bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ruptured imaginings amid emerging nationhood: The unsettled narrative of “unity in resistance” in South Sudanese history textbooks
Authors: Bentrovato Denise , Skårås Merethe 
Published: April 2023

AbstractThis article explores the place of history education in state‐sponsored nation‐building in war‐torn South Sudan, the world's youngest country. It examines discourses around nationhood transmitted via the first history curricula, textbooks and teacher guides issued in the midst of civil war, after the country's secession from Sudan to its north. The analysis uncovers a central memory of violence and an ostensibly unifying narrative of the South's historical victimisation and struggle. An emerging emotionally charged discourse of “unity in resistance” illustrates the construction of a “usable past” through silencing and othering. Its offshoot is an unsettled narrative whose key focus on unity undergoes repeated rupture.
Protecting healthcare workers' mental health against COVID‐19‐related stress: The effects of stress mindset and psychological resilience
Authors: Emirza Sevgi , Yılmaz Kozcu Gizem 
Published: April 2023

AbstractHealthcare workers have been on the frontline of the battle against COVID‐19 disease. However, this has taken a toll on them, resulting in elevated stress and poor mental health. We argue that healthcare workers' stress mindset and resilience could mitigate negative outcomes of COVID‐19‐related stress by helping them view this stressful situation in a more positive light and appraise it as a challenge rather than a threat. Accordingly, we hypothesized that both a stress‐is‐enhancing mindset about COVID‐19‐related stress and resilience would improve healthcare workers' appraisal of their personal resources and increase their challenge appraisals, positively contributing to their mental health. We collected data from 160 healthcare workers and performed structural equation modeling for hypothesis testing. The results indicate that both a stress‐is‐enhancing mindset about COVID‐19‐related stress and psychological resilience are indirectly related to better mental well‐being and lower health‐related anxiety through challenge appraisals. This study contributes to research in mental health by suggesting that protecting and promoting healthcare workers' mental health is possible by empowering them through increasing personal resources such as a positive mindset about stressful situations and resilience.
Night‐time detection and response in relation to deteriorating inpatients: A scoping review
Authors: Hotta Soichiro , Ashida Kaoru , Tanaka Makoto 
Published: April 2023

AbstractBackgroundAlthough detection and response to clinical deterioration have been studied, the range and nature of studies focused on night‐time clinical setting remain unclear.AimThis study aimed to identify and map existing research and findings concerning night‐time detection and response to deteriorating inpatients in usual care or research settings.Study DesignA scoping review method was used. PubMed, CINAHL, Web of Science, and Ichushi‐Web databases were systematically searched. We included studies focusing on night‐time detection and response to clinical deterioration.ResultsTwenty‐eight studies were included. These studies were organized into five categories: night‐time medical emergency team or rapid response team (MET/RRT) response, night‐time observation using the early warning score (EWS), available resources for physicians' practice, continuous monitoring of specific parameters, and screening for night‐time clinical deterioration. The first three categories were related to interventional measures in usual care settings, and relevant findings mainly demonstrated the actual situation and challenges of night‐time practice. The final two categories were related to the interventions in the research settings and included innovative interventions to identify at‐risk or deteriorating patients.ConclusionsSystematic interventional measures, such as MET/RRT and EWS, could have been sub‐optimally performed at night. Innovations in monitoring technologies or implementation of predictive models could be helpful in improving the detection of night‐time deterioration.Relevance to Clinical PracticeThis review provides a compilation of current evidence regarding night‐time practice concerning patient deterioration. However, a lack of understanding exists on specific and effective practices regarding timely action for deteriorating patients at night.
Identifying behaviors that characterize emergence delirium: An observational study
Authors: O'Brien Jennifer M. , McKay William P. S. , McDonald Marguerite 
Published: April 2023

