bluuebunny/crossref_metadata_2025_split huggingface dataset:
Debate as L2 Pedagogy: The Effects of Debating on Writing Development in Secondary Education
Authors: MAJIDI ABID EL , GRAAFF RICK DE , JANSSEN DANIEL 
Published: November 2020

AbstractResearch has painted a pessimistic picture of students’ second language (L2) writing skills in secondary education. One innovative tool that may help students foster their L2 proficiency, including writing ability, is in‐class debate. Debate is commonly associated with oral communication and argumentation skills. However, debate may also offer advantages as an effective vehicle for L2 writing instruction. This study evaluates the effect of a debate intervention on the writing competence of Dutch secondary‐school students. The intervention consisted of a number of speaking and writing activities, including case writing and note taking. The study, which employed a pretest–posttest design with a control group, involved 8 classes at 3 secondary schools in the Netherlands (N = 146). To measure the effect of the intervention, we analyzed 2 opinion writing tasks produced by the students: just prior to the first debate (pretest) and approximately 10 weeks later (posttest). We used a variety of measures, tapping into different aspects of writing performance, including fluency, syntactic and lexical complexity, accuracy, and cohesion. Multilevel analysis of the data revealed that the students in the intervention group significantly improved on a number of measures in comparison to the control group.
The seed germination spectrum of alpine plants: a global meta‐analysis
Authors: Fernández‐Pascual Eduardo , Carta Angelino , Mondoni Andrea , Cavieres Lohengrin A. , Rosbakh Sergey , Venn Susanna , Satyanti Annisa , Guja Lydia , Briceño Verónica F. , Vandelook Filip , Mattana Efisio , Saatkamp Arne , Bu Haiyan , Sommerville Karen , Poschlod Peter , Liu Kun , Nicotra Adrienne , Jiménez‐Alfaro Borja 
Published: November 2020

Summary

Assumptions about the germination ecology of alpine plants are presently based on individual species and local studies. A current challenge is to synthesise, at the global level, the alpine seed ecological spectrum.

We performed a meta‐analysis of primary data from laboratory experiments conducted across four continents (excluding the tropics) and 661 species, to estimate the influence of six environmental cues on germination proportion, mean germination time and germination synchrony; accounting for seed morphology (mass, embryo : seed ratio) and phylogeny.

Most alpine plants show physiological seed dormancy, a strong need for cold stratification, warm‐cued germination and positive germination responses to light and alternating temperatures. Species restricted to the alpine belt have a higher preference for warm temperatures and a stronger response to cold stratification than species whose distribution extends also below the treeline. Seed mass, embryo size and phylogeny have strong constraining effects on germination responses to the environment.

Globally, overwintering and warm temperatures are key drivers of germination in alpine habitats. The interplay between germination physiology and seed morphological traits further reflects pressures to avoid frost or drought stress. Our results indicate the convergence, at the global level, of the seed germination patterns of alpine species.
Coumarin accumulation and trafficking in Arabidopsis thaliana: a complex and dynamic process
Authors: Robe Kevin , Conejero Geneviève , Gao Fei , Lefebvre‐Legendre Linnka , Sylvestre‐Gonon Elodie , Rofidal Valérie , Hem Sonia , Rouhier Nicolas , Barberon Marie , Hecker Arnaud , Gaymard Frédéric , Izquierdo Esther , Dubos Christian 
Published: November 2020

Summary

Iron (Fe) is a major micronutrient and is required for plant growth and development. Nongrass species have evolved a reduction‐based strategy to solubilize and take up Fe. The secretion of Fe‐mobilizing coumarins (e.g. fraxetin, esculetin and sideretin) by plant roots plays an important role in this process. Although the biochemical mechanisms leading to their biosynthesis have been well described, very little is known about their cellular and subcellular localization or their mobility within plant tissues.

Spectral imaging was used to monitor, in Arabidopsis thaliana, the in planta localization of Fe‐mobilizing coumarins and scopolin. Molecular, genetic and biochemical approaches were also used to investigate the dynamics of coumarin accumulation in roots.

These approaches showed that root hairs play a major role in scopoletin secretion, whereas fraxetin and esculetin secretion occurs through all epidermis cells. The findings of this study also showed that the transport of coumarins from the cortex to the rhizosphere relies on the PDR9 transporter under Fe‐deficient conditions. Additional experiments support the idea that coumarins move throughout the plant body via the xylem sap and that several plant species can take up coumarins present in the surrounding media.

