Authors: Brownlie Rebecca J. , Kennedy Ruth , Wilson Erica B. , Milanovic Maja , Taylor Claire F. , Wang Dapeng , Davies John R. , Owston Heather , Adams Emma J. , Stephenson Sophie , Caeser Rebecca , Gewurz Benjamin E. , Giannoudis Peter V. , Scuoppo Claudio , McGonagle Dennis , Hodson Daniel J. , Tooze Reuben M. , Doody Gina M. , Cook Gordon , Westhead David R. , Klein Ulf
Published: March 2023

Multiple myeloma (MM) shows constitutive activation of canonical and noncanonical nuclear factor κB (NF-κB) signaling via genetic mutations or tumor microenvironment (TME) stimulations. A subset of MM cell lines showed dependency for cell growth and survival on the canonical NF-κB transcription factor RELA alone, suggesting a critical role for a RELA-mediated biological program in MM pathogenesis. Here, we determined the RELA-dependent transcriptional program in MM cell lines and found the expression of the cell surface molecules interleukin-27 receptor-α (IL-27Rα) and the adhesion molecule JAM2 to be responsive to RELA at the messenger RNA and protein levels. IL-27Rα and JAM2 were expressed on primary MM cells at higher levels than on healthy long-lived plasma cells (PCs) in the bone marrow. IL-27 activated STAT1, and to a lesser extent STAT3, in MM cell lines and in PCs generated from memory B cells in an IL-21–dependent in vitro PC differentiation assay. Concomitant activity of IL-21 and IL-27 enhanced differentiation into PCs and increased the cell-surface expression of the known STAT target gene CD38. In accordance, a subset of MM cell lines and primary MM cells cultured with IL-27 upregulated CD38 cell-surface expression, a finding with potential implications for enhancing the efficacy of CD38-directed monoclonal antibody therapies by increasing CD38 expression on tumor cells. The elevated expression of IL-27Rα and JAM2 on MM cells compared with that on healthy PCs may be exploited for the development of targeted therapeutic strategies that modulate the interaction of MM cells with the TME.
dbGaPCheckup: pre-submission checks of dbGaP-formatted subject phenotype files
Authors: Heinsberg Lacey W. , Weeks Daniel E.
Published: March 2023

Background

Data archiving and distribution are essential to scientific rigor and reproducibility of research. The National Center for Biotechnology Information’s Database of Genotypes and Phenotypes (dbGaP) is a public repository for scientific data sharing. To support curation of thousands of complex data sets, dbGaP has detailed submission instructions that investigators must follow when archiving their data.

Results

We developed dbGaPCheckup, an R package which implements a series of check, awareness, reporting, and utility functions to support data integrity and proper formatting of the subject phenotype data set and data dictionary prior to dbGaP submission. For example, as a tool, dbGaPCheckup ensures that the data dictionary contains all fields required by dbGaP, and additional fields required by dbGaPCheckup; the number and names of variables match between the data set and data dictionary; there are no duplicated variable names or descriptions; observed data values are not more extreme than the logical minimum and maximum values stated in the data dictionary; and more. The package also includes functions that implement a series of minor/scalable fixes when errors are detected (e.g., a function to reorder the variables in the data dictionary to match the order listed in the data set). Finally, we also include reporting functions that produce graphical and textual descriptives of the data to further reduce the likelihood of data integrity issues. The dbGaPCheckup R package is available on CRAN (https://CRAN.R-project.org/package=dbGaPCheckup) and developed on GitHub (https://github.com/lwheinsberg/dbGaPCheckup).

Conclusion

dbGaPCheckup is an innovative assistive and timesaving tool that fills an important gap for researchers by making dbGaP submission of large and complex data sets less error prone.
Patterns of home care and community support preferences among older adults with disabilities in China: a latent class analysis
Authors: Xiao Feng , Cao Songmei , Xiao Mingzhao , Xie Liling , Zhao Qinghua
Published: March 2023

Background

Ageing in place is the preferred choice for most older adults worldwide. The role of the family as a core care resource has diminished as a result of changes in family structure, thus extending the responsibility for caring for older adults from within the family to outside it and requiring considerably more support from society. However, there is a shortage of formal and qualified caregivers in many countries, and China has limited social care resources. Therefore, it is important to identify home care patterns and family preferences to provide effective social support and reduce government costs.

