bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare costs of post‐stroke oropharyngeal dysphagia and its complications: malnutrition and respiratory infections
Authors: Marin Sergio , Serra‐Prat Mateu , Ortega Omar , Audouard Fericgla Monica , Valls Jordi , Palomera Elisabet , Cunillera Ramon , Palomeras Ernest , Ibàñez Josep Maria , Clavé Pere 
Published: June 2021

AbstractBackground and purposeThe healthcare economic costs of post‐stroke oropharyngeal dysphagia (OD) are not fully understood. The purpose of this study was to assess the acute, subacute and long‐term costs related to post‐stroke OD and its main complications (malnutrition and respiratory infections).MethodsA cost of illness study of patients admitted to Mataró Hospital (Catalonia, Spain) from May 2010 to September 2014 with a stroke diagnosis was performed. OD, malnutrition and respiratory infections were assessed during hospitalization and follow‐up (3 and 12 months). Hospitalization and long‐term costs were measured from hospital and healthcare system perspectives. Multivariate linear regression analysis was performed to assess the independent effect of OD, malnutrition and respiratory infections on healthcare costs during hospitalization, and at 3 and 12 months’ follow‐up.ResultsIn all, 395 patients were included of whom 178 had OD at admission. Patients with OD incurred major total in‐hospital costs (€5357.67 ± €3391.62 vs. €3976.30 ± €1992.58, p < 0.0001), 3‐month costs (€8242.0 ± €5376.0 vs. €5320.0 ± €4053.0, p < 0.0001) and 12‐month costs (€11,617.58 ± €12,033.58 vs. €7242.78 ± €7402.55, p < 0.0001). OD was independently associated with a cost increase of €789.68 (p = 0.011) during hospitalization and of €873.5 (p = 0.084) at 3 months but not at 12 months. However, patients with OD who were at risk of malnutrition or malnourished and suffered respiratory infections incurred major mean costs compared with those patients without OD (€19,817.58 ± €13,724.83 vs. €7242.8 ± €7402.6, p < 0.0004) at 12 months’ follow‐up.ConclusionOropharyngeal dysphagia causes significant high economic costs during hospitalization that strongly and significantly increase with the development of malnutrition and respiratory infections at long‐term follow‐up.
Parental self‐efficacy: Examining its mediating and reciprocally predictive roles in supportive emotion socialization
Authors: Fung Wing Kai , Chung Kevin Kien Hoa , Lam Chun Bun 
Published: June 2021

AbstractThis longitudinal study examined the associations between child negative affect, parental self‐efficacy (PSE), and parents’ approaches to the provision of supportive socialization. It also investigated the bidirectionality between PSE, problem‐focus socialization, and emotion‐focus socialization across two time points separated by one year. Participants were 757 Hong Kong Chinese parents (47.4% fathers) of kindergarten children. At both time 1 and time 2, parents reported their PSE, problem‐focus socialization, and emotion‐focus socialization. Additionally, parents rated their child's negative affect at time 1. Results from the cross‐lagged panel model revealed that, controlling for the effects of school's socioeconomic strata, child gender, parental age, and educational level, PSE at time 1 mediated the indirect links of child negative affect at time 1 with problem‐focus (indirect effect: β = −.02, SE = .02, p < .05) and emotion‐focus (indirect effect: β = −.02, SE = .01, p < .05) socialization at time 2 and that PSE (β = .10, SE = .06, p < .01) and problem‐focus socialization (β = .15, SE = .03, p < .05) were reciprocally associated with each other. Findings underscored the role of PSE in understanding parental provision of supportive socialization and the co‐development of belief about parenting and parenting behaviors.
Buried treasure – the teaching potential of Kodachrome slides brought into the digital age
Authors: Zufall Alina Gertrud , Mark Erica Jaclyn , Pollack Karlyn , Russell Mark 
Published: June 2021

