bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paediatric Nurses' Personal Accounts of Being Told Not to Disclose Information to Children With Serious Illness—An Interpretative Phenomenological Study
Authors: El Ali Mandy (Mervat) , O'Neill Jenny , Gillam Lynn 
Published: November 2024

ABSTRACTAimsTo explore the experiences, and perceptions of nurses who are told to withhold clinical information from children diagnosed with serious illnesses.DesignAn interpretative qualitative phenomenological design was used for the study. Sampling was purposive and data were collected using semi‐structured interviews from nurses working in a paediatric setting within the preceding 5 years. Nurse‐participants described their personal experiences of withholding situations (‘non‐disclosure directives’). Their accounts of specific examples of situations (‘personal accounts’) were extracted from the interview transcripts and analysed using inductive content analysis to identify patterns and concepts within the descriptions. Data management was supported using Dedoose.SettingNurse‐participants were interviewed face‐to face and online between November 2019 and December 2020.ParticipantsTwenty‐six Australian nurses who have cared for seriously ill children within the preceding 5 years participated in the study.ResultsThirty‐nine accounts of non‐disclosure situations (personal accounts) were extracted from interview transcripts. Four types of non‐disclosure were identified in the personal accounts: withholding information, temporary withholding, lying and combined withholding/lying. The inductive content analysis identified three key aspects of nurse‐participants' accounts: beliefs and perceptions (about the child and parents), the nature of the experience and feelings about the experience.DiscussionMoral distress occurred when nurses' actions conflicted with their moral values in response to a non‐disclosure directive, particularly when asked to directly lie to children. Nurses felt disempowered by the parent's authority and the institutional hierarchy that limited their ability to participate in discussions where a non‐disclosure directive was given.Conclusion and ImpactNurse‐participants were afforded a platform for reflection which proved valuable in allowing them to process their experiences in a non‐disclosure situation.RecommendationsNurses directed to withhold medical information from children should be afforded opportunities for reflection to mitigate moral distress. Nurses should be included in the planning of ethically appropriate responses to withholding directives.
Exosomal miR‐155‐5p promote the occurrence of carotid atherosclerosis
Authors: Yang Wen‐Wen , Li Qing‐Xiang , Wang Fei , Zhang Xin‐Ran , Zhang Xian‐Li , Wang Meng , Xue Dong , Zhao Ying , Tang Lu 
Published: November 2024

AbstractPeriodontitis is a significant independent risk factor for atherosclerosis. Yet, the exact mechanism of action is still not fully understood. In this study, we investigated the effect of exosomes‐miR‐155‐5p derived from periodontal endothelial cells on atherosclerosis in vitro and in vivo. Higher expression of miR‐155‐5p was detected in the plasma exosomes of patients with chronic periodontitis (CP) and carotid atherosclerosis (CAS) compared to patients with CP. Also, the expression level of miR‐155‐5p was associated with the severity of CP. miR‐155‐5p‐enriched exosomes from HUVECs increased the angiogenesis and permeability of HAECs and promoted the expression of angiogenesis, permeability, and inflammation genes. Along with the overexpression or inhibition of miR‐155‐5p, the biological effect of HUVECs‐derived exosomes on HAECs changed correspondingly. In ApoE−/− mouse models, miR‐155‐5p‐enriched exosomes promoted the occurrence of carotid atherosclerosis by increasing permeable and angiogenic activity. Collectively, these findings highlight a molecular mechanism of periodontitis in CAS, uncovering exosomal miR‐155‐5p derived periodontitis affecting carotid endothelial cells in an ‘exosomecrine’ manner. Exosomal miR‐155‐5p may be used as a biomarker and target for clinical intervention to control this intractable disease in future, and the graphic abstract was shown in Figure .
A Qualitative Service Evaluation of the Introduction of Single Session Therapy for Families in a Child and Adolescent Mental Health Service in England, United Kingdom
Authors: Flynn Kiran , Stimpson Kirsty , Brown Solomon , De Silvo Sarah , Parker Jan 
Published: November 2024

