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Research interest in thriving at work has burgeoned over the past decades, but little is known about how human resource (HR) practices affect employees' thriving at work. Drawing upon self‐determination theory and person‐organization fit theory, we developed and tested a moderated mediation model to explain how fun HR practices influence employees' thriving at work. The results of two studies, a scenario experiment (N = 164) and a time‐lagged survey (N = 253), supported our hypotheses. Specifically, the findings revealed that fun HR practices relates positively to employees' thriving at work. Autonomous motivation partially mediates the abovementioned relationship. Furthermore, fun HR practices translate into higher autonomous motivation and subsequent thriving at work for employees with higher preference for workplace fun. Our research contributes to the existing literature by identifying fun HR practices as an antecedent of thriving at work and revealing the psychological mechanisms through which fun HR practices affect employees' thriving at work. The practical implications, limitations, and future research avenues are also discussed. [ABSTRACT FROM AUTHOR]

Based on research on meta‐stereotypes and signaling theory, we examined the effects of organizational signaling on the attraction of autistic applicants. Our model predicted that meta‐stereotypes and the combination of expressed and evidence‐based autism‐conscious signals would have simple and joint effects on candidates' fit perceptions, which would, in turn, affect their job pursuit intentions. Further, we expected that the effect of signaling on our outcomes would be weaker among candidates with strong negative autism meta‐stereotypes. Prior to testing our hypotheses, we conducted a focus group to determine the supports that autistic job seekers deemed most important. As the ability to work from home (WFH) was overwhelmingly the most cited support, we included this as our evidence‐based signal. Specifically, we examined the combined effect of disability‐conscious (vs. disability‐blind) diversity statements and WFH (vs. retirement benefits) on expected fit and subsequent job pursuit intentions. Both meta‐stereotypes and combined signals significantly influenced fit expectations. Further, the autism‐friendly signals significantly affected the fit of candidates with weak and moderate negative meta‐stereotype, but not the fit of candidates with strong meta‐stereotypes. In addition, our results indicate that the signal x meta‐stereotype interaction had an indirect effect on job pursuit intentions. Findings are discussed vis‐à‐vis the research on signaling theory and practical guidance is offered to employers seeking to attract the growing number of autistic job seekers. [ABSTRACT FROM AUTHOR]

To operationalize the extent to which firms place a strategic emphasis on human capital and human resource management (HRM), we draw on the strategy field's dominant logic theory and on the emerging literature on executive compensation for the heads of major firm functions, such as HRM. Specifically, we investigate whether the pay of human resource executives (HREs) relative to other members of top management teams (TMTs) is related to firm performance. After controlling for the endogeneity of HRE status as one of the highest paid executives on the TMT, we find in a comprehensive sample of the largest US firms that HRE relative pay is positively related to firm financial performance, specifically Tobin's Q. We also find that the relationship of HRE relative pay with Tobin's Q is stronger in relatively smaller and younger firms in our sample. The findings suggest that a strategic emphasis on human capital and HRM leads to higher firm value. [ABSTRACT FROM AUTHOR]

We integrate the job characteristics and dual work passion models to explore the indirect (via work meaningfulness) effects of job characteristics (i.e., job autonomy, task identity, skill variety, task significance, feedback from the job and feedback from others) on two types of work passion, harmonious passion (HP) and obsessive passion (OP). We first advance occupation‐specific predictions for job characteristics‐to‐work passion relationships and then explore differences in those relationships between HP and OP across four occupational sectors: knowledge work (n = 201), blue‐collar work (n = 148), nonprofit work (n = 141), and managerial work (n = 133). Our findings demonstrate that job characteristics are important drivers of work passion. However, our key discovery is that the motivational impact of the job characteristics is not universally applicable but rather depends on the specific occupational context and whether passion is harmonious or obsessive. We therefore conclude that when it comes to translating job characteristics into work passion, the one‐size‐fits‐all approach is not appropriate. [ABSTRACT FROM AUTHOR]

Summary: Data aggregation, in its basic form, has been widely used, and several solutions have been proposed for IoT environments. However, to calculate statistical metrics, detect anomalies, and predict future trends, we need to perform various data analysis functions on the aggregated data. Recently, multifunctional data aggregation (MFDA) has been proposed to calculate various statistical functions such as sum, mean, variance, covariance, and analyze of variance (ANOVA). The purpose of MFDA is to enable the improvement of decision making, resource allocation and system performance by providing diverse and varied statistical data. However, the existing solutions involving MFDA generate significant communication and calculation costs. Furthermore, they cannot prevent malicious aggregators from sending fake data. Recently, the Fog computing paradigm has been adopted in IoT environments to address various challenges and enhance the efficiency of data processing and storage. The blockchain technology has been integrated in various IoT applications to enhance the security, increase transparency, and facilitate decentralized data exchange and transactions. In this article, we propose BMDA, a blockchain‐based secure multifunctional data aggregation method for IoT‐Fog environments. BMDA employs an encoding function to structure the data before their transmission. Furthermore, to ensure privacy preservation, authentication, data integrity and to resist malicious aggregators, we employ Paillier homomorphic encryption, BLS signature, and blockchain technology. The security analysis demonstrates the robustness of our proposal, and the performance analysis in terms of computations and communications shows the effectiveness of BMDA compared to existing solutions. [ABSTRACT FROM AUTHOR]

Semiparametric probabilistic index models allow for the comparison of two groups of observations, whilst adjusting for covariates, thereby fitting nicely within the framework of generalized pairwise comparisons (GPC). As with most regression approaches in this setting, the limited amount of data results in invalid inference as the asymptotic normality assumption is not met. In addition, separation issues might arise when considering small samples. In this article, we show that the parameters of the probabilistic index model can be estimated using generalized estimating equations, for which adjustments exist that lead to estimators of the sandwich variance‐covariance matrix with improved finite sample properties and that can deal with bias due to separation. In this way, appropriate inference can be performed as is shown through extensive simulation studies. The known relationships between the probabilistic index and other GPC statistics allow to also provide valid inference for example, the net treatment benefit or the success odds. [ABSTRACT FROM AUTHOR]

In this study, a new ellipse‐fitting algorithm is proposed to achieve the reconstruction of bubble shapes in bubbly flow captured by a high‐speed camera in the gas–liquid two‐phase column reactor. Bubble flow patterns and geometric parameters in the experimental images are recognized and identified successfully, represented by means of the topological parameters. Three logical steps are carried out in detail. First, the area threshold and the circularity factors are established to identify the bubbles whether belonging to a single bubble or not. The overlapping bubbles in images can be separated from single bubbles based on a watershed segmentation algorithm. Second, a single bubble image and an overlapping bubble image are combined into one image. After that, statistical analysis for the size distributions and ellipse area bubbles is performed for further analysis and discussion. The advantage of this algorithm is that it can make use of a set of major and minor axes of an ellipse to capture the ellipse parameters more effectively. Simulation results are well agreed with experimental measurements. Moreover, it can be used to detect many ellipse‐like bubbles that are dispersed in high‐speed camera images, indicating that it is a better strategy for the recognition and identification of bubbly turbulent flow accurately. [ABSTRACT FROM AUTHOR]

Sir David Cox published four papers in the Scandinavian Journal of Statistics and two in the Scandinavian Actuarial Journal. This note provides some brief summaries of these papers. [ABSTRACT FROM AUTHOR]

Summary: In person‐centric applications, the prevalence of shared names significantly hampers document retrieval, web search, and database integration, highlighting the critical need for name disambiguation. Network embedding based unsupervised name disambiguation methods have received much attention due to their wide applicability and superior disambiguation performance. However, existing methods require complex feature engineering, such as extracting biographical and source content features or constructing supplementary features from external knowledge bases, which are unavailable in privacy‐preserving scenarios. Moreover, they may face challenges such as imbalanced node training or overlooking global statistical information during node embedding learning. In this article, we propose a method to tackle the name disambiguation problem based on high‐degree penalty and global statistical information using only relational data. First, we construct a weighted source similarity network based on multi‐hop collaborator relationships. Second, we employ a high‐degree penalty based global statistical network embedding model to learn low‐dimensional node embeddings and preserve the structural features of the network. Finally, we cluster the same sources using a joint clustering algorithm that does not require prior knowledge of the number of clusters. The experiment validates the effectiveness of the proposed method on two real‐life datasets. [ABSTRACT FROM AUTHOR]