AbstractClinical images on Kodachrome slides have been used for decades in dermatologic education. While the technology to view these images is becoming obsolete, many training programs possess high‐quality slides that have educational benefit. The University of Virginia Department of Dermatology possesses a collection of such slides that are currently being digitized and integrated into an educational software program. We present this article as a means of providing a uniform protocol for institutions with large Kodachrome collections to do the same. Our work has proven beneficial for both medical students interested in dermatology, allowing them to gain exposure to a variety of conditions that are not well emphasized in the general curriculum, as well as for dermatology residents, who use the program as a means to hone their diagnostic skills. Not only is there educational benefit to be derived from digitizing these slides but time is of the essence, as these slides can easily become damaged or degraded, and the technology needed to scan them is quickly becoming less available.
Contribution of functional genomics to identify the genetic basis of water‐deficit tolerance in barley and the related molecular mechanisms
Authors: Marok Mohamed Amine , Marok‐Alim Djamila , Rey Pascal 
Published: June 2021

AbstractDrought, a major environmental constraint, has increasing impact on agricultural production. Genetic improvement for maintaining crop productivity in such adverse conditions is a critical challenge for breeders. Barley exhibits a remarkable genetic diversity associated with a widespread geographical distribution in contrasted climates. This diversity, which resides in regional landraces and wild accessions, has been only recently explored using functional genomics. Here, we review the data gained to identify in the barley germplasm collections, candidate genes participating in mechanisms conferring drought tolerance via signalling and protective mechanisms. We particularly focus on genes, for which QTL determination and association genetic‐based mapping methods validate their likely roles in tolerance. Thus, allelic variants coding for transcription factors, heat shock or late embryogenesis proteins, and actors involved in ABA‐signalling pathways, proline biosynthesis or redox regulation, have been characterized in wild and landrace populations, and constitute a solid basis for improving barley drought tolerance. The huge advance in sequencing technology and mass spectrometry, combined with the power of bioinformatics tools, makes it possible to envisage trials including a large number of genotypes to compare their physiological and biochemical features upon water deficit, and simultaneously determine the genetic basis of their differential behaviour. The implementation of such approaches will be powerful to identify promising loci for breeders for improving barley responses to drought.
Investigating the role of competing wage opportunities in truck driver occupational choice
Authors: Phares Jonathan , Balthrop Andrew 
Published: June 2021

AbstractA perceived driver shortage causing difficulty in hiring and retaining qualified drivers threatens carrier productivity and profitability. Logistics literature concerning driver turnover has focused on three primary groups of factors contributing to the driver turnover: driver demographics, manager quality, and work environment. A key consideration, however, is that drivers have an outside option to work in other industry‐occupations. We leverage the Roy model of occupational choice to develop hypotheses regarding the effects of wages and tenure on workers’ occupational choice. To test our theory, we conduct a series of econometric studies on a panel data set we assemble from publicly available data sets. Our results show that relative wages strongly influence the choice of whether to drive a truck for a living. A particularly important finding is that the effect of relative wages varies significantly across industry‐occupations. In fact, contravening industry wisdom that wages are insufficient to attract qualified workers, wage elasticities are greater in trucking than in competing industry‐occupations, such as construction or retail. These results persist after accounting for a wage–tenure interaction. This indicates that the persistent “driver shortage” faced by the industry is the result of wages failing to keep pace with wage increases in competing industry‐occupations.
Effects of intermittent very‐low calorie diet on glycemic control and cardiovascular risk factors in obese patients with type 2 diabetes mellitus: A randomized controlled trial
Authors: Umphonsathien Mongkontida , Rattanasian Peedaporn , Lokattachariya Siriporn , Suansawang Wanlapa , Boonyasuppayakorn Kunwadee , Khovidhunkit Weerapan 
Published: June 2021

