bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in Ia proprioceptive input to spinal motoneurons between male and female rats
Authors: Krutki Piotr , Drzymała‐Celichowska Hanna , Bączyk Marcin , Piotr Magdalena , Celichowski Jan
Published: June 2023

Male and female rats differ in muscle fibre composition, related motor unit contractile properties, and muscle spindle density but not number. On the other hand, their motoneurons' intrinsic properties, excitability and firing properties are similar. The aim of this study was to investigate whether apparent sex differences in body mass and muscle force influence the proprioceptive input from muscle spindles to motoneurons. Medial gastrocnemius motoneurons were investigated intracellularly in deeply anaesthetised male and female rats. Monosynaptic Ia excitatory postsynaptic potentials (EPSPs) were evoked using electrical stimulation of primary afferents from homonymous muscle. Data were analysed using a mixed linear model. The central latencies of EPSPs were 0.38–0.80 ms, with no differences in means between males and females. The maximum EPSP amplitude varied between 2.03 and 8.09 mV in males and 1.24 and 6.79 mV in females. The mean maximum EPSP amplitude was 26% higher in males than in females. The mean EPSP rise time, half‐decay time and total duration did not differ between the sexes. EPSP amplitudes correlated with the resting membrane potential, input resistance and EPSP rise time in both sexes. The observed sex differences in the Ia proprioceptive input may be related either to mechanical loading differences in males and females associated with their different body mass or hormonal differences influencing the levels of neuromodulation in spinal circuits. The results highlight the importance of taking sex into consideration in the studies on the influence of afferent inputs on MN excitability.
Negative effects of urbanisation on diurnal and nocturnal pollen‐transport networks
Authors: Ellis Emilie E. , Edmondson Jill L. , Maher Kathryn H. , Hipperson Helen , Campbell Stuart A.
Published: June 2023

Pollinating insects are declining due to habitat loss and climate change, and cities with limited habitat and floral resources may be particularly vulnerable. The effects of urban landscapes on pollination networks remain poorly understood, and comparative studies of taxa with divergent niches are lacking. Here, for the first time, we simultaneously compare nocturnal moth and diurnal bee pollen‐transport networks using DNA metabarcoding and ask how pollination networks are affected by increasing urbanisation. Bees and moths exhibited substantial divergence in the communities of plants they interact with. Increasing urbanisation had comparable negative effects on pollen‐transport networks of both taxa, with significant declines in pollen species richness. We show that moths are an important, but overlooked, component of urban pollen‐transport networks for wild flowering plants, horticultural crops, and trees. Our findings highlight the need to include both bee and non‐bee taxa when assessing the status of critical plant‐insect interactions in urbanised landscapes.
Relationship between parental involvement and emotional well‐being in Chinese left‐behind children: A moderated mediation model
Authors: Chen Shi‐Min , Gao Liang , Lin Shi‐Hui , Zhang Ying
Published: June 2023

Objective

The goal was to examine (a) how parental involvement affects mental health in left‐behind children (LBC), and (b) how the interaction effect of parental involvement and grandparent involvement affects mental health in LBC.

Background

Given the rapid industrialization and urbanization in China, a substantial number of rural laborers have migrated to cities to earn a living. However, it is difficult for many children to stay with their parents and they have to be left behind.

Methods

The sample consisted of 309 left‐behind children who had grandparents to care for them. The participants completed the Inventory of Father Involvement, Inventory of Mother Involvement, Inventory of Closest Grandparent Involvement, Needs Satisfaction Questionnaire, and Emotional Experience of Well‐being Questionnaire.

Results

Needs satisfaction mediated the effect of father involvement on emotional well‐being (EWB) and the effect of mother involvement on EWB in LBC. The closest grandparent involvement of LBC moderated the effect of mother involvement on needs satisfaction, but it did not moderate the effect of father involvement on needs satisfaction. The closest grandparent involvement of LBC moderated the indirect effect of mother involvement on EWB through needs satisfaction.

Conclusions

Needs satisfaction is an essential mediator between parental involvement and EWB. Grandparental involvement of LBC plays a complementary role in mother involvement. Their interaction effect facilitates the fulfilment of needs, and improves their EWB in LBC.

Implications

The mental health of LBC can be improved by helping their mothers and grandparents to meet various needs of LBC.
Outsourcing domestic work: A double‐edged sword for marital relations among dual‐earner couples
Authors: Cheung Adam Ka‐Lok , Lui Lake
Published: June 2023

Objective

This study examines the relationship between domestic outsourcing, housework evaluations, and marital conflict, while also comparing the effects of parents' informal help and paid domestic workers' formal help on marital relations.

Background

Whereas the role‐strain perspective asserts that shifting the housework burden to a third party can reduce marital conflict arising from housework division, the conflict perspective contends otherwise, especially when an additional family member is involved.

Methods

We analyzed household survey data with a representative sample of full‐time dual‐earning married couples in Hong Kong (N = 1,197). We used bivariate analysis and linear regression models to evaluate the relationship between domestic outsourcing, housework evaluations, and marital conflict.

Results

Results showed that getting help had significant indirect effects on marital conflict through housework evaluations. However, the two types of help were also positively associated with marital conflicts. The two types of help had simultaneously positive direct effects and negative indirect effects on marital conflicts, canceling out the effect of each other.

