bluuebunny/crossref_metadata_2025 huggingface dataset:
Fusion Points: The Perceived, Performed, and Passive Merging of Criminality and Mobility in Mexico
Authors: Yates Caitlyn
Published: March 2021

Organized criminal actors increasingly diversify criminal portfolios, streamline illicit supply chains, and expand social networks in a process referred to as convergence. The frame is simultaneously used by State actors to justify the criminalization of certain populations, including irregular migrants. Relying on ethnographic and quantitative research with Central American migrants in Mexico, this paper argues that the supposed threat posed by convergence grossly overstates the relationship between organized criminal activities and migrants’ own experiences. There are spaces and times when migrants do interact with organized criminal actors to facilitate their transits. These interactions, though, do not point to convergence. Rather, they demonstrate the brief but fundamental encounters of migrants with criminal/ized actors in Mexico. I refer to these instances as fusion points to elucidate the ways that Central American migrants advance their journeys.
Citizens of the City: Undocumented Latinx Migrants Organising Politically in Post-Katrina New Orleans
Authors: Daser Deniz
Published: March 2021

Across the globe marginalised urban residents have organised for improved access to rights nominally afforded them as citizens. While studies of such insurgent citizenship movements mostly focus on formal citizens, I examine here how undocumented migrants have drawn upon past labour to organise for improved working conditions and the “right to the city” free of deportation. Based on ethnographic fieldwork with Latinx migrants who worked in post-Hurricane Katrina rebuilding in New Orleans, Louisiana, this study identified wage theft, work injury, and potential deportation as shaping their political activism. As reconstruction ended and immigration enforcement hardened throughout the 2010s, these workers framed their past labour as a moral and economic contribution worthy of rights and recognition. Key US industries such as construction rely on undocumented workers. These findings thus contribute to a growing literature on how undocumented migrants are also insurgent citizens by shifting analysis to labour’s importance in movement building.
Hollywood and the Myth of Criminal Convergence. The Case of Sicario: Day of the Soldado
Authors: Massari Alice
Published: March 2021

Narratives of drug cartels progressively assuming control of migration routes by smuggling and trafficking migrants and Islamic terrorists across borders is not only common in academic accounts and international organizations’ reports. It is also emerging in popular culture. This article sheds light on how the myth of criminal convergence can be created and conveyed to the public through crime-action films. I look at one of the most important places for mythmaking of any kind: Hollywood. Based on a visual social semiotic analysis of the film Sicario: Day of the Soldado, this article will show how the myth of convergence is conveyed throughout it, and what its implications are. It will argue that the rhetoric of criminal convergence fuels a simplistic account of the existence of a battle between good (law enforcement) and evil (criminals working on all sorts of interconnected cross-border crimes), thereby legitimizing every action in the fight against crime.
Intra-annual dynamics of cambial and xylem phenology in subalpine conifers at Deogyusan National Park in the Republic of Korea
Authors: Park Jun-Hui , Choi En-Bi , Park Hong-Chul , Lee Na-Yeon , Seo Jeong-Wook
Published: March 2021

