bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative methodological approaches involving participants with intellectual disabilities: Scoping review of literature exploring death and dying
Authors: Diaz Marissa A , Bickenbach Jerome E , Sabariego Carla , Bernard Renaldo M 
Published: June 2023

AbstractBackgroundA paucity of qualitative research on sensitive topics that focuses on participants with intellectual disabilities leaves their views unexplored. This scoping review mainly aimed to provide an overview of qualitative data collection methods used in research involving participants with intellectual disabilities to explore death and dying.MethodA scoping review of primary research and methodological papers published between January 2008 and March 2022 was conducted. The PRISMA‐ScR checklist was followed.ResultsWe identified 25 articles utilising four data collection methods: interviews, focus groups, the Nominal Group Technique, and participant observation. Data collection trends were identified, including accommodations for participants with intellectual disabilities, visual media used as a facilitator, and reporting of distress protocols. Most participants had mild to moderate intellectual disabilities.ConclusionsThe included studies demonstrate a flexible approach that relies on the use of multiple methods. Future research must adequately report study characteristics to ensure transparency and reliability.
A case of fulminant type 1 diabetes and protein C deficiency complicated by deep vein thrombosis
Authors: Kohata Masato , Kodama Shinjiro , Yaoita Nobuhiro , Hosaka Shinichiro , Takahashi Kei , Kaneko Keizo , Imai Junta , Yasuda Satoshi , Katagiri Hideki 
Published: June 2023

AbstractA 25‐year‐old man was diagnosed with diabetic ketoacidosis (DKA) at the onset of fulminant type 1 diabetes. After acute‐phase DKA treatment including placement of a central venous catheter, a massive deep vein thrombosis (DVT) and pulmonary embolism (PE) were detected on hospital day 15. His protein C (PC) activity and antigen levels were low even 33 days after completing the DKA treatment, indicating partial type I PC deficiency. Severe PC dysfunction, due to overlapping of partial PC deficiency and hyperglycemia‐induced PC suppression, concomitant with dehydration and catheter treatment, may have induced the massive DVT with PE. This case suggests that anti‐coagulation therapy should be combined with acute‐phase DKA treatment in patients with PC deficiency, even those who have been asymptomatic. As patients with partial PC deficiency should perhaps be included among those with severe DVT complications of DKA, venous thrombosis should always be considered as a potential complication of DKA.
Evolution of territoriality in Hylinae treefrogs: Ecological and morphological correlates and lineage diversification
Authors: Luría-Manzano Ricardo , Pinheiro Paulo D. P. , Kohlsdorf Tiana , Haddad Célio F. B. , Martins Marcio 
Published: June 2023

Abstract
Given the diverse nature of traits involved in territorial defence, they may respond to different selective pressures and then exhibit distinct patterns of evolution. These selective pressures also may cause territorial behaviour to be associated with environmental and morphological variables. Such associations, however, have mostly been studied at the intraspecific level, being phylogenetic analyses of territoriality in a broad taxonomic framework rare in the literature. We used the anuran subfamily Hylinae to test (1) whether two territorial-behaviour traits with different levels of aggression—territorial call and physical combat—are evolutionarily more labile than a morphological trait used in physical combat—the spine-shaped prepollex; (2) whether reproduction in lentic waters and phytotelmata, as well as resource scarcity, might favour the occurrence of territoriality; (3) if physical combat is more important than territorial call for the evolution of body size and sexual size dimorphism and (4) the relationships between territorial-behaviour traits and lineage diversification. We mainly used the literature to build two datasets with different levels of certainty. Territorial-behaviour traits exhibited intermediate levels of phylogenetic signal in Hylinae, whereas the phylogenetic signal for the presence of the spine-shaped prepollex was strong. We found support for the hypothesis that reproduction in lentic water favours the occurrence of territorial behaviour, because the expression of territorial-behaviour traits was more associated with reproduction in lentic than in lotic waters. Territorial-behaviour traits were not correlated with annual precipitation nor with habitat complexity. Body size and sexual size dimorphism were not correlated with the presence of territorial call nor with physical combat. We identified negative correlations between diversification rates and physical combat. Relationships of territorial call and physical combat with diversification rates suggest that these territorial behaviours influence evolutionary processes in different ways.
Abstract
We used the anuran subfamily Hylinae to study the evolutionary dynamics of two territorial-behaviour traits: territorial call and physical combat. We found that these traits exhibit intermediate levels of phylogenetic signal, their expression is associated with reproduction in lentic waters and diversification rates are negatively correlated with physical combat. Photo credit Leandro Drummond.
Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study
Authors: Jones Aaron , Watt Jennifer A. , Maclagan Laura C. , Swayze Sarah , Jaakkimainen Liisa , Schull Michael J. , Bronskill Susan E. 
Published: June 2023

