bluuebunny/crossref_metadata_2025 huggingface dataset:
Relatedness dynamics and sex-biased dispersal in a seasonal cycle of corn mice from intensively managed agroecosystems
Authors: Sommaro Lucia V , Martínez Juan J , Chiappero Marina B , Steinmann Andrea R , Gardenal Cristina N , Priotto José W
Published: November 2022

The sex-biased dispersal and kinship dynamics are important factors shaping the spatial distribution of individuals and are key parameters affecting a variety of ecological and evolutionary processes. Here, we studied the spatial distribution of related individuals within a population of corn mice Calomys musculinus in a seasonal cycle to infer dispersal patterns. The sampling was carried out from spring 2005 to winter 2006 in field borders of intensively managed agroecosystems. Genotyping data from 346 individuals with 9 microsatellites showed spatial genetic structure was weak for males, but not for females. The results indicate a complex spatial kinship dynamic of related females across all seasons. Which, contrary to our expectations, dispersal distances decrease with the increase of the population abundance. Meanwhile, male dispersal distances were greater when population abundance increased and thus the availability of active females. Males disperse greater distances to mate and sire offspring with distant females as a possible inbreeding avoidance mechanism. This study shows that C. musculinus is capable of much greater scattering distances than previously reported and that dispersal occurs fluidly and without barriers across the agroecosystem. The indirect benefit of dispersal on individual fitness could be related to relaxing the competition in the natal area and increasing the mating rate. Our study highlights the value of combining genetic relatedness, fieldwork observations, and behavioral data to estimate dispersal at a fine geographical scale.
Acinetobase: the comprehensive database and repository of Acinetobacter strains
Authors: Valcek Adam , Collier James , Botzki Alexander , Van der Henst Charles
Published: November 2022

Acinetobacter baumannii is one of the most problematic nosocomial pathogens that can efficiently thrive within hospital settings, mainly due to resistances toward antibiotics, desiccation, disinfectants, human serum and oxidative stress. Recently, increased resistance against last-resort antibiotics earns this bacterium the highest priority concern classified by the Centers for Disease Control and Prevention and the World Health Organization. An obvious hallmark of this bacterium is the high heterogeneity observed among A. baumannii isolates, with a limited core genome. This feature complexifies the study of A. baumannii bacteria as an entity, subsequently reflected in a diversity of phenotypes of not only antimicrobial and environmental resistance but also virulence. A high degree of genome plasticity, along with the use of a limited subset of established strains, can lead to strain-specific observations, decreasing the global understanding of this pathogenic agent. Phenotypic variability of A. baumannii strains is easily observable such as with the macrocolony morphologies, in vitro and in vivo virulence, natural competence level, production of different capsular polysaccharide structures and cellular densities. Some strains encode several virulence factors, while others, including the established strains, lack key ones. The lack/excess of genes or specific physiological processes might interfere with in vivo and in vitro experiments, thus providing a limited impact on the global understanding of Acinetobacter bacteria. As an answer to the high heterogeneity among A. baumannii strains, we propose a first comprehensive database that includes the bacterial strains and the associated phenotypic and genetic data. This new repository, freely accessible to the entire scientific community, allows selecting the best bacterial isolate(s) related to any biological question, using an efficient and fast exchange platform.

Database URL: https://acinetobase.vib.be/
Comparing latent inequality with ordinal data
Authors: Kaplan David M , Zhao Wei
Published: November 2022

We propose new ways to compare two latent distributions when only ordinal data are available, and without imposing parametric assumptions on the underlying continuous distributions. First, we contribute identification results. We show how certain ordinal conditions provide evidence of between-group inequality, quantified by particular quantiles being higher in one latent distribution than in the other. We also show how other ordinal conditions provide evidence of higher within-group inequality in one distribution than in the other, quantified by particular interquantile ranges being wider in one latent distribution than in the other. Second, we propose an ‘inner’ confidence set for the quantiles that are higher for the first latent distribution. We also describe frequentist and Bayesian inference on features of the ordinal distributions relevant to our identification results. Our contributions are illustrated by empirical examples with mental health and general health.
Individualized exercise prescription and cardiac rehabilitation following a spontaneous coronary artery dissection or aortic dissection
Authors: Van Iterson Erik H , Laffin Luke J , Svensson Lars G , Cho Leslie
Published: November 2022

Aims

Prescribed aerobic-based exercise training is a low-risk fundamental component of cardiac rehabilitation (CR). Secondary prevention therapeutic strategies following a spontaneous coronary artery dissection (SCAD) or aortic dissection (AD) should include CR. Current exercise guidance for post-dissection patients recommends fundamental training components including target heart rate zones are not warranted. Omitting fundamental elements from exercise prescriptions risks safety and makes it challenging for both clinicians and patients to understand and implement recommendations in real-world practice. We review the principles of exercise prescription for CR, focusing on translating guidelines and evidence from well-studied high-risk CR populations to support the recommendation that exercise testing and individualized exercise prescription are important for patients following a dissection.