Subalpine conifers are highly sensitive to climatic changes. In these trees, the intra-annual dynamics of cambial activity and phenological process in xylem development are closely associated with climatic conditions. However, these scientific findings have not been verified for subalpine conifers in the Republic of Korea. Therefore, we initiated such a study with four subalpine conifers, viz. Abies koreana, Pinus koraiensis, Taxus cuspidata, and Picea jezoensis, growing between 1573 and 1594 m a.s.l. at Deogyusan National Park. Microcores (Ø 2 mm) of these trees were obtained using a mini borer, called as Trephor, every week between April 7 and September 25 in 2017 to monitor their growing seasons, the intra-annual dynamics of the cambial activity, and the number of cells during phenological phases of cell enlargement and cell-wall thickening. For the study, five trees were selected for each conifer species. Results showed that the cambial activity of A. koreana, P. koraiensis, and P. jezoensis required at least 73.8 heat-sum values, whereas the T. cuspidata needed 109.6 heat-sum. The durations of cambial activity of A. koreana, P. koraiensis, T. cuspidata, and P. jezoensis were 134 (127–144), 113 (92–128), 113 (106–120), and 100 (76–128) days, respectively. The intra-annual variations of the number of cells in the cambium, during the cell enlargement phase and cell-wall thickening phase showed predominantly a bell-shaped curve, with a delay of approximately 2–4 weeks between each other. On the other hand, the number of cumulated mature cells showed an S-shaped curve. Through this study, the first fundamental data on phenological process in xylem development of subalpine conifers in the Republic of Korea have been successfully presented.
Clinical and radiological outcomes of acetabular revision surgery with trabecular titanium cups in Paprosky type II and III bone defects
Authors: Perticarini Loris , Rossi Stefano Marco Paolo , Medetti Marta , Benazzo Francesco
Published: March 2021

Background

This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery.

Methods

Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29–90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect.

Results

Average follow-up was 91 (range 24–146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25–70; SD 9) preoperatively to 84.4 (range 46–99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan–Meier survivorship was assessed to be 88.54% (95% CI 80.18–93.52%) at 71 months, with failure of the cup for any reason as the endpoint.

Conclusion

Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects.

Level of evidence

Level IV prospective case series
R.ROSETTA: an interpretable machine learning framework
Authors: Garbulowski Mateusz , Diamanti Klev , Smolińska Karolina , Baltzer Nicholas , Stoll Patricia , Bornelöv Susanne , Øhrn Aleksander , Feuk Lars , Komorowski Jan
Published: March 2021

Background

Machine learning involves strategies and algorithms that may assist bioinformatics analyses in terms of data mining and knowledge discovery. In several applications, viz. in Life Sciences, it is often more important to understand how a prediction was obtained rather than knowing what prediction was made. To this end so-called interpretable machine learning has been recently advocated. In this study, we implemented an interpretable machine learning package based on the rough set theory. An important aim of our work was provision of statistical properties of the models and their components.

Results

We present the R.ROSETTA package, which is an R wrapper of ROSETTA framework. The original ROSETTA functions have been improved and adapted to the R programming environment. The package allows for building and analyzing non-linear interpretable machine learning models. R.ROSETTA gathers combinatorial statistics via rule-based modelling for accessible and transparent results, well-suited for adoption within the greater scientific community. The package also provides statistics and visualization tools that facilitate minimization of analysis bias and noise. The R.ROSETTA package is freely available at https://github.com/komorowskilab/R.ROSETTA. To illustrate the usage of the package, we applied it to a transcriptome dataset from an autism case–control study. Our tool provided hypotheses for potential co-predictive mechanisms among features that discerned phenotype classes. These co-predictors represented neurodevelopmental and autism-related genes.

Conclusions

R.ROSETTA provides new insights for interpretable machine learning analyses and knowledge-based systems. We demonstrated that our package facilitated detection of dependencies for autism-related genes. Although the sample application of R.ROSETTA illustrates transcriptome data analysis, the package can be used to analyze any data organized in decision tables.
Whole genome de novo sequencing and comparative genomic analyses suggests that Chlamydia psittaci strain 84/2334 should be reclassified as Chlamydia abortus species
Authors: Longbottom David , Livingstone Morag , Ribeca Paolo , Beeckman Delphine Sylvie Anne , van der Ende Arie , Pannekoek Yvonne , Vanrompay Daisy
Published: March 2021

Background

Chlamydia abortus and Chlamydia psittaci are important pathogens of livestock and avian species, respectively. While C. abortus is recognized as descended from C. psittaci species, there is emerging evidence of strains that are intermediary between the two species, suggesting they are recent evolutionary ancestors of C. abortus. Such strains include C. psittaci strain 84/2334 that was isolated from a parrot. Our aim was to classify this strain by sequencing its genome and explore its evolutionary relationship to both C. abortus and C. psittaci.

