bluuebunny/crossref_metadata_2025 huggingface dataset:
A new method to determine stretch reflex latency
Authors: Topkara Betilay , Aydin Tugba , Corum Mustafa , Karaoglu Ayse , Ekici Zincirci Dilara , S Bugdayci Derya , Ones Kadriye , Paker Nurdan , Kesiktas Nur , Karacan Ilhan , Türker Kemal S.
Published: October 2021

Introduction/Aims

Motion artifact signals (MASs) created by the relative movement of intramuscular wire electrodes are an indicator of the mechanical stimulus arrival time to the muscle belly. This study proposes a method that uses wire electrodes as an intramuscular mechanosensor to determine the stretch reflex (SR) latency without lag time.

Methods

Gastrocnemius SR was induced by tendon tap, heel tap, and forefoot tap. The MASs recorded by intramuscular wire electrodes were extracted from background electromyographic activity using the spike‐triggered averaging technique. Simultaneous recordings were obtained from multiple sites to validate the MAS technique.

Results

Using intramuscular wire electrodes, the MASs were successfully determined and extracted for all stimulus sites. In the records from the rectus femoris, MASs were also successfully extracted; thus, the reflex latency could be calculated.

Discussion

Wire electrodes can be used as an intramuscular mechanosensor to determine the mechanical stimulus arrival time to the muscle belly.
Autonomous traffic at intersections: An optimization‐based analysis of possible time, energy, and CO savings
Authors: Le Do Duc , Merkert Maximilian , Sorgatz Stephan , Hahn Mirko , Sager Sebastian
Published: October 2021

In the field of autonomous driving, traffic‐light‐controlled intersections are of special interest. We analyze how much an optimized coordination of vehicles and infrastructure can contribute to efficient transit through these bottlenecks, depending on traffic density and certain regulations of traffic lights. To this end, we develop a mixed‐integer linear programming model to describe the interaction between traffic lights and discretized traffic flow. It is based on a microscopic traffic model with centrally controlled autonomous vehicles. We aim to determine a globally optimal traffic flow for given scenarios on a simple, but extensible, urban road network. The resulting models are very challenging to solve, in particular when involving additional realistic traffic‐light regulations such as minimum red and green times. While solving times exceed real‐time requirements, our model allows an estimation of the maximum performance gains due to improved communication and serves as a benchmark for heuristic and decentralized approaches.
A case of well‐healed foot amputation in early China (8th–5th centuries BCE)
Authors: Zhang Xuhui , Zhan Xiaoya , Ding Yan , Li Yanfeng , Yeh Hui‐Yuan , Chen Liang
Published: October 2021

This research is intended to report on a case of healed foot amputation in Central Plains, China, and to provide a differential diagnosis on the amputation. The material used is an adult skeleton, dating back to 8th–5th Centuries BCE, from Chongpingyuan site, Shaanxi, China. The methods used are macroscopic observations, microscope, and X‐ray. Macroscopic observations indicated that the individual of interest was probably a male, around 50 to 70 years old, with a stature around 168.51 cm. Nearly one third of the distal end of his left tibia and fibula was absent, and the surface was remodeled with obvious signs of healing. Meanwhile, this individual suffered from osteoarthritis, lumbosacral transitional vertebrae, and several oral pathologies. Osteoarthritis was more profoundly found on the right limbs. Yue penalty (刖刑), which is often seen on scripts and artifacts in Bronze Age China, was an explanation for this amputation, while surgery amputation or traumatic incident cannot be entirely excluded. Contemporary images and artifacts of amputees suggested the usage of crutches. The social status and possibility of punitive amputation lead to the argument that this individual was unlikely to receive positive treatments after amputation. This study supplements the current research of ancient amputation in early China and provides an opportunity to look at the penal system and medical knowledge of the Zhou Dynasty. The absence of cutting marks left a questionable point with regards to the tools used for amputations.
Policies to address weight discrimination and bullying: Perspectives of adults engaged in weight management from six nations
Authors: Puhl Rebecca M. , Lessard Leah M. , Pearl Rebecca L. , Grupski Allison , Foster Gary D.
Published: October 2021

Objective

Across the world, it remains legal to discriminate against people because of their weight. Although US studies demonstrate public support for laws to prohibit weight discrimination, multinational research is scarce. The present study conducted a multinational comparison of support for legislative measures to address weight discrimination and bullying across six countries.

Methods

Participants were adults (n = 13,996) enrolled in an international weight‐management program and residing in Australia, Canada, France, Germany, the UK, and the US. Participants completed identical online surveys that assessed support for antidiscrimination laws and policies to address weight bullying, demographic characteristics, and personal experiences of weight stigma.

Results

Across countries, support was high for laws (90%) and policies (92%) to address weight‐based bullying, whereas greater between‐country variation emerged in support for legislation to address weight‐based discrimination in employment (61%, 79%), as a human rights issue (57%), and through existing disability protections (47%). Findings highlight few and inconsistent links between policy support and sociodemographic correlates or experienced or internalized weight stigma.

