bluuebunny/crossref_metadata_2025_split huggingface dataset:
Navigating tensions when life‐sustaining treatment is withdrawn: A thematic synthesis of nurses' and physicians' experiences
Authors: Choi Hye Ri , Ho Mu‐hsing , Lin Chia‐Chin 
Published: February 2024

AbstractAimTo synthesise nurses' and physicians' experiences with withdrawing life‐sustaining treatment in an intensive care unit.DesignThe chosen methodology is thematic synthesis. The Preferred Reporting Items for Systematic Review and Meta‐Analyses and Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement.Methods and Data SourcesA systematic search is conducted in APA PsycINFO, CINAHL Plus, EMBASE, PubMed and Web of Science following the inclusion and exclusion criteria in April 2023. Two reviewers independently screened and extracted the qualitative data. Subsequently, data analysis was conducted using thematic analysis of qualitative research. This study was not registered with any review registry due to the irrelevance of the data to health‐related outcomes.ResultsFrom the 16 articles, 267 quotes were extracted and analysed. The findings of the study revealed five analytical themes: (1) tensions between interdependent collaboration and hierarchical roles; (2) tensions between dignified dying or therapeutic perspectives; (3) family members' reflections of patient's wishes; (4) tensions in family members' positions; and (5) double‐sidedness of distress.ConclusionThis study contributes to nursing knowledge by providing a more nuanced understanding of this complex phenomenon of withdrawing life‐sustaining treatment. The findings of this study have revealed significant variations globally in the practices surrounding the withdrawal of life‐sustaining treatment in intensive care units, emphasising the need for further research to inform clinical practices that cater to diverse contexts.Reporting MethodEnhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement (ENTREQ statement).Patient or Public ContributionSince this study reported a potential collision between the patient's dignified dying and the family member's perceptions and interests, the family member's wishes should be carefully distinguished from the patient's quality of end of life in practice.
Interventions to address parenting stress among caregivers of children with chronic diseases: An umbrella review
Authors: Yang Jinrong , Gao Yuqin , Wang Weiren , Wang Junyan , Wang Yanjie , Yuan Lulu 
Published: February 2024

AbstractBackgroundCaregivers of children with chronic diseases suffer from great parenting pressure, which directly affects the treatment and rehabilitation of children, reduces the quality of life of caregivers and damages family functioning. Existing reviews have not systematically summarized and evaluated interventions for parenting stress in caregivers of children with chronic diseases.Data SourcesEmbase, PubMed, Web of Science, OVID, CNKI, CBM, Wan Fang and Cochrane Library were searched for eligible reviews in November 2021 and October 2022.MethodsTwo reviewers independently screened titles and abstracts, reviewed full texts of articles for eligibility, and appraised the quality of reviews using JBI. The quality of the evidence was assessed using GRADE. Findings are reported in accordance with PRISMA checklist. Narrative summaries grouped findings by intervention types.ResultsOut of 2632 records, we included 21 systematic reviews for a synthesis. Interventions for parenting stress in children with chronic diseases were divided into seven categories. Cognitive behavioural interventions, psychosocial interventions, child behavioural and/or developmental parent interventions and synthesized interventions have shown high‐level evidence in reducing parenting stress for caregivers of children with chronic diseases. Furthermore, outcome measures and intervention protocols were highly heterogeneous across interventions.ConclusionsThis umbrella review suggest that reducing the parenting stress of caregivers of children with chronic diseases can directly target caregivers' parenting stress through cognitive behavioural interventions/psychosocial interventions and/or provide guidance to parents on the behavioural and developmental problems of children with chronic diseases. A more standardized approach to outcome measures is essential to assess efficacy and compare interventions across studies.Relevance to Clinical PracticeThe findings provide information and evidence for reducing parenting stress among caregivers of children with chronic diseases to guide the development of comprehensive intervention strategies.Patient or Public ContributionPatient or public contribution does not apply to this study.
Nurses' views on the presence of family members during invasive procedures in hospitalised children: A questionnaire survey
Authors: Ventura Expósito Laia , Arreciado Marañón Antonia , Gomà Tous Mireia , Ferrerons Sánchez Mercè , Zuriguel‐Pérez Esperanza 
Published: February 2024

