bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timing Effect of Adenosine-Directed Immunomodulation on Mouse Experimental Autoimmune Uveitis
Authors: Ko Minhee K , Shao Hui , Kaplan Henry J , Sun Deming 
Published: June 2021

Abstract
Adenosine is an important regulatory molecule of the immune response. We have previously reported that treatment of experimental autoimmune uveitis (EAU)–prone mice with an adenosine-degrading enzyme (adenosine deaminase) prohibited EAU development by inhibiting Th17 pathogenic T cell responses. To further validate that the targeting of adenosine or adenosine receptors effectively modulates Th17 responses, we investigated the effect of adenosine receptor antagonists. In this study, we show that the A2AR antagonist SCH 58261 (SCH) effectively modulates aberrant Th17 responses in induced EAU. However, timing of the treatment is important. Whereas SCH inhibits EAU when administered during the active disease stage, it did not do so if administered during quiescent disease stages, thus implying that the existing immune status influences the therapeutic effect. Mechanistic studies showed that inhibition of γδ T cell activation is crucially involved in adenosine-based treatment. Adenosine is an important costimulator of γδ T cell activation, which is essential for promoting Th17 responses. During ongoing disease stages, adenosine synergizes with existing high levels of cytokines, leading to augmented γδ T cell activation and Th17 responses, but in quiescent disease stages, when existing cytokine levels are low, adenosine does not enhance γδ T cell activation. Our results demonstrated that blockade of the synergistic effect between adenosine and inflammatory cytokines at active disease stages can ameliorate high-degree γδ T cell activation and, thus, suppress Th17 pathogenic T cell responses.
Effect of a Community-led Total Sanitation Intervention on the Incidence and Prevalence of Diarrhea in Children in Rural Ethiopia: A Cluster-randomized Controlled Trial
Authors: Cha Seungman , Jung Sunghoon , Bizuneh Dawit Belew , Abera Tadesse , Doh Young-Ah , Seong Jieun , Schmidt Wolf-Peter 
Published: June 2021

ABSTRACT.
We conducted a cluster-randomized trial in 48 rural villages of Ethiopia to assess the effect of community-led total sanitation (CLTS) on the diarrhea incidence of children. Twenty-four villages were randomly assigned to the intervention group and the other 24 were assigned to the control group. A CLTS intervention was implemented from January 2016 through January 2017. Baseline data collection was conducted during October and November 2015. At baseline, 906 children were recruited and followed-up until January 2017. These 906 children were randomly selected among all children in the 48 villages. To determine the 7-day period prevalence of diarrhea, four household-based surveys were conducted by independent data collectors at 3, 5, 9, and 10 months after the CLTS was initiated. To determine the incidence and longitudinal prevalence, the presence of daily diarrhea presence was recorded for 140 days using diary methods. The loss to follow-up rates were 95% for period prevalence and 93% for incidence and longitudinal prevalence. The incidence ratio and longitudinal prevalence ratio were 0.66 (95% confidence interval [CI], 0.45–0.97; P = 0.03) and 0.70 (95% CI, 0.52–0.95; P = 0.02) after adjusting for clustering and stratification. The relative risk of period prevalence was 0.66 (95% CI, 0.45–0.98; P = 0.04) at 3 months after initiation. Improved toilet coverage increased from 0.0% at baseline to 35.0% at 10 months in the intervention villages, whereas it increased from 0.7% to 2.8% in the control villages. Adherence to the intervention was comparable with that of previous studies; therefore, we suggest that the findings of this study are replicable.
Case Report: Progressive Dysphonia and Dysphagia due to Laryngeal Leishmaniasis
Authors: Renard Laura , Lemaignen Adrien , Desoubeaux Guillaume , Bakhos David 
Published: June 2021

ABSTRACT.
Laryngeal leishmaniasis is an unusual form of the disease. We report the case of a patient who consulted for dysphonia and dysphagia in a context of asthenia and weight loss. The patient had lesions that were suggestive of laryngeal cancer but were revealed to be leishmaniasis by histopathology examination and polymerase chain reaction. Treatment with amphotericin B and miltefosine permitted complete resolution of the lesions and no recurrence during the 18-month follow-up period.
Case Report: A Great Mimicker of Neoplasm: Pulmonary Cryptococcosis in an Immunocompetent Host After High-Altitude Descent
Authors: Johnson Keely , Dhamrah Umaima , Amin Aisha , Masci Joseph 
Published: June 2021