AbstractBackgroundResearch on factors associated with recurrent emergency department (ED) visits and their implications for improving dementia care is lacking. The objective of this study was to examine associations between the individual characteristics of older adults living with dementia and recurrent ED visits.MethodsWe used health administrative databases to conduct a population‐based retrospective cohort study among older adults with dementia in Ontario, Canada. We included community‐dwelling adults 66 years and older who visited the ED between April 1, 2010, and March 31, 2019 and were discharged home. We recorded all ED visits within one year after the baseline visit. We used recurrent event Cox regression to examine associations between repeat ED visits and individual clinical, demographic, and health service use characteristics. We fit conditional inference trees to identify the most important factors and define subgroups of varying risk.ResultsOur cohort included 175,863 older adults with dementia. ED use in the year prior to baseline had the strongest association with recurrent visits (3+ vs.0 adjusted hazard ratio (aHR): 1.92 (1.89, 1.94), 2vs.0 aHR: 1.45 (1.43, 1.47), 1vs.0 aHR: 1.23 (1.21, 1.24)). The conditional inference tree utilized history of ED visits and comorbidity count to define 12 subgroups with ED revisit rates ranging from 0.79 to 7.27 per year. Older adults in higher risk groups were more likely to live in rural and low‐income areas and had higher use of anticonvulsants, antipsychotics, and benzodiazepines.ConclusionsHistory of ED visits may be a useful measure to identify older adults with dementia who would benefit from additional interventions and supports. A substantial proportion of older adults with dementia have a pattern of recurrent visits and may benefit from dementia‐friendly and geriatric‐focused EDs. Collaborative medication review in the ED and closer follow‐up and engagement with community supports could improve patient care and experience.
Medicaid home and community‐based services spending for older adults: Is there a “woodwork” effect?
Authors: McGarry Brian E. , Grabowski David C. 
Published: June 2023

AbstractBackgroundAlthough older adults prefer to age at home, Medicaid has a longstanding institutional bias in funding long‐term services and supports (LTSS). Some states have resisted expanding Medicaid funding for home‐ and community‐based services (HCBS) due to budgetary concerns related to the so‐called “woodwork” effect whereby individuals enroll on Medicaid to access HCBS.MethodsTo examine the implications associated with state Medicaid HCBS expansion, we obtained state‐year data for 1999–2017 from various sources. We estimated difference‐in‐differences regressions comparing outcomes in states that expanded Medicaid HCBS aggressively versus those that expanded less aggressively, controlling for several covariates. We examined a range of outcomes including Medicaid enrollment, nursing home census, Medicaid institutional LTSS spending, total Medicaid LTSS spending, and Medicaid HCBS waiver enrollment. We measured HCBS expansion by the total share of state Medicaid LTSS spending for aged and disabled persons devoted to HCBS.ResultsHCBS expansion was not associated with increased Medicaid enrollment among individuals ages 65 and older. A 1% increase in HCBS spending was associated with reductions in the state nursing home population of 47.1 residents (95% confidence interval [CI]: −80.5, −13.8) and institutional Medicaid LTSS spending of $7.3 million (95% CI: −$12.1M, −$2.4M). A $1 increase in HCBS spending was associated with $0.74 increase (95% CI: $0.57, $0.91) in total LTSS spending, suggesting each dollar directed to HCBS was offset by $0.26 savings from decreased nursing home use. Increased HCBS waiver spending was associated with more older adults receiving LTSS at a lower cost per beneficiary served relative to the nursing home setting.ConclusionsWe did not find evidence of a woodwork effect in those states that expanded Medicaid HCBS more aggressively, as measured by age 65 and older Medicaid enrollment. However, they did experience Medicaid savings from reduced nursing home use, suggesting states that expand Medicaid HCBS are able to use these additional dollars to serve more LTSS recipients.
“A lot to manage and still have some kind of a life”: How multiple myeloma impacts the function and quality‐of‐life of Black–White patient–caregiver dyads
Authors: Bates‐Fraser Lauren C. , Mills Jiona , Mihas Paul , Wildes Tanya M. , Kent Erin E. , Erisnor Gabriell , Adams Leah , Grant Shakira J. 
Published: June 2023

