bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep eutectic solvents improve the stability of forsythoside A
Authors: Zhang Qin , Dong Zhe , Du Huizhi 
Published: May 2021

AbstractForsythoside A is used as the main chemical marker for quality control of Forsythia suspensa (Thunb.) Vahl (F. suspensa, Lianqiao in Chinese) fruits and leaves. The hydrolysis of forsythoside A at high temperature and effects of deep eutectic solvents (DESs) on stability of forsythoside A were studied in the article. Forsythoside A, I, and H may be directly converted into each other at high temperature. With more heating time, they are gradually decomposed into smaller molecular compounds. High temperature, alkaline conditions, high humidity, the oxidant, and light drastically destroyed stability of forsythoside A, while acidic conditions and the antioxidant protected it. Compared with water and alcohol solvents, DESs improved effectively stability of forsythoside A due to the formation of hydrogen bonds between DESs and forsythoside A. Our research preliminarily uncovered the converting mechanism of forsythoside A and confirmed that DES improved the stability of forsythoside A.
Was it worth it? Benefits of transcatheter aortic valve implantation from a patient's perspective
Authors: Beishuizen Sara J. E. , Festen Suzanne , van der Werf Hindrik W. , de Graeff Pauline , van Munster Barbara C. 
Published: May 2021

AbstractObjectivesTranscatheter aortic valve implantation (TAVI) is an important treatment option for patients with severe aortic stenosis. To improve patient selection, shared decision‐making is recommended to elicit patients' treatment expectations and goals. We assessed patients' expectations and goals before TAVI treatment and whether these were met after treatment. Additionally, we evaluated how meeting these goals aligned with quality of life and functional recovery.DesignA mixed method study.SettingAn academic medical center.ParticipantsSeventy‐four patients undergoing TAVI between 2015 and 2017.MeasurementsPatients' expectations and goals were assessed qualitatively before treatment. Six to twelve months post procedure, quality of life was measured with the EuroQuol‐5D and any change in the number of dependencies in (instrumental) activities of daily living was assessed.ResultsMean age of patients was 81.5 years, and 37.8% were male. Regaining the ability to engage in a specific hobby or activity was the most important treatment goal (33 patients, 54.1%), followed by reducing symptoms (19 patients 31.1%). 66.2% of patients stated that their treatment goal was met. Quality of life was higher in this group, as compared with patients who had not met their treatment goal. Twenty‐three patients (31.1%) showed functional improvement.ConclusionTAVI patients were quite capable of eliciting treatment goals and a majority stated, after treatment, that these had been met patients' experience of treatment benefits regarding these goals had poor alignment with functional outcomes. This raises questions regarding relevant outcome measurements in this population, and could aid in improving shared decision‐making and patient selection for TAVI.
Dying with dementia in Medicare Advantage, Accountable Care Organizations, or traditional Medicare
Authors: Teno Joan M. , Keohane Laura M. , Mitchell Susan L. , Meyers David J. , Bunker Jennifer N. , Belanger Emmanuelle , Gozalo Pedro L. , Trivedi Amal N. 
Published: May 2021

AbstractBackground/ObjectiveMedicare Advantage (MA) and Accountable Care Organizations (ACOs) operate under incentives to reduce burdensome and costly care at the end of life. We compared end‐of‐life care for persons with dementia who are in MA, ACOs, or traditional Medicare (TM).Design, Setting, and ParticipantsRetrospective study of decedents with dementia enrolled in MA, attributed to an ACO, or in TM. Decedents had a nursing home stay between 91 and 180 days prior to death, two or more functional impairments, and mild to severe cognitive impairment.MeasurementsHospitalization, invasive mechanical ventilation (IMV) use, and in‐hospital death in the last 30 days of life reported in Medicare billing.ResultsAmong 370,094 persons with dementia, 93,801 (25.4%) were in MA (mean age [SD], 86.9 [7.7], 67.6% female), 39,586 (10.7%) were ACO attributed (mean age [SD], 87.2 [7.6], 67.3% female), and 236,707 (63.9%) were in TM (mean age [SD], 87.0 [7.8], 67.6% female). The proportion hospitalized in the last 30 days of life was higher among TM enrollees (27.9%) and those ACO attributed (28.1%) than among MA enrollees (20.5%, p ≤ 0.001). After adjustment for socio‐demographics, cognitive and functional impairments, comorbidities, and Hospital Referral Region, adjusted odds of hospitalization in the 30 days prior to death was 0.72 (95% confidence interval [CI] 0.70–0.74) among MA enrollees and 1.05 (95% CI 1.02–1.09) among those attributed to ACOs relative to TM enrollees. Relative to TM, the adjusted odds of death in the hospital were 0.78 (95% CI 0.75–0.81) among MA enrollees and 1.02 (95% CI 0.96–1.08) for ACO participants. Dementia decedents in MA had a lower likelihood of IMV use (adjusted odds ratio 0.80, 95% CI 0.75–0.85) compared to TM.ConclusionsAmong decedents with dementia, MA enrollees but not decedents in ACOs experienced less costly and potentially burdensome care compared with those with TM. Policy changes are needed for ACOs.
Hair transplantation Follicular Unit Excision (FUE): Introducing the multipurpose octagonal ring punch
Authors: Trivellini Roberto , Gupta Aditya K 
Published: May 2021

