bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a conventional mood stabilizer alone or in combination with second‐generation antipsychotics on recurrence rate and discontinuation rate in bipolar I disorder in the maintenance phase: A systematic review and meta‐analysis of randomized, placebo‐controlled trials
Authors: Kishi Taro , Sakuma Kenji , Okuya Makoto , Matsuda Yuki , Esumi Satoru , Hashimoto Yasuhiko , Hatano Masakazu , Miyake Nobumi , Miura Itaru , Mishima Kazuo , Iwata Nakao
Published: February 2021

Objectives

A systematic review and meta‐analysis of double‐blind, randomized placebo‐controlled trials were conducted to examine how soon an increase in recurrence risk could be observed among bipolar I disorder (BDI) patients who were clinically stable with the combination therapy of mood stabilizers with second‐generation antipsychotics (SGA+MS) treatment following second‐generation antipsychotics discontinuation (i.e., MS alone) compared with SGA+MS maintenance.

Methods

Embase, PubMed, and CENTRAL databases were used for systematic literature searches until May/22/2020. The primary outcome was the recurrence rate of any mood episode at 6 months. The secondary outcomes were the recurrence rates of manic/hypomanic/mixed and depressive episodes and all‐cause discontinuation at 6 months. The recurrence rates at 1, 2, 3, 9, and 12 months were also investigated.

Results

Eight studies (mean study duration = 58.25 ± 33.63 weeks) were identified (SGA+MS group [n = 1,456: 3 aripiprazole+MS studies, 1 lurasidone+MS study, 1 olanzapine+MS study, 2 quetiapine+MS studies, 1 ziprasidone+MS study] and placebo+MS group [n = 1,476]). Pooled SGA+MS exhibited lower recurrence rates of any mood episode, manic/hypomanic/mixed episodes, and depressive episodes as well as reduced all‐cause discontinuation at every observational point. The risk ratios (95% confidence interval) of the recurrence rate at 6 months were 0.51 (0.39–0.86) for any mood episode, 0.42 (0.30–0.59) for manic/hypomanic/mixed episodes, and 0.39 (0.28–0.54) for depressive episodes. The RR for all‐cause discontinuation was 0.67 (0.50–0.89). Both aripiprazole+MS and quetiapine+MS outperformed placebo+MS in the recurrence of any mood, manic/hypomanic/mixed, and depressive episodes at 6 months.

Conclusions

SGA+MS prevented recurrence for up to 12 months for BDI compared with placebo+MS.
Effects of early intervention on parenting stress after preterm birth: A meta‐analysis
Authors: Girabent‐Farrés Montserrat , Jimenez‐Gónzalez Amanda , Romero‐Galisteo Rita Pilar , Amor‐Barbosa Marta , Bagur‐Calafat Caritat
Published: February 2021

Background

Preterm infants have a higher risk of development disorders. Prematurity can be considered a source of stress, in both children and their parents, due to the high number of interventions that they require. Early intervention (EI) programmes have shown to have a positive influence on the neurodevelopment of children with neurological risk. On the other hand, parenting stress has a negative influence on the development of any child. This systematic review aimed to identify the effect of EI programmes on decreasing parenting stress suffered by parents of preterm babies.

Methods

Systematic review and meta‐analysis of experimental studies in accordance with the PRISMA declaration guidelines were applied in this work.

Results

Fifteen randomized clinical trials were included whose methodological quality was assessed using the PEDro scale. Stress data extraction was meta‐analysed using the inverse variance method in a random effects model. Statistical heterogeneity was assessed with the I2 heterogeneity statistic. The domains most commonly reported in the trials were the childcare‐related stress (Child Domain), personal discomfort (Parent Domain) and computation of both (Total Stress). The results showed significant (P < 0,05) and clinically relevant differences in favour of the EI programme group at 18 months and 5 years.

Conclusions

This review found moderate to strong evidence of the impact of EI programmes on the reduction of parenting stress in parents of preterm babies. These findings offer useful insights regarding the delivery of current support and the development of future family interventions. Finally, recommendations are provided for future intervention evaluation studies in this area.
Trabecular bone score and bone mineral density in patients with long‐term controlled acromegaly
Authors: Calatayud María , Pérez‐Olivares Martín Laura , Librizzi María Soledad , Lora Pablos David , González Méndez Violeta , Aramendi Ramos Mercedes , Martínez Diaz‐Guerra Guillermo , Hawkins Federico
Published: February 2021

Objective

Acromegaly is associated with increased vertebral fracture (VFs) risk not correlated to bone mineral density (BMD). Trabecular bone score (TBS), related to bone microarchitecture, provides information on bone strength. This cross‐sectional study considered the usefulness of TBS and BMD to assess bone status in long‐term controlled acromegalic patients.

Design, patients, measurements

26 acromegaly patients (14 female and 12 males) were included in the study. A further 117 subjects were recruited as controls (58 females and 57 males). BMD was measured using dual‐energy X‐ray absorptiometry (DXA), TBS was obtained applying Medimaps software 2.0. Biochemical parameters were determined by standardized techniques.

