bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of heart rate variability with progression of retinopathy among adults with type 2 diabetes
Authors: Kaze Arnaud D. , Yuyun Matthew F. , Ahima Rexford S. , Sachdeva Mira M. , Echouffo‐Tcheugui Justin B.
Published: April 2022

Aim

We evaluated the associations of heart rate variability (HRV) with incident vision‐threatening retinopathy and retinopathy progression among adults with type 2 diabetes.

Methods

Participants recruited to the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study with HRV measures at baseline were analysed. HRV measures included standard deviation of all normal‐to‐normal intervals (SDNN) and root mean square of successive differences between normal‐to‐normal intervals (rMSSD). Low SDNN was defined as SDNN <8.2 ms; low rMSSD as rMSSD <8.0 ms. We used multivariable adjusted Cox proportional hazards and modified Poisson regression models to generate risk estimates for incident vision‐threatening retinopathy and retinopathy progression, respectively.

Results

A total of 5810 participants without incident vision‐threatening retinopathy at baseline (mean age 62 years, 40.5% women, 63.5% White) were included. Over a median of 4.7 years, 280 incident vision‐threatening retinopathy cases requiring treatment occurred. Low HRV (vs. normal HRV) was associated with higher risk of incident vision‐threatening retinopathy (adjusted hazard ratio 1.32 [95%CI 1.03–1.71] and 1.14 [95%CI 1.01–1.28] for low SDNN and rMSSD, respectively). In the subset of 2184 participants with complete eye examinations at baseline and 4 years, 191 experienced retinopathy progression, and low HRV (vs. normal HRV) was associated with a higher risk of retinopathy progression (adjusted relative risks 1.36 [95%CI 1.01–1.83] and 1.36 [95%CI 1.01–1.84] for low SDNN and rMSSD, respectively).

Conclusions

Cardiac autonomic neuropathy, as assessed by low HRV, was independently associated with increased risks of incident vision‐threatening retinopathy and overall retinopathy progression in a large cohort of adults with type 2 diabetes.
Redox profiles of amyotrophic lateral sclerosis lymphoblasts with or without known SOD1 mutations
Authors: Cunha‐Oliveira Teresa , Silva Daniela Franco , Segura Luis , Baldeiras Inês , Marques Ricardo , Rosenstock Tatiana , Oliveira Paulo J. , Silva Filomena S. G.
Published: April 2022

Background

Amyotrophic lateral sclerosis (ALS) is a fatal and rapidly progressing neurodegenerative disease that affects motor neurons. This disease is associated with oxidative stress especially in mutant superoxide dismutase 1 (mutSOD1) patients. However, less is known for the most prevalent sporadic ALS form, due to a lack of disease models. Here, we studied oxidative stress profiles in lymphoblasts from ALS patients with mutSOD1 or unknown (undSOD1) mutations.

Methods

mutSOD1 and undSOD1 lymphoblasts, as well as sex/age‐matched controls (3/group) were obtained from Coriell and divided into 46 years‐old‐men (C1), 46 years‐old‐women (C2) or 26/27 years‐old‐men (C3) cohorts. Growth curves were performed, and several parameters associated with redox homeostasis were evaluated, including SOD activity and expression, general oxidative stress levels, lipid peroxidation, response to oxidative stimulus, glutathione redox cycle, catalase expression, and activity, and Nrf2 transcripts. Pooled (all cohorts) and paired (intra‐cohort) statistical analyses were performed, followed by clustering and principal component analyses (PCA).

Results

Although a high heterogeneity among lymphoblast redox profiles was found between cohorts, clustering analysis based on 7 parameters with high chi‐square ranking (total SOD activity, oxidative stress levels, catalase transcripts, SOD1 protein levels, metabolic response to mM concentrations of tert‐butyl hydroperoxide, glutathione reductase activity, and Nrf2 transcript levels) provided a perfect cluster segregation between samples from healthy controls and ALS (undSOD1 and mutSOD1), also visualized in the PCA.

Conclusions

Our results show distinct redox signatures in lymphoblasts from mutSOD1, undSOD1 and healthy controls that can be used as therapeutic targets for ALS drug development.
The puzzle of the anchovy–sardine inverse fishery at the south‐eastern coast of the Arabian Sea and climate variability
Authors: Hamza Faseela , Valsala Vinu , Varikoden Hamza
Published: April 2022

An out‐of‐phase pattern of fishery between anchovy and sardine exists in upwelling systems of different geographical locations. We examined the inverse relationship of anchovy (Stolephorus sp., Engraulidae) and sardine (Sardinella longiceps, Clupeidae) fishery along the coast of the south‐eastern Arabian Sea (SEAS) by analysing the annual landing data of Kerala, Karnataka, and Goa states. Landings of anchovy and sardine showed wide fluctuations with distinct episodes of abundance and decline. We selected anchovy period (1984–1996) and sardine period (2000–2013) for close examination according to the environmental data availability. The study reveals that the observed inverse fishery along the coast of SEAS is well connected to regional environmental parameters and global climate variability. During the abundant anchovy period, the anomalies of surface currents were observed towards the north and also towards the coast during the spawning periods of anchovy (March–May, October–December). The pattern of surface current anomalies is reversed during the abundant sardine period. Anomalies of surface current is directed towards offshore during the early life stage of sardine (June–September), but it reversed towards the coast during the abundant sardine period. Similarly, an opposite upwelling pattern is noted in both species’ spawning seasons during the anchovy and sardine abundant periods. During these periods, the spatial distribution of global surface air temperature and wind anomalies showed contrasting spatial patterns and hence they are related to various climate indices in sardine and anchovy abundant periods in the SEAS.
Real‐world decision‐making in the management of patients presenting with major bleeding on rivaroxaban: the Auckland regional experience
Authors: Grainger Brian T. , Merriman Eileen , Royle Gordon , Eaddy Nicola , Ockelford Paul , Young Laura
Published: April 2022

