bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of resilience on clinical nurses' moral courage during COVID‐19: A moderated mediation model of ethical climate and moral distress
Authors: Yang Qingqing , Zheng Zhihui , Ge Li , Huang Bi Xia , Liu Jujuan , Wang Jie , Lu Kangyuan , Huang Yufeng , Zhang Jiahui 
Published: August 2023

AbstractAimThe purpose of this study was to explore whether clinical ethical climate mediates the relationship between resilience and moral courage in a population of clinical nurses during COVID‐19, and if moral distress faced by nurses is a moderating factor.BackgroundResilience can help nurses maintain their personal health during COVID‐19 when they face great physical and psychological shock and are prone to health problems. Moral courage, as an ethical competency, helps nursing staff in adhering to the principles and values of professional ethics. There is a strong correlation between resilience and moral courage, but the mechanism by which resilience contributes to moral courage is unclear.MethodA cross‐sectional study research is designed. Three hundred thirty clinical nurses from six hospitals in Beijing, Sichuan, and Fujian of China were included between August 2021 and March 2022. The survey instruments include the Nurses' Moral Courage Scale (NMCS), Connor‐Davidson Resilience Scale (CD‐RISC), Moral Distress Scale‐Revised (MDS‐R), and Hospital Ethical Climate Scale (HECS).ResultsEthical climate mediates 15% of the relationship between resilience and moral courage. The association between resilience and ethical climate, as well as the indirect relationship between resilience and moral courage, was modified by moral distress.DiscussionThis study investigated the mechanisms by which resilience affects moral courage in clinical nurses in the context of COVID‐19, suggesting that moral courage can be increased by alleviating moral distress and increasing ethical climate.Implications for nursing and health policyThis study confirms the mediating effect of moral climate on the relationship between resilience and moral courage, as well as the moderating effect of moral distress. Hospital policymakers should value nurses' psychological resilience and moral courage, develop effective policies to prevent and manage stressors, build social support systems, and create a positive ethical climate.
Treating necrotizing fasciitis patients at the topmost referral hospital in West Java, Indonesia: 6 years experience
Authors: Soedjana Hardisiswo , Christine Sitha , Sisca Fransisca 
Published: August 2023

AbstractNecrotizing fasciitis is a progressive and rare disease, with high potential to be life‐threatening because of its potential for systemic toxicity. Characterized by fascial infection, it is often followed by systemic toxicity, such as septic shock and multi‐organ failure. The aim of this study is to establish reliable data on the treatment of necrotizing fasciitis patients at the topmost referral hospital in West Java, Indonesia. We collected medical record data from January 2015 to December 2021 at Rumah Sakit Umum Pusat Dr. Hasan Sadikin (RSHS), Bandung, Indonesia. We recorded the infection region, bacterial isolates, empirical antibiotics, waiting time for the first surgery, surgical management, length of stay and we analysed the pattern of bacterial isolates, antibiotic use, waiting time for the first surgery, length of stay and mortality. A total of 90 patients' medical records were analysed. We found that the infection was most found in the genitalia and inguinal region (37%). Eighty‐five percent of all samples containing gram‐negative bacteria. The most used empirical antibiotics were from Cephalosporin class (31%), most of them combined with nitroimidazole (metronidazole) and with quinolones (levofloxacin, ciprofloxacin). Overall mortality rate was 13.3%. Highest mortality rate came from gram‐negative bacteria group (14.2%—11 out of 77 patients), patients receiving Ceftriaxone–Metronidazole as empirical antibiotics (28.57%—4 out of 14 patients), patients with no surgery group (37%—3 out of 8 patients), with no mortality came from patients, which were performed debridement followed by fasciotomy/skin graft/flap and amputation. We conclude that the most found bacterial aetiology was Acinetobacter baumanii though it has no significant relation to mortality. We highly recommend early aggressive surgical intervention in reducing mortality rate due to necrotizing fasciitis for source control accompanied by deliberate defect closure and early administration of empirical antibiotics with more susceptibility for gram‐negative bacteria, such as Meropenem.
Geriatric sarcopenia is associated with hypertension: A systematic review and meta‐analysis
Authors: Quan Yawen , Wang Chang , Wang Linfeng , Li Gang 
Published: August 2023

