bluuebunny/crossref_metadata_2025 huggingface dataset:
Did You Get That? Predicting Learners’ Comprehension of a Video Lecture from Visualizations of Their Gaze Data
Authors: Kok Ellen M. , Jarodzka Halszka , Sibbald Matt , van Gog Tamara
Published: February 2023

In online lectures, unlike in face‐to‐face lectures, teachers lack access to (nonverbal) cues to check if their students are still “with them” and comprehend the lecture. The increasing availability of low‐cost eye‐trackers provides a promising solution. These devices measure unobtrusively where students look and can visualize these data to teachers. These visualizations might inform teachers about students’ level of “with‐me‐ness” (i.e., do students look at the information that the teacher is currently talking about) and comprehension of the lecture, provided that (1) gaze measures of “with‐me‐ness” are related to comprehension, (2) people not trained in eye‐tracking can predict students’ comprehension from gaze visualizations, (3) we understand how different visualization techniques impact this prediction. We addressed these issues in two studies. In Study 1, 36 students watched a video lecture while being eye‐tracked. The extent to which students looked at relevant information and the extent to which they looked at the same location as the teacher both correlated with students’ comprehension (score on an open question) of the lecture. In Study 2, 50 participants watched visualizations of students’ gaze (from Study 1), using six visualization techniques (dynamic and static versions of scanpaths, heatmaps, and focus maps) and were asked to predict students’ posttest performance and to rate their ease of prediction. We found that people can use gaze visualizations to predict learners’ comprehension above chance level, with minor differences between visualization techniques. Further research should investigate if teachers can act on the information provided by gaze visualizations and thereby improve students’ learning.
Cetylpyridinium chloride cationic finishing improves the dyeing and antibacterial properties of madder dyed cotton
Authors: Dai Yue , Li Hong , Xu Lanjie , Zhang Li , Cai Xiaoyu , Yan Jun
Published: February 2023

In this work, after cationic pretreatment of cotton fabric with cetylpyridinium chloride (CPC), the compound of citric acid (CA) and succinic acid (SUA) were used as crosslinking agents to dye cotton fabrics with natural madder dye to improve the dyeing and antibacterial properties and realise the multifunctional finishing of cotton fabric. The effects of mordant dyeing, CA + SUA crosslinked dyeing, and CPC/CA + SUA crosslinked dyeing on the microstructure and properties of cotton fabrics were compared. The dyeing by the three processes occurred primarily in the amorphous zone of the fibres, and all kept the original crystalline form of the cotton. CA + SUA crosslinked dyeing and CPC/CA + SUA crosslinked dyeing increased the thermal stability of the cotton fabric. CPC/CA + SUA crosslinked dyed cotton obtained excellent dyeing results with the colour depth value (K/S) of 12.3 and rubbing fastness and washing fastness of levels 4–5, and the levelness and dye permeability were acceptable. Furthermore, the antibacterial rate against Escherichia coli and Staphylococcus aureus reached 99.99%, and the ultraviolet protection factor (UPF) reached 50+. Moreover, the wrinkle recovery angle (WRA) increased by 55% compared with raw cotton. This showed that CPC/CA + SUA crosslinked dyed cotton had excellent antibacterial, anti‐ultraviolet, and anti‐wrinkle performances.
Internet trade of a previously unknown wildlife product from a critically endangered marine fish
Authors: Pytka Jennifer M. , Moore Alec B. M. , Heenan Adel
Published: February 2023

Online research methods are increasingly used in conservation science to monitor and collect data on online wildlife trade. Shark‐like rays (Rhinopristiformes) are among the most threatened vertebrates, prized for their high‐value fins while other uses for their derivatives are largely unrecognized in the literature. The bowmouth guitarfish (Rhina ancylostomus) is characterized by ridges of enlarged thorns, sometimes sold as amulets. Listed on the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II, the thorn‐market has been ignored and undocumented. Using systematic, retrospective online searches, we recorded 977 bowmouth‐derivatives for sale. In our global and multi‐lingual scope, 97% of products were offered from Thailand, despite prohibited trade. 98% of all products were thorns (USD3‐300) and sold alongside high‐profile CITES‐listed taxa (e.g., tiger claws). Consistent advertisements from 2012 revealed a previously unquantified trade of an often‐neglected marketplace in elasmobranch research. Our findings offer insight into the drivers of the thorn trade, potentially rooted in cultural beliefs. Our accessible research methods can be applied internationally and across species, providing quantitative and qualitative insights on aspects of the wildlife trade of a critically endangered fish. Continued monitoring of online markets, like this study, is necessary to fill critical gaps for informed policy and species‐specific management.
Decomposing trends in bird populations: Climate, life histories and habitat affect different aspects of population change
Authors: Storch David , Koleček Jaroslav , Keil Petr , Vermouzek Zdeněk , Voříšek Petr , Reif Jiří
Published: February 2023

Aim

Despite the complexity of population dynamics, most studies concerning current changes in bird populations reduce the trajectory of population change to a linear trend. This may hide more complex patterns reflecting responses of bird populations to changing anthropogenic pressures. Here, we address this complexity by means of multivariate analysis and attribute different components of bird population dynamics to different potential drivers.