Background

Rivaroxaban is used increasingly as an oral anticoagulant; however, a specific reversal agent is not currently available in the Australasian setting. There is also variation across international consensus guidelines regarding advice on the management of bleeding.

Aims

To review the real‐world management of rivaroxaban‐associated major bleeding across the public hospitals of New Zealand's largest city.

Methods

A retrospective cohort analysis was performed of patients prescribed rivaroxaban who presented to four metropolitan hospital Emergency Departments between 1 August 2018 and 31 May 2021 with major bleeding as defined by the International Society on Thrombosis and Haemostasis.

Results

One hundred and twelve patients were identified, accounting for 115 major bleeding presentations. Upper gastrointestinal (34%) and intracranial (31%) bleeding sites were most common. Procedural intervention was required in 44% of patients. Haemostatic management involved tranexamic acid (TXA) in 26%, prothrombin complex concentrate (PCC) in 55% (dose range 1000–6000 IU or 10–65 IU/kg), vitamin K in 16% and fresh frozen plasma in 1%. Rivaroxaban was discontinued permanently following 56 (49%) events, switched to another anticoagulant in 24 (21%) and withheld in 30 (26%) from 2 days to 3 months (median 8.5 days). All‐cause mortality at 90 days after bleeding was 17% (19 patients), and the incidence of combined venous and arterial thrombotic events was 10%.

Conclusions

There is considerable heterogeneity in the acute clinical management of patients presenting with rivaroxaban‐related major bleeding. The use of PCC and dosage administered is inconsistent. TXA was utilised in only approximately one‐quarter of all cases. Evidence‐based guidance for treating rivaroxaban‐related bleeding would improve the management of these patients and potentially improve clinical outcomes.
Myth or measurement: What does the new minimum wage research say about minimum wages and job loss in the United States?
Authors: Neumark David , Shirley Peter
Published: April 2022

The disagreement among studies on the employment effects of minimum wages in the United States is well known. Less well known, and more puzzling, is the absence of agreement on what the research literature says—that is, how economists summarize the body of evidence on the employment effects of minimum wages. Summaries range from “it is now well established that higher minimum wages do not reduce employment,” to “the evidence is very mixed with effects centered on zero so there is no basis for a strong conclusion one way or the other,” to “most evidence points to adverse employment effects.” We explore the question of what conclusions can be drawn from the literature, focusing on the evidence using subnational minimum wage variation within the United States that has dominated the research landscape since the early 1990s. To accomplish this, we assembled the entire set of published studies in this literature and identified the core estimates that support the conclusions from each study, in most cases relying on responses from the researchers who wrote these papers. Our key conclusions are as follows: (i) there is a clear preponderance of negative estimates in the literature; (ii) this evidence is stronger for teens and young adults and the less educated; (iii) the evidence from studies of directly affected workers points even more strongly to negative employment effects; and (iv) the evidence from studies of low‐wage industries is less one‐sided.
Collaboration and optimization in farmland exchanges
Authors: Rönnqvist Mikael , Frisk Mikael , Flisberg Patrik , Casimir Justin , Engström Jonas , Hansson Erik , Kihlstedt Annika
Published: April 2022

To keep businesses competitive in world markets, the number of farms in most countries is decreasing while farm size is increasing, and parcels making up the farm area are extremely fragmented. It is common for farms to expand faster than available arable land near the farm center, leading to longer distances between the farm center and field areas. Consequently, logistic costs increase and affect the farm's profitability and the environment. Moreover, there is often substantial overlap between different farms, which implies that it is possible for farmers to collaborate with each other. We developed and proposed three optimization models to describe different levels of collaboration and sharing restrictions. Many practical considerations need to be weighed, such as the soil type and crops used. We collected detailed information on farms, parcels, and cost drivers in seven large instances for our case study in Sweden. One instance had 1431 farms and 32,091 parcels with 96 crop types. The resulting optimization models were very large; special pre‐processing and optimization techniques were developed for their solutions. The theoretical potential for collaboration in logistic cost reduction was very large, ranging from approximately 10% to 50% depending on the form of the collaboration. Because a large part of costs comes from less use of diesel for transport resources, the reduction in cost is directly related to a reduction in CO2 emissions.
High‐entropy boride–carbide ceramics by sequential boro/carbothermal synthesis
Authors: Smith Steven M. , Feng Lun , Fahrenholtz William G. , Hilmas Greg E. , Huang Tieshu
Published: April 2022

