bluuebunny/crossref_metadata_2025 huggingface dataset:
A mediation analysis of the motivation for learning in the process of knowledge acquisition and transfer
Authors: Vega Chica Mayra Liuviana , Valle Lituma Luis Ángel
Published: November 2023

Purpose

This study aims to explore the mediating role of the motivation for learning in knowledge acquisition and knowledge transfer in students of higher education programs in business and management.

Design/methodology/approach

Quantitative correlational design. Data was collected from a sample of 366 students studying and working in the business and entrepreneurial sector in Ecuador. The instrument used was a Likert scale questionnaire. Correlation analyses were used to specify the relationships between variables. Multiple regression analysis was used to test the hypotheses.

Findings

The results evidenced the mediating effect of the motivation for learning on the relationship between knowledge acquisition and knowledge transfer of undergraduate and graduate students in higher education programs in the area of business and entrepreneurship.

Research limitations/implications

The model investigated is a contribution to the literature since the variables have been little studied by the students as transfer channels, and there is a need to explore these relationships between variables in other productive sectors.

Practical implications

Organizations will be able to identify relevant factors in knowledge transfer, the motivation for learning for the context of working, create ideal conditions for knowledge flow and maintain a commitment to take advantage of this cooperation.

Social implications

The results contribute to the three agents involved in knowledge transfer: students, educational institutions and organizations. Students can have a greater understanding of the skills they need to improve their learning and application of knowledge. Educational institutions will have a better understanding of and approach to developing competencies in their students.

Originality/value

This simple regression model enriches the current literature on the mediating effect of the motivation for learning on the relationship between knowledge acquisition and knowledge transfer in higher education institutions in Latin American countries.
Common home hazards among healthy older aged adults and potential modifications required for age‐friendly housing
Authors: Aclan Roslyn , George Stacey , Laver Kate
Published: November 2023

Introduction

The creation of age‐friendly home environments enables middle‐aged and older aged people to live independently at home while adapting to age‐related changes. Little is currently known about existing home hazards that may potentially hinder healthy older people as they age.

Methods

Prospective cohort study of healthy adults who received an age‐friendly home environment assessment conducted by an occupational therapist. Adults aged 60 and over, without significant disability, living in homes within metropolitan Adelaide, South Australia were recruited through community advertising.

Results

Sixty age‐friendly home environment assessments were conducted. Common areas where potential hazards were identified, and modifications recommended were bathrooms, toilets and backyards. Gardens were commonly identified as potentially requiring modifications in the future. Participants were more likely to consider moving to new housing if additional modifications were needed to their homes.

Conclusion

Affordable and accessible age‐friendly housing is required to support an ageing population. Education on age‐friendly housing for healthy middle and older aged people is required enabling proactive planning rather than awaiting health crises.
Impartiality in Public Broadcasting
Authors: Sambrook Richard , Cushion Stephen
Published: November 2023

Impartiality has been a core principle of public service broadcasting (PSB) in the UK for 100 years. However, it is under growing pressure as audiences increasingly rely on more opinion led content on television and especially online. The hostility towards PSB has been fuelled by politicians and commercial media undermining the value of regulation in the twenty‐first century. The UK regulator, Ofcom, has offered a flexible approach to oversight which the authors argue may have contributed to further confusion over what impartiality is, and its value in a competitive media environment. Greater independence, accountability and transparency—for both broadcasters and regulator—are suggested to be vital to maintaining the value of impartiality in PSB.
Using citizen science data to assess the vulnerability of bottlenose dolphins to human impacts along England's South Coast
Authors: Corr S. , Dudley R. , Brereton T. , Clear N. , Crosby A. , Duncan S. , Evans P. G. H. , Jones D. , Sayer S. , Taylor T. , Tregenza N. , Williams R. , Witt M. J. , Ingram S. N.
Published: November 2023

Coastal bottlenose dolphin populations are highly vulnerable due to their small population sizes and proximity to human activities. Long‐term studies in the UK have monitored populations protected within Special Areas of Conservation (SACs) since the 1990s, but a small community of bottlenose dolphins inhabiting the coastal waters of southern England has received much less attention. The English Channel is one of the most heavily impacted marine ecosystems worldwide and increasing anthropogenic pressures pose a severe threat to the long‐term viability of this population. Conservation measures to protect these animals have been hindered by a lack of knowledge of population size, distribution and ranging behaviour. This study aimed to fill these knowledge gaps. A citizen science sighting network yielded 7458 sighting reports of bottlenose dolphins between 2000 and 2020. Resightings of identified individuals were used to estimate abundance, distribution, and ranging behaviour. Social structure analysis revealed a discrete interconnected group of animals in shallow coastal waters, which did not appear to mix with conspecifics identified further offshore. A Bayesian multi‐site mark–recapture analysis estimated that this population comprises around 48 animals (CV = 0.18, 95% HPDI = 38–66). These dolphins ranged between North Cornwall and Sussex, with an average individual range of 530 km (68–760 km). Areas of high‐modelled habitat suitability were found to overlap with high levels of anthropogenic pressure, with pollution and boat traffic identified as the most pervasive threats. Although adult survival rates indicated that the population was relatively stable from 2008 to 2019 (0.945 (0.017 ± SE)), the small population size implies a significant risk to their long‐term viability and resilience to environmental change. By highlighting the most deleterious anthropogenic activities and regions of conservation significance, our results will be useful for developing management policies for threat mitigation and population conservation, to protect this vulnerable group of dolphins.
A de novo variant in RERE causes autistic behavior by disrupting related genes and signaling pathway
Authors: Li Qian , Li Wenbo , Hu Kaiyue , Wang Yaqian , Li Yang , Xu Jiawei
Published: November 2023

