bluuebunny/crossref_metadata_2025 huggingface dataset:
Inter‐rater reliability of the assessment of learning powered mobility use, version 2.0, when applied with children and adults engaged in Driving to Learn in a powered wheelchair
Authors: Svensson Eva , Nilsson Lisbeth
Published: November 2020

Introduction

The Assessment of Learning Powered mobility use (ALP) tool including the ALP instrument and facilitating strategies, was developed for Driving to Learn. This therapeutic intervention aims to provide children and adults who have profound cognitive disabilities with opportunities to learn tool use through powered mobility practise. To allow for longer intervention periods, a partnership was developed between professionals supervising Driving to Learn and persons accompanying children or adults to their practice sessions. Accompanying persons (relatives or assistants) gradually took on shared responsibility for applying the intervention and conducting assessments with the ALP‐instrument. The aim of this study was to test the inter‐rater reliability of the ALP‐instrument version 2.0 as applied in this novel partnership in assessment and intervention.

Method

A psychometric analysis compared pair‐wise assessments with the ALP‐instrument version 2.0, made independently by professional supervisors and accompanying persons following each Driving to Learn session. Weighted kappa statistic was used to compare the matched pair ordinal data.

Results

Eight professional supervisors and 22 accompanying persons independently completed assessments with the ALP‐instrument after 55 sessions with six children and five adults, who each participated in five Driving to Learn sessions. When the scores from the 55 pairs of assessments were compared, a weighted kappa value of 0.85 was obtained, indicating very good inter‐rater reliability between the two rater groups.

Conclusion

The resulting inter‐rater reliability suggests that it is reliable to implement the ALP‐instrument as part of partnership in intervention between supervisors and accompanying persons. Provision of longer periods of Driving to Learn is possible when those who accompany the child or adult are able to gradually assume responsibility for practice and assessment under the supervision of a professional. This partnership approach enables children and adults with multiple and complex disabilities to practise and learn in accordance with their conditions and needs.
How Governments Respond to Business Demands for Tax Cuts: A Study of Corporate and Inheritance Tax Reforms in Austria and Sweden
Authors: Klitgaard Michael Baggesen , Paster Thomas
Published: November 2020

How responsive are democratic governments to business demands for tax cuts? We research this question in comparative case studies of cuts in corporate taxes and inheritance taxes in Austria and Sweden. We find that governments, regardless of partisan composition, are responsive to business demands, but that fiscal and electoral goals attenuate responsiveness. In both countries, the limited revenues generated by inheritance taxation and greater alignment of business demands with middle‐class voter interests resulted in governments heading business demands for an abolition of this tax. Goal conflict were larger for corporate tax cuts. In both countries, governments tried to minimize these goal conflict by adopting compensatory policy measures, specifically measures to broaden the tax base and simultaneous tax cuts for low‐income groups. The findings suggest that the policy output of business‐friendly tax cuts reflect a balancing of conflicting goals, rather than outright business dominance.
Understanding and strengthening the role of catastrophe lottery in catastrophe risk transfer system
Authors: Kong Feng
Published: November 2020

Against the background of global climate change and rapid urbanization, all kinds of catastrophic events occur, which challenge regional socio‐economic and sustainable development. This Forum contribution introduces the tools and systems of catastrophe risk transfer and its characteristics in practice. The case is then made that the catastrophe risk transfer system needs to be innovated. It is found that the current catastrophe risk transfer system in China cannot on its own meet the needs of catastrophe risk transfer. This contribution argues that a lottery mechanism is one important means for catastrophe risk transfer. Its basic function is risk transfer and thereby raises funds for disaster recovery and reconstruction. Finally, this contribution suggests ways in which to normalize the independent issuance of catastrophe lottery, to strengthen the relevant research work for catastrophe lottery and to explore the catastrophe risk transfer mode of the combination of catastrophe lottery and disaster insurance.
Early and late pregnancy loss in women with polycystic ovary syndrome undergoing IVF/ICSI treatment: a retrospective cohort analysis of 21 820 pregnancies
Authors: Cai He , Mol BW , Gordts S , Wang H , Wang T , Li N , Shi J
Published: November 2020

Objective

To examine early and late pregnancy loss in women with and without polycystic ovary syndrome (PCOS) undergoing IVF/ICSI transfers.

Design

Retrospective cohort study.

Setting

Reproductive medicine centre at a tertiary hospital.

Population

We studied women with a positive β‐human chorionic gonadotropin (β‐hCG) after in vitro fertilisation/intra‐cytoplasmic sperm injection (IVF/ICSI) treatment from May 2014 to April 2019.

Methods

Odds ratios (OR) for early (≤13 weeks) and late (>13 weeks) pregnancy loss were calculated among women with and without PCOS for plurality of the pregnancy with adjustment for confounding factors.

Main outcome measures

Early pregnancy loss (EPL) and late pregnancy loss (LPL).