ABSTRACTRationaleThis service evaluation details the process of introducing Single Session Therapy (SST) with families to a Child and Adolescent Mental Health Service in the United Kingdom. SST is a model of short‐term psychotherapy intervention which can be applied to family contexts to provide timely mental health support.Aims and ObjectivesThis service evaluation had two objectives: (1) Review the existing evidence base and literature for SST. (2) Evaluate the implementation of a new SST treatment pathway in CAMHS, including patient experiences and satisfaction with the service.MethodSQUIRE Guidelines are used to report on this new knowledge of healthcare. This evaluation used qualitative methods to evaluate the impact of the new service. The team also used existing frameworks within the Trust, namely discharge data, which is collected routinely as part of service evaluation.ResultsThis evaluation suggests positive support for this model, and that many families appreciate and value the opportunity to build on strengths and work toward their goals as families. This project outcome appears to support some of Talmon's (1990) findings that the most commonly attended number of sessions is one, and that of those who attended only one session, many perceived the session as useful. Waiting times for our service are extremely long. The pace and structure around goals and solutions could feel both galvanising, as some reported, but others felt it was an insufficient response to the severity of their difficulties.ConclusionMore high‐quality research is needed before judgments can be made around the cost‐effectiveness or efficacy of SST over existing approaches in the United Kingdom. While implementing SST should not be used to justify reduction in existing interventions, it offers a positive additional service for young people experiencing mental health difficulties and their families.
Insulin Injection Technique and Related Complications in Patients With Diabetes in a Northwest City of China
Authors: Zhou Tao , Zheng Yan , Li Juan , Zou Xiangjun 
Published: November 2024

ABSTRACTObjectivesAppropriate insulin injection technique can help to enhance positive clinical outcomes in insulin‐treated patients. This cross‐sectional survey was undertaken to assess the present state of injection technique practices of patients administering insulin and the incidence of local complications associated with insulin injection.MethodsThis cross‐sectional study was conducted at 11 tertiary hospitals in Xi'an City. A total of 1370 patients with diabetes were enroled in the survey. Each patient was asked questions on the Injection Technique questionnaire, demonstrated insulin injection on an injection training pad and had their injection sites inspected by a nurse.ResultsAbout 98% of participants were type 2 diabetic patients. The 5 mm length needles were used by 640 (46.71%) patients. Around 1286 participants reused pen needles. Only one‐third of patients rotate the injection sites. Around 901 patients had ecchymosis at injection sites, 43 participants suffered rash and or pruritus and 661 patients had lipohypertrophy. About 2.99% of patients reported having infection at the injection sites. Most patients (72.55%) occasionally felt pain when injecting insulin. The results of the multivariable logistict analysis showed that gender (male), needle length, priming the pen before injections and correct site rotation were negatively associated with the incidence of injection site ecchymosis. Lower incidence of lipohypertrophy was associated with needle length 4 mm, needle length 6 mm, single use of pen needles, priming the pen before injections and correct site rotation. Higher incidence of injection site infection was related to not disinfecting injection sites before each injection.ConclusionsDespite some improvements detected in some aspects of patients' insulin injection practice in recent years, a large gap still exists between insulin injection guidelines and patients' actual injection behaviour. Injection‐related complications at injection sites are still considerably common among our study population. Patients' education regarding insulin injection technique should be conducted repeatedly and regularly to make sure patients' compliance to injection guidelines.
Pathogenicity of CsRV2 and CdPBV1 in Callinectes danae: An Imminent Concern for Crab Production in Brazil
Authors: Tavares Camila Prestes dos Santos , Dal Pont Giorgi , Stica Paula Valeska , da Silva Ubiratan de Assis Teixeira , Westphal Gisela Geraldine Castilho , Schott Eric J. , Ostrensky Antonio 
Published: November 2024

