bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is it worth it? Using DEA to analyze the efficiency gains and costs of merging university departments: a case study of the Complutense University of Madrid
Authors: Santín Daniel , Tejada Juan 
Published: May 2024

AbstractThe aim of this paper is to analyze the benefits of the university department merger undertaken by the Complutense University of Madrid (UCM) in 2017. The merger led to a new structure in which the original 184 departments were reduced to 97. To do this, we use the data envelopment analysis (DEA) to evaluate the efficiency gains of a merger process decomposing efficiency into three savings effects: learning, harmony, and scale effects. They decomposed efficiency into three savings effects: learning, harmony, and scale effects. Additionally, we introduce a new regulatory effect, which accounts for other potential recursive savings not included in the DEA analysis. Our results suggest that the merger process undertaken by the UCM achieved savings of around 20.5 million euros, approximately 6.6 million euros, which is accounted for by the regulatory effect. These savings will reproduce and accumulate annually over time. The results also show that, as a result of the intense negotiations, academic staff based at faculties engaged in the merger process may have taken more days of sick leave than academics from unmerged faculties in 2017, although the increase is not significant at standard levels.
Effect of early catheter ablation of atrial fibrillation in patients with heart failure
Authors: Tóth Patrik , Arnóth Bence , Komlósi Ferenc , Szegedi Nándor , Salló Zoltán , Perge Péter , Osztheimer István , Merkely Béla , Gellér László , Nagy Klaudia Vivien ,   and members of the SU EP Study Group
Published: May 2024

AbstractIntroductionAccording to current guidelines, pulmonary vein isolation as first‐line therapy should be considered for patients with atrial fibrillation (AF), however, optimal timing of the procedure is still unknown in patients with heart failure (HF). We aimed to evaluate the effect of early catheter ablation (CA) in patients with HF and left ventricular ejection fraction (LVEF) below 50%.MethodsWe analyzed data from a structured registry comprising 227 patients with paroxysmal or persistent AF and HF with LVEF < 50% who underwent radiofrequency CA between 2015 and 2022. Early CA was defined as a procedure performed within 12 months of AF diagnosis. The median follow‐up duration was 1748 (1176.3–2353.5) days, with a minimum follow‐up of 365 days. Our endpoints were AF recurrence after a 3‐months blanking period and all‐cause mortality.ResultsAmong the 227 patients with a median age of 64.3 years, 97 (42.7%) experienced AF recurrence and 55 (24.2%) died during the follow‐up period. The median LVEF was 40% for early CA and 38% for delayed CA (p = .053). Early CA significantly reduced AF recurrence (HR = 0.25 [0.15–0.42], p < .001), however, the timing of procedure did not affect all‐cause mortality (p = .16). These findings were consistent regardless of AF subtype or the burden of comorbidities, as assessed by the CHA2DS2‐VASc score.ConclusionThe timing of CA of AF appears to be an important factor in patients with HF. Early CA reduced AF recurrence, although it does not impact all‐cause mortality. We found similar results regardless of AF subtype or burden of comorbidities.
Do maternal allocations towards offspring quality and quantity ameliorate the effects of predators on offspring survival?
Authors: Ugine Todd A. , Mutz Jessie , Underwood Nora , Thaler Jennifer S. 
Published: May 2024