Implications

Our study illuminates the positive effect of outsourcing through housework evaluation. However, the benefit of domestic outsourcing cannot be realized if the conflicts induced by domestic outsourcing are not resolved.
Creep mechanical characteristics and nonlinear viscoelastic‐plastic creep model of sandstone after high temperature heat treatment
Authors: Pan Xiaokang , Berto Filippo , Zhou Xiaoping
Published: June 2023

This work studies the creep mechanical characteristics and nonlinear viscoelastic‐plastic creep model of sandstone treated at different temperatures. The peak strain, uniaxial compressive strength (UCS), and Young's modulus of sandstone treated at different temperatures are discussed as well as creep strain and long‐term strength. The conventional uniaxial compression curves and uniaxial creep curves of sandstone treated at different temperatures are compared. Moreover, a nonlinear generalized Kelvin model is developed to simulate the decay creep deformation; a time‐triggered nonlinear viscoplastic model is proposed to simulate the accelerated creep deformation. By combining the time‐triggered nonlinear viscoplastic model with the nonlinear generalized Kelvin model, plastic element, and viscous element, a nonlinear viscoelastic‐plastic creep model that can well reflect the entire creep process of sandstone treated at different temperatures is established. According to the results of model validation and parameter inversion, the new nonlinear creep model can be employed to predict the creep instability of rocks under high temperature environment.
Impact of liver fibrosis on the relative abundance of a urease‐positive Streptococcus salivarius group from saliva in patients with chronic liver disease
Authors: Také Akira , Uojima Haruki , Sakaguchi Yoshihiko , Gotoh Kazuyoshi , Satoh Takashi , Hidaka Hisashi , Horio Kazue , Mizokami Masashi , Hayashi Shunji , Kusano Chika
Published: June 2023

Aim

We performed genomic analysis to study the relative abundance of a urease‐positive Streptococcus salivarius group isolated from the saliva of patients with chronic liver disease.

Methods

Male and female patients with chronic liver disease aged over 20 years were included. First, we assessed the frequency and type of the S. salivarius group isolated from oral saliva using molecular biology techniques based on 16S rRNA and dephospho‐coenzyme A kinase gene sequencing. Next, we assessed the correlation between the urease positivity rate in the S. salivarius group isolated from oral saliva and liver fibrosis based on chronic liver disease. Urease‐positive strains were identified by the urease test using urea broth (Difco, Franklin Lakes, NJ, USA). Liver fibrosis was evaluated by the liver stiffness measurement value based on magnetic resonance elastography.

Results

A total of 45 patients identified using the multiplex polymerase chain reaction for the 16S rRNA gene were tested using the multiplex polymerase chain reaction for the dephospho‐coenzyme A kinase gene. Confirming the strains detected in each of the 45 patients, urease‐positive S. salivarius was detected in 28 patients (62%), urease‐negative S. salivarius in 25 patients (56%), and urease‐positive Streptococcus vestibularis in 12 patients (27%). There was no patient with urease‐negative S. vestibularis. The urease‐positive rate of the S. salivarius group in the cirrhosis and non‐cirrhosis groups were 82.2% and 39.2%, respectively. The liver cirrhosis group had a higher urease positivity rate than the non‐cirrhotic group (p < 0.001).

Conclusions

Liver fibrosis influences the frequency of a urease‐positive S. salivarius group isolated from oral saliva.
Disease prevalence in an urban raptor related to pest species: The case of Eurasian Scops Owl Otus scops infection by Gongylonema sp.
Authors: Hernández‐Téllez Irene , Martínez‐Miranzo Beatriz , Gil‐Tapetado Diego , Lopes Francisca , Esperón Fernando , Cabrero‐Sañudo Francisco J. , Aguirre José Ignacio
Published: June 2023

Urbanization is often associated with homogenization, including the homogenization of biodiversity and overpopulation by generalist species that can change community and disease dynamics. In Madrid, nestlings of Eurasian Scops Owl Otus scops frequently suffer necrotic oropharyngeal disease as a result of infection by Gongylonema sp., a parasitic nematode transmitted by adult owls to their offspring through the diet, more specifically through consumption of a pest species: the oriental cockroach Blatta orientalis. We studied how the presence of cockroaches and owl infection rates are affected by urban features such as green areas. We found that a higher number of birds were affected by the parasite in the initial period of the breeding season and in areas with greater surface area of green spaces. We suggest that urban management should promote the diversity of insects in green areas so that the owls diversify their dietary offer to their offspring, to reduce the prevalence of the disease and improve their breeding success in the city of Madrid, as this problem has not yet been described in other cities.
CREDIT CONSTRAINTS, ENDOGENOUS INNOVATIONS, AND PRICE SETTING IN INTERNATIONAL TRADE
Authors: Eckel Carsten , Unger Florian
Published: June 2023

