bluuebunny/crossref_metadata_2025 huggingface dataset:
Using in silico viral kinetic models to guide therapeutic strategies during a pandemic: An example in SARS‐CoV‐2
Authors: Patel Kashyap , Dodds Michael , Gonçalves Antonio , Kamal Mohamed A. , Rayner Craig R. , Kirkpatrick Carl M. , Smith Patrick F.
Published: December 2020

Aims

We propose the use of in silico mathematical models to provide insights that optimize therapeutic interventions designed to effectively treat respiratory infection during a pandemic. A modelling and simulation framework is provided using SARS‐CoV‐2 as an example, considering applications for both treatment and prophylaxis.

Methods

A target cell‐limited model was used to quantify the viral infection dynamics of SARS‐CoV‐2 in a pooled population of 105 infected patients. Parameter estimates from the resulting model were used to simulate and compare the impact of various interventions against meaningful viral load endpoints.

Results

Robust parameter estimates were obtained for the basic reproduction number, viral release rate and infected‐cell mortality from the infection model. These estimates were informed by the largest dataset currently available for SARS‐CoV‐2 viral time course. The utility of this model was demonstrated using simulations, which hypothetically introduced inhibitory or stimulatory drug mechanisms at various target sites within the viral life‐cycle. We show that early intervention is crucial to achieving therapeutic benefit when monotherapy is administered. In contrast, combination regimens of two or three drugs may provide improved outcomes if treatment is initiated late. The latter is relevant to SARS‐CoV‐2, where the period between infection and symptom onset is relatively long.

Conclusions

The use of in silico models can provide viral load predictions that can rationalize therapeutic strategies against an emerging viral pathogen.
Population pharmacokinetics of ganciclovir and valganciclovir in paediatric solid organ and stem cell transplant recipients
Authors: Franck Bénédicte , Woillard Jean‐Baptiste , Théorêt Yves , Bittencourt Henrique , Demers Emile , Briand Annabelle , Marquet Pierre , Lapeyraque Anne‐Laure , Ovetchkine Philippe , Autmizguine Julie
Published: December 2020

Aims

Ganciclovir (GCV) and its prodrug valganciclovir (VGCV) are first‐line agents to prevent and treat cytomegalovirus in transplant recipients. There is high pharmacokinetic (PK) interindividual variability and PK data are scarce, especially in paediatric stem cell transplant (SCT) recipients. We sought to determine the optimal GCV and VGCV dosing in transplanted children.

Methods

We conducted a single‐centre retrospective population PK (POPPK) study of IV GCV and enteral VGCV in paediatric solid organ transplant (SOT) and SCT recipients. We included children who were transplanted and had available plasma GCV concentrations, done per standard of care. POPPK analysis was performed using a nonlinear mixed effects modelling approach with NONMEM. Optimal dosing was determined based on the achievement of the surrogate efficacy target: GCV 24 h area under the concentration–time curve (AUC0‐24h) of 40–60 mg.h.L−1.

Results

Fifty children with a median [range] age of 7.5 years [0.5–17.4] contributed 580 PK samples. A two‐compartment model with first‐order absorption with a lag time and first‐order elimination fit the data well. Creatinine clearance and body weight (WT) were significant covariates for GCV clearance (CL); and WT for the volumes of distribution. IV GCV 15–20 mg.kg−1.day−1 divided every 12 hours achieved the highest probability of target achievement (PTA) (33.0–33.8%). Enteral VGCV 30 and 40 mg.kg−1.day−1 divided every 12 hours in children 0–<6 years, and 6–18 years, respectively, achieved the highest PTA (29.1–33.0%).

Conclusion

This is the first POPPK model developed in children with either SOT or SCT. Concentration target achievement was low, suggesting a potential benefit for therapeutic drug monitoring to ensure optimal exposure.
Validating a blended teaching readiness instrument for primary/secondary preservice teachers
Authors: Archibald Douglas E. , Graham Charles R. , Larsen Ross
Published: December 2020

Blended learning is the fastest growing teaching modality in North America and much of the world. However, research and training in blended learning are far outpaced by its usage. To remedy this gap, we developed a competency framework and Blended Teaching Readiness Instrument (BTRI) to help teachers and researchers evaluate teacher readiness for blended environments. The purpose of this research is to show that the blended teaching readiness model and accompanying BTRI are reliable for use with teacher candidates both before and after going through a blended teaching course. This knowledge would allow researchers and practitioners to have greater confidence in using the BTRI for future growth curve modeling for the identified blended teaching competencies. To accomplish this, we collected pre‐ and post‐data from teacher candidates across multiple semesters who were studying in a blended teaching course. Using confirmatory factor analysis, we determined the pre‐class survey results fell within the range of the four fit statistics cutoffs (RMSEA = 0.045, CFI = 0.933, TLI = 0.929 and SRMR = 0.043). And, the post‐class survey results had good fit as well (RMSEA = 0.044, CFI = 0.911, TLI = 0.905 and SRMR = 0.051). We also showed that the factor loadings and communalities were statistically significant. By testing the factors in this way, we make a case for the survey to be a valid and reliable instrument in assessing blended teacher competency. Additionally, we tested the model for measurement invariance and found that we could reliably use the BTRI for pre‐post growth modeling.