Results

73% of patients with acromegaly exhibited normal lumbar spine (LS) BMD. TBS was normal in 38% of acromegalic patients and partially degraded or degraded in 31% of patients, respectively. No differences were found in LS BMD between acromegalic patients and controls. TBS values were significantly lower in patients with acromegaly (1.27 ± 0.13 vs. 1.35 ± 0.17, p = .01). Postsurgical remission was associated with higher TBS values (1.35 ± 0.10 vs. 1.23 ± 0.13, p = .02) and pituitary radiotherapy treatment with lower TBS values (1.18 ± 0.12 vs. 1.31 ± 0.12, p = .004). On multivariate analysis, age, BMI and LS BMD were predictors of TBS changes in patients with acromegaly (p < .05).

Conclusions

Patients with long‐term controlled acromegaly can exhibit deterioration of bone microstructure measured with TBS, despite BMD measurement not showing bone loss. Our study suggests that TBS is useful for monitoring the bone status changes in acromegalic patients.
Consensus statements on the clinical understanding and use of bupropion in Hong Kong
Authors: Lee Wing‐King , Au Yeung Kwok‐Leung , Lam Ho‐Bun , Wong Chi‐Keung , Wong Ting‐Chi , Fu Chi‐Kin , Sham Shiu‐Kow , Au Ming‐Kai , Lam Tat‐Chung , Ki‐Yan Mak Daniel
Published: February 2021

Objectives

To develop a local consensus to guide medical practitioners and psychiatrists on the use of bupropion in different psychiatric conditions in Hong Kong.

Methods

By utilizing the modified Delphi technique, a group of 10 local physicians with extensive experience in the management of major depressive disorder (MDD) developed and voted (using an anonymous, electronic voting system) on the practicality of recommendation of a set of consensus statements on the clinical use and understanding of bupropion in Hong Kong.

Results

There was a very high degree of agreement among the panelists on the 11 finalized consensus statements.

Conclusions

The present consensus statements are developed as general recommendations for medical practitioners and psychiatrists to be practically referred to in clinical settings.
Wait expectations: The impact of delisting as an outcome from the kidney transplant waitlist
Authors: Sokas Claire , Cooper Zara , Salim Ali , Rodrigue James R. , Adler Joel T.
Published: February 2021

Background

While kidney transplantation is optimal for the treatment of end‐stage kidney disease, available organs do not meet demand. Little is known about the outcomes of patients who are delisted (removed from the waitlist) and unable to benefit from transplant. We describe patients who are delisted and their life expectancy after delisting.

Methods

Patients ≥ 18 years listed for deceased donor kidney transplant between 01/2003 and 12/2013 were identified in the Scientific Registry of Transplant Recipients and followed through 12/2018. A competing risk model was used to measure the association of demographic and clinical factors with waitlist outcomes of delisting, transplant, and death. Multivariate Cox modeling was used to evaluate factors associated with death after delisting.

Results

Of 324,582 patients listed, 18.0% were delisted, most common reasons were “too sick” or “other.” After delisting, half (49.7%) had died by end of follow‐up; time to death after removal was 5 years. Increasing age and public insurance were associated with increased risk of death.

Conclusions

Nearly one in five patients will be delisted from the kidney transplant waitlist. These patients live a surprisingly long time after removal. Much remains unknown about these patients, which could be improved through data collection. Delisting is an important patient outcome that warrants further exploration.
Grizzled Skippers stuck in the south: Population‐level responses of an early‐successional specialist butterfly to climate across its UK range over 40 years
Authors: Bell Fiona , Botham Marc , Brereton Tom M. , Fenton Andy , Hodgson Jenny
Published: February 2021

Aim

Climate change has been predicted to facilitate poleward expansion of many early‐successional specialist invertebrates. The Grizzled Skipper, Pyrgus malvae, is a threatened butterfly in long‐term decline that has not met expectations of northern expansion in Britain, possibly indicating that climate change has not improved northern habitat suitability or that another driver (e.g. land use change) is masking its effects. Here, we explore the effect of climate on population size trends over four decades, and whether any regions show an improving population trend that may be a precursor to northern expansion. Examining detailed spatio‐temporal abundance data can reveal unexpected limitations to population growth that would not be detectable in widely used climate envelope models.

Location

Central and southern England.

Methods

Mixed models were used to investigate P. malvae population size in relation to time and monthly climate measures across its UK range since 1976, based on repeated transect walks.

Results

We found that P. malvae population size declined more over time in the north and west of its UK range than in the south and east, and was negatively related to high December temperature and summer rainfall. However, the effect sizes of temperature and rainfall were minimal.

Main Conclusions

The last 40 years of climate change have not ameliorated climate suitability for P. malvae at its range edge, contrary to expectations from spatial‐only climate envelope models. The clear long‐term downward trends in population size are independent of climate change and we propose probably due to habitat deterioration. Our findings highlight potential hazards in predicting species range expansions from spatial models alone. Although some climate variables may be associated with a species’ distribution, other factors may be more dominant drivers of trends and therefore more useful predictors of range changes.
Barriers and facilitators of physical activity participation for young people and adults with childhood‐onset physical disability: a mixed methods systematic review
Authors: Mckenzie Georgia , Willis Claire , Shields Nora
Published: February 2021

Aim

To understand the attitudes, barriers, and facilitators to physical activity participation for young people and adults with childhood‐onset physical disability.

