bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of the clinical nurse specialist in stoma care: A modified Delphi consensus
Authors: Burch Jennie , Bird Andrew , Thorpe Gabrielle 
Published: December 2023

AbstractIntroductionThe role of the clinical nurse specialist is complex but is defined differently across the world. The role of clinical nurse specialist stoma care is undefined and it is uncertain what aspects of the role are included in the general day‐to‐day working role.AimsThe aim was to gain consensus opinion to answer the research question: ‘What is the role of the clinical nurse specialist in stoma care?’DesignDelphi consensus.MethodsPrevious data gained from a scoping review and expert consultation was utilized to form role statements. At a UK conference the 13 statements and 173 sub‐categories were voted upon. Consensus was agreed if 75% of voters voted agree or strongly agree. Two stages of voting occurred with results from the first vote being shared in the second voting session.ResultsAll 13 statement and most (150/193) statement sub‐categories reached consensus, with 20 sub‐categories added during voting session one.ConclusionsThe four pillars of advanced practice were met by the 13 statements with clinical and education reaching higher consensus and agreement than leadership/management and research. The results of the consensus study provide a clearer articulation of the clinical nurse specialist stoma care role, which is complex and multifaceted which has not been described previously.Implications for PracticeConsideration of role evolution is made possible, to gain a greater expertise in the scope of practice it is necessary to include prescribing, management and research which could improve service delivery and optimize patient outcomes. There was no patient or public contribution, which in hindsight would have potentially improved the process but it was considered that patients might not recognize the full role of the nurse, understanding only aspects of the role that were patient‐centred.Patient or Public ContributionNo patients or public were involved in any aspect of this paper—in hindsight this might have been useful.
Unravelling the cavity‐nesting network at large spatial scales: The biogeographic role of woodpeckers as ecosystem engineers
Authors: Alaniz Alberto J. , Carvajal Mario A. , Quiroz Madelaine , Vergara Pablo M. , Marquet Pablo A. , Fierro Andrés , Sieving Kathryn E. , Moreira‐Arce Darío , Hidalgo‐Corrotea Claudia , Rodríguez‐San Pedro Annia , Allendes Luis , Machuca Katerine 
Published: December 2023

AbstractAimPrimary cavity nesters (e.g. woodpeckers) act as ecosystem engineers by providing tree cavities to several vertebrates that use them as nests or refuges. Although diverse assemblages of primary excavators are assumed to increase the number of tree cavities, environmental factors can limit populations of primary excavators, thus weakening their ecological function. We aim to test the biogeographical‐scale relationships between primary excavators and cavity users by distinguishing the contribution of environmental variables.LocationSouthern South America.Materials and MethodsWe used species distribution models, which combine bioclimatic and remote sensing derived variables, to map the richness of vertebrates composing the cavity‐network of temperate and Mediterranean forests of South America. Based on a resampling procedure for ensuring spatial independence, we fitted structural equation models to estimate relationships between forest characteristics and cavity user vertebrates.ResultsRichness of secondary cavity users (mammals, obligated, habitat generalists and forest specialists) were positively and strongly influenced by the richness of primary excavators. Environmental variables affected differently the richness of primary and secondary cavity users. The richness of primary cavity users responded to tree richness and height while that of habitat specialist secondary users was positively affected by primary productivity and negatively by sclerophyll forests.Main ConclusionsOur results confirm the role of primary excavators as ecosystem engineers but highlight the importance of considering large spatial scales when analysing cavity‐nesting networks. Biogeographical patterns of tree diversity and forest structure can be important drivers of cavity nesting networks that remain hidden when studies are conducted over fine spatial scales.
Low‐dose aspirin for prevention of cardiovascular mortality in patients with type 2 diabetes and chronic kidney disease: A real‐world nationwide cohort study
Authors: Lin Yi‐Cheng , Chen Bi‐Li , Chen Wan‐Ting , Chien Li‐Nien , Huang Chun‐Yao 
Published: December 2023