Methods

Data were obtained from the Chinese Longitudinal Healthy Longevity Study 2018. Latent class analysis models were estimated using Mplus 8.3. Multinomial logistic regression analysis was adopted to explore the influencing factors with the R3STEP method. Lanza’s method and the chi-square goodness-of-fit test were used to explore community support preferences among different categories of families of older adults with disabilities.

Results

Three latent classes were identified based on older adults with disabilities’ characteristics (degree of disability, demand satisfaction), caregivers’ characteristics (length of providing care, care performance) and living status: Class 1- mild disability and strong care (46.85%); Class 2- severe disability and strong care (43.92%); and Class 3- severe disability and incompetent care (9.24%). Physical performance, geographic region and economic conditions jointly influenced home care patterns (P < 0.05). Home visits from health professionals and health care education were the top two forms of community support that were most preferred by the older adults with disabilities’ families (residual > 0). Families in the Class 3 subgroup preferred personal care support more than those in the other two subgroups (P < 0.05).

Conclusion

Home care is heterogeneous across families. Older adults’ degrees of disability and care needs may be varied and complex. We classified different families into homogeneous subgroups to reveal differences in home care patterns. The findings can be used by decision-makers in their attempts to design long-term care arrangements for home care and to adjust the distribution of resources for the needs of older adults with disabilities.
Assessment of Autologous Blood marker localIzation and intraoperative coLonoscopy localIzation in laparoscopic colorecTal cancer surgery (ABILITY): a randomized controlled trial
Authors: Zhang Ke-hui , Li Jing-ze , Zhang Hai-bin , Hu Ren-hao , Cui Xi-mao , Du Tao , Zheng Liang , Zhang Shun , Song Chun , Xu Mei-dong , Jiang Xiao-hua
Published: March 2023

Background

Laparoscopic colorectal surgery has been proved to have similar oncological outcomes with open surgery. Due to the lack of tactile perception, surgeons may have misjudgments in laparoscopic colorectal surgery. Therefore, the accurate localization of a tumor before surgery is important, especially in the early stages of cancer. Autologous blood was thought a feasible and safe tattooing agent for preoperative endoscopic localization but its benefits remain controversial. We therefore proposed this randomized trial to the accuracy and safety of autogenous blood localization in small, serosa-negative lesion which will be resected by laparoscopic colectomy.

Methods

The current study is a single-center, open-label, non-inferiority, randomized controlled trial. Eligible participants would be aged 18–80 years and diagnosed with large lateral spreading tumors that could not be treated endoscopically, malignant polyps treated endoscopically that required additional colorectal resection, and serosa-negative malignant colorectal tumors (≤ cT3). A total of 220 patients would be randomly assigned (1:1) to autologous blood group or intraoperative colonoscopy group. The primary outcome is the localization accuracy. The secondary endpoint is adverse events related to endoscopic tattooing.

Discussion

This trial will investigate whether autologous blood marker achieves similar localization accuracy and safety in laparoscopic colorectal surgery compared to intraoperative colonoscopy. If our research hypothesis is statistically proved, the rational introduction of autologous blood tattooing in preoperative colonoscopy can help improve identification of the location of tumors for laparoscopic colorectal cancer surgery, performing an optimal resection, and minimizing unnecessary resections of normal tissues, thereby improving the patient’s quality of life. Our research data will also provide high quality clinical evidence and data support for the conduction of multicenter phase III clinical trials.

