bluuebunny/crossref_metadata_2025 huggingface dataset:
Trifecta outcomes of robotic partial nephrectomy in obese patients: A comparison of body mass index <25, 25 to <30, and ≥30
Authors: Ohsugi Haruyuki , Ikeda Junichi , Takayasu Kenta , Takizawa Nae , Taniguchi Hisanori , Yanishi Masaaki , Kinoshita Hidefumi
Published: July 2024

Objective

We analyzed robotic partial nephrectomy (RPN) outcomes in obese patients based on body mass index (BMI) and trifecta achievement.

Methods

We retrospectively reviewed 296 patients who underwent RPN at Kansai Medical University Hospital between 2014 and 2022. The preoperative clinical data and perioperative outcomes were evaluated. Trifecta achievement (negative surgical margin, no major complications, and no acute kidney injury on postoperative day three) and its relationship to three BMI groups (<25, 25 to <30, and ≥30) were the primary outcome. The correlation between factors in achieving trifecta and BMI was evaluated. Univariate and multivariate analyses assessed variables for achieving the trifecta with logistic regression analysis. C‐statistics quantitatively evaluated the prediction accuracy.

Results

Among 296 patients, 264 (89.2%) achieved trifecta (BMI categories were <25 [89.9%], 25 to <30 [89.4%], and ≥30 [82.6%]). There was no significant BMI‐related difference (p = 0.566). Intraoperative blood loss increased with the BMI (p = 0.034). Multivariate analyses showed preoperative aspects and dimensions used for anatomic (PADUA) score independently predicted trifecta failure (odds ratio 1.71; 95% confidence interval 1.32–2.20;p < 0.001). The C‐statistics of the PADUA score increased with increasing BMI.

Conclusions

Higher BMI patients had more intraoperative blood loss during RPN. However, RPN remains safe and has acceptable quality and functional outcomes. Since patients with high PADUA scores combined with a high BMI may be at risk of trifecta failure, this should be explained before RPN.
Optimising the structure of outpatient clinic letters: insights from a survey of general practitioners and hospital doctors
Authors: Jayawardena Thisuri , Lei Cory , McLeod Katie , Chakera Aron
Published: July 2024

Outpatient letters are an essential communication tool in healthcare. Yet doctors receive little training on letter writing and what details recipients consider important. We surveyed 106 hospital doctors and 63 general practitioners (GPs), identifying differences in each group's preferences; GPs preferred more structured, detailed letters. Opportunities for feedback, formal templates and advanced software systems can improve communication in outpatient clinics.
People Living With Mental Illness Perceptions of Physical Health, Mental Health and Well‐Being
Authors: Porter Cassandra , Aggar Christina , Duncanson Kerith
Published: July 2024

Understanding the perspectives of regional people living with mental illness is crucial to adapting services, improving holistic care and meeting individual needs. This study explored people living with mental illness perceptions of physical health, mental health and well‐being. A descriptive qualitative study design underpinned by empowerment theory was conducted. Qualitative data were collected verbally via semi‐structured interviews, with demographic details provided verbally at the end of the interview. Thematic analysis was utilised to identify themes. The COREQ checklist was used for reporting. Fourteen participants admitted to regional mental health inpatient units aged between 25 and 84 years old were interviewed. Participants felt their overall well‐being was good despite feeling their physical health or mental health was suboptimal, suggesting that their perceived well‐being is influenced by factors beyond their physical and mental health. Most participants reported looking after their physical health, mental health and well‐being and identified various behavioural lifestyle strategies they found helpful. Thematic analysis identified three themes: functioning well, feeling in control and meeting basic needs. Mental health services and clinicians play an important role in empowering people with mental illness to improve their physical health, mental health and well‐being while admitted to inpatient services; however, it is acknowledged resources can be limited. Mental health services may consider referring people with mental illness to social prescribing programmes to meet their individualised needs on discharge.
Family Caregivers' Perceptions and Experiences of Supporting Older People to Cope With Loneliness: A Qualitative Interview Study
Authors: Cheng Ka Man , Zhao Ivy Yan , Maneze Della , Holroyd Eleanor , Leung Angela Yee Man
Published: July 2024

