bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of abnormal left ventricular geometry in patients without cardiovascular disease through machine learning: An ECG‐based approach
Authors: Angelaki Eleni , Marketou Maria E. , Barmparis Georgios D. , Patrianakos Alexandros , Vardas Panos E. , Parthenakis Fragiskos , Tsironis Giorgos P.
Published: January 2021

Cardiac remodeling is recognized as an important aspect of cardiovascular disease (CVD) progression. Machine learning (ML) techniques were applied to basic clinical parameters and electrocardiographic features, in order to detect abnormal left ventricular geometry (LVG) even before the onset of left ventricular hypertrophy (LVH), in a population without established CVD. The authors enrolled 528 patients with and without essential hypertension, but no other indications of CVD. All patients underwent a full echocardiographic evaluation and were classified into 3 groups; normal geometry (NG), concentric remodeling without LVH (CR), and LVH. Abnormal LVG was identified as increased relative wall thickness (RWT) and/or left ventricular mass index (LVMi). The authors trained supervised ML models to classify patients with abnormal LVG and calculated SHAP values to perform feature importance and interaction analysis. Hypertension, age, body mass index over the Sokolow‐Lyon voltage, QRS‐T angle, and QTc duration were some of the most important features. Our model was able to distinguish NG from CR+LVH combined, with 87% accuracy on an unseen test set, 75% specificity, 97% sensitivity, and area under the receiver operating curve (AUC/ROC) equal to 0.91. The authors also trained our model to classify NG and CR (NG + CR) against those with LVH, with 89% test set accuracy, 93% specificity, 67% sensitivity, and an AUC/ROC value of 0.89, for a 0.4 decision threshold. Our ML algorithm effectively detects abnormal LVG even at early stages. Innovative solutions are needed to improve risk stratification of patients without established CVD, and ML may enable progress in this direction.
Grain‐sized moxibustion promotes NK cell antitumour immunity by inhibiting adrenergic signalling in non–small cell lung cancer
Authors: Hu Dan , Shen Weiming , Gong Chenyuan , Fang Cheng , Yao Chao , Zhu Xiaowen , Wang Lixin , Zhao Chen , Zhu Shiguo
Published: January 2021

Lung cancer is the leading cause of cancer‐related death worldwide, and non–small cell lung cancer (NSCLC) accounts for 85% of lung cancer diagnoses. As an ancient therapy, moxibustion has been used to treat cancer‐related symptoms in clinical practice. However, its antitumour effect on NSCLC remains largely unexplored. In the present study, a Lewis lung cancer (LLC) xenograft tumour model was established, and grain‐sized moxibustion (gMoxi) was performed at the acupoint of Zusanli (ST36). Flow cytometry and RNA sequencing (RNA‐Seq) were used to access the immune cell phenotype, cytotoxicity and gene expression. PK136, propranolol and epinephrine were used for natural killer (NK) cell depletion, β‐adrenoceptor blockade and activation, respectively. Results showed that gMoxi significantly inhibited LLC tumour growth. Moreover, gMoxi significantly increased the proportion, infiltration and activation of NK cells, whereas it did not affect CD4+and CD8+T cells. NK cell depletion reversed gMoxi‐mediated tumour regression. LLC tumour RNA‐Seq indicated that these effects might be related to the inhibition of adrenergic signalling. Surely, β‐blocker propranolol clearly inhibited LLC tumour growth and promoted NK cells, and gMoxi no longer increased tumour regression and promoted NK cells after propranolol treatment. Epinephrine could inhibit NK cell activity, and gMoxi significantly inhibited tumour growth and promoted NK cells after epinephrine treatment. These results demonstrated that gMoxi could promote NK cell antitumour immunity by inhibiting adrenergic signalling, suggesting that gMoxi could be used as a promising therapeutic regimen for the treatment of NSCLC, and it had a great potential in NK cell–based cancer immunotherapy.
Impact of acne on the daily life of adult patients: building a self‐administered patient questionnaire
Authors: Dréno B. , Khammari A. , Seité S. , Legrand C. , Halioua B. , Misery L. , Ezzedine K. , Shourick J. , Taieb C.
Published: January 2021

Background

Acne is a long‐lasting disease in adolescents and adults impacting the patient’s daily life. Currently, there is no specific questionnaire that assesses its impact in adult patients.

Aim

To build a self‐administered questionnaire assessing the impact of acne on the daily life in adult patients.

Method

A multidisciplinary working group was created, including 3 experts in healthcare questionnaires and dermatologists specialized in acne. A questionnaire using a standardized methodology for designing self‐administered patient questionnaires according to conceptual, development and validation phases was developed. A cultural and linguistic validation into US English was conducted, based on the original French version.

Results

A 14‐item questionnaire demonstrating consistency, reproducibility and high reliability was build. The questionnaire significantly correlated with the SF‐12 mental and SF‐12 physical scores and CADI, indicating good external validity.