Results

From 21 820 women identified with a positive β‐hCG, 2357 (10.8%) women had PCOS, and 19 463 (89.2%) women did not. EPL occurred in 16.6% (391) of women with PCOS versus 18.3% (3565) in women with non‐PCOS (OR 0.89, 95% CI 0.79–0.99, P = 0.04). After adjustment for age and other confounders, the rate of EPL was not statistically significantly associated with PCOS status (adjusted OR [aOR] 0.91, 95% CI 0.80–1.05). Women with PCOS demonstrated a higher rate of LPL (6.4% in PCOS versus 3.6% in non‐PCOS, OR 1.81, 95% CI 1.48–2.21, P < 0.001). In multivariable analysis, the potential impact of PCOS was less strong (aOR 1.38, 95% CI 0.96–1.98), with BMI and maternal comorbidities also associated with LPL (aOR 1.08, 95% CI 1.04–1.1 and aOR 2.07, 95% CI 1.43–3.00, respectively).

Conclusions

Polycystic ovary syndrome was not independently associated with EPL. There was an increased risk of LPL but this difference was not statistically significant.

Tweetable abstract

Polycystic ovary syndrome women are at increased risk of late pregnancy loss, partly driven by elevated BMI and maternal comorbidities.
Associations between mean systemic filling pressure and acute kidney injury: An observational cohort study following cardiac surgery
Authors: Neuman Jemma , Schulz Luis , Aneman Anders
Published: November 2020

Background

Venous congestion has been implied in cardiac surgery‐associated acute kidney injury (CSA‐AKI). The mean systemic filling pressure may provide a physiologically more accurate estimate of renal venous pressure and renal perfusion pressure but its association with CSA‐AKI has not been reported.

Methods

Patients admitted to ICU following cardiac surgery without pre‐operative renal dysfunction were included with monitoring of mean arterial pressure (MAP) and central venous pressure (CVP) and cardiac output (CO) to calculate the mean systemic filling pressure analogue (Pmsa). The AKI‐KDIGO guidelines were used to define CSA‐AKI. Logistic regression models including CO, heart rate, MAP, CVP and Pmsa were used to ascertain the association with CSA‐AKI and reported by odds ratio (OR) with 95% confidence interval (95%CI) and area under the curve (AUROC).

Results

One hundred and thirty patients (out of 221 screened) were included of whom 66 (51%) developed CSA‐AKI. Patients with CSA‐AKI were older, with greater weight and increased stay in ICU while the proportion of comorbidities, type of surgical procedures, APACHE III scores and fluid volumes administered were similar to patients without AKI. The Pmsa, but not CVP, was associated with CSA‐AKI (OR 1.2 95%CI [1.16‐1.25]). Renal perfusion pressure was associated with CSA‐AKI estimated as MAP‐Pmsa (OR 0.81 [0.76‐0.86]) and MAP‐CVP (OR 0.89 [0.85‐0.93]) with the former generating a higher AUROC (median difference 0.10 [0.07‐0.12], P < .001) in the regression model.

Conclusions

The Pmsa in post‐operative cardiac surgery patients was associated with the development of CSA‐AKI also when incorporated into estimates of renal perfusion pressure.
Effect of low vs high haemoglobin transfusion trigger on cardiac output in patients undergoing elective vascular surgery: Post‐hoc analysis of a randomized trial
Authors: Møller Anders , Wetterslev Jørn , Shahidi Saeid , Hellemann Dorthe , Secher Niels H. , Pedersen Ole B. , Marcussen Klaus V. , Ramsing Benedicte G. U. , Mortensen Anette , Nielsen Henning B.
Published: November 2020

Background

During vascular surgery, restricted red‐cell transfusion reduces frontal lobe oxygen (ScO2) saturation as determined by near‐infrared spectroscopy. We evaluated whether inadequate increase in cardiac output (CO) following haemodilution explains reduction in ScO2.

Methods

This is a post‐hoc analysis of data from the Transfusion in Vascular surgery (TV) Trial where patients were randomized on haemoglobin drop below 9.7 g/dL to red‐cell transfusion at haemoglobin below 8.0 (low‐trigger) vs 9.7 g/dL (high‐trigger). Fluid administration was guided by optimizing stroke volume. We compared mean intraoperative levels of CO, haemoglobin, oxygen delivery, and CO at nadir ScO2 with linear regression adjusted for age, operation type and baseline. Data for 46 patients randomized before end of surgery were included for analysis.

Results

The low‐trigger resulted in a 7.1% lower mean intraoperative haemoglobin level (mean difference, −0.74 g/dL; P < .001) and reduced volume of red‐cell transfused (median [inter‐quartile range], 0 [0‐300] vs 450 mL [300‐675]; P < .001) compared with the high‐trigger group. Mean CO during surgery was numerically 7.3% higher in the low‐trigger compared with the high‐trigger group (mean difference, 0.36 L/min; 95% confidence interval (CI.95), −0.05 to 0.78; P = .092; n = 42). At the nadir ScO2‐level, CO was 11.9% higher in the low‐trigger group (mean difference, 0.58 L/min; CI.95, 0.10‐1.07; P = .024). No difference in oxygen delivery was detected between trial groups (MD, 1.39 dLO2/min; CI.95, −6.16 to 8.93; P = .721).

Conclusion

Vascular surgical patients exposed to restrictive RBC transfusion elicit the expected increase in CO making it unlikely that their potentially limited cardiac capacity explains the associated ScO2 decrease.
Genotype‐guided antiplatelet treatment versus conventional therapy: A systematic review and meta‐analysis
Authors: Zhang Hanxu , Xiang Qian , Liu Zhiyan , Mu Guangyan , Xie Qiufen , Zhou Shuang , Ma Lingyue , Wang Zining , Hu Kun , Wang Zhe , Cui Yimin
Published: November 2020

Aim

This meta‐analysis was carried out to explore if a personalized antiplatelet strategy based on genotyping is superior to conventional therapy.

