bluuebunny/crossref_metadata_2025 huggingface dataset:
A microanalysis of expert‐student dialogue videos: Supporting preparation and learning for clinical competence assessment
Authors: Botelho Michael G. , Chan Albert K. M.
Published: March 2021

Introduction

The aim of this qualitative study was to analyse students’ perceptions and impact of using a novel video genre designed to support their learning and preparation for a clinical competence assessment. The videos demonstrate expert‐student dialogue (ESD) of authentic, one‐on‐one discourse between the teacher and student, relating to the case presentation and self‐evaluation of the assessment.

Methods

Students who were about to perform a competence assessment were invited to participate in the study. Students were asked to watch a relevant ESD video they had not previously had access to, which showed the examiner‐examinee dialogue relating to a peer's tooth preparation for the competence assessment. Immediately after watching the video, a video simulated recall approach was performed to analyse students’ perceptions. Thematic analysis was performed to induce relevant themes.

Results

Five themes were identified: analysis and judgement, observational learning from expert dialogue, observational learning from student dialogue, self‐efficacy and empathy. Positive responses from interviews suggested high cognitive engagement with this video genre with an affective component that was also valued as an informative learning resource. Students reported the video could stimulate them to think, make it easier to remember knowledge, avoid errors observed, and gain insights into assessment process and examiner's expectations. Empathy was also reported towards the examinee in the video.

Conclusions

The ESD videos facilitated students’ active and analytical thinking as well as improved their assessment preparedness. This video genre has shown how observing ESD can support students’ learning and preparation for a clinical competence assessment.
Healthcare resource utilisation and sickness absence in newly diagnosed multiple myeloma patients who did not undergo autologous stem cell transplantation: Trends in Sweden with the changing treatment landscape
Authors: Borgsten Fredrik , Gatopoulou Xenia , Pisini Marta , Tambour Magnus , Schain Frida , Jones Christina V. , Kwok Kelvin Ho Man , Batyrbekova Nurgul , Björkholm Magnus
Published: March 2021

Objectives

The introduction of novel drugs has significantly improved outcomes for multiple myeloma (MM) patients. This study describes survival, healthcare resource utilisation and sickness absence in association with the changing MM treatment landscape over time, focussing on patients who did not undergo autologous stem cell transplantation (ASCT).

Methods

Population‐based, retrospective registry study in Sweden, where 7012 non‐ASCT patients diagnosed between 2001 and 2015 were stratified into diagnosis periods 2001‐2005 (n = 2053), 2006‐2010 (n = 2372) and 2011‐2015 (n = 2587).

Results

Median survival increased from 2.5 to 3.4 years from 2001‐2005 to 2011‐2015. During the first 3 years of follow‐up, patients diagnosed during 2011‐2015 spent 29% and 12% less time in health care (55 days; inpatient admissions and outpatient visits) than patients diagnosed during 2001‐2005 (78 days) and 2006‐2010 (63 days), respectively. This was associated with less inpatient and more outpatient healthcare usage. Average 3‐year sickness absence (362 days) was 31% and 12% less than for patients diagnosed during 2001‐2005 (522 days) and 2006‐2010 (410 days), respectively.

Conclusions

These findings of improved survival, reduced healthcare needs and greater productivity in non‐ASCT MM patients with access to improved treatment practices and novel drugs provide important real‐world cost‐benefit insights for the continued development and introduction of treatments for MM.
Climate change transforms the functional identity of Mediterranean coralligenous assemblages
Authors: Gómez‐Gras Daniel , Linares Cristina , Dornelas Maria , Madin Joshua S. , Brambilla Viviana , Ledoux Jean‐Baptiste , López‐Sendino Paula , Bensoussan Nathaniel , Garrabou Joaquim
Published: March 2021

Quantifying changes in functional community structure driven by disturbance is critical to anticipate potential shifts in ecosystem functioning. However, how marine heatwaves (MHWs) affect the functional structure of temperate coral‐dominated communities is poorly understood. Here, we used five long‐term (> 10 years) records of Mediterranean coralligenous assemblages in a multi‐taxa, trait‐based analysis to investigate MHW‐driven changes in functional structure. We show that, despite stability in functional richness (i.e. the range of species functional traits), MHW‐impacted assemblages experienced long‐term directional changes in functional identity (i.e. their dominant trait values). Declining traits included large sizes, long lifespans, arborescent morphologies, filter‐feeding strategies or calcified skeletons. These traits, which were mostly supported by few sensitive and irreplaceable species from a single functional group (habitat‐forming octocorals), disproportionally influence certain ecosystem functions (e.g. 3D‐habitat provision). Hence, MHWs are leading to assemblages that are deficient in key functional traits, with likely consequences for the ecosystem functioning.
Partial and nonresponders to onabotulinumtoxinA can benefit from anti‐CGRP monoclonal antibodies preventive treatment: A real‐world evidence study
Authors: Alpuente Alicia , Gallardo Victor J. , Caronna Edoardo , Torres‐Ferrús Marta , Pozo‐Rosich Patricia
Published: March 2021

Background and purpose

Monoclonal antibodies targeting CGRP or its receptor, anti‐CGRP mAbs, are proven to be effective treatments in migraine prevention. Real‐world evidence studies assessing their efficacy are scarce.

