bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between native species richness and exotic species richness or occurrence will always be negative when the total number of species is accounted for in statistical models: A response to Beaury et al.
Authors: Muthukrishnan Ranjan
Published: May 2021

Beaury et al. (2020) attempt to address the scale dependence of evidence for biotic resistance by including environmental covariates that can account for total species richness. However, this approach will incorrectly estimate relationships, driven by the accuracy of the covariates rather than the true relationship between native and exotic species.
Surveying the Measurement Profession to Assist Recruiting in the United States
Authors: Leventhal Brian C. , Thompson Kathryn N.
Published: May 2021

We conducted a comprehensive survey of the educational measurement profession to assist recruiting to the measurement profession in the United States. Specifically, in April and May 2019, we surveyed measurement professionals and graduate students by targeting six areas to assist recruitment efforts: demographics of the field, compensation for professionals, graduate student funding, where to work, what work life entails, and mentoring opportunities. We evidence a profession trending toward being more diverse, professionals having a median annual salary between $110,000 and $130,000 (U.S.) dollars, varying graduate student funding opportunities, and flexibility in work location and tasks performed. For each of the six target areas, we present detailed results from the survey as well as implications for practice. We conclude the manuscript by discussing a change needed in the field that would assist in recruitment efforts.
Spatiotemporal spawning patterns and early growth of Japanese sardine in the western North Pacific during the recent stock increase
Authors: Niino Yohei , Furuichi Sho , Kamimura Yasuhiro , Yukami Ryuji
Published: May 2021

Spatiotemporal patterns in spawning of fish influence growth and survival by affecting the environment experienced by offspring during their early life stages. Therefore, identifying changes in spawning patterns can help researchers understand population dynamics and recruitment fluctuations. The Japanese sardine Sardinops melanostictus is a small pelagic fish that undergoes large stock fluctuations. Although spawning patterns are known to change spatially and temporally with stock abundance, little information is available on the processes underlying stock increases. This study aimed to describe changes in spawning pattern and early growth of Japanese sardine during the recent period of stock increase and to clarify the effects of different spawning periods on offspring growth. We examined trends in egg abundance in the western North Pacific in 2004–2018 and analyzed hatch dates and growth trajectories by otolith microstructure analysis of juveniles from the Kuroshio–Oyashio transition region (the species’ main nursery area). During the study period, the main spawning area shifted from the western to the eastern part of this region off Japan, and spawning in the eastern part roughly coincided with juvenile hatch dates. Hatch dates also shifted from mid‐March at the earliest to February and early March from 2013 onward. Although early‐hatched cohorts (which originate offshore of eastern Japan) experienced slower initial growth, they likely played an important role in the recent stock increase. Successful recruitment of these cohorts may have been facilitated by factors such as early hatching and transport to the nursery, which reduces the frequency of predator encounters.
Performance of a clinical risk prediction model for inhibitor formation in severe haemophilia A
Authors: Hassan Shermarke , Palla Roberta , Valsecchi Carla , Garagiola Isabella , El‐Beshlawy Amal , Elalfy Mohsen , Ramanan Vijay , Eshghi Peyman , Karimi Mehran , Gouw Samantha Claudia , Mannucci Pier Mannuccio , Rosendaal Frits Richard , Peyvandi Flora ,   SIPPET study group
Published: May 2021

Background

There is a need to identify patients with haemophilia who have a very low or high risk of developing inhibitors. These patients could be candidates for personalized treatment strategies.

Aims

The aim of this study was to externally validate a previously published prediction model for inhibitor development and to develop a new prediction model that incorporates novel predictors.

Methods

The population consisted of 251 previously untreated or minimally treated patients with severe haemophilia A enrolled in the SIPPET study. The outcome was inhibitor formation. Model discrimination was measured using the C‐statistic, and model calibration was assessed with a calibration plot. The new model was internally validated using bootstrap resampling.

Results

Firstly, the previously published prediction model was validated. It consisted of three variables: family history of inhibitor development, F8 gene mutation and intensity of first treatment with factor VIII (FVIII). The C‐statistic was 0.53 (95% CI: 0.46–0.60), and calibration was limited. Furthermore, a new prediction model was developed that consisted of four predictors: F8 gene mutation, intensity of first treatment with FVIII, the presence of factor VIII non‐neutralizing antibodies before treatment initiation and lastly FVIII product type (recombinant vs. plasma‐derived). The C‐statistic was 0.66 (95 CI: 0.57–0.75), and calibration was moderate. Using a model cut‐off point of 10%, positive‐ and negative predictive values were 0.22 and 0.95, respectively.

Conclusion

Performance of all prediction models was limited. However, the new model with all predictors may be useful for identifying a small number of patients with a low risk of inhibitor formation.
Cardiac, biochemical and histopathological analysis reveals impaired heart function in hypertensive rats with apical periodontitis
Authors: Milojevic Samanovic Andjela , Jakovljevic Vladimir , Vasovic Miroslav , Mitrovic Slobodanka , Rankovic Marina , Mihajlovic Katarina , Bolevich Sergey , Zivkovic Vladimir
Published: May 2021

Aim

To investigate the association between experimentally induced apical periodontitis (AP) and heart function in hypertensive rats.