ABSTRACTAims/IntroductionCardiovascular mortality risk is elevated among patients with diabetes and concurrent chronic kidney disease. However, controversy surrounds the use of aspirin for primary prevention within this population. This study aims to assess the effectiveness and safety of low‐dose aspirin for primary prevention in patients with diabetes and pre‐end‐stage renal disease.Materials and MethodsThis was a retrospective population‐based cohort study using the National Health Insurance Research Database in Taiwan. The study included adults with type 2 diabetes who were enrolled in the pre‐end‐stage renal disease pay‐for‐performance program and had no atherosclerotic cardiovascular disease. We used propensity score analysis to control baseline characteristics between the two groups. Clinical outcomes including cardiovascular mortality, all‐cause mortality, major bleeding, and renal disease progression were compared between patients who first received aspirin and those who did not.ResultsBetween January 2012 and December 2015, a total of 2,155 low‐dose aspirin users and 6,737 nonaspirin users were identified. Following propensity score adjustment, aspirin use exhibited a comparable risk of cardiovascular death compared with nonaspirin users (adjusted hazard ratio [aHR] 1.12; 95% confidence interval [CI] 0.65–1.95; P = 0.681). The risk of all‐cause mortality was similar between the two groups (aHR 1.07; 95% CI 0.92–1.24; P = 0.385). Similar risks were observed in terms of major bleeding and renal disease progression.ConclusionsIn patients with diabetes and pre‐end‐stage renal disease who lacked atherosclerotic cardiovascular disease, low‐dose aspirin did not demonstrate a reduction in mortality. These findings do not support the use of aspirin for primary prevention in this high‐risk population.
TOPK promotes the development of psoriasis and worenine alleviates psoriasiform dermatitis by inhibiting TOPK activity
Authors: Lu Hui , Huang Yingze , Ni Xiaofang , Ma Tengfei , Chang Teding , Liu Man , Li Nijie , Lu Peijiang , Yuan Ping , Liu Lin , Shi Fei , Xiao Juanjuan , Xiao Han , Duan Qiuhong , Zhu Feng 
Published: December 2023

AbstractBackgroundPsoriasis is an inflammatory skin disease. The pathogenesis of psoriasis has not been fully elucidated. T‐lymphokine‐activated killer cell‐originated protein kinase (TOPK) activity increases in a proinflammatory environment, and inhibiting TOPK blocks inflammation. However, whether TOPK is involved in the pathogenesis of psoriasis remains to be identified.ObjectivesWe aimed to study the role of TOPK in psoriasis and attempted to find a drug targeting TOPK for the prevention and treatment of psoriasis.MethodFirstly, the expressions of TOPK in psoriatic patients, psoriatic cell and animal model were analysed by Gene Expression Omnibus database, immunohistochemistry (IHC) staining and western blot (WB). After inhibiting TOPK by chemical or gene knockout, the effect of TOPK on the development of psoriasis was verified in cell and animal model by WB, qRT‐PCR, ELISA, haematoxylin–eosin (H&E) and IHC staining. Moreover, phosphoproteomic analysis was performed to explore the signalling pathways regulated by TOPK in the occurrence and development of psoriasis. Then, an in vitro kinase assay was performed to prove TOPK kinase activity was inhibited by worenine. Ultimately, WB, qRT‐PCR, ELISA, H&E and IHC staining were used to verify the anti‐psoriasis effect of worenine by inhibiting TOPK was in cell and animal model.ResultsIn this study, we found that TOPK was highly expressed in psoriasis patients, psoriatic cell and animal model, which suggests that TOPK might be associated with psoriasis pathogenesis. Interestingly, chemical or genetic inhibition of TOPK alleviated M5‐ and imiquimod (IMQ)‐induced psoriasis‐like dermatitis, which further confirmed the role of TOPK in promoting the development of psoriasis. Moreover, we determined that worenine inhibited TOPK kinase activity. In addition, worenine relieved M5‐ and IMQ‐induced psoriasiform dermatitis by inhibiting TOPK activity.ConclusionsT‐lymphokine‐activated killer cell‐originated protein kinase promotes the development of psoriasis. Therefore, TOPK might be a promising drug target for the prevention and treatment of psoriasis. Worenine alleviates psoriasiform dermatitis by inhibiting TOPK activity, providing new strategies for clinical intervention.
Understanding the anatomy of dermoscopy of melanocytic skin tumours: Correlation in vivo with line‐field optical coherence tomography
Authors: Soglia S. , Pérez‐Anker J. , Albero R. , Alós L. , Berot V. , Castillo P. , Cinotti E. , Del Marmol V. , Fakih A. , García A. , Lenoir C. , Monnier J. , Perrot J. L. , Puig S. , Rubegni P. , Skowron F. , Suppa M. , Tognetti L. , Venturini M. , Malvehy J. 
Published: December 2023

