bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical role of bronchoalveolar lavage in dermatomyositis-associated interstitial lung disease
Authors: He Linrong , Ge Yongpeng , Li Sizhao , Huang Ke , Liu Xia , Chen Fang , Li Shanshan , Yang Hongxia , Lu Xin , Wang Guochun , Shu Xiaoming 
Published: July 2021

Abstract

Objective
To investigate the role of bronchoalveolar lavage (BAL) in DM-associated interstitial lung disease (ILD).

Methods
We retrospectively reviewed the medical records of patients with DM-ILD who underwent bronchoscopy between October 2015 and September 2019. We then collated clinical features, laboratory data and bronchoscopy findings. The follow-up study was terminated on the 1 May 2020.

Results
A total of 113 DM-ILD patients were included in this study, including 27 patients with acute/subacute interstitial pneumonia (A/SIP) and 86 patients with chronic interstitial pneumonia (CIP). The A/SIP group had significantly lower proportions of lymphocytes and eosinophils in the bronchoalveolar lavage fluid (BALF) than the CIP group, but had a significantly higher proportion of neutrophils. Pathogens were discovered in BALF from 28 (24.8%) patients. Twenty-five (22.1%) patients commenced or changed antibiotic therapy on the basis of their bronchoscopy results. Lymphopenia and intensive care unit care were significantly associated with pathogen-positive BALF findings. Complications of bronchoscopy occurred in nine (8.0%) patients; fever (5.3%) was the most common complication. Twenty-five deaths (25/106, 23.6%) were observed during a mean follow-up of 22 months. Age, A/SIP and anti-MDA5 antibody were identified as independent predictors of a poor outcome, while mechanic’s hands was an independent protective factor. However, cellular and pathogen findings in BALF had no significant influence on 30-day or overall mortality.

Conclusion
Bronchoscopy is a relatively useful instrument to evaluate ILD in patients with DM, and BAL can improve the diagnosis of infection. However, cellular and pathogen findings from BALF had no significant influence on prognosis.
Identification of plexin D1 on circulating extracellular vesicles as a potential biomarker of polymyositis and dermatomyositis
Authors: Uto Kenichi , Ueda Koji , Okano Takaichi , Akashi Kengo , Takahashi Soshi , Nakamachi Yuji , Imanishi Takamitsu , Awano Hiroyuki , Morinobu Akio , Kawano Seiji , Saegusa Jun 
Published: July 2021

Abstract

Objectives
We aimed to identify disease-specific surface proteins on extracellular vesicles (EVs) as novel serum biomarkers of PM/DM.

Methods
We performed liquid chromatography–tandem mass spectrometry (LC/MS) on purified EVs from sera of 10 PM/DM patients, 23 patients with other autoimmune diseases and 10 healthy controls (HCs). We identified membrane proteins preferentially present in EVs of PM/DM patients by bioinformatics and biostatistical analyses. We developed an EV sandwich ELISA for directly detecting serum EVs expressing disease-specific membrane proteins and evaluated their clinical utility using sera from 54 PM/DM, 24 RA, 20 SLE, 13 SSc and 25 Duchenne and Becker types of muscular dystrophy (DMD/BMD) patients and 36 HCs.

Results
LC/MS analysis identified 1220 proteins in serum EVs. Of these, plexin D1 was enriched in those from PM/DM patients relative to HCs or patients without PM/DM. Using a specific EV sandwich ELISA, we found that levels of plexin D1+ EVs in serum were significantly greater in PM/DM patients than in HCs or RA, SLE or DMD/BMD patients. Serum levels of plexin D1+ EVs were greater in those PM/DM patients with muscle pain or weakness. Serum levels of plexin D1+ EVs were significantly correlated with levels of aldolase (rs = 0.481), white blood cells (rs = 0.381), neutrophils (rs = 0.450) and platelets (rs = 0.408) in PM/DM patients. Finally, serum levels of plexin D1+ EVs decreased significantly in patients with PM/DM in clinical remission after treatment.