Results

In this study, methods based on multi-locus sequence typing (MLST) of seven housekeeping genes and on typing of five species discriminant proteins showed that strain 84/2334 clustered with C. abortus species. Furthermore, whole genome de novo sequencing of the strain revealed greater similarity to C. abortus in terms of GC content, while 16S rRNA and whole genome phylogenetic analysis, as well as network and recombination analysis showed that the strain clusters more closely with C. abortus strains. The analysis also suggested a closer evolutionary relationship between this strain and the major C. abortus clade, than to two other intermediary avian C. abortus strains or C. psittaci strains. Molecular analyses of genes (polymorphic membrane protein and transmembrane head protein genes) and loci (plasticity zone), found in key virulence-associated regions that exhibit greatest diversity within and between chlamydial species, reveal greater diversity than present in sequenced C. abortus genomes as well as similar features to both C. abortus and C. psittaci species. The strain also possesses an extrachromosomal plasmid, as found in most C. psittaci species but absent from all sequenced classical C. abortus strains.

Conclusion

Overall, the results show that C. psittaci strain 84/2334 clusters very closely with C. abortus strains, and are consistent with the strain being a recent C. abortus ancestral species. This suggests that the strain should be reclassified as C. abortus. Furthermore, the identification of a C. abortus strain bearing an extra-chromosomal plasmid has implications for plasmid-based transformation studies to investigate gene function as well as providing a potential route for the development of a next generation vaccine to protect livestock from C. abortus infection.
The complete chloroplast genome of Stauntonia chinensis and compared analysis revealed adaptive evolution of subfamily Lardizabaloideae species in China
Authors: Wen Feng , Wu Xiaozhu , Li Tongjian , Jia Mingliang , Liu Xinsheng , Liao Liang
Published: March 2021

Background

Stauntonia chinensis DC. belongs to subfamily Lardizabaloideae, which is widely grown throughout southern China. It has been used as a traditional herbal medicinal plant, which could synthesize a number of triterpenoid saponins with anticancer and anti-inflammatory activities. However, the wild resources of this species and its relatives were threatened by over-exploitation before the genetic diversity and evolutionary analysis were uncovered. Thus, the complete chloroplast genome sequences of Stauntonia chinensis and comparative analysis of chloroplast genomes of Lardizabaloideae species are necessary and crucial to understand the plastome evolution of this subfamily.

Results

A series of analyses including genome structure, GC content, repeat structure, SSR component, nucleotide diversity and codon usage were performed by comparing chloroplast genomes of Stauntonia chinensis and its relatives. Although the chloroplast genomes of eight Lardizabaloideae plants were evolutionary conserved, the comparative analysis also showed several variation hotspots, which were considered as highly variable regions. Additionally, pairwise Ka/Ks analysis showed that most of the chloroplast genes of Lardizabaloideae species underwent purifying selection, whereas 25 chloroplast protein coding genes were identified with positive selection in this subfamily species by using branch-site model. Bayesian and ML phylogeny on CCG (complete chloroplast genome) and CDs (coding DNA sequences) produced a well-resolved phylogeny of Lardizabaloideae plastid lineages.

Conclusions

This study enhanced the understanding of the evolution of Lardizabaloideae and its relatives. All the obtained genetic resources will facilitate future studies in DNA barcode, species discrimination, the intraspecific and interspecific variability and the phylogenetic relationships of subfamily Lardizabaloideae.
Minimal important difference and patient acceptable symptom state for pain, Constant-Murley score and Simple Shoulder Test in patients with subacromial pain syndrome
Authors: Kanto Kari , Lähdeoja Tuomas , Paavola Mika , Aronen Pasi , Järvinen Teppo L. N. , Jokihaara Jarkko , Ardern Clare L. , Karjalainen Teemu V. , Taimela Simo
Published: March 2021

Background

The results of clinical trials should be assessed for both statistical significance and importance of observed effects to patients. Minimal important difference (MID) is a threshold denoting a difference that is important to patients. Patient acceptable symptom state (PASS) is a threshold above which patients feel well.