Methods and results

When patients self-perceive exercise intensity there is a tendency to underestimate intensities within metabolic domains that should be strictly avoided during routine exercise training following a dissection. However, exercise testing associated with CR enrolment has gained support and has not been linked to adverse events in optimally medicated post-dissection patients. Graded heart rate and blood pressure responses recorded throughout exercise testing provide key information for developing an exercise prescription. An exercise prescription that is reflective of medical history, medications, and cardiorespiratory fitness optimizes patient safety and yields improvements in blood pressure control and cardiorespiratory fitness, among other benefits.

Conclusion

This clinical practice and education article demonstrates how to develop and manage a CR exercise prescription for post-acute dissection patients that can be safe and effective for maintaining blood pressure control and improving cardiorespiratory fitness pre–post CR.
Availability of virtual-assisted lung mapping affects procedure selection for early-stage lung cancer: a web-based cross-sectional study
Authors: Yamaguchi Hirokazu , Sato Masaaki , Yamamoto Kazumichi , Shinohara Kiyomi , Yanagiya Masahiro , Hashisako Mizuho , Wannous Muhammad , Nakajima Jun
Published: November 2022

OBJECTIVES

The availability of new techniques may affect surgeons’ procedure selection and thereby affect clinical outcomes. This study aimed to evaluate the effect of the availability of virtual-assisted lung mapping (VAL-MAP) on the selection of lung resection methods.

METHODS

Members of the Japanese Association for Chest Surgeons were invited to participate in a web-based survey. Participants were divided into those who had never used VAL-MAP (group 0), those who had used only VAL-MAP 1.0 (multiple dye marks on the pleural surface; group 1) and those who had used VAL-MAP 2.0 (multiple dye marks and intrabronchial microcoils for three-dimensional mapping; group 2). Participants were shown chest computed tomography images of 6 ground-glass opacity nodules and asked to choose surgical procedures to resect the nodules with sufficient resection margins greater than the lesion diameter or 2 cm.

RESULTS

There were 197 surgeons in group 0, 49 in group 1 and 26 in group 2. All groups showed a similar trend of avoiding wedge resection for deeply located nodules. However, group 1 showed a trend of disagreeing with the selection of wedge resection compared with group 0 as measured by a Likert scale (1–5) by −0.21 points (95% confidence interval, −0.41 to −0.008 points, P = 0.042). This tendency disappeared in group 2.

CONCLUSIONS

The availability of VAL-MAP 1.0 led to the selection of segmentectomy, while the availability of VAL-MAP 2.0 led to aggressive deep wedge resection.
Conduction system pacing in everyday clinical practice: EHRA physician survey
Authors: Kircanski Bratislav , Boveda Serge , Prinzen Frits , Sorgente Antonio , Anic Ante , Conte Giulio , Burri Haran
Published: November 2022

With the increasing interest in conduction system pacing (CSP) over the last few years and the inclusion of this treatment modality in the current guidelines, our aim was to provide a snapshot of current practice across Europe. An online questionnaire was sent to physicians participating in the European Heart Rhythm Association research network as well as to national societies and over social media. Data on previous experience with CSP, current indications, preferred tools, unmet needs, and perceptions for the future are reported and discussed.
P-wave duration and atrial fibrillation recurrence after catheter ablation: a systematic review and meta-analysis
Authors: Intzes Stergios , Zagoridis Konstantinos , Symeonidou Marianthi , Spanoudakis Emmanouil , Arya Arash , Dinov Borislav , Dagres Nikolaos , Hindricks Gerhard , Bollmann Andreas , Kanoupakis Emmanuel , Koutalas Emmanuel , Nedios Sotirios
Published: November 2022

Aims

Atrial fibrillation (AF) is a global health problem with high morbidity and mortality. Catheter ablation (CA) can reduce AF burden and symptoms, but AF recurrence (AFr) remains an issue. Simple AFr predictors like P-wave duration (PWD) could help improve AF therapy. This updated meta-analysis reviews the increasing evidence for the association of AFr with PWD and offers practical implications.

Methods and results

Publication databases were systematically searched and cohort studies reporting PWD and/or morphology at baseline and AFr after CA were included. Advanced interatrial block (aIAB) was defined as PWD ≥ 120 ms and biphasic morphology in inferior leads. Random-effects analysis was performed using the Review Manager 5.3 and R programs after study selection, quality assessment, and data extraction, to report odds ratio (OR) and confidence intervals. : Among 4175 patients in 22 studies, 1138 (27%) experienced AFr. Patients with AFr had longer PWD with a mean pooled difference of 7.8 ms (19 studies, P < 0.001). Pooled OR was 2.04 (1.16–3.58) for PWD > 120 ms (13 studies, P = 0.01), 2.42 (1.12–5.21) for PWD > 140 ms (2 studies, P = 0.02), 3.97 (1.79–8.85) for aIAB (5 studies, P < 0.001), and 10.89 (4.53–26.15) for PWD > 150 ms (4 studies, P < 0.001). There was significant heterogeneity but no publication bias detected.