A dual‐phase high‐entropy boride (HEB)/carbide (HEC) ceramic with a fine grain size was synthesized by a sequential boro/carbothermal process. In the first step, an Hf–Nb–Ta–Ti–Zr‐containing carbide was synthesized by a carbothermal reduction of oxides followed by the reaction of the carbide with B4C and ZrH2 to convert part of the carbide to boride. The resulting composition was ∼29 vol% HEB with an average grain size of ∼1.1 μm. Solid solution formation occurred at the densification temperature of 1900°C resulting in a relative density higher than 99%. The Vickers hardness was 26.5 ± 1.4 GPa. This is the first report of synthesizing dual‐phase boride–carbide high‐entropy ceramics from carbothermally synthesized, HEC powders.
Evaluating fundamental care knowledge to inform educational leadership
Authors: Nowell Lorelli , Davidson Sandra , Gospodinov Julia , Laing Catherine , Shajani Zahra , Dewell Sarah , Conroy Tiffany , Button Didy
Published: April 2022

Aim

To explore undergraduate nursing students' understanding of fundamental care and identify educational leadership opportunities to deepen students' understanding of fundamental care concepts.

Design

Sequential‐explanatory mixed methods study.

Methods

We conducted a cross sectional survey (n = 202) and focus groups (n = 24) to explore undergraduate nursing students' ability to identify fundamental care needs. All data were collected between November 2020 and April 2021. Survey data were analysed using descriptive and inferential statistics and focus group data were thematically analysed.

Results

Year One students scored significantly lower in their ability to identify fundamental care needs compared with students in other years, even after controlling for route, gender and age. Post‐degree students scored significantly higher than direct entry or transfer students. Students ≤19 years of age had significantly lower scores compared with students ≥25 years of age. Our focus group findings highlighted that students were often unable to define fundamental care, but they identified learning about various components of fundamental care in a variety of ways. While students understood that fundamental care was required in all settings, they were challenged in providing this care in acute and virtual settings. Students shared several suggestions to support fundamental care skills development across the curriculum.

Conclusions

There is a need for a clear definition and description of the fundamentals of care that is used consistently by faculty, students and curriculum documents. It is important to encourage and support educators to share real‐world nursing stories, offer students time to share their personal experiences, develop creative learning opportunities and foster student reflection to deepen students' understanding of the fundamentals of care.

Impact

Educators need support to meaningfully incorporate fundamentals of care learning opportunities across multiple care settings. Educational leaders can use these findings to develop or adapt their curricula to support fundamental care skill development.
Exploring the link between self‐regulated learning and learner behaviour in a massive open online course
Authors: Jansen Renée S. , van Leeuwen Anouschka , Janssen Jeroen , Kester Liesbeth
Published: April 2022

Background

Learners in Massive Open Online Courses (MOOCs) are presented with great autonomy over their learning process. Learners must engage in self‐regulated learning (SRL) to handle this autonomy. It is assumed that learners' SRL, through monitoring and control, influences learners' behaviour within the MOOC environment (e.g., watching videos). The exact relationship between SRL and learner behaviour has however not been investigated.

Objectives

We explored whether differences in SRL are related to differences in learner behaviour in a MOOC. As insight in this relationship could improve our understanding of the influence of SRL on behaviour, could help explain the variety in online learner behaviour, and could be useful for the development of successful SRL support for learners.

Methods

MOOC learners were grouped based on their self‐reported SRL. Next, we used process mining to create process models of learners' activities. These process models were compared between groups of learners.

Results and conclusions

Four clusters emerged: average regulators, help seekers, self‐regulators, and weak regulators. Learners in all clusters closely followed the designed course structure. However, the process models also showed differences which could be linked to differences in the SRL scores between clusters.

Takeaways

The study shows that SRL may explain part of the variability in online learner behaviour. Implications for the design of SRL interventions include the necessity to integrate support for weak regulators in the course structure.
Students' use of technology and their perceptions of its usefulness in higher education: International comparison
Authors: Cohen Anat , Soffer Tal , Henderson Michael
Published: April 2022

Background

The rapid globalization along with the growing trend of openness and sharing approach enabled widespread of digital technologies all over the world. However, we can still find differences between countries in technology use and perceptions of usefulness for learning. Understanding students' use of educational technology and their perceptions of its usefulness is especially significant today, given the rapid penetration of online learning into higher education as a response to Covid‐19.

Objectives

This research aimed to understand students' actual experiences with digital technologies during their academic studies and their perceptions of technology usefulness across institutional and international contexts (Israel and Australia).

Methods

This quantitative study used data from a large‐scale bi‐national online survey of 3003 students in both countries. Comparative analyses were conducted. In addition, factor analysis was used to identify latent factors from 16 variables of students' perceptions of the usefulness of digital resources usefulness.