Autism spectrum disorder (ASD) is a highly variable neurodevelopmental disorder that typically manifests childhood, characterized by a triad of symptoms: impaired social interaction, communication difficulties, and restricted interests with repetitive behaviors. De novo variants in related genes can cause ASD. We present the case of a 6‐year‐old Chinese boy with autistic behavior, including language communication impairments, intellectual disabilities, stunted development, and irritability in social interactions. Using Sanger sequencing, we confirmed a pathogenic in the RERE gene (NM_012102.4) (c.3732delC, p.Tyr1245Thrfs*12; EX21; Het). Subsequently, we generated an RERE point mutation cell line (ReMut) using CRISPR/Cas9 Targeted Genome Editing. Immunofluorescence was conducted to determine the location of the mutant RERE. RNA‐sequencing and mass spectrometry analyses were performed to elucidate the ASD‐related genes and signaling pathways disrupted by this variant in RERE. We identified 3790 differentially expressed genes and 684 differentially expressed proteins. The SHH signaling pathway was found to be downregulated, and the Hippo pathway was upregulated in ReMut. Genes implicated in autism, such as CNTNAP2, STX1A, FARP2, and GPC1, were significantly downregulated. Simultaneously, we noted alterations in HDAC1 and HDAC2, which are members of the WHHERE complex, suggesting their role in the pathogenesis of this patient. In conclusion, we report a de novo variant in RERE associated with autistic behavior. The finding that ASD is associated with RERE variants underscore the role of genetic factors in ASD and provides insights regarding the mechanisms underlying RERE variants in disease onset.
Trends in alcohol‐related harm among Swedish youth: Do in‐patient care registry data match drinking trends?
Authors: Stafström Martin , Raninen Jonas
Published: November 2023

Introduction

Youth drinking has been declining in Sweden since the year 2000. There is a paucity of studies examining trends in alcohol‐related harm during this period. The overall aim of the present study is to examine how trends in alcohol‐related harm match trends in drinking among Swedish youths during 2000–2021.

Methods

Measures of alcohol use were obtained from national school surveys. Prevalence rates of any alcohol use and heavy episodic drinking were used. Alcohol‐related harm indicators were obtained from registry information from the National Board of Health and Welfare. Annual trends in harm indicators were tested with linear regression models and correlations between alcohol use and alcohol‐related harm indicators were assessed using Pearson's correlation on annual data.

Results

Statistically significant negative trends were observed for all alcohol‐related harm indicators for the period 2000–2021. Significant correlations were found for both measures of alcohol use and all alcohol‐related harm indicators.

Discussion and Conclusions

The levels of alcohol‐related harm have declined among youths in Sweden during the period 2000–2021. The trends in harm seem to reflect the decline in youth drinking that has occurred during the same period.
Migratory redhorse suckers provide subsidies of nitrogen but not phosphorus to a spawning stream
Authors: Hudson Ryan R. , Wheeler Kit , White Mack , Murdock Justin N.
Published: November 2023

Spawning migrations of fishes are common case studies for examining the magnitude of resource subsidies; however, no studies have evaluated this phenomenon in iteroparous migrations of the Catostomid (i.e. suckers) genus Moxostoma (i.e. redhorses). Fish resource subsidies are usually represented as nitrogen (N) and phosphorus (P), and migratory redhorses can deliver these nutrients via excretion and eggs. We evaluated whether redhorses deliver N and P subsidies to Brasstown Creek—a fourth‐order stream in the Southeastern US—during their spawning migrations. We measured individual‐level nutrient contributions from excretion and eggs and extrapolated those values to estimate nutrient contributions based on daily abundances of migratory redhorses. We compared daily nutrient inputs to daily nutrient exports to determine the potential for resource subsidies. We estimated 71.6 kg of N and 4.4 kg of P were delivered to Brasstown Creek over a 98‐day migration period. N input exceeded N export on 15 of the 98 days, but phosphorus input never exceeded P export. Eggs accounted for the majority of N and P input at 51% and 100% respectively. Redhorse N inputs peaked in the spring during a period of low N exports, suggesting that redhorse subsidies were delivered during times of elevated nutrient demand and relatively low nutrient availability. Suckers receive little management attention, and several species of redhorses are imperilled. Given our conclusion that redhorses provide a temporally critical N subsidy that is likely available to multiple consumers in freshwater food webs, this study provides compelling motivation for increased conservation of these species and their migrations.
Hydroxyurea at escalated dose versus fixed low‐dose hydroxyurea in adults with sickle cell disease
Authors: Ogu Ugochi O. , Mukhopadhyay Ayesha , Patel Kruti , Nelson Marquita N. , Strahan KayLee S. , Wu Lin , Smeltzer Matthew P. , Ataga Kenneth I.
Published: November 2023