AbstractAims and Objectives(I) To identify the opinion and practices of nursing professionals regarding the presence of family members during invasive procedures in hospitalised children; (II) to determine the knowledge of nursing professionals about the patient‐and family‐centred care model.BackgroundFamily presence in invasive procedures benefits the patient and their relatives, but varied attitudes exist among healthcare personnel, with some being favourable and others unfavourable toward family presence.DesignObservational, descriptive, cross‐sectional study.MethodsStudy population: Nurses from paediatric critical care services, emergency services, hospital wards, day hospitals and outpatient clinics at a Catalan tertiary hospital who participated voluntarily between September 2021 and July 2022. Data collection instrument: A questionnaire prepared by the researchers, based on the literature and reviewed by experts. REDCap link with access to the questionnaire was sent out to potential respondents through the institutional email. Bivariate analysis was performed with the R 4.2 program. The study was approved by the hospital's Clinical Research Committee and participants gave informed consent before responding to the questionnaire.ResultsA total of 172 nurses participated, and 155 valid responses were obtained. All respondents consider the family as a key element in paediatric care and report inviting family members to participate in the care given to their child. However, 12.0% of nurses do not invite the family to be present in invasive procedures. Almost all respondents note the need for training to acquire communication skills and improve the management of emotions.ConclusionsThe results show a favourable opinion towards the presence of family members and highlight the need to train nurses to develop communication skills.Relevance to clinical practiceThe data provided can favour the design of measures to improve and promote the presence of parents during invasive procedures, reinforcing the patient‐and family‐centred care model and improving the quality of care provided. One example is the creation of family care protocols where the inclusion of parents and the roles of each individual involved in the care process appears.
Content analysis of the nursing diagnosis of ineffective peripheral tissue perfusion in patients with diabetic foot
Authors: Fontenele Nascimento Lorrany , Maia Pascoal Lívia , de Oliveira Lopes Marcos Venícios , Santos Neto Marcelino , Arrais Sampaio Santos Francisca Aline , Pereira De Jesus Costa Ana Cristina , Stabnow Santos Floriacy 
Published: February 2024

AbstractAimTo analyse the content of the nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot.DesignA methodological study with a quantitative approach was performed.MethodsThe analysis was performed between January and May 2021 by 34 nurses with clinical/theoretical/research experience with diabetes or nursing diagnoses. These nurses evaluated the relevance, clarity and precision of 12 diagnosis‐specific etiological factors, 22 clinical indicators and their conceptual and operational definitions.FindingsAll 12 etiological factors analysed were considered relevant to diagnostic identification. However, five showed inconsistencies regarding the clarity or precision of the operational definitions, requiring adjustments. Regarding the 22 clinical indicators evaluated, all of them presented a Content Validity Index (CVI) that was statistically significant. However, in the indicators, the colour does not return to lowered limb after 1 min of leg elevation, and cold foot had Content Validity Index (CVI) <0.9 regarding relevance and accuracy of operational definitions.ConclusionsTwelve etiological factors and 22 clinical indicators were validated. Thus, this study revealed new and relevant aspects characterising peripheral perfusion in patients with diabetic foot that have not yet been clinically validated.Implications for Nursing PracticeThis study contributes to support the professional practice of nurses through the early identification of etiological factors and clinical indicators in persons with diabetic foot. As a proposal, we suggest the inclusion of new defining characteristics and related factors for the nursing diagnosis ineffective peripheral tissue perfusion in the NANDA‐I taxonomy.ImpactThe research highlights new and relevant aspects such as etiological factors and clinical indicators to characterise peripheral perfusion in patients with diabetic foot. Based on these findings, clinical validation is recommended to confirm the relevance of the proposed elements in the population studied for greater reliability and improved diagnostic assessment for the professional practice of nurses.Reporting MethodEQUATOR guidelines were adhered to using the GRRAS checklist for reporting reliability and agreement studies.Patient or Public ContributionNo patient or public contribution.
Epigenetics in the diagnosis and prognosis of head and neck cancer: A systematic review
Authors: Lim Isaac , Tan Jade , Alam Anneka , Idrees Majdy , Brenan Peter A. , Coletta Ricardo Della , Kujan Omar 
Published: February 2024