AbstractBackgroundDiagnostic criteria for emergence agitation are sensitive but not specific; they misclassify patients who are angry or upset as having emergence delirium.AimsThe aim of this three‐phase study was to determine expert agreement on the behaviors that differentiate children with emergence delirium from those without.MethodsIn the first phase of this observational study, pediatric dental patients were video recorded while awakening from anesthesia. In the second phase, salient 10 s segments of the recordings showing patient activity were shown to an expert audience of pediatric dentists, anesthesiologists and Post Anesthetic Care nurses, who scored the recordings as showing or not showing “true emergence delirium.” In phase 3, the video segments were assessed by three research assistants using a behavior checklist for features that discriminate between those scored “true emergence delirium” and those scored “NOT true emergence delirium” by the experts.ResultsOne hundred and fifty‐four pediatric dental patients were included. Subsequently, an expert audience consisting of 10 anesthesiologists, 12 anesthesiology residents, 3 pediatric dentists, and 4 experienced Post Anesthesia Care Unit nurses rated each 10‐second video segment. This resulted in three groups of patients: a group for whom all experts agreed was “True emergence delirium” (n = 33; CI 21 to 45), a group for whom all agreed was “Not True emergence delirium” (n = 120; CI 107 to 133), and a group where experts disagreed (n = 11; CI 4 to 18). Three research assistants then completed a behavior checklist for each of the 33 “True emergence delirium” video segments and matched “Not True” controls. Twenty‐four behaviors were identified as significantly different between videos scored True emergence delirium and those scored Not True emergence delirium. Research assistants reached almost perfect agreement (0.81–1.00) on one behavior, and substantial agreement (0.61–0.80) on seven behaviors that characterized “True emergence delirium.”ConclusionsEight behaviors that differentiate pediatric dental patients with emergence delirium from those without were found. These discriminators may be used to develop a scale that will lead to better diagnosis and treatment of emergence delirium.
Loneliness and social anxiety in young adults: The moderating and mediating roles of emotion dysregulation, depression and social isolation risk
Authors: Eres Robert , Lim Michelle H. , Bates Glen 
Published: April 2023

AbstractObjectivesWe aimed to investigate the mechanisms underlying loneliness, social anxiety, depression and emotion dysregulation, as well as how these relationships differ based on social isolation risk.DesignWe employed an online survey study to measure variables cross‐sectionally.MethodsA total of 1239 (77.2% Female, Mage = 21.52, SD = 2.32) participants completed measures of loneliness, social isolation risk, social anxiety, depression and emotion dysregulation. A moderated serial mediation model was conducted to determine whether emotion dysregulation and depression jointly mediate the relationship between loneliness and social anxiety and to determine whether these relationships are moderated by risk of social isolation.ResultsLoneliness was found to predict social anxiety and was mediated by emotion dysregulation and depression both independently and combined. Participants with a low risk of social isolation were found to be protected against poor mental health.ConclusionsOur studies replicate previous findings showing a relationship between loneliness and social anxiety. We also extend current knowledge to show the importance of social contact for protecting against elevated levels of social anxiety and depression. Overall, we provide empirical evidence for the role of social connection in managing mental health symptoms.
Morphology and molecular phylogeny of the marine diatom genus Nagumoea (Bacillariophyceae) from Japan
Authors: Sugawara Kazuki , Suzuki Hidekazu , Kamiya Mitsunobu , Osada Keigo , Witkowski Andrzej 
Published: April 2023

