bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teaching With Picture Books on Deaf and Hard-of-Hearing Students’Creativity
Authors: Wang Chonggao , Fu Wangqian , Cheng Li , Wang Yan , Duan Shifei 
Published: November 2020

AbstractStudies have shown that teaching with picture books can help improve creativity development of deaf and hard-of-hearing (DHH) students. A quasi-experimental research design was applied in this study. Deaf and hard-of-hearing students in grades 3–6 from two cities, B and T, were selected as the samples in a pilot study. The Evaluation of Potential Creativity (EPoC) test tool (Ver. A) was applied to measure creativity through student performance on individual tests of divergent and integrative thinking. Following thirty 40-min lessons over 10 weeks, the EPoC test tool (Ver. B) was used to measure student creativity in the experimental and control groups. The results showed the following: (1) the performance of DHH students was better on graphic divergence than on verbal divergence, (2) performance on the divergent dimensions of creativity was significantly higher for DHH students from the experimental group than the control group, and (3) there was no difference in integrative thinking between the two groups in the posttest. In practice, teachers could use picture books in their lesson plans to improve the creativity of DHH students that results from divergent thinking. Future research should focus on the development of creativity in DHH students through integrative thinking with a longer teaching intervention.
Excess mortality from COVID-19: weekly excess death rates by age and sex for Sweden and its most affected region
Authors: Modig Karin , Ahlbom Anders , Ebeling Marcus 
Published: November 2020

Abstract

Background
Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic.

Methods
By estimating weekly age- and sex-specific death rates during 2020 and during the preceding 5 years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm.

Results
Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by &lt;1 year for Sweden and 1.5 years for Stockholm compared to 2019.

Conclusions
The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.
Hospitalization Trajectories in Home- and Community-Based Services Recipients: The Influence of Physician and Social Care Density
Authors: Kim Min Hee , Xiang Xiaoling 
Published: November 2020

Abstract

Objectives
Repeated hospitalizations among older adults receiving Home- and Community-Based Services (HCBS) may indicate unmet medical and social needs. This study examined all-cause hospitalization trajectories and the association between area-level resource density for medical and social care and the trajectory group membership.

Methods
The study participants included 11,223 adults aged 60 years or older who were enrolled in public HCBS programs in Michigan between 2008 and 2012. Data sources included the Michigan interRAI-Home Care, Dartmouth Atlas of Health Care Data, the American Community Survey, and the County Business Patterns from the Census Bureau. The group-based trajectory modeling was used to identify trajectories of hospitalization over 15 months. Correlates of the trajectories were examined using multinomial logistic regression.

Results
Four distinct hospitalization trajectory groups emerged: “never” (43.1%)—individuals who were rarely hospitalized during the study period, “increasing” (19.9%)—individuals who experienced an increased risk of hospitalization, “decreasing” (21.6%)—individuals with a decreased risk, and “frequent” (15.8%)—individuals with frequent hospitalizations. Older adults living in areas with a higher number of social service organizations for older adults and persons with disability were less likely to be on the “frequent” trajectory relative to the “decreasing” trajectory. The density of primary care physicians was not associated with the trajectory group membership.

Discussion
Area-level social care resource density contributes to changes in 15-month hospitalization risks among older adult recipients of HCBS.
Contribution of CD3+CD8- and CD3+CD8+ T Cells to TNF-α Overexpression in Crohn Disease–Associated Perianal Fistulas and Induction of Epithelial-Mesenchymal Transition in HT-29 Cells
Authors: Bruckner Ramona S , Spalinger Marianne R , Barnhoorn Marieke C , Feakins Roger , Fuerst Alois , Jehle Ekkehard C , Rickenbacher Andreas , Turina Matthias , Niechcial Anna , Lang Silvia , Hawinkels Lukas J A C , van der Meulen-de Jong Andrea E , Verspaget Hein W , Rogler Gerhard , Scharl Michael 
Published: November 2020

Abstract

Background
Fistulas represent a frequent and severe complication in patients with Crohn disease (CD). Tumor necrosis factor-alpha (TNF-α), transforming growth factor-beta, and interleukin (IL)-13 are known to trigger epithelial-mesenchymal transition (EMT), promoting fistula formation. Here, we investigated the role of T-lymphocytes (T cells) in fistula pathogenesis.