ABSTRACT.
Cryptococcus exposure in certain global regions is common and yet virulence in the immunocompetent host remains rare. Radiological findings of pulmonary cryptococcosis may include nonspecific lung nodules or masses indistinguishable from lung cancer or pulmonary tuberculosis. We present a case of an immunocompetent diabetic female who presented with progressively worsening pleuritic chest pain and cough with travel between Tibet and New York 2 months earlier. Chest imaging demonstrated a large lobulated mass, acid-fast bacillus smears were negative, and our patient underwent pulmonary biopsy, which grew rare budding yeast later confirmed by mucicarmine staining as Cryptococcus. Our patient was successfully treated with fluconazole therapy. We hypothesize that the high altitude of Tibet may allow for clinical latency followed by symptomatic reactivation on descent. A raised index of suspicion for pulmonary cryptococcosis with careful attention to travel history is expected to facilitate timely diagnosis.
A Novel Blended Curriculum for Communication of Informed Consent With Surgical Interns
Authors: Anderson Tiffany N. , Kaba Aboubacar , Gros Eniola , Schmiederer Ingrid S. , Shi Robert , Aalami Lauren R. , Lin Dana T. , Lau James N. 
Published: June 2021

ABSTRACT

Background
Interns often conduct procedural informed consent discussions (ICDs), identified as a core entrustable professional activity. Deficiencies in the training process for ICDs span across specialties.

Objective
We provide evidence for a curriculum and assessment designed to standardize the training process and ensure ICD competency in surgical interns.

Methods
In March 2019, PowerPoint educational materials were emailed to one academic institution's new surgical interns, who in June participated in an onsite 1-hour role-play “hot seat” group activity (GA) with an untrained simulated patient, and in October completed a single trained simulated patient (real-time raters) verification of proficiency (VOP) assessment. Curriculum evaluation was measured through intern pre-/post-confidence (5-point scale), and the VOP's Cronbach's alpha and test-retest were examined. Data were analyzed with descriptive statistics, paired t tests, and 2-way random effects models.

Results
Of 44 new interns, 40 (91%) participated in the remote teaching and live GA and were assessed by the VOP. Pre-/post-GA confidence increased a mean difference of 1.3 (SD = 0.63, P &lt; .001). The VOP's Cronbach's alpha was 0.88 and test-retest was 0.84 (95% CI 0.67–0.93, P &lt; .001), with a 95% pass rate. The 2 first-time fail students required remediation. Time commitment included 1 hour maximum for individual training and implementation and 30 minutes for assessment. The use of volunteers and donated space mitigated additional costs.

Conclusions
Remote asynchronous and group skills teaching for new general surgical interns improved their confidence in conducting procedural ICDs. A patient-simulation verification process appeared feasible with preliminary evidence of retest and internal consistency.
Assessing the Transition of Training in Health Systems Science From Undergraduate to Graduate Medical Education
Authors: Santen Sally A. , Hamstra Stanley J. , Yamazaki Kenji , Gonzalo Jed , Lomis Kim , Allen Bradley , Lawson Luan , Holmboe Eric S. , Triola Marc , George Paul , Gorman Paul N. , Skochelak Susan 
Published: June 2021

ABSTRACT

Background
The American Medical Association Accelerating Change in Medical Education (AMA-ACE) consortium proposes that medical schools include a new 3-pillar model incorporating health systems science (HSS) and basic and clinical sciences. One of the goals of AMA-ACE was to support HSS curricular innovation to improve residency preparation.

Objective
This study evaluates the effectiveness of HSS curricula by using a large dataset to link medical school graduates to internship Milestones through collaboration with the Accreditation Council for Graduate Medical Education (ACGME).

Methods
ACGME subcompetencies related to the schools' HSS curricula were identified for internal medicine, emergency medicine, family medicine, obstetrics and gynecology (OB/GYN), pediatrics, and surgery. Analysis compared Milestone ratings of ACE school graduates to non-ACE graduates at 6 and 12 months using generalized estimating equation models.