SUMMARYThe canal‐bearing diatom genus Nagumoea, described based on only morphological evidence, was tentatively assigned to the order Bacillariales, although its phylogenetic position remained unclear. Because three isolates of Nagumoea (SK002, SK024 and SK053) were successfully established from Japanese coasts, we performed their morphological observations and molecular phylogenetic analyses to discuss the phylogeny and taxonomic position of this genus. Strains SK002 and SK024 were identified as Nagumoea africana, whereas SK053 conformed with Nagumoea serrata. There was high interspecific divergence between N. africana and N. serrata in the rbcL sequences (8.03–8.17%), indicating their distinctness. Furthermore, intraspecific variations were detected within N. africana (2.35%) in the rbcL, implying its cryptic diversity. The maximum likelihood and Bayesian phylogenetic trees inferred from the plastid rbcL, psbC and nuclear 18S rDNA genes recovered Nagumoea as monophyletic with strong statistical support and embedded within an unresolved, poorly supported lineage containing Achnanthes, Craspedostauros, Staurotropis and Undatella in the canal‐bearing order Bacillariales (= the family Bacillariaceae). Although the constrained tree based on the monophyly of Nagumoea and the other canal‐bearing clade (Surirellales and Rhopalodiales) was statistically rejected by the topology tests, the phylogenetic position of Nagumoea with other Bacillarialean members remains equivocal. The possession of two plastids positioned fore and aft, observed in the present study, and lack of keel, typical of the Bacillariales, indicate the possibility of Nagumoea being part of the ingroup of the Bacillariales or its closely related outgroup.
Assessing late‐life anxiety in Japanese older adults: psychometric evaluation of the Japanese version of the Geriatric Anxiety Scale
Authors: Kashimura Masami , Ishizu Kenichiro , Kokubo Naomi , Segal Daniel L. 
Published: April 2023

BackgroundThis study developed a Japanese version of the Geriatric Anxiety Scale (GAS‐J) and its short form (GAS‐10‐J) to evaluate anxiety in Japanese older adults and assess its psychometric properties using a cross‐sectional design.MethodsA total of 331 community‐dwelling older adult participants (208 men, 116 women, seven unknowns; mean age = 73.47 ± 5.17 years, range = 60–88 years) recruited from two Silver Human Resources Centres in the Kanto region, Japan, answered a set of self‐report questionnaires. Of these respondents, 120 participated in a follow‐up survey to evaluate test–retest reliability.ResultsConfirmatory factor analysis suggested that, as with the original GAS, the GAS‐J had a three‐factor structure and the GAS‐10‐J had a unifactor structure with high standardised factor loadings. Test–retest correlations and internal consistency analyses indicated that these scales were reliable. Correlations between the GAS‐J/GAS‐10‐J with the Geriatric Anxiety Inventory, Generalised Anxiety Disorder‐7, Geriatric Depression Scale‐15, World Health Organization‐Five Well‐Being Index, and Kihon Checklist were mostly consistent with our hypotheses, thereby supporting the construct validity of the GAS‐J/GAS‐10‐J.ConclusionsThe findings indicate that the GAS‐J and GAS‐10‐J have robust psychometric properties for assessing late‐life anxiety in Japanese older adults. Further GAS‐J studies are required for clinical groups.
The influence of risk awareness and government trust on risk perception and preparedness for natural hazards
Authors: Cisternas Pamela C. , Cifuentes Luis A. , Bronfman Nicolás C. , Repetto Paula B. 
Published: April 2023

AbstractRisk perception is considered the primary motivator for taking preparedness actions. But people with prior experience and a high‐risk perception are not necessarily more prepared. This relationship is even more complex when assessing preparedness levels for hazards with different characteristics. These inconsistent findings can be explained by how preparedness has been measured and the influence of other factors, such as trust and risk awareness. Thus, the main goal of this study was to analyze the role of risk awareness and trust in authorities on risk perception and intention to prepare for natural hazards in a coastal city in Chile. A representative sample of the city of Concepción, located in the center‐south zone of Chile (n = 585), completed a survey. We measured risk awareness, risk perception, trust in authorities, and intention to prepare for two hazards: earthquakes/tsunamis and floods. Through structural equation models, we tested five hypotheses. We found that the perception of risk maintained a direct and positive influence on the intention to prepare for both hazards. The results showed that awareness and risk perception influence the intention to prepare and should be considered different concepts. Finally, trust did not significantly influence risk perception when faced with known hazards for the population. Implications for understanding the relationship between risk perception and direct experience are discussed.
An extremely rare case of Oro‐facial digital syndrome: A case report
Authors: Dwivedi Shilpy , Thakur Arpita 
Published: April 2023

