bluuebunny/crossref_metadata_2025 huggingface dataset:
A retrospective descriptive study of NANDA‐I nursing diagnoses used by midwives working in obstetrics and gynecologic service: An example from south‐eastern Turkey
Authors: Yeşil Yeşim , Baran Leyla
Published: May 2023

Purpose

This study aims to identify NANDA‐I nursing diagnoses that midwives working in obstetrics and gynecologic service use while managing the electronic nursing care process.

Methods

This retrospective study was conducted in a descriptive way to evaluate electronic care plan records of 3025 patients staying in obstetrics and gynecologic service between April 1, 2020. and April 1, 2021. Diagnoses in the records of the electronic care process were digitalized by two faculty members. Then, NANDA‐I nursing diagnoses used by midwives were identified. NANDA‐I nursing diagnoses used by midwives were identified.

Findings

It was determined that diagnoses in care plans documented from the system within the 1‐year period fell into eight domains and 10 classes, and 5819 diagnoses were given in total. The most frequent diagnoses given in obstetrics and gynecologic service were “acute pain” and “risk for bleeding.”

Conclusion

Findings of this study revealed that nursing care records in obstetrics and gynecologic service did not have a large number of diagnoses and interventions.

Implications for nursing practice

Care plans directly reflect the contribution of the care to the patient. Consequently, midwives being aware of and recording nursing diagnoses while giving care will ensure a standardized language and visibility in care. More coverage of midwifery‐related diagnoses in the midwifery curriculum will make NANDA‐I nursing diagnoses more visible in midwifery as well.
SPAG6 c.900 T>C affects boar semen quality and blood–testis barrier function by creating a new splice acceptor site
Authors: Bai Rong , Chen Dake , Xiong Hao , Song Huibin , Wang Tiansu , Yang Xinpeng , Tang Jinhua , Feng Yue , Li Jialian , Li Fenge
Published: May 2023

Sperm associated antigen 6 (SPAG6) acts as a scaffolding protein in the center of the flagellar axoneme and has an impact on the maturation of the motility of mammalian sperm flagella and the maintenance of sperm structure. In our previous research, SPAG6 c.900 T>C in exon 7 and exon 7 skipped transcript was identified by analyzing RNA‐seq data of testicular tissues from 60 day (sexually immature) and 180 day (sexually mature) Large White boars. Herein, we found porcine SPAG6 c.900 T>C to be associated with semen quality traits in Duroc, Large White and Landrace pigs. SPAG6 c.900 C can generate a new splice acceptor site, inhibit the occurrence of SPAG6 exon 7 skipping to a certain extent, thereby promote the growth of Sertoli cells and maintain the normal blood–testis barrier function. This study provides new insights into the molecular regulation of spermatogenesis and a new genetic marker for the improvement of semen quality in pigs.
Lariciresinol protects rats from complete Freund's adjuvant induced arthritis in rats via modulation of transforming growth factor‐β and nuclear factor kappa B pathway: An in vivo and in silico study
Authors: Zhao Xiangzhuo , Wang Ying , Wang Ronghua , Shen Jingfang , Wang Jingxu , Li Lianju
Published: May 2023

Rheumatoid arthritis (RA) is a severe inflammatory auto‐immune disorder affecting millions of people across the globe. The current therapeutic options are not adequate to address the complications of RA. Therefore, the present study was conducted to elucidate the protective effect of lariciresinol, a lignan, against Complete Freund's adjuvant (CFA)‐induced arthritis in rats. The results of the study showed that lariciresinol improves paw swelling and arthritic scores in rats as compared to CFA rats. Lariciresinol also showed a significant reduction in rheumatoid factor, C‐reactive protein, tumor necrosis factor‐α, interleukin (IL)‐17, and tissue inhibitor of metalloproteinases‐3 level with a simultaneous increase in IL‐4 level. The burden of oxidative stress was also reduced in CFA rats, as shown by reduced MDA levels and increased SOD and GPx after the administration of lariciresinol. In a Western blot analysis, lariciresinol showed a significant reduction of transforming growth factor‐β and nuclear factor‐κB (NF‐κB) protein levels in CFA rats. To understand the binding characteristic of lariciresinol with NF‐κB, molecular docking analysis was conducted, which showed Larciresinol interacted with the active site of NF‐κB. Our study demonstrated the significant protective effect of lariciresinol against RA via multi‐target action.
A novel homozygous variant in ZFP36L2 cause female infertility due to oocyte maturation defect
Authors: Zhou Zhou , Fan Huizhen , Shi Rong , Zeng Yang , Liu Ruyi , Gu Hao , Li Qiaoli , Sang Qing , Wang Lei , Shi Juanzi , Chen Biaobang
Published: May 2023

Normal oocyte maturation is an important requirement for the success of human reproduction, and defects in this process will lead to female infertility and repeated IVF/ICSI failures. In order to identify genetic factors that are responsible for oocyte maturation defect, we used whole exome sequencing in the affected individual with oocyte maturation defect from a consanguineous family and identified a homozygous variant c.853_861del (p.285_287del) in ZFP36L2. ZFP36L2 is a RNA‐binding protein, which regulates maternal mRNA decay and oocyte maturation. In vitro studies showed that the variant caused decreased protein levels of ZFP36L2 in oocytes due to mRNA instability and might lead to the loss of its function to degrade maternal mRNAs. Previous study showed that the pathogenic variants in ZFP36L2 were associated with early embryonic arrest. In contrast, we identified a novel ZFP36L2 variant in the affected individual with oocyte maturation defect, which further broadened the mutational and phenotypic spectrum of ZFP36L2, suggesting that ZFP36L2 might be a genetic diagnostic marker for the affected individuals with oocyte maturation defect.
Visually Abstracting Event Sequences as Double Trees Enriched with Category‐Based Comparison
Authors: Krause Cedric , Agarwal Shivam , Burch Michael , Beck Fabian
Published: May 2023

