bluuebunny/crossref_metadata_2025_split huggingface dataset:
Amongst Norwegian paediatricians there is little agreement in management of cases of suspected child maltreatment
Authors: Vollmer‐Sandholm Mary Jo , Myhre Arne Kristian , Otterman Gabriel , Lydersen Stian , Stray‐Pedersen Arne 
Published: July 2021

AbstractAimChild maltreatment is not unusual in our society but little is known about the medical management of cases in the Nordic countries. This study investigated physician knowledge and practice in cases of suspected physical and sexual abuse and neglect.MethodsUsing a patient vignette questionnaire, we assessed paediatrician knowledge and clinical decision‐making on paediatric wards at 17 hospitals in Norway. Experts and non‐experts in child maltreatment responded to the survey which described six potential cases of physical and sexual abuse and neglect.ResultsA total of 156 paediatricians, 67% of whom were female and with a mean age of 40, responded. There was a high level of unanimity in recognition of abuse, but wide variation and little consensus in clinical decision‐making and adherence to national guidelines, with Fleiss kappa ranging from −0.002 to 0.468. In cases involving physical abuse concerns in infants and toddlers, less than half of all paediatricians reported they would order a full radiologic skeletal survey and head MRI/CT imaging, and less than 30% would plan follow‐up consultations.ConclusionThis study shows little agreement in the paediatric management of child maltreatment cases. These findings suggest the need for a national plan ensuring appropriate paediatric care for maltreated children.
Old, but gold? A dual‐pathway model of age bias in personnel selection decisions
Authors: Fatfouta Ramzi , Ghoniem Amir 
Published: July 2021

AbstractWe present a dual‐pathway model that differentiates two underlying mechanisms by which age affects selection decisions. In two experimental studies, one with lay persons (n = 316) and one with experienced Human Resource professionals (n = 103), we demonstrate that the relationship between older age and hireability is negatively mediated by perceived appearance, indicating that older candidates receive less favorable ratings because they are perceived as being less physically appealing. Moreover, we demonstrate that the relationship between older age and hireability is positively mediated by perceived experience, indicating that older candidates receive more favorable ratings because they are perceived as being more experienced. Importantly, these two pathways neutralize each other, yielding a null effect when their effects are neglected.
Dose equivalence between metaraminol and norepinephrine in critical care
Authors: Abu Sardaneh Arwa , Goradia Shruti , Narayan Sujita W. , Penm Jonathan , McLachlan Andrew J. , Patanwala Asad E. 
Published: July 2021

AimsThe aim of this study was to determine the conversion dose ratio between continuous infusion metaraminol and norepinephrine in critically ill patients with shock.MethodsA retrospective cohort study was conducted in adult patients with shock admitted to an intensive care unit from 29 October 2018 to 30 October 2019 and who transitioned from metaraminol monotherapy to norepinephrine monotherapy. Mean arterial pressure (MAP) and infusion doses for both drugs were collected at hourly intervals; 2 hours before to 5 hours after switching from metaraminol monotherapy to norepinephrine monotherapy. The conversion dose ratio was defined as the ratio of metaraminol (μg.kg−1.min‐1): norepinephrine (μg.kg−1.min−1) required to achieve a similar MAP.ResultsA total of 43 out of 144 eligible patients were included. The median age was 68 years (IQR 56–76) and 22 (51%) were male. There was no significant difference between the baseline MAP during metaraminol monotherapy (median 71 mm Hg, IQR 66–76) and the post‐transition MAP during norepinephrine monotherapy (median 70 mm Hg, IQR 66–73) (P = .09). The median conversion dose ratio between metaraminol and norepinephrine was 13 (IQR 7–24). In the sensitivity analyses, the median conversion dose ratio using the maximum and the mean norepinephrine infusion dose was 8 (IQR 5–16) and 12 (IQR 8–23), respectively.ConclusionA conversion dose ratio of 10:1 (metaraminol μg.kg−1.min−1:norepinephrine μg.kg−1.min−1) may be used in critically ill patients with shock to account for ease of calculations and variability of the conversion ratio in the primary and sensitivity analyses.
Metformin use and cirrhotic decompensation in patients with type 2 diabetes and liver cirrhosis
Authors: Yen Fu‐Shun , Huang Yi‐Hsiang , Hou Ming‐Chih , Hwu Chii‐Min , Lo Yu‐Ru , Shin Shyi‐Jang , Hsu Chih‐Cheng 
Published: July 2021