Conclusions

Support for policies to address weight stigma is present among people engaged in weight management across Westernized countries; findings offer an informative comparison point for future cross‐country research and can inform policy discourse to address weight discrimination and bullying.
Preparation and properties of foamed cellulose acetate/polylactic acid blends
Authors: Zhang Chenghao , Wan Lei , Gu Han , Hu Qipeng , Ding Yajun , Ying Sanjiu
Published: October 2021

In order to improve the foaming performance of pure cellulose acetate (CA), blends were prepared by mixing polylactic acid (PLA) in CA and foamed by supercritical CO2 (ScCO2) in this study. The effect of PLA content (percentage by mass of blend) on structure, thermal properties, rheological properties, foaming properties and mechanical properties of the blends was investigated. The results showed that the addition of PLA destroyed the original hydrogen bonds of CA, while the blends had good crystallization properties. At the same time, compared with pure CA, the glass transition temperature (Tg) of the blends decreased, and the initial decomposition temperature (T0) was reduced from 349.41°C (pure CA) to 334.68°C (CA/20%PLA). In addition, the rheological properties of the blends were improved, and the viscosity was reduced, which was obviously beneficial to foaming process. The pore size and density of the foamed blends both reached the maximum value at 20%PLA. The presence of PLA could degrade the mechanical properties of the blends. However, the overall drop (1.01 KJ/m2) of impact strength of the blends after foaming is much smaller than that before foaming (12.11 KJ/m2), indicating that the improvement of foaming performance was beneficial to improve its impact strength.
Recombinant botulinum neurotoxin serotype A1 in vivo characterization
Authors: Périer Cindy , Martin Vincent , Cornet Sylvie , Favre‐Guilmard Christine , Rocher Marie‐Noelle , Bindler Julien , Wagner Stéphanie , Andriambeloson Emile , Rudkin Brian B. , Marty Rudy , Vignaud Alban , Beard Matthew , Lezmi Stephane , Kalinichev Mikhail
Published: October 2021

Clinically used botulinum neurotoxins (BoNTs) are natural products of Clostridium botulinum. A novel, recombinant BoNT type A1 (rBoNT/A1; IPN10260) has been synthesized using the native amino acid sequence expressed in Escherichia coli and has previously been characterized in vitro and ex vivo. Here, we aimed to characterize rBoNT/A1 in vivo and evaluate its effects on skeletal muscle. The properties of rBoNT/A1 following single, intramuscular administration were evaluated in the mouse and rat digit abduction score (DAS) assays and compared with those of natural BoNT/A1 (nBoNT/A1). rBoNT/A1‐injected tibialis anterior was assessed in the in situ muscle force test in rats. rBoNT/A1‐injected gastrocnemius lateralis (GL) muscle was assessed in the compound muscle action potential (CMAP) test in rats. The rBoNT/A1‐injected GL muscle was evaluated for muscle weight, volume, myofiber composition and immunohistochemical detection of cleaved SNAP25 (c‐SNAP25). Results showed that rBoNT/A1 and nBoNT/A1 were equipotent and had similar onset and duration of action in both mouse and rat DAS assays. rBoNT/A1 caused a dose‐dependent inhibition of muscle force and a rapid long‐lasting reduction in CMAP amplitude that lasted for at least 30 days. Dose‐dependent reductions in GL weight and volume and increases in myofiber atrophy were accompanied by immunohistochemical detection of c‐SNAP25. Overall, rBoNT/A1 and nBoNT/A1 exhibited similar properties following intramuscular administration. rBoNT/A1 inhibited motoneurons neurotransmitter release, which was robust, long‐lasting, and accompanied by cleavage of SNAP25. rBoNT/A1 is a useful tool molecule for comparison with current natural and future modified recombinant neurotoxins products.
Experiment on influence of inert powder on deflagration of oil shale dust research
Authors: Chen Guowei , Meng Xiangbao , Li Xuan , Yan Ke , Liu Yong
Published: October 2021

To study the effect of inert powder on the deflagration of oil shale dust, the Hartmann tube experiment device and 20 L spherical explosion experiment device were used. The effects of three kinds of inert powder (KH2PO4, NaHCO3, Al(OH)3) and widely used rock powder (CaCO3) on the deflagration of oil shale dust in different proportions were studied. The results show that the four inert powders can effectively dilute the concentration of oil shale dust cloud, slow down the reaction rate, delay the flame propagation, and reduce the maximum flame propagation speed. When 50 wt% KH2PO4, NaHCO3, CaCO3, Al(OH)3 inert powder is added, the maximum flame propagation speed is 44.14%, 41.11%, 31.79%, 58.96%, and the maximum explosion pressure drop is 70.0%, 66.0%, 59.5%, 77.0%. When Al(OH)3 was added at 10 wt%, 30 wt%, and 50 wt%, the combustion time of oil shale was extended to 162.7, 223.4, and 321.5 ms, respectively. With the addition of Al(OH)3, the time from ignition time to maximum explosion pressure of oil shale dust increases gradually, the maximum flame propagation distance is shortened obviously, the maximum flame propagation speed and maximum explosion pressure drop the most, and the effect of inhibiting oil shale dust deflagration flame is the best.
Potentially inappropriate medications in the elderly
Authors: Lam Y. W. Francis
Published: October 2021

