bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Frequency of Periorbital Hyperpigmentation Risk Factors
Authors: Heidari Fateme , Ebrahim Zadeh Mohammad , Haji Abole Zadeh Maryam , Namiranian Nasim 
Published: February 2025

ABSTRACTBackgroundPeriorbital hyperpigmentation (POH) is a common complaint worldwide. Although this cosmetic condition is not a medical concern, it can impact emotional well‐being. Few investigations have evaluated the association of various factors with POH, which is contradictory in some ways.AimThe present study is conducted to elucidate the accurate impact of risk factors on the severity of POH.Patients/MethodsThis cross‐sectional study was performed on 116 patients attending a skin Outpatient Department in Iran from March to August 2022. A complete physical examination divided patients into mild, moderate, severe, and very severe classes. Valid questionnaires were filled out by participants about their demographic data, underlying diseases, and their habits. The chi‐square and linear regression tests were done. All data were analyzed using SPSS version 24.ResultAmong demographic factors, positive family history had a significant association with POH. There was a significant association between POH and stress, prolonged exposure to sun or television, and taking hormonal pills. Surprisingly, sleep quality was not significantly related to POH. In addition, there was a relationship between POH and some underlying diseases.DissuasionThe present study agreed with others about the significant impact of factors like family history, prolonged sun exposure, stress, and anemia. The current investigation elucidated doubts about the insignificant effect of sleep quality on the severity of POH. In contrast to previous studies, a remarkable relationship between POH and atopy was not revealed.ConclusionPOH is an undesirable condition. Two key factors associated with this cosmetic problem are rubbing eyes and prolonged exposure to television.
Diet and Living Environment as Novel Etiological Factors for Melasma: The Results Form a Retrospective Case–Control Study of 150 Chinese Patients
Authors: Shi Yue , Guo Shun , Tan Cheng 
Published: February 2025

ABSTRACTBackgroundMelasma, a condition with complex and multifactorial pathogenesis, has traditionally been linked to factors such as ultraviolet (UV) exposure, hormonal changes, and genetic predisposition. Despite societal advances and shifts in lifestyle, updates on causal factors remain limited. Our study aims to address this gap by investigating emerging pathogenic factors that differ from those conventionally reported.ObjectiveWe conducted a case–control study to explore novel etiological factors contributing to the onset of melasma in Chinese patients, with an emphasis on how these differ from previously established causes.MethodsThe study included 150 patients (144 women and 6 men) diagnosed with melasma at Jiangsu Province Hospital of Chinese Medicine from April to October 2023. A control cohort of individuals without melasma was enrolled from the community. Demographic and clinical characteristics were collected, along with exogenous factors and histories of related dermatoses and non‐dermatoses, through a questionnaire administered with the guidance of a dermatologist. Etiological factors were assessed using univariate analysis followed by multivariate analysis.ResultsOverall, our results were consistent with previous studies. In addition, alcohol intake (OR: 20.05, 95% CI: 1.17–343.17) and breast cystic hyperplasia (OR: 15.98, 95% CI: 4.28–59.72) were found to be novel triggering factors of melasma, whereas change of residence (OR: 0.03, 95% CI: 0.00–0.30), house renovation (OR: 0.13, 95% CI: 0.03–0.58) and soft drink intake (OR: 0.04, 95% CI: 0.00–0.83) were protective.ConclusionThese findings suggest that diet and the living environment are novel etiological factors for melasma.
Determination of menstrual symptoms and genital hygiene behaviors of female healthcare professionals after the earthquake in Türkiye
Authors: Gürel Reyyan , Atilla Rabia , Savaş Vildan 
Published: February 2025