Objective

To determine MID and PASS for common outcome instruments in patients with subacromial pain syndrome (SAPS).

Methods

We used data from the FIMPACT trial, a randomised controlled trial of treatment for SAPS that included 193 patients. The outcomes were shoulder pain at rest and on arm activity, both measured with the 0–100 mm visual analogue scale (VAS), the Constant-Murley score (CS), and the Simple Shoulder Test (SST). The transition question was a five-point global rating of change. We used three anchor-based methods to determine the MID for improvement: the receiver operating characteristic (ROC) curve, the mean difference of change and the mean change methods. For the PASS, we used the ROC and 75th percentile methods and calculated estimates using two different anchor question thresholds.

Results

Different MID methods yielded different estimates. The ROC method yielded the smallest estimates for MID: 20 mm for shoulder pain on arm activity, 10 points for CS and 1.5 points for SST, with good to excellent discrimination (areas under curve (AUCs) from 0.86 to 0.94). We could not establish a reliable MID for pain at rest. The PASS estimates were consistent between methods. The ROC method PASS thresholds using a conservative anchor question threshold were 2 mm for pain at rest, 9 mm for pain on activity, 80 points for CS and 11 points for SST, with AUCs from 0.74 to 0.83.

Conclusion

We recommend the smallest estimate from different methods as the MID, because it is very unlikely that changes smaller than the smallest MID estimate are important to patients: 20 mm for pain VAS on arm activity, 10 points for CS and 1.5 points for SST. We recommend PASS estimates of 9 mm for pain on arm activity, 80 points for CS, and 11 points for SST.

Trial registration

ClinicalTrials.govNCT00428870 (first registered January 29, 2007).
Onset of acid-neutralizing action of a calcium/magnesium carbonate-based antacid using an artificial stomach model: an in vitro evaluation
Authors: Voropaiev Maxim , Nock Deborah
Published: March 2021

Background

Calcium carbonate antacids are potent over-the-counter antacids, made more effective by adding magnesium carbonate (as in Rennie, Bayer). However, published studies on their onset of action are scarce. Therefore, we carried out an in vitro study comparing Rennie and placebo under simulated conditions of the human stomach (artificial stomach model) to reconfirm the onset of action of Rennie.

Methods

The validated Simulator of the Human Intestinal Microbial Ecosystem apparatus (SHIME, ProDigest, Belgium) was used, comprising five reactors simulating different parts of the human gastrointestinal tract. Both Rennie and placebo were dosed at two tablets per incubation over six independent, 2-h stomach incubations each. Primary objectives: to evaluate the time required to achieve pH 3.0, 3.5, 4.0 and 4.5, as well as the maximum pH reached. Secondary objective: to evaluate pepsin activity over the entire 2-h gastric incubation.

Results

After addition of Rennie, the gastric medium reached a pH of 3.0 within 40 s. The maximum pH of 5.24 was maintained for almost 10 min. In contrast, the maximum pH with placebo was 1.28 during the entire gastric simulation. Furthermore, Rennie strongly reduced the activity of mucosa-damaging pepsin during the period of increased pH. With placebo, the lower pH resulted in consistently high loads of digested peptides, reflecting the high cumulative and instantaneous pepsin activity.

Conclusions

New data is a critical component in informed decision making. Our data confirm the high efficacy and fast onset of acid-neutralizing action of Rennie, which begins to work within seconds.
Patient factors associated with new prescribing of potentially inappropriate medications in multimorbid US older adults using multiple medications
Authors: Jungo Katharina Tabea , Streit Sven , Lauffenburger Julie C.
Published: March 2021

Background

The use of potentially inappropriate medications (PIMs) is common in older adults and is associated with potential negative consequences, such as falls and cognitive decline. Our objective was to investigate measurable patient factors associated with new outpatient prescribing of potentially inappropriate medications in older multimorbid adults already using multiple medications.