Methods

PubMed, Web of Science, EMBASE and the Cochrane Library were searched from the inception of each database to 5 May 2020. Studies reporting endpoints in genotype‐guided treatment group and conventional treatment group were included. The endpoint results were presented as the risk ratio (RR), with 95% confidence interval (CI).

Results

A total of 10 561 patients from 16 studies (eight randomized controlled trials [RCT] and eight cohort studies) were included in the meta‐analysis. The rates of major adverse cardiovascular events (MACE), stent thrombosis and myocardial infarction (MI) were significantly lower in the genotype‐guided group than in the conventional treatment group (RR 0.56, 95% CI 0.44‐0.73, P < .0001; RR 0.40, 95% CI 0.24‐0.67, P = .0005; RR 0.45, 95% CI 0.35‐0.58, P < .00001, respectively). A significant difference was found between the two groups in major bleeding (RR 0.73, 95% CI 0.55‐0.98, P = .04), which was not robust after sensitivity analysis.

Conclusion

Genotype‐guided antiplatelet treatment could decrease the risk of MACE, stent thrombosis and MI in patients with coronary artery disease or undergoing percutaneous coronary intervention, without increasing the risk of bleeding over a long follow‐up period. The decreased risk of efficacy outcomes was more obvious in cohort studies. Well‐organized RCTs and clinical trials are required to verify the benefit of genotype‐guided therapy.
Cognitive load and online course quality: Insights from instructional designers in a higher education context
Authors: Caskurlu Secil , Richardson Jennifer C. , Alamri Hamdan A. , Chartier Katherine , Farmer Tadd , Janakiraman Shamila , Strait Marquetta , Yang Mohan
Published: November 2020

This multiple case study investigates instructional designers’ perceptions of online course quality, their use of cognitive load strategies when designing online courses, and whether utilization of these strategies contribute to online course quality. The participants of this study were instructional designers (n = 5) who worked in various campus programs at a large Midwestern university. Data sources included pre‐interview survey, semi‐structured interview and sample course design documents. Employing a pattern matching technique, the results showed that instructional designers (a) define online course quality based on established standards and rubrics; (b) apply cognitive load strategies intuitively while designing online courses; and (c) consider CLT design strategies as an element contributing to course quality. The results also showed instructional designers’ use of cognitive load strategies mainly focused on reducing extraneous cognitive load. Implications for practice and research as well as directions for future research are discussed.

Practitioner Notes

What is already known about this topic

Cognitive load theory (CLT) provides empirically tested strategies to manage cognitive load in different settings

CLT strategies has a positive impact on student learning processes and outcomes

When designing online courses, it is important for faculty to collaborate with instructional designers to manage cognitive load and improve online course quality

There is a need to investigate instructional designers’ perceptions of online course quality and their use of CLT strategies when designing online courses

What this paper adds

Provides a deep understanding of instructional designers perspectives on online course quality, application of CLT strategies while designing online courses and how application of these strategies contribute to the online course quality

Although instructional designers identify multiple CLT strategies from their work and perceive CLT strategies as an element contributing to course quality, they apply these strategies innately

Implications for practice and/or policy

Multiple stakeholders should be involved in determining online course quality

Collaboration between faculty and instructional designers is essential to manage cognitive load and increase online course quality

CLT and related theories should be emphasized in instructional design programs

Future research should focus on how instructional designers integrate CLT strategies into the systematic instructional design process and instructional designers’ decision‐making process through think‐aloud and/or journaling efforts
Vertical stratification of seed‐dispersing vertebrate communities and their interactions with plants in tropical forests
Authors: Thiel Sarina , Tschapka Marco , Heymann Eckhard W. , Heer Katrin
Published: November 2020

Vertical stratification (VS) is a widespread phenomenon in plant and animal communities in forests and a key factor for structuring their species richness and biodiversity, particularly in tropical forests. The organisms composing forest communities adjust and shape the complex three‐dimensional structure of their environment and inhabit a large variety of niches along the vertical gradient of the forest. Even though the degree of VS varies among different vertebrate groups, patterns of compositional stratification can be observed across taxa. Communities of birds, bats, primates, and non‐flying small mammals are vertically stratified in terms of abundance, species richness, diversity, and community composition. Frugivorous members of these taxa play important roles as seed dispersers and forage on fruit resources that, in turn, vary in quantity and nutritional value along the vertical gradient. As a consequence, plant–seed disperser interaction networks differ among strata, which is manifested in differences in interaction frequencies and the degree of mutual specialization. In general, the canopy stratum is composed of strong links and generalized associations, while the lower strata comprise weaker links and more specialized interactions. Investigating the VS of communities can provide us with a better understanding of species habitat restrictions, resource use, spatial movement, and species interactions. Especially in the face of global change, this knowledge will be important as these characteristics can imply different responses of species and taxa at a fine spatial scale.
Conflicting and harmonious sibling relationships of children and adolescent siblings of children with autism spectrum disorder
Authors: Guidotti Laura , Musetti Alessandro , Barbieri Gian Luca , Ballocchi Ilenia , Corsano Paola
Published: November 2020

Background

The presence of a child with autism spectrum disorder (ASD) could have a strong psychological and emotional impact on typical development (TD) siblings, with different ways of adjustment and perception of fraternal relationships. In this study, we aimed to investigate the experience of the TD siblings of children with ASD, combining both quantitative and qualitative methodologies.