AbstractAimThe aim of this study was to describe the post‐earthquake menstrual symptoms, genital hygiene behaviors and the relationship between them among female healthcare workers who experienced the devastating earthquake in February 2023.MethodsThe sample of this descriptive and cross‐sectional study consists of female healthcare professionals working in a public hospital in Iskenderun. Data were collected through face‐to‐face interviews between June 7 and September 7, 2023. Sociodemographic Form, Menstrual Symptom Scale, and Genital Hygiene Scale were used as data collection tools.ResultsThe mean age of the participants was 34.07 ± 8.08. Before the earthquake, 81.5% had regular menses, while in 58.6% of them the pattern of menses changed after the earthquake. It was found that there was a negative and weakly significant relationship between the total mean scores of “Menstrual Symptom Scale” and “Genital Hygiene Scale” (p < 0.05). Significant differences were found between “age,” “perceived income level,” “marital status,” and “experiencing women's health problems after the earthquake” with menstrual symptoms. Additionally, significant differences were observed between “changes in menstrual regulation after the earthquake,” “the major earthquake's impact on the availability of hygienic products,” and genital hygiene behaviors (p < 0.05).ConclusionsIt was determined that the menstrual symptoms experienced by health workers after the earthquake were above moderate severity and their genital hygiene behaviors were less positive. Furthermore, genital hygiene behaviors were more negatively affected as the severity of menstrual symptoms increased.
Two‐Year Follow‐Up of a Communication Intervention on Medication Adherence and Health Literacy in Kidney Transplanted Recipients—A Randomised Controlled Study
Authors: Vidnes Tone K. , Wahl Astrid K. , Larsen Marie H. , Meyer Käthe B. , Hermansen Åsmund , Andersen Marit H. 
Published: February 2025

ABSTRACTBackgroundPatients with chronic conditions, including kidney transplanted recipients, are required to actively participate in their continuous care and maintain motivation to adhere consistently to treatment.ObjectivesOur study aimed to test long‐term effectiveness of a new health communication intervention designed to improve on medication adherence and health literacy in kidney transplant recipients 2 years following transplantation.DesignA randomised controlled non‐blinded study was conducted between March 2020 and August 2023.ParticipantsOne hundred and ninety‐five kidney transplant recipients were included.MeasurementsPrimary outcomes were self‐reported medication adherence, measured by the BAASIS questionnaire, and health literacy, measured by the Health Literacy Questionnaire. The response rate was 87% (170 of 195 patients).ResultsThis study showed a significant difference between groups in favour of the intervention group for medication adherence (p < 0.02) and two essential Health Literacy Questionnaire domains—‘navigating the health care system’ (p < 0.02) and ‘having social support for health’ (p > 0.03)—2 years after transplantation. Regarding health literacy, three Health Literacy Questionnaire domains showed a significant correlation with adherence: ‘having sufficient information to manage health’ (p < 0.04), ‘having social support for health’ (p < 0.04), and ‘ability to understand health information well enough to know what to do’ (p < 0.05).ConclusionThe findings in the study highlight the pivotal role of health communication in enhancing medication adherence and supporting important health literacy aspects for kidney transplant recipients.
Red Flags in the Evaluation of the Tiptoeing Child
Authors: Baldo Francesco , Traunero Arianna , Ballaben Andrea , Zago Alessandro , Barbi Egidio 
Published: February 2025

ABSTRACTBackgroundTiptoeing is a common phenomenon in gate development. However, in some cases, it can be the first clinical sign of a medical condition, more often a neurological or muscle disorder.AimTo provide a practical guide for paediatricians on how to approach tiptoeing and its possible causes.MethodsInput from the literature were used to construct this guide. We evaluated articles both on the general topic and the various conditions associated with tiptoeing.ResultsRed flags in tiptoeing are its persistence for more than 6 months after the establishment of independent walking, its persistence after 2 years of age and its appearance afterwards. Historical and physical examination clues, together with few blood tests and radiological investigations, are key elements to direct the clinician's diagnosis in the right direction, especially nowadays, considering that many of these conditions have a specific treatment.ConclusionIn presence of red flags, tiptoeing should never be underestimated and must be considered a sign of a pathological condition until proven otherwise.
Reconstructing evolutionary history of Chinese walnuts (Juglans)
Authors: Dang Meng , Zhou Hui‐Juan , Ye Hang , Zhu Shao‐Hong , Wang Rui , Zhao Gui‐Fang , Woeste Keith , Yue Ming , Zhang Xiao , Zhao Peng 
Published: February 2025