Results
At 6 months both groups demonstrated similar HSS-related levels of Milestone performance on the selected ACGME competencies. At 1 year, ACE graduates in OB/GYN scored minimally higher on 2 systems-based practice (SBP) subcompetencies compared to non-ACE school graduates: SBP01 (1.96 vs 1.82, 95% CI 0.03-0.24) and SBP02 (1.87 vs 1.79, 95% CI 0.01-0.16). In internal medicine, ACE graduates scored minimally higher on 3 HSS-related subcompetencies: SBP01 (2.19 vs 2.05, 95% CI 0.04-0.26), PBLI01 (2.13 vs 2.01; 95% CI 0.01-0.24), and PBLI04 (2.05 vs 1.93; 95% CI 0.03-0.21). For the other specialties examined, there were no significant differences between groups.

Conclusions
Graduates from schools with training in HSS had similar Milestone ratings for most subcompetencies and very small differences in Milestone ratings for only 5 subcompetencies across 6 specialties at 1 year, compared to graduates from non-ACE schools. These differences are likely not educationally meaningful.
Morphological features of the leaves in clematises as a reflection of their ecological peculiarities
Authors: Kovalyshyn Iryna , Pinchuk Andrii , Likhanov Artur 
Published: June 2021

Quantitative morpho-anatomical features of leaves of nine Clematis taxa (C. alpina ‘Pamela Jackman’, C. macropetala ‘Maidwell Hall’, C. integrifolia ‘Aljonushka’, C. ispahanica ‘Zvezdograd’, C. fargesii ‘Paul Farges’, C. texensis ‘Princess Diana’, C. tibetana, C. viticella, and C. heracleifolia) were determined with the aim to analyze their adaptation to the environmental conditions.Among investigated clematises, there were plants with hypostomatic (C. viticella, C. fargesii ‘Paul Farges’, C. heracleifolia, C. texensis ‘Princess Diana’, C. macropetala ‘Maidwell Hall’, and C. alpina ‘Pamela Jackman’), and amphistomatic leaves (C. ispahanica ‘Zvezdograd’ and C. tibetana). In C. integrifolia ‘Aljonushka’ leaves were hypostomatic, but few solitary stomata were also present on the adaxial surface. In the leaves of investigated taxa, the palisade coefficient ranged from 27.3% (C. alpina ‘Pamela Jackman’) to 49.9% (C. tibetana). The leaves also differed significantly in size. In particular, leaves of C. integrifolia ‘Aljonushka’ were almost ten times smaller than such of C. heracleifolia.As a result of UPGMA clustering, the plants that can survive in severe windy weather in open rocky areas, Clematis tibetana and C. ispahanica ‘Zvezdograd’, were joined in a separate cluster. The second cluster combined C. alpina ‘Pamela Jackman’ and C. macropetala ‘Maidwell Hall’ – cultivars blooming in the spring, during a period of significant difference in daily temperatures. A relatively small leaf area in plants from these two clusters may indicate an adaptation by reducing the transpiration area and general windage. The third cluster united the rest of investigated taxa, mostly – the mesophytic plants with a relatively large leaf area. However, due to similar morpho-anatomical structure of the leaf, the third cluster also comprised C. integrifolia ‘Aljonushka’ with the smallest leaves.
Violencia política contra las mujeres en razón de género y feminicidio.
Authors: Gazca Herrera Luis Alejandro , Lezama Martínez Maty , Cervantes Martínez Josué 
Published: June 2021

Es una realidad la existencia de actos de rezago y exclusión histórica en las que las mujeres han sido objeto, actos que lastiman y debilitan severamente a la democracia e impide el libre ejercicio de sus derechos. Hablar de la erradicación de la violencia política en razón de género y feminicidio, demanda y requiere del compromiso pleno de las diversas autoridades en el ámbito de sus respectivas competencias, de las y los actores políticos y, por supuesto de la sociedad misma. Este artículo tiene como objetivo presentar información relevante sobre la violencia política contra las mujeres y feminicidio, esto con el fin de razonar la problemática que se presenta en México, identificando una falta de cultura de respeto a los derechos políticos y electorales de las mujeres. El presente documento se desarrolló basado en una investigación de tipo descriptiva, para lo cual se realizó la revisión conceptual y literaria pertinente considerando documentos nacionales e internacionales sobre los conceptos en cuestión. Como resultados de la investigación se encontró que, aunque se tienen avances significativos en cuanto a la tutela jurídica de los derechos políticos y electorales de las mujeres actualmente representa es una lucha inacabada.
Potenciación de la coordinación motriz en adolescentes con síndrome de Down
Authors: Bravo Panezo Katherine Karolina , Mayorga Coyago Cristian David , Chávez Cevallos Enrique 
Published: June 2021

