bluuebunny/crossref_metadata_2025 huggingface dataset:
Scaling strategies, organizational capabilities and scaling social impact: An investigation of social enterprises in China
Authors: Yu Xiao‐Min , Bi Xiang‐Yang
Published: March 2023

Most social enterprises (SEs) face constant challenges to scale up their social impact, especially for those in transforming societies such as China, where the ecosystem of SEs is still immature. Previous literature has examined how and why SEs select specific scaling strategies; however, the scaling performance of different scaling strategies has rarely been empirically explored. Therefore, this study takes a hypothesis‐testing quantitative approach, for the first time, to investigate how different scaling strategies contribute divergently to scaling performance and how their contributions are subject to the moderating role of SEs’ organizational capabilities. The findings show that the three types of scaling strategies positively contribute to scaling performance, and the magnitude and significance of their influences descend from knowledge dissemination, through organizational growth, to contractual partnerships. Meanwhile, when SEs have a higher level of stakeholder engagement capabilities or strategic management capabilities, knowledge dissemination has a stronger effect on scaling performance. Conversely, when SEs have a lower level of marketing capabilities or strategic management capabilities, organizational growth has a stronger effect on scaling performance. These results offer practical implications, suggesting that SEs selecting knowledge dissemination as a scaling strategy should prioritize advancing their stakeholder engagement capabilities and strategic management capabilities.
Behavioral and emotional problems and related risk factors of primary school children aged 6–11 in Guangdong, China
Authors: Li Yaodong , Peng Ting , Xu Huanyu , Lian Jie , Lei Jiarong , Huang Zaiping , Lin Jieping , Zheng Qingmei , Zhao Cai , Huang Yu , Wang Wen , Yang Guang , Liang Rongdi , Dai Yu , Luo Xiaonian
Published: March 2023

Background

China has seen rapid urbanization and industrialization in recent decades and children behavioral and emotional problems accompanied have been a heavy burden on family and society. We therefore aimed to estimate the prevalence and risk factors of behavioral and emotional problems in primary school children aged 6–11 in an urbanized area of China.

Methods

Primary school children aged 6–11 from 15 primary schools were enrolled from Shunde District, Guangdong. The Child Behavior Checklist (CBCL) was used to assess behavioral and emotional problems and then determined risk factors associated with the behavioral and emotional problems.

Results

In total, 12 868 were included in the present analysis. The prevalence of total behavioral and emotional problems was 8.4% (95% CI, 7.9%–8.9%), which was gradually increased with age in both boys and girls. The prevalence was higher in boys than girls (9.8% vs. 6.8%, p < .001) and in children without siblings than those with siblings (9.9% vs. 8.1%, p = .006). In boys, age was positively associated with delinquent behavior, depression, poor contact, compulsive activity, social withdrawal, attention problems and aggressive behavior and was negatively associated with schizoid (p < .05). While in girls, age was positively associated with delinquent behavior, somatic complaints, social withdrawal and schizoid/compulsive activity but was negatively associated with aggressive behavior and sexual problems (p < .05).

Conclusion

Behavioral and emotional problems are common in primary school children in the urbanized area of China and are associated with sex and siblings. These findings suggest that close attention should be given to these primary school children.
Review article: Functional dyspepsia—a gastric disorder, a duodenal disorder or a combination of both?
Authors: Broeders B. W. L. C. M. , Carbone F. , Balsiger L. M. , Schol J. , Raymenants K. , Huang I. , Verheyden A. , Vanuytsel T. , Tack J.
Published: March 2023

Background

Functional dyspepsia (FD) is one of the most frequent conditions in gastroenterological outpatient health care. Most recent research in FD has shifted its focus to duodenal pathophysiological mechanisms, although current treatments still focus mainly the stomach.

Aim

The aim of the study was to provide a comprehensive overview of the pathophysiology of FD focusing on a paradigm shift from gastric towards duodenal mechanisms.

Methods

We conducted a literature search in PubMed for studies describing mechanisms that could possibly cause FD.

Results

The pathophysiology of FD remains incompletely understood. Recent studies show that duodenal factors such as acid, bile salt exposure and eosinophil and mast cell activation correlate with symptom pattern and burden and can be associated with gastric sensorimotor dysfunction. The evolving data identify the duodenum an interesting target for new therapeutic approaches. Furthermore, the current first‐line treatment, that is proton pump inhibitors, reduces duodenal low‐grade inflammation and FD symptoms.