Methodology

Forty‐eight normotensive Wistar albino and spontaneously hypertensive (SHR) rats were divided into four equal groups: control (C), normotensive with AP (AP), SHR and SHR with AP (SHR + AP). AP was induced on the first right mandibular molars by exposing the pulp chambers to the oral environment for four weeks and confirmed radiographically. Thereafter, the animals were sacrificed by cervical dislocation, whilst hearts were isolated and perfused according to the Langendorff technique gradually increasing coronary perfusion pressures 40–120 cmH2O. The hemimandibles were analysed radiographically (mm2 and pixels) to verify the presence of AP. Biomarkers of cardiac oxidative stress (OS) were determined in coronary venous effluent and cardiac tissue homogenate. Cardiac tissue was analysed histopathologically for signs of heart damage (oedema, fibrosis and necrosis). All data were analysed by Kruskal–Wallis and one‐way anova tests (p < .05).

Results

The levels of the maximum left ventricular pressure development rate of the SHR + AP group were significantly increased compared to the AP and C groups, and of the SHR group compared with the C group (p < .05). The levels of the minimum left ventricular pressure development rate of the SHR + AP group were significantly decreased compared to the AP, SHR and C groups, and of the SHR group compared to the C group (p < .05). The radiographic AP area was significantly larger in the SHR + AP group than in the AP group (p < .01). The levels of superoxide anion were significantly higher in the SHR + AP group than in the AP, SHR and C groups (p < .05). The activities of superoxide dismutase in cardiac tissue homogenate were significantly lower in the SHR + AP and AP groups compared with the SHR and C groups (p < .05).

Conclusions

In rats, AP was associated with impaired cardiodynamics, disturbed cardiac OS, antioxidant defence and cardiac pathologic changes in hypertensive conditions. Hypertension was associated with an increase in the AP radiographic area. Further studies should confirm whether root canal treatment can have a cardioprotective effect and reduce cardiac OS in hypertensive conditions.
Ultrasonic vibration and thermo‐hydrodynamic technique for filling root canals: Technical overview and a case series
Authors: Cho Yong‐Sik
Published: May 2021

Aim

To present a novel root canal filling technique: Ultrasonic Vibration & Thermo‐Hydrodynamic Obturation (VibraTHO), and its rationale with a series of cases.

The VibraTHO technique was used to fill the root canals of three clinically challenging cases: A C‐shaped mandibular molar with complex anatomy, a C‐shaped mandibular molar with an infected root canal system and a periapical lesion that required retreatment, and apically bifurcating mesiobuccal canals with a common orifice in a maxillary second molar. The cases were followed up for 15, 7 and 37 months, respectively. After follow‐up, normal periapical status was observed without any noticeable radiographic change in the root canal fillings in each case. Periapical radiographs revealed complete healing of the periapical area in cases with pre‐operative periapical lesions.
Development and psychometric evaluation of the Caregiver Caregiving Self‐Efficacy Scale for family members with oral cancer
Authors: Cheng Jen‐Chan , Chang Tzu‐Ting , Wang Ling‐Wei , Liang Shu‐Yuan , Hsu Shu‐Chen , Wu Shu‐Fang , Wang Tsae‐Jyy , Liu Chieh‐Yu
Published: May 2021

Aim

The aim of this study was to develop and initially assess the psychometric properties of the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer (CSES‐OC).

Methods

In total, 28 items in the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer were originally employed for a reliability and validity test based on expert suggestions and qualitative findings. The Cronbach's alpha coefficient and test–retest reliability were evaluated with the pilot sample, which included 30 caregivers. The main test, which included 107 caregivers during May 2016 to 2018, was used to execute the exploratory factor analysis (EFA) and concurrent validity.

Results

The results of the main test showed a Cronbach's alpha coefficient of .95 for the revised 18‐item total scale after EFA. Four factors (acquiring resources, managing sudden and uncertain patient conditions, managing patient‐related nutritional issues and exploring and making decisions on patient care) were classified from EFA of the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer. The r coefficient was .59 (P < .01), which supported the concurrent validity between CSES‐OC and General Self‐Efficacy Scale.

Conclusion

The study results show appropriate psychometric properties for the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer that was constructed for evaluating caregiver caregiving self‐efficacy in caring for family members with oral cancer.
Human transitional and IgMlow mature naïve B cells preserve permissive B‐cell receptors
Authors: Zhang Zhiguo , Jara Christopher J , Singh Mandeep , Xu Huji , Goodnow Christopher C , Jackson Katherine JL , Reed Joanne H
Published: May 2021

The level of immunoglobulin M (IgM) displayed on the surface of peripheral blood B cells exhibits a broad dynamic range and has been associated with both development and selection. To determine whether IgM surface expression associates with distinct immunoglobulin heavy‐chain (IGH) repertoire properties, we performed deep IgM sequencing of peripheral blood transitional and mature naïve B cells in the upper and lower quartiles of surface IgM expression for 12 healthy donors. Mature naïve B cells within the lowest quartile for surface IgM expression displayed more diverse IGH features including increased complementarity‐determining region 3 length, IGHJ6 segment usage and aromatic amino acids compared with mature naïve B cells with high surface IgM. There were no differences between IGH repertoires for transitional B cells with high or low surface IgM. These findings suggest that a selection checkpoint during progression of transitional to mature naïve B cells reduces the breadth of the IGH repertoire among high surface IgM B cells but that diversity is preserved in B cells expressing low levels of surface IgM.
The parasite cytokine mimic Hp‐TGM potently replicates the regulatory effects of TGF‐β on murine CD4+ T cells
Authors: White Madeleine P J , Smyth Danielle J , Cook Laura , Ziegler Steven F , Levings Megan K , Maizels Rick M
Published: May 2021

