bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreased grey matter volume in dorsolateral prefrontal cortex and thalamus accompanied by compensatory increases in middle cingulate gyrus of premature ejaculation patients
Authors: Gao Songzhan , Chen Jianhuai , Liu Jia , Guan Yichun , Liu Rusheng , Yang Jie , Yang Xianfeng
Published: October 2023

Introduction

The prefrontal–cingulate–thalamic areas are associated with ejaculation control. Functional abnormalities of these areas and decreased grey matter volume (GMV) in the subcortical areas have been confirmed in premature ejaculation (PE) patients. However, no study has explored the corresponding GMV changes in the prefrontal–cingulate–thalamic areas, which are considered as the important basis for functional abnormalities. This study aimed to investigated whether PE patients exhibited impaired GMV in the brain, especially the prefrontal–cingulate–thalamic areas, and whether these structural deficits were associated with declined ejaculatory control.

Methods

T1‐weighted structural magnetic resonance imaging (MRI) data were acquired from 50 lifelong PE patients and 50 age‐, and education‐matched healthy controls (HCs). The PE diagnostic tool (PEDT) was applied to assess the subjective symptoms of PE. Based on the method of voxel‐based morphometry (VBM), GMV were measured and compared between groups. In addition, the correlations between GMV of brain regions showed differences between groups and PEDT scores were evaluated in the patient group.

Results

PE patients showed decreased GMV in the right dorsolateral superior frontal gyrus (clusters = 13, peak T‐values = −4.30) and left thalamus (clusters = 47, T = −4.33), and increased GMV in the left middle cingulate gyrus (clusters = 12, T = 4.02) when compared with HCs. In the patient group, GMV of the left thalamus were negatively associated with PEDT scores (r = −0.35; P = 0.01). Receiver operating characteristic (ROC) analysis showed that GMV of the right dorsolateral superior frontal gyrus (AUC = 0.71, P < 0.01, sensitivity = 60%, specificity = 78%), left thalamus (AUC = 0.72, P < 0.01, sensitivity = 92%, specificity = 46%) and middle cingulate gyrus (AUC = 0.69, P < 0.01, sensitivity = 50%, specificity = 90%), and the combined model (AUC = 0.84, P < 0.01, sensitivity = 78%, specificity = 80%) all had the ability to distinguish PE patients from HCs.

Conclusion

Disturbances in GMV were revealed in the prefrontal–cingulate–thalamic areas of PE patients. The findings implied that decreased GMV in the dorsolateral prefrontal cortex and thalamus might be associated with the central pathological neural mechanism underlying the declined ejaculatory control while increased GMV in the middle cingulate gyrus might be the compensatory mechanism underlying PE.
Using priority effects for grassland restoration: Sequential sowing can promote subordinate species
Authors: Durbecq Aure , Bischoff Armin , Buisson Elise , Corcket Emmanuel , Jaunatre Renaud
Published: October 2023

Aims

The influence of priority effects on plant community succession is increasingly discussed in community ecology. However, most grassland restoration approaches involving seed addition transfer all target species at the same time. Our objective was to tackle the question: does the order of arrival influence the establishment of restored communities?

Location

La‐Bâtie‐Neuve, Southern Alps, France.

Methods

We applied sequential sowing using two groups, one set of dominant species and one set of subordinate species, each comprising three different perennial plant species. We tested four sowing treatments: control (without any sowing), two sequential sowing treatments (dominants first or subordinates first) and synchronous sowing. We analysed plant cover each year for three years after sowing and calculated priority and earliness indices (the third year) for each group and each sown species.

Results

Manipulating the order of arrival shaped community composition and trajectories. Some species of both groups were positively affected by being sown first compared to being sown synchronously. However, dominant and subordinate groups differed in their earliness index, showing a significant benefit for subordinates to be sown first. The subordinate species Onobrychis viciifolia and Plantago lanceolata established only when they were sown first, while Festuca cinerea showed greater establishment when sown first and simultaneously, compared to late sowing. The dominant Anthyllis vulneraria was not affected by date or type of sowing. However, the cover of the most dominant Bromopsis erecta was lower when being sown second, allowing a control of its dominance by delayed sowing.

Conclusion

The strength of priority effects differs between species, which may depend on niche characteristics or microenvironment, influencing (negatively or positively) the establishment of late‐arriving species and affecting their competitive abilities. Our study provides evidence that plant community assembly was influenced by the order of arrival, but demonstrated a strong species‐specific response to priority effects.
Free heme and hemopexin in acute kidney injury after cardiopulmonary bypass and transient renal ischemia
Authors: Greite Robert , Schott Sebastian , Wang Li , Gohlke Lukas , Kreimann Kirill , Derlin Katja , Gutberlet Marcel , Schmidbauer Martina , Leffler Andreas , Tudorache Igor , Salman Jawad , Ius Fabio , Natanov Ruslan , Fegbeutel Christine , Haverich Axel , Lichtinghagen Ralf , Hüsing Anne M. , von Vietinghoff Sibylle , Schmitt Roland , Shushakova Nelli , Rong Song , Haller Hermann , Schmidt‐Ott Kai M. , Gram Magnus , Vijayan Vijith , Scheffner Irina , Gwinner Wilfried , Immenschuh Stephan
Published: October 2023

