bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring causality between collaborative and individual gaze metrics for collaborative problem‐solving with intelligent tutoring systems
Authors: Sharma Kshitij , Olsen Jennifer K. , Aleven Vincent , Rummel Nikol 
Published: June 2020

AbstractWhen students are working collaboratively and communicating verbally in a technology‐enhanced environment, the system cannot track what collaboration is happening outside of the technology, making it difficult to fully assess the collaboration of the students and adapt accordingly. In this article, we propose using gaze measures as a proxy for cognitive processes to achieve collaboration awareness. Specifically, we use Granger causality to analyse the causal relationships between collaborative and individual gaze measures from students working on a fractions intelligent tutoring system and the influence that the students' dialogue, prior knowledge, or success has on these relationships. We found that collaborative gaze patterns drive the individual focus in the pairs with high posttest scores and when they are engaged in problem‐solving dialogues but the opposite with low performing students. Our work adds to the literature by extending the correlational relationships between individual and collaborative gaze measures to causal relationships and suggests indicators that can be used within an adaptive system.
Suicide assessment and treatment in pediatric primary care settings
Authors: Sisler Shawna M. , Schapiro Naomi A. , Nakaishi Michelle , Steinbuchel Petra 
Published: June 2020

AbstractTopicThis article will briefly review screening for depression and suicidal ideation in primary care and school‐based clinics, with a focus on in‐depth screening for imminent suicide risk, developing a safety plan, and incorporating handoffs to urgent and emergency mental health care personnel. The article will cover current definitions of levels of suicidal risk and clinic‐based protocols for a team approach to adolescents in crisis.PurposeTo provide primary care and behavioral health nurses with evidence‐based suicide risk screening and assessment tools and best practices for using them in patient‐centered encounters with adolescents with suicidal thinking or behavior.Sources UsedJournal articles, books, and reports.ConclusionPast studies have shown that many individuals who died by suicide had seen a primary care provider in 30 days before their deaths. Nurses in primary care settings should develop clinic‐based protocols for screening all adolescents for suicide risk, developing safety plans, and providing suicidal youth and families with monitoring, appropriate referrals, follow‐up, and support.
The role of stretch, tachycardia and sodium‐calcium exchanger in induction of early cardiac remodelling
Authors: Djalinac Natasa , Ljubojevic‐Holzer Senka , Matzer Ingrid , Kolesnik Ewald , Jandl Katharina , Lohberger Birgit , Rainer Peter , Heinemann Akos , Sedej Simon , von Lewinski Dirk , Bisping Egbert 
Published: June 2020

AbstractStretch and tachycardia are common triggers for cardiac remodelling in various conditions, but a comparative characterization of their role in the excitation‐transcription coupling (ETC) and early regulation of gene expression and structural changes is lacking. Here, we show that stretch and tachycardia directly induced hypertrophy of neonatal rat cardiac myocytes and also of non‐myocytes. Both triggers induced similar patterns of hypertrophy but had largely distinct gene expression profiles. ACTA1 served as good hypertrophy marker upon stretch, while RCAN1 was found increased in response to tachycardia in a rate‐dependent fashion. Mechanistically, several calcium‐handling proteins, including the sodium‐calcium exchanger (NCX), contributed to ETC. Phosphorylation of the calcium/calmodulin‐dependent protein kinase II (CaMKII) was elevated and occurred downstream of NCX activation upon tachycardia, but not stretch. Microarray profiling revealed that stretch and tachycardia regulated around 33% and 20% genes in a NCX‐dependent manner, respectively. In conclusion, our data show that hypertrophy induction by stretch and tachycardia is associated with different gene expression profiles with a significant contribution of the NCX.
Practitioner review: Co‐design of digital mental health technologies with children and young people
Authors: Bevan Jones Rhys , Stallard Paul , Agha Sharifah Shameem , Rice Simon , Werner‐Seidler Aliza , Stasiak Karolina , Kahn Jason , Simpson Sharon A. , Alvarez‐Jimenez Mario , Rice Frances , Evans Rhiannon , Merry Sally 
Published: June 2020