AbstractBackgroundOro‐facial digital(OFD) syndrome is a rare anomaly which is often missed out as just cleft lip and palate.It is an X‐linked dominant condition with lethality in males. It however results from the pleotropic effect of a morphogenetic impairment affecting almost invariably the mouth, face and digits and it also includes lower IQ and mental retardation. 14 different variations of these syndrome can be seen with the majority of cases of type 1 and 2 based on characteristic clinical manifestations.Case reportPresent case report describes a 9 year old girl patient who was mis‐diagnosed with partial cleft palate and was later diagnosed as orofacial digital syndrome based on the clinical and oral features.ConclusionNot much literature is present regarding this topic and with no relevent family history makes this case a one in a million case of OFD. Therefore, this case report is a complete insight on Oro‐facial digital syndrome.
Revisiting the vulnerable dark triad hypothesis using a bifactor model
Authors: Gamache Dominick , Maheux‐Caron Véronique , Théberge David , Côté Alexandre , Rancourt Marie‐Anne , Hétu Sébastien , Savard Claudia 
Published: April 2023

Miller et al. (2010) previously suggested that borderline pathology, vulnerable narcissism, and Factor 2 psychopathy share a common “Vulnerable Dark Triad” (VDT) core. The present study (N = 1,023 community participants) aims to test that hypothesis using exploratory and confirmatory bifactor analyses. We found support for a bifactor model that obtained satisfactory fits and other adequate validity indices, which included a general VDT factor and three group factors (Reckless, Entitled, Hiding). The general VDT factor was mostly saturated with borderline symptoms items reflecting self‐hatred and worthlessness, which did not form a group factor; these results add to previous research suggesting that features of borderline pathology may represent the core of personality pathology. The three group factors had distinctive relationships with Dark Triad traits, pathological trait domains, and aggression. In contrast with the three group factors, the general VDT factor more strongly incremented the prediction of negative affectivity and hostility; the group factors more strongly incremented the prediction of grandiosity, egocentrism, callousness, Machiavellianism, and direct (physical/verbal) aggression. Alignment of the retained bifactor model with influent models of personality pathology and conceptual/methodological implications of the present results for research on the hypothesized VDT are discussed, as well as some clinical implications of the findings.
RSI1/FLD and its epigenetic target RRTF1 are essential for the retention of infection memory in Arabidopsis thaliana
Authors: Singh Deepjyoti , Patil Vishal , Kumar Ranjan , Gautam Janesh Kumar , Singh Vijayata , Nandi Ashis Kumar 
Published: April 2023

SUMMARYPlants can retain a memory of previous pathogen infections to mount a more robust defense response during subsequent infections by developing systemic acquired resistance (SAR). However, the mechanism through which plants develop and retain infection memory is not known. Experiments have shown the association of epigenetic modifications of specific defense‐related genes with SAR. RSI1/FLD codes for a histone demethylase and is required for the activation of SAR in Arabidopsis. Here we report the identification of RRTF1 as an epigenetic target of RSI1. RRTF1 expression is higher in pathogen‐free distal tissues of the rsi1 mutant. Experiments with loss‐of‐function and overexpression lines suggest RRTF1 is a negative regulator of basal defense against virulent and avirulent pathogens as well as SAR. Enhanced expression of RRTF1 in a wild‐type (WT) background specifically impairs SAR without impacting local resistance. RSI1 is recruited at the RRTF1 locus in a SAR‐inducible manner and contributes to H3K4me2 and H3K4me3 demethylation. Introduction of the rrtf1 mutation rescues the loss‐of‐SAR phenotype of rsi1 plants. However, these plants fail to retain infection memory beyond 7 days post‐primary inoculation, whereas WT plants retain memory for at least 11 days. Our results demonstrate that RSI1 and RRTF1 form a functional module for retaining infection memory in Arabidopsis.
Association between minimal decrease in platelet counts and outcomes in septic patients: a retrospective observational study
Authors: Liu Xing , Yin Wanhong , Li Yi , Qin Yiwei , Zou Tongjuan 
Published: April 2023