Conclusion
We identified levels of circulating plexin D1+ EVs as a novel serum biomarker for PM/DM.
Fertility and pregnancy outcomes in women with spondyloarthritis: a systematic review and meta-analysis
Authors: Hamroun Sabrina , Hamroun Aghilès , Bigna Jean-Joël , Allado Edem , Förger Frauke , Molto Anna 
Published: July 2021

AbstractObjectiveThe aim of this study was to determine the impact of SpA and its treatments on fertility and pregnancy outcomes, as well as the impact of pregnancy on disease activity.MethodsA systematic review and meta-analyses were performed, including studies in women with SpA [axial (axSpA) and peripheral SpA, including PsA]. The heterogeneity between studies was quantified (I2), and in the case of substantial heterogeneity, the results were reported in a narrative review.ResultsOf 4397 eligible studies, 21 articles were included, assessing a total of 3566 patients and 3718 pregnancies, compared with 42 264 controls. There is a lack of data on fertility in the literature. We found an increased risk of preterm birth [pooled odds ratio (OR) 1.64 (1.15–2.33), I2 =24% in axSpA and 1.62 (1.23–2.15), I2 =0.0% in PsA], small for gestational age [pooled OR 2.05 (1.09–3.89), I2 =5.8% in axSpA], preeclampsia [pooled OR 1.59 (1.11–2.27], I2 =0% in axSpA] and caesarean section [pooled OR 1.70 (1.44–2.00), I2 =19.9% in axSpA and 1.71 (1.14–2.55), I2 =74.3% in PsA], without any other unfavourable pregnancy outcome. Further analysis showed a significantly higher risk of elective caesarean section [pooled OR 2.64 (1.92–3.62), I2 =0.0% in axSpA and 1.47 [1.15–1.88], I2 =0,0% in PsA), without increased risk of emergency caesarean section in PsA. During pregnancy, there appears to be a tendency for unchanged or worsened disease activity in axSpA and unchanged or improved disease activity in PsA. Both conditions tend to flare in the postpartum period.ConclusionSpA seems to be associated with an increased risk of preterm birth, small for gestational age, preeclampsia, and caesarean section.
Psychosis Biotypes: Replication and Validation from the B-SNIP Consortium
Authors: Clementz Brett A , Parker David A , Trotti Rebekah L , McDowell Jennifer E , Keedy Sarah K , Keshavan Matcheri S , Pearlson Godfrey D , Gershon Elliot S , Ivleva Elena I , Huang Ling-Yu , Hill S Kristian , Sweeney John A , Thomas Olivia , Hudgens-Haney Matthew , Gibbons Robert D , Tamminga Carol A 
Published: July 2021

Abstract
Current clinical phenomenological diagnosis in psychiatry neither captures biologically homologous disease entities nor allows for individualized treatment prescriptions based on neurobiology. In this report, we studied two large samples of cases with schizophrenia, schizoaffective, and bipolar I disorder with psychosis, presentations with clinical features of hallucinations, delusions, thought disorder, affective, or negative symptoms. A biomarker approach to subtyping psychosis cases (called psychosis Biotypes) captured neurobiological homology that was missed by conventional clinical diagnoses. Two samples (called “B-SNIP1” with 711 psychosis and 274 healthy persons, and the “replication sample” with 717 psychosis and 198 healthy persons) showed that 44 individual biomarkers, drawn from general cognition (BACS), motor inhibitory (stop signal), saccadic system (pro- and anti-saccades), and auditory EEG/ERP (paired-stimuli and oddball) tasks of psychosis-relevant brain functions were replicable (r’s from .96–.99) and temporally stable (r’s from .76–.95). Using numerical taxonomy (k-means clustering) with nine groups of integrated biomarker characteristics (called bio-factors) yielded three Biotypes that were virtually identical between the two samples and showed highly similar case assignments to subgroups based on cross-validations (88.5%–89%). Biotypes-1 and -2 shared poor cognition. Biotype-1 was further characterized by low neural response magnitudes, while Biotype-2 was further characterized by overactive neural responses and poor sensory motor inhibition. Biotype-3 was nearly normal on all bio-factors. Construct validation of Biotype EEG/ERP neurophysiology using measures of intrinsic neural activity and auditory steady state stimulation highlighted the robustness of these outcomes. Psychosis Biotypes may yield meaningful neurobiological targets for treatments and etiological investigations.
Mode of delivery of Cognitive Behavioral Therapy for Insomnia: a randomized controlled non-inferiority trial of digital and face-to-face therapy
Authors: Kallestad Håvard , Scott Jan , Vedaa Øystein , Lydersen Stian , Vethe Daniel , Morken Gunnar , Stiles Tore Charles , Sivertsen Børge , Langsrud Knut 
Published: July 2021