Transforming growth factor‐beta (TGF‐β) family proteins mediate many vital biological functions in growth, development and regulation of the immune system. TGF‐β itself controls immune homeostasis and inflammation, including conversion of naïve CD4+ T cells into Foxp3+ regulatory T cells (Tregs) in the presence of interleukin‐2 and T‐cell receptor ligands. The helminth parasite Heligmosomoides polygyrus exploits this pathway through a structurally novel TGF‐β mimic (Hp‐TGM), which binds to mammalian TGF‐β receptors and induces Tregs. Here, we performed detailed comparisons of Hp‐TGM with mammalian TGF‐β. Compared with TGF‐β, Hp‐TGM induced greater numbers of Foxp3+ Tregs (iTregs), with more intense Foxp3 expression. Both ligands upregulated Treg functional markers CD73, CD103 and programmed death‐ligand 1, but Hp‐TGM induced significantly higher CD39 expression than did TGF‐β. Interestingly, in contrast to canonical TGF‐β signaling through Smad2/3, Hp‐TGM stimulation was slower and more sustained. Gene expression profiles induced by TGF‐β and Hp‐TGM were remarkably similar, and both types of iTregs suppressed T‐cell responses in vitro and experimental autoimmune encephalomyelitis‐driven inflammation in vivo. In vitro, both types of iTregs were equally stable under inflammatory conditions, but Hp‐TGM‐induced iTregs were more stable in vivo during dextran sodium sulfate‐induced colitis, with greater retention of Foxp3 expression and lower conversion to a ROR‐γt+ phenotype. Altogether, results from this study suggest that the parasite cytokine mimic, Hp‐TGM, may deliver a qualitatively different signal to CD4+ T cells with downstream consequences for the long‐term stability of iTregs. These data highlight the potential of Hp‐TGM as a new modulator of T‐cell responses in vitro and in vivo.
Leptin receptor is a key gene involved in the immunopathogenesis of thyroid‐associated ophthalmopathy
Authors: Chen Ziyi , Chen Zhe , Wang Jingya , Zhang Meng , Wang Xiaofei , Cuomu Deji , Shi Bingyin , Wang Yue
Published: May 2021

Thyroid‐associated ophthalmopathy (TAO), the most common and severe manifestation of Graves' disease (GD), is a disfiguring and potentially blinding autoimmune disease. The high relapse rate (up to 20%) and substantial side effects of glucocorticoid treatment further decrease the life quality of TAO patients. To develop novel therapies, we amid to explore the immunopathogenesis of TAO. To identify the key immune‐related genes (IRGs) in TAO, we integrated the IRG expression profiles in thyrocytes from a GD patient set (GD vs healthy control) and a TAO patient set (TAO vs GD). Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), protein‐protein interaction (PPI) and receiver operating characteristic (ROC) curve analyses identified the leptin receptor (LEPR) gene as the key IRG in TAO immunopathogenesis. Gene set enrichment analysis (GSEA) suggested enrichment of the antigen presentation pathway in TAO patients with higher LEPR. Increased LEPR expression was validated in TAO orbital tissues, and weighted gene co‐expression network analysis (WGCNA) showed that cell adhesion processes were positively correlated with LEPR. Our study revealed that LEPR is a key gene in TAO immunopathogenesis and plays different roles in thyrocytes and orbital tissues. Our findings provide new insights into diagnostic and therapeutic biomarkers for TAO.
How Transmembrane Inner Ear (TMIE) plays role in the auditory system: A mystery to us
Authors: Farhadi Mohammad , Razmara Ehsan , Balali Maryam , Hajabbas Farshchi Yeganeh , Falah Masoumeh
Published: May 2021

Different cellular mechanisms contribute to the hearing sense, so it is obvious that any disruption in such processes leads to hearing impairment that greatly influences the global economy and quality of life of the patients and their relatives. In the past two decades, transmembrane inner ear (TMIE) protein has received a great deal of research interest because its impairments cause hereditary deafness in humans. This evolutionarily conserved membrane protein contributes to a fundamental complex that plays role in the maintenance and function of the sensory hair cells. Although the critical roles of the TMIE in mechanoelectrical transduction or hearing procedures have been discussed, there are little to no review papers summarizing the roles of the TMIE in the auditory system. In order to fill this gap, herein, we discuss the important roles of this protein in the auditory system including its role in mechanotransduction, olivocochlear synapse, morphology and different signalling pathways; we also review the genotype‐phenotype correlation that can per se show the possible roles of this protein in the auditory system.
Association between glycemic control and cardiovascular events in older Japanese adults with diabetes mellitus: An analysis of the Japanese medical administrative database
Authors: Yokote Koutaro , Suzuki Ryo , Gouda Maki , Iijima Hiroaki , Yamazaki Akiko , Inagaki Masaya
Published: May 2021

Aims/Introduction

The relationship between glycated hemoglobin (HbA1c) and cardiovascular events in older adults was investigated using a Japanese administrative medical database.