Event sequence visualization aids analysts in many domains to better understand and infer new insights from event data. Analysing behaviour before or after a certain event of interest is a common task in many scenarios. In this paper, we introduce, formally define, and position double trees as a domain‐agnostic tree visualization approach for this task. The visualization shows the sequences that led to the event of interest as a tree on the left, and those that followed on the right. Moreover, our approach enables users to create selections based on event attributes to interactively compare the events and sequences along colour‐coded categories. We integrate the double tree and category‐based comparison into a user interface for event sequence analysis. In three application examples, we show a diverse set of scenarios, covering short and long time spans, non‐spatial and spatial events, human and artificial actors, to demonstrate the general applicability of the approach.
Investigation of genetic sex‐specific molecular profile in well‐differentiated thyroid cancer: Is there a difference between females and males?
Authors: Morand Grégoire B. , Tessler Idit , Krasner Josh , Pusztaszeri Marc. P. , Yamin Tzahi , Gecel Nir A. , Avior Galit , Payne Richard J.
Published: May 2023

Background

Although more common in females, thyroid cancer is deemed to be more aggressive in males. The reasons for sex disparities in thyroid cancer are not well understood. We hypothesised that differences in molecular mutations between females and males contribute to this phenomenon.

Methods

Retrospective multicentre multinational study of thyroid nodules that underwent preoperative molecular profiling between 2015 and 2022. The clinical characteristics and mutational profiles of tumours in female and male patients were compared. Collected data included demographics, cytology results, surgical pathology, and molecular alterations.

Results

A total of 738 patients were included of which 571 (77.4%) were females. The extrathyroidal extension was more common in malignancies in males (chi‐squared, p = 0.028). The rate of point mutations and gene fusions were similar in both sex groups (p > 0.05 for all mutations). Patients with nodules with BRAFV600E mutations were significantly younger than BRAF wild‐type nodule patients (t‐test, p = 0.0001). Conversely, patients with TERT promoter mutations were significantly older than patients with wild‐type TERT (t‐test, p < 0.0001). For patients harbouring both BRAFV600E and TERT mutations, the difference in age at presentation was significantly different in females (t‐test, p = 0.009) but not in males (t‐test, p = 0.433). Among females, patients with BRAFV600E and TERT mutations were significantly older than their wild‐type or single‐mutation counterpart (t‐test, p = 0.003).

Conclusion

The absolute rate of molecular mutations was similar in females and males. We found that extrathyroidal extension was more common in males. Moreover, BRAFV600E and TERT mutations occur at a younger age in males than in females. These two findings are factors that may explain the tendency of more aggressive disease in males.
A prospective evaluation of neck and shoulder function following treatments of early‐stage human papillomavirus‐associated oropharynx cancer
Authors: Gulati Arushi , Plonowska‐Hirschfeld Karolina , Stephens Erika M. , Kansara Sagar , Zebolsky Aaron L. , Ochoa Edgar , Xu Mary J. , Ha Patrick K. , Heaton Chase M. , Yom Sue S. , Chan Jason W. , Algazi Alain P. , Kang Hyunseok , Ryan William R.
Published: May 2023

Objectives

To compare post‐treatment neck and shoulder function between human papillomavirus‐associated oropharynx squamous cell carcinoma (HPV + OPSCC) treatments.

Design

Prospective, repeated‐measures study.

Setting

Tertiary care center.

Participants

Treatment‐naïve patients with American Joint Committee on Cancer eighth edition stage T0‐3/N0‐2 HPV+OPSCC.

Main Outcome Measures

Patients completed the Neck Dissection Impairment Index (NDII) pre‐treatment and 3‐months and 1‐year post‐treatment. The NDII assesses 10 neck and shoulder functions scored 0–5 (total score 0–100), with higher scores suggesting better function.

Results

A total of 106 patients underwent: surgery alone (SA, n = 46, 43%), surgery with adjuvant radiation ± chemotherapy (S + a[C]XRT, n = 18, 17%), or definitive radiation ± chemotherapy (d[C]XRT, n = 42, 40%). cTN classification and pre‐treatment NDII scores did not differ between groups. SA patients reported worsened 3‐month post‐treatment versus pre‐treatment self‐care (4.6 vs. 5.0), lifting light (4.6 vs. 5.0) and heavy (4.2 vs. 4.8) objects, overhead reach (4.5 vs. 4.9), activity (4.5 vs. 4.9), socialization (4.7 vs. 4.9), recreation (4.6 vs. 4.9), and overall score (86.8 vs. 95.3) (all p < 0.05). One‐year post‐treatment scores (n = 34) were no different than pre‐treatment in all domains. S + a[C]XRT patients reported worsened 3‐month versus pre‐treatment stiffness (4.0 vs. 4.8), lifting heavy objects (3.8 vs. 4.9), overhead reach (4.2 vs. 4.9), socialization (4.6 vs. 5.0), recreation (4.4 vs. 4.9) and overall score (82.4 vs. 96.0) (all p < 0.05). One‐year post‐treatment scores (n = 13) were no different than pre‐treatment in all domains. d[C]XRT patients reported worsened 3‐month versus pre‐treatment difficulty lifting heavy objects (4.3 vs. 4.7) and recreation (4.3 vs. 4.7). One‐year posttreatment scores (n = 21) were no different than pre‐treatment in all domains.