Method

An explanatory sequential design was employed. Forty‐four TD siblings of children with ASD, aged 6 to 17 years old, participated in the study. Each participant completed the Sibling Relationship Inventory that investigated warmth, rivalry and conflict in sibling relationships. Moreover, in order to thoroughly evaluate the participants' perception of their sibling relationship, they were asked to draw themselves with their sibling with ASD in a condition of harmony and conflict. The drawings were collected and coded using the well‐validated Pictorial Assessment of Interpersonal Relationships. Quantitative and qualitative analyses were conducted.

Results

In general, TD siblings showed affection for their siblings with ASD. However, males showed more conflict than females. Quantitative analyses of the drawings showed high levels of similarity between the siblings, despite the disability. In drawings, greater cohesion emerged in conditions of harmony and greater distancing in situations of conflict. Content analysis of the drawings showed that the conflict is represented mainly at home and the siblings often show opposite emotions, with TD siblings experiencing negative emotions. Moreover, adolescent TD siblings displayed more annoyance, shame and embarrassment than child TD siblings.

Conclusions

It is important to combine quantitative and qualitative tools to understand the experience of TD siblings in detail. In particular, drawing is a useful tool for providing quantitative and qualitative information, supplying rich and detailed information that can be well integrated with the results coming from quantitative tools.
Repetitive nasal allergen challenge in allergic rhinitis: Priming and Th2‐type inflammation but no evidence of remodelling
Authors: Orban Nara T. , Jacobson Mikila R. , Nouri‐Aria Kayhan T. , Durham Stephen R. , Eifan Aarif O.
Published: November 2020

Background

Local tissue eosinophilia and Th2 cytokines are characteristic features of seasonal allergic rhinitis. Airway remodelling is a feature of asthma whereas evidence for remodelling in allergic rhinitis (AR) is conflicting.

Objective

By use of a novel human repetitive nasal allergen challenge (RAC) model, we evaluated the relationship between allergic inflammation and features of remodelling in AR.

Methods

Twelve patients with moderate–severe AR underwent 5 alternate day challenges with diluent which after 4 weeks were followed by 5 alternate day challenges with grass pollen extract. Nasal symptoms, Th1/Th2 cytokines in nasal secretion and serum were evaluated. Nasal biopsies were taken 24 hours after the 1st and 5th challenges with diluent and with allergen. Sixteen healthy controls underwent a single challenge with diluent and with allergen. Using immunohistochemistry, epithelial and submucosal inflammatory cells and remodelling markers were evaluated by computed image analysis.

Results

There was an increase in early and late‐phase symptoms after every allergen challenge compared to diluent (both P < .05) with evidence of both clinical and immunological priming. Nasal tissue eosinophils and IL‐5 in nasal secretion increased significantly after RAC compared to corresponding diluent challenges (P < .01, P = .01, respectively). There was a correlation between submucosal mast cells and the early‐phase clinical response (r = 0.79, P = .007) and an association between epithelial eosinophils and IL‐5 concentrations in nasal secretion (r = 0.69, P = .06) in allergic rhinitis. No differences were observed after RAC with regard to epithelial integrity, reticular basement membrane thickness, glandular area, expression of markers of activation of airway remodelling including α‐SMA, HSP‐47, extracellular matrix (MMP7, 9 and TIMP‐1), angiogenesis and lymphangiogenesis for AR compared with healthy controls.

Conclusion

Novel repetitive nasal allergen challenge in participants with severe persistent seasonal allergic rhinitis resulted in tissue eosinophilia and increases in IL‐5 but no structural changes. Our data support no link between robust Th2‐inflammation and development of airway remodelling in AR.
How to screen for at‐risk alcohol use in transplant patients? From instrument selection to implementation of the AUDIT‐C
Authors: Verhalle Lieza , Van Bockstaele Kristof , Duerinckx Nathalie , Vanhoof Jasper , Dierickx Katrien , Neyens Leen , Van Cleemput Johan , Gryp Sabine , Kums Dominica , De Bondt Katleen , Schaevers Veronique , Demuynck Florian , Dewispelaere Anne , Dobbels Fabienne ,   the Transplantation Innovation Team (TRANSIT)
Published: November 2020

Background

Given that drinking >2–3 units of alcohol daily might already have adverse health effects, regular screening of at‐risk drinking is warranted. We aimed to select and pilot a short instrument to accurately screen for at‐risk drinking in transplant patients.

Methodology and results

Five consecutive steps were completed: A comprehensive literature review identified 24 possible self‐report instruments (step 1). These instruments were scored on six yes/no criteria (ie, length, concept measured, diagnostic accuracy, population, manual available, cost) (step 2). Four nurses piloted three instruments with the highest score and were interviewed on their experiences with using the AUDIT‐C, TWEAK, and Five Shot. The AUDIT‐C was the easiest to use and score, and items were clear. Cognitive debriefings with 16 patients were conducted to verify clarity of instructions and items, and suggestions were incorporated into a modified version of the AUDIT‐C (step 4). A convenience sample of 130 Dutch‐speaking heart transplant patients completed the modified AUDIT‐C during a scheduled visit (Step 5), revealing that 27.6% of patients showed at‐risk drinking.