Altogether, the data presented here demonstrate that coumarin storage and accumulation in roots is a highly complex and dynamic process.
Evaluation of the health‐related quality of life in Turkish cystic fibrosis patients
Authors: Alishbayli Gulzar , Kilinc Ayse Ayzit , Cokugras Haluk 
Published: November 2020

AbstractBackgroundProlongation of life expectancy in cystic fibrosis (CF) to the fourth decade makes health‐related quality of life (HRQOL) an important issue in this population. This study aims to evaluate the effects of clinical and socio‐demographic characteristics of patients on different aspects of HRQOL in a pediatric CF population. We also intend to assess some measures of reliability and validity of the Turkish CF Questionnaire‐Revised (CFQ‐R) forms.MethodsFifty‐four CF patients and 46 parents / caregivers filled the appropriate CFQ‐R forms. Disease severity was evaluated via modified Shwachman–Kulczycki (SK) scores, and additional clinical information was obtained from patient records.ResultsForty‐three percent (n = 23) of patients were female, the mean age of patients being 13.3 ± 3.96 years. Self‐ and proxy‐reported points showed a strong correlation (Spearman’s rho > 0.6) on more observable domains of HRQOL (e.g. physical functioning). No significant difference was found between sexes on any HRQOL domain. When compared between age groups, treatment burden appeared to worsen with age, while social functioning improved. All three forms of the CFQ‐R Turkish version showed acceptable internal consistency reliability and convergence with disease severity measures.ConclusionsThe CFQ‐R showed a fair correlation with the Shwachman–Kulczycki score and the FEV1% value, which makes its longitudinal use possible in clinical practice. It is important to use self‐reported evaluations as well as parent / caregiver‐reported HRQOL evaluations, especially in young children. More studies are needed to assess the psychometric properties of Turkish CFQ‐R forms.
“To Be, or Not to Be, That Is the Question”: Modeling and Differentiation Among Siblings Participating in Organized Youth Sport
Authors: Osai Keith V. , Dorsch Travis E. , Whiteman Shawn D. 
Published: November 2020

Organized youth sport is a relatively common family context in which sibling dynamics are not well understood. The present study was designed to address two contrasting mechanisms of socialization—modeling and differentiation—in examining older siblings’ influence on younger siblings’ sport participation. American youth (N = 221) age 10–15 years (M = 12.38, SD = 1.01) who were active sport participants completed an online survey measuring individual and family demographics, sibling relationship qualities, and parent–child relationship dimensions. The participants reported on their most proximal older siblings, all of whom were within 4 years of age. The analyses suggest that sibling differentiation dynamics decreased the likelihood of playing the same primary sport as an older sibling for (a) the same biological sex, close in age to siblings; (b) the same biological sex, further in age from siblings; and (c) mixed biological sex, wide in age from siblings. The “Discussion” section highlights the practical value of understanding the impact of sibling influence processes on the individual, sibling dyad, and family system.
Consulting with young people: informing guidelines for children’s palliative care
Authors: Taylor Johanna , Murphy Sarah , Chambers Lizzie , Aldridge Jan 
Published: November 2020

ObjectiveIncreasingly the views of young people are sought when improving healthcare; however, it is unclear how they shape policy or practice. This paper presents a consultation with young people commissioned by the National Institute for Health and Care Excellence (NICE) to inform clinical guidelines for paediatric palliative care (end-of-life care for infants, children and young people).MethodsThe consultation involved qualitative thematic analysis of data from 14 young people (aged 12–18 years) with a life-limiting or life-threatening condition who took part in focus groups or interviews. The topics explored were predefined by NICE: information and communication; care planning; place of care; and psychological care. Data collection consisted of discussion points and activities using visual cues and was informed by a pilot consultation group with five young adults (aged 19–24 years). Findings were shared with participants, and feedback helped to interpret the findings.ResultsFour overarching themes were identified, cutting across the predetermined topic areas: being treated as individuals with individual needs and preferences; quality of care more important than place; emotional well-being; and living as a young person. Importantly, care planning was viewed as a tool to support living well and facilitate good care, and the young people were concerned less about where care happens but who provides this.ConclusionYoung people’s priorities differ from those of parents and other involved adults. Incorporating their priorities within policy and practice can help to ensure their needs and preferences are met and relevant research topics identified.
Unilateral leg swelling in a newborn
Authors: Cortellazzo Wiel Luisa , Berti Irene , Starc Meta , Murru Flora Maria , Barbi Egidio , Risso Francesco Maria 
Published: November 2020