Conclusion

Future research for the treatment of FD should focus on the inhibition of duodenal mast cell activation, eosinophilia and loss of mucosal integrity.
Regional and interregional networks of ancient Eleon during the early 12th century BCE as seen from the petrographic and neutron activation analyses of pottery
Authors: Lis Bartłomiej , Mommsen Hans , Sterba Johannes H. , Van Damme Trevor
Published: March 2023

In this article, we present the results of application of petrographic and neutron activation analyses to a group of pottery fragments dating to the 12th century BCE deriving from ancient Eleon (Boeotia, Greece) as a means of investigating regional and interregional networks in which the site participated. Production centres in Boeotia and central Euboea provided, as could be expected, the majority of sampled pottery across various shapes. A number of more distant areas, however, such as eastern Attica, the Cyclades, Macedonia, and western Crete, are also documented in the present study, suggesting their products were available to local consumers at ancient Eleon. These results are discussed with reference to consumer preferences and exchange networks operating at that time. Finally, some of the identified petrographic and chemical groups can be securely identified at the macroscopic level, allowing us to arrive at conclusions pertinent to a substantial part of the entire pottery assemblage.
Developing a framework for determining when a company should introduce a new ethical norm
Authors: Kaptein Muel
Published: March 2023

When should a company introduce a new ethical norm? This article uses the value‐belief‐norm theory to argue that the more an ethical issue threatens a company's ethical value and the more the company has an ethical responsibility to protect such value against such threat, then the more desirable it is for a company to establish ethical norms to protect said value. Distinguishing seven characteristics of an ethical issue and four conditions for a company's ethical responsibility helps identify the situations in which a company should introduce a new ethical norm. The resulting framework, with corresponding guidelines, specifies two accelerators and one inhibitor that influence the desirable speed for introducing new norms.
Mortality and burden of post‐COVID‐19 syndrome have reduced with time across SARS‐CoV‐2 variants in haematology patients
Authors: Willan John , Agarwal Gaurav , Bienz Nicola
Published: March 2023

Haematology patients contracting SARS‐CoV‐2 were identified at the start of the pandemic to be at higher risk of death or of persistent symptoms (post‐COVID‐19 syndrome). As variants with altered pathogenicity have emerged, uncertainty remains around how that risk has changed. We prospectively set up a dedicated post‐COVID‐19 clinic to monitor haematology patients infected with COVID‐19 from the start of the pandemic. In total, 128 patients were identified and telephone interviews were conducted with 94 of 95 survivors. Ninety‐day mortality attributed to COVID‐19 has fallen sequentially from 42% for the Original and Alpha strains to 9% and to 2% for the Delta and Omicron variants respectively. Furthermore, the risk of post‐COVID‐19 syndrome in survivors has fallen from 46% for the Original or Alpha strains to 35% for Delta and 14% for the Omicron strain. Since vaccine uptake has been nearly universal in haematology patients, it is not possible to determine whether improved outcomes reflect the reduced pathogenicity of the virus, or widespread vaccine deployment. Whilst mortality and morbidity remain higher in haematology patients than in the general population, our data suggest that the absolute risks are now significantly lower. Given this trend, we believe clinicians should initiate conversations about risk with their patients on whether to maintain any self‐imposed social isolation.
From bench to behaviour: The role of lifestyle factors on intraocular pressure, neuroprotection, and disease progression in glaucoma
Authors: Kumar Anika , Ou Yvonne
Published: March 2023

Current glaucoma management centres on intraocular pressure (IOP) reduction through pharmacological and surgical therapy. Despite broad interest in active management of glaucoma through lifestyle modifications, such recommendations have yet to be incorporated into standards of treatment. In this review, noteworthy preclinical studies and their translations in clinical populations are discussed to evaluate the roles of lifestyle factors in lowering IOP, offering neuroprotection, and/or slowing disease progression in those with open‐angle glaucoma. Current literature suggests that aerobic exercise may be associated with neuroprotection and decreased disease progression. Mindfulness is associated with IOP reductions and neuroprotection. Caffeine is associated with mild, transient IOP elevations of uncertain significance. Nicotinamide supplementation is associated with neuroprotection and short‐term visual function improvement. This review also highlights knowledge gaps regarding these factors and opportunities to strengthen our understanding of their role in glaucoma, including future preclinical studies that elucidate underlying mechanisms and clinical studies with additional functional endpoints and longer follow‐up.
Exploring possibilities for child participation in guideline development: The need for a fundamental reconsideration and reconfiguration of the system
Authors: Harmsen Simone , Broerse Jacqueline E. W. , Pittens Carina A. C. M.
Published: March 2023

While the right of children to be involved in decisions that concern them has been widely recognised, they are currently barely involved in guideline development in healthcare. This paper aims to explore what a future guideline development system in which children are meaningfully involved might look like and to reflect on the transition required to achieve this. We used a systems innovation perspective, exploring child participation within its systemic context and complexity. To this end, we conducted 24 interviews with various actors, about their ideas on and experiences with child participation in guideline development in the Dutch system (between August 2018 and September 2020), complemented with a scoping review. The current system is characterised by a high‐speed, rigid process that relies heavily on scientific evidence. Children are usually not included or taken seriously. The contours of a system in which children are meaningfully involved would differ markedly: children would be considered capable and taken seriously, and the guideline development process would be flexible, with time for interaction with children and discussion about the implications of their perspectives. We encountered few examples of child participation in guideline development worldwide, and believe our results are indicative of the situation in other Western countries. We propose the following actions: (1) Development of a discussion arena to create a joint vision on the aim of guideline development and subsequently the role of child participation therein. (2) Set up of transition experiments unbound by the current constellation, conducted by front‐runners who are open to children's perspectives. These are essential to clarify pathways towards a future in which the voices of children are meaningfully integrated. It remains to be seen, however, whether there are sufficient actors who feel the necessary urgency for change.
Contact sensitization to benzisothiazolinone: IVDK‐data of the years 2002 to 2021
Authors: Geier Johannes , Brans Richard , Weisshaar Elke , Wagner Nicola , Szliska Christiane , Heratizadeh Annice , Schubert Steffen ,   for the IVDK
Published: March 2023

Background

Benzisothiazolinone (BIT; CAS no. 2634‐33‐5) is used as a biocide in various products, including water‐based paints, metalworking fluids, and household products. In recent years, increasing sensitization rates have been observed in Europe.