Hydroxyurea reduces the frequency of vaso‐occlusive complications, increases hemoglobin, and decreases mortality in sickle cell disease (SCD). Although current guidelines recommend escalation to maximum tolerated dose (MTD), the use of fixed low‐dose hydroxyurea is common in low‐resource countries. We conducted a systematic review and meta‐analysis to evaluate the efficacy of escalated doses versus fixed low‐dose of hydroxyurea in adults with SCD. Nine studies were included in the quantitative synthesis, four evaluating fixed low‐dose and five evaluating escalated doses of hydroxyurea. Average daily doses of hydroxyurea in the fixed low‐dose and escalated dose studies were ~10 and 22 mg/kg, respectively. There was no difference in the estimate of vaso‐occlusive crisis rate between escalated and fixed low‐dose studies (p = .73). The mean difference in hemoglobin from baseline to follow‐up was greater for fixed low‐dose than escalated dose studies (1.07 g/dL vs. 0.54 g/dL, p = .01). No difference was seen in the mean estimate of fetal hemoglobin. Despite limited eligible studies and substantial heterogeneity of effect between the studies for several outcomes, there appears to be clinical equipoise regarding the most appropriate hydroxyurea dosing regimen in adults with SCD. Controlled studies of hydroxyurea at MTD versus fixed low‐dose in adults with SCD are required.
Quota use in mixed‐stock fisheries
Authors: Karp William A. , Melnychuk Michael C. , Forrest Robyn E. , Little Lorne Richard , McQuaw Kristin , Demarest Chad , Hilborn Ray , Baker Nicole , Mose Brian , Turris Bruce , Lado Ernesto Penas
Published: November 2023

Although most fisheries assessment and management focuses on the status of individual stocks, and regulations are commonly established as single‐species total allowable catch limits (TACs), much of the catch from global fisheries comes from mixed‐stock fisheries where species cannot be harvested separately. We show that in some fisheries where TAC and catch of demersal fish stocks are tracked, the average fraction of TAC harvested ranges from 21% to 68% overall and is declining. This is, in part, related to efforts to protect all species from overfishing, leading to ‘choke species’, which limit fishing pressure on other target species. While some choke species arise from a mix of low and high‐productivity species, others result from allocation processes, which can be aggravated by shifting distributions due to climate change. Underutilization of TACs can also result from market limitations, low value of individual species, undercapacity or management measures. Proposed methods for increasing long‐term yield require species to be managed in stock groups, or allowing the abundance of some stocks to fall below target reference points. We suggest that the observed low and declining aggregate harvests are due, primarily, to the focus on single‐stock sustainability measures, rather than performance of the fisheries in relation to potential overall yield. While there is a growing consensus that single‐species management should be replaced by an ecosystem‐based approach, this will require clear legislative directives regarding management of the trade‐offs involved. Time series considered in this analysis do not extend beyond 2019.
The polygenic and reactive nature of observed parenting
Authors: Runze Jana , Bakermans‐Kranenburg Marian J. , Cecil Charlotte A. M. , van IJzendoorn Marinus H. , Pappa Irene
Published: November 2023

In Wertz et al. (2019), parents' polygenic scores of educational attainment (PGS‐EA) predicted parental sensitive responses to the child's needs for support, as observed in a dyadic task (i.e., observed sensitivity). We aimed to replicate and expand these findings by combining longitudinal data, child genotype data and several polygenic scores in the Generation R Study. Mother–child dyads participated in two developmental periods, toddlerhood (14 months old; n = 648) and early childhood (3–4 years old, n = 613). Higher maternal PGS‐EA scores predicted higher observed sensitivity in toddlerhood (b = 0.12, 95% CI 0.03, 0.20) and early childhood (b = 0.16, 95% CI 0.08, 0.24). Child PGS‐EA was significantly associated with maternal sensitivity in early childhood (b = 0.11, 95% CI 0.02, 0.21), and the effect of maternal PGS‐EA was no longer significant when correcting for child PGS‐EA. A latent factor of PGSs based on educational attainment, intelligence (IQ) and income showed similar results. These polygenic scores might be associated with maternal cognitive and behavioral skills that help shape parenting. Maternal PGSs predicted observed sensitivity over and above the maternal phenotypes, showing an additional role for PGSs in parenting research. In conclusion, we replicated the central finding of Wertz et al. (2019) that parental PGS‐EA partially explains parental sensitivity. Our findings may be consistent with evocative gene–environment correlation (rGE), emphasizing the dynamic nature of parenting behavior across time, although further research using family trios is needed to adequately test this hypothesis.
Drivers for the maturity of integrated governance in organizations—An empirical investigation
Authors: d'Arcy Anne , Eulerich Marc
Published: November 2023