Materials and Methods

Anonymized medical data on patients with diabetes mellitus aged ≥65 years for the period from January 2010 to December 2019 were extracted from the EBM Provider database. The primary end‐point was a composite of cardiovascular events, whereas the other end‐points included severe hypoglycemia and fracture. The association between cardiovascular events and HbA1c at the index date (i.e., approximately 10 months after initial diabetes mellitus diagnosis) was evaluated using the Cox proportional hazards model.

Results

Among the 3,186,751 patients in the database, 3,946 older adults with diabetes mellitus were eligible for inclusion and were subsequently grouped according to HbA1c quartiles at the index date. Cardiovascular events occurred in 142 patients. Patients with HbA1c in the highest quartile had significantly higher risk of hospitalization for cardiovascular disease than those with HbA1c in the lowest quartile (hazard ratio 1.948; 95% confidence interval 1.252–3.031, P = 0.003). However, the events risk was similar across subgroups with HbA1c <7.2%. The incidence of hypoglycemia and fracture was not significantly associated with the level of glycemic control.

Conclusions

Among older adults with diabetes mellitus, those with poor glycemic control were at higher risk for cardiovascular events compared with those with better glycemic control. However, strict glycemic control had no effect on cardiovascular risk in patients with HbA1c <7.2%.
Childhood atopic dermatitis is associated with a decreased chance of completing education later in life: a register‐based cohort study
Authors: Pálsson K. , Slagor R.M. , Flachs E.M. , Nørreslet L.B. , Agner T. , Ebbehøj N.E.
Published: May 2021

Background

Atopic dermatitis (AD) has far‐reaching consequences in childhood and later in working life, but information on how it affects completion of education is sparse.

Objectives

To compare the educational achievement of individuals with AD in childhood/adolescence and individuals without a history of AD.

Methods

The study population included patients diagnosed with AD prior to the age of 16 registered in the Danish National Patient Register (DNPR) born in the period 1977–1993 and a 23‐fold matched control group from the background population. Cross‐linkage of five different Danish registers from 1977 to 2015 allowed comparison of AD patients with controls regarding completion of education.

Results

In total, 10 173 individuals were registered with AD in the DNPR, while 234 683 individuals served as control group. Mild/moderate AD was associated with a decreased chance of completing basic compulsory education [hazard ratios (HR): 0.92, 95% CI: 0.90–0.95] and further academic education (HR: 0.96, 95% CI: 0.93–0.98). Severe AD was associated with a decreased chance of completing further academic education (HR: 0.86, 95% CI: 0.80–0.92), further vocational education (HR: 0.90, 95% CI: 0.84–0.97) and higher education: master's level (HR: 0.66, 95% CI: 0.53–0.81).

Conclusion

Atopic dermatitis in childhood/adolescence is associated with a decreased chance of completing an education.
Mapping risk factors for cumulative life course impairment in patients with chronic skin diseases – a systematic review
Authors: von Stülpnagel C.C. , Augustin M. , Düpmann L. , da Silva N. , Sommer R.
Published: May 2021

Patients with chronic skin diseases suffer from physical and psychosocial impairments which can lead to a cumulative life‐long burden. Therefore, the concept of cumulative life course impairment (CLCI) was introduced, referring to the non‐reversible damage due to the persistent life‐long burden. This systematic review (PROSPERO registry number: CRD42020179141) aimed at mapping the risk factors and the associated burden over time in patients with psoriasis, atopic dermatitis (AD) and hidradenitis suppurativa (HS). Three electronic databases were searched (date of the last search: December 2019). Studies with a longitudinal study design that assessed the association between a risk factor and the associated burden over time in patients with psoriasis, AD and HS were included. Quality assessment of the included studies was done using Critical Appraisal Skills Programme (CASP) checklists. In total, 40 publications reflecting 25 different studies were included: nine studies addressed patients with psoriasis, 13 patients with AD, two studies included patients with HS and one study enrolled patients with psoriasis and AD, respectively. Twenty‐two potential risk factors with underlying evidence were found in this review. These risk factors include mainly sociodemographic (such as age or gender) and clinical (such as disease severity or comorbidities) variables. Disease severity and comorbidities were the most often studied risk factors, while only a few studies evaluated psychosocial risk factors over time. Patients with chronic skin diseases are at high risk to develop a life‐long negative impact from the disease. However, there is a lack of data that evaluates the psychosocial burden and its influence on the patients’ life course over time. The risk factors found in this review help to identify patients at risk, to treat them adequately and, ultimately, to prevent CLCI. These results can be the basis to develop a highly needed tool to assess the risk for CLCI in the future.
The role of miRNAs in MDMX‐p53 interplay
Authors: Yu Dehua , Xu Zhiyuan , Cheng Xiangdong , Qin Jiangjiang
Published: May 2021