A female neonate was born with asymmetric lower limbs, the right leg appearing enlarged, with thickened, reddish-purple skin and ectasic superficial reticulum (figure 1A,B). Limb pulses were present and symmetrical. The girl’s family history and prenatal scans were unremarkable. Laboratory findings were within the normal range, except for a mild thrombocytopenia (90 000/μL), which spontaneously resolved during the next few days. A leg X-ray and the Doppler analysis ruled out the presence of calcifications and venous varices, respectively. Ultrasound showed significant skin thickening, with marked dermal hypertrophy and hyperechogenicity. Magnetic resonance showed circumferential thickening of the derma, with mild hypertrophy of some perforating vessels (figure 2). A biopsy of the right thigh showed capillary malformations on histology.Figure 1(A, B) Hypertrophy of the right lower limb, with large capillary malformation extending to the gluteus and the external genitalia.Figure 2Axial THRIVE magnetic resonance scan of the thighs’ proximal third, showing circumferential dermal thickening and inhomogeneity of the right leg’s subcutaneous tissue.QuestionsBased on the clinical picture and investigations results, which is the most likely diagnosis?Beckwith-WiedemannCLOVES syndromeKlippel-Trenaunay syndromeKaposiform hemangioendotheliomaHow can the diagnosis be confirmed?CT with PETLymphoscintigraphyGenetic testingNone of the above, the diagnosis is clinicalWhat is the mainstay of management?Conservative with follow-upPharmacotherapySclerotherapySurgeryWhich of the following complications can occur?ScoliosisGlaucomaUrinary and gastrointestinal bleedingAll of the aboveAnswers can be found on page 02.
Machine learning to determine relative contribution of modifiable and non-modifiable risk factors of major eye diseases
Authors: Nusinovici Simon , Zhang Liang , Chai Xiaoran , Zhou Lei , Tham Yih Chung , Vasseneix Caroline , Majithia Shivani , Sabanayagam Charumathi , Wong Tien Yin , Cheng Ching Yu 
Published: November 2020

AimsTo use machine learning (ML) to determine the relative contributions of modifiable and non-modifiable clinical, metabolic, genetic, lifestyle and socioeconomic factors on the risk of major eye diseases.MethodsWe conducted analyses in a cross-sectional multi-ethnic population-based study (n=10 033 participants) and determined a range of modifiable and non-modifiable risk factors of common eye diseases, including diabetic retinopathy (DR), non-diabetic-related retinopathy (NDR); early and late age-related macular degeneration (AMD); nuclear, cortical and posterior subcapsular (PSC) cataract; and primary open-angle (POAG) and primary angle-closure glaucoma (PACG). Risk factors included individual characteristics, metabolic profiles, genetic background, lifestyle patterns and socioeconomic status (n~100 risk factors). We used gradient boosting machine to estimate the relative influence (RI) of each risk factor.ResultsAmong the range of risk factors studied, the highest contributions were duration of diabetes for DR (RI=22.1%), and alcohol consumption for NDR (RI=6.4%). For early and late AMD, genetic background (RI~20%) and age (RI~15%) contributed the most. Axial length was the main risk factor of PSC (RI=30.8%). For PACG, socioeconomic factor (mainly educational level) had the highest influence (20%). POAG was the disease with the highest contribution of modifiable risk factors (cumulative RI~35%), followed by PACG (cumulative RI ~30%), retinopathy (cumulative RI between 20% and 30%) and late AMD (cumulative RI ~20%).ConclusionThis study illustrates the utility of ML in identifying factors with the highest contributions. Risk factors possibly amenable to interventions were intraocular pressure (IOP) and Body Mass Index (BMI) for glaucoma, alcohol consumption for NDR and levels of HbA1c for DR.
Perceived quality of surgical care in association with patient-related factors and correlation to reported postoperative complications in Finland: a cross-sectional study
Authors: Saarinen Ira Helena , Koivisto Jaana-Maija , Kaipia Antti , Haavisto Elina 
Published: November 2020

ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.
Biofortification of wheat with zinc for eliminating deficiency in Pakistan: study protocol for a cluster-randomised, double-blind, controlled effectiveness study (BIZIFED2)
Authors: Lowe Nicola M , Zaman Mukhtiar , Moran Victoria Hall , Ohly Heather , Sinclair Jonathan , Fatima Sadia , Broadley Martin R , Joy Edward J M , Mahboob Usman , Lark R Murray , Zia Munir H , Ander E Louise , Sharp Paul A , Bailey Elizabeth H , Young Scott D , Khan Muhammad Jaffar 
Published: November 2020