This article analyzes the role of credit frictions in a trade model where producers differ in their capabilities to conduct process and quality innovations and require external finance for investments. Accounting for cost‐based and quality‐based sorting of firms in a unified framework allows us to demonstrate that the reactions of prices and commonly used productivity measures do not necessarily reflect welfare implications. Credit frictions lead to distortions through aggravated access to finance and endogenous price adjustments so that the responses of quantity‐based and revenue‐based productivity differ substantially. In counterfactual scenarios, we show that these differential effects are quantitatively important.
Challenging transitions? Assessing the occupational mobility patterns of US immigrants by gender
Authors: Lee Annie S. , Rodgers William M. , Breau Sebastien
Published: June 2023

This article uses the New Immigrant Survey to assess the occupational mobility of US immigrants. Estimates from OLS and Heckman selection models show the occupational mobility of immigrants follows a U‐shaped pattern: immigrants arriving in the United States see their occupational status decline before it gradually improves. However, even 9 years after coming to the United States, the occupational status of immigrants remains lower than prior to their arrival in the country. Our findings also suggest that immigrant women with higher occupational status tend to move more often to the United States than immigrant men. Conversely, immigrant women are more likely than men to experience career interruptions after migration. Finally, occupational employment growth rates (defined as the growth rate in the number of jobs for an occupation) have a positive impact on both men and women immigrants' ability to recover their occupational status, though the impact appears to be greater for immigrant women.
Reproductive characteristics and gamete development of the soft coral Sclerophytum cf. heterospiculatum in Okinawa Island, Japan
Authors: Jamodiong Emmeline A. , Reimer James Davis
Published: June 2023

Sexual reproduction data are important to understand how organisms can replenish their populations and proliferate on coral reefs. Despite the importance of such data, the reproductive characteristics of most soft coral species are still unknown. Here, we examined the reproductive strategies of a species from the often‐dominant genus Sclerophytum in a coral reef on subtropical Okinawa Island, Japan. DNA barcoding and histological examinations of the tissues were conducted to confirm colony conspecificity and identify reproductive characteristics, respectively, between March 2020 and March 2021. Results indicated that the studied species, identified as Sclerophytum cf. heterospiculatum, exhibits gonochorism with longer oogenesis and shorter spermatogenesis. Female colonies produced immature oocytes throughout the year, with mature oocytes observed from late July to early September, and thus, extended spawning is likely characteristic of this species. In male colonies, spermatogenesis took place over ~5 months, with spermaries present from April through August. Mature spermaries were noted beginning in July and the inferred peak of sperm release was between late August and early September, which suggests that spermatogenesis duration was ~5 months. The largest mean oocyte and spermary sizes (628.45 ± 61.36 and 240.04 ± 49.49 μm, respectively) were both recorded in August. Gamete spawning presumably occurred during the summer season, which suggests seasonality in reproduction as influenced by changes in seawater temperature. However, the proximate cue for exact dates of spawning could be the lunar period because the inferred release of spawning materials seemed to occur between full moon and last‐quarter moon phases in both the months of August and September. The results of this study represent the first detailed report of reproductive characteristics of the genus Sclerophytum in Japan.
First record of the genus Schizothorax in rivers of the Central Himalayas in China
Authors: Li Xixi , Mu Tong , Wang Ziwang , Qian Jianshuo , Zhu Ren
Published: June 2023

A total of 40 specimens of the genus Schizothorax (Cyprinidae: Schizothoracinae), including 10 matured males, 19 matured females and 11 juveniles, were captured from the Kirong Tsangpo River in China, which is located in the southern slope of the Central Himalayas. These specimens are identified as Schizothorax richardsonii (Grey, 1832) based on morphological characters and molecular analyses using mitochondrial Cyt b gene sequences. The Kirong population of S. richardsonii is relatively isolated from other populations in the Himalayas and has low genetic diversity. This is the first record of the genus Schizothorax fish in rivers of the Central Himalayas in China. As S. richardsonii is a vulnerable species on the IUCN Red List, a protection plan should be conducted to reduce the impact of anthropogenic disturbance by monitoring the natural population dynamics and assessing the ecological determinants of its distribution.
Genetics of inflammatory bowel disease in East Asia: From population to individual
Authors: Kakuta Yoichi , Kinouchi Yoshitaka , Masamune Atsushi
Published: June 2023

Genetic analysis of inflammatory bowel disease has identified many disease susceptibility genes in a large number of cases, mainly in Europe and North America. However, because of the ethnic differences in genetic background, analysis in various ethnic groups is needed. Although genetic analysis in East Asia began at the same time as in the West, the total number of patients analyzed has remained limited in Asia. To address these issues, meta‐analyses across East Asian countries are underway, and the genetic analysis of inflammatory bowel disease in East Asians is entering a new phase. New findings on the genetic background factors associated with inflammatory bowel disease originating from East Asia have also been made, such as the association between chromosomal mosaic alteration and this disease. Genetic analysis has been conducted mainly through studies that consider patients as a group. Some of these results, such as the identified relationship between the NUDT15 gene and thiopurine‐related adverse events, are beginning to be applied to the actual treatment of individuals. Meanwhile, genetic analyses of rare diseases have focused on the development of diagnostic methods and therapies by identifying causative gene mutations. Recently, genetic analysis has been moving from research on populations and pedigrees to the stage of identifying and using personal genetic information of each patient, which is important for personalized medical care. To achieve this, close collaboration between specialists in complex genetic analysis and clinicians will be critical.
The complementary feeding practices of low‐income Black mothers with infants between 6 and 24 months of age: A qualitative study
Authors: Adams Ingrid K. R. , Meshelemiah Jacquelyn C. A. , Noble ShyAnne T. , Piperata Barbara A.
Published: June 2023

Background

The period from 6 to 24 months in an infant's life presents a critical window for understanding feeding practices and for designing culturally appropriate interventions. However, little is known about the complementary feeding practices of Black mothers and how this period can be used to optimise the long‐term health of their children. The present study aimed to identify factors that influence the complementary feeding practices of low‐income Black mothers with children aged 6–24 months.