Location

Czech Republic.

Methods

We used data on population trajectories (1982–2019) of 111 common breeding bird species, decomposed them into independent components by means of the principal component analysis (PCA), and related these components to multiple potential drivers comprising climate, land use change and species' life histories.

Results

The first two ordination axes explained substantial proportion of variability of population dynamics (42.0 and 12.5% of variation in PC1 and PC2 respectively). The first axis captured linear population trend. Species with increasing populations were characterized mostly by long lifespan and warmer climatic niches. The effect of habitat was less pronounced but still significant, with negative trends being typical for farmland birds, while positive trends characterized birds of deciduous forests. The second axis captured the contrast between hump‐shaped and U‐shaped population trajectories and was even more strongly associated with species traits. Species migrating longer distances and species with narrower temperature niches revealed hump‐shaped population trends, so that their populations mostly increased before 2000 and then declined. These patterns are supported by the trends of total abundances of respective ecological groups.

Main Conclusion

Although habitat transformation apparently drives population trajectories in some species groups, climate change and associated species traits represent crucial drivers of complex population dynamics of central European birds. Decomposing population dynamics into separate components brings unique insights into non‐trivial patterns of population change and their drivers, and may potentially indicate changes in the regime of anthropogenic effects on biodiversity.
Dental patient‐reported outcomes following traumatic dental injuries and treatment: A narrative review
Authors: Nagendrababu Venkateshbabu , Vinothkumar Thilla Sekar , Rossi‐Fedele Giampiero , Doğramacı Esma J. , Duncan Henry F. , Abbott Paul V. , Levin Liran , Lin Shaul , Dummer Paul M. H.
Published: February 2023

Dental patient‐reported outcomes (dPROs) are self‐reported descriptions of a patient's oral health status that are not modified or interpreted by a healthcare professional. Dental patient‐reported outcome measures (dPROMs) are objective or subjective measurements used to assess dPROs. In oral healthcare settings, the emphasis on assessing treatment outcomes from the patient's perspective has increased and this is particularly important after traumatic dental injuries (TDIs), as this group of injuries represent the fifth most prevalent disease or condition worldwide. The purpose of this review is to summarize the current use of dPROs and dPROMs in the field of dental traumatology. Oral Health‐Related Quality of Life, pain, swelling, aesthetics, function, adverse effects, patient satisfaction, number of clinical visits and trauma‐related dental anxiety are the key dPROs following TDIs. Clinicians and researchers should consider the well‐being of patients as their top priority and conduct routine evaluations of dPROs using measures that are appropriate, accurate and reflect what is important to the patient. After a TDI, dPROs can assist clinicians and patients to choose the best management option(s) for each individual patient and potentially improve the methodology, design and relevance of clinical studies.
Influence of comorbidity on mortality in patients with epilepsy and psychogenic nonepileptic seizures
Authors: Tan Michael , Pearce Neil , Tobias Aurelio , Cook Mark J. , D'Souza Wendyl J.
Published: February 2023

Objective

This study aims to determine the contribution of comorbidities to excess psychogenic nonepileptic seizures (PNES) mortality.

Methods

A retrospective cohort study was conducted of tertiary epilepsy outpatients from St. Vincent's Hospital Melbourne, Australia with an 8:1 comparison cohort, matched by age, sex, and socioeconomic status (SES) to national administrative databases between 2007 and 2017. Privacy‐preserving data linkage was undertaken with the national prescription, National Death Index, and National Coronial Information System. Forty‐five comorbid disease classes were derived by applying the Australian validated RxRisk‐V to all dispensed prescriptions. We fitted Cox proportional hazard models controlling for age, sex, SES, comorbidity, disease duration, and number of concomitant antiseizure medications, as a marker of disease severity. We also performed a parallel forward‐selection change in estimate strategy to explore which specific comorbidities contributed to the largest changes in the hazard ratio.

Results

A total of 13 488 participants were followed for a median 3.2 years (interquartile range = 2.4–4.0 years), including 1628 tertiary epilepsy outpatients, 1384 patients with epilepsy, 176 with PNES, and 59 with both. Eighty‐two percent of epileptic seizures and 92% of typical PNES events were captured in an epilepsy monitoring unit. The age‐/sex‐/SES‐adjusted hazard ratio was elevated for epilepsy (4.74, 95% confidence interval [CI] = 3.36–6.68) and PNES (3.46, 95% CI = 1.38–8.68) and remained elevated for epilepsy (3.21, 95% CI = 2.22–4.63) but not PNES (2.15, 95% CI = .77–6.04) after comorbidity adjustment. PNES had more pre‐existing comorbidities (p = .0007), with a three times greater median weighted Rx‐RiskV score. Psychotic illness, opioid analgesia, malignancies, and nonopioid analgesia had the greatest influence on PNES comorbid risk.

Significance

Higher comorbidity appears to explain the excess PNES mortality and may represent either a wider underrecognized somatoform disorder or a psychological response to physical illness. Better understanding and management of the bidirectional relationship of these wider somatic treatments in PNES could potentially reduce the risk of death.
Racial discrimination, depressive symptoms, and parenting in African American families
Authors: Armah Annabelle E. , Lavner Justin A. , Varner Fatima A. , Beach Steven R. H.
Published: February 2023

Objective

The goal was to examine direct and indirect associations between racial discrimination and parenting among African American mothers and fathers.