AbstractBackgroundMultiple myeloma (MM) is an incurable debilitating blood cancer associated with the lowest health related quality of life (HRQoL) of all cancers. With nearly 88% of adults aged ≥55 years at diagnosis, age‐associated physical losses, comorbidities, and social factors contribute to worsening HRQoL. This qualitative study assessed dyadic (patient–informal caregiver) perspectives on the factors contributing to HRQoL in MM survivors.MethodsWe recruited 21 dyads from the UNC‐Chapel Hill Lineberger Comprehensive Cancer between 11/2021 and 04/2022. Participants completed a single dyadic semistructured interview capturing broad perspectives on MM. We used ATLAS. ti v 9 for project management and to facilitate data analysis using the Sort and Sift, Think and Shift approach (ResearchTalk, Inc.). This iterative approach allowed the exploration and identification of themes within and across transcripts.ResultsThe mean age at enrollment was 71 years (median: 71, range: 57–90) for patients and 68 years (median 67, range: 37–88) for caregivers. All dyads were racially concordant (11 Black/AA and 10 White). However, we aggregated the findings due to no consistent racial differences. Six themes related to (1) physical burden, (2) treatment challenges, (3) losses of independence, (4) caregiver burden, (5) patient and caregiver perseverance, and (6) adjustment to a new normal were identified. Dyads also experienced MM together, resulting in patients and caregivers experiencing changes in their ability to engage in physical and social activities, which further contributed to poor HRQoL. Patients' increased need for social support led to shifts in the caregiver roles, resulting in caregivers feeling burdened by their responsibilities. All dyads acknowledged the need for perseverance and adaptability to a new normal with MM.ConclusionThe functional, psychosocial, and HRQoL of older patients with MM and their caregivers remain impacted ≥6 months after a new diagnosis highlighting clinical and research opportunities to focus on preserving or improving the health of dyads living with MM.
Microneedling with glutathione versus microneedling alone in treatment of facial melasma: Split‐face comparative study
Authors: Mohamed Marwa , beshay Yostena Mahrous Aziz , Assaf Hanan Metwally 
Published: June 2023

AbstractBackgroundMelasma is a distressing disfiguring acquired pigmentary disorder especially affecting females and it is of high tendency of recurrence. Up till now, treatment of melasma is a challenging problem.ObjectivesWe evaluated the effectiveness of microneedling with glutathione versus microneedling alone in treatment of melasma.Patients and MethodsIn this study, 29 adult females with epidermal type of melasma (confirmed with Wood's light examination) were enrolled. The affected area was subjected to microneedling using dermapen followed by application of glutathione solution on the right side only. This session was performed every 2 weeks for 3 months (six sessions for every patient). The response to therapy was measured using modified melasma area and severity index (m MASI) that were calculated on each side of the face (Hemi‐ m MASI) before treatment sessions.ResultsThere was statistically significant reduction in the mean of Hemi‐ m MASI score over the sessions on both sides of the face but the right side (microneedling with glutathione) showed more reduction and earlier response to therapy than the left side (microneedling alone). On the left side, mean of Hemi‐ m MASI score before and after sessions was (4.06 ± 1.91, 2.31 ± 1.450) and on the right side, it was (4.21 ± 2.08, 1.96 ± 1.30), respectively and this was statistically significant. Percentage of improvement on the left side was 46.92 ± 16.30 (%) while on the right side was 55.17 ± 15.50 (%) and this was statistically significant.ConclusionsMicroneedling is an effective promising tool in treatment of melasma and its combination with glutathione as a whitening agent, increases and accelerates its efficacy. So, combined therapy is more preferred than monotherapy in treatment of facial melasma.
What constitutes brilliant aged care? A qualitative study of practices that exceed expectation
Authors: Dadich Ann , Kearns Rachael , Harris‐Roxas Ben , Ni Chroinin Danielle , Boydell Katherine , Ní Shé Éidín , Lim David , Gonski Peter , Kohler Friedbert 
Published: June 2023