Conclusion

The present acne burden questionnaire AI‐ADL allows the practioner to assess quickly and easily the burden of acne in patients during his daily clinical practice. Moreover, its short format allows patients to express easily and quickly their feelings and to initiate a conversation between the practioner and his patient. Thus, AI‐ADL may help to better understand the multidimensional nature of acne, as well as the individual impact on the acne patient’s daily life and moreover, it may play a key role in the decision‐making process of treatment initiation and involvement of the patient in the management of his acne.
New infrared heat treatment approaches to dry and combat fungal contamination of shelled corn
Authors: Mohammadi Shad Zeinab , Oduola Abass A. , Wilson Shantae , Smith Deandrae , Shafiekhani Soraya , Bruce Rebecca , Atungulu Griffiths G.
Published: January 2021

Commercial application of infrared (IR) heat has been hampered by a lack of readily available data adaptable to high‐throughput (HT) drying requirements in the grain processing industry. This study evaluated the effectiveness of a continuous flow IR heating system to simultaneously dry and decontaminate corn over various drying bed thicknesses (1.5, 2.7, and 4.5 cm). Additionally, impacts of intermediate tempering treatment and variation of IR emitter angle (zero [E‐0] and 30 [E‐30] degrees) on drying and decontamination of the corn were determined. Although IR heating was able to dry and decontaminate corn at the initial moisture content (MC) of ≈21% wet basis (w.b.), moisture removal was most effective at the least bed thickness (1.5 cm). At 1.5 cm bed thickness, a safe storage MC (<14%) was achieved after 15 min of IR heating. At all the bed thicknesses, IR heating with intermediate tempering resulted in higher fungal inactivation than IR heating without tempering. Infrared heating of corn at 1.5 cm bed thickness plus tempering resulted in a total fungal count (TFC) reduction of 3.1 and 4.6 log CFU/g using IR emitters at E‐30 and E‐0° angles, respectively. However, increasing the bed thickness to 2.7 cm resulted in a TFC reduction of 4.8 and 4.6 log CFU/g using E‐30 and E‐0, respectively. Infrared heating using E‐0, compared to using E‐30, accelerated TFC reduction when corn samples were dried at 1.5 cm bed thickness. These results could help guide the design of HT corn drying and decontamination systems.
Amount of contamination on the face shield of endoscopists during upper endoscopy between patients in two positions: A randomized study
Authors: Pittayanon Rapat , Faknak Natee , Ananchuensook Prooksa , Prasoppokakorn Thaninee , Plai‐dum Suppawatsa , Thummongkhol Tiwaporn , Paitoonpong Leilani , Rerknimitr Rungsun
Published: January 2021

Background and Aim

During the Coronavirus Disease 2019 pandemic, esophagogastroduodenoscopy (EGD) has been recognized as an aerosol‐generating procedure. This study aimed to systematically compare the degree of face shield contamination between endoscopists who performed EGD on patients lying in the left lateral decubitus (LL) and prone positions.

Methods

This is a randomized trial in patients scheduled for EGD between April and June 2020. Eligible 212 patients were randomized with 1:1 allocation. Rapid adenosine triphosphate test was used to determine contamination level using relative light units of greater than 200 as a cutoff value. All eligible patients were randomized to lie in either the LL or prone position during EGD. The primary outcome was the rate of contamination on the endoscopist's face shield.

Results

The majority of patients were female (63%), with a mean age of 60 ± 13 years. Baseline characteristics were comparable between the two groups. There was no face shield contamination after EGD in either group. The number of coughs in the LL group was higher than the prone group (1.38 ± 1.8 vs 0.89 ± 1.4, P = 0.03). The mean differences in relative light units on the face shield before and after EGD in the LL and prone groups were 9.9 ± 20.9 and 4.1 ± 6 (P = 0.008), respectively.

Conclusion

As measured by the adenosine triphosphate test, performing diagnostic EGD does not lead to contamination on the face shield of the endoscopist. However, placing patients in the prone position may further mitigate the risk.
How to handle the policy conflict between resource circulation and hazardous substances in the use of waste?
Authors: Johansson Nils , Krook Joakim
Published: January 2021

A circular economy creates a policy conflict between increased resource circulation and decreased dispersal of hazardous substances. On the basis of three case studies in the EU, we have therefore identified various regulatory questions that can be posed to address the occurrence of hazardous substances in the use of waste. For each of these questions, we have proposed two possible responses influencing the design of the regulation and analyzed their consequences both from a circularity and from a toxicity perspective.

Currently, the regulations focus on reducing the dispersal of hazardous substances rather than stimulating resource circulation. The allowable contamination levels in the waste are typically regulated in relation to its mass rather than its content of valuable resources. The regulation of hazards in waste can be further developed in two general ways, by emphasizing either the risk of exposure to hazards or the total content of hazards. A risk approach is beneficial for short‐term circularity and waste producers. A hazard approach is beneficial for long‐term circularity and waste users. In order to improve the balancing of the policy conflict in question, values, underlying assumptions, and the effects of hazardous substances and resource circulation need to be better understood.
Untangling the effect of insulin action on brain mitochondria and metabolism
Authors: Schell Mareike , Wardelmann Kristina , Kleinridders André
Published: January 2021

