bluuebunny/crossref_metadata_2025_split huggingface dataset:
I have not come here because I have nothing better to do: The lived experience of presenting to the emergency department for people with a psychosocial disability and an NDIS plan—A qualitative study
Authors: McIntyre Heather , Loughhead Mark , Hayes Laura , Allen Caroline , Barton‐Smith Dean , Bickley Brooke , Vega Louis , Smith Jewels , Wharton Ursula , Procter Nicholas 
Published: November 2023

AbstractAlmost 60 000 people have a psychosocial disability (PSD) and a National Disability Insurance Scheme (NDIS) plan. As PSD can be a fluctuating condition, people with a PSD and an NDIS plan, at times, may require crisis care and present to the emergency department (ED). This national study explored the experiences of people with a PSD and an NDIS plan when presenting to the ED. To understand the unique lived experience of people with a PSD and an NDIS plan, semi‐structured interviews were conducted with 24 people between March and November 2022 and were analysed thematically. A lived experience advisory group was engaged as part of the research team. Participants were asked about their experiences in the ED including barriers to therapeutic care and what worked well. Participants reported emotional distress caused by receiving a biomedical rather than a person‐centred mental health response. A previous mental health history overshadowed diagnostic decisions and most participants interviewed stated they would not choose to return to the ED. Half of the participants spoke of one presentation only where needs were met. Four main themes emerged from the data: (a) Diagnostic overshadowing; (b) Judgement and stigma; (c) Waiting without hope; and (d) If things went well. This study provides evidence of the unique lived experience of people with a PSD and an NDIS plan when presenting to the ED. The results highlight the need for clinicians in the ED to understand the complexity and nuances of supporting people with a PSD. Recommendations for a person‐centred care approach are provided. Alternative support options for this group of people need to be explored.
Predictive model for temporomandibular disorder in adolescents: Decision tree
Authors: Waked Jorge Pontual , de Aguiar Camilla Siqueira , Aroucha João Marcílio Coelho Neto Lins , Godoy Gustavo Pina , de Melo Ricardo Eugenio Varela Ayres , Caldas Arnaldo 
Published: November 2023

AbstractBackgroundTemporomandibular disorders (TMD) do not only occur in adults but also in adolescents, with negative impacts on their development.AimTo propose a predictive model for TMD in adolescents using a decision tree (DT) analysis and to identify groups at high and low risk of developing TMD in the city of Recife, PE, Brazil.DesignThis cross‐sectional study was conducted in Recife on 1342 schoolchildren of both sexes aged 10–17 years. The analyses were performed using Pearson's chi‐squared test and Fisher's exact test, as well as the CHAID algorithm for the construction of the DT. The SPSS statistical program was used.ResultsThe prevalence of TMD was 33.2%. Statistically significant associations were observed between TMD and sex, depression, self‐reported orofacial pain, and orofacial pain on clinical examination. The DT consisted of self‐reported orofacial pain, orofacial pain on physical examination, and depression, with an overall predictive power of 73.0%.ConclusionThe proposed tree has a good predictive capacity and permits to identify groups at high risk of developing TMD among adolescents, such as those with self‐reported orofacial pain or orofacial pain on examination associated with depression.
Association between psychological factors and molar–incisor hypomineralization: A cross‐sectional study
Authors: Mafla Ana Cristina , Orozco‐Tovar Ana Elizabeth , Ortiz‐Gómez Floralba , Ortiz‐Pizán Álvaro Javier , González‐Ruano Andrea Viviana , Schwendicke Falk 
Published: November 2023