This paper sheds light on the factors driving the maturity levels of integrated governance by analysing survey responses from 148 companies that reported on their efforts to coordinate and align their separated assurance functions. When an organization's assurance functions lack coordination, it can lead to challenges like isolated risk functions, incomplete risk coverage and redundant controls. Integrated governance aims to incorporate and optimize on organization's assurance functions to support an effective risk control environment and the integrity of information used by management and the governing bodies. Despite this goal, research indicates that no organization has achieved a mature level of integrated governance yet. To address this research gap, we identify key drivers for integrated governance maturity such as the awareness of integrated governance within the organization, the implementation of the Three Lines (of Defense) Model and the maturity levels of subsystems, that is, the risk management function and the internal control system.
Flexible ureteroscopy with novel flexible ureteral access sheath versus mini‐percutaneous nephrolithotomy for treatment of 2–3 cm renal stones
Authors: Chen Yujun , Xi Haibo , Yu Yue , Cheng Xiaofeng , Yang Heng , Deng Wen , Liu Wei , Wang Gongxian , Zhou Xiaochen
Published: November 2023

Objectives

To assess and compare the effectiveness and safety of flexible ureteroscopy (f‐URS) with a novel flexible ureteral access sheath (f‐UAS) versus mini‐percutaneous nephrolithotripsy (mini‐PCNL) in treating 2–3 cm renal stones.

Methods

Retrospectively analyzed consecutive cases that underwent f‐URS with f‐UAS (12/14 Fr) from January 29, 2022, to November 30, 2022. Consecutive cases that underwent mini‐PCNL (18 Fr) from June 5, 2021, to January 26, 2022, were selected as controls. The f‐UAS is a novel device with a 10 cm anterior tip that passively bends along with the f‐URS to enter the renal calyx. We analyzed demographic characteristics, stone parameters, operative time, stone‐free rates (SFR), hospitalization time, and complication.

Results

A total of 96 consecutive cases that underwent f‐URS with f‐UAS and 96 consecutive cases that underwent mini‐PCNL were included in the study. There were no significant differences between the two groups in terms of operative time (p = 0.06), stone volume clearance (p = 0.533) and complete SFR (p = 0.266) on the first postoperative day or residual Stone after 1 month (p = 0.407). We observed a significantly shorter postoperative hospital stay (1.4 days vs. 2.1 days; p < 0.001) and a lower decrease in hemoglobin levels (0.39 g/dL vs. 0.68 g/dL; p < 0.001) in the f‐UAS group. The mini‐PCNL group had a significantly higher overall complication rate (13.5%) compared with the f‐UAS group (5.2%; p = 0.048).

Conclusions

In the treatment of 2–3 cm renal stones, f‐URS with a novel f‐UAS may provide a superior alternative to mini‐PCNL, potentially challenging its established status.
Capital inflows to emerging countries and their sensitivity to the global financial cycle
Authors: Buono Ines , Corneli Flavia , Stefano Enrica Di
Published: November 2023

We studied how the effect of global and domestic factors on capital flows towards emerging market economies has changed in the last 25 years. We find that both the global financial crisis and the so‐called “taper tantrum” (TT) event, defined as the point in time when investors perceived the end of the US Federal Reserve's unconventional monetary policy, triggered changes in the sensitivity of capital inflows to their main drivers. In particular, we provide evidence that international investors devoted growing attention to global factors. Moreover, we show that the TT marked the beginning of a new phase, characterized by increased sensitivity to both global conditions and government borrowing by recipient countries.
A systematic review of interventions to reduce mechanical restraint in adult mental health inpatient settings
Authors: Pedersen Martin Locht , Gildberg Frederik Alkier , Baker John , Tingleff Ellen Boldrup
Published: November 2023

Mechanical restraint is a commonly used restrictive practice worldwide, although reducing its use is an international priority. Interventions to reduce mechanical restraint are needed if reducing mechanical restraint is to succeed. Therefore, this systematic review aimed to examine evaluated evidence‐based interventions that seek to reduce the incidence of and/or time in mechanical restraint in adult mental health inpatient settings. The JBI framework was used to guide this systematic review. The search strategy included peer‐reviewed primary research literature published between 1999 and 2023. Two authors independently conducted the systematic search, selection process and data extraction process. Forty‐one studies were included in this review. Using content analysis, we grouped interventions into four categories: (I) calm‐down methods, (II) staff resources, (III) legal and policy changes and (IV) changing staff culture. Interventions to reduce mechanical restraint in adult mental health inpatient settings have shown some promise. Evidence suggests that a range of interventions can reduce the incidence of and/or time in mechanical restraint. However, controlled trials were lacking and consensus was lacking across studies. Furthermore, specific findings varied widely, and reporting was inconsistent, hampering the development of interventions for this issue. Further research is needed to strengthen the evidence base for reducing mechanical restraint in mental health inpatient settings.
The distinct effects of information technologies and communication technologies on skill demand
Authors: Blanas Sotiris
Published: November 2023