Loneliness has become a significant public health issue among community‐dwelling older adults particularly those with multimorbidity. Family caregivers are crucial care resources for dependent older adults living in the community before transitioning to institutional services. However, understanding of their perceptions in supporting older adults with multimorbidity to cope with loneliness is limited. This qualitative study aimed to elucidate on the experiences of caring and explore the experiences and perceptions of family caregivers in supporting older community‐dwelling adults with multimorbidity to cope with loneliness. Eleven family caregivers, aged 51–93 years old, with at least 2 years of caregiving experience were purposively recruited and interviewed individually. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was utilised to report the study. Three key themes were generated from the inductive analysis: (1) recognising older adults' loneliness through the expression of unusual emotions, behaviour/s, social network alteration and speech; (2) variations in perceptions and responses to loneliness among different family caregiving relationships; and (3) challenges in addressing loneliness. Positive feedback from cared‐for older adults was appreciated by their family caregivers which in turn motivated further actions to alleviate loneliness. The findings emphasised the importance of developing specific patients and family caregivers centred interventions, such as communication skills training to enhance effective communications. Cultural values and norms of individuals should be respected in those interventions, ensuring that emotional expression is facilitated in a comfortable way for both older patients and family caregivers.
Community health services in European literature: A systematic review of their features, outcomes, and nursing contribution to care
Authors: Caponnetto Valeria , Dante Angelo , El Aoufy Khadija , Melis Maria Ramona , Ottonello Giulia , Napolitano Francesca , Ferraiuolo Fabio , Camero Francesco , Cuoco Angela , Erba Ilaria , Rasero Laura , Sasso Loredana , Bagnasco Annamaria , Alvaro Rosaria , Manara Duilio Fiorenzo , Rocco Gennaro , Zega Maurizio , Cicolini Giancarlo , Mazzoleni Beatrice , Lancia Loreto
Published: July 2024

Background

To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored.

Introduction

Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational models, outcomes, nursing contribution to care, and nursing‐related determinants of outcomes.

Methods

A systematic review was performed by searching PubMed, CINAHL, Scopus, and Embase in October 2022 and October 2023 (for updated results). Quantitative studies investigating the effects of community care, including nursing contribution, on patient outcomes were included and summarized. Reporting followed the PRISMA checklist. The review protocol was registered on PROSPERO (CRD42022383856).

Results

Twenty‐three studies describing six types of community care services were included, which are heterogeneous in terms of target population, country, interventions, organizational characteristics, and investigated outcomes. Heterogeneous services’ effects were observed for access to emergency services, satisfaction, and compliance with treatment. Services revealed a potential to reduce rehospitalizations of people with long‐term conditions, frail or older persons, children, and heart failure patients. Models are mainly multidisciplinary and, although staffing and workload may also have an impact on provided care, this was not enough investigated.

Discussion

Community health services described in European literature in the last decade are in line with population needs and suggest different suitable models and settings according to different care needs. Community care should be strengthened in health systems, although the influence of staffing, workload, and work environment on nursing care should be investigated by developing new management models.

Conclusions and implications for health policy

Community care models are heterogeneous across Europe, and the optimum organizational structure is not clear yet. Future policies should consider the impact of community care on both health and economic outcomes and enhance nursing contributions to care.
The information effect versus governance effect of comment letters: Evidence from the cost of equity capital
Authors: Chen Yikun , Hu Ning , Cao Yanan , Guo Savannah (Yuanyuan) , Wang Yuhan
Published: July 2024

This paper uses a sample of comment letters issued and disclosed by the Shanghai and Shenzhen Stock Exchanges in China from 2015 to 2019 and empirically investigates the impact of comment letters on the cost of equity capital. The results show that the cost of equity capital raises after firms receive comment letters. However, when repeating the analysis using comment letters issued but undisclosed between 2013 and 2014, the observed effect dissipates, indicating an information disclosure channel. Moreover, the cost of equity capital is higher when the letters include more questions and demand independent opinions from auditors. Cross‐sectional tests show that this effect is influenced by investor protection, corporate information environment, and internal control quality. Additional tests show a negative association between the receipt of comment letters and both the likelihood and the amount of seasoned equity offerings, which can be attributed to the elevated cost of equity. Overall, our paper not only underscores the importance of public disclosure of government regulatory information, but also provides empirical evidence supporting the effectiveness of regulation by stock exchanges.
An exploration of nursing students' lived experience of clinical placement in adult male prisons: A phenomenological study
Authors: Brooke Joanne , Rybacka Monika , Sarwan Shubhangi , Ojo Omorogieva
Published: July 2024

Aim

To explore nursing students' lived experience of a clinical placement within healthcare in a prison, to gain an insight into the support provided prior to and during this unique clinical placement.

Design

An inductive phenomenological study.

Methods

Participants included 14 nursing students from three undergraduate nursing programmes in England, Adult (n = 4), Learning Disability (n = 3) and Mental Health (n = 7). Following a clinical placement in a prison, each participant completed a semistructured audio‐recorded interview on MS Teams between October and December 2021. Audio recordings were transcribed verbatim and thematic analysis was completed.

Results

Two overarching themes were identified, ‘shock’ due to the (a) reality of prison; (b) overwhelming emotional impact and (c) frequency and severity of self‐harm and ‘surprise’ due to (a) the need to work with prison officers; (b) recognizing and addressing preconceptions of people in prison and (c) the development of clinical knowledge, skills and becoming a nurse.

Conclusions

The need remains for a comprehensive strategy of preparation and orientation for nursing students before commencing a clinical placement in prison, which includes the development of knowledge and clinical skills to support the complex health and social care needs of people in prison.