AbstractBackgroundMolar–incisor hypomineralization (MIH) is a developmental enamel defect characterized by opacities from white to brownish color. A suspected multifactorial etiology has been suggested, whereas psychological factors during pregnancy have only been limitedly analyzed.AimWe assessed the association between stress, depression, and anxiety in pregnancy and the presence of MIH in children at a later age.DesignUsing a cross‐sectional Web‐based questionnaire, we included 384 mothers who had children aged 6 and 12 years from Pasto, Colombia. Data were collected between October 2021 and March 2022. Sociodemographic variables; maternal and child factors related to prenatal, natal, or postnatal problems; and psychological factors such as stress and symptoms of anxiety and depression in pregnancy were inquired. Utilizing photographs depicting MIH lesions, mothers assessed their child's MIH status. A directed acyclic graph (DAG) analysis was performed to create causal assumptions, and logistic regression models were estimated to evaluate these assumptions. p‐value was set at p < .05.ResultsThe prevalence of MIH was 33.3%; 12.8% of the participants exhibited hypomineralization in both molars and incisors. DAG analysis and logistic regression models determined that MIH (present or not) was associated with symptoms of maternal depression (ORadj = 3.26, 95% CI: 1.92–5.52, p < .001), and MIH (both molars and incisors) was associated with symptoms of maternal anxiety (ORadj = 3.49, 95% CI: 1.80–6.76, p < .001).ConclusionPsychological factors, among others, were significantly associated with the presence of MIH.
Influence of environmental risk factors on the development of wounds associated with squamous cell carcinoma
Authors: Jia Yulei , Chen Fengchao , Yan Tongtong , Zhang Siya , Salem Mohamed M. , Singh Soumya , Salem‐Bekhit Mounir M. , Kumar Sanjay Kirshan , Ali Muhammad Mehr 
Published: November 2023

AbstractThe incidence of squamous cell carcinoma (SCC) is on the rise, making it a significant global health concern. Environmental risk factors are crucial to the development of SCC. This study sought to examine comprehensively the impact of these factors on the onset of SCC. We conducted a cross‐sectional study involving 480 participants at Beijing tertiary care hospital. Utilizing structured questionnaires, data on demographics, environmental exposures, medical history and clinical characteristics were collected. The cohort was composed of 272 men (56.67%) and 208 women (43.33%). The majority (44.38%) were between ages of 41 and 60, and Type III skin predominated (34.79%). Most of the participants belonged to the middle socioeconomic class (60.83%). ‘Vegetarian’ dietary habits (46.67%) were prevalent, as was the ‘Sedentary’ lifestyle (49.79%). Regarding environmental exposures, moderate sun exposure of 3 to 5 h per day (54.58%) and UV protective eyewear (30.83%) were prevalent. The majority (69.58%) of respondents indicated ‘Never’ exposure to carcinogens. A variety of wound characteristics were observed, with ‘non‐smokers’ (64.17%) dominating. Most SCC lesions were located on the extremities (40.21%), lasted less than 6 months (44.38%) and measured 1–3 cm (39.79%). The majority (54.58%) did not have a history of cutaneous injuries. Our research uncovered substantial relationships between SCC and numerous environmental variables, gender, Fitzpatrick skin type, occupation, duration of sun exposure, exposure to carcinogens, dietary practices, history of skin wounds, wound location, duration, size and depth were significantly associated with the onset of SCC. These results highlighted the complexity of SCC aetiology and need for individualized prevention and treatment strategies.
Experiences and needs of adult informal carers of adults at risk of suicide: A systematic review with mixed methods analysis
Authors: Lascelles Karen Moya , Davey Zoe , Jackson Debra , Aveyard Helen 
Published: November 2023

AbstractAimTo systematically review and synthesize primary research on experiences and needs of adult informal caregivers of adults at risk of suicide.DesignSystematic review with a data‐based convergent synthesis.Data SourcesMEDLINE, PsychINFO and CINAHL were searched in April 2022 and February 2023. English language research focusing on experiences of adult carers of adults was included.MethodsArticles were screened by title (n = 9077) and abstract (n = 132) with additional articles (n = 6) obtained via citation and hand searching. Thirty‐one included studies were quality assessed using the Mixed Methods Appraisal Tool and study data were systematically extracted prior to thematic synthesis.ResultsFive interconnected themes resulted: transitions; living with fear and uncertainty; changing relationships; interface with healthcare professionals and services; what carers need and want. Caring impacts mental, physical and social wellbeing. Relationships are affected in ways which might not be evident when caring for a minor. Repeated suicidal behaviour is particularly challenging with ongoing hypervigilance contributing to burden, burnout and interpersonal strain. Poor carer support exacerbates negative effects; carers need to feel informed, educated, involved and holistically supported.ConclusionTimely support for carers is essential. Interventions should address emotional responses, relational changes and effective care recipient support. Longitudinal research is required to understand effects of ongoing caring where there are multiple suicide attempts.ImplicationsNurses can provide carers with early support and information and longer term psychosocial interventions. If carers are adequately equipped and supported patient safety and wellbeing will be improved.ImpactFindings of this systematic review include relational changes due to carer hypervigilance reducing autonomy and living with the possibility of suicide. Clinician awareness of the potential for relational shifts will help them prepare and support carers.Patient or Public ContributionThere was no patient or public contribution.
Role of health literacy profiles in fluid management of individuals receiving haemodialysis: A cross‐sectional study
Authors: Chen Chen , Zheng Jing , Liu Xu , Liu Jiali , You Liming 
Published: November 2023