Objective

To describe a time trend of sensitization to BIT, analyse concomitant reactions, and identify patients with increased risk of BIT sensitization.

Methods

Retrospective analysis of data from 26 739 patients patch tested with BIT, sodium salt, 0.1% petrolatum as part of several special test series within the Information Network of Departments of Dermatology (IVDK), 2002 to 2021.

Results

Positive reactions to BIT were noted in 771 patients (2.9%). Sensitization frequency varied over time and increased in recent years, peaking at 6.5% in 2020. Painters and metalworkers handling metalworking fluids, but not cleaners, had a significantly increased risk of BIT sensitization. From our data, there is no evidence of immunological cross‐reactivity between BIT and other isothiazolinones.

Conclusion

The increasing frequency of sensitization justifies adding BIT to the baseline series. More research on the clinical relevance of positive patch test reactions to BIT and the cause for the rising numbers of BIT sensitization is needed.
Prognostic impact of left ventricular systolic dysfunction in patients with mixed aortic valve disease undergoing aortic valve replacement
Authors: Saijo Yoshihito , Wang Tom Kai Ming , Isaza Nicolas , Conic Julijana Z. , Johnston Douglas , Roselli Eric E. , Desai Milind Y. , Grimm Richard A. , Svensson Lars G. , Kapadia Samir R. , Griffin Brian P. , Popović Zoran B.
Published: March 2023

Background

The implications of left ventricular remodeling and dysfunction before and after aortic valve replacement (AVR) for mixed aortic valve disease (MAVD) are not well understood. This study aims to evaluate the impact of AVR on left ventricular (LV) systolic function in MAVD, and determine the prognostic value of postoperative LV global longitudinal strain (LV‐GLS) and LV ejection fraction (LVEF).

Methods

We retrospectively assessed 489 consecutive patients with MAVD (defined as at least moderate aortic stenosis and at least moderate aortic regurgitation) and baseline LVEF ≥50%, who underwent AVR between February 2003 and August 2018. All patients had baseline echocardiography, whereas 192 patients underwent postoperative echocardiography between 3 and 18 months after AVR. The primary endpoint was all‐cause mortality.

Results

Mean age was 65 ± 15 years, and 65% were male. AVR in MAVD patients has a neutral effect on LV systolic function quantitated by LVEF and LV‐GLS. During a median follow‐up period of 5.8 years, 65 patients (34%) of 192 patients with follow‐up echocardiography died. The patients with postoperative LVEF ≥50% had better survival than those with postoperative LVEF <50% (P < .001). Furthermore, among patients with postoperative LVEF ≥50%, mortality differed between patients with postoperative LV‐GLS worse than –15% and those with postoperative LV‐GLS better than ‐15% (P < .001).

Conclusions

In patients with MAVD who underwent AVR, the mean postoperative LV‐GLS and LVEF remain at a similar value to baseline. However, worse postoperative LV‐GLS and LVEF were both independently associated with higher mortality in this population.
Energy loss index as a predictor of all‐cause mortality after transcatheter aortic valve replacement: A long‐term follow‐up
Authors: Johal Gurkaran , Jonnala Vinesh , Pourafkari Leili , Sedghi Siavash , Jafarsis Samira , Fernandez Stanley , Iyer Vijay , Nader Nader D.
Published: March 2023

Background

As transcatheter aortic valve replacement (TAVR) procedures become more widely available, there is a growing need to monitor and evaluate postoperative outcomes accurately. The energy loss index (ELI) of the ascending aorta has been commonly used to examine the agreement between the echocardiographic and Gorlin measurement of the aortic valve area.

Objectives

This project aims to demonstrate a link between ELI values and mortality following implanted TAVR valves and determine an ELI cutoff value associated with post‐TAVR events.

Method

We retrospectively reviewed patients undergoing TAVR from 2012 to 2017. We calculated ELI values for patients immediately postoperative after a TAVR procedure. Using Receiver‐Operator Characteristic and Cox Regression analyses, we identified a cutoff value to distinguish between “High ELI” (≥ 1.34) and “Low ELI” (< 1.34) patients.

Results

This study showed low ELI (hazard ratio, 2.30; 95% confidence interval 1.57–3.36, p < .001) as representative of patients with a high risk of mortality post‐TAVR. Additionally, post‐TAVR, ejection fraction increased by 3.6% (p < .001), and the aortic valve effective orifice area increased by 1.41 cm squared (p < .001) while the mean transvalvular gradient decreased by 32.8 mmHg (p < .001) and the peak transvalvular gradient decreased by 49.0 mmHg (p < .001).

