bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early identification of patients with acute gastrointestinal bleeding using natural language processing and decision rules
Authors: Shung Dennis , Tsay Cynthia , Laine Loren , Chang David , Li Fan , Thomas Prem , Partridge Caitlin , Simonov Michael , Hsiao Allen , Tay J Kenneth , Taylor Andrew 
Published: October 2020

AbstractBackground and AimGuidelines recommend risk stratification scores in patients presenting with gastrointestinal bleeding (GIB), but such scores are uncommonly employed in practice. Automation and deployment of risk stratification scores in real time within electronic health records (EHRs) would overcome a major impediment. This requires an automated mechanism to accurately identify (“phenotype”) patients with GIB at the time of presentation. The goal is to identify patients with acute GIB by developing and evaluating EHR‐based phenotyping algorithms for emergency department (ED) patients.MethodsWe specified criteria using structured data elements to create rules for identifying patients and also developed multiple natural language processing (NLP)‐based approaches for automated phenotyping of patients, tested them with tenfold cross‐validation for 10 iterations (n = 7144) and external validation (n = 2988) and compared them with a standard method to identify patient conditions, the Systematized Nomenclature of Medicine. The gold standard for GIB diagnosis was the independent dual manual review of medical records. The primary outcome was the positive predictive value.ResultsA decision rule using GIB‐specific terms from ED triage and ED review‐of‐systems assessment performed better than the Systematized Nomenclature of Medicine on internal validation and external validation (positive predictive value = 85% confidence interval:83%–87% vs 69% confidence interval:66%–72%; P < 0.001). The syntax‐based NLP algorithm and Bidirectional Encoder Representation from Transformers neural network‐based NLP algorithm had similar performance to the structured‐data fields decision rule.ConclusionsAn automated decision rule employing GIB‐specific triage and review‐of‐systems terms can be used to trigger EHR‐based deployment of risk stratification models to guide clinical decision making in real time for patients with acute GIB presenting to the ED.
Tracking oral health in a standardized, evidence‐based, prevention‐focused dental care system
Authors: White Joel M. , Brandon Ryan G. , Mullins Joanna M. , Simmons Kristen L. , Kottek Aubri M. , Mertz Elizabeth A. 
Published: October 2020

AbstractObjectivesLearning health‐care systems are foundational for measuring and achieving value in oral health care. This article describes the components of a preventive dental care program and the quality of care in a large dental accountable care organization.MethodsA retrospective study design describes and evaluates the cross‐sectional measures of process of care (PoC), appropriateness of care (AoC), and outcomes of care (OoC) extracted from the electronic health record (EHR), between 2014 and 2019. Annual and composite measures are derived from EHR‐based clinical decision support for risk determination, diagnostic and treatment terminology, and decayed‐missing‐filled‐teeth (DMFT) measures.ResultsAnnually, 253,515 ± 27,850 patients were cared for with 618,084 ± 80,559 visits, 209,366 ± 22,300 exams, and 2,072,844 ± 300,363 clinical procedures. PoC metrics included provider adherence (98.3 percent) in completing caries risk assessments and patient receipt (96.9 percent) of a proactive dental care plan. AoC metrics included patients receiving prevention according to the risk‐based protocol. The percent of patients at risk for caries receiving fluoride varnish was 95.4 ± 0.4 percent. OoC metrics included untreated decay and new decay. The 6‐year average prevalence of untreated decay was 11.3 ± 0.3 percent, and average incidence of new decay was 13.6 ± 0.5 percent, increasing with risk level: low = 7.5 percent, medium = 18.8 percent, high = 29.4 percent, and extreme = 28.1 percent.ConclusionsThe preventive dental care system demonstrates excellent provider adherence to the evidence‐based prevention protocol, with measurably better dental outcomes by patient risk compared to national estimates. These achievements are enabled by a value‐centric, accountable model of care and incentivized by a compensation model aligned with performance measures.
Keratose‐dominated sponge grounds from temperate mesophotic ecosystems (NW Mediterranean Sea)
Authors: Enrichetti Francesco , Bavestrello Giorgio , Betti Federico , Coppari Martina , Toma Margherita , Pronzato Roberto , Canese Simonepietro , Bertolino Marco , Costa Gabriele , Pansini Maurizio , Bo Marzia 
Published: October 2020