AbstractThis meta‐analysis aimed to explore the potential relationship between senile sarcopenia and hypertension in older people. A comprehensive search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library, up to November 2022. Ten studies comprising 14 804 participants were enrolled. The odds ratio (OR) and 95% confidence interval (CI) was pooled to evaluate the correlation between sarcopenia and hypertension in older people utilizing a random‐effects model. Subgroup and sensitivity analyses were then carried out to explore the potential sources of heterogeneity. The results revealed a substantial correlation between sarcopenia and hypertension among older people (OR = 1.39, 95% CI: 1.15–1.67, p < .01). Further subgroup analysis revealed an association between sarcopenic obesity and hypertension (OR = 1.49, 95% CI: 1.37–1.62, p < .01). In conclusions, our findings highlighted a significant relationship between sarcopenia and hypertension among older people, with sarcopenic obesity amplifying this risk.
Talkin' Bout a Revolution? Institutional Change in the EU Recovery and Resilience Facility: The Case of Climate Policy
Authors: Bocquillon Pierre , Brooks Eleanor , Maltby Tomas 
Published: August 2023

AbstractThe European Union (EU) post‐COVID‐19 investment and reform programme, the Recovery and Resilience Facility (RRF), has been hailed as novel and ambitious, both as a fiscal instrument and as a lever for accelerating progress towards EU climate commitments. Yet, its design also exhibits strong path dependency, drawing on existing processes and commitments. Adapting theories of institutional change and models of hard/soft governance, we argue that the RRF is an example of significant yet gradual change – of evolution rather than revolution – taking place via layering and conversion of existing frameworks, and alteration of their logics of action. We show how the RRF repurposes the European Semester and track continuity and change in climate policy, a key priority area. Our findings suggest that the literature on institutional change should give greater consideration to the interplay between layering and conversion as a mechanism of gradual yet transformative evolution.
An analysis of iris pattern as a risk factor for skin cancer development in immunosuppressed renal transplant recipients
Authors: Leahy M. , Griffin L. , Prendergast G. , Griffin M. , Laing M. 
Published: August 2023

AbstractIntroductionRenal transplant recipients are at increased risk of keratinocyte skin cancers with a tendency to have multiple, aggressive and difficult to treat tumours. The eye and the skin share the same embryological ectoderm. Iris pattern has recently been reported as a predictive risk factor for skin cancer in non‐immunosuppressed Southern European (Grigore et al., J Eur Acad Dermatol Venereol, 2018, 1662) and Irish populations (Ridge et al., J Eur Acad Dermatol Venereol, 2022, e542).AimsTo analyse if an individual's iris pattern is an independent risk factor for the development of keratinocyte skin cancers in renal transplant recipients.MethodsIris patterns of 110 renal transplant recipients were evaluated using the Simionescu visual three‐step technique (iris periphery, colarette and iris freckling [Simionescu et al., Ann Res Rev Biol, 2014, 2525]). Established risk factors for skin cancer in transplant patients were recorded as confounding factors.ResultsObservational cross‐sectional study including 110 renal transplant population. Thirty‐one participants had skin cancer. In the skin cancer group, iris periphery was blue/grey in 74.3% (p = 0.053, OR 2.5), the colarette was light brown in 57.1% (p < 0.0043) and iris freckles were present in 55%(p = 0.044). Dark brown and blue colarettes were observed in controls. Binary Logistic Regression analysis showed light brown colarette is a significant independent risk factor for skin cancer (OR 4.54, p < 0.02, CI 1.56–10.57).ConclusionWithin this renal transplant population a blue iris periphery, light brown colarette and presence of freckling confers an independent risk for keratinocyte skin cancer. Iris pattern is a useful tool for identification of transplant patients at risk of keratinocyte skin cancer and an easy‐to‐use technique for risk evaluation in this cohort. This is the first study looking at iris pattern and keratinocyte skin cancer risk in renal transplant population.
The larval attachment organ of the bowfin Amia ocellicauda Richardson, 1836 (Amiiformes: Amiidae) and its phylogenetic significance
Authors: Pinion Amanda K. , Britz Ralf , Kubicek Kole M. , Siegel Dustin S. , Conway Kevin W. 
Published: August 2023