Free heme is released from hemoproteins during hemolysis or ischemia reperfusion injury and can be pro‐inflammatory. Most studies on nephrotoxicity of hemolysis‐derived proteins focus on free hemoglobin (fHb) with heme as a prosthetic group. Measurement of heme in its free, non‐protein bound, form is challenging and not commonly used in clinical routine diagnostics. In contrast to fHb, the role of free heme in acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery is unknown. Using an apo‐horseradish peroxidase‐based assay, we identified free heme during CPB surgery as predictor of AKI in patients undergoing cardiac valve replacement (n = 37). Free heme levels during CPB surgery correlated with depletion of hemopexin (Hx), a heme scavenger‐protein. In mice, the impact of high levels of circulating free heme on the development of AKI following transient renal ischemia and the therapeutic potential of Hx were investigated. C57BL/6 mice were subjected to bilateral renal ischemia/reperfusion injury for 15 min which did not cause AKI. However, additional administration of free heme in this model promoted overt AKI with reduced renal function, increased renal inflammation, and reduced renal perfusion on functional magnetic resonance imaging. Hx treatment attenuated AKI. Free heme administration to sham operated control mice did not cause AKI. In conclusion, free heme is a predictor of AKI in CPB surgery patients and promotes AKI in transient renal ischemia. Depletion of Hx in CPB surgery patients and attenuation of AKI by Hx in the in vivo model encourage further research on Hx therapy in patients with increased free heme levels during CPB surgery.
Effects of vagus nerve stimulation on the quality of sleep and sleep apnea in patients with drug‐resistant epilepsy: A systematic review
Authors: Seth Jayant , Couper R. Grace , Burneo Jorge G. , Suller Marti Ana
Published: October 2023

Objective

The objective was to systematically evaluate the current evidence surrounding the effect of vagus nerve stimulation (VNS) on quality of sleep and obstructive sleep apnea (OSA) among patients with epilepsy.

Methods

A literature search was conducted using the Embase and MEDLINE databases. Studies were included if they involved patients with drug‐resistant epilepsy treated with VNS and used validated tools to report on quality of sleep or sleep apnea. The literature search yielded 112 citations related to VNS and sleep quality, and 82 citations related to sleep apnea. Twelve articles were included in the review, of which five measured quality of sleep among patients who underwent VNS, six studies measured sleep apnea, and one study measured both outcomes.

Results

Studies measuring quality of sleep used different methods, including sleep quality questionnaires and the percentage of sleep in each cycle. Studies also varied in patient populations, the use of control groups, and whether multiple measurements were taken for each patient. Some studies found improved sleep quality after VNS, whereas others found reductions in deep sleep stages. Additionally, mixed results in sleep quality were found when comparing patients with epilepsy who received VNS treatment versus patients with epilepsy who did not receive VNS treatment. Variables such as VNS intensity and age could potentially confound quality of sleep. Studies measuring sleep apnea consistently found increased proportions of patients diagnosed with OSA or increased sleep index scores after VNS implantation.

Significance

Overall, the effect of VNS on quality of sleep remains unclear, as studies were very heterogeneous, although the effect on sleep apnea has consistently shown an increase in sleep apnea severity indices after VNS implantation. Future studies with consistent measures and discussions of confounding are required to determine the effect of VNS on quality of sleep, and the effect of VNS parameters should be further explored among patients who develop sleep apnea.
Longitudinal associations between the quality of family interactions and school‐age children's narrative abilities in the context of financial insecurity
Authors: Sabourin‐Guardo Éléonore , Miljkovitch Raphaële , Bernier Annie , Cyr Chantal , St‐Laurent Diane , Dubois‐Comtois Karine
Published: October 2023

This longitudinal study investigates whether the quality of family interactions at 3–5 years of age predicts narrative abilities in 7–9‐year‐old children from socioeconomically disadvantaged families. The sample consists of 67 children and their parents receiving social welfare. Family interactions were filmed during mealtime at home and coded using the Mealtime Interaction Coding System. Children's narrative abilities were measured based on their capacity to coherently elaborate and resolve stories from the Attachment Story Completion Task. Results revealed that children exposed to family interactions of higher quality make their narratives more accessible and understandable and include more appropriate expression of affects in their stories 4 years later, even after accounting for maternal education and verbal abilities. The results of this study highlight the importance of considering family interactions in the context of financial insecurity when studying socioemotional competence in childhood.
Indirect treatment comparisons of the gene therapy etranacogene dezaparvovec versus extended half‐life factor IX therapies for severe or moderately severe haemophilia B
Authors: Klamroth Robert , Bonner Ashley , Gomez Keith , Monahan Paul E. , Szafranski Kirk , Zhang Xiang , Walsh Sarah , Wang Di , Yan Songkai
Published: October 2023

Introduction

Etranacogene dezaparvovec gene therapy for haemophilia B demonstrated superior efficacy at 24 months in reducing bleeds versus a ≥6‐month lead‐in period of prophylaxis with FIX products in the phase 3 trial, HOPE‐B. In the absence of head‐to‐head comparisons of etranacogene dezaparvovec versus FIX products, indirect treatment comparisons (ITC) can be used.

Aim

To compare the efficacy of etranacogene dezaparvovec versus rIX‐FP, rFIXFc and N9‐GP using ITC, and support HOPE‐B results.