Conclusion

P-wave duration is an independent predictor for AF recurrence after left atrium ablation. The AFr risk is increasing exponentially with PWD prolongation. This could facilitate risk stratification by identifying high-risk patients (aIAB, PWD > 150 ms) and adjusting follow up or interventions.
Overexpression of miR390b promotes stem elongation and height growth in Populus
Authors: Shi Qiaofang , Tian Dongdong , Wang Jieyu , Chen Aoli , Miao Yuqing , Chen Yiming , Li Jun , Wu Xiaomeng , Zheng Bo , Guo Wenwu , Shi Xueping
Published: November 2022

MicroRNA390 (miR390) is involved in plant growth and development by down-regulating the expression of the downstream genes trans-acting short interfering RNA3 (TAS3) and AUXIN RESPONSE FACTORs (ARFs). There is a scarcity of research on the involvement of the miR390-TAS3-ARFs pathway in the stem development of Populus. Here, differentially expressed miRNAs during poplar stem development were screened by small RNA sequencing analysis, and a novel function of miR390b in stem development was revealed. Overexpression of miR390b (OE-miR390b) resulted in a large increase in the number of xylem fiber cells and a slight decrease in the cell length at the longitudinal axis. Overall increases in stem elongation and plant height were observed in the OE-miR390b plants. According to transcriptome sequencing results and transient co-expression analysis, TAS3.1 and TAS3.2 were identified as the target genes of miR390 in poplar and were negatively regulated by miR390 in the apex. The transcription levels of ARF3.2 and ARF4 were significantly repressed in OE-miR390b plants and strongly negatively correlated with the number of xylem fiber cells along the longitudinal axis. These findings indicate that the conserved miR390-TAS3-ARFs pathway in poplar is involved in stem elongation and plant height growth.
At odds: How intraprofessional conflict and stratification has stalled the Ontario paramedic professionalization project
Authors: Brydges Madison , Dunn James R , Agarwal Gina , Tavares Walter
Published: November 2022

Historically, self-regulation has provided some professions with power and market control. Currently, however, governments have scrutinized this approach, and priorities have shifted toward other mandates. This study examines the case of paramedics in Ontario, Canada, where self-regulation is still the dominant regulatory model for the healthcare professions but not for paramedics. Instead, paramedics in Ontario are co-regulated by government and physician-directed groups, with paramedics subordinate to both. This paper, which draws on interviews with paramedic industry leaders analyzed through the lens of institutional work, examines perspectives on the relevance of self-regulation to the paramedic professionalization project. Participants had varying views on the importance of self-regulation in obtaining professional status, with some rejecting its role in professionalization and others embracing regulatory reform. Because paramedics disagree on what being a profession means, the collective professionalization project has stalled. This research has implications for understanding the impact of intraprofessional relationships and conflict on professionalization projects.
The Right to a Favor: International Scholarships, Clientelism, and the Class Politics of Merit in Post-Revolutionary Mexico
Authors: Newman Rachel Grace
Published: November 2022

This article considers the ways that middle-class and elite citizens in post-revolutionary Mexico pursued access to exclusive favors from the state in the 1920s and 1930s and emphasizes the overlooked role of merit as political logic in this era. Examining political discourse within clientelist exchanges through the close reading of petitions, I explore ideas about class and nation as articulated by young strivers and their families who sought scholarships for foreign study. The article argues that working within clientelism, upwardly mobile Mexicans strategically wielded merit to preserve and legitimate their status amid social tectonic shifts. Petitioners’ ideas of merit encompassed individual loyalty and patriotism, unique talents, and inherited status. I identify heritable and disciplinary merit as distinct yet compatible understandings of worthiness used by privileged citizens. These citizens claimed that exceptional Mexicans trained abroad would make an outsized contribution to the national well-being and thus deserved special rewards, an argument which anticipated rationales that the Mexican state would later embrace for its modernization policy. After 1940, the state expanded international scholarship programs and invoked the same terms that citizens had used in the early post-revolutionary period to justify socially regressive benefits providing foreign education for the already fortunate.
Genetic enhancement: an avenue to combat aging-related diseases
Authors: Cai Yusheng , Ji Zhejun , Wang Si , Zhang Weiqi , Qu Jing , Belmonte Juan Carlos Izpisúa- , Liu Guang-Hui
Published: November 2022

Aging is a major risk factor for multiple diseases, including cardiovascular diseases, neurodegenerative disorders, osteoarthritis, and cancer. It is accompanied by the dysregulation of stem cells and other differentiated cells, and the impairment of their microenvironment. Cell therapies to replenish the abovementioned cells provide a promising approach to restore tissue homeostasis and alleviate aging and aging-related chronic diseases. Importantly, by leveraging gene editing technologies, genetic enhancement, an enhanced strategy for cell therapy, can be developed to improve the safety and efficacy of transplanted therapeutic cells. In this review, we provide an overview and discussion of the current progress in the genetic enhancement field, including genetic modifications of mesenchymal stem cells, neural stem cells, hematopoietic stem cells, vascular cells, and T cells to target aging and aging-associated diseases. We also outline questions regarding safety and current limitations that need to be addressed for the continued development of genetic enhancement strategies for cell therapy to enable its further applications in clinical trials to combat aging-related diseases.
A study of the hydrostatic mass bias dependence and evolution within The Three Hundred clusters
Authors: Gianfagna Giulia , Rasia Elena , Cui Weiguang , De Petris Marco , Yepes Gustavo , Contreras-Santos Ana , Knebe Alexander
Published: November 2022