AbstractLarval attachment organs (LAOs) are unicellular or multicellular organs that enable the larvae of many actinopterygian fishes to adhere to a substrate before yolk‐sac absorption and the free‐swimming stage. Bowfins (Amiiformes) exhibit a sizable LAO on the snout, which was first described in the late 19th and early 20th centuries. In this study, we document the LAO of Amia ocellicauda (Richardson, 1836) using a combination of scanning electron microscopy (SEM) and light microscopy, and histochemistry. We examined material representing three stages with SEM ranging in size from 5.8 to 11.2 mm in notochord length and one stage histochemically. We compare the LAO of A. ocellicauda to that of the lepisosteid Atractosteus tropicus Gill, 1863 and show that although the LAOs of A. ocellicauda and A. tropicus are both super‐organs, the two differ in the ultrastructure of the entire organ. A. ocellicauda possesses two distinct lobes, with the organs arranged on the periphery with none in the middle, whereas A. tropicus also possesses two lobes, but with the organs scattered evenly across the super‐organ. The individual organs of A. ocellicauda possess adhesive cells set deep to support cells with the adhesive substance released through a pore, whereas A. tropicus possesses both support cells and adhesive cells sitting at a similar level, with the adhesive substance released directly onto the surface of the organ. We additionally provide a table summarizing vertebrate genera in which attachment organs have been documented and discuss the implications of our study for hypotheses of the homology of attachment organs in the Holostei.
Do gut microbiome‐targeted therapies improve liver function in cirrhotic patients? A systematic review and meta‐analysis
Authors: Jiang Honglin , Xu Ning , Zhang Wei , Wei Hongjian , Chen Yue , Jiang Qingwu , Zhou Yibiao 
Published: August 2023

AbstractBackground and AimMicrobiome‐targeted therapies (MTTs) are considered as promising interventions for cirrhosis, but the impact of gut microbiome modulation on liver function and disease severity has not been fully assessed. We comprehensively evaluated the efficacy of MTTs in patients with liver cirrhosis.MethodsData from randomized controlled trials were collected through MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrial.gov from inception to February 20, 2023. Clinical outcomes were pooled and expressed in terms of risk ratios or mean differences (MD). Additional subgroup and sensitivity analyses were performed to validate the robustness of findings. A trial sequential analysis was applied to calculate the required information size and evaluate the credibility of the meta‐analysis results.ResultsTwenty‐one studies with a total of 1699 cirrhotic patients were included for meta‐analysis. MTTs were associated with a significant reduction in aspartate aminotransferase (MD, −3.62; 95% CI, −6.59 to −0.65), the risk of hepatic encephalopathy (risk ratio = 0.56, 95% CI: 0.46 to 0.68), model for end‐stage liver disease score (MD, −0.90; 95% CI, −1.17 to −0.11), ammonia (MD, −11.86; 95% CI, −16.39 to −7.33), and endotoxin (MD, −0.14; 95% CI, −0.23 to −0.04). The trial sequential analysis yielded reliable results of these outcomes. No effects were observed on the changes of other hepatic function indicators.ConclusionMTTs appeared to be associated with a slowed deterioration in liver cirrhosis, which could provide reference for clinicians in treatment of cirrhotic patients based on their conditions.
Trauma treatment using Narrative Exposure Therapy adapted to persons with intellectual disabilities or severe chronic mental disorders – a randomised controlled pilot study with an embedded observational study
Authors: Mayer B. , Elbing U. , Ostermann T. 
Published: August 2023