BackgroundThere is increasing interest in digital technologies to help improve children and young people’s mental health, and the evidence for the effectiveness for these approaches is rising. However, there is concern regarding levels of user engagement, uptake and adherence. Key guidance regarding digital health interventions stress the importance of early user input in the development, evaluation and implementation of technologies to help ensure they are engaging, feasible, acceptable and potentially effective. Co‐design is a process of active involvement of stakeholders, requiring a change from the traditional approaches to intervention development. However, there is a lack of literature to inform the co‐design of digital technologies to help child and adolescent mental health.MethodsWe reviewed the literature and practice in the co‐design of digital mental health technologies with children and young people. We searched Medline, PsycInfo and Web of Science databases, guidelines, reviews and reference lists, contacted key authors for relevant studies, and extracted key themes on aspects of co‐design relevant to practice. We supplemented this with case studies and methods reported by researchers working in the field.ResultsWe identified 25 original articles and 30 digital mental health technologies that were designed/developed with children and young people. The themes identified were as follows: principles of co‐design (including potential stakeholders and stages of involvement), methods of involving and engaging the range of users, co‐designing the prototype and the challenges of co‐design.ConclusionsCo‐design involves all relevant stakeholders throughout the life and research cycle of the programme. This review helps to inform practitioners and researchers interested in the development of digital health technologies for children and young people. Future work in this field will need to consider the changing face of technology, methods of engaging with the diversity in the user group, and the evaluation of the co‐design process and its impact on the technology.
Post‐glacial establishment of locally adapted fish populations over a steep salinity gradient
Authors: Leder Erica H. , André Carl , Le Moan Alan , Töpel Mats , Blomberg Anders , Havenhand Jonathan N. , Lindström Kai , Volckaert Filip A. M. , Kvarnemo Charlotta , Johannesson Kerstin , Svensson Ola 
Published: June 2020

AbstractStudies of colonization of new habitats that appear from rapidly changing environments are interesting and highly relevant to our understanding of divergence and speciation. Here, we analyse phenotypic and genetic variation involved in the successful establishment of a marine fish (sand goby, Pomatoschistus minutus) over a steep salinity drop from 35 PSU in the North Sea (NE Atlantic) to two PSU in the inner parts of the post‐glacial Baltic Sea. We first show that populations are adapted to local salinity in a key reproductive trait, the proportion of motile sperm. Thereafter, we show that genome variation at 22,190 single nucleotide polymorphisms (SNPs) shows strong differentiation among populations along the gradient. Sequences containing outlier SNPs and transcriptome sequences, mapped to a draft genome, reveal associations with genes with relevant functions for adaptation in this environment but without overall evidence of functional enrichment. The many contigs involved suggest polygenic differentiation. We trace the origin of this differentiation using demographic modelling and find the most likely scenario is that at least part of the genetic differentiation is older than the Baltic Sea and is a result of isolation of two lineages prior to the current contact over the North Sea–Baltic Sea transition zone.
Unravelling the polyphony in clinical reasoning research in medical education
Authors: Koufidis Charilaos , Manninen Katri , Nieminen Juha , Wohlin Martin , Silén Charlotte 
Published: June 2020

AbstractRationaleClinical reasoning lies at the heart of medical practice and has a long research tradition. Nevertheless, research is scattered across diverse academic disciplines with different research traditions in a wide range of scientific journals. This polyphony is a source of conceptual confusion.Aims and objectivesWe sought to explore the underlying theoretical assumptions of clinical reasoning aiming to promote a comprehensive conceptual and theoretical understanding of the subject area. In particular, we asked how clinical reasoning is defined and researched and what conceptualizations are relevant to such uses.MethodsA scoping review of the clinical reasoning literature was undertaken. Using a “snowball” search strategy, the wider scientific literature on clinical reasoning was reviewed in order to clarify the different underlying conceptual assumptions underlying research in clinical reasoning, particularly to the field of medical education. This literature included both medical education, as well as reasoning research in other academic disciplines outside medical education, that is relevant to clinical reasoning. A total of 124 publications were included in the review.ResultsA detailed account of the research traditions in clinical reasoning research is presented. In reviewing this research, we identified three main conceptualisations of clinical reasoning: “reasoning as cognitive activity,” “reasoning as contextually situated activity,” and “reasoning as socially mediated activity.” These conceptualisations reflected different theoretical understandings of clinical reasoning. Each conceptualisation was defined by its own set of epistemological assumptions, which we have identified and described.ConclusionsOur work seeks to bring into awareness implicit assumptions of the ongoing clinical reasoning research and to hopefully open much needed channels of communication between the different research communities involved in clinical reasoning research in the field.
Clinical effects of dehydration on tooth color: How much and how long?
Authors: Hatırlı Hüseyin , Karaarslan Emine Şirin , Yaşa Bilal , Kılıç Enes , Yaylacı Ayla 
Published: June 2020

