bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tocqueville's State of Nature Foundation
Authors: Rodríguez Raúl G. 
Published: December 2020

AbstractThis article presents an entirely new interpretation of the foundations of Alexis de Tocqueville's liberalism. The current scholarly consensus is that Tocqueville rejects the state of nature foundation of early modern political thought. In contrast to this orthodox view, I maintain that this early modern theory serves as one of the foundations of his political philosophy. This essay contends that Tocqueville's Memoir on Pauperism proves that he has an anthropology that is heavily indebted to state of nature theory, particularly Rousseau's. Moreover, key sections of Democracy in America, read in light of the Memoir on Pauperism, reveal that state of nature theory is operative in Tocqueville's new political science. Finally, The Old Regime and the Revolution explains why Tocqueville was a moderate state of nature thinker. By unearthing this hitherto unnoticed foundation, I hope to challenge scholars to reexamine the enduring importance of Tocqueville's innovative liberalism.
T‐wave and its association with myocardial fibrosis on cardiovascular magnetic resonance examination
Authors: Zareba Karolina M. , Truong Vien T. , Mazur Wojciech , Smart Suzanne M. , Xia Xiaojuan , Couderc Jean‐Philippe , Raman Subha V. 
Published: December 2020

AbstractBackgroundRisk stratification in non‐ischemic myocardial disease poses a challenge. While cardiovascular magnetic resonance (CMR) is a comprehensive tool, the electrocardiogram (ECG) provides quick impactful clinical information. Studying the relationships between CMR and ECG can provide much‐needed risk stratification. We evaluated the electrocardiographic signature of myocardial fibrosis defined as presence of late gadolinium enhancement (LGE) or extracellular volume fraction (ECV) ≥29%.MethodsWe evaluated 240 consecutive patients (51% female, 47.1 ± 16.6 years) referred for a clinical CMR who underwent 12‐lead ECGs within 90 days. ECG parameters studied to determine association with myocardial fibrosis included heart rate, QRS amplitude/duration, T‐wave amplitude, corrected QT and QT peak, and Tpeak‐Tend. Abnormal T‐wave was defined as low T‐wave amplitude ≤200 µV or a negative T wave, both in leads II and V5.ResultsOf the 147 (61.3%) patients with myocardial fibrosis, 67 (28.2%) had ECV ≥ 29%, and 132 (54.6%) had non‐ischemic LGE. An abnormal T‐wave was more prevalent in patients with versus without myocardial fibrosis (66% versus 42%, p < .001). Multivariable analysis demonstrated that abnormal T‐wave (OR 1.95, 95% CI 1.09–3.49, p = .03) was associated with myocardial fibrosis (ECV ≥ 29% or LGE) after adjustment for clinical covariates (age, gender, history of hypertension, and heart failure). Dynamic nomogram for predicting myocardial fibrosis using clinical parameters and the T‐wave was developed: https://normogram.shinyapps.io/CMR_Fibrosis/.ConclusionLow T‐wave amplitude ≤ 200 µV or negative T‐waves are independently associated with myocardial fibrosis. Prospective evaluation of T‐wave amplitude may identify patients with a high probability of myocardial fibrosis and guide further indication for CMR.
Mobile app features that scaffold pre‐school learning: Verbal feedback and leveling designs
Authors: Callaghan Melissa N. , Reich Stephanie M. 
Published: December 2020

AbstractGuiding hints and challenge can help scaffold learners to progress beyond what they would achieve independently. The interactive and adaptive capabilities of mobile devices allow educational applications (apps) to support learning through scaffolding designs. However, little research has tested the effects of scaffolding features in apps on young children’s learning. Using a 3 × 2 between‐subjects design, this study experimentally tests how three types of app feedback (nonverbal sounds, verbal encouragement, or scaffolded verbal hints) and two types of leveling (gradual vs. random‐ordered challenge) influence 4–5‐year‐old children’s learning of novel words (N = 240). Results showed that scaffolded feedback was especially useful when provided at the beginning of app play (p < .01), and scaffolded leveling through gradual increases in difficulty supported faster and more accurate responses than random order challenge (p < .001).
Practitioner NotesWhat is already known about this topic