ObjectivesAlthough platelets have been linked to inflammatory development in sepsis, knowledge on their role as an indicator in sepsis treatment is scarce. Here, we investigated the association between time-dependent changes in platelet counts with mortality rates to reveal the role of platelets in sepsis therapy.DesignA retrospective cohort study.SettingWe screened the Medical Information Mart for Intensive Care (MIMIC-IV), a public database comprising data from critical care subjects at the Beth Israel Deaconess Medical Center (BIDMC) in Boston, Massachusetts, USA.ParticipantsA total of 7981 patients, who were admitted to the BIDMC between 2008 and 2019, were analysed based on Sepsis-3 criteria from MIMIC-IV.Primary and secondary outcome measuresPrimary and secondary outcomes included 30-day mortality after admission and length of intensive care unit (ICU) stay and hospitalisation, respectively.ResultsPatients with ≤10% reduction in proportion of platelet counts were associated with significantly lower 30-day mortality (14.1% vs 23.5%, p<0.001, Kaplan-Meier analysis, p<0.0001). Multivariable analysis revealed that decreased platelet-count percentage ≤10% on day 4 after ICU admission was associated with lower probability of 30-day non-survival (OR=0.73, 95% CI 0.64 to 0.82, p＜0.001). Patients in the ≤10% group had significantly shorter ICU stays than those in the >10% group (6.8 vs 7.5, p＜0.001). Restricted cubic spline curves revealed that mortality rates decreased with increase in proportion of platelet counts.ConclusionsA ≤10% decrease in platelet-count percentage among sepsis patients after treatments is independently associated with decreased 30-day mortality, suggesting that changes in proportion of platelet counts after treatments could be an indicator for assessing the therapeutic effects of sepsis.
Effects of discontinuation of levothyroxine treatment in older adults: protocol for a self-controlled trial
Authors: Ravensberg A Janneke , Poortvliet Rosalinde K E , Du Puy Robert S , Dekkers Olaf M , Mooijaart Simon P , Gussekloo Jacobijn 
Published: April 2023

BackgroundMany older persons use the thyroid hormone levothyroxine which is often continued for life. Scientifically, there is much uncertainty whether simple continuation is the optimal approach. First, the physical need for levothyroxine can decrease with age thereby posing a higher risk of overtreatment and adverse effects. Second, large trials in subclinical hypothyroidism have shown no benefit for the use of levothyroxine. Interestingly, guidelines do not address re-evaluation of the indication. This self-controlled trial aims to determine the effects of discontinuation of levothyroxine treatment in older adults.Methods and analysisParticipants are community-dwelling subjects aged ≥60 years using levothyroxine continuously at a stable dosage of ≤150 µg and a level of thyroid-stimulating hormone (TSH) <10 mU/L. After a control period of 12 weeks, levothyroxine treatment is discontinued gradually using a stepwise approach with regular monitoring of thyroid function guided by their GP. The primary outcome is the proportion of participants withdrawn from levothyroxine while maintaining a free T4 level within the reference range and a TSH level <10 mU/L, 52 weeks after the start of discontinuation. Secondary outcomes are compared with the control period (self-controlled) and include among others, the effects on thyroid-specific and general health-related quality of life. Furthermore, patients’ attitudes towards deprescribing and regret regarding discontinuing levothyroxine treatment will be recorded. A total of 513 participants will be recruited to estimate the expected proportion of 50% with a 95% CI ranging from 45% to 55%.Ethics and disseminationApproval was obtained from the institutional Medical Ethics Committee. The Older People Advisory Board Health and Well-being has reviewed the research proposal and their comments were used for improvement. In line with the funding policies of the grant organisation funding this study, the study results will be proactively disseminated to the general public and key public health stakeholders.Trial registration numberNL7978;NCT05821881.