Practitioner Notes

What is already known about this topic?

Blended learning is the fastest growing teaching modality in Canada and the United States, and is expanding rapidly throughout the rest of the world.

Teaching in blended learning settings requires distinct skills and dispositions specific to the modality.

A blended‐teaching‐focused competency framework is a necessary element in any blended teacher preparation program. Though there have been attempts to make a blended teaching framework before, none of these exclusively focus on the distinct skills of blended teaching nor have they been validated.

What this paper adds?

Describes our free, publicly accessible competency framework that focuses exclusively on blended teaching

Validates a concise Blended Teaching Readiness Instrument (BTRI) to go along with the framework.

Confirms pre‐post measurement invariance for the BTRI which allows for use with pre‐post growth modeling.

Implications for practice and policy

The competency framework and validation are a theoretical contribution to the rapidly expanding field of blended learning research.

With the valid BTRI instrument and framework, teachers can get feedback on their strengths and weaknesses in blended teaching and learn how to improve and help others.
Pathological evaluation of tumor grade for salivary adenoid cystic carcinoma: A proposal of an objective grading system
Authors: Morita Naruhiko , Murase Takayuki , Ueda Kaori , Nagao Toshitaka , Kusafuka Kimihide , Nakaguro Masato , Urano Makoto , Taguchi Ken‐ichi , Yamamoto Hidetaka , Kano Satoshi , Tada Yuichiro , Tsukahara Kiyoaki , Okami Kenji , Onitsuka Tetsuro , Fujimoto Yasushi , Kawakita Daisuke , Sakurai Kazuo , Nagao Toru , Hanai Nobuhiro , Kawata Ryo , Hato Naohito , Otsuki Naoki , Nibu Ken‐ichi , Inagaki Hiroshi
Published: December 2020

Three pathological grading systems advocated by Perzin/Szanto, Spiro, and van Weert are currently used for adenoid cystic carcinoma (AdCC). In these systems, the amount or presence of the solid tumor component in AdCC specimens is an important index. However, the “solid tumor component” has not been well defined. Salivary AdCC cases (N = 195) were collected after a central pathology review. We introduced a novel criterion for solid tumor component, minAmax (minor axis maximum). The largest solid tumor nest in each AdCC case was histologically screened, the maximum oval fitting the solid nest was estimated, and the length of the minor axis of the oval (minAmax) was measured. The prognostic cutoff for the minAmax was determined using training and validation cohorts. All cases were evaluated for the four grading systems, and their prognostic impact and interobserver variability were examined. The cutoff value for the minAmax was set at 0.20 mm. Multivariate prognostic analyses showed the minAmax and van Weert systems to be independent prognostic tools for overall, disease‐free, and distant metastasis‐free survival while the Perzin/Szanto and Spiro systems were selected for overall survival but not for disease‐free or distant metastasis‐free survival. The highest hazard ratio for overall survival (11.9) was obtained with the minAmax system. The reproducibility of the minAmax system (kappa coefficient of 0.81) was scored as very good while those of the other three systems were scored as moderate. In conclusion, the minAmax is a simple, objective, and highly reproducible grading system useful for prognostic stratification for salivary AdCC.
Regulating the traditional kinship care practice in Ghana: Reflections from young people with kinship care experience
Authors: Abdullah Alhassan , Cudjoe Ebenezer , Young Susan , Choi Anna W.M. , Jordan Lucy P. , Chiu Marcus Y.L. , Emery Clifton R.
Published: December 2020

Background

Kinship care has become a favourable alternative care option for orphans and vulnerable children without adequate parental care in Ghana. However, kinship care practices in Ghana are considered informal cultural practices without formal regulations. The absence of formal regulations could have consequences on the health and development of children due to the lack of proper supervision and empirical assessment of children's needs. In line with recent policy discussions on mechanisms to regulate informal kinship care practices, this study aimed to identify how the State could be involved in improving kinship care experience for children.

Methods

Qualitative in‐depth interviews were conducted with 22 young persons (aged 18–23) who had been received into kinship care to share their experiences on how the State could be involved in improving kinship care experience for children. Narratives from the young people were analysed following the constructivist grounded theory approach.

Results

Introduction of a welfare scheme for kinship caregivers, policy on child care, provision of start‐up capital and training for caregivers, were measures suggested by the young people to improve kinship care practice. Providing start‐up capital to kinship caregivers was identified to mitigate caregivers' unemployment challenges, which could have ripple effects on the well‐being of children by escalating caregiver stress.

