bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental Health Attribution for Mexican-Origin Latinx and Non-Latinx Older Adults: A Latent Class Analysis
Authors: Mendez Stephanie E A , Mendez-Luck Carolyn A , Nylund-Gibson Karen , Ng Bernardo
Published: July 2020

Background and Objectives

Providing appropriate and culturally sensitive care to the rapidly growing number of U.S. Latinx older adults with psychiatric conditions presents a major public health challenge. We know little about older Latinx adults’ perceived causes of mental health problems, offering clinicians limited insight to guide successful and culturally congruent treatment. Moreover, there is a paucity of mental health research examining heterogeneity in how Latinx individuals may attribute mental health symptoms. The present study sought to identify how Latinx and non-Latinx older adults attributed the sources of their mental health problems and how these types of attributions differ by ethnicity.

Research Design and Methods

This study analyzed data collected from a retrospective chart review and survey of 673 adults aged 55–95 years (430 Mexican origin and 244 non-Latinx) from a rural psychiatric outpatient clinic near the California–Mexico border. We conducted stratified latent class analysis (LCA) by race/ethnicity to explore the mental health attribution beliefs of Mexican-origin and non-Latinx clinic patients.

Results

Different LCA patterns for Mexican-origin Latinx versus non-Latinx groups were found. For non-Latinx adults, there was a class of individuals who attributed their mental health issues to social and financial problems. For Mexican-origin adults, there was a class of individuals who attributed their mental health issues to spiritual and/or supernatural factors, unaffected by acculturation level, depressive symptom severity, and time spent in the United States, but differing by gender. We found within-group heterogeneity: Not all Mexican-origin or non-Latinx older adults were alike in how they conceptualized their mental health.

Discussion and Implications

Mexican-origin Latinx and non-Latinx older adults attributed their mental health issues to different causes. More Mexican-origin older adults attributed their symptoms to spiritual causes, even after controlling for contextual factors. Further research is needed to determine whether attribution beliefs are affected by specific mental health diagnoses and other cultural factors not measured in this study.
Media Effects on Individual Worldview and Wellness for Long-Term Care Residents Amid the COVID-19 Virus
Authors: Schroyer David
Published: July 2020

The following article serves as a means to highlight the need for increased scrutiny of the value and potentially adverse effect the 24-h news cycle has on individuals, particularly residents in a long-term care setting amid the COVID-19 pandemic or other large-scale catastrophic events. The work will emphasize what is currently known regarding the impact media plays on an individual, including mood, opinion, worldview, and overall mental health and wellness. The conclusion will focus on discussing current means of assessment with future recommendations for heightened evaluation in this already vulnerable population.
A generalizable data-driven multicellular model of pancreatic ductal adenocarcinoma
Authors: Aguilar Boris , Gibbs David L , Reiss David J , McConnell Mark , Danziger Samuel A , Dervan Andrew , Trotter Matthew , Bassett Douglas , Hershberg Robert , Ratushny Alexander V , Shmulevich Ilya
Published: July 2020

Background

Mechanistic models, when combined with pertinent data, can improve our knowledge regarding important molecular and cellular mechanisms found in cancer. These models make the prediction of tissue-level response to drug treatment possible, which can lead to new therapies and improved patient outcomes. Here we present a data-driven multiscale modeling framework to study molecular interactions between cancer, stromal, and immune cells found in the tumor microenvironment. We also develop methods to use molecular data available in The Cancer Genome Atlas to generate sample-specific models of cancer.

Results

By combining published models of different cells relevant to pancreatic ductal adenocarcinoma (PDAC), we built an agent-based model of the multicellular pancreatic tumor microenvironment, formally describing cell type–specific molecular interactions and cytokine-mediated cell-cell communications. We used an ensemble-based modeling approach to systematically explore how variations in the tumor microenvironment affect the viability of cancer cells. The results suggest that the autocrine loop involving EGF signaling is a key interaction modulator between pancreatic cancer and stellate cells. EGF is also found to be associated with previously described subtypes of PDAC. Moreover, the model allows a systematic exploration of the effect of possible therapeutic perturbations; our simulations suggest that reducing bFGF secretion by stellate cells will have, on average, a positive impact on cancer apoptosis.

Conclusions

The developed framework allows model-driven hypotheses to be generated regarding therapeutically relevant PDAC states with potential molecular and cellular drivers indicating specific intervention strategies.
Efficacy of extracorporeal membrane oxygenation before surgery of a post-infarction ventricular septal rupture in cardiogenic shock
Authors: Takaki Hidenobu , Hashizume Kenichi , Matsuoka Tadashi , Ikebata Koki
Published: July 2020

A 73-year-old man with an acute myocardial infarction experienced severe cardiogenic shock due to an inferior ventricular septal rupture with a massive left-to-right shunt. Emergency surgery was considered a too high mortality risk. The patient was implanted with an extracorporeal membrane oxygenation system as a bridge to surgery. On the seventh day after admission, the ventricular septal defect was successfully repaired. Our case study demonstrates that extracorporeal membrane oxygenation could be an option in cases of ventricular septal rupture as a bridge for stabilizing patients.
Can synthetic controls improve causal inference in interrupted time series evaluations of public health interventions?
Authors: Degli Esposti Michelle , Spreckelsen Thees , Gasparrini Antonio , Wiebe Douglas J , Bonander Carl , Yakubovich Alexa R , Humphreys David K
Published: July 2020