Methods

Participants were recruited through Research Match, Facebook advertising, flyers, and snowballing techniques. Low‐income, Black mothers, with a 6–24‐month‐old infant, and who lived in Franklin County, Ohio, USA, were eligible for the study. A cross‐sectional design using in‐depth interviews was used. Reflexive thematic analysis was utilised to analyse and interpret the feeding practices of Black mothers.

Results

Mothers (n = 8) were aged between 18 and 30 years old and most completed college or had some college education (n = 6). Half (n = 4) were married, employed, and rated their diet quality and their children's as very good. Three themes emerged: (a) complementary feeding at ≥ 6 months of age; (b) involvement of health care providers and service organisations in feeding decisions; and (c) use of responsive feeding cues.

Conclusions

All mothers breastfed exclusively and most (n = 6) initiated complementary feeding at 6 months. Paediatricians, other health providers and service organisations were instrumental in helping Black mothers adopt complementary feeding practices. Mothers also engaged in responsive feeding practices. These findings point to the critical nature of access and education in helping Black mothers in the study achieve feeding recommendations for their infants.
Priorities to improve woman‐centred gestational diabetes mellitus care: A qualitative study to compare views between clinical and consumer end‐users
Authors: Wan Ching Shan , Nankervis Alison , Teede Helena , Aroni Rosalie
Published: June 2023

Background

Immigrants worldwide have a two‐fold higher risk of gestational diabetes mellitus (GDM) than women of the host country. Providing culturally appropriate woman‐centred GDM care to attenuate adverse maternal and neonatal health outcomes is a persistent challenge for health services. Underpinned by the Knowledge to Action Framework, understanding and comparing the views of patients from different ethnic backgrounds and healthcare professionals (HCPs) about current and optimal GDM care can highlight priority areas to improve woman‐centred care. This qualitative study aimed to compare the views of ethnic Chinese and Australian‐born Caucasian women and their HCPs, including endocrinologists, obstetricians, midwives, diabetes nurse educators and dietitians, about what constitutes optimal GDM care and how to improve woman‐centred GDM care.

Methods

Purposive sampling was used to recruit 42 Chinese and 30 Caucasian women with GDM and 17 HCPs from two large Australian hospital maternity services to complete in‐depth, semi‐structured interviews. Patients’ and HCPs’ views were thematically analysed and compared.

Results

Four out of nine themes showed misalignments between patients’ and HCPs’ views on GDM care, reflecting priority areas to improve woman‐centred care by (i) reaching agreement on the attitudes towards different treatment targets between HCPs; (ii) enhancing inter‐professional communication; (iii) improving GDM care transition to postpartum care; and (iv) providing detailed dietary advice tailored to Chinese patients’ cultural diet.

Conclusions

Further research on reaching consensus on treatment targets, enhancing inter‐professional communication, developing a perinatal care transition model from pregnancy to postpartum, and developing Chinese patient‐oriented educational resources is required to improve woman‐centred care.
Trauma‐Informed Psychosocial Screening and Care Planning: A Patient‐Centered Improvement Project in a Midwife Clinic
Authors: Lefever‐Rhizal Debra , Collins‐Fulea Catherine , Bailey Joanne Motino
Published: June 2023

Introduction

Traumatic stress is associated with increases in preterm birth, low birth weight, and other perinatal complications. Yet the identification of patients with traumatic stress and intervention for traumatic stress prevention or treatment remain low. Locally in this university hospital‐based midwife clinic, a health records review found that trauma exposure was documented in 5% of patient records, and no records had a diagnosis of posttraumatic stress disorder (PTSD). This is lower than research‐based population estimates of 25% to 50% for trauma exposure and 8% for PTSD during pregnancy. The clinic staff did not screen for posttraumatic stress, and exposure screening was limited to intimate personal violence. Staff had not been trained in trauma‐informed care (TIC) as defined by the Substance Abuse and Mental Health Services Administration. The aim for this improvement project was to provide trauma screening and trauma‐related care planning, collectively referred to as trauma‐informed psychosocial care, to midwifery patients 85% of the time.

Process

Interventions were implemented over 4 plan‐do‐study‐act (PDSA) cycles. These included staff training in TIC; written screening at the new prenatal, third trimester, and postpartum visits; verbal broad inquiry at every visit; and bidirectional trauma‐specific care planning emphasizing patient and provider input into treatment choice. The clinic flow was changed to create privacy for patient‐staff interaction at every visit. Field notes and data were analyzed every 2 weeks and iterative changes applied.

Outcomes

Trauma disclosure increased from 5% to 30% and identification of PTSD from 0% to 7%. Bidirectional care plan documentation increased from 8% to 67%. Staff rated the workload as reasonable.