MicroRNAs (miRNAs) are endogenous noncoding RNAs of 19‐24 nucleotides in length and are tightly related to tumorigenesis and progression. Recent studies have demonstrated that the tumor suppressor p53 and its negative controller MDMX are regulated by miRNAs in different ways. Some miRNAs directly target p53 and regulate its expression and function, whereas some miRNAs target MDMX and regulate p53's activity indirectly. The overexpression of several miRNAs can restore the activity of p53 by negatively regulating MDMX in cancer cells. Therefore, a better understanding of the miRNAs‐MDMX‐p53 network will put forward potential research directions for developing anticancer therapeutics. In the present review, we mainly focus on the regulatory effects of miRNAs on the MDMX‐p53 interplay as well as the role of the miRNAs‐MDMX‐p53 network in human cancer.
Comparative analysis of routed flood frequency for reservoirs in parallel incorporating bivariate flood frequency and reservoir operation
Authors: Zhou Ting , Jin Juliang
Published: May 2021

Flood frequency is commonly defined by natural flood characteristics such as flood peak, volume and duration. However, for floods at reservoir site, reservoir operation will significantly alter the natural flood process and flood frequency. This article presents a framework of routed flood frequency which incorporates multi‐reservoir flood correlation and considers the effect of reservoir operation. Aggregated flood volume during reservoir operation has been adopted as indicator for the routed flood frequency curve (RFFC). A comparison has been made with a 62‐year series of historic flood inflows observed at two parallel reservoirs in Eastern China. By comparing the derived RFFC with traditional univariate and bivariate flood frequency results, it can be seen that the RFFC results provide a reasonable estimation of flood frequency. A sensitivity analysis indicated that the reservoir maximum release allocation has significant impact on RFFC, and a balanced allocation of flood peak can greatly decrease the overtopping risk. The “peak–peak” contour lines of the RFFC show that there are different flood combination zones which need different operation strategies in real‐time operation. Our findings improve the understanding of flood frequency concepts when considering the impact of reservoir operation and provide reference to manage real‐time reservoir operation.
Deep eutectic solvents improve the stability of forsythoside A
Authors: Zhang Qin , Dong Zhe , Du Huizhi
Published: May 2021

Forsythoside A is used as the main chemical marker for quality control of Forsythia suspensa (Thunb.) Vahl (F. suspensa, Lianqiao in Chinese) fruits and leaves. The hydrolysis of forsythoside A at high temperature and effects of deep eutectic solvents (DESs) on stability of forsythoside A were studied in the article. Forsythoside A, I, and H may be directly converted into each other at high temperature. With more heating time, they are gradually decomposed into smaller molecular compounds. High temperature, alkaline conditions, high humidity, the oxidant, and light drastically destroyed stability of forsythoside A, while acidic conditions and the antioxidant protected it. Compared with water and alcohol solvents, DESs improved effectively stability of forsythoside A due to the formation of hydrogen bonds between DESs and forsythoside A. Our research preliminarily uncovered the converting mechanism of forsythoside A and confirmed that DES improved the stability of forsythoside A.
Was it worth it? Benefits of transcatheter aortic valve implantation from a patient's perspective
Authors: Beishuizen Sara J. E. , Festen Suzanne , van der Werf Hindrik W. , de Graeff Pauline , van Munster Barbara C.
Published: May 2021

Objectives

Transcatheter aortic valve implantation (TAVI) is an important treatment option for patients with severe aortic stenosis. To improve patient selection, shared decision‐making is recommended to elicit patients' treatment expectations and goals. We assessed patients' expectations and goals before TAVI treatment and whether these were met after treatment. Additionally, we evaluated how meeting these goals aligned with quality of life and functional recovery.

Design

A mixed method study.

Setting

An academic medical center.

Participants

Seventy‐four patients undergoing TAVI between 2015 and 2017.

Measurements

Patients' expectations and goals were assessed qualitatively before treatment. Six to twelve months post procedure, quality of life was measured with the EuroQuol‐5D and any change in the number of dependencies in (instrumental) activities of daily living was assessed.

Results

Mean age of patients was 81.5 years, and 37.8% were male. Regaining the ability to engage in a specific hobby or activity was the most important treatment goal (33 patients, 54.1%), followed by reducing symptoms (19 patients 31.1%). 66.2% of patients stated that their treatment goal was met. Quality of life was higher in this group, as compared with patients who had not met their treatment goal. Twenty‐three patients (31.1%) showed functional improvement.

Conclusion

TAVI patients were quite capable of eliciting treatment goals and a majority stated, after treatment, that these had been met patients' experience of treatment benefits regarding these goals had poor alignment with functional outcomes. This raises questions regarding relevant outcome measurements in this population, and could aid in improving shared decision‐making and patient selection for TAVI.
Dying with dementia in Medicare Advantage, Accountable Care Organizations, or traditional Medicare
Authors: Teno Joan M. , Keohane Laura M. , Mitchell Susan L. , Meyers David J. , Bunker Jennifer N. , Belanger Emmanuelle , Gozalo Pedro L. , Trivedi Amal N.
Published: May 2021

Background/Objective

Medicare Advantage (MA) and Accountable Care Organizations (ACOs) operate under incentives to reduce burdensome and costly care at the end of life. We compared end‐of‐life care for persons with dementia who are in MA, ACOs, or traditional Medicare (TM).

Design, Setting, and Participants

Retrospective study of decedents with dementia enrolled in MA, attributed to an ACO, or in TM. Decedents had a nursing home stay between 91 and 180 days prior to death, two or more functional impairments, and mild to severe cognitive impairment.

Measurements

Hospitalization, invasive mechanical ventilation (IMV) use, and in‐hospital death in the last 30 days of life reported in Medicare billing.