Background

Experiences of racial discrimination are common among African Americans, with well‐documented effects on individual functioning. Greater attention to associations between racial discrimination and family functioning, including parenting, is needed, as are tests of whether these associations might arise indirectly through depressive symptoms.

Method

Data from 346 African American families were used to examine correlations between racial discrimination and nurturant involved parenting, consistent discipline, and educational involvement among mothers and fathers, and to examine indirect effect models testing linkages through depressive symptoms.

Results

There was minimal evidence of significant direct (bivariate) associations between racial discrimination and parenting. There were, however, significant negative indirect effects from racial discrimination to nurturant involved parenting and to consistent discipline through depressive symptoms for mothers and fathers.

Conclusion

Higher levels of racial discrimination were associated with lower levels of nurturant involved parenting and consistent discipline through higher depressive symptoms.

Implications

Conceptual models describing the effects of racial discrimination on families should integrate indirect effects through individual functioning. Interventions focused on supporting African American parents should address the harmful effects of racial discrimination on individual and family well‐being.
Nitrogen availability mediates soil carbon cycling response to climate warming: A meta‐analysis
Authors: Bai Tongshuo , Wang Peng , Qiu Yunpeng , Zhang Yi , Hu Shuijin
Published: February 2023

Global climate warming may induce a positive feedback through increasing soil carbon (C) release to the atmosphere. Although warming can affect both C input to and output from soil, direct and convincing evidence illustrating that warming induces a net change in soil C is still lacking. We synthesized the results from field warming experiments at 165 sites across the globe and found that climate warming had no significant effect on soil C stock. On average, warming significantly increased root biomass and soil respiration, but warming effects on root biomass and soil respiration strongly depended on soil nitrogen (N) availability. Under high N availability (soil C:N ratio < 15), warming had no significant effect on root biomass, but promoted the coupling between effect sizes of root biomass and soil C stock. Under relative N limitation (soil C:N ratio > 15), warming significantly enhanced root biomass. However, the enhancement of root biomass did not induce a corresponding C accumulation in soil, possibly because warming promoted microbial CO2 release that offset the increased root C input. Also, reactive N input alleviated warming‐induced C loss from soil, but elevated atmospheric CO2 or precipitation increase/reduction did not. Together, our findings indicate that the relative availability of soil C to N (i.e., soil C:N ratio) critically mediates warming effects on soil C dynamics, suggesting that its incorporation into C‐climate models may improve the prediction of soil C cycling under future global warming scenarios.
Do Simple Analytical Models Capture Complex Fractured Bedrock Hydraulics? Oscillatory Flow Tests Suggest Not
Authors: Patterson Jeremy R. , Cardiff Michael
Published: February 2023

Fractured sedimentary bedrock aquifers represent complex flow systems that may contain fast, fracture‐dominated flow paths and slower, porous media‐dominated flow paths. Thus, characterizing the dynamics of flow and transport through these aquifers remains a fundamental hydrogeologic challenge. Recent studies have demonstrated the utility of a novel hydraulic testing approach, oscillatory flow testing, in field settings to characterize single bedrock fractures embedded in low‐porosity sedimentary bedrock. These studies employed an idealized analytical model assuming Darcian flow through a nondeforming, constant‐aperture, nonleaky fracture for data interpretation, and reported period‐dependent effective fracture flow parameters. Here, we present the application of oscillatory flow testing across a range of frequencies and inter‐well spacings on a fracture embedded in poorly cemented sedimentary bedrock with considerable primary porosity at the Field Site for Research in Fractured Sedimentary Rock. Consistent with previous studies, we show an apparent period‐dependence in returned flow parameters, with hydraulic diffusivity decreasing and storativity increasing with increasing oscillation period, when assuming an idealized fracture conceptual model. We present simple analyses that examine non‐Darcian flow and borehole storage effects as potential test design artifacts and a simple analytical model that examines fluid leakage to the surrounding host rock as a potential hydraulic mechanism that might contribute to the period‐dependent flow parameters. These analyses represent a range of conceptual assumptions about fracture behavior during hydraulic testing, none of which account for the measured responses during oscillatory flow testing, leading us to argue that other hydraulic processes (e.g., aperture heterogeneity and/or fracture hydromechanics) are necessary to accurately represent pressure propagation through fractured sedimentary bedrock.
Incidence and risk factors of falls in patients undergoing hemodialysis: A multicenter survey in northern China
Authors: Liang Junqing , Wang Ying , Zhang Weilin , Ding Hong , Gao Yanjun , Wang Rui , Sun Xiaofei , Peng Ying , Gan Liangying , Zuo Li
Published: February 2023

Introduction

Patients undergoing hemodialysis (HD) are at a higher risk of falls than healthy individuals. Further knowledge regarding the risk of falls could lead to better risk prevention strategies. We designed a multicenter, prospective cohort study according to the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines to investigate the incidence and risk factors of falls in patients undergoing hemodialysis in Northern China.