AbstractReproductive allocation is often balanced between the quantity and quality of offspring. Ecological stresses, like exposure to predators, can cause organisms to shift their allocations along this continuum. While the consequences of such plastic shifts for offspring performance are often untested, they are critical to understanding the potential long‐term benefits of manipulating predation risk as an agricultural pest management technique. Predation risk induces reductions in egg production and increases in nutritional condition due to maternal provisioning in Colorado potato beetles (Leptinotarsa decemlineata, CPB). Here, we tested whether reductions in density or increases in offspring condition, which may increase per‐capita larval survival, can compensate for the reduction in total egg production, especially when offspring are exposed to predators. In two field trials, we manipulated density and condition of larval CPB and measured survival through development to adulthood in field cages with and without predaceous stink bugs (Podisus maculiventris). As expected, cages with the higher initial larval densities had more larvae and adults surviving in the treatments without predators – about 30%–50% survival across densities. When predators were present, this relationship did not hold because of density‐dependent predation. Larval condition interacted with density and impacted larval survival in both trials albeit in different ways. In trial 1, unprovisioned beetles had higher survival at the higher densities; in trial 2, provisioned beetles had higher survival across densities. Synthesis and Applications: Overall, our test of the effects of predation risk via manipulations of larval density and condition revealed few net compensatory benefits to the prey of reduced density and higher condition. Benefits to the prey of shifts in allocation from the quantity to quality of offspring may depend on factors that influence the strength of density dependence, including predation intensity. Our results suggest a new strategy of taking advantage of the reductions in prey density due to non‐consumptive effects of predators as a pest management approach to protect plants.
It's never too late to be financially literate: Evaluating a financial education intervention for adults in Italy
Authors: Iannotta Gabriele , Cannistrà Marta , Agasisti Tommaso 
Published: May 2024

AbstractFinancial education represents a powerful tool for improving economic literacy of citizens. This paper presents results from an experiment providing a group of 136 workers in an Italian university (administrative staff) an online, synchronous course. Classes were organized in 5 sessions of 2h each and covered basic topics about personal finance. The effectiveness of the course is assessed through a rigorous randomized controlled trial (RCT). In addition to the analysis of improvements in financial knowledge, financial self‐efficacy and the role of prior attitudes and behaviors were explored. Participants obtained post‐test scores statistically higher than individuals in the control group, with an average effect size of 0.55 SD. The effect is particularly relevant for participants starting with low levels of financial knowledge. Moreover, two novel findings emerge: financial self‐efficacy increases (0.51 SD) after the course, and pre‐treatment individuals' financial attitudes and behaviors shed further light on the financial learning process.
First report of Botrytis cinerea causing flower blight on macadamia in South Africa
Authors: Jami Fahimeh , Duma Sanelisiwe , Fourie Gerda , Botha Gerhard , Schoeman Maritha 
Published: May 2024

AbstractMacadamia cultivation plays significant role in the economy of South Africa. Despite its importance, the industry grapples with disease‐related challenges, notably flower blight, which threatens substantial economic losses by affecting yield and nut quality. In 2022, diagnostic services at the Agricultural Research Council and the Forestry and Agricultural Biotechnology Institute received macadamia flowers displaying blight symptoms. Employing two methods for fungal isolation, 25 isolates were obtained which were classified into one group based on morphological characteristics. DNA analysis identified the isolates as Botrytis cinerea. The pathogenicity testing was conducted on macadamia flowers to confirm Koch's postulates. This is the first report of B. cinerea affecting Macadamia integrifolia Maiden & Betche in South Africa, underlining its potential threat to the industry.
Effects of the low Fowler's sleep position and methazolamide treatment on sleep bruxism: A randomized controlled trial
Authors: Zhong Zhijun , Li Qi , Zou Xueliang , Ouyang Qian , Zhang Ling , Liu Xinting , Luo Yaxing , Yao Dongyuan 
Published: May 2024