Discussion

Redesigning psychosocial screening to align with TIC principles increased the discovery of trauma to levels consistent with research‐based population estimates. Gains were made in bidirectional care planning. This project illustrates practical methods of implementing TIC principles.
Retention of newly graduated registered nurses in the hospital setting: A systematic review
Authors: Vázquez‐Calatayud Mónica , Eseverri‐Azcoiti Mari Carmen
Published: June 2023

Background

There is a gap in the literature on identifying and describing effective interventions for the retention of newly graduated registered nurses in hospital settings. To the best of our knowledge, no systematic review has been conducted on this issue.

Aim

To identify effective interventions that promote the retention of newly graduated registered nurses in the hospital setting and their components.

Design

A systematic review was conducted according to PRISMA 2020 Statement.

Methods

Information derived from the PubMed, CINAHL, Scopus, PsycINFO and Cochrane Library databases was reviewed, for the period January 2012–October 2022. Screening, data extraction and quality appraisal were conducted independently by two reviewers. The Joanna Briggs Institute Critical Appraisal tools were used for descriptive, quasi‐experimental and cohort studies. Disagreements between the two reviewers were resolved through discussion.

Results

Following the critical appraisal, nine studies were included. The evidence reveals the heterogeneity of programmes developed in the hospital context to promote the retention of newly graduated registered nurses, clarifies the three competencies to be addressed (core, cross‐cutting and specific), their components (programme development framework, duration, content and support components), and shows significant improvements after their implementation.

Conclusions

This systematic review identifies that either nurse residency or individualised mentoring programmes, lasting 1 year, and multi‐component, addressing core and specific competencies and including preceptor or mentor components seem to be the most comprehensive and effective in promoting the retention of new nurses in the hospital setting.

Relevance to Clinical Practice

The knowledge provided by this review will contribute to developing and implementing more effective and context‐specific strategies directed at retaining newly graduated registered nurses and subsequently enhancing patient safety and healthcare costs.

No Patient or Public Contribution

Given the study design and focus.
The onset of sepsis as experienced by patients and family members: A qualitative interview study
Authors: Olander Agnes , Andersson Henrik , Sundler Annelie J. , Hagiwara Magnus Andersson , Bremer Anders
Published: June 2023

Aims and Objectives

To explore the onset of sepsis based on patients' and family members' experiences.

Background

Knowledge about the onset of sepsis is limited among patients and their families, which makes early recognition of sepsis difficult. Previous studies argue that their stories are important to recognising sepsis and reduced suffering and mortality.

Design

A descriptive design with a qualitative approach was used.

Methods

In total, 29 patients and family members participated in 24 interviews with open‐ended questions, including five dyadic and 19 individual interviews. The interviews were conducted during 2021, and participants were recruited from a sepsis group on social media. A thematic analysis based on descriptive phenomenology was performed. The study followed the COREQ checklist.

Findings

Two themes emerged from the experiences: (1) When health changes into something unknown, including the two subthemes; Bodily symptoms and signs being vague but still tangible and Feelings of uncertainty, and (2) Turning points when warnings signs are deemed as serious, including the two subthemes Passing borders when feeling out of control and Difficulties understanding the seriousness.

Conclusions

Patients' and family members' stories of the onset of sepsis indicate that symptoms and signs appeared insidiously and then noticeably worsen. The symptoms and signs seemed not be attributed to sepsis; instead, there was uncertainty about what the symptoms and signs meant. It was mainly family members who possibly understood the seriousness of the disease.

Implications for the profession and patient care

Patients' experiences of their symptoms and signs and family members' unique knowledge of the patient, indicate that healthcare professionals should listen and try to understand what the patient and family members are telling and take their concerns seriously. How the condition appears, and family members' concerns are important pieces of the assessment to recognise patients with sepsis.

Patient or public contribution

Patients and family members contributed to the data collected.
Cardiovascular risk in rheumatoid arthritis patients treated with targeted synthetic and biological disease‐modifying antirheumatic drugs: A multi‐centre cohort study
Authors: Tong Xinning , Shen Chin‐Yao , Jeon Ha‐Lim , Li Yihua , Shin Ju‐Young , Chan Shirley CW , Yiu Kai Hang , Pratt Nicole L. , Ward Michael , Lau Chak Sing , Wong Ian CK , Li Xue , Lai Edward Chia‐Cheng
Published: June 2023

Background

This study aimed to compare the cardiovascular safety of interleukin‐6 inhibitors (IL‐6i) and Janus Kinase inhibitors (JAKi) to tumour necrosis factor inhibitors (TNFi).

Methods

We conducted a retrospective cohort study using population‐based electronic databases from Hong Kong, Taiwan and Korea. We identified newly diagnosed patients with rheumatoid arthritis (RA) who received b/tsDMARDs first time. We followed patients from b/tsDMARD initiation to the earliest outcome (acute coronary heart disease, stroke, heart failure, venous thromboembolism and systemic embolism) or censoring events (death, transformation of b/tsDMARDs on different targets, discontinuation and study end). Using TNFi as reference, we applied generalized linear regression for the incidence rate ratio estimation adjusted by age, sex, disease duration and comorbidities. Random effects meta‐analysis was used for pooled analysis.