Methods

Patients undergoing hemodialysis in six hemodialysis units were recruited from January 2019 to January 2020. Data on demographics and disease conditions were collected at baseline. Data on other variables, the incidence of falls, and related conditions were collected every 3 months during a 1‐year follow‐up. The Generalized Estimating Equation model was used to evaluate factors associated with falls.

Findings

This study included 472 patients. The incidence of falls was 0.31 per patient year. In patients aged 45–64 years (p = 0.01; odds ratio [OR]: 14.801; 95% confidence interval [CI]: 1.897–115.453) and ≥ 65 years (p = 0.007; OR: 16.562; 95% CI: 2.118–129.521), anemia (p = 0.015; OR: 2.122; 95% CI: 1.154–3.902) and moderately (p = 0.003; OR: 5.439; 95% CI: 1.791–16.516) and severely abnormal timed up and go test (TUGT) levels (p = 0.001; OR: 7.032; 95% CI: 2.226–22.216) were identified as independent risk factors of falls.

Discussion

Falls are prevalent among patients undergoing in‐center hemodialysis. Advanced age, anemia, and moderately and severely abnormal TUGT levels may be risk factors of falls.
Quantifying model selection uncertainty via bootstrapping and Akaike weights
Authors: Rigdon Edward , Sarstedt Marko , Moisescu Ovidiu‐Ioan
Published: February 2023

Picking one ‘winner’ model for researching a certain phenomenon while discarding the rest implies a confidence that may misrepresent the evidence. Multimodel inference allows researchers to more accurately represent their uncertainty about which model is ‘best’. But multimodel inference, with Akaike weights—weights reflecting the relative probability of each candidate model—and bootstrapping, can also be used to quantify model selection uncertainty, in the form of empirical variation in parameter estimates across models, while minimizing bias from dubious assumptions. This paper describes this approach. Results from a simulation example and an empirical study on the impact of perceived brand environmental responsibility on customer loyalty illustrate and provide support for our proposed approach.
A Christological Problem of Epectasy
Authors: Walker‐Lenow Joseph
Published: February 2023

This paper argues that the theological and anthropological assumptions underlying Gregory of Nyssa's doctrine of epectasy, an understanding of our eschatological state as one of perpetual growth in the love of God, mandate a christological conclusion that many will find undesirable: there will come a time in the course of eternal life at which each of the redeemed come to love the Father more than Christ did on the cross as he offered his life for the life of the world, and more than Christ did on Easter Sunday as he conquered death.
Do childcare policies and schedule control enhance variable time workers' work–life balance? A gender analysis across European countries
Authors: Kim Ji Hyun , Choi Young Jun
Published: February 2023

Variable time work is no longer abnormal in the post‐industrial economy and is accelerating due to digitisation and the COVID‐19 pandemic. Previous studies have revealed a causal relationship between working time variability and work–life balance at the individual level; however, there has been less discussion of the role of the institutional context. This study examines the interplay among childcare policy, schedule control, and its relationship with work–life balance. We conducted a multilevel analysis using the European Working Conditions Survey. The analyses revealed that childcare policy has a U‐shaped relationship with work–life balance for female variable time workers without schedule control. In contrast, workers with schedule control and male workers did not have a curvilinear relationship with the outcome. Our analyses imply that sufficient childcare intervention and its interaction with schedule control are necessary to offset the negative effect of childcare services on work–life balance.
Nature‐mimicking layering with composite resins through a bio‐inspired analysis: 25 years of the polychromatic technique
Authors: Ricci Weber Adad , Fahl Newton
Published: February 2023

Objectives

For decades, the dental community has discussed which materials would be the ideal substitutes for lost tooth structure. Initially, the biomimetic approach advocated that feldspathic ceramics would be the material of choice for enamel. However, given the complexity of obtaining excellent dental technicians and the financial cost, are composite resins a suitable replacement? The optical properties with opalescence and fluorescence effects, as well as this material's high fracture toughness, indicate it as a long‐lasting restorative material. However, because this material depends on the operator's expertise, knowledge of layering techniques and the selection of each material for the different layers is required. Thus, knowledge of the polychromatic technique through a bioinspired approach is necessary to obtain results of life‐like restorations. This article aims to review the polychromatic layering technique (PLT), considering the optical and mechanical properties of dentin and enamel and correlating these properties with current composite resins to guide clinicians in selecting the most suitable restoratives for their clinical challenges.

Clinical Considerations

The polychromatic layering technique is revisited, cross‐referencing the properties of dentin and enamel with current composite resin restoratives and their biomimetic properties. The effectiveness and predictability of the PLT are corroborated in clinical cases of varying degrees of difficulty requiring different layering strategies.

Conclusion

After the bio‐inspired analysis, using nature as a model to be understood and followed, it is possible to note how the polychromatic technique remains current and viable in mimicking nature, providing esthetic and natural results in the layering of composite resins.

Clinical Significance

Composite resins effectively replicate the optical and mechanical characteristics of natural dentin and enamel through the bioinspired approach presented by the polychromatic layering technique.
Reduced 3‐year risk of hospital admission and mortality after 12‐week resistance training of cirrhosis patients: A follow‐up of a randomized clinical trial
Authors: Aamann Luise , Dam Gitte , Jepsen Peter , Borre Mette , Drljevic‐Nielsen Aska , Overgaard Kristian , Andersen Henning , Vilstrup Hendrik , Aagaard Niels Kristian
Published: February 2023

Background and Aim

Physical activity confers health benefits in many diseases but remains almost unstudied for cirrhosis.