Conclusion

ELI is an additional prognostic factor that should be considered during risk assessment before TAVR. This study shows that patients with Low ELI had decreased cumulative survival post‐TAVR. These patients almost had a fivefold increased risk of death following TAVR.
Mortality after a first‐ever unprovoked seizure
Authors: Pang Elaine W. , Lawn Nicholas D. , Lee Judy , Dunne John W.
Published: March 2023

Objective

Although increased mortality associated with epilepsy is well understood, data in patients after their first‐ever seizure are limited. We aimed to assess mortality after a first‐ever unprovoked seizure and identify causes of death (CODs) and risk factors.

Methods

A prospective cohort study was undertaken of patients with first‐ever unprovoked seizure between 1999 and 2015 in Western Australia. Two age‐, gender‐, and calendar year‐matched local controls were obtained for each patient. Mortality data, including COD, based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes, were obtained. Final analysis was performed in January 2022.

Results

One thousand two hundred seventy‐eight patients with a first‐ever unprovoked seizure were compared to 2556 controls. Mean follow‐up was 7.3 years (range = .1–20). Overall hazard ratio (HR) for death after a first unprovoked seizure compared to controls was 3.06 (95% confidence interval [CI] = 2.48–3.79), with HRs of 3.30 (95% CI = 2.26–4.82) for those without seizure recurrence and 3.21 (95% CI = 2.47–4.16) after a second seizure. Mortality was also increased in patients with normal imaging and no identified cause (HR = 2.50, 95% CI = 1.82–3.42). Multivariate predictors of mortality were increasing age, remote symptomatic causes, first seizure presentation with seizure cluster or status epilepticus, neurological disability, and antidepressant use at time of first seizure. Seizure recurrence did not influence mortality rate. The commonest CODs were neurological, most relating to the underlying cause of seizures rather than being seizure‐related. Substance overdoses and suicide were more frequent CODs in patients compared to controls and were commoner than seizure‐related deaths.

Significance

Mortality is increased two‐ to threefold after a first‐ever unprovoked seizure, independent of seizure recurrence, and is not only attributable to the underlying neurological etiology. The greater likelihood of deaths related to substance overdose and suicide highlights the importance of assessing psychiatric comorbidity and substance use in patients with first‐ever unprovoked seizure.
Influence of spatial and temporal variation on establishing stable isotope baselines of δ15N, δ13C, and δ34S in a large freshwater lake
Authors: Heuvel Cecilia Elizabeth , Zhao Yingming , Fisk Aaron Thomas
Published: March 2023

It is essential to establish a baseline in studies using stable isotopes to interpret trophic relationships across ecosystems and through time. Studies in freshwater ecosystems struggle to quantify baseline stable isotopes due to difficulties collecting representative samples, particularly from pelagic habitats. We assessed temporal and spatial variation in δ13C, δ15N, and δ34S in a commonly used pelagic baseline, seston (n = 156), in Lake Erie to understand mechanisms that correlate with baseline stable isotope dynamics in large lakes. Seston contains a wide range of material which can confound stable isotope interpretation, and we examined the utility of element content and ratios to account for variation in sample source.

Seston was collected in each of the three basins of Lake Erie from May to October in 2017–2019 at nearshore (<10 m depth) and offshore (>10 m depth) sites. General linear models were conducted on each stable isotope (δ15N, δ13C, and δ34S) and sample composition (variables: %N, %C, %S, C:N, C:S, and N:S) to assess how basin, month, and collection year influenced seston stable isotopes and composition.

Sample composition (variables: %N, %C, %S, C:N, C:S, and N:S), which is rarely reported for organisms in stable isotope studies, was constant throughout the sample period with no temporal or spatial trends except for small variations in %C, C:N, C:S, and N:S. This indicated that the temporal and spatial trends observed within the stable isotopes were related to seasonal changes in system processes and plankton community dynamics, with few or minimal changes in the amount of detrital and inorganic material within seston.

Values and trends of δ15N, δ13C, and δ34S in seston were comparable to those measured previously in Lake Erie and other Laurentian Great Lakes. All three isotopes increased from May to October of each sample year and varied spatially, δ15N was higher, δ34S was lower, and δ13C was the same in the west basin compared to the central and eastern basins of Lake Erie, which did not differ. These trends probably reflect seasonal changes in plankton community composition and nutrient cycling throughout the lake and are potentially linked to the presence of Microcystis blooms in the western basin during the late summer and autumn.

Seston turns over quickly, as shown by the rapid changes in stable isotope values throughout the study, which confounds the investigation of stable isotopes in upper trophic levels, and especially in organisms that have slower tissue turnover and move throughout the lake seasonally. Additionally, the variable composition of seston (e.g., % C, % N, % S, C:N, C:S, N:S) necessitates analysing sample composition to determine the degree of abiotic (e.g., detritus, sediment, particulate organic matter) and biotic (e.g., phytoplankton, zooplankton) content in it.
U‐Th‐Pb and Trace Element Evaluation of Existing Titanite and Apatite LA‐ICP‐MS Reference Materials and Determination of 208Pb/232Th‐206Pb/238U Date Discordance in Archaean Accessory Phases
Authors: Droubi Omar Khalil , Bauer Ann M. , Bonamici Chloë , Nachlas William O. , Tappa Michael J. , Garber Joshua M. , Reimink Jesse R.
Published: March 2023