Conclusion

The study's findings suggest that the State has a significant role to ensure that caregivers are equipped with the needed resources to provide adequate care for children. Regulating kinship care practices should embrace a strength‐based empowerment model that builds on the capacity of the caregivers to ensure better outcomes for children. Studies that explore the views of policy makers and caregivers in a larger sample may yield promising results to complement the current findings.
Home environment: Short‐term trends and predictors in early childhood from an Indian community birth cohort
Authors: Koshy Beena , Karthikeyan Arun , Bose Anuradha , Roshan Reeba , Ramanujam Karthikeyan , Mohan Venkata Raghava , John Sushil , Kang Gagandeep
Published: December 2020

Background

Early childhood home environment is intricately linked to child development and later cognitive and academic skills. There is limited literature evaluating home environmental trends and predictors in the low‐ and middle‐income country settings.

Aims

Determine the trends of early childhood home environment changes between 6 and 36 months of age, and the factors associated with these changes.

Study design

Longitudinal community‐based birth cohort follow‐up study in a semi‐urban slum in Vellore, South India.

Subjects

Consecutive sampling of a birth cohort between March 2010 and February 2012.

Outcome measures

Home environment was objectively assessed using the ‘Home Observation for the Measurement of the Environment’ (HOME) scale. Predictors of change in the home environment over time also were analyzed. Multivariable linear regression models and linear mixed effect models were used to identify the factors associated with HOME score at individual time points and over‐a‐time period, respectively.

Results

The birth cohort enrolled 251 children with a follow‐up of 235, 228 and 218 children at 6, 24 and 36 months, respectively. The socio‐economic status (SES) was the single biggest predictor for the HOME score at each time point, with increasing strength over time. Maternal education predicted home environment at 24 months, while maternal depression was negatively associated at 6 and 24 months of age. SES and maternal factors contributed to the overall change in the HOME score. Maternal factors predicted relational home environmental change over time.

Conclusion

SES and maternal factors consistently predicted early childhood home environment at 6, 24 and 36 months of age and its change over time. It is important to support maternal education and wellbeing along with socio‐economic measures to optimize early childhood environment.
Identification of the laterality of motor unit behavior in female patients with parkinson's disease using high‐density surface electromyography
Authors: Nishikawa Yuichi , Watanabe Kohei , Holobar Aleš , Maeda Noriaki , Maruyama Hirofumi , Tanaka Shinobu
Published: December 2020

Patients with Parkinson's disease (PD) have greater laterality of muscle contraction properties than other people with parkinsonism diseases. However, few studies have reported the laterality of MU activation properties of the lower extremity muscles in patients with PD. The aim of the present study was to identify the laterality of MU behavior in PD patients using high‐density surface electromyography (HD‐SEMG). Eleven female patients with PD (age, 69.2 ± 6.2 years, disease duration, 2.7 ± 0.9 years, Unified Parkinson's disease Rating Scale score, 13 (9–16)), and 9 control female subjects (age, 66.8 ± 3.5 years) were enrolled in the present study. All subjects performed a sustained isometric knee extension in a 30% maximal voluntary contraction (MVC) task for 20 s. HD‐SEMG signals were used to record and extract single MU firing behavior in the vastus lateralis muscle during submaximal isometric knee extensor contractions with 64 electrodes and decomposed with the convolution kernel compensation technique to extract individuals MUs. Compared to the control subjects, the patients with PD exhibited laterality of the MU firing rate and an absence of a relationship between the mean MU firing rate and MU threshold. Patients with PD exhibit laterality of MU behavior and experience MU behavioral abnormalities even with mild symptoms such as Hoehn & Yahr stage ≤ 3 and disease duration = 2.7 ± 0.9. These findings suggest the importance of considering the detection of abnormal muscle properties in PD patients beginning in the early phase of the disease.
Buddy Watch: Care and Constraint Under the Watchful Eye of Military Suicide Risk Management in War
Authors: Lim Chua Jocelyn
Published: December 2020

Officially referred to as “unit watch” and more colloquially as “buddy watch,” the use of continuous direct observation and restrictive measures enforced by peers is a widely used, though controversial, tool in the US Army's suicide prevention efforts. Borrowing from the Army concept and system of the battle buddy, the partnering of soldiers who assist each other in and out of combat, the unit watch is simultaneously conceived as a means of “family” concern, treatment, surveillance, restraint, and even mentorship. Drawing on fieldwork among soldiers and veterans of the Iraq and Afghanistan wars, I explore what the practice of unit watch reveals about institutional and psychiatric interventions as a form of constraint‐as‐care in settings of global US military power. I emphasize the bodily and affective dimensions of the unit watch and the forms of sociality, including coerced obligation and forced intimacy, that the unit watch can produce. Soldiers’ accounts of being watched and watching others under the sign of unauthorized violence also highlight the tense and ambivalent nature of managing suicide in material, institutional, and geopolitical settings organized for the production of violence.
Export trade and smog pollution: Empirical evidence from China
Authors: Bai Junhong , Yu Xuewei
Published: December 2020

This paper examines the impact of China's export trade on smog pollution. Based on provincial panel data from 2006 to 2016 in China, we use spatial econometric methods to empirically investigate the smog pollution effects of China's export trade from two dimensions, export scale and export structure. It has been found that smog pollution in various regions of China has obvious spatial correlation; China's export trade has a significant positive impact on smog pollution, whether in terms of export scale or export structure. After establishing different forms of spatial weight matrices and considering alternative indicators of smog pollution, the results of this paper are still robust.
Prescribing practices of migraine‐specific pharmacotherapy associated with emergency department use for migraine
Authors: Cheng Vivian , Billups Sarah J. , Saseen Joseph J.
Published: December 2020

Objective

This study compared migraine medication prescribing between patients with a migraine diagnosis who used versus did not use the emergency department (ED) for migraine.