Conclusion

HPV + OPSCC patients may experience mild shoulder/neck dysfunction 3 months after treatment that usually resolves by 1 year, independent of treatment modality.
Population pharmacokinetics, enzyme occupancy, and 24S‐hydroxycholesterol modeling of soticlestat, a novel cholesterol 24‐hydroxylase inhibitor, in healthy adults
Authors: Yin Wei , Facius Axel , Wagner Thomas , Tsai Max , Asgharnejad Mahnaz , Lahu Gëzim , Vakilynejad Majid
Published: May 2023

Soticlestat is a first‐in‐class, selective inhibitor of cholesterol 24‐hydroxylase (CH24H), which catabolizes cholesterol to 24S‐hydroxycholesterol (24HC) in the brain, in phase III development for Dravet syndrome and Lennox–Gastaut syndrome treatment. This study aimed to develop a model of soticlestat pharmacokinetics (PKs) and pharmacodynamics (PDs) using 24HC plasma concentrations and CH24H enzyme occupancy (EO) time profiles. Subsequently, model‐based simulations were conducted to identify dosing strategies for phase II trials in children and adults with developmental and epileptic encephalopathies (DEEs). Four phase I trials of healthy adults involving oral administration of soticlestat 15–1350 mg were used to develop the mixed‐effect population PK/EO/PD model. The population PK analysis utilized 1727 observations (104 individuals), PK/EO analysis utilized 20 observations (11 individuals), and PK/PD analysis utilized 2270 observations (99 individuals). Optimal dosing strategies were identified from model‐based PK, EO, and PD simulations. The PK/EO/PD model described the observed data well and comprised a two‐compartment model with dose as a covariate on peripheral volume, linear elimination, and intercompartmental clearance. Transit and effect‐site compartments were included to accommodate different dosage forms and the delay between plasma drug concentrations and EO. Model‐based simulations indicated that soticlestat 100–300 mg twice daily may be an optimal adult dosing regimen with weight‐adjusted pediatric dosing strategies identified for evaluation in phase II trials. The population PK/EO/PD model provided understanding of the soticlestat PK/PD relationship with partial delineation of sources of variability, and identified dosing strategies for phase II trials of children and adults with DEEs.
Negotiating the challenges of an interracial marriage: An interpretive phenomenological analysis of the perception of diaspora Indian partners
Authors: Daniel Shaji
Published: May 2023

Objective

This interpretive phenomenological analysis study aimed to explore the marriage experience of diaspora Indians who chose to marry a non‐Indian partner and to fill in the literature gap to inform the counseling practices.

Background

Diaspora Indians have the lowest level of interracial marriage of any immigrant group living in the United States at about 20%. The resistance to marrying someone of another culture and insufficient empirical research in the field makes it difficult for counselors to adjust counseling services when dealing with diaspora Indian interracial couples.

Method

Using interpretivism and phenomenology as the philosophical ground for the research, the researcher explored the subjective experiences of interracial marriage among diaspora Indians through in‐depth interviews, which were transcribed and analyzed using coding and thematic analysis.

Results

The results illustrate those cultural issues, based on the differences between the collectivist nature of the Indian American community and the individualist American culture, caused considerable stress on interracial marriage and were the major driver of therapeutic intervention for the interracial couple.

Conclusion

The study identified various coping mechanisms that could potentially reduce marital stress among diaspora Indians engaged in interracial marriage. Findings indicate that the cultural perspective should be at the core of counseling services rendered to interracial couples.

Implications

Multicultural competence and cultural humility are essential for helping practitioners to understand nuances related to interracial marriage, especially those joining the collectivist diaspora Indian culture with that of more individualistic races and ethnicities in the United States. Future studies in the field may use longitudinal research for observing the evolution of interracial couples while managing their cultural differences and other marital issues.
Densification behavior and attrition resistance of porous Al2O3beads prepared by dripping‐ice templating
Authors: Hou Zhaoping , Yang Xinhe , Tian Zihan , Liu Liangliang
Published: May 2023

Porous Al2O3ceramic beads with a small‐scale lamellar pore structure were prepared by the dripping‐ice templating method. The densification behavior of lamellar walls and the attrition resistance of porous Al2O3beads were investigated. For the two‐dimensional structural lamellar walls, the intrinsic pores shrunk, and the necking area grew during the sintering process, leading to the densification of lamellar walls and the shrinking of porous beads. In addition, the two‐dimensional lamellar walls and three‐dimensional Al2O3bulk are compared and possibilities of elaborating of the discrepancy in grain size and pore morphology are discussed. Attrition resistance was determined by a grinding test. The dominant attrition mechanism of porous Al2O3beads is abrasion. High sintering temperature led to a decrease in the attrition rate due to a wider necking area and denser pore walls.
Digital assessment of peripheral blood and bone marrow aspirate smears
Authors: Lewis Joshua E. , Pozdnyakova Olga
Published: May 2023