AbstractAimThis study aimed to explore what constitutes brilliant aged care.BackgroundAlthough many aged care services do not offer the care that older people and carers need and want, some perform better. Rather than focus on problems with aged care, this study examined brilliant aged care—practices that exceeded expectation.DesignThe methodology for this study was informed by grounded theory, underpinned by constructionism to socially construct meaning.MethodsThis study invited nominations for a Brilliant Award via a survey, and interviews with the nominees via web conference. After receiving survey responses from 10 nominators, interviews were conducted with 12 nominees. Data were analysed using reflexive thematic analysis and documented according to COREQ guidelines to optimise rigour and transparency.ResultsAccording to participants, brilliant aged care involved being relationally attuned to older people, a deep understanding of the older person, recognition of aged care as more than a job, innovative practices and permission to reprioritise.ConclusionsThis study suggests that, in aged care, brilliance happens. It emphasises the importance of meaningful connections and relationships in aged care, where thoughtful acts acknowledge an older person's value and humanity as well as creativity and innovation.Relevance to Clinical PracticeFor those who manage and deliver aged care, the findings suggest that small practice changes can make a positive difference to older people. Brilliant aged care can involve acts of empathy; enthusiasm for aged care; innovative practices, even those that are small scale; and reprioritising workplace tasks to spend time with older people. For policymakers, this study highlights the need to recognise and raise the profile of the pockets of brilliance within the aged care sector. This might be achieved via awards and other initiatives that serve to celebrate and learn from brilliance in its myriad forms.Patient or Public ContributionThe nominees, who included carers, were invited to participate in workshops with other carers and older people to co‐design a model of brilliant aged care, during which workshop participants discussed and critiqued the findings constructed from the data.
The Dent in the Floor: Ecological Knowing in the Skilful Performance of Work
Authors: Butler Michael J. R. , Cunliffe Ann L. 
Published: June 2023

AbstractThis paper draws on a phenomenological perspective to explore how people develop and enact skill in work at throughecological knowing– a sensuous form of knowing in one's being embedded in and across place and time. In doing so, we abductively interweave the work of Finnish architect Juhani Pallasmaa and British anthropologist Tim Ingold with an empirical study of two industrial museums and two contemporary illustrations of choral conducting and motion capture performance. Our contribution is threefold: first, we expand theories of knowledge and corporeality by theorizing ecological knowing as encompassing emplaced wisdom and embodied skill – thus elevating embedded and embodied human agency in contrast to studies that focus on the body, skill, and knowledge as objects. Secondly, we present an alternative way of understanding how expertise develops and is enacted in work activities. Finally, we offer methodological resources, currently underutilized in management studies, for studying this sensorial form of knowing in a way that is consistent with its underlying phenomenological commitments.
How does it feel to be greedy? The role of pride in avaricious acquisition
Authors: Mercadante Eric J. , Tracy Jessica L. 
Published: June 2023

AbstractBackgroundPsychologists define greed as a desire to acquire more and the dissatisfaction of never having enough, but studies have not examined the psychological processes that underlie and sustain this disposition. We propose that a desire to attain pride might be one emotional mechanism that promotes greedy acquisition. In this account, greedy people experience a boost of pride from acquisition but these feelings are short‐lived, potentially leading to the perpetual acquisitiveness characteristic of dispositional greed.MethodFour studies (including one reported in the SOM due to space limitations) using correlational, longitudinal, and daily‐diary methods (N = 1778) test hypotheses about how individuals high in dispositional greed respond emotionally to new acquisitions, both when they occur and several weeks later.ResultsGreedy people experience heightened feelings of authentic pride in response to new acquisitions, but these feelings quickly fade. This pattern is distinct to authentic pride and not attributable to shared variance with positive affect. Greedy people also feel elevated hubristic pride in response to acquisitions, but this seems to be part of a dispositional tendency observed in response to a range of events.ConclusionsThese studies provide a new understanding of a psychological process that is associated with, and could partially explain, greedy acquisition.
Associations between higher plasma ferritin and hepcidin levels with liver stiffness in patients with type 2 diabetes: An exploratory study
Authors: Mantovani Alessandro , Csermely Alessandro , Castagna Annalisa , Antinori Elisa , Danese Elisa , Zusi Chiara , Sani Elena , Ravaioli Federico , Colecchia Antonio , Maffeis Claudio , Valenti Luca , Girelli Domenico , Targher Giovanni 
Published: June 2023