SummaryIntracranial pressure is one of the determinants of sympathetic activities, and sleep bruxism is associated with increased sympathetic activities. This study aimed to investigate effects of the low Fowler's sleep position and methazolamide treatment on the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes in patients with sleep bruxism in a randomized controlled trial. Polysomnographic recordings were performed on the patients with sleep bruxism sleeping in the low Fowler's (15°–30°) or supine position (n = 11), and with methazolamide or placebo treatment (100 mg, 3–4 hr before bedtime, P.O., n = 9), and changes in sleep variables and heart rate variance during sleep in the low Fowler's position or with methazolamide treatment were determined. Sleep bruxism index, number of masseter muscle electromyographic bursts per hour of sleep, ratio of rhythmic masticatory muscle activities/sleep bruxism duration to the total sleep duration, index of total limb movements, index of limb movements with rhythmic masticatory muscle activities, and number of sleep bruxism clusters per hour of sleep in the low Fowler's position and after methazolamide intake were significantly smaller (p < 0.05–0.001) than those in the supine position and after placebo intake, respectively. The low‐frequency heart rate variance powers during non‐rapid eye movement sleep stage 2 (N2) in the low Fowler's position and with methazolamide treatment were significantly lower (p < 0.05) than those during sleep in the supine position and with placebo treatment, respectively. In conclusion, sleep in the low Fowler's position and methazolamide treatment were associated with significant decreases in the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes, which might be due to a reduction in intracranial pressure and sympathetic activities mainly during non‐rapid eye movement sleep stage 2.
A systematic review and meta‐analysis combining adolescent and adult data to evaluate weight loss and the effect of age following the laparoscopic sleeve gastrectomy
Authors: Karasko Danielle 
Published: May 2024

SummaryObesity is a grave concern within the United States, resulting in lost productivity, increased medical costs, and comorbidities with lifelong repercussions. The laparoscopic sleeve gastrectomy is a treatment option for obesity. The following meta‐analysis sought to combine adolescent and adult literature to determine the overall effect of the sleeve gastrectomy on weight loss, to evaluate the effect of age at the time of surgery on weight loss, and to describe and explore variation in weight loss by sample characteristics. Overall weight loss was assessed at proximal and distal points, a dichotomous moderator variable analysis was conducted with subjects ≤21 years of age and >21 years of age, and a meta‐regression assessing % male, % female, and baseline BMI was conducted to assess moderator variables. The laparoscopic sleeve gastrectomy was effective at facilitating weight loss with effect sizes varying from 0.916 to2.816. Age, biological sex, and baseline BMI were not found to have an impact on weight loss. The clinical consequences of prolonged obesity are evident and earlier intervention may be justified to counter the long‐term effects caused by obesity related comorbidities. Standardized reporting of comorbidities and the effect of bariatric surgery on comorbid conditions is essential to allow further analysis.
Novel species, morpho‐molecular identification and pathogenicity of Allophoma (Didymellacaeae) causing leaf spots of true mangroves and mangrove associates in Thailand
Authors: Aumentado Herbert Dustin R. , Armand Alireza , Chethana K. W. Thilini , Phukhamsakda Chayanard , Norphanphoun Chada , Hyde Kevin D. , Jones E. B. Gareth , Jayawardena Ruvishika S. 
Published: May 2024

AbstractTrue mangroves and mangrove associates are salt‐tolerant trees and shrubs that serve a critical role in preserving the ecological balance of tropical and subtropical estuarine environments. However, they are not immune to the damage caused by fungal pathogens. In this study, leaves exhibiting leaf spot symptoms were gathered from mangrove estuary and forests in Prachuap Khiri Khan, Thailand. Through morphological and multilocus phylogenetic analyses (LSU, ITS, RPB2 and TUB2) along with genealogical concordance phylogenetic species recognition, we identified Allophoma acanthi sp. nov. from Acanthus ilicifolius. Additionally, A. minor was identified as the causative agent of leaf spots in true mangrove and mangrove associate species, namely, Acanthus ilicifolius, Combretum sp., Hibiscus tiliaceus, Intsia bijuga, Lumnitzera racemosa and Sonneratia alba. We also provide evidence to support the synonymization of A. thunbergiae with A. minor. All eight isolates of Allophoma species in this study demonstrated pathogenicity to their original hosts with varied virulence, confirming Koch's postulates. Our findings contribute to the understanding of fungal pathogens affecting true mangroves and mangrove associates.
Cost-effectiveness of incentives for physical activity in coronary heart disease in Germany: pre-trial health economic model of a complex intervention following the new MRC framework
Authors: Mohebbi Damon , Ogurtsova Katherine , Dyczmons Jan , Dintsios Markos , Kairies-Schwarz Nadja , Jung Christian , Icks Andrea 
Published: May 2024

