bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐acting porcine ACTH stimulated salivary cortisol reduces the overdiagnosis of adrenal insufficiency compared to serum cortisol in cirrhosis liver
Authors: Karthik Vijayakumar , Jabbar Puthiyaveetil Khadar , Krishnadas Devadas , Nair Abilash , George Geena Susan , Jayakumari Chellamma , Soumya Sarayu , Asok Arsha , Basheer Shameer
Published: February 2024

Background

There are no reliable methods in clinical practice to diagnose adrenal insufficiency (AI) in patients with cirrhosis owing to variable cortisol‐binding protein levels. This leads to unreliable results in ACTH stimulated serum cortisol test. We aimed to estimate the long‐acting porcine (LA)ACTH‐stimulated serum and salivary cortisol levels of patients at different stages of cirrhosis using second generation electrochemiluminescence and to determine the prevalence of true adrenal insufficiency in these patients.

Design, Patients and Measurements

We included 135 noncritical patients with cirrhosis (45 each from CHILD A, B and C) and 45 healthy controls. Serum and salivary samples were collected at baseline in the morning and at 1 and 2 h after LA‐ACTH injection.

Results

In healthy subjects, the 2.5th centile of 2 h ACTH stimulated serum and salivary cortisol were 19.8 and 0.97 μg/dL, which were used as cut‐offs for defining AI based on serum and saliva respectively. The median (interquartile‐range) 2‐h stimulated salivary cortisol in Child A, B, C categories and controls were 1.36(1.23–2.38), 1.46(1.18–2.22), 1.72(1.2–2.2) and 2.12(1.42–2.72) μg/dL respectively. Six subjects (4.4%) were diagnosed to have AI based on stimulated salivary cortisol cut‐off, whereas 39 (28.9%) cirrhosis subjects had inadequately stimulated serum cortisol. Three patients (symptomatic) required steroid replacement therapy. Hypoalbuminemia was identified as a major risk factor for the misdiagnosis of adrenal insufficiency by serum cortisol‐based testing.

Conclusions

Long‐acting porcine ACTH stimulated salivary cortisol reduces the overdiagnosis of adrenal insufficiency compared to serum cortisol in cirrhosis liver. Stimulated salivary cortisol is a promising investigation for evaluation of adrenal function in cirrhosis and more studies are required for its further validation before clinical use.
Annexin A6 mitigates neurological deficit in ischemia/reperfusion injury by promoting synaptic plasticity
Authors: Wang Yilin , Yang Zhenhong , Wang Rongliang , Zheng Yangmin , Han Ziping , Fan Junfen , Yan Feng , Liu Ping , Luo Yumin
Published: February 2024

Aims

Alleviating neurological dysfunction caused by acute ischemic stroke (AIS) remains intractable. Given Annexin A6 (ANXA6)'s potential in promoting axon branching and repairing cell membranes, the study aimed to explore ANXA6's potential in alleviating AIS‐induced neurological dysfunction.

Methods

A mouse middle cerebral artery occlusion model was established. Brain and plasma ANXA6 levels were detected at different timepoints post ischemia/reperfusion (I/R). We overexpressed and down‐regulated brain ANXA6 and evaluated infarction volume, neurological function, and synaptic plasticity‐related proteins post I/R. Plasma ANXA6 levels were measured in patients with AIS and healthy controls, investigating ANXA6 expression's clinical significance.

Results

Brain ANXA6 levels initially decreased, gradually returning to normal post I/R; plasma ANXA6 levels showed an opposite trend. ANXA6 overexpression significantly decreased the modified neurological severity score (p = 0.0109) 1 day post I/R and the infarction area at 1 day (p = 0.0008) and 7 day (p = 0.0013) post I/R, and vice versa. ANXA6 positively influenced synaptic plasticity, upregulating synaptophysin (p = 0.006), myelin basic protein (p = 0.010), neuroligin (p = 0.078), and tropomyosin‐related kinase B (p = 0.150). Plasma ANXA6 levels were higher in patients with AIS (1.969 [1.228–3.086]) compared to healthy controls (1.249 [0.757–2.226]) (p < 0.001), that served as an independent risk factor for poor AIS outcomes (2.120 [1.563–3.023], p < 0.001).

Conclusions

This study is the first to suggest that ANXA6 enhances synaptic plasticity and protects against transient cerebral ischemia.
Increasing non‐cosmetic exposure and sensitization to isothiazolinones require action for prevention: Review
Authors: Lidén Carola , White Ian R.
Published: February 2024

Frequent use of methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI in cosmetic products has been the main cause of widespread sensitization and allergic contact dermatitis to these preservatives (biocides). Their use in non‐cosmetic products is also an important source of sensitization. Less is known about sensitization rates and use of benzisothiazolinone (BIT), octylisothiazolinone (OIT), and dichlorooctylisothiazolinone (DCOIT), which have never been permitted in cosmetic products in Europe. BIT and OIT have occasionally been routinely patch‐tested. These preservatives are often used together in chemical products and articles. In this study, we review the occurrence of contact allergy to MI, BIT, OIT, and DCOIT over time, based on concomitant patch testing in large studies, and case reports. We review EU legislations, and we discuss the role of industry, regulators, and dermatology in prevention of sensitization and protection of health. The frequency of contact allergy to MI, BIT, and OIT has increased. The frequency of contact allergy to DCOIT is not known because it has seldom been patch‐tested. Label information on isothiazolinones in chemical products and articles, irrespective of concentration, is required for assessment of relevance, information to patients, and avoidance of exposure and allergic contact dermatitis.
Long‐term outcomes after COVID‐19 infection in transplant recipients
Authors: Freels Kaitlyn L. , Saharia Kapil K. , Baddley John W. , Costa Nadiesda A. , Niederhaus Silke V.
Published: February 2024

Background

Long‐term outcomes after COVID‐19 infection unique to solid organ transplant recipients (SOTR) are not published. We describe outcomes including readmission, allograft rejection, allograft dysfunction, allograft failure, and death.

