bluuebunny/crossref_metadata_2025_split huggingface dataset:
Romania: Political Developments and Data in 2021
Authors: STAN LAVINIA , ZAHARIA RAZVAN 
Published: May 2022

AbstractRomania was affected by Cabinet instability, an energy crisis and the Covid‐19 pandemic in 2021, a year when no elections or referenda were held. Its self‐interested political elite, rocked by scandals related to plagiarism and preoccupied almost exclusively with the distribution of positions, was unable to address the oil and gas crisis affecting every household, and unwilling to help an underfunded healthcare system.
The black summer bushfires: impacts and risk factors for livestock bushfire injury in south‐eastern Australia
Authors: Cowled BD , Hillman A , Ward MP , Clutterbuck H , Doyle M , Webb Ware J , Thomas M , Plain K , Barwell R , Laurence M , Pfeiffer C 
Published: May 2022

BackgroundThe 2019/2020 Australian bushfires were the largest bushfire event in modern Australian history. While actions to mitigate risk to homes from bushfires are well reported, there is very little research reported on the impacts of bushfires on livestock. With an increasing incidence of bushfires predicted, there is an urgent need to identify how farmers can best protect their livestock.ObjectivesCompare bushfire affected farms with and without injured livestock to identify associations between risk factors and bushfire injury. Infer management approaches that can be used to reduce bushfire injury in livestock.MethodA case‐control study using a structured interview questionnaire, delivered in late 2020 to cattle and sheep farmers in south‐eastern Australia (New South Wales and Victoria) whose farmland was burnt in the 2019/2020 Australian bushfires. Case farms were farms with bushfires injured or killed livestock. Control farms were farms that had no bushfire injured livestock but that still had fire present on the farm. Interview responses were summarised and information theoretical approaches were used to identify potential risk factors for livestock bushfire injury and protective actions that could inform future fire‐preparation recommendations.Results and discussionOf 46 farms in the case‐control study, 21 (46%) reported bushfire injured or killed livestock. Apparent protective factors identified included: preparation (having a bushfire plan and more than two farm bushfire fighting units), backburning and receiving assistance from fire authorities. Combined beef and sheep grazing enterprises appeared to have an increased risk of bushfire injury to livestock.
Using intra‐task flexibility on an intelligent tutoring system to promote arithmetic problem‐solving proficiency
Authors: del Olmo‐Muñoz Javier , González‐Calero José Antonio , Diago Pascual D. , Arnau David , Arevalillo‐Herráez Miguel 
Published: May 2022

AbstractProblem solving is often regarded as one of the most essential cognitive functions in our daily lives, and, for that reason, educational theorists have long stressed the need for its development. As cognitive flexibility is a fundamental characteristic necessary throughout the problem‐solving process, the purpose of this study is to analyse students' problem‐solving performance after following intra‐task flexibility‐based training mediated by an intelligent tutoring system. With this aim, 110 fifth and sixth grade students took part in a quasi‐experimental study that included six forty‐five‐minute flexibility‐based training sessions preceded and followed by test sessions in order to evaluate eventual problem‐solving proficiency improvements. The findings show that intra‐task flexibility training enhances students' ability to solve arithmetic word problems, especially when flexibility‐related activities are completed sequentially in the same session and not in different sessions. Furthermore, the proposed instruction is particularly helpful in improving girls' problem‐solving competence, which can minimize eventual gender gaps and strengthen their STEM vocation.
Practitioner notesWhat is already known about this topic

Cognitive flexibility is beneficial in finding appropriate problem‐solving strategies.
Exposing students to a variety of problem‐solving methods or strategies can improve their cognitive flexibility.
Boys are more likely than girls to flexibly apply multiple solution paths while solving problems, which leads to gender differences in mathematics.
By contrast, girls are more prone to take advantage of instructional advice when using intelligent tutoring systems (ITS).
What this paper adds

Prompting students to apply multiple resolution strategies within the same problem (intra‐task flexibility instruction) is comparatively more efficient than standard instruction in promoting problem‐solving performance.
It is more effective in terms of problem‐solving proficiency to ask students to find different resolutions for a problem sequentially in the same session than to do so in separate sessions.
Effectiveness of ITS‐mediated flexibility‐based training leads to the promotion of problem‐solving proficiency, particularly in the case of female students.
Implications for practice and/or policy