We use a set of about 300 simulated clusters from the three hundred Project to calculate their hydrostatic masses and evaluate the associated bias by comparing them with the true cluster mass. Over a redshift range from 0.07 to 1.3, we study the dependence of the hydrostatic bias on redshift, concentration, mass growth, dynamical state, mass, and halo shapes. We find almost no correlation between the bias and any of these parameters. However, there is a clear evidence that the scatter of the mass-bias distribution is larger for low-concentrated objects, high mass growth, and more generically for disturbed systems. Moreover, we carefully study the evolution of the bias of 12 clusters throughout a major-merger event. We find that the hydrostatic-mass bias follows a particular evolution track along the merger process: to an initial significant increase of the bias recorded at the begin of merger, a constant plateaus follows until the end of merge, when there is a dramatic decrease in the bias before the cluster finally become relaxed again. This large variation of the bias is in agreement with the large scatter of the hydrostatic bias for dynamical disturbed clusters. These objects should be avoided in cosmological studies because their exact relaxation phase is difficult to predict, hence their mass bias cannot be trivially accounted for.
Self-interacting superfluid dark matter droplets
Authors: Delgado Vicente , Muñoz Mateo Antonio
Published: November 2022

We assume dark matter to be a cosmological self-gravitating Bose–Einstein condensate of non-relativistic ultralight scalar particles with competing gravitational and repulsive contact interactions and investigate the observational implications of such model. The system is unstable to the formation of stationary self-bound structures that minimize the energy functional. These cosmological superfluid droplets, which are the smallest possible gravitationally bound dark matter structures, exhibit a universal mass profile and a corresponding universal rotation curve. Assuming a hierarchical structure formation scenario where granular dark matter haloes grow around these primordial stationary droplets, the model predicts cored haloes with rotation curves that obey a single universal equation in the inner region ($r\, \lesssim \, 1$ kpc). A simultaneous fit to a selection of galaxies from the SPARC data base chosen with the sole criterion of being strongly dark matter dominated even within the innermost region, indicates that the observational data are consistent with the presence of a Bose–Einstein condensate of ultralight scalar particles of mass m ≃ 2.2 × 10−22 eV c−2 and repulsive self-interactions characterized by a scattering length as ≃ 7.8 × 10−77 m. Such small self-interactions have profound consequences on cosmological scales. They induce a natural minimum scale length for the size of dark matter structures that makes all cores similar in length (∼1 kpc) and contributes to lower their central densities.
Time-scale-dependent X-ray to UV time lags of NGC 4593 using high-intensity XMM–Newton observations with Swift and AstroSat
Authors: Beard Max W J , McHardy Ian M , Kumari Kavita , Dewangan Gulab C , Papadakis Iossif , Bhattacharya Dipankar , Singh Kulinder Pal , Kynoch Daniel , Pahari Mayukh
Published: November 2022

We present a 140 ks observation of NGC 4593 with XMM–Newton providing simultaneous and continuous pn X-ray and OM UV (UVW1 2910 Å) light curves, which sample short-time-scale variations better than previous observations. These observations were simultaneous with 22 d of Swift X-ray and UV/optical monitoring reported previously, and 4 d of AstroSat Soft X-ray Telescope (SXT), far (FUV 1541 Å) and near (NUV 2632 Å) UV allowing lag measurements between them and the highly-sampled XMM. From the XMM, we find that UVW1 lags behind the X-rays by 29.5 ± 1.3 ks, ∼half the lag previously determined from the Swift monitoring. Re-examination of the Swift data reveals a bimodal lag distribution, with evidence for both the long and short lags. However, if we detrend the Swift light curves by LOWESS filtering with a 5 d width, only the shorter lag (23.8 ± 21.2 ks) remains. The NUV observations, compared to pn and SXT, confirm the ∼30 ks lag found by XMM, and after 4 d filtering is applied to remove the long-time-scale component, the FUV shows a lag of ∼23 ks. The resultant new UVW1, FUV, and NUV lag spectrum extends to the X-ray band without requiring additional X-ray to UV lag offset, which if the UV arises from reprocessing of X-rays implies direct illumination of the reprocessor. By referencing previous Swift and HST lag measurements, we obtain an X-ray to optical lag spectrum, which agrees with a model using the KYNreverb disc-reprocessing code, assuming the accepted mass of 7.63 × 106 M⊙ and a spin approaching maximum. Previously noted lag contribution from the BLR in the Balmer and Paschen continua are still prominent.
Exploration of simple scenarios involving fuzzy dark matter cores and gas at local scales
Authors: Álvarez-Rios Iván , Guzmán Francisco S
Published: November 2022