AbstractDifferently from the North Atlantic Ocean, only few examples of sponge grounds are known from the Mediterranean Sea, mainly thriving in the deep sea. In this study, a novel temperate mesophotic ecosystem dominated by massive keratose sponges is reported from the Ligurian deep continental shelf. An extensive Remotely Operated Vehicle (ROV) survey allowed to study the structure and large‐scale distribution of this biocoenosis. The sponge grounds here described are highly fragmented, being formed by a large number of dense, discrete aggregations of Sarcotragus foetidus (up to 7.7 specimens/m2) and other sponges, including Spongia lamella and Axinella polypoides. They mainly occur on flat, patchy and highly silted hardgrounds between 40 and 70 m depth. These sponge‐dominated ecosystems have an exceptionally wide spatial distribution, estimated to cover up to nearly 200 hectares, with the largest sponge grounds occurring along the westernmost part of the Ligurian coast, probably in relation to more suitable oceanographic conditions. The dominant sponge species reach considerable heights (up to 65 cm), greatly increasing the habitat three‐dimensionality and acting as poles of attraction for a diverse sessile and vagile fauna. In addition, the high abundance of the keratose sponge grounds at mesophotic depths might represent a larval source for shallow‐water populations that in the last decades have been stricken by several mass mortality events.
Neuropathological features of cognitive decline in Lewy body dementia
Authors: Sengoku Renpei 
Published: October 2020

AbstractParkinson's disease (PD) is associated with mild cognitive impairment and dementia. The causes of cognitive impairment in PD are diverse, and some remain unclear. Cognitive impairment in PD is thought to be caused by abnormal protein accumulation, neurotransmitter circuit dysfunction, synaptic dysfunction, neuroinflammation, mitochondrial dysfunction, and/or changes in microglia and astroglia. PD with dementia (PDD) and dementia with Lewy bodies (DLB) are defined as dementia syndromes that have many overlapping clinical features and underlying genetics. As such, it is difficult to distinguish between PDD and DLB neuropathologically. In this paper, we will use the term “Lewy body dementia” to refer to the dementia syndromes of both diseases. Furthermore, we will describe the cognitive impairment that accompanies PDD and DLB from a neuropathological perspective according to recent research.
Flourishing at work: Nurses' motivation through daily communication – An ethnographic approach
Authors: Ahlstedt Carina , Eriksson Lindvall Carin , Holmström Inger K. , Muntlin Åsa 
Published: October 2020

AbstractShortage and turnover of registered nurses are worldwide challenges, and work motivation is one factor in retaining staff in the healthcare sector. The aim of this study was to explore registered nurses' motivation expressed in daily communication, using the basic needs in self‐determination theory as a framework. A secondary analysis of ethnographic data, collected through participant observations, informal interviews during observations, and individual interviews, was used. A total sample of all registered nurses employed at a hospital unit in Sweden (n = 10) participated. The data were analyzed thematically through the lens of the basic needs in self‐determination theory: autonomy, competence, and relatedness. Self‐regulation of learning, the possibilities to discuss work‐related challenges with colleagues, and having registered nurses lead dialogues with physicians were factors connected to autonomy. Having a registered nurse and physician solve problems together was a factor connected to competence. A sense of belonging and security in a permissive climate between registered nurses was connected to relatedness. This paper has implications for increased awareness of the three basic motivational needs, which could be used in the development of attractive workplaces.
Agrobacterium T‐DNA integration in somatic cells does not require the activity of DNA polymerase θ
Authors: Nishizawa‐Yokoi Ayako , Saika Hiroaki , Hara Naho , Lee Lan‐Ying , Toki Seiichi , Gelvin Stanton B. 
Published: October 2020

Summary

Integration of Agrobacterium tumefaciens transferred DNA (T‐DNA) into the plant genome is the last step required for stable plant genetic transformation. The mechanism of T‐DNA integration remains controversial, although scientists have proposed the participation of various nonhomologous end‐joining (NHEJ) pathways. Recent evidence suggests that in Arabidopsis, DNA polymerase θ (PolQ) may be a crucial enzyme involved in T‐DNA integration.