AbstractObjectiveTo evaluate effects of dehydration on tooth color determine whether color returns to baseline after 30 min or 24 h.Materials and methodsThirty participants with intact maxillary central and lateral incisors were recruited for the study. Color measurements were performed with a spectrophotometer (SpectroShade Micro) at baseline and at 10, 20, and 30 min of dehydration, as well as 30 min and 24 h of rehydration. CIEDE2000 color parameters were used to calculate color difference. The data were analyzed for color changes over time by repeated‐measures analysis of variance (ANOVA), and the Bonferroni‐Tukey test was used for post‐ANOVA comparisons (P < .05).ResultsAfter 30 min of dehydration, all the tested teeth were above the perceptibility threshold (ΔE00 = 0.8), and 85% of the teeth were above the acceptability threshold (ΔE00 = 1.8). After 30 min of rehydration, 78.3% of the tested teeth were above the perceptibility threshold, and 31.6% of the teeth were above the acceptability threshold. After 24 h of rehydration, 99.2% of the teeth were below the acceptability threshold, and 90% of the values were below the perceptibility threshold.ConclusionsThirty‐minute tooth dehydration can result in a clinically significant color change. After a 24‐h rehydration period, reliable color assessment can be performed.Clinical significanceTooth dehydration causes significant color change, thus assessment of final color or clinical success should be considered after tooth rehydration for esthetic restorations and tooth bleaching.
Clinical course of duodenal mucosa‐associated lymphoid tissue lymphoma: Comparison with gastric mucosa‐associated lymphoid tissue lymphoma
Authors: Na Hee Kyong , Won Sung Hyun , Ahn Ji Yong , Kim Ga Hee , Jung Kee Wook , Lee Jeong Hoon , Kim Do Hoon , Choi Kee Don , Song Ho June , Lee Gin Hyug , Jung Hwoon‐Yong , Kim Hwa Jung 
Published: June 2020

AbstractBackground and AimThere are few cases of duodenal mucosa‐associated lymphoid tissue (MALT) lymphoma reported in the literature, and little is known about the clinical course of this disease. Here, we aimed to characterize the clinical features of duodenal MALT lymphoma by comparison with gastric MALT lymphoma.MethodsThirteen patients diagnosed with duodenal MALT lymphoma at Asan Medical Center from March 1997 to February 2017 were included in this retrospective study, along with patients with gastric MALT lymphoma, matched by age and sex at a 1:10 ratio.ResultsMedian age of patients with duodenal MALT lymphoma was 49 (range 20–72) years, and 53.8% (7/13) were male. Comparison of patient characteristics indicated that Helicobacter pylori infection (46.2% vs 90.8%, P < 0.001) and lymph node metastasis (23.1% vs 5.4%, P = 0.049) rates differed between patients with duodenal and gastric MALT lymphoma. Overall complete remission (61.5% vs 86.2%, P = 0.021) and complete remission after initial H. pylori eradication therapy (50% vs 87.7%, P = 0.037) were significantly lower in patients with duodenal than gastric MALT lymphoma. Complications including bleeding, stricture, and transformation to high‐grade lymphoma occurred in a total of seven patients (4.9%), with a higher incidence in patients with duodenal than gastric MALT lymphoma (38.5% vs 1.5%, P < 0.001).ConclusionsDuodenal MALT lymphoma is very rare, and treatment outcomes appear to be inferior to those of gastric MALT lymphoma.
Safer Prescribing for Hospitalized Older Adults with an Electronic Health Records‐Based Prescribing Context
Authors: Drago Kathleen , Sharpe Jackie , De Lima Bryanna , Alhomod Abdulaziz , Eckstrom Elizabeth 
Published: June 2020