AbstractMembers of the genus Juglans (walnuts, family Juglandaceae) are typical Tertiary relict tree species. They are widely distributed in China and are well known for their edible nuts and high‐quality wood. The genetic structure and historical gene flow patterns of Chinese Juglans still need to be resolved. Here, we collected samples from a total of 2242 trees from 142 populations of three walnut species (Juglans regia L., Juglans sigillata Dode, and Juglans mandshurica Maxim.) and a hybrid taxon Juglans × hopeiensis. These samples were distributed throughout China. We analyzed population genetic structure, interspecific relationships, lineage differentiation, and speciation using 21 EST‐SSR genetic markers. All populations of J. regia and J. sigillata clustered into one lineage, corresponding to the Juglans sect. Dioscaryon, and all J. mandshurica and Juglans × hopeiensis populations (section Cardiocaryon) clustered into a second lineage. For J. mandshurica, there was an obvious north–south genetic cline. Interestingly, except for seven populations of the hybrid Juglans × hopeiensis, there was almost no gene flow between the populations of section Juglans/Dioscaryon and section Cardiocaryon. A DIYABC analysis showed that J. regia and J. mandshurica differentiated during the Oligocene. Juglans sigillata originated during the Pliocene to the Pleistocene. Subsequently, during the Middle Pleistocene, J. regia and J. mandshurica hybridized within a narrow zone to produce Juglans × hopeiensis. These results demonstrate the impact of repeated turbulent climate changes in the Quaternary on the evolutionary history of Tertiary relict plants.
Use of Text Messaging to Educate Family Caregivers of Children With Asthma
Authors: Wang Chen , Foronda Cynthia , Gattamorta Karina A. , Sotolongo Cardenas Monica R. 
Published: February 2025

ABSTRACTPurposeKnowledge deficiencies among family caregivers of children with asthma impede optimal disease management. Current research has shown that texting caregivers is an effective method for delivering family‐centered health education. The aim of this quality improvement project was to implement a short message service (SMS)‐based intervention to educate family caregivers of children with asthma and evaluate its effect on caregiver knowledge and confidence in asthma management.Design and MethodsThis project employed a pre‐posttest design with questionnaires completed at the beginning and conclusion of the intervention. Nineteen caregivers received daily educational messages over a 3‐week period.ResultsThe intervention resulted in a significant increase in the caregiver asthma knowledge (p = 0.037), but not their confidence (p = 0.604). Caregivers indicated high satisfaction with the length and content of the messages.ConclusionsThis project suggests that the SMS‐based education intervention holds potential to assist family caregivers in better managing their child's asthma.Practice ImplicationsThis quality improvement project seeks to fill the existing gap of inadequate family caregiver education, strengthen caregiver confidence in asthma management, and ultimately, enhance the care experience of asthmatic children. As chronically ill children have the best care experience when their parents are well‐informed about the disease and able to formulate solutions to manage emerging symptoms, family caregivers benefit as well. The educational messages enrich their asthma knowledge, enabling them to administer medicine promptly and appropriately when their child exhibits symptoms. Early medical attention minimizes the incidence of asthma attacks as well as the demand for emergency room visits, easing the burden on the healthcare providers. Therefore, using text messaging to educate family caregivers of children with asthma may positively affect child, parent, and provider outcomes.
Local GMM Estimation for Nonparametric Time‐Varying Coefficient Moment Condition Models
Authors: Bai Yu 
Published: February 2025

ABSTRACTWe develop a local continuously updated GMM estimator for nonparametric time‐varying coefficient moment condition models. The uniform consistency rate and the pointwise asymptotic normality of the proposed estimator are derived. Implementation issues regarding bandwidth selection, construction of pointwise confidence intervals, and testing for overidentifying restrictions are discussed. The finite sample performance of the proposed estimator and test statistic are investigated through a Monte Carlo study and an empirical application on asset pricing models with stochastic discount factor (SDF) representation.
The Idiot's Guide to Effective Population Size
Authors: Waples Robin S. 
Published: February 2025