AbstractBackgroundAberrant epigenetic modifications significantly develop and progress human malignancies including head and neck squamous cell carcinoma (HNSCC). Taking into account issues of late diagnosis and poor prognosis associated with HNSCC, this systematic review is designed to provide an up‐to‐date insight of epigenetic changes in the management of HNSCC.MethodsAll studies that assessed the diagnostic and prognostic utilities of epigenetic changes (DNA methylation and histone modifications) among patients diagnosed with HNSCC or oral potentially malignant disorders (OPMDs) were considered for inclusion till June 2023. Pre‐defined Medical Subject Headings terms were used to search Web of Science, Pubmed, Scopus and Embase Ovid databases.ResultsTwenty‐five studies were deemed eligible for inclusion with a total number of 3790 samples (2123 HNSCCs, 334 OPMDs and 1333 as controls). DNA methylation was investigated in 18 studies while the role of histone modifications was assessed in seven studies. The most investigated biomarkers among the studies were H3, DAPK and TIMP3. The diagnostic accuracy of the epigenetic biomarkers in detecting HNSCC was assessed in eight studies where the following biomarkers showed the highest area under the curve values: TIPM3, DCC, DAPK, SEPT9, SHOX9, HOXA9 and TRH. None of the studies assessed the predictability of the epigenetic biomarkers in HNSCC and OPMDs.ConclusionAlthough initial promising results were seen using the epigenetic biomarkers in the early detection of HNSCC, the limited number of patients and the absence of well‐designed longitudinal studies limit the clinical applicability of the outcomes.
Multiperiod peer‐to‐peer risk sharing
Authors: Abdikerimova Samal , Boonen Tim J. , Feng Runhuan 
Published: February 2024

AbstractRisk sharing has been practiced in various forms in the financial industry. This paper is the first to study both dynamic and static risk‐sharing mechanisms for a group of participants over multiple periods. The design of risk‐sharing strategies is based on the Pareto optimization of quadratic utilities of participants' reserves. Such a framework builds a connection between portfolio optimization in the finance literature and that for risk sharing in the insurance literature. Building on the most common form of reinsurance—pro rata treaties, we propose a peer‐to‐peer (P2P) network for risk sharing. Assuming independent multivariate losses over time, we find that the optimal risk‐sharing allocation exhibits a three‐component structure with the long‐term limit and two correction terms. This allows us to show convergence of the risk‐sharing solution and the ratios of long‐term reserves. Furthermore, we study the impact of actuarial fairness on various risk‐sharing strategies and their long‐term limits.
Dietary supplementation of water extract of Eucommia ulmoides bark improved caecal microbiota and parameters of health in white‐feathered broilers
Authors: Lu Min , Zhao Zhong‐Tao , Xin Ye , Chen Guoxun , Yang Fang 
Published: February 2024

AbstractEucommia ulmoides has been used as a food and medicine homologue for a long time in China. We hypothesize that Eucommia ulmoides achieves its health‐promoting effects via altering gut microbiota. Here, we investigated the effects of water extract of Eucommia ulmoides bark on caecal microbiota and growth performance, antioxidant activity, and immunity in white‐feathered broilers treated for 42 days. A total of 108 one‐day‐old Cobb white‐feathered broilers were randomly assigned to three treatment groups: control diet, 0.75% Eucommia ulmoides diet (EU Ⅰ) and 1.5% Eucommia ulmoides diet (EU Ⅱ). The results showed that EU Ⅱ treatment improved average body weight (ABW), thigh muscle quality and total length of intestines, and decreased the serum total triglycerides and total cholesterol (TC) (p < 0.05). Eucommia ulmoides supplementation increased serum superoxide dismutase (SOD), glutathione peroxidase (GSH‐Px), total antioxidant activities and content of immunoglobulins, and reduced levels of malondialdehyde and tumour necrosis factor‐α (TNF‐α) (p < 0.05). Moreover, the supplementation increased the diversity of caecal microbiota and reduced the pathogenic genera Escherichia Shigella and Helicobacter. The genera Ochrobactrum, Odoribater, Klebsiella, Enterobacter, Georgenia and Bifidobacterium were positively associated with the ABW, total intestinal length, serum levels of GSH‐Px, SOD and immunoglobulins (p < 0.001) and negatively associated with the TC and TNF‐α (p < 0.01), suggesting an association of the changes of gut microbiota and improvement of broiler health. Meanwhile, Eucommia ulmoides supplementation enriched the Kyoto Encyclopedia of Genes and Genomes pathway of exocrine secretion from the pancreas, circadian entrainment and inhibited lipopolysaccharide biosynthesis. In conclusion, Eucommia ulmoides water extract can be used as a feed additive to improve poultry industry production.
Effect of paprika extracts on growth performance, haemolymph chemistry, intestinal microbiota and antioxidant enzyme activities of white‐leg shrimp (Litopenaeus vannamei)
Authors: Erfanifar Elnaz , Khoei Zahra Amini , Abolfathi Marzieh , Erfanifar Elahe , Tamadoni Jahromi Saeid , Taee Hadis Mansouri , Pourmozaffar Sajjad 
Published: February 2024