Interrupted time series designs are a valuable quasi-experimental approach for evaluating public health interventions. Interrupted time series extends a single group pre-post comparison by using multiple time points to control for underlying trends. But history bias—confounding by unexpected events occurring at the same time of the intervention—threatens the validity of this design and limits causal inference. Synthetic control methodology, a popular data-driven technique for deriving a control series from a pool of unexposed populations, is increasingly recommended. In this paper, we evaluate if and when synthetic controls can strengthen an interrupted time series design. First, we summarize the main observational study designs used in evaluative research, highlighting their respective uses, strengths, biases and design extensions for addressing these biases. Second, we outline when the use of synthetic controls can strengthen interrupted time series studies and when their combined use may be problematic. Third, we provide recommendations for using synthetic controls in interrupted time series and, using a real-world example, we illustrate the potential pitfalls of using a data-driven approach to identify a suitable control series. Finally, we emphasize the importance of theoretical approaches for informing study design and argue that synthetic control methods are not always well suited for generating a counterfactual that minimizes critical threats to interrupted time series studies. Advances in synthetic control methods bring new opportunities to conduct rigorous research in evaluating public health interventions. However, incorporating synthetic controls in interrupted time series studies may not always nullify important threats to validity nor improve causal inference.
Using UMLS for electronic health data standardization and database design
Authors: Reimer Andrew P , Milinovich Alex
Published: July 2020

Objective

Patients that undergo medical transfer represent 1 patient population that remains infrequently studied due to challenges in aggregating data across multiple domains and sources that are necessary to capture the entire episode of patient care. To facilitate access to and secondary use of transport patient data, we developed the Transport Data Repository that combines data from 3 separate domains and many sources within our health system.

Methods

The repository is a relational database anchored by the Unified Medical Language System unique concept identifiers to integrate, map, and standardize the data into a common data model. Primary data domains included sending and receiving hospital encounters, medical transport record, and custom hospital transport log data. A 4-step mapping process was developed: 1) automatic source code match, 2) exact text match, 3) fuzzy matching, and 4) manual matching.

Results

431 090 total mappings were generated in the Transport Data Repository, consisting of 69 010 unique concepts with 77% of the data being mapped automatically. Transport Source Data yielded significantly lower mapping results with only 8% of data entities automatically mapped and a significant amount (43%) remaining unmapped.

Discussion

The multistep mapping process resulted in a majority of data been automatically mapped. Poor matching of transport medical record data is due to the third-party vendor data being generated and stored in a nonstandardized format.

Conclusion

The multistep mapping process developed and implemented is necessary to normalize electronic health data from multiple domains and sources into a common data model to support secondary use of data.
The Efficacy of Five Different Wound Dressings on Some Histological Parameters in Children With Partial-Thickness Burns
Authors: Harma Birsen , Gül Mehmet , Demircan Mehmet
Published: July 2020

An ideal dressing should ensure that the wound remains moist with exudates but not macerated. Currently, there is no dressing available to suit all wounds, at all stages of the healing process. Although silver-containing dressings are the gold standard for burn wound care, few high-level trials have been completed comparing the clinical utilities of these dressings. In our study, five different types of wound dressings: carboxymethyl cellulose hydrofiber dressing with ionized silver (CMCH-Ag), polyethylene-polyethylene terephthalate aqua fiber dressing with elementary silver (PPAF-Ag), calcium alginate (CA), calcium + zinc alginate (CZA), and 0.2% nitrofurazone-embedded (NF) gauze dressings were compared in regard to histopathological parameters. Children aged between 0 and 18 years with small or middle-sized partial-thickness burns that affected less than 30% of the total body surface area were included in this study. The study groups (CMCH-Ag, PPAF-Ag, CA, and CZA) and the control group (NF) were randomly attained. Wound healing was evaluated by punch biopsies on the 21st day. The thickness of the stratum corneum and the epithelium, the number of papillae, and the papillary length were calculated and compared. The histological parameters of healing, except the stratum corneum thickness, did not show any statistical significance among the groups (P > .05). The dressings that included silver, calcium, or zinc showed useful and similar effects in noninfective burn wounds when compared with nitrofurazone-only dressings. Thus, it may be concluded that silver-containing wound dressings should not be considered as the gold standard in noninfective partial-thickness burn wounds in children.
‘Fitting In’ and ‘Giving Back’: Constructions of Australia’s ‘Ideal’ Refugee Through Discourses of Assimilation and Market Citizenship
Authors: Haw Ashleigh L
Published: July 2020