Covering the bulk of economic activity in ten developed countries over 1982–2005, this paper is the first to study the distinct effects of Information Technologies (IT) and Communication Technologies (CT) on labor, and in particular, the relative demand for different education groups of workers. Consistent with evidence on automation‐induced job and skill polarization, IT capital intensity decreased the demand for the middle‐educated relative to the highly and low‐educated. Instead, CT capital intensity increased the demand for the highly educated relative to the low‐educated, suggesting that CT facilitate the leverage of knowledge by the former group in production teams or the identification of new investment opportunities for their companies. Additional evidence, especially on the effects of CT, yields a richer set of insights.
Missions
Authors: Soko‐de Jong Thandi
Published: November 2023

This paper discusses the impact of colonization on Christian mission encounters and activities. It utilizes the decolonial epistemic framework to analyze the limitations of approaches that advocate “dialogue,” “revelation,” and “mutual growth.” The paper argues that focusing on these three approaches overlooks the asymmetrical power dynamics inherent in the history of Western Christian missions. Conversely, a focus on a deeper experience of the divine highlights the existing epistemic and spiritual knowledge of individuals and communities who have become “othered” within a colonial framework. The paper begins by defining the terms that describe the power dynamics of colonization. Following is a discussion of the impact of colonization on Christian missions. Next, the paper explores the limits of dialogue, revelation, and mutual growth, and finally, it argues the importance of focusing on a more profound experience of the divine.
Occurrence of tripletail Lobotes surinamensis (Bloch, 1790) in the inner Bristol Channel, UK
Authors: Ellis Jim R. , Rumney Paul , Cogan Stephanie
Published: November 2023

A specimen of tripletail Lobotes surinamensis (total length: 402 mm, total mass: 1262 g) was caught in the shallow waters of the inner Bristol Channel on September 2, 2019, with this only the second known capture of this species from the British Isles. Given the cosmopolitan distribution of this species, the potential origin of this specimen is uncertain.
Gorges partition diversity within New Zealand flathead Galaxias populations
Authors: Waters Jonathan M. , King Tania M. , Craw Dave
Published: November 2023

Understanding the landscape factors governing population connectivity in riverine ecosystems represents an ongoing challenge for freshwater biologists. We used DNA sequence analysis to test the hypothesis that major geomorphological features underpin freshwater‐limited fish diversity in a tectonically dynamic region of New Zealand. Phylogeographic analysis of 101 Galaxias depressiceps cytochrome b sequences, incorporating 55 localities from southern New Zealand, revealed 26 haplotypes, with only one shared among rivers. We detect strong hierarchical genetic differentiation both among and within river systems. Genetic structuring is particularly pronounced across the Taieri River system (63 individuals from 35 sites, 18 haplotypes), with 92% of variation partitioned among locations. Distinctive within‐river genetic clusters are invariably associated with major subcatchment units, typically isolated by substantial gorges. The anomalous distribution of a single lineage across a major drainage divide is consistent with local, tectonically driven headwater capture. We conclude that major landscape features such as gorges can strongly partition riverine fish diversity and constrain freshwater biodiversity.
Potential of PAQosome as a therapeutic target for hepatic fibrosis
Authors: Shi Liu , Feng Gong , Yang Xueliang , Zhang Yang , Zhang Yu , Cheng Jun , Lin Shumei
Published: November 2023

Background and Aim

The condition of hepatic fibrosis is hazardous. Therefore, it is vital that we investigate the mechanism of hepatic fibrosis to provide new targets for treatment.

Methods

Preliminary screening and research was carried out based on our prior results and our speculated role of the particle with quaternary structure arrangement (PAQosome) in hepatic fibrosis. The experiments were conducted using LX‐2 or HepG2 cell lines by western blotting, quantitative real‐time polymerase chain reaction, luciferase assays, and co‐immunoprecipitation and were further validated in the Gene Expression Omnibus (GEO) database.

Results

We screened and proved that several subunits of the PAQosome regulate the development of liver fibrosis, including the asparagine synthetase domain‐containing 1 upstream open reading frame (ASDURF), prefoldin subunit 4 (PFDN4), prefoldin subunit 5 (PFDN5), unconventional prefoldin RNA polymerase II subunit 5 interactor (URI1), and ubiquitously expressed prefoldin‐like chaperone (UXT). ASDURF promotes hepatic fibrosis through the transforming growth factor‐β1 (TGFβ1)/Sekelsky mothers against decapentaplegic homologue 3 (Smad3) and NF‐κB signaling pathways. ASDURF regulates the expression of asparagine synthetase domain‐containing 1 (ASNSD1). PFDN4, PFDN5, URI1, and UXT regulate cell proliferation through the PI3K/AKT pathway, and thus regulate liver fibrosis. A hepatic fibrosis score ≥ F2 was selected as the diagnostic criteria for hepatic fibrosis in the GSE96971 database. The area under the receiver operating characteristic curve of PFDN4, PFDN5, UXT, and ASNSD1 were 0.862 (confidence interval [CI]: 0.6588–1.000), 0.538 (CI: 0.224–0.853), 0.708 (CI: 0.449–0.966), and 0.831 (CI: 0.638–1.000), respectively.