Background

Headache is the fifth most common chief complaint for ED visits nationwide and the third most common potentially avoidable ED diagnosis in the University of Colorado Health system. The reasons some patients use the ED for migraine management while others do not and whether some ED admissions might be preventable remain unclear.

Methods

This retrospective cohort study identified adults with migraine‐related diagnoses within 1 year before the index date of July 1, 2018 and compared patient characteristics and migraine medication prescribing patterns between those who did or did not have a subsequent migraine‐related ED encounter the following year. ED admission notes were manually reviewed to identify potentially preventable circumstances that led to the ED visit. The primary outcome was the proportion of patients with an active triptan prescription at the index date.

Results

Of the 3843 patients identified, 35 patients (0.9%) had a migraine‐related ED encounter. Of these, 17/35 (49%) had an active triptan prescription compared to 1360/3808 (36%) of non‐ED utilizers (p = 0.114), OR 1.22 (95% CI 0.61–2.45). More ED utilizers had an active prescription for opioids (11/35 [31%] vs. 663/3808 [17%], p = 0.030) and migraine preventive therapy (19/35 [54%] vs. 1149/3808 [30%], p = 0.002), and neurology referrals (20/35 [57%] vs. 654/3808 [17%], p < 0.001) compared to non‐ED utilizers. The most common circumstance for migraine‐related ED visits was nonresponse to migraine abortive medications administered at home.

Conclusions

Triptan prescribing did not differ between ED utilizers and non‐ED utilizers for migraine. Overall, less than half of the total patient population had a triptan prescribed. More ED utilizers had neurology referrals, prescriptions for opioids and preventive therapies, and a history of previous ED visit for any reason, which may be markers for higher disease severity or behavior patterns. Future research and interventions to reduce migraine‐related ED use could target high‐risk patients such as those with previous ED visits for any indication and neurology referrals.
Improving waterbird monitoring and conservation in the Sahel using remote sensing: a case study with the International Waterbird Census in Sudan
Authors: Suet Marie , Lozano‐Arango Juan Guillermo , Defos Du Rau Pierre , Deschamps ClÉmence , Abdalgader Mohammed Mohammed Adam , Elbashary Adam Elfirdous , Mohammed Eldegair Eltayeb , Ali Elbadawi Mohamed Elmekki , Mohammed Hashim Ibrahim , Kirrem Kpoore Noman , Mohammed Mohammed Adam , Mohammed Ibrahim Bihery Manal , Adam Mutassim Essa Abdallah , Pineau Olivier , Mondain‐Monval Jean‐Yves
Published: December 2020

In several regions of the world, the remoteness of potential bird hotspots and lack of trained observers have often prevented countries from effectively designing proper monitoring schemes at a national scale. For many countries, it is not known whether certain bird strongholds have been missed that should be included for more complete censuses. Such gaps at national scales, sometimes large, may be detrimental for global monitoring schemes. To address this, we used the irregular participation of Sudan to the International Waterbird Census (IWC) as a case study. We designed and tested a method based on remote‐sensing data of the country’s lowlands to detect open water bodies in order to develop predictive models of the potential distribution of waterbird abundance and diversity. To identify open water bodies and their flooding duration, we used a Modified Normalized Difference Water Index (MNDWI) derived from Landsat 8 data. Field ornithological surveys were then used as ground‐truth data to estimate the method’s accuracy. The statistical results (overall accuracy = 0.972; Kappa index = 0.93) confirmed its effectiveness. Remotely sensed water bodies and additional environmental covariates were then used to build simple habitat models of the distribution of waterbird abundance and diversity based on IWC field survey data. Of the 3119 remotely sensed clusters of open water bodies, three were predicted to host more than 10 000 waterbirds, 89 more than 1000 waterbirds and five more than 30 waterbird species. Located mainly in the southern agricultural floodplains along the main rivers, these predicted waterbird strongholds are therefore recommended for inclusion in the next IWC survey in Sudan. Our findings indicate that using remote sensing to identify open water bodies combined with simple statistical modelling is likely to be a cost‐effective solution to improve IWC sampling and to enhance both waterbird and wetland monitoring in vast under‐surveyed regions.
Evidence of incubation trade‐offs in Leach's Storm‐Petrel (Oceanodroma leucorhoa): ptilochronology as a measure of reproductive investment in a long‐lived seabird
Authors: Elliott Lisa H. , Grady Jennifer , Cerchiara Jack , Haussmann Mark F. , Mauck Robert A.
Published: December 2020