The last decade has seen a marked increase in U‐Th‐Pb petrochronological studies focused on titanite and apatite. This has motivated the need for detailed, phase‐specific method development and well‐characterised reference materials with a wide variety of ages and chemical compositions. This study presents new U‐Th‐Pb isotope and major‐, minor‐ and trace‐element mass fraction data for ten titanite and five apatite reference materials based on integrated EPMA, LA‐ICP‐MS and isotope‐dilution (ID) multi‐collector (MC)‐ICP‐MS characterisation. Cross‐comparison of EPMA and LA‐ICP‐MS data for the same titanite reference material suite demonstrates that careful selection of EPMA primary reference materials is necessary to minimise inaccuracies. We further identify a significant X‐ray interference when measuring low Ce abundances in Ti‐bearing phases and outline a method for its correction. New ID‐MC‐ICP‐MS and LA‐ICP‐MS data suggest tri‐concordance (defined as concordant ages for the 238U‐206Pb, 235U‐207Pb and 232Th‐208Pb decay systems) of the MKED‐1 titanite reference material and demonstrate the reproducibility of 208Pb/232Th measurements in some secondary titanite reference materials. Integration of 208Pb/232Th results with U‐Pb geochronology provides a meaningful tool to help interpret complex U‐Th‐Pb isotopic age spectra. We provide example applications of 208Pb/232Th LA‐ICP‐MS measurements toward interpreting Archaean titanite ages from the Acasta Gneiss Complex, Northwest Territories, Canada.
Re‐examining and developing the notion of academic citizenship: A critical literature review
Authors: Albia Joclarisse , Cheng Ming
Published: March 2023

The notion of academic citizenship has been largely associated with the service role which is a part of academic work seen as additional to teaching and research. The changing landscapes of higher education and the increasing diversity of academic work have prompted debates on what academic citizenship means. This paper challenges the conventional association of academic citizenship with the service role and presents a critical review of the key themes and issues explored in extant literature on the subject. Drawing upon the general view of citizenship as practice, it proposes that the different dimensions of academic work be seen integratively, with academic citizenship reframed beyond the service role. We argue that academic citizenship needs to be conceptualised as a practice of enactment, that is, by the values, processes and means by which it is enacted and asserted as academics draw on freedoms, autonomy and individual motivations.
Health information seeking behaviour and decision making by patients undergoing breast cancer surgery: A qualitative study
Authors: Madge Octavia‐Luciana , Marincaș Augustin Marian , Daha Claudiu , Simion Laurențiu
Published: March 2023

Background

Information is critical for patients having to decide about the best treatment option, and an in‐depth understanding of their information behaviour can help health and information services to improve and facilitate their access to reliable information.

Objective

To investigate the health information‐seeking behaviour and information sources and their roles in decision making among breast cancer patients in Romania in the context of the surgical treatment.

Methods

Semi‐structured interviews were conducted with 34 patients who were treated surgically for breast cancer at the Bucharest Oncology Institute.

Results

Most participants searched for information independently, before and after the operation, and their information needs evolved during the progression of their disease. The surgeon was regarded as the most trusted source of information. Most patients adopted a paternalistic or a shared approach for decision making.

Discussion

Besides findings consistent with research from other countries, our study also revealed findings in contrast to previous research. None of the interviewed patients made any reference to the library as a source of information even if books were mentioned.

Conclusions

Health information specialists should develop a detailed guide and online information services to help physicians and other health professionals to provide relevant and reliable health care information to surgical inpatients from Romania.
Pellino3 ligase negatively regulates influenza B dependent RIG‐I signalling through downregulation of TRAF3‐mediated induction of the transcription factor IRF3 and IFNβ production
Authors: Kula Anna , Makuch Edyta , Lisowska Marta , Reniewicz Patryk , Lipiński Tomasz , Siednienko Jakub
Published: March 2023

Viral infection activates the innate immune system, which recognizes viral components by a variety of pattern recognition receptors and initiates signalling cascades leading to the production of pro‐inflammatory cytokines. To date, signalling cascades triggered after virus recognition are not fully characterized and are investigated by many research groups. The critical role of the E3 ubiquitin ligase Pellino3 in antibacterial and antiviral response is now widely accepted, but the precise mechanism remains elusive. In this study, we sought to explore Pellino3 role in the retinoic acid‐inducible gene I (RIG‐I)‐dependent signalling pathway. In this work, the molecular mechanisms of the innate immune response, regulated by Pellino3, were investigated in lung epithelial cells during influenza B virus infection. We used wild‐type and Pellino3‐deficient A549 cells as model cell lines to examine the role of Pellino3 ligase in the type I interferon (IFN) signalling pathway. Our results indicate that Pellino3 is involved in direct ubiquitination and degradation of the TRAF3, suppressing interferon regulatory factor 3 (IRF3) activation and interferon beta (IFNβ) production.
From traditional counselling to health‐promoting conversations? Registered nurses' experiences of providing health counselling to people living with severe mental ill‐health in supported housing
Authors: Molin Jenny , Jonsson Lars Isaksson , Antonsson Helena
Published: March 2023