We introduce a tool that solves the Schrödinger–Euler–Poisson system of equations and allows the study of the interaction between ultralight bosonic dark matter, whose dynamics is described with the Schrödinger–Poisson system and luminous matter which, as a first approximation, is modelled with a single component compressible ideal fluid. The two matter fields are coupled through the Poisson equation, whose source is the addition of both, dark matter and fluid densities. We describe the numerical methods used to solve the system of equations and present tests for each of the two components, which show the accuracy and convergence properties of the code. As simple possible applications we present some toy scenarios: (i) the merger between a core of dark matter with a cloud of gas, (ii) the merger of bosonic dark matter plus fluid configurations, and (iii) the post-merger properties, including the dark matter offset from gas and the correlation between oscillations of the bosonic core and those of the gas.
Trends in Individualized Affordability of Factory-Made Cigarettes: Findings of the 2008–2020 International Tobacco Control Netherlands Surveys
Authors: Geboers Cloé , Candel Math J J M , Chaloupka Frank J , Nagelhout Gera E , de Vries Hein , van den Putte Bas , Shang Ce , Fong Geoffrey T , Willemsen Marc C
Published: November 2022

Introduction

Cigarette affordability, the price of tobacco relative to consumer income, is a key determinant of tobacco consumption.

Aims and Methods

This study examined trends over 12 years in individualized factory-made cigarette affordability in the Netherlands, and whether these trends differed by sex, age, and education. Data from 10 waves (2008–2020) of the International Tobacco Control Netherlands Surveys were used to estimate individualized affordability, measured as the percentage of income required to buy 100 cigarette packs (Relative Income Price [RIP]), using self-reported prices and income. The higher the RIP, the less affordable cigarettes are. Generalized estimating equation regression models assessed trends in individualized affordability over time and by sex, age, and education.

Results

Affordability decreased significantly between 2008 and 2020, with RIP increasing from 1.89% (2008) to 2.64% (2020) (p ≤ .001), except for 2008–2010, no significant year-on-year changes in affordability were found. Lower affordability was found among subgroups who have a lower income level: Females (vs. males), 18–24 and 25–39-year-olds (vs. 55 years and over) and low or moderate-educated individuals (vs. highly educated). Interactions between wave and education (p = .007) were found, but not with sex (p = .653) or age (p = .295). A decreasing linear trend in affordability was found for moderately (p = .041) and high-educated (p = .025), but not for low-educated individuals (p = .149).

Conclusions

Cigarettes in the Netherlands have become less affordable between 2008 and 2020, yet this was mostly because of the decrease in affordability between 2008 and 2010. There is a need for more significant increases in tax to further decrease affordability.

Implications

Our findings suggest that cigarettes have become less affordable in the Netherlands between 2008 and 2020. But, this appears to be the result of a steep decrease in affordability between 2008 and 2010. Affordability was lower among groups who have on average lower incomes (females, young adults, and low- and moderate-educated individuals), and differences in trends across education levels could be explained by per capita income changes. Our individualized measure indicated lower affordability than published aggregate affordability estimations. Future tax increases should be large enough to result in a lower affordability.
The role of resistivity in hot accretion flows with anisotropic pressure: Comparing magnetic field models
Authors: Ghoreyshi Sayyedeh Masoumeh , Khesali Alireza
Published: November 2022

In hot accretion flows, such as the accretion flow in the Galactic center (Sgr A*) and in M 87, the collisional mean free path of the charged particles is significantly larger than the typical length-scale of the accretion flows. Under these conditions, the pressure perpendicular to the magnetic field and that parallel to the magnetic field are not the same; therefore, the pressure is anisotropic to magnetic field lines. On the other hand, the resistivity as a dissipative mechanism plays a key role in the structure and the heating of hot accretion flows. In the present paper, we study the dynamics of resistive hot accretion flows with anisotropic pressure when the magnetic fields have even z-symmetry about the midplane. By presenting a set of self-similar solutions, we find that if the magnetic fields have even z-symmetry or the viscosity form depends on the strength of magnetic field, the disc properties can be entirely different. In the presence of symmetric fields, the velocity components and the disc temperature increase considerably. Also, we show that the increase in infall velocity and temperature due to the anisotropic pressure can be more significant if the resistivity is taken into account. Our results indicate that the resistivity can be an effective mechanism for the heating of hot accretion flows in the high-limit of the magnetic diffusivity parameter. Moreover, the heating due to the anisotropic pressure is comparable to the resistive heating, only when the strength of anisotropic pressure is about unity. The increase of disc temperature can lead to the acceleration of the electrons in such flows. This helps us to explain the origin of phenomena such as the flares in Sgr A*. Our results predict that the presence of resistivity makes it easier for outflows to launch from hot accretion flows.
Young Adult Pain Rehabilitation: Interdisciplinary Development and Preliminary Outcomes of a Novel Treatment Program
Authors: Morrison Eleshia J , Tsai-Owens Michele S , Luedtke Connie A , Eickhoff Andrea L , Evans Michele M , Oetjen Laurel A , Johannsen Amanda L , Schiebel Cindy J , Boyum Kirsti K , Reynolds Andrea L , Dresher Emily R , Ellingson Andrea M , Harrison Tracy E , Rohe Daniel E , Gilliam Wesley P , Loukianova Larissa L , Harbeck-Weber Cynthia
Published: November 2022

Background

Young adults with chronic pain and symptoms experience disruptions to their social, emotional, physical, and vocational functioning. Interdisciplinary pain rehabilitation programs for pediatric and adult populations are not designed specifically to address the developmental needs of young adults.