Methods
CD3+CD8-, CD3+CD8+, or CD45+CD3- cells from healthy volunteers, patients with CD, and patients with CD with perianal fistula were co-cultured with HT-29 cells. The EMT, cytokine production, and mRNA expression were analyzed. Perianal CD fistula specimens were immunohistochemically stained for cytokines and their receptors. The effect of cytokines on EMT induction was investigated using an EMT spheroid model.

Results
Patients with CD with fistula revealed more CD3+CD8- and less CD3+CD8+ T cells in blood than healthy control patients and patients with CD without fistula. In perianal fistula specimens, CD4+ cells—and to a lesser extent CD8+ cells—were highly present around fistula tracts. When co-cultured with HT-29 cells, both cell subsets promoted EMT-related gene expression and TNF-α production in a time-dependent manner. The CD3+CD8- T cells from patients with CD with fistula also produced higher amounts of IL-13 than cells from healthy control patients or patients with CD without a fistula. We found that IL-22 and IL-22Rα1 were highly expressed in perianal CD fistula specimens and that IL-22 cotreatment potentiated TNF-α-induced EMT in HT-29 spheroids.

Conclusions
Our data indicate that both CD3+CD8- and CD3+CD8+ T cells play an important role in the pathogenesis of perianal CD fistulas by the secretion of TNF-α. Our data support clinical evidence indicating that anti-TNF-α therapy is effective in fistula treatment and identify IL-13 and IL-22 as possible novel therapeutic targets for fistula therapy.
Predictors of Ustekinumab Failure in Crohn’s Disease After Dose Intensification
Authors: Dalal Rahul S , Njie Cheikh , Marcus Jenna , Gupta Sanchit , Allegretti Jessica R 
Published: November 2020

Abstract

Background
Many patients with Crohn’s disease (CD) who lose response to the standard ustekinumab dose interval of every 8 weeks (q8w) undergo dose intensification to q4w or q6w. However, baseline factors that predict success or failure after dose intensification are unknown. We sought to identify predictors of failure of ustekinumab after dose intensification for patients with CD.

Methods
This was a retrospective cohort study of adult CD patients undergoing ustekinumab dose intensification at a tertiary referral center between January 1, 2016, and January 31, 2019. Electronic health records were reviewed to obtain patient demographics, CD history, and laboratory data. The primary outcome was failure to achieve corticosteroid-free remission (Harvey-Bradshaw Index &lt;5) within 12 months after intensification. The secondary outcome assessed was time to new biologic therapy after dose intensification. We used multivariable logistic regression and Cox regression to identify predictors of these outcomes.

Results
We included 123 patients who underwent ustekinumab dose intensification to q4w (n = 64), q5w (n = 1), q6w (n = 55), or q7w (n = 3). Multivariable logistic regression demonstrated that perianal disease, Harvey-Bradshaw Index, and opioid use at time of intensification were associated with failure to achieve remission. Cox regression demonstrated that perianal disease and corticosteroid use at time of intensification were associated with shorter time to a new biologic.