Methods

Data were leveraged from Phase 3 pivotal trials: HOPE‐B, PROLONG‐9FP, B‐LONG and Paradigm 2. Annualised bleeding rates (ABR), spontaneous (AsBR) and joint (AjBR) bleeding rates, percentage of patients with no bleeds, and FIX consumption were assessed using inverse probability of treatment weighting and matching adjusted indirect comparisons.

Results

Etranacogene dezaparvovec demonstrated statistically significantly lower bleeding rates versus all comparators. Rate ratios for ABR, AsBR and AjBR versus rIX‐FP were 0.19 (p < .0001), 0.08 (p < .0001) and 0.09 (p < .0001), respectively. Rate ratios for ABR, AsBR and AjBR versus rFIXFc were 0.14 (p < .0001), 0.13 (p = .0083) and 0.15 (p = .0111), respectively. Rate ratios for ABR and AsBR, versus N9‐GP were 0.24 (p = .0231) and 0.13 (p = .0071), respectively. Etranacogene dezaparvovec demonstrated significantly higher percentage of patients with no bleeds versus rIX‐FP and rFIXFc; odds ratios: 17.60 (p < .0001) and 5.65 (p = .0037), respectively. Etranacogene dezaparvovec resulted in significantly lower FIX consumption than all comparators.

Conclusions

ITC suggests that etranacogene dezaparvovec offers patients with haemophilia B (≤2% of normal FIX expression) a single dose treatment that can significantly reduce bleeding rates and eliminate routine infusions associated with FIX therapies.
A comprehensive review on the antioxidant activities and health benefits of microgreens: current insights and future perspectives
Authors: Tallei Trina Ekawati , Kepel Billy Johnson , Wungouw Herlina Inneke Surjane , Nurkolis Fahrul , Adam Ahmad Akroman , Fatimawali
Published: October 2023

Microgreens contain an abundance of antioxidants (glucosinolates, carotenoids, and phenolic compounds), vitamins (C, E, and K), minerals (iron and magnesium), and other nutrients (fibre and omega‐3 fatty acids). They have been shown to promote cardiovascular health, reduce inflammation, combat cancer, manage diabetes, protect the nervous system, and improve digestion. This review investigates the antioxidant content and health implications of microgreens, providing current insights and prospective outlooks. The types of antioxidants found in microgreens, as well as the factors that influence their content, such as species, growing conditions, and harvesting time, are discussed. The review highlights antioxidants' role in cardiovascular health, inflammation reduction, cancer defence, diabetes management, and nervous system protection. The antioxidant properties of microgreen varieties are discussed. The bioavailability of antioxidants from microgreens, culinary applications, and incorporation into the diet are elaborated. The section of future perspectives covers the commercial potential of microgreens, optimal harvest timing, research directions, and potential functional food and nutraceutical uses. The aim and scope of this review are to provide a comprehensive understanding of the antioxidant content in microgreens and their associated health benefits. It also seeks to identify gaps in current research and suggest avenues for future studies, especially concerning their relevance in human health and nutrition.
Continuing education for advanced practice nurses: A scoping review
Authors: Wright Mea Mirella Marjatta , Kvist Tarja Anneli , Imeläinen Sanna Marika , Jokiniemi Krista Susanna
Published: October 2023

Aim

The aim of the study was to identify the nature and extent of scientific research addressing continuing education for advanced practice nurses.

Design

A scoping review.

Review Methods

The Joanna Briggs Institute's methodology for scoping reviews.

Data Sources

Electronic search was conducted on 17 September 2023 via CINAHL, PsycINFO, PubMed, Scopus, Web of Science, Cochrane Library and the Joanna Briggs Institute's Evidence‐Based Practice Database for research articles published between 2012 and 2023.

Results

Nineteen papers were included in this review. Scientific research on continuing education for advanced practice nursing roles (i.e. nurse practitioner, clinical nurse specialist) has primarily been conducted in the United States and mostly addresses online‐delivered continuing education interventions for clinical care competency. Most of the interventions targeted nurse practitioners.

Conclusion

Continuing education has a pivotal role in supporting advanced practice nursing competency development. In addition to clinical care, future continuing education research should focus on other advanced practice nursing competencies, such as education, leadership, supporting organizational strategies, research and evidence implementation.

Implications for the Profession and/or Patient Care

Continuing education programmes for advanced practice nurses should be rigorously developed, implemented and evaluated to support the quality and effectiveness of patient care.

Impact

Continuing education for advanced practice nursing roles is an understudied phenomenon. This review highlights future research priorities and may inform the development of continuing education programmes.

Reporting Method

PRISMA‐ScR.
Obesity, diabetes and their metabolic correlates in middle‐aged adults with Down syndrome
Authors: Luchsinger J. A. , Pang D. , Krinsky‐McHale S. J. , Schupf N. , Lee J. H. , Silverman W. , Zigman W. B.
Published: October 2023

Background

Obesity in adults without Down syndrome is associated with an adverse metabolic profile including high prevalence of pre‐diabetes and diabetes, high levels of insulin, non‐high‐density lipoprotein (HDL) cholesterol, leptin and high‐sensitivity C‐reactive protein (hsCRP) and low levels of HDL and adiponectin. We examined whether obesity in middle‐aged adults with Down syndrome is also related to an adverse metabolic profile.