This study aimed to reduce subjectivity bias in scoring dental macrowear quantity and direction using the Brabant index, which previously relied solely on written descriptions. To achieve this, we present a new, optimized visual guide incorporating buccal and lingual scores. The optimization process involved conceptualizing and illustrating a visual guide using Holocene southern African hunter‐gatherer and herder teeth, featuring both buccal and lingual scores for multicuspid teeth. The guide was hand‐drawn using a stippling technique and digitized to depict surface details for each wear stage and tooth type. We conducted intra‐ and inter‐observer assessments to evaluate the optimized method using both the original and optimized Brabant indices. Statistical analysis was performed in R using Cohen's kappa for direction and Cohen's weighted kappa for quantity. Intra‐observer results for the original method yielded kappa values of 0.84 for direction and 0.94 for quantity, while the optimized version both resulted in improved values of 0.99. Inter‐observer results revealed some differences between an inexperienced and an experienced observer. The inexperienced observer achieved kappa scores of 0.20 for direction and 0.86 for quantity with the original method, and 0.17 and 0.80, respectively, with the optimized version. The experienced observer's results using the original index were 0.66 for direction and 0.89 for quantity, and 0.75 and 0.96, respectively, with the optimized version. These findings demonstrate that the optimized method enhances data reliability for experienced observers, highlighting the value of a published visual guide and multicuspid scoring adjustments. However, reduced or unappreciable changes in accuracies for the inexperienced observer illustrate the need for dental expertise when scoring for dental wear, even with a modified method. [ABSTRACT FROM AUTHOR]

ABSTRACT I would like to reconsider a recent analysis by Prof. Senn on the statistics of the Pfizer‐BioNTech vaccine trial, to express some different opinions and to clarify some theoretical points, especially regarding the clinical applications of Bayesian statistics. [ABSTRACT FROM AUTHOR]

Key points Physiologists often express the change in the value of a measurement made on two occasions as a ratio of the initial value. This is usually motivated by an assumption that the absolute change fails to capture the true extent of the alteration that has occurred in attaining the final value – if there is initial variation among individual cases. While it may appear reasonable to use ratios to standardize the magnitude of change in this way, the perils of doing so have been widely documented. Ratios frequently have intractable statistical properties, both when taken in isolation and when analysed using techniques such as regression. A new method of computing a standardized metric of change, based on principal components analysis (PCA), is described. It exploits the collinearity within sets of initial, absolute change and final values. When these sets define variables subjected to PCA, the standardized measure of change is obtained as the product of the loading of absolute change onto the first principal component (PC1) and the eigenvalue of PC1. It is demonstrated that a sample drawn from a population of these standardized measures: approximates a normal distribution (unlike the corresponding ratios); lies within the same range; and preserves the rank order of the ratios. It is also shown that this method can be used to express the magnitude of a physiological response in an experimental condition relative to that obtained in a control condition. The intractable statistical properties of ratios and the perils of using ratios to standardize the magnitude of change are well known. A new method of computing a standardized metric, based on principal components analysis (PCA), is described, which exploits the collinearity within sets of initial, absolute change and final values. A sample drawn from a population of these PCA‐derived measures: approximates a normal distribution (unlike the corresponding ratios); lies within the same range as the ratios; and preserves the rank order of the ratios. The method can also be applied to express the magnitude of a physiological response in an experimental condition relative to a control condition. [ABSTRACT FROM AUTHOR]

ABSTRACT In digital healthcare engineering (DHE) for aging monopile‐type offshore wind turbines, predictive health analysis is essential for robust future maintenance planning. This paper presents the development of a DHE module for the predictive health analysis of corroded monopile‐type offshore wind turbines, focusing on wind and rotor blade rotation effects. An empirical formula for predicting time‐variant corrosion wastage is derived from a statistical analysis of a decade‐long corrosion wastage database and applied to predict the corrosion depth of a 5 MW monopile‐type offshore wind turbine, serving as an illustrative example. Nonlinear finite element analyses using LS‐DYNA are performed on the corroded turbine tower under combined wind‐induced loads and rotor‐induced thrust forces. Two types of corrosion wastage, pitting, and uniform (general) corrosion, are considered. The health condition of the corroded tower is evaluated based on serviceability limit state and ultimate limit state criteria. The methodology developed in this paper will be integrated into the DHE system currently being developed by the authors for aging monopile‐type offshore wind turbines. [ABSTRACT FROM AUTHOR]

In this article, we consider test for the two null hypotheses for H0:SX(t)=α$H_0: S_X(t)=\alpha$ and H0:SX(t)=SY(t)$H_0: S_X(t)=S_Y(t)$, two widely useful tests in reliability, based on ranked set sampling (RSS). We derive the likelihood ratio test as well as the associated exact and asymptotic results. Considering a fixed significance level and power of the test, we show that the proposed test statistic outperforms the existing test. In small sample cases, the proposed test leads to a much narrower confidence interval for the reliability function SX(t)$S_X(t)$. Then, the test statistics obtained from simple random sampling and RSS schemes are compared through which, the efficiency of using RSS is demonstrated. For illustration, we apply the proposed test to a degradation data from the reliability literature. Upon using RSS, the cost of measurement gets reduced and efficiency gets improved, suggesting the importance and use of RSS data in reliability experiments and their design. [ABSTRACT FROM AUTHOR]

Examining mechanisms underlying sex differences in children's play styles, we studied girls with congenital adrenal hyperplasia (CAH) who provide a test of the relative effects of prenatal androgens versus rearing, and of behavioural similarity versus gender identity and cognitions. In this exploratory study, 40 focal children (girls and boys with and without CAH), aged 3–8 years, played for 14 min with a same‐sex peer in a task designed to elicit rough‐and‐tumble play. Time‐indexed ratings of positive affect and vigour of activity were evaluated via network mapping for sex‐related differences in both levels and play dynamics (temporal relations among behaviours). Results suggest influences of both gender identity‐aligned social cognitions and prenatal androgens: there was greater dyadic synchrony between positive affect for girls (regardless of CAH status) than boys, but girls with CAH displayed positive affect levels and directed vigorous peer play dynamics similar to boys. [ABSTRACT FROM AUTHOR]

Highlights In a time when global initiatives to lower CO2 emissions are accelerating the shift towards bio‐based products, various efforts are being made to develop wood plastic composites (WPCs) and similar bio‐composites using a variety of raw materials. This paper first showcases benchmark material properties serving as standards and models the composition, for polypropylene‐based WPCs integrating wood flour and maleic anhydride‐modified polypropylene. Subsequently, by applying statistical modeling techniques, we demonstrate an adaptive experimental design that efficiently and rapidly adjusts formulations. Beginning with an empirical dataset (24 samples), we established high‐performing models that articulate the individual contributions of the constituents on ten vital properties of WPCs. Our adaptive experimental design, leveraging nonlinear partial least squares regression and the Bayesian optimization, successfully refined formulations to enhance bending and impact strengths. Notably, we proposed optimal conditions starting from just eight samples with minimal iterations. This study shows that statistical techniques can quickly optimize WPC formulations, making the overall development process faster. By addressing the multiple conflicting properties, these techniques can greatly reduce the time and effort needed for development. Applied several regression methods to analyze ten properties of PP‐based WPCs. Showcased distinct impacts of the formulations of WF and MAPP on WPCs. Implemented the adaptive experimental design for formulation optimization. Enhanced bending and impact strengths in the formulations of WPCs. Advanced sustainable material development with data‐driven approach. [ABSTRACT FROM AUTHOR]

The delivery of academic statistical collaboration resources can vary among types of institutions and across time. In particular, this variation might occur in the management of infrastructure and the business model, the staffing model and opportunities for staff development. In this manuscript, we present examples of these three themes in modern academic statistical collaboration units and describe key advantages and challenges. [ABSTRACT FROM AUTHOR]

Clinical and academic research continues to become more complex as our knowledge and technology advance. A substantial and growing number of specialists in biostatistics, data science and library sciences are needed to support these research systems and promote high‐calibre research. However, that support is often marginalized as optional rather than a fundamental component of research infrastructure. By building research infrastructure, an institution harnesses access to tools and support/service centres that host skilled experts who approach research with best practices in mind and domain‐specific knowledge at hand. We outline the potential roles of data scientists and statisticians in research infrastructure and recommend guidelines for advocating for the institutional resources needed to support these roles in a sustainable and efficient manner for the long‐term success of the institution. We provide these guidelines in terms of resource efficiency, monetary efficiency and long‐term sustainability. We hope this work contributes to—and provides shared language for—a conversation on a broader framework beyond metrics that can be used to advocate for needed resources. [ABSTRACT FROM AUTHOR]