Impact

Our research identified the support provided to nursing students prior to clinical placement in prison varies considerably. The development of a preparation and orientation programme has the potential to reduce pre‐placement anxiety, emotional burden and support nursing students in addressing their preconceptions of people in prison. This approach is essential to support future nursing students to embrace the unique opportunity of a clinical placement within a prison, enhance their clinical knowledge and skills, and develop as a nurse.

Reporting Method

Our paper adheres to the consolidated criteria for reporting qualitative research (COREQ).

Patient or Public Contribution to the Development of this Study

None.
Job gain and job loss dynamics in the truck transportation industry
Authors: Miller Jason W. , Phares Jonathan , Burks Stephen V.
Published: July 2024

Every year, roughly 27% of all jobs in the truck transportation sector (NAICS 484) are reshuffled across motor carriers as existing carriers grow or shrink, new entrants begin operations, and existing firms exit. We take a first look at job gain and job loss dynamics in truck transportation, with a special emphasis on the roles of carrier age and job gain and loss dynamics in the manufacturing sector, the source for most trucking ton‐miles. In doing so, we draw on and extend theory in both supply chain management and economics. We test our predictions using archival administrative data covering 1995 through 2019 from the Census Bureau's Business Dynamics Statistics program that tracks the universe of truck transportation firms with employees. Results from fitting a series of mixed effects models provide strong evidence that job gain and job loss dynamics at trucking firms decline rapidly as carriers age. We further find these age‐related dynamics are moderated by employment dynamics in the manufacturing sector. Robustness testing shows job gains and losses dynamics in manufacturing are more predictive than the same dynamics in the distribution sector (wholesaling, retailing, and warehousing). We discuss implications of these findings for theory and practice.
Functions of Epimedin C in a zebrafish model of glucocorticoid‐induced osteoporosis
Authors: Zhou Xiaoyang , Lian Kai , Jia Junjie , Zhao Xue , Duan Peng , Huang Jiaolong , Shi Yihua
Published: July 2024

Epimedium is thought to enhance the integrity of tendons and bones, ease joint discomfort and rigidity and enhance kidney function. Although glucocorticoids are commonly used in clinical practice, the mechanism by which the active compound Epimedin C (EC) alleviates glucocorticoid‐induced osteoporosis (GIOP) is not well understood. The therapeutic potential of EC in treating GIOP was evaluated using alizarin red S staining, calcein immersion and fluorescence imaging, and bone mineralization, bone mass accumulation and bone density in zebrafish larvae were determined. Using the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, the key signalling pathways related to bone development were identified. A protein–protein interaction network (PPIN) was constructed to identify osteoclast characteristic genes and the findings were verified using real‐time quantitative PCR (RT‐qPCR). The bone tissue damage caused by prednisolone was reduced by EC. It also altered physiological processes, improved bone density, boosted mineralization and increased bone mass and activity. Subsequent empirical investigations showed that EC impacted the major signalling pathways involved in bone development, such as osteoclast differentiation, oestrogen, MAPK, insulin resistance, PPAR and AMPK signalling pathways. It also decreased the expression of genes typical of osteoclasts. The results of our study uncover a previously unknown function of EC in controlling bone formation and emphasize the potential of EC as a therapeutic target. The osteoprotective effect of EC indicates its potential as a cost‐effective strategy for treating GIOP.
Structure, governance and delivery of specialist training programs in periodontology and implant dentistry
Authors: Goldstein Moshe , Donos Nikolaos , Teughels Wim , Gkranias Nikolaos , Temmerman Andy , Derks Jan , Kuru Bahar Eren , Carra Maria Clotilde , Castro Ana Belen , Dereka Xanthippi , Dekeyser Christel , Herrera David , Vandamme Katleen , Calciolari Elena
Published: July 2024

Aim

To update the competences and learning outcomes and their evaluation, educational methods and education quality assurance for the training of contemporary specialists in periodontology, including the impact of the 2018 Classification of Periodontal and Peri‐implant Diseases and Conditions (2018 Classification hereafter) and the European Federation of Periodontology (EFP) Clinical Practice Guidelines (CPGs).

Methods

Evidence was gathered through scientific databases and by searching for European policies on higher education. In addition, two surveys were designed and sent to program directors and graduates.

Results

Program directors reported that curricula were periodically adapted to incorporate advances in diagnosis, classification, treatment guidelines and clinical techniques, including the 2018 Classification and the EFP CPGs. Graduates evaluated their overall training positively, although satisfaction was limited for training in mucogingival and surgical procedures related to dental implants. Traditional educational methods, such as didactic lectures, are still commonly employed, but they are now often associated with more interactive methods such as case‐based seminars and problem‐based and simulation‐based learning. The evaluation of competences/learning outcomes should employ multiple methods of assessment.