Results

We identified 8689 participants for this study. Median (interquartile range) follow‐up years were 1.45 (2.77) in Hong Kong, 1.72 (2.39) in Taiwan and 1.45 (2.46) in Korea. Compared to TNFi, the adjusted incidence rate ratios (aIRRs) (95% confidence interval [CI]) of IL‐6i in Hong Kong, Taiwan and Korea are 0.99 (0.25, 3.95), 1.06 (0.57, 1.98) and 1.05 (0.59, 1.86) and corresponding aIRR of JAKi are 1.50 (0.42, 5.41), 0.60 (0.26, 1.41), and 0.81 (0.38, 1.74), respectively. Pooled aIRRs showed no significant risk of cardiovascular events (CVEs) associated with IL‐6i (1.05 [0.70, 1.57]) nor JAKi (0.80 [0.48, 1.35]) compared to TNFi.

Conclusion

There was no difference in the risk of CVE among RA patients initiated with IL‐6i, or JAKi compared to TNFi. The finding is consistent in Hong Kong, Taiwan and Korea.
The medical internship as a meaningful transition: A phenomenographic study
Authors: Carlsson Yvonne , Bergman Stefan , Nilsdotter Anna , Liljedahl Matilda
Published: June 2023

Background

The transition from student to doctor is often depicted as a struggle in the literature, and previous research has focused on interventions to minimise difficulties in transitioning from undergraduate to postgraduate training. In considering this transition as a potential transformative experience, we intend to produce new insights into how junior doctors experience the transition to clinical work. The aim of this study was to explore medical interns' conceptualisations of the transition from student to doctor through studying the Swedish medical internship, which serves as a bridge between undergraduate and postgraduate studies. The research question was formulated as follows: How do medical interns perceive the meaning of the medical internship?

Methods

The data were collected through in‐depth interviews with 12 senior medical interns in western Sweden. The transcribed interviews were analysed using a phenomenographic approach, which resulted in four qualitatively varying ways of perceiving the meaning of the internship, organised hierarchically in a phenomenographic outcome space.

Results

The interns perceived the meaning of the internship as an opportunity to work and learn in an authentic setting (internship as in‐service training) and in a protected environment (internship as a space). The internship guaranteed a minimum level of competence (internship as a quality marker) and allowed the interns to gain new insights into themselves and their world (internship as an eye‐opener).

Discussion

Being allowed to be learners in a protected space seemed pivotal for the interns to develop into competent, confident and independent practitioners. The medical internship studied here could be viewed as a meaningful transition into new ways of experiencing, allowing for an increased understanding of oneself and the world. This study adds to the scientific literature on what constitutes a transformative transition.
Sex differences in paroxysmal atrial fibrillation catheter ablation: A difference‐in‐difference propensity score matched analysis
Authors: Ma Yibo , Guo Lanyan , Liu Cheng , Xu Jian , Wang Yi , Yi Fu
Published: June 2023

Background

Whether male and female patients with atrial fibrillation (AF) differ in their risk of recurrence after catheter ablation remains controversial. Large differences in baseline characteristics between males and females often affect study results.

Methods

Patients with drug‐refractory paroxysmal AF who received their first catheter ablation procedure between January 2018 and December 2020 were retrospectively enrolled. Propensity score matching was used to adjust for age, body mass index, and AF duration. Our main concerns were sex differences in comorbidities, procedures, arrhythmia recurrences, and procedure‐related complications.

Results

For this study, 352 patients (176 pairs) were matched, and baseline characteristics were comparable between the two groups. Intraprocedural sex differences were apparent as more male patients received cavotricuspid isthmus ablation (55.00% vs. 31.43%, p = .005). Full follow‐up, 1‐year, 2‐year, and 3‐year AF recurrence rates were comparable between male and female groups. Multivariable Cox regression showed that the recurrence risk of paroxysmal AF was similar between male and female patients. AF duration was the only potential risk factor and occurred for only male patients. There were no significant differences in the subgroup analyses. Procedure‐related complications were comparable between the male and female groups.

Conclusion

We did not observe differences in baseline characteristics, arrhythmia recurrences, or procedure‐related complications between male and female patients. Sex differences were reflected mainly in the finding that male patients received more cavotricuspid isthmus ablations, and atrial fibrillation duration was the only potential risk factor for recurrence and only for male patients.
Childhood granulomatous periorificial dermatitis in 31 Chinese children successfully treated with oral roxithromycin
Authors: Wang Senfen , Li Ping , Li Jianhong , Zhang Huan
Published: June 2023

Data regarding the treatment of childhood granulomatous periorificial dermatitis (CGPD) using oral therapies are limited. This study included 31 Chinese children with CGPD treated with oral roxithromycin. After 12 weeks of treatment, 90.3% of the patients recovered, and there were no severe adverse effects. Our results suggest that oral roxithromycin is an effective and safe treatment for CGPD.
An Aesthetics of Chinese Calligraphy
Authors: Shi Xiongbo
Published: June 2023