The regulation of energy homeostasis is controlled by the brain and, besides requiring high amounts of energy, it relies on functional insulin/insulin‐like growth factor (IGF)‐1 signalling in the central nervous system. This energy is mainly provided by mitochondria in form of ATP. Thus, there is an intricate interplay between mitochondrial function and insulin/IGF‐1 action to enable functional brain signalling and, accordingly, propagate a healthy metabolism. To adapt to different nutritional conditions, the brain is able to sense the current energy status via mitochondrial and insulin signalling‐dependent pathways and exerts an appropriate metabolic response. However, regional, cell type and receptor‐specific consequences of this interaction occur and are linked to diverse outcomes such as altered nutrient sensing, body weight regulation or even cognitive function. Impairments of this cross‐talk can lead to obesity and glucose intolerance and are linked to neurodegenerative diseases, yet they also induce a self‐sustainable, dysfunctional ‘metabolic triangle’ characterised by insulin resistance, mitochondrial dysfunction and inflammation in the brain. The identification of causal factors deteriorating insulin action, mitochondrial function and concomitantly a signature of metabolic stress in the brain is of utter importance to offer novel mechanistic insights into development of the continuously rising prevalence of non‐communicable diseases such as type 2 diabetes and neurodegeneration. This review aims to determine the effect of insulin action on brain mitochondrial function and energy metabolism. It precisely outlines the interaction and differences between insulin action, insulin‐like growth factor (IGF)‐1 signalling and mitochondrial function; distinguishes between causality and association; and reveals its consequences for metabolism and cognition. We hypothesise that an improvement of at least one signalling pathway can overcome the vicious cycle of a self‐perpetuating metabolic dysfunction in the brain present in metabolic and neurodegenerative diseases.
Intranasal insulin
Authors: Hallschmid Manfred
Published: January 2021

The intranasal (IN) route enables the delivery of insulin to the central nervous system in the relative absence of systemic uptake and related peripheral side effects. Intranasally administered insulin is assumed to travel along olfactory and adjacent pathways and has been shown to rapidly accumulate in cerebrospinal fluid, indicating efficient transport to the brain. Two decades of studies in healthy humans and patients have demonstrated that IN insulin exerts functional effects on metabolism, such as reductions in food intake and body weight and improvements of glucose homeostasis, as well as cognition, ie, enhancements of memory performance both in healthy individuals and patients with mild cognitive impairment or Alzheimer's disease; these studies moreover indicate a favourable safety profile of the acute and repeated use of IN insulin. Emerging findings suggest that IN insulin also modulates neuroendocrine activity, sleep‐related mechanisms, sensory perception and mood. Some, but not all studies point to sex differences in the response to IN insulin that need to be further investigated along with the impact of age. “Brain insulin resistance” is an evolving concept that posits impairments in central nervous insulin signalling as a pathophysiological factor in metabolic and cognitive disorders such as obesity, type 2 diabetes and Alzheimer's disease, and, notably, a target of interventions that rely on IN insulin. Still, the negative outcomes of longer‐term IN insulin trials in individuals with obesity or Alzheimer's disease highlight the need for conceptual as well as methodological advances to translate the promising results of proof‐of‐concept experiments and pilot clinical trials into the successful clinical application of IN insulin.
Effectiveness of a Nurse‐Led Tele‐Homecare Program for Patients With Multiple Chronic Illnesses and a High Risk for Readmission: A Randomized Controlled Trial
Authors: Liang Hui Yu , Hann Lin Lieh , Yu Chang Chang , Mei Wu Fu , Yu Shu
Published: January 2021

Purpose

Multiple chronic illnesses, such as those associated with advanced age, are leading causes of poor health, disability, death, and high healthcare expenditures. Tele‐homecare is a novel method for providing home care to patients with chronic illnesses. The purpose of this study was to evaluate the effectiveness of an integrated nurse‐led tele‐homecare program for patients with multiple chronic illnesses and a high risk for readmission.

Design

A randomized controlled trial.

Methods

Two hundred patients from a regional hospital who were scheduled to receive home care after discharge were randomly assigned to the intervention group (n = 100) or the control group (n = 100). The patients in the intervention group participated in an integrated tele‐homecare program. For outcome evaluation, primary outcomes included the number of emergency department (ED) visits as well as readmittance and mortality. Secondary outcomes included patients’ medication adherence, activities of daily living, health status, and quality of life (QOL). Data were collected at three time points: pretest baseline (T0), 3 months after intervention (T3), and 6 months after intervention (T6). A generalized estimating equation model was used to compare changes and evaluate the effect of differences between the two groups over time.

Findings

For primary outcome evaluation, we found that the tele‐homecare program significantly reduced mortality and ED visits, whereas no significant effect on readmission was observed. For secondary outcome evaluation, patients’ QOL indicated significant improvement.

Conclusions and Clinical Relevance

The nurse‐led tele‐homecare program involves daily 24‐hr remote monitoring and surveillance. In this study, the system detected patients’ physical changes early and provided timely and appropriate management, consequently reducing ED visits and mortality. Additionally, it improved patients’ QOL. On the basis of our findings, nurses’ independent roles and functions revealed that the effectiveness of this nurse‐led tele‐homecare program strengthened the care of patients with multiple chronic illnesses.
Chronic wound care delivery in wound clinics, community nursing and residential aged care settings: A qualitative analysis using Levine’s Conservation Model
Authors: Monaro Susan , Pinkova Jana , Ko Natalie , Stromsmoe Nicole , Gullick Janice
Published: January 2021

Aims and objectives

To explore patient experience of chronic wound care across diverse models of outpatient wound care delivery.

