bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of cardiometabolic risk in the association between accumulation of affective symptoms across adulthood and mid-life cognitive function: national cohort study
Authors: John Amber , Desai Roopal , Richards Marcus , Gaysina Darya , Stott Joshua 
Published: July 2020

BackgroundAffective symptoms are associated with cognition in mid-life and later life. However, the role of cardiometabolic risk in this association has not been previously examined.AimsTo investigate how cardiometabolic risk contributes to associations between affective symptoms and mid-life cognition.MethodData were used from the National Child Development Study (NCDS), a sample of people born in Britain during one week in 1958. Measures of immediate and delayed memory, verbal fluency and information processing speed and accuracy were available at age 50. Affective symptoms were assessed at ages 23, 33 and 42 years and a measure of accumulation was derived. A cardiometabolic risk score was calculated from nine cardiometabolic biomarkers at age 44. Path models were run to test these associations, adjusting for sex, education, socioeconomic position and affective symptoms at age 50.ResultsAfter accounting for missing data using multiple imputation, path models indicated significant indirect associations between affective symptoms and mid-life immediate memory (β = −0.002, s.e. = 0.001, P = 0.009), delayed memory (β = −0.002, s.e. = 0.001, P = 0.02) and verbal fluency (β = −0.002, s.e. = 0.001, P = 0.045) through cardiometabolic risk.ConclusionsThese findings suggest that cardiometabolic risk may play an important role in the association between affective symptoms and cognitive function (memory and verbal fluency). Results contribute to understanding of biological mechanisms underlying associations between affective symptoms and cognitive ageing, which can have implications for early detection of, and intervention for, those at risk of poorer cognitive outcomes.
Methylphenidate and mortality in children with attention-deficit hyperactivity disorder: population-based cohort study
Authors: Chen Vincent Chin-Hung , Chan Hsiang-Lin , Wu Shu-I , Lu Mong-Liang , Dewey Michael E. , Stewart Robert , Lee Charles Tzu-Chi 
Published: July 2020

BackgroundLittle is known about methylphenidate (MPH) use and mortality outcomes.AimsTo investigate the association between MPH use and mortality among children with an attention-deficit hyperactivity disorder (ADHD) diagnosis.MethodThis population-based cohort study analysed data from Taiwan's National Health Insurance Research Database (NHIRD). A total of 68 096 children and adolescents aged 4–17 years with an ADHD diagnosis and prescribed MPH between 2000 and 2010 were compared with 68 096 without an MPH prescription, matched on age, gender and year of first ADHD diagnosis. All participants were followed to death, migration, withdrawal from the National Health Insurance programme or 31 December 2013. MPH prescriptions were measured on a yearly basis during the study period, and the association between MPH use and mortality was analysed using a repeated-measures time-dependent Cox regression model. The outcome measures included all-cause, unnatural-cause (including suicide, accident and homicide) and natural-cause mortality, obtained from linkage to the National Mortality Register in Taiwan.ResultsThe MPH group had lower unadjusted all-cause, natural-, unnatural- and accident-cause mortality than the comparison group. After controlling for potential confounders, MPH use was associated with a significantly lower all-cause mortality (adjusted hazard ratio AHR = 0.81, 95% CI 0.67–0.98, P = 0.027), delayed use of MPH was associated with higher mortality (AHR = 1.05, 95% CI 1.01–1.09) and longer MPH use was associated with lower mortality (AHR = 0.83, 95% CI 0.70–0.98).ConclusionsMPH use is associated with a reduced overall mortality in children with ADHD in this cohort study, but unmeasured confounding cannot be excluded absolutely.
Evidence that ABC transporter-mediated autocrine export of an eicosanoid signaling molecule enhances germ cell chemotaxis in the colonial tunicate Botryllus schlosseri
Authors: Kassmer Susannah H. , Rodriguez Delany , De Tomaso Anthony W. 
Published: July 2020