This article introduces the aesthetic significance of Chinese calligraphy, one of the highest art forms in China. It focuses on three major aesthetic concerns manifested in classical texts on this art. First, Chinese art theory stresses that the forms (xing) of successful calligraphic works are never static; rather, they should be filled with internal force (shi). Second, calligraphic creation can be understood as a psychosomatic process, that is, involving coordination between the mind and the hand. Third, appreciation of Chinese calligraphy is identified with the process of reconstructing the calligrapher's creation of the work, which is analogous to Richard Wollheim's identifying criticism as retrieval. The last section examines the concept of qi and discusses what kind of aesthetic considerations encourage us to make a connection between Chinese calligraphy and abstract art.
Evolving Concepts of Functional Localization
Authors: McCaffrey Joseph B.
Published: June 2023

Functional localization is a central aim of cognitive neuroscience. But the nature and extent of functional localization in the human brain have been subjects of fierce theoretical debate since the 19thCentury. In this essay, I first examine how concepts of functional localization have changed over time. I then analyze contemporary challenges to functional localization drawing from research on neural reuse, neural degeneracy, and the context‐dependence of neural functions. I explore the consequences of these challenges for topics in philosophy of science and philosophy of mind including localizationist versus anti‐localizationist approaches to cognitive neuroscience, multiple realizability, reverse inference in functional neuroimaging, and the modularity of mind.
The Beginning of Hegel'sLogic
Authors: Dunphy Robb
Published: June 2023

This article discusses two topics, both commonly referred to using the label “the beginning of Hegel'sLogic”: (1) Hegel's justification for the claim that a science of logic must begin by considering the concept of “pure being”. (2) Hegel's discussion of the concepts “being”, “nothing”, and “becoming” in the first chapter of hisLogic. Discussing recent work on both of these topics, two primary claims are defended: Regarding (1): the strongest interpretations of Hegel's case for beginning a science of logic with the concept of pure being are those which take him to argue that this concept must be necessarily both “immediate” and “mediated” at the same time. Regarding (2): The widespread tendency to take Hegel's treatment of the concepts of being, nothing, and becoming as an example with which to illustrate his “dialectical method” should be replaced with an interpretation of that chapter which understands it to rather make possible the kind of dialectical transitions which make up the rest of Hegel'sScience of Logic.
Reducing the Price of Naïveté in return‐to‐play from sports‐related concussion
Authors: Garcia Gian‐Gabriel P. , Lavieri Mariel S. , McAllister Thomas W. , McCrea Michael A. , Broglio Steven P. , CARE Consortium Investigators
Published: June 2023

Patient‐reported outcomes (PROs) play an increasingly important role in medical decision making. Yet, patients whose objectives differ from their physician's may strategically report symptoms to alter treatment decisions. For example, athletes may underreport symptoms to expedite return‐to‐play (RTP) from sports‐related concussion (SRC). Thus, clinicians must implement treatment policies that mitigate the Price of Naïveté, that is, the reduction in health outcomes due to naïvely believing strategically reported symptoms. In this study, we analyze dynamic treatment cessation decisions with strategic patients. Specifically, we formulate the Behavior‐Aware Partially Observable Markov Decision Process (BA‐POMDP), which optimizes the timing of treatment cessation decisions while accounting for known symptom‐reporting behaviors. We then analytically characterize the BA‐POMDP's optimal policy, leading to several practical insights. Next, we formulate the Behavior‐Learning Partially Observable Markov Decision Process (BL‐POMDP), which extends the BA‐POMDP by learning a patient's symptom‐reporting behavior over time. We show that the BL‐POMDP is decomposable into several BA‐POMDPs, allowing us to leverage the BA‐POMDP's structural properties for solving the BL‐POMDP. Then, we apply the BL‐POMDP to RTP from SRC using data from 29 institutions across the United States. We estimate the Price of Naïveté by comparing the BL‐POMDP to naïve benchmark policies. Accordingly, the BL‐POMDP reduces premature RTP by over 44% and provides up to 3.63 additional health‐adjusted athletic exposures per athlete compared to current practice. Overall, changing the interpretation of reported symptoms can better reduce the Price of Naïveté over adjusting treatment cessation thresholds. Therefore, to improve patients' health outcomes, clinicians must understand how strategic behavior manifests in PROs.
Neurodevelopmental outcomes in children after prenatal marijuana exposure
Authors: Isik Oliver G. , Guo Ling , Whitehouse Andrew J. O. , Li Guohua , Ing Caleb
Published: June 2023

Background

The effect of prenatal marijuana exposure (PME) on child neurodevelopment remains poorly understood. Prior studies have demonstrated inconsistent results.

Objectives

This study evaluated the association between PME and neuropsychological test scores in late childhood and early adulthood, accounting for a wide range of parental characteristics.

Methods

This study evaluated participants from the Raine Study, a cohort of 2868 children born between 1989 and 1992. Children whose mothers provided information on marijuana use during pregnancy were included. The primary outcome was the Clinical Evaluation of Language Fundamentals (CELF) at age 10. Secondary outcomes included the Peabody Picture Vocabulary Test (PPVT), Child Behaviour Checklist (CBCL), McCarron Assessment of Neuromuscular Development (MAND), Coloured Progressive Matrices (CPM), Symbol Digit Modality Test (SDMT) and Autism Spectrum Quotient (AQ) scores. Exposed and unexposed children were matched by propensity score using optimal full matching. Missing covariate data were imputed using multiple imputation. Inverse probability of censoring weighting (IPCW) was used to adjust for missing outcome data. Linear regression within matched sets, adjusted by IPCW, evaluated score differences between exposed and unexposed children. As a secondary analysis, modified Poisson regression, adjusted by match weights and IPCW, evaluated the risk of clinical deficit in each outcome following PME.