Conclusion
Perianal disease, Harvey-Bradshaw Index, current opioid use, and current corticosteroid use are associated with ustekinumab failure after dose intensification in CD. Larger, prospective studies are needed to corroborate these findings and guide therapeutic strategies for patients who lose response to standard ustekinumab dosing.
The urban–rural education gap: do cities indeed make us smarter?
Authors: van Maarseveen Raoul 
Published: November 2020

Abstract
Despite the large urban–rural education gap observed in most countries, little attention has been paid to whether cities actually enjoy a comparative advantage in the production of human capital. Using Dutch administrative data, this paper finds that children growing in urban regions consistently attain higher levels of human capital compared with children in rural regions, conditional on observed cognitive ability and various family characteristics. The elasticity of university attendance with respect to population density is 0.07, which is robust across a variety of specifications. Hence, the paper offers a different explanation to explain the recent success of cities.
Assessing improvements in metastatic renal cell carcinoma systemic treatments from the pre-cytokine to the immune checkpoint inhibitor eras: a retrospective analysis of real-world data
Authors: Ishihara Hiroki , Takagi Toshio , Kondo Tsunenori , Fukuda Hironori , Tachibana Hidekazu , Yoshida Kazuhiko , Iizuka Junpei , Kobayashi Hirohito , Okumi Masayoshi , Ishida Hideki , Tanabe Kazunari 
Published: November 2020

Abstract

Objective
Studies assessing outcome improvements over a long period according to systemic therapy strategies for metastatic renal cell carcinoma using real-world data, including the results of the recent era of immune checkpoint inhibitors, are limited. Herein, we retrospectively evaluated patients who were diagnosed with metastatic renal cell carcinoma over a 40-year span.

Methods
Patients were classified into four groups based on when their metastases were diagnosed as follows: (i) the pre-cytokine era (1980–1986), (ii) the cytokine era (1987–2007), (iii) the molecular-targeted therapy (mTT) era (2008 to August 2016) and (iv) the immune checkpoint inhibitor era (September 2016 to 2018). The immune checkpoint inhibitor era consisted of second- or later-line nivolumab. Overall survival from the diagnoses of metastases was evaluated.

Results
In total, 576 patients were evaluated, including 22 (3.82%), 231 (40.1%), 253 (43.9%) and 70 (12.2%) patients from the pre-cytokine, cytokine, molecular-targeted therapy and immune checkpoint inhibitor eras, respectively. The overall survival significantly improved with each successive era (median: 13.1 vs. 24.5 vs. 44.4 months vs. not reached in pre-cytokine vs. cytokine vs. molecular-targeted therapy vs. immune checkpoint inhibitor eras, P &lt; 0.0001). The implementation of molecular-targeted therapy improved overall survival compared with that of cytokine (cytokine vs. molecular-targeted therapy eras, P &lt; 0.0001). Multivariate analysis demonstrated that the era was an independent factor for overall survival (P &lt; 0.0001), together with histopathological type; metastasis status (i.e. synchronous or metachronous); systemic therapy status (i.e. absence or presence) and bone, liver or lymph node metastasis status (all, P &lt; 0.05).

Conclusion
This retrospective study of real-world data indicated that metastatic renal cell carcinoma outcomes improved with successive systemic therapy paradigms.
Synanthropy of Sarcophaginae (Diptera: Sarcophagidae) From Southern Brazil and Its Sanitary Implications
Authors: Souza Carina M , Madeira-Ott Tais , Masiero Franciele S , Bunde Paulo R S , Ribeiro Gladis A , Thyssen Patricia J 
Published: November 2020

Abstract
Although different feeding habits have been reported for Sarcophaginae (Diptera, Sarcophagidae), most species are associated with decomposing organic matter such as feces and decaying corpses. This study provides the synanthropy index for males of species of Sarcophaginae collected during a 12-mo period in three different environments (urban, rural, and wild) of the state of Rio Grande do Sul, in Southern Brazil, linking this parameter with the sanitary issue. This article also investigated the presence of pathogenic bacteria on the external surface of Oxysarcodexia paulistanensis (Mattos), the most abundant species collected using a sanitized entomological net. Almost all the species collected most abundantly, including O. paulistanensis (n = 241), Ravinia advena (Walker) (n = 87), and O. thornax (Walker) (n = 58), were classified as synanthropic; O. thornax was the species with the highest synanthropy index (+80.3). Escherichia coli (Escherich), Shigella spp. (Enterobacteriaceae), and Staphylococcus aureus (Rosenbach) (Staphylococcaceae) were isolated and identified from the external surface of O. paulistanensis. The isolation and identification of pathogenic bacteria, and their synanthropic behavior, adds weight to potential role of some flesh flies, as O. paulistanensis, in a sanitary context.
Snorting the Brain Away: Cerebral Damage as an Extension of Cocaine-Induced Midline Destructive Lesions
Authors: García-Pérez Daniel , Ruiz-Ortiz Mariano , Panero Irene , Eiriz Carla , Moreno Luis Miguel , García-Reyne Ana , García Alfredo , Martín-Medina Patricia , Salvador-Álvarez Elena , Hernández-Lain Aurelio , Serrano Antonio , Gil-Etayo Francisco Javier , Castaño-León Ana María , Paredes Igor , Pérez-Núñez Ángel 
Published: November 2020