AbstractAims/IntroductionVery few studies assess the effectiveness of different protocols of intermittent very‐low calorie diet (VLCD) in patients with diabetes. This study was designed to compare the effects of 2 days/week and 4 days/week of intermittent VLCD on glycemic control, diabetes remission, metabolic parameters and quality of life in patients with type 2 diabetes and obesity.Materials and MethodsParticipants with obesity and type 2 diabetes were recruited and randomly assigned to three groups, consisting of control, 2 days/week and 4 days/week of intermittent VLCD. In the intermittent VLCD groups, participants received a 600‐kcal diet per day on restricted days and ad libitum food consumption on non‐restricted days. Glycemic control, rate of diabetes remission, metabolic parameters and quality of life were evaluated at baseline, weeks 2, 10 and 20.ResultsA total of 40 participants were enrolled. The mean body mass index was 30.1 ± 5.9 kg/m2, and the mean glycated hemoglobin was 7.4 ± 1.2%. At week 20, there was an improvement in glycemic control in both intermittent VLCD groups with significant decreases in glycated hemoglobin levels and insulin resistance index throughout the study periods. Diabetes remission without the need for medications was equally found in 29% of participants in both intermittent VLCD groups. Serum triglyceride, bodyweight, body mass index and fat mass were also significantly decreased in both VLCD groups. No serious adverse events were encountered.ConclusionIntermittent VLCD was highly effective in achieving optimal glycemic control. The effects of 2 days/week and 4 days/week of intermittent VLCD on diabetes remission were relatively similar.
Brain iron enrichment attenuates α‐synuclein spreading after injection of preformed fibrils
Authors: Dauer née Joppe Karina , Tatenhorst Lars , Caldi Gomes Lucas , Zhang Shuyu , Parvaz Mojan , Carboni Eleonora , Roser Anna‐Elisa , El DeBakey Hazem , Bähr Mathias , Vogel‐Mikuš Katarina , Wang Ip Chi , Becker Stefan , Zweckstetter Markus , Lingor Paul 
Published: June 2021

AbstractRegional iron accumulation and α‐synuclein (α‐syn) spreading pathology within the central nervous system are common pathological findings in Parkinson's disease (PD). Whereas iron is known to bind to α‐syn, facilitating its aggregation and regulating α‐syn expression, it remains unclear if and how iron also modulates α‐syn spreading. To elucidate the influence of iron on the propagation of α‐syn pathology, we investigated α‐syn spreading after stereotactic injection of α‐syn preformed fibrils (PFFs) into the striatum of mouse brains after neonatal brain iron enrichment. C57Bl/6J mouse pups received oral gavage with 60, 120, or 240 mg/kg carbonyl iron or vehicle between postnatal days 10 and 17. At 12 weeks of age, intrastriatal injections of 5‐µg PFFs were performed to induce seeding of α‐syn aggregates. At 90 days post‐injection, PFFs‐injected mice displayed long‐term memory deficits, without affection of motor behavior. Interestingly, quantification of α‐syn phosphorylated at S129 showed reduced α‐syn pathology and attenuated spreading to connectome‐specific brain regions after brain iron enrichment. Furthermore, PFFs injection caused intrastriatal microglia accumulation, which was alleviated by iron in a dose‐dependent way. In primary cortical neurons in a microfluidic chamber model in vitro, iron application did not alter trans‐synaptic α‐syn propagation, possibly indicating an involvement of non‐neuronal cells in this process. Our study suggests that α‐syn PFFs may induce cognitive deficits in mice independent of iron. However, a redistribution of α‐syn aggregate pathology and reduction of striatal microglia accumulation in the mouse brain may be mediated via iron‐induced alterations of the brain connectome.
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Is partial privatization of universities a solution for higher education?
Authors: Lahmandi‐Ayed Rim , Lasram Hejer , Laussel Didier 
Published: June 2021

AbstractThis paper accounts simply for the link between higher education and the productive economy through educated workers. We study a model of vertical successive monopolies where students/workers acquire qualification from a University then “sell” skilled labor to a monopoly which itself sells its final product to consumers, linking through quality the education sector to the labor and output markets. We determine the optimal share the State should keep in the University to compensate for the market imperfections, while taking into account the inefficiencies of public management. The resulting partially privatized University fixes the tuition fees so as to maximize a weighted sum of profits and social welfare. We derive the optimal public share under the hypothesis that the State may subsidize the tuition fees/University losses, then under the constraint that the University should make a nonnegative profit. We prove that in both cases, the State should keep a substantial share (higher under the first hypothesis) in the University, unless public management is too inefficient in which case the University's management should be completely private.
Self‐reported sleep and sleep deficiency: Results from a large initiative of sailors attached to U.S. Navy warships
Authors: Russell Dale W. , Markwald Rachel R. , Jameson Jason T. 
Published: June 2021