Conclusions

These findings demonstrate that the PAQosome is a brand new target for hepatic fibrosis therapy.
Diagnostic accuracy of the Family Confusion Assessment Method for delirium detection: A systematic review and meta‐analysis
Authors: Zhou Chenxi , Wang Hui , Wang Lan , Zhou Yanrong , Wu Qiansheng
Published: November 2023

Background

Delirium is frequently disproportionately under‐recognized despite its high prevalence, detrimental impact, and potential lethality. Informant‐based delirium detection tools can offer structured assessment and increase the timeliness and frequency of detection. We aimed to examine the diagnostic accuracy of the Family Confusion Assessment Method (FAM‐CAM) for delirium detection.

Methods

We systematically searched the MEDLINE, EMBASE, PsycINFO, CINAHL, CNKI, WANFANG, and SinoMed databases from January 1988 to December 2022. Two reviewers independently screened studies and evaluated methodological quality using the revised quality assessment of diagnostic accuracy studies (QUADAS‐2) tool. A bivariate random effects model was undertaken, and univariable meta‐regression was carried out to explore heterogeneity.

Results

Seven studies with 483 dyads of participants and family caregivers were identified. Pooled sensitivity and specificity were 0.74 (95% CI: 0.59, 0.86) and 0.91 (95% CI: 0.83, 0.95), respectively, with an area under curve (AUC) of 0.91. The positive likelihood ratio was 8.27 (95% CI: 3.97, 17.25), and the negative likelihood ratio was 0.28 (95% CI: 0.16, 0.50). Settings impacted specificity (p = 0.02).

Conclusions

Available evidence indicates that FAM‐CAM exhibits moderate sensitivity and high specificity for delirium screening in adults. The FAM‐CAM is concise and easy to use, making it appropriate for routine clinical practice, which might benefit early delirium detection and potentially foster delirium management.

PROSPERO Registration Number

CRD42022378742.
Childhood personality and academic performance: A sibling fixed‐effects study
Authors: Constantinou Andrea , von Soest Tilmann , Zachrisson Henrik Daae , Torvik Fartein Ask , Cheesman Rosa , Ystrom Eivind
Published: November 2023

Objective

This study investigated the associations between personality traits at age 8 and academic performance between ages 10 and 14, controlling for family confounds.

Background

Many studies have shown links between children’s personality traits and their school performance. However, we lack evidence on whether these associations remain after genetic and environmental confounders are accounted for.

Method

Sibling data from the Norwegian Mother and Child Cohort Study (MoBa) were used (n = 9701). First, we estimated the overall associations between Big Five personality traits and academic performance, including literacy, numeracy, and foreign language. Second, we added sibling fixed effects to remove unmeasured confounders shared by siblings as well as rating bias.

Results

Openness to Experience (between‐person β = 0.22 [95% CI: 0.21–0.24]) and Conscientiousness (between‐person β = 0.18 [95% CI 0.16–0.20]) were most strongly related to educational performance. Agreeableness (between‐person β = 0.06 [95% CI −0.08–0.04]) and Extraversion (between‐person β = 0.02 [95% CI 0.00–0.04]) showed small associations with educational performance. Neuroticism had a moderate negative association (between‐person β = −0.14 [95% CI −0.15–0.11]). All associations between personality and performance were robust to confounding: the within‐family estimates from sibling fixed‐effects models overlapped with the between‐person effects. Finally, childhood personality was equally predictive of educational performance across ages and genders.

Conclusions

Although family background is influential for academic achievement, it does not confound associations with personality. Childhood personality traits reflect unbiased and consistent individual differences in educational potential.
Comparative short‐term safety and efficacy of hypnotics: A quantitative risk–benefit analysis
Authors: Cheung Janet M. Y. , Scott Hannah , Muench Alexandria , Grunstein Ronald R. , Krystal Andrew D. , Riemann Dieter , Perlis Michael
Published: November 2023

Several professional societies have provided recommendations for prescribing medications for insomnia. None has provided an integrative analysis that concurrently quantifies safety and efficacy (e.g., risk–benefit ratios). This represents an important gap for informing clinician decision‐making. Accordingly, the aim of the present review is to provide such an analysis for five classes of sleep‐promoting medications. Adverse event data values were extracted from the most recent FDA‐approved package inserts and converted to an integer before being placebo‐adjusted and standardized as a rate per 1000 (AEr). Efficacy data, pre‐to‐post self‐reported data for active and placebo conditions were acquired from pivotal trials identified in “white papers” and systematic reviews/meta‐analyses. Weighted effect sizes were calculated for subjective sleep latency, wake time after sleep onset and total sleep time, and then were averaged by medication class for each sleep continuity variable. Overall efficacy was represented by a single variable, SWT (sleep latency + wake time after sleep onset + total sleep time). Risk–benefit was represented using a simple ratio value. For safety, it was found that melatonin receptor agonists had the lowest adverse event rate (AEr = 43.1), and non‐benzodiazepine benzodiazepine receptor agonists had the highest rate (AEr = 255.0). For efficacy, it was found that the pre‐to‐post placebo adjusted effect sizes were largest for benzodiazepines (effect size = 1.94) and smallest for melatonin receptor agonists (effect size = 0.109). For risk–benefit, histamine antagonist had the most favourable profile (risk–benefit = 69.5), while melatonin receptor agonist had the least favourable profile (risk–benefit = 395.7). Overall, the combined metric for risk–benefit suggests that treatment with a histamine antagonist is optimal and potentially represents the best first‐line therapy for the medical management of insomnia.
Effects of Form‐Focused Practice and Feedback: A Multisite Replication Study of Yang and Lyster (2010)
Authors: Mifka‐Profozic Nadia , Behney Jennifer , Gass Susan M. , Macis Marijana , Chiuchiù Gaia , Bovolenta Giulia
Published: November 2023