ABSTRACTUnderstanding the pathogenicity of viral infections in aquatic organisms is vital due to their substantial impact on aquaculture and wild populations. This study assessed the pathogenicity of Callinectes sapidus Reovirus 2 in Callinectes danae and its effects on the metabolic, immunological and behavioural parameters. CsRV2‐negative specimens were divided into CsRV2 inoculum (n = 10) and saline injection (n = 15). After 14 days, all the crabs that received the inoculum tested positive for CsRV2. However, 11 crabs from the control group also tested positive and were subsequently considered an additional experimental group. The cumulative mortality in the group challenged reached 70% after 14 days. RT–PCR revealed Callinectes danae Portunibunyavirus 1 presence in CsRV2‐injected crabs, explaining heightened mortality. Ammonia flow remained unaffected, but oxygen consumption was significantly impacted (p < 0.05) by CsRV2 and coinfection, suggesting increased metabolic energy expenditure. The coinfection caused an increase in the proportion of crabs with reflex impairment as a likely consequence of physiological exhaustion. Additionally, there was a trend toward reducing the number of granulocytes in coinfected crabs, indicating that granulocytes may be more affected by coinfection. These findings demonstrate the pathogenicity of CsRV2 in C. danae, with coinfection exacerbating metabolic, behavioural and immunological changes, increasing mortality.
Complications of Subcision for Acne Scarring: Experience From Clinical Practice and Review of the Literature
Authors: Sun Cong , Lim Davin 
Published: November 2024

ABSTRACTBackgroundSubcision is a surgical technique frequently used in the management of atrophic acne scars. The advent of new instruments, which includes sharp, blunt and energy assisted, have increased the efficacy of the procedure. The aim of this article was to review the safety of subcision in view of the new development in technology.ObjectiveTo review the safety of subcision procedure for acne scarring and to provide clinicians with both evidence‐based and practical information regarding the complications that can be associated with this procedure.MethodsA search through MEDLINE and Google Scholar was conducted for articles from January 2000 to January 2023 that involves subcision as a monotherapy for the treatment of acne scarring.ResultsTen articles involving subcision monotherapy were identified. The main complications of subcision were pain/tenderness, bruising, infection, formation of subcutaneous lumps, and dyspigmentation. Recommendations on how to minimize the complications from subcision have also been provided based on the clinical experience of the authors.ConclusionSubcision is a safe treatment for acne scarring and clinicians need to be aware of the associated complication which occurs more with sharp instrumentation.
Effect of Delaying High School Start Time on Teen Physical Activity, Screen Use, and Sports and Extracurricular Activity Participation: Results From START
Authors: Berger Aaron T. , Erickson Darin J. , Johnson Kayla T. , Billmyer Emma , Wahlstrom Kyla , Laska Melissa N. , Widome Rachel 
Published: November 2024

ABSTRACTBackgroundWe aimed to characterize relationships between delayed high school start time policy, which is known to lengthen school night sleep duration, and patterns in activity outcomes: physical activity, non‐school electronic screen time (non‐schoolwork), and sports and extracurricular activity among adolescents.MethodsWe used data from the START study, a multi‐site evaluation of a natural experiment, assessing the effects of a school start time policy change in high schools in the Minneapolis, Minnesota metropolitan area. The study follows students in 2 schools that shifted to a later start time (8:20 or 8:50 am) after baseline year and 3 schools that maintained a consistent, early start time (7:30 am) over the 3‐year study period. Activity was measured by participant self‐report on an in‐school survey. The analysis used a difference‐in‐differences estimator, in which the changes in each outcome observed in the comparison schools estimate the changes in each outcome that would have been observed in the late‐start adopting schools had they not delayed their start times after baseline.ResultsOver 2 years of follow‐up, no changes emerged to suggest that later school start times either interfered with, or promoted, any activity‐related outcome that was measured.ImplicationsCommunities interested in promoting sleep by delaying start times may do so knowing that there are unlikely to be adverse effects on adolescent physical activity, electronic screen time, or organized sports and activity participation.ConclusionsA shift to later school start times does not appear to enhance or detract from the healthfulness of students' activity level.
Factors influencing the inclusion of diverse volunteer patients within medical student primary care placements
Authors: Malik Mohammad , Tyson Leanne , Bryant Pauline , Patel Payal , Young Richard , Semlyen Joanna 
Published: November 2024