SummaryChronic insufficient sleep is known to lead to a broad range of negative consequences (e.g. poor health and cognitive performance). While insufficient sleep and associated fatigue are present in many diverse populations, it is of special concern in high‐risk military environments, where a mishap can result in catastrophic outcomes. Although many studies have been conducted to characterise sleep in general military populations, relatively few have been conducted using a large representative sample of sailors assigned to United States Naval warships. The present cross‐sectional study characterises self‐reported sleep parameters in sailors (N = 11,738) and explores the role of possible contributors to insufficient sleep. The results indicate that sailors, across a variety of different subgroups, do not obtain the amount of sleep that they report requiring for feeling well‐rested. Of the many potential factors thwarting sleep, workload and an uncomfortable mattress are the most promising candidates to target for improvement.
Historical population declines prompted significant genomic erosion in the northern and southern white rhinoceros (Ceratotherium simum)
Authors: Sánchez‐Barreiro Fátima , Gopalakrishnan Shyam , Ramos‐Madrigal Jazmín , Westbury Michael V. , de Manuel Marc , Margaryan Ashot , Ciucani Marta M. , Vieira Filipe G. , Patramanis Yannis , Kalthoff Daniela C. , Timmons Zena , Sicheritz‐Pontén Thomas , Dalén Love , Ryder Oliver A. , Zhang Guojie , Marquès‐Bonet Tomás , Moodley Yoshan , Gilbert M. Thomas P. 
Published: June 2021

AbstractLarge vertebrates are extremely sensitive to anthropogenic pressure, and their populations are declining fast. The white rhinoceros (Ceratotherium simum) is a paradigmatic case: this African megaherbivore has suffered a remarkable decline in the last 150 years due to human activities. Its subspecies, the northern (NWR) and the southern white rhinoceros (SWR), however, underwent opposite fates: the NWR vanished quickly, while the SWR recovered after the severe decline. Such demographic events are predicted to have an erosive effect at the genomic level, linked to the extirpation of diversity, and increased genetic drift and inbreeding. However, there is little empirical data available to directly reconstruct the subtleties of such processes in light of distinct demographic histories. Therefore, we generated a whole‐genome, temporal data set consisting of 52 resequenced white rhinoceros genomes, representing both subspecies at two time windows: before and during/after the bottleneck. Our data reveal previously unknown population structure within both subspecies, as well as quantifiable genomic erosion. Genome‐wide heterozygosity decreased significantly by 10% in the NWR and 36% in the SWR, and inbreeding coefficients rose significantly by 11% and 39%, respectively. Despite the remarkable loss of genomic diversity and recent inbreeding it suffered, the only surviving subspecies, the SWR, does not show a significant accumulation of genetic load compared to its historical counterpart. Our data provide empirical support for predictions about the genomic consequences of shrinking populations, and our findings have the potential to inform the conservation efforts of the remaining white rhinoceroses.
How can inhabited institutionalism inform the analysis of medical education?
Authors: Gulasaryan Aleksandra , Aitken Gillian , Fawns Tim , Jones Derek , Napier Jordan , Walker Kim 
Published: June 2021

AbstractContextMedical schools are complex organisations existing at the intersection of higher education and healthcare services. This complexity is compounded by many competing pressures and drivers from professional and regulatory bodies, the wider political environment and public expectations, producing a range of challenges for those involved in all stages of medical education. There are established approaches that have been used to address research questions related to these challenges; some focus on organisational structures, characteristics and performance; others on the interactions that take place in a particular setting. Less common are approaches that integrate data on macro‐level structures with the micro‐level interactions of the people who inhabit those structures. Looking at the interaction of the macro and the micro opens up possibilities for the new insights.FrameworkWe propose using an approach with roots in social theory—Inhabited Institutionalism (II)—that is largely unexplored in medical education. II has been described as Janus‐faced, looking both outwards, at the broader context of medical education, and inwards, at the ways in which meanings are constructed and re‐constructed by participants within a particular setting.MethodsAfter describing the theoretical framework of II, we explain how it can be used to understand medical education as subject to both broader societal structures (the macro level) and interactions between people (the micro level), as well as—crucially—their mutual influence.ConclusionII offers the opportunity to combine macro‐ and micro‐level perspectives, leading to a more expansive understanding of the operation of medical education which sees its form and function as neither entirely determined by structures nor a construction of individuals engaged in it. In doing so, it potentially offers a valuable way of considering the intractable problem of how to successfully manage change, offering a combined top‐down and bottom‐up perspective.
State of Medical Mycology at German Academic Medical Centres: A Survey of the German‐Speaking Mycological Society (DMYKG) and the Paul‐Ehrlich‐Society for Chemotherapy (PEG)
Authors: Groll Andreas H. , Gordon Kathrin , Buchheidt Dieter , Willinger Birgit , Heinz Werner J. , Kurzai Oliver , Rickerts Volker , Cornely Oliver A. ,   The Medical Mycology at German Academic Medical Centers (MMGAMC) Study Group
Published: June 2021