Polypharmacy involving potentially inappropriate medications (PIMs) poses a major concern in the elderly. This practice often leads to increased morbidity, due in part to the age‐related physiological and functional changes that alter the drugs' pharmacokinetics and pharmacodynamics.
Simultaneous primary hyperparathyroidism and multiple myeloma in a dog with hypercalcaemia
Authors: Sztukowski Keira , Gin Taylor , Neel Jennifer , Lunn Katharine
Published: October 2021

A 14‐year‐old male castrated Pomeranian was found to be hypercalcaemic and hyperglobulinaemic during investigation of anorexia and haematochezia. Ionised hypercalcaemia, increased serum parathyroid hormone concentration, normophosphatemia and a parathyroid nodule found on cervical ultrasound examination were diagnostic for primary hyperparathyroidism (PHPT). Thoracic radiographs revealed ovoid lytic lesions in multiple bones. To investigate the hyperglobulinaemia, serum electrophoresis and immunoglobulin (Ig) quantification were performed, revealing an IgA biclonal gammopathy. Bone marrow cytopathology confirmed multiple myeloma (MM). Following bilateral parathyroidectomy, the dog's hypercalcaemia resolved, and pulse‐dose chemotherapy with prednisone and melphalan was initiated to treat MM. To the authors' knowledge, this is a unique case report of simultaneous PHPT and MM in the veterinary literature, diseases that are rarely reported concurrently in humans. This case highlights the need to thoroughly investigate multiple problems when they are not explained by a single diagnosis.
Physico‐chemical characterization of littoral water of Lake Kivu (Southern basin, Central Africa) and use of water quality index to assess their anthropogenic disturbances
Authors: Hyangya Béni Lwikitcha , Riziki Jacques Walumona , Masilya Pascal Mulungula , Zabene François Zagabe , Alunga Georges Lufungula , Kaningini Boniface Mwenyemali , Kankonda Alidor Busanga
Published: October 2021

Freshwater ecosystems provide many services such as moderation of the local microclimate and a source of water and food for riparian communities. It is also a preferred habitat for many organisms such as plankton, benthic macroinvertebrates and fish. However, these ecosystems are among the most affected by various anthropogenic threats that modify water quality and ecological processes, thus affecting biodiversity. The objective of this study was the spatio‐temporal characterization of physico‐chemical littoral water parameters and the assessment of anthropogenic disturbance on the littoral zone by a water quality index (WQI). Physico‐chemical water quality data including temperature, dissolved oxygen, conductivity, pH, TDS, turbidity, SiO2, PO43−, NO2−, and NH4+ were collected from January to December 2018. They were used to calculate the WQI to assess water quality according to aquatic life, using limits values of Canadian Council of Ministers of the Environment (CCME), United States Environmental Protection Agency (USEPA) and Australian and New Zeland Environment and Conservation Council (ANZECC). PO43− is out of range in all the stations while NO2− and Turbidity are out of range in some of the anthropized stations according to ANZECC, CCME, and USEPA recommended values for aquatic life. The WQI values range from medium to good and the high WQI values obtained in the non‐anthropized stations that reflect the negative influence of human disturbance on water quality in the Lake littoral zone. The results suggest the need for an integrated lake watershed management system in order to maintain the ecological functions of the lake and support livelihoods from the lake.
Modular symmetry and zeros in magnetic compactifications
Authors: Tatsuta Yoshiyuki
Published: October 2021

Abstract

We discuss the modular symmetry and zeros of zero-mode wave functions on two-dimensional torus T2 and toroidal orbifolds T2/ℤN (N = 2, 3, 4, 6) with a background homogeneous magnetic field. As is well-known, magnetic flux contributes to the index in the Atiyah-Singer index theorem. The zeros in magnetic compactifications therefore play an important role, as investigated in a series of recent papers. Focusing on the zeros and their positions, we study what type of boundary conditions must be satisfied by the zero modes after the modular transformation. The consideration in this paper justifies that the boundary conditions are common before and after the modular transformation.
Gesundheit und Gesundheitsversorgung von trans Personen während der COVID‑19-Pandemie: Eine Online-Querschnittstudie in deutschsprachigen Ländern
Authors: Szücs Daria , Köhler Andreas , Holthaus Mika M. , Güldenring Annette , Balk Lena , Motmans Joz , Nieder Timo O.
Published: October 2021

Einleitung und Ziel

Seit dem Frühjahr 2020 hat die COVID‑19-Pandemie nahezu alle Bereiche des gesellschaftlichen Lebens erheblich eingeschränkt, was bei vielen Menschen sowohl zu psychischen als auch zu körperlichen Belastungen geführt hat. In diesem Artikel nehmen wir die Situation von trans Personen in den Blick, die infolge ihrer gesellschaftlichen Diskriminierung und Marginalisierung sowie spezifischer, gesundheitsbezogener Anliegen durch eine besondere Vulnerabilität gekennzeichnet sein können.

Methoden

Unter Beachtung partizipativer Elemente haben wir mit einer Online-Querschnitterhebung im Zeitraum vom 01.05.2020 bis zum 31.01.2021 die psychische und physische Gesundheit von trans Personen im deutschsprachigen Raum sowie deren Zugang zur Trans-Gesundheitsversorgung während der COVID‑19-Pandemie untersucht.