Results and conclusion

The results revealed significant differences in technology usage and its perceived usefulness between students in the two countries. They confirmed the predominance of ‘official’ digital resources, such as learning management systems and online library resources. However, large percentages also reported the use of ‘non‐official’ digital resources, including academic search services; subject‐related videos and audio recordings on content‐sharing websites such as YouTube and Wikipedia; and communication and/or collaboration with other students through social networks. Thus, universities need to consider the potential use of incorporating these resources for improving teaching and learning. Moreover, understanding the differences will assist in implementing tailored techno‐pedagogical solutions to the students.
Pseudo and resistant hypertension: A chaotic perspective
Authors: Moreno Heitor
Published: April 2022

Systemic blood pressure (BP) may oscillate for homeostatic needs (equilibrium by constancy) or just as shifts in other intrinsic and extrinsic variables known as allostatic changes. This transitory pressure often rises alerts physicians to out‐of‐control hypertension or even hypertensive crisis. There is a very complex theory underlying these stochastic phenomena, which physicists and mathematicians translate into a single word: chaos. These changes happen according to a stochastic probabilistic pattern that presumes chaotic but somewhat predictable and nonlinear modeling of BP‐related dynamics as a mathematical approach. Based on the chaos theory, small changes at the initial BP (baseline overtime) values could disturb the homeostasis leading to extreme BP chaotic shifts. These almost insignificant oscillations may also affect other variables and systems, leading to the misdiagnosis of hypertension, “out‐of‐control” BP levels, and resistant hypertension (RHT). Thus, these unpredictable and transient increases in BP values may be improperly diagnosed as the white coat and masked or resistant hypertension. Indeed, the interference of the chaos in any phenotype of (true or false) hard to control BP is not considered in clinical settings. This review provides some basic concepts on chaos theory and BP regulation. Besides pseudoresistant hypertension (lack of adherence, circadian variations, and others (white‐coat, masked, early morning effects or hypertension), chaotic changes can be responsible for out‐of‐control hypertension.
The importance of shared meaning‐making for sustainable knowledge translation and health literacy
Authors: Wahl Astrid K. , Andersen Marit H. , Ødemark John , Reisæther Anna , Urstad Kristin H. , Engebretsen Eivind
Published: April 2022

The aim of the present paper is to describe and discuss how recent theories about translation, bridging medical and humanistic understandings of knowledge translation, in the medical humanities can bring about a new understanding of health literacy in the context of patient education. We argue that knowledge translation must be understood as active engagement with contextual meaning, considering the understandings, interpretation, and expertise of both patient and health care provider (deconstruction of the distinction between biomedical and cultural knowledge). To illustrate our points, we will describe the case of Jim, a kidney transplant recipient who received standard patient education but lost the graft (the new kidney). If we apply Kristeva's view to this context, graft function is not merely biology but a complex biocultural fact. In this perspective, graft function is seen as a phenomenon that embraces translation between health as a biomedical phenomenon and healing as lived experience, and that opens for shared meaning‐making processes between the patient and the health care provider. In Jim's case, this means that we need to rethink the approach to patient education in a way that encourages the patient's idiosyncratic way of thinking and experiencing, and to transform health information into a means for sustaining Jim's singular life – not biological life “in general.” The patient education programme did not take into consideration the singularities of Jim's biographical temporality, with its changes in everyday life, priorities, attitudes, and values. Hence, we claim that health literacy should involve a simultaneous interrogation of the patients and the health professional's constructions of knowledge.
Calibrating the Magnitude of the Countercyclical Capital Buffer Using Market‐Based Stress Tests
Authors: VAN OORDT MAARTEN R.C.
Published: April 2022

This paper proposes a novel methodology to calibrate the magnitude of the countercyclical capital buffer (CCyB) using market‐based stress tests. The macroprudential authority in our paper aims to contain the possibility of a breach of a minimum capital ratio in the event of a severe system‐wide shock within a certain permissible failure probability. We apply the methodology by stress‐testing major banks in six advanced economies on a quarterly basis over a period of 27 years. The estimates suggest that the cap on the CCyB should not be less than around 1.7% of total assets. Its potential normal‐times level is estimated at approximately 0.8% of total assets.
Double devaluations: Class, value and the rise of the right in the Global North
Authors: Kalb Don
Published: April 2022

This article builds on the contributions of anthropologists of Europe in discovering, tracing and explaining the neo‐nationalist ascendancy of the last 20 years. It picks up on earlier publications to make a succinct case for a decidedly anthropological class analysis of this worldwide and world‐shaking phenomenon, with a view mainly on Europe and the United States. It suggests the usefulness of a notion of ‘double devaluation’ in understanding and explaining recent rightward shifts in popular politics in the Global North, encompassing both rural and urban spaces.
Temporal hollowing causes, classifications, and treatment options: A systematic review
Authors: Shay Tamir , Shachar Tal , Olshinka Asaf , Ad‐El Dean D. , Ibelli Taylor , Shilo Yaacobi Dafna
Published: April 2022

Background

Recent developments in surgical techniques and grading schemas to treat temporal hollowing necessitate critically assessing their efficacy. This systematic review presents the currently available protocols for temporal hollowing, aimed toward improving the clinical approach, for the benefit of the surgeon and patient.

Methods

A search was conducted in PubMed, EMBASE, and Google Scholar in September 2021 using the keywords “temporal hollowing” and “temporal augmentation.” Inclusion criteria were English‐written articles published in peer‐reviewed journals that reported an outcome relating to the cause, classification, or procedure used to prevent or correct hollowing in humans.

Results

Of the 413, 966 publications retrieved, 24 met the study inclusion criteria. Twenty‐one publications discussed the etiology of temporal hollowing, 12 discussed a classification or grading system for temporal hollowing, and 19 discussed a procedure to prevent or correct temporal hollowing. The most commonly reported etiology for temporal hollowing was iatrogenic (63%). For classifying temporal hollowing severity, visual analogue scales (25%) were most commonly used. Mesh (26%) and autologous fat grafts (26%) were the most popular procedures used to prevent or correct temporal hollowing.