We conducted quantitative transformation assays of wild‐type and polQ mutant Arabidopsis and rice, analyzed T‐DNA/plant DNA junction sequences, and (for Arabidopsis) measured the amount of integrated T‐DNA in mutant and wild‐type tissue.

Unexpectedly, we were able to generate stable transformants of all tested lines, although the transformation frequency of polQ mutants was c. 20% that of wild‐type plants. T‐DNA/plant DNA junctions from these transformed rice and Arabidopsis polQ mutants closely resembled those from wild‐type plants, indicating that loss of PolQ activity does not alter the characteristics of T‐DNA integration events. polQ mutant plants show growth and developmental defects, perhaps explaining previous unsuccessful attempts at their stable transformation.

We suggest that either multiple redundant pathways function in T‐DNA integration, and/or that integration requires some yet unknown pathway.
Sleep‐disordered breathing in pediatric heart transplant recipients
Authors: Powell Weston T. , Chen Maida , Kraft Danielle , Albers Erin 
Published: October 2020

AbstractBackgroundSleep‐disordered breathing is commonly found in adults with heart failure both before and after HTx. Untreated sleep‐disordered breathing post‐transplant has been linked to late graft dysfunction, reduced quality of life, and increased morbidity. Sleep‐disordered breathing has not been investigated in pediatric HTx recipients.MethodsWe conducted retrospective review of patients <21yo who underwent primary HTx at our center from 2009 to 2019 to describe clinical characteristics, cardiac history, and PSG results.ResultsOne hundred and fifty patients were included; 60% had congenital heart disease, and 40% had cardiomyopathy. Fifty patients had PSG performed at median age of 6.1 years. Forty‐one were referred for symptoms of sleep‐disordered breathing. Obstructive sleep apnea was diagnosed in 45 patients and central sleep apnea in 3 patients. Of those with first PSG post‐transplant (n = 36), median AHI was 9.1/h, and 19 (53%) were diagnosed with moderate or severe sleep apnea. Patients diagnosed with obstructive sleep apnea on PSG had more post‐transplant ventilator days (median 3 vs 2 days, P < .05) and longer post‐transplant lengths of stay (median 28 vs 22 days, P < .05).ConclusionsIn this single‐center cohort of pediatric HTx recipients, sleep‐disordered breathing was common and associated with longer peri‐transplant respiratory support and length of stay. Given the high incidence of moderate and severe OSA detected in this population, clinicians should regularly screen for SDB and consider PSG testing more frequently in children who have undergone HTx. Further study into the long‐term impact of sleep‐disordered breathing in pediatric HTx recipients is needed.
Co‐culture model reveals the characteristics of theca cells and the effect of granulosa cells on theca cells at different stages of follicular development
Authors: Gan Xiang , Wang Yushi , Gao Shanyan , Chen Xi , Hu Shenqiang , Wang Jiwen , Hu Jiwei , Li Liang , Han Chunchun 
Published: October 2020