AbstractBackgroundEarly melanoma detection is the main factor affecting prognosis and survival. For that reason, non‐invasive technologies have been developed to provide a more accurate diagnosis. Recently, line‐field confocal optical coherence tomography (LC‐OCT) was developed to provide an in vivo, imaging device, with deep penetration and cellular resolution in three dimensions. Combining the advantages of conventional OCT and reflectance confocal microscopy, this tool seems to be particularly suitable for melanocytic lesions.ObjectivesThe objective of this study was to identify and describe the correlation between specific dermoscopic criteria and LC‐OCT features in three dimensions associated with melanocytic lesions.MethodsDermoscopic and LC‐OCT images of 126 melanocytic lesions were acquired in three different centres. The following dermoscopic criteria have been considered: reticular pattern, dots and globules, structureless areas, blue‐whitish veil, regression structures, negative network, homogeneous pattern, streaks and blotches.Results69 (55%) benign and 57 (45%) malignant lesions were analysed. A regular reticular pattern was found associated in the 75% of the cases with the presence of elongated rete ridges with pigmented cells along the basal layer, while atypical reticular pattern showed an irregular organization of rete ridges with melanocytic hyperplasia, broadened and fused ridges and elongated nests. Both typical and atypical dots and globules were found associated with melanocytic nests in the dermis or at the dermoepidermal junction (DEJ), as well as with keratin cysts/pseudocysts. Grey globules corresponded to the presence of melanin‐containing dermal inflammatory cells (melanophages) within the papillae. Structureless brown/black areas correlated with alterations of the DEJ. We observed the same DEJ alterations, but with the presence of dermal melanophages, in 36% of the cases of blue/white/grey structureless areas. A description of each LC‐OCT/dermoscopy correlation was made.ConclusionsLC‐OCT permitted for the first time to perform an in vivo, 3D correlation between dermoscopic criteria and pathological‐like features of melanocytic lesions.
Simulation and experimental study on the effect of deformation on heat and mass transfer in potato chips during superheated steam drying
Authors: Fu Hanyu , Zheng Zhaohui , Ren Liuyang , Yang Pei , Xu Jingshen , Xie Weijun , Yang Deyong 
Published: December 2023

AbstractSuperheated steam drying is a drying technology with enormous potential and numerous advantages. Volume change and substantial deformation will occur on the materials to be dried during the superheated steam drying, which would affect the heat and mass transfer of the sample. However, the influence mechanism is not clear. Therefore, the nonuniform volume change of potato slices was studied, and the deformation model (DM) and the non‐DM (NDM) were constructed and verified to study the heat and mass transfer processes of the sample. The results showed that there was little difference between the measured and simulated temperatures based on DM and NDM with a maximum error of 4.22% and 5.03%, respectively, but there was obvious difference between simulated moisture contents with a maximum error of 5.76% and 12.21%, respectively. The volume in DM was in good agreement with the experimental data. Temperature distribution and moisture distribution in potato chips during superheated steam drying were nonuniform and the maximum temperature gradient and moisture gradient appeared in the early period. The moisture gradient existed in the whole drying process, and the stress caused by the moisture gradient was the main factor causing the drying deformation.Practical applicationsThis work can reveal that the volume change and substantial deformation have a significant impact on the heat and mass transfer during drying. In production practice, there are many similar phenomena. The results would be helpful to understand the heat and mass transfer mechanism, optimize quality parameters to obtain better products in potato drying industry, and expand the applied range of the superheated steam drying technology.
Breeding maize of ideal plant architecture for high‐density planting tolerance through modulating shade avoidance response and beyond
Authors: Jafari Fereshteh , Wang Baobao , Wang Haiyang , Zou Junjie 
Published: December 2023