The concept of a reference ecosystem is fundamental in restoration ecology, especially in assessing the success of ecological restoration projects. In response to criticism, it has undergone conceptual evolutions in its definition and use in the last decades. Even though there is still a need to develop statistical methods and analyses to account for reference variability. Here, we focus on two original and one literature‐based calculation methods for designed indexes, which all aim to compare a community to be assessed (undergoing restoration) with a variable set of reference communities. These methods either use the average reference situation (species composition and abundance) as the restoration target or on the contrary, allow any reference site to be considered a relevant target. We compare the results of these methods by analyzing a simulated dataset. We then illustrate the application of the most relevant index by a real case study that compared a created Mediterranean temporary pond to a panel of 27 reference ponds located in the south of France. The results show that the Distance to Reference Communities Index (DRCI) correctly measures differences in species composition and abundance between an assessed and a reference panel of communities. It takes into account the variability of the reference communities, while the use of other indexes focuses on unrealistic average and fixed reference values. DRCI is complementary to a detailed ecological interpretation and to the use of other commonly used indexes, by giving a synthetic metric. [ABSTRACT FROM AUTHOR]

Objective: To carry out a systematic review and meta‐analysis of randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) comparing scaling and root planing (SRP) or placebo with subgingival application of xanthan‐based CHX (chlorhexidine) gel as adjunct to SRP. Materials and Methods: The literature search was carried out in PubMed/MEDLINE, EMBASE, and SCOPUS; primary outcomes were probing pocket depth (PPD) reduction and gain in clinical attachment level (CAL). Results: Overall, 15 studies were included. Three studies were judged to be at moderate risk of bias while the remaining 12 were rated at high risk of bias. A significant improvement in PPD reduction (standardized mean difference, SMD, 0.87, 95% CI, 0.41–1.34) and CAL gain (SMD = 0.84, 95% CI, 0.36–1.33) emerged for the SRP + CXH gel compared to the SRP alone group, in the presence of significant high heterogeneity among the studies. Conclusions: Our systematic review and meta‐analysis showed that xanthan‐based chlorhexidine gel as adjunct to non‐surgical periodontal therapy gives benefit in terms of PPD reduction and CAL gain as compared to non‐surgical periodontal therapy only. Since there was high heterogeneity among studies and the quality of the evidence is low, further studies characterized by a better methodology, adequate sample size and longer follow‐up are warranted in the next future. Registration: The protocol of this scoping review was registered in the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/PROSPERO) with ID: CRD42023391589. [ABSTRACT FROM AUTHOR]

This research aims to examine the impact of programmed cell death 4 (PDCD4), microRNA‐21 (miR‐21) and microRNA‐208a (miR‐208a) transcripts, and protein levels on oral epithelial dysplasia (OED) development in oral squamous cell carcinoma (OSCC). Methods: The research investigation involved the collection of saliva, blood, and tissue samples from a total of 20 patients diagnosed with OSCC, 15 patients diagnosed with OED, and 15 healthy individuals. PDCD4, miR‐21, and miR‐208a expression was performed by quantitative reverse transcription polymerase chain reaction (qRT‐PCR). PDCD4 protein levels were assessed using enzyme‐linked immunosorbent assay (ELISA) in both saliva and blood samples. For statistical analysis, the Kruskal–Wallis test and the Spearmen rank test were utilised. Results: PDCD4 expression levels were considerably lower in patients with OSCC and OED (p < 0.05) in three biological samples. In contrast, miR‐21 expression was higher in OED and OSCC patients. Patients with low PDCD4 mRNA levels and strong miR‐21 expression had a significant connection (p < 0.05) with tumor size and depth. Conclusions: Examining PDCD4 and miR‐21 transcript levels may help detect the transition from OED to OSCC. This work suggests that PDCD4 and miR‐21 expression levels in liquid biopsies may be biomarkers for OED monitoring in the future. [ABSTRACT FROM AUTHOR]

Objectives: We assessed the radiation dosages (Dmean) on implant regions to identify the threshold for implant loss in patients with an intraoral malignancy treated with dental implants to support a mandibular denture during ablative surgery before volumetric‐modulated arc therapy (VMAT). Materials and Methods: Data was collected prospectively from 28 patients treated surgically for an intraoral malignancy, followed by postoperative radiotherapy (VMAT) and analyzed retrospectively. Patients received 2 implants in the native mandible during ablative surgery. Implant‐specific Dmean values were retrieved from the patients' files. Radiographic bone loss was measured 1 year after implant placement and during the last follow‐up appointment. Implant survival was analyzed with the Kaplan–Meier method. Univariate logistic regression and Cox‐regression analyses were performed to investigate the effect of increasing implant‐specific radiation dosages on implant loss. Results: Five out of 56 placed implants were lost during follow‐up (median 36.0 months, IQR 39.0). Radiographically, peri‐implant bone loss occurred in implants with a Dmean > 40 Gy. Implant loss occurred only in implants with a Dmean > 50 Gy. Conclusion: An implant‐specific Dmean higher than 50 Gy is related to more peri‐implant bone loss and, eventually, implant loss. [ABSTRACT FROM AUTHOR]

In fencing, it remains unclear whether practice enhances visual‐spatial attention allocation. We explored whether this ability is improved in fencers and if it is related to attack speed and accuracy. Twelve novices (<1 year of experience) and 12 trained epee fencers (18 ± 10 years of experience) visited the laboratory twice (familiarization and testing session). They performed a covert orienting of visuospatial attention test (COVAT) on a computer and an epee test, involving 30 trials of 3 shuttles followed by fast attack phases where the fencers quickly hit a target (randomly proposed out of 8). We measured COVAT reaction time, number of successful target hits, and execution time to hit in the fencing test. We found shorter COVAT reaction time for trained fencers (332 ± 24 ms) versus novices (367 ± 32 ms; p < 0.001). The number of hits was greater for trained fencers (22 ± 3) versus novices (16 ± 3; p < 0.001). ANCOVA showed a difference in execution time at the test (823 ± 73 ms vs. 913 ± 141 ms, p = 0.035). A relationship was found between hits and execution time and between execution time and COVAT reaction time for the trained group (r = 0.62, p = 0.03 and r = 0.70, p = 0.01, respectively) but not in the novice group (r = 0.11, p = 0.72 and r = 0.45, p = 0.14, respectively). Mediation analysis showed that the relationship between execution time and number of hits (ADE: p = 0.008) was not mediated by COVAT reaction time (ACME: p = 0.17). These results evidence the importance of visual‐spatial attention allocation in fencing and evidence differences between novices and trained fencers with important implications for talent development in the early career stage. Highlights: This is the first study investigating visual‐spatial attention allocation ability by comparing computer and fencing‐specific tests in trained versus novice epee fencers.Speed and accuracy at the fencing test and reaction time at the computer test were greater for trained epee fencers compared to novices.Only trained epee fencers showed a trade‐off between accuracy and speed of execution at the fencing test.This relationship was not mediated by covert‐orienting attention ability despite a correlation between speed of execution and reaction time at the computer test.These results underline the importance of attention allocation and technical abilities, which could improve independently with practice and play a role in epee fencing performance. [ABSTRACT FROM AUTHOR]

Aims: To develop a standardised, automated protocol for detecting protein gene product 9.5 (PGP9.5) positive intra‐epidermal nerve fibres (IENFs) in skin biopsies, transitioning from the established manual technique to an automated platform. This automated method, although currently intended for research applications, may improve the accessibility of this diagnostic test for small fibre neuropathy in clinical settings. Methods: Skin biopsies (n = 274) from 100 participants (fibromyalgia syndrome n = 62; idiopathic small fibre neuropathy: n = 16; healthy volunteers: n = 22) were processed using an automated immunohistochemistry platform. IENF quantification was performed by blinded examiners, with reliability assessed via a two‐way mixed‐effects model to evaluate inter‐ and intra‐observer variability. Results: The automated staining system reproduced intra‐epidermal nerve fibre density (IENFD) counts consistent with free‐floating sections (mean ± standard deviation: free‐floating: 5.6 ± 3.4 fibres/mm; automated: 5.9 ± 3.2 fibres/mm). A median difference of 0.3 with a lower bound 95% Confidence Interval (CI) at −0.00005 established non‐inferiority against a margin of −0.4 (p =.08). Specifically, the inter‐class correlation coefficient (class denotes consistency in measured observations) was 99% (95% CI: 0.9–1), indicating excellent agreement between free‐floating and automated methods. The inter‐ and intra‐class coefficient between examiners were both 99% (95% CI: 0.9–0.1) for IENFD, demonstrating high reliability using sections stained using the automated method. Interpretation: Automated immunohistochemistry provides high‐throughput reliable and reproducible intra‐epidermal nerve fibre quantification. This method, although currently proof‐of‐concept, for research use only, may be more widely deployed in histopathology laboratories to increase the adoption of IENFD assessment for the diagnosis of peripheral neuropathies. [ABSTRACT FROM AUTHOR]