AbstractTheca cells (TCs) play an important role in follicular development, which cannot be separated from granulosa cells (GCs). However, compared with mammals, the TCs and the effects of GCs on TCs at different follicular development stages (FDSs) have specific characteristics in avian species, but none of them have been clearly defined. In this study, we established an in vitro co‐culture (with GC at the corresponding stage) model of goose TCs at different FDSs (pre‐hierarchical, hierarchical and F1) by using a transwell system. The properties of TCs in co‐culture at the three FDSs, including cell morphology, activity and intracellular lipid content, as well as the expression of key genes involved in de novo lipogenesis, steroidogenesis, proliferation and apoptosis, were examined and defined. We further compared the mono‐culture and co‐culture groups. After co‐culture, the activity of TCs showed significant (p < .01) increases in all stages; moreover, in pre‐hierarchical TCs, the expression levels of FAS, SREBP, 3β‐HSD and CCND1 were promoted, and PPARγ, CYP19, BCL2 and CAS3 were inhibited (p < .05); in the hierarchical TCs, the expression levels of PPARγ, FAS, CYP19, CCND1 and BCL2 were promoted, and SREBP, STAR, 3β‐HSD and CAS3 were inhibited (p < .05), whereas in the F1 TCs, the expression levels of PPARγ, FAS, 3β‐HSD, CYP19 and CCND1 were promoted, and STAR and CAS3 were inhibited (p < .05). These results suggested that GCs at the three FDSs have dynamic and complex influences on the physiological characteristics of TCs, and the influences on TCs at the three FDSs were varied.
Religion in African literature: Representation, critique and imagination
Authors: van Klinken Adriaan 
Published: October 2020

AbstractThe study of religion and literature has emerged as a field of considerable academic interest. Although some work has been done on religion and African literature, research in this area tends to be fragmented and dispersed over various fields and disciplines. Reviewing available scholarship in this area, this article explores what engaging with African literary writing brings to the table of the study of religion in Africa. Focussing on postcolonial and contemporary African literature, it identifies a three‐fold contribution: first, the creative representation of religious traditions and dynamics; second, the critique of religious beliefs and institutions, and third, the imagination of alternative religious possibilities. It illustrates these contributions by specifically focussing on issues of (neo)colonialism, gender and sexuality. Hence the article foregrounds the importance of engaging with religion for interpreting African literary texts, and the significance of literary writing for understanding religion as part of African social and cultural life.
Political origins of financial structure in developing countries
Authors: Ghardallou Wafa 
Published: October 2020

AbstractThe structure of the financial system refers to the way funding is shared between banks and financial markets. This paper investigates the determinants of the financial structure variability across emerging economies. It particularly seeks to study the effects of democratic versus autocratic political regimes on the financial system structure. The results provide evidence that democracy is associated with higher market‐based financial systems. In this line, democracy tends to promote financial systems where stock markets are more active and efficient than banks. Therefore, policymakers are recommended to strengthen democratic institutions through reinforcing political rights and civil liberties, as part of a strategy of stock markets development.
An Ethos of Affirmative Laughter in Nietzsche’sZarathustra
Authors: Hurst Andrea 
Published: October 2020

AbstractInThus Spoke Zarathustra(2006), Nietzsche presents Zarathustra as a sage and parodic prophet, who acquires and offers insight over the narrated journey of his spiritual development. Nietzsche’s conception ofZarathustraas a gift (to “all and none”) endorses learning as the kind of emulation condensed into Zarathustra’s complex formulation: rather than “corpses that I carry with me wherever I want . . . I need living companions who follow me because they want to follow themselves—wherever I want.” Thus I aim, firstly, to follow the text closely to see what is given. However, noting thatZarathustrais deeply imbued with figures of laughter, I also impose an interpretation. “Repeating differently,” as demanded by Zarathustra, I outline a practicable, spiral‐shaped “learning curve” of traversal and return to various “shades of laughter,” advancing from the worst laughters to “goldenlaughter,” which embraces complexity. This represents what it means to laugh well. In so doing, I hope to demonstrate that the complex ethos of affirmative laughter inZarathustraremains strikingly pertinent for a contemporary era urgently tasked with embracing complexity.
Fearlessness about death predicts adolescent suicide attempt: A preliminary analysis
Authors: Ferm Mikael S. , Frazee Laura A. , Kennard Betsy D. , King Jessica D. , Emslie Graham J. , Stewart Sunita M. 
Published: October 2020