Researchers have worked to apply what we know about traditional in‐person teaching with young learners and how that might translate to digital platforms.
Parent and teacher scaffolding has been shown to successfully help young children learn. Guidance through increased difficulty and explanatory feedback can help learners gradually build their skills and reflect more deeply on the content they are learning.
What this paper adds

This study adds to the newly growing collection of experiments testing the design features of educational pre‐school apps.
Findings show that scaffolding through educational app feedback and leveling can support young children learning.
Results also show that the impact of scaffolding can depend on when the guidance is presented during app play – at the very beginning of play versus later on.
Implications for practice and/or policy

Findings can help educators and other consumers identify which types of apps are better for scaffolding young children’s learning.
Suggestions are provided to support educational app developers in designing products that are truly effective.
Findings suggest that combinations of app designs may differently impact young children’s learning, providing next step testing conditions for educational app designs.
Rigor and reproducibility training for first year medical students in research pathways
Authors: Lapane Kate L. , Dube Catherine E. 
Published: December 2020

AbstractIn the Spring of 2020, we launched a rigor and reproducibility curriculum for medical students in research training programs. This required class consisted of eight, 2‐h sessions, which transitioned to remote learning in response to the coronavirus disease 2019 (COVID‐19) epidemic. The class was graded as pass/fail. Flipped classroom techniques, with multiple hands‐on exercises, were developed for first‐year medical students (MD/PhD [n = 9], Clinical and Translational Research Pathway (CTRP) students [n = 9]). Four focus groups (n = 13 students) and individual interviews with the two instructors were conducted in May 2020. From individual interviews with instructors and focus groups with medical students, the course and its components were favorably reviewed. Students thought the course was novel, important, relevant, and practical—and teaching strategies were effective (e.g., short lectures, interactive small group exercises, and projects). Most students expressed concerns about lack of time for course preparation. Sharper focus and streamlining of preparation work may be required. Pre‐ and post‐student self‐assessments of rigor and reproducibility competencies showed average post‐scores ranging from high/moderate to strong understanding (n = 11). We conclude that rigor and reproducibility can be taught to first‐year medical students in research pathways programs in a highly interactive and remote format.
Study Highlights

WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

The rigor and reproducibility crisis calls for robust training of scientists in best practices for enhancing the research rigor.

WHAT QUESTION DID THIS STUDY ADDRESS?
We evaluated a curriculum to develop physician‐scientists skilled at documenting research workflow from idea generation to publication with reproducibility in mind.

WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?
Highly interactive exercises, coupled with a hands‐on replication group project provide a pathway for students to gain competencies important to the improvement of rigor and reproducibility in scientific research. Rigor and reproducibility can be taught in a highly interactive format and using a remote format.

HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?
Formal training is needed to raise awareness of the reproducibility crisis and improve the rigor of research conducted. If techniques taught are used, the transparency and reproducibility of clinical and translational science will be improved.
Double‐chambered left ventricle: An unusual finding in a middle‐aged woman
Authors: Monzo Luca , Giannuzzi Sara , Lanzillo Chiara , Ferrazza Alessandro Maria , Calò Leonardo 
Published: December 2020

AbstractDouble‐chambered left ventricle (DCLV) is a rare congenital abnormality and is characterized by the subdivision of the left ventricle into two separate chambers by an abnormal septum or muscle band. This rare congenital entity is usually diagnosed in the neonatal or pediatric age. Nevertheless, it can be asymptomatic and incidentally found in the adulthood. A comprehensive multimodality imaging approach is crucial for the correct final diagnosis.
Assessing the atria in pediatric sickle cell disease: Beyond the dilation
Authors: Loar Robert W. , George Alex , Varghese Nidhy P. , Liu Asela M. , Colquitt John L. , Pignatelli Ricardo H. 
Published: December 2020