Method

Seven electronic databases (Embase, MEDLINE, PsychINFO, AMED, CINAHL, SPORTDiscus, and ERIC) were searched to November 2019. English language studies were included if they investigated attitudes, barriers, or facilitators to physical activity for young people (≥15y) or adults with childhood‐onset physical disabilities. Two reviewers applied eligibility criteria and assessed methodological quality. Data were synthesized in three stages: (1) thematic analysis into descriptive themes, (2) thematic synthesis via conceptual framework, and (3) an interpretive synthesis of the thematic results.

Results

Nineteen studies were included. Methodological quality varied, with only four qualitative studies and one quantitative study meeting all quality items. An overarching theme of ‘finding the right balance’ emerged. Six subthemes relating to capability, opportunity, and motivation contributed to physical activity participation being seen as ‘the right fit’ or ‘all too hard’. The interpretive synthesis found social connections, social environment support, and an appropriate physical environment were essential to ‘finding the right balance’ to be physically active.

Interpretation

Physical activity participation for young people and adults with childhood‐onset physical disabilities is primarily influenced by the social and physical environment.

What this paper adds

Physical activity participation for young people and adults with childhood‐onset physical disabilities is primarily influenced by environmental factors.

‘Finding the right balance’ between enabling and inhibitory factors was important to physical activity participation being perceived as ‘the right fit’.

The opportunity for social connection is an important motivator for physical activity participation for young people and adults.

The physical environment continues to act as a barrier to physical activity participation for those with physical disabilities.
Social impairment in relation to clinical symptoms in youth at high risk for bipolar disorder
Authors: Weintraub Marc J. , Keenan‐Miller Danielle , Schneck Christopher D. , Forgey Borlik Marcy , Suddath Robert L. , Marvin Sarah E. , Singh Manpreet K. , Chang Kiki D. , Miklowitz David J.
Published: February 2021

Aim

Social impairment is common in individuals with bipolar disorder (BD), although its role in youths at high‐risk for BD (i.e., mood symptoms in the context of a family history of BD) is not well understood. Social impairment takes many forms including social withdrawal, relational aggression, physical aggression, and victimization. The aim of this study was to explore the links between social impairment and clinical symptoms in youth at high‐risk for BD.

Methods

The sample included 127 youths with elevations in mood symptoms (depression or hypomania) and at least one first and/or second degree relative with BD. Measures of youths' current psychopathology (i.e., depressive and manic severity, suicidality, anxiety, and attention‐deficit/hyperactivity disorder [ADHD]) were regressed onto youths' self‐reports of social impairment (i.e., social withdrawal, relational aggression, physical aggression, and victimization).

Results

Depressive symptoms, suicidal ideation, and anxiety symptoms were related to social withdrawal. Suicidal ideation was also related to reactive aggression. ADHD symptoms related to reactive and proactive aggression as well as relational victimization. Manic symptoms were not associated with social impairment in this sample.

Conclusions

Although cross‐sectional, study findings point to potential treatment targets related to social functioning. Specifically, social withdrawal should be a target for treatment of childhood depressive and anxiety symptoms. Treatments that focus on social skills and cognitive functioning deficits associated with BD may also have clinical utility.
Basic self‐disturbance in schizotypy
Authors: Hazan Hadar , Reese Elaine , Linscott Richard J.
Published: February 2021

Aim

Phenomenological researchers argue that schizophrenia spectrum disorders are primarily disorders of the basic self. To test this argument, we compared self‐report and lexical measures of basic self‐disturbance between schizophrenia spectrum (high‐schizotypy) and non‐spectrum groups (low‐schizotypy).

Methods

From an initial sample (n = 310) screened with the (SPQ), n = 39 were classified as high schizotypy (z > 1.28 on at least one SPQ factor scale) and were compared to a randomly selected low‐schizotypy group (z < 1 on all three SPQ factor scales; n = 41). Participants wrote four narratives about personal and fictional experiences and completed the Ego Strength Questionnaire and a self‐report version of the Schizophrenia Proneness Instrument. The written narratives were subjected to linguistic inquiry to examine pronoun usage (lexical measures).

Results

The high‐schizotypy group reported higher levels of basic symptoms, lower ego strength, and used third‐person and personal pronouns more frequently than the low‐schizotypy group. Self‐report measures correlated significantly with lexical measures. Self‐report and lexical measures were useful tools in predicting high schizotypy, correctly classifying 68% and 69% of schizotypy and non‐schizotypy, respectively.

Conclusion

In line with phenomenologists' arguments, high schizotypy was associated, to some extent, with basic self‐disturbance.
Comorbidities in multiple myeloma and implications on survival: A population‐based study
Authors: Sverrisdóttir Ingigerður S. , Rögnvaldsson Sölvi , Thorsteinsdottir Sigrún , Gíslason Gauti K. , Aspelund Thor , Turesson Ingemar , Björkholm Magnus , Gregersen Henrik , Hveding Blimark Cecilie , Landgren Ola , Kristinsson Sigurður Y.
Published: February 2021