Ergebnisse

Trans Personen erleben seit Beginn der COVID‑19-Pandemie vermehrt Barrieren sowohl bei geschlechtsangleichenden Behandlungen und psychosozialen Unterstützungsangeboten als auch im Bereich der COVID‑19-bezogenen medizinischen Versorgung. Im Vergleich zur Gesamtbevölkerung berichten sie übermäßig häufig von somatischen Erkrankungen, auch von solchen, die ein erhöhtes Risiko für schwere Verläufe einer COVID‑19-Infektion darstellen. Außerdem berichten die Teilnehmenden verschiedene Faktoren, die ein Risiko für eine erhöhte psychische Belastung darstellen können (z. B. Zugehörigkeit zu einer Minderheit aufgrund nicht-heterosexueller Orientierung, niedriges Einkommen).

Diskussion

Die Ergebnisse unserer Untersuchung weisen darauf hin, dass bisherige Vulnerabilitäten für gesundheitliche Probleme und der eingeschränkte Zugang zu einer qualifiziert informierten Trans-Gesundheitsversorgung durch die Folgen der COVID‑19-Pandemie verschärft wurden.
Bullöses Pemphigoid mit Aussparung eines Armes nach axillärer Lymphadenektomie
Authors: Janßen S. , Homey B. , Jansen T. M.
Published: October 2021

Wir präsentieren den Fall einer 83-jährigen Patientin mit einem bullösen Pemphigoid (BP) unter Aussparung des linken Armes bei Zustand nach axillärer Lymphadenektomie nach Mammakarzinom. Lokalisierte Formen des bullösen Pemphigoids treten v. a. bei Lymphödemen oder nach Radiatio auf. Das Fehlen des Blasenbefalls nach einer Lymphadenektomie stellt eine seltene und interessante Manifestation dar. Pathophysiologisch könnte durch den Rückgang der T‑Zell-Aktivierung bei fehlenden peripheren Lymphknoten und somit vermindertem entzündlichem Infiltrat die Blasenbildung abgeschwächt sein bzw. vollkommen ausbleiben.
Gender-specific analysis of the authors and the editorial board of Naunyn–Schmiedeberg’s Archives of Pharmacology from 2000 to 2020
Authors: Zehetbauer Rebecca , von Haugwitz Florentin , Seifert Roland
Published: October 2021

Motivated by the worldwide debate on gender equality, we analyzed the gender structure of the authors and the editorial board of Naunyn–Schmiedeberg’s Archives of Pharmacology. We wrote an algorithm to assign authors’ first names to a gender to determine the gender distribution of publications. We evaluated publications from German research institutes from 2000 to 2020. This resulted in a data set of 2929 authors. We could assign a first name to almost all authors. The percentage of female authors increased until 2008, but thereafter stagnated at around 30%. The position of senior author is far less often held by women (around 15%). Even though multiple political measures were implemented to increase the female participation, our analysis has shown no increase regardless. We also observed a strong decrease in German authorship (both male and female) since 2000. In the editorial board and for advisory editors, there has been a substantial increase in the proportion of women since 2016 as the result of appointments by the editor-in-chief. We discuss the strengths and limitations of our study in context with the literature and current developments in society and science and methodological pitfalls of studies in this field. More research is required to obtain a full picture of gender structure in science and to be able to properly interpret the data.
Rare manifestation of a large stenosing gastrointestinal tumor caused by Mycobacterium tuberculosis in a previously healthy man from Austria
Authors: Shao Guangyu , Chitechi Bakari , Demireli Gamze , Ornig Karoline , Neuböck Matthias J. , Heldt Sven , Mandl Michael , Paar Christian , Winkler Markus , Lamprecht Bernd , Salzer Helmut J. F.
Published: October 2021

Background

Gastrointestinal tuberculosis (TB) is a rare manifestation in low TB-incidence countries such as Austria. It is usually seen in immunocompromised patients or in migrants being more susceptible for extrapulmonary disease manifestations.

Case description

We report a very rare manifestation of severe gastrointestinal TB in a 49-year-old previously healthy man from Upper Austria. Endoscopy showed a large tumor mass obstructing about 2/3 of the lumen of the cecum. Positron emission tomography/computed tomography scan revealed not only a high metabolic activity in the tumor mass, but also active pulmonary lesions in both upper lung lobes. Bronchial secretion showed acid-fast bacilli in the microscopy and polymerase chain reaction was positive for M. tuberculosis complex. Phenotypic resistance testing showed no resistance for first-line anti-TB drugs. Treatment with isoniazid, rifampicin, pyrazinamide and ethambutol was initiated. Based on therapeutic drug monitoring, the standard treatment regime was adapted to rifampicin high dose. TB treatment was well tolerated and the patient achieved relapse-free cure one year after the end of treatment.