AbstractAimsTo identify health literacy profiles in individuals receiving haemodialysis and to explore how these profiles interact with individuals' self‐efficacy, engagement with traditional dietary habits, self‐reported fluid restriction and relative‐interdialytic weight gain.DesignA cross‐sectional study engaging nephrology departments from four hospitals in Guangdong Province, China.MethodsA sample of 433 individuals receiving haemodialysis participated between December 2018 and July 2019. We assessed health literacy, self‐efficacy and self‐reported fluid restriction using the Health Literacy Questionnaire, the Fluid Self‐efficacy Scale and the Fluid Adherence Subscale, respectively. Traditional dietary habits, including daily tea drinking, soup drinking and preserved food consumption, were measured using three yes/no questions. Relative‐interdialytic weight gain was calculated by dividing the mean interdialytic weight gain (from three recent intervals) by dry weight. Latent profile analysis and structural equation modelling were performed.ResultsThree health literacy profiles were identified: low, moderate and high. Compared to those in the low health literacy profile, individuals in high and moderate health literacy profiles demonstrated an indirect association with reduced relative‐interdialytic weight gain. This reduction can be attributed to their higher self‐efficacy levels, decreased reliance on dietary habits and higher self‐reported fluid restrictions.ConclusionsMost participants exhibited either low or moderate levels of health literacy. Improving health literacy has the potential to promote self‐efficacy and foster effective fluid restriction, ultimately leading to a reduction in relative‐interdialytic weight gain in individuals receiving haemodialysis.ImpactThis study reveals heterogeneity in health literacy levels among individuals receiving haemodialysis and illuminates the connections between an individual's entire spectrum of health literacy and fluid management. These findings provide valuable insights for developing person‐centred fluid management interventions, especially for individuals with diverse cultural dietary backgrounds within the haemodialysis population.Reporting MethodWe adhered to the STROBE guideline.Patient or Public ContributionPatients were included only for collecting their data.
The impact of COVID‐19 on nursing students' lives and online learning: A cross‐sectional survey
Authors: Griscti Odette , Sammut Roberta , Camilleri Liberato , Phee‐Donovan Erica 
Published: November 2023

AbstractAimsTo explore the impact of COVID‐19 on students' lives and their online learning experience.DesignA cross‐sectional survey design was used in this study.MethodsA total of 44 nursing students who were enrolled in an undergraduate programme at a Canadian University participated in the study. The students were asked to fill out a 35‐item survey that was developed by the European Students' Union and that was circulated across Europe in April 2020.ResultsThe COVID‐19 pandemic and subsequent lockdown affected students mentally, and emotionally. Findings also revealed that whilst most students had the privilege to study from home, many students did not have a desk, or a quiet place to study in their home and some had problems with Internet connectivity. Online lectures were delivered according to students' preferences; however, students were dissatisfied with the way their practice was organized.ConclusionThe similarities between this study and the European study provide common grounds for academics around the world to connect, collaborate and work on the challenges in providing nurse education in emergencies such as national disasters or pandemics to ensure preparedness for such future events.Patient or Public ContributionNo Patient or Public Contribution.ImpactThe commonalities experienced in nursing education across the globe should act as an impetus for globalized nursing action. Educators need to prepare and reinvent a role for students in the clinical area in the event of future disasters/pandemics. Policy makers and administrators need to ensure when switching to online education no student is underprivileged or marginalized in the process.
Left atrial strain is a good predictor of atrio‐ventricular synchrony in leadless pacemaker pacing
Authors: Troisi Federica , Caccavo Vincenzo P. , Santobuono Vincenzo E. , Sgarra Luca , Carella Maria C. , Basile Paolo , Guaricci Andrea I. , Grimaldi Massimo 
Published: November 2023