SUMMARYThe technique of follicular unit excision for harvesting grafts for hair transplantation procedures has become very popular. This technique relies on the use of small punches to remove viable grafts. Many different punch shapes have been developed to accommodate the varying nature of skin and hair characteristics, resulting in hair transplant surgeons requiring a variety of punches to suit a wide range of patients, which can be overwhelming to the beginner when trying to decide on the optimal choice of a punch to suit a particular skin characteristic. We describe a novel multipurpose ring punch that can be used on patients with a variety of skin and hair characteristics, as well as for shaved and long hair FUE. Features of this punch include an octagonal ring that protrudes from the outer wall of the punch and functions to control the punch’s trajectory into the deeper dermis during incision. Additionally, this punch has a dull, notched edge which allows for use in long hair and shaved FUE without sacrificing ease of incision through the epidermis. This punch is the first of its kind to have this breadth of versatility with a one‐size‐fits‐all design.
Our anesthesia experiences in COVID‐19 positive patients delivering by cesarean section: A retrospective single‐center cohort study
Authors: Karasu Derya , Kilicarslan Nermin , Ozgunay Seyda Efsun , Gurbuz Hande 
Published: May 2021

AbstractAimPregnancy increases susceptibility to respiratory complications of viral diseases. This study aims to evaluate our anesthesia practices in pregnant women with COVID‐19 undergoing cesarean section.MethodsA total of 61 patients who underwent cesarean section and had positive Polymerase chain reaction (PCR) testing for COVID‐19 with nasopharyngeal swabs were included in the study. Patient demographics and information about anesthesia were analyzed retrospectively from the patient medical files.ResultsA total of 61 parturients undergoing cesarean section that had positive SARS‐CoV‐2 PCR tests were assessed. General anesthesia was applied to only three patients (4.9%), while spinal anesthesia was administered to the remaining 58 patients (95.1%). The incidence of hypotension was 25.9% in the spinal anesthesia group. Forty‐one (67.2%) parturients were asymptomatic. While the rate of pneumonia in symptomatic patients was 45% (9/20), the pneumonia incidence among all SARS‐CoV‐2 PCR (+) parturients was 14% (9/61). Three (4.9%) COVID‐19 patients required intensive care in the perioperative period. The overall mortality rate was 1.6% (1/61) among parturients with COVID‐19 undergoing cesarean section, while it was 11.1% (1/9) in patients with pneumonia.ConclusionIt was observed that COVID‐19 is associated with mortality in pregnant women undergoing cesarean section. Spinal anesthesia was safely and effectively administered in COVID‐19 parturients, especially in patients with pneumonia.
Occupational characteristics and parents' childcare time
Authors: Hook Jennifer L. , Ruppanner Leah , Casper Lynne M. 
Published: May 2021