This paper examines how the ‘ideal’ refugee is conceptualized in discussions about Australia’s humanitarian policies. Critical Discourse Analysis of semi-structured interviews with 24 Western Australians revealed strong themes of assimilation alongside the neoliberal concept of ‘market citizenship’, where the ‘ideal’ refugee is positioned as achieving economic success through contributions to Australia’s labour market. These discourses served competing ends—they were voiced both in support of, and opposition to, Australia’s acceptance of refugees. I argue that by constructing refugees’ deservingness of protection along market citizenship lines, their belonging becomes contingent upon their adherence to a narrowly defined ideal. Consequently, refugees who do not fit within this ideal face continued exclusion, with their ‘human capital’ prioritized over their safety and human rights. This article calls for a reconsideration of arguments that focus on refugees’ capacity to ‘fit in’ and ‘give back’ as these narratives may exacerbate their experiences of exclusion and stigmatization.
Aircraft disinsection: what is the usefulness as a public health measure?
Authors: Grout Andrea , Russell Richard C
Published: July 2020

Rationale for review

Insecticide treatments in aircraft (termed ‘aircraft disinsection’) aim to support the containment of potentially disease-carrying vector insects. The introduction of non-endemic mosquito species is of concern as some mosquitoes can act as vectors of many serious human diseases. Expansion of vectors to previously non-endemic regions, extended flight networks and mosquito resistance to insecticides pose challenges to contemporary vector-control approaches. Despite established efficacy of aircraft disinsection in trials, there is increasing concern over its effectiveness and feasibility in flight operations, and its usefulness as a public health measure.

Key findings

We explored the literature on disinsection through a narrative approach to obtain a pragmatic assessment of existing and future implementation challenges. We describe the shortcomings that hinder evaluation of the success of aircraft disinsection. These shortcomings include operational constraints that may impact effective treatment outcomes, lack of longitudinal data on pesticide exposure scenarios, lack of compliance mechanisms, pesticide resistance in mosquitoes, and limited evidence of the extent and type of mosquito species potentially transported via aircraft.

Conclusions and recommendations

Concerns about the introduction of non-endemic mosquito vectors reinforce the need for effective preventive measures. Import of disease vectors is likely to occur in the future under changing environmental and operational conditions. Optimal impact from disinsection requires appropriate deployment, commitment and use. The current system of evaluation is inadequate for producing the evidence needed for informed policy decisions. While utilizing the results of research into environmentally sustainable vector-control methods for use in aircraft, future approaches to aircraft disinsection require improved evidence of anticipated benefits and harms, reliable monitoring data on insecticide resistance, and must be supported by strong vector control at airports.
Change is Hard: Leadership is Harder
Authors: Roberts Teresa
Published: July 2020

The transformation of the Military Health System to the Defense Health Agency under the National Defense Authorization Act of 2017 is a change of historical proportion. Change can be seen as hard, yet change is always happening. What is actually hard is providing leadership to accomplish the mission and goals for ourselves and our organizations within constant change. Those of us selected for leadership positions often receive standardized preparation and experiences to help us with this challenge. The hard part, though, is not what we often think it is. Leadership is not hard because of the amount of change or the people we are leading. Leadership is hard because, as we increase our rank and responsibilities, there are more people we need to see as people, having an outward mindset toward them, to have a positive influence and impact. In this article, I share the challenge I experienced with an outward mindset in leading the transition of our military treatment facility under the transformation to Defense Health Agency.
Distribution and kinematics of 26Al in the Galactic disc
Authors: Fujimoto Yusuke , Krumholz Mark R , Inutsuka Shu-ichiro
Published: July 2020

26Al is a short-lived radioactive isotope thought to be injected into the interstellar medium (ISM) by massive stellar winds and supernovae (SNe). However, all-sky maps of 26Al emission show a distribution with a much larger scale height and faster rotation speed than either massive stars or the cold ISM. We investigate the origin of this discrepancy using an N-body + hydrodynamics simulation of a Milky-Way-like galaxy, self-consistently including self-gravity, star formation, stellar feedback, and 26Al production. We find no evidence that the Milky Way’s spiral structure explains the 26Al anomaly. Stars and the 26Al bubbles they produce form along spiral arms, but, because our simulation produces material arms that arise spontaneously rather than propagating arms forced by an external potential, star formation occurs at arm centres rather than leading edges. As a result, we find a scale height and rotation speed for 26Al similar to that of the cold ISM. However, we also show that a synthetic 26Al emission map produced for a possible Solar position at the edge of a large 26Al bubble recovers many of the major qualitative features of the observed 26Al sky. This suggests that the observed anomalous 26Al distribution is the product of foreground emission from the 26Al produced by a nearby, recent SN.
The PDR structure and kinematics around the compact H ii regions S235 A and S235 C with [C ii], [13C ii], [O i], and HCO+ line profiles
Authors: Kirsanova M S , Ossenkopf-Okada V , Anderson L D , Boley P A , Bieging J H , Pavlyuchenkov Ya N , Luisi M , Schneider N , Andersen M , Samal M R , Sobolev A M , Buchbender C , Aladro R , Okada Y
Published: July 2020