The use of the ITS HINTS has the potential to promote the use of multiple solutions in problem solving by monitoring the resolution paths of the student, which can be difficult in a traditional classroom setting.
ITS‐mediated flexibility‐based training is especially effective in improving girls' problem‐solving competence, which can minimize eventual gender gaps and strengthen their STEM vocation.
Clinical significance of IDC‐P as predictive factor after intensity‐modulated radiation therapy
Authors: Aizawa Rihito , Tsuzuki Toyonori , Haga Hironori , Nakamura Kiyonao , Ogata Takashi , Inoue Takahiro , Kobayashi Takashi , Akamatsu Shusuke , Goto Takayuki , Ogawa Osamu , Mizowaki Takashi 
Published: May 2022

AbstractThe clinical significance of intraductal carcinoma of the prostate (IDC‐P) in men with nonmetastatic prostate cancer (PCa) treated with high‐dose external‐beam radiation therapy remains unclear. The aim of this study was to evaluate the impact of IDC‐P in men who received intensity‐modulated radiation therapy (IMRT) for nonmetastatic PCa. All patients with high‐risk (H‐R) and very high–risk (VH‐R) PCa who received IMRT between September 2000 and December 2013 at our institution were analyzed retrospectively. We re‐reviewed biopsy cores for the presence of IDC‐P. Treatment consisted of IMRT (median: 78 Gy at 2 Gy per fraction) plus 6‐month neoadjuvant hormonal therapy (HT). In total, 154 consecutive patients with H‐R and VH‐R PCa were analyzed. Intraductal carcinoma of the prostate was present in 27.9% (n = 43). The median follow‐up period was 8.4 years. The 10‐year PCa‐specific survival, biochemical failure (BF), clinical failure, and castration‐resistant PCa rates were 90.0%, 47.8%, 27.5%, and 24.5% in patients with IDC‐P, and 96.6%, 32.6%, 10.8%, and 7.0% in those without IDC‐P, respectively (p = 0.12, 0.04, 0.0031, and 0.012, respectively). In multivariable analysis, IDC‐P was not identified as an independent predictive factor for BF (p = 0.26). The presence of IDC‐P was correlated with a significantly higher incidence of disease progression in men with H‐R and VH‐R PCa who received IMRT, although it was not identified as an independent predictive factor for BF. Further investigations are needed to determine the significance of IDC‐P as an independent predictive factor for survival outcomes.
Measuring steroids in hair opens up possibilities to identify congenital adrenal hyperplasia in developing countries
Authors: Waaijers Selma , Utari Agustini , van der Doelen Rick H. A. , Faradz Sultana M. H. , Hensen‐Lodewijk Renate , Olthaar Andre J. , Geutjes Paul J. , Sweep Fred C. , Claahsen‐van der Grinten Hedi L. , van Herwaarden Antonius E. 
Published: May 2022

AbstractObjectivePatients with congenital adrenal hyperplasia (CAH) in developing countries have limited access to appropriate laboratory facilities for diagnosis and follow‐up. The aim of this study is to evaluate steroid measurement in hair as a diagnostic tool to identify and monitor CAH in these patients.DesignA method was developed to measure steroids in hair, the stability of steroids in hair was assessed, and the concentration range in healthy volunteers was determined. Hair samples of patients, before and after starting therapy, were transported at ambient temperature to The Netherlands for analysis.PatientsTwenty‐two Indonesian CAH patients and 84 healthy volunteers participated.MeasurementsCortisol, 17‐hydroxyprogesterone (17OHP), androstenedione, and testosterone in hair were measured by liquid chromatography with tandem mass spectrometry.ResultsSteroids in hair could be measured and remained stable (<4.9% deviation) for at least 3 weeks at 4°C and 30°C. In each of the untreated patients, hair concentrations of 17OHP (9.43–1135 pmol/g), androstenedione (36.1–432 pmol/g), and testosterone (2.85–69.2 pmol/g) were all above the upper limit of the corresponding range in healthy volunteers; 5.5 pmol/g, 13 pmol/g, and 1.8 pmol/g, respectively. After starting glucocorticoid treatment, the steroid concentrations in the hair of CAH patients decreased significantly for androstenedione (73%) and testosterone (59%) after 6 months.ConclusionsCAH could be confirmed in Indonesian patients based on the concentration of 17OHP, androstenedione, and testosterone in hair, and a treatment effect was observed. These findings open up opportunities to diagnose and/or monitor CAH in developing countries with a simple noninvasive technique.
Evidence for a Shared Instrument Prototype from English, Dutch, and German
Authors: Rissman Lilia , van Putten Saskia , Majid Asifa 
Published: May 2022