Conclusion

An update of competences and learning outcomes of specialist training in periodontology is proposed, including knowledge and practical application of the 2018 Classification and CPGs. Harmonizing specialist training in periodontology is a critical issue at the European level.
The impact of limited English proficiency on oncological outcomes in the United States: A systematic review
Authors: Smith Kierstyn M. , Rogers Camille R. , Akinola Olawale O. , Holbert Natalie A. , Blunt Heather B. , Yen Renata W.
Published: July 2024

Background

The increasing number of immigrants in the United States (U.S.) has resulted in more patients with limited English proficiency (LEP). LEP contributes to patient‐provider language discordance, which may impact oncologic health outcomes.

Objectives

To assess the effects of LEP compared to English proficiency (EP) for oncological outcomes in adult cancer patients in the United States.

Search Methods

We searched MEDLINE (Ovid), the Cochrane Library (Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials), PsycINFO, CINAHL and Scopus from data inception to 26 January 2023. We also searched the reference lists and cited lists of included studies. Studies were limited to the United States and the English language.

Selection Criteria

We included retrospective and cross‐sectional studies that analyzed one or more clinical outcomes (survival, readmission, length of stay, complications and discharge disposition) in LEP and EP cancer patients. Studies were eligible if they assessed cancer patients in the United States who were 18 years and older.

Data Collection and Analysis

Using a piloted, standardized data collection form, two non‐blinded, independent reviewers extracted data in duplicate from studies meeting our inclusion criteria. Reviewers resolved discrepancies through discussion. We then performed a qualitative assessment of the findings.

Main Results

We retrieved 2425 records from the database searches. We screened 1496 records by title and abstract and reviewed the full text of eight records. We retrieved 347 records from additional search methods and reviewed the full text of six records. We included 14 papers in total for analysis. The studies included 55,141 total patients and assessed outcomes in brain, oesophageal, head and neck, pancreatic and skin cancer. Our qualitative assessment demonstrated limited information on whether LEP impacted survival, complications and discharge disposition. We found no significant association between LEP and readmission or length of stay.

Conclusions

Studies assessing the impact of LEP and EP on the health outcomes of cancer patients are sparse and inconsistent in the measurements of outcomes and data reporting. The inconclusiveness of our study indicates that further standardized research is needed to assess the impact of LEP on the outcomes of cancer patients in the United States.
Characterization of Photobacterium damselae subsp. damselae isolated from diseased Asian seabass (Lates calcarifer) and the preliminary development of a formalin‐killed cell vaccine
Authors: Weawsawang Warisara , Homsombat Theeyathart , Nuanmanee Saransiri , Saleetid Nattakan , Thawonsuwan Jumroensri , Pumchan Ansaya , Hirono Ikuo , Kondo Hidehiro , Unajak Sasimanas
Published: July 2024

Asian seabass (Lates calcarifer) is an economically important fish species that is widely cultivated in Thailand. However, aquaculture of Asian seabass is limited by infectious diseases. One of the most serious diseases is photobacteriosis, caused by Photobacterium damselae. Vaccination is recognized as an efficient disease prevention and pathogen control method for strengthening the aquaculture industry. To promote vaccine development, the characterization of pathogenic bacteria and their pathogenesis is required. In this study, isolates of P. damselae were obtained from commercial aquaculture farms in Thailand during 2019–2021. Analyses of 16S rRNA and the urease subunit alpha genes identified the isolates as P. damselae subsp. damselae (Phdd). Antibiotic susceptibility analyses showed that all Phdd isolates were resistant to amoxicillin (10 μg). Haemolysis and phospholipase activities were used to categorize P. damselae into three groups based on their biological activities. The pathogenicity of four candidates (SK136, PD001, PD002 and T11L) was tested in Asian seabass. Isolate SK136 showed the highest virulence, with a lethal dose (LD50) of 1.47 × 105 CFU/fish, whereas isolate PD001 did not show any virulence. Genotypic characterization, based on multi‐locus sequence typing analysis, demonstrated that all candidates were novel strains with new sequence types (64, 65, 66 and 67). Preliminary vaccination using formalin‐killed cells (FKCs) protected Asian seabass from artificial challenges. Taken together, these results provide fundamental knowledge for vaccine development against Phdd infection in Asian seabass.
Morphological Markedness and the Temporal Dynamics of Gender Agreement Processing in Spanish as a Majority and a Heritage Language
Authors: Keating Gregory D.
Published: July 2024

For Spanish nouns, masculine gender is unmarked and feminine is marked. Effects of markedness on gender agreement processing are inconsistent, possibly owing to differences between online methods. This study presents a reanalysis of eye‐tracking data from Keating's (2022) study on the processing of noun‐adjective gender agreement in speakers of Spanish as a majority and a heritage language. Pairwise comparisons by noun class showed that both groups displayed sensitivity to gender violations with masculine nouns earlier in the time course of agreement processing than they did to violations with feminine nouns, although sensitivity to errors with both classes emerged later for heritage speakers. The time course advantage for detecting gender violations with masculine nouns disappeared when a word occurred between nouns and adjectives. In sum, the native Spanish parser utilizes markedness information during online computation of gender agreement dependencies, even when exposure to native language input is significantly reduced.
Length–Weight Relationship, Condition Factor and Maturity Characteristics of an Invasive Oreochromis niloticus (Cichlidae) in an Alkaline‐Saline Lake Nakuru, Kenya
Authors: Mutie Alice , Morara George N. , Waithaka Edna , Obegi Beatrice , Loki Patrick
Published: July 2024