Trial registration

This study is registered with ClinicalTrials.gov, NCT05597384. Registered 28 October 2022
Diagnostic aid to subepidermal calcified nodule with dermoscopy and reflectance confocal microscopy: a case report
Authors: Zhu Xiaomei , Zhang Xiaoyan , Yang Kun
Published: March 2023

Background

Subepidermal calcified nodule (SCN) is a type of calcinosis cutis that usually occurs in children. The lesions in the SCN resemble those of other skin diseases, such as pilomatrixoma, molluscum contagiosum, and juvenile xanthogranuloma, leading to a high rate of misdiagnoses. Noninvasive in vivo imaging techniques, represented by dermoscopy and reflectance confocal microscopy (RCM), have dramatically accelerated skin cancer research over the past decade, and their applications have greatly expanded into other skin disorders. However, the features of an SCN in dermoscopy and RCM have yet to be reported previously. Combining these novel approaches with conventional histopathological examinations is a promising method for increasing diagnostic accuracy.

Case presentation

We report on a case of SCN of the eyelid diagnosed with the aid of dermoscopy and RCM. A 14-year-old male patient who presented with a painless yellowish-white papule on his left upper eyelid was previously diagnosed with a common wart. Unfortunately, treatment with recombinant human interferon gel was not effective. To achieve a correct diagnosis, dermoscopy and RCM were performed. The former showed closely grouped multiple yellowish-white clods surrounded by linear vessels, and the latter exhibited hyperrefractile material nests at the dermal–epidermal junction level. The alternative diagnoses were, therefore, excluded because of in vivo characterizations. Subsequent surgical excision, histological examination, and von Kossa staining were performed. Pathology showed hyperkeratosis of the epidermis, a downward-directed basal-layer expansion, and small amorphous basophilic deposits scattered throughout the papillary dermis. The von Kossa staining confirmed calcium deposits in the lesion. An SCN was then diagnosed. During the 6-month follow-up, no relapse was observed.

Conclusions

Patients with SCN could benefit from dermoscopy and RCM, which help achieve an accurate diagnosis. Clinicians should consider the possibility of an SCN for an adolescent patient with painless yellowish-white papules.
The advantages of domestic ear molding system in molding bilateral neonatal congenital auricular deformities
Authors: Li Jie , Tan Junlong , Yang Denghua , Chen Liyan
Published: March 2023

Background

There are different types of ear molding devices on the market. However, due to high cost, the wide application of the ear molding is hindered, especially for children with bilateral congenital auricular deformities (CAD). This study is designed to correct the bilateral CAD with the flexible use of Chinese domestic ear molding system.

Methods

Newborns diagnosed with bilateral CAD were recruited in our hospital from September 2020 to October 2021. For each subject, one ear wore a set of domestic ear molding system, while the contralateral ear used only matching Retractor and Antihelix Former. Medical charts were reviewed to collect data on the types of CAD, the incidence of complications, the initiation and duration of treatment, as well as the satisfaction after treatment. Treatment outcomes were graded into three levels: excellent, good, and poor, according to the improvement of auricular morphology evaluated by both doctors and parents, respectively.

Results

A total of 16 infants (32 ears) were treated with the Chinese domestic ear molding system, which contains 4 cases with Stahl’s ear (8 ears), 5 cases with Helical rim deformity (10 ears), 3 cases with Cup ear (6 ears), 4 cases with Lop ear (8 ears). All infants accomplished the correction completely. Both parents and doctors were satisfied with the outcomes. No obvious complication was observed.

Conclusions

Ear molding is an effective nonsurgical treatment for CAD. Molding with Retractor and Antihelix Former is simple and effective. Domestic ear molding system can be flexibly used in correcting bilateral CAD. With this approach, infants with bilateral CAD will benefit more in the near future.
Perceptions of friendship, peers and influence on adolescent smoking according to tobacco control context: a systematic review and meta-ethnography of qualitative research
Authors: Littlecott H. J. , Moore G. F. , Evans R. E. , Melendez-Torres G. J. , McCann M. , Reed H. , Mann M. , Dobbie F. , Jennings S. , Donaldson C. , Hawkins J.
Published: March 2023

Background

A relationship between smoking and interpersonal influences has been well established within the literature. There have been cultural shifts in denormalisation and a reduction in tobacco smoking in many countries. Hence there is a need to understand social influences on adolescents’ smoking across smoking normalisation contexts.