AbstractBackgroundCurrently, there is no information about the association between circulating levels of ferritin and hepcidin and liver fibrosis in patients with type 2 diabetes mellitus (T2DM) and non‐alcoholic fatty liver disease (NAFLD).MethodsWe enrolled 153 patients with T2DM with no known liver diseases, who consecutively attended our diabetes outpatient service and who underwent liver ultrasonography and liver stiffness measurement (LSM) by vibration‐controlled transient elastography (Fibroscan® for the non‐invasive assessment of liver fibrosis). Plasma ferritin and hepcidin concentrations were measured with an electrochemiluminescence immunoassay and mass spectrometry‐based assay, respectively.ResultsAfter stratification of patients by LSM tertiles [1st tertile median LSM: 3.6 (interquartile range: 3.3–4.0) kPa, 2nd tertile: 5.3 (4.9–5.9) kPa and 3rd tertile: 7.9 (6.7–9.4) kPa], we found that plasma ferritin and hepcidin concentrations increased across LSM tertiles [median ferritin: 68.7 (interquartile range: 25.1–147) vs. 85.8 (48.3–139) vs. 111 (59.3–203) μg/L, p = 0.021; median hepcidin: 2.5 (1.1–5.2) vs. 4.4 (2.5–7.3) vs. 4.1 (1.9–6.8) nmol/L, p = 0.032]. After adjustment for age, sex, diabetes duration, waist circumference, haemoglobin A1c, HOMA‐insulin resistance score, triglycerides, haemoglobin, presence of hepatic steatosis on ultrasonography and patatin‐like phospholipase domain‐containing‐3 (PNPLA3) rs738409 genetic variant, higher plasma ferritin levels were associated with greater LSM values (adjusted‐odds ratio 2.10, 95% confidence interval 1.23–3.57, p = 0.005). Higher plasma hepcidin levels were also associated with greater LSM values (adjusted‐odds ratio 1.90, 95% confidence interval 1.15–3.13, p = 0.013).ConclusionsHigher levels of plasma ferritin and hepcidin were associated with greater NAFLD‐related liver fibrosis (assessed by LSM) in patients with T2DM, even after adjustment for established cardiometabolic risk factors, diabetes‐related variables and other potential confounders.
The PcMYB44‐mediated miR397‐PcLACs module regulates defence‐induced lignification in pear resistance to fungal disease
Authors: Yang Yuekun , He Ying , Lv Shamei , Zhu Haodong , Wang Tingting , Wang Guoping , Hong Ni , Wang Liping 
Published: June 2023

AbstractDiseases caused by Alternaria alternata and Botryosphaeria dothidea diminish pear yield and quality, and restrict the pear agricultural industry. Lignification is a conserved mechanism for plant resistance against pathogen invasion. The regulatory mechanisms underlying defence‐induced lignification in pear in response to fungal pathogen infection remain unknown. In this study, analysis of lignification level and lignin content in pear revealed that A. alternata and B. dothidea induced lignification, and transcriptomics showed that lignin biosynthesis was affected. To explore whether laccases (LACs) mediated by miR397 regulate lignification in pear, we investigated the role of PcmiR397 in repressing the expression of PcLACs using 5′‐RNA ligase‐mediated‐RACE and co‐transformation in tobacco. Opposite expression patterns for PcmiR397 and PcLAC target genes were observed in pear in response to pathogens. Transient transformation in pear demonstrated that silencing PcmiR397 and overexpressing a single PcLAC enhanced resistance to pathogens via lignin synthesis. To further reveal the mechanism underpinning the PcMIR397 response of pear to pathogens, the PcMIR397 promoter was analysed, and pMIR397‐1039 was found to be inhibited by pathogen infection. The transcription factor PcMYB44 was up‐regulated, and it bound to the PcMIR397 promoter and inhibited transcription following pathogen infection. The results demonstrate the role of PcmiR397‐PcLACs in broad‐spectrum resistance to fungal disease, and the potential role of PcMYB44 involved in the miR397‐PcLAC module in regulating defence‐induced lignification. The findings provide valuable candidate gene resources and guidance for molecular breeding to improve resistance to fungal disease in pear.