Abstract

Study Objectives
Digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) has demonstrated efficacy in reducing insomnia severity in self-referred and community samples. It is unknown, however, how dCBT-I compares to individual face-to-face (FtF) CBT-I for individuals referred to clinical secondary services. We undertook a randomized controlled trial to test whether fully automated dCBT-I is non-inferior to individual FtF CBT-I in reducing insomnia severity.

Methods
Eligible participants were adult patients with a diagnosis of insomnia disorder recruited from a sleep clinic provided via public mental health services in Norway. The Insomnia Severity Index (ISI) was the primary outcome measure. The non-inferiority margin was defined a priori as 2.0 points on the ISI at week 33.

Results
Individuals were randomized to FtF CBT-I (n = 52) or dCBT-I (n = 49); mean baseline ISI scores were 18.4 (SD 3.7) and 19.4 (SD 4.1), respectively. At week 33, the mean scores were 8.9 (SD 6.0) and 12.3 (SD 6.9), respectively. There was a significant time effect for both interventions (p &lt; 0.001); and the mean difference in ISI at week 33 was −2.8 (95% CI: −4.8 to −0.8; p = 0.007, Cohen’s d = 0.7), and −4.6 at week 9 (95% CI −6.6 to −2.7; p &lt; 0.001), Cohen’s d = 1.2.

Conclusions
At the primary endpoint at week 33, the 95% CI of the estimated treatment difference included the non-inferiority margin and was wholly to the left of zero. Thus, this result is inconclusive regarding the possible inferiority or non-inferiority of dCBT-I over FtF CBT-I, but dCBT-I performed significantly worse than FtF CBT-I. At week 9, dCBT-I was inferior to FtF CBT-I as the 95% CI was fully outside the non-inferiority margin. These findings highlight the need for more clinical research to clarify the optimal application, dissemination, and implementation of dCBT-I.
Clinicaltrials.gov: NCT02044263: Cognitive Behavioral Therapy for Insomnia Delivered by a Therapist or on the Internet: a Randomized Controlled Non-inferiority Trial.
Daily-level effects of alcohol, marijuana, and simultaneous use on young adults’ perceived sleep health
Authors: Graupensperger Scott , Fairlie Anne M , Vitiello Michael V , Kilmer Jason R , Larimer Mary E , Patrick Megan E , Lee Christine M 
Published: July 2021

Abstract

Study Objectives
Simultaneous alcohol and marijuana (SAM) use is increasingly prevalent among young adults but has adverse health consequences. The current study examined daily-level associations between perceived sleep health and SAM use, relative to non-substance-use days and alcohol- or marijuana-only days. We also estimated linear associations between alcohol/marijuana use and perceived sleep health and explored whether effects were moderated by combined use of alcohol and marijuana.

Methods
A community sample of SAM-using young adults (N = 409; Mage = 21.61, SD = 2.17; 50.9% female; 48.2% White; 48.9% college students) completed twice-daily surveys for five 14-day sampling bursts. Daily measurements assessed substance use and perceived sleep health in terms of subjective sleep quality, negative impact of sleep on functioning, and symptoms of insomnia.

Results
Multilevel models indicated that, relative to non-substance-use days, participants reported poorer perceived sleep health on alcohol-only days, better perceived sleep health on marijuana-only days, and mixed evidence regarding SAM use (i.e. fewer perceived symptoms of insomnia, but poorer perceived next day functioning attributed to sleep). Daily-level estimates showed increased alcohol use was associated with poorer perceived sleep health, while stronger effects from marijuana were associated with better perceived sleep health. Across all indices of sleep health, only one linear association was moderated by combined use: The adverse association between alcohol and next day functioning was weaker on days alcohol was combined with marijuana.