Avian incubation investment represents a trade‐off between the energetic demands of the parent and the thermal needs of the embryo. Parental energy balance and investment in somatic maintenance relative to incubation investment can be indexed by the rate of feather growth. Feather growth rates, or ptilochronology, of adult Leach's Storm‐PetrelsOceanodroma leucorhoawere used to assess parental investment to (1) determine whether individuals that invest heavily in current reproduction pay a cost for future reproduction as indicated by a cost for somatic maintenance and (2) assess whether this trade‐off is detected using ptilochronology, which may be a more direct measure of reproductive investment compared with body mass in seabirds. We found positive relationships between duration of the incubation period and both egg neglect and a mated pair's mean rate of induced feather growth, although we did not find a relationship between either egg neglect and feather growth or hatching success and feather growth. Our results suggest that during the incubation period a trade‐off exists between energy allocated to self‐maintenance and reproduction in this species, although egg neglect does not appear to be the mechanism that extends the incubation period in response to increased energetic demands of somatic maintenance. The lack of correlation between feather growth and egg neglect further suggests that some pairs may be better able to manage competing demands of self‐maintenance and incubation, possibly due to individual quality, coordination of incubation effort, burrow quality or some other factor.
Yearly temperature fluctuations and survey speed influence road counts of wintering raptors
Authors: McClure Christopher J. W. , Rolek Brian W. , Grove Gregory W. , Katzner Todd E.
Published: December 2020

Globally, evaluation of population trends is the most pressing research need for many species of conservation concern. Road counts for birds of prey are useful for monitoring long‐term population trends and examining year‐to‐year variations in abundance. We examined data from 2155 road surveys conducted from 2001 to 2018 by community scientists who recorded > 85 000 individuals of 14 species of raptors while participating in the Pennsylvania Winter Raptor Survey, in Pennsylvania, USA. We estimated abundance and population growth rates while accounting for observation error by using dynamic Bayesian state‐space models. Model estimates indicated that counts of wintering Bald EaglesHaliaeetus leucocephalus,Red‐shouldered HawksButeo lineatusand Black VultureCoragyps atratusincreased over the course of the study. Counts of Rough‐legged BuzzardButeo lagopus, Red‐tailed HawkButeo jamaicensis, Northern HarrierCircus hudsonius, Turkey VultureCathartes auraand American KestrelFalco sparveriusvaried more (CV > 5.0) over the duration of the study than other species did. Higher winter temperatures were associated with increases in counts of species whose local populations are partially migratory (American Kestrel and Red‐tailed Hawk), and with lower counts of a long‐distance arctic migrant – Rough‐legged Buzzard. Counts of these species were therefore correlated such that more American Kestrels and Red‐tailed Hawks were counted during years when Rough‐legged Buzzards were less frequently seen. Generally, the number of individuals counted declined as survey speed increased. A general rule for road counts therefore seems to be ‘slower is better’, consistent with past recommendations that observers travel at a speed < 40 km/h during road counts. Our study highlights the utility of road surveys and advances analytical approaches to monitor raptors.
Demography of a widespread raptor across disparate regions
Authors: McClure Christopher J. W. , Brown Jessi L. , Schulwitz Sarah E. , Smallwood John , Farley Kathleen E. , Therrien Jean‐Francois , Miller Karl E. , Steenhof Karen , Heath Julie A.
Published: December 2020

Demographic differences between stable and declining populations can lend insight into drivers of population decline. The American KestrelFalco sparveriusis a widespread and often‐studied falcon, yet its demography is poorly understood, and the causes of observed population declines across much of North America remain unknown. Using integrated population models and sensitivity analysis, we examine how vital rates drive growth in population levels of American Kestrels at four discrete study sites – Florida, Idaho and Pennsylvania with stable nestbox occupancy, and New Jersey, where occupancy is declining. Population growth was most sensitive to changes in adult survival, yet was most correlated with immigration, in all populations. Additionally, population growth was positively correlated with survival rates of juveniles in Pennsylvania. We found evidence for density‐dependence in at least one vital rate for all populations except Florida. Fecundity was density‐dependent in New Jersey and Idaho, and the population growth rate was density‐dependent in Idaho. Adult survival, immigration and the population growth rate were density‐dependent in Pennsylvania. The New Jersey population had the highest rate of fecundity, suggesting that declines there are probably not caused by reproductive failure. Our study demonstrates that two principal demographic processes, adult survival and immigration, drive population dynamics of American Kestrels – both of which are understudied.
Post‐fledging migration and wintering strategies of individual juvenile Lesser Black‐backed Gulls (Larus fuscus)
Authors: Borrmann Rahel M. , Phillips Richard A. , Clay Thomas A. , Garthe Stefan
Published: December 2020