AbstractBackgroundDiastolic dysfunction (DD) and pulmonary hypertension (PH) are common causes of mortality for sickle cell disease (SCD) patients in developed countries. We hypothesized that left and right atrial strain (LAS‐Ɛ, RAS‐rƐ) are decreased in SCD adolescents, and that worsening values correlate with laboratory markers of disease severity.MethodsProspective cohort study of patients with HbSS genotype of SCD was compared with healthy controls. LAS and RAS were measured from 4‐ and 2‐chamber views by a blinded reader. Peak strain and strain rate values were obtained for atrial contraction (ac), reservoir (res), and conduit (con) phases. Mitral/tricuspid Doppler velocities, left atrial volume, right atrial area were obtained. Laboratory variables were obtained from the electronic record with the three prior values being averaged. Differences in variables were assessed with Wilcoxon rank sum test, and correlations assessed with Spearman's coefficient.ResultsThere were 33 SCD patients compared to 35 healthy controls of similar age, gender, and size. SCD patients had increased left atrial volume and right atrial area. For LAS, Ɛres was significantly lower in SCD patients. For RAS, RƐcon was significantly lower. Neither measurement correlated with clinical markers. The majority of SCD patients had relatively normal atrial strain values. Those with markedly lower values had similar atrial size.ConclusionsA sub‐set of SCD patients have markedly low Ɛres and rƐcon. No correlation with clinical markers was identified. Larger, longitudinal studies may determine utility of atrial strain as a screening tool in this at‐risk population.
Rate and predictors of interrupted patient follow‐up after first‐episode psychosis ‐ a retrospective cohort study in France
Authors: Guitter Marie , Laprevote Vincent , Lala Adrian , Sturzu Livia , Dobre Daniela , Schwan Raymund 
Published: December 2020

AbstractBackgroundPatient adherence to follow‐up after a first episode of psychosis (FEP) is currently a major challenge. Patient's early adherence reduces the risk of relapse and improves their prognosis in the short and long term. The primary goal of our study was to determine the incidence of treatment disengagement at 1‐year follow‐up in patients with first‐episode schizophrenia, schizophreniform or schizoaffective disorder. The secondary goal was to assess the factors associated with treatment disengagement in this patient population.MethodsWe conducted a monocentric retrospective study of 136 patients in France. Relevant information was collected on sociodemographic, pre‐morbidities and co‐morbidities data, as well as the management and treatment characteristics at 1.3 and 12 months. Survival analysis was used to assess the association between clinical variables, management and treatment disengagement.ResultsEighty‐four patients (62%) have interrupted their medical follow‐up at 1 year, 16% at 1 month and 34% at 3 months. A higher number of out‐patient appointments after a FEP was associated with better adherence (HR:0.85 p < .0001 95% IC = [0.0–0.9]). Initial management seems to play an important role. Involuntary admissions (HR:7.14 p = .015 95% IC = [1.48–34.52]) and total number of admissions (HR:6.86 p < .0001 95% IC = [2.47–19.05]) predict disengagement at 1 month while an increased number of out‐patient appointments at 3 months predicts adherence (HR:0.60 p < .0001 95% IC = [0.00–0.74]). Being a single parent is associated with disengagement at 3 months (HR:15.51 p = .022 95% IC = [1.49–161.65]).ConclusionsIncidence of disengagement is high. It might be necessary to change our management in order to develop out‐patient or day‐admission care and intensify care for patients at risk.
Headache at onset of first‐ever ischemic stroke: Clinical characteristics and predictors
Authors: Lebedeva Elena R. , Ushenin Anton V. , Gurary Natalia M. , Tsypushkina Tatiana S. , Gilev Denis V. , Kislyak Nadezda V. , Olesen Jes 
Published: December 2020