Background

Chronic wounds represent a significant personal, family and healthcare system burden. Evidence suggests specialist wound clinics are more effective and less expensive, however, most outpatient wound care is delivered by general community nurses. There is little understanding of how patients experience diverse models of wound care delivery and the subsequent impact on their capacity to adapt to imbalances in their internal/external environment.

Design

Descriptive, qualitative study.

Methods

Eighteen patients with chronic wounds from three wound services were engaged in semi‐structured interviews. Initial inductive analysis was refined deductively using Levine's Conservation Model.

Results

Chronic wounds lead to imbalances and subsequent adaptions in energy conservation and personal, social and structural integrity. Nursing process and wound care system responses suggest specialist wound clinics provide access to the right person and care at the right time, with less care variation. The community nursing model is most effective with a small team of nurses and a documented care plan, with specialist wound nurse oversight. Residential aged care facilities emerged as important sites for wound care delivery revealing higher variance in care and less specialist wound oversight.

Conclusions

The application of Levine's conservation model provides a theoretical understanding and important insights into the patient experience of nurse and system elements across diverse models of wound care delivery. Specialist oversight by expert wound nurses with the capacity for medical specialist referral is the cornerstone of good wound care. A frequently reviewed wound care plan and skill development for nurses in primary, aged care and community settings are vital.

Relevance to clinical practice

Shared care between specialist and primary care should include evidence‐based pain assessment, clear referral pathways, collaborative relationships, telehealth capacity, patient‐held wound plans and upskilling of frontline clinicians.
“MANY‐CITEDNESS”: CITATIONS MEASURE MORE THAN JUST SCIENTIFIC QUALITY
Authors: D'Ippoliti Carlo
Published: January 2021

Citation counts are increasingly used to create rankings of scholars or institutions: while social scientists are often skeptical of the resulting indexes, economists have mostly been supporters of this approach. Yet, citation metrics have raised two debates in the literature: empirical, regarding their technical use, and theoretical, regarding their meaning and, more generally, the meaning of “scientific quality.” I review this literature highlighting the consequences for the use of citations for research assessment. As an application, I further study the network of citations of publications indexed in Web of Science, authored by all Italian academic economists between 2011 and 2015. I find that the probability of a citation between any two authors depends on similarity in their methods and topics but also, significantly, on various measures of social community and even of ideological proximity. The influence of social relations does not cancel out in the aggregate, as total citations to an individual depend on their network centrality. In the case of economics, citations cannot be interpreted as unbiased proxies of scientific quality.
Relationship between ascites volume and clinical outcomes in epithelial ovarian cancer
Authors: Quan Quan , Zhou Shuwei , Liu Yao , Yin Wanchun , Liao Qianqian , Ren Siling , Zhang Fenfen , Meng Yu , Mu Xiaoling
Published: January 2021

Objective

Ascites is a tumor microenvironment, ascites and massive ascites‐induce compression could promote the progression of epithelial ovarian cancer (EOC); however, the impact of ascites volume on clinical outcomes has not been studied extensively. We aimed to investigate the association between ascites volume and clinical outcomes especially platinum resistance in EOC.

Methods

We retrospectively evaluated a total of 546 EOC patients with respect to the amount of ascites, clinicopathologic factors, and survival. Using the threshold of 1500 ml to classify patients into small‐ and large‐volume ascites groups, we analyzed the correlation between ascites volume and clinicopathological factors, including platinum‐free interval (PFI), and prognosis.

Results

Patients with large volume ascites were more likely to present with later stage disease, primary platinum‐resistant (PPR) cancer, and suboptimal cytoreduction. Prolonged PFI was associated with decreased ascites volume. The large‐volume ascites group showed worse progression‐free survival (PFS) and overall survival (OS). An increase in ascites volume was associated with an increased risk of disease recurrence (hazard ratio [HR] = 1.115, 95% confidence interval [CI]: 1.035–1.200) and death (HR = 1.213, 95% CI: 1.090–1.350).

Conclusions

Ascites was an independent predictor of PFS and OS in EOC patients. A large volume of ascites predicated a shortened PFI, an increased incidence of PPR and suboptimal cytoreduction. Thus, the volume of ascites is a simply available clinical parameter, which could be used to evaluate the prognosis and platinum resistance of EOC patients early, it contributes to formulate individualized treatment plan and improve the outcome of EOC patients.
Soil fungal networks moderate density‐dependent survival and growth of seedlings
Authors: Liang Minxia , Shi Liuqing , Burslem David F. R. P. , Johnson David , Fang Miao , Zhang Xinyi , Yu Shixiao
Published: January 2021

Pathogenic and mutualistic fungi have contrasting effects on seedling establishment, but it remains unclear whether density‐dependent survival and growth are regulated by access to different types of mycorrhizal fungal networks supported by neighbouring adult trees.