We investigated whether a period of resistance training affects the subsequent long‐term risk of hospitalization or mortality among patients with cirrhosis.

Methods

The study includes 39 participants with cirrhosis Child–Pugh class A/B who participated in a prior clinical trial randomized to either resistance training three times per week for 12 weeks or a control group. We gathered data through medical records from trial entry and the following 3 years. The outcomes were time to first hospitalization and all‐cause mortality. We used regression models to examine the associations between trial groups and outcomes, adjusting for Child–Pugh class, age, gender, and comorbidity.

Results

Nine patients who trained and 15 controls were hospitalized, resulting in a lower risk of first hospitalization in the training group (adjusted subdistribution hazard ratio of 0.40, 95% confidence interval [CI] [0.17, 0.92]; P = 0.03). One patient who trained and six controls died, resulting in a lower all‐cause mortality in the training group (adjusted hazard ratio of 0.06, 95% CI [0.01, 0.66]; P = 0.02).

Conclusion

Twelve weeks of resistance training was associated with a reduced risk of first hospitalization and mortality among patients with cirrhosis Child–Pugh class A/B 3 years after trial entry. The mechanisms of this effect are not identified, and larger studies are warranted.
Types and correlates of school absenteeism among students with intellectual disability
Authors: Melvin G. A. , Freeman M. , Ashford L. J. , Hastings R. P. , Heyne D. , Tonge B. J. , Bailey T. , Totsika V. , Gray K. M.
Published: February 2023

Background

It appears that students with intellectual disability (ID) are more frequently absent from school compared with students without ID. The objective of the current study was to estimate the frequency of absence among students with ID and the reasons for absence. Potential reasons included the attendance problems referred to as school refusal, where absence is related to emotional distress; truancy, where absence is concealed from parents; school exclusion, where absence is instigated by the school; and school withdrawal, where absence is initiated by parents.

Methods

Study participants were 629 parents (84.6% mothers) of Australian school students (Mage = 11.18 years; 1.8% Aboriginal and/or Torres Strait Islander) with an ID. Participants completed a questionnaire battery that included the School Non‐Attendance ChecKlist via which parents indicated the reason their child was absent for each day or half‐day absence their child had over the past 20 school days. The absence data presented to parents had been retrieved from school records.

Results

Across all students, absence occurred on 7.9% of the past 20 school days. In terms of school attendance problems as defined in existing literature, school withdrawal accounted for 11.1% of absences and school refusal for 5.3% of absences. Students were also absent for other reasons, most commonly illness (32.0%) and appointments (24.2%). Of students with more than one absence (n = 217; 34.5%), about half were absent for more than one reason. Students attending mainstream schools had lower attendance than those attending special schools.

Conclusions

Students with ID were absent for a range of reasons and often for multiple reasons. There were elevated rates of school withdrawal and school refusal. Understanding the reasons for absenteeism can inform targeted prevention and intervention supports.
Local Experiences, Search, and Spillovers in the Housing Market
Authors: GARGANO ANTONIO , GIACOLETTI MARCO , JARNECIC ELVIS
Published: February 2023

Recent local price growth explains differences in search behavior across prospective homebuyers. Those experiencing higher growth in their postcode of residence search more broadly across locations and house characteristics, without changing attention devoted to individual sales listings, and have shorter search duration. Effects are stronger for homeowners, in particular those living in less wealthy areas and looking for a new primary residence. We use reduced‐form analysis and a quantitative equilibrium model to show that the expansion of search breadth translates into widespread spillovers onto house sales prices and inventories of listings across postcodes within a metropolitan area.
Contrasting seasonal patterns in diet and dung‐associated invertebrates of feral cattle and horses in a rewilding area
Authors: Thomassen Emil Ellegaard , Sigsgaard Eva Egelyng , Jensen Mads Reinholdt , Olsen Kent , Hansen Morten D. D. , Svenning Jens‐Christian , Thomsen Philip Francis
Published: February 2023

Trophic rewilding is increasingly applied in restoration efforts, with the aim of reintroducing the ecological functions provided by large‐bodied mammals and thereby promote self‐regulating, biodiverse ecosystems. However, empirical evidence for the effects of megafauna introductions on the abundance and richness of other organisms such as plants and invertebrates, and the mechanisms involved still need strengthening. In this study, we use environmental DNA (eDNA) metabarcoding of dung from co‐existing feral cattle and horses to assess the seasonal variation in plant diet and dung‐associated arthropods and nematodes. We found consistently high diet richness of horses, with low seasonal variability, while the generally lower dietary diversity of cattle increased substantially during summer. Intriguingly, season‐specific diets differed, with a greater proportion of trees in the horses' diet during winter, where cattle relied more on shrubs. Graminoids were predominantly found in the diet of horses, but were generally underrepresented compared to previous studies, possibly due to the high prevalence of forbs in the study area. Dung‐associated arthropod richness was higher for cattle, largely due to a high richness of flies during summer. Several species of dung‐associated arthropods were found primarily in dung from one of the two herbivores, and our data confirmed known patterns of seasonal activity. Nematode richness was constantly higher for horses, and nematode communities were markedly different between the two species. Our results demonstrate complementary effects of cattle and horses through diet differences and dung‐associated invertebrate communities, enhancing our understanding of large herbivore effects on vegetation and associated biodiversity. These results are directly applicable for decision‐making in rewilding projects, suggesting biodiversity‐benefits by inclusion of functionally different herbivores.
Using a Madurella mycetomatis‐specific PCR on grains obtained via non‐invasive fine‐needle aspirated material is more accurate than cytology
Authors: Siddig Emmanuel Edwar , Ahmed Ayman , Hassan Omnia Babekir , Bakhiet Sahar Mubarak , Verbon Annelies , Fahal Ahmed Hassan , van de Sande Wendy W. J.
Published: February 2023