Background and Objectives: Systemic Lupus Erythematosus (SLE) often causes damage to small nerve fibers, leading to distressing painful and autonomic symptoms. Despite this, Small Fiber Neuropathy (SFN) remains an underrecognized complication for SLE patients. In this cross‐sectional study, we aimed to assess SFN in patients with SLE and to explore its correlations with immunologic disease features and clinical manifestations. Methods: We recruited 50 SLE patients (1 male to 12.5 females, aged 20–80 years) reporting painful disturbances. We conducted a comprehensive clinical and neurophysiological evaluation, using Nerve Conduction Studies and Quantitative Sensory Testing. Additionally, we carried out an extensive laboratory assessment of disease‐related serological parameters. We also performed a thorough skin biopsy analysis, investigating somatic and autonomic innervation while detecting complement and inflammatory cell infiltrates within the skin. Results: Out of 50 patients, 19 were diagnosed with SFN, primarily characterized by a non‐length‐dependent distribution; 7 had a mixed neuropathy, with both large and small fiber involvement. Patients with SFN were younger than patients with a mixed neuropathy (p =.0143); furthermore, they were more likely to have a history of hypocomplementemia (p =.0058) and to be treated with cyclosporine A (p =.0053) compared to patients without neuropathy. However, there were no significant differences in painful and autonomic symptoms between patients with and without SFN. Discussion: This study highlights the relevant frequency of SFN with a non‐length‐dependent distribution among SLE patients experiencing painful symptoms. Indeed, SFN emerges as an early manifestation of SLE‐related neuropathy and is closely associated with hypocomplementemia, suggesting a potential pathogenic role of the complement system. Moreover, SFN may be influenced by disease‐modifying therapies. However, the precise role of SFN in shaping painful and autonomic symptoms in patients with SLE remains to be fully elucidated. [ABSTRACT FROM AUTHOR]

Background: Anticholinergic (AC) and sedative medications are a risk factor for cognitive impairment. This study sought to characterize AC and sedative use in older patients seen for outpatient neuropsychological evaluation and evaluate their associations with different cognitive domains. We hypothesized that AC and sedative use would be associated with worse attention/processing speed (AP), executive functioning (EF), and memory. Methods: We conducted a cross‐sectional chart review of 392 patients (mean [M] age = 72 ± 7.7 years, range = 54–91). Medications were characterized by number of AC medications (≥1 on the Anticholinergic Cognitive Burden Scale [ACB]), number of sedative medications, and polypharmacy (≥5 daily medications). Demographically adjusted composites were calculated for AP, EF, and memory. Bivariate Pearson correlations assessed relationships between medication use and cognition. Multivariate linear regressions evaluated significant medication‐cognition associations, controlling for total medications, medical comorbidities, and estimated premorbid cognitive functioning. Results: Polypharmacy was common (80%; n = 314). Most patients (70%; n = 275) used ≥1 sedative medications (range = 0–9). Over half (63%; n = 248) used ≥1 AC drugs (range = 0–7), yet ACB scores were ≤2 in 74% of patients. Sedative use was negatively correlated with AP (r = −0.134, p = 0.008) and EF (r = −0.105, p = 0.04). ACB scores were negatively correlated with AP (r = −0.106, p = 0.037). Sedatives and a priori covariates significantly predicted AP performance (R2 = 0.127, p < 0.001); using more sedative medications was uniquely associated with worse AP (β = −0.426, p = 0.049). No significant associations were found with memory. Conclusion: AC and sedative medications and polypharmacy were prevalent in this sample of older patients. Though both drug classes had negative relationships with AP and EF, sedatives had a particularly negative association with AP. Contrary to our hypotheses, memory was not associated with medication use; however, anticholinergic burden was low within the sample, and AP and EF deficits may masquerade as memory problems. [ABSTRACT FROM AUTHOR]

Objectives: Our aim was to predict the prevalence of osteopenia and osteoporosis and their associated risk factors among postmenopausal women from Jordan. Methodology: In this cross‐sectional study, a total of 368 postmenopausal women were recruited from King Abdullah University Hospital (KAUH) in the North of Jordan between September 2022 and April 2023. Bone mineral density (BMD) was measured using a dual‐energy X‐ray absorptiometry scan. T‐score was used for osteoporosis diagnosis in accordance with the International Society for Clinical Densitometry (ISCD) guidelines. Data about sociodemographic and lifestyle variables were collected using face‐to‐face interviews. Medical records were used to retrieve participants' BMD information. Predictors of osteoporosis were identified using logistic regression. Results: Prevalence of osteoporosis was 40.5%, while 44.6% of participants were diagnosed with osteopenia. The lumbar spine had the highest frequency of osteoporosis (30.4%), while the left femoral neck had the highest prevalence of osteopenia (46.3%). Postmenopausal women's age (p‐value =.024), and history of chronic diseases (p‐value =.038) were significant factors associated with increased osteoporosis risk. Conclusions: Postmenopausal women from Jordan had high prevalence of osteoporosis and osteopenia. It is therefore necessary to target risk factors leading to osteoporosis and to improve patients' lifestyles through patient education. Healthcare systems should consider early screening approaches for osteoporosis at the age of menopause and thereafter. Supplements of calcium and vitamin D may be routinely considered for this age group depending on their serum levels. [ABSTRACT FROM AUTHOR]

Objective: Health inequalities are universal, but their magnitude and determinants vary according to geographic areas, and understanding variations is essential to designing and implementing preventive and corrective policies. Our objective was to evaluate health inequalities in the Maresme region (Catalonia, Spain) and the relationship with socioeconomic indicators. Design: Cross‐sectional ecological study (2017). Site: Maresme region. Participants: Population assigned to any of the Maresme's 21 basic health areas (BHAs). Measures: Sociodemographic, socioeconomic, health, and health resource use indicators published by the Catalan Health Service's Information and Knowledge Unit. Results: Differences observed between BHAs were 49% in mortality, 266% in diabetes incidence, 348% in stroke incidence, and 89% in hospitalizations. In the most compared to the least disadvantaged BHAs, socioeconomic deprivation, as measured by the socioeconomic index (SEI), was 4.6 times greater and the percentage population with low educational attainment (EA) was 3.7 times higher. Greater deprivation was associated with greater prevalence of diabetes, chronic obstructive pulmonary disease, and high blood pressure, and greater incidence of diabetes, ischemic heart disease, and cancer. Likewise, a greater percentage population with low EA was associated with higher premature mortality and avoidable hospitalizations. Conclusion: Great variation exists in socioeconomic, health, and health resource use between the different Maresme BHAs. Socioeconomic deprivation is strongly correlated with the prevalence and incidence of certain chronic diseases, and low EA is correlated with premature mortality and avoidable hospitalizations. Our findings point to the urgency of taking health inequalities into account in designing and implementing healthcare strategies, programs, and policies. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted as a randomized controlled trial to evaluate the technology‐based parent school program. Design: The study was conducted in the well‐child care outpatient clinic of a hospital in Turkey. Data were collected between October 31, 2022 and February 17, 2023. The parent school was prepared based on Meleis' transition theory. Sample: Forty‐eight parents participated in the study. Parents in the intervention group participated in a 10‐week parent school program (five website modules, five online interactive group trainings, and counseling). Measures: Data were collected before the program, after the program, and 1 month after the program. Results: There were increases in the mean scores of the "Parent Skill Assessment Form" and "Skills Assessment Form for the Toddler Development" items in the intervention group compared to the control group. The difference between the groups in the mean scores of the Self‐Efficacy for Parenting Task Index Toddler Scale (1–3 years) was not statistically significant. However, the difference between the times was statistically significant. Conclusion: It was concluded that the technology‐based parent school training program could guide parents with children aged 1–3 years on child‐rearing. Trial registration: It was registered at ClinicalTrials.gov in May 2022 (NCT05370989). [ABSTRACT FROM AUTHOR]