Methods

This cross‐sectional study included 143 adults with Down syndrome, with a mean age of 55.7 ± 5.7 years and 52.5% women. Body mass index (BMI) was classified as underweight (BMI < 18.5 kg/m2), normal (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2) and obese (BMI ≥ 30 kg/m2). Diabetes was ascertained by history or by haemoglobin A1c (HbA1c) as normal glucose tolerance (HbA1c < 5.7%), pre‐diabetes (HbA1c 5.7–6.4%) and diabetes (HbA1c ≥ 6.5%). We measured non‐fasting lipids, hsCRP, insulin, adiponectin and leptin.

Results

The majority of the sample had an overweight (46.9%) or obesity (27.3%) status. However, there was a relatively low prevalence of pre‐diabetes (9.8%) and diabetes (6.9%). Overweight and obesity status were not associated with lower HDL and adiponectin and higher insulin, non‐HDL cholesterol and hsCRP as expected in adults without Down syndrome. However, overweight and obesity were strongly associated with higher leptin (P < 0.001).

Conclusions

The only metabolic correlate of obesity in middle‐aged adults with Down syndrome was high leptin levels. Our findings are limited by non‐fasting laboratory tests but suggest that middle‐aged adults with Down syndrome do not have the adverse metabolic profile related to obesity found in adults without Down syndrome.
Increased risk of dementia differs across cardiovascular diseases and types of dementia – Data from a nationwide study
Authors: Kauko Anni , Engler Daniel , Niiranen Teemu , Ortega‐Alonso Alfredo , Schnabel Renate B.
Published: October 2023

Aims

Dementia is a major health problem. Cardiovascular diseases (CVD) and risk factors are associated with incident dementia. However, whether there is an association among CVD, Alzheimer's disease (AD) and vascular dementia (VD) at the population level remains unclear.

Methods

We analysed the association between CVD (heart failure [HF], atrial fibrillation [AF], myocardial infarction [MI], peripheral arterial disease, stroke and transient ischemic attack) and the incidence of dementia using nationwide FinnGen data of 218,192 individuals. The last follow‐up information on dementia was available from October 2021.

Results

The age at the end of the follow‐up was 61.7 ± 17.1 years, and 53% were women. Overall, we observed 9701 (4.4%) dementia, 6323 (2.9%) AD and 1918 (0.7%) VD cases. Individuals with CVD had a higher risk of developing dementia than unexposed individuals. In the multivariable‐adjusted Cox models, stroke was most strongly associated with dementia (hazard ratio [HR] 1.7, 95% confidence interval [CI] 1.6–1.8). CVD was more strongly associated with VD than with AD. Individuals with HF and MI had an increased risk of AD (HF: HR 1.11, 95% CI 1.04–1.19; MI: HR 1.10, 95% CI 1.02–1.18). AF was associated with VD (HR 1.58, 95% CI 1.42–1.77), but not with AD (HR 1.03, 95% CI 0.97–1.09). Clinical characteristics, such as diabetes, smoking and alcohol abuse, were associated with both types of dementia.

Conclusion

All major CVDs were associated with an increased risk of developing dementia, particularly VD. Therefore, CVD onset should prompt an assessment of cognitive decline and possible preventive measures.
Double auction for trading perfect complements
Authors: Chaturvedi Rakesh , Pandey Ashish Kumar
Published: October 2023

For a trading problem where a buyer is interested in an aggregate resource with fragmented ownership, the individually owned resources are perfect complements in trade. A double auction, chosen in accordance with a value alignment principle which we formulate, is shown to be strategy proof for owners. Since it also values the aggregate resource correctly, it mitigates the holdout problem by changing the source of inefficiency from complementarity on owners' side to lack of competition on buyer side. The value alignment principle implies that this double auction has a majority trading rule. With multiple buyers, a suitable modification makes the double auction strategy proof even for the buyers, thus mitigating the holdout problem by achieving approximate ex post efficiency when the number of owners is large.
A view from the top: A qualitative exploration of top‐level health care leaders’ perceptions on the implementation of simulation‐based education in postgraduate medical education
Authors: Nayahangan Leizl Joy , Thinggaard Ebbe , Khan Farsana , Gustafsson Amandus , Mørcke Anne Mette , Dubrowski Adam , Hirshfield Laura E. , Konge Lars
Published: October 2023

Introduction

Although there is substantial evidence supporting the benefits of simulation‐based education (SBE), its widespread and effective implementation remains challenging. The aim of this study was to explore the perceptions of top‐level health care leaders regarding SBE and the barriers and facilitators that influence its wide implementation as part of the postgraduate surgical curricula in Denmark.

Methods

We conducted semi‐structured interviews with top‐level health care leaders who were chosen based on their roles in ensuring high‐quality patient care delivery and developing strategies to achieve the goals of the entire health care system. The interview transcripts were translated into English, and a thematic approach was used to code and inductively analyse the data. We used the Consolidated Framework for Implementation Research to identify and understand the determinants to a successful implementation of SBE.

Results

We interviewed 13 participants from different political and administrative levels. We found that the participants had limited knowledge about SBE, which highlighted a disconnection between these leaders and the educational environment. This was further compounded by a lack of effective communication and inadequate information dissemination between simulation centres and higher‐level organisations. While participants recognised the benefits of SBE for doctors in training, they expressed concerns about the implementation given the already strained health care system and limited resources. The need for evidence, particularly in the context of patient safety, was emphasised to facilitate SBE implementation. Although participants supported the implementation of SBE, it was unclear who should initiate action.