Introducción: La coordinación motriz se relaciona con la capacidad musculo-esquelética del cuerpo de sincronizarse bajo parámetros de trayectoria y movimiento. Su potenciación depende de numerosas variables, requiriendo adaptaciones en dependencia de las características del sujeto a intervenir, siendo igualmente especiales las intervenciones para sujetos con síndrome de Down. Objetivo: potenciar la coordinación motriz en adolescentes con síndrome de Down de la Fundación Virgen de la Merced. Métodos: investigación cuasiexperimental de orden correlativa, estudiando a 20 adolescentes con síndrome de Down (13-16 años). Se aplica el test de Ozeretski en dos momentos del estudio, implementando en seis meses un grupo de ejercicios para potenciar la coordinación motriz. Resultados: la coordinación estática (CE) inicial obtuvo 4 aciertos, y en el postest 16 aciertos (p=0.001), la coordinación dinámica de manos obtuvo 3 aciertos en el pretest y 13 en el postest (p=0.002), y la coordinación dinámica general obtuvo 1 acierto en el pretest y 11 en el postest (p=0.002). Conclusiones: se evidencia una mejora significativa en la coordinación estática, la coordinación dinámica de manos y la coordinación dinámica general en los adolescentes con síndrome de Down sometido al proceso de intervención con ejercicios físicos especializados.
ON THE FUNCTIONS OF ANTONOMASIA IN POLITICAL DISCOURSE
Authors: Poghosyan Ofelya , Ghumashyan Varduhi 
Published: June 2021

Political discourse carried out with powerful linguistic and extralinguistic means is utterly linked with the usage of antonomasia. In fact, it is the language of politicians used as a tool to manipulate the audience. Political speech is not necessarily a success because of its correctness or truth, rather it may be a matter of persuading valid arguments.
Political discourse as a teaching and persuasive, impressive and effective speech is one of the means to give solutions to the most important problems of constructing optimal speech interchange varying from political negotiations to orations and appeals (including the ones in the mass media). It is a well-known fact that the audience of politicians is very large, and their aim is to make the audience believe or agree with them, accept their viewpoints or at least share their approaches to the solutions of these or those problems. In this regard the role of proper utilization of antonomasia in political discourse becomes of utmost importance as it presupposes the realization of a particular language function in terms of the politician’s intention to send the necessary information to his audience, either readers or listeners.
In the scope of the present article we focus on the study of the functions of antonomasia in political discourse and apply the methods of observation, discourse analysis, as well as the descriptive and explanatory methods.
Hence, in political discourse stylistic devices are frequently used by politicians to carry out this or that particular purpose of utterance and in this connection the usage of antonomasia is not an exception.
Building Bridges: Integrating Disability Ethics Into Occupational Therapy Practice
Authors: McArthur Amy Roder , Gill Carol J. 
Published: June 2021

Abstract
Throughout the course of their careers, occupational therapy practitioners will encounter many ethical dilemmas as a part of service provision to disabled people. This article illustrates how disability ethics can strengthen the application of the Occupational Therapy Code of Ethics in practice. To maintain the integrity of the occupational therapy profession, it is critical that practitioners integrate concepts of disability ethics into the profession so their practice will promote environments in which disabled people will flourish.
“A Legitimate Place in the Profession”: Author Reflections on the 2005 Disability Studies Special Issue
Authors: Sheth Alisa Jordan , Kish Jacqueline , VanPuymbrouck Laura H. , Heffron Jenna L. , Lee Danbi , Mahaffey Lisa 
Published: June 2021