High proportion of patients with multiple myeloma suffer from comorbidities which may alter clinical management. Therefore, our aims were to evaluate the prevalence of comorbidities and their impact on survival. We included patients diagnosed with multiple myeloma 1990‐2013 in Sweden and all diagnoses from each patient from 1985. A total of 13 656 patients with multiple myeloma were included in the study, thereof 7404 (54%) had comorbidity at diagnosis. The risk of death was increased for those with one comorbidity at diagnosis compared to those without any comorbidity (hazard ratio = 1.19; 95% confidence interval:1.14‐1.25); this risk was higher for those with two (1.38; 1.30‐1.47) and three or more comorbidities (1.72; 1.62‐1.83). Furthermore, the risk of death was increased in patients with prior history of cancer, arrhythmia, heart failure, diabetes mellitus, cerebrovascular disease, chronic lung disease, psychological disease, peptic ulcer, neurological disease, peripheral vascular disease, chronic kidney disease, dementia, and inflammatory bowel disease. This large study shows that over 50% of multiple myeloma patients have a comorbidity at diagnosis and survival decreased with increasing numbers of comorbidities. This emphasizes the importance of comorbidities when evaluating patients and deciding on treatment strategies for individuals with multiple myeloma.
Acute, but not longer‐term, exposure to environmental enrichment attenuates Pavlovian cue‐evoked conditioned approach and Fos expression in the prefrontal cortex in mice
Authors: Margetts‐Smith Gabriella , Macnaghten Anastasia I. , Brebner Leonie S. , Ziminski Joseph J. , Sieburg Meike C. , Grimm Jeffrey W. , Crombag Hans S. , Koya Eisuke
Published: February 2021

Exposure to environmental enrichment can modify the impact of motivationally relevant stimuli. For instance, previous studies in rats have found that even a brief, acute (~1 day), but not chronic, exposure to environmentally enriched (EE) housing attenuates instrumental lever pressing for sucrose‐associated cues in a conditioned reinforcement setup. Moreover, acute EE reduces corticoaccumbens activity, as measured by decreases in expression of the neuronal activity marker “Fos.” Currently, it is not known whether acute EE also reduces sucrose seeking and corticoaccumbens activity elicited by non‐contingent or “forced” exposure to sucrose cues, which more closely resembles cue exposure encountered in daily life. We therefore measured the effects of acute/intermittent (1 day or 6 day of EE prior to test day) versus chronic (EE throughout conditioning lasting until test day) EE on the ability of a Pavlovian sucrose cue to elicit sucrose seeking (conditioned approach) and Fos expression in the medial prefrontal cortex (mPFC), orbitofrontal cortex (OFC), and nucleus accumbens (NAc) in mice. One day, but not 6 day or chronic EE , reduced sucrose seeking and Fos in the deep layers of the dorsal mPFC. By contrast, 1 day, 6 day, and chronic EE all reduced Fos in the shallow layers of the OFC. None of the EE manipulations modulated NAc Fos expression. We reveal how EE reduces behavioral reactivity to sucrose cues by reducing activity in select prefrontal cortical brain areas. Our work further demonstrates the robustness of EE in its ability to modulate various forms of reward‐seeking across species.
Gender differences in post‐stroke functional outcome at discharge from an intensive rehabilitation hospital
Authors: Poggesi Anna , Insalata Greta , Papi Gioele , Rinnoci Valentina , Donnini Ida , Martini Monica , Falsini Catuscia , Hakiki Bahia , Romoli Annamaria , Barbato Carmen , Polcaro Paola , Casamorata Francesca , Macchi Claudio , Cecchi Francesca , Salvadori Emilia
Published: February 2021

Background

Gender differences in stroke functional recovery after rehabilitation are poorly investigated. Our aim was to compare functional outcomes at discharge from an intensive rehabilitation hospital after stroke in men and women, and to analyze their prognostic factors.

Methods

Retrospective observational study of consecutive stroke patients discharged from an intensive neurological rehabilitation hospital, from January 2018 to June 2019. Modified Rankin Scale (mRS) at discharge was the main outcome measure.

Results

Among the 208 included patients (mean age 73.4 ± 13.6 years), 105 (50.5%) were women. Women were significantly older (75.3 ± 13.8 vs. 71.4 ± 13.2 years, respectively, p = 0.041), and less often had a history of smoking habit (27% vs. 50%, p < 0.001). No gender differences emerged for vascular risk factors and comorbidities, pre‐stroke functional status, length of hospital stay, stroke type, and number of clinical deficits. At admission to the rehabilitation hospital, mRS score distributions were not different (p = 0.795). At discharge, mRS score distributions and destinations did not differ between men and women (p = 0.391, p = 0.785, respectively). A significant interaction between gender and the change in mRS score from admission to discharge was found (F = 6.6, p = 0.011) taking into account age, stroke type, and number of initial clinical deficits. Dividing the cohort according to age, elderly women showed a better functional recovery compared to men.

Conclusions

At admission to an intensive rehabilitation hospital, men and women presented a similar functional and clinical status and a substantial overlap of functional recovery after stroke. At higher ages, the potential for recovery appeared better in women compared to men.
The cerebellum could serve as a potential imaging biomarker of dementia conversion in patients with amyloid‐negative amnestic mild cognitive impairment
Authors: Kim Hyung‐Ji , Cheong E‐nae , Jo Sungyang , Lee Sunju , Shim Woo‐Hyun , Kwon Miseon , Kim Jae Seung , Kim Bum Joon , Lee Jae‐Hong
Published: February 2021

Background and purpose

As part of network‐specific neurodegeneration, changes in cerebellar gray matter (GM) volume and impaired cerebello–cerebral functional networks have been reported in Alzheimer disease (AD). Compared with healthy controls, a volume loss in the cerebellum has been observed in patients with continuum of AD. However, little is known about the anatomical or functional changes in patients with clinical AD but no brain amyloidosis. We aimed to identify the relationship between cerebellar volume and dementia conversion of amyloid‐negative mild cognitive impairment (MCI).