AbstractIntroductionResearch shows that medical students are graduating with inadequate teaching on diverse patients and insufficient experience of working with diverse patient groups. The inclusion of patients from diverse groups is necessary in healthcare teaching to ensure medical students are adequately prepared for practice. In this study, we explored the perspectives of General Practitioner (GP) tutors on the recruitment of diverse volunteer patients for medical student primary clinical care placements. In particular, we focused on the current representation of diverse volunteer patients, barriers affecting their inclusion and recommendations to help with this.MethodsFocus groups were carried out with GP tutors involved in the recruitment of volunteer patients from one region in the United Kingdom. Transcripts were analysed using Thematic Analysis.ResultsParticipants acknowledged the importance of ensuring that medical students have clinical experience in assessing and managing patients from diverse populations, but most did not actively think about the diversity of the patients they were recruiting. Instead, recruitment was driven by the need to cover the curriculum and teaching requirements.To ensure that students' learning was not diminished and recognising time was a significant factor, participants automatically discounted certain patients from being a volunteer patient. They acknowledged that they did not feel comfortable identifying patients based on their demographics and were more likely to invite patients who had been volunteer patients before.DiscussionSuggested solutions to overcome the factors affecting the recruitment of diverse patients are presented. Patient populations will continue to become more diverse, and therefore, medical schools must prepare their students for this and encourage GP tutors to make a conscious effort to recruit diverse patient volunteers for teaching.
How attitudes towards independence reshaped Scottish elections: A longitudinal analysis (1999–2021)
Authors: Daoust Jean‐François , Gareau‐Paquette Thomas 
Published: November 2024

AbstractBritish and Scottish politics are undergoing a period of tumultuous change, leading to what some scholars have labelled ‘electoral shocks’, which have altered the relative importance of the main issues explaining citizens' political behaviour. The conventional wisdom now posits that attitudes towards Scottish independence play an increasing role in structuring citizens' vote choice in Scotland. However, a longitudinal assessment of this claim is lacking. In this research, we seek to fill this gap by making use of data from 1999 to 2021, which covers every Scottish election since devolution, and providing the first‐ever systematic assessment of the strength of attitudes towards Scottish independence in explaining electoral behaviour over time. Our findings reveal a substantial increase in the importance of attitudes towards independence, which we can quantify throughout the 1999–2021 period. We conclude by discussing the implications of this for British and Scottish politics.
Musculoskeletal Multimorbidity Burden and Trajectory in Relation to Later‐Life Holistic Well‐Being Among Middle‐Aged and Elderly Individuals: A Prospective Study
Authors: Zhu Yuanpeng , Zhang Haoran , Li Qing , Zhang Terry Jianguo , Wu Nan 
Published: November 2024

ABSTRACTObjectivesUnderstanding the patterns and implications of coexisting musculoskeletal conditions is crucial for developing effective management strategies and improving care for older adults. This study aimed to examine the associations between musculoskeletal multimorbidity burden and trajectory and holistic well‐being among middle‐aged and older adults.MethodsThis prospective study employed data from nine consecutive waves of the English Longitudinal Study of Aging (ELSA), spanning 2002–2018. We used latent class trajectory models (LCTM) to identify groups based on changes in musculoskeletal multimorbidity status. Subsequently, we employed linear mixed models to investigate the associations between musculoskeletal disease burden, trajectory groups, and seven dimensions of holistic well‐being: Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), depression, memory, loneliness, social interactions, and life satisfaction.ResultsIn total, 5272 participants (mean age: 71.9 years; SD: 8.9) were included in the final analysis. Four distinct trajectories were identified: a low‐burden group (48.37%), an emerging group (14.76%), a moderate‐burden group (26.00%), and a persistent burden group (10.87%). After adjustment, the findings demonstrate that the musculoskeletal disorder burden significantly impacts ADLs, depression, memory, social interactions, and life satisfaction in middle‐aged and older adults, with minor effects on IADLs and loneliness. Moreover, with the escalation of the burden, its impact significantly intensifies (p for trend is < 0.001). Compared with the low‐burden group, participants in both the moderate and persistent burden groups exhibited significantly lower capabilities in ADLs, poorer memory, increased social interactions, and lower life satisfaction. The emerging group displayed a similar trend, though without statistically significant results.ConclusionsOur study suggests that the extent and persistence of musculoskeletal disease burden can significantly affect holistic well‐being among middle‐aged and older individuals.
Leaf Photosynthetic and Photoprotective Acclimation in the Ultraviolet‐A1 and Blue Light Regions Follow a Continuous, Shallow Gradient
Authors: Sun Xuguang , Kaiser Elias , Marcelis Leo F. M. , Li Tao 
Published: November 2024