AimsTo compare the risks of all‐cause mortality, hepatic outcomes, major adverse cardiovascular events between metformin users and nonusers for patients with diabetes and cirrhosis.MethodsFrom the Taiwan's National Health Insurance Research Database, we selected propensity‐score matched metformin users and nonusers from the cohorts of type 2 diabetes mellitus with compensated (n = 26 164) or decompensated liver cirrhosis (n = 15 056) between 1 January 2000 and 31 December 2009, and followed them until 31 December 2010. Cox proportional hazards models with robust sandwich standard error estimates were used to assess risk of investigated outcomes for metformin users.ResultsThe incidence rates of mortality during follow‐up were 3.8 and 3.3 per 100 patient‐years (adjusted hazard ratio [aHR] 1.13, 95% confidence interval 1.01–1.25) for metformin users and nonusers, respectively. The incidence rates of cirrhotic decompensation during follow‐up were 5.9 and 4.9 per 100 patient‐years (aHR 1.15, 95% confidence interval 1.04–1.27) for metformin users and nonusers. The risk of death (P for trend <.01) and cirrhotic decompensation (P for trend <.0001) associated with metformin use was significant for those taking metformin for >40 defined daily doses in 90 days or >1000 mg/d. The outcomes of metformin use vs nonuse for type 2 diabetes mellitus with decompensated liver cirrhosis were not statistically different, except that metformin users had higher risk of mortality (aHR 1.15).ConclusionMetformin use was associated with higher risks of mortality and cirrhotic decompensation in patients with compensated liver cirrhosis. Prospective studies are required to confirm our results.
Population pharmacokinetic‐pharmacodynamic model‐based exploration of alternative ustekinumab dosage regimens for patients with Crohn's disease
Authors: Wang Zhigang , Verstockt Bram , Sabino João , Vermeire Séverine , Ferrante Marc , Declerck Paul , Dreesen Erwin 
Published: July 2021

AimsIn the UNITI endoscopy sub‐study, only 17.4% of patients with Crohn's disease (CD) on ustekinumab achieved endoscopic response and 10.9% of patients achieved endoscopic remission at week (w)44. We aimed to evaluate the impact of alternative ustekinumab dosage regimens on endoscopic outcomes based on population pharmacokinetic‐pharmacodynamic (popPK‐PD) modelling and simulation analysis.MethodsReal‐world data were obtained from 83 patients with moderate‐to‐severe CD (95% biological‐refractory) enrolled in a prospective cohort study receiving intravenous ustekinumab (~6 mg/kg) followed by every eight‐week (q8w) subcutaneous maintenance therapy (90 mg). Three sequential models were developed: a two‐compartment popPK model linking ustekinumab dose to ustekinumab exposure, an indirect response popPK‐PD model describing the effect of ustekinumab exposure on fecal calprotectin (fCal), and a logistic regression outcome model linking fCal to endoscopic outcomes.ResultsUstekinumab clearance increased with decreasing serum albumin and increasing bodyweight. fCal decreased with increasing ustekinumab exposure. The probability of endoscopic response at w24 increased from 10.0% to 17.9% with fCal at w8 decreasing from 1800 μg/g to 694 μg/g (EC50). The probability of endoscopic remission at w24 increased from 2.1% to 10.0% with fCal at w8 decreasing from 1800 μg/g to 214 μg/g (EC50). Simulation‐based comparison of q8w and q4w maintenance dosing regimens predicted 16.7% and 22.2% endoscopic response rates, respectively. Endoscopic remission rates were estimated to be 4.2% on q8w dosing and 6.7% on q4w dosing.ConclusionsThe developed models can guide clinical trial design and support model‐informed dose optimization (stratified or individualized dosing) to improve endoscopic outcomes.
Fish oil supplementation alters emotion‐generated corticolimbic functional connectivity in depressed adolescents at high‐risk for bipolar I disorder: A 12‐week placebo‐controlled fMRI trial
Authors: McNamara Robert K. , Li Wenbin , Lei Du , Tallman Maxwell J. , Welge Jeffrey A. , Strawn Jeffrey R. , Patino Luis Rodrigo , DelBello Melissa P. 
Published: July 2021