The aim of this work is to study structure and gas kinematics in the photodissociation regions (PDRs) around the compact H ii regions S235 A and S235 C. We observe the [C ii], [13C ii], and [O i] line emission, using SOFIA/upGREAT, and complement them by data of HCO+ and CO. We use the [13C ii] line to measure the optical depth of the [C ii] emission, and find that the [C ii] line profiles are influenced by self-absorption, while the [13C ii] line remains unaffected by these effects. Hence, for dense PDRs, [13C ii] emission is a better tracer of gas kinematics. The optical depth of the [C ii] line is up to 10 in S235 A. We find an expanding motion of the [C ii]-emitting layer of the PDRs into the front molecular layer in both regions. Comparison of the gas and dust columns shows that gas components visible neither in the [C ii] nor in low-J CO lines may contribute to the total column across S235 A. We test whether the observed properties of the PDRs match the predictions of spherical models of expanding H ii region + PDR + molecular cloud. Integrated intensities of the [13C ii], [C ii], and [O i] lines are well represented by the model, but the models do not reproduce the double-peaked [C ii] line profiles due to an insufficient column density of C+. The model predicts that the [O i] line could be a more reliable tracer of gas kinematics, but the foreground self-absorbing material does not allow using it in the considered regions.
Ultracompact H ii regions with extended emission: the case of G43.89–0.78 and its molecular environment
Authors: de la Fuente Eduardo , Tafoya Daniel , Trinidad Miguel A , Porras Alicia , Nigoche-Netro Alberto , Kemp Simon N , Kurtz Stanley E , Franco José , Rodríguez-Rico Carlos A
Published: July 2020

The Karl Jansky Very Large Array (VLA), Owens Valley Radio Observatory (OVRO), Atacama Large Millimetric Array (ALMA), and the infrared Spitzer observatories are powerful facilities to study massive star formation regions and related objects such as ultra-compact (UC) H ii regions, molecular clumps, and cores. We used these telescopes to study the UC H ii region G43.89–0.78. The morphological study at arcminute scales using NVSS and Spitzer data shows that this region is similar to those observed in the bubble-like structures revealed by Spitzer observations. With this result, and including a physical characterization based on 3.6 cm data, we suggest G43.89–0.78 be classified as an UC H ii region with Extended Emission because it meets the operational definition given in this paper comparing radio continuum data at 3.6 and 20 cm. For the ultra-compact component, we use VLA data to obtain physical parameters at 3.6 cm confirming this region as an UC H ii region. Using ALMA observations, we detect the presence of a dense (2.6 × 107 cm−3) and small (∼ 2.0 arcsec; 0.08 pc) molecular clump with a mass of 220 M⊙ and average kinetic temperature of 21 K, located near to the UC H ii region. In this clump, catalogued as G43.890–0.784, water masers also exist, possibly tracing a bipolar outflow. We discover in this vicinity two additional clumps which we label as G43.899–0.786 (Td = 50 K; M  = 11 M⊙) and G43.888–0.787 (Td = 50 K; M  = 15 M⊙).
Orbital period cut-off of W UMa-type contact binaries
Authors: Zhang Xu-Dong , Qian Sheng-Bang
Published: July 2020

Period cut-off and period–colour relation are two special characters of W UMa-type contact binaries. In the past, many authors noted these two properties, however, a comprehensive study was still lacking. In order to reveal a theoretical mechanism behind these two peculiarities, we collected 365 contact binaries whose orbital periods, mass ratios, masses, and radii are compiled and attempted to make this idea come true by statistical means. Then, we obtained a lower limit (0.15 d) of orbital period by studying the correlation among four physical parameters (orbital period P, mass ratio q, mass of primary star M1, and separation between two components a). Furthermore, we used the most reliable parameters (P and q) to check our result, fortunately, all evidence indicated that our predicted value is credible. In the end, the reason why the period–colour relation exists was also discussed.
A comprehensive rat transcriptome built from large scale RNA-seq-based annotation
Authors: Ji Xiangjun , Li Peng , Fuscoe James C , Chen Geng , Xiao Wenzhong , Shi Leming , Ning Baitang , Liu Zhichao , Hong Huixiao , Wu Jun , Liu Jinghua , Guo Lei , Kreil David P , Łabaj Paweł P , Zhong Liping , Bao Wenjun , Huang Yong , He Jian , Zhao Yongxiang , Tong Weida , Shi Tieliu
Published: July 2020

The rat is an important model organism in biomedical research for studying human disease mechanisms and treatments, but its annotated transcriptome is far from complete. We constructed a Rat Transcriptome Re-annotation named RTR using RNA-seq data from 320 samples in 11 different organs generated by the SEQC consortium. Totally, there are 52 807 genes and 114 152 transcripts in RTR. Transcribed regions and exons in RTR account for ∼42% and ∼6.5% of the genome, respectively. Of all 73 074 newly annotated transcripts in RTR, 34 213 were annotated as high confident coding transcripts and 24 728 as high confident long noncoding transcripts. Different tissues rather than different stages have a significant influence on the expression patterns of transcripts. We also found that 11 715 genes and 15 852 transcripts were expressed in all 11 tissues and that 849 house-keeping genes expressed different isoforms among tissues. This comprehensive transcriptome is freely available at http://www.unimd.org/rtr/. Our new rat transcriptome provides essential reference for genetics and gene expression studies in rat disease and toxicity models.
The Relationship Between Stimulation Current and Functional Site Localization During Brain Mapping
Authors: Muster Rachel H , Young Jacob S , Woo Peter Y M , Morshed Ramin A , Warrier Gayathri , Kakaizada Sofia , Molinaro Annette M , Berger Mitchel S , Hervey-Jumper Shawn L
Published: July 2020

BACKGROUND

Gliomas are often in close proximity to functional regions of the brain; therefore, electrocortical stimulation (ECS) mapping is a common technique utilized during glioma resection to identify functional areas. Stimulation-induced seizure (SIS) remains the most common reason for aborted procedures. Few studies have focused on oncological factors impacting cortical stimulation thresholds.