Here, we conducted an extensive field survey to test how mycorrhizal and pathogenic fungal colonization of arbuscular mycorrhizal (AM) and ectomycorrhizal (ECM) seedlings in a subtropical forest respond to density of neighbouring adult trees. In addition, we undertook a hyphal exclusion experiment to explicitly test the role of soil fungal networks in driving density‐dependent effects on seedling growth and survival.

Conspecific adult density was a strong predictor for the relative abundance of putative pathogens, which was greater in roots of AM than of ECM seedlings, while mycorrhizal fungal abundance and colonization were not consistently affected by conspecific adult density. Both ECM and AM fungal networks counteracted conspecific density‐dependent mortality, but ECM fungi were more effective at weakening the negative effects of high seedling density than AM fungi.

Our findings reveal a critical role of common fungal networks in mitigating negative density‐dependent effects of pathogenic fungi on seedling establishment, which provides mechanistic insights into how soil fungal diversity shapes plant community structure in subtropical forests.
Determining the short‐term effects of different maxillary protraction methods on pharyngeal airway dimensions
Authors: Kale Burak , Buyukcavus Muhammed Hilmi
Published: January 2021

Objective

This study sought to evaluate the effects of different maxillary protraction methods on the pharyngeal airway in Class III patients with maxillary retrognathia.

Setting and Sample Population

A total of 59 individuals (31 females and 28 males) with a mean age of 11.38 ± 1.24 years were included in this study.

Material and Methods

Fifty‐nine treated maxillary retrognathic patients who underwent different protraction methods were evaluated. Twenty patients treated with RME (Rapid Maxillary Expansion) made up the first group, and 20 patients treated with 5‐week Alt‐RAMEC (Alternate Rapid Maxillary Expansion and Constriction) protocol comprised the second group. Lastly, 19 patients on whom face masks with miniplates were applied were included in the skeletal anchorage (SA) group. Sixteen linear and four areal pharyngeal airway measurements were made on lateral cephalograms before and after treatment. Differences between the groups were assessed using analysis of variance (ANOVA) tests.

Results

The mean maxillary protraction levels were determined as 2.7, 3.69 and 4.01 mm in the RME, Alt‐RAMEC and SA groups, respectively. In the nasopharynx, AD1‐PNS, AD2‐PNS, PNS‐Ba and PNS‐Ho measurements revealed a significant increase in the SA group compared to the other groups (P < .05). In the oropharynx, PNS‐Ep measurement increased significantly in the RME group (P < .05). In the total pharyngeal airway area, an increase was detected in the SA, Alt‐RAMEC, and RME groups.

Conclusion

The most effective protraction method in terms of pharyngeal airway dimensions, especially in the nasopharynx, is the application of the face mask with skeletal anchorage. A greater increase in vertical airway length (PNS‐Ep) was observed with RME.
Root zone warming represses foliar diseases in tomato by inducing systemic immunity
Authors: Gupta Rupali , Leibman‐Markus Meirav , Marash Iftah , Kovetz Neta , Rav‐David Dalia , Elad Yigal , Bar Maya
Published: January 2021

Plants employ systemic‐induced resistance as part of their defence arsenal against pathogens. In recent years, the application of mild heating has been found to induce resistance against several pathogens. In the present study, we investigated the effect of root zone warming (RZW) in promoting tomato's resistance against the necrotrophic fungus Botrytis cinerea (Bc), the hemibiotrophic bacterium Xanthomonas campestris pv. vesicatoria (Xcv) and the biotrophic fungus Oidium neolycopersici (On). We demonstrate that RZW enhances tomato's resistance to Bc, On and Xcv through a process that is dependent on salicylic acid and ethylene. RZW induced tomato immunity, resulting in increased defence gene expression, reactive oxygen species (ROS) and ethylene output when plants were challenged, even in the absence of pathogens. Overall, the results provide novel insights into the underlying mechanisms of warming‐induced immune responses against phytopathogens with different lifestyles in tomato.
Nudging Public Employees Through Descriptive Social Norms in Healthcare Organizations
Authors: Belle Nicola , Cantarelli Paola
Published: January 2021

We draw on the focus theory of normative conduct and nudge theory to experimentally test the effect of descriptive social norms on desired behaviors that public employees may engage in at suboptimal levels, namely, vaccination and help‐seeking. Through a series of framed randomized controlled trials with 19,984 public healthcare professionals, we demonstrate that descriptive norms—doing what the majority of others do—trigger conformity. Specifically, employees are more likely to get a flu shot and advocate vaccination when knowing that the majority of their colleagues get vaccinated against the seasonal influenza compared to when most colleagues do not. Similarly, the probability of making help requests on the job is noticeably higher when asking colleagues for advice is the norm rather than not. We discuss the theoretical and practical implications of these experiments for scholars and policy makers interested in predictably altering high‐stakes behaviors among public employees through low‐powered incentives.
The Timing of Managerial Responses to Fiscal Stress
Authors: Brien Spencer T. , Eger Robert J. , Matkin David S. T.
Published: January 2021

