bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe necrotizing soft tissue infections—Is wound microbiology a prognostic factor for clinical outcome?
Authors: Friederichs Jan , Gerl Benedikt , Schneidmüller D. , Hungerer Sven 
Published: August 2023

AbstractNecrotizing soft tissue infections (NSTIs) represent similar pathophysiological features, but the clinical course might range from subacute to a rapidly progressive, fulminant sepsis. Initial wound microbiology is the base for the Guiliano classification. The timeline of microbiological colonization has not been described during the clinical course. The role of the different microbiological pathogens on the outcome and mortality is unclear. One hundred eighty patients were included with septic inflammation response syndrome on admission. Initial wound microbiology and the changes in wound microbiology were analysed during the clinical course and correlated with outcome and risk indicators. Overall mortality was 35%. Higher age, a high Charlson Comorbidity Index or ASA score and truncal infections were highly prognostic for a lethal outcome. Microbiological findings revealed significant differences in the persistence of bacteria during the course of disease. Streptococci were only detectable within the first 5 days, whereas other bacteria persisted over a longer period of time. Initial microbiological findings correlated with better prognosis when no causative agent was identified and for gram‐negative rods. Varying survival rates were observed for different Streptococci, Staphylococci, Enterococci and other bacteria. The highest odds ratio for a lethal outcome was observed for Enterococci and fungi. Microbiological colonization changes during the clinical course of NSTIs and some microbiologic pathogens are predictive for worsening the outcome and survival. Streptococcus pyogenes is only detectable in the very early phase of NSTI and after 6 days not anymore detectable. Later Enterococci and fungi showed the highest odds ratios for a lethal outcome. Enterococci bacteria and fungi have yet not been considered of clinical relevance in NSTI or even as indicator for worsening the outcome.
Influence of endoscopists' expertise level on clinical outcomes after bridge‐to‐surgery stenting in obstructive colorectal cancer
Authors: Park Suhyun , Lee Jae Yong , Hong Seung Wook , Hwang Sung Wook , Park Sang Hyoung , Yang Dong‐Hoon , Ye Byong Duk , Myung Seung‐Jae , Yang Suk‐Kyun , Byeon Jeong‐Sik 
Published: August 2023

AbstractBackground and AimThis study aimed to investigate the effect of stenting‐related factors, including endoscopists' expertise, on clinical outcomes after bridge‐to‐surgery (BTS) stenting for obstructive colorectal cancer (CRC).MethodsWe analyzed BTS stenting‐related factors, including stenting expertise and the interval between stenting and surgery, in 233 patients (63 [13] years, 137 male) who underwent BTS stenting for obstructive CRC. We evaluated the influence of these factors on post‐BTS stenting clinical outcomes such as stent‐related complications and cancer recurrence.ResultsThe interval between stenting and surgery was ≤ 7 days in 79 patients (33.9%) and > 7 days in 154 patients (66.1%). BTS stenting was performed by endoscopists with ≤ 50, 51–100, and > 100 prior stenting experiences in 94, 43, and, 96 patients, respectively. The clinical success rate of BTS stenting was 93.1%. Stent‐related and postoperative complications developed in 19 (8.2%) and 20 (8.6%) patients, respectively. Cancer recurrence occurred in 76 patients (32.6%). Short BTS interval of ≤ 7 days increased the risk of postoperative complications (odds ratio [OR], 2.61 [1.03–6.75]; P = 0.043). Endoscopists' stenting experience > 100 showed greater clinical success of stenting (OR, 5.50 [1.45–28.39]; P = 0.021) and fewer stent‐related complications (OR, 0.26 [0.07–0.80]; P = 0.028) compared with stenting experience ≤ 50. BTS stenting‐related factors did not affect long‐term oncological outcomes.ConclusionGreater expertise of endoscopists was associated with better short‐term outcomes, including high stenting success rate and low rate of stent‐related complications after BTS stenting for obstructive CRC. An interval of > 7 days between BTS stenting and surgery was required to decrease postoperative complications.
Experimental investigation of biostimulatory effects after polydioxanone thread insertion in a pig model
Authors: Su Diya , Wang Shiwei , He Tong , Wang Jieqing 
Published: August 2023