Methods

We conducted a retrospective cohort study of mostly unvaccinated SOTR with COVID‐19 from March 2020 to November 2021. Disease severity was assigned by NIH criteria. Data included demographics, clinical features, treatment, and outcomes and are presented as mean ± standard deviation or median (range).

Results

One hundred and thirty‐eight SOTR were diagnosed with COVID‐19 at a median of 5 (IQR 3–8) years post‐transplant with a mean age of 57 ± 12 years at diagnosis. Forty‐one recovered at home; 97 were admitted. 12/32 (37.5%) SOTR with critical disease expired during initial admission. Among those who recovered, 48/126 (38.0%) had asymptomatic or mild infection, 31/126 (24.6%) had moderate, 27/126 (21.4%) severe, and 20/126 (15.9%) critical infection. 38/85 (44.7%) of SOTR who survived initial admission had 74 readmissions within 180 days (Figure 1). The 6‐month mortality rate among those who survived infection was 4/126 (3.2%). The mean time from initial infection to death was 32 ± 66 days in inpatient deaths and 95 ± 39 days in those who were discharged or never admitted. Six‐month graft dysfunction occurred in 18/125 (14.4%) and graft failure in 9/126 (7.2%); five failures were deaths with function.

Conclusion

Readmissions after COVID‐19 infection were frequent after the index admission. Rejection was relatively infrequent; graft dysfunction at 6 months post‐infection was more common than rejection. Six‐month mortality following COVID‐19 recovery in SOTR was significant; close follow‐up of patients is warranted.
The effect of genetic variants in the transcription factor TSPYL family on the CYP3A4 mediated cyclosporine metabolism in kidney transplant patients
Authors: Zhai Qinglian , Moes Dirk Jan A. R. , van Gelder Teun , van der Lee Maaike , Sanders Jan‐Stephan , Bemelman Frederike J. , de Fijter Johan W. , Klein Kathrin , Schwab Matthias , Swen Jesse J.
Published: February 2024

CYP3A4 activity shows considerable interindividual variability. Although studies indicate 60%–80% is heritable, common single nucleotide variants (SNVs) in CYP3A4 together only explain ~10%. Transcriptional factors, such as the testis‐specific Y‐encoded‐like proteins (TSPYLs) family, have been reported to regulate the expression of CYP enzymes including CYP3A4 in vitro. Here, we investigated the effect of genetic variants in TSPYL on CYP3A4 activity using data from a clinical study and a human liver bank. Five SNVs (rs3828743, rs10223646, rs6909133, rs1204807, and rs1204811) in TSPYL were selected because of a reported effect on CYP3A4 expression in vitro or suggested clinical effect. For the clinical study, whole blood concentrations, clinical data, and DNA were available from 295 kidney transplant recipients participating in the prospective MECANO study. A multivariate pharmacokinetic model adjusted for body weight, steroid treatment, and CYP3A4 genotype was used to assess the effect of the genetic variants on cyclosporine clearance. In multivariate analysis, homozygous carriers of rs3828743 had a 18% lower cyclosporin clearance compared to the wild‐type and heterozygous patients (28.72 vs. 35.03 L/h, p = 0.018) indicating a lower CYP3A4 activity and an opposite direction of effect compared to the previously reported increased CYP3A4 expression. To validate, we tested associations between rs3828743 and CYP3A4 mRNA and protein expression as well as enzyme activity with data from a liver bank (n = 150). No association with any of these end points was observed. In conclusion, the totality of evidence is not in support of a significant role for TSPYL SNV rs3828743 in explaining variability in CYP3A4 activity.
Using a wearable patch to develop a digital monitoring biomarker of inflammation in response to LPS challenge
Authors: Avey Stefan , Chatterjee Meenakshi , Manyakov Nikolay V. , Cooper Philip , Sabins Nina , Mosca Kenneth , Mori Simone , Baribaud Frédéric , Morris Mark , Lehar Joseph , Deiteren Annemie , Cossu Marta , Smets Sophie , Huizer Tanja , Lamousé‐Smith Esi , Campbell Kim , Pandis Ioannis
Published: February 2024