Limited information is available regarding the knowledge of Cardiovascular Disease (CVD) risk factors and the actual risk behaviors among African American (AA) older women living in rural areas of Alabama. A pilot study of needs assessment for CVD prevention behaviors was conducted to collect such data from rural AA women. This paper reports the quantitative part of the needs assessment of this pilot study. We recruited participants (N = 30) using convenience sampling. Data collection measures included: i) American Heart Association's CVD‐related knowledge questionnaire, ii) Five Times Sit to Stand Test to measure dynamic balance and iii) Six minute walk test (6MWT) to assess exercise endurance iv) standard weighing scale to measure body weight and v) standard measurements scale to measure height. Descriptive and inferential statistics were used to analyze the data. The majority (76%) of participants had hypertension (70%), diabetes (60%), poor balance (70%), and low exercise endurance (100%). Most of the participants had low knowledge related to CVD risk factors. This study demonstrated the need to conduct a large‐scale study to assess knowledge related to heart health and the actual needs and preferences of these individuals. Conducting such a study would lay the foundation for developing a need‐based program for these underserved individuals while incorporating their preferences and the strategies that would help engage them in a heart health intervention. [ABSTRACT FROM AUTHOR]

Background: The health‐related quality of life instrument with 8 items (HINT‐8) was developed to measure health‐related quality of life (HRQoL) in Korea. However, the HINT‐8 has not yet been validated among the family caregivers of people with dementia (PwD). Design: A cross‐sectional pilot study. Objective: The study aimed to examine the convergent and discriminant validity of the HINT‐8 among family caregivers of individuals with dementia. Sample: Forty‐seven family caregivers of PwD. Measurements: HINT‐8 was compared with the 5‐level EQ‐5D (EQ‐5D‐5L) to assess its convergent and discriminant validity. Additionally, the association between the two instruments assessing HRQoL was examined using the short‐form Bédard‐Zarit Burden Interview (SZBI). Results: The HINT‐8 was a promising and valid HRQoL instrument for family caregivers of PwD. There was a significantly high correlation between the overall HINT‐8 and EQ‐5D‐5L indices (r = 0.85, p <.001). The HINT‐8 had acceptable psychometric properties compared to the commonly used EQ‐5D‐5L, as indicated by the subdomains associated with family caregiversʼ burden measured by the SZBI. Conclusion: Future studies should compare the HINT‐8 with existing dementia carer‐specific QoL instruments among a larger study sample to enhance its statistical power and confirm its reliability and structural validity. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression is among the most common complications associated with child‐bearing having a period prevalence rate of 17%. Despite the prevalence of postpartum depression, recognition and treatment remains low. Methods: This paper examines the predictors of help‐seeking behavior among a sample (N = 326) of postpartum women. A cross‐sectional survey was deployed, and participants were recruited via social media through snowball and convenient sampling techniques. Results: Binary logistic regression was used to analyze the data. Results indicate the severity of depression and favorable attitudes toward help‐seeking were predictors of help‐seeking behavior among postpartum women in this sample. Discussion/conclusion: This study has implications for healthcare workers, including the allied health professions. Access to treatment is, in part, influenced by a woman's ability to ask for help from health professionals. Social workers and nurses have an opportunity to educate and discuss postpartum mental health and improve treatment seeking. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the job performance and predictability of job demands, job resources, personal resources, work engagement, job crafting, and the transformational leadership of nurse managers on this among nurses in Myanmar. Background: The ongoing crisis of nursing shortages along with heavy workloads combines to form a major challenge in Myanmar and these affected the job performance of nurses during the COVID‐19 pandemic. Methods: Utilizing a stratified random sample of 474 nurses from tertiary‐level general hospitals in the Republic of the Union of Myanmar, a descriptive predictive analysis was carried out. The Demographic Data Sheet, Job Performance Scale, Work Engagement Scale, Job Demands Scale, Job Resources Scale, Personal Resources Scale, Job Crafting Scale, and Global Transformational Leadership Scale were utilized to collect data. Results: The overall level of job performance was perceived to be high, considering various factors such as job demands, personal resources, work engagement, and job crafting were found as significant predictors of nurses' job performance, explaining 63.30% of the total variance. Discussion: These findings make a valuable contribution toward enhancing nurses' job performance by addressing job demands, fostering work engagement, and nurturing their job‐crafting capabilities. Self‐reporting data collection may not have accurately represented the actual level of study variable. Conclusion: This study highlighted factors that significantly affect nurses' job performance in general hospitals in Myanmar. Implications for nursing and health policy: The findings provide important evidence for nursing administrators and policymakers wishing to develop strategies to enhance the working environment and remain active in helping the performance of nurses. [ABSTRACT FROM AUTHOR]

Background: Previous research has shown a significant link between gut microbiota in children with autism spectrum disorder (ASD) and attention‐deficit hyperactivity disorder (ADHD). However, much remains unknown because of the heterogeneity of disorders and the potential confounders such as dietary patterns and control group variations. Methods: Children aged 6–12 years who had been clinically diagnosed with ASD and/or ADHD, their unaffected neurotypical siblings, and non‐related neurotypical volunteers were recruited cross‐sectionally. The ASD diagnosis was confirmed using the Autism Diagnostic Observation Schedule‐2 (ADOS‐2) in all patients, including those with ADHD. Standardized DNA extraction and sequencing methods were used to compare gut microbial alpha‐diversity among the groups. Dietary diversity was calculated from a standardized dietary questionnaire form. We compared the difference in gut microbiome between patients with ASD and/or ADHD with neurotypical siblings and non‐related neurotypical controls. Results: Ninety‐eight subjects were included in the study (18 with ASD, 19 with ADHD, 20 with both ASD and ADHD, 13 neurotypical siblings, and 28 non‐related neurotypical controls). The alpha‐diversity indices, such as Chao 1 and Shannon index, showed a significant difference between the groups in a Linear mixed‐effect model (F(4, 93) = 4.539, p =.02), (F(4, 93) = 3.185, p =.017), respectively. In a post‐hoc pairwise comparison, patients with ASD had lower alpha‐diversity compared with non‐related controls after Bonferroni correction. Dietary diversity shown in Shannon index did not differ among the groups (F(4, 84) = 1.494, p =.211). Conclusions: Our study indicates disorder‐specific microbiome differences in patients with ASD. In future research on gut microbiota in neurodevelopmental disorders, it is necessary to consider the impact of ASD and ADHD co‐occurrence, and strictly control for background information such as diet, to elucidate the gut–microbiota interaction in ASD and ADHD for exploring the potential of therapeutic interventions. [ABSTRACT FROM AUTHOR]

Background: Research exploring the relationship between prenatal infection and child behavioural outcomes would benefit from further studies utilising full‐population samples with the scale to investigate specific infections and to employ robust designs. We tested the association among several common infections requiring inpatient admission during and after pregnancy with a range of childhood behavioural outcomes, to determine whether any negative impact was specific to the period of foetal development. Methods: The sample included all mother–offspring pairs from the Australian state of New South Wales (NSW) for whom the child commenced their first year of full‐time schooling in 2009 (~age 5 years; n = 77,302 offspring), with records linked across four health administrative data sets including the NSW perinatal data collection (PDC), the NSW admitted patient data collection (APDC) and the NSW component of the 2009 Australian Early Development Census (AEDC). Multivariable linear regression was used to test associations between a number of infections requiring inpatient admission during and after pregnancy with a range of teacher assessed behavioural outcomes. Results: Associations specific to the prenatal period were only found for streptococcus A although this would need to be reproduced in external samples given the low prevalence. Otherwise, 12 out of 15 selected infections either showed no association prenatally or also demonstrated associations in the 12 months after pregnancy. For example, prenatal hepatitis C, influenza and urinary E. coli infections were associated with lower scores of several domains of childhood behaviour, but even stronger associations were found when these same maternal infections occurred after pregnancy. Conclusions: The prenatal infections we tested appeared not to impact childhood behaviour by altering foetal neurodevelopment. Rather, the strong associations we found among infections occurring during and after pregnancy point to either residual socioeconomic/lifestyle factors or a shared familial/genetic liability between infections and behavioural problems. [ABSTRACT FROM AUTHOR]