Methods

Our objective was to assess the efficacy of anti‐CGRP mAbs in our clinical cohort resistant to onabotulinumtoxinA. We prospectively analyzed ≥50% response rate in patients who initiated treatment with anti‐CGRP mAbs and who were partial or nonresponders to onabotulinumtoxinA.

Results

One hundred fifty‐five patients completed treatment with anti‐CGRP mAbs at 3 months of follow‐up. No statistically significant differences were found in ≥50% response in headache frequency in patients with prior onabotulinumtoxinA treatment partial or complete failure. Regarding dual therapy with onabotulinumtoxinA and anti‐CGRP mAbs, no statistically significant differences were found in ≥50% response in headache frequency between monotherapy or dual therapy.

Conclusions

Patients with prior treatment failure or partial efficacy to onabotulinumtoxinA respond to anti‐CGRP mAbs. After 3 months, in our cohort, dual therapy does not seem to add more benefit than anti‐CGRP mAbs in monotherapy.
Systemic antimicrobial therapy in foals
Authors: Floyd E. F. , Easton‐Jones C. A. , Theelen M. J. P.
Published: March 2021

Antimicrobial agents are commonly used in neonatal foals for the treatment or prevention of sepsis. However, due to concerns about the development of antimicrobial resistance and increasing pressure on veterinarians to rationalise antimicrobial use, we should be trying to reduce the unnecessary use of antimicrobials. This article reviews many of the important considerations when selecting an antimicrobial for use in neonatal foals. Firstly, we consider general differences in neonatal pharmacology and physiology. Secondly, we review common antimicrobial drugs and their indications. Finally, we review antimicrobial stewardship.
MOSQUITO‐NET: A deep learning based CADx system for malaria diagnosis along with model interpretation using GradCam and class activation maps
Authors: Kumar Aayush , Singh Sanat B. , Satapathy Suresh Chandra , Rout Minakhi
Published: March 2021

Malaria is considered one of the deadliest diseases in today's world, which causes thousands of deaths per year. The parasites responsible for malaria are scientifically known as Plasmodium, which infects the red blood cells in human beings. Diagnosis of malaria requires identification and manual counting of parasitized cells in microscopic blood smears by medical practitioners. Its diagnostic accuracy is primarily affected by extensive scale screening due to the unavailability of resources. State of the art Computer‐Aided Diagnostic techniques based on deep learning algorithms such as CNNs, which perform an end to end feature extraction and classification, have widely contributed to various image recognition tasks. In this paper, we evaluate the performance of Mosquito‐Net, a custom made convnet to classify the infected and uninfected blood smears for malaria diagnosis. The CADx system can be deployed on IoT and mobile devices due to its fewer parameters and computation power, making it wildly preferable for diagnosis in remote and rural areas that lack medical facilities. Statistical analysis demonstrates that the proposed model achieves greater accuracy than the previous SOTA architectures for malaria diagnosis despite being 10 times lighter in parameters and inference time. Mosquito‐Net achieves an AUC of 99.009% and an F‐1 score of 96.7% on the validation set.
Motoneuron‐specific loss of VAChT mimics neuromuscular defects seen in congenital myasthenic syndrome
Authors: Joviano‐Santos Julliane V. , Kljakic Ornela , Magalhães‐Gomes Matheus P. S. , Valadão Priscila Aparecida C. , de Oliveira Leonardo R. , Prado Marco A. M. , Prado Vania F. , Guatimosim Cristina
Published: March 2021

Motoneurons (MNs) control muscle activity by releasing the neurotransmitter acetylcholine (ACh) at the level of neuromuscular junctions. ACh is packaged into synaptic vesicles by the vesicular ACh transporter (VAChT), and disruptions in its release can impair muscle contraction, as seen in congenital myasthenic syndromes (CMS). Recently, VAChT gene mutations were identified in humans displaying varying degrees of myasthenia. Moreover, mice with a global deficiency in VAChT expression display several characteristics of CMS. Despite these findings, little is known about how a long‐term decrease in VAChT expression in vivo affects MNs structure and function. Using Cre‐loxP technology, we generated a mouse model where VAChT is deleted in select groups of MNs (mnVAChT‐KD). Molecular analysis revealed that the VAChT deletion was specific to MNs and affected approximately 50% of its population in the brainstem and spinal cord, with alpha‐MNs primarily targeted (70% in spinal cord). Within each animal, the cell body area of VAChT‐deleted MNs was significantly smaller compared to MNs with VAChT preserved. Likewise, muscles innervated by VAChT‐deleted MNs showed atrophy while muscles innervated by VAChT‐containing neurons appeared normal. In addition, mnVAChT KD mice had decreased muscle strength, were hypoactive, leaner and exhibited kyphosis. This neuromuscular dysfunction was evident at 2 months of age and became progressively worse by 6 months. Treatment of mutants with a cholinesterase inhibitor was able to improve some of the motor deficits. As these observations mimic what is seen in CMS, this new line could be valuable for assessing the efficacy of potential CMS drugs.
Effects of fish stocking and fishing pressure on fish community structures in French lakes
Authors: Daupagne Léa , Rolan‐Meynard Marlène , Logez Maxime , Argillier Christine
Published: March 2021