OBJECTIVE

To examine oncological factors thought to impact stimulation threshold in order to understand whether a linear relationship exists between stimulation current and number of functional cortical sites identified.

METHODS

We retrospectively reviewed single-institution prospectively collected brain mapping data of patients with dominant hemisphere gliomas. Comparisons of stimulation threshold were made using t-tests and ANOVAs. Associations between oncologic factors and stimulation threshold were made using multivariate regressions. The association between stimulation current and number of positive sites was made using a Poisson model.

RESULTS

Of the 586 patients included in the study, SIS occurred in 3.92% and the rate of SIS events differed by cortical location (frontal 8.5%, insular 1.6%, parietal 1.3%, and temporal 2.8%; P = .009). Stimulation current was lower when mapping frontal cortex (P = .002). Stimulation current was not associated with tumor plus peritumor edema volume, world health organization) (WHO grade, histology, or isocitrate dehydrogenase (IDH) mutation status but was associated with tumor volume within the frontal lobe (P = .018). Stimulation current was not associated with number of positive sites identified during ECS mapping (P = .118).

CONCLUSION

SISs are rare but serious events during ECS mapping. SISs are most common when mapping the frontal lobe. Greater stimulation current is not associated with the identification of more cortical functional sites during glioma surgery.
Functional Outcomes and Health-Related Quality of Life Following Glioma Surgery
Authors: De Witt Hamer Philip C , Klein Martin , Hervey-Jumper Shawn L , Wefel Jeffrey S , Berger Mitchel S
Published: July 2020

Functional outcome following glioma surgery is defined as how the patient functions or feels. Functional outcome is a coprimary end point of surgery in patients with diffuse glioma, together with oncological outcome. In this review, we structure the functional outcome measurements following glioma surgery as reported in the last 5 yr. We review various perspectives on functional outcome of glioma surgery with available measures, and offer suggestions for their use. From the recent neurosurgical literature, 160 publications were retrieved fulfilling the selection criteria. In these publications, neurological outcomes were reported most often, followed by activities of daily living, seizure outcomes, neurocognitive outcomes, and health-related quality of life or well-being. In more than a quarter of these publications functional outcome was not reported. A minimum essential consensus set of functional outcome measurements would benefit comparison across neurosurgical reports. The consensus set should be based on a combination of clinician- and patient-reported outcomes, assessed at a predefined time before and after surgery. The selected measurements should have psychometric properties supporting the intended use including validity-related evidence, reliability, and sensitivity to detect meaningful change with minimal burden to ensure compliance. We circulate a short survey as a start towards reporting guidelines. Many questions remain to better understand, report, and improve functional outcome following glioma surgery.
Association between abnormal maternal serum levels of vitamin B12 and preeclampsia: a systematic review and meta-analysis
Authors: Mardali Farzaneh , Fatahi Somaye , Alinaghizadeh Maryam , Kord Varkaneh Hamed , Sohouli Mohammad Hassan , Shidfar Farzad , Găman Mihnea-Alexandru
Published: July 2020

Context

Some evidence has shown an association between maternal vitamin B12 levels and the development of preeclampsia in pregnant women, but the relationship between preeclampsia and vitamin B12 is not clear.

Objective

The aim of this systematic review was to compare serum vitamin B12 levels in women with preeclampsia with those in normotensive pregnant women.

Data Sources

The PubMed/MEDLINE, Scopus, and Web of Science databases were searched up to August 2019, along with the reference lists of included articles.

Study Selection

The literature was searched for observational studies that investigated vitamin B12 levels in women with preeclampsia.

Data Extraction

Data were extracted independently by 2 authors. Data were pooled using a random-effects model.

Results

Vitamin B12 levels in women with preeclampsia were significantly lower than those in healthy women (mean, −15.24 pg/mL; 95%CI, −27.52 to −2.954; P < 0.015), but heterogeneity between studies was high (I2 = 97.8%; P = 0.0103). Subgroup analyses based on folic acid supplementation, homocysteine concentrations, and gestational age at the time of sampling for vitamin B12 assessment did not identify the sources of heterogeneity.

Conclusions

Women with preeclampsia had significantly lower vitamin B12 concentrations than normotensive pregnant women.
Maternal diet and offspring telomere length: a systematic review
Authors: Habibi Nahal , Bianco-Miotto Tina , Phoi Yan Yin , Jankovic-Karasoulos Tanja , Roberts Claire T , Grieger Jessica A
Published: July 2020

Context

Many studies assert a negative influence of inappropriate maternal diet and nutritional status during pregnancy on offspring, not only in utero but throughout life, because of the role in the programing of noncommunicable diseases. Telomere length is a biomarker of aging, and shorter telomeres are associated with chronic disease later in life. Maternal nutrition and nutritional status may be an important determinant of offspring telomere length.

Objective

A systematic review was conducted to determine the effect of maternal nutrition and nutritional status in pregnancy on offspring telomere length.