Results

Of the 2804 children in this cohort, 285 (10.2%) had PME. After optimal full matching and IPCW, exposed children scored similarly on CELF Total (−0.33 points, 95% confidence interval [CI] −4.71, 4.05), Receptive (+0.65 points, 95% CI −4.08, 5.38) or Expressive (−0.53 points, 95% CI −5.07, 4.02). PME was not associated with secondary outcomes or risks of clinical deficit in any neuropsychological assessments.

Conclusions

After adjusting for sociodemographic and clinical covariates, PME was not associated with worse neuropsychological test scores at age 10 or autistic traits at 19–20.
Dominance of face over voice in human attractiveness judgments: ERP evidence
Authors: Liu Meng , Sommer Werner , Yue Siqi , Li Weijun
Published: June 2023

The attractiveness of a person, a complex, and socially relevant type of information, is transmitted in many ways, not least through face and voice. However, it is unclear how the stimulus domains carrying attractiveness information interact. The present study explored the audiovisual perception of attractiveness in a Stroop‐like paradigm using event‐related potentials (ERPs). Participants were presented with face‐voice pairs carrying congruent or incongruent attractiveness information and, in turn, judged the attractiveness level of each domain while ignoring the other. Voice attractiveness judgments were influenced by unattended face attractiveness, in terms of both, early perceptual encoding (N170, P200) as well as later evaluative stages (N400, LPC). In contrast, effects of unattended voice attractiveness on face attractiveness judgments were confined to early perceptual encoding (N170). These results demonstrate not only the interaction of multiple domains in human attractiveness perception at different processing stages but also a relative dominance of face over voice attractiveness.
Creative ambivalence: implementing need‐solution pairs in household 3D printing
Authors: Kuk George
Published: June 2023

Household sector innovators often create solutions to address their own personal needs, but while need‐solution pairs can have important functions in creativity and design, the solutions that are initially devised as part of a working prototype are likely to be imperfect. This presents an adoption‐related puzzle that revolves around how an imperfect solution created to meet a unique personal need can subsequently be used by others. I develop a multilevel model to propose that creative ambivalence is an in‐between state for describing how mixed emotions, which capture reflective accounts in the creation of need‐solution pairs, can influence implementation. Using Thingiverse, a longitudinal dataset of designers in an online community, the designers' own reflective accounts and commentaries on their creative work, I find that creative ambivalence encourages implementation and that creative ambivalence at a personal level positively increases the implementation of need‐solution pairs in the production of household products, whereas ambivalence at an artefact level reveals no influence. In addition, solution adoption in follow‐on design derivatives accentuates the effect of creative ambivalence on implementation, so that the positive relationship between creative ambivalence and implementation is stronger when solution adoption is high. The multilevel model and results offer important theoretical contributions to research on affect and creativity and lead userness and practical implications for identifying lead users in online communities.
Association of accelerometer‐measured physical activity and midlife income: A Northern Finland Birth Cohort 1966 Study
Authors: Junttila Hanna Elina , Vaaramo Mikko Matias , Huikari Sanna Martta , Kari Jaana Tuulikki , Leinonen Anna‐Maiju , Farrahi Vahid , Korpelainen Raija , Korhonen Marko Juhani
Published: June 2023

This study investigated the association between physical activity (PA) and midlife income. The population‐based data comprised employed members of the Northern Finland Birth Cohort 1966 (N = 2797). Using binned scatterplots and polynomial regressions, we evaluated the association between accelerometer‐measured moderate PA (MPA), vigorous PA (VPA), and moderate‐to‐vigorous PA (MVPA) at 46 years old and register‐based income at 50 years old. The models were adjusted for sex, marital status, number of children, education, adolescent PA, occupational physical strenuousness, and time preference. We found MPA (p < 0.001), VPA (p < 0.05), and MVPA (p < 0.001) to associate curvilinearly with income. In subgroup analyses, a curvilinear association was found between MPA (p < 0.01) and MVPA (p < 0.01) among those with physically strenuous work, VPA among all females (p < 0.01) and females with physically light work (p < 0.01), and MPA and MVPA among all males and males with physically strenuous work (p < 0.05; p < 0.01; p < 0.05; p < 0.05, respectively) and income. The highest income benefits occurred at PA volumes higher than current PA guidelines. Linear associations between PA and income were found among females for MPA (p < 0.05) and MVPA (p < 0.05), among those with physically light work for MPA (p < 0.05), VPA (p < 0.05), and MVPA (p < 0.05), and among females with physically strenuous work for VPA (p < 0.05). We conclude that PA up to the current recommended level is associated with income, but MPA exceeding 505.4 min/week, VPA exceeding 216.4 min/week, and MVPA exceeding 555.0 min/week might have a negative association with income.