Research into the patterns and drivers of juvenile migration is important for understanding the development of individual migration strategies. Although several recent studies have tracked adult large gulls throughout the annual cycle, the movements of juveniles remain poorly understood. We fitted Global Positioning System (GPS) devices that transmit locations through the Global System for Mobile Communications (GSM) to ten juvenile Lesser Black‐backed Gulls Larus fuscus prior to fledging on the island of Spiekeroog, Germany, to study their first autumn migration and wintering behaviour. The tracked birds initially departed on similar compass bearings south to south‐west, after which migration routes diverged. Individuals took 38–107 days to reach their wintering sites in Algeria, Morocco or Spain. Birds visited 6.7 ± 3.7 (mean ± sd) stopover sites en route and spent substantial time in northern Europe, with some individuals converging at the same sites over small spatial scales (<1 km), but not over the same time periods. Birds increased travel speeds in the second half of their migration. They showed relatively high site‐fidelity after arrival at wintering sites, and there was no evidence that the size of foraging areas increased over time, suggesting limited exploratory behaviour. Individuals used the same predominant habitats – cropland, open water and built‐up areas – to varying degrees, but showed limited variation in habitat use over time. Overall, the migration routes and timings of juveniles broadly resembled those of previously tracked adults. Given their similar initial bearings and abundance of large gulls on the flyway, we suggest that social learning is likely to be an important process shaping the individual migration and wintering strategies of juvenile gulls.
NATURALLY OCCURRING PREFERENCES AND GENERAL EQUILIBRIUM: A LABORATORY STUDY
Authors: Crockett Sean , Friedman Daniel , Oprea Ryan
Published: December 2020

We examine whether economies constructed using experimentally measured preferences (for risk) tend to suffer from aggregation pathologies (like nonexistence and multiplicity of equilibrium) cautioned by the Sonnenschein–Mantel–Debreu theorem. We show that aggregation pathologies should be expected to arise frequently in homogeneous exchange economies, but dwindle and eventually disappear as economies grow diverse. When subjects actually trade, general equilibrium predictions are accurate in most cases, and the failures occur only in economies a priori classified as fragile to preference instability. Our study uses individual‐level experimental data to address longstanding questions in general equilibrium theory that are unanswerable using prior methods.
Pharmacological activation of PPAR‐γ: a potential therapy for skin fibrosis
Authors: Ghosh Asish K.
Published: December 2020

Skin fibrosis caused by excessive collagen synthesis and deposition in the dermis affects the quality of daily life of hundreds of thousands of people around the world. The skin quality, including its smoothness in young age and wrinkly during the aging process, depends largely on the levels of extracellular matrix proteins such as collagen in skin. As physiological levels of collagen are desirable for skin homeostasis, beauty, and its flexibility, too much collagen deposition in the skin is associated with tight hard skin, loss of adipose layer, and flexibility, the pathological manifestations of skin fibrosis in fibrotic diseases such as scleroderma. To understand the molecular basis of skin fibrosis and in search of its therapy, different cellular, molecular, epigenetic, and preclinical studies have been undertaken to control abnormal excessive synthesis and accumulation of matrix protein collagen. Over the last two decades, numerous phase 1 through 3 clinical trials have been conducted to test the safety and efficacy of a wide variety of compounds in amelioration of skin fibrosis and other pathologies in scleroderma, yet, no effective therapy for skin fibrosis is available. This article solely focuses on the role of a nuclear receptor and transcription factor, peroxisome proliferator‐activated receptor‐gamma (PPAR‐γ), as an anti‐skin fibrotic driving force and the potential therapeutic efficacies of PPAR‐γ‐specific ligands/agonists including antidiabetic drugs and other natural or semi‐synthetic compounds derived from cannabis in amelioration of skin fibrosis in scleroderma. The underlying molecular basis of agonist‐activated PPAR‐γ‐mediated suppression of profibrogenic signaling and skin fibrogenesis is also highlighted.
Excessive accumulation of visceral fat is associated with lower urinary symptoms including overactive bladder in female patients
Authors: Otsubo Asato , Miyata Yasuyoshi , Matsuo Tomohiro , Mukae Yuta , Mitsunari Kensuke , Ohba Kojiro , Sakai Hideki
Published: December 2020

Objective

To assess the relationship between visceral fat accumulation and lower urinary tract symptoms in female patients.

Methods

In this single‐center study, we enrolled all women who underwent screening abdominal computed tomography 3 months before the study, irrespective of whether they experienced lower urinary tract symptoms. The Overactive Bladder Symptom Score was used to assess subjective symptoms. Uroflowmetry and ultrasound assessment of post‐void residual urine were carried out to assess objective signs. We analyzed the relationship between lower urinary tract symptoms and various body fat accumulation parameters, including visceral fat area, visceral fat volume and total abdominal fat volume, assessed using computed tomography scans.

Results

A total of 182 patients were divided into the overactive bladder (n = 71, 39.0%) and the non‐overactive bladder (n = 111, 61.0%) groups. The visceral fat area, visceral fat volume and visceral fat volume/total abdominal fat volume values were all significantly higher in the overactive bladder group than in the non‐overactive bladder group (P < 0.001). Of these parameters, the visceral fat volume/total abdominal fat volume ratio showed the strongest correlation with the total Overactive Bladder Symptom Score (r = 0.394, P < 0.001). The maximum urine flow rate correlated negatively with the visceral fat volume/total abdominal fat volume value (visceral fat volume/total abdominal fat volume r = –0.289, P < 0.001). Subsequent multivariate analysis showed that a high visceral fat volume/total abdominal fat volume value, age and metabolic syndrome‐related diseases were independent risk factors for the presence of overactive bladder.