The diagnosis of benign and neoplastic hematologic disorders relies on analysis of peripheral blood and bone marrow aspirate smears. As demonstrated by the widespread laboratory adoption of hematology analyzers for automated assessment of peripheral blood, digital analysis of these samples provides many significant benefits compared to relying solely on manual review. Nonetheless, analogous instruments for digital bone marrow aspirate smear assessment have yet to be clinically implemented. In this review, we first provide a historical overview detailing the implementation of hematology analyzers for digital peripheral blood assessment in the clinical laboratory, including the improvements in accuracy, scope, and throughput of current instruments over prior generations. We also describe recent research in digital peripheral blood assessment, particularly in the development of advanced machine learning models that may soon be incorporated into commercial instruments. Next, we provide an overview of recent research in digital assessment of bone marrow aspirate smears and how these approaches could soon lead to development and clinical adoption of instrumentation for automated bone marrow aspirate smear analysis. Finally, we describe the relative advantages and provide our vision for the future of digital assessment of peripheral blood and bone marrow aspirate smears, including what improvements we can soon expect in the hematology laboratory.
Axes of heterogeneity in human tissue‐resident memory T cells
Authors: Szabo Peter A.
Published: May 2023

Tissue‐resident memory T cells (TRM) represent a dedicated layer of localized immune memory in virtually every organ throughout the human body. By virtue of their long‐term residence in disparate tissues, TRM are shaped by a myriad of site‐specific influences and exhibit remarkable heterogeneity in form and function. Here, we review the major axes by which TRM vary, including their surface phenotypes, transcriptional programming, and the tissue‐specific adaptations that accrue over their tenancy. We discuss how localization within distinct anatomic niches both within and across major organ systems shapes TRM identity and examine mechanisms and prevailing models for TRM generation. Understanding the drivers of differentiation, function and maintenance of the various subpopulations that together define the TRM lineage may hold the key to unlocking the full potential of TRM to promote localized and protective tissue immunity throughout the body.
Get me out of here: Sphingosine 1‐phosphate signaling and T cell exit from tissues during an immune response
Authors: Hallisey Victoria M. , Schwab Susan R.
Published: May 2023

During an immune response, the duration of T cell residence in lymphoid and non‐lymphoid tissues likely affects T cell activation, differentiation, and memory development. The factors that govern T cell transit through inflamed tissues remain incompletely understood, but one important determinant of T cell exit from tissues is sphingosine 1‐phosphate (S1P) signaling. In homeostasis, S1P levels are high in blood and lymph compared to lymphoid organs, and lymphocytes follow S1P gradients out of tissues into circulation using varying combinations of five G‐protein coupled S1P receptors. During an immune response, both the shape of S1P gradients and the expression of S1P receptors are dynamically regulated. Here we review what is known, and key questions that remain unanswered, about how S1P signaling is regulated in inflammation and in turn how S1P shapes immune responses.
Incidence, hospitalization, and mortality in children aged 5 years and younger with respiratory syncytial virus‐related diseases: A systematic review and meta‐analysis
Authors: Duan Yuping , Jiang Mingyue , Huang Qiangru , Jia Mengmeng , Yang Weizhong , Feng Luzhao
Published: May 2023

Objectives

Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection in young children. We aimed to analyze the factors affecting the estimation of RSV‐related disease burden, and to provide evidence to help establish a surveillance system.

Methods

We searched the English‐ and Chinese‐language databases for articles published between January 1, 2010 and June 2, 2022. The quality of the included articles was assessed using the Agency for Healthcare Research and Quality scale. Random‐effects models were used for data synthesis and subgroup analyses. This review was registered in the Prospective Register of Systematic Reviews (PROSPERO: CRD42022372972).

Results

We included 44 studies (149,321,171 participants), all of which were of medium or high quality. The pooled RSV‐related disease incidence, hospitalization rate, in‐hospital mortality, and overall mortality rates in children aged 5 years and younger were 9.0 per 100 children per year (95% confidence interval [CI]: 7.0–11.0), 1.7 per 100 children per year (95% CI: 1.3–2.1), 0.5 per 100 children per year (95% CI: 0.4–0.5), and 0.05 per 100 children per year (95% CI: 0.04–0.06), respectively. Age, economics, surveillance types, case definition, and data source were all recognized as influencing factors.

Conclusions

A standardized and unified RSV surveillance system is required. Case definition and surveillance types should be fully considered for surveillance of different age groups.
Abuse of social care clients committed by nurses and other social service employees—Analysis of employees' reports
Authors: Härkänen Marja , Koskiniemi Saija , Syyrilä Tiina , Ranta Jouko , Säilä Minna , Mäntymaa Mia , Pehkonen Aini , Vehviläinen‐Julkunen Katri
Published: May 2023

Aim

The aim of the study was to describe the alleged abuse of social care clients committed by nurses and other social services employees and actions as well as sanctions that followed the alleged abuse.

Design

A retrospective study using a descriptive qualitative analysis.

Methods

The data comprised mandatory reports made by social service employees under the Social Welfare Act. This study focused on the reported abuses of clients (n = 75) by social services employees from 11 October 2016 to 31 December 2020 in Finland. The data were analysed using inductive content analysis and quantification.