Background: The stress‐sensitive maternal hypothalamic–pituitary–adrenal (HPA) axis through the end‐product cortisol, represents a primary pathway through which maternal experience shapes fetal development with long‐term consequences for child neurodevelopment. However, there is another HPA axis end‐product that has been widely ignored in the study of human pregnancy. The synthesis and release of dehydroepiandosterone (DHEA) is similar to cortisol, so it is a plausible, but neglected, biological signal that may influence fetal neurodevelopment. DHEA also may interact with cortisol to determine developmental outcomes. Surprisingly, there is virtually nothing known about human fetal exposure to prenatal maternal DHEA and offspring neurodevelopment. The current study examined, for the first time, the joint impact of fetal exposure to prenatal maternal DHEA and cortisol on infant emotional reactivity. Methods: Participants were 124 mother–infant dyads. DHEA and cortisol were measured from maternal hair at 15 weeks (early gestation) and 35 weeks (late gestation). Observational assessments of positive and negative emotional reactivity were obtained in the laboratory when the infants were 6 months old. Pearson correlations were used to examine the associations between prenatal maternal cortisol, prenatal maternal DHEA, and infant positive and negative emotional reactivity. Moderation analyses were conducted to investigate whether DHEA might modify the association between cortisol and emotional reactivity. Results: Higher levels of both early and late gestation maternal DHEA were linked to greater infant positive emotional reactivity. Elevated late gestation maternal cortisol was associated with greater negative emotional reactivity. Finally, the association between fetal cortisol exposure and infant emotional reactivity was only observed when DHEA was low. Conclusions: These new observations indicate that DHEA is a potential maternal biological signal involved in prenatal programming. It appears to act both independently and jointly with cortisol to determine a child's emotional reactivity. Its role as a primary end‐product of the HPA axis, coupled with the newly documented associations with prenatal development shown here, strongly calls for the inclusion of DHEA in future investigations of fetal programming. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to develop and validate cutoff values in the systemic Juvenile Arthritis Disease Activity Score 10 (sJADAS10) that distinguish the states of inactive disease (ID), minimal disease activity (MDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with systemic juvenile idiopathic arthritis, based on subjective disease state assessment by the treating pediatric rheumatologist. Methods: The cutoff definition cohort was composed of 400 patients enrolled at 30 pediatric rheumatology centers in 11 countries. Using the subjective physician rating as an external criterion, six methods were applied to identify the cutoffs: mapping, calculation of percentiles of cumulative score distribution, the Youden index, 90% specificity, maximum agreement, and receiver operating characteristic curve analysis. Sixty percent of the patients were assigned to the definition cohort, and 40% were assigned to the validation cohort. Cutoff validation was conducted by assessing discriminative ability. Results: The sJADAS10 cutoffs that separated ID from MDA, MDA from MoDA, and MoDA from HDA were ≤2.9, ≤10, and >20.6, respectively. The cutoffs discriminated strongly among different levels of pain, between patients with and without morning stiffness, and among patients whose parents judged their disease status as remission or persistent activity or flare or were satisfied or not satisfied with current illness outcome. Conclusion: The sJADAS cutoffs revealed good metrologic properties in both definition and validation cohorts and are therefore suitable for use in clinical trials and routine practice. [ABSTRACT FROM AUTHOR]

Objective: Relapses of antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis are important events that can cause organ dysfunction and reduce quality of life. Understanding the effects of the initial treatments for ANCA‐associated vasculitis on the subsequent risk of relapse may help guide monitoring and treatment. Methods: We performed a post hoc analysis of participants with severe ANCA‐associated vasculitis enrolled in an international two‐by‐two factorial randomized controlled trial comparing the effects of plasma exchange (PLEX) to no PLEX and a regimen of reduced glucocorticoid exposure to a standard regimen. We estimated the effects of treatments on relapses of any severity using three competing risk time‐to‐event models adjusted for patient and disease characteristics and other treatments. Each model was adjusted for disease manifestations in different ways. Results: Of 704 participants, 649 (92.2%) achieved remission and 147 (22.7%) experienced 204 relapses. The relapse rate was 10.3 (95% confidence interval [CI] 8.4–12.1) relapses per 100 patient‐years. Neither the use of PLEX (subhazard ratio 0.91–0.94; 95% CIs range from 0.66 to 1.31) nor a glucocorticoid regimen (subhazard ratio 0.93–0.94; 95% CIs range from 0.67 to 1.35) appreciably changed the risk of relapse. Proteinase 3–ANCA and the presence of nonhemorrhagic respiratory manifestations of the disease at trial entry were associated with increased risks of relapse. Receiving dialysis at baseline and administration of oral cyclophosphamide as induction therapy were associated with lower risks of relapse. Conclusion: In patients with severe ANCA‐associated vasculitis, relapses remain common; neither the use of PLEX nor an initial glucocorticoid tapering regimen impacted relapse risk. [ABSTRACT FROM AUTHOR]

Background: Quality of life (QOL) among older adults is a crucial aspect of geriatric care, particularly in the context of global demographic shifts toward ageing societies. Understanding the determinants of QOL in older adults is essential for developing effective interventions to promote well‐being in this population. Methods: This cross‐sectional study conducted in Greece aimed to investigate the complex relationship between depression, frailty, nutritional status, and QOL on 90 older adults (aged ≤65). Assessment instruments including the World Health Organization Quality of Life (WHOQoL)‐BREF questionnaire, Geriatric Depression Scale (GDS), Clinical Frailty Scale (CFS), and Mini Nutritional Assessment (MNA) were utilised to evaluate various dimensions of QOL, depressive symptoms, frailty, and nutritional status. Results: The study revealed significant negative correlations between depression and frailty with all domains of QOL (P < 0.05), indicating that higher levels of depressive symptoms and frailty were associated with lower QOL across physical, psychological, social, and environmental dimensions. Conversely, positive correlations were found between nutritional status and all QOL domains (P < 0.05), suggesting that better nutritional status was linked to higher QOL. Multivariate logistic regression analysis further demonstrated associations between nutritional status and participant characteristics, with females being more likely to be malnourished (odds ratio (OR) = 6.56, P = 0.013), while better health status (OR = 0.34, P = 0.486) and marital status (OR = 0.02, P = 0.019) were protective against malnutrition. Conclusion: These findings underscore the interconnectedness of depression, frailty, and nutritional status in shaping QOL among individuals. Holistic interventions targeting mental health, physical vulnerability, and nutritional well‐being are essential for promoting overall well‐being and functional outcomes in this population. [ABSTRACT FROM AUTHOR]

Summary: Objective: This study identified metabolite modules associated with adiposity and body fat distribution in childhood using gold‐standard measurements. Methods: We used cross‐sectional data from 329 children at mid‐childhood (age 5.3 ± 0.3 years; BMI 15.7 ± 1.5 kg/m2) from the Genetics of Glucose regulation in Gestation and Growth (Gen3G), a prospective pre‐birth cohort. We quantified 1038 plasma metabolites and measured body composition using the gold‐standard dual‐energy x‐ray absorptiometry (DXA), in addition to skinfold, waist circumference, and BMI. We applied weighted‐correlation network analysis to identify a network of highly correlated metabolite modules. Spearman's partial correlations were applied to determine the associations of adiposity with metabolite modules and individual metabolites with false discovery rate (FDR) correction. Results: We identified a 'green' module of 120 metabolites, primarily comprised of lipids (mostly sphingomyelins and phosphatidylcholine), that showed positive correlations (all FDR p < 0.05) with DXA estimates of total and truncal fat (ρadjusted = 0.11–0.19), skinfold measures (ρadjusted = 0.09–0.26), and BMI and waist circumference (ρadjusted = 0.15 and 0.18, respectively). These correlations were similar when stratified by sex. Within this module, sphingomyelin (d18:2/14:0, d18:1/14:1)*, a sphingomyelin sub‐specie that is an important component of cell membranes, showed the strongest associations. Conclusions: A module of metabolites was associated with adiposity measures in childhood. [ABSTRACT FROM AUTHOR]

Objective: To compare the color change, the risk and intensity of tooth sensitivity (TS), and gingival irritation (GI) of at‐home bleaching applied on the buccal surface only or the buccal and lingual surfaces. Materials and Methods: Sixty patients with canines A2 or darker were selected and their superior arches were randomized in two groups: at‐home bleaching on the buccal‐only or on the buccal and lingual surfaces, with 7.5% hydrogen peroxide, for 1 h daily/2 weeks. The color change was evaluated at baseline, 7, 14 days, and 1 month after bleaching using shade guides scales (ΔSGU) and a spectrophotometer (ΔEAB, ΔE00, and ΔWID). Risk and intensity of TS and GI were recorded daily using visual analogic scale (0–10). Patient satisfaction was evaluated with the orofacial esthetics. Paired t‐test, McNemar's, and Wilcoxon signed‐rank test were used for data analysis (α = 5%). Results: Neither the color change nor the risk/intensity of TS was statistically different between groups (p > 0.05). Patient satisfaction increased after bleaching for both groups (p < 0.05). Conclusion: The addition of one contact surface does not result in an increased whitening degree compared to bleaching applied solely on the buccal surface. Clinical Significance: Understanding the influence of surfaces interacting with the bleaching agent is crucial for comprehending the bleaching mechanism and avoiding unnecessary material expenses. Notably, employing the buccal‐only technique is sufficient to achieve the desired efficacy. [ABSTRACT FROM AUTHOR]