Conclusion

Gastrointestinal involvement mimicking an intestinal tumor is a very rare TB manifestation in previously healthy Austrians. However, it should be kept in mind due to increasing migration from countries with higher rates of extrapulmonary TB and due to an increasing number of immunocompromised patients. TB telephone consultations can support medical professionals in the diagnosis and the management of complex TB patients. TB management is currently at a transitional stage from a programmatic to personalized management concept including therapeutic drug monitoring or biomarker-guided treatment duration to achieve relapse-free cure.
Identity-Related Factors Protect Well-Being Against Stigma for Transgender and Gender Non-Conforming People
Authors: Doyle David Matthew , Begeny Christopher T. , Barreto Manuela , Morton Thomas A.
Published: October 2021

Relatively little is known about identity-related resilience factors associated with well-being among transgender and gender non-conforming (TGNC) people. Drawing upon theory on stigma-related stress and resilience and work examining group identification as a buffer against discrimination, the aim of the current study was to model perceived discrimination, transgender identification, and gender identity affirmation as predictors of well-being for TGNC people. We also tested whether the positive association between gender identity affirmation and well-being might be explained by the benefits affirmation has for individual self-concept clarity. Participants were 105 TGNC individuals (42% transgender male, 39% transgender female, 19% other gender non-conforming [e.g., non-binary]) recruited through online forums and support groups in the UK and North America who completed an online survey including self-report measures of key constructs. Results from structural equation models demonstrated that: (1) experiences of discrimination were associated with lower well-being overall, but having a stronger transgender identity moderated this association; (2) after adjustment for discrimination and transgender identification, experiences of gender identity affirmation were independently associated with greater well-being for TGNC people. Secondary analyses demonstrated that gender identity affirmation was linked to well-being through reinforcing a strong, internalized sense of clarity about individual self-concept. Results are discussed in terms of the implications for TGNC health and well-being, particularly with regard to the need for supportive, identity-affirming social environments.
A Polygenic Approach to Understanding Resilience to Peer Victimisation
Authors: Armitage Jessica M. , Wang R. Adele H. , Davis Oliver S. P. , Haworth Claire M. A.
Published: October 2021

Previous studies suggest an individual’s risk of depression following adversity may be moderated by their genetic liability. No study, however, has examined peer victimisation, an experience repeatedly associated with mental illness. We explore whether the negative mental health outcomes following victimisation can be partly attributed to genetic factors using polygenic scores for depression and wellbeing. Among participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), we show that polygenic scores and peer victimisation are significant independent predictors of depressive symptoms (n=2268) and wellbeing (n=2299) in early adulthood. When testing for interaction effects, our results lead us to conclude that low mental health and wellbeing following peer victimisation is unlikely to be explained by a moderating effect of genetic factors, as indexed by current polygenic scores. Genetic profiling is therefore unlikely to be effective in identifying those more vulnerable to the effects of victimisation at present. The reasons why some go on to experience mental health problems following victimisation, while others remain resilient, requires further exploration, but our results rule out a major influence of current polygenic scores.
The Role of Atmospheric Stability and Turbulence in Offshore Wind-Farm Wakes in the German Bight
Authors: Platis Andreas , Hundhausen Marie , Lampert Astrid , Emeis Stefan , Bange Jens
Published: October 2021

Airborne meteorological in situ measurements as well as stationary measurements at the offshore masts FINO1 and FINO3 in the German Bight are evaluated in order to examine the hypothesis that the wake dissipation downstream of large offshore wind farms depends on atmospheric stability. A long-term study of the mast data for the years 2016 and 2017 demonstrates a clear dependence of stability on the wind direction. Stable conditions are predominantly expected during southerly winds coming from the land. The analysis of various stability and turbulence criteria shows that the lapse rate is the most robust parameter for stability classification in the German Bight, but further implies that stability depends on the measurement height. A near-surface (0 to 30 m), predominantly convective, layer is present and more stable conditions are found aloft (55 to 95 m). Combing the stability data with the airborne measurements of the offshore wind-farm wakes reveals the trend of a correlation between longer wake lengths and an increase in the initial wind-speed deficit downwind of a wind farm with stronger thermal stability. However, the stability correlation criteria with the wake length downstream of the four investigated wind farms, Godewind, Amrumbank West, Meerwind Süd/Ost, and Nordsee Ost, contain large variance. It is assumed that the observed scattering is due to the influence of the wind-farm architecture and temperature inversions around hub height. These, however, are crucial for the classification of stability and illustrate the complexity of a clear stability metric.
Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data
Authors: Kwon Osung , Na Wonjun , Hur Jaehee , Kim Ju Hyeon , Jun Tae Joon , Kang Hee Jun , Lee Hojoon , Kim Young-Hak
Published: October 2021

Purpose

To estimate the risk of recurrent cardiovascular events in a real-world population of very high-risk Korean patients with prior myocardial infarction (MI), ischemic stroke (IS), or symptomatic peripheral artery disease (sPAD), similar to the Further cardiovascular OUtcomes Research with proprotein convertase subtilisin–kexin type 9 Inhibition in subjects with Elevated Risk (FOURIER) trial population.

Methods

This retrospective study used the Asan Medical Center Heart Registry database built on electronic medical records (EMR) from 2000 to 2016. Patients with a history of clinically evident atherosclerotic cardiovascular disease (ASCVD) with multiple risk factors were followed up for 3 years. The primary endpoint was a composite of MI, stroke, hospitalization for unstable angina, coronary revascularization, and all-cause mortality.

Results

Among 15,820 patients, the 3-year cumulative incidence of the composite primary endpoint was 15.3% and the 3-year incidence rate was 5.7 (95% CI 5.5–5.9) per 100 person-years. At individual endpoints, the rates of deaths, MI, and IS were 0.4 (0.3–0.4), 0.9 (0.8–0.9), and 0.8 (0.7–0.9), respectively. The risk of the primary endpoint did not differ significantly between recipients of different intensities of statin therapy. Low-density lipoprotein cholesterol (LDL-C) goals were only achieved in 24.4% of patients during the first year of follow-up.