We conducted a multisite replication of Yang and Lyster's (2010) study investigating the effects of recasts and prompts on learning English regular and irregular past tense. Our study was conducted with intact high school and vocational school classes in Italy and Bosnia. Our participants were young adolescents (14–15 and 16–17 years old), a population that has been largely ignored in second language acquisition (SLA) research. We followed the design of the original study, but we also included a few modifications regarding the elicitation materials. The findings from our study did not fully align with Yang and Lyster's results. We found no effect of group and no evidence of the superiority of either prompts or recasts in either written or oral data in either Bosnia or Italy. However, we found a steady increase in scores over time from pretest to posttests in oral data in all groups at both sites.
Genomics‐informed conservation units reveal spatial variation in climate vulnerability in a migratory bird
Authors: Miller Caitlin V. , Bossu Christen M. , Saracco James F. , Toews David P. L. , Rushing Clark S. , Roberto‐Charron Amélie , Tremblay Junior A. , Chandler Richard B. , DeSaix Matthew G. , Fiss Cameron J. , Larkin Jeff L. , Haché Samuel , Nebel Silke , Ruegg Kristen C.
Published: November 2023

Identifying genetic conservation units (CUs) in threatened species is critical for the preservation of adaptive capacity and evolutionary potential in the face of climate change. However, delineating CUs in highly mobile species remains a challenge due to high rates of gene flow and genetic signatures of isolation by distance. Even when CUs are delineated in highly mobile species, the CUs often lack key biological information about what populations have the most conservation need to guide management decisions. Here we implement a framework for CU identification in the Canada Warbler (Cardellina canadensis), a migratory bird species of conservation concern, and then integrate demographic modelling and genomic offset to guide conservation decisions. We find that patterns of whole genome genetic variation in this highly mobile species are primarily driven by putative adaptive variation. Identification of CUs across the breeding range revealed that Canada Warblers fall into two evolutionarily significant units (ESU), and three putative adaptive units (AUs) in the South, East, and Northwest. Quantification of genomic offset, a metric of genetic changes necessary to maintain current gene–environment relationships, revealed significant spatial variation in climate vulnerability, with the Northwestern AU being identified as the most vulnerable to future climate change. Alternatively, quantification of past population trends within each AU revealed the steepest population declines have occurred within the Eastern AU. Overall, we illustrate that genomics‐informed CUs provide a strong foundation for identifying current and future regional threats that can be used to inform management strategies for a highly mobile species in a rapidly changing world.
Encoder–decoder with pyramid region attention for pixel‐level pavement crack recognition
Authors: Yao Hui , Liu Yanhao , Lv Haotian , Huyan Ju , You Zhanping , Hou Yue
Published: November 2023

Timely and accurate extraction of pavement crack information is crucial to maintain service conditions and structural safety for infrastructures and reduce further road maintenance costs. Currently, deep learning techniques for automated pavement crack detection are far superior to traditional manual approaches in both speed and accuracy. However, existing deep learning models may easily lose crack details when processing images containing complex background textures or other noises. Although many studies have alleviated this challenge by introducing attention mechanisms, especially the non‐local (NL) block, which has the ability to efficiently capture long‐range dependencies to facilitate crack pixel capture, the huge computational cost of NL makes the inference time of the model too long, which is not conducive to practical implementation. In this study, a new module, namely, the pyramid region attention module (PRAM), was developed by combining the pyramid pooling module in the pyramid scene parsing network and optimized NL, which can achieve global multi‐scale context integration and long‐range dependencies capture at a relatively lower computational cost. By applying PRAM to deep skip connections in the modified U‐Net, an effective crack segmentation model called CrackResU‐Net was developed. The test results on the existing CrackForest dataset showed that CrackResU‐Net not only achieved an F1 score of 0.9580 but also took only 25.89 ms to process an image with a resolution of 480 × 320, which had advantages in accuracy and speed, compared with several other state‐of‐the‐art crack segmentation approaches. It was fully demonstrated that this approach could realize automatic fast and high‐precision recognition of pavement cracks for engineering purposes.
Global variability of vascular and peritoneal access for chronic dialysis
Authors: Ghimire Anukul , Shah Samveg , Okpechi Ikechi G. , Ye Feng , Tungsanga Somkanya , Vachharajani Tushar , Levin Adeera , Johnson David , Ravani Pietro , Tonelli Marcello , Thompson Stephanie , Jha Vivekananda , Luyckx Valerie , Jindal Kailash , Shah Nikhil , Caskey Fergus J. , Kazancioglu Rumeyza , Bello Aminu K.
Published: November 2023

Aim

Vascular and peritoneal access are essential elements for sustainability of chronic dialysis programs. Data on availability, patterns of use, funding models, and workforce for vascular and peritoneal accesses for dialysis at a global scale is limited.