Remote inflammation monitoring with digital health technologies (DHTs) would provide valuable information for both clinical research and care. Controlled perturbations of the immune system may reveal physiological signatures which could be used to develop a digital biomarker of inflammatory state. In this study, molecular and physiological profiling was performed following an in vivo lipopolysaccharide (LPS) challenge to develop a digital biomarker of inflammation. Ten healthy volunteers received an intravenous LPS challenge and were monitored for 24 h using the VitalConnect VitalPatch (VitalPatch). VitalPatch measurements included heart rate (HR), heart rate variability (HRV), respiratory rate (RR), and skin temperature (TEMP). Conventional episodic inpatient vital signs and serum proteins were measured pre‐ and post‐LPS challenge. The VitalPatch provided vital signs that were comparable to conventional methods for assessing HR, RR, and TEMP. A pronounced increase was observed in HR, RR, and TEMP as well as a decrease in HRV 1–4 h post‐LPS challenge. The ordering of participants by magnitude of inflammatory cytokine response 2 h post‐LPS challenge was consistent with ordering of participants by change from baseline in vital signs when measured by VitalPatch (r = 0.73) but not when measured by conventional methods (r = −0.04). A machine learning model trained on VitalPatch data predicted change from baseline in inflammatory protein response (R2 = 0.67). DHTs, such as VitalPatch, can improve upon existing episodic measurements of vital signs by enabling continuous sensing and have the potential for future use as tools to remotely monitor inflammation.
Elastofibromatous changes in giant cell fibroma and amalgam tattoo: Unusual findings in common oral lesions
Authors: Silva Evânio Vilela , Martins Karina Helen , Reyes Magdalena Raquel Torres , da Silva Anderson Tangerino Ferreira , Dominguete Matheus Henrique Lopes , Ferreira Antônio Carlos , León Jorge Esquiche
Published: February 2024

Several cases of elastofibromatous lesion affecting the oral mucosa have been reported. Clinically, these lesions may appear as small exophytic lesions or less often as white lesions. Therefore, fibrous hyperplasia and leukoplakia are not uncommonly considered in clinical differential diagnosis. Microscopically, elastic and fibrous connective tissue deposition is seen. Rarely, elastofibromatous changes can be detected when assessing intraoral lesions, including cysts, salivary gland neoplasms, and epithelial dysplasia. Here we report two oral lesions showing elastofibromatous changes, expanding their clinicopathological spectrum. The first case was a 46‐year‐old man with a history of asymptomatic nodular lesion on the palate 1 year ago, diagnosed as giant cell fibroma with elastofibromatous changes. The second case was a 79‐year‐old woman who presented a pigmented and mildly symptomatic lesion on the mandibular alveolar mucosa several months ago, diagnosed as amalgam tattoo associated with elastofibromatous changes.
The fatigue crack growth behavior of hydrogenated 9Cr‐1Mo steel: An experimental and numerical study
Authors: Bharati Mahesh , Maity Rathin , Singh Akhilendra , Paul Surajit Kumar
Published: February 2024

This research investigates the fatigue crack evolution in P91 steel through experiments and extended finite element method (XFEM) simulation for as‐received and hydrogenated conditions. Hydrogen pre‐charging is performed using a constant current electrochemical method in 1 M sulfuric acid solution. The study compares the experimental fatigue crack growth rate (FCGR) of hydrogenated and as‐received conditions and employs an XFEM simulation to replicate FCGR. The results of the experiments reveal an increased FCGR in hydrogenated specimens. Fracture surface analysis confirms the co‐occurrence of the “hydrogen‐enhanced localized plasticity” (HELP) and “hydrogen‐enhanced decohesion” (HEDE) mechanism (HELP+HEDE, HEDE>HELP). The simulation results closely align with the experimental findings, validating the model's accuracy. Consequently, these findings are the basis for proposing a damage tolerance approach‐based numerical algorithm. This algorithm allows the prediction of component integrity by considering a known crack length. Furthermore, fracture toughness (KIQ) was experimentally evaluated to enhance the understanding of the material's mechanical properties.
Feeding ecology of two reef‐associated snappers (Lutjanus fulviflamma and L. fulvus): Influence of lunar phase on feeding activity
Authors: Shimose Tamaki
Published: February 2024

The lunar phase is known to influence the spawning activity of some Lutjanus snappers, however, information on its influence on feeding activity is limited. In the present study, diet, feeding habit, and lunar periodicity of feeding activity on two reef‐associated sympatric snappers, blackspot snapper Lutjanus fulviflamma (n = 339) and blacktail snapper L. fulvus (n = 172), were investigated by stomach content analyses in the Yaeyama region (24°N, 124°E), southern Japan. Diets of the two snappers were similar and mainly consumed fishes, crabs, and shrimps. Relative volume of the stomach contents to body weight was compared by season, lunar day, and predator size using a generalized linear model. Larger individuals fed on larger fish prey and tended to show higher stomach fullness for both snappers. Periodic regression revealed that the lunar periodicity of the feeding activity is different between the two Lutjanus snappers. The feeding activity of L. fulviflamma increased around the spring tides of both new and full moons during a single lunar cycle. On the other hand, the feeding activity of L. fulvus increased only before the new moon but decreased before the full moon. Spawning of L. fulvus is known to occur only around the full moon, and enlarged gonads are considered to suppress the feeding activity of the species. Individuals with much stomach contents did not have large gonads for both snappers, and this supports the above supposition. Spawning and feeding activities are closely linked and simultaneous temporal analysis will enable a clearer understanding of the ecological role of these predators.
Geographies of inland waterscapes: Thinking with watery places
Authors: Visentin Francesco , Kaaristo Maarja
Published: February 2024