ABSTRACT
The colonial ascidian Botryllus schlosseri regenerates the germline during repeated cycles of asexual reproduction. Germline stem cells (GSCs) circulate in the blood and migrate to new germline niches as they develop and this homing process is directed by a Sphigosine-1-Phosphate (S1P) gradient. Here, we find that inhibition of ABC transporter activity reduces migration of GSCs towards low concentrations of S1P in vitro. In addition, inhibiting phospholipase A2 (PLA2) or lipoxygenase (Lox) blocks chemotaxis towards low concentrations of S1P. These effects can be rescued by addition of the 12-Lox product 12-S-HETE. Blocking ABC transporter, PLA2 or 12-Lox activity also inhibits homing of germ cells in vivo. Using a live-imaging chemotaxis assay in a 3D matrix, we show that a shallow gradient of 12-S-HETE enhances chemotaxis towards low concentrations of S1P and stimulates motility. A potential homolog of the human receptor for 12-S-HETE, gpr31, is expressed on GSCs and differentiating vasa+ germ cells. These results suggest that 12-S-HETE might be an autocrine signaling molecule exported by ABC transporters that enhances chemotaxis in GSCs migrating towards low concentrations of S1P.
A Nodal/Eph signalling relay drives the transition from apical constriction to apico-basal shortening in ascidian endoderm invagination
Authors: Fiuza Ulla-Maj , Negishi Takefumi , Rouan Alice , Yasuo Hitoyoshi , Lemaire Patrick 
Published: July 2020

ABSTRACT
Gastrulation is the first major morphogenetic event during animal embryogenesis. Ascidian gastrulation starts with the invagination of 10 endodermal precursor cells between the 64- and late 112-cell stages. This process occurs in the absence of endodermal cell division and in two steps, driven by myosin-dependent contractions of the acto-myosin network. First, endoderm precursors constrict their apex. Second, they shorten apico-basally, while retaining small apical surfaces, thereby causing invagination. The mechanisms that prevent endoderm cell division, trigger the transition between step 1 and step 2, and drive apico-basal shortening have remained elusive. Here, we demonstrate a conserved role for Nodal and Eph signalling during invagination in two distantly related ascidian species, Phallusia mammillata and Ciona intestinalis. Specifically, we show that the transition to step 2 is triggered by Nodal relayed by Eph signalling. In addition, our results indicate that Eph signalling lengthens the endodermal cell cycle, independently of Nodal. Finally, we find that both Nodal and Eph signals are dispensable for endoderm fate specification. These results illustrate commonalities as well as differences in the action of Nodal during ascidian and vertebrate gastrulation.
Technical Debt and Firm Performance
Authors: Banker Rajiv , Liang Yi , Ramasubbu Narayan 
Published: July 2020

Technical debt refers to the design, development, and implementation shortcuts taken by firms when deploying accounting information systems. Prior system-level studies have shown that such shortcuts decrease the reliability of systems and increase the long-term system maintenance obligations. On the one hand, technical debt may cause system disruptions that impair firm-level performance. On the other hand, incurring technical debt may aid firms to expedite their systems deployment and to implement idiosyncratic functionalities that may enhance performance. In this firm-level study, we examine the economic implications of technical debt accumulated by 26 firms in their customer relationship management (CRM) systems over an 11-year period. We find that firms operating in industries with higher “clockspeed” and higher competitive threats tend to accumulate more technical debt. After controlling for industry- and firm-level factors, our analysis reveals that technical debt embedded in the CRM systems negatively impacts firms’ performances, measured as gross profit scaled by beginning-of-year total assets (GROA). We estimate that a 10% increase in technical debt reduces GROA by 16% on average. The negative impact of technical debt on GROA increases over the lifecycle of the systems, which significantly reduces the long-term business value of those systems. Highly experienced information technology teams and the presence of a chief information officer in a firm’s top management team, however, serve to mitigate, at least partially, the negative impact of technical debt. We discuss the implications of these findings for research on the business value and governance of accounting information systems and performance evaluation. This paper was accepted by Shiva Rajgopal, accounting.
Spiritual wellbeing and its relationship with perceived stress, anxiety and depression in Iranian cardiac patients
Authors: Senmar Mojtaba , Hasannia1 Elham , Aliakbari Mohaddeseh , Alamoti Fateme Safari , Gholamhoseini Maryam , Razaghpoor Ali , Noorian Sajad , Rafiei Hossein 
Published: July 2020