Conclusions

Excessive accumulation of visceral fat is independently associated with overactive bladder in females.
Prediction, Estimation, and Attribution
Authors: Efron Bradley
Published: December 2020

The scientific needs and computational limitations of the twentieth century fashioned classical statistical methodology. Both the needs and limitations have changed in the twenty‐first, and so has the methodology. Large‐scale prediction algorithms—neural nets, deep learning, boosting, support vector machines, random forests—have achieved star status in the popular press. They are recognizable as heirs to the regression tradition, but ones carried out at enormous scale and on titanic datasets. How do these algorithms compare with standard regression techniques such as ordinary least squares or logistic regression? Several key discrepancies will be examined, centering on the differences between prediction and estimation or prediction and attribution (significance testing). Most of the discussion is carried out through small numerical examples.
Physical interactions facilitate sex change in the protogynous orange‐spotted grouper, Epinephelus coioides
Authors: Chen Jiaxing , Peng Cheng , Huang Jingjun , Shi Herong , Xiao Ling , Tang Lin , Lin Haoran , Li Shuisheng , Zhang Yong
Published: December 2020

Sex change in teleost fishes is commonly regulated by social factors. In species that exhibit protogynous sex change, such as the orange‐spotted grouper Epinephelus coioides, when the dominant males are removed from the social group, the most dominant female initiates sex change. The aim of this study was to determine the regulatory mechanisms of socially controlled sex change in E. coioides. We investigated the seasonal variation in social behaviours and sex change throughout the reproductive cycle of E. coioides, and defined the behaviour pattern of this fish during the establishment of a dominance hierarchy. The social behaviours and sex change in this fish were affected by season, and only occurred during the prebreeding season and breeding season. Therefore, a series of sensory isolation experiments was conducted during the breeding season to determine the role of physical, visual and olfactory cues in mediating socially controlled sex change. The results demonstrated that physical interactions between individuals in the social groups were crucial for the initiation and completion of sex change, whereas visual and olfactory cues alone were insufficient in stimulating sex change in dominant females. In addition, we propose that the steroid hormones 11‐ketotestosterone and cortisol are involved in regulating the initiation of socially controlled sex change.
An Examination of the Relationship Between Media Exposure and Fear of Victimization: Implications of the Superpredator Narrative on Juvenile Justice Policies
Authors: Allen Terrence T. , Whitt Ahmed
Published: December 2020

The media allow crime to infiltrate the public’s consciousness in every conceivable way, thereby playing a major role in shaping the public’s opinion and attitude toward crime and crime issues (Barak, 1995; Fields & Jerin, 1996; Kappeler & Potter, 2005). Reporters constantly talk about crime, and crime related stories dominate the headlines of local and national newspaper outlets (Dowler, 2003; Pizarro et al, 2007). Some of the most highly rated television programs are based on crime plots and people across social, political, and racial demographics are constantly engaged in crime dialogue generated from local or national news stories. When the focus of these mediums is on youth they become even more profound and contentious. The images portrayed conjure up stereotypes that lead to fear and inflammatory remarks that become entrenched into the national lexicon. The current study uses data from the National Opinion Survey of Crime and Justice to test the relationship between crime‐related media viewership and fear of victimization within a nationally representative adult sample. Approximately 42.67% of respondents reported regularly watching crime shows and about the same proportion (42.83%) believed their local media paid too much attention to violent crime. In addition to regular crime‐show viewership, confidence in the police, gender, and recent contact with the police were associated with fear of victimization. This article adds to an existing body of research through a largely unexplored area in the administration of justice. It does so within the context of the U.S. juvenile justice system.
MI Implementation in Juvenile Justice: A Case Report
Authors: Brooks Merrian J. , Leskovac Joshua , Benedetto Mark F. , Miller Elizabeth , Mulvey Edward P.
Published: December 2020

Motivational interviewing (MI) is a communication style focused on enhancing clients’ own motivation towards change. In the justice system MI has evidence to support that it enhances communication and change behaviors in youth. As most MI training is designed for healthcare settings training and implementation of MI must be adapted to fit the juvenile justice model. This includes both rehabilitation and restorative justice. Here we describe the details that allowed one county small county in Pennsylvania to roll out MI training and initial skills review in less than 6 months. The case reviews the details of planning, trainings, and timing of activities. We then discuss what elements of those details fit into a greater implementation plan that may be applied elsewhere. Four key elements were instrumental to implementation: 1) appreciation of JPO time constraints, 2) cost containment 3) using blending to enhance JPO flexibility with MI use, and 4) policies that normalize use of MI. This outline may assist other courts in their own implementation efforts.
A Roadmap for CANS Validation
Authors: Kraus David R.
Published: December 2020

In nearly every jurisdiction, juvenile or family courts will be using the Child and Adolescent Needs and Strengths (CANS) tool to assess whether children can safely be treated in family‐like settings to meet federal Family First Prevention Services Act (FFPSA) requirements. Yet, a number of peer‐reviewed publications have raised serious concerns regarding the lack of CANS validation research. Rather than reject CANS, this article provides a roadmap for validating the tool with data that jurisdictions have already collected. Courts should require these three simple analyses before relying on the assessment.
Patients with post‐transplant biliary strictures have significantly higher rates of liver transplant failure and rejection: A nationwide inpatient analysis
Authors: Kohli Divyanshoo R , Desai Madhav V , Kennedy Kevin F , Pandya Prashant , Sharma Prateek
Published: December 2020

Background and Aim

Biliary strictures are a common complication of liver transplantation. We assess the impact of post‐transplant biliary strictures and describe the outcomes of endoscopic retrograde cholangiopancreatography (ERCP), interventional radiology (IR), and surgical therapies.