Humans and water have a complex relationship that includes various dimensions such as sociocultural, political, legal and ecological. Considering the ubiquity of water, we need a more holistic perspective to help us see water not as a static entity but rather as one in constant movement, physically and conceptually; acknowledging the interplay between water and humans is essential to understanding societal narratives deeply embedded in places. In this special section, an interdisciplinary group of scholars explore inland waters, taking a water‐centric view instead of a land‐centric one. The special section delves into the emerging hydro‐social connections, diverse forms of expertise, governance models, collective and spontaneous actions, and resilience strategies within the context of inland water bodies, exploring how canals, rivers and wetlands are experienced and represented as places. The papers in this collection show that any form of placemaking should take responsible stewardship of water, embrace its dynamic nature, and present a realistic pathway towards sustainable solutions for present and future water challenges.
Helicobacter pylori antigens as immunomodulators of immune system
Authors: Marzhoseyni Zeynab , Mousavi Mohammad Javad , Ghotloo Somayeh
Published: February 2024

Helicobacter pylori (H. pylori) is one of the most prevalent human pathogens and the leading cause of chronic infection in almost half of the population in the world (~59%). The bacterium is a major leading cause of chronic gastritis, gastric and duodenal ulcers, and two type of malignancies, gastric adenocarcinoma and mucosa‐associated lymphoid tissue (MALT) lymphoma. Despite the immune responses mounted by the host, the bacteria are not cleared from the body resulting in a chronic infection accompanied by a chronic inflammation. Herein, a review of the literature discussing H. pylori antigens modulating the immune responses is presented. The mechanisms that are involved in the modulation of innate immune response, include modulation of recognition by pattern recognition receptors (PRRs) such as modulation of recognition by toll like receptors (TLR)4 and TLR5, modulation of phagocytic function, and modulation of phagocytic killing mediated by reactive oxygen species (ROS) and nitric oxide (NO). On the other hands, H. pylori modulates acquired immune response by the induction of tolerogenic dendritic cells (DCs), modulation of apoptosis, induction of regulatory T cells, modulation of T helper (Th)1 response, and modulation of Th17 response.
Gender mainstreaming in the Japan Self‐Defense Forces
Authors: Kawano Hitoshi
Published: February 2024

The issue of “gender integration” within the military organization has long been a major research topic in military sociology. In the last two decades, however, specific topics such as “gender mainstreaming,” “diversity management,” and “diversity and inclusion” have pervaded sociological studies on military organizations. In this article, I examine the current state of gender integration in the Japan Self‐Defense Forces (JSDF), focusing on efforts to promote gender mainstreaming. In particular, following the National Action Plan to implement the United Nations Security Council Resolution 1325 was formulated in 2015, the Ministry of Defense issued the JSDF Female Personnel Empowerment Initiative in 2017, in which previous challenges for career development of female SDF personnel were to be removed by making virtually all job categories available for women including combat pilot, missile boat crew, and tank driver. While the number and ratio of female personnel have increased and their prospects of career development have substantially improved in the last few years, work–life conflict and sexual/power harassment remain to be challenging issues for the retention of female personnel. Due to the deep‐rooted male‐dominant organizational culture of the military organization, further organizational challenges remain for JSDF to shift its overarching human resource management paradigm from “Diversity 1.0” to “Diversity 2.0,” with the strong commitment of top leaders to innovate organizational culture.
Impact of problematic mobile phone use among nursing students in India: Exploring associations with depression, insomnia, self‐esteem and satisfaction with life
Authors: Jose Sinu , Cyriac Maneesha C. , Sebastian Sherin , Lidiyamol P. V. , Dhandapani Manju
Published: February 2024

Aim

This research aimed to determine the impact of problematic mobile phone use on negative mental health outcomes among nursing students in India, highlighting the necessity for targeted interventions and support mechanisms to enhance the overall well‐being and adaptability of future healthcare professionals.

Methods

A cross‐sectional survey was conducted in three randomly selected nursing colleges in South India, employing validated and standardized tools such as the Mobile Phone Problematic Use Scale, Patient Health Questionnaire, Insomnia Severity Index Scale, Satisfaction with Life Scale and Rosenberg Self‐Esteem Scale.

Results

The study included 402 nursing students with an average age of 20.47 years, revealing a 39% prevalence of severe problematic mobile phone usage. Positive correlations were observed between mobile phone problematic use and age, depression and insomnia. Additionally, strong negative correlations were found between satisfaction with life and self‐esteem. Depression and satisfaction with life served as chain mediators in the impact of self‐esteem on problematic mobile phone use, and both self‐esteem and satisfaction with life negatively predicted problematic mobile phone use.

Conclusion

The study highlights a prevalent issue of problematic mobile phone use among nursing students, indicating a pressing need for timely intervention, as it correlates with depression, sleep insomnia, low self‐esteem and life dissatisfaction.
Chromogranin A as a diagnostic marker of pheochromocytoma and paraganglioma: A systematic review and meta‐analysis
Authors: Xing Yanbo , Shi Haoying , Guo Qiang , Wang Cong , Li Chengyong , Hao Chuan
Published: February 2024

Objectives

This work aims to assess the diagnostic value of chromogranin A (CgA) in the laboratory diagnosis of neuroendocrine tumors classified as pheochromocytoma and paraganglioma (PPGL).