Studies on the length–weight relationship (LWR), condition factor (K) and size at first maturity status are important aspects of fish biology and fisheries management. Although many studies have reported about growth parameters of Oreochromis niloticus under various fishery waters and aquaculture systems, a recent invasion of the species in Lake Nakuru (Kenya) is a new case study. Therefore, this paper provides baseline data on LWR, K and Lm50 of O. niloticus in relation to limnological conditions in the lake. Water quality parameters (pH, temperature, conductivity, dissolved oxygen, salinity and total suspended solids) and indicators of eutrophication status (phosphates, nitrates and chlorophyll‐a.) were analysed in November 2020 and November 2021. Fish samples were collected using experimental gillnets with assorted mesh sizes from 2 to 4 in., and their morphometric data was analysed. Results show significant spatial variations (ANOVA; p < 0.05) in all the water quality parameters. These parameters, except the temperature, also significantly differed between the study periods (t‐test; p < 0.05). O. niloticus was the most dominant species, comprising 75.3% and 90.8%, in 2020 and 2021, respectively. Mean total length (19.80 cm) and weight (169 g) of the fish in 2021 were greater than 19.20 cm and 153 g in 2020. Nile tilapia exhibited an isometric LWR (b = 3), better well‐being (K>1), but it matured at smaller sizes (<25 cm) in both sexes. Further monitoring of water quality changes in Lake Nakuru and their future impact on the population of O. niloticus is recommended.
Zircon U‐Pb provenance analysis of impact melt and target rocks from the Rochechouart impact structure, France
Authors: Guerrero Daniela , Reimold Wolf Uwe , Hauser Natalia , Figueiredo Igor , Kenni Lucas , Lambert Philippe
Published: July 2024

The Rochechouart impact structure in the northwestern part of the French Massif Central (FMC) has a great diversity of impactites, including monomict impact breccias, suevite, and impact melt rocks (IMRs). The structure is strongly eroded, which allows the study of impactites of the crater fill and the transition into the crater floor. The FMC has had a multistage geological evolution from the late Neoproterozoic to the Ordovician (600–450 Ma) until the later stages of the Variscan orogeny (~300 Ma). Previous geochronological work on Rochechouart has been focused mainly on the impactites and constraining the impact age, and scarce work has been done on the FMC‐related target rocks. Here, U‐Pb isotope analysis by LA‐MC‐ICP‐MS has been conducted on zircon from two IMRs from the Recoudert and Montoume localities, and from a monzodiorite, a paragneiss, and two amphibolite samples of the basement to the impact structure. Zircon from the target rocks yielded mainly Neoproterozoic to Carboniferous ages (~924 to ~301 Ma) that can mostly be correlated to different stages of the geological evolution of the FMC. The monzodiorite also yielded a Permian age of 272 ± 12 Ma. Zircon from the IMRs, and especially from the Montoume sample, gave a comparatively higher diversity of Neoproterozoic to Jurassic ages (~552 to ~195 Ma). Provenance analysis for the zircon age populations of the impactites compared to those of the basement rocks shows overall poor correlation between the two age groups. This suggests that other target lithologies were involved in the formation of these impact melts as well. Post‐Variscan and preimpact ages (281–226 Ma) obtained for both melt rocks probably reflect a previously unconstrained event in the evolution of the regional geological history. Ages similar to the currently most widely accepted impact age of ~204–206 Ma were obtained from both IMR samples. In addition, the Montoume melt rock yielded several post‐204 Ma ages, which might reflect a to date unconstrained, about 194 Ma postimpact thermal/hydrothermal event.
Self‐training with Bayesian neural networks and spatial priors for unsupervised domain adaptation in crack segmentation
Authors: Chun Pang‐jo , Kikuta Toshiya
Published: July 2024

This study proposes a novel self‐training framework for unsupervised domain adaptation in the segmentation of concrete wall cracks using accumulated crack data. The proposed method incorporates Bayesian neural networks for uncertainty estimation of pseudo‐labels, and spatial priors of cracks for screening noisy labels. Experiments demonstrate that the proposed approach achieves significant improvements in F1 score. Comparing the F1 scores, Bayesian DeepLabv3+ and Bayesian U‐Net showed performance improvements of 0.0588 and 0.1501, respectively, after domain adaptation. Furthermore, the integration of Stable Diffusion for few‐shot image generation enhances domain adaptation performance by 0.0332. The proposed framework enables high‐precision crack segmentation with as few as 100 target images, which can be easily obtained at the site, reducing the cost of model deployment in infrastructure maintenance. The study also investigates the optimal number of iterations for domain adaptation based on the uncertainty score, providing insights for practical implementation. The proposed method contributes to the development of efficient and automated structural health monitoring using AI.
Transforming settler nationalism in Québec: Recovering the principles of the historical treaties
Authors: Cardin‐Trudeau Étienne
Published: July 2024