AbstractBackgroundDespite an increased likelihood of experiencing traumatic events and increased vulnerability, there are only few publications on trauma therapy for persons with intellectual disabilities (IDs). This pilot study for the first time investigates the feasibility and effectiveness of Narrative Exposure Therapy (NET) within this target group modified by Plain Language.MethodsA group of n = 10 participants with ID dual diagnoses and another group of n = 5 participants with severe and chronic mental disorders were separately stratified and randomised, then forming together an intervention group (n = 7) and a waiting list control group (n = 8). All participants were treated with NET attuned to their communication abilities by using Plain Language. Primary outcome was the post‐traumatic stress measured with the Post‐Traumatic Symptom Scale‐10 before and after the intervention. In addition, the Adverse Childhood Experience Index was used for diagnostic purposes. Data were analysed using t‐test for repeated measures and analysis of covariance.ResultsNarrative Exposure Therapy and the randomised controlled trial study proved to be successfully conductible with participants with IDs in a congregated residential service. Although the corresponding effect size was high (partial eta square = 0.188), the between‐group difference was not significant (P = 0.12). Analysis of the observational study resulted in a highly significant improvement for participants with IDs (P < 0.001; Hedges' g = 2.36) and in a significant improvement in participants with severe and chronic mental disorders (P < 0.013; Hedges' g = 1.52). Additionally, the participants with IDs show a significantly better reduction of symptom burden (P = 0.03; partial eta square = 0.327).ConclusionsThe results provide a first evidence for a possible and successful implementation of NET modified in Plain Language for persons with IDs and complex mental health support needs. Completeness in responding to the items of Post‐Traumatic Symptom Scale‐10 and Adverse Childhood Experience Index indicates the suitability of these instruments for both groups of participants. Although the group difference in the randomised controlled trial failed to achieve statistical significance mainly due to the small sample size, the results of the embedded observational study are promising for the conduct of further studies with the modified NET.
Accuracy, scanning time, and patient satisfaction of stereophotogrammetry systems for acquiring 3D dental implant positions: A systematic review
Authors: Gómez‐Polo Miguel , Barmak Abdul B. , Ortega Rocío , Rutkunas Vygandas , Kois John C. , Revilla‐León Marta 
Published: August 2023

AbstractPurposeTo evaluate accuracy, scanning time, and patient satisfaction of photogrammetry (PG) systems for recording the 3D position of dental implants.Material and MethodsA literature search was completed in five databases: PubMed/Medline, Scopus, Embase, World of Science, and Cochrane. A manual search was also conducted. Studies reporting the use of commercially available PG systems were included. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus.ResultsA total of 14 articles were included: 3 in vivo, 6 in vitro, and 6 case report manuscripts. One clinical study evaluated trueness, another one tested precision, and the third one assessed impression time and patient and operator satisfaction. All the in vitro studies evaluated the trueness and precision of a PG system. Additionally, all the reviewed studies investigated completely edentulous conditions with multiple implants. The number of placed implants per arch among the reviewed clinical studies varied from 4 to 8 implants, while the number of implants placed on the reference casts included 4, 5, 6, or 8 implants. Not all the studies compared the accuracy of PG systems with conventional impression methods, using intraoral scanners as additional experimental groups. For the PIC system, trueness ranged from 10 to 49 μm and precision ranged from 5 to 65 μm. For the iCam4D system, trueness ranged from 24 to 77 μm and the precision value ranged from 2 to 203 μm.ConclusionsPG systems may provide a reliable alternative for acquiring the 3D position of dental implants. However, this conclusion should be interpreted carefully, as one study reported a mean precision value of one PG system higher than the clinically acceptable discrepancy. Lower scanning time and higher patient and operator satisfaction have been reported when compared with conventional techniques. Further studies are needed to increase the evidence regarding the accuracy, scanning time, and patient and operator satisfaction of the commercially available PG systems.
Premature exit from and delayed entrance into the less developed status: An empirical appraisal of the structural funds allocation criterion
Authors: Scotti Francesco , Dell'Agostino Laura , Flori Andrea , Pammolli Fabio 
Published: August 2023