AbstractBackgroundLittle is known about the infrastructure to translate advances in the management of patients at risk to develop invasive opportunistic fungal diseases. To assess the current state of Medical Mycology support in Germany, we conducted a survey among all 36 academic medical centres.MethodsThe survey consisted of a 3‐pages questionnaire sent out in the first half of 2019. Information included details of infrastructure, education and teaching; consultation services and interdisciplinary conferences; research activities and participation in network groups; radiology, microbiology and pharmacology support; publication activity; and European Confederation for Medical Mycology (ECMM) Excellence Center designation, if assigned.ResultsInformation was returned from 24 centres (67%). Thirteen institutions (54%) reported an independent infectious disease, and two a separate Medical Mycology department (8%); a Medical Mycology working group was reported for nine institutions (38%). An infectious disease consultation service was existent in 16 institutions (67%) and a multidisciplinary conference in 13 (54%). Fifteen institutions reported a separate study office with activities in infectious disease studies (63%). Laboratory capability for fungal identification and susceptibility testing was confirmed by all 24 institutions; testing of galactomannan by 23 (96%), cryptococcal antigen by 21 (88%), ß‐D‐Glucan by 9 (38%), and panfungal and Pneumocystis PCR by 21 and 22 (88% and 92%), respectively. Therapeutic drug monitoring of voriconazole was reported to be available in 15 (63%) institutions with a turnaround of ≤24 h during weekdays in 10 (42%). Two of the 24 University hospitals (8%) reported ECMM Diamond Excellence Status.ConclusionsThe results of this survey document the continuing need to improve the availability of specialised Medical Mycology support in German academic medical centres.
Sodium‐glucose cotransporter‐2 inhibitors and non‐steroidal mineralocorticoid receptor antagonists: Ushering in a new era of nephroprotection beyond renin‐angiotensin system blockade
Authors: Shenoy Srinivas Vinayak , Nagaraju Shankar Prasad , Bhojaraja Mohan Varadanayakanahalli , Prabhu Ravindra Attur , Rangaswamy Dharshan , Rao Indu Ramachandra 
Published: June 2021

AbstractThe therapeutic options for preventing or slowing the progression of chronic kidney disease (CKD) have been thus far limited. While angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) are, without a doubt, safe and effective drugs, a significant proportion of patients with CKD still progress to end‐stage kidney disease. After decades of negative trials, nephrologists have finally found cause for optimism with the introduction of sodium‐glucose cotransporter‐2 (SGLT2) inhibitors and non‐steroidal mineralocorticoid receptor antagonists (MRAs). Recent trials such as EMPA‐REG OUTCOME and CREDENCE have provided evidence of the renal benefits of SGLT2 inhibitors, which have now found widespread acceptance as first‐line agents for diabetic CKD, in addition to ACEi/ARBs. Considering results from the DAPA‐CKD study, it is expected that their use will soon be expanded to other causes of albuminuric CKD as well, although confirmation from further trials, such as the EMPA‐KIDNEY study is awaited. Likewise, although the role of mineralocorticoid receptor overactivation in CKD progression has been known for decades, it is only now with the FIDELIO‐DKD study that we have evidence of benefits of MRAs on hard renal endpoints, specifically in patients with diabetic CKD. While further research is ongoing, given the evidence of synergism between the three drug classes, it is foreseeable that a combination of two or more of these drugs may soon become the standard of care for CKD, regardless of underlying aetiology. This review describes pathophysiologic mechanisms, current evidence and future perspectives on the use of SGLT2 inhibitors and novel MRAs in CKD.