Methods

A comprehensive search was performed in PubMed, Embase, the Cochrane Library, and Web of Science databases to obtain relevant studies reporting the diagnostic accuracy of CgA in patients with PPGL. The search involved studies written in English between the time of library inception and May 1, 2023. We computed the pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Additionally, the receiver operating characteristic curve and area under the curve (AUC) were determined. The heterogeneity was assessed using the Chi‐square test and the I2 test. The subgroup analyses were performed to investigate the origins of heterogeneity. Stata 15.1 statistical software was used in all data analyses.

Results

This meta‐analysis included 13 studies involving 1470 patients. CgA had a pooled diagnostic sensitivity of 0.86 (95% CI 0.81–0.91), a specificity of 0.90 (95% CI 0.81–0.95), and a DOR of 57 (95% CI 23–142). CgA had an AUC of 0.93. The studies did not reveal any threshold effect (r = −0.165; p > 0.05). The subgroup analyses revealed that the control group category and the detection method caused the overall heterogeneity.

Conclusions

Our study suggests that CgA is a helpful PPGL biomarker. However, relying solely on CgA for diagnosis is not advisable. A comprehensive approach is essential for accurate diagnosis. Future large‐scale research is needed to refine CgA's clinical application.
New spinel‐structured high‐entropy oxides with high‐ and stable‐infrared radiation properties
Authors: Wan Qifa , Zhang Faming , Xiong Yifeng
Published: February 2024

Spinel‐structured high‐entropy oxides (HEOs), the novel materials, have recently attracted great attention for their unexpected properties and extensive applications. In this work, employing a facile scalability process of solid‐state reaction method, we synthesized a new kind of non‐equimolar (Co2/11Mn2/11Fe2/11Cr2/11Ni2/11Cu1/11)3O4 HEOs powder. However, under the same condition, the raw mixed oxide powders, with equimolar cations and higher configuration entropy, cannot form single‐phase HEOs powder but with the mixture of (Co,Mn,Fe,Cr,Ni,Cu)3O4 and residual CuO powders, ruling out the crucial role of entropy effect in forming single‐phase spinel‐structured HEOs. In addition to (Co2/11Mn2/11Fe2/11Cr2/11Ni2/11Cu1/11)3O4 powder, various (Co,Mn,Fe,Cr,Ni,Cu)3O4 HEOs powders can be obtained by controlling the Cu cation content in an appropriate range. To explore the application of the spinel‐structured HEOs in high‐temperature infrared field, the infrared radiation properties of the (Co2/11Mn2/11Fe2/11Cr2/11Ni2/11Cu1/11)3O4 powder were evaluated and exhibited a high‐infrared radiation emissivity of 0.880 in the near‐infrared wavelength range (0.78–2.5 µm) and superior thermal stability. Notably, the infrared radiation emissivity of the HEOs powder was maintained at 0.855 with a slight loss of 2.8% after high‐temperature treatment. This work not only provides a valuable strategy for fabricating high‐ and stable‐infrared radiation properties materials but also expands the great potential application of spinel‐structured HEOs to high‐temperature infrared field, such as energy saving in industrial high‐temperature furnaces.
Who is at risk? Adults with intellectual disability at risk of admission to mental health inpatient care
Authors: Durand Marianne , Nathan Rajan , Holt Sophie , Nall‐Evans Sharleen , Woodrow Ceri
Published: February 2024

Background

NHS England's Transforming Care agenda aims to reduce the number of adults with intellectual disabilities and autistic adults in mental health hospitals. The aim was to understand the demographic and clinical characteristics of those most at risk of admission.

Method

A cohort, retrospective study of adults using community intellectual disability services in the North West of England from 2018 to 2022 was undertaken.

Results

We compared 211 adults at imminent risk of admission to a mental health hospital and 249 at significant (but not imminent) risk on a validated risk stratification tool. Individuals at significant risk were more likely to have moderate intellectual disability. Individuals at imminent risk were more likely to have diagnoses of mild intellectual disability, autism, personality disorder, or psychosis.

Conclusion

By furthering our understanding of the clinical characteristics of those most at risk of admission, the findings inform more appropriate targeting of resources.
A numerical assessment to select the optimal geometry of a specific cyclone separator of wheat flour processing
Authors: Emami Faezeh , Rostampour Vahid , Rezvanivand Fanaei Adel , Feyzollahzadeh Maziar , Qarachoboogh Ayoub Fatollahi
Published: February 2024

In this study, the effect of the cyclone body height on the flow field within the specific cyclone and also on the performance parameters of the cyclone has been investigated. The five heights of the cyclone as various configurations were I = 600, II = 675, III = 750, IV = 825, and V = 900 mm. A pressure‐based solver was used and the turbulent Reynolds stress model was utilized to simulate the flow. Then, the Lagrangian discrete phase model was used to simulate the solid phase. As the height of the cyclone increases, the pressure drop decreases. Also, the best separation efficiency and the highest particle velocity value were achieved at a height of 750 mm. The maximum values of turbulence intensity, skin friction coefficient, and strain rate were obtained as negative components of cyclone performance at the cyclone body height of 900 mm. The height of 750 mm was recognized as the best height of the cyclone's body.