AbstractThis study aims to evaluate the effects of paprika extract on the survival rate, growth performance and stimulation of the innate immune system of Litopenaeus vannamei. In this experiment, 240 healthy shrimp (3.22 ± 0.12 g) were randomly divided into four groups. The shrimp were fed diets with different concentrations of paprika oil extracts (0%, 0.5%, 1% and 2%) for 8 weeks. The results showed that growth performance, urea, uric acid, creatinine, cholesterol levels, aspartate aminotransferase and alkaline phosphatase activities were not significantly affected by adding paprika extract to the shrimp diet (p > 0.05). Diets containing 1% and 0.5% paprika extract showed the highest levels of total protein and triglyceride, respectively (p < 0.05). There was a significant decrease in haemolymph glucose concentration in shrimp‐fed diets containing 1% and 2% paprika extract (p < 0.05). Moreover, a diet containing 0.5% paprika extract resulted in the highest levels of total heamocyte count, hyaline cells and large‐granular cells in shrimp (p < 0.05). Higher catalase and superoxide dismutase activities were also exhibited in the paprika groups (p < 0.05). Vibrio sp. bacteria were not significantly reduced by paprika extract in the intestines of L. vannamei (p > 0.05). A significant decrease in heterotrophic bacteria was observed with increasing extract concentrations (p < 0.05). The shrimp culture industry can utilize paprika extract as a cost‐effective, efficient and environmentally friendly immune stimulant at a concentration of 0.5%.
The global status of human milk banking
Authors: Israel‐Ballard Kiersten , LaRose Emily , Mansen Kimberly 
Published: February 2024

AbstractHuman milk provides essential nutrition for infants and holds many health benefits for infants and mothers. When a mother's own milk is not available for her infant, the World Health Organization recommends feeding donor human milk (DHM) from a human milk banking facility. DHM is human milk produced, collected then donated to a human milk bank (HMB). HMBs serve many vital functions, including screening donor mothers, then collecting, processing, storing, and allocating DHM to recipients. The first HMB opened in 1909, and today there are more than 700 HMBs globally. Unfortunately, HMB facilities are not present in all locales, with notable gaps in South Asia and Africa. Additionally, there are no global standards to guide HMB operational procedures. Even though most HMBs attempt to employ quality control systems to provide safe DHM, differences in community needs, resource availability, and a range of methods and policies to execute processes result in significant variations in DHM quality and HMB operations. Robust and collaborative systems that ensure safe and equitable access to DHM are needed. In this paper, we present a global snapshot of current human milk banking practices; review an interdisciplinary framework to guide and support HMB activities as an integrated part of health and newborn care systems; discuss factors that contribute to HMB sustainability; outline barriers to scaling HMBs worldwide; and highlight knowledge, policy, and research gaps. Developing global HMB guidance and rigorous, adaptable standards would strengthen efforts to improve newborn health.
Virtual‐real‐fusion simulation framework for evaluating and optimizing small‐spatial‐scale placement of cooperative roadside sensing units
Authors: Ma Y. , Zheng Y. B. , Wang S. Y. , Wong Y. D. , Easa S. M. 
Published: February 2024