AbstractObjectiveThis study examines how occupational resources and demands are associated with parents' childcare time.BackgroundScholars recognize parental employment as important for understanding parental time use. Yet, given data limitations, we know relatively little about how strain‐based demands (demands that can produce negative psychological states) are associated with parent's time with children.MethodOccupational‐level data in the O*NET Database are linked to the American Time Use Survey (ATUS) 2011–2019 (n = 10,274 workday diaries from employed parents in 427 occupations). Ordinary Least Squares regression (OLS) is used to examine how occupational resources and demands are associated with parents' time with children and in childcare on workdays.ResultsMothers in occupations with greater strain‐based demands—competitive pressure, aggression‐conflict, monotony, and physicality‐hazards—spend less time with their children and less time on physical childcare activities. For fathers, associations are weaker with monotonous jobs also associated with less time with children. Workplace conditions, however, are weakly or even positively associated with parents' time on nonworkdays, suggesting that the daily experience of work affects parents' time use at home. Autonomy, an occupational resource, is positively associated with fathers' time with children and with mothers' time in interactive care.ConclusionResources and strain‐based demands—measured at the occupational‐level—are associated with parents' time use. The O*NET Database can be linked to the ATUS to better understand families' time use.
G3BP1 may serve as a potential biomarker of proliferation, apoptosis, and prognosis in oral squamous cell carcinoma
Authors: Hu Xin , Xia Kun , Xiong Haofeng , Su Tong 
Published: May 2021

AbstractBackgroundG3BP1 is a prognostic biomarker for many types of cancers; however, its role in oral squamous cell carcinoma remains unclear. We investigated the role of G3BP1 as a potential biomarker for proliferation, apoptosis, and prognosis in oral squamous cell carcinoma.MethodsWe obtained samples of normal oral mucosa (n = 17), oral squamous cell carcinoma tissues (n = 61), and paired adjacent tissues (n = 47) from Xiangya Hospital for immunohistochemical evaluation to measure the expression of G3BP1, E‐cadherin, Ki67, and Cleaved‐caspase3. Using data from The Cancer Genome Atlas, we performed bioinformatics analysis to investigate the prognosis, functions, signaling pathways, and immune infiltrate significance related to G3BP1 in oral squamous cell carcinoma.ResultsThe G3BP1 protein level was significantly upregulated in oral squamous cell carcinoma tissues and was also positively associated with Ki67 and negatively associated with Cleaved‐caspase3. Based on information available in online database, the G3BP1 mRNA level was significantly higher in oral squamous cell carcinoma than in normal tissues. High G3BP1 mRNA levels were associated with poor overall survival rates in patients with oral squamous cell carcinoma. Enrichment analysis showed that G3BP1 was involved in the helicase/catalytic/ATPase activity functions and spliceosome/RNA transport/ cell cycle pathways. Furthermore, G3BP1 mRNA levels were positively associated with CD4+ T‐cell infiltration.ConclusionsG3BP1 may serve as a potential biomarker for proliferation, apoptosis, and prognosis of oral squamous cell carcinoma.
Improved Knowledge of Disaster Preparedness in Underrepresented Secondary Students: A Quasi‐Experimental Study
Authors: White‐Lewis Sharon , Beach Elaine , Zegers Carli 
Published: May 2021

ABSTRACTBACKGROUNDDisasters cause significant human and monetary destruction and society as a whole is underprepared to address them. Disaster preparedness education is not covered extensively enough for health professionals or for the general public.METHODSA disaster preparedness education intervention was performed using a non‐randomized controlled trial of a convenience sample with a pre‐ and post‐intervention survey. The adapted Emergency Preparedness Information Questionnaire (EPIQ), a validated survey tool, was utilized. Participants came from a health professions educational enrichment program for students from under‐resourced high schools in the Kansas City area.RESULTSThe experimental group shows statistically significant improvement in knowledge of disaster topics post‐intervention. Of 18 adapted EPIQ tool questions, 17 show statistically significant improvement in disaster knowledge post‐intervention for the experimental group with significance set at p < .05 (range of significant p values .000‐.017).CONCLUSIONSThe education intervention was effective and cost‐efficient. Disaster preparedness education should be included in THE secondary school curriculum.
Free and second‐best entry in oligopolies with network effects
Authors: Gama Adriana , Samano Mario 
Published: May 2021

AbstractWe compare the number of firms in equilibrium in a Cournot industry with positive network effects and complete compatibility, under free and second‐best entry. Under free entry, the firms decide whether to enter the market or not; in the second‐best problem, the number of firms is established by the regulator to maximize social welfare (the regulator controls entry but not production). We show that when individual equilibrium output decreases with entry (business‐stealing competition), free entry may lead to more or less firms than the second‐best problem. This contrasts with the standard (nonnetwork) Cournot oligopoly model, wherein with business‐stealing competition, free entry leads to an excessive number of firms compared with the second‐best solution.
A Molecular Analysis of Microalgae from Around the Globe to Revise Raphidonema (Trebouxiophyceae, Chlorophyta)
Authors: Yakimovich Kurt M. , Gauthier Nick P.G. , Engstrom Casey B. , Leya Thomas , Quarmby Lynne M. 
Published: May 2021