BACKGROUND/OBJECTIVESHospitalized older adults are at risk of receiving potentially inappropriate medication (PIM) doses, driven in part by age‐independent dose defaults used by electronic health records (EHRs), leading providers to prescribe for older adults as they do for younger adults. We studied whether an automated EHR‐based medication support tool would reduce PIM dosing for hospitalized older adults.DESIGNPre‐post study design.SETTINGTertiary care, level 1 trauma, academic medical center in Oregon.PARTICIPANTSHospitalized adults 75 years and older in the inpatient, nonemergency setting prescribed medications with geriatric‐specific dose considerations.INTERVENTIONAn EHR‐based, automated set of evidence‐based, age‐specific dose and frequency defaults called the Geriatric Prescribing Context (GPC).MEASUREMENTSThe process measure is percentage of orders consistent with geriatric dose recommendations, and outcome measures are average dose (AD) in milligrams and total daily dose (TDD) in milligrams in the 12 months before and after implementation.RESULTSUse of recommended geriatric doses with the context improved for all 10 of the most commonly ordered medications. In the year after implementation, there was a trend toward decreasing TDD and AD across all drug classes.CONCLUSIONThe GPC is a simple, elegant, and effective means to align prescribing practices with safety standards for older adults, improving prescribing safety for all. It works within the current prescriber workflow without triggering alert fatigue and requires minimal resources for development and maintenance.
The Effects of Dementia Care Co‐Management on Acute Care, Hospice, and Long‐Term Care Utilization
Authors: Jennings Lee A. , Hollands Simon , Keeler Emmett , Wenger Neil S. , Reuben David B. 
Published: June 2020

BACKGROUND/OBJECTIVESAlthough nurse practitioner dementia care co‐management has been shown to reduce total cost of care for fee‐for‐service (FFS) Medicare beneficiaries, the reasons for cost savings are unknown. To further understand the impact of dementia co‐management on costs, we examined acute care utilization, long‐term care admissions, and hospice use of program enrollees as compared with persons with dementia not in the program using FFS and managed Medicare claims data.DESIGNQuasi‐experimental controlled before‐and‐after comparison.SETTINGUrban academic medical center.PARTICIPANTSA total of 856 University of California, Los Angeles (UCLA) Alzheimer's and Dementia Care program patients were enrolled between July 1, 2012, and December 31, 2015, and 3,139 similar UCLA patients with dementia not in the program. Comparison patients were identified as having dementia using International Classification of Diseases‐9 codes and natural language processing of clinical notes. Coarsened exact matching was used to reduce covariate imbalance between intervention and comparison patients.INTERVENTIONDementia co‐management model using nurse practitioners partnered with primary care providers and community organizations.MEASUREMENTSAverage difference‐in‐differences per quarter over the 2.5‐year intervention period for all‐cause hospitalization, emergency department (ED) visits, intensive care unit (ICU) stays, and number of inpatient hospitalization days; admissions to long‐term care facilities; and hospice use in the last 6 months of life.RESULTSIntervention patients had fewer ED visits (odds ratio [OR] = .80; 95% confidence interval [CI] = .66–.97) and shorter hospital length of stay (incident rate ratio = .74; 95% CI = .55–.99). There were no significant differences between groups for hospitalizations or ICU stays. Program participants were less likely to be admitted to a long‐term care facility (hazard ratio = .65; 95% CI = .47–.89) and more likely to receive hospice services in the last 6 months of life (adjusted OR = 1.64; 95% CI = 1.13–2.37).CONCLUSIONComprehensive nurse practitioner dementia care co‐management reduced ED visits, shortened hospital length of stay, increased hospice use, and delayed admission to long‐term care.
Feasibility and reliability of the Assessing Levels of Physical Activity health‐related fitness test battery in adults with intellectual disabilities
Authors: Cabeza‐Ruiz R. , Sánchez‐López A. M. , Trigo M. E. , Gómez‐Píriz P. T. 
Published: June 2020