Methods

This article describes the development of a novel intensive interdisciplinary outpatient rehabilitation program tailored to the unique needs of young adults with chronic pain and symptoms. Tailored content included vocational assessment and consultation, financial literacy education, and sexual health education.

Results

Outcome data demonstrate treatment gains, with reductions in pain interference, pain severity, pain catastrophizing, and depressive symptoms, as well as improvements in mental and physical quality of life, perceived performance, perceived satisfaction with performance, and objective measures of physical functioning.

Conclusions

The article concludes with clinical recommendations for the management of chronic pain and symptoms in young adults, applicable across multiple treatment settings.
Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) versus Virtual Reality Relaxation (VRelax) for People With a Psychotic Disorder: A Single-Blind Multicenter Randomized Controlled Trial
Authors: Nijman S A , Pijnenborg G H M , Vermeer R R , Zandee C E R , Zandstra D C , van der Vorm D , de Wit - de Visser A C , Meins I A , Geraets C N W , Veling W
Published: November 2022

Background and Hypothesis

Social cognition training (SCT), an intervention for social cognition and social functioning, might be improved by using virtual reality (VR), because VR may offer better opportunities to practice in a potentially more realistic environment. To date, no controlled studies have investigated VR-SCT. This study investigated a VR-SCT, “DiSCoVR”. We hypothesized that DiSCoVR would improve social cognition and social functioning.

Study Design

Participants were randomized to DiSCoVR (n = 41) or VR relaxation (‘VRelax’, n = 40), an active control condition, and completed 16 twice-weekly sessions. Three assessments (baseline, posttreatment, and 3-month follow-up) were performed by blinded assessors. The primary outcome was social cognition (emotion perception and theory of mind). Secondary outcomes included social functioning (measured with an interview and experience sampling), psychiatric symptoms, information processing, and self-esteem. Data were analyzed using mixed-models regression analysis. Treatment effects were evaluated by the time by condition interaction terms.

Study Results

No significant time by condition interactions were found for any of the outcome variables, indicating an absence of treatment effects. Between-group effect sizes ranged from negligible to moderate (Cohen’s d < |0.53|). Main effects of time were found for several outcomes.

Conclusions

These results suggest that DiSCoVR was not effective, possibly because of inadequate simulation of emotional expressions in VR. This lack of efficacy may indicate that current SCT protocols are relatively unsuitable for improving social functioning. Previous studies showed small to moderate effects on higher order social cognition, but the SCT approach may need critical reevaluation, as it may not sufficiently lead to functional improvement.
The Behavioral Mapping of Psychomotor Slowing in Psychosis Demonstrates Heterogeneity Among Patients Suggesting Distinct Pathobiology
Authors: Nadesalingam Niluja , Lefebvre Stéphanie , Alexaki Danai , Baumann Gama Daniel , Wüthrich Florian , Kyrou Alexandra , Kerkeni Hassen , Kalla Roger , Walther Sebastian
Published: November 2022

Objectives

Psychomotor slowing (PS) occurs in up to half of schizophrenia patients and is linked to poorer outcomes. As standard treatment fails to improve PS, novel approaches are needed. Here, we applied the RDoC framework using 3 units of analysis, ie, behavior, self-report, and physiology to test, whether patients with PS are different from patients without PS and controls.

Methods

Motor behavior was compared between 71 schizophrenia patients with PS, 25 without PS, and 42 healthy controls (HC) using 5 different measures: (1) for behavior, an expert rating scale: Motor score of the Salpêtrière Retardation Rating Scale, (2) for self-report, the International Physical Activity Questionnaire; and for physiology, (3) Actigraphy, which accounts for gross motor behavior, (4) Gait velocity, and (5) coin rotation task to assess manual dexterity.

Results

The ANCOVAs comparing the 3 groups revealed differences between patients with PS and HC in expert ratings, self-report, and instrumental measures (all P ≤ .001). Patients with PS also scored higher in expert ratings and had lower instrumental activity levels compared to patients without PS (all P ≤ .045). Instrumental activity levels correlated with an expert rating of PS (rho = −0.51, P-fdr corrected <.001) and classified similarly at 72% accuracy.

Conclusions

PS is characterized by slower gait, lower activity levels, and slower finger movements compared to HC. However, only actigraphy and observer ratings enable to clearly disentangle PS from non-PS patients. Actigraphy may become the standard assessment of PS in neuroimaging studies and clinical trials.
Blended care to discontinue benzodiazepine receptor agonists use in patients with chronic insomnia disorder: a pragmatic cluster randomized controlled trial in primary care
Authors: Coteur Kristien , Henrard Gilles , Schoenmakers Birgitte , Laenen Annouschka , Van den Broeck Kris , De Sutter An , Anthierens Sibyl , Devroey Dirk , Kacenelenbogen Nadine , Offermans Anne-Marie , Van Nuland Marc
Published: November 2022

Study Objectives

International guidelines recommend using benzodiazepine receptor agonists (BZRA) for maximally four weeks. Nevertheless, long-term use for chronic insomnia disorder remains a common practice. This study aimed to test the effectiveness of blended care for discontinuing long-term BZRA use in general practice.