Results

The majority of the reports were submitted practical nurses and other nursing personnel and by registered nurses. The severity of the abuse was most often mild or moderate. The most common abusers were nurses. The types of alleged abuse committed by professionals were as follows: (1) neglect of care, (2) physical violence/strong‐arm treatments, (3) neglect of hygiene, (4) inappropriate or threatening behaviour and (5) sexual abuse. The actions and sanctions that followed the alleged abuse were: (1) discussing the situation together, requesting an explanation, initiating hearing or defining developmental measures, (2) initiating disciplinary actions and providing verbal or written warnings, (3) dismissing or terminating the employee and (4) initiating a police investigation.

Conclusion

Nurses are an important group working in social services and might also be involved in cases of abuse.

Implications for the Profession and/or Patient Care

It is important that risks, wrongdoings and abuses are reported. Transparent reporting indicates strong professional ethics.

Impact

Knowledge about abuse in social services from the viewpoint of nursing is important for ensuring the quality and safety of services.

Reporting Method

The Standards for Reporting Qualitative Research guideline was followed.

Patient or Public Contribution

No patient or public contribution.
First record of bottom‐feeding behaviour in the whale shark (Rhincodon typus)
Authors: Whitehead Darren A. , Gayford Joel
Published: May 2023

Despite being the world's largest fish, many questions remain regarding the ecology and behaviour of the whale shark (Rhincodon typus). We present the first direct evidence of whale sharks engaging in bottom‐feeding behaviour and provide potential explanations for this foraging strategy. We suggest that whale sharks actively feed on benthic prey, either predominantly in deepwater environments or where the abundance of such prey exceeds that of planktonic food sources. We also highlight the potential for ecotourism and citizen science projects to contribute to our understanding of marine megafauna behavioural ecology.
Precision medicine in rare diseases: What is next?
Authors: Tesi Bianca , Boileau Catherine , Boycott Kym M. , Canaud Guillaume , Caulfield Mark , Choukair Daniela , Hill Sue , Spielmann Malte , Wedell Anna , Wirta Valtteri , Nordgren Ann , Lindstrand Anna
Published: May 2023

Molecular diagnostics is a cornerstone of modern precision medicine, broadly understood as tailoring an individual's treatment, follow‐up, and care based on molecular data. In rare diseases (RDs), molecular diagnoses reveal valuable information about the cause of symptoms, disease progression, familial risk, and in certain cases, unlock access to targeted therapies. Due to decreasing DNA sequencing costs, genome sequencing (GS) is emerging as the primary method for precision diagnostics in RDs. Several ongoing European initiatives for precision medicine have chosen GS as their method of choice. Recent research supports the role for GS as first‐line genetic investigation in individuals with suspected RD, due to its improved diagnostic yield compared to other methods. Moreover, GS can detect a broad range of genetic aberrations including those in noncoding regions, producing comprehensive data that can be periodically reanalyzed for years to come when further evidence emerges. Indeed, targeted drug development and repurposing of medicines can be accelerated as more individuals with RDs receive a molecular diagnosis. Multidisciplinary teams in which clinical specialists collaborate with geneticists, genomics education of professionals and the public, and dialogue with patient advocacy groups are essential elements for the integration of precision medicine into clinical practice worldwide. It is also paramount that large research projects share genetic data and leverage novel technologies to fully diagnose individuals with RDs. In conclusion, GS increases diagnostic yields and is a crucial step toward precision medicine for RDs. Its clinical implementation will enable better patient management, unlock targeted therapies, and guide the development of innovative treatments.
Value of patient decision aids for shared decision‐making in kidney failure
Authors: van Eck van der Sluijs Anita , Vonk Sanne , Bonenkamp Anna A. , Prantl Karen , Riemann Aase T. , van Jaarsveld Brigit C. , Abrahams Alferso C. ,   DOMESTICO study group
Published: May 2023

Background

It is unknown how often Dutch patient decision aids are used during kidney failure treatment modality education and what their impact is on shared decision‐making.

Objectives

We determined the use of Three Good Questions, ‘Overviews of options’, and Dutch Kidney Guide by kidney healthcare professionals. Also, we determined patient‐experienced shared decision‐making. Finally, we determined whether the experience of shared decision‐making among patients changed after a training workshop for healthcare professionals.

Design

Quality improvement study.

Participants

Healthcare professionals answered questionnaires regarding education/patient decision aids. Patients with estimated glomerular filtration rate <20 mL/min/1.73 m2 completed shared decision‐making questionnaires. Data were analysed with one‐way analysis of variance and linear regression.

Results

Of 117 healthcare professionals, 56% applied shared decision‐making by discussing Three Good Questions (28%), ‘Overviews of options’ (31%–33%) and Kidney Guide (51%). Of 182 patients, 61%–85% was satisfied with their education. Of worst scoring hospitals regarding shared decision‐making, only 50% used ‘Overviews of options’/Kidney Guide. Of best scoring hospitals 100% used them, needed less conversations (p = 0.05), provided information about all treatment options and more often provided information at home. After the workshop, patients' shared decision‐making scores remained unchanged.