AbstractObjectiveTo evaluate the effects of fish oil (FO), a source of the omega‐3 polyunsaturated fatty acids (n‐3 PUFA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on emotion‐generated corticolimbic functional connectivity in depressed youth at high risk for developing bipolar I disorder.MethodsThirty‐nine antidepressant‐free youth with a current depressive disorder diagnosis and a biological parent with bipolar I disorder were randomized to 12‐week double‐blind treatment with FO or placebo. At baseline and endpoint, fMRI (4 Tesla) scans were obtained while performing a continuous performance task with emotional and neutral distractors (CPT‐END). Seed‐to‐voxel functional connectivity analyses were performed using bilateral orbitofrontal cortex (OFC) and amygdala (AMY) seeds. Measures of depression, mania, global symptom severity, and erythrocyte fatty acids were obtained.ResultsErythrocyte EPA+DHA composition increased significantly in the FO group (+47%, p ≤ 0.0001) but not in the placebo group (−10%, p = 0.11). Significant group by time interactions were found for functional connectivity between the left OFC and the left superior temporal gyrus (STG) and between the right AMY and right inferior temporal gyrus (ITG). OFC‐STG connectivity increased in the FO group (p = 0.0001) and decreased in the placebo group (p = 0.0019), and AMY‐ITG connectivity decreased in the FO group (p = 0.0014) and increased in the placebo group (p < 0.0001). In the FO group, but not placebo group, the decrease in AMY‐ITG functional connectivity correlated with decreases in Childhood Depression Rating Scale‐Revised and Clinical Global Impression‐Severity Scale scores.ConclusionsIn depressed high‐risk youth FO supplementation alters emotion‐generated corticolimbic functional connectivity which correlates with changes in symptom severity ratings.
Efficient odds ratio estimation under two‐phase sampling using error‐prone data from a multi‐national HIV research cohort
Authors: Lotspeich Sarah C. , Shepherd Bryan E. , Amorim Gustavo G. C. , Shaw Pamela A. , Tao Ran 
Published: July 2021

AbstractPersons living with HIV engage in routine clinical care, generating large amounts of data in observational HIV cohorts. These data are often error‐prone, and directly using them in biomedical research could bias estimation and give misleading results. A cost‐effective solution is the two‐phase design, under which the error‐prone variables are observed for all patients during Phase I, and that information is used to select patients for data auditing during Phase II. For example, the Caribbean, Central, and South America network for HIV epidemiology (CCASAnet) selected a random sample from each site for data auditing. Herein, we consider efficient odds ratio estimation with partially audited, error‐prone data. We propose a semiparametric approach that uses all information from both phases and accommodates a number of error mechanisms. We allow both the outcome and covariates to be error‐prone and these errors to be correlated, and selection of the Phase II sample can depend on Phase I data in an arbitrary manner. We devise a computationally efficient, numerically stable EM algorithm to obtain estimators that are consistent, asymptotically normal, and asymptotically efficient. We demonstrate the advantages of the proposed methods over existing ones through extensive simulations. Finally, we provide applications to the CCASAnet cohort.
Examining perceptions, selections, and products in undergraduates’ learning from multiple resources
Authors: List Alexandra , Campos Oaxaca Gala S. , Lee Eunseo , Du Hongcui , Lee Hye Yeon 
Published: July 2021

BackgroundWhen learning about complex topics using the Internet, students commonly encounter a multitude of textual, non‐textual (e.g., images and graphs), and multimedia (e.g., videos) resources. Yet students’ learning from multiple texts and multiple (non‐textual) resources (MT‐MR learning) has received insufficient consideration in the literature.AimsWe examine the associations among (1) undergraduates’ conceptions of reasons for multiple resource access, (2) log‐data of resource use when completing a MT‐MR task, and (3) writing performance.SampleParticipants were 72 undergraduate students in the United States.MethodsUndergraduates were provided with a library of five texts and one video, with the option of accessing supplemental data (e.g., graphs and maps) in association with each resource. Log‐data (e.g., time and supplemental data access) of undergraduates’ resource use were collected. Undergraduates were then asked to compose a research report and to describe what they considered the purpose of multiple resource access to be.ResultsFour types of conceptions were identified, reflecting a desire to (1) access a lot of information, (2) understand multiple perspectives, (3) corroborate and evaluate information, and (4) develop a personal understanding of a given topic. Undergraduates who considered corroboration and evaluation to be the purpose of multiple resource access were more likely to access more supplemental data sources and performed better on a multiple resource learning task.ConclusionsUndergraduates in our sample held conceptions largely similar to, but in some aspects distinct from, those identified by Barzilai and Zohar (Cognit Instruct, 30, 2012, 39). Conceptions were associated with resource access during task completion and with writing performance.
Latent motivation profiles for choosing teaching as a career: How are they linked to self‐concept concerning teaching subjects and emotions during teacher education training?
Authors: Lohbeck Annette , Frenzel Anne Christiane 
Published: July 2021