Conclusion

The AUDIT‐C might be a suitable instrument to identify at‐risk drinking in routine post‐transplant follow‐up. Further validation, however, is indicated.
Estimation of Body Fat Percentage for Clinical Pharmacokinetic Studies in Children
Authors: Green Thomas P. , Binns Helen J. , Wu Huali , Ariza Adolfo J. , Perrin Eliana M. , Quadri Maheen , Hornik Christoph P. , Cohen‐Wolkowiez Michael
Published: November 2020

Obesity is a prevalent childhood condition and the degree of adiposity appears likely to be an important covariate in the pharmacokinetics (PKs) of many drugs. We undertook these studies to facilitate the evaluation and, where appropriate, quantification of the covariate effect of body fat percentage (BF%) on PK parameters in children. We examined two large databases to determine the values and variabilities of BF% in children with healthy body weights and in those with obesity, comparing the accuracy and precision of BF% estimation by both clinical methods and demographically derived techniques. Additionally, we conducted simulation studies to evaluate the utility of the several methods for application in clinical trials. BF% was correlated with body mass index (BMI), but was highly variable among both children with healthy body weights and those with obesity. Bio‐impedance and several demographically derived techniques produced mean estimates of BF% that differed from dual x‐ray absorptiometry by < 1% (accuracy) and a SD of 5% or less (precision). Simulation studies confirmed that when the differences in precision among the several methods were small compared with unexplained between‐subject variability of a PK parameter, the techniques were of similar value in assessing the contribution of BF%, if any, as a covariate for that PK parameter. The combination of sex and obesity stage explained 68% of the variance of BF% with BMI. The estimation of BF% from sex and obesity stage can routinely be applied to PK clinical trials to evaluate the contribution of BF% as a potential covariate.
Insights for protection of high species richness areas for the conservation of Mesoamerican endemic birds
Authors: Ramírez‐Albores Jorge E. , Prieto‐Torres David A. , Gordillo‐Martínez Alejandro , Sánchez‐Ramos Luis E. , Navarro‐Sigüenza Adolfo G.
Published: November 2020

Aim

To assess the representativeness values of Mesoamerican endemic birds within the current network of protected areas (PAs) to determine high‐priority and complementary conservation areas to maximize the long‐term protection of species.

Location

From central Mexico to southern Panama.

Methods

We selected 180 bird species that are geographically restricted to Mesoamerica and estimated their potential ranges using species distribution models. Then, using two different removal rules in ZONATION software, we assessed the species’ representativeness levels within the current PA network. We also defined forest remnants that could be used to strategically expand PAs (to reach Aichi biodiversity targets) and maximize the species protection, explicitly considering anthropic pressures.

Results

Current PAs cover ~13% of the land area of Mesoamerica, representing an average of ~19% of the total potential distribution for the endemic bird species considered. We also observed that there is <30% overlap between current PAs and the priority areas we define. Our prioritization analyses showed that strategically increasing protection coverage to 17%, as stipulated in the Aichi targets, would substantially increase the representativeness values of PAs (regardless of the removal rule used) and would increase the range by >35% for all species and >29% for threatened species. The consensus priority conservation areas identified were mainly distributed in Costa Rica (~48%), Mexico (~28%), and Panama (~10%).

Main conclusions

Consistent with the global picture, Mesoamerican PAs showed low representativeness of their vulnerable endemic avifauna; therefore, well‐informed decisions to guide conservation strategies are imperative. We provide insights about where future conservation efforts should focus to accomplish a representative and well‐connected regional PA network.
Brain malformations and cognitive performance in spina bifida
Authors: Schneider Joanna , Mohr Naomi , Aliatakis Niko , Seidel Ulrich , John Rainer , Promnitz Gabriel , Spors Birgit , Kaindl Angela M
Published: November 2020

Aim

To systematically characterize radiological features of patients with spina bifida, their relationship to cognitive function, and differences between spina bifida aperta (SBA) and spina bifida occulta (SBO).

Method

In a retrospective study of 265 patients (117 females, 148 males; median age at imaging 11y, range 1–47y; SBA n=206, SBO n=59), the radiological phenotype was assessed through magnetic resonance imaging (MRI) (SBA n=171, SBO n=59). In 126 patients (SBA n=116, SBO n=10) Kaufman Assessment Battery for Children (KABC) or Wechsler Intelligence Scale for Children, Fourth Edition (WISC‐IV) and Wechsler Adult Intelligence Scale, Fourth Edition (WAIS‐IV) were performed.

Results

Patients with spina bifida show numerous brain malformations, always present for SBA but rarely for SBO. The most frequent brain malformations in SBA included abnormal corpus callosum (69%), hypoplastic pons (50%), and hypoplastic mesencephalon (20%). Cognitive total IQ scores were below average in 44% (KABC) to 49% (WISC‐IV) of children with SBA, while almost all children with SBO scored at least average. Stenogyria (p=0.006), pons (p=0.003), and mesencephalon hypoplasia (p=0.01) correlated with lower total IQ score and verbal comprehension. Various brain malformations correlate significantly with several cognitive domains, while lesion level only correlates with processing speed.

Interpretation

IQ scores were significantly lower in patients with SBA than in patients with SBO. Verbal competence, perceptual reasoning, and working memory were significantly impaired for SBA and correlated with stenogyria and abnormalities of the midbrain and corpus callosum.