Discussion

We presented the spectrum of temporal hollowing grading schemas and treatment modalities currently published in the field. The use, by a majority of publications, of a grading system based on the subjective judgment of the examiner (either alone or adjunct to imaging results) suggests the need for a more standardized measurement tool. Future studies should investigate a universally applicable temporal hollowing classification system and its impact on treatment outcomes.
Warm saline effectiveness for pain relief in office hysteroscopy: A systematic review and meta‐analysis of randomized controlled trials
Authors: Baradwan Saeed , Khalil Mohamed , Alshahrani Majed S. , Albouq Bayan , AlSghan Rayan , Khadawardi Khalid , Mohamed Doaa F. , Yousef Doaa H. , Kamal Shaimaa H. M. , Abdel Halim Hala W. , Elhawary Mona A. A. , Alkholy Eman A. , Elsharkawy Mostafa R. M. , Abdelhakim Ahmed M. , Abbas Ahmed M. , Dahshan Shaimaa A. , Alshawadfy Abdelrhman , Soror Ghada I.
Published: April 2022

Aim

To evaluate the impact of warm distension medium versus room temperature distension medium on pain control among patients undergoing office hysteroscopy.

Methods

A systematic search was done in PubMed, Cochrane Library, Scopus, and ISI web of science from inception to October 2021. We selected randomized clinical trials (RCTs) compared warmed saline distension medium in the intervention group versus room temperature distension medium in the control group among women undergoing diagnostic and/or operative office hysteroscopy. Revman software was utilized for performing our meta‐analysis. Our primary outcomes were pain scores evaluated by the visual analog scale (VAS) during and after the procedure. Our secondary outcome was the patient satisfaction between both groups.

Results

Five RCTs met our inclusion criteria with a total number of 441 patients. We found warm saline was linked to a significant reduction in the VAS pain score during the procedure compared to the control group (mean difference [MD] = −1.12, 95% confidence interval [CI] [−1.80, −0.45], p = 0.001). Moreover, the VAS pain score after the procedure was significantly declined among the warm saline group (MD = −0.62, 95% CI [−0.97, −0.27], p = 0.005). Interestingly, more patients were significantly satisfied with warm saline distension medium application compared to room temperature group (odds ratio [OR] = 3.71, 95% CI [2.01, 6.86], p < 0.001).

Conclusions

Warm saline application in office hysteroscopy is effective in reducing pain during and after the procedure as well as improvement in patient satisfaction.
The Associations between Contextual and Cultural Stressors, Internalizing Symptoms, and Social Support
Authors: Chancy Daphney F. , Witherspoon Dawn P. , Wei Wei , Glover Briah , Hughes Diane L. , Way Niobe
Published: April 2022

The current study aims to examine the associations between neighborhood safety, racial‐ethnic discrimination, and depressive symptoms, as well as explore social support as a protective factor using the Minority Stress Model for three different BIPOC groups (i.e. African American, Puerto Rican, and Dominican). African American and Latino youth living in urban environments often encounter multiple stressors at the same time, and it is critical to learn more about how these stressors influence well‐being in tandem. The results showed that among African American youth safety concerns were associated with depressive symptoms while discrimination was associated with Latino youth's depressive symptoms.
Rural and urban differences in perceptions, behaviors, and health care disruptions during the COVID‐19 pandemic
Authors: Greteman Breanna B. , Garcia‐Auguste Crystal J. , Gryzlak Brian M. , Kahl Amanda R. , Lutgendorf Susan K. , Chrischilles Elizabeth A. , Charlton Mary E.
Published: April 2022

Purpose

The objective of this study was to assess perceptions, health behaviors, and disruptions related to the COVID‐19 pandemic in a largely rural, Midwestern state, and to examine differences between rural and urban respondents.

Methods

A questionnaire was mailed August 2020 to a sample of 10,009 registered voters in Iowa ages 18‐100 years, with oversampling from 6 select rural counties. Previously validated and tested items assessed COVID‐19 precautions, health care disruptions, emotional reactions, health behavior changes, telehealth and experiences with the internet, and demographic characteristics.

Findings

There were 4,048 respondents (40% response rate); 65% were rural and 35% were urban residents. The average age of respondents was 58.3 years and 45% of respondents identified as female. Rural respondents reported less concern about COVID‐19 in their community (29% vs 40%, P<.001) and lower perceived importance of social distancing (51% vs 64%, P<.001). Urban respondents more often reported experiencing disruption to daily living, stronger negative emotional reactions, and displayed more pronounced behavior change compared to their rural counterparts. For example, urban respondents reported more pandemic‐related job losses (6% vs 4%, P = .05), disruptions to daily activities (48% vs 35%, P<.001), and use of telehealth services during the pandemic (24% vs 16%, P<.001).