People with severe mental ill‐health have lower life expectancies than the rest of the population, partly due to unhealthy lifestyles. Counselling to help these people improve their health can also be complex, and registered nurses are key to its success. The aim of this study was to elucidate registered nurses' experiences of providing health counselling to people living with severe mental ill‐health in supported housing. We conducted eight individual semi‐structured interviews with registered nurses working in this context and subjected the responses to qualitative content analysis. The results show that registered nurses who counsel people with severe mental ill‐health feel dispirited, but they defend their often fruitless endeavours and strive, through health counselling, to help these people meet healthier lifestyle goals. Shifting the focus from traditional health counselling to person‐centred care using health‐promoting conversations could strengthen registered nurses in their efforts towards improving lifestyles among people living with severe mental ill‐health in supported housing. Therefore, to facilitate healthier lifestyles among this population, we recommend that community healthcare support registered nurses working in supported housing by educating them in the use of health‐promoting conversations, including teach‐back techniques.
Fundamental nursing actions for frail older people in the emergency department: A national cross‐sectional survey and a qualitative analysis of practice guidelines
Authors: Ekermo David , Ronnås Matilda , Muntlin Åsa
Published: March 2023

Aims

To map how frailty among older people is assessed at Swedish emergency departments and to describe fundamental nursing care actions for these patients.

Design

Descriptive national survey and a qualitative analysis of text.

Methods

A majority (82%, n = 54) of the Swedish hospital‐based emergency departments for adults were included, representing all six healthcare regions. An online survey was used to collect data, together with submitted local practice guidelines for older people at the emergency departments. Data were collected during February–October 2021. Descriptive and comparative statistics were performed together with a deductive content analysis framed by the Fundamentals of Care framework.

Results

Sixty‐five per cent (35 of 54) of the emergency departments identified frailty, with less than half of them using an established assessment instrument. Twenty‐eight (52%) of the emergency departments have practice guidelines containing fundamental nursing actions for the care of frail older people. The majority of nursing actions in the practice guidelines were related to patients' physical care needs (91%), followed by psychosocial care needs (9%). No actions could be identified as relational actions (0%) according to the Fundamentals of Care framework.

Conclusion

Many Swedish emergency departments identify frail older people, but they use a range of different assessment instruments. While practice guidelines directing fundamental nursing actions for frail older people are often in place, a holistic, person‐centred view addressing the patient's physical, psychosocial and relational care needs is missing.

Impact

The population is growing older, and more people are needing more complex hospital care. Frail older people have an increased risk of negative outcomes. The use of a variety of assessment instruments for frailty may pose a challenge to equal care. To ensure a holistic, person‐centred view of frail older people, the Fundamentals of Care framework can be used in developing and reviewing practice guidelines.

Patient or Public Contribution

Clinicians and non‐health professionals were invited to review the survey to ensure face and content validity.
Factors that shape large‐scale gradients in clonality
Authors: Zhang Hongxiang , Chen Si‐Chong , Bonser Stephen P. , Hitchcock Timothy , Moles Angela T.
Published: March 2023

Aim

Many plant species reproduce clonally. However, ecologists still have much to learn about the factors that shape large‐scale patterns in plant clonal growth and reproduction, especially in the southern hemisphere. We addressed this knowledge gap by quantifying relationships between reproductive mode and a suite of plant characteristics and environmental variables.

Location

Australia.

Taxon

Spermatophytes.

Methods

We used data for 914,456 species‐site combinations (including 4116 unique species) in Australia to quantify the bivariate relationships between the probability of species having clonal reproduction and four plant characteristics and 16 environmental variables, using phylogenetic logistic regressions. We also compared the relative effects across plant characteristics and environmental variables groups through principal component analysis and phylogenetic logistic regressions.

Results

The probability of species having clonal reproduction was much more strongly related to plant characteristics than to environmental variables. Short, herbaceous plants and monocots were more likely to have clonal reproduction and were more common in environments with low temperatures, low solar radiation, high moisture availability, high net primary productivity (NPP) and high soil organic carbon and nitrogen contents. Tall, woody plants and eudicots tended to have only sexual reproduction, and were more common in dry and soil impoverished environments.

Main conclusions

Our results advance the understanding of the factors that shape large‐scale patterns in plant reproduction strategy. For example, the fact that clonality is more common in shorter, herbaceous species suggests that clonality can be added to the suite of traits that align species on the fast‐slow continuum. The fact that clonal reproduction is more tightly correlated with moisture availability, NPP and soil nutrients than climatic extremes and variations suggests that clonal reproduction may be better understood as a strategy for population expansion in resource abundant sites than as a strategy for reproductive assurance under environmental stress.
β‐Lactoglobulin affects the oxidative status and viability of equine endometrial progenitor cells via lncRNA‐mRNA‐miRNA regulatory associations
Authors: Data Krzysztof , Marcinkowska Klaudia , Buś Klaudia , Valihrach Lukas , Pawlak Edyta , Śmieszek Agnieszka
Published: March 2023