AbstractThis paper investigates the impact of the main criterion employed by the European Commission for the allocation of the largest portion of Structural Funds, based on the threshold of the 75% of European Union (EU) average gross domestic product (GDP) per capita. We focus on the 2014–2020 programming period and on EU‐15 regions to analyze if this criterion has penalized some of them, as a consequence of the 2004 EU enlargement, which has represented an exogenous shock in the allocation process, due to the economic backwardness of new member states. Through the application of Synthetic Control Methods and Difference‐in‐Differences estimators at different geographical scales, we show that regions that did not obtain the less developed status in both the programming period 2007–2013 and 2014–2020, but that would have obtained it in the period 2014–2020 without the 2004 EU enlargement, experienced a significantly lower GDP per capita growth between −10.5% and −5.7%. Conversely, territories that in the period 2014–2020 lost the less developed status, previously obtained in the time frame 2007–2013, were not characterized by a significantly lower economic growth, providing some evidence of the effectiveness of the safety net.
Cognitive behavioural therapy for insomnia disorder: Extending the stepped care model
Authors: Baglioni Chiara , Espie Colin A. , Altena Ellemarije , Gavriloff Dimitri , Jernelöv Susanna , Holzinger Brigitte , Schlarb Angelika , Riemann Dieter 
Published: August 2023

SummaryDespite cognitive behaviour therapy for insomnia (CBT‐I) being the first‐line intervention for the disorder, it is often not readily available to patients in need. The stepped care model (SCM) represents an approach to facilitating efficient and wide‐ranging provision of evidence‐based care to those with insomnia. The SCM reflects a pyramid of therapeutics based on CBT‐I gradually increasing in clinical intensity and addressing clinical complexity. By applying CBT‐I through the SCM it is hoped that the treatment gap can be bridged such that not only more patients can be reached, but that clinical resource can be more effectively distributed, with patients receiving more tailored care as needed. Nevertheless, this should not be done at the risk of a lower quality of care being offered, and high‐standard training for clinicians and scrutiny of non‐clinician led interventions remains important. As national health laws within European countries have substantial differences, the application of the SCM as it relates to the treatment of insomnia may be challenged by contrasting interpretations. In order that the SCM is appropriately implemented: (a) only evidence‐based CBT‐I treatments should be promoted within the model; (b) clinicians involved in SCM should be suitably qualified to offer CBT in general, and have appropriate further training in CBT‐I; (c) professionals involved in interventions not included in the SCM, but related to it, such as preventive and educational programmes, diagnostic procedures, and pharmacological treatments, should also have good knowledge of the SCM in order to promote correct allocation to the appropriate interventional step.
Repeated specific canine pancreatic lipase measurements do not identify multiple acquired portosystemic shunts in dogs after extrahepatic portosystemic shunt attenuation
Authors: Serrano Gonçalo , Devriendt Nausikaa , de Rooster Hilde 
Published: August 2023

AbstractBackgroundIn dogs with portal hypertension (PH), spec cPL is suggested to be increased despite normal pancreatic histology. After attenuation of congenital extrahepatic portosystemic shunts (cEHPSS), multiple acquired portosystemic shunt (MAPSS) can develop as consequence of sustained PH. Presence of MAPSS affects future therapeutic options and prognosis.ObjectiveEvaluate if spec cPL concentrations increase postoperatively in dogs that develop MAPSS and can thus serve as an indicator of PH.AnimalsTwenty‐four dogs with cEHPSS.MethodsDogs classified according to surgical outcome after cEHPSS attenuation (8 with MAPSS [group M], 9 with closed cEHPSS [group C] and 7 with patent blood flow through the original cEHPSS, without evidence of MAPSS [group P]). Spec cPL was measured in preoperative samples (T0), 4 days (T1) and 1 (T2) and 3‐ to 6‐months (T3) after surgery.ResultsSpec cPL was within reference interval (<200 μg/L) at all timepoints except at T1. At T1, 2 dogs in group M (321 and >2000 μg/L) and also 1 in group C (688 μg/L) and 1 in group P (839 μg/L) had increased spec cPL concentrations. No differences in spec cPL concentrations between groups or changes over time were identified.Conclusions and Clinical ImportanceSpec cPL is not consistently increased in dogs that develop MAPSS after cEHPSS attenuation and has no potential as a biomarker for the identification of MAPSS after cEHPSS attenuation.