Conclusions

The majority of respondents reported disruptions to normal activities, medical appointment cancellations, and emotional distress during the first 6 months of the pandemic. The impact of the pandemic on urban residents appeared to be greater than for rural respondents. Timing of pandemic spread and varying beliefs are potential explanations.
Parental sleep when their child is sick: A phased principle‐based concept analysis
Authors: Smith Stephanie , Tallon Mary , Smith James , Angelhoff Charlotte , Mörelius Evalotte
Published: April 2022

Sleep is a common challenge for parents with sick children and can impact parents' health, wellbeing, and caregiving responsibilities. Despite the vast research around parental sleep when their child is sick, the concept is not clearly defined. A phased principle‐based concept analysis that includes triangulation of methods and quality criteria assessment was used to explore how the concept is described, used, and measured in the current literature. The aim was to analyse and clarify the conceptual, operational, and theoretical basis of parental sleep when their child is sick to produce an evidence‐based definition and to identify knowledge gaps. A systematic literature search including databases CINAHL, Embase, MEDLINE, PsychARTICLES, PsychINFO, Pubmed, Scopus and Web of Science, identified 546 articles. The final dataset comprised 74 articles published between 2005 and 2021 and was assessed using a criteria tool for principle‐based concept analysis. Data were managed using NVivo, and thematic analysis was undertaken. A precise definition is not present in the literature. Various tools have been used to measure parents' sleep, as well as exploration via interviews, open‐ended questions, and sleep diaries. The terminology used varied. Parental sleep when their child is sick is interrelated with other concepts (e.g., stress). A recommended definition is offered. A conceptual understanding of parental sleep when their child is sick will help to guide translational research and to conduct studies critical to clinical practice and research. Future research includes developing a measurement tool for parental sleep when their child is sick to be used in study design and future interventions.
Pharmacokinetics of single and repeated oral doses of pregabalin oral solution formulation in cats
Authors: Lamminen Terttu , Doedée Anne , Hyttilä‐Hopponen Minja , Kaskinoro Janne
Published: April 2022

The study was designed to determine the pharmacokinetic profile and bioavailability of a novel pregabalin 50 mg/ml oral solution formulation (Bonqat®, Orion Corporation Orion Pharma) in 6 healthy laboratory cats. The cats received pregabalin as single oral doses of 2.5, 5, and 7.5 mg/kg, dose 5 mg/kg on two consecutive days, and a single intravenous dose of 2.5 mg/kg. The washout period between each administration was four weeks. The cats were monitored for clinical signs and level of sedation, and blood samples were taken before pregabalin dosing and at pre‐defined time points up to 168 h after dosing. Plasma concentrations of pregabalin were determined using a validated liquid chromatography–tandem mass spectrometry method. The mean maximum plasma concentration of 10.1 μg/ml was reached between 0.5 and 1 h after oral administration of the clinical dose 5 mg/kg. The mean half‐life after oral administration of dose 5 mg/kg was 14.7 h and the mean systemic bioavailability was 94%. Pregabalin showed linear pharmacokinetics from 2.5 to 7.5 mg/kg. Exposures after a single dose and re‐dosing of 5 mg/kg at 24 h were comparable. Pregabalin was well tolerated with mild sedation and mildly uncoordinated movements observed in few cats at dose 7.5 mg/kg. As a conclusion, study results show rapid absorption, linear pharmacokinetics, and high oral bioavailability of pregabalin without safety concerns after administration of oral solution in cats.
Comprehension across disciplines: A practical framework for reading research
Authors: Frean Jennifer
Published: April 2022

The increase in screen‐based publishing over the past 30 years has sparked an evolution of reading. Reading's natural scope has ignited interest across paradigms. The resulting scholarship offers rich opportunity, but also presents a concerning challenge – approaches differ across disciplines, producing results that can be difficult to interpret and apply between fields.

This article introduces both a framework for use by reading researchers across disciplines and an original interpretation of Schramm's communication model as it applies to reading. Drawing on theory and practice from communication, literacy, psychology, neuroscience and education, this article proposes a practical approach with the flexibility to accommodate a broad spectrum of research interests and goals. Using Schramm's communication model as its guiding logic, this framework unifies and extends Mangen and van der Weel's integrative framework for reading research (2016) to produce a further iteration of the framework that can be engaged at all stages of the research process, encouraging replicable and – most importantly – usable research findings for all interested stakeholders. This transdisciplinary approach aims to overcome academic silos and support more compatible, transferable research outcomes for both qualitative and quantitative projects.
Arpu Kuilpu: An H5 from the outer main belt
Authors: Shober Patrick M. , Devillepoix Hadrien A. R. , Sansom Eleanor K. , Towner Martin C. , Cupák Martin , Anderson Seamus L. , Benedix Gretchen , Forman Lucy , Bland Phil A. , Howie Robert M. , Hartig Benjamin A. D. , Laubenstein Matthias , Cary Francesca , Langendam Andrew
Published: April 2022

On June 1, 2019, just before 7:30 p.m. local time, the Desert Fireball Network (DFN) detected a −9.3 magnitude fireball over South Australia near the Western Australia border. The event was observed by six fireball observatories, and lasted for 5 s. One station was nearly directly underneath the trajectory, greatly constraining the trajectory solution. This trajectory's backward numerical integrations indicate that the object originated from the outer main belt with a semimajor axis of 2.75 au. A light curve was also extracted and showed that the body experienced very little fragmentation during its atmospheric passage. A search campaign was conducted with several DFN team members and other volunteers. One 42 g fragment was recovered within the predicted fall area based on the dark flight model. Based on measurements of short‐lived radionuclides, the fragment was confirmed to be a fresh fall. The meteorite, Arpu Kuilpu, has been classified as an H5 ordinary chondrite. This marks the fifth fall recovered in Australia by the DFN, and the smallest meteoroid (≃2 kg) to ever survive entry and be recovered as a meteorite.
Chromosome‐level genome assembly for takin (Budorcas taxicolor) provides insights into its taxonomic status and genetic diversity
Authors: Li Anning , Yang Qimeng , Li Ran , Dai Xuelei , Cai Keli , Lei Yinghu , Jia Kangsheng , Jiang Yu , Zan Linsen
Published: April 2022