BackgroundNumerous studies have explored pre‐service teachers’ motivation for choosing teaching as a career and the relations of pre‐service teachers’ motivation profile membership to long‐term consequences. In contrast, little is still known about certain predictors and the more proximal consequences of pre‐service teachers’ motivation profile membership.AimsUsing the conceptualization of motivation proposed by Pohlmann and Möller (2010, Zeitschrift für Pädagogische Psychologie, 24, 73–84), the present study aimed to identify pre‐service teachers’ motivation profiles for choosing teaching as a career and to explore the relations of those profiles to certain individual characteristics (i.e., gender, age, specific school type, number of semesters, scholastic grade point average, self‐concept concerning teaching subjects) as predictors and emotions pertaining to the teacher education programme (i.e., enjoyment, anger, anxiety) as outcomes.SampleA total of 559 pre‐service teachers from a mid‐sized university in the North of Germany participated in this study.MethodsTo identify pre‐service teachers’ motivation profile for choosing teaching as a career, latent profile analysis (LPA) with one to eight profile solutions was performed. Furthermore, to explore the specific relations of pre‐service teachers’ motivation profile membership to the predictors and outcomes under study, several multinomial logistic regression analyses were conducted.ResultsResults of LPA revealed four distinct motivation profiles labelled ‘Educationally Motivated’ (26.9%), ‘Utility Oriented’ (14.9%), ‘Motivationally Balanced’ (55.4%), and ‘Extrinsically Motivated’ (2.7%). Higher self‐concepts concerning teaching subjects increased almost twice the membership into the ‘Educationally Motivated’ profile relative to the ‘Utility Oriented’ and ‘Extrinsically Motivated’ profiles but decreased the membership into the ‘Utility Oriented’ profile relative to the ‘Motivationally Balanced’ profile. The ‘Educationally Motivated’ profile showed the highest level of enjoyment and lowest levels of anxiety and anger, while the ‘Utility Oriented’ profile exhibited the least enjoyment and highest levels of anxiety and anger.
Large‐conductance calcium‐activated K+ channels, rather than KATP channels, mediate the inhibitory effects of nitric oxide on mouse lymphatic pumping
Authors: Kim Hae Jin , Li Min , Nichols Colin G. , Davis Michael J. 
Published: July 2021

Background and PurposeKATP channels are negative regulators of lymphatic vessel excitability and contractility and are proposed to be targets for immune cell products that inhibit lymph transport. Previous studies in rat and guinea pig mesenteric lymphatics found that NO‐mediated inhibition of lymphatic contraction was prevented or reversed by the KATP channel inhibitor, glibenclamide. We revisited this hypothesis using mouse lymphatic vessels and KATP channel knockout mice.Experimental ApproachMouse popliteal lymphatics were isolated, and contractility was assessed using pressure myography. K+ channel expression was determined by PCR analysis of FACS‐purified lymphatic smooth muscle cells.Key ResultsThe NO‐producing agonist, ACh, and the NO donor, NONOate, both produced dose‐dependent inhibition of spontaneous lymphatic contractions that were blocked by the soluble GC inhibitor, ODQ, or the PKG inhibitor, Rp‐8‐Br‐PET‐cGMPS. Surprisingly, the inhibitory effects of both were preserved in Kir6.1−/− vessels, suggesting that KATP channels did not mediate NO‐induced responses. We hypothesized a role for BK channels, given their prominence in arterial smooth muscle. Indeed, BK channels were expressed in mouse lymphatic smooth muscle and NS11021 (a BK channel activator) caused dilation and reduced contraction frequency, whereas iberiotoxin and penitrem A (BK channel inhibitors) produced right‐ward shifts in NONOate concentration–response curves.Conclusion and ImplicationsInhibition of mouse lymphatic contractions by NO primarily involves activation of BK channels, rather than KATP channels. Thus, BK channels are a potential target for therapeutic reversal of lymph pump inhibition by NO generated by immune cell activation of iNOS in chronic lymphoedema.
Why Does Classroom‐Level Victimization Moderate the Association Between Victimization and Depressive Symptoms? The “Healthy Context Paradox” and Two Explanations
Authors: Pan Bin , Li Tengfei , Ji Linqin , Malamut Sarah , Zhang Wenxin , Salmivalli Christina 
Published: July 2021