Aim This study was conducted to examine spiritual wellbeing and its relationship with perceived stress, anxiety and depression among cardiac patients. Methods The present descriptive study was conducted on 120 patients with cardiac diseases. The Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Paloutzian and Ellison Spiritual Wellbeing Questionnaire were used for data collection. Results Of 120 patients, 79 were diagnosed with acute coronary syndrome, 30 were diagnosed with heart failure, and the rest were diagnosed with cardiac arrhythmia (mostly atrial fibrillation). The mean scores for depression, anxiety and stress in the studied patients were 10.1, 9.9, and 19.5, respectively. The mean score of the total spiritual wellbeing was 86.2. Results showed an inverse and significant relationship between spiritual wellbeing with perceived stress (R2=−0.535, P=0.001), anxiety (R2=−0.389, P<0.001), and depression (R2=−0.388, P<0.001). Conclusions Improving cardiac patients’ spiritual wellbeing should be recognised as an essential part of holistic care and an effective strategy in reducing depression, anxiety and stress among cardiac patients.
A method for identifying cost-efficient practices in the treatment of thoracic empyema
Authors: Thanassoulis Emmanuel , Takamura-Tweedy Alexander , Patel Mitul , Rao Satish 
Published: July 2020

Background/Aims There is a need to identify cost-efficient practices in delivering healthcare. This study illustrates how cost-efficient practices can be identified and disseminated in treating thoracic empyema. Methods Data envelopment analysis was used to identify the scope for reducing length of stay, and therefore costs, at inpatient spell level for thoracic empyema. Results The potential for length of stay reduction was identified, representing about 50% of the recorded length of stay. Significant differences in potential for length of stay reduction were also found between consultant teams and between sources of patient admission. Conclusions Data envelopment analysis enables multiple conditioning factors affecting costs at inpatient spell level to be taken into account simultaneously. It enables management to identify and disseminate best practice within its own hospital. The approach can be transferred to other inpatient settings beyond thoracic empyema.
Effect of allicin on wound healing: an experimental diabetes model
Authors: Toygar Ismail , Tureyen Aynur , Demir Derya , Cetinkalp Sevki 
Published: July 2020

Objective:The aim of this study was to investigate the effect of allicin on wound healing in an experimental diabetes model.Method:In this randomised controlled study, 50 Wistar albino rats (25 females, 25 males) each weighing 200–300g were used. To develop the diabetes model, 30 rats were induced with 50mg/kg streptozotocin (STZ); 20 rats were not induced in order to compare diabetic and nondiabetic rats. The diabetic rats were divided into three groups, according to dressing material used (allicin, physiological serum and control, where no dressing was used), and the nondiabetic rats were divided into two groups (allicin and control, where no dressing was used). The wound area was calculated and recorded on days 0, 7, 14 and 21. In addition, biopsies were taken from the wound area on days 0, 7, 14 and 21 and used for microscopic examination. Day 0 was used as a reference to calculate wound healing percentage.Results:On days 7 and 14, there were statistically significant differences between groups. Wound surface areas were smaller in the allicin group than in other groups on days 7 and 14. There were no statistically significant differences between the groups on day 21. In addition, it was determined that neutrophil, mononuclear cell, intraepithelial oedema and dermal oedema density were lower and fibroblast, angiogenesis and collagen density were higher in the allicin groups on days 7 and 14.Conclusion:In this study, allicin was found to be potentially effective on wound healing. Future research should be conducted in order to clarify how it affects wound healing.
Treatment of hard-to-heal leg ulcers with hyaluronic acid, sodium alginate and negative pressure wound therapy
Authors: Cetinkaya Omer Arda , Celik Suleyman Utku , Boztug Can Yahya , Uncu Hakan 
Published: July 2020