ABSTRACTAlthough blue light is known to produce leaves with high photosynthetic capacity, the role of the blue‐adjacent UV‐A1 (350–400 nm) in driving leaf photosynthetic acclimation is less studied. Tomato plants were grown under hybrid red and blue (RB; 95/5 μmol m−2 s−1), as well as four treatments in which RB was supplemented with 50 μmol m−2 s−1 peaking at 365, 385, 410 and 450 nm, respectively. Acclimation to 365–450 nm led to a shallow gradient increase in trait values (i.e., photosynthetic capacity, pigmentation and dry mass content) as the peak wavelength increased. Furthermore, both UV‐A1 and blue light grown leaves showed efficient photoprotection under high light intensity. When treated plants were transferred to fluctuating light for 5 days, leaves from all treatments showed increases in photosynthetic capacity, which were strongest in RB, followed by additional UV‐A1 treatments; RB grown leaves showed reductions in maximum quantum yield of photosystem II, while UV‐A1 grown leaves showed increases. We conclude that both UV‐A1 and blue light effectively trigger photosynthetic and photoprotective acclimation, the extent of acclimation becoming stronger the longer the peak wavelength is. Acclimatory responses to UV‐A1 and blue light are thus not distinct from one another, but follow a continuous gradient.
Pediatric Cutaneous T‐Cell Neoplasms: Clinical and Pathological Features, Updated Classifications, and Critical Differential Diagnoses
Authors: Cheng Jinjun , Wistinghausen Birte , Kirkorian A. Yasmine 
Published: November 2024

ABSTRACTCutaneous T‐cell lymphoid neoplasms in childhood are exceedingly rare, presenting with a wide spectrum of clinical presentation and outcomes. Due to numerous clinical and pathological mimics, an integrated evaluation of clinical, histopathological, immunohistochemical, and molecular findings is critical for a diagnosis. Here, we review the clinical and pathological features, updated classifications, and critical differential diagnoses of cutaneous T‐cell lymphoid neoplasms in children.
Pediatric Keloids: A Retrospective, Single‐Institution Cohort Analysis in Korea
Authors: Kim Jin Seop , Lee Ga‐Young , Chae Seoung Wan , Kim Won‐Serk , Choi Young‐Jun 
Published: November 2024

ABSTRACTBackground/ObjectivesThere are scant established data on the cause, distribution, treatment options, and recurrence rate of pediatric keloids in Asian populations. We characterized clinical features by comprehensively categorizing pediatric keloid patients into prepubertal and postpubertal groups at a single tertiary center.MethodsWe searched the database of Kangbuk Samsung Hospital for pediatric patients (< 18 years) with clinically proven keloids who underwent outpatient‐based treatment from 2007 to 2021. Clinical features, including demographics, distribution, underlying cause, treatment modality, and recurrence, were analyzed.ResultsOf the 93 patients (total 110 keloids), 42 females (45.2%) and 51 males (54.8%), with a mean age of 14.5 ± 4.1 years (range, 1–18 years), were retrospectively analyzed. The mean length of follow‐up was 22.0 ± 14.2 months (range, 6–63). Of the 100 keloids with assessable causes, piercing (22%) and acne (19%) were the most common. In the prepubertal group, the lower and upper limbs (n = 7, 28%; n = 6, 24%) were the two most common locations, suggesting that post‐traumatic keloids are common during this developmental period. In the postpubertal group, the ear (n = 25, 29.4%) was the most common site, which corresponds to the frequency of cosmetic piercing at this age. No differences were found between the effects of treatment methods on relapse rate.ConclusionsUnderstanding the clinical features of pediatric keloids is important in the therapeutic considerations for pediatric keloids. Future studies should analyze a larger number of children with keloids over longer observation periods.
Furcuncular Myiasis of the Scalp Caused by Chrysomya bezziana
Authors: Gaurav Vishal , Tyagi Mehul , Das Shukla , Pandhi Deepika 
Published: November 2024

ABSTRACTWe report a rare case of furuncular myiasis in a 7‐year‐old boy presenting with a discharging nodule over the scalp. The report details the clinical presentation, examination findings, and dermoscopic features of furuncular myiasis. To the best of our knowledge, Chrysomya bezziana has never been reported to cause furuncular myiasis. In vivo and ex vivo dermoscopy features help in diagnosis by obviating the need for microscopy.