Conclusions

The use of specifically developed patient decision aids during kidney failure treatment modality education is limited. Hospitals that did use them had higher shared decision‐making scores. However, the degree of shared decision‐making experienced by patients remained unchanged after healthcare professionals were trained on shared decision‐making and the implementation of patient decision aids.
Basal forebrain parvalbumin neurons modulate vigilant attention and rescue deficits produced by sleep deprivation
Authors: Schiffino Felipe L. , McNally James M. , Maness Eden B. , McKenna James T. , Brown Ritchie E. , Strecker Robert E.
Published: May 2023

Attention is impaired in many neuropsychiatric disorders, as well as by sleep disruption, leading to decreased workplace productivity and increased risk of accidents. Thus, understanding the neural substrates is important. Here we test the hypothesis that basal forebrain neurons that contain the calcium‐binding protein parvalbumin modulate vigilant attention in mice. Furthermore, we test whether increasing the activity of basal forebrain parvalbumin neurons can rescue the deleterious effects of sleep deprivation on vigilance. A lever release version of the rodent psychomotor vigilance test was used to assess vigilant attention. Brief and continuous low‐power optogenetic excitation (1 s, 473 nm @ 5 mW) or inhibition (1 s, 530 nm @ 10 mW) of basal forebrain parvalbumin neurons was used to test the effect on attention, as measured by reaction time, under control conditions and following 8 hr of sleep deprivation by gentle handling. Optogenetic excitation of basal forebrain parvalbumin neurons that preceded the cue light signal by 0.5 s improved vigilant attention as indicated by quicker reaction times. By contrast, both sleep deprivation and optogenetic inhibition slowed reaction times. Importantly, basal forebrain parvalbumin excitation rescued the reaction time deficits in sleep‐deprived mice. Control experiments using a progressive ratio operant task confirmed that optogenetic manipulation of basal forebrain parvalbumin neurons did not alter motivation. These findings reveal for the first time a role for basal forebrain parvalbumin neurons in attention, and show that increasing their activity can compensate for disruptive effects of sleep deprivation.
Application of machine learning models to animal health pharmacovigilance: A proof‐of‐concept study
Authors: Whittle Edward , Novotny Mark J. , McCaul Sean P. , Moeller Fabian , Junk Malte , Giraldo Camilo , O'Gorman Michael , de Chenu Christian , Dzavan Pavol
Published: May 2023

Machine learning (ML) models were applied to pharmacovigilance (PV) data in a two‐component proof‐of‐concept study. PV data were partitioned into Training, Validation, and Holdout datasets for model training and selection. During the first component ML models were challenged to identify factors in individual case safety reports (ICSRs) involving spinosad and neurological and ocular clinical signs. The target feature for the models were these clinical signs that were disproportionately reported for spinosad. The endpoints were normalized coefficient values representing the relationship between the target feature and ICSR free text fields. The deployed model accurately identified the risk factors “demodectic,” “demodicosis,” and “ivomec.” In the second component, the ML models were trained to identify high quality and complete ICSRs free of confounders. The deployed model was presented with an external Test dataset of six ICSRs, one that was complete, of high quality, and devoid of confounders, and five that were not. The endpoints were model‐generated probabilities for the ICSRs. The deployed ML model accurately identified the ICSR of interest with a greater than 10‐fold higher probability score. Although narrow in scope, the study supports further investigation and potential application of ML models to animal health PV data.
Planning and optimization of green infrastructures for stormwater management: The case of Tehran West Bus Terminal
Authors: Saeedi Iman , Mikaeili Tabrizi Ali Reza , Bahremand Abdolreza , Salmanmahiny Abdolrassoul
Published: May 2023

Green Infrastructures as Best Management Practice (GI‐BMP) play important role in preserving cities from urban flood and excessive runoff. In the process of using GI‐BMP in cities for stormwater management, a number of steps are taken that normally include selection of suitable sites, formulating proper combination of infrastructures, and optimization of the place and design of GI‐BMPs to maximize their cost‐effectiveness. This paper presents a site‐scale GI‐BMP implementation in Tehran West Bus Terminal (TWBT), Iran. To achieve this goal, this study applies a three steps framework namely GI‐BMP suitability analysis, GI‐BMP combination planning, and GI‐BMP optimization. In the first step, using the BMP Siting Tool, the suitable places for allocating GI practices were identified. In the next step, suitable GI‐BMP practices, including permeable pavements, bioretention basin, infiltration trench, and rain barrel were planned and arranged for each subwatersheds of the study area. In the third step, with the use of System for Urban Stormwater Treatment and Analysis Integration (SUSTAIN) model and NSGA‐II algorithm, the sizes of the planned GI‐BMP types were optimized for each subwatershed. The results indicate that runoff problem caused by surface runoff in the study area was serious and needed to be controlled. The results also revealed that there were 104 near‐optimal solutions that help reduce runoff volume by up to 70%. According to the results, applying GI‐BMPs in TWBT will reduce 60% of flow volume in the site with the price of 353,568$. This research is of practical importance for stormwater management using nature‐based solutions in bus terminals.
Information Equivalence among Transformations of Semi‐parametric Nonlinear Panel Data Models*
Authors: Brown Nicholas
Published: May 2023

This paper considers transformations of nonlinear semi‐parametric mean functions that yield moment conditions for estimation. Such transformations are said to be information equivalent if they yield the same asymptotic efficiency bound. I derive a unified theory of algebraic equivalence for moment conditions created by a given linear transformation. The main equivalence result states that under standard regularity conditions, transformations that create conditional moment restrictions in a given empirical setting need only to have an equal rank to reach the same efficiency bound. I compare feasible and infeasible transformations of both nonlinear models with multiplicative heterogeneity and linear models with unobserved factor structures.
Association of carotid intima‐media thickness with periodontitis may depend on glycemic control
Authors: Yang Hong , Cao Pei , Wang Xiaoxia , Xu Xiao , Yang Yifan , Xue Fei , Luan Qingxian , Guo Lixin
Published: May 2023

Background

There is evidence indicating that atherosclerosis is associated with periodontitis, especially in those with diabetes. The purpose of the present study was to determine whether glycemic control influences such association.