Results

Among 370,094 persons with dementia, 93,801 (25.4%) were in MA (mean age [SD], 86.9 [7.7], 67.6% female), 39,586 (10.7%) were ACO attributed (mean age [SD], 87.2 [7.6], 67.3% female), and 236,707 (63.9%) were in TM (mean age [SD], 87.0 [7.8], 67.6% female). The proportion hospitalized in the last 30 days of life was higher among TM enrollees (27.9%) and those ACO attributed (28.1%) than among MA enrollees (20.5%, p ≤ 0.001). After adjustment for socio‐demographics, cognitive and functional impairments, comorbidities, and Hospital Referral Region, adjusted odds of hospitalization in the 30 days prior to death was 0.72 (95% confidence interval [CI] 0.70–0.74) among MA enrollees and 1.05 (95% CI 1.02–1.09) among those attributed to ACOs relative to TM enrollees. Relative to TM, the adjusted odds of death in the hospital were 0.78 (95% CI 0.75–0.81) among MA enrollees and 1.02 (95% CI 0.96–1.08) for ACO participants. Dementia decedents in MA had a lower likelihood of IMV use (adjusted odds ratio 0.80, 95% CI 0.75–0.85) compared to TM.

Conclusions

Among decedents with dementia, MA enrollees but not decedents in ACOs experienced less costly and potentially burdensome care compared with those with TM. Policy changes are needed for ACOs.
Hair transplantation Follicular Unit Excision (FUE): Introducing the multipurpose octagonal ring punch
Authors: Trivellini Roberto , Gupta Aditya K
Published: May 2021

The technique of follicular unit excision for harvesting grafts for hair transplantation procedures has become very popular. This technique relies on the use of small punches to remove viable grafts. Many different punch shapes have been developed to accommodate the varying nature of skin and hair characteristics, resulting in hair transplant surgeons requiring a variety of punches to suit a wide range of patients, which can be overwhelming to the beginner when trying to decide on the optimal choice of a punch to suit a particular skin characteristic. We describe a novel multipurpose ring punch that can be used on patients with a variety of skin and hair characteristics, as well as for shaved and long hair FUE. Features of this punch include an octagonal ring that protrudes from the outer wall of the punch and functions to control the punch’s trajectory into the deeper dermis during incision. Additionally, this punch has a dull, notched edge which allows for use in long hair and shaved FUE without sacrificing ease of incision through the epidermis. This punch is the first of its kind to have this breadth of versatility with a one‐size‐fits‐all design.
Our anesthesia experiences in COVID‐19 positive patients delivering by cesarean section: A retrospective single‐center cohort study
Authors: Karasu Derya , Kilicarslan Nermin , Ozgunay Seyda Efsun , Gurbuz Hande
Published: May 2021

Aim

Pregnancy increases susceptibility to respiratory complications of viral diseases. This study aims to evaluate our anesthesia practices in pregnant women with COVID‐19 undergoing cesarean section.

Methods

A total of 61 patients who underwent cesarean section and had positive Polymerase chain reaction (PCR) testing for COVID‐19 with nasopharyngeal swabs were included in the study. Patient demographics and information about anesthesia were analyzed retrospectively from the patient medical files.

Results

A total of 61 parturients undergoing cesarean section that had positive SARS‐CoV‐2 PCR tests were assessed. General anesthesia was applied to only three patients (4.9%), while spinal anesthesia was administered to the remaining 58 patients (95.1%). The incidence of hypotension was 25.9% in the spinal anesthesia group. Forty‐one (67.2%) parturients were asymptomatic. While the rate of pneumonia in symptomatic patients was 45% (9/20), the pneumonia incidence among all SARS‐CoV‐2 PCR (+) parturients was 14% (9/61). Three (4.9%) COVID‐19 patients required intensive care in the perioperative period. The overall mortality rate was 1.6% (1/61) among parturients with COVID‐19 undergoing cesarean section, while it was 11.1% (1/9) in patients with pneumonia.

Conclusion

It was observed that COVID‐19 is associated with mortality in pregnant women undergoing cesarean section. Spinal anesthesia was safely and effectively administered in COVID‐19 parturients, especially in patients with pneumonia.
Occupational characteristics and parents' childcare time
Authors: Hook Jennifer L. , Ruppanner Leah , Casper Lynne M.
Published: May 2021

Objective

This study examines how occupational resources and demands are associated with parents' childcare time.

Background

Scholars recognize parental employment as important for understanding parental time use. Yet, given data limitations, we know relatively little about how strain‐based demands (demands that can produce negative psychological states) are associated with parent's time with children.

Method

Occupational‐level data in the O*NET Database are linked to the American Time Use Survey (ATUS) 2011–2019 (n = 10,274 workday diaries from employed parents in 427 occupations). Ordinary Least Squares regression (OLS) is used to examine how occupational resources and demands are associated with parents' time with children and in childcare on workdays.

Results

Mothers in occupations with greater strain‐based demands—competitive pressure, aggression‐conflict, monotony, and physicality‐hazards—spend less time with their children and less time on physical childcare activities. For fathers, associations are weaker with monotonous jobs also associated with less time with children. Workplace conditions, however, are weakly or even positively associated with parents' time on nonworkdays, suggesting that the daily experience of work affects parents' time use at home. Autonomy, an occupational resource, is positively associated with fathers' time with children and with mothers' time in interactive care.