Background

Eumycetoma is a chronic subcutaneous inflammatory fungal infection most often caused by the fungus Madurella mycetomatis. Using a species‐specific PCR on DNA directly isolated from grains is currently the most reliable method for species identification. However, so far, PCR has been performed on grains obtained through deep‐seated surgical biopsies, which are invasive procedures. Grains can also be obtained via ultrasound‐guided fine‐needle aspiration (US‐FNA). Here we determined the diagnostic performance of species‐specific PCRs performed on samples obtained through US‐FNA.

Methods

From 63 patients, US‐FNA was performed to obtain eumycetoma grains; 34 patients also underwent a deep‐seated biopsy. From the grains, DNA was isolated, and one pan‐fungal and two M. mycetomatis‐specific PCRs were performed. The sensitivity and specificity were determined.

Results

Of the 63 patients who underwent US‐FNA, 78% (49/63) had evidence of eumycetoma based on cytology and 93.7% (59/63) based on species‐specific PCRs. In the 34 patients for whom surgical biopsies were performed as well, 31 patients had a positive PCR for M. mycetomatis when DNA was isolated from the deep‐seated biopsy, and 30 had a positive PCR when DNA was obtained from the US‐FNA material. This resulted in a 96.8% sensitivity, and 100% specificity with 97.1% diagnostic accuracy for PCR performed on US‐FNA.

Conclusion

PCR performed on the US‐FNA material has a similar sensitivity and specificity as PCR performed on deep‐seated biopsies. Therefore, when using PCR, a deep‐seated biopsy may not be necessary to obtain grains.
Prognostic factors for mycological cure in patients with onychomycosis caused by Neoscytalidium dimidiatum: A retrospective cohort study
Authors: Leeyaphan Charussri , Chai‐Adisaksopha Chatree , Tovanabutra Napatra , Phinyo Phichayut , Bunyaratavej Sumanas
Published: February 2023

Background

The prognostic factors for cure have been derived from cases of dermatophyte onychomycosis. However, there are limited studies in non‐dermatophyte onychomycosis. Neoscytalidium dimidiatum is the common causative agents of non‐dermatophyte onychomycosis which has proven to be recalcitrant to treatment.

Objective

This retrospective cohort study investigated mycological cure and prognostic factors in Neoscytalidium onychomycosis patients.

Methods

Patients aged 18 or older with newly diagnosed Neoscytalidium onychomycosis were enrolled. All patients were treated and followed up for at least 1 year. Mycological cure was analysed with Cox proportional hazard regression. The hazard ratios (HRs) of previously reported potential prognostic factors were included in univariable and multivariable stratified Cox regression analyses.

Results

From total 198 patients, mycological cure was achieved in 108 (54.6%) patients with a median of 490 (± SD 62.2) days. The poor prognostic factors for mycological cure were age ≥ 70 years (HR, 0.63; 95% CI, 0.41–0.97; p = .034); nail thickness ≥2 mm (HR, 0.20; 95% CI, 0.11–0.35; p < .001); and peripheral vascular disease (HR, 0.46; 95% CI, 0.28–0.77; p = .003). Combination therapy was associated with achieving a mycological cure (HR, 2.55; 95% CI, 1.49–4.38; p < .001).

Conclusions

Approximately half of the patients with onychomycosis caused by Neoscytalidium dimidiatum achieved a mycological cure, with a median time to cure exceeding 1 year. Combined topical and systemic antifungal treatments yield a higher chance of mycological cure than monotherapies. Advanced age, nail thickness and peripheral vascular disease are obstacle factors to cure.
Pressure ulcers after prone positioning in patients undergoing extracorporeal membrane oxygenation: A cross‐sectional study
Authors: Binda Filippo , Marelli Federica , Galazzi Alessandro , Gambazza Simone , Vinci Elisa , Roselli Paola , Adamini Ileana , Laquintana Dario
Published: February 2023

Background

The combination of prone positioning and extracorporeal membrane oxygenation (ECMO) in patients with acute respiratory distress syndrome (ARDS) is recognized as safe but its use has been limited due to potential complications.

Aim

To report the prevalence of pressure ulcers and other complications due to prone positioning in adult patients receiving veno–venous ECMO.