AbstractIntroductionThe importance of atrio‐ventricular synchrony pacing in sinus rhythm patients is known. To identify patients in whom leadless pacemakers are able to guarantee this atrio‐ventricular synchrony, we explored correlations among echocardiographic measures of left atrial (LA) size and function (doppler parameter and strain) with A4 amplitude in patients implanted with new generation Micra‐AV device.MethodsAfter implantation with Micra‐AV system, patients underwent device interrogation to evaluate AV synchrony based on the sensing of atrial mechanics and echocardiographic exam to assess LA morphology and LA function.ResultsIn the 21 studied patients (14 males, 72 ± 13 years), the A4 wave amplitude values inversely correlated with LA antero‐posterior diameter, LA volume, LA contraction strain and LA conduit strain, while they were positively related with LA reservoir strain.DiscussionOur results indicate a statistically significant relationship between morphological echocardiographic LA parameters and atrial contraction signal (A4), detected by leadless pacemakers and used to synchronize ventricular pacing with the atrium. Instantaneous LA function assessment obtained with LA strain provides incremental information over morphological parameters. LA strain evaluates atrial myocardial deformation during the whole cardiac cycle. We found higher value of A4 in patients that have grater absolute value of LAsr, LAscd and LAsct, that are simple and measurable parameters of LA functional capacity.ConclusionPreimplant echocardiographic evaluation of the atrial contractility may be useful in predicting adequate A4 sensing and consequently a good atrio‐ventricular synchrony pacing. Echocardiography LA strain study seems promising in Micra‐AV patient selection.
Dynamic expression analysis of peripheral blood derived small extracellular vesicle miRNAs in sepsis progression
Authors: Liu Xinyan , Yu Dapeng , Li Tiantian , Zhu Kehan , Bi Yang , Wang Chaofan , Wang Chunting , Song Xuan 
Published: November 2023

AbstractImmune disorders caused by sepsis have recently drawn much attention. We sought to dynamically monitor the expression of small extracellular vesicle (sEV) miRNAs in peripheral blood during sepsis to explore these miRNAs as potential biomarkers for monitoring immune function in sepsis patients. This study included patients with sepsis. Blood samples were obtained from 10 patients on the first through 10th days, the 12th day and the 14th day since sepsis onset, resulting in 120 collected samples. Serum sEVs were extracted from peripheral venous blood, and levels of MIR497HG, miR‐195, miR‐497, and PD‐L1 in serum sEVs were detected by qPCR, and clinical information was recorded. Our study revealed that the levels of MIR497HG, miR‐195, miR‐497 and PD‐L1 in serum sEVs showed periodic changes; the time from peak to trough was approximately 4–5 days. The levels of sEV MIR497HG and miR‐195 had a positive linear relationship with SOFA score (r values were −0.181 and −0.189; p values were 0.048 and 0.039, respectively). The recorded quantities of sEV MIR497HG, miR‐195 and PD‐L1 showed a substantial correlation with ARDS. ROC curve analysis revealed that sEV MIR497HG, miR‐195 and miR‐497 could predict the 28‐day mortality of sepsis patients with an AUC of 0.66, 0.68 and 0.72, respectively. Levels of sEVs MIR497HG, miR‐195, miR‐497 and PD‐L1 showed periodic changes with the immune status of sepsis, which provides a new exploration direction for immune function biomarkers and immunotherapy timing in sepsis patients.
Phototherapy for atopic dermatitis: A survey of European practice
Authors: Steyn M. , Gerbens L. A. A. , Spuls P. I. , Mashayekhi S. , Deleuran M. , Barbarot S. , Wollenberg A. , Ferguson J. , Ibbotson S. , Flohr C. 
Published: November 2023