Methods

This study was a retrospective cohort study of patients over the age 50 years with amyloid‐negative amnestic MCI who visited the memory clinic of Asan Medical Center with no less than a 36‐month follow‐up period. All subjects underwent detailed neuropsychological tests, 3 T brain magnetic resonance imaging scans including three‐dimensional T1 imaging, and fluorine‐18[F18]‐florbetaben amyloid positron emission tomography scans. A spatially unbiased atlas template of the cerebellum and brainstem was used for analyzing cerebellar GM volume.

Results

During the 36 months of follow‐up, 39 of 107 (36.4%) patients converted to dementia from amnestic MCI. The converter group had more severe impairments in all visual memory tasks. In terms of volumetric analysis, reduced crus I/II volume adjusted with total intracranial volume, and age was observed in the converter group.

Conclusions

Significant cerebellar GM atrophy involving the bilateral crus I/II may be a novel imaging biomarker for predicting dementia progression in amyloid‐negative amnestic MCI patients.
Worsening of myasthenia due to antiepileptic, antipsychotic, antidepressant, and sedative medication: An estimation of risk based on reporting frequency
Authors: Trillenberg Peter , Katalinic Alexander , Junghanns Klaus , Thern Julia
Published: February 2021

Background and purpose

Many drugs can worsen myasthenia symptoms. The clinician usually relies on cautionary lists compiled according to case reports. We intended to provide a quantitative basis for a risk comparison within the groups of antiepileptic, antidepressant, neuroleptic, and sedative drugs.

Methods

We extracted adverse drug reaction (ADR) counts (total and myasthenia related) for drugs from these groups and calculated the reporting odds ratio (ROR) within the drug groups from the World Health Organization pharmacovigilance database. For a given drug, the ROR was increased above 1 if the proportion of myasthenia‐related ADRs for this drug was larger than the same proportion for the rest of drugs in that same group. If the 95% confidence interval of ROR was >1, this was taken as a signal for a higher risk of the given drug as compared to the average of the respective group.

Results

Gabapentin, sertraline, citalopram, lithium, and amisulpride had a signal for the ROR to be increased above 1 within their respective groups. Bupropion, desvenlafaxine, duloxetine, escitalopram, and paroxetine had ROR values <1. For all other drugs, 1 was within the ROR confidence interval.

Conclusions

For gabapentin and lithium, the analysis of RORs confirmed case reports and cautionary lists. For a number of antidepressant drugs associated with a higher‐than‐average risk, no case reports exist substantiating our results. For these drugs, special attention should be paid to this risk. The remarkable difference between citalopram and escitalopram could prompt experimental work to confirm differential influence of the two preparations on neuromuscular transmission.
In vivo diagnosis of skin cancer with a portable Raman spectroscopic device
Authors: Bratchenko Ivan A. , Bratchenko Lyudmila A. , Moryatov Alexander A. , Khristoforova Yulia A. , Artemyev Dmitry N. , Myakinin Oleg O. , Orlov Andrey E. , Kozlov Sergey V. , Zakharov Valery P.
Published: February 2021

In this study, we performed in vivo diagnosis of skin cancer based on implementation of a portable low‐cost spectroscopy setup combining analysis of Raman and autofluorescence spectra in the near‐infrared region (800–915 nm). We studied 617 cases of skin neoplasms (615 patients, 70 melanomas, 122 basal cell carcinomas, 12 squamous cell carcinomas and 413 benign tumors) in vivo with a portable setup. The studies considered the patients examined by GPs in local clinics and directed to a specialized Oncology Dispensary with suspected skin cancer. Each sample was histologically examined after excisional biopsy. The spectra were classified with a projection on latent structures and discriminant analysis. To check the classification models stability, a 10‐fold cross‐validation was performed. We obtained ROC AUCs of 0.75 (0.71–0.79; 95% CI), 0.69 (0.63–0.76; 95% CI) and 0.81 (0.74–0.87; 95% CI) for classification of a) malignant and benign tumors, b) melanomas and pigmented tumors and c) melanomas and seborrhoeic keratosis, respectively. The positive and negative predictive values ranged from 20% to 52% and from 73% to 99%, respectively. The biopsy ratio varied from 0.92:1 to 4.08:1 (at sensitivity levels from 90% to 99%). The accuracy of automatic analysis with the proposed system is higher than the accuracy of GPs and trainees, and is comparable or less to the accuracy of trained dermatologists. The proposed approach may be combined with other optical techniques of skin lesion analysis, such as dermoscopy‐ and spectroscopy‐based computer‐assisted diagnosis systems to increase accuracy of neoplasms classification.
Steepness is a slippery slope
Authors: Miller Timothy J. , Brooks Elizabeth N.
Published: February 2021