Methods

The search was conducted in July 2019 and updated in March 2022 within 11 databases and secondary sources. Search terms included schools, adolescents, smoking, peers, social norms and qualitative research. Screening was conducted by two researchers independently and in duplicate. Study quality was assessed using the eight-item Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-centre) tool for the appraisal of qualitative studies. Results were synthesised using a meta-narrative lens for meta-ethnography and compared across smoking normalisation contexts.

Results

Forty one studies were included and five themes were developed, mapping onto the socio ecological model. The social processes by which adolescents take up smoking differed according to a mixture of school type, peer group structure and the smoking culture within the school, as well as the wider cultural context. Data available from smoking denormalised contexts, described changes in social interactions around smoking to cope with its stigmatisation. This was manifested through i) direct peer influence, whereby subtle techniques were employed, ii) group belonging whereby smoking was less likely to be seen as a key determinant of group membership and smoking was less commonly reported to be used as a social tool, and iii) popularity and identity construction, whereby smoking was perceived more negatively in a denormalised context, compared with a normalised context.

Conclusions

This meta-ethnography is the first study to demonstrate, drawing on international data, that peer processes in adolescent smoking may undergo changes as smoking norms within society change. Future research should focus on understanding differences across socioeconomic contexts, to inform the adaptation of interventions.
High-pressure balloon dilatation of primary obstructive megaureter in children: a systematic review
Authors: Ripatti Liisi , Viljamaa Hanna-Reeta , Suihko Anna , Pakkasjärvi Niklas
Published: March 2023

Objective

We aimed to evaluate the effectiveness and complication rates of endoscopic high-pressure balloon dilatation (HPBD) in treating primary obstructive megaureter (POM) in children based on current literature. Specifically, we wanted to clarify the evidence on the use of HPBD in children under one year of age.

Methods

A systematic search of the literature was performed via several databases. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed. The primary outcomes studied in this systematic review were the effectiveness of HBPD in relieving obstruction and reducing hydroureteronephrosis in children. The secondary outcome was to study the complication rate of endoscopic high-pressure balloon dilatation. Studies that reported one or both of these outcomes (n = 13) were considered eligible for inclusion in this review.

Results

HPBD significantly decreased both ureteral diameter (15.8 mm [range 2–30] to 8.0 mm [0–30], p = 0.00009) and anteroposterior diameter of renal pelvis (16.7 mm [0–46] to 9.7 mm [0–36], p = 0.00107). The success rate was 71% after one HPBD and 79% after two HPBD. The median follow-up time was 3.6 years (interquartile range 2.2–6.4 years). A complication rate of 33% was observed, but no Clavien–Dindo grade IV–V complications were reported. Postoperative infections and VUR were detected in 12% and 7.8% of cases, respectively. For children under one year of age, outcomes of HPBD seem to be similar to those in older children.

Conclusions

This study indicates that HPBD appears to be safe and can be used as the first-line treatment for symptomatic POM. Further comparative studies are needed addressing the effect of treatment in infants, and also long-term outcomes of the treatment. Due to the nature of POM, identifying those patients who will benefit from HPBD remains challenging.
Under- and post-graduate training to manage the acutely unwell patient: a scoping review
Authors: Church Helen R. , Murdoch-Eaton Deborah , Sandars John
Published: March 2023

Background

Junior doctors are often the first responders to acutely unwell patients and yet frequently report feeling under-prepared to do so. To understand whether this is consequential of how medical students and doctors are trained to manage acutely unwell patients, a scoping review was conducted using a systematic approach.

Methods

The review, informed by the Arksey and O’Malley and PRISMA-ScR guidelines, identified educational interventions targeting the management of acutely unwell adults. Seven major literature databases were searched for journal articles published in English from 2005 to 2022, in addition to the Association of Medical Education in Europe (AMEE) conference proceedings from 2014 to 2022.

Results

Seventy-three articles and abstracts were eligible for the review, the majority of which were from the UK or USA, and demonstrated that educational interventions were more commonly targeted at medical students than qualified doctors. The majority of studies used simulation, but very few integrated complexities of the clinical environment within scenarios such as multidisciplinary working, distraction-handling techniques and other non-technical skills. A wide range of learning objectives pertaining to acute patient management were stated across studies, but few explicitly cited educational theory underpinning their study.