What this paper adds

Brain malformations occur more frequently in spina bifida aperta (SBA) than in spina bifida occulta (SBO).

Cognitive impairment is less frequent in SBO.

Hydrocephalus, stenogyria, midbrain, and corpus callosum abnormalities are associated with lower cognitive function.

Difference in prognosis in SBO versus SBA can alter prenatal counselling.
Sitagliptin for the prevention and treatment of perioperative hyperglycaemia in patients with type 2 diabetes undergoing cardiac surgery: A randomized controlled trial
Authors: Cardona Saumeth , Tsegka Katerina , Pasquel Francisco J. , Jacobs Sol , Halkos Michael , Keeling W. Brent , Davis Georgia M. , Fayfman Maya , Albury Bonnie , Urrutia Maria A. , Galindo Rodolfo J. , Migdal Alexandra L. , Macheers Steven , Guyton Robert A. , Vellanki Priyathama , Peng Limin , Umpierrez Guillermo E.
Published: November 2020

Aim

To assess whether treatment with sitagliptin, starting before surgery and continued during the hospital stay, can prevent and reduce the severity of perioperative hyperglycaemia in patients with type 2 diabetes undergoing coronary artery bypass graft (CABG) surgery.

Materials and Methods

We conducted a double‐blinded, placebo‐controlled trial in adults with type 2 diabetes randomly assigned to receive sitagliptin or matching placebo starting 1 day prior to surgery and continued during the hospital stay. The primary outcome was difference in the proportion of patients with postoperative hyperglycaemia (blood glucose [BG] > 10 mmol/L [>180 mg/dL]) in the intensive care unit (ICU). Secondary endpoints included differences in mean daily BG in the ICU and after transition to regular wards, hypoglycaemia, hospital complications, length of stay and need of insulin therapy.

Results

We included 182 participants randomized to receive sitagliptin or placebo (91 per group, age 64 ± 9 years, HbA1c 7.6% ± 1.5% and diabetes duration 10 ± 9 years). There were no differences in the number of patients with postoperative BG greater than 10 mmol/L, mean daily BG in the ICU or after transition to regular wards, hypoglycaemia, hospital complications or length of stay. There were no differences in insulin requirements in the ICU; however, sitagliptin therapy was associated with lower mean daily insulin requirements (21.1 ± 18.4 vs. 32.5 ± 26.3 units, P = .007) after transition to a regular ward compared with placebo.

Conclusion

The administration of sitagliptin prior to surgery and during the hospital stay did not prevent perioperative hyperglycaemia or complications after CABG. Sitagliptin therapy was associated with lower mean daily insulin requirements after transition to regular wards.
Thomas Aquinas and the complex simplicity of the rational soul
Authors: Skrzypek Jeremy W.
Published: November 2020

Thomas Aquinas holds that the rational soul is not only, like other created immaterial substances, mereologically simple, in that it is completely lacking in any kind of material parts, but also mereologically complex, in that it includes within its composition its own essence, an act of existence, and various powers. Aquinas's account of the mereological complexity of the rational soul introduces several tensions with his understanding of the soul as the substantial form of the body and his larger ontology of the human person. After providing an overview of several key mereological notions operative in Aquinas's thought, and an overview of the mereological simplicity and mereological complexity of immaterial substances in his ontology, I introduce three potential concerns for the Thomistic account, all of which might have been avoided had Aquinas instead understood the rational soul to be entirely mereologically simple—serving as the source and subject of, but bearing some other nonmereological relation to, the aforementioned parts. Though Aquinas does not pursue this simpler solution, I argue that he already has built into his ontology the resources to make such a solution consistent with the rest of his thought.
Equity of African American Men in Headache in the United States: A Perspective From African American Headache Medicine Specialists (Part 1)
Authors: Charleston Larry , Spears Roderick C. , Flippen Charles
Published: November 2020

Migraine and severe headache affect approximately 1 in 6 U.S. adults and migraine is one of the most disabling disorders worldwide. Approximately 903,000 to 1.5 million African American (AA) men are affected by migraine in the United States. Racial disparities in headache medicine exist. In addition, there are limited headache studies that attest to the inclusion of or have robust data on AA men in headache medicine in the United States. Racial concordance between provider and patient may ameliorate some aspects of care disparities. Moreover, it has been demonstrated that diversity and inclusion particularly in leadership of organizations has consistently produced positive change, increased innovation, and long‐term success. Most national headache organizations strive to improve the care and lives of people living with headache disorders yet only ~0.5% of their physician members are AA men. Herein, we provide an observation of equity issues from the perspective of AA men in the headache medicine subspecialty. Part 1 of this manuscript explores inherent and potential challenges of the equity of AA men in headache medicine including headache disparities, mistrust, understudied/lack of representation in research, cultural differences, implicit/explicit bias, and the diversity tax. Part 2 of this work offers possible solutions to achieve equity for AA men in headache including: (1) addressing head and facial pain disparities and mistrust in AA men; (2) professionalism and inclusion; (3) organizational/departmental leadership buy‐in for racial diversity; (4) implicit/explicit and other bias training; (5) diversity panels with open discussion; (6) addressing diversity tax; (7) senior mentorship; (8) increased opportunities for noteworthy and important roles; (9) forming and building alliances and partnerships; (10) diversity leadership training programs; (11) headache awareness, education, and literacy with focus to underrepresented in medicine trainees and institutions; and (12) focused and supported the recruitment of AA men into headache medicine. More work is needed for equity of AA men in headache medicine.
Sensory words may facilitate certain haptic exploratory procedures in facial cosmetics
Authors: Arakawa Naomi , Watanabe Tomoko , Fukushima Kyoko , Nakatani Masashi
Published: November 2020

Objective

Many people want to have healthy facial skin. They tend to check their skin’s condition by touching their face with their hands. In the cosmetic industry, we need to understand what consumers are perceiving in a tactile sense when touching their own facial skin. The purpose of this study was to investigate these observation methods in order to systematically understand people’s haptic exploratory procedures (HEPs).