The Beverton–Holt and Ricker stock‐recruit functions were derived in terms of two pre‐recruit mortality parameters. Mace, & Doonan, (1988, A generalized bioeconomic simulation model for fish population dynamics) reparameterized the stock‐recruit function in terms of steepness, which combines pre‐recruit mortality with post‐recruit biological parameters defining unfished spawning biomass per recruit. Their parameterization explicitly assumes a stable age distribution at unexploited conditions, but also implicitly assumes that unexploited spawning biomass per recruit is time invariant. Temporal variation could occur in either pre‐recruit mortality rates or post‐recruit biological parameters, but different dynamics are produced. The former results in variation in both the stock‐recruit curve and the population equilibria, whereas variation in the latter only changes the points of equilibria on the curve. Thus, variation in either pre‐ or post‐recruit parameters will result in variation in steepness, maximum sustainable yield and associated management reference points. Empirical measures of components of post‐recruit productivity (maturity and mass at age, e.g.) are available for many managed fish stocks and often exhibit temporal variability. Yet use of the steepness parameterization requires an analyst to specify one set of post‐recruit biological parameters to define unexploited spawning biomass per recruit for the full time series. This misspecification leads to misperception of biological reference points and has implications for meta‐analyses of steepness, and interpretation of the dynamicconcept. Returning to the original parameterization allows the isolation of any temporal or inter‐population variation in pre‐ and post‐recruit productivity and reduces the potential for mechanistic bias in stock‐recruit parameters.
Disputes Over Frozen Embryos in Family Law Cases – A Defense of Counsel or Contemporaneous Mutual Consent
Authors: Schlesinger Tim
Published: February 2021

Disputes about what to do with unused, cryopreserved, pre‐implantation, pre‐embryos (“frozen embryos”) in family law cases have been making headlines for nearly 30 years. At least 15 cases have been decided by courts of appeal across the U.S., and the result of these decisions is uncertainty. Cases have been decided primarily based on three different approaches: the contract approach; the balancing of interests approach; and the contemporaneous mutual consent approach. There is great reluctance to decide any case in a manner that will compel parenthood against a person's wishes. The article proposes that we adopt the approach of counsel or contemporaneous mutual consent.
Setting Standards for Child‐Inclusive Restorative Justice
Authors: Gal Tali
Published: February 2021

Childhood victimization occurs everywhere: in homes, kindergartens and schools, in state‐care institutions, neighborhoods, workplaces, and online. The most vulnerable children are least likely to disclose their victimization and see their cases prosecuted. Restorative justice (RJ) offers an alternative way for addressing criminality. It promotes accountability and reparation, without the debilitating effects of incarceration. RJ places victims at the center and enables them to communicate with perpetrators, usually with state monitoring. Recent decades have seen the widespread use of RJ worldwide. Yet, despite indications that RJ reduces violent crime, most programs target cases involving misdemeanors, juveniles, and first‐time offenders. Childhood victimization has generally been left outside the scope of RJ programs, apart from juvenile offending, where the main goal is offender rehabilitation. Consequently, when the victim is a child, the promise of RJ to give victims a voice is often unfulfilled. The high rates of childhood victimization and the shortcomings of criminal justice systems in prosecuting such crimes highlight the need for child‐inclusive RJ programs targeting crimes against children. The present article reviews findings from the fields of RJ, children's rights, psychology, and victimology. Through integrating these practices and approaches, it proposes a set of standards for developing child‐inclusive RJ programs.
Decoding The Jargon: Article on Terminology
Authors: Page Stephen
Published: February 2021

The article discusses the more commonly seen terms, including using internationally used consensus definitions, so that discussion of ART is navigable.
The History and Future Trends of ART Medicine and Law
Authors: Crockin Susan L. , Altman Amy B. , Edmonds Meagan A.
Published: February 2021

The Assisted Reproductive Technologies (“ART”) have resulted in over eight million births to date, heralding remarkable advances in reproductive medicine with a transformational impact on both medicine and law. The effects have been acutely felt on the modern family, as well as on a myriad of areas of legal practice—including Family Law, Estate Planning, Contract, Health, Constitutional, Criminal, Discrimination, Tort Law and, for international arrangements, Immigration and Citizenship laws. This article examines the historical context, present impact, and future trends of ART and the Law. Its purpose is to help better understand these unique developments in order to help law and policy makers harness and craft the policies and frameworks that will be needed to monitor, shape and guide these remarkable possibilities for participants, professionals, law and society.
A Puzzling Paradox: Advancements in Reproductive Technology and New York's Ban on Commercial Surrogacy Agreements
Authors: Dundon Emily L.
Published: February 2021

With infertility on the rise in the United States and the legalization of same sex marriage, it has become increasingly difficult for many Americans to start a family. Advancements in modern medicine have addressed this issue and now couples can create their family through surrogacy. However, New York's current laws have not caught up to the changing times and surrogacy agreements are still invalid and unenforceable. This Note proposes the repeal of New York's surrogacy ban and the adoption of legislation to recognize and enforce surrogacy agreements in order to bring New York's laws within the purview of modern medicine.
Therapists Behind Bars: Criminalizing Gay‐to‐Straight Conversion Therapy
Authors: Taglienti James
Published: February 2021