Conclusions

The results of this review encourages future educational initiatives to consider enhancing authenticity within simulation to promote transfer of learning to clinical practice, and use educational theory to augment the sharing of educational approaches within the community of clinical education practice. Additionally, increasing the focus on post-graduate learning, building upon undergraduate educational foundations, is essential to promoting lifelong learning within the ever-changing healthcare environment.
Widespread allele-specific topological domains in the human genome are not confined to imprinted gene clusters
Authors: Richer Stephen , Tian Yuan , Schoenfelder Stefan , Hurst Laurence , Murrell Adele , Pisignano Giuseppina
Published: March 2023

Background

There is widespread interest in the three-dimensional chromatin conformation of the genome and its impact on gene expression. However, these studies frequently do not consider parent-of-origin differences, such as genomic imprinting, which result in monoallelic expression. In addition, genome-wide allele-specific chromatin conformation associations have not been extensively explored. There are few accessible bioinformatic workflows for investigating allelic conformation differences and these require pre-phased haplotypes which are not widely available.

Results

We developed a bioinformatic pipeline, “HiCFlow,” that performs haplotype assembly and visualization of parental chromatin architecture. We benchmarked the pipeline using prototype haplotype phased Hi-C data from GM12878 cells at three disease-associated imprinted gene clusters. Using Region Capture Hi-C and Hi-C data from human cell lines (1-7HB2, IMR-90, and H1-hESCs), we can robustly identify the known stable allele-specific interactions at the IGF2-H19 locus. Other imprinted loci (DLK1 and SNRPN) are more variable and there is no “canonical imprinted 3D structure,” but we could detect allele-specific differences in A/B compartmentalization. Genome-wide, when topologically associating domains (TADs) are unbiasedly ranked according to their allele-specific contact frequencies, a set of allele-specific TADs could be defined. These occur in genomic regions of high sequence variation. In addition to imprinted genes, allele-specific TADs are also enriched for allele-specific expressed genes. We find loci that have not previously been identified as allele-specific expressed genes such as the bitter taste receptors (TAS2Rs).

Conclusions

This study highlights the widespread differences in chromatin conformation between heterozygous loci and provides a new framework for understanding allele-specific expressed genes.
SRTsim: spatial pattern preserving simulations for spatially resolved transcriptomics
Authors: Zhu Jiaqiang , Shang Lulu , Zhou Xiang
Published: March 2023

Spatially resolved transcriptomics (SRT)-specific computational methods are often developed, tested, validated, and evaluated in silico using simulated data. Unfortunately, existing simulated SRT data are often poorly documented, hard to reproduce, or unrealistic. Single-cell simulators are not directly applicable for SRT simulation as they cannot incorporate spatial information. We present SRTsim, an SRT-specific simulator for scalable, reproducible, and realistic SRT simulations. SRTsim not only maintains various expression characteristics of SRT data but also preserves spatial patterns. We illustrate the benefits of SRTsim in benchmarking methods for spatial clustering, spatial expression pattern detection, and cell-cell communication identification.
Loss of MLL3/4 decouples enhancer H3K4 monomethylation, H3K27 acetylation, and gene activation during embryonic stem cell differentiation
Authors: Boileau Ryan M. , Chen Kevin X. , Blelloch Robert
Published: March 2023

Background

Enhancers are essential in defining cell fates through the control of cell-type-specific gene expression. Enhancer activation is a multi-step process involving chromatin remodelers and histone modifiers including the monomethylation of H3K4 (H3K4me1) by MLL3 (KMT2C) and MLL4 (KMT2D). MLL3/4 are thought to be critical for enhancer activation and cognate gene expression including through the recruitment of acetyltransferases for H3K27.