We isolated five microalgal strains from alpine snow near Vancouver, Canada, which display morphological features suggestive of the genera Koliella and Raphidonema. Due to variations in cell size and shape, we could not make a clear delimitation based on morphology. We proceeded to a molecular analysis and included 22 strains from the CCCryo culture collection, previously identified as members of four closely related genera: Raphidonema, Koliella, Stichococcus, and Pseudochlorella. For greater taxonomic context in our phylogenetic analysis, we also obtained authentic strains for the type species of Koliella and Pseudochlorella, but were unable to find one for Raphidonema. To examine generic boundaries, we did a phylogenetic analysis on the rbcL gene for all strains, establishing distinct lineages. Our novel isolates fell within Raphidonema, and so we analyzed the ITS2 gene of all Raphidonema strains to delimit species. To support species delimitations, we did a Compensatory Base Change analysis using the secondary structure of the ITS2 gene to assist in aligning the sequence. We also computed a maximum likelihood phylogenetic tree to examine species clades of Raphidonema. We assigned epitypes for two Raphidonema species based on the best morphological match to strains in the ITS2 clades. We then amended their diagnoses so they can be more reliably identified using DNA sequence data. We also propose two new species, R. catena and R. monicae, that formed their own species clades according to our ITS2 analysis.
Positive airway pressure (PAP) treatment reduces glycated hemoglobin (HbA1c) levels in obstructive sleep apnea patients with concomitant weight loss: Longitudinal data from the ESADA
Authors: Tasbakan Mehmet Sezai , Grote Ludger , Hedner Jan , Kvamme John Arthur , Verbraecken Johan , McNicholas Walter T. , Roisman Gabriel , Tkacova Ruzena , Bonsignore Maria R. , Saaresranta Tarja , Steiropoulos Paschalis , Marrone Oreste , Basoglu Ozen K. ,   ESADA Collaborators
Published: May 2021

SummaryPatients with obstructive sleep apnea (OSA) are at increased risk of developing metabolic disease such as diabetes. The effects of positive airway pressure on glycemic control are contradictory. We therefore evaluated the change in glycated hemoglobin (HbA1c) in a large cohort of OSA patients after long‐term treatment with positive airway pressure. HbA1c levels were assessed in a subsample of the European Sleep Apnea Database [n=1608] at baseline and at long‐term follow up with positive airway pressure therapy (mean 378.9±423.0 days). In a regression analysis, treatment response was controlled for important confounders.Overall, HbA1c decreased from 5.98±1.01% to 5.93±0.98% (p=0.001). Patient subgroups with a more pronounced HbA1c response included patients with diabetes (−0.15±1.02, p=0.019), those with severe OSA baseline (−0.10±0.68, p=0.005), those with morbid obesity (−0.20±0.81, p<0.001). The strongest HbA1c reduction was observed in patients with a concomitant weight reduction >5 kilos (−0.38±0.99, p<0.001). In robust regression analysis, severe OSA (p=0.038) and morbid obesity (p=0.005) at baseline, and weight reduction >5 kilos (p<0.001) during follow up were independently associated with a reduction of HbA1c following PAP treatment. In contrast, PAP treatment alone without weight reduction was not associated with significant Hb1Ac reduction.In conclusion, positive airway pressure therapy is associated with HbA1c reduction in patients with severe OSA, in morbidly obese patients. and most obviously in those with significant weight lost during the follow‐up. Our study underlines the importance to combine positive airway pressure use with adjustments in lifestyle to substantially modify metabolic complications in OSA.
Teaching by Analogy: From Theory to Practice
Authors: Gray Maureen E. , Holyoak Keith J. 
Published: May 2021