Using 34 years of data from Florida counties, we examine the effect of multiple fiscal stressors on expenditures over time to test theoretical propositions in Charles Levine's seminal study on cutback management. We demonstrate support for Levine's stages model and his claims on linkages between the causes of fiscal stress and managerial responses. Specifically, unemployment levels produce differential effects by service area (e.g., human services bear the most significant share of the reductions), especially in relation to the persistence of the stressor. We cannot support the stages model with other stressor measures. We expand the literature to include county governments, enhancing the contemporary literature on local government fiscal stress.
When nothing is certain, anything is possible: open innovation and lean approach at MVM
Authors: Di Guardo Maria Chiara , Marku Elona , Bonivento Walter Marcello , Castriotta Manuel , Ferroni Fernando , Galbiati Cristiano , Gorini Giuseppe , Loi Michela
Published: January 2021

Using a participatory observation approach, this paper aims at exploring how public and private organizations have collaborated in response to the COVID‐19 pandemic. We examine the case of Mechanical Ventilator Milano (MVM), an international project with over 250 contributors and partners; this project aimed to achieve the challenging goal of designing and realizing a mechanical ventilator for mass production in about 6 weeks. The project received the Emergency Use Authorization granted by the U.S. Food and Drug Administration. The MVM ventilator is a reliable, fail‐safe, and easy‐to‐operate mechanical ventilator that can be produced quickly at a large‐scale, based on the readily available parts. The success of the MVM case is unique as it adopts open innovation practices to generate technology innovation, in addition to a lean perspective. Through the MVM project description, this study offers a framework that explains the interplay between open innovation and lean approach, highlighting the different internal and external forces and types of collaborations, and offering fine‐grained insights into the role of universities as platforms of multidisciplinary knowledge. This framework might serve as a basis for future theoretical and empirical research, providing practitioners with new best practices that are essential when facing a severe crisis like COVID‐19.
The examination of a vignette activity sequence in a secondary mathematics methods course
Authors: Shelton Ryann N. , Kerschen Keith , Wilkerson Trena L.
Published: January 2021

Because of their brief nature, vignettes are a strategic way to highlight or explore complex instructional practices. Using a qualitative approach, we examined how the use of vignettes in a Vignette Activity Sequence contributed to secondary mathematics preservice teachers’ understanding of the Mathematical Practices and the Mathematics Teaching Practices. By examining three vignettes used in two iterations of a secondary mathematics methods course, the researchers found that preservice teachers were able to draw connections between the vignettes and their own teaching experiences. However, some misconceptions or incomplete understandings related to the practices were revealed. Preservice teachers sometimes provided vague evidence when identifying particular practices in the vignettes that did not clearly indicate if they understood the practices. Taken together, the researchers found the Vignette Activity Sequence to be a valuable formative assessment that could be used to inform instruction in a secondary mathematics methods course. These findings have implications for teacher preparation programs and mathematics teacher educators.
A global barley panel revealing genomic signatures of breeding in modern Australian cultivars
Authors: Hill Camilla Beate , Angessa Tefera Tolera , Zhang Xiao‐Qi , Chen Kefei , Zhou Gaofeng , Tan Cong , Wang Penghao , Westcott Sharon , Li Chengdao
Published: January 2021

The future of plant cultivar improvement lies in the evaluation of genetic resources from currently available germplasm. Today’s gene pool of crop genetic diversity has been shaped during domestication and more recently by breeding. Recent efforts in plant breeding have been aimed at developing new and improved varieties from poorly adapted crops to suit local environments. However, the impact of these breeding efforts is poorly understood. Here, we assess the contributions of both historical and recent breeding efforts to local adaptation and crop improvement in a global barley panel by analysing the distribution of genetic variants with respect to geographic region or historical breeding category. By tracing the impact that breeding had on the genetic diversity of Hordeum vulgare (barley) released in Australia, where the history of barley production is relatively young, we identify 69 candidate regions within 922 genes that were under selection pressure. We also show that modern Australian barley varieties exhibit 12% higher genetic diversity than historical cultivars. Finally, field‐trialling and phenotyping for agriculturally relevant traits across a diverse range of Australian environments suggests that genomic regions under strong breeding selection and their candidate genes are closely associated with key agronomic traits. In conclusion, our combined data set and germplasm collection provide a rich source of genetic diversity that can be applied to understanding and improving environmental adaptation and enhanced yields.
1,135 ionomes reveal the global pattern of leaf and seed mineral nutrient and trace element diversity in Arabidopsis thaliana
Authors: Campos Ana Carolina A. L. , van Dijk William F. A. , Ramakrishna Priya , Giles Tom , Korte Pamela , Douglas Alex , Smith Pete , Salt David E.
Published: January 2021