AbstractAt conceptual and linguistic levels of cognition, events are said to be represented in terms of abstract categories, for example, the sentenceJackie cut the bagel with a knifeencodes the categories Agent (i.e.,Jackie) and Patient (i.e.,the bagel). In this paper, we ask whether entities such asthe knifeare also represented in terms of such a category (often labeled “Instrument”) and, if so, whether this category has a prototype structure. We hypothesized the Proto‐instrument is atool: a physical object manipulated by an intentional agent to affect a change in another individual or object. To test this, we asked speakers of English, Dutch, and German to complete an event description task and a sentence acceptability judgment task in which events were viewed with more or less prototypical instruments. We found broad similarities in how English, Dutch, and German partition the semantic space of instrumental events, suggesting there is a shared concept of the Instrument category. However, there was no evidence to support the specific hypothesis that tools are the core of the Instrument category—instead, our results suggest the most prototypical Instrument is the direct extension of an intentional agent. This paper supports theoretical frameworks where thematic roles are analyzed in terms of prototypes and suggests new avenues of research on how instrumental category structure differs across linguistic and conceptual domains.
The relationship between absolute counts of lymphocyte subsets and clinical features in patients with pulmonary tuberculosis
Authors: An Hui‐Ru , Bai Xue‐Juan , Liang Jian‐Qin , Wang Tao , Wang Zhong‐Yuan , Xue Yong , Liu Yin‐Ping , Wang Lan , Wu Xue‐Qiong 
Published: May 2022

AbstractBackgroundThe aim of the present study is to investigate the clinical value and characteristics of peripheral blood lymphocyte subsets in patients with pulmonary tuberculosis (PTB) using flow cytometry.MethodsThe absolute counts of T, CD4+T, CD8+T, natural killer (NK), NKT and B lymphocytes in 217 cases of PTB were detected, and the variations in lymphocyte subset counts between different ages and genders and between aetiological detection results and chest radiography results were analysed.ResultsIn 75.3% of the patients with PTB, six subset counts were lower than the normal reference range, and 44% showed lower‐than‐normal CD4+T lymphocyte levels. The counts of T, CD4+T, CD8+T and B lymphocytes were significantly lower in patients aged >60 years, and the NKT cell counts were significantly lower in female patients than in male patients. Among the patients with positive aetiological results, 40.8% had reduced CD8+T counts; these were significantly lower than those in patients with negative aetiological results (P = 0.0295). The cell counts of T, CD4+T, CD8+T and B lymphocytes reduced as lesion lobe numbers increased. The counts of T, CD4+T and CD8+T lymphocytes were significantly higher in the group with lesions affecting one lobe than in the groups with two to three lobes or four to five lobes, and the counts of B lymphocytes were significantly higher in the group with one lobe and the group with two to three lobes than in the group with four to five lobes. The counts of CD4+T and CD8+T lymphocytes were highest in the no cavity group and showed a downward trend with the increase in cavities; the T lymphocyte count was significantly higher in the no cavity group than in the group with five or more cavities (P = 0.014), and the CD8+T lymphocyte count was significantly higher in the no cavity group than in the group with one to two cavities and the group with five or more cavities (P = 0.001 and 0.01, respectively).ConclusionsIn most patients with tuberculosis, immune function is impaired. The absolute counts of peripheral blood lymphocyte subsets are closely related to the aetiological results and lesion severity in patients with PTB; this could be used as evidence for immune intervention and monitoring curative effects.
Construction and validation of prognostic nomograms for elderly patients with metastatic non‐small cell lung cancer
Authors: Sun Haishuang , Liu Min , Yang Xiaoyan , Ren Yanhong , Dai Huaping , Wang Chen 
Published: May 2022