Conversion therapy is a practice used to “change” an individual's sexual orientation from homosexual to heterosexual. Parents who expose their child to conversion therapy drastically increase the child's likelihood of developing anxiety, depression and self‐destructive behavior. Currently, 18 states ban mental health professionals from conducting conversion therapy. However, in those states, if a mental health professional conducts the therapy, the penalty is only a relatively small fine for unprofessional conduct. Additionally, to report their therapist, victims must file a complaint, which poses difficulties for minors. This Note proposes a criminal statute for mental health professionals who conduct conversion therapy.
Par‐3 family proteins in cell polarity & adhesion
Authors: Thompson Barry J.
Published: February 2021

The Par‐3/Baz family of polarity determinants is highly conserved across metazoans and includes C. elegans PAR‐3, Drosophila Bazooka (Baz), human Par‐3 (PARD3), and human Par‐3‐like (PARD3B). The C. elegans PAR‐3 protein localises to the anterior pole of asymmetrically dividing zygotes with cell division cycle 42 (CDC42), atypical protein kinase C (aPKC), and PAR‐6. The same C. elegans ‘PAR complex’ can also localise in an apical ring in epithelial cells. Drosophila Baz localises to the apical pole of asymmetrically dividing neuroblasts with Cdc42‐aPKC‐Par6, while in epithelial cells localises both in an apical ring with Cdc42‐aPKC‐Par6 and with E‐cadherin at adherens junctions. These apical and junctional localisations have become separated in human PARD3, which is strictly apical in many epithelia, and human PARD3B, which is strictly junctional in many epithelia. We discuss the molecular basis for this fundamental difference in localisation, as well as the possible functions of Par‐3/Baz family proteins as oligomeric clustering agents at the apical domain or at adherens junctions in epithelial stem cells. The evolution of Par‐3 family proteins into distinct apical PARD3 and junctional PARD3B orthologs coincides with the emergence of stratified squamous epithelia in vertebrates, where PARD3B, but not PARD3, is strongly expressed in basal layer stem cells – which lack a typical apical domain. We speculate that PARD3B may contribute to clustering of E‐cadherin, signalling from adherens junctions via Src family kinases or mitotic spindle orientation by adherens junctions in response to mechanical forces.
Potential of hotspot solar‐induced chlorophyll fluorescence for better tracking terrestrial photosynthesis
Authors: Hao Dalei , Asrar Ghassem R. , Zeng Yelu , Yang Xi , Li Xing , Xiao Jingfeng , Guan Kaiyu , Wen Jianguang , Xiao Qing , Berry Joseph A. , Chen Min
Published: February 2021

Remote sensing of solar‐induced fluorescence (SIF) opens a new window for quantifying a key ecological variable, the terrestrial ecosystem gross primary production (GPP), because of the revealed strong SIF–GPP correlation. However, similar to many other remotely sensed metrics, SIF observations suffer from the sun‐sensor geometry effects, which may have important impacts on the SIF–GPP relationship but remain poorly understood. Here we used remotely sensed SIF, globally distributed tower GPP data, and a mechanistic model to provide a systematic analysis. Our results reveal that leaf physiology, canopy structure, and sun‐sensor geometries all affect the SIF–GPP relationship. In particular, we found that SIF observations in the sun‐tracking hotspot direction can be a better proxy of GPP due to the similar responses of light use efficiency and SIF escaping probability in the hotspot direction to the increasing incoming solar radiation. Such conclusions are supported by a variety of modeling simulations and satellite observations over various plant function types, at different time scales and with satellite observational modes. This study demonstrates the potential and advantage of normalizing SIF observations to the hotspot direction for better global GPP estimations. This study also demonstrates the great potentials of current and future spaceborne sun‐tracking satellite missions for a significant improvement in measuring and monitoring, at a wide range of spatial and temporal scales, the changes in terrestrial ecosystem GPP in response to anticipated changes in the Earth's environmental conditions.
Using network DEA to inform policy: The case of the teaching quality of higher education in England
Authors: Lee Boon L. , Johnes Jill
Published: February 2021

Current literature on higher education (HE) performance only considers the production of graduates and not graduate employment. The latter needs to be factored into the HE production model as it not only measures the true impact of HE institutions (HEIs), but also provides policy implications on how resources should be allocated. Furthermore, the current literature on HE does not incorporate student responses into outputs, which should be in order to evaluate the teaching quality of HEIs. This study contributes to the existing literature by employing a network data envelopment analysis model that truly reflects the production process of HEIs and incorporates qualitative and quantitative data drawn from the UK Teaching Excellence Framework (TEF) to capture the effects from teaching quality and the graduate employment outcomes. The study allows us to compare the actual TEF outcomes with the teaching efficiency scores and determine the sources of inefficiencies which lead to policy implications.
L'évaluation par le client comme méthode de surveillance: les enjeux de la réputation numérique du travailleur à la lumière du Règlement général sur la protection des données de l'Union européenne
Authors: TODOLÍ‐SIGNES Adrián
Published: February 2021

L'évaluation du travailleur par le client ou l'employeur ainsi que la publication des avis qui en résultent constituent une méthode de contrôle et de surveillance qui pose de multiples problèmes au regard du droit européen. Sous couvert d'une approche client, elle soumet le travailleur à une surveillance de tous les instants, qui va bien au‐delà de ce qui prévaut dans un cadre de travail classique. L'auteur examine les enjeux de la question à la lumière du Règlement général sur la protection des données de l'Union européenne (UE), qui fixe des limites très précises à la collecte et la publication d'informations concernant les travailleurs.
Nurse resilience for clinical practice: An integrative review
Authors: Cooper Alannah L. , Brown Janie A. , Leslie Gavin D.
Published: February 2021

Aim

To evaluate and synthesize research that has investigated nurse resilience, to develop an understanding of what nurses' feel affects their resilience, their experiences and how resilience can impact individual nurses, patients and employers.