In our mobile working world, boundaries between work and non‐work domains are more and more blurred, which can impair professionals' recovery and well‐being. Consequently, managing work–non‐work boundaries represents an important challenge for professionals. Research suggests that boundary work tactics conveyed in boundary management interventions may promote recovery and well‐being. However, the efficacy of boundary work tactics is largely unknown, as well as theoretical mechanisms that may explain the effectiveness of boundary management interventions in regard of both training design and training transfer. Building on the social cognitive theory of self‐regulation, we develop a web‐based boundary management training. Based on the integrated training transfer and effectiveness model, we evaluate its effects on the three levels of training effectiveness: (1) perceived learning, (2) cognitions and behaviours, with boundary control and boundary creation as indicators, and (3) recovery and well‐being. Results of our randomized controlled intervention study show several expected changes in boundary creation, suggesting that drawing on the social cognitive theory of self‐regulation for training design can result in effective behaviour change. Intervention effects on recovery and well‐being are more ambiguous, hinting at the power but likewise potential limitations of boundary creation. [ABSTRACT FROM AUTHOR]

We examined how potential job candidates react to a hiring organization that requests diversity, equity and inclusion (DEI) statements, which conservatives in the United States and elsewhere have criticized as being unrelated to job function and inappropriately political or ideological. Across three studies (two of which were pre‐registered), we compared reactions to requests for DEI (vs. teamwork or conservative values) statements as a function of race (Black vs. White), political conservatism and symbolic racism (Total N = 1108). When a DEI (vs. teamwork or politically conservative values) statement was requested, participants who were more (vs. less) conservative perceived the organization as less just, expressed less interest in the job, and expected poorer person‐organization fit, even when a job‐related rationale was provided. Further, participants who were more (vs. less) conservative evaluated a request for a statement consistent with conservative values more favourably. Thus, criticisms that DEI statements are overly political are not applied to other statements that might elicit similar concerns. Moreover, an internal meta‐analysis suggested that the relationships of conservatism to justice and interest (but not person‐organization fit) in response to requests for DEI (vs. teamwork) statements were not independent of racism. Findings were consistent with social dominance theory; racism may underlie seemingly race‐neutral backlash to DEI statements. [ABSTRACT FROM AUTHOR]

Background: Physical restraint of patients in intensive care units (ICUs) has an estimated prevalence of 50%. Many medical centres do not have specific protocols for physical restraint, and the decision of whether to physically restrain a patient is up to the nursing staff. Disadvantages of physical restraint include injuries, exacerbation of agitation and an increased risk of developing post‐traumatic stress disorder (PTSD). Aim: To report prevalence and outcomes in terms of morbidity and mortality of physical restraint in general ICU patients in an 800‐bed secondary medical centre. Study Design: This retrospective study included 647 patients admitted to a general ICU in an 800‐bed secondary medical centre in Kfar Saba, Israel, between January and December 2020. Data included demographics, medical history, length of stay, need for mechanical ventilation, number of ventilation days, 28‐day mortality, reason for admission, agitation rate assessed by Richmond Agitation and Sedation Scale (RASS) score, need for physical restraint and need for anti‐psychotics. Results: Among the patients, 40% (256 of 647) required physical restraint. Older adult patients had a greater likelihood of being physically restrained along with those admitted because of sepsis or acute respiratory failure. Among the study sample, 11% (71 of 647) required anti‐psychotics. Patients who were restrained had longer duration of ventilation (5.9 ± 8.2 vs. 0.36 ± 1.4 days; p <.001) and higher 28‐day mortality (0.26 ± 0.45 vs. 0.07 ± 0.25, Z = 6.86, p <.001). There was no difference in medical history, except for chronic drug abuse, which was more frequent in the restraint group (18 [6.9%] vs. 11 [2.8%], respectively; p =.019), as well as the use of anti‐psychotic medications (24 [9.3%] vs. 19 [4.8%], respectively; p =.034) and anti‐depressants (55 [21.2%] vs. 59 [14.8%], respectively; p =.042). The restraint group had higher disease severity scores, as reflected in requirements for vasopressor support (174 [67.2%] vs. 69 [17.3%], respectively; p <.001) and need for dialysis (39 [15.1%] vs. 19 [4.8%], respectively; p <.001); higher frequency of in‐hospital anti‐psychotic treatment (60 [23.2%] vs. 11 [2.8%], respectively; p <.001); a greater tendency for agitation events and more severe agitation scores (episodes of RASS above zero [1.7 ± 4.0 vs. 0.04 ± 0.27, respectively; p <.001] and maximum RASS score [0.19 ± 1.6 vs. 0.01 ± 0.54, respectively; p <.001]). Overall, advanced age, number of ventilation days and need for dialysis were associated with increased 28‐day mortality. In the restraint group, advanced age, chronic use of diuretics and the use of dialysis during ICU admission were associated with increased mortality risk. Conclusions: Restrained patients tended to have higher morbidity and mortality during ICU and hospital stays, as well as a greater tendency for agitation events and more severe agitation scores, with an increased need for in‐hospital anti‐psychotic treatment. These findings regarding patient characteristics might be used to formulate treatment plans to reduce the rate of physical restraint in the ICU. Relevance to Clinical Practice: Because restrained ICU patients tend to have higher morbidity and mortality, treatment plans should be formulated to reduce the rate of physical restraint in the ICU. Clinical trial registration: NCT04771793. [ABSTRACT FROM AUTHOR]

Background: Preoperative nursing care affects many factors such as reducing the length of hospital stay of the patients in the perioperative period, the rate of postoperative complications, the duration of the operation, decrease of postoperative pain level and early mobilization. Aim: We aimed to determine the effect of preoperative evidence‐based care education that given to cardiac surgery clinical nurses on the postoperative recovery of patients. Study Design: The research was planned as quasi‐experimental. Eighty‐six patients who underwent cardiovascular surgery were divided into control and intervention groups. First, the ongoing preoperative care practices and patient recovery outcomes of the clinic were recorded for the control group data. Second, education was provided for the clinical nurses about the preoperative evidence‐based care list, and a pilot application was implemented. Finally, the evidence‐based care list was applied by the nurses to the intervention group, and its effects on patient outcomes were evaluated. The data were collected using the preoperative evidence‐based care list, descriptive information form, intraoperative information form and postoperative patient evaluation form. Results: The evidence‐based care list was applied to the patients in the intervention group, with 100% adherence by the nurses. All pain level measurements in the intervention group were significantly lower in all measurements (p =.00). The body temperature measurements (two measurements) of the intervention group were higher (p =.00). The postoperative hospital stays of the control group and the intervention group were 11.21 ± 8.41 and 9.50 ± 3.61 days. Conclusion: The presented preoperative evidence‐based care list can be used safely in nursing practices for patients. It provides effective normothermia, reduces the level of pain, shortens the hospital stay and reduces the number of postoperative complications. Relevance to Clinical Practice: By applying a preoperative evidence‐based care to patients undergoing cardiac surgery, pain levels, hospital stays and the number of complications decrease, and it is possible to maintain normothermia. An evidence‐based care can be used to ensure rapid postoperative recovery for patients undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]

Background: Pneumonia has a high incidence in traumatic brain injury (TBI) patients and lacks effective treatments. Early mobilization (EM) may be a potentially effective treatment. Aim: To explore the impact of EM on TBI‐related pneumonia in the neurosurgical intensive care unit (NICU). Study Design: This study was a historical control study. 100 TBI patients who received EM intervention were prospectively included as the experimental group (EM cohort), and 250 TBI patients were retrospectively included as the control group. The propensity score matching (PSM) method was employed to balance baseline and minimize potential bias. The relationship between EM and TBI‐related pneumonia was investigated by univariate and multivariate logistic regression, then further determined by subgroup analysis. The influence of other variables was excluded by interaction analyses. Finally, the effect of EM on the prognosis of TBI patients was analysed by comparing the Glasgow Coma Scale (GCS) and the hospital stay. Results: After screening, 86 patients were included in the EM cohort and 199 patients were included in the control cohort. There were obvious differences between the two cohorts at baseline, and these differences were eliminated after PSM, when the incidence of pneumonia was significantly lower in the EM cohort than in the control cohort (35.0% vs. 61.9%, p <.001). Multivariate logistic regression showed that EM was an independent risk factor for TBI‐related pneumonia and was significantly associated with a decreased incidence of pneumonia. This correlation was present in most subgroups and was not affected by other variables (p for interaction >.05). Patients in the EM cohort had shorter length of ICU stay (6 vs. 7 days, p =.017) and higher GCS at discharge (12 vs. 11, p =.010). Conclusion: EM is a safe and effective treatment for TBI patients in NICU, which can reduce the incidence of pneumonia, help to improve prognosis and shorten the length of ICU stay. Relevance to Clinical Practice: Although the utilization rate of EM is low in TBI patients for various reasons, EM is still an effective method to prevent complications. Our study confirms that a scientific and detailed EM strategy can effectively reduce the incidence of pneumonia while ensuring the safety of TBI patients, which is worthy of further research and clinical application. [ABSTRACT FROM AUTHOR]