AbstractBackgroundPeople with intellectual disabilities (IDs) seem to have a lower physical fitness (PF) than their peers without disabilities, which coincides with reduced autonomy, life expectancy and quality of life. To assess PF in these individuals, it is necessary to use appropriate tools that permit the assessment of their physical capacities taking into account their specific characteristics. The aim of this work is to study the feasibility and reliability of the Assessing Levels of Physical Activity (ALPHA)‐Fit test battery for adults in a group of men and women with mild to moderate ID.MethodsForty‐one adults with ID of both sexes, ranging in age from 20 to 60 years old, participated in the study. To identify the feasibility and reliability of the ALPHA‐Fit test battery for adults, two complete assessments were done for each one of the tests included in the battery. The assessments were performed for a period of no more than 2 weeks (test–retest). An intraclass correlation coefficient was used to determinate test–retest reliability, and a mixed analysis of variance factorial was used for each of the dependent variables. Bland–Altman plots were also used to assess consistency between the two measurements. Feasibility was calculated as the percentage of people who were able to perform the tests correctly (not feasible <50%, fairly feasible 50%–75% and feasible >75%). In order to determine other psychometric properties, minimal detectable change and standard error of measurement (SEM) were also calculated.ResultsOf the 10 tests in the ALPHA‐Fit test battery, eight were shown to be feasible. High reliability was obtained (>0.90) for the variables related to body composition. In the hand‐grip test, reliability was high in the men's group but low in the women's group. Good reliability results were also found (0.80–0.89) in the dynamic sit‐up test for women, but not for men. Fair reliability (0.70–0.79) was found in jump‐and‐reach and neck‐shoulder mobility tests. The variables in the 2‐km walk and agility tests indicated poor reliability. All tests showed SEM values related to high variability. However, Bland–Altman plots showed results related to lack of consistency.ConclusionsThe feasibility and reliability calculations, as well as the SEM values, confirm that not all the tests of the ALPHA‐Fit Test Battery for Adults are suitable for the assessment of PF in adults with ID, probably because of the complexity of the motor fitness tests. The authors emphasise the necessity of making adaptations to the protocols used or of using other tests more appropriate to the characteristics of people with mild to moderate ID.
H63D variant of the homeostatic iron regulator (HFE) gene alters α‐synuclein expression, aggregation, and toxicity
Authors: Kim Yunsung , Stahl Mark C. , Huang Xuemei , Connor James R. 
Published: June 2020

AbstractPathological features of Parkinson's disease include the formation of Lewy bodies containing α‐synuclein and the accumulation of iron in the substantia nigra. Previous studies have suggested that iron accumulation contributes to the Parkinson's disease pathology through reactive oxygen species production and accelerated α‐synuclein aggregation. This study examines the effects of commonly occurring H63D variant of the homeostatic iron regulatory (HFE) gene on α‐synuclein pathology in cell culture and animal models. H63D HFE expression in SH‐SY5Y cells lowered endogenous α‐synuclein levels and significantly decreased pre‐formed fibril‐induced α‐synuclein aggregation. H63D HFE cells were also protected from pre‐formed fibril‐induced apoptosis. Autophagic flux, a major pathway for α‐synuclein clearance, was increased in H63D HFE cells. Expression of REDD1 was elevated and rapamycin treatment was unable to further induce autophagy, indicating mTORC1 inhibition as the main mechanism of autophagy induction. Moreover, siRNA knockdown of REDD1 in H63D HFE cells decreased autophagic flux and increased the sensitivity to PFF‐mediated toxicity. While iron chelator (deferiprone) treatment rescued WT HFE cells from pre‐formed fibril toxicity, it exacerbated or was unable to rescue H63D HFE cells. In the in vivo pre‐formed fibril intracranial injection model, H67D Hfe (mouse homolog of the human H63D HFE variant) C57BL/6J × 129 mice showed less α‐synuclein aggregation and less decline in motor function compared to WT Hfe. Collectively, this study suggests that H63D HFE variant modifies α‐synuclein pathology through the induction of autophagy and has the potential to impact the pathogenesis and treatment response in Parkinson's disease.
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Ultraviolet and COVID‐19 pandemic
Authors: Türsen Ümit , Türsen Belma , Lotti Torello 
Published: June 2020

AbstractBackgroundCOVID‐19 virus causes coronavirus disease.AimsIt is a highly contagious viral infection.Patients/Methods/Results/ConclusionIn this article, we will discuss the potential phototherapy problems and also alternative options for dermatologists, ultraviolet treatment against COVID‐19 virus, and vitamin D–associated problems in these coronavirus days.