AbstractBackgroundPolydioxanone (PDO) threads have been widely used to tighten and lift the facial soft tissue.ObjectiveThis research aims to determine the collagenation and inflammation changes that occur in the adipose tissue over time when different types of threads are implanted.Methods & MaterialsThree threads types, PDO, poly glycolic‐co‐lactic acid (PGLA), and nylon, were inserted in the subcutaneous fat of 12‐month‐old Bama miniature pigs. Collagen production and inflammatory response were evaluated by hematoxylin and eosin and Masson trichrome staining at 1, 4, 12, 24, and 48 weeks.ResultsThe integrity of the PDO thread lasted up to 24 weeks with mild inflammation and collagen production. The PGLA thread integrity lasted until 12 weeks and had a strong inflammatory response. The nylon thread's integrity was maintained for 48 weeks and showed minor inflammation and collagen production.ConclusionOur data suggest that PDO thread is the best choice for clinicians, as it has a mild action process with minimal irritation, moderate collagen production, a reasonable explanation time, with obvious bridging fibrous tissue, and thickening action for the superficial fascia.
Sleep characteristics and parameters of bone turnover and strength in the adult population: results from the Study of Health in Pomerania‐TREND
Authors: Rassow Kathrin , Obst Anne , Nauck Matthias , Völzke Henry , Stubbe Beate , Fietze Ingo , Penzel Thomas , Ewert Ralf , Hannemann Anke 
Published: August 2023

SummaryPoor sleep quality or sleep deprivation may be related to decreased bone mineral density. We aimed to assess whether associations of sleep characteristics and bone turnover or strength are present in adults from the general population and whether these are independent of common risk factors such as sex, age, and obesity. A total of 1037 participants from the Study of Health in Pomerania‐TREND underwent laboratory‐based polysomnography and quantitative ultrasound measurements at the heel. Of these participants, 804 completed standardised questionnaires to assess daytime sleepiness, insomnia, and sleep quality. Serum concentrations of two bone turnover markers, intact amino‐terminal propeptide of type 1 procollagen (P1NP) and carboxy‐terminal telopeptide of type 1 collagen (CTX) were measured. Cross‐sectional associations of polysomnography variables (total sleep time, sleep efficiency, time spent wake after sleep onset, oxygen desaturation index, apnea–hypopnea index, and obstructive sleep apnea [OSA]), as well as sleep questionnaire scores with the bone turnover markers and the ultrasound‐based stiffness index were assessed in linear regression models. In adjusted models, higher insomnia scores and lower sleep quality scores were related to a higher bone turnover in women but not in men. However, associations between polysomnography variables or questionnaire scores and the stiffness index were absent. Our study provides limited evidence for relationships between sleep characteristics and bone turnover and strength independent of common risk factors for OSA and osteoporosis. Nevertheless, women reporting poor sleep or insomnia in combination with risk factors for osteoporosis might benefit from an evaluation of bone health.
Effects of feeding and habitat on resting metabolic rates of the Pacific walrus
Authors: Rode Karyn D. , Rocabert Joan , Borque‐Espinosa Alicia , Ferrero‐Fernández Diana , Fahlman Andreas 
Published: August 2023

AbstractArctic marine mammals live in a rapidly changing environment due to the amplified effects of global warming. Pacific walruses (Odobenus rosmarus divergens) have responded to declines in Arctic sea‐ice extent by increasingly hauling out on land farther from their benthic foraging habitat. Energy models can be useful for better understanding the potential implications of changes in behavior on body condition and reproduction but require behavior‐specific metabolic rates. Here we measured the resting metabolic rates (RMR) of three captive, adult female Pacific walruses through breath‐by‐breath respirometry when fed and fasted resting out of water (sitting and lying down) and while fed resting in water. RMR in and out of water were positively related with pretrial energy intake when not fasted and 25% higher than RMR when walruses were fasted and out of water. Overall, RMR was higher than previously estimated for this species. Fasting RMR out of water was only 25% lower than subsurface swimming metabolic rates suggestive of relatively efficient swimming in adult females. Our results identify the importance of considering feeding status and species‐specific differences in affecting metabolic costs. Further research is needed to better understand potential energetic costs of thermoregulation at temperatures experienced by wild walruses.
Challenges of delivering care to older persons in the intensive care unit: A qualitative study based on the third wave of COVID‐19 in China
Authors: Tang Li , Wu Xiaoyu , Li Jiuhong , Xie Xia , Huang Lingzhi 
Published: August 2023