Methods

Thirty‐four participants living in the United States and twenty‐two participants living in Japan freely explored their faces and answered which side felt more closely related to the six tactile adjectives. A new analysis was applied to classify the observed HEPs into six classifications within two categories and three sizes of contact area by experts.

Result

It was confirmed that the new task was useful to observe the HEPs for participants from United States and Japan. The US participants’ HEPs for ‘moisturized’ were mainly a middle‐sized contact area using a stroking motion. On the other hand, Japanese participants’ HEPs for ‘moisturized’ (‘shittori’ in Japanese) mainly used a pushing movement. Moreover, the US participants’ HEPs for ‘soft’ included both pushing and stroking, but Japanese participants HEPs for ‘soft’ (‘yawarakai’ in Japanese) were again mainly pushing.

Conclusion

This study suggests that the proposed analysis method enables the systematic understanding of HEPs when checking the skin, along with the cross‐cultural differences affecting those procedures. These systematic findings could allow cosmetic formulators to have a better understanding of the tactile sensations consumers themselves are feeling in a variety of different global markets.
Trust barriers to online shopping: Investigating and prioritizing trust barriers in an intuitionistic fuzzy environment
Authors: Rasty Fereshte , Mirghafoori Seyyed Habibollah , Saeida Ardekani Saeid , Ajdari Peyman
Published: November 2020

Although the internet plays a significant role in daily activities, particularly shopping, some individuals are reluctant to shop online due to distrust in the online environment. This research aims to investigate trust barriers to online shopping from the relevant literature and prioritize them in an intuitionistic fuzzy environment. After reviewing the relevant literature, 18 barriers were extracted and a questionnaire based on these barriers was distributed among 150 internet users to rank three criteria of Failure Mode and Effect Analysis (FMEA), namely severity, occurrence, and detection. Afterward, using the entropy method based on FMEA in an intuitionistic fuzzy environment, the priority of each barrier was assessed. The findings showed that the most important barriers to trust in online shopping are ‘privacy risk’, ‘lack of feel‐and‐touch associated with online purchases’, ‘psychological risk’, ‘social risk’ and ‘feeling that e‐vendors are pretending to care about buyers’ welfare’. Based on the findings, marketing managers should focus on improving and promoting the infrastructure security of their online shopping sites, providing comprehensive information, and benefiting from influencers and celebrities’ endorsements in order to increase customer trust.
Mucoscopy of lip squamous cell carcinoma and correlation with skin phototype and histological differentiation: a multicentric retrospective observational study by the International Dermoscopy Society
Authors: Jha Abhijeet Kumar , Sonthalia Sidharth , Sławińska Martyna , Lallas Aimilios , Vinay Keshavamurthy , Sobjanek Michał , Kamińska‐Winciorek Grazyna , Zeeshan Md , Errichetti Enzo
Published: November 2020

Background

There is a scarcity of published data on the dermoscopic morphology of lip squamous cell carcinoma (SCC) and its variability according to the histological differentiation degree and patient’s ethnicity as per skin phototype.

Objectives

To evaluate the dermoscopic features of SCC of the lips and identify possible dermoscopic clues that may aid in differentiation between well‐differentiated, moderately‐differentiated, and poorly‐differentiated lesions, as well as between “fair” skin (Fitzpatrick skin phototypes I‐III) and “dark” skin (Fitzpatrick skin phototypes IV‐VI).

Methods

The clinical profile and dermoscopic images of patients of any age and either gender with histologically confirmed lip SCC collated from seven dermatological centers were retrospectively evaluated for dermoscopic clues as per certain predefined criteria.

Results

A total of 60 lesions from 60 patients were included in the analysis. Histologically, well, moderate, and poordifferentiation were seen in 24 (40%), 14 (23.3%), and 22 (36.7%) of the lesions, respectively. Other than the presence of brown‐to‐gray dots/globules, which was exclusively seen in cases with dark phototypes (19.4% P = 0.035), no other dermoscopic feature was statistically significant in differentiating between the two skin types. Some dermoscopic findings were observed specifically with statistical significance: perivascular white halos (P = 0.049) and whitish‐yellow background in well‐differentiated lesions (P = 0.003); pink background in moderately‐differentiated lesions (P = 0.003); and red background with dense vascularity in poorly‐differentiated lesions (P < 0.001).