The β‐lactoglobulin (β‐LG) was previously characterized as a mild antioxidant modulating cell viability. However, its biological action regarding endometrial stromal cell cytophysiology and function has never been considered. In this study, we investigated the influence of β‐LG on the cellular status of equine endometrial progenitor cells under oxidative stress. The study showed that β‐LG decreased the intracellular accumulation of reactive oxygen species, simultaneously ameliorating cell viability and exerting an anti‐apoptotic effect. However, at the transcriptional level, the reduced mRNA expression of pro‐apoptotic factors (i.e. BAX and BAD) was accompanied by decreased expression of mRNA for anti‐apoptotic BCL‐2 and genes coding antioxidant enzymes (CAT, SOD‐1, GPx). Still, we have also noted the positive effect of β‐LG on the expression profile of transcripts involved in endometrial viability and receptivity, including ITGB1, ENPP3, TUNAR and miR‐19b‐3p. Finally, the expression of master factors of endometrial decidualization, namely prolactin and IGFBP1, was increased in response to β‐LG, while non‐coding RNAs (ncRNAs), that is lncRNA MALAT1 and miR‐200b‐3p, were upregulated. Our findings indicate a novel potential role of β‐LG as a molecule regulating endometrial tissue functionality, promoting viability and normalizing the oxidative status of endometrial progenitor cells. The possible mechanism of β‐LG action includes the activation of ncRNAs essential for tissue regeneration, such as lncRNA MALAT‐1/TUNAR and miR‐19b‐3p/miR‐200b‐3p.
The show must go on: The EU's quest to sustain multilateral institutions since 2016
Authors: Schuette Leonard , Dijkstra Hylke
Published: March 2023

Multilateralism is in crisis. States increasingly contest, undermine and even withdraw from international organisations and other multilateral institutions. Challenges emanate not only from emerging powers but also from established Western states and civil society. No other actor but the EU is more intimately entangled with multilateralism. This article therefore reviews to what extent and how the EU has actively sustained multilateral institutions since 2016. It identifies three types of mechanisms: the defence, reform and extension of multilateral institutions. Based on interviews with senior officials in the EU institutions and the member states, the article finds that the EU has proven to be rather successful in temporarily defending existing institutions. However, it largely failed to reform multilateral institutions and extend multilateral institutions to new areas. In doing so, the article contributes to our understanding of the EU as a foreign policy actor and the processes of the crisis of multilateralism.
Bacterial biofilm reduction by 275 and 455 nm light pulses emitted from light emitting diodes
Authors: Prasad Amritha , Roopesh M. S.
Published: March 2023

Eradication of biofilms from the food contact surfaces is a challenging task, owing to their increased resistance to sanitizers and regular cleaning practices. The treatment with the light pulses emitted from the light emitting diode (LED) is an emerging surface decontamination technology, that can produce the antibiofilm effect by photodynamic inactivation. The objective of this study was to understand the antibiofilm efficacy of the 275 (Ultraviolet‐C [UV‐C]) and 455 nm (Blue) light pulses emitted from the LEDs against single and dual‐species biofilms of Salmonella Typhimurium ATCC13311 and Aeromonas australiensis 03‐09 on stainless steel (SS) coupons formed at different time. The biofilm formation by S. Typhimurium was improved when grown with A. australiensis in dual‐species culture. Both 275 and 455 nm light pulses showed significant antibiofilm activity against S. Typhimurium and A. australiensis in single and dual‐species biofilms. For instance, the 275 nm LED treatment of surfaces of SS coupons with 1.8 J/cm2 dose on each surface, produced reductions of 4.24 and 3.9 log (CFU/cm2) in single (cell attachment) and dual‐species biofilms of S. Typhimurium, and reductions of 4.45 and 4.99 log (CFU/cm2) in single and dual‐species biofilms of A. australiensis. However, the susceptibility of A. australiensis toward 455 nm LED treatments was influenced by the presence of S. Typhimurium in the dual‐species biofilm. The confocal laser scanning microscopy images revealed significant cell membrane damage in the dual‐species biofilms by the LED treatments with 275 and 455 nm light pulses. Overall, several factors like surface temperature increase, strains used, treatment dose, treatment time, and incubation period of biofilms influenced the inactivation efficacy of the 275 and 455 nm LED treatments against the biofilms formed on SS coupons. This study provides an insight into the inactivation efficacy of LED light pulses against bacterial biofilms on food grade SS surfaces.
Patterns of parent screen use, child screen time, and child socio‐emotional problems at 5 years
Authors: Cost Katherine T. , Unternaehrer Eva , Tsujimoto Kimberley , Vanderloo Leigh L. , Birken Catherine S. , Maguire Jonathon L. , Szatmari Peter , Charach Alice
Published: March 2023