AbstractBackgroundWith the aging population and the ongoing pandemic, older persons account for a large proportion of ICU admissions. Despite numerous studies on the impact of COVID‐19 on older persons, there has been a small body of research investigating nursing practice with critically ill older patients admitted to ICU for COVID‐19.AimsTo explore current challenges in the nursing care of older persons with severe COVID‐19 through the experience of frontline nurses.Study DesignA qualitative descriptive design was used. In‐depth and semi‐structured interviews with 18 ICU nurses were conducted to explore the experience of providing care for older persons with severe COVID‐19 in the Omicron wave. A content analysis approach was adopted to analyse qualitative data.FindingsThree themes emerged as follows: (1) no plan survives first contact with the enemy, (2) expectations versus Reality and (3) difficulty in providing holistic care.ConclusionsChallenges could be encountered in different stages of providing care for older persons with severe COVID‐19, including the preparation and training of knowledge and skills in the early stage, the challenges posed by old age in the diagnostic and treatment stage and the challenges of psychological care and rehabilitation care.Relevance to Clinical PracticeWith the regular prevention and control of COVID‐19, our study provides guidance for establishing measures (training courses of ICU nurses) to improve the nursing quality of older persons with severe COVID‐19.
The epistemic insignificance of phenomenal force
Authors: Teng Lu 
Published: August 2023

AbstractDoes phenomenal force, the distinctive phenomenology attributed to perceptual experience, really form an integral part of the latter? If not, what implications does it have for perceptual justification? In this paper, I first argue for a metacognitive account, according to which phenomenal force constitutes a separate, metacognitive state. This account opens up a previously unexplored path for challenging phenomenal conservatism or dogmatism, which has been a prominent theory of perceptual justification over the past two decades. Moreover, I investigate several alternative possibilities in which phenomenal force might still be deemed as significant, but ultimately demonstrate that its epistemic role remains marginal at best.
Divergent rainforest tree microbiomes between phases of the monsoon cycle, host plants and tissues
Authors: Calvert J. , McTaggart A. , Carvalhais L. C. , Rensink S. , Dennis P. G. , Drenth A. , Shivas R. 
Published: August 2023

AbstractThe Australian Monsoon Tropics (AMT) contain some of the most biodiverse forests on the continent. Little is known about the dynamics of rainforest plant microbiomes in general, and there have been no community‐level studies on Australian rainforest endophytes, their seasonality, tissue and host specificity.We tested whether community composition of tropical tree endophytes (fungi and bacteria) differs: (i) at different points during a monsoon cycle, (ii) between leaf and stem tissues, (iii) between forest microclimates (gully/ridge), and between (iv) host plant species, and (v) host plant clade, using amplicon sequencing of the bacterial 16S and fungal ITS2 gene regions.Results indicated that the composition of rainforest plant microbiomes differs between wet and dry seasons, which may be explained by physiological shifts in host plants due to annual climate fluctuations from mesic to xeric. Endophyte microbiomes differed between leaves and stems. Distinct fungal communities were associated with host species and clades, with some trees enriched in a number of fungal taxa compared to host plants in other clades. Diversity of bacterial endophytes in plant stems increased in the dry season.We conclude that the microbiomes of tropical plants are responsive to monsoonal climate variation, are highly compartmentalised between plant tissues, and may be partly shaped by the relatedness of their host plants.
Factors associated with depression and suicidal ideation among oldest‐old adults aged 85 years or older based on gender, using the survey data of South Korea
Authors: Kim Yujeong , Nam Eunhee , Yun Younghee 
Published: August 2023