AbstractBackgroundMetastatic non‐small cell lung cancer (NSCLC) is mostly seen in older patients and is associated with poor prognosis. There is no reliable method to predict the prognosis of elderly patients (≥60 years old) with metastatic NSCLC. The aim of our study was to develop and validate nomograms which accurately predict survival in this group of patients.MethodsNSCLC patients diagnosed between 2010 and 2015 were all identified from the Surveillance, Epidemiology, and End Results (SEER) database. Nomograms were constructed by significant clinicopathological variables (p < 0.05) selected in multivariate Cox analysis regression.ResultsA total of 9584 patients met the inclusion criteria and were randomly allocated in the training (n = 6712) and validation (n = 2872) cohorts. In training cohort, independent prognostic factors included age, gender, race, grade, tumor site, pathology, T stage, N stage, radiotherapy, surgery, chemotherapy, and metastatic site (p < 0.05) for lung cancer‐specific survival (LCSS) and overall survival (OS) were identified by the Cox regression. Nomograms for predicting 1‐, 2‐, and 3‐years LCSS and OS were established and showed excellent predictive performance with a higher C‐index than that of the 7th TNM staging system (LCSS: training cohort: 0.712 vs. 0.534; p < 0.001; validation cohort: 0.707 vs. 0.528; p < 0.001; OS: training cohort: 0.713 vs. 0.531; p < 0.001; validation cohort: 0.710 vs. 0.528; p < 0.001). The calibration plots showed good consistency from the predicted to actual survival probabilities both in training cohort and validation cohort. Moreover, the decision curve analysis (DCA) achieved better net clinical benefit compared with TNM staging models.ConclusionsWe established and validated novel nomograms for predicting LCSS and OS in elderly patients with metastatic NSCLC with desirable discrimination and calibration ability. These nomograms could provide personalized risk assessment for these patients and assist in clinical decision.
Effect of inhaled corticosteroids on microbiome and microbial correlations in asthma over a 9‐month period
Authors: Huang Chunrong , Ni Yingmeng , Du Wei , Shi Guochao 
Published: May 2022

AbstractThe effect of inhaled corticosteroids (ICS) on the airway microbiome requires longitudinal research for corroboration. Asthma patients, not undergoing ICS treatment (baseline), were enrolled and prescribed ICS; all these patients were followed up with regular visits at 3 months (visit 1) and 9 months (visit 2). Induced sputum was collected, and fungal microbiota (mycobiome) and bacterial microbiota (bacteriome) were estimated using 16S rRNA and internal transcribed spacer (ITS) sequencing. Bacterial α diversity indices were not significantly different between baseline, visit 1, and visit 2. Visit 1 showed lower fungal evenness than the baseline, and visit 2 showed lower fungal diversity and evenness than the baseline. Fungal, but not bacterial, community compositions differed significantly between the baseline, visit 1, and visit 2. The most abundant bacterial phyla and genera did not differ significantly between the baseline, visit 1, and visit 2. Compared with the baseline, visit 1 showed significantly increased frequency of the fungal phylum Ascomycota and lower frequency of Basidiomycota. We found sharply decreased fungal genera Wallemia, Cladosporium, Penicillium, and Alternaria at visit 1 and visit 2 compared with the baseline, although the differences were not statistically significant. We also found the proportion of Basidiomycota was positively correlated with percentages of sputum eosinophils and neutrophils. The proportions of Saccharomyces, Wallemia, and Aplosporella were positively correlated with percentage of sputum eosinophils. Moreover, we identified distinct inter‐ and intra‐kingdom interactions in baseline, visit 1, and visit 2. Therefore, ICS use altered the airway microbial diversity, evenness, community composition, and microbial connections.
Influence of CYP2D6 genetic variation on adverse events with propafenone in the pediatric and young adult population
Authors: Sunthankar Sudeep D. , Kannankeril Prince J. , Gaedigk Andrea , Radbill Andrew E. , Fish Frank A. , Van Driest Sara L. 
Published: May 2022

AbstractPropafenone is an antiarrhythmic drug metabolized primarily by cytochrome P450 2D6 (CYP2D6). In adults, propafenone adverse events (AEs) are associated with CYP2D6 poor metabolizer status; however, pediatric data are lacking. Subjects were tested for 10 CYP2D6 allelic variants and copy number status, and activity scores assigned to each genotype. Seventy‐six individuals (median 0.3 [range 0–26] years old) were included. Propafenone AEs occurred in 29 (38%); 14 (18%) required drug discontinuation due to AE. The most common AEs were QRS (n = 10) and QTc (n = 6) prolongation. Those with AEs were older at the time of propafenone initiation (1.58 [0.13–9.92] vs. 0.20 [0.08–2.01] years old; p = 0.042). CYP2D6 activity scores were not associated with presence of an AE (odds ratio [OR] 0.48 [0.22–1.03]; p = 0.055) but with the total number of AE (β1 = −0.31 [−0.60, −0.03]; p = 0.029), systemic AEs (OR 0.33 [0.13–0.88]; p = 0.022), and drug discontinuation for systemic AEs (OR 0.28 [0.09–0.83]; p = 0.017). Awareness of CYP2D6 activity score and patient age may aid in determining an individual's risk for an AE with propafenone administration.
Protease‐activated receptor‐mediated platelet aggregation in patients with type 2 diabetes on potent P2Y12 inhibitors
Authors: Panzer Benjamin , Wadowski Patricia P. , Huber Kurt , Panzer Simon , Gremmel Thomas 
Published: May 2022