Discussion

This study highlighted the perspectives of top‐level health care leaders regarding SBE and identified the determinant factors for a successful implementation. Effective communication channels are crucial to enhance collaborations and reduce the disconnection between the different health care organisational levels. Strategic implementation processes, including the roles and responsibilities, should be defined and established. These will inform decisions regarding the implementation strategies to effectively integrate SBE into the residency training curricula.
Budget starting position matters: A “field‐in‐lab” experiment testing simulation engagement and budgetary preferences
Authors: Mohr Zach , Afonso Whitney
Published: October 2023

Budget scholars have long theorized the impact of citizen engagement in the budget process. However, there is a void in the literature on modern types of engagement such as online budget simulations. Basic questions like what governments can do to increase the level of engagement and what effects such changes have on outcomes remain unanswered. Using a behavioral public budget and finance framework, we designed and tested an experiment with a local government budget simulation and varied the starting condition between balance, surplus, and deficit to assess the impact of starting condition on relevant outcomes of engagement and budgetary preferences. Results show that two measures of engagement and most budget preferences were influenced by the starting condition. Field‐in‐lab experiments like this one have the potential to further develop behavioral budget theory and be used to test online government platforms that are used by governments for engagement and many other purposes.
Review of pediatric combined heart‐liver transplantation: A roadmap to success
Authors: Lee Jason T. C. , Sarode Deepika , Emamaullee Juliet A.
Published: October 2023

Background

Combined heart‐liver transplantation (CHLT) is a promising technique to address end stage organ failure in patients with concomitant heart failure and chronic liver disease. While most experience with CHLT has involved adult patients, the expanding population of children born with univentricular congenital heart disease who underwent the Fontan procedure and develop Fontan‐associated liver disease (FALD) has emerged as a growing indication for pediatric CHLT.

Methods

Currently, CHLT is performed at a select subset of experienced transplant centers, especially in the pediatric population.

Results

While technically demanding, CHLT may offer survival benefit when compared to heart transplant alone with decreased rejection of both synchronous allografts and equivalent outcomes with respect to waitlist time and post‐operative complications. Limitations in the technique can be attributed to need for an appropriate multidisciplinary care center, challenges with donor organ availability and allocation, and the complexity associated with patient selection and peri‐operative management.

Conclusion

In this review, we summarize the history of CHLT, discuss patient selection, and highlight key facets of peri‐operative care in the pediatric population.
Investigating the skills of a preschool leader: A latent profile analysis
Authors: Held Lindsey L. , Gilpin Ansley T. , Xia Mengya
Published: October 2023

Individuals emerge as leaders across the lifespan; however, research investigating early childhood leaders is scant. This study assessed leadership in early childhood (N = 375) by using latent profile analysis of secondary data to examine how skill profiles are related to preschool leader scores. Skill profiles included scores for executive functioning, emotion regulation, imagination, theory of mind, vocabulary, and reception of prosocial behaviors (likeability). Six distinct profiles emerged with variation of high and low skill groupings. Four profiles with higher skill groupings also scored the highest on the leader construct but were not statistically different from each other. These findings support previous research that suggests that leaders may be identifiable in early childhood, and that there may be more than one pathway to early childhood leadership (i.e., differing skill combinations). With further research, these findings may have implications for curriculum development and the selection of peer models in clinical practice.
Medicaid expansions and private insurance “crowd‐out” (1999–2019)
Authors: Semprini Jason
Published: October 2023

Background

Recent Medicaid expansions have rekindled the debate around private insurance “crowd‐out.” Prior research is limited by short‐time horizons and state‐specific analyses. Our study overcomes these limitations by evaluating 20 years of Medicaid expansions across the entire United States.

Methods

We obtain data from the U.S. Census Bureau for all U.S. states and District of Columbia for private insurance coverage rates of adults 18–64 for years 1999–2019. After estimating a naïve, staggered Two‐way fixed effects difference‐in‐differences regression model, we implement four novel econometric methods to diagnose and overcome threats of bias from staggered designs. We also test for pre‐treatment differential trends and heterogenous effects over time.

Results

Our findings suggest that Medicaid expansion was associated with a 1.5 percent‐point decline in private insurance rates (p < 0.001). We also observe significant heterogeneity over time, with estimates peaking 4 years after expansion.

Conclusions

Medicaid expansions reduced private insurance rates. Future research should assess whether or how this crowd‐out may have affected consumer welfare or government budgets. Recognizing the crowd‐out should enable policymakers to make informed decisions regarding healthcare policy. The importance of a 1‐2 percent‐point crowd‐out, we leave for future research and debate.
Reflective practice in medicine: The hidden curriculum challenge
Authors: Ní Mhurchú Michelle , Cantillon Peter
Published: October 2023

Background

Despite the known benefits of reflection in various health care professions, it is still not a thriving practice in medical education. The literature suggests that this may be due to tensions between epistemological tenets of reflection and biomedicine. Further research is needed into experiences of doctors as they implement reflection in medical education settings. We set out to explore how these experiences were influenced by hidden curricula to provide insights into personal and contextual features of medical settings influencing engagement in reflection.