Fish stocking and regulation of fishing activities are widely implemented by freshwater fisheries authorities who have to protect aquatic communities. The effects of fish management on fish communities have not received sufficient attention. As a result of two datasets, one from EU Water Framework Directive (WFD) monitoring surveys, and one from a French survey targeting angler's associations, this study investigated the impacts of both fishing intensity and fish stocking on fish communities in French lakes. Both co‐inertia analysis and community size spectra analysis, showed that: (i) stocking does not contribute to the standing stocks for five of the six most stocked fish species in France; and (ii) neither fishing intensity nor fish stocking lead to a change in the proportion of large and small fish. The results support alternative methods being promoted to enhance native fish populations.
Footprints of fixed‐gear fisheries in relation to rising whale entanglements on the U.S. West Coast
Authors: Feist Blake E. , Samhouri Jameal F. , Forney Karin A. , Saez Lauren E.
Published: March 2021

On the U.S. West Coast, reports of whales entangled in fishing gear increased dramatically in 2014. In this study, a time series of fishing activity maps was developed from 2009 to 2016 for the four fixed‐gear fisheries most commonly implicated in entanglements. Maps were generated using vessel monitoring system (VMS) data linked to port‐level landings databases, which were related to entangled whale reports over the same time period and with modelled distributions of humpback whales Megaptera novaeangliae Borowski. Over the full study period, neither marked increases in fishing activity nor changes in fisheries footprints within regions with high whale densities were detected. By contrast, a delayed fishery opening in California due to a harmful algal bloom in spring of 2016 led to ~5–7 times average levels of Dungeness crab Metacarcinus magister (Dana) fishing activity, which was consistent with a high rate of entanglement in that year. These results are consistent with current hypotheses that habitat compression caused by a marine heatwave increased the overlap of whales with fishing activity, despite minimal changes in the fisheries themselves. This study adds to literature on bycatch of protected species in otherwise sustainable fisheries, highlighting the value of using VMS data for reducing human–wildlife conflict in the ocean.
Stakeholder perspectives on the implementation and impact of Indigenous health interventions: A systematic review of qualitative studies
Authors: Chando Shingisai , Tong Allison , Howell Martin , Dickson Michelle , Craig Jonathan C. , DeLacy Jack , Eades Sandra J. , Howard Kirsten
Published: March 2021

Background

Evaluations of health interventions for Indigenous peoples rarely report outcomes that reflect participant and community perspectives of their experiences. Inclusion of such data may provide a fuller picture of the impact of health programmes and improve the usefulness of evaluation assessments.

Aim

To describe stakeholder perspectives and experiences of the implementation and impact of Indigenous health programmes.

Methods

We conducted a systematic review of qualitative studies evaluating complex health interventions designed for Indigenous communities in high‐income countries. We searched 6 electronic databases (through to January 2020): MEDLINE, PreMEDLINE, Embase, PsycINFO, EconLit and CINAHL and hand‐searched reference lists of relevant articles.

Results

From 28 studies involving 677 stakeholders (mostly clinical staff and participants), six main themes were identified: enabling engagement, regaining control of health, improving social health and belonging, preserving community and culture, cultivating hope for a better life, and threats to long‐term programme viability.

Conclusion

The prominence of social, emotional and spiritual well‐being as important aspects of the health journey for participants in this review highlights the need to reframe evaluations of health programmes implemented in Indigenous communities away from assessments that focus on commonly used biomedical measures. Evaluators, in consultation with the community, should consistently assess the capacity of health professionals to meet community needs and expectations throughout the life of the programme. Evaluations that include qualitative data on participant and community‐level outcomes can improve decision‐makers' understanding of the impact that health programmes have on communities.

Patient or public contribution

This paper is a review of evaluation studies and did not involve patients or the public.
Dealing with host and food searching in a diurnal parasitoid: consequences of light at night at intra‐ and trans‐generational levels
Authors: Gomes Elisa , Rey Benjamin , Débias François , Amat Isabelle , Desouhant Emmanuel
Published: March 2021

Light pollution is a widespread phenomenon with major consequences on nocturnal organisms from individual to community. However, its effects on diurnal organisms are still scarcely studied.

We exposed diurnal parasitoid wasps (Venturia canescens) to low (0.7 lux) or high (20 lux) artificial light for two to eight consecutive nights, and quantified its consequences on their physiology and daytime behaviour compared to a control group (0 lux). We next considered potential trans‐generational effects on offspring whose mothers were exposed to light pollution.

While in the dark night the wasps showed no activity, exposure to artificial light triggered nocturnal activity and altered diurnal behaviours related to foraging. Wasps exposed to light at night had a greater propensity to choose hosts rather than food compared to controls. They also spent more time feeding when exposed to 0.7 lux of light at night. However, these behavioural modifications were not related to changes in individual energy reserves.

Light pollution effects persisted at trans‐generational level: offspring development time and latency before feeding increased when mothers were exposed to 0.7 lux light at night.