The takin (Budorcas taxicolor) is one of the largest bovid herbivores in the subfamily Caprinae. The takin is at high risk of extinction, but its taxonomic status and genetic diversity remain unclear. In this study, we constructed the first reference genome of Bu. taxicolor using PacBio long High‐Fidelity reads and Hi‐C technology. The assembled genome is ~2.95 Gb with a contig N50 of 68.05 Mb, which were anchored onto 25+XY chromosomes. We found that the takin was more closely related to muskox than to other Caprinae species. Compared to the common ancestral karyotype of bovidae (2n = 60), we found the takin (2n = 52) experienced four chromosome fusions and one large translocation. Furthermore, we resequenced nine golden takins from the main distribution area, the Qinling Mountains, and identified 3.3 million single nucleotide polymorphisms. The genetic diversity of takin was very low (θπ = 0.00028 and heterozygosity =0.00038), among the lowest detected in domestic and wild mammals. Takin genomes showed a high inbreeding coefficient (FROH =0.217), suggesting severe inbreeding depression. The demographic history showed that the effective population size of takins declined significantly from ~100,000 years ago. Our results provide valuable information for protection of takins and insights into their evolution.
Goodwin, Baumol & Lewis: How structural change can lead to inequality and stagnation
Authors: Rada Codrina , Schiavone Ansel , von Arnim Rudiger
Published: April 2022

This paper presents a labor‐constrained aggregate model of growth that explains stagnation and inequality as the result of structural change, which is defined as an exogenous increase in the employment share of low‐productivity services. Productivity growth is increasing in the labor share, reminiscent of induced technical change. Productivity and real wage growth further are assumed to respond negatively to structural change. We label the positive (negative) difference between these effects dominant Lewis (Baumol) dynamics. In steady state, and across two model variants, structural change leads to stagnation. Only the model version with Keynesian aggregate demand, dominant Lewis dynamics and a weak profit squeeze also exhibits a falling labor share, and hence conforms to key stylized facts.
The chicken and the egg: Clinical reasoning and uncertainty tolerance
Authors: Richmond Anna
Published: April 2022

Richmond aruges that clinical reasoning and uncertainty tolerance development occur simultaneously and that deficit in either domain will affect the development of the other. Implications for curriculum design are offered.
Results from a Phase 1/2 trial of BB2603, a terbinafine‐based topical nano‐formulation, in onychomycosis and tinea pedis
Authors: Fuhr Rainard , Cook David , Ridden John , Nield Kerry , Leigh Emma , Cook Julie , Davies‐Strickleton Heather , Dobmeyer Juergen
Published: April 2022

BB2603 is a nano‐formulation of the antifungal drug terbinafine with the polymer polyhexamethylene biguanide (PHMB) as an excipient to enhance solubility and drug delivery to skin and nails. BB2603 is delivered topically using a low‐velocity spray. It is being developed in different strength formulations for the treatment of fungal infections of the nail and skin, including onychomycosis and tinea pedis, with BB2603‐1 (0.01% terbinafine) tested in the present trial. The aim of this study was to assess systemic exposure, safety and tolerability of BB2603‐1 compared with Lamisil® AT 1% spray and BB2603‐1 vehicle control in onychomycosis and tinea pedis. Preliminary mycological and clinical activity were also investigated. This was a single‐centre Phase 1/2, randomised, partially blinded, active‐ and vehicle‐controlled, parallel‐group trial in 46 subjects with onychomycosis associated with tinea pedis. Part 1 investigated BB2603‐1 versus Lamisil AT 1% spray and BB2603‐1 vehicle (4 weeks treatment). Part 2 investigated BB2603‐1 versus BB2603‐1 vehicle (additional 48 weeks treatment). No measurable systemic exposure of terbinafine was shown over 52 weeks of treatment with BB2603‐1. BB2603‐1 had an excellent safety and tolerability profile with no drug‐related safety findings and no evidence of skin sensitisation. BB2603‐1 showed preliminary evidence of anti‐dermatophyte activity, demonstrated by a reduction in dermatophyte positive cultures and a reduction in microscopic evidence of dermatophytes. The pharmacokinetic, safety and efficacy data from this trial support further development of the topical terbinafine‐based nano‐formulation BB2603 in fungal infections of the skin and nail, including onychomycosis and tinea pedis.
Fasting pyloric diameter and distensibility by functional endoluminal imaging probe in unsedated healthy volunteers
Authors: Zheng Ting , Vosoughi Kia , Busciglio Irene , Tebay Lisa , Burton Duane , Camilleri Michael
Published: April 2022

Background

Recent studies with functional endoluminal imaging probe (EndoFLIP®) measure physiologic characteristics of the pylorus. EndoFLIP® has the potential to select optimal candidates for gastric peroral endoscopic myotomy (G‐POEM). Normative values of the pylorus using EndoFLIP® have not been established.