AbstractNo studies have prospectively investigated headache at onset of first‐ever ischemic stroke along with a large concurrent control group. Our aims were to answer two important questions: (i) Are headaches at stroke onset causally related to the stroke, and what are their typical clinical characteristics? (ii) What etiology of stroke is associated with these headaches?The study population consisted of 550 patients (mean age = 63.1, 54% males) with first‐ever ischemic stroke and 192 control patients (mean age = 58.7, 36% males) admitted to the emergency room without any acute neurological deficits or serious disorders. All data were collected prospectively, using a standardized case‐report form during face‐to‐face interviews by neurologists.Headache at onset of ischemic stroke was present in 82 (14.9%) of 550 patients. More than half (56%) had a new type of headache (mainly migraine‐like) simultaneously with stroke onset, and 36% had headache with altered characteristics (mainly tension‐type‐like headache). Headaches were associated with cardioembolism (p = 0.002, odds ratio [OR] = 2.4, 95% confidence interval [CI] = 1.4–4.1), posterior circulation stroke (p = 0.01, OR = 2.0, 95% CI = 1.2–3.5), infarcts >15 mm (p = 0.03, 95% CI = 1.1–2.7), infarcts of the cerebellum (p = 0.02, OR = 2.3, 95% CI = 1.1–4.8), good neurological status (p = 0.01, OR = 2.5, 95% CI = 1.2–4.9), and low frequency of large‐artery atherosclerosis (p = 0.004, OR = 0.4, 95% CI = 0.2–0.8).At stroke onset, headache of a new type and headache with altered characteristics were related to ischemic stroke. They were associated with certain etiologies of stroke.
Safety and efficacy of mechanical thrombectomy in infective endocarditis: A matched case–control analysis from the German Stroke Registry–Endovascular Treatment
Authors: Feil Katharina , Küpper Clemens , Tiedt Steffen , Dimitriadis Konstantinos , Herzberg Moriz , Dorn Franziska , Liebig Thomas , Dieterich Marianne , Kellert Lars ,   for the GSR Investigators
Published: December 2020

AbstractBackground and purposeUp to 30% of infective endocarditis (IE) patients have ischemic stroke as a complication. Standard treatment with mechanical thrombectomy (MT) with or without intravenous thrombolysis for large vessel occlusion (LVO) has not been evaluated formally in these patients.MethodsPatients enrolled in the German Stroke Registry–Endovascular Treatment (GSR‐ET) between June 2015 and December 2019 were analyzed. Patients with stroke due to IE and patients with cardioembolic stroke and atrial fibrillation (AF) were compared using propensity score matching. Successful reperfusion was defined as modified Thrombolysis in Cerebral Infarction score = 2b–3. Modified Rankin Scale (mRS) = 0–2 at 3 months indicated good outcome.ResultsOf 6635 patients, 55 patients (age = 69.0 ± 13.3 years, 43.6% female, median premorbid mRS (pmRS) = 1, interquartile range [IQR] = 0–1, National Institutes of Health Stroke Scale [NIHSS] = 15, IQR = 10–21) presented with septic embolic stroke due to IE and were compared to 104 patients (age = 66.5 ± 13.4 years, 39.4% female, pmRS = 0, IQR = 0–2, NIHSS = 16, IQR = 10–20) with cardioembolic stroke due to AF. Successful recanalization was achieved in 74.5% of endocarditis patients compared to 87.5% of controls (p = 0.039). Intracranial hemorrhage rates were comparable (30.9% vs. 21.6%, p = 0.175). Good functional outcome was 20.0% in patients with IE compared to 43.3% in matched patients (p = 0.006), with a significantly higher mortality (60.0% vs. 28.8%, p < 0.001). IE was strongly associated with poor outcome (odds ratio [OR] = 0.32, 95% confidence interval [CI] = 0.11–0.87, p = 0.03 for good outcome) and mortality (OR = 4.49, 95% CI = 1.80–10.68, p = 0.001).ConclusionsAlthough MT results in high successful recanalization rates with acceptable safety profile, patients with LVO stroke due to IE have poor outcome.
Ministering at the Margins in a Time of Pandemic
Authors: Goatley David Emmanuel 
Published: December 2020

AbstractCOVID‐19 is having a devastating effect globally, especially among those who live at the margins of societies. Health and economic crises are impacting communities and countries, with particularly adverse effects on vulnerable populations. COVID‐19’s impact is increased when we factor in racism, land displacement, and gender injustice. The marginalization and oppression experienced from racial injustice, displacement, and gender injustice increase vulnerability and intensify trauma from COVID‐19 globally. Churches can respond effectively to the COVID‐19 pandemic with particular focus on communities at the margins. Churches that respond to COVID‐19 through ministries of evangelism, compassion, empowerment, and advocacy can demonstrate Christ’s love in the midst of the pandemic and contribute to reconciliation and solidarity with vulnerable communities forced to the margins. This article offers insights related to four themes identified by the reference group for the Pilgrimage of Justice and Peace that was initiated at the 10th Assembly of the World Council of Churches in Busan in 2013.
A Search for a Theology of Life
Authors: Kosmidis Nikos 
Published: December 2020