Abstract
Cocaine consumption is associated with a variety of clinical manifestations. Though cocaine intranasal inhalation always determines nasal mucosal damages, extensive septum perforations, and midline destructions—known as cocaine-induced midline destructive lesions (CIMDL)—affect only a limited fraction of patients. CIMDL is viewed as a cocaine-associated autoimmune phenomenon in which the presence of atypical anti-neutrophil cytoplasmic antibody (ANCA) promotes and/or defines the disease phenotype. A 51-year-old man presented with an intracranial tumor-like lesion by its space-occupying effect. CT also revealed the destruction of the nasal septum and skull base. A diagnosis of CIMDL was made in light of the patient’s history as well as findings of the physical and endoscopic examinations, imaging studies, and laboratory testing. There was no evidence of other pathologies. Histopathological results from cerebral biopsy led us to consider the intracranial pathology as an extension of the CIMDL. CIMDL is the result of a necrotizing inflammatory tissue response triggered by cocaine abuse in a subset of predisposed patients. The reported case is the first CIMDL consistent with brain extension mimicking a tumor-like lesion. While the presence of atypical ANCA seems to promote and/or define the disease phenotype, the specific role of these and other circulating autoantibodies needs further investigation.
Shaping leaf vein pattern by auxin and mechanical feedback
Authors: Burian Agata , Raczyńska-Szajgin Magdalena , Pałubicki Wojtek 
Published: November 2020

This article comments on:
Kneuper I, Teale W, Dawson JE, Tsugeki R, Katifori E, Palme K, Ditengou FA. 2021. Auxin biosynthesis and cellular efflux act together to regulate leaf vein patterning. Journal of Experimental Botany 72, 1151–1165.
Developmental differences in genome replication program and origin activation
Authors: Rausch Cathia , Weber Patrick , Prorok Paulina , Hörl David , Maiser Andreas , Lehmkuhl Anne , Chagin Vadim O , Casas-Delucchi Corella S , Leonhardt Heinrich , Cardoso M Cristina 
Published: November 2020

AbstractTo ensure error-free duplication of all (epi)genetic information once per cell cycle, DNA replication follows a cell type and developmental stage specific spatio-temporal program. Here, we analyze the spatio-temporal DNA replication progression in (un)differentiated mouse embryonic stem (mES) cells. Whereas telomeres replicate throughout S-phase, we observe mid S-phase replication of (peri)centromeric heterochromatin in mES cells, which switches to late S-phase replication upon differentiation. This replication timing reversal correlates with and depends on an increase in condensation and a decrease in acetylation of chromatin. We further find synchronous duplication of the Y chromosome, marking the end of S-phase, irrespectively of the pluripotency state. Using a combination of single-molecule and super-resolution microscopy, we measure molecular properties of the mES cell replicon, the number of replication foci active in parallel and their spatial clustering. We conclude that each replication nanofocus in mES cells corresponds to an individual replicon, with up to one quarter representing unidirectional forks. Furthermore, with molecular combing and genome-wide origin mapping analyses, we find that mES cells activate twice as many origins spaced at half the distance than somatic cells. Altogether, our results highlight fundamental developmental differences on progression of genome replication and origin activation in pluripotent cells.
Critical Role of NdhA in the Incorporation of the Peripheral Arm into the Membrane-Embedded Part of the Chloroplast NADH Dehydrogenase-Like Complex
Authors: Yamamoto Hiroshi , Sato Nozomi , Shikanai Toshiharu 
Published: November 2020