Soil is a heterogeneous reservoir of essential elements needed for plant growth and development. Plants have evolved mechanisms to balance their nutritional needs based on availability of nutrients. This has led to genetically based variation in the elemental composition, the ‘ionome’, of plants, both within and between species. We explore this natural variation using a panel of wild‐collected, geographically widespread Arabidopsis thaliana accessions from the 1001 Genomes Project including over 1,135 accessions, and the 19 parental accessions of the Multi‐parent Advanced Generation Inter‐Cross (MAGIC) panel, all with full‐genome sequences available. We present an experimental design pipeline for high‐throughput ionomic screenings and analyses with improved normalisation procedures to account for errors and variability in conditions often encountered in large‐scale, high‐throughput data collection. We report quantification of the complete leaf and seed ionome of the entire collection using this pipeline and a digital tool, Ion Explorer, to interact with the dataset. We describe the pattern of natural ionomic variation across the A. thaliana species and identify several accessions with extreme ionomic profiles. It forms a valuable resource for exploratory genetic mapping studies to identify genes underlying natural variation in leaf and seed ionome and genetic adaptation of plants to soil conditions.
Medical chart validation of inpatient diagnosis codes for transfusion‐related acute lung injury 2013‐2015
Authors: Fuller Candace C. , Nambudiri Vinod E. , Spencer‐Smith Caren , Curtis Lesley H. , Shinde Mayura , Cosgrove Austin , Johnson Margaret , Hickok Jason , Honda Stacey , Ismail Heba , Kaufman Richard Max , Kennedy Adee , Miller Karla M. , Mohlman David J. , Poland Russell E. , Rosofsky Robert , Smith Kimberly , Surani Salim R. , Baker Meghan A.
Published: January 2021

Introduction

Transfusion‐related acute lung injury (TRALI), an adverse event occurring during or within 6 hours of transfusion, is a leading cause of transfusion‐associated fatalities reported to the US Food and Drug Administration. There is limited information on the validity of diagnosis codes for TRALI recorded in inpatient electronic medical records (EMRs).

Study Designs and Methods

We conducted a validation study to establish the positive predictive value (PPV) of TRALI International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) diagnosis codes recorded within a large hospital system between 2013 and 2015. A physician with critical care expertise confirmed the TRALI diagnosis. As TRALI is likely underdiagnosed, we used the specific code (518.7), and codes for respiratory failure (518.82) in combination with transfusion reaction (999.80, 999.89, E934.7).

Results

Among almost four million inpatient stays, we identified 208 potential TRALI cases with ICD‐9‐CM codes and reviewed 195 medical records; 68 (35%) met clinical definitions for TRALI (26 [38%] definitive, 15 [22%] possible, 27 [40%] delayed). Overall, the PPV for all inpatient TRALI diagnoses was 35% (95% confidence interval (CI), 28‐42). The PPV for the TRALI‐specific code was 44% (95% CI, 35‐54).

Conclusion

We observed low PPVs (<50%) for TRALI ICD‐9‐CM diagnosis codes as validated by medical charts, which may relate to inconsistent code use, incomplete medical records, or other factors. Future studies using TRALI diagnosis codes in EMR databases may consider confirming diagnoses with medical records, assessing TRALI ICD, Tenth Revision, Clinical Modification codes, or exploring alternative ways for of accurately identifying TRALI in EMR databases.

Key Points

In 169 hospitals, we identified 208 potential TRALI cases, reviewed 195 charts, and confirmed 68 (35%) cases met TRALI clinical definitions.

As many potential TRALI cases identified with diagnosis codes did not meet clinical definitions, medical record confirmation may be prudent.
Weed seedbank diversity and sustainability indicators for simple and more diverse cropping systems
Authors: Liebman Matt , Nguyen Huong T. X. , Woods Matthew M. , Hunt Natalie D. , Hill Jason D.
Published: January 2021

Storkey and Neve (2018) hypothesised that weed seedbank diversity could be used as an indicator of agroecosystem sustainability, with cropping systems associated with higher weed seedbank diversity being more agronomically and environmentally sustainable than those with lower weed diversity. We evaluated their hypothesis using multiple years of empirical data collected from a long‐term field experiment in Iowa, USA, and life cycle assessment models parameterised with data from that experiment. We found that diversifying a 2‐year maize–soyabean rotation with two additional crop phases, oat and lucerne, to form a 4‐year rotation (a) increased Simpson's diversity index for weed species in the soil seedbank, while (b) increasing maize and soyabean productivity, (c) maintaining total crop energy production and profitability, and (d) reducing herbicide‐related aquatic toxicity, fossil energy consumption, greenhouse gas emissions, damage to human health due to fine particulate matter, and discharge of soil sediment, nitrogen, and phosphorus. Increased weed biomass production and greater weed species diversity that occurred within oat and lucerne phases of the 4‐year rotation sequence did not result in a loss of weed control within maize and soyabean phases of the rotation. We suggest that while there was no cause‐and‐effect relationship between greater weed seedbank diversity and improved agroecosystem sustainability in agronomic, economic and environmental dimensions, all of these responses were driven in a parallel manner by cropping system diversification. Consequently, weed seedbank diversity may indeed be a useful agroecosystem sustainability indicator. Further evaluation of this hypothesis in more systems is warranted.
Experimental increase of blood glucose alters resting state EEG measures of excitation–inhibition balance
Authors: Walker Christopher P. , Buse John B. , Frohlich Flavio
Published: January 2021

New Findings

What is the central question of this study?

Glucose is the dominant energy source for the brain. However, little is known about how glucose metabolism impacts the coordination of network activity in the brain in healthy adults.

What is the main finding and its importance?

We demonstrate that both α oscillations and the aperiodic signal components of the resting EEG are modulated by experimentally elevated blood glucose concentrations. Our findings suggest that glucose increases measures associated with excitation–inhibition (E:I) balance, but that the effect on α oscillations might plateau. Understanding the relationship between glucose consumption and E:I balance is crucial to developing our understanding of how metabolism shapes human brain activity.