Design

Integrative review.

Data Sources

CINAHL, MEDLINE and PsycINFO, searched from the date each database was available to July 2019.

Review Methods

Primary research studies explicitly investigating resilience in any type of licensed nurse were eligible for inclusion. Studies were critically appraised for methodological quality using the Joanna Briggs Institute Quality Appraisal Framework. Data from each study were abstracted, coded and themes were identified according to the review aims and key findings of each study.

Results

Twenty‐seven studies met the inclusion criteria. Eight sub‐themes and three main themes were identified: The Resilient Nurse, Nurses' Experiences of Resilience and Employment Conditions and Nurse Resilience.

Conclusion

Nurse resilience is a complex and dynamic process, and high levels of resilience are associated with reduced psychological harm and increased well‐being. Attempts to determine the characteristics of the resilient nurse have been inconclusive and research has predominately focussed on individual factors which could affect resilience, with minimal research exploring external factors which affect nurse resilience including work environment and conditions. Nursing work was characterized by adversity and nurses described the development and use of strategies to maintain their resilience.

Impact

This review found that individual factors have received most attention in research investigating nurse resilience. Findings suggest that nurse resilience protects against negative psychological outcomes and nurses independently develop and use strategies to manage adversity. Factors in the workplace which affect resilience are under‐researched, and addressing this gap could assist with the development of comprehensive interventions and policies to build and maintain nurse resilience.
The association between EAE development in mice and the production of autoantibodies and abzymes after immunization of mice with different antigens
Authors: Aulova Kseniya S. , Urusov Andrey A. , Sedykh Sergey E. , Toporkova Ludmila B. , Lopatnikova Julia A. , Buneva Valentina N. , Sennikov Sergei V. , Budde Thomas , Meuth Sven G. , Popova Nelly A. , Orlovskaya Irina A. , Nevinsky Georgy A.
Published: February 2021

We have previously shown that immunization of C57BL/6 mice, prone to spontaneous development of experimental autoimmune encephalomyelitis (EAE), with three antigens (MOG35‐55, DNA‐histone complex or DNA‐methylated BSA complex), alters the differentiation profiles of bone marrow haematopoietic stem cells (HSCs). These are associated with the production of autoantibodies (auto‐Abs) against these antigens and the formation of abzymes hydrolysing DNA, MOG, myelin basic protein (MBP) and histones. Immunization of mice with antigens accelerates the development of EAE. This work is the first to analyse the ratio of auto‐Abs without and with catalytic activities at different stages of EAE development (onset, acute and remission phases) after immunization of mice with the three specific antigens. Prior to immunization and during spontaneous in‐time development of EAE, the concentration of auto‐Abs against MBP, MOG, histones and DNA and activities of IgG antibodies in the hydrolysis of substrates increased in parallel; correlation coefficients = +0.69‐0.94. After immunization with MOG, DNA‐histone complex or DNA‐met‐BSA complex, both positive (from +0.13 to +0.98) and negative correlations (from −0.09 to −0.69) were found between these values. Our study is the first showing that depending on the antigen, the relative amount of harmful auto‐Abs without and abzymes with low or high catalytic activities may be produced only at onset and in acute or remission phases of EAE. The antigen governs the EAE development rate, whereby the ratio of auto‐Abs without catalytic activity and with enzymatic activities of harmful abzymes hydrolysing MBP, MOG, histones and DNA varies strongly between different disease phases.
Phylotranscriptomic insights into Asteraceae diversity, polyploidy, and morphological innovation
Authors: Zhang Caifei , Huang Chien‐Hsun , Liu Mian , Hu Yi , Panero Jose L. , Luebert Federico , Gao Tiangang , Ma Hong
Published: February 2021

Biodiversity is not evenly distributed among related groups, raising questions about the factors contributing to such disparities. The sunflower family (Asteraceae, >26,000 species) is among the largest and most diverse plant families, but its species diversity is concentrated in a few subfamilies, providing an opportunity to study the factors affecting biodiversity. Phylotranscriptomic analyses here of 244 transcriptomes and genomes produced a phylogeny with strong support for the monophyly of Asteraceae and the monophyly of most subfamilies and tribes. This phylogeny provides a reference for detecting changes in diversification rates and possible factors affecting Asteraceae diversity, which include global climate shifts, whole‐genome duplications (WGDs), and morphological evolution. The origin of Asteraceae was estimated at ~83 Mya, with most subfamilies having diverged before the Cretaceous–Paleocene boundary. Phylotranscriptomic analyses supported the existence of 41 WGDs in Asteraceae. Changes to herbaceousness and capitulescence with multiple flower‐like capitula, often with distinct florets and scaly pappus/receptacular bracts, are associated with multiple upshifts in diversification rate. WGDs might have contributed to the survival of early Asteraceae by providing new genetic materials to support morphological transitions. The resulting competitive advantage for adapting to different niches would have increased biodiversity in Asteraceae.