ABSTRACTMaize is a major staple crop widely used as food, animal feed, and raw materials in industrial production. High‐density planting is a major factor contributing to the continuous increase of maize yield. However, high planting density usually triggers a shade avoidance response and causes increased plant height and ear height, resulting in lodging and yield loss. Reduced plant height and ear height, more erect leaf angle, reduced tassel branch number, earlier flowering, and strong root system architecture are five key morphological traits required for maize adaption to high‐density planting. In this review, we summarize recent advances in deciphering the genetic and molecular mechanisms of maize involved in response to high‐density planting. We also discuss some strategies for breeding advanced maize cultivars with superior performance under high‐density planting conditions.
Molecular evolution of the rbcS multiple gene family in Oryza punctata
Authors: Xu Si , Meng Lu , Bao Ying 
Published: December 2023

AbstractRubisco is assembled from large subunits (encoded by chloroplast gene rbcL) and small subunits (encoded by the nuclear rbcS multigene family), which are involved in the processes of carbon dioxide fixation in the Calvin cycle of photosynthesis. Although Rubisco has been studied in many plants, the evolutionary divergences among the different rbcS genes are still largely unknown. Here, using a rice closely related wild species, Oryza punctata Kotschy ex Steud, we investigated the differential properties of the rbcS genes in the species. We identified five rbcS genes (OprbcS1 through OprbcS5), OprbcS1 showed a different evolutionary pattern from the remaining four genes in terms of chromosome location, gene structure, and sequence homology. Phylogenetic analysis revealed that plant rbcS1 and other non‐rbcS1 genes originated from a common ancient duplication event that occurred at least in seed plants ancestor. RbcS1 was then retained in a few plant lineages, including Oryza, whereas non‐rbcS1 was mainly amplified in angiosperms. OprbcS1, OprbcS2–OprbcS4, and OprbcS5 were prominently expressed in stems and seeds, young leaves, and mature leaves, respectively. The yeast two‐hybrid assay detected a significant decrease in the interaction between OprbcS1 and OprbcL compared to the other four pairs of proteins (OprbcS2–OprbcS5 and OprbcL). We propose that OprbcS1 might be assigned a divergent function that was predominantly specific to nonphotosynthetic organs, whereas OprbcS2–OprbcS5, having different affinity in the assembly process of Rubisco, might be subfunctionalized in photosynthetic organs. This study not only deepens our understanding of the fine assembly of Rubisco, but also sheds some light on future de novo domestication of wild rice.
Social cognition and the origin of concepts in Durkheim's sociology of knowledge
Authors: D. Walsh Philip 
Published: December 2023

AbstractThis paper re‐examines a key feature of Emile Durkheim's sociology of knowledge from a critical realist perspective. It is argued that Durkheim's attempt to establish a social basis for the categories in The Elementary Forms of Religious Life should be understood along ontological rather than epistemological lines. This brings to light new problems with the argument which, however, can be brought fruitfully into contact with the more recent social psychological literature on collective intentionality. This yields insights into future lines of inquiry into social cognition and theories of human conceptualizing capacities.
Machine‐learning model comprising five clinical indices and liver stiffness measurement can accurately identify MASLD‐related liver fibrosis
Authors: Fan Rong , Yu Ning , Li Guanlin , Arshad Tamoore , Liu Wen‐Yue , Wong Grace Lai‐Hung , Liang Xieer , Chen Yongpeng , Jin Xiao‐Zhi , Leung Howard Ho‐Wai , Chen Jinjun , Wang Xiao‐Dong , Yip Terry Cheuk‐Fung , Sanyal Arun J. , Sun Jian , Wong Vincent Wai‐Sun , Zheng Ming‐Hua , Hou Jinlin 
Published: December 2023