AbstractBackgroundAntiplatelet therapy is a cornerstone in the secondary prevention of ischemic events following percutaneous coronary intervention (PCI). The new P2Y12 receptor inhibitors prasugrel and ticagrelor have been shown to improve patients' outcomes. Whether or not these drugs have equal efficacy in individuals with or without diabetes is disputed. Furthermore, platelets can be activated by thrombin, which is, at least in part, independent of P2Y12‐mediated platelet activation. Protease‐activated receptor (PAR)‐1 and −4 are thrombin receptors on human platelets. We sought to compare the in vitro efficacy of prasugrel (n = 121) and ticagrelor (n = 99) to inhibit PAR‐mediated platelet aggregation in individuals with type 2 diabetes (prasugrel n = 26, ticagrelor n = 29).Materials and MethodsWe compared P2Y12‐, PAR‐1‐ and PAR‐4‐mediated platelet aggregation as assessed by multiple electrode platelet aggregometry between prasugrel‐ and ticagrelor‐treated patients without and with type 2 diabetes who underwent acute PCI.ResultsOverall, there were no differences of P2Y12‐, PAR‐1‐ and PAR‐4‐mediated platelet aggregation between prasugrel‐ and ticagrelor‐treated patients. However, both drugs inhibited P2Y12‐mediated platelet aggregation stronger, and thereby to a similar extent in patients with type 2 diabetes than in those without diabetes. There was no correlation between either P2Y12‐, or PAR‐1‐ or PAR‐4‐mediated platelet aggregation and levels of HbA1c or the body mass index (BMI). However, we observed patients with high residual platelet reactivity in response to PAR‐1 and PAR‐4 stimulation in all cohorts.ConclusionPrasugrel and ticagrelor inhibit P2Y12‐ and PAR‐mediated platelet aggregation in individuals with diabetes to a similar extent, irrespective of HbA1c levels and BMI.
Dynamics of public opinion and policy response under proportional and plurality elections
Authors: McGann Anthony J. , Dellepiane‐Avellaneda Sebastian , Bartle John 
Published: May 2022

AbstractWe compare the patterns of adjustment of government policy to changes in public opinion in the Netherlands and the United Kingdom. These countries are similar in many ways, except that the United Kingdom has plurality elections and single‐party government, while the Netherlands has proportional representation (PR) and coalition government. This provides the first application of the Macro Polity approach to a country with PR elections. We find that government policy in the Netherlands is highly responsive to public opinion. This cannot be the result of alternation of government, but instead must be the result of some other process, such as coalition bargaining. In the United Kingdom, however, the dynamic of adjustment is far more complex. Alternation of government does not produce responsiveness, but rather seems to get in the way of it. This leads to an over‐correction dynamic in which policy can be out of line with public opinion for long periods of time.
Natural history and burden of Huntington's disease in the UK: A population‐based cohort study
Authors: Furby Hannah , Siadimas Athanasios , Rutten‐Jacobs Loes , Rodrigues Filipe B. , Wild Edward J. 
Published: May 2022

AbstractBackgroundHuntington's disease (HD) is a rare neurodegenerative disease that presents with progressive psychological, cognitive and motor impairment. These diverse symptoms place a high burden on the patient, families and the healthcare systems they rely on. This study aimed to describe the epidemiology and clinical burden in individuals with HD compared with controls from the general population.MethodsThis cohort study utilised data from general practitioner medical records to estimate the prevalence and incidence of HD between January 2000 and December 2018. A cohort of incident HD cases were matched 1:3 to controls from the general population, in whom common clinical diagnoses, medications and healthcare interventions were compared at the time of first recorded diagnosis and at a time close to death. Incidence rates of common diagnoses and mortality were compared with matched controls in the time following HD diagnosis.ResultsPrevalence of HD increased between 2000 and 2018, whilst incidence remained stable. Prevalence of psychiatric diagnoses and symptomatic treatments were higher in HD cases than controls. A higher relative risk of psychotic disorders, depression, insomnia, dementia, weight loss, pneumonia and falls was observed in HD cases. Risk of death was >4 times higher in HD, with a median survival of ~12 years from first recorded diagnosis.ConclusionsThis study demonstrates the significant and progressive clinical burden in individuals with HD up to 18 years after first recorded diagnosis.