Conclusion

By analyzing EMR data representing routine practice in Korea, we found that patients with very high-risk ASCVD were at substantial risk of further cardiovascular events in 3 years. Given the observed risk of recurrent events with suboptimal lipid management by statin, additional treatment to control LDL-C might be necessary to reduce the burden of further cardiovascular events for very high-risk ASCVD patients.
Global scenarios of residential heating and cooling energy demand and CO2 emissions
Authors: Mastrucci Alessio , van Ruijven Bas , Byers Edward , Poblete-Cazenave Miguel , Pachauri Shonali
Published: October 2021

Buildings account for 36% of global final energy demand and are key to mitigating climate change. Assessing the evolution of the global building stock and its energy demand is critical to support mitigation strategies. However, most global studies lack granularity and overlook heterogeneity in the building sector, limiting the evaluation of demand transformation scenarios. We develop global residential building scenarios along the shared socio-economic pathways (SSPs) 1–3 and assess the evolution of building stock, energy demand, and CO2 emissions for space heating and cooling with MESSAGEix-Buildings, a modelling framework soft-linked to an integrated assessment framework. MESSAGEix-Buildings combines bottom-up modelling of energy demand, stock turnover, and discrete choice modelling for energy efficiency decisions, and accounts for heterogeneity in geographical contexts, socio-economics, and buildings characteristics.

Global CO2 emissions for space heating are projected to decrease between 34.4 (SSP3) and 52.5% (SSP1) by 2050 under energy efficiency improvements and electrification. Space cooling demand starkly rises in developing countries, with CO2 emissions increasing globally by 58.2 (SSP1) to 85.2% (SSP3) by 2050. Scenarios substantially differ in the uptake of energy efficient new construction and renovations, generally higher for single-family homes, and in space cooling patterns across income levels and locations, with most of the demand in the global south driven by medium- and high-income urban households. This study contributes an advancement in the granularity of building sector knowledge to be assessed in integration with other sources of emissions in the context of global climate change mitigation and sustainable development.
Psychomotor learning theory informing the design and evaluation of an interactive augmented reality hand hygiene training app for healthcare workers
Authors: Lacey Gerard , Gozdzielewska Lucyna , McAloney-Kocaman Kareena , Ruttle Jonathan , Cronin Sean , Price Lesley
Published: October 2021

Hand hygiene is critical for infection control, but studies report poor transfer from training to practice. Hand hygiene training in hospitals typically involves one classroom session per year, but psychomotor skills require repetition and feedback for retention. We describe the design and independent evaluation of a mobile interactive augmented reality training tool for the World Health Organisation (WHO) hand hygiene technique. The design was based on a detailed analysis of the underlying educational theory relating to psychomotor skills learning. During the evaluation forty-seven subjects used AR hand hygiene training over 4 weeks. Hand hygiene proficiency was assessed at weekly intervals, both electronically and via human inspection. Thirty eight participants (81%) reached proficiency after 24.3 (SD = 17.8) two-minute practice sessions. The study demonstrated that interactive mobile applications could empower learners to develop hand hygiene skills independently. Healthcare organizations could improve hand hygiene quality by using self-directed skills-based training combined with regular ward-based assessments.
Determinants of blood and saliva lead concentrations in adult gardeners on urban agricultural sites
Authors: Bramwell Lindsay , Morton Jackie , Harding Anne-Helen , Lin Nan , Entwistle Jane
Published: October 2021

Soil Pb concentrations at urban agriculture sites (UAS) commonly exceed recommended safe levels. There is a lack of evidence regarding uptake of Pb by gardeners using such sites for food crops. Our study aimed to elucidate whether gardening in soil with raised Pb levels results in Pb body burdens of concern to health, and to assess confounding factors influencing Pb body burden. Our cross-sectional case study measured Pb in saliva and blood of UAS gardeners (n = 43), soil and produce samples from their UAS, and home tap water. Blood and saliva Pb concentrations were compared with those from non-UAS gardener controls (n = 29). A health risk threshold of 5 µg dL−1 blood Pb level (BLL) was selected in keeping with international guidance. Detailed surveys investigated individuals’ anthropometrics and potential Pb exposures from diet, and historic and everyday activities. Saliva was not found to be a suitable biomarker of adult Pb exposure in this context. Predictors of higher BLLs were being older, being male and eating more root vegetables and shrub fruit. Eating more green vegetables predicted a lower BLL, suggesting a protective effect against Pb uptake. UAS gardeners’ BLLs (geometric mean 1.53; range 0.6–4.1 µg dL−1) were not significantly higher (p = 0.39) than the control group (geometric mean 1.43; range 0.7–2.9 µg dL−1). All BLLs were below 5 µg dL−1 except one resulting from occupational exposure. Having paired the UAS gardeners with closely matched controls, we found Pb in UAS soils (with range 62–1300 mg kg−1from common urban sources) unlikely to pose an additional risk to adult health compared to their neighbours who did not access UAS. As such, other Pb sources may be the dominant factor controlling BLL.
Understanding entropy
Authors: Nelson Peter G.
Published: October 2021