Data Sources

This systematic review was conducted according to PRISMA guidelines. Database searches of PubMed, CINAHL, Scopus, Medline, and Web of Science were performed.

Study Selection

Included studies assessed the association between maternal nutrition (dietary intake and nutritional status) during pregnancy and offspring telomere length measured in cord blood, serum, plasma, and peripheral blood mononuclear cells.

Data Extraction

Three authors screened and determined the quality of the articles; disagreements were resolved by a fourth author. All authors compared the compiled data.

Results

Seven studies were extracted and evaluated. Studies comprised a double-blind placebo-controlled trial (n = 1), prospective cohort studies (n = 5), and a cross-sectional study (n = 1). Higher circulating maternal folate and 25-hydroxyvitamin D3 concentrations, along with higher maternal dietary caffeine intakes, were associated with longer offspring telomere length, whereas higher dietary intake of carbohydrate, folate, n-3 polyunsaturated fatty acids, vitamin C, or sodium was not.

Conclusion

The limited but suggestive evidence highlights the need for further research to be conducted in this area, particularly longitudinal studies involving larger cohorts of pregnant women.

Systematic review registration

PROSPERO registration no. CRD42019136506
Institutionalising Citizen Deliberation in Parliament: The Permanent Citizens’ Dialogue in the German-speaking Community of Belgium
Authors: Niessen Christoph , Reuchamps Min
Published: July 2020

In recent years, an increasing number of scholars and politicians have called for institutionalising deliberative citizen participation within Parliaments. The Parliament of the German-speaking Community of Belgium has paved the way in this direction by institutionalising a permanent deliberative citizen assembly that is directly linked to the parliamentary process. It consists in a permanent Citizens’ Council drawn by lot, which can initiate Citizens’ Assemblies, also drawn by lot, whose mission is to deliberate and formulate recommendations on the subject that the Citizens’ Council had submitted to them. At the end of the deliberations, the recommendations are discussed in a joint committee between the members of the Citizens’ Assembly, elected representatives and the minister in charge. The latter two then need to indicate whether and how the recommendations will be implemented by parliamentary or governmental measures—with rejections requiring specific justification. This article analyses how such a far-reaching process of citizen participation and deliberation became introduced at the core of the parliamentary institution and what are its features.
Epigenetic Regulation of Gibberellin Metabolism and Signaling
Authors: Xie Yongyao , Chen Letian
Published: July 2020

The precise regulation of gibberellin (GA) metabolism and signaling is essential for plant development and environmental responses. Epigenetic regulatory mechanisms, such as histone modification, noncoding RNA-mediated regulation, chromatin remodeling and DNA methylation, are emerging as important means of fine-tuning gene expression. Recent studies have significantly improved our understanding of the relationships between epigenetic regulation and GA metabolism and signaling. Here, we summarize the molecular mechanisms by which epigenetic modifications affect GA metabolism and signaling pathways and provide new insight into an unfolding avenue of research related to the epigenetic regulation of GA pathways.
Inkan Seals as Tools of Labor Selection in Early 20th Century Mining
Authors: MORIMOTO Mayo
Published: July 2020

In this study, I analyze a hiring mechanism prevalent in the coal mining industry in the first decade of the 1900s by investigating ‘job applications’, which are assumed to have functioned as employment contracts. These job applications include the names, ages, addresses, and previous occupations of 775 applicants, as well as the names of respective referrers, all of which have been compiled in a database. It is noteworthy that some of the applicants affixed personal seals to their job applications. At the time, the use of seals—a traditional Japanese practice—was not pervasive throughout the entire citizenry, as it is now. Coal miners of that era tended to be rustic people with little formal education who were accorded a relatively low socio-economic status. In this article, we explore possible motivations underlying their use of seals. Our results indicate a statistically significant tendency toward the use of seals among these relatively low-skilled workers, as well as a tendency for applicants who used seals to be hired directly by the mining company, rather than through referral hiring, even though the latter was widely used at the time. These trends are consistent with the supposition that the company sought disciplined and diligent workers to hire people who owned seals. This is also consistent with the supposition that low-skilled workers employed seals as a signal to project an image of diligence.
Genome Sequence Resource of ‘Candidatus Liberibacter asiaticus’ strain 9PA From Brazil
Authors: Silva P. A. , Huang J. , Wulff N. A. , Zheng Z. , Krugner R. , Chen J.
Published: July 2020

‘Candidatus Liberibacter asiaticus’, an unculturable α-proteobacterium, is associated with citrus huanglongbing (HLB), a devastating disease threatening citrus production in Brazil and worldwide. In this study, a draft whole-genome sequence of ‘Ca. L. asiaticus’ strain 9PA from a sweet orange (cultivar Pera) tree collected in São Paulo State, Brazil, is reported. The 9PA genome is 1,231,881 bp, including two prophages, with G+C content of 36.7%. This is the first report of a whole-genome sequence of ‘Ca. L. asiaticus’ from Brazil or South America. The 9PA genome sequence will enrich ‘Ca. L. asiaticus’ genome resources and facilitate HLB research and control in Brazil and the world.
A Guide to Performance Evaluation for the Intensivist: Ongoing Professional Practice Evaluation and Focused Professional Practice Evaluation in the ICU
Authors: Sterling Michael , Gregg Sara , Bakshi Vishal , Moll Vanessa
Published: July 2020