Methods

Using an interpretative phenomenological analysis (IPA) approach, four semi‐structured qualitative interviews were conducted virtually. Participants were doctors who graduated from a postgraduate diploma in clinical education with core reflective practice components. Interviews were recorded, transcribed, coded and analysed using IPA. Opportunities to review and amend transcriptions were provided.

Findings

Three superordinate themes were identified including epistemological divergence, fear of showing vulnerability and reflection volte‐face. Challenges in engaging in practices epistemologically different to predominant discourses in medicine were compounded by fears of vulnerability and a common antipathy towards reflection. All developed more accommodating perspectives towards reflection with shared experiences of a programme incorporating reflective practice.

Conclusion

The hidden curriculum can have positive and negative impacts on doctors' engagement in reflection. In facilitating reflective practice for this group, we recommend assisting with awareness of ways of thinking and being in medicine, offering reassurance that reflection may initially feel like running contrary to predominant discourses and finally, role modelling openness to vulnerability to better integrate and promote meaningful engagement in reflection.
A Whole-Core Transient Thermal Hydraulic Model for Fluoride Salt-Cooled Reactors
Authors: Chandrasekaran Sriram , Garimella Srinivas
Published: October 2023

A thermal hydraulic model is developed for a solid pin-fueled fluoride-salt-cooled small modular advanced high temperature reactor (SmAHTR). This preconceptual SmAHTR was developed by the Oak Ridge National Laboratory (ORNL). For the fuel assembly configuration investigated in this study, the fuel and non-fuel pins are arranged in a hexagonal layout. The molten FLiBe salt coolant flows parallel to the bank of pins. A finite volume model is developed and used to compute temperatures in the solid regions (fuel and non-fuel pins, and the graphite reflectors) in the core. The temperature, flow, and pressure profiles for the coolant flowing through the pin bundles in the core are calculated using the conventional subchannel methodology. Pertinent closure relations are used to compute the hydraulic losses, momentum, and energy exchange between adjacent subchannels, and heat transfer between the solid and fluid regions. The resulting model can perform both steady-state and transient computations across the entire core. This fully implicit model also includes an adaptive time-stepping algorithm for automatic time-step adjustment. A preliminary code-to-code comparison demonstrates good agreement between the present subchannel-based model and a computational fluid dynamics (CFD)-based model for a transient case in which the core inlet flowrate varies with time. Following the code-to-code comparison, the thermal hydraulic model is used to analyze the protected loss of heat sink (P-LOHS) accident scenario. Key results such as the transient evolution of peak fuel, non-fuel, and coolant temperatures, and 3-D core temperature distribution are presented and discussed.
A Differential Error-Based Self-Triggered Model Predictive Control With Adaptive Prediction Horizon for Discrete Systems
Authors: He Ning , Chen Shuoji , Xu Zhongxian , Cheng Fuan , Li Ruoxia , Gao Feng
Published: October 2023

For discrete time nonlinear networked control systems, a novel self-triggered adaptive model predictive control (MPC) strategy is developed. Different from the existing self-triggered MPC methods that determine the triggering instants based on the difference between the optimal and real states at one single instant, the proposed approach updates the MPC system according to the differential form of the state error of two consecutive sampling moments to effectively reduce the computation and communication burden while maintaining the ideal control performance. In addition, this paper introduces a new adaptive prediction horizon mechanism to the self-triggered MPC, so that the amplitude of prediction horizon contraction is sufficiently large to further reduce the computational burden of the MPC method. Finally, the recursive feasibility and robust stability of this proposed strategy are proved strictly by theoretical analysis, and the simulation comparison results are shown to verify the proposed framework.
The Research for Quickly Measuring the Diameter and Roundness of Solder Balls Based on Machine Vision Technology
Authors: Wang Tongju , Liu Yahao , Zhang Wenqian , Lei Yongping , Lin Jian , Fu Hanguang , Lin Zipeng
Published: October 2023

Solder balls used in electronic packaging should have high dimensional and shape accuracy requirements to ensure the connection quality of solder balls during soldering. However, the existing solder ball detection methods were hard to measure the diameter and roundness in an integrated and fast manner. Therefore, a new method and device for measuring the diameter and roundness of solder balls was proposed based on machine vision technology, including detection device and software design. The experimental device could detect the parameters of at least 40 solder balls at a time. The solder ball image was preprocessed in the software system to improve the quality of the solder ball image, and then the Harris operator successfully detected the concave point on the bonded solder ball image and realized the solder ball separation based on the shortest path matching criterion. Compared with the scanning electron microscope (SEM) measurement value, the diameter and roundness of solder balls measured by the detection system were smaller than 3%.
Aerodynamics and Flowfield of Distributed Electric Propulsion Tiltwing During Transition With Deflected Trailing-Edge Flap
Authors: Lee T. , Ni T. , Lin G.
Published: October 2023