AbstractBackground & AimsaMAP score, as a hepatocellular carcinoma risk score, is proven to be associated with the degree of chronic hepatitis B‐related liver fibrosis. We aimed to evaluate the ability of aMAP score for metabolic dysfunction‐associated steatotic liver disease (MASLD; formerly NAFLD)‐related fibrosis diagnosis and establish a machine‐learning (ML) model to improve the diagnostic performance.MethodsA total of 946 biopsy‐proved MASLD patients from China and the United States were included in the analysis. The aMAP score, demographic/clinical indices and liver stiffness measurement (LSM) were included in seven ML algorithms to build fibrosis diagnostic models in the training set (N = 703). The performance of ML models was evaluated in the external validation set (N = 125).ResultsThe AUROCs of aMAP versus fibrosis‐4 index (FIB‐4) and aspartate aminotransferase‐platelet ratio (APRI) in cirrhosis and advanced fibrosis were (0.850 vs. 0.857 [P = 0.734], 0.735 [P = 0.001]) and (0.759 vs. 0.795 [P = 0.027], 0.709 [P = 0.049]). When using dual cut‐off values, aMAP had a smaller uncertainty area and higher accuracy (26.9%, 86.6%) than FIB‐4 (37.3%, 85.0%) and APRI (59.0%, 77.3%) in cirrhosis diagnosis. The seven ML models performed satisfactorily in most cases. In the validation set, the ML model comprising LSM and 5 indices (including age, sex, platelets, albumin and total bilirubin used in aMAP calculator), built by logistic regression algorithm (called LSM‐plus model), exhibited excellent performance. In cirrhosis and advanced fibrosis detection, the LSM‐plus model had higher accuracy (96.8%, 91.2%) than LSM alone (86.4%, 67.2%) and Agile score (76.0%, 83.2%), respectively. Additionally, the LSM‐plus model also displayed high specificity (cirrhosis: 98.3%; advanced fibrosis: 92.6%) with satisfactory AUROC (0.932, 0.875, respectively) and sensitivity (88.9%, 82.4%, respectively).ConclusionsThe aMAP score is capable of diagnosing MASLD‐related fibrosis. The LSM‐plus model could accurately identify MASLD‐related cirrhosis and advanced fibrosis.
‘The program director's word … it's stronger than the word of God’: Epistemic injustice revealed through narratives of remediated graduate medical education residents
Authors: Percival Candace S. , Maggio Lauren A. , Wyatt Tasha R. , Martin Paolo C. 
Published: December 2023

AbstractBackgroundThough graduate medical education (GME) residency training provides positive experiences for many trainees, it may also result in major stressors and negative experiences, particularly for those requiring remediation. Residents requiring remediation may experience feelings of dismay, shame and guilt that can negatively affect their training, self‐efficacy and their medical careers. Power differentials between educators and residents may set the stage for epistemic injustice, which is injustice resulting from the silencing or dismissing a speaker based on identity prejudice. This can lead to decreased willingness of trainees to engage with learning. There is a paucity of literature that explores GME experiences of remediation from the resident perspective.ObjectiveTo synthesise the narratives of physician experiences of remediation during residency through the lens of epistemic injustice.MethodsBetween January and July 2022, we interviewed US physicians who self‐identified as having experienced remediation during residency. They shared events that led to remediation, personal perspectives and emotions about the process and resulting outcomes. Interviews were analysed using narrative analysis with attention to instances of epistemic injustice.ResultsWe interviewed 10 participants from diverse backgrounds, specialties and institutions. All participants described contextual factors that likely contributed to their remediation: (1) previous academic difficulty/nontraditional path into medicine, (2) medical disability or (3) minoritised race, gender or sexual identity. Participants felt that these backgrounds made them more vulnerable in their programmes despite attempts to express their needs. Participants reported instances of deflated credibility and epistemic injustices with important effects.ConclusionsParticipant narratives highlighted that deep power and epistemic imbalances between learners and educators can imperil GME trainees' psychological safety, resulting in instances of professional and personal harm. Our study suggests applying an existing framework to help programme directors (PDs) approach remediation with epistemic humility.