ABSTRACTThis is a reference manual for the elegant, yet hideously complex concept of effective population size (Ne), inspired by a classic, self‐published manual of automotive repair ‘for the compleat idiot’. The Guide is timely, given the recent Kunming‐Montreal Global Biodiversity Framework, where 196 Parties committed to tracking genetic diversity—and estimating Ne—for all species. Ne is a human construct, but a useful one that allows us to capture diverse aspects of an organism's biology in a single number. The Guide collates in one location factual information about effective population size, with a focus on topics of practical relevance to scientists and managers studying real populations; it covers definition, computation and estimation of effective size, both demographically and genetically. As appropriate, the reader is directed to other primary sources for more details. A ‘Don't Do These Things’ section lists several ill‐advised approaches to dealing with Ne, and an Appendix provides useful tools and practical suggestions for interested users. A special section considers both possibilities and challenges presented by the genomics revolution. Availability of vast numbers of genetic markers increases precision, but less than some might think, and simultaneously introduces new challenges involving filtering and bioinformatics processing. As annotated genomes become more common for non‐model species, opportunities are opened to address qualitatively different questions, including reconstructing historical changes in Ne through time.
The Lived Experience of Adults With Inflammatory Bowel Disease in Rural Areas: Phenomenological Study
Authors: Bosco Vincenzo , Mercuri Caterina , Doldo Patrizia , Nocerino Rita , Guillari Assunta , Virgolesi Michele , Rea Teresa , Giordano Vincenza , Simeone Silvio 
Published: February 2025

ABSTRACTInflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a chronic gastrointestinal condition with a multifactorial etiology. It significantly impacts patients' quality of life, particularly, in rural areas where access to specialized care is limited. Challenges such as increased travel costs, social isolation, and restricted healthcare access are recognized, but their specific impact on rural Italian patients remains underexplored. This study aims to fill this gap. Using Cohen's hermeneutic phenomenological approach, in‐depth interviews were conducted with 17 IBD patients from rural areas. Thematic analysis identified key patterns and themes. Two main themes emerged: “challenges of rural living,” including economic concerns and social isolation, and “communication that bridges distances.” Rural IBD patients face unique challenges extending beyond disease management, with economic hardship and social isolation being prominent. These findings highlight the need for tailored interventions to bridge healthcare gaps and improve the quality of life for rural patients, offering novel insights into their lived experiences in Italy.
Development of an Implementation Science Higher Diploma for Registered Nurses: Phase III of the EQUIP Initiative
Authors: Al‐Moteri Modi , Aljuaid Jamil 
Published: February 2025

ABSTRACTImplementation science (ImpSci) programs are emerging in nursing postgraduate education. The Evidence‐Based Quality Improvement Project (EQUIP) is a multiphase initiative aimed at equipping implementation lead nurses (IL nurses) with the skills necessary for practice changes. This study leveraged EQUIP's outcomes to develop a 1‐year Higher Diploma in ImpSci for registered nurses, preparing graduates to conduct ImpSci projects that improve healthcare quality. Using a co‐participatory design, the study engaged IL nurses (n = 10), clinician nurses (n = 3), clinical research nurses (n = 1), and academic staff (n = 2) in collaboratively developing the ImpSci Higher Diploma curriculum. Six co‐designed learning domains were established, aligning with the program's mission to advance evidence‐based education, research‐driven clinical practice, and sustainable quality initiatives, with a focus on ImpSci. Nine program learning outcomes were mapped to eight domains of competence, creating a framework to prepare IL nurses to conduct ImpSci projects, address challenges, and improve patient outcomes. ImpSci Higher Diploma builds on previous work in evidence‐based practice (EBP) implementation, equipping graduates to lead critical quality improvement efforts and advance nursing education and healthcare delivery.
Soil microbial legacies and drought mediate diversity–invasibility relationships in non‐native communities
Authors: Yi Jiahui , Tao Zhibin , Zhang Kaoping , Nie Baoguo , Siemann Evan , Huang Wei 
Published: February 2025