The aerodynamics and flowfield of a rectangular semiwing equipped with four four-bladed propellers and a 40%-chord full-span plain trailing-edge flap were investigated by using force balance and particle image velocimetry (PIV). The distributed electric propulsion (DEP) wing was tilted from zero to 90-deg angle of attack. The maximum lift coefficient, lift-curve slope, and stall angle of the DEP wing were found to increase significantly with increasing propeller rotation. The DEP wing also exhibited a gradual stall in contrast to the sudden stall of the baseline wing. The lift coefficient of the DEP wing positioned vertically at 90 deg was also found to be greatly increased with increasing propeller rotation. Regardless of the magnitude of propeller rotation, the general pattern and behavior of the lift curve were consistent. The deployment of the flap led to a further increase in the maximum lift coefficient and lift-curve slope but an earlier stall and an increased drag of the DEP wing as compared to the unflapped wing. The flap deflection also led to a lowered lift coefficient in the poststall angle-of-attack regime as compared to the unflapped DEP wing. Gurney flap was also employed to further increase the lift generation of the DEP wing. The lift augmentation produced by the propeller slipstream was supplemented by the PIV flowfield measurements.
Mitigation of Wave Force on a Tunnel in the Presence of Submerged Porous Plate Over Trench-Type Bottom Topography
Authors: Choudhary Sunita , Martha S. C.
Published: October 2023

Thin porous plates serve as an effective model for the construction of breakwater. Thus, the problem involving oblique wave interaction with a tunnel in the presence of a submerged horizontal porous plate over a trench-type bottom is investigated. In this article, for the mathematical formulation of the physical model, water wave potentials are defined using Havelock’s expansions and flow past over porous structure is modeled based on Darcy’s law. The advantage of the trench type of bottom and horizontal plate is studied through the numerical results of forces on the tunnel. The study reveals that more energy loss and less force on the tunnel are obtained if the porous effect parameter of the plate or the length of the plate is increased up to a moderated value of these parameters. Compared to the case without porous plate and trench-type bottom topography, there are significant changes in forces due to this porous breakwater and trench-type bottom topography. In addition, from the present results, it may be noted that the load on the submerged tunnel is reduced by adding a submerged horizontal porous plate and asymmetric trench, which is helpful in understanding the role of porous breakwaters and trenches in applications to ocean and coastal engineering.
A Mixed Zero-Equation and One-Equation Turbulence Model in Fluid-Film Thrust Bearings
Authors: Deng Xin
Published: October 2023

A thrust bearing is a rotary bearing that facilitates rotational movement between components and is specifically engineered to provide support for a load that is parallel to the axis of rotation. The generation of the inter-surface film pressure is attributed to the relative motion (rotation) of the surfaces, which results in the lubricant being drawn into the converging wedge formed between them. The interface between the unmovable and moving parts is demarcated by a slender layer of lubricating fluid, including but not limited to oil, water, air, or other process fluid. The conventional zero-equation model can be enhanced to achieve higher precision in forecasting and reduce dependence on empirical data, owing to its inherent limitations. A novel turbulence model that combines zero-equation and one-equation approaches has been developed and implemented in the recently introduced modeling tool package for thrust bearings. In the Prandtl one-equation turbulence model, the length scale is a necessary but undetermined term. A novel mixed model has been implemented utilizing the Prandtl one-equation along with a novel-length scale. The tool package is a Thermo-Hydrodynamic (THD) code that involves iterative computations between the Reynolds’ equation, turbulence equation, energy equation within the film, and conduction equation in pad and runner. The new model yields an eddy viscosity that exhibits a substantial level of proximity to both eddy viscosity transport (EVT) and direct numerical simulation (DNS), and exhibits significant enhancements in comparison to the traditional Ng–Pan zero-equation turbulence model.
Mites (Acari) infesting stored animal feed products in northern Thailand
Authors: Ta-Phaisach Naphacharakorn , Konvipasruang Ploychompoo , Sringarm Korawan , Chiu Chun-I , Attasopa Korrawat , Chanbang Yaowaluk
Published: October 2023

Storage mites are serious pests of stored animal feeds and animals that consume mite-infested feed could reduce feed intake and eventually cause weight loss. To understand the mite species and infestation rates of them in animal feeds, we conducted a survey of mite infestations in samples of animal feeds from animal feed shops, feed mills, or chicken farms in eight provinces in northern Thailand. High mite infestation rates were observed in chicken feed (42.9%), followed by pig feed (26.7%). No mites were observed in fish and frog feeds. Mites were common in pelleted feeds (n = 96) or raw materials (n = 3), but was never observed in extruded feeds (n = 33). The mite species identified include three storage mites: Suidasia pontifica, Dermatophagoides farinae, and Aleuroglyphus chinensis, as well as the predatory mites Cheyletus malaccensis, Blattisocius keegani, and B. everti. Among them, A. chinensis and B. everti, are newly recorded in Thailand. Suidasia pontifica was dominant in chicken and pig feeds, and could be the major storage mite pest in northern Thailand. Figures and identification keys are provided.
Biodiversity of spider mites of Ankara, with a checklist of the Tetranychinae and first report of Schizotetranychus ibericus Reck for Turkey (Acari: Prostigmata)
Authors: Çobanoğlu Sultan , Erdoğan Tuğba , Ueckermann Edward A.
Published: October 2023