Objective: Hard-to-heal lower extremity ulcer is a common healthcare problem and can lead to a poor quality of life (QoL). Despite the advances in wound care, conventional therapies, such as necrotic tissue debridement, cleansing, treatment of infection and local treatment with dressing application are still considered the standard of care in patients with hard-to-heal leg ulcers. However, managing hard-to-heal ulcers that do not respond well to these methods has led to new treatment strategies. In this study, the effects of hyaluronic acid (HA) and sodium alginate (SA), combined with negative pressure wound therapy (NPWT), in patients with hard-to-heal leg ulcers are evaluated. Method: Patients with hard-to-heal lower extremity ulcers were treated with HA-SA combined with NPWT (HA-SA-NWPT, n=11), or conventional therapy (n=14), between June 2014 and September 2015. Demographics, comorbidities, time to complete healing and change in wound area were recorded and compared. Results: A total of 25 patients took part. Complete healing was achieved in 63.6% (n=7) of the patients in the HA-SA with NPWT group, compared with 14.3% (n=2) of the patients in the conventional therapy group (p=0.017). The mean decrease in wound size was significantly higher in the HA-SA-NPWT group than in the conventional therapy group (73.8% versus 34.8%, respectively, p=0.029). Despite a shorter healing period in the HA-SA-NPWT group than in the conventional group, no statistically significant difference was found between groups for time to complete healing (37 days versus 55 days, respectively). Conclusion: These results demonstrate that the combination of HA-SA-NPWT is a promising treatment for decreasing the healing time and increasing the success rate by their synergistic effect on wound healing in hard-to-heal lower extremity ulcers. However, further studies with a larger number of patients are needed to confirm the results.
Primary School Students’ Creative Thinking Skills in Mathematics Problem Solving
Authors: Yayuk Erna , Purwanto Purwanto , As’ari Abdur Rahman , Subanji Subanji 
Published: July 2020

<p style="text-align:justify">This study aims to analyze students’ creative thinking skills in answering the problem-solving questions. This study employs qualitative design, involving 110 fifth graders in Malang Municipality and Regency as the subjects. The obtained data were analyzed using the descriptive-explorative approach. The findings reveal that the high-achievers in Mathematics showed good skills in the aspects of fluency and flexibility, but were still struggling in the novelty aspect. The average-achievers showed good skills in flexibility aspects but were lacking in the fluency and novelty aspects. They showed an understanding of Mathematics problems but found it difficult to decide the solving strategies, and thus their answers were lacking in structure and less systematic. When solving a problem, the calculation made seemed rushing, was less careful, and frequented with trial and error strategy. The low-achievers showed difficulties in understanding the problems. Their answers were not systematic, not well-structured, and not detailed. This indicates that the low-achievers had not shown creative thinking skills in fluency, flexibility, and novelty aspects.</p>
The European Union’s global strategy: Complementarity and specialization
Authors: Barroso Luís , Cruz Marco 
Published: July 2020

AbstractAs a grand strategy, European Union Global Strategy (EUGS) is a roadmap to convert the European Union (EU) in a key strategic actor. The evidence of some conceptual vulnerabilities, particularly the EU lack of classical means and strategic autonomy, limits its implementation. Thus, this article aims to find some relevant actions that the EU needs to put in place to enhance her global image as a credible and specialized actor where the power of her strategic partners, as NATO and United Sates, need to be complemented. To that effect, first, the EU must demonstrate leadership and mobilize the support of member states to carry out its strategy. Second, it must leverage its strategic autonomy by intervening in crises and conflicts where the military means are not the most important. Third, it must focus on preventing or solving the problems in the EU’s neighbourhood as it will suffer direct repercussions if it fails to do so. Implementing the EUGS will require a generic but encompassing grand strategy concept; to communicate its achievements through annual reviews, laying a foundation upon which the EU can build its internal and external credibility, providing it with the strategic autonomy it so direly needs. Finally, the EU must invest on Europeanization processes by ‘transforming’ societies through the ‘global’ application of EU instruments.
« Les Grands Buffets », une éducation commensale
Authors: Lardellier Pascal 
Published: July 2020

« Les Grands Buffets » de Narbonne, dont il va être question dans ces pages, constituent un cas unique en France dans l’univers de la restauration. Il s’agit en effet d’un restaurant d'exception qui, entre narrations et discours, concilie les codes de la « cuisine traditionnelle française » et la formule « buffet à volonté ». Etonnant appariement dont cet article se fera l’écho.
Assessment of maternal health services utilization in Pakistan: the role of socio-demographic characteristics
Authors: Aslam Muhammad , Sadiq Maryam , Mehmood Tahir 
Published: July 2020

Abstract

Background
High-quality prenatal care has a significant positive impact on maternal and infant health as it helps timely diagnosis and treatment of pregnancy complications.