Objectives:

In 2008, The Joint Commission implemented a new standard mandating a detailed evaluation of a provider’s performance. The Ongoing Professional Practice Evaluation was designed to provide ongoing performance evaluation as opposed to periodic evaluation. The Focused Professional Practice Evaluation was designed to evaluate the performance of providers new to the medical staff or providers who are requesting new privileges. To date, we are unable to find critical care specific literature on the implementation of Ongoing Professional Practice Evaluation/Focused Professional Practice Evaluation. The purpose of this concise definitive review is to familiarize the reader with The Joint Commission standards and their application to Ongoing Professional Practice Evaluation/Focused Professional Practice Evaluation design and implementation, literature review in the noncritical care setting, and future process optimization and automation.

Data Sources:

Studies were identified through MEDLINE search using a variety of search phrases related to Ongoing Professional Practice Evaluation, Focused Professional Practice Evaluation, critical care medicine, healthcare quality, and The Joint Commission. Additional articles were identified through a review of the reference lists of identified articles.

Study Selection:

Original articles, review articles, and systematic reviews were considered.

Data Extraction:

Manuscripts were selected for inclusion based on expert opinion of well-designed or key studies and review articles.

Data Synthesis:

There is limited data for the process of Ongoing Professional Practice Evaluation and Focused Professional Practice Evaluation implementation in critical care medicine. Key recommendations exist from The Joint Commission but leave it up to healthcare institutions to realize these. The process and metrics can be tailored to specific institutions and departments.

Conclusions:

Currently, there is no standard process to develop Ongoing Professional Practice Evaluation and Focused Professional Practice Evaluation processes in critical care medicine. Departments and institutions can tailor metrics and processes but it might be useful to standardize some metrics to assure the overall quality of care. In the future utilization of newer technologies like applications might make this process less time-intensive.
Urinary Titin Is a Novel Biomarker for Muscle Atrophy in Nonsurgical Critically Ill Patients: A Two-Center, Prospective Observational Study
Authors: Nakanishi Nobuto , Tsutsumi Rie , Hara Kanako , Takashima Takuya , Nakataki Emiko , Itagaki Taiga , Matsuo Masafumi , Oto Jun , Sakaue Hiroshi
Published: July 2020

Objectives:

Although skeletal muscle atrophy is common in critically ill patients, biomarkers associated with muscle atrophy have not been identified reliably. Titin is a spring-like protein found in muscles and has become a measurable biomarker for muscle breakdown. We hypothesized that urinary titin is useful for monitoring muscle atrophy in critically ill patients. Therefore, we investigated urinary titin level and its association with muscle atrophy in critically ill patients.

Design:

Two-center, prospective observational study.

Setting:

Mixed medical/surgical ICU in Japan.

Patients:

Nonsurgical adult patients who were expected to remain in ICU for greater than 5 days.

Interventions:

None.

Measurements and Main Results:

Urine samples were collected on days 1, 2, 3, 5, and 7 of ICU admission. To assess muscle atrophy, rectus femoris cross-sectional area and diaphragm thickness were measured with ultrasound on days 1, 3, 5, and 7. Secondary outcomes included its relationship with ICU-acquired weakness, ICU Mobility Scale, and ICU mortality. Fifty-six patients and 232 urinary titin measurements were included. Urinary titin (normal range: 1–3 pmol/mg creatinine) was 27.9 (16.8–59.6), 47.6 (23.5–82.4), 46.6 (24.4–97.6), 38.4 (23.6–83.0), and 49.3 (27.4–92.6) pmol/mg creatinine on days 1, 2, 3, 5, and 7, respectively. Cumulative urinary titin level was significantly associated with rectus femoris muscle atrophy on days 3–7 (p ≤ 0.03), although urinary titin level was not associated with change in diaphragm thickness (p = 0.31–0.45). Furthermore, cumulative urinary titin level was associated with occurrence of ICU-acquired weakness (p = 0.01) and ICU mortality (p = 0.02) but not with ICU Mobility Scale (p = 0.18).

Conclusions:

In nonsurgical critically ill patients, urinary titin level increased 10–30 times compared with the normal level. The increased urinary titin level was associated with lower limb muscle atrophy, occurrence of ICU-acquired weakness, and ICU mortality.
Standardization of the Perioperative Management for Neonates Undergoing the Norwood Operation for Hypoplastic Left Heart Syndrome and Related Heart Defects
Authors: Natarajan Shobha S. , Stagg Alyson , Taylor April M. , Griffis Heather M. , Bosler Christy K. , Cates Margaret , Dewitt Aaron G. , Giglia Therese M. , Mascio Christopher E. , Ravishankar Chitra , Rossano Joseph W. , Taylor Lillith C. , Ware Eileen P. , Nicolson Susan C. , Rome Jonathan J.
Published: July 2020

Objectives:

In-hospital complications after the Norwood operation for single ventricle heart defects account for the majority of morbidity and mortality. Inpatient care variation occurs within and across centers. This multidisciplinary quality improvement project standardized perioperative management in a large referral center.