Methods

A pragmatic cluster randomized controlled superiority trial compared blended care to usual care through urine toxicology screening. In the intervention, care by the general practitioner (GP) was complemented by an interactive e-learning program, based on cognitive behavioral therapy for insomnia. Adults using BZRA daily for minimally 6 months were eligible. Participants were clustered at the level of the GP surgery for allocation (1:1). Effectiveness was measured as the proportion of patients who had discontinued at one-year follow-up. Data analysis followed intention-to-treat principles.

Results

In total, 916 patients in 86 clusters, represented by 99 GPs, were randomized. Primary outcome data was obtained from 727 patients (79%). At one-year follow-up, 82 patients (18%) in blended care, compared to 91 patients (20%) in usual care, had discontinued. There was no statistically significant effect for the intervention (OR: 0.924; 95% CI: 0.60; 1.43). No adverse events were reported to the research team.

Conclusions

The findings did not support the superiority of blended care over usual care. Both strategies showed clinical effectiveness, with an average of 19% of patients having discontinued at one-year follow-up. Further research is important to study the effect of structurally implementing digital interventions in general practice.

Clinical trial

Big Bird trial; KCE-17016. This trial is registered at clinicaltrials.gov (NCT03937180).
Imputation as a mechanism for quantifying beneficial ownership in the family home
Authors: Pawlowski Mark
Published: November 2022

The article examines the device of imputation used by the English courts to determine the parties’ beneficial shares in the family home if they have not themselves expressed any common intention as to the extent of their respective equitable entitlement and the court is unable to infer that intention from the parties’ conduct.
Viscoelastic versus conventional coagulation tests to reduce blood product transfusion in patients undergoing liver transplantation
Authors: Aceto Paola , Punzo Giovanni , Di Franco Valeria , Teofili Luciana , Gaspari Rita , Wolfango Avolio Alfonso , Del Tedesco Filippo , Posa Domenico , Lai Carlo , Sollazzi Liliana
Published: November 2022

BACKGROUND

Recent literature suggests viscoelastic test (VET)-guided transfusion management could be associated with reduced blood product administration in patients undergoing liver transplantation.

OBJECTIVE(S)

To assess the effectiveness of coagulation management guided by VETs compared with conventional coagulation tests (CCTs) in reducing blood product transfusion in patients undergoing liver transplantation.

DESIGN

Systematic review and meta-analysis of randomised (RCTs) and nonrandomised clinical trials performed according to PRISMA guidelines. The protocol was previously published (PROSPERO: CRD42021230213)

DATA SOURCES

The Cochrane Central Library, PubMed/MEDLINE, Embase and the Transfusion Evidence Library were searched up to 30thJanuary 2022.

ELIGIBILITY CRITERIA

Setting: operating room. Patients: liver transplantation recipients. Intervention: use of VETs versus CCTs. Main outcome measures: the primary outcome was the mean number of transfused units for each blood product including red blood cells (RBCs), fresh frozen plasma (FFP), platelets (PLTs) and cryoprecipitate. Secondary outcomes included mortality rate, intensive care unit (ICU) and hospital length of stay (LOS).

RESULTS

Seventeen studies (n = 5345 patients), 15 observational and two RCTs, were included in this review. There was a mean difference reduction in RBCs [mean difference: −1.40, 95% confidence interval (95% CI), −1.87 to −0.92;P < 0.001,I2 = 61%) and FFP units (mean difference: −2.98, 95% CI, −4.61 to −1.35;P =  < 0.001;I2 = 98%) transfused in the VETs group compared with the CCTs one. A greater amount of cryoprecipitate was administered in the VETs group (mean difference: 2.71, 95% CI, 0.84 to 4.58;P = 0.005;I2 = 91%). There was no significant difference in the mean number of PLT units, mortality, hospital and ICU-LOS.

CONCLUSION

Our meta-analysis demonstrated that VETs implementation was associated with reduced RBC and FFP consumption in liver transplantation patients without effects on mortality and hospital and ICU-LOS. The certainty of evidence ranged from moderate to very low. Further well conducted RCTs are needed to improve the certainty of evidence.
An Effective Response to Healthcare Disparities Begins With a Strategic Plan
Authors: Brooks-Williams Denise
Published: November 2022

For too long, healthcare disparities have negatively affected underrepresented groups in urban areas throughout the United States. Disparities in care and outcomes related to social determinants were known, and efforts were made to address them. Effective change for all moved up to top priority in the wake of COVID-19's arrival, police brutality, social unrest, and the murders of Black Americans, including George Floyd. Henry Ford Health (HFH), working with leading local community organizations, immediately pledged to address social and racial injustices. Unfortunately, many neighborhoods still suffer disproportionately from maternal and infant mortality, food insecurity, and other social vulnerabilities. HFH's commitment to equity includes creatively meeting the needs of the underserved. HFH has developed innovative ways to address the social, economic, and educational challenges to the health of Metro Detroit. Through thoughtful consideration and passionate leadership, HFH is strategically creating authentic and scalable social change to address racism and discrimination in healthcare.
Were hospitals with sustained high performance more successful at reducing mortality during the pandemic’s second wave?
Authors: Al-Amin Mona , Li Kate , Hefner Jennifer , Islam Md Nazmul
Published: November 2022

Background

In 2019, the COVID-19 pandemic emerged. Variation in COVID-19 patient outcomes between hospitals was later reported.