A new way of understanding entropy as a macroscopic property is presented. This is based on the fact that heat flows from a hot body to a cold one even when the hot one is smaller and has less energy. A quantity that determines the direction of flow is shown to be the increment of heat gained (q) divided by the absolute temperature (T). The same quantity is shown to determine the direction of other processes taking place in isolated systems provided thatqis determined by the state (s) of the system. Entropy emerges as the potent energy of a system [Σ(qs/T)], the potency being determined by 1/T. This is shown to tie in with the statistical mechanical interpretation of entropy. The treatment is shorter than the traditional one based on heat engines.
Characteristics Associated with Homeless Pregnant Women in Columbus, Ohio
Authors: Ervin Emma , Poppe Barbara , Onwuka Amanda , Keedy Hannah , Metraux Stephen , Jones Leslie , Sandel Megan , Kelleher Kelly
Published: October 2021

Introduction

The effects of homelessness on pregnant women are substantial. We aim to identify key characteristics of a group of women identified as homeless and pregnant in order to understand their history of housing, family composition, health, and demographics as a first step for future intervention.

Methods

We present cross-sectional survey data on a sample of 100 women reporting homelessness and pregnancy in the prior year in Columbus, Ohio, identified through social service and housing not for profit agencies. Our analysis uses data collected from a survey of health behaviors, housing, employment status, and demographics. Continuous measures are described with means and standard deviations, and categorical variables are described with percentages.

Results

The majority (81%) of the women identified as African American. Over 95% of the women were single, and 74 women reported a prior pregnancy. Almost half of the women reported being behind on rent at least one time in the last 6 months, and 43% indicated that they had lived in more than three places in the last year. Approximately 34% of the sample reported cigarette use during pregnancy, while 12% and 30% reported alcohol and illicit drug use, respectively.

Discussion

Women who were pregnant and experiencing homelessness in our study reported a multitude of complex and severe problems ranging from high rates of substance use, longstanding housing insecurity and financial stress. Programs hoping to successfully support women will need to address a variety of service needs while recognizing the resilience of many women.
Justification and the knowledge-connection
Authors: Hirvelä Jaakko
Published: October 2021

I will present a novel account of justification in terms of knowledge on which one is justified in believingpjust in case one could know thatp. My main aim is to unravel some of the formal properties that justification has in virtue of its connection to knowledge. Assuming that safety is at least a necessary condition for knowledge, I show that justification (1) doesn’t iterate trivially; (2) isn’t a luminous condition; (3) is closed under a certain kind of multi-premise closure principle, but; (4) surprisingly one can nevertheless believe with justification a set of claims that’s jointly inconsistent. This last feature allows for a rather satisfying solution to the preface paradox. Finally, I contrast my account with other knowledge-first accounts of justification.
Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population
Authors: Teni Fitsum Sebsibe , Gerdtham Ulf-G. , Leidl Reiner , Henriksson Martin , Åström Mimmi , Sun Sun , Burström Kristina
Published: October 2021

Purpose

This study aimed to investigate inequality and heterogeneity in health-related quality of life (HRQoL) and to provide EQ-5D-5L population reference data for Sweden.

Methods

Based on a large Swedish population-based survey, 25,867 respondents aged 30‒104 years, HRQoL is described by sex, age, education, income, economic activity, health-related behaviours, self-reported diseases and conditions. Results are presented by EQ-5D-5L dimensions, respondents rating of their overall health on the EQ visual analogue scale (EQ VAS), VAS index value and TTO (time trade-off) index value allowing for calculation of quality-adjusted life years (QALYs). Ordinary Least Squares and multivariable logistic regression analyses were used to study inequalities in observed EQ VAS score between socioeconomic groups and the likelihood to report problems on the dimensions, respectively, adjusted for confounders.

Results

In total, 896 different health states were reported; 24.1% did not report any problems. Most problems were reported with pain/discomfort. Women reported worse HRQoL than men, and health deteriorated with age. The strongest association between diseases and conditions and EQ VAS score was seen for depression and mental health problems. There was a socioeconomic gradient in HRQoL; adjusting for health-related behaviours, diseases and conditions slightly reduced the differences between educational groups and income groups, but socioeconomic inequalities largely remained.

Conclusion

EQ-5D-5L population reference (norms) data are now available for Sweden, including socioeconomic differentials. Results may be used for comparisons with disease-specific populations and in health economic evaluations. The observed socioeconomic inequality in HRQoL should be of great importance for policy makers concerned with equity aspects.
Charisma and Democracy: Max Weber on the Riddle of Political Change in Modern Societies
Authors: T. Magalhães Pedro
Published: October 2021

The elite theory of Max Weber has recently been rediscovered by political scientists and political theorists who have sought to explore both the heuristic and the normative potential of plebiscitary leader democracy. Notwithstanding the merits of this wave of studies, this paper argues that attention should be shifted from Weber's context-specific defence of plebiscitary leadership in post-WWI Germany to his broader conception of charisma as an attempt to grasp the enigma of significant social and political change. Contemporary democratic theory, this paper contends, can fruitfully draw on Weber to sink into the antinomies and ambiguities of a transformative democratic politics.
Celebrity Politics and Democratic Elitism
Authors: Archer Alfred , Cawston Amanda
Published: October 2021