ObjectivesThe German Incentives for Physical Activity in Cardiac Patients trial is a three-arm, randomised controlled trial for secondary prevention of coronary heart disease (CHD). Guidance for developing complex interventions recommends pre-trial health economic modelling. The aim of this study is to model the long-term cost-effectiveness of the incentive-based physical activity interventions in a population with CHD.MethodsA decision-analytical Markov model was developed from a health services provider perspective, following a cohort aged 65 years with a previous myocardial infarction for 25 years. Monetary and social incentives were compared relative to no incentive. Intervention effects associated with physical activity were used to determine the costs, quality-adjusted life-years (QALYs) gained, incremental cost-effectiveness and cost–utility ratios. The probability of cost-effectiveness was calculated through sensitivity analyses.ResultsThe incremental QALYs gained from the monetary and social incentives, relative to control, were respectively estimated at 0.01 (95% CI 0.00 to 0.01) and 0.04 (95% CI 0.02 to 0.05). Implementation of the monetary and social incentive interventions increased the costs by €874 (95% CI €744 to €1047) and €909 (95% CI €537 to €1625). Incremental cost–utility ratios were €25 912 (95% CI €15 056 to €50 210) and €118 958 (95% CI €82 930 to €196 121) per QALY gained for the social and monetary incentive intervention, respectively. With a willingness-to-pay threshold set at €43 000/QALY, equivalent to the per-capita gross domestic product in Germany, the probability that the social and monetary incentive intervention would be seen as cost-effective was 95% and 0%, respectively.ConclusionsExercise-based secondary prevention using inventive schemes may offer a cost-effective strategy to reduce the burden of CHD.
Variant classification changes over time in the clinical molecular diagnostic laboratory setting
Authors: Hahn Elan , Mighton Chloe , Fisher Yael , Wong Andrew , Di Gioacchino Vanessa , Watkins Nicholas , Mayers Justin , Bombard Yvonne , Charames George S , Lerner-Ellis Jordan 
Published: May 2024

BackgroundVariant classification in the setting of germline genetic testing is necessary for patients and their families to receive proper care. Variants are classified as pathogenic (P), likely pathogenic (LP), uncertain significance (VUS), likely benign (LB) and benign (B) using the standards and guidelines recommended by the American College of Medical Genetics and the Association for Molecular Pathology, with modifications for specific genes. As the literature continues to rapidly expand, and evidence continues to accumulate, prior classifications can be updated accordingly. In this study, we aim to characterise variant reclassifications in Ontario.MethodsDNA samples from patients seen at hereditary cancer clinics in Ontario from January 2012 to April 2022 were submitted for testing. Patients met provincial eligibility criteria for testing for hereditary cancer syndromes or polycystic kidney disease. Reclassification events were determined to be within their broader category of significance (B to LB or vice versa, or P to LP or vice versa) or outside of their broader category as significance (ie, significant reclassifications from B/LB or VUS or P/LP, from P/LP to VUS or B/LB, or from VUS to any other category).ResultsOf the 8075 unique variants included in this study, 23.7% (1912) of variants were reassessed, and 7.2% (578) of variants were reclassified. Of these, 351 (60.7%) variants were reclassified outside of their broader category of significance. Overall, the final classification was significantly different for 336 (58.1%) variants. Importantly, most reclassified variants were downgraded to a more benign classification (n=245; 72.9%). Of note, most reclassified VUS was downgraded to B/LB (n=233; 84.7%).ConclusionsThe likelihood for reclassification of variants on reassessment is high. Most reclassified variants were downgraded to a more benign classification. Our findings highlight the importance of periodic variant reassessment to ensure timely and appropriate care for patients and their families.
Percutaneous Microaxial Ventricular Assist Device Versus Intra‐Aortic Balloon Pump for Nonacute Myocardial Infarction Cardiogenic Shock
Authors: Watanabe Atsuyuki , Miyamoto Yoshihisa , Ueyama Hiroki , Gotanda Hiroshi , Tsugawa Yusuke , Kuno Toshiki 
Published: May 2024

Background
Evidence on the comparative outcomes following percutaneous microaxial ventricular assist devices (pVAD) versus intra‐aortic balloon pump for nonacute myocardial infarction cardiogenic shock is limited.