The samples were collected at weekly intervals between April and October from 2011 to 2014 on rosaceous plants and Quercus trees in Ankara, Turkey. Twelve spider mite species (Acari: Tetranychidae), Amphitetranychus viennensis (Zacher), Schizotetranychus ibericus Reck, Tetranychus urticae Koch, T. turkestani (Ugarov & Nikolskii), Eoteteranychus populi (Koch), E. pruni (Oudemans), E. coryli Reck, E. tiliarium (Hermann) Panonychus ulmi (Koch) (Tetranychinae), Bryobia rubrioculus (Scheuten), B. praetiosa Koch and B. sp. (Bryobiinae) were identified in Ankara. Schizotetranychus ibericus Reck, 1947 is a new record for Turkey. Tetranychus urticae and A. viennensis occurred in all the sampling localities, while S. ibericus was collected only on a Quercus sp. (Fagaceae). Tetranychus urticae Koch (Tetranychidae) was the most abundant and common species while some other species were represented by only two specimens such as Eotetranychus populi and E. tiliarum (Hermann). Apple harbored the highest number of spider mite species (9) while Prunus mahaleb and Quercus had only 2 and 1 species, respectively. The preferred hosts plants were Malus domestica (1007), Prunus domestica (749) and Prunus avium (479), while Prunus armeniaca (164), Prunus mahaleb (66) and Quercus sp. (17) were less preferred hosts. Collection data and geographical distribution of these species are provided. The checklist of the previous identified Tetranychinae species of Turkey is provided.
Effect of temperature on the life history and development of Typhlodromus athiasae Porath and Swirski (Acari: Phytoseiidae) as a predator of Tetranychus urticae Koch (Acari: Tetranychidae)
Authors: Kasap İsmail , Kök Şahin , Pehlivan Serkan
Published: October 2023

The present study determined the effects of different temperatures on the life history parameters and development of Typhlodromus athiasae Porath and Swirski (Acari: Phytoseiidae) for the first time. The study was conducted at 20, 25 and 30°C and the predators fed on Tetranychus urticae Koch (Acari: Tetranychidae) under laboratory conditions. Our results show that temperature significantly affected pre-adult and adult durations of T. athiasae. The adult longevity was calculated as 47.90, 22.88, 19.50 days for females, 26.11, 19.90, 20.46 days for males at 20, 25 and 30°C, respectively. The adult females of T. athiasae laid 15.80 (eggs/female), 17.20 (eggs/female) and 12.38 (eggs/female) eggs at the respective temperatures tested. The highest net reproductive rate (R0= 8.90 offspring/individual) determined at 25°C but no significant difference was found among the other temperatures. The highest intrinsic rate of increase (r= 0.12 day-1) was observed at 25°C and 30°C. Although the highest finite rate of increase (λ= 1.13 day-1) was determined at 25°C, no significant difference was observed between this temperature and 30°C. Also, the shortest mean generation time (T=14.97 day) was obtained at 30°C whereas the longest mean generation time (T=28.39 day) was observed at 20°C. Our results revealed that 25°C was more suitable for mass production even if the female and male of T. athiasae survived and reproduced at all temperatures. Consequently, our present results and the data to be obtained in greenhouse and field conditions will reveal the potential of T. athiasae as a biological control agent of T. urticae.
An efficient tool for collecting arboreal mites
Authors: Fan Qing-Hai
Published: October 2023

N/A
Intraspecific variation in Storchia pacifica (Summers) (Trombidiformes: Stigmaeidae), a widespread species intercepted by Australian biosecurity from seventeen countries
Authors: Seeman Owen D. , Beard Jennifer J. , Otto Jurgen
Published: October 2023

Storchia pacifica (Summers, 1964) is redescribed from specimens intercepted by staff of the Australian Department of Agriculture, Fisheries and Forestry from Cambodia, Fiji, India, Indonesia, Kiribati, Laos, Pakistan, Papua New Guinea, New Zealand, Nigeria, Samoa, Singapore, Solomon Islands, Tonga, Uganda, Vanuatu, and Vietnam. Most of the specimens were intercepted on products made from woven natural fibre such as mats and baskets. The specimens show variation in the form of their dorsal setae, which are slender and tapered to strongly clavate distally. Otherwise, dorsal and leg chaetotaxy is consistent, as is the characteristic pattern of body striation of this species.
High phase resolution: Probing interactions in complex interfaces with sum frequency generation
Authors: Shultz Mary Jane , Bisson Patrick , Wang Jing , Marmolejos Joam , Davies Rebecca G. , Gubbins Emma , Xiong Ziqing
Published: October 2023

An often-quoted statement attributed to Wolfgang Pauli is that God made the bulk, but the surface was invented by the devil. Although humorous, the statement really reflects frustration in developing a detailed picture of a surface. In the last several decades, that frustration has begun to abate with numerous techniques providing clues to interactions and reactions at surfaces. Often these techniques require considerable prior knowledge. Complex mixtures on irregular or soft surfaces—complex interfaces—thus represent the last frontier. Two optical techniques: sum frequency generation (SFG) and second harmonic generation (SHG) are beginning to lift the veil on complex interfaces. Of these techniques, SFG with one excitation in the infrared has the potential to provide exquisite molecular- and moiety-specific vibrational data. This Perspective is intended both to aid newcomers in gaining traction in this field and to demonstrate the impact of high-phase resolution. It starts with a basic description of light-induced surface polarization that is at the heart of SFG. The sum frequency is generated when the input fields are sufficiently intense that the interaction is nonlinear. This nonlinearity represents a challenge for disentangling data to reveal the molecular-level picture. Three, high-phase-resolution methods that reveal interactions at the surface are described.