Results

Here we test this model by evaluating the impact of MLL3/4 loss on chromatin and transcription during early differentiation of mouse embryonic stem cells. We find that MLL3/4 activity is required at most if not all sites that gain or lose H3K4me1 but is largely dispensable at sites that remain stably methylated during this transition. This requirement extends to H3K27 acetylation (H3K27ac) at most transitional sites. However, many sites gain H3K27ac independent of MLL3/4 or H3K4me1 including enhancers regulating key factors in early differentiation. Furthermore, despite the failure to gain active histone marks at thousands of enhancers, transcriptional activation of nearby genes is largely unaffected, thus uncoupling the regulation of these chromatin events from transcriptional changes during this transition. These data challenge current models of enhancer activation and imply distinct mechanisms between stable and dynamically changing enhancers.

Conclusions

Collectively, our study highlights gaps in knowledge about the steps and epistatic relationships of enzymes necessary for enhancer activation and cognate gene transcription.
Harmful and potentially harmful constituents (HPHCs) in two novel nicotine pouch products in comparison with regular smokeless tobacco products and pharmaceutical nicotine replacement therapy products (NRTs)
Authors: Back Susanne , Masser Anna E. , Rutqvist Lars E. , Lindholm Johan
Published: March 2023

Background

Tobacco-free nicotine pouches is a novel category of oral nicotine-delivery products. Among current tobacco users such pouches may serve as a low-risk alternative to cigarettes or conventional, tobacco-based oral products e.g., snus and moist snuff. In the United States (U.S.), the market leading nicotine-pouch brand is ZYN®. However, no data on the chemical characteristics of ZYN have been published.

Methods

We screened for 43 compounds potentially present in tobacco products in seven oral nicotine-delivery products: ZYN (dry and moist), snus (General®), moist snuff (CRP2.1 and Grizzly Pouches Wintergreen), and two pharmaceutical, nicotine replacement therapy products (NRTs, Nicorette® lozenge and Nicotinell® gum). Thirty-six of the tested compounds are classified as harmful and potentially harmful constituents (HPHCs) by the Center for Tobacco Products at the U.S. Food and Drug Administration (FDA-CTP). Five additional compounds were included to cover the GOTHIATEK® product standard for Swedish snus and the last two compounds were chosen to include the four primary tobacco specific nitrosamines (TSNAs).

Results

The tested products contained nicotine at varying levels. The two ZYN products contained no nitrosamines or polycyclic aromatic hydrocarbons (PAHs) but low levels of ammonia, chromium, formaldehyde, and nickel. In the NRT products we quantified low levels of acetaldehyde, ammonia, cadmium, chromium, lead, nickel, uranium-235, and uranium-238. The largest number (27) and generally the highest levels of HPHCs were quantified in the moist snuff products. For example, they contained six out of seven tested PAHs, and seven out of ten nitrosamines (including NNN and NNK). A total of 19 compounds, none of which were PAHs, were quantified at low levels in the snus product. NNN and NNK levels were five to 12-fold lower in snus compared to the moist snuff products.

Conclusions

No nitrosamines or PAHs were quantified in the ZYN and NRT products. Overall, the number of quantified HPHCs were similar between ZYN and NRT products and found at low levels.
The effect of diurnal light cycles on biohydrogen production in a thermosiphon photobioreactor
Authors: Bosman Catharine Elizabeth , van Wyk Petrie , Pott Robert William McClelland , Bradshaw Steven Martin
Published: March 2023

Hydrogen production via microbial photofermentation shows great promise as a method for sustainable hydrogen production; however, operating costs associated with photofermentative hydrogen production need to be reduced. Costs can be reduced using a passive circulation system like the thermosiphon photobioreactor, and by operating it under natural sunlight. In this study, an automated system was implemented to investigate the effect of diurnal light cycles on the hydrogen productivity and growth of Rhodopseudomonas palustris and on the operation of a thermosiphon photobioreactor, under controlled conditions. Diurnal light cycles, simulating daylight times, were found to reduce hydrogen production in the thermosiphon photobioreactor demonstrating a low maximum production rate of 0.015 mol m−3 h−1 (± 0.002 mol m−3 h−1) as compared to 0.180 mol m−3 h−1 (± 0.0003 mol m−3 h−1) under continuous illumination. Glycerol consumption as well as hydrogen yield also decreased under diurnal light cycles. Nonetheless, hydrogen production in a thermosiphon photobioreactor under outdoor conditions was demonstrated as possible avenue for further investigation.