AbstractBackgroundSouth Korea is predicted to become a superaged society around 2025. Depression in older adults is a major factor influencing suicide. South Korea exhibits the highest suicide rate among the Organization for Economic Co‐operation and Development countries.MethodsThis study aimed to examine the factors associated with depression and suicidal ideation among individuals aged 85 years or older based on gender. Data were obtained from the Korea Institute for Health and Social Affairs, 2017. Overall, 768 individuals aged ≥85 years were included in the final analysis. The participants' general, health‐related, and social characteristics were analyzed as factors influencing depression and suicidal ideation.ResultsAmong male oldest‐old adults, living arrangements and the number of chronic diseases were factors affecting depression, while activities of daily living restrictions and the number of chronic diseases were factors affecting suicidal ideation. Among female oldest‐old adults, only the number of chronic diseases affected depression, while financial status and the number of chronic diseases were the factors affecting suicidal ideation.ConclusionsThe healthcare and welfare services for older adults must be expanded to cater to oldest‐old adults who live alone, have activities of daily living restrictions, and have lower financial status. Additionally, the oldest age group's psychological health must be monitored regularly for depression and suicidal ideation to implement active interventions for this high‐risk group.
Leading digital transformation: A narrative perspective
Authors: Nielsen Jeppe Agger , Elmholdt Kasper Trolle , Noesgaard Mette Strange 
Published: August 2023

AbstractChange communication is a critical dimension for leading digital transformation. Existing literature predominantly theorizes change communication as part of the earliest stages of the transformation, but how it evolves over time to remain relevant in this context is understudied. We address this shortcoming through a four‐year study of a digital transformation initiative in a local government's health care department. Drawing on a narrative perspective, we offer a processual account and describe the ongoing communicative work of public managers as they attempt to shape frontline workers' expectations of digital transformation. We theorize three narrative types—aspirational, setback, and persistence—that work as communicative resources in dealing with hopes, delays, and emerging concerns. Our article contributes to the literature on leading digital transformation in the public sector by providing a narrative perspective that details how managers produce narratives, navigate existing ones, and tailor them to emerging concerns.
Optimal fiscal policy under monopolistic competition with firm heterogeneity
Authors: Chang Cheng‐wei 
Published: August 2023

AbstractGovernment spending is a policy instrument used to sustain economic development and improve social welfare. Empirical observations, however, reveal a significant decrease in the government spending to GDP ratio for the United States. In addition, the United States has been observed to exhibit a rise in firm heterogeneity in productivity in recent decades. This paper shows that the optimal size of government expenditure will decrease as firm heterogeneity increases. We thus indicate that the rise in firm heterogeneity in productivity may serve as a plausible vehicle to explain the decline in the share of government spending in GDP for the United States.
Effects of freeze–thaw cycles and the soil water content on carbon and nitrogen changes in different soil types of Heilongjiang Province, China
Authors: Kong Fandan , Gao Yu , Li Tianxiao , Fu Qiang , Liu Dong , Su Zhongbin , Shen Weizheng , Wang Jinwu , Zhou Wenqi , Wang Yijia 
Published: August 2023