Study Design

This cross‐sectional study was conducted in a tertiary level intensive care unit (ICU) in Milan (Italy), between January 2015 and December 2019. The study population was critically ill adult patients undergoing veno–venous ECMO. Statistical association between pressure ulcers and the type of body positioning (prone versus supine) was explored fitting a logistic model.

Results

In the study period, 114 patients were treated with veno–venous ECMO and 62 (54.4%) patients were placed prone for a total of 130 prone position cycles. ECMO cannulation was performed via femoro–femoral configuration in the majority of patients (82.4%, 94/114). Pressure ulcers developed in 57.0% of patients (95%CI: 44.0%–72.6%), most often arising on the face and the chin (37.1%, 23/62), particularly in those placed prone. The main reason of prone positioning interruption was the decrease of ECMO blood flow (8.1%, 5/62). The fitted model showed no association between body position during ECMO and occurrence of pressure ulcers (OR 1.3, 95%CI: 0.5–3.6, p = .532).

Conclusions

Facial pressure ulcers were the most frequent complications of prone positioning. Nurses should plan and implement evidence‐based care to prevent such pressure injuries in patients undergoing ECMO.

Relevance to Clinical Practice

The combination of prone positioning and ECMO shows few life‐threating complications. This manoeuvre during ECMO is feasible and safe when performed by experienced ICU staff.
The epigenetic landscape of oligodendrocyte lineage cells
Authors: Selcen Ipek , Prentice Emily , Casaccia Patrizia
Published: February 2023

The epigenetic landscape of oligodendrocyte lineage cells refers to the cell‐specific modifications of DNA, chromatin, and RNA that define a unique gene expression pattern of functionally specialized cells. Here, we focus on the epigenetic changes occurring as progenitors differentiate into myelin‐forming cells and respond to the local environment. First, modifications of DNA, RNA, nucleosomal histones, key principles of chromatin organization, topologically associating domains, and local remodeling will be reviewed. Then, the relationship between epigenetic modulators and RNA processing will be explored. Finally, the reciprocal relationship between the epigenome as a determinant of the mechanical properties of cell nuclei and the target of mechanotransduction will be discussed. The overall goal is to provide an interpretative key on how epigenetic changes may account for the heterogeneity of the transcriptional profiles identified in this lineage.
Regional variation of pediatric interhospital critical care transport in Japan
Authors: Miura Shinya , Miyata Satoshi , Kawaguchi Atsushi , Yamaoka Kazue
Published: February 2023

Background

An in‐depth understanding of the epidemiology of ill or injured children transported between hospitals is crucial in building regional medical transport services in public health. Although the epidemiological situation varies by nation and region, it has not been well documented in Japan. In this report we described the number of pediatric interhospital transportations and examined the regional variations and trends in the recent decade.

Methods

We performed repeated, cross‐sectional analyses of children (<15 years) undergoing interhospital transportation in 2010, 2013, and 2016–19, using the national database of public ambulances of the Fire and Disaster Management Agency in Japan. We stratified the cases into critical care transport (CCT) or non‐critical care transport (NonCCT) by the illness/injury severity of the transported children. We calculated the national population‐adjusted number of CCTs and described prefectural variations in CCT numbers with analytical thinking.

Results

There were 23,506 CCTs and 138,347 NonCCTs. The national average of population‐adjusted CCT numbers was 255 per 1,000,000 person‐years. The statistics varied by prefectures, ranging from 25–536 per 1,000,000 person‐years. The annual trends were also diverse across prefectures, increasing in nine, decreasing in six, and static in 31 prefectures. In analytical thinking of regional variations, potential contributing factors included available interhospital transport services and the threshold of direct admission and referral to tertiary‐care hospitals, whereas regional variations were not well associated with geographical patterns or population size.

Conclusions

Public ambulance services were substantially used for CCTs and NonCCTs in Japan. Regional variations should be taken into account for the future policymaking on pediatric interhospital transportation.
Intergenerational relationships and marriage in China: Within‐family longitudinal associations and between‐family differences
Authors: Li Xiaomin , Zhao Zhenqiang , Johnson Matthew , Fang Xiaoyi
Published: February 2023

Marriage is embedded in the web of spouses' broader social ties, and relationship quality with parents and parents‐in‐law is associated with marital quality. Guided by Family Systems theory and using three waves of dyadic data from 268 Chinese different‐sex couples across the first several years of marriage, we first conducted a Random‐Intercept Actor‐Partner Interdependence Cross‐lagged Panel Model (RI‐APIM‐CLPM) to examine the within‐family longitudinal associations among husbands' and wives' relationship quality with parents, parents‐in‐law, and spouse. Then, husbands' and wives' filial obligations were added as predictors of between‐family differences in their own and their partner's relationship quality in the three social ties. Among husbands, increased relationship quality in one social tie (e.g., with parents) predicted reductions in relationship quality in the other social ties (e.g., relationships with parents‐in‐law and marital quality). Our examination of between‐family differences demonstrated that high levels of filial obligations predicted higher intergenerational relationship quality and marital quality. By simultaneously considering the within‐family associations of multiple social ties and how filial obligations account for between‐family differences in relationship quality, we contribute to a nuanced understanding of how Chinese couples' romantic partnerships are embedded in their broader family system.
Immunogenicity of a quadrivalent human papillomavirus vaccine in pediatric kidney and liver transplant recipients
Authors: Kitano Taito , Schwartz Kevin L. , Abdulnoor Mariana , Garfield Hartley , Booran Nasser Khodai , Avitzur Yaron , Teoh Chia Wei , Hébert Diane , Allen Upton
Published: February 2023

Background

Solid‐organ transplant recipients are at increased risk of developing human papillomavirus‐related diseases.