Conclusions

The presence of vessels, scale/crust, and keratinization‐associated white structures were the most common dermoscopic clues in lip SCC.
Probiotics as potential detoxification tools for mitigation of pesticides: a mini review
Authors: Mohammadi Mehrdad , Shadnoush Mahdi , Sohrabvandi Sara , Yousefi Mojtaba , Khorshidian Nasim , Mortazavian Amir M.
Published: November 2020

Pesticides play a key role in agriculture and food production by controlling the insects, weeds, plant pathogens and microbial contaminations. Although they are useful in some aspects, their inappropriate application can induce health problems including carcinogenicity, reproductive toxicity, neurodegenerative diseases and disruption of endocrine system. In this respect, efficient strategies should be applied to reduce pesticide residue in foodstuffs. Several methods have been proposed in food processing for reduction of pesticides residue. Recently, detoxification via microorganisms such as lactic acid bacteria and probiotics has been extensively studied and degradation of pesticides through hydrolytic enzymes has been introduced as the possible mechanism and it has been highlighted that some probiotics harbour pesticide‐degrading genes. The aim of this review is to evaluate the efficacy of probiotics in detoxification of pesticides.
Women‐centred workplace health promotion interventions: a systematic review
Authors: Jiménez‐Mérida M. R. , Romero‐Saldaña M. , Molina‐Luque R. , Molina‐Recio G. , Meneses‐Monroy A. , De Diego‐Cordero R. , Vaquero‐Abellán M.
Published: November 2020

Aim

To analyse workplace health promotion interventions implemented exclusively for the female population.

Background

The differences in biological, psychological and social characteristics, as well as the type of work carried out by men and women, make it necessary for workplace health promotion to be specific for each group. This study focussed on working women.

Introduction

Workplace health promotion interventions are centred on increasing the well‐being and health of the employees. Occupational health nurses play an essential role in the implementation of these interventions.

Methods

A systematic review was carried out using the MEDLINE and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines.

Results

Twelve articles met the inclusion criteria. Two lines of interventions were found: (1) promotion of breastfeeding (16.6%) and (2) promotion of physical activity and other healthy lifestyles (83.4%). The interventions studied underlined promoting breastfeeding, preventing a sedentary lifestyle, improving body composition, reducing cardiovascular risk, relieving premenstrual symptoms, time of breastfeeding after returning to work, and showing favourable results.

Discussion

The lack of studies on the subject and the medium‐to‐low quality of the articles included in the review have made it difficult to analyse workplace health promotion interventions, making it necessary to continue research in this area.

Conclusion

There are very few occupational health promotion interventions targeting women (1.9%), and the majority of them focus on promoting physical activity. It is worrying that specific aspects of women's health are poorly addressed.

Implications for nursing practice and health policy

The work of the occupational nurse essentially is to guarantee the health of women in the workplace, being the key figure in the research and development of gender‐related policies in the field of public health.
Chinese economic policy uncertainty and U.S. corporate investment
Authors: Lee Kiryoung , Jeon Yoontae , Samarbakhsh Laleh , Kim Insik
Published: November 2020

Prior findings suggest that firms reduce investment when they face a higher degree of domestic economic policy uncertainty. In this paper, we provide a new finding that corporate investment of U.S. firms also declines when Chinese economic policy uncertainty rises, after controlling for U.S. economic policy uncertainty. Additional analysis suggests that the result is stronger for firms located in states with larger exports to China, implying the importance of global supply chain link in understanding firms' investment decisions.
Incidence and characteristics of silent cerebral embolisms after radiofrequency‐based atrial fibrillation ablation: A propensity score‐matched analysis between different mapping catheters and indices for guiding ablation
Authors: Nakamura Kohki , Sasaki Takehito , Take Yutaka , Minami Kentaro , Inoue Mitsuho , Asahina Chisa , Sasaki Wataru , Kishi Shohei , Yoshimura Shingo , Okazaki Yoshinori , Motoda Hiroyuki , Niijima Katsura , Miki Yuko , Goto Koji , Kaseno Kenichi , Yamashita Eiji , Koyama Keiko , Funabashi Nobusada , Naito Shigeto
Published: November 2020

Introduction

The difference in the incidence and characteristics of silent cerebral events (SCEs) after radiofrequency‐based atrial fibrillation (AF) ablation between the different mapping catheters and indices used for guiding radiofrequency ablation remains unclear. This study aimed to compare the incidence and characteristics of postablation SCEs between the following two groups: Group C, Ablation Index‐guided ablation using two circular mapping catheters with CARTO (Biosense Webster); Group R, local impedance‐guided ablation using one mini‐basket catheter and one circular mapping with Rhythmia (Boston Scientific).

Methods and Results

Of 211 consecutive patients who underwent an AF ablation and brain magnetic resonance (MR) imaging after the ablation, 120 patients (each group, n = 60) were selected by propensity score matching. SCEs were detected in 37 patients (30.8%). Group R had a higher incidence of SCEs (51.7% vs. 10.0%; p < .001) and more SCEs per patient (median, 3 vs. 1, p = .028) than Group C. A multivariate analysis demonstrated that nonparoxysmal AF and being Group R were independent positive predictors of SCEs (odds ratios, 6.930 and 15.464; both p < .001). On the follow‐up MR imaging, all SCEs in Group C and 87.9% of the SCEs in Group R disappeared (p = .537).

Conclusions

Group R had a significantly higher incidence of SCEs than Group C. Most probably the use of a complexly designed basket mapping catheter is the reason for the difference in the incidence of SCEs but further validation is needed. A nonparoxysmal form of AF may also increase the risk of SCEs during these ablation procedures.