The settler nature of Québécois society makes it a distinct case of minority nationalism. Québec's claim of self‐determination is necessarily more complex and intricately woven with parallel claims from the Indigenous peoples of the territory. This paper argues, first, that Québécois society holds significant obligations toward Indigenous peoples reflected in the commitments made in the historical French treaties and second, that the normative principles embedded in those treaties should be used to transform the relationships it holds with Indigenous peoples and Québec's nationalist project itself. Overall, the paper suggests that Québécois nationalism needs to move away from settler colonialism by considering more seriously the shared nature of the territory it purports to have sovereignty over and by upholding the principles that allowed settlers to stay on the land.
Atypical Periprosthetic Femoral Fracture Might be Considered a Distinct Subtype of Atypical Femoral Fracture: A Retrospective Study
Authors: Huang Kai , Zeng Yi , Zhang Qingyi , Tan Jie , Li Hexi , Yang Jing , Xie Huiqi , Shen Bin
Published: July 2024

Objective

The exact relationship among atypical periprosthetic femoral fractures (APFFs), typical periprosthetic femoral fractures (PFFs), and atypical femur fractures (AFFs) remains unclear. This study aimed to investigate the prevalence of APFFs among PFFs and to identify the clinical characteristics, management, and prognosis that distinguish APFFs from typical PFFs and AFFs to further determine the relationship among these three fracture types.

Methods

In this retrospective study, we reviewed the clinical data of 117 consecutive patients who had PFFs after hip arthroplasty between January 2012 and December 2022 and further classified them into an APFF group and a typical PFF group according to the revised ASBMR diagnostic criteria for AFF. Moreover, patients who had subtrochanteric or femoral shaft fractures in the same period and met the diagnostic criteria for AFF were recruited and classified into the AFF group. Demographic information, minor features of AFF, comorbidities, history of medication usage, management, and complications were collected and compared among patients with typical PFFs, APFFs, and AFFs.

Results

Eleven PFFs were identified as APFFs, and the prevalence of APFFs among PFFs was 9.4%. Significant differences were found in generalized increase in cortical thickness (p = 0.019), prodromal symptoms (p < 0.001), and the incidence of bilateral fractures (p = 0.010) among the groups, where the incidences of these minor features in the APFF group and the AFF group were higher than those in the typical PFF group. Of note, the duration of fracture healing of APFFs was significantly longer than that of typical PFFs and AFFs (p < 0.001 and p = 0.004, respectively). In addition, the APFF group and the AFF group had higher proportions of patients with rheumatoid arthritis (p = 0.004 and p = 0.027, respectively), bisphosphonate (BP) usage (p = 0.026 and p < 0.001, respectively), and longer duration of BP usage (p = 0.003 and p = 0.007, respectively) than the typical PFF group. Furthermore, significant differences were found in management (p < 0.001) and complication rate (p = 0.020) among the groups, and the rate of complications in the APFF group and the AFF group was higher than that in the typical PFF group.

Conclusions

APFFs not only fulfilled the mandatory and major diagnostic criteria for AFF but also had many clinical characteristics, management and prognosis distinguishing them from typical PFFs but resembling AFFs; hence, the diagnostic criteria for AFF might be revised to incorporate APFF as a distinct subtype of the condition.
Efficacy and Safety of Bone Wax Application at Different Time Points to Reduce Postoperative Blood Loss in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial
Authors: Ye Shuwei , Gan Yanfeng , Li Qianhao , Cai Lijun , Kang Pengde
Published: July 2024

Objective

In addition to the surface hemorrhage of cancellous bone after large‐area osteotomy, the intramedullary hemorrhage after the reamed knee joint is also a major cause of postoperative bleeding after total knee arthroplasty (TKA). This study evaluated the efficacy and safety of bone wax application at different time points of prone hemorrhage to reduce perioperative blood loss.

Methods

From August 2023 to December 2023, 150 patients undergoing primary unilateral TKA were included in this prospective, randomized controlled trial, patients were randomly divided into three groups: group A, after autogenous osteotomy plug was used to fill the femoral medullary cavity, the residual space was sealed with bone wax and the exposed cancellous bone surface around the prosthesis was coated with bone wax after the prosthesis adhesion; group B, only the exposed cancellous bone surface around the prosthesis was coated with bone wax; and group C, no bone wax was used. The primary outcome was total perioperative blood loss. Secondary outcomes included occult blood loss, postoperative hemoglobin reduction, blood transfusion rate, lower limb diameter, and knee function, while length of hospital stay was recorded. Tertiary outcomes included the incidence of postoperative related adverse events.