ABSTRACTAnalogy is a powerful tool for fostering conceptual understanding and transfer in STEM and other fields. Well‐constructed analogical comparisons focus attention on the causal‐relational structure of STEM concepts, and provide a powerful capability to draw inferences based on a well‐understood source domain that can be applied to a novel target domain. However, analogy must be applied with consideration to students' prior knowledge and cognitive resources. We briefly review theoretical and empirical support for incorporating analogy into education, and recommend five general principles to guide its application so as to maximize the potential benefits. For analogies to be effective, instructors should use well‐understood source analogs and explain correspondences fully; use visuospatial and verbal supports to emphasize shared structure among analogs; discuss the alignment between semantic and formal representations; reduce extraneous cognitive load imposed by analogical comparison; and encourage generation of inferences when students have some proficiency with the material. These principles can be applied flexibly to topics in a wide variety of domains.
Social media in undergraduate medical education: A systematic review
Authors: Guckian Jonathan , Utukuri Mrudula , Asif Aqua , Burton Oliver , Adeyoju Joshua , Oumeziane Adam , Chu Timothy , Rees Eliot L. 
Published: May 2021

AbstractIntroductionThere are over 3.81 billion worldwide active social media (SoMe) users. SoMe are ubiquitous in medical education, with roles across undergraduate programmes, including professionalism, blended learning, well being and mentoring. Previous systematic reviews took place before recent explosions in SoMe popularity and revealed a paucity of high‐quality empirical studies assessing its effectiveness in medical education. This review aimed to synthesise evidence regarding SoMe interventions in undergraduate medical education, to identify features associated with positive and negative outcomes.MethodsAuthors searched 31 key terms through seven databases, in addition to references, citation and hand searching, between 16 June and 16 July 2020. Studies describing SoMe interventions and research on exposure to existing SoMe were included. Title, abstract and full paper screening were undertaken independently by two reviewers. Included papers were assessed for methodological quality using the Medical Education Research Study Quality Instrument (MERSQI) and/or the Standards for Reporting Qualitative Research (SRQR) instrument. Extracted data were synthesised using narrative synthesis.Results112 studies from 26 countries met inclusion criteria. Methodological quality of included studies had not significantly improved since 2013. Engagement and satisfaction with SoMe platforms in medical education are described. Students felt SoMe flattened hierarchies and improved communication with educators. SoMe use was associated with improvement in objective knowledge assessment scores and self‐reported clinical and professional performance, however evidence for long term knowledge retention was limited. SoMe use was occasionally linked to adverse impacts upon mental and physical health. Professionalism was heavily investigated and considered important, though generally negative correlations between SoMe use and medical professionalism may exist.ConclusionsSocial media is enjoyable for students who may improve short term knowledge retention and can aid communication between learners and educators. However, higher‐quality study is required to identify longer‐term impact upon knowledge and skills, provide clarification on professionalism standards and protect against harms.
A method for mapping morphological convergence on three‐dimensional digital models: the case of the mammalian sabre‐tooth
Authors: Melchionna Marina , Profico Antonio , Castiglione Silvia , Serio Carmela , Mondanaro Alessandro , Modafferi Maria , Tamagnini Davide , Maiorano Luigi , Raia Pasquale , Witmer Lawrence M. , Wroe Stephen , Sansalone Gabriele 
Published: May 2021

AbstractMorphological convergence can be assessed using a variety of statistical methods. None of the methods proposed to date enable the visualization of convergence. All are based on the assumption that the phenotypes either converge, or do not. However, between species, morphologically similar regions of a larger structure may behave differently. Previous approaches do not identify these regions within the larger structures or quantify the degree to which they may contribute to overall convergence. Here, we introduce a new method to chart patterns of convergence on three‐dimensional models using the R function conv.map. The convergence between pairs of models is mapped onto them to visualize and quantify the morphological convergence. We applied conv.map to a well‐known case study, the sabre‐tooth morphotype, which has evolved independently among distinct mammalian clades from placentals to metatherians. Although previous authors have concluded that sabre‐tooths kill using a stabbing ‘bite’ to the neck, others have presented different interpretations for specific taxa, including the iconic Smilodon and Thylacosmilus. Our objective was to identify any shared morphological features among the sabre‐tooths that may underpin similar killing behaviours. From a sample of 49 placental and metatherian carnivores, we found stronger convergence among sabre‐tooths than for any other taxa. The morphological convergence is most apparent in the rostral and posterior parts of the cranium. The extent of this convergence suggests similarity in function among these phylogenetically distant species. In our view, this function is most likely to be the killing of relatively large prey using a stabbing bite.