Brain network oscillations can be divided broadly into periodic and aperiodic signal components, which are sensitive to state‐dependent changes in network coordination and excitation–inhibition (E:I) balance. We sought to address whether the dominant energy source of the brain, glucose, is implicated in the regulation of network activity and excitability. We conducted an experimenter‐blind, crossover study of the effect of blood glucose level (BGL) on the resting EEG frequency spectrum. Participants consumed a glucose drink (75 g glucose) or an equivalent volume of water on two separate visits. EEG data were sampled before and ≤3 h after the drink. We found that the experimentally induced changes in BGL exhibited an inverted U‐shaped relationship, with changes in the individual α frequency peak, whereas the slope of the aperiodic signal component of the frequency spectrum showed a positive linear association suggestive of greater excitation. In contrast, peak α power, which is typically associated with top‐down inhibitory processes, was negatively associated with changes in BGL. Collectively, these results suggest that high BGL alters brain network coordination in the form of α oscillations and measures associated with E:I balance.
Effects of syllable stress in adaptation to altered auditory feedback in vowels
Authors: Bakst Sarah , Niziolek Caroline A.
Published: January 2021

Unstressed syllables in English most commonly contain the vowel quality [ə] (schwa), which is cross-linguistically described as having a variable target. The present study examines whether speakers are sensitive to whether their auditory feedback matches their target when producing unstressed syllables. When speakers hear themselves producing formant-altered speech, they will change their motor plans so that their altered feedback is a better match to the target. If schwa has no target, then feedback mismatches in unstressed syllables may not drive a change in production. In this experiment, participants spoke disyllabic words with initial or final stress where the auditory feedback of F1 was raised (Experiment 1) or lowered (Experiment 2) by 100 mels. Both stressed and unstressed syllables showed adaptive changes in F1. In Experiment 1, initial-stress words showed larger adaptive decreases in F1 than final-stress words, but in Experiment 2, stressed syllables overall showed greater adaptive increases in F1 than unstressed syllables in all words, regardless of which syllable contained the primary stress. These results suggest that speakers are sensitive to feedback mismatches in both stressed and unstressed syllables, but that stress and metrical foot type may mediate the corrective response.
Motion parameter estimation of multitonal sources with a single hydrophone
Authors: Chi Jing , Gao Dazhi , Zhang Xuegang , Zhang Xinyao , Wang Zhizhuan
Published: January 2021

In this letter, a method is proposed to estimate the motion parameters of a multitonal source with a single hydrophone when only the acquisition time of the pressure field is known. Source motion parameters, including the time of closest point of approach (tCPA) and the ratio of the range at the closest point of approach to the source speed (rCPA/v) are obtained by correlation of two resampled tonal signals. Only two tones emitted by the same source and a value of the waveguide invariant are required. The proposed method is validated by simulation and data from the SWellEx-96 experiment.
Influence of a Coach Development Curriculum on Preservice Coaches’ Habitus
Authors: Kuklick Clayton , Harvey Stephen , King Roch
Published: January 2021

The purpose of this cross-sectional study was to analyze the influences of a 4-year university-based coach development curriculum on coaching-students’ habitus. The occupational socialization framework and Bourdieu’s theory of practice were used to capture the socialization factors that influence how coaching habitus remain continuous or are modified across the temporal phases of coaching-students’ socialization (i.e., acculturation and preservice professionalization). Data were collected through interviews, interview reflections, and coaching philosophies, which were analyzed and compared across entering (ENCS;n = 23) and exiting (XCS;n = 10) cohorts.Habitus formation,enacting coaching habitus, andinfluences on coaching habituswere the main themes. XCS differed from ENCS by utilizingindividualized instructional coaching,planning and programming, variousmethods of coaching,andreflection and lifelong learningas key strategies toenact their habitus, which showed the influence of preservice professionalization on gaining cultural capital in the coaching field. The findings provide support for howpracticum cites,course content, andcoach developerswithin the curriculum influenced coaching-students’ habitus. This research offers novel insights in regard to the approaches used in the curriculum, the integration of occupational socialization and Bourdieu’s theory of practice frameworks, and the cross-comparative design for analyzing programmatic effectiveness.
Diversity in STEM includes scientists with disabilities
Authors: Ham Becky
Published: January 2021

Now in its 25th year, Entry Point! has placed more than 500 STEM majors in summer internships
Cultural transmission of vocal dialect in the naked mole-rat
Authors: Barker Alison J. , Veviurko Grigorii , Bennett Nigel C. , Hart Daniel W. , Mograby Lina , Lewin Gary R.
Published: January 2021

The queen's chirp rules

Naked mole-rats are known for their eusocial lifestyle, living in colonies that consist of many workers and a single breeding queen. Little is known about how individuals within these colonies navigate the many interactions that must occur in such a complex cooperative group. Barker
et al.
show that calls emitted by individuals, in particular the common “chirp” call, convey information specific to the animal's group (see the Perspective by Buffenstein). Group differences are cultural, rather than genetic, and are related to the queen: Cross-fostered pups adopt their rearing colony's dialects, and dialects change with queen replacement.

Science
, this issue p.
503
; see also p.
461