Purpose

This study aims to determine whether sustainers—hospitals with sustained high performance on Hospital Value-Based Purchasing Total Performance Score (HVBP-TPS)—more effectively responded to the pandemic and therefore had better patient outcomes.

Methodology

We calculated hospital-specific risk-standardized event rates using deidentified patient-level data from the UnitedHealth Group Clinical Discovery Database. HVBP-TPS from 2016 to 2019 were obtained from Centers for Medicare & Medicaid Services. Hospital characteristics were obtained from the American Hospital Association Annual Survey Database (2019), and county-level predictors were obtained from the Area Health Resource File. We use a repeated-measures regression model assuming an AR(1) type correlation structure to test whether sustainers had lower mortality rates than nonsustainers during the first wave (spring 2020) and the second wave (October to December 2020) of the pandemic.

Results

Sustainers did not have significantly lower COVID-19 mortality rates during the first wave of the pandemic, but they had lower COVID-19 mortality rates during the second wave compared to nonsustainers. Larger hospitals, teaching hospitals, and hospitals with higher occupancy rates had higher mortality rates.

Conclusion

During the first wave of the pandemic, mortality rates did not differ between sustainers and nonsustainers. However, sustainers had lower mortality rates than nonsustainers in the second wave, most likely because of their knowledge management capabilities and existing structures and resources that enable them to develop new processes and routines to care for patients in times of crisis. Therefore, a consistently high level of performance over the years on HVBP-TPS is associated with high levels of performance on COVID-19 patient outcomes.

Practice Implications

Investing in identifying the knowledge, processes, and resources that foster the dynamic capabilities needed to achieve superior performance in HVBP might enable hospitals to utilize these capabilities to adapt more effectively to future changes and uncertainty.
Improving Hourly Rounding on an Orthopaedic/Trauma Unit
Authors: Macy Evan
Published: November 2022

Hourly rounding impacts multiple patient care outcomes. The task of rounding has several obstacles and is made more time-consuming by donning and doffing protective personal equipment kits, especially in the setting of the COVID-19 pandemic. To improve the frequency of hourly rounding performance on the unit, nurses and unlicensed assistive personnel on an orthopaedic/trauma unit at an academic hospital in the Midwest United States were introduced to potential interventions in several PDSA (Plan-Do-Study-Act) cycles using quality improvement methodology. Methods included chart auditing, repetitive interventions designed by evaluating previous iterations, creation of educational material, and changing unit policy by communication during unit huddle. Results found a 10-percentage point improvement of hourly rounding compliance, from 77.3% to 87.3%, with use of a “redline” policy for isolation precautions. The policy implementation was a success. Future research may consider the expansion of this policy to other units.
Evaluation of Electroconvulsive Therapy in Adolescents With Major Depressive and Bipolar Disorders
Authors: Shao Wen , Zheng Yi , Li Qingxia , Shao Kangning , Zhao Fujun , Guan Lin , Zhang Zhixia , Li Fenghua
Published: November 2022

Objective

This study aims to provide an evaluation of electroconvulsive therapy (ECT) in hospitalized adolescents with major depressive and bipolar disorders by examining its treatment outcomes as well as comparing it with outcomes of hospitalized patients, treated as usual (TAU).

Methods

This is a retrospective study based on medical records documented between April 2011 and December 2017 from Beijing An Ding Hospital. Patients were diagnosed according to the International Classification of Diseases, Tenth Revision. The study included 288 inpatients, with 2 groups of 171 patients treated by ECT and 117 TAU. The primary outcome was measured using the severity subscale of Clinical Global Impression. Mann-Whitney U test, χ
2 test, and linear regression with mixed models were used to analyze the data.

Results

Symptom severity reduced significantly for both groups (β = −0.62, t
975.93 = −20.54, P < 0.001). The TAU group was associated with lower score on the severity subscale of Clinical Global Impression (β = 0.28, t
980.32 = 8.36, P < 0.001). The ECT group had a higher remission rate (28.65%) than the TAU group (16.24%), but the time required for remission was longer (U [N
ECT = 49, N
TAU = 19] = 615, z = 2.10, P = 0.04). Adverse events of ECT were barely observed.

Conclusion

Electroconvulsive therapy is an efficacious and safe treatment for adolescents. However, as the superiority in efficacy was not evident in ECT group, its prescription should be prudently considered for younger patients who respond well to other treatments.