Methods

Cross‐sectional data on 214 patients diagnosed with type 2 diabetes mellitus were obtained including results of basic laboratory tests, a periodontal examination, and carotid measurements. The association of periodontal parameters and carotid intima‐media thickness (cIMT) or carotid plaque (CP) was evaluated in subgroups.

Results

Mean cIMT was significantly correlated with mean PLI, mean BI or number of PD ≥4 mm in the whole sample and the group with poor glycemic control. In the group with good glycemic control, however, only the number of PD ≥4 mm was associated with mean cIMT. A multiple logistic regression analysis also revealed that each 1 increase in mean PLI, mean BI or number of PD ≥4 mm was correlated with an increased cIMT in the whole sample.

Conclusions

In addition to confirming the relationship between periodontitis and atherosclerosis, our study found a stronger association in groups with poor glycemic control compared to those with good glycemic control, suggesting that blood glucose modifies the association between periodontitis and arterial injury.
Investigating transplantation as a mechanism for seagrass restoration in South Africa
Authors: Mokumo Mosihla Frederick , Adams Janine B. , von der Heyden Sophie
Published: May 2023

The extent of seagrasses has declined globally, with restoration through transplantation seen as an important tool for reversing population loss, yet restoration studies for African seagrass species are scarce. This study investigated the use of different planting patterns (straight‐line, compact, and star) and core sizes (11, 18, and 25 cm Ø) in transplanting ecotypes (intertidal and subtidal) in the predominantly open Knysna and temporarily closed Klein Brak estuaries in South Africa. Cores of the endangered seagrass, Zostera capensis, were transplanted in two experimental repeats per ecotype and core size along transects to investigate survival of plants post‐transplant. No significant differences were observed among core sizes, patterns, or ecotypes in the Knysna Estuary, but cores with the compact pattern had better survival rates in the Klein Brak Estuary. Holes left by the smallest cores in donor sites recovered faster through sediment deposition compared to larger holes. Our study demonstrated that seagrass restoration in South Africa is challenging due to limited suitable habitats and strong environmental variability in estuarine ecosystems. It is important that careful consideration, including of genomic diversity and population structure, as well as ecological similarity between donor and recipient populations must be made for each restoration site when assessing its restoration potential. Effective “no‐take bait zones” and upstream catchment management will be important for protecting potential donor meadows.
On partially observed competing risks model for Chen distribution under generalized progressive hybrid censoring
Authors: Singh Kundan , Kumar Mahto Amulya , Mani Tripathi Yogesh
Published: May 2023

In this paper, we discuss the inference for the competing risks model when the failure times follow Chen distribution. With assumption of two causes of failures, which are partially observed, are considered as independent. The existence and uniqueness of maximum likelihood estimates for model parameters are obtained under generalized progressive hybrid censoring. Also, we discussed the classical and Bayesian inferences of the model parameters under the assumption of restricted and nonrestricted parameters. Performance of classical point and interval estimators are compared with Bayesian point and interval estimators by conducting extensive simulation study. In addition to that, for illustration purpose, a real life example is discussed. Finally, some concluding remarks, regarding the presented model, are made.
Neurophysiological Effects of Repeated Soccer Heading in Youth
Authors: Huber Colin M. , Patton Declan A. , Rownd Kathryn R. , Patterson Gentile Carlyn , Master Christina L. , Arbogast Kristy B.
Published: May 2023

Repeated head loading in sports is associated with negative long-term brain health, and there is growing evidence of short-term neurophysiological changes after repeated soccer heading. The objective of this study was to quantify the head kinematics and effects of repetitive soccer headers in adolescents using an instrumented mouthguard. Adolescent soccer players aged 13–18 years were randomly assigned to a kicking control, frontal heading, or oblique heading group. Participants completed neurophysiological assessments at three-time points: immediately prior to, immediately after, and approximately 24 h after completing 10 headers or kicks. The suite of assessments included the Post-Concussion Symptom Inventory, visio-vestibular exam, King-Devick test, modified Clinical Test of Sensory Interaction and Balance with force plate sway measurement, pupillary light reflex, and visual evoked potential. Data were collected for 19 participants (17 male). Frontal headers resulted in significantly higher peak resultant linear acceleration (17.4 ± 0.5 g) compared to oblique headers (12.1 ± 0.4 g, p < 0.001), and oblique headers resulted in significantly higher peak resultant angular acceleration (frontal: 1147 ± 45 rad/s2, oblique: 1410 ± 65 rad/s2, p < 0.001). There were no neurophysiological deficits for either heading group or significant differences from controls at either post-heading timepoint, and therefore, a bout of repeated headers did not result in changes in the neurophysiological measures evaluated in this study. The current study provided data regarding the direction of headers with the goal to reduce the risk of repetitive head loading for adolescent athletes.
Singularity Parametrization With a Novel Kinematic Decoupled Model for Non-Spherical Wrist Robots
Authors: Rodriguez-Guerra Diego , Sorrosal Gorka , Cabanes Itziar , Mancisidor Aitziber , Calleja Carlos
Published: May 2023