Background: Delirium commonly occurs in paediatric patients with acute critical illness and negatively affects clinical outcomes. Variations in delirium knowledge levels and its management have been noted among nurses. Aims: This study investigated nurses' experiences and knowledge levels regarding paediatric delirium. Additionally, we aimed to assess the gap between knowledge levels and practical experiences with paediatric delirium. Study Design: This cross‐sectional descriptive study conveniently sampled paediatric nurses from a university hospital in South Korea between September 2022 and March 2023. Nursing experiences with paediatric delirium and delirium knowledge levels were measured using structured survey questionnaires. Delirium knowledge was scored 0 to 47, and higher scores indicated higher levels of delirium‐related knowledge. Data were analysed using descriptive statistics and presented as mean, standard deviation, frequency and percentage. Results: A total of 127 paediatric nurses participated in this study; 40.2% had experience with 1–5 delirium cases in the previous year, and 86.6% (n = 110) had never used assessment tools for paediatric delirium assessment. The mean total delirium knowledge score was 34.45 ± 5.4; the mean scores of knowledge regarding aetiology, signs and symptoms and nursing management of delirium were 8.93 ± 1.31, 13.24 ± 2.81 and 12.3 ± 2.7, respectively. Interventions associated with a lower level of delirium‐related knowledge and a lower performance rate included avoiding restraint use and maintaining hydration and electrolyte levels. Interventions associated with a higher level of delirium‐related knowledge but a lower rate of performance comprised providing orientation, offering emotional support, allowing participants to stay with family members and administering medications to manage delirium. Conclusions: Although nurses working in paediatric units exhibited high rate of delirium nursing care, there was the gap between their delirium‐related knowledge and practice. Nurses need to be aware of the insufficient part of delirium care, and paediatric delirium education should be reinforced. Relevance to Clinical Practice: Preventing, assessing and systematically managing paediatric delirium is crucial, and considering the study results, delirium education among nurses is needed. [ABSTRACT FROM AUTHOR]

Background: Physical restraint is applied in pediatric intensive care units to carry out certain painful procedures and to ensure the maintenance and continuity of life support devices. There is a need to analyse the factors that influence the behaviour or intention to use physical restraint. Aim: To create and test psychometrically a paediatric version of the Physical Restraint‐Theory of Planned Behaviour Questionnaire to assess paediatric critical care nurses' intention to use physical restraint. Study Design: A psychometric study. Five medical‐surgical Paeditric Intensive care Units from five hospitals in Spain. The study took place in three phases. In phase 1, the questionnaire was adapted. In phase 2, the content validity of each item was determined, and a pilot test was conducted. In phase 3, we administered the questionnaire and determined its psychometric properties. Results: The assessment of the intention to use physical restraint was extended to all critical paediatric patients, two items were eliminated from the initial questionnaire, four new items were included, and the clinical scenarios of the intention subscale were expanded from three to six. Overall content validity index for the full instrument of 0.96 out of 1. The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is made up of four subscales (attitude, subjective norms (SN), perceived behavioural control (PBC), and intention) subdivided into 7 factors and 51 items. The internal consistency for the attitude subscale obtained a Cronbach's Alpha of 0.80 to 0.73, for the SN it was 0.72 to 0.89, for the PBC it was from 0.80 to 0.73 and for the intention subscale it was 0.75. Conclusions: The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is an instrument composed of seven factors and 51 items that validly and reliably assesses the intention of paediatric nurses to apply PR in PICUs. Relevance for Clinical Practice: Having this instrument will help health centres move towards restraint‐free care by allowing managers to assess professionals' attitudes, beliefs, and intentions around the use of PR in PICUs. [ABSTRACT FROM AUTHOR]

Background: Electrocardiographic (ECG) monitoring and recording are seen as the most commonly used non‐invasive diagnostic tool to identify cardiac arrhythmia and myocardial damage in the clinical setting. There is an expectation that critical care nurses are ideally trained to interpret abnormalities and morphology in the ECG more proficiently than nurses from general ward areas. However, the ability to interpret and recognise ECG abnormalities is dependent on which critical care area nurses are currently working in and their level of experience. Aim: The aim of this study was to investigate registered nurses' knowledge in being able to identify and interpret select electrocardiographic rhythms. Study Design: This was a cross‐sectional study that evaluated registered nurses' knowledge of electrocardiogram rhythm identification and interpretation. A convenience sample of 105 registered nurses currently enrolled in a 2‐year Master's programme leading to critical care specialism and advanced practice nurse award were recruited. A 20‐item multiple choice questionnaire that provided examples of electrocardiogram rhythm (n=14) abnormalities and rhythm abnormalities caused by electrolyte disturbances (n=6) Results: The study included registered nurses from critical care and general ward areas. The overall results were poor with only 55% of questions answered correctly. Coronary care nurses scored the highest in identifying ECG rhythms (12/20 ± 1.58; p <.001). When ECG abnormalities associated with electrolyte imbalances were analysed, both groups were unable to identify the effects of hypokalaemia and hypomagnesaemia effectively (p =.748). Length of time as a registered nurse (r = −0.304, p =.002) and length of time in current work environment were weakly correlated (r = −0.328, p =.001). Having a critical care background showed a positive relationship with nursing knowledge of ECG rhythm identification (r = 0.614, p <.001). Conclusion: The results of this study demonstrate that nurses have a poor knowledge of ECG rhythm identification and interpretation, a consistent finding from other work. A possible solution is a revamp of education and training associated with ECG recognition and morphology. Relevance to Clinical Practice: Monitoring and assessing ECG morphology provide important details about cardio‐electroconductive stability, especially with fluctuations in serum electrolyte levels seen in critical illness or trauma. For this, critical nurses must improve their proficiency through education/training or internal quality improvement activities in detecting abnormalities associated with ECG changes beyond those most easily recognizable rhythms such as atrial fibrillation or ventricular tachycardia. [ABSTRACT FROM AUTHOR]

Background: Physical restraint is frequently used in intensive care units to prevent patients' life‐threatening removal of indwelling devices. In France, their use is poorly studied. Therefore, to evaluate the need for physical restraint, we have designed and implemented a decision support tool. Aims: Besides describing the prevalence of physical restraint use, this study aimed to assess whether the implementation of a nursing decision support tool had an impact on restraint use and to identify the factors associated with this use. Study Design: A large observational, multicentre study with a repeated one‐day point prevalence design was conducted. All adult patients hospitalized in intensive care units were eligible for this study. Two study periods were planned: before (control period) and after (intervention period) the deployment of the decision support tool and staff training. A multilevel model was performed to consider the centre effect. Results: During the control period, 786 patients were included, and 510 were in the intervention period. The prevalence of physical restraint was 28% (95% CI: 25.1%–31.4%) and 25% (95% CI: 21.5%–29.1%) respectively (χ2 = 1.35; p =.24). Restraint was applied by the nurse and/or nurse assistant in 96% of cases in both periods, mainly to wrists (89% vs. 83%, p =.14). The patient‐to‐nurse ratio was significantly lower in the intervention period (1:3.0 ± 1 vs. 1:2.7 ± 0.7, p <.001). In multivariable analysis, mechanical ventilation was associated with physical restraint (aOR [95% CI] = 6.0 [3.5–10.2]). Conclusion: The prevalence of physical restraint use in France was lower than expected. In our study, the decision support tool did not substantially impact physical restraint use. Hence, the decision support tool would deserve to be assessed in a randomized controlled trial. Relevance to Clinical Practice: The decision to physically restrain a patient could be protocolised and managed by critical care nurses. A regular evaluation of the level of sedation could allow the most deeply sedated patients to be exempted from physical restraint. [ABSTRACT FROM AUTHOR]