Conclusion

Resources and strain‐based demands—measured at the occupational‐level—are associated with parents' time use. The O*NET Database can be linked to the ATUS to better understand families' time use.
G3BP1 may serve as a potential biomarker of proliferation, apoptosis, and prognosis in oral squamous cell carcinoma
Authors: Hu Xin , Xia Kun , Xiong Haofeng , Su Tong
Published: May 2021

Background

G3BP1 is a prognostic biomarker for many types of cancers; however, its role in oral squamous cell carcinoma remains unclear. We investigated the role of G3BP1 as a potential biomarker for proliferation, apoptosis, and prognosis in oral squamous cell carcinoma.

Methods

We obtained samples of normal oral mucosa (n = 17), oral squamous cell carcinoma tissues (n = 61), and paired adjacent tissues (n = 47) from Xiangya Hospital for immunohistochemical evaluation to measure the expression of G3BP1, E‐cadherin, Ki67, and Cleaved‐caspase3. Using data from The Cancer Genome Atlas, we performed bioinformatics analysis to investigate the prognosis, functions, signaling pathways, and immune infiltrate significance related to G3BP1 in oral squamous cell carcinoma.

Results

The G3BP1 protein level was significantly upregulated in oral squamous cell carcinoma tissues and was also positively associated with Ki67 and negatively associated with Cleaved‐caspase3. Based on information available in online database, the G3BP1 mRNA level was significantly higher in oral squamous cell carcinoma than in normal tissues. High G3BP1 mRNA levels were associated with poor overall survival rates in patients with oral squamous cell carcinoma. Enrichment analysis showed that G3BP1 was involved in the helicase/catalytic/ATPase activity functions and spliceosome/RNA transport/ cell cycle pathways. Furthermore, G3BP1 mRNA levels were positively associated with CD4+ T‐cell infiltration.

Conclusions

G3BP1 may serve as a potential biomarker for proliferation, apoptosis, and prognosis of oral squamous cell carcinoma.
Improved Knowledge of Disaster Preparedness in Underrepresented Secondary Students: A Quasi‐Experimental Study
Authors: White‐Lewis Sharon , Beach Elaine , Zegers Carli
Published: May 2021

BACKGROUND

Disasters cause significant human and monetary destruction and society as a whole is underprepared to address them. Disaster preparedness education is not covered extensively enough for health professionals or for the general public.

METHODS

A disaster preparedness education intervention was performed using a non‐randomized controlled trial of a convenience sample with a pre‐ and post‐intervention survey. The adapted Emergency Preparedness Information Questionnaire (EPIQ), a validated survey tool, was utilized. Participants came from a health professions educational enrichment program for students from under‐resourced high schools in the Kansas City area.

RESULTS

The experimental group shows statistically significant improvement in knowledge of disaster topics post‐intervention. Of 18 adapted EPIQ tool questions, 17 show statistically significant improvement in disaster knowledge post‐intervention for the experimental group with significance set at p < .05 (range of significant p values .000‐.017).

CONCLUSIONS

The education intervention was effective and cost‐efficient. Disaster preparedness education should be included in THE secondary school curriculum.
Free and second‐best entry in oligopolies with network effects
Authors: Gama Adriana , Samano Mario
Published: May 2021

We compare the number of firms in equilibrium in a Cournot industry with positive network effects and complete compatibility, under free and second‐best entry. Under free entry, the firms decide whether to enter the market or not; in the second‐best problem, the number of firms is established by the regulator to maximize social welfare (the regulator controls entry but not production). We show that when individual equilibrium output decreases with entry (business‐stealing competition), free entry may lead to more or less firms than the second‐best problem. This contrasts with the standard (nonnetwork) Cournot oligopoly model, wherein with business‐stealing competition, free entry leads to an excessive number of firms compared with the second‐best solution.
A Molecular Analysis of Microalgae from Around the Globe to Revise Raphidonema (Trebouxiophyceae, Chlorophyta)
Authors: Yakimovich Kurt M. , Gauthier Nick P.G. , Engstrom Casey B. , Leya Thomas , Quarmby Lynne M.
Published: May 2021

We isolated five microalgal strains from alpine snow near Vancouver, Canada, which display morphological features suggestive of the genera Koliella and Raphidonema. Due to variations in cell size and shape, we could not make a clear delimitation based on morphology. We proceeded to a molecular analysis and included 22 strains from the CCCryo culture collection, previously identified as members of four closely related genera: Raphidonema, Koliella, Stichococcus, and Pseudochlorella. For greater taxonomic context in our phylogenetic analysis, we also obtained authentic strains for the type species of Koliella and Pseudochlorella, but were unable to find one for Raphidonema. To examine generic boundaries, we did a phylogenetic analysis on the rbcL gene for all strains, establishing distinct lineages. Our novel isolates fell within Raphidonema, and so we analyzed the ITS2 gene of all Raphidonema strains to delimit species. To support species delimitations, we did a Compensatory Base Change analysis using the secondary structure of the ITS2 gene to assist in aligning the sequence. We also computed a maximum likelihood phylogenetic tree to examine species clades of Raphidonema. We assigned epitypes for two Raphidonema species based on the best morphological match to strains in the ITS2 clades. We then amended their diagnoses so they can be more reliably identified using DNA sequence data. We also propose two new species, R. catena and R. monicae, that formed their own species clades according to our ITS2 analysis.
Positive airway pressure (PAP) treatment reduces glycated hemoglobin (HbA1c) levels in obstructive sleep apnea patients with concomitant weight loss: Longitudinal data from the ESADA
Authors: Tasbakan Mehmet Sezai , Grote Ludger , Hedner Jan , Kvamme John Arthur , Verbraecken Johan , McNicholas Walter T. , Roisman Gabriel , Tkacova Ruzena , Bonsignore Maria R. , Saaresranta Tarja , Steiropoulos Paschalis , Marrone Oreste , Basoglu Ozen K. ,   ESADA Collaborators
Published: May 2021