Even at low intensity, light pollution alters foraging behaviour of a diurnal insect. Searching for hosts or food being essential for fitness, light pollution is likely to have long‐term repercussions on insect populations.

Light pollution caused behavioural modifications potentially beneficial for V. canescens in the short term. However, longer term studies (e.g. on lifetime reproductive success) are needed to fully understand its consequences on insects.
In vitro skin model for characterization of sunscreen substantivity upon perspiration
Authors: Keshavarzi Fatemeh , Knudsen Nina Ø. , Brewer Jonathan R. , Ebbesen Morten F. , Komjani Niloufarsadat M. , Moghaddam Saeed Z. , Jafarzadeh Shadi , Thormann Esben
Published: March 2021

Objective

The resistance of sunscreens to the loss of ultraviolet (UV) protection upon perspiration is important for their practical efficacy. However, this topic is largely overlooked in evaluations of sunscreen substantivity due to the relatively few well‐established protocols compared to those for water resistance and mechanical wear.

Methods

In an attempt to achieve a better fundamental understanding of sunscreen behaviour in response to sweat exposure, we have developed a perspiring skin simulator, containing a substrate surface that mimics sweating human skin. Using this perspiring skin simulator, we evaluated sunscreen performance upon perspiration by in vitro sun protection factor (SPF) measurements, optical microscopy, ultraviolet (UV) reflectance imaging and coherent anti‐Stokes Raman scattering (CARS) microscopy.

Results and conclusion

Results indicated that perspiration reduced sunscreen efficiency through two mechanisms, namely sunscreen wash‐off (impairing the film thickness) and sunscreen redistribution (impairing the film uniformity). Further, we investigated how the sweat rate affected these mechanisms and how sunscreen application dose influenced UV protection upon perspiration. As expected, higher sweat rates led to a large loss of UV protection, while a larger application dose led to larger amounts of sunscreen being washed‐off and redistributed but also provided higher UV protection before and after sweating.
The importance of polyreactive antibodies in protection against pneumococcal infection
Authors: Milling Simon
Published: March 2021

Antibodies are a key element of the immune response. They can bind their molecular targets with exquisite sensitivity and specificity, providing protection against a multitude of pathogens. They have long been understood to be markers of a successful response to vaccination, and are now widely manufactured as highly specific and robust immunotherapeutic agents. Less well understood are the polyreactive antibodies, found in serum, which are able to bind more than one target molecule. Here, we highlight new research into these naturally occurring polyreactive antibodies, which demonstrates their importance for protection against Streptococcus pneumoniae, a common cause of airway infection.
The terrible twos: How children cope with frustration and tantrums and the effect of maternal and paternal behaviors
Authors: Deichmann Felix , Ahnert Lieselotte
Published: March 2021

Experimental Frustration Procedures with 158 children (15–39 months) of two‐parent families were conducted, with each parent separately involved. We examined diverse characteristics of children's frustration and focused on specific behaviors of how children coped and parents supported them. In addition, external observers measured child attachment security (via Attachment Q Sort) toward the mother and the father during two home visits. Children with high attachment security became frustrated later and for a shorter time, and fathers, as compared to mothers, relieved these frustration patterns and reduced them. Although 22.2% children exhibited intense frustration responses up to tantrums, levels remained unaffected by child gender, but decreased with child age. Time‐lag analyses revealed that children's self‐comforting behaviors reduced frustration responses only by around 20%, but self‐distracting (in younger children) and pretend‐playing (in older children) by around 50% and 70%. Of the parent behaviors, demonstrating reduced children's frustration by up to 40% whereas distracting and reframing by around 60% (mothers) and 80% (fathers). In general, mothers tended to protect the child from distress, whereas fathers assisted the child in coping with frustration. However, if mothers soothed and fathers encouraged, children's frustration intensified.
Health professionals’ perspectives of safety issues in mental health services: A qualitative study
Authors: Albutt Abigail , Berzins Kathryn , Louch Gemma , Baker John
Published: March 2021

The study aimed to explore mental health professionals’ perceptions of patient safety issues across community and inpatient mental health services. Fourteen mental health professionals across community and inpatient settings participated in qualitative interviews. Framework analysis, guided by the Yorkshire Contributory Factors Framework – Mental Health, was used to analyse the data. Safety issues identified by mental health professionals mapped on to 19 of the 21 factors in the Yorkshire Contributory Factors Framework – Mental Health. The factors most frequently mentioned by participants were ‘safety culture’ which focused on raising concerns, learning from incidents and the influence of targets; ‘communication systems’ to support effective communication between staff; ‘service user factors’ including a perceived increase in illness acuity; ‘service process’ including how patients access and interact with services; and ‘staff workload’ perceived being as unmanageable. Mental health professionals consider there to be a broad range of safety issues associated with mental health services. Future research should aim to develop interventions to improve safety focused across the factors raised by professionals.
Effect of the COVID‐19 pandemic on behavioural and psychosocial factors related to oral health in adolescents: A cohort study
Authors: Brondani Bruna , Knorst Jessica Klöckner , Tomazoni Fernanda , Cósta Marina Dutra , Vargas Andressa Weber , Noronha Thaís Gioda , Mendes Fausto Medeiros , Ardenghi Thiago Machado
Published: March 2021

Background

The impact of the COVID‐19 pandemic on behavioural and psychosocial aspects related to oral health is unknown.