IntroductionMicronutrient deficiencies, commonly referred to as ‘hidden hunger’, affect more than two billion people worldwide, with zinc and iron-deficiency frequently reported. The aim of this study is to examine the impact of consuming zinc biofortified flour (Zincol-2016) on biochemical and functional measures of status in adolescent girls and children living in a low-resource setting in Pakistan.Methods and analysisWe are conducting a pragmatic, cluster-randomised, double-blind, controlled trial. A total of 482 households have been recruited from two catchment areas approximately 30–40 km distance from Peshawar. Household inclusion criteria are the presence of both an adolescent girl, aged 10–16 years, and a child aged 1–5 years. The study duration is 12 months, divided into two 6-month phases. During phase 1, all households will be provided with locally procured flour from standard varieties of wheat. During phase 2, clusters will be paired, and randomised to either the control or intervention arm of the study. The intervention arm will be provided with zinc biofortified wheat flour, with a target zinc concentration of 40 mg/kg. The control arm will be provided with locally procured wheat flour from standard varieties with an expected zinc concentration of 20 mg/kg. The primary outcome measure is plasma zinc concentration. Secondary outcomes include anthropometric measurements, biomarkers of iron and zinc status, and the presence and duration of respiratory tract infections and diarrhoea.Ethics and disseminationEthical approval was granted from the University of Central Lancashire STEMH Ethics Committee (reference number: STEMH 1014) and Khyber Medical University Ethics Committee (DIR/KMU-EB/BZ/000683). The final study methods will be published in peer-reviewed journals, alongside the study outcomes. In addition, findings will be disseminated to the scientific community via conference presentations and abstracts and communicated to the study participants through the village elders at an appropriate community forum.Trial registration numberISRCTN17107812; Pre-results.
Health professionals’ perceptions of weight loss programmes and recommendations for future implementation: a qualitative study
Authors: Jessen-Winge Christina , Ilvig Pia Marie , Thilsing Trine , Lee Kim , Fritz Heather , Christensen Jeanette Reffstrup 
Published: November 2020

ObjectiveObesity is an increasing public health challenge and most weight loss programmes are still inadequate to support sustainable weight loss. One reason for the continued lack of success might be the dominant biomedical, individualised approach to weight loss. Holistic approaches that focus on overall health and well-being in addition to weight loss are increasingly recommended. In Denmark, health professionals in the municipalities are responsible for developing and conducting weight loss programmes. The objective of this study was to explore what health professional’s perceived as an ideal, holistic weight loss programme that could be feasibly implemented in the municipalities.DesignA phenomenological-hermeneutical qualitative study was performed using semistructured interviews.SettingThirty-two Danish municipalities were weight loss programmes are developed and conducted.ParticipantsThirty-five health professionals with experience conducting weight loss programmes.ResultsThree themes emerged from the analysis: Support from the social network are important both during and after a weight loss, Changing the self-belief by positive discussions and doing activities, Maintaining changes through daily life.ConclusionFuture municipal weight loss programmes should emphasise overall health and well-being instead of weight loss and adopt a holistic approach including a focus on social relationships, meaningful activities and successes as part of a balanced daily life.
Prospective association between social engagement and cognitive impairment among middle-aged and older adults: evidence from the China Health and Retirement Longitudinal Study
Authors: Zhou Shuduo , Song Suhang , Jin Yinzi , Zheng Zhi-Jie 
Published: November 2020

ObjectivesCognitive impairment is a precursor of dementia. This study aimed to examine the association of social engagement with cognitive decline during the process of normal ageing.MethodsWe used data from the China Health and Retirement Longitudinal Study. The cognitive functions were tested at baseline, and 2-year and 4-year follow-up visits. Social engagement was constructed as a comprehensive measure including the quantity and frequency of social activities. Activities of social engagement were classified into three types. Multilevel logistic model was fitted to evaluate the prospective association between social engagement and cognitive impairment.ResultsAfter 2-year follow-up, compared with participants with the lowest level of social engagement, those with level-2, level-3 and level-4 social engagement had a 12% (OR=0.88, 95% CI 0.71 to 1.09, p=0.242), 17% (OR=0.83, 95% CI 0.71 to 0.97, p=0.020) and 25% (OR=0.75, 95% CI 0.61 to 0.93, p=0.008) lower risk for developing cognitive impairment, respectively. A similar pattern of significantly protective association was found at 4-year follow-up. Combined effect analysis showed that participants who attended one type of social engagement had a lower risk of developing cognitive impairment and the protective effect was even larger with those who attended two or three types of social engagement.ConclusionsSocial engagement had a protective effect on cognitive impairment among middle-aged and older adults in China. Given the growing epidemic of dementia and rapid pace of ageing in low-income and middle-income countries, our study shed lights on comprehensive and tailored public health programmes for improving social engagement, to delay cognitive impairment at mid-age and later life.