Methods

An electronic survey of national leaders of nephrology societies, consumer representative organizations, and policymakers was conducted from July to September 2018. Questions focused on types of accesses used to initiate dialysis, funding for services, and availability of providers for access creation.

Results

Data from 167 countries were available. In 31 countries (25% of surveyed countries), >75% of patients initiated haemodialysis (HD) with a temporary catheter. Seven countries (5% of surveyed countries) had >75% of patients initiating HD with arteriovenous fistulas or grafts. Seven countries (5% of surveyed countries) had >75% of their patients starting HD with tunnelled dialysis catheters. 57% of low‐income countries (LICs) had >75% of their patients initiating HD with a temporary catheter compared to 5% of high‐income countries (HICs). Shortages of surgeons to create vascular access were reported in 91% of LIC compared to 46% in HIC. Approximately 95% of participating countries in the LIC category reported shortages of surgeons for peritoneal dialysis (PD) access compared to 26% in HIC. Public funding was available for central venous catheters, fistula/graft creation, and PD catheter surgery in 57%, 54% and 54% of countries, respectively.

Conclusion

There is a substantial variation in the availability, funding, workforce, and utilization of vascular and peritoneal access for dialysis across countries regions, with major gaps in low‐income countries.

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Resilience, Accelerated Aging, and Persistently Poor Health: Diverse Trajectories of Health in Malawi
Authors: Hoang Cung Truong , Kohler Iliana V. , Amin Vikesh , Behrman Jere R. , Kohler Hans‐Peter
Published: November 2023

Individuals age at vastly different rates resulting in significant within‐population heterogeneity in health and aging outcomes. This diversity in health and aging trajectories has rarely been investigated among low‐income aging populations that have experienced substantial hardships throughout their lifecourses. Utilizing 2006–2019 data from the Malawi Longitudinal Study of Families and Health and estimating group‐based trajectory models, our analyses identified three distinct lifecourse health trajectories: (1) comparatively good initial mental and physical health that persisted throughout the lifecourse (“resilient aging”), (2) relatively good initial mental and physical health that started to deteriorate during mid‐adulthood (“accelerated aging”), and (3) poor initial mental and physical health that further declined over the lifecourse (“aging with persistently poor health”). For both physical and mental health, men were more likely to enjoy resilient aging than women. Predictors other than gender of trajectory membership sometimes confirmed, and sometimes contradicted, hypotheses derived from high‐income country studies. Our analyses highlight the long arm of early life conditions and gender in determining aging trajectories and show that a nontrivial subpopulation is characterized by aging with persistently poor health. The study uncovers widening gaps in health outcomes between those who age with resilience and those who experience accelerated aging.
Skin branding for jaundice in children: A brutal cultural dermatosis
Authors: Arun Babu Thirunavukkarasu , Nagendran Prabhakaran
Published: November 2023

Dermatological conditions associated with socio‐cultural and religious practices, known as “cultural dermatoses,” are commonly seen in medical practice. This article presents seven cases of children who underwent skin branding for jaundice in Southern India. Skin branding, a traditional healing method, involves applying heated objects to cause third‐degree burns. Healthcare providers should be aware of these cultural practices to avoid misdiagnosis.
Photoprotective measures among adolescents stratified by region: An analysis utilizing the National College Health Assessment
Authors: Shareef Sarah J. , Jackson Shanelle , Lane Brittany N. , Kallabat Ellanya , Boopathy Deepika , Fakhoury Joseph W. , Lim Henry W.
Published: November 2023

Background/Purpose

Exposure to sunlight has been shown to cause pigmentary alterations, photoaging and photocarcinogenesis. Understanding photoprotective patterns in adolescent populations is beneficial to public health initiatives. We utilized data provided by the American College Health Association's National College Health Assessment to evaluate photoprotective behaviors among adolescent populations.

Methods

Behavioral questions related to photoprotection were analyzed from the American College Health Association (ACHA) National College Health Assessment (NCHA) (Version III).

Results

When comparing races, Black/African American respondents had the lowest association of practicing photoprotective behaviors in comparison to white respondents (p < .05). When comparing US geographic regions, the south had the lowest association of photoprotective measures (p < .05).

Limitations

The response rate of each institution varied, although there was still a large quantity of respondents. Finally, we cannot discern the specific reasoning for adolescent populations not using sunscreen.

Conclusion

These data identify demographics where efforts to enhance education on photoprotective behaviors, specifically among skin of color and southern population, to support public health initiatives.