AbstractRoadside sensing units’ (RSUs) perception capability may be substantially impaired by occlusion issue even they work cooperatively. However, the joint influence of static and dynamic occlusions in real‐life situations remains inadequately considered in optimizing RSUs’ placement. This study proposes a virtual‐real‐fusion simulation (VRFS) framework that combines traffic simulation and point clouds of real‐world road environment to optimize RSUs’ deployment. Point clouds and triangular meshes are used to model static and dynamic obstacles, respectively. A structure‐retained spherical projection method is developed to efficiently emulate RSUs’ data collection. Based on the developed VRFS, the probabilistic occupancy maps (POM) are created to represent traffic scenarios. The POM‐based cross entropy (CE) is proposed as the surrogate metric for evaluating the detection performance of cooperative RSUs. The Bayesian optimizer is applied to optimize the RSUs’ placement parameters (decision variables) by minimizing CE. Test results show that it is viable to use the POM‐based CE as a proxy for evaluating cooperative RSUs’ sensing performance. Considering the occlusion effect adds to the efficacy of POM‐based CE as a surrogate metric. Compared with traffic volume, the adverse effect of the proportion of large vehicles on RSUs’ detection performance is more significant. There are no significant patterns regarding how the optimized RSU positions vary with traffic parameters. The comparisons with existing methods further verify the importance of considering both static and dynamic occlusions in optimizing RSUs’ placement. Besides, the proposed method can yield better optimization results more efficiently than existing approaches.
Changes in the locus coeruleus during the course of Alzheimer's disease and their relationship to cortical pathology
Authors: Beardmore Rebecca , Durkin Matthew , Zayee‐Mellick Faizan , Lau Laurie C. , Nicoll James A. R. , Holmes Clive , Boche Delphine 
Published: February 2024

AbstractAimsIn Alzheimer's disease (AD), the locus coeruleus (LC) undergoes early and extensive neuronal loss, preceded by abnormal intracellular tau aggregation, decades before the onset of clinical disease. Neuromelanin‐sensitive MRI has been proposed as a method to image these changes during life. Surprisingly, human post‐mortem studies have not examined how changes in LC during the course of the disease relate to cerebral pathology following the loss of the LC projection to the cortex.MethodsImmunohistochemistry was used to examine markers for 4G8 (pan‐Aβ) and AT8 (ptau), LC integrity (neuromelanin, dopamine β‐hydroxylase [DβH], tyrosine hydroxylase [TH]) and microglia (Iba1, CD68, HLA‐DR) in the LC and related temporal lobe pathology of 59 post‐mortem brains grouped by disease severity determined by Braak stage (0‐II, III‐IV and V‐VI). The inflammatory environment was assessed using multiplex assays.ResultsChanges in the LC with increasing Braak stage included increased neuronal loss (p < 0.001) and microglial Iba1 (p = 0.005) together with a reduction in neuromelanin (p < 0.001), DβH (p = 0.002) and TH (p = 0.041). Interestingly in LC, increased ptau and loss of neuromelanin were detected from Braak stage III‐IV (p = 0.001). At Braak stage V/VI, the inflammatory environment was different in the LC vs TL, highlighting the anatomical heterogeneity of the inflammatory response.ConclusionsHere, we report the first quantification of neuromelanin during the course of AD and its relationship to AD pathology and neuroinflammation in the TL. Our findings of neuromelanin loss early in AD and before the neuroinflammatory reaction support the use of neuromelanin‐MRI as a sensitive technique to identify early changes in AD.
The bHLH transcription factor OsPRI1 activates the Setaria viridis PEPC1 promoter in rice
Authors: Carvalho Pedro , Gomes Célia , Gonçalves Ivan , Lourenço Tiago F. , Vlad Daniela , Langdale Jane A. , Saibo Nelson J. M. 
Published: February 2024

Summary

Photosynthetic efficiency is reduced by the dual role of Rubisco, which acts either as a carboxylase or as an oxygenase, the latter leading to photorespiration. C4 photosynthesis evolved as a carbon‐concentrating mechanism to reduce photorespiration. To engineer C4 into a C3 plant, it is essential to understand how C4 genes, such as phosphoenolpyruvate carboxylase (PEPC1), are regulated to be expressed at high levels and in a cell‐specific manner.

Yeast one‐hybrid screening was used to show that OsPRI1, a rice bHLH transcription factor involved in iron homeostasis, binds to the Setaria viridis PEPC1 promoter. This promoter drives mesophyll‐specific gene expression in rice. The role of OsPRI1 in planta was characterized using a rice line harbouring SvPEPC1pro::GUS.

We show that OsPRI1 activates the S. viridis PEPC1 promoter by binding to an N‐box in the proximal promoter, and that GUS activity is highly reduced in SvPEPC1pro::GUS lines when OsPRI1 is mutated. Cross‐species comparisons showed that the SvPRI1 homolog binds to the SvPEPC1 promoter but the maize ZmPRI1 does not bind to the ZmPEPC1 promoter.

Our results suggest that elements of the iron homeostasis pathway were co‐opted to regulate PEPC1 gene expression during the evolution of some but not all C4 species.