AbstractThe COVID‐19 pandemic offers the opportunity for theological meditation on several themes: life, death, illness, loneliness, fear, human relations, suffering, and social responsibility. This article addresses these themes only briefly, aiming not to build a systematic theological reflection but to share honest thoughts and concerns. Perhaps in our postmodern times we need, not so much theological certainties, but a theology that accompanies human life. Life and death are the only certainties, regardless of our worldview, perceptions, and theological convictions. The current global crisis has illuminated our shortcomings, failures, and disbeliefs on different levels. As Christians, we are united today also around our weakness, grief, and the loss of “normality.” We are challenged, together with the rest of humanity. Could this be a God‐given opportunity for renewal in our theology and church life?
Christ’s Love in the Midst of Pandemic
Authors: Moe‐Lobeda Cynthia D. 
Published: December 2020

AbstractThe COVID‐19 pandemic has revealed vividly the pandemic of economic inequality, the pandemic of racism, and the pandemic of climate catastrophe. This article explores what it means to manifest Christ’s love, moving the world, in the midst of these pandemics. It begins by recalling firm faith claims on which to build a response, moving on to “reading” the context of these four pandemics, noting five signs of the times as guides for discerning how to respond. It concludes with four suggestions regarding gospel‐grounded response: (1) seeking to address one of these pandemics without deep attention to the others is dangerous; (2) the four pandemics converge in a holy call to economic restructuring; (3) the movement toward a moral economy is not an impossible dream; and (4) religion, including the World Council of Churches, has a crucial role to play. They are suggestions, in other words, about the form of Christ’s love moving the world in the midst of these pandemics.
Caught in a bottleneck: Habitat loss for woolly mammoths in central North America and the ice‐free corridor during the last deglaciation
Authors: Wang Yue , Widga Chris , Graham Russell W. , McGuire Jenny L. , Porter Warren , Wårlind David , Williams John W. 
Published: December 2020

AbstractAimIdentifying how climate change, habitat loss, and corridors interact to influence species survival or extinction is critical to understanding macro‐scale biodiversity dynamics under changing environments. In North America, the ice‐free corridor was the only major pathway for northward migration by megafaunal species during the last deglaciation. However, the timing and interplay among the late Quaternary megafaunal extinctions, climate change, habitat structure, and the opening and reforestation of the ice‐free corridor have been unclear.LocationNorth America.Time period15–10 ka.Major taxa studiedWoolly mammoth (Mammuthus primigenius).MethodsFor central North America and the ice‐free corridor between 15 and 10 ka, we used a series of models and continental‐scale datasets to reconstruct habitat characteristics and assess habitat suitability. The models and datasets include biophysical and statistical niche models Niche Mapper and Maxent, downscaled climate simulations from CCSM3 SynTraCE, LPJ‐GUESS simulations of net primary productivity (NPP) and woody cover, and woody cover based upon fossil pollen from Neotoma.ResultsThe ice‐free corridor may have been of limited suitability for traversal by mammoths and other grazers due to persistently low productivity by herbaceous plants and quick reforestation after opening 14 ka. Simultaneously, rapid reforestation and decreased forage productivity may have led to declining habitat suitability in central North America. This was possibly amplified by a positive feedback loop driven by reduced herbivory pressures, as mammoth population decline led to the further loss of open habitat.Main conclusionsDeclining habitat availability south of the Laurentide Ice Sheet and limited habitat availability in the ice‐free corridor were contributing factors in North American extinctions of woolly mammoths and other large grazers that likely operated synergistically with anthropogenic pressures. The role of habitat loss and attenuated corridor suitability for the woolly mammoth extinction reinforce the critical importance of protected habitat connectivity during changing climates, particularly for large vertebrates.