AbstractBackgroundPhototherapy is used to treat atopic dermatitis (AD). Evidence for its efficacy, impact on quality of life, cost‐effectiveness and short‐ and long‐term safety with real‐life usage is weak.ObjectivesWe established a taskforce to examine how phototherapy is currently being used as a treatment for AD across the United Kingdom and Europe to inform our understanding and guide future research into management of patients with AD using UV‐based phototherapies.MethodsAn anonymous electronic multiple‐response survey exploring phototherapy prescribing practices and experience of phototherapy modalities was developed by the study authors and sent to members of phototherapy networks from the United Kingdom and Europe. Responses were received between February and July 2021.ResultsAbout 144 respondents from 27 European countries completed the survey. NBUVB was the most widely used [n = 138 (96%)]. Home‐based NBUVB was available in 8/27 countries (25/144 respondents, 17%). Oral psoralen‐UVA (PUVA) was more widely available than bath PUVA (n = 106, 74% vs. n = 60, 42%) and used mainly in adult patients. 49/144 (34%) of respondents had access to UVA1. Phototherapy would be considered instead of systemic treatment in 96% of adults and 82% of children for NBUVB, versus 40% of adults and 3% of children for PUVA. Starting doses, standard dosing increments, length of treatment courses, lifetime limits for treatments and thresholds for performing annual skin assessments varied between responders.ConclusionsNBUVB was the most widely used phototherapy for AD in adult and paediatric patients, while PUVA and UVA1 were less used. Prescribing practices varied considerably, highlighting the lack of consensus practice in many different aspects of phototherapy for the treatment of AD in children and adults. This indicates that further studies are required to determine optimal phototherapeutic regimens for AD and informs our understanding of parameters that should be included in future high‐quality randomized controlled trials (RCT) of phototherapy.
Effect of triggering receptor expressed on myeloid cells 2‐associated alterations on lipid metabolism in macrophages in the development of non‐alcoholic fatty liver disease
Authors: Ji Pei‐Xuan , Chen Yu‐Xin , Ni Xi‐Xi , Miao Qi , Hua Jing 
Published: November 2023

AbstractBackground and AimTriggering receptor expressed on myeloid cells 2 (TREM2) plays crucial roles in metabolic homeostasis and inflammatory response. Altered metabolic function in macrophages could modulate their activation and immune phenotype. The present study aimed to investigate the expression of TREM2 in non‐alcoholic fatty liver disease (NAFLD) and to clarify the underlying mechanism of TREM2 on macrophages lipid metabolism and oxidative stress.MethodsHepatic TREM2 expression and its relationship with NAFLD progression were analyzed in patients with NAFLD and mice fed a high‐fat diet. Lipid metabolism and oxidative stress were investigated in macrophages from NAFLD mice or stimulated with saturated fatty acids. Knockdown and overexpression of TREM2 were further explored.ResultsTriggering receptor expressed on myeloid cells 2+ macrophages were increased along with NAFLD development, characterized by aggravated steatosis and liver damage in humans and mice. TREM2 expression was upregulated and lipid metabolism was changed in macrophages from NAFLD mice or metabolically activated by saturated fatty acid in vitro, as demonstrated by increased lipid uptake and catabolism, but reduced de novo synthesis of fatty acids (FAs). Regulation of TREM2 expression in lipid‐laden macrophages reprogrammed lipid metabolism, especially the fatty acid oxidation capacity of mitochondria. TREM2 knockdown promoted oxidative stress by aggravating FAs deposition in mitochondria. Intervention of mitochondrial FAs transport in lipid‐laden macrophages alleviated FA deposition and reactive oxygen species production induced by TREM2 knockdown.ConclusionsTriggering receptor expressed on myeloid cells 2 expression was associated with the lipid metabolic profile and reactive oxygen species production in macrophages. High expression of TREM2 in macrophages may protect the liver from oxidative stress in NAFLD.