The present longitudinal study examined how and why classroom‐level victimization moderates the prospective association between peer victimization and depressive symptoms with 2,643 third‐ and fourth‐graders (Mage = 10.01 years) in China. Multilevel modeling revealed that peer victimization was more strongly associated with increasing depressive symptoms in classrooms with lower classroom‐level victimization. Moreover, two mechanisms were identified to explain the moderating effect of classroom‐level victimization. First, low classroom‐level victimization reduced victimized children’s received friendship nominations from peers, thereby leading to increases in depressive affect. Second, low classroom‐level victimization affected victimized children’s depressive symptoms through damage to their social self‐concept. These findings provide support for the “healthy context paradox” in the Chinese culture, and highlight the mechanisms of this phenomenon.
Breaking bad news: Child welfare workers' informing parents of care order proceedings
Authors: Tonning Otterlei Marte , Studsrød Ingunn 
Published: July 2021

AbstractRemoving children from parents through care orders is a highly intrusive intervention. This article explores how 12 experienced Norwegian child welfare workers perceive and cope with breaking bad news to parents of the decision for a care order initiative. A thematic analysis of qualitative in‐depth interviews revealed that the task of breaking bad news to parents includes several challenging aspects involving ethics, care and control that are influenced by relational and emotional aspects. Caseworkers felt obligated to convey the decision humanely and caretake children and parents, ensuring safety, determinacy and control. Caseworkers struggled to endure heightened emotions, handle the painful switch from helper to traitor and cope with an extreme though necessary intervention of child protection work. Care order meetings are complex and unpredictable and challenge child welfare workers professional and human capacity, as it represents considerable professional and personal demands. The article discusses the challenges of breaking bad news in the child protection profession compared with professions in the health care field. Moreover, discussing how caseworkers' coping strategies may impact their practice and highlights caseworkers' burden with the task, pointing to practical implications.
CHEDDA syndrome is an underrecognized neurodevelopmental disorder with a highly restricted ATN1 mutation spectrum
Authors: Palmer Elizabeth E. , Whitton Chloe , Hashem Mais O. , Clark Robin D. , Ramanathan Subhadra , Starr Lois J. , Velasco Danita , De Dios John Karl , Singh Emily , Cormier‐Daire Valerie , Chopra Maya , Rodan Lance H. , Nellaker Christoffer , Lakhani Shenela , Mallack Eric J. , Panzer Karin , Sidhu Alpa , Wentzensen Ingrid M. , Lacombe Didier , Michaud Vincent , Alkuraya Fowzan S. 
Published: July 2021

AbstractWe describe the clinical features of nine unrelated individuals with rare de novo missense or in‐frame deletions/duplications within the “HX motif” of exon 7 of ATN1. We previously proposed that individuals with such variants should be considered as being affected by the syndromic condition of congenital hypotonia, epilepsy, developmental delay, and digital anomalies (CHEDDA), distinct from dentatorubral‐pallidoluysian atrophy (DRPLA) secondary to expansion variants in exon 5 of ATN1. We confirm that the universal phenotypic features of CHEDDA are distinctive facial features and global developmental delay. Infantile hypotonia and minor hand and feet differences are common and can present as arthrogryposis. Common comorbidities include severe feeding difficulties, often requiring gastrostomy support, as well as visual and hearing impairments. Epilepsy and congenital malformations of the brain, heart, and genitourinary systems are frequent but not universal. Our study confirms the clinical entity of CHEDDA secondary to a mutational signature restricted to exon 7 of ATN1. We propose a clinical schedule for assessment upon diagnosis, surveillance, and early intervention including the potential of neuroimaging for prognostication.