Results

The total blood loss in group A (551.5 ± 224.5 mL) and group B (656.3 ± 267.7 mL) was significantly lower than that in group C (755.3 ± 248.3 ml, p < 0.001), and the total blood loss in group A was also lower than that in group B (p < 0.05). There were also significant differences in the reduction of hemoglobin level and hidden blood loss among the three groups (p < 0.05). However, there was no significant improvement in postoperative lower limb swelling, knee joint activity and hospitalization time; there was no significant difference in the incidence of complications such as thromboembolism.

Conclusion

The use of bone wax in TKA can safely and effectively reduce perioperative blood loss and hemoglobin drop rate, and multiple use at time points during the operation when blood loss is prone to occur can produce more significant hemostatic effect.
Hobbled across the Road: Ontological Securities, Security Values, and the Threat Perception of China in Australian, South Korean, and US Contexts
Authors: Liu Tianyang , Guan Tianru , Yang Yilu
Published: July 2024

Despite the escalating perception of China as a “threat” in some Western countries, existing cross‐national investigations lack a psychological framework that incorporates identity factors such as ontological security (OS) and diverse security value orientations to predict the threat. This study introduces a framework of self‐reported individual‐difference measures, tapping into ontological security and security value orientation, to analyze their influence on China threat perception in Australia, South Korea, and the USA. Based on our examination of four dimensions of ontological security (biographical, dread, self‐integrity, and trust), the findings challenge current theories that assume a coherent, integrated model of the four OS dimensions. We thus dispute OS as an initiated and unified form of security, revealing a tension between theoretical and empirical perspectives on individual‐level ontological security. In this tension, dread has a generalizing effect on China threat perception, while self‐continuity lacks substantial impact. Regarding security orientation values, individuals favoring an absolutist notion of security, alongside violent and collective means, are more prone than others to perceive China as a threat. This study contributes to the constructivist school in OS‐threat association within international relations and enhances ontological security research on China perception in the Asia‐Pacific context.
An AP2/ERF member LlERF012 confers thermotolerance via activation of HSF pathway in lily
Authors: Li Ting , Wu Ze , Zhang Yinyi , Xu Sujuan , Xiang Jun , Ding Liping , Teng Nianjun
Published: July 2024

Heat stress transcription factors (HSFs) are core factors of plants in response to heat stress (HS), but their regulatory network is complicated and remains elusive in a large part, especially HSFBs. In this study, we reported that the LlERF012‐LlHSFA1 module participates in heat stress response (HSR) by directly regulating HSF pathway in lily (Lilium longiflorum). LlHSFB1 was confirmed as a positive regulator in lily thermotolerance and a heat‐inducible AP2/ERF member LlERF012 (Ethylene Response Factor 012) was further identified to be a direct trans‐activator of LlHSFB1. Overexpression of LlERF012 elevated the thermotolerance of transgenic Arabidopsis and lily, but silencing LlERF012 reduced thermotolerance in lily. Further analysis showed LlERF012 interacted with LlHSFA1, which led to enhanced transactivation activity and DNA‐binding capability of LlERF012. In addition, LlERF012 also directly activated the expression of LlHSFA1 by binding its promoter. As expected, we found that LlERF012 bound the promoters of LlHSFA2, LlHSFA3A, and LlHSFA3B to stimulate their expression, and LlERF012‐LlHSFA1 interaction enhanced these activation effects. Overall, our data suggested that LlERF012 was a key factor for lily thermotolerance and the LlERF012‐LlHSFA1 interaction synergistically regulated the activity of the HSF pathway including the class A and B members, which might be of great significance for coordinating the functions of different HSFs.
The classification of melanocytic gene signatures
Authors: Hu Min , Coleman Samuel , Judson‐Torres Robert L. , Tan Aik Choon
Published: July 2024

Gene expression profiling technologies have revolutionized cell biology, enabling researchers to identify gene signatures linked to various biological attributes of melanomas, such as pigmentation status, differentiation state, proliferative versus invasive capacity, and disease progression. Although the discovery of gene signatures has significantly enhanced our understanding of melanocytic phenotypes, reconciling the numerous signatures reported across independent studies and different profiling platforms remains a challenge. Current methods for classifying melanocytic gene signatures depend on exact gene overlap and comparison with unstandardized baseline transcriptomes. In this study, we aimed to categorize published gene signatures into clusters based on their similar patterns of expression across clinical cutaneous melanoma specimens. We analyzed nearly 800 melanoma samples from six gene expression repositories and developed a classification framework for gene signatures that is resilient against biases in gene identification across profiling platforms and inconsistencies in baseline standards. Using 39 frequently cited published gene signatures, our analysis revealed seven principal classes of gene signatures that correlate with previously identified phenotypes: Differentiated, Mitotic/MYC, AXL, Amelanotic, Neuro, Hypometabolic, and Invasive. Each class is consistent with the phenotypes that the constituent gene signatures represent, and our classification method does not rely on overlapping genes between signatures. To facilitate broader application, we created WIMMS (what is my melanocytic signature, available at https://wimms.tanlab.org/), a user‐friendly web application. WIMMS allows users to categorize any gene signature, determining its relationship to predominantly cited signatures and its representation within the seven principal classes.
The relationship between the frequency of use of non‐medication coping strategies with urinary incontinence and depression in older adults
Authors: Öz Yildirim Özge , İŞeri Özge
Published: July 2024

Background

The aim of this study is to examine the relationship between the frequency of use of non‐medication coping strategies with urinary incontinence (UI) and depression in older adults.