AbstractObjectiveSeveral theories of suicide suggest that people will only attempt suicide if they have both the desire to die and the capability for suicide. Fearlessness about death is a key component of capability for suicide. There is little information in the literature about the prospective relationship between fearlessness about death and suicide attempt in adolescents.MethodWe obtained baseline fearlessness about death from adolescents (N = 122; ages 12–18; 80% girls; 82% Caucasian) who received intensive outpatient treatment for active suicidal ideation and/or a recent attempt. We tested if fearlessness about death at treatment entry predicted an attempt (n = 14) between entry and six‐month follow‐up after discharge from the program.ResultsFearlessness about death significantly predicted the presence of an attempt between treatment entry and six‐month follow‐up after controlling for common covariates (Quade F = 2.15, p < .02).ConclusionsIn a preliminary analysis of a group of suicidal adolescents, fearlessness about death was a significant independent predictor of attempt between treatment entry and six months post‐discharge, even when controlling for other commonly cited risk factors.
An appraisal of Turkey's voluntary individual pension system from a perspective of pension equality
Authors: Babat Sertac , Gultekin‐Karakas Derya , Hisarciklilar Mehtap 
Published: October 2020

AbstractSince 2003, Turkey's pension policy has been increasingly based on facilitation of individual savings administered by private pension funds. The introduction of private pensions is expected to reinforce inequalities as a result of socio‐demographic features and pension system design. This article evaluates voluntary individual pension system with a perspective on pension equality. Monthly contributions to pension accounts are explored on the basis of socio‐economic and demographic characteristics of the customers of a currently operating pension company. Findings reveal that differences in people's saving capacities have become a source for pension inequality. Furthermore, state subsidies, which increase in proportion to individual contributions, strengthen unequal distributional dynamics. Pension privatization harms social solidarity as it intensifies existing social inequalities.
Impacts of professional development focused on teaching engineering applications of mathematics and science
Authors: Hammack Rebekah , Gannon Paul , Foreman Christine , Meyer Elijah 
Published: October 2020

AbstractWith the recent national emphasis on preparing children for future careers in science, technology, engineering, and mathematics, K‐12 teachers are being called upon to include engineering in their instruction. This study explores the impacts of a summer professional development (PD) program focused on the engineering applications of mathematics and science on in‐service K‐12 teachers' (a) personal engineering efficacy, (b) engineering teaching efficacy, and (c) perceived barriers to teaching engineering. This quantitative study revealed that a single engineering‐focused PD could increase teachers' personal engineering efficacy and engineering teaching efficacy and reduce particular perceived barriers to teaching engineering. No differences existed in pre‐ to post workshop assessment scores based on grade level taught, gender, or years of teaching experiences. However, pre‐ to post workshop assessment differences existed between participants depending on the discipline they taught and wether or not they had previously used engineering activities in their classrooms. These findings suggest that a single engineering PD can have significant impacts on in‐service teachers' personal engineering efficacy, engineering teaching efficacy, and perceived barriers to teaching engineering, but a one‐size‐fits‐all approach to such PD is not equally effective for all participants.
Providing ability to probability: Reducing cognitive load through worked‐out examples
Authors: Hadfield KimberLeigh Felix 
Published: October 2020

AbstractUndergraduate students tend to struggle with probability in their introductory statistics course. Probability problem solving requires several steps. First, students must make sense of the probability scenario, then determine the appropriate probability rules, and finally, execute the procedures to solve the problem. With no previous exposure to probability, this presents too great a cognitive load for many students. Using worked‐out problems then transitioning to partially worked‐out problems in an introductory statistics course at a large university helped students succeed at solving probability problems. The worked‐out problems included writing prompts to encourage self‐explanation of students' thinking through studying the worked‐out examples. This paper explains the use of these instructional principles and their implementation in an introductory statistics course for non‐STEM majors, resulting in higher student achievement and understanding.