Abstract
The chloroplast NADH dehydrogenase-like (NDH) complex mediates ferredoxin-dependent plastoquinone reduction in the thylakoid membrane. In angiosperms, chloroplast NDH is composed of five subcomplexes and further forms a supercomplex with photosystem I (PSI). Subcomplex A (SubA) mediates the electron transport and consists of eight subunits encoded by both plastid and nuclear genomes. The assembly of SubA in the stroma has been extensively studied, but it is unclear how SubA is incorporated into the membrane-embedded part of the NDH complex. Here, we isolated a novel Arabidopsis mutant chlororespiratory reduction 16 (crr16) defective in NDH activity. CRR16 encodes a chloroplast-localized P-class pentatricopeptide repeat protein conserved in angiosperms. Transcript analysis of plastid-encoded ndh genes indicated that CRR16 was responsible for the efficient splicing of the group II intron in the ndhA transcript, which encodes a membrane-embedded subunit localized to the connecting site between SubA and the membrane subcomplex (SubM). To analyze the roles of NdhA in the assembly and stability of the NDH complex, the homoplastomic knockout plant of ndhA (ΔndhA) was generated in tobacco (Nicotiana tabacum). Biochemical analyses of crr16 and ΔndhA plants indicated that NdhA was essential for stabilizing SubA and SubE but not for the accumulation of the other three subcomplexes. Furthermore, the crr16 mutant accumulated the SubA assembly intermediates in the stroma more than that in the wild type. These results suggest that NdhA biosynthesis is essential for the incorporation of SubA into the membrane-embedded part of the NDH complex at the final assembly step of the NDH–PSI supercomplex.
Determining Grades in the Internal Medicine Clerkship: Results of a National Survey of Clerkship Directors
Authors: Hernandez Caridad A. , Daroowalla Feroza , LaRochelle Jeffrey S. , Ismail Nadia , Tartaglia Kimberly M. , Fagan Mark J. , Kisielewski Michael , Walsh Katherine 
Published: November 2020

Purpose
Trust in and comparability of assessments are essential in clerkships in undergraduate medical education for many reasons, including ensuring competency in clinical skills and application of knowledge important for the transition to residency and throughout students’ careers. The authors examined how assessments are used to determine internal medicine (IM) core clerkship grades across U.S. medical schools.

Methods
A multisection web-based survey of core IM clerkship directors at 134 U.S. medical schools with membership in the Clerkship Directors in Internal Medicine was conducted in October through November 2018. The survey included a section on assessment practices to characterize current grading scales used, who determines students’ final clerkship grades, the nature/type of summative assessments, and how assessments are weighted. Respondents were asked about perceptions of the influence of the National Board of Medical Examiners (NBME) Medicine Subject Examination (MSE) on students’ priorities during the clerkship.

Results
The response rate was 82.1% (110/134). There was considerable variability in the summative assessments and their weighting in determining final grades. The NBME MSE (91.8%), clinical performance (90.9%), professionalism (70.9%), and written notes (60.0%) were the most commonly used assessments. Clinical performance assessments and the NBME MSE accounted for the largest percentage of the total grade (on average 52.8% and 23.5%, respectively). Eighty-seven percent of respondents were concerned that students’ focus on the NBME MSE performance detracted from patient care learning.

Conclusions
There was considerable variability in what IM clerkships assessed and how those assessments were translated into grades. The NBME MSE was a major contributor to the final grade despite concerns about the impact on patient care learning. These findings underscore the difficulty in comparing learners across institutions and serve to advance discussions for how to improve accuracy and comparability of grading in the clinical environment.