Design:

Quality improvement project.

Setting:

High volume cardiac center, tertiary care children’s hospital.

Patients:

Neonates undergoing Norwood operation.

Interventions:

The quality improvement team developed and implemented a clinical guideline (preoperative admission to 48 hr after surgery). The composite process metric, Guideline Adherence Score, contained 13 recommendations in the guideline that reflected consistent care for all patients.

Measurements and Main Results:

One-hundred two consecutive neonates who underwent Norwood operation (January 1, 2013, to July 12, 2016) before guideline implementation were compared with 50 consecutive neonates after guideline implementation (July 13, 2016, to May 4, 2018). No preguideline operations met the goal Guideline Adherence Score. In the first 6 months after guideline implementation, 10 of 12 operations achieved goal Guideline Adherence Score and continued through implementation, reaching 100% for the last 10 operations. Statistical process control analysis demonstrated less variability and decreased hours of postoperative mechanical ventilation and cardiac ICU length of stay during implementation. There were no statistically significant differences in major hospital complications or in 30-day mortality. A higher percentage of patients were extubated by postoperative day 2 after guideline implementation (67% [30/47] vs 41% [41/99], respectively; p = 0.01). Of these patients, reintubation within 72 hours of extubation significantly decreased after guideline implementation (0% [0/30] vs 17% [7/41] patients, respectively; p = 0.02).

Conclusions:

This initiative successfully implemented a standardized perioperative care guideline for neonates undergoing the Norwood operation at a large center. Positive statistical process control centerline shifts in Guideline Adherence Score, length of postoperative mechanical ventilation, and cardiac ICU length of stay were demonstrated. A higher percentage were successfully extubated by postoperative day 2. Establishment of standard processes can lead to best practices to decrease major adverse events.
eStablish And Formalize Expert Criteria for Avoidable Resuscitation Review (SAFECARR) Electronic Delphi: Development of a Consensus Framework for Classifying and Reviewing Cardiac Arrests Within the PICU
Authors: Dewan Maya , O’Halloran Amanda , Kleinman Monica , Tegtmeyer Ken , Gallagher Regan , Nadkarni Vinay , Sutton Robert M. , Wolfe Heather A.
Published: July 2020

Objectives:

To develop a consensus framework that can guide the process of classifying and reviewing pediatric in-hospital cardiac arrest in the PICU.

Design:

A three-round electronic Delphi consensus study with an additional in-person session with pediatric resuscitation experts. The modified electronic Delphi consisted of survey questions sent to the expert panel with the goals of (1) achieving consensus on definitions of avoidable, potentially avoidable, and unavoidable PICU in-hospital cardiac arrest and (2) achieving consensus and ranking of a list of factors that contribute to potentially avoidable PICU in-hospital cardiac arrest.

Setting:

Electronic surveys of resuscitation experts including pediatric critical care, cardiac critical care, emergency medicine, and hospital medicine physicians, nurses, advance practice nurses, and resuscitation researchers.

Patients:

Not applicable.

Interventions:

Not applicable.

Measurements and Main Results:

Over three rounds of an electronic Delphi, 24 resuscitation experts participated. In Round 1, consensus was reached for the definitions of potentially avoidable and unavoidable cardiac arrest. Consensus was not reached for avoidable cardiac arrest. In Round 2, the expert panel agreed with seven factors from the literature and achieved consensus on an additional seven factors. Consensus was achieved on the modified definition of avoidable cardiac arrest. In Round 3, participants were asked to rank the contributing factors in order of their importance. For the in-person session, the consensus definitions and contributing factors from the modified electronic Delphi were presented to a multidisciplinary group of pediatric resuscitation experts and reached consensus for all three definitions.

Conclusions:

A multidisciplinary group of pediatric resuscitation experts generated a consensus-based framework to classify and review pediatric in-hospital cardiac arrest in the PICU. Future work will focus on the application of this framework and further validation of these definitions and contributing factors for in-hospital cardiac arrest both within and outside the PICU.
Evolutionary dynamics drives role specialization in a community of players
Authors: Jia Danyang , Wang Xinyu , Song Zhao , Romić Ivan , Li Xuelong , Jusup Marko , Wang Zhen
Published: July 2020

The progression of game theory from classical to evolutionary and spatial games provided a powerful means to study cooperation, and enabled a better understanding of general cooperation-promoting mechanisms. However, current standard models assume that at any given point players must choose either cooperation or defection, meaning that regardless of the spatial structure in which they exist, they cannot differentiate between their neighbours and adjust their behaviour accordingly. This is at odds with interactions among organisms in nature who are well capable of behaving differently towards different members of their communities. We account for this natural fact by introducing a new type of player—dubbed link players—who can adjust their behaviour to each individual neighbour. This is in contrast to more common node players whose behaviour affects all neighbours in the same way. We proceed to study cooperation in pure and mixed populations, showing that cooperation peaks at moderately low densities of link players. In such conditions, players naturally specialize in different roles. Node players tend to be either cooperators or defectors, while link players form social insulation between cooperative and defecting clusters by acting both as cooperators and defectors. Such fairly complex processes emerging from a simple model reflect some of the complexities observed in experimental studies on social behaviour in microbes and pave a way for the development of richer game models.