Abstract
Importance: In 2005, the American Journal of Occupational Therapy published a special issue focused on disability studies. Contributing authors challenged readers to reflect on their practices and recommended ways to change the field, yet literature on the current state of the integration of disability studies into occupational therapy is scarce.
Objective: To engage the original authors of the 2005 special issue in an examination of perspectives on how disability studies perspectives have contributed to changes within occupational therapy and what work remains.
Design: The research team conducted semistructured interviews with 11 authors who published an article in the special issue. Interview transcripts were analyzed using thematic analysis. Triangulation of coders, multiple phases of data analysis, and member checking were used to establish trustworthiness.
Results: Five themes emerged from the data: (1) exposure to disability and disability studies, (2) impact of the special issue on occupational therapy, (3) changes observed in occupational therapy beyond the special issue, (4) challenges integrating disability studies into occupational therapy, and (5) disability studies–informed recommendations for occupational therapy.
Conclusions and Relevance: Although the original contributing authors acknowledged the transformative impact of disability studies on their own practice and scholarship, the results suggest that disability studies remains outside mainstream occupational therapy scholarship. Exploring the connections and divergence between disability studies and fields such as occupational science could improve understanding of how disability studies concepts are defined and used in theory and practice.
What This Article Adds: Since the publication of the original special issue in 2005, the field of disability studies has continued to influence occupational therapy, although more often in individual than in systemic ways. Work is needed to embrace a disability studies–informed critical and intersectional foundation for the profession and explore the ways in which occupational therapy can better partner with populations through a disability studies lens.
Environmental Modifications and Supports for Participation Among Adults Aging With Intellectual and Developmental Disabilities: A Scoping Review
Authors: Washington Selena E. , Johnson Khalilah R. , Hollenbeck Jesse M. 
Published: June 2021

Abstract
Importance: Adults aging with intellectual and developmental disabilities (IDD) continue to face barriers to participation in meaningful occupation; moreover, the increased life expectancy of adults with IDD intensifies the need for age- and environment-specific support.
Objective: To map and categorize transdisciplinary literature on environmental modifications and supports for adults aging with IDD.
Data Sources: Studies published between January 1, 2000, and January 1, 2019, identified through PubMed and Scopus.
Study Selection and Data Collection: Eleven articles met the inclusion criteria and contained information specific to occupational participation based on environmental modification (e.g., physical space, technology, universal design, type of living setting), social supports (e.g., family members, caretakers, peer groups, health care professionals, policies, organizational infrastructure), or both and adults age ≥35 yr with IDD.
Findings: Eleven studies met the criteria for this scoping review. Thematic coding was used to examine the articles within one or more themes: definition of need, environmental risk and assessment, environmental setting, intervention and program planning, use of technology, and bureaucracy.
Conclusions and Relevance: This review highlights collective and individual outcomes in the areas of assessment, intervention, and advocacy. Further research is needed within the scope of occupational therapy and disability studies that examines environmental factors and participation outcomes in this population.
What This Article Adds: The authors define the interconnectedness of adults aging with IDD and environmental factors, identify barriers to participation, and guide occupational therapy practitioners’ logic on how to positively affect environmental change and supports through intervention.
Psychological Impact of COVID-19 on Occupational Therapists: An Online Survey in Japan
Authors: Ishioka Toshiyuki , Ito Ayahito , Miyaguchi Hideki , Nakamura Haruki , Sawamura Daisuke 
Published: June 2021

Abstract
Importance: Coronavirus disease 2019 (COVID-19) has had a severe psychological impact on frontline and second-line medical workers. However, few empirical reports have been published on its impact on occupational therapists. Clarifying the mental health status of occupational therapists is important to maintain care quality and prevent psychological problems in this population.
Objective: To investigate the psychological impact of COVID-19 on Japanese occupational therapists in prefectures with and without severe pandemic-related restrictions and elucidate factors associated with psychological problems such as anxiety, depression, and insomnia.
Design: A cross-sectional online survey using region-stratified two-stage cluster sampling conducted May 28–31, 2020.
Participants: The sample included 371 participants (63.1% women) in the prefectures under specific cautions (i.e., where residents were strictly advised to refrain from outings) and 1,312 in the prefectures without such cautions (61.9% women).
Results: The increase in workload due to the pandemic was significantly related to an increase in anxiety, depression, and insomnia, and an attempt to avoid talking face to face with others was significantly related to an increase in anxiety regardless of area. In prefectures under specific cautions as of May 25, 2020, the provision of sufficient information on COVID-19 by the workplace significantly reduced the risk of insomnia. In other prefectures, the provision of sufficient information significantly reduced the risk of depression.
Conclusions and Relevance: These results demonstrate the severe negative psychological impact of the increase in workload resulting from COVID-19 and suggest the importance of psychological support for occupational therapists, such as the provision of sufficient information by the workplace.
What This Article Adds: This study highlights the importance of providing psychological support for occupational therapists worldwide.