Is there good reason to worry about celebrity involvement in democratic politics? The rise of celebrity politicians such as Donald Trump and Vladimir Zelensky has led political theorists and commentators to worry that the role of expertise in democratic politics has been undermined. According to one recent critique (Archer et al. 2020), celebrities possess a significant degree of epistemic power (the power to influence what people believe) that is unconnected to appropriate expertise. This presents a problem both for deliberative and epistemic theories of democratic legitimacy, which ignore this form of power, and for real existing democracies attempting to meet the standards of legitimacy set out by these theories. But do these critiques apply to democratic elitism? In this paper, we argue that recognition of celebrity epistemic power in fact represents a valuable resource for supporting the legitimacy and practice of democratic elitism, though these benefits do come with certain risks to which elite theories are particularly vulnerable.
Enactivism and the Paradox of Moral Perception
Authors: Van Grunsven Janna
Published: October 2021

In this paper I home in on an ethical phenomenon that is powerfully elucidated by means of enactive resources but that has, to my knowledge, not yet been explicitly addressed in the literature. The phenomenon in question concerns what I will term the paradox of moral perception, which, to be clear, does not refer to a logical but to a phenomenological-practical paradoxicality. Specifically, I have in mind the seemingly contradictory phenomenon that perceiving persons as moral subjects is at once incredibly easy and incredibly difficult; it is something we do nearly effortlessly and successfully all the time without giving it much thought and it is something that often requires effort and that we fail at all the time (also often without giving it much thought). As I will argue, enactivism offers distinctive resources for explaining the paradoxical nature of moral perception. These resources, moreover, bring out two important dimensions of ethical life that are frequently overlooked in contemporary ethical theory: namely the embodied and socio-technical environment-embedded dimensions of moral perception and moral visibility. As I make my argument, I will be connecting enactivism with insights from David Hume’s and Iris Murdoch’s moral philosophy as well as insights from the field of Epistemic Injustice. As such, I aim to situate enactivism within the larger theoretical ethical landscape; showing connections with existing ethical theories and identifying some of the ways in which enactivism offers unique contributions to our understanding of ethical life. While doing so, I will furthermore introduce two forms of moral misperception: particular moral misperception and categorial moral misperception.
Where I Belong: Identification Processes of Young Volunteers in Super-Diverse Cities
Authors: Lehner Marie , Mattes Astrid , van Breugel Ilona , Reeger Ursula , Scholten Peter
Published: October 2021

In the context of super-diverse cities, scholars and policy makers are increasingly interested in the potential of volunteering to establish identification for newcomers and locals alike. In this paper, we address the question of how young volunteers in Rotterdam and Vienna negotiate belonging within their super-diverse surroundings. Our exploratory study builds on a cross-national research project in which we collected qualitative interview data from volunteering youth. We follow a weak-theory approach and conceptualise belonging as emotional, procedural, and relational. We trace identification processes of newcomers and locals in terms of belonging through volunteering in urban contexts of super-diversity. Our paper demonstrates that volunteering serves as a vehicle for feelings of belonging and inclusion for young volunteers, specifically addressing the urban super-diversity of Vienna and Rotterdam. Our research also indicates the partiality and temporality of volunteering as a source of belonging and the function of volunteering as a structure of inclusion, not necessarily enabling structural inclusion.
Comparison of antibody and T cell responses elicited by BBIBP-CorV (Sinopharm) and BNT162b2 (Pfizer-BioNTech) vaccines against SARS-CoV-2 in healthy adult humans
Authors: Vályi-Nagy István , Matula Zsolt , Gönczi Márton , Tasnády Szabolcs , Bekő Gabriella , Réti Marienn , Ajzner Éva , Uher Ferenc
Published: October 2021

In the present study, humoral and T cell-mediated immune responses elicited by BBIBP-CorV (inactivated virus) and BNT162b2 (mRNA-based) vaccines against SARS-CoV-2 virus were compared. Convalescent volunteers were also investigated to evaluate adaptive immunity induced by live virus. Although both vaccines induced antibody- and T cell-mediated immune responses, our analysis revealed significant quantitative and qualitative differences between the two types of challenges. The BBIBP-CorV vaccine elicited antireceptor-binding domain (RBD) IgG, as well as anti-spike protein (S) IgG and IgA antibodies in healthy individuals, the levels of which were much lower than after BNT162b2 vaccination but still higher than in the convalescent patients. The cumulative IFNγ-positive T cell response, however, was only twofold higher in participants injected with BNT162b2 compared to those who were primed and boosted with BBIBP-CorV vaccine. Moreover, the inactivated virus vaccine induced T cell response that targets not only the S but also the nucleocapsid (N) and membrane (M) proteins, whereas the mRNA vaccine was able to elicit a much narrower response that targets the S protein epitopes only. Thus, the pattern of BBIBP-CorV-induced T cell response in virus-naive participants was similar to the cell-mediated anti-SARS-CoV-2 response observed in convalescent patients. Based on these data, we can conclude that the BBIBP-CorV inactivated virus vaccine is immunologically effective. However, the duration of BBIBP-CorV-induced integrated, antibody, and T cell-mediated, immune responses needs further investigation.