Methods

Twenty‐four healthy volunteers (20–56 years old; 15 females) underwent unsedated, transoral EndoFLIP® measurements of the pylorus after 8 h of fasting. Measurements of diameter (DM), balloon pressure, and distensibility index (DI) of the pylorus were obtained twice over 5 min at 40, 50, and 60 ml balloon distensions.

Key Results

Pyloric DM at 40, 50, and 60 ml balloon distensions were 13.0 ± 2.5, 14.3 ± 1.8, and 17.2 ± 2.0 mm, respectively. DM with 60 ml distension was notably higher than with 40 and 50 ml distensions. Pyloric DI at 40, 50, and 60 ml distensions were 10.9 ± 4.8, 11.3 ± 5.8, and 11.1 ± 4.3 mm2/mm Hg, respectively (p = 0.86). Linear regression and Bland–Altman plots showed similar distribution of the DM and DI during the second minute compared with the full 5‐min measurements at 50 ml distension, as well as between two sequential measurements using 50 ml distension. With 50 ml balloon distension, intraindividual coefficients of variation (COVintra) for DM and DI were 13.8% and 29.6%, respectively, and interindividual COV (COVinter) were 12.6% and 51.3%, respectively. Similar reproducibility was obtained with 40 ml balloon distension.

Conclusions and Inferences

Unsedated EndoFLIP® can be used to characterize human fasting pyloric diameter and distensibility, with best performance observed with 40 ml and 50 ml distensions and data collection during the second minute. Normative values reported serve as reference values for future studies.
Informal caregiving from the perspectives of older people living alone in India
Authors: Gustafsson Lena‐Karin , Asztalos Morell Ildikó , Johansson Carl , De Santa
Published: April 2022

Background

The cultural and social norms in India stipulate that family and preferably children of the older person, provide the support and care that is needed. In recent years, we have witnessed an overall upsurge in interest in informal care from all countries in the developed world considering their ageing populations. The older people living alone group is, especially interesting in this matter, since it seems to deviate from the expectations of extended family living.

Objective

The aim was to describe older persons' experiences of informal care when living alone in India.

Methods

The study has a hermeneutic design, analysing interviews of older persons living alone in India.

Results

Findings revealed informal care as the thematic patterns: Informal care as a fundamental human responsibility, an obligation and thereby a way to act in ‘common sense’. It was a way of ‘paying‐back’ care that they had received from others in their life history, motivated by governmental care was not presented as an option. Informal care also created safety by the provision of alert and actionable care by loved ones, including spatial safety. Most of the informants experienced themselves as informal caregivers assisting others in need even if they themselves were old and fragile. Providing self care was also seen as a part of informal care conducted by capable and worthy persons. They also pointed out their own obligation to seek informal care and even to listen to the suggestions of younger generations regarding the type and scope of care.

Conclusions/Implications for practice

Informal care in India is not only dependent on having children who ensure that you receive the care you need. Extended family, neighbours and friends feel a basic human obligation to care for the older people in their environment. This responsibility is deeply rooted even within the older people who become fragile in old age.
Reconstruction for Massive Proximal Tibial Bone Defects Using Patient‐Customized Three‐Dimensional‐Printed Metaphyseal Cones in Revision Total Knee Arthroplasty
Authors: Li Yang , Wang Xinguang , Tian Hua
Published: April 2022

Objective

To review the clinical outcomes of revision total knee arthroplasty (RTKA) with massive proximal tibial bone defects using patient‐customized three‐dimensional (3D) printed highly porous metaphyseal cones.

Methods

A retrospective study of all patients at our institution who underwent RTKA with the Anderson Orthopaedic Research Institute type III tibial defects using patient‐customized 3D‐printed highly porous metaphyseal cones was performed from 2016 to 2018. Seven patients were enrolled in this study. General results (age, sex, and body mass index); intraoperative results (interface compatibility and stability, and operating time); and perioperative complications (total blood loss, blood transfusion rate, and deep venous thrombosis) were recorded and analyzed. Clinical improvement and functional evaluation (survivorship of implant, improvement of Hospital for Special Surgery Score and McMaster Universities Osteoarthritis Index, and improvement of range of motion [ROM]), and radiographic improvement and implant evaluation (progressive radiolucent lines or radiographic loosening, and mechanical alignment) were evaluated at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years, and then annually, postoperatively.

Results

The mean age at diagnosis was 68 (61–77) years. The mean follow‐up was 25.3 (19–36) months. At the latest follow‐up, no aseptic loosening, prosthetic joint infection, or other complications were noted. The mean Hospital for Special Surgery Score increased from 49 (39–63) to 78 (70–83) (P < 0.01), whereas the mean Western Ontario and McMaster Universities Osteoarthritis Index increased from 59 (46–73) to 26 (12–38) (P < 0.01). All patients achieved improved postoperative ROM with the mean flexion angle increasing from 66° (30°–80°) to 93° (80°–100°), and improved mechanical alignment with all hip–knee–ankle (HKA) angles within ±3°.

Conclusions

The patient‐customized 3D‐printed metaphyseal cone is useful technique for reconstructing massive proximal tibial bone defects, with encouraging clinical and radiological outcomes in RTKA.