Summary
High native species diversity generally suppresses non‐native invasions, but many ecosystems are now characterized by non‐native assemblages that vary in species diversity. How this non‐native species diversity affects subsequent invaders and its environmental dependence remain unclear.
We conducted a plant–soil feedback experiment. In the conditioning phase, we created three diversity levels (1, 2, or 4 species) using six non‐native species to condition the soil. In the responding phase, we planted these six species individually with soil inocula and exposed them to two watering treatments (well‐watered vs drought).
Under well‐watered conditions, the non‐native biomass increased with soil inocula generated by different non‐native diversity. This biomass pattern was mainly related to arbuscular mycorrhizal fungal richness which increased with non‐native species diversity. However, under drought conditions, the non‐native biomass did not depend on soil inocula generated by non‐native diversity.
Our results reveal the crucial role of soil microbial legacies in driving the positive diversity–invasibility relationships of non‐native communities and drought stress can eliminate these positive relationships. These findings provide an explanation for the commonly observed co‐occurrence of multiple non‐native species in nature, predicting an accelerating accumulation of non‐native species in a benign environment, but not in a stressed environment.
Continental‐scale empirical evidence for relationships between fire response strategies and fire frequency
Authors: Yang Sophie , Ooi Mark K. J. , Falster Daniel S. , Cornwell William K. 
Published: February 2025

Summary
Theory suggests that the dominance of resprouting and seeding, two key mechanisms through which plants persist with recurrent fire, both depend on other traits and vary with fire regime. However, these patterns remain largely untested over broad scales.
We analysed the relationships between mean fire frequency, derived from MODIS satellite data, and resprouting and seeding strategies, respectively, for c. 10 000 woody and herbaceous species in Australia. We tested whether leaf economics traits differed among these strategies.
Probability of resprouting exhibits a monotonic increase with fire frequency for woody plants; for herbaceous plants, a hump‐shaped relationship is observed. Probability of seeding exhibits a hump shape with fire frequency in woody plants. In herbaceous plants, probability of resprouting was associated with higher leaf mass per area (LMA), and probability of seeding with lower LMA. A broader range of leaf investment strategies occurred in woody plants.
Our findings provide the largest empirical support to date for theory connecting fire response strategy to fire frequency. Woody seeders appear constrained by immaturity and senescence risk. Herbaceous and woody seeders showed different placements along the leaf economics spectrum, suggesting an important interaction between growth form and growth rate for seeders.
Nursing Practice for Early Detection of Long‐Term Care Resident Deterioration: A Qualitative Study
Authors: Ogawara Hirofumi , Fukahori Hiroki , Mashida Yuriko , Matsumoto Sachiko , Nasu Katsumi , Doorenbos Ardith Z 
Published: February 2025

ABSTRACTIntroductionIn long‐term care (LTC) facilities, nurses play a key role in detecting changes in residents' health conditions and preventing avoidable emergency transfers and hospitalisations through multidisciplinary collaboration. This study aimed to explore how nurses detect changes that indicate the deterioration in LTC residents' conditions.MethodsSemi‐structured interviews were conducted with 23 nurses from 14 LTC facilities. Data from these interviews were qualitatively analysed using coding and constant comparison methods.ResultsThe three main categories were ‘preparing’, ‘assessing’ and ‘judging’. Nurses worked closely with care workers who spent a considerable amount of time with the residents, and by sharing information, the nurses could rapidly respond to changes in the residents' conditions. They also evaluated the risk of residents experiencing changes by leveraging their clinical experience.ConclusionThis study found that LTC nurses should collaborate with care workers to enhance their health assessment skills, enabling them to detect changes in residents' conditions. Findings from this study can be used to promote collaboration between nurses and care workers and to develop effective educational interventions to improve nursing practice in LTC facilities.Implications for PracticeThis study underscores the necessity of nurses' ability to identify early deterioration in LTC residents. The findings reveal key symptoms and warning signs that nurses should prioritize in their assessments. By leveraging clinical experience and close observation, nurses can make timely and effective decisions to address residents' health changes, preventing further deterioration and enhancing their quality of life.