Aim

This study evaluated the psychosocial and behavioural changes related to oral health in adolescents immediately before and during the pandemic period of COVID‐19, enabling a longitudinal assessment of the perceived changes.

Design

This cohort study evaluated 290 adolescents from November 2019 to February 2020 (T1—before the pandemic in Brazil) and from June to July 2020 (T2) in southern Brazil. Sociodemographic, behavioural, and psychosocial variables were measured before and during the pandemic. Issues related to social distancing and job loss were also collected. The differences between the variables in T1 and T2, as well as the effect of social distancing, were assessed using a multilevel‐adjusted logistic regression model for repeated measures.

Results

A total of 207 adolescents were re‐evaluated at T2 (a response rate of 71.3%). During the pandemic, the frequency of toothbrushing, the use of dental services, and the self‐perceived need for dental treatment significantly decreased. Sugar consumption, bruxism, and quality of sleep did not change significantly.

Conclusion

Behavioural and psychosocial factors showed significant changes due to the COVID‐19 pandemic in adolescents.
Association between possible awake bruxism and bullying among 8‐ to 11‐year‐old children/adolescents
Authors: Alonso Letícia Silva , Serra‐Negra Júnia Maria , Abreu Lucas Guimarães , Martins Isabela Melo , Tourino Luciana Fonseca Pádua Gonçalves , Vale Miriam Pimenta
Published: March 2021

Background

Bruxism is characterized by tooth grinding and/or clenching.

Aim

To evaluate the association between possible awake bruxism (PAB) and bullying among individuals aged 8–11 years.

Design

A representative cross‐sectional study was conducted with 434 eight‐ to eleven‐year‐old children/adolescents. Parents/caregivers answered a questionnaire to provide data on sociodemographic characteristics. Children/adolescents answered a questionnaire about the occurrence of PAB. The Olweus Bully/Victim Questionnaire was used. The Poisson regression analysis was performed.

Results

Of the 434 children/adolescents, 209 (48.2%) were boys and 225 (51.8%) were girls. The mean age of the children/adolescents was 9.14 years (±1.00). Children/adolescents who were victims of bullying (PR = 1.52, 95% CI = 1.14‐2.04, P = .005) and bullies‐victims (PR = 2.08, 95% CI = 1.36‐3.17, P = .001) presented a higher frequency of PAB than those who were not involved in bullying.

Conclusion

Children/adolescents who were bullying victims and bullies‐victims had a higher frequency of PAB.
The retention effect of staff education programme: Sustaining a decrease in hospital‐acquired pressure ulcers via culture of care integration
Authors: Al Mutair Abbas , Al Mutairi Alya , Schwebius Deborah
Published: March 2021

Hospital‐acquired pressure ulcers (HAPUs) negatively affect patients during hospitalisation, putting patients at risk for further complications. HAPUs are one of the hospital quality key performance indicators (KPIs) that necessitate quality initiatives and/or programmes to minimise its occurrence and consequences. When quality initiatives are put into place and proven effective, the next important focus is sustainability of the effects. The original Saudi Arabian study based on data collected from 50 441 patients, showed that implementation of the pressure ulcer prevention programme (PUPP) was successful showing a statistically significant reduction of HAPUs from 0.20% in 2014 to 0.06% in 2018 (P value <.001). The aim of this follow‐up check of the original study was to assess if the PUPP's effectiveness success was retained. Also, to try and determine why the implemented quality improvement programme to prevent HAPUs was so successfully retained. Designed and conducted as a systemic review, it tracked the outcomes of pressure ulcer rates during and post PUPP implementation that mostly focused on evidence‐based staff education, concentrating on years 2016 to 2018. Statistically significant reductions were captured by data that have been presented through Pearson Chi squares. HAPU decline was notable between year 2017 and 2018. This was followed by a further reduction in year 2018. The results determine retention effect sustainability of the initial positive results achieved. By doing so, the study was further able to establish that the PUPP had been integrated into the hospital system's care culture as evidenced by the reduction of HAPUs despite a large inpatient growth. Consideration of what contributing factors led to this successful integration of new knowledge into the care culture are also examined. KPIs can be used as indicators to help reinforce staff education. Culture of care (support of values and interventions taught during the PUPP) offer hope that these may be duplicated in future improvement projects. The supportive nature of a given culture of care may in fact be just as important as the practical education provided to staff members.
Corporate social responsibility and operating cash flows management: An examination of credit market incentives
Authors: Oh Hyung Il , Kim Hyunpyo , Kim Jeong‐Bon , Lee Yong Gyu
Published: March 2021