Conclusions
Findings provide additional evidence for daily-level effects of alcohol and marijuana use on perceived sleep health and address an important literature gap regarding potential adverse effects of SAM use.
Making the Cut: Status, Credentials, and Hiring in Medicine
Authors: Jenkins Tania M 
Published: July 2021

Abstract
Little is known about how employers interpret prestigious and non-prestigious credentials in professional recruitment, or how organizations shape and structure this process. Such research is needed to elucidate how employers and organizations contribute to stratification among professionals based on social class, especially since graduates of less selective schools tend to come from lower-SES backgrounds. Using data from a comparative ethnography of residency recruitment at two hospitals, I ask: 1) how do employers interpret prestigious and non-prestigious professional degrees in recruitment, and 2) how does organizational context influence how employers interpret these credentials? The findings add to a growing literature that focuses on qualitative differences between credentials to understand how employers make sense of elite and non-elite credentials within a single profession. The literature disagrees, however, about how employers interpret credentials. I reframe the debate to show that employers rely on combinations of interpretations in sequence, rather than finding evidence for one interpretation or another. I show how organizational context shapes these interpretations, with different employers interpreting the same credentials differently. The article also demonstrates that the order in which employers use different credential interpretations is heavily shaped by organizational status, with implications for inequality.
Higher water and nutrient use efficiencies in savanna than in rainforest lianas result in no difference in photosynthesis
Authors: Zhang Yun-Bing , Yang Da , Zhang Ke-Yan , Bai Xiao-Long , Wang Yang-Si-Ding , Wu Huai-Dong , Ding Ling-Zi , Zhang Yong-Jiang , Zhang Jiao-Lin 
Published: July 2021

AbstractDifferences in traits between lianas and trees in tropical forests have been studied extensively; however, few have compared the ecological strategies of lianas from different habitats. Here, we measured 25 leaf and stem traits concerning leaf anatomy, morphology, physiology and stem hydraulics for 17 liana species from a tropical seasonal rainforest and for 19 liana species from a valley savanna in south-west China. We found that savanna lianas had higher vessel density, wood density and lower hydraulically weighted vessel diameter and theoretical hydraulic conductivity than tropical seasonal rainforest lianas. Compared with tropical seasonal rainforest lianas, savanna lianas also showed higher leaf dry matter content, carbon isotope composition (δ13C), photosynthetic water use efficiency, ratio of nitrogen to phosphorus, photosynthetic phosphorus use efficiency and lower leaf size, stomatal conductance and nitrogen, phosphorus and potassium concentrations. Interestingly, no differences in light-saturated photosynthetic rate were found between savanna and tropical seasonal rainforest lianas either on mass or area basis. This is probably due to the higher water and nutrient use efficiencies of savanna lianas. A principal component analysis revealed that savanna and tropical seasonal rainforest lianas were significantly separated along the first axis, which was strongly associated with acquisitive or conservative resource use strategy. Leaf and stem functional traits were coordinated across lianas, but the coordination or trade-off was stronger in the savanna than in the tropical seasonal rainforest. In conclusion, a relatively conservative (slow) strategy concerning water and nutrient use may benefit the savanna lianas, while higher nutrient and water use efficiencies allow them to maintain similar photosynthesis as tropical seasonal rainforest species. Our results clearly showed divergences in functional traits between lianas from savanna and tropical seasonal rainforest, suggesting that enhanced water and nutrient use efficiencies might contribute to the distribution of lianas in savanna ecosystems.
California’s Paid Family Leave Law and the Employment of 45- to 64-Year-Old Adults
Authors: Bartel Ann P , Kim Soohyun , Ruhm Christopher J , Waldfogel Jane 
Published: July 2021

AbstractPaid family leave allows workers to take time off from work to care for a family member with a serious health condition, with reduced financial risk and increased job continuity. In 2004, California was the first state in the nation to implement a paid family leave program allowing workers to take up to 8 weeks off work with partial pay to care for their own or a family member’s serious health condition. Although the effects of California’s law on the labor supply of parents of newborns have been extensively studied, the role of paid family leave in the labor supply of workers who may need to provide care for a spouse has not been studied widely. We examine the effects of California’s law on the employment of workers who are aged 45–64 and have a disabled spouse, using the 2001–2008 American Community Survey. Our preferred estimates suggest the paid leave program increased the employment of 45- to 64-year-old women with a disabled spouse in California by around 0.9 percentage points (or 1.4% on a prelaw base rate of 65.9%) in the postlaw period compared with their counterparts in other states, with a 2.9 percentage point rise in private-sector employment. The employment of men with a disabled spouse in California also increased, but by a smaller amount: 0.7 percentage points (or 0.8% on a prelaw base 86.8%; with a nonsignificant 0.4 percentage point decrease in private-sector employment).
14Disability Studies
Authors: Dilodovico Amanda 
Published: July 2021