Methods and Results
We included 704 and 2140 Medicare fee‐for‐service beneficiaries aged 65 to 99 years treated with pVAD and intra‐aortic balloon pump, respectively, for nonacute myocardial infarction cardiogenic shock from 2016 to 2020. Patients treated using pVAD compared with those treated using intra‐aortic balloon pump were more likely to be concurrently treated with mechanical ventilation, renal replacement therapy, and blood transfusions. We computed propensity scores for undergoing pVAD using patient‐ and hospital‐level factors and performed a matching weight analysis. The use of pVAD was associated with higher 30‐day mortality (adjusted odds ratio, 1.92 [95% CI, 1.59–2.33]) but not associated with in‐hospital bleeding (adjusted odds ratio, 1.00 [95% CI, 0.81–1.24]), stroke (adjusted odds ratio, 0.91 [95% CI, 0.56–1.47]), sepsis (OR, 0.91 [95% CI, 0.64–1.28]), and length of hospital stay (adjusted mean difference, +0.4 days [95% CI, −1.4 to +2.3]). A quasi‐experimental instrumental variable analysis using the cross‐sectional institutional practice preferences showed similar patterns, though not statistically significant (adjusted odds ratio, 1.38; 95% CI, 0.28–6.89).

Conclusions
Our investigation using the national sample of Medicare beneficiaries showed that the use of pVAD compared with intra‐aortic balloon pump was associated with higher mortality in patients with nonacute myocardial infarction cardiogenic shock. Providers should be cautious about the use of pVAD for nonacute myocardial infarction cardiogenic shock, while adequately powered high‐quality randomized controlled trials are warranted to determine the clinical effects of pVAD.
Management of the Nasolacrimal Duct in Expanded Endoscopic Approaches to the Maxillary Sinus: A Systematic Review with Evidence-based Recommendations
Authors: Godse Neal Rajan , Sreenath Satyan , Lobo Brian C. , Sindwani Raj 
Published: May 2024

Background Utilizing expanded endoscopic approaches to the maxillary sinus for the endonasal management of a variety of tumors is increasing in popularity. The nasolacrimal duct (NLD) may be injured inadvertantly or need to be removed during tumor resection or to augment visualization. Management of the NLD can take the form of transection alone, transection with stenting, or performing a formal dacryocystorhinostomy to avoid postoperative sequelae of injury. The purpose of this study was to review the literature and determine the optimal management of the NLD during expanded maxillary sinus approaches. Methods A systematic review of Ovid, Embase, Medline, and Cochrane databases was performed to identify studies involving expanded approaches to the maxillary sinus and that explicitly reported the status of the NLD and postoperative outcomes. Results Nineteen studies were included in the analysis and divided into two groups: NLD-preserving (n = 9 studies; n = 191 patients in aggregate) and NLD-involving (n = 10 studies; n = 296 patients in aggregate). In the NLD-preserving subgroup, one patient out of a subgroup aggregate of 191 patients (0.5%) developed epiphora. In the NLD-involving subgroup, sharp transection alone was the most common method of NLD removal and was associated with a low rate of epiphora (study rates: 0 to 18.2%; aggregated subgroup rate: 7.0%, 21 / 296). Spontaneous resolution of symptoms was common (60%-100% cases). Conclusions The NLD should be preserved when feasible from an exposure and tumor-control perspective. When pathology or approach requires the removal of the NLD, rates of persistent epiphora are very low, regardless of surgical technique. When expanded maxillary approaches are employed, particularly for benign tumors, and require removal of the NLD, sharp transection is the simplest method of removal, provides a low rate of postoperative epiphora, and is supported by the available literature.