This paper examines whether firms that engage in corporate social responsibility activities (CSR firms) manage reported cash flows from operations (CFO) when they have strong credit market incentives. We find that CSR firms near financial distress and those having a long‐term credit rating near the investment/non‐investment grade cutoff are more likely to inflate reported CFO, compared to all other firms. We also find evidence that CSR firms with these credit market incentives appear to resort mainly to classification rather than timing as a tool for managing CFO. Further, we find that the degree of CFO management performed by those CSR firms is more pronounced under weaker corporate governance. Overall, our findings suggest that CSR firms with stronger credit market incentives are more likely to manage CFO, and that such CFO management behavior is likely to be implemented at the expense of shareholders’ interest.
Virtual reality in K‐12 and higher education: A systematic review of the literature from 2000 to 2019
Authors: Luo Heng , Li Gege , Feng Qinna , Yang Yuqin , Zuo Mingzhang
Published: March 2021

This study is a systematic review of 20 years of research on the usage of virtual reality (VR) in K‐12 and higher education settings, which aims to consolidate, evaluate, and communicate evidence that can inform both the theory and practice of VR‐based instruction. A total of 149 articles were selected from three major academic databases using search strings and manual screening protocols. The literature analysis emphasized four interrelated aspects of VR‐based instruction: instructional context, instructional design, technological affordances, and research findings. The results revealed evolving trends in the VR literature in terms of publication patterns, pedagogical assumptions, equipment usage, and research methodologies, as well as the contextual factors behind VR adoption in education. Additionally, a meta‐analysis was conducted to examine the efficacy of VR‐based instruction, with results indicating an overall medium effect and several moderating factors. Finally, practical implications and a future research agenda for VR‐based instruction are discussed.
Ferroptosis‐related gene CHAC1 is a valid indicator for the poor prognosis of kidney renal clear cell carcinoma
Authors: Li Deng , Liu Shiwei , Xu Jie , Chen Lei , Xu Chaoliang , Chen Feiteng , Xu Zijie , Zhang Yu , Xia Shujie , Shao Yi , Wang Yi
Published: March 2021

To evaluate the validity of CHAC1 for predicting the prognosis of kidney renal clear cell carcinoma (KIRC) and to explore its therapeutic potential for KIRC, we conducted several bioinformatic analyses using the sequencing data and clinical information derived from online databases. We found CHAC1 is down‐regulated in KIRC samples when compared with normal samples but up‐regulated in KIRC samples with relatively higher malignancy and later stages. Univariate cox analysis and multivariate cox regression analysis were conducted and the results revealed up‐regulated CHAC1 is an independent risk factor for poor prognosis of KIRC. Further, the nomogram model based on the result of multivariate cox regression analysis was constructed and effectively predicted patients' 1‐year, 3‐year and 5‐year survival respectively. The correlation analyses showed CHAC1 is associated with the immune pathway markers of memory B cell, natural killer cell and type1 T helper cell as well as the checkpoint genes like ADORA2A, CD200, CD44, CD70, HHLA2, NRP1, PDCD1LG2 and TNFRSF18. Furthermore, experiments in vitro indicated CHAC1 could induce cell death in KIRC cell lines but had limited influence on cell migration and cell invasion. In conclusion, CHAC1 is found a valid indicator for poor prognosis of kidney renal clear cell carcinoma.
Impact of an antimicrobial stewardship intervention in neonatal intensive care: Recommendations and implementation
Authors: Villanueva Paola , Freyne Bridget , Hickey Leah , Carr Jeremy , Bryant Penelope A
Published: March 2021

Aim

To (i) determine the appropriateness of antimicrobial prescribing in the neonatal intensive care unit (NICU) and (ii) assess the impact of a collaborative antimicrobial stewardship (AMS) intervention on prescribing practices.

Methods

The intervention was a weekly AMS audit‐feedback joint ward round (6‐month period) of Neonatology and Infectious Diseases clinicians in a tertiary neonatal intensive care unit in Melbourne, Australia. Antibiotic prescriptions were audited and recommendations delivered in real time. The proportion of recommendations implemented was used to assess acceptability of the intervention.

Results

During the study period, there were 23 AMS rounds, during which 249 patients were reviewed at 627 separate episodes. Of these, 233 (37%) episodes were for patients receiving antimicrobials. Of these, 147 (63%) received empirical antimicrobial treatment, 43 (18%) targeted antimicrobial treatment and 43 (18%) antimicrobial prophylaxis. There were 58 (25%) of 233 episodes of inappropriate antibiotic use, and 62 recommendations for improvement. Most common recommendations were to narrow (33/62, 53%) or stop (12/62, 19%) antimicrobials. The majority (45, 73%) of recommendations were accepted, resulting in significant improvement in the proportion of the 233 episodes that had completely appropriate antibiotic prescribing: 175 (75%) to 217 (93%) (relative risk 1.2, 95% confidence intervals 1.1–1.3, P < 0.001).