Methods

Using the Nationwide Readmissions Database (NRD), hospitalized liver transplant recipients were identified using the International Classification of Diseases 10th Revision codes. Patients with post‐transplant biliary strictures were identified, and outcomes (inpatient mortality, 30‐day readmission, transplant rejection/infection/failure, and disposition) were compared with transplant recipients without strictures. Among transplant patients with biliary strictures who underwent therapeutic intervention, corresponding outcomes were compared between IR, surgical interventions, and ERCP.

Results

Of the 8300 liver transplant recipients meeting selection criteria, 554 patients (age 48.9 ± 18.2 years, mean ± SD; 39.5% women) had biliary strictures. Compared with patients without strictures, the adjusted odds ratio (OR) for various outcomes in patients with biliary strictures were as follows: 1.46 (1.20, 1.77; P < 0.001) for 30‐day non‐elective readmission, 2.71 (2.04, 3.59; P < 0.001) allograft rejection, 2.32 (1.61, 3.37; P < 0.001) liver transplant failure, 3.05 (1.39, 6.73; P < 0.01) infection, and 1.41 (1.08, 1.82; P = 0.01) disposition to skilled nursing or intermediate care facility. Therapeutic interventions during index hospitalization were performed in 350 patients: ERCP 46.6% (n = 163), surgery 41% (n = 144), and IR 12.3% (n = 43) patients. Compared with ERCP, the adjusted odds for various outcomes were disposition to skilled nursing or intermediate care facility 2.72 (1.08, 6.87; P = 0.03) and 2.09 (1.05, 4.15; P = 0.036), prolongation of hospitalization 14.4 (3.7, 25.1; P = 0.008) and 15.0 (7.4, 22.7; P < 0.001), and failure of liver allograft 8.47 (1.47, 48.6; P = 0.017) and 12.23 (2.74, 54.4; P = 0.001) for IR and surgical interventions, respectively.

Conclusion

Post‐liver transplant biliary strictures are associated with increased rates of allograft rejection, allograft failure/infections, and readmissions. Compared with ERCP, management of these patients with IR or surgical interventions is associated with significantly higher rates of allograft failure and hospital stay.
Prevalence and clinical significance of esophageal motility disorders in patients with laryngopharyngeal reflux symptoms
Authors: Sikavi Daniel R , Cai Jennifer X , Carroll Thomas L , Chan Walter W
Published: December 2020

Background and Aim

Esophageal motor dysfunction may underlie impaired bolus/refluxate clearance in laryngopharyngeal reflux (LPR). However, the prevalence of esophageal dysmotility and its correlation with reflux parameters and symptoms in LPR is not well established. The aim of this study was to evaluate the prevalence of coexisting esophageal dysmotility among patients with suspected LPR.

Methods

This was a retrospective cohort study of 194 consecutive patients with LPR symptoms referred for high‐resolution manometry (HRM) and combined hypopharyngeal–esophageal multichannel intraluminal impedance and pH testing at a tertiary center in March 2018 to August 2019. Validated symptom surveys were prospectively collected at time of testing, including Reflux Symptom Index, Gastroesophageal Reflux Disease Questionnaire, dominant symptom intensity, and 12‐Item Short‐Form Health Survey. HRM findings were categorized using Chicago Classification v3.0.

Results

Abnormal findings on HRM were identified in 84 (43.3%) patients, with ineffective esophageal motility (n = 60, 30.9%) as the most common diagnosis. A disorder of esophagogastric junction outflow or a major disorder of peristalsis was identified in 26 (13.4%) patients, including 2 (1%) with achalasia and 7 (3.6%) with jackhammer esophagus. Reflux burden (distal, proximal, or pharyngeal) on combined hypopharyngeal–esophageal multichannel intraluminal impedance and pH testing did not differ across HRM findings. Patients reporting esophageal symptoms were more likely to have a primary motility disorder (odds ratio 2.34, P = 0.04). However, no significant differences in Reflux Symptom Index, Gastroesophageal Reflux Disease Questionnaire, or 12‐Item Short‐Form Health Survey were noted across HRM diagnoses.

Conclusion

Esophageal motility disorders are prevalent among patients with LPR symptoms, including up to one in seven with esophagogastric junction outflow or major peristaltic disorder. Patients with abnormal motility more likely report esophageal symptoms. Clinicians should be aware of these coexisting conditions, particularly in those with refractory symptoms.