AbstractTo reveal the influence of freeze–thaw cycles (FTCs) on soil carbon and nitrogen changes, six typical soils in Northeast China were selected as the research objects to conduct a FTC simulation test in an artificial climate chamber. Three soil volumetric water contents (10%, 20%, 30%) and eight FTCs (0, 2, 4, 6, 8, 10, 15, 20) were set. The results showed that the soil organic carbon (SOC) and microbial biomass carbon (MBC) contents of different soil types under the FTCs initially exhibited a downward and then an upward trend, while the dissolved organic carbon (DOC) content exhibited an upward and then a downward trend. Otherwise, the fourth and sixth FTCs were the key points of change. The SOC, MBC and DOC contents in paddy fields were higher than those in dry fields, showing upward and then downward trends spatially from northeast to southwest. The SOC and MBC contents in each soil type were the highest at the 20% water content, and the DOC content gradually increased with increasing water content. The ammonium nitrogen (NH4+‐N) content in different soil types at different water contents under the FTCs showed an upward trend first, then a downward trend and finally an upward trend. The NH4+‐N content in paddy fields was higher than that in dry fields. The nitrate nitrogen (NO3‒‐N) content showed a downward trend first, then an upward trend and finally a downward trend. The NO3‒‐N content in dry fields was higher than that in paddy fields. The NH4+‐N contents in the three soil types on the Sanjiang Plain were significantly higher than those on the Songnen Plain. The NH4+‐N and NO3‒‐N contents showed upward trends with increasing water content, but the differences were not significant. The results have implications for the study of different types of soils and provide references for research on the mechanism of soil carbon and nitrogen transformation in typical farming areas in Northeast China.
The sovereign citizen superconspiracy: Contemporary issues in native title anthropology
Authors: Taplin Pascale , Holland Claire , Billing Lorelei 
Published: August 2023

AbstractThe Australian Native Title Act 1993 (Cth) provides for the recognition of rights and interests which arise from the traditional laws and customs of Australian First Nation peoples. Processing applications for a determination of native title can take many years and involves numerous stakeholders, presentation of evidence of ongoing connection with the land and sea within a claim area, negotiations with other parties including from industry and government, as well as negotiations between Indigenous groups. The process can be long, arduous, and often outcomes fail to satisfy the expectations of native title claimants. In this paper we investigate how individuals who either disagree with the premise underlying native title, or who have suffered negative impacts through the course of native title claims, may be either targeted by, or swept up in, Australian sovereign citizen rhetoric. We aim to contextualise presentations of sovereign citizen ideas in native title claim processes by providing an overview of the history of sovereign citizen thought, and examples of its contemporary expression in some Australian online forums. In doing this we aim to provide a broad foundation for future research into the issue. The dialogue in sovereign citizen online communities exposes people to extremism and superconspiracies. This article will provide a theoretical framework and historical context to the Australian sovereign citizen phenomena and describe online amplification of disinformation in Australia that has the potential to cause harm. We illustrate how stakeholders who are drawn to relatively moderate online content (such as opposing native title) may be radicalised through gradual exposure to extremist anti‐government sentiment and hate speech. This article highlights the need for further research into sovereign citizenry in Australia, and strategies for native title practitioners to engage claimants who subscribe to and disseminate sovereign citizen disinformation in native title processes.
The spacing effect: Improving electrocardiogram interpretation
Authors: Cunningham John M. , Johnson Melissa , Kincaid Troy , Christensen Wendy , Baker Jaime , Turbyfill William , Adams Jennifer E. 
Published: August 2023

AbstractBackgroundAccurate electrocardiogram (ECG) interpretation is critical for safe patient care, making this skill a necessary competency for medical school graduation. Improved long‐term memory retention with repeated exposure to material is one of the most evidenced‐based components of adult learning science. This curricular innovation aimed to determine if implementing spaced repetition and retrieval practice using ECG quizzes during the principal clinical year would improve ECG interpretation skills among medical students enrolled in a Longitudinal Integrated Clerkship (LIC).ApproachThe curricular innovation applied the spacing effect and retrieval practice. Cognitive science demonstrates enhanced long‐term retention through repeated interval exposure to learned material. Studies of spaced retrieval indicate that memory retention is enhanced through tests involving effortful recall. LIC students in an intervention group were exposed to the spacing effect with periodic ECG quizzes throughout their clinical clerkship year.EvaluationThe results of the 17‐item post‐test for 140 students were analysed: LIC intervention, N = 54; block control, N = 62; and LIC control, N = 24. The ANOVA test was significant (p < 0.001). Games–Howell post hoc testing showed that the mean score in the LIC intervention group was significantly higher compared with the LIC control group (p < 0.001) and the block control group (p < 0.001). There was no significant difference between the LIC control and block control groups (p = 0.59).ImplicationsSpaced repetition of material through ECG quizzes improved ECG interpretation skills on an ECG post‐test and mitigates the forgetting curve, maintaining student competency in ECG interpretation.