Abstract
This chapter reviews recent publications in the field of disability studies on disability and criminal justice systems, particularly through the processes of institutionalization and incarceration. The main texts that serve as the corpus for this review define disability broadly, though devote analysis to historical constructions of intellectual/developmental disability and psychosocial disorders, labels that are critically evaluated in each text as well as in this review. By concentrating on institutionalization and incarceration, these texts are specifically focused on how ‘disability’ is entangled in the criminal justice systems of Anglo legal structures (USA, Canada, England, Scotland, Wales, Northern Ireland, the Republic of Ireland, New Zealand/Aotearoa, Australia) that developed out of English-speaking imperial forces. Specifically, these texts take issue with the idea that the process of deinstitutionalization, the movement of disabled individuals from enclosed facilities to inclusive community settings, was successful in liberating disabled individuals, specifically disabled black, Indigenous populations. This chapter proceeds in four sections. First, we focus on the contemporary definitions of institutionalization and incarceration across the different legal systems traversed by each author. Second, we consider the organizing tension of neoliberal capitalism as a framework through which to analyze and critique continued forms of institutionalization and incarceration. Third, we observe the need to center disabled black, Indigenous experiences of incarceration and institutionalization under the auspices of ‘inclusion’ in the supposed era of deinstitutionalization. Lastly, we move through the alternatives to the forms of institutionalization and incarceration assessed in these texts and offer directions for further critical thought.
Diversity Is Not Enough: Advancing a Framework for Antiracism in Medical Education
Authors: Solomon Sonja R. , Atalay Alev J. , Osman Nora Y. 
Published: July 2021

Medical students, residents, and faculty have begun to examine and grapple with the legacy and persistence of structural racism in academic medicine in the United States. Until recently, the discourse and solutions have largely focused on augmenting diversity across the medical education continuum through increased numbers of learners from groups underrepresented in medicine (UIM). Despite deliberate measures implemented by medical schools, residency programs, academic institutions, and national organizations, meaningful growth in diversity has not been attained. To the contrary, the UIM representation among medical trainees has declined or remained below the representation in the general population. Inequities continue to be observed in multiple domains of medical education, including grading, admission to honor societies, and extracurricular obligations. These inequities, alongside learners’ experiences and calls for action, led the authors to conclude that augmenting diversity is necessary but insufficient to achieve equity in the learning environment.
In this article, the authors advance a 4-step framework, built on established principles and practices of antiracism, to dismantle structural racism in medical education. They ground each step of the framework in the concepts and skills familiar to medical educators. By drawing parallels with clinical reasoning, medical error, continuous quality improvement, the growth mindset, and adaptive expertise, the authors show how learners, faculty, and academic leaders can implement the framework’s 4 steps—see, name, understand, and act—to shift the paradigm from a goal of diversity to a stance of antiracism in medical education.
Understanding Ethical Challenges in Medical Education Research
Authors: Klitzman Robert L. 
Published: July 2021

Rapidly advancing biomedical and electronic technologies, ongoing health disparities, and new online educational modalities are all changing medicine and medical education. As medical training continues to evolve, research is increasingly critical to help improve it, but medical education research can pose unique ethical challenges.
As research participants, medical trainees may face several risks and in many ways constitute a vulnerable group. In this commentary, the author examines several of the ethical challenges involved in medical education research, including confidentiality and the risk of stigma; the need for equity, diversity, and inclusion; genetic testing of students; clustered randomized trials of training programs; and questions about quality improvement activities. The author offers guidance for navigating these ethical challenges, including the importance of engaging with institutional review boards. Academic medical institutions should educate and work closely with faculty to ensure that all research adheres to appropriate ethical guidelines and regulations and should provide instruction about the ethics of medical education research to establish a strong foundation for the future of the field.
Research on medical education will become increasingly important. Given the potential sensitivity of the data collected in such research, investigators must understand and address potential ethical challenges as carefully as possible.