Conclusions

A collaborative audit‐feedback AMS intervention was effective in identifying inappropriate antimicrobial prescriptions and impacted positively on treatment plans. Ancillary benefits were improved communication between departments and the revision of antimicrobial prescribing guidelines.
Influence of Social Anxiety on People's Preferences for Robots as Daily Life Communication Partners Among Young Japanese
Authors: Suzuki Tomohiro , Yamada Sachie , Kanda Takayuki , Nomura Tatsuya
Published: March 2021

This study investigates whether people prefer robots versus humans as communication partners for different roles and situations in daily life, and the influence of social anxiety on people's preferences for robots versus humans among young Japanese. A total of 206 young Japanese (men: 103, women: 103; mean age: 25.2 years, SD = 2.91 years, range: 20–29 years) participated in an online survey and completed items assessing the participants' preferences for robots versus humans as communication partners, as well as a Japanese version of the Social Avoidance and Distress Scale. Results showed that in Japan, a certain number of people preferred robots as communication partners in many roles and situations, and for structured tasks especially. Additionally, social anxiety influenced these preferences. This result suggests that robots would be particularly useful for individuals with high social anxiety.
Use it and bruise it: copulation rates are associated with muscle inflammation across anole lizard species
Authors: Martin K. S. , Kahrl A. F. , Ivanov B. , Johnson M. A.
Published: March 2021

The use of skeletal muscles causes cellular damage, a process that leads to inflammation. Although this process is well studied in mammals, it is largely unexplored in other taxa, and the behavioral use of a muscle has not been linked to muscle inflammation in a comparative framework. In this study, we examined the relationship between muscle use and inflammation across 22 anole lizard species. We tested the hypothesis that inflammation in the retractor penis magnus (RPM), a muscle used only during mating, is positively associated with copulation rate and/or with hemipenis size. We measured copulation rates for each species in the field and measured RPM inflammation for both wild‐caught males and, for one species, captive virgin male anoles. We found a positive relationship between RPM inflammation and copulation rate, yet there was no correlation between RPM inflammation and hemipenis size or body size. This finding supports the generality of the relationship between muscle use and inflammation within and across species, suggesting that inflammation could act as a snapshot of recent muscle activity across vertebrate taxa.
Edible dormouse (Glis glis) population study in south‐western Poland provides evidence of multiple paternity and communal nesting
Authors: Moska M. , Mucha A. , Wierzbicki H. , Nowak B.
Published: March 2021

The mating system of small populations, isolated as a result of habitat fragmentation, is a key factor in their survival. As such populations are at risk of losing their genetic variation, reduction of their evolutionary potential is a distinct possibility. A flexible mating system may therefore provide a means of maintaining genetic variation. The mating system of the edible dormouse (Glis glis), a small arboreal rodent endangered by the fragmentation of its habitats, is not well understood. To date, only one study has provided evidence of multiple paternity in dormice. We present the results of a four‐year study of eight isolated dormouse populations. Using 138 individuals and 10 polymorphic autosomal microsatellite loci, we examined the prevalence of multiple paternity in these populations. In addition, we investigated the frequency of communal nesting and the genetic relationships between the females and juveniles occupying a single nest box. We found a high prevalence of multiple paternity (70% of the litters were multiple‐sired), a weak genetic relationship between the juveniles and the accompanying females (in 81% of cases the female residing with juveniles in a nest box was not their biological mother) and a 10.5% frequency of communal nesting in all nests. Given the low genetic variability of dormice, the multiple paternity and promiscuity observed in this species can help to maintain its genetic diversity.
How the Canadian sentencing system impacts policy reform: An examination of the Harper era
Authors: Puddister Kate
Published: March 2021

During the Harper era (2006–2015), the Canadian government actively pursued criminal justice policy reform. Many of its efforts focused on reforming the Canadian sentencing regime by increasing the severity of penalties, including expanding mandatory minimums. Yet, Canada's rate of incarceration remains stable. The inconsistency between the considerable focus on sentencing policy by the Harper government and the lack of significant change in incarceration rates merits further scrutiny. This contrast between policy effort and policy impact also presents an opportunity to examine how the context of criminal justice policy in Canada influences the nature of policy reform. Taking up this focus, this article articulates the context of Canadian criminal justice policy and considers how this context shapes the policymaking process and policy reform.
An overview of the NP versus DP debate
Authors: Köylü Yılmaz
Published: March 2021

This article provides an overview of what is known as the noun phrase (NP) versus determiner phrase (DP) debate. I first revisit the arguments by which a language would be assigned an NP or rather a DP structure, followed by the proper characterisation, function and features of determiners. I then summarise the typological endeavour of Bošković, surveying some of the syntactic and semantic correlates of the NP versus DP parameter and applying four of the diagnostics Bošković developed to Turkish as well as providing examples from other languages such as Korean, Vietnamese and Lithuanian. For each diagnostic, I provide some counterarguments that cast doubt on the validity of those diagnostics. I conclude, in line with Kornfilt (2017, 2018) that proposing correlations between an NP or a DP status of the nominal domain and a certain clustering of syntactic or semantic properties should be abandoned.
Building mental models from multiple texts: How readers construct coherence from inconsistent sources
Authors: Saux Gaston , Britt Mary Anne , Vibert Nicolas , Rouet Jean‐François
Published: March 2021