Practical Applications

Applying numerical simulation in food processing is a novel method to minimize equipment construction and reach a high‐accuracy design. Computational fluid dynamics can provide an accurate and detailed flow analysis in the cyclone separators utilized in the flour processing plant. The dimensional analysis can help the researchers to achieve the optimum design and enhance the cyclone performance by reducing pressure drop and increasing separation efficiency. Also, the maintenance cost would be significantly reduced due to detecting the critical sections and strengthening them.
Pressurized liquid extraction of soybean oil using intermittent process with ethanol and hexane as solvent: Extraction yield and physicochemical parameters comparison
Authors: Ramos Paulo Rodolfo , Vicentini‐Polette Carolina Medeiros , Mazalli Mônica Roberta , de Lima Caneppele Fernando , de Oliveira Alessandra Lopes
Published: February 2024

This research demonstrates pressurized liquid extraction (PLE) in an intermittent process in obtaining soybean oil using less solvent than conventional extraction. Temperature (T), solvent rinse volume (VS), contact time between the solvent and the matrix (St) in each cycle and number of cycles (C) were screened. Yield, fatty acids profile (FAs), and triacylglycerols were evaluated. After preliminary testing, T and St were tested for yield while VS, C, and P were fixed at 60% of total volume of the fixed bed extractor, 3 cycles, and 10.34 MPa respectively. The highest oil recoveries were 94.40% (85°C, 13 min, with hexane) and 86.16% (80°C, 12 min, with ethanol). The mass ratio of solvent/feeds resulted in a yield increase of 1.47% (hexane) and 3.99% (ethanol). The concentration of β‐sitosterol (≤182.78 mg/100 g of oil, hexane; ≤71.64 mg/100 g of oil, ethanol) and the fatty acid profile were not affected by the different solvents or process. The main fatty acids were linoleic (≤51.12%, ethanol; ≤40.31%, hexane) and oleic (≤24.98%, ethanol; ≤26.62%, hexane). The main triacylglycerols identified were LLO, LLL, and OOL. The results indicate that soybean oil can be obtained by a new process that uses a safe and renewable solvent, indicating that PLE in an intermittent process can replace conventional extraction without changing the main characteristics of the oil, with good yield using less solvent.

Practical applications

The practical application of this research is related to the possibility of demonstrating the feasibility of PLE in obtaining soybean oil using pressurized ethanol. The solvent used in most oilseed extraction plants is commercial hexane, a toxic and non‐renewable solvent. The experiments were carried out with pressurized hexane to demonstrate the economy of solvents and compare with the results obtained when pressurized ethanol was used as a solvent. The ethanol study aimed to show high extraction yields, even using a polar solvent in soybean oil extraction. High yields and oil characterization showed that it is possible to use a green and clean technology to obtain vegetable oils.
Novice nurses' transition shock and professional identity: The chain mediating roles of self‐efficacy and resilience
Authors: Li Yan Ran , Liu Jing Ya , Fang Yuan , Shen Xin , Li Shu Wen
Published: February 2024

Aims and Objectives

The aim of this study was to explore the association between transition shocks and professional identity and the mediating roles of self‐efficacy and resilience among Chinese novice nurses.

Background

Novice nurses experience transition shock when they start their careers, which might lead to decreased professional identity and ultimately turnover. By contrast, self‐efficacy and resilience are excellent psychological resources that may be associated with higher professional identity. It is unclear how transition shock affects professional identity by influencing these two internal resources.

Design

A cross‐sectional survey.

Methods

The STROBE guidelines were followed to report this study. Convenience sampling was used to recruit participants, and 252 novice nurses completed the Transition Shock of Novice Nurses Scale, the Professional Identity Assessment Scale, the General Self‐Efficacy Scale and the Connor‐Davidson Resilience Scale between April 2022 and May 2022. Influencing factors were primarily identified using independent‐sample t‐tests and a one‐way ANOVA. Structural equation modelling was used to detect the mediating effects of self‐efficacy and resilience.

Results

Differences in novice nurses' levels of professional identity were found across age groups, hospitals and departments. Transition shock was negatively related to professional identity. Self‐efficacy and resilience mediated the complete chain relationship between transition shock and professional identity.

Conclusion

To our knowledge, this study is the first to explore the mediating effect of self‐efficacy and resilience on transition shock and professional identity. Higher transition shock may lead to lower professional identity by reducing self‐efficacy and resilience.

Relevance to Clinical Practice

Nursing managers ought to emphasise the significant role of psychological resources in the work adaptation process of novice nurses. It may be more effective to improve professional identity and maintain the stability of the health care system.

Patient or Public Contribution

Nursing administrators working at seven preselected hospitals actively assisted us in the process of collecting self‐report questionnaires from novice nurses, such as by booking appointments and providing access for questionnaire administration. In addition, the participants were actively involved in the data collection process.
Educational interventions and identification of risk factors to prevent and reduce peritonitis in peritoneal dialysis: A scoping review
Authors: Fernàndez Labadía Elena , Masot Olga , Tejero Vidal Lorena Lourdes , Botigué Teresa , Bielsa‐Gracia Sara
Published: February 2024

Background

Peritonitis is a common and serious complication of peritoneal dialysis and is one of the main causes of peritoneal dialysis technique failure and long‐term hemodialysis conversion.