Most of the current commercial collaborative robots present a non-spherical wrist, so they cannot utilize singularity handling techniques efficiently to avoid excessive safety stops while dynamically avoiding collisions. These robots usually require heavier algorithms due to their kinematics or online methods that shift the original singularities. Therefore, to enable more efficient computations on singularity handling and collision avoidance controllers, this paper proposes a novel method to characterize singular configurations of non-spherical wrist collaborative robots (6 and 7 degrees-of-freedom). This method is based on a new decoupled kinematic model that allows lighter kinematic computations and enables the joint-dependant characterization of the robot singularities to avoid shifting the singular configurations. Finally, the proposed kinematic model is particularized for a UR10e, where its kinematic behavior has been tested against two different literature models in simulation. In this manner, a novel singularity category (belonging to the internal singularities) is proposed, and a new closed set of characterized singular solutions is obtained.
Insertion of IS
Pa1635
in IS
CR1
Creates a Hybrid Promoter for
bla
PER-1
Resulting in Resistance to Novel β-lactam/β-lactamase Inhibitor Combinations and Cefiderocol
Authors: Wang Leilei , Zhang Xuefei , Zhou Xun , Bi Yingmin , Wang Minggui , Guo Qinglan , Yang Fan
Published: May 2023

Eleven
bla
PER-1
-positive
Pseudomonas aeruginosa
clinical isolates showed variable susceptibility to ceftazidime-avibactam (CZA). The genetic contexts of
bla
PER-1
were identical (IS
CR1
-
bla
PER-1
-
gst
) except for the ST697 isolate HS204 (IS
CR1
-IS
Pa1635
-
bla
PER-1
-
gst
).
Polyvalent Protein Adhesin MEFA-II Induces Functional Antibodies against Enterotoxigenic Escherichia coli (ETEC) Adhesins CS7, CS12, CS14, CS17, and CS21 and Heat-Stable Toxin (STa)
Authors: Upadhyay Ipshita , Parvej Shafiullah M. D. , Li Siqi , Lauder Kathryn L. , Shen Yiyang , Zhang Weiping
Published: May 2023

An effective vaccine is lacking against ETEC, a primary cause of children’s diarrhea and traveler’s diarrhea and a threat to global health. The key challenge in ETEC vaccine development is that ETEC bacteria express heterogeneous virulence determinants (>25 adhesins and two toxins).
Complete Genome Sequence of the Extensively Drug-Resistant Extended-Spectrum β-Lactamase-Producing Proteus mirabilis Isolate HK294, Obtained from Poultry Feces in Hong Kong
Authors: Biggel Michael , Boss Sara , Uea-Anuwong Theethawat , Lugsomya Kittitat , Magouras Ioannis , Stephan Roger
Published: May 2023

Here, we report the complete genome sequence of
Proteus mirabilis
isolate HK294, recovered from pooled poultry feces in Hong Kong in 2022. The chromosome contained 32 antimicrobial resistance genes, including the extended-spectrum β-lactamases
bla
CTX-M-65
and
bla
CTX-M-3
. Almost all resistance genes were part of either an integrative conjugative element or a Tn
7
-like transposon.
Caffeine Consumption Helps Honey Bees Fight a Bacterial Pathogen
Authors: Motta Erick V. S. , Arnott Ryan L. W. , Moran Nancy A.
Published: May 2023

The consumption of caffeine is a remarkable feature of the human diet. Common drinks, such as coffee and tea, contain caffeine as a stimulant.
Reduced Staphylococcus Abundance Characterizes the Lesional Microbiome of Actinic Keratosis Patients after Field-Directed Therapies
Authors: Kehrmann Jan , Koch Fiona , Zumdick Skrollan , Höwner Anna , Best Lara , Masshöfer Lars , Scharfenberg Sarah , Zeschnigk Michael , Becker Jürgen C. , Schadendorf Dirk , Buer Jan , Roesch Alexander
Published: May 2023

The relevance of the skin microbiome for development of actinic keratosis (AK), its progression into squamous skin cancer, and for field-directed treatment response is unknown. An overabundance of staphylococci characterizes the skin microbiome of AK lesions.
Late-onset multiple acyl-CoA dehydrogenase deficiency: an insidious presentation
Authors: Rao Naini Nishita , Burns Kharis , Manolikos Catherine , Hodge Samantha
Published: May 2023

Multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare inborn error of metabolism that results in impairment of mitochondrial β-oxidation of fatty acids. It is inherited in an autosomal recessive manner and impairs electron transfer in the electron transport chain. The clinical manifestations of MADD are highly variable and include exercise intolerance, myopathy, cardiomyopathy, encephalopathy, coma and death. Early-onset MADD is often associated with a high mortality with significant number of patients presenting with severe metabolic acidosis, non-ketotic hypoglycaemia and/or hyperammonaemic presentations. While late-onset MADD is suggested to have a lower mortality, the severe encephalopathic presentations may well be under-reported as a diagnosis of MADD may not be considered.

MADD is treatable with riboflavin and appropriate nutrition with a focus on prevention and early management of metabolic decompensation. The neonatal phenotype differs significantly from late-onset MADD, where diagnosis may be delayed due to heterogeneity in clinical features, atypical presentation and confounding comorbidities, together with lower awareness among physicians.

This report describes a woman in her 30s who presented with acute-onset ataxia, confusion and hyperammonaemic encephalopathy requiring intubation. Subsequent biochemical investigation revealed a diagnosis of MADD. At present, there are no national guidelines in Australia for the management of MADD. This case highlights the investigation and treatment of late-onset MADD.