Objective
To examine factors associated with the utilization of maternal health care using the optimal count regression model.

Methods
A sample of 16,314 women of reproductive ages (15–49) was used. Andersen and Newman's behavioral model of health services utilization was employed for the selection of covariates. Poisson, negative binomial, zero-inflated Poisson, zero-inflated negative binomial (ZINB), Poisson hurdle, and negative binomial hurdle models were fitted and compared to identify the best model. Maternal health care utilization is found associated with maternal age and education, area of residence, domestic violence, the income level of family, access to media, knowledge about AIDS, parity, birth order, and having a child who later died.

Results
ZINB model is found to be best fitted for the observed data resulting strong influence of mother's education and income level of the family on maternal health care utilization.

Conclusion
Interventions to improve maternal care services utilization should address individuals and systems to reduce social and economic marginalization.
Clinical trials of homeopathy in urological disorders: a systematic review
Authors: Nayak Chaturbhuja , Manchanda Rajkumar , Khurana Anil , Chalia Deepti Singh , Pannek Jürgen , Chattopadhyay Abhijit , Koley Munmun , Saha Subhranil 
Published: July 2020

Abstract

Objectives
Homeopathy remains one of the most sought after therapies for urological disorders. The aim of this paper was to systematically review the available clinical researches of homeopathy in the said conditions.

Content
Relevant trials published between Jan 1, 1981 and Dec 31, 2016 (with further extension up to Dec 31, 2017) was identified through a comprehensive search. Internal validity of the randomized trials and observational studies was assessed by The Cochrane Collaboration’s tool and methodological index for non-randomized studies (MINORS) criteria respectively, homeopathic model validity by Mathie’s six judgmental domains, and quality of homeopathic individualization by Saha’s criteria.

Summary
Four controlled (three randomized and one sequentially allocated controlled trial) trials were reviewed and 14 observational studies alongside – all demonstrated positive effect of homeopathy. Major focus areas were benign prostatic hypertrophy and renal stones. One of the four controlled trials had ‘adequate’ model validity, but suffered from ‘high’ risk of bias. None of the non-randomized studies was tagged as ‘ideal’ as all of those underperformed in the MINORS rating. Nine observational studies had ‘adequate’ model validity and quality criteria of individualization. Proof supporting individualized homeopathy from the controlled trials remained promising, still inconclusive.

Outlook
Although observational studies appeared to produce encouraging effects, lack of adequate quality data from randomized trials hindered to arrive at any conclusion regarding the efficacy or effectiveness of homeopathy in urological disorders. The findings from the RCTs remained scarce, underpowered and heterogeneous, had low reliability overall due to high or uncertain risk of bias and sub-standard model validity. Well-designed trials are warranted with improved methodological robustness.

Funding
None; Registration web-link: https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018081624&ID=CRD42018081624.
Simulation of Human Ear Recognition Sound Direction Based on Convolutional Neural Network
Authors: Wang Zhuhe , Li Nan , Wu Tao , Zhang Haoxuan , Feng Tao 
Published: July 2020

Abstract
In recent years, more and more people are applying Convolutional Neural Networks to the study of sound signals. The main reason is the translational invariance of convolution in time and space. Thereby the diversity of the sound signal can be overcome. However, in terms of sound direction recognition, there are also problems such as a microphone matrix being too large, and feature selection. This paper proposes a sound direction recognition using a simulated human head with microphones at both ears. Theoretically, the two microphones cannot distinguish the front and rear directions. However, we use the original data of the two channels as the input of the convolutional neural network, and the resolution effect can reach more than 0.9. For comparison, we also chose the delay feature (GCC) for sound direction recognition. Finally, we also conducted experiments that used probability distributions to identify more directions.