Objectives

The aim of the review was to identify and clarify peritonitis risk factors and learn about strategies employed at international level to prevent and reduce the occurrence of peritoneal dialysis associated infections and their complications.

Design

A scoping review.

Participants

Adults in pertitoneal dialysis.

Measurements

The methodology framework of Arksey and O'Malley and PRISMA for Scoping Reviews guidelines were applied. A search was conducted of PubMed, Scopus and CINAHL using terms to identify peritoneal dialysis ‐associated risk factors and interventions carried out for the prevention and reduction of peritonitis in adult persons living at home.

Results

The 17 studies selected were based on work carried out in nine different countries. Eleven articles analysed modifiable risk factors (low educational level, being a foreigner and low adherence to aseptic technique) and non‐modifiable risk factors (age and comorbidities) that predispose to peritonitis in peritoneal dialysis. The other six studies applied an intervention to improve the prevalence of peritonitis considering educational practices adapted to patient characteristics and the application of retraining.

Conclusions

Personalised patient training and the identification of risk factors for peritonitis are key to reducing complications and enhancing the survival of peritoneal dialysis patients and the effectiveness of the technique.
Rural–urban disparities in health care delivery for children with medical complexity and moderating effects of payer, disability, and community poverty
Authors: Arakelyan Mary , Freyleue Seneca D. , Schaefer Andrew P. , Austin Andrea M. , Moen Erika L. , O'Malley A. James , Goodman David C. , Leyenaar JoAnna K.
Published: February 2024

Purpose

Children with medical complexity (CMC) may be at increased risk of rural–urban disparities in health care delivery given their multifaceted health care needs, but these disparities are poorly understood. This study evaluated rural–urban disparities in health care delivery to CMC and determined whether Medicaid coverage, co‐occurring disability, and community poverty modified the effects of rurality on care delivery.

Methods

This retrospective cohort study of 2012–2017 all‐payer claims data from Colorado, Massachusetts, and New Hampshire included CMC <18 years. Health care delivery measures (ambulatory clinic visits, emergency department visits, acute care hospitalizations, total hospital days, and receipt of post‐acute care) were compared for rural‐ versus urban‐residing CMC in multivariable regression models, following established methods to evaluate effect modification.

Findings

Of 112,475 CMC, 7307 (6.5%) were rural residing and 105,168 (93.5%) were urban residing. A total of 68.9% had Medicaid coverage, 33.9% had a disability, and 39.7% lived in communities with >20% child poverty. In adjusted analyses, rural‐residing CMC received significantly fewer ambulatory visits (risk ratio [RR] = 0.95, 95% confidence interval [CI]: 0.94–0.96), more emergency visits (RR = 1.12, 95% CI: 1.08–1.16), and fewer hospitalization days (RR = 0.90, 95% CI = 0.85–0.96). The estimated modification effects of rural residence by Medicaid coverage, disability, and community poverty were each statistically significant. Differences in the odds of having a hospitalization and receiving post‐acute care did not persist after incorporating sociodemographic and clinical characteristics and interaction effects.

Conclusions

Rural‐ and urban‐residing CMC differed in their receipt of health care, and Medicaid coverage, co‐occurring disabilities, and community poverty modified several of these effects. These modifying effects should be considered in clinical and policy initiatives to ensure that such initiatives do not widen rural–urban disparities.
Pharmacologic interventions for the treatment of equine herpesvirus‐1 in domesticated horses: A systematic review
Authors: Goehring Lutz , Dorman David C. , Osterrieder Klaus , Burgess Brandy A. , Dougherty Kelsie , Gross Peggy , Neinast Claire , Pusterla Nicola , Soboll‐Hussey Gisela , Lunn David P.
Published: February 2024

Background

Equine herpes virus type 1 (EHV‐1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death.

Review Question

Does pharmacological therapy decrease either the incidence or severity of disease or infection caused by EHV‐1 in domesticated horses?

Methods

A systematic review was preformed searching AGRICOLA, CAB Abstracts, Cochrane, PubMed, Web of Science, and WHO Global Health Index Medicus Regional Databases to identify articles published before February 15, 2021. Selection criteria were original research reports published in peer reviewed journals, and studies investigating in vivo use of therapeutic agents for prevention or treatment of EHV‐1 in horses. Outcomes assessed included measures related to clinical outcomes that reflect symptomatic EHV‐1 infection or virus infection. We evaluated risk of bias and performed a GRADE evaluation of the quality of evidence for interventions.

Results

A total of 7009 unique studies were identified, of which 9 met the inclusion criteria. Two studies evaluated valacyclovir or small interfering RNAs, and single studies evaluated the use of a Parapoxvirus ovis‐based immunomodulator, human alpha interferon, an herbal supplement, a cytosine analog, and heparin. The level of evidence ranged between randomized controlled studies and observational trials. The risk of bias was moderate to high and sample sizes were small. Most studies reported either no benefit or minimal efficacy of the intervention tested.