Text comprehension theories propose that readers try to achieve a coherent representation of the situation depicted in a text. When reading multiple texts on the same topic, however, achieving a coherent representation of a situation poses additional challenges. Different sources may offer inconsistent descriptions or interpretations of the situation, or even contradict one another. Thus, additional assumptions are needed to explain how readers build a coherent representation of a situation when reading multiple individual texts on the same subject. This paper reviews research contributions from the psychology of text comprehension on how readers integrate inconsistent information from multiple sources. We concentrate on two key processes: The construction of an interconnected representation of sources and text contents, and the evaluation of the acquired information. We begin by briefly discussing the standard approach of single‐text comprehension theories to representational coherence. Then, we examine the Documents Model Framework and other, associated proposals that claim that readers can achieve coherence of divergent text contents by constructing a representation of the texts which integrates information about the sources of the contents. We also consider the role of source evaluation as a reader strategy for constructing a single, coherent solution. Finally, we discuss theoretical and practical implications and we make suggestions for further readings.
Nursing care and prevalence of adverse events in prone position: Characteristics of mechanically ventilated patients with severe SARS‐CoV‐2 pulmonary infection
Authors: Rodríguez‐Huerta María Dolores , Díez‐Fernández Ana , Rodríguez‐Alonso María Jesús , Robles‐González María , Martín‐Rodríguez María , González‐García Alberto
Published: March 2021

Background

Because of the coronavirus disease 2019 (COVID‐19) pandemic, the use of prone positioning has dramatically increased in the intensive care unit (ICU). Because this manoeuvre is related to several complications, it must be performed in a protocolized manner by the appropriate personnel.

Aim

To determine the prevalence of adverse events (AEs) in patients admitted to the ICU with a diagnosis of COVID‐19‐related acute respiratory distress syndrome (C‐ARDS) undergoing mechanical ventilation in prone position (PP).

Design

Descriptive ambispective study of patients admitted to the ICU diagnosed with C‐ARDS undergoing mechanical ventilation who were in the PP at least once.

The number of PP manoeuvres and the time spent in the PP were recorded for each subject. AEs proportions and frequencies were calculated, and analysis of variance was used to assess mean differences in the number of manoeuvres and total hours in PP stratified by the number of facial pressure ulcers. IBM SPSS Statistics v.25.0. and EPIDAT 4.1 software were used.

Results

Forty‐four patients were analysed, and 130 PP manoeuvres were performed. The most frequently observed AEs were facial oedema in 26 patients (80.3%) and facial pressure ulcers in 20 (60.6%). There was a significant positive association between the time spent in PP and the development of facial pressure ulcers (P < .001). Enteral nutrition was well tolerated, and no serious AEs or sentinel events were noted.

Conclusion

Despite the stressful, demanding situation during the peak of the pandemic, the large number of PP manoeuvres, and long duration spent in this position, no serious AEs occurred. This study highlights the need to implement preventive measures to avoid the development of pressure ulcers secondary to prone positioning.

Relevance to practice

Prone positioning requires a nursing protocol to prevent the occurrence of AEs that may reduce the quality of nursing care.
The relationship between self‐esteem and psychological distress in critical care nurses
Authors: Duran Sedef , Önel Çisem , Güloğlu Pelin , Ümit Sibel
Published: March 2021

Background

Self‐esteem can be described as negative or positive beliefs people have about themselves. It is an important personal source to combat stress and protect health, and related to job satisfaction.

Aims and objectives

The aim of this study was to examine the relationship between self‐esteem and psychological distress in critical care nurses.

Design

A cross‐sectional study.

Methods

The research population of study consisted of 121 critical care nurses working at a university hospital in Edirne, Turkey between January and April 2017. A questionnaire consisting of 26 questions was used to obtain the personal and demographic information. The Symptom Check List‐90‐R test was used to determine the emotional status and the self‐esteem scale was used to determine the self‐esteem status of the participants. Participants were divided into two groups according to the self‐esteem scale median score (Group 1: below 60, and Group 2: 60 and above).

Results

The general severity index of the nurses was 1.11 (95% confidence interval [CI] 1.00‐1.21). The general severity index of those with a self‐esteem scale score below 60 was 1.47 (95% CI 1.37‐1.57), while for those who with a self‐esteem score of 60 and above, it was 0.73 (95% CI 0.59‐0.87). The general severity index of the nurses in Group 1 was statistically significantly higher than that for those in Group 2. The number of nurses with a high symptom level in Group 1 was statistically significantly higher than those in Group 2.

Conclusions

The study showed that the general severity index and poor symptom level ratios associated with mental well‐being are high in critical care nurses. However, critical care nurses with high self‐esteem had fewer psychological problems than those with lower self‐esteem.

Relevance to clinical practice

Critical care nurses with low self‐esteem should be given assertiveness, resilience, and interpersonal communication skills training, even outside of health care.
Passiflora carajasensis (Passifloraceae), a new species of subgenus Passiflora, series Quadrangulares, from the Brazilian Amazon
Authors: Koch Ana Kelly , Ilkiu‐Borges Anna Luiza
Published: March 2021

A new species of Passiflora series Quadrangulares is described and illustrated from National Forest of Carajás in the Brazilian state of Pará, viz Passiflora carajasensis. This new species is recognized by linear‐lanceolate stipules, long‐ovate to oblong leaf blades, bracts 3–3.5 × 1.5–2.5 cm, erect sepals and petals, and corona with 6 series. It resembles P. longifilamentosa and P. trialata in having 3‐angular winged stems, and 3‐angular petioles and peduncles and a comparison of morphological characteristics between these species is provided, as well as a key for all species of Passiflora series Quadrangulares.