Digital media screens have become an essential part of our family life. However, we have insufficient knowledge about parental screen use patterns and how these affect children's socio‐emotional development. In total, 867 Canadian parents of 5‐year‐old children from the TARGet Kids! Cohort (73.1% mothers, mean ± SD age = 38.88 ± 4.45 years) participated in this study from 2014 to the end of 2019. Parents reported parental and child time on television (TV) and handheld devices and completed the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis identified six latent profiles of parent screen use: low handheld users (P1, reference; n = 323), more TV than handheld (P2; n = 261), equal TV and handheld (P3; n = 177), more handheld than TV (P4; n = 57), high TV and handheld (P5; n = 38), and extremely high TV and handheld (P6; n = 11). Parents that were more likely to belong to P6 were also more likely to be living in single‐parent households compared to P1 (estimate = −1.49 ± 0.70), p = .03). High membership probability for P2 (estimate = −0.67 ± 0.32, p = .04) and P4 (estimate = −1.42 ± 0.40, p < 0.001) was associated with lower household income compared to P1. Children of parents with higher P4 (χ2 = 12.32, p < 0.001) or P5 (χ2 = 9.54, p = .002) membership probability had higher total screen time compared to P1. Finally, a higher likelihood to belong to P6 (χ2 = 6.82, p = .009) was associated with a higher SDQ Total Difficulties Score compared to P1. Thus, patterns of parent screen use were associated with child screen use and child socio‐emotional problems. The emerging link between parental screen use profiles and child behaviors suggests the need for more research on parent screen time.
Learning Modality and Quality of Life Among US School‐Age Children During the Coronavirus Pandemic
Authors: Cox Casey F. , Messiah Sarah E. , Knell Gregory
Published: March 2023

BACKGROUND

Shifts from in‐person learning to virtual and hybrid learning modes in response to the coronavirus pandemic potentially impacted children's physical, emotional, social, and academic development. This study examined the association between virtual, in‐person, and hybrid learning modality with parent‐reported quality of life among US students (kindergarten‐12th) in early 2021.

METHODS

Parents reported current learning modality and physical, emotional, social, and school quality of life for children (aged 5‐11, n = 1381) and adolescents (aged 12‐17, n = 640). Multivariable logistic regression models assessed the odds of impaired quality of life by learning modality.

RESULTS

Among children, hybrid and virtual learners had greater odds of impaired quality of life (adjusted odds ratio [aOR] 1.79, 95% confidence interval [CI] 1.22, 2.64 and aOR 1.57, 95% CI 1.17, 2.12, respectively) relative to in‐person learners. Among adolescents, virtual learners had greater odds impaired physical (aOR 2.06, 95% CI 1.26, 3.38) and school function (aOR 2.23, 95% CI 1.38, 3.61) relative to in‐person learners.

CONCLUSIONS

Learning modality was associated with student well‐being, and appropriate alternative learning modalities may differ for younger and older students in terms of educational quality and quality of life.
Reducing Student Exposure to Digital Food and Beverage Marketing: Policy and Practice Recommendations
Authors: Wilking Cara , Moukalled Summer , Polacsek Michele
Published: March 2023

Digital marketing of unhealthy foods and beverages to children and adolescents is pervasive, highly effective, undermines healthy eating, and contributes to health inequities. Expanded use of electronic devices and remote learning during the COVID‐19 pandemic has increased the urgency for policy interventions to limit digital food marketing in schools and on school‐issued devices. The US Department of Agriculture provides little guidance to schools for how to address digital food marketing. Federal and state privacy protections for children are inadequate. Considering these policy gaps, state and local education authorities can incorporate strategies to reduce digital food marketing into school policies for: content filtering on school networks and on school‐issued devices; digital instructional materials; student‐owned device use during lunch; and school use of social media to communicate with parents and students. Model policy language is provided. These policy approaches can leverage existing policy mechanisms to address digital food marketing from a variety of sources.
Altitudinal gradients and body size variation among Chinese lizards in different terrains
Authors: Liang T. , Dai W. , Zhang Z. , Bempah G. , Shi L. , Lu C.
Published: March 2023

Spatial patterns of body size are associated with environmental factors like temperature, seasonality, precipitation, resources, and altitude, among the most relevant. Latitudinal size patterns have been extensively studied. Studies on altitudinal gradients of body size, however, are relatively few. Besides, it is still unclear whether there is variation in the relationship between environmental factors and body size of species, or correlations within different altitudes. China provides a good opportunity to assess the altitudinal gradients of body size, because the entire terrain of China changes from high altitude in the west to low altitude in the east, with three natural terrain stages (low: less than 660 m.a.s.l.; medium: 660–2600 m.a.s.l.; and high: more than 2600 m.a.s.l.). Similarly, lizards are distributed across a wide altitudinal range (from −154.31 m to ~6000 m above sea level). We examined 211 lizard species in China and assessed the altitudinal gradients of Chinese lizard body sizes at assemblage and interspecific levels. Piecewise structural equation models (pSEM) were used to investigate the direct and indirect relationships between body size and environmental factors within different terrains (low, medium, and high altitudes). Overall, we found that body size in Chinese lizards decreases with increasing altitude. However, there were variations in the altitudinal gradients and drivers within the three terrain stages. Altitude has both direct (medium and low stages) and indirect (high stages) effects in shaping lizard size. We established that body size increased with increasing altitudes in the low and medium terrain stages. Seasonality had different effects on body size in medium (positively) and low (negatively) stages. However, among the three terrain stages, temperature was consistently negatively correlated with lizard size. Overall, we identified complex patterns and drivers of altitudinal gradients of body size within the three terrain stages, probably due to the different environmental conditions across altitudes.