Methods

To evaluate the immunogenicity of a quadrivalent vaccine, a prospective observational study included females aged 12–19 years who had received kidney or liver transplants, or were otherwise healthy volunteers. With the three‐dose vaccination, serum antibodies were measured.

Results

The study included 17 transplant recipients (seven kidney and 10 liver) and 16 healthy participants. Six of seven kidney transplant recipients were on three immunosuppressive medications, whereas 9 of the 10 liver transplant recipients were on one. For the serology within 6 months from the last vaccine dose, the geometric mean titers of human papillomavirus types 6, 11, 16, and 18 were 26.7, 8.6, 35.7, and 42.4 (kidney transplant); 579.2, 569.3, 3097.3, and 835.7 (liver transplant); and 860.5, 638.8, 4391.6, and 902.6 milli‐Merck Units/ml (healthy). The seropositivity rates of kidney transplant recipients for the four serotypes ranged from 50% to 75%, while all liver transplant recipients and healthy participants had 100% seropositivity rates for all four types. While there were no statistical differences of titers between liver transplant recipients and healthy participants, the titers of kidney transplant recipients were lower than those of healthy participants for type 6 (p = .034), type 11 (p = .032), and type 16 (p = .032).

Conclusions

The results support the recommendation of human papillomavirus vaccination in pediatric transplant recipients given the significant risk of human papillomavirus‐related diseases in this population, though immunogenicity was lower in kidney transplant recipients on multiple immunosuppressive medications.
The blurred line between epistemic and metaphysical modalities in the modal epistemology of imagination
Authors: Larrauri Pertierra Iñaki Xavier
Published: February 2023

Modal epistemologies that rely on a fallibilism about modal claims have been gaining traction over the years. This paper critically discusses the accounts of Kung (2009, 2010, 2016) and Dohrn (2018, 2019, 2020b) and argues that they are invariably susceptible to being read as entailing claims of epistemic possibility. Both Kung and Dohrn seek to ground modal intuitions on non‐modal ones, and primarily appeal to the modalizing capacity of imagination to aid in the discovery of modal truths. However, insofar as inference from non‐modal imagination to modal truths remains fallible, then no non‐ad hocdistinction can be made between substantiation of fallible metaphysically modal claims and infallible epistemically modal ones. This is because, barring an agent's infallible knowledge of modal truths, how these truths are argued for must attend the agent's imperfect epistemic access thereof, therefore entailing claims of modality consistent with her epistemic state—that is, claims of epistemic possibility. If modal epistemologies in general non‐modally ground their modal assertions in this fallible fashion, then they seem inevitably interpretable in terms of epistemic possibility as opposed to some non‐epistemic reading of metaphysical possibility.
Recalibrating prognostic models to improve predictions of in‐hospital child mortality in resource‐limited settings
Authors: Ogero Morris , Ndiritu John , Sarguta Rachel , Tuti Timothy , Aluvaala Jalemba , Akech Samuel
Published: February 2023

Background

In an external validation study, model recalibration is suggested once there is evidence of poor model calibration but with acceptable discriminatory abilities. We identified four models, namely RISC‐Malawi (Respiratory Index of Severity in Children) developed in Malawi, and three other predictive models developed in Uganda by Lowlaavar et al. (2016). These prognostic models exhibited poor calibration performance in the recent external validation study, hence the need for recalibration.

Objective

In this study, we aim to recalibrate these models using regression coefficients updating strategy and determine how much their performances improve.

Methods

We used data collected by the Clinical Information Network from paediatric wards of 20 public county referral hospitals. Missing data were multiply imputed using chained equations. Model updating entailed adjustment of the model's calibration performance while the discriminatory ability remained unaltered. We used two strategies to adjust the model: intercept‐only and the logistic recalibration method.

Results

Eligibility criteria for the RISC‐Malawi model were met in 50,669 patients, split into two sets: a model‐recalibrating set (n = 30,343) and a test set (n = 20,326). For the Lowlaavar models, 10,782 patients met the eligibility criteria, of whom 6175 were used to recalibrate the models and 4607 were used to test the performance of the adjusted model. The intercept of the recalibrated RISC‐Malawi model was 0.12 (95% CI 0.07, 0.17), while the slope of the same model was 1.08 (95% CI 1.03, 1.13). The performance of the recalibrated models on the test set suggested that no model met the threshold of a perfectly calibrated model, which includes a calibration slope of 1 and a calibration‐in‐the‐large/intercept of 0.

Conclusions

Even after model adjustment, the calibration performances of the 4 models did not meet the recommended threshold for perfect calibration. This finding is suggestive of models over/underestimating the predicted risk of in‐hospital mortality, potentially harmful clinically. Therefore, researchers may consider other alternatives, such as ensemble techniques to combine these models into a meta‐model to improve out‐of‐sample predictive performance.