Methods

This study followed a descriptive design and was conducted with 345 older adults over the age of 65. The data of the study were collected using the Geriatric Depression Scale Short Form and the Frequency of Non‐Medication Coping Strategies with Urinary Incontinence Scale. The data analysis of the study was conducted using descriptive statistics, Pearson correlation analysis, and hierarchical multiple regression analysis. The significance level was accepted as P < 0.05.

Results

The mean age of the participants was 71.86 ± 5.43 years. Among the older adults, 58.8% were male and 50.2% were primary school graduates. It was determined that 43.8% of the participants experienced the frequency of UI more than once a week, 36.2% experienced stress incontinence, 51.9% consulted a physician due to UI, 53.6% received treatment for UI, and 47.8% reported that UI had an impact on their social life. The relationship between the frequency of use of non‐medication coping strategies with UI and geriatric depression (β = −0.017; P = 0.043) was found to be significant and negative. It was found that there was a significant and positive relationship between age, frequency of UI, type of UI, the impact of UI on social life, and geriatric depression (P < 0.05).

Conclusion and Suggestions

The older adults in this study were found to have moderate depression. It was determined that the level of depression was higher in the older adults who experienced UI more than once a week, those who experienced stress UI, those whose social lives were impacted, and those who had a higher frequency of non‐medication coping strategies.
The Historical Pronunciation of Koinē Greek and Why It MattersThe Pronunciation of New Testament Greek: Judeo‐Palestinian Greek Phonology and Orthography From Alexander to Islam, BenjaminKantor, Eerdmans, 2023 (ISBN 978‐0‐8028‐7831‐1), liv + 842 pp., hb $99.99A Short Guide to the Pronunciation of New Testament Greek, BenjaminKantor, Eerdmans, 2023 (ISBN 978‐0‐8028‐7832‐8), xvi + 134 pp., pb $14.99
Authors: Lookadoo Jonathon
Published: July 2024

This essay reviews two recent publications in historical Greek linguistics. While many in university and seminary education learn to read Greek texts, little attention is given to pronunciation and even less to how the language may have been pronounced historically. The volumes reviewed in this essay reconstruct changes in the pronunciation of Greek in Judeo‐Palestine by examining discrepancies in spelling and transliteration. The books also have implications for sociological studies in addition to pedagogical applications.
Epidermal growth factor receptor and programmed cell death‐1 expression levels in peripheral T cell subsets of patients with non‐small cell lung cancer
Authors: Ceylan Ayca , Artac Mehmet , Kocak Mehmet Zahid , Artac Hasibe
Published: July 2024

Lung cancer is the leading cause of cancer‐related deaths, in part due to its late diagnosis. Increased epidermal growth factor receptor (EGFR) expression in cancer cells is associated with a poor prognosis, and EGFR tyrosine kinase inhibitors are widely used in cancer treatment. This study aimed to clarify the relationship between EGFR expression on T cells and cancer prognosis in patients with non‐small cell lung cancer (NSCLC). Forty patients with NSCLC and 40 healthy volunteers were included in this study. Peripheral CD4+T helper (Th1, Th2, Th9, Th17, Th1Th17, follicular and peripheral Th) and cytotoxic T lymphocyte (CD8+follicular and peripheral T) subsets were identified with flow cytometry according to their chemokine receptors. EGFR expression on T lymphocytes in relation to overall survival (OS) was investigated in patients with NSCLC. The patients [mean age (min‐max) = 64.03 (45–83); 20 stage I–III and 20 stage IV] had increased EGFR expression on CD3+T, CD4+Th, Th1, Th2, and Th17 cells compared to the controls (p < 0.05). High EGFR expression on CD3+T, CD4+Th, Th1, and Th2 cells was associated with poor OS. Also, PD‐1 expression on lymphocytes, CD3+T, and Th cells was increased in patients with NSCLC compared to controls. The high expression of EGFR and PD‐1 on Th cells and the reduced percentage of lymphocytes and Th cells, especially in stage IV patients with NSCLC, revealed that increased EGFR activity may trigger apoptosis of Th cells and promote the development of metastases, while high EGFR expression on CD3+T, CD4+Th, Th1, and Th2 cells may be an independent poor prognostic marker in NSCLC.