Conclusions and Clinical Importance

Our review indicates minimal or limited benefit either as a prophylactic or post‐exposure treatment for any of the studied interventions in the mitigation of EHV‐1‐associated disease outcome.
Associations between breastfeeding duration and adherence to complementary feeding recommendations in Scotland
Authors: Garcia Ada L. , Huang Jiali , Wright Charlotte M.
Published: February 2024

We aimed to describe how breastfeeding relates to adherence to complementary feeding (CF) recommendations, diet diversification and feeding skills development and whether sociodemographic factors explain any differences observed. The Scottish Maternal Infant and Nutrition Survey for infants aged 8–12 months collected breastfeeding history, CF practices, diet and sociodemographic data using a self‐completion questionnaire. Non‐healthful CF practices were starting CF < 6 months, any consumption of sugar‐sweetened beverages (SSBs), sweet or salty snacks (treats) or unmodified cow's milk and regular consumption of commercial baby foods. Diet diversification and feeding skills were assessed by amount of self‐feeding and number of food groups, meals and snacks eaten daily. Of the 2730 mothers, 20% were solely infant formula fed (IFF) and 48% continued breastfeeding ≥6 months. Compared to IFF babies, mothers who gave any breast milk ≥6 months were more likely to start CF ≥ 6 months compared to those IFF (66% vs. 37%) and less likely to give treats (15% vs. 45%), SSBs (11% vs. 20%) and commercial baby foods (31% vs. 53%). These associations remained highly significant (p < 0.001) even after sociodemographic factor adjustment. Despite starting CF later, infants breastfed ≥6 months ate the same number of food groups and meals as those IFF, were just as likely to self‐feed purees and more likely to self‐feed finger foods daily (87% vs. 81% p < 0.001). Mothers who breastfeed beyond 6 months adhere more to CF recommendations and start CF later compared to IFF, but their babies eat a similarly diverse diet and have similar feeding skills.
Pain intensity and self‐perceived burden mediate the relationship between family functioning and pain catastrophizing in patients with neuropathic pain
Authors: Fang Yu , Liu Mengjie , Wu Min , Liu Mengshi , Niu Tianchen , Zhang Xiaoman
Published: February 2024

This cross‐sectional study aimed to investigate the relationship between family functioning, pain intensity, self‐perceived burden, and pain catastrophizing. Moreover, we also wanted to explore the multiple mediating roles of pain intensity and self‐perceived burden. From October 2022 to March 2023, 252 Chinese people with neuropathic pain completed face‐to‐face questionnaires to assess family functioning, pain intensity, self‐perceived burden, and pain catastrophizing. Data analysis was done using descriptive statistics and a structural equation model. The results showed better family functioning was significantly associated with more intense pain, less self‐perceived burden, and less pain catastrophizing. Mediation analysis showed that family functioning could indirectly affect pain catastrophizing through pain intensity and self‐perceived burden in addition to a direct effect on pain catastrophizing. Moreover, the mediating variable of pain intensity played a masking role. These findings suggest that good family functioning can effectively reduce the self‐perceived burden and pain catastrophizing in patients with neuropathic pain. However, family functioning cannot show its maximum effectiveness, and it may be necessary to construct a model of family functioning suitable for patients with neuropathic pain in the future.
Barriers to early diagnosis and management of oral cancer in Latin America and the Caribbean
Authors: Martínez‐Ramírez Josefina , Saldivia‐Siracusa Cristina , González‐Pérez Leonor‐Victoria , Cuadra Zelaya Florence Juana Maria , Gerber‐Mora Roberto , Cabrera Osmani Fabricio Guevara , Bologna‐Molina Ronell , Gilligan Gerardo , Delgado‐Azañero Wilson , Rajendra Santosh Arvind Babu , González‐Arriagada Wilfredo Alejandro , Villarroel‐Dorrego Mariana , Rojas Bernardo Venegas , Gallagher Karen Patricia Domínguez , Tager Elena María José Román , Aranda‐Romo Saray , García‐Heredia Gilda Lucía , Garcia Efrain Cima , Hurtado Ileana , Turcios Claudette Arambú , Espinal Leira Patricia Solis , González Rúben Alexander Martínez , Prado Ribeiro Ana Carolina , Ribeiro‐Rotta Rejane Faria , Kowalski Luiz Paulo , Curado Maria Paula , Toporcov Tatiana Natasha , Sollecito Thomas Peter , Carvalho Andre Lopes , Lopes Marcio Ajudarte , Warnakulasuriya Saman , Santos‐Silva Alan Roger
Published: February 2024

Objective

This study aimed to explore perceived barriers to early diagnosis and management of oral cancer, as well as potential pathways for improvement in Latin America and the Caribbean (LAC).

Methods

This cross‐sectional study used a self‐administered online questionnaire created via the Research Electronic Data Capture platform. The survey was distributed to health professionals trained in Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery, and Dentists with clinical and academic expertise in oral potentially malignant disorder (OPMD) and oral cancer. Data obtained were systematically organized and analyzed descriptively using Microsoft Excel.

Results

Twenty‐three professionals from 21 LAC countries participated. Major barriers included the limited implementation of OPMD and oral cancer control plans (17.4%), low compulsory reporting for OPMD (8.7%) and oral cancer (34.8%), unclear referral pathways for OPMD (34.8%) and oral cancer (43.5%), and a shortage of trained professionals (8.7%). Participants endorsed the utility of online education (100%) and telemedicine (91.3%).

Conclusion

The survey highlights major perceived barriers to early diagnosis and management of OPMD and oral cancer in LAC, as well as potential avenues for improvement.