Patients with obstructive sleep apnea (OSA) are at increased risk of developing metabolic disease such as diabetes. The effects of positive airway pressure on glycemic control are contradictory. We therefore evaluated the change in glycated hemoglobin (HbA1c) in a large cohort of OSA patients after long‐term treatment with positive airway pressure. HbA1c levels were assessed in a subsample of the European Sleep Apnea Database [n=1608] at baseline and at long‐term follow up with positive airway pressure therapy (mean 378.9±423.0 days). In a regression analysis, treatment response was controlled for important confounders.

Overall, HbA1c decreased from 5.98±1.01% to 5.93±0.98% (p=0.001). Patient subgroups with a more pronounced HbA1c response included patients with diabetes (−0.15±1.02, p=0.019), those with severe OSA baseline (−0.10±0.68, p=0.005), those with morbid obesity (−0.20±0.81, p<0.001). The strongest HbA1c reduction was observed in patients with a concomitant weight reduction >5 kilos (−0.38±0.99, p<0.001). In robust regression analysis, severe OSA (p=0.038) and morbid obesity (p=0.005) at baseline, and weight reduction >5 kilos (p<0.001) during follow up were independently associated with a reduction of HbA1c following PAP treatment. In contrast, PAP treatment alone without weight reduction was not associated with significant Hb1Ac reduction.

In conclusion, positive airway pressure therapy is associated with HbA1c reduction in patients with severe OSA, in morbidly obese patients. and most obviously in those with significant weight lost during the follow‐up. Our study underlines the importance to combine positive airway pressure use with adjustments in lifestyle to substantially modify metabolic complications in OSA.
Teaching by Analogy: From Theory to Practice
Authors: Gray Maureen E. , Holyoak Keith J.
Published: May 2021

Analogy is a powerful tool for fostering conceptual understanding and transfer in STEM and other fields. Well‐constructed analogical comparisons focus attention on the causal‐relational structure of STEM concepts, and provide a powerful capability to draw inferences based on a well‐understood source domain that can be applied to a novel target domain. However, analogy must be applied with consideration to students' prior knowledge and cognitive resources. We briefly review theoretical and empirical support for incorporating analogy into education, and recommend five general principles to guide its application so as to maximize the potential benefits. For analogies to be effective, instructors should use well‐understood source analogs and explain correspondences fully; use visuospatial and verbal supports to emphasize shared structure among analogs; discuss the alignment between semantic and formal representations; reduce extraneous cognitive load imposed by analogical comparison; and encourage generation of inferences when students have some proficiency with the material. These principles can be applied flexibly to topics in a wide variety of domains.
Social media in undergraduate medical education: A systematic review
Authors: Guckian Jonathan , Utukuri Mrudula , Asif Aqua , Burton Oliver , Adeyoju Joshua , Oumeziane Adam , Chu Timothy , Rees Eliot L.
Published: May 2021

Introduction

There are over 3.81 billion worldwide active social media (SoMe) users. SoMe are ubiquitous in medical education, with roles across undergraduate programmes, including professionalism, blended learning, well being and mentoring. Previous systematic reviews took place before recent explosions in SoMe popularity and revealed a paucity of high‐quality empirical studies assessing its effectiveness in medical education. This review aimed to synthesise evidence regarding SoMe interventions in undergraduate medical education, to identify features associated with positive and negative outcomes.

Methods

Authors searched 31 key terms through seven databases, in addition to references, citation and hand searching, between 16 June and 16 July 2020. Studies describing SoMe interventions and research on exposure to existing SoMe were included. Title, abstract and full paper screening were undertaken independently by two reviewers. Included papers were assessed for methodological quality using the Medical Education Research Study Quality Instrument (MERSQI) and/or the Standards for Reporting Qualitative Research (SRQR) instrument. Extracted data were synthesised using narrative synthesis.

Results

112 studies from 26 countries met inclusion criteria. Methodological quality of included studies had not significantly improved since 2013. Engagement and satisfaction with SoMe platforms in medical education are described. Students felt SoMe flattened hierarchies and improved communication with educators. SoMe use was associated with improvement in objective knowledge assessment scores and self‐reported clinical and professional performance, however evidence for long term knowledge retention was limited. SoMe use was occasionally linked to adverse impacts upon mental and physical health. Professionalism was heavily investigated and considered important, though generally negative correlations between SoMe use and medical professionalism may exist.

Conclusions

Social media is enjoyable for students who may improve short term knowledge retention and can aid communication between learners and educators. However, higher‐quality study is required to identify longer‐term impact upon knowledge and skills, provide clarification on professionalism standards and protect against harms.