Methods

In this retrospective US cohort study, we used linked Medicare pharmacy and medical claims and electronic health record data from a large healthcare system in Massachusetts between 2007 and 2014. We identified patients aged ≥65 years with an office visit who had not been prescribed or used a PIM in the prior 180 days. PIMs were defined using 2019 Beers criteria of the American Geriatrics Society. To specifically evaluate factors in patients with polypharmacy and multimorbidity, we selected those who filled medications for ≥90 days (i.e., chronic use) from ≥5 pharmaceutical classes in the prior 180 days and had ≥2 chronic conditions. Multivariable Cox regression analysis was used to estimate the association between baseline demographic and clinical characteristics on the probability of being prescribed a PIM in the 90-day follow-up period.

Results

In total, we identified 17,912 patients aged ≥65 years with multimorbidity and polypharmacy who were naïve to a PIM in the prior 180 days. Of those, 10,497 (58.6%) were female, and mean age was 78 (SD = 7.5). On average, patients had 5.1 (SD = 2.3) chronic conditions and previously filled 6.1 (SD = 1.4) chronic medications. In total, 447 patients (2.5%) were prescribed a PIM during the 90-day follow-up. Male sex (adjusted hazard ratio (HR) = 1.29; 95%CI: 1.06–1.57), age (≥85 years: HR = 0.75, 95%CI: 0.56–0.99, 75–84 years: HR = 0.87, 95%CI: 0.71–1.07; reference: 65–74 years), ambulatory visits (18–29 visits: HR = 1.42, 95%CI: 1.06–1.92; ≥30 visits: HR = 2.12, 95%CI: 1.53–2.95; reference: ≤9 visits), number of prescribing orders (HR = 1.02, 95%CI: 1.01–1.02 per 1-unit increase), and heart failure (HR = 1.38, 95%CI: 1.07–1.78) were independently associated with being newly prescribed a PIM.

Conclusion

Several demographic and clinical characteristics, including factors suggesting lack of care coordination and increased clinical complexity, were found to be associated with the new prescribing of potentially inappropriate medications. This knowledge could inform the design of interventions and policies to optimize pharmacotherapy for these patients.
Adverse outcomes associated with rapid linear and non-linear patterns of chronic kidney disease progression
Authors: Ali Ibrahim , Chinnadurai Rajkumar , Ibrahim Sara T. , Kalra Philip A.
Published: March 2021

Background

Patients with rapidly declining renal function face the dual threat of end-stage renal disease (ESRD) and mortality prior to ESRD. What is less well characterised is whether the pattern of the renal trajectory, linear or non-linear, unmasks subgroups of rapidly progressing patients that face adverse outcomes in a differential manner.

Methods

An individual eGFR slope was applied to all outpatient estimated glomerular filtration rate (eGFR) values for each patient in the Salford Kidney Study from 2002 to 2018 who had at least 2 years follow-up, ≥4 eGFR values and baseline eGFR 15 to < 60 ml/min/1.73m2. Rapid progression was defined as an annual eGFR slope of ≤ − 3 ml/min/1.73m2/yr and patients were categorised as linear or non-linear progressors based on the nature of their eGFR-time graphs. A Fine-Gray competing risk hazard model was used to determine factors associated with progression to ESRD and with mortality prior to ESRD. Cumulative incidence function curves highlighted differences in outcomes between linear and non-linear patients.

Results

There were 211 rapidly deteriorating patients with linear eGFR trajectories and 61 rapid non-linear patients in the study cohort. Factors associated with ESRD included younger age, male gender, lower baseline eGFR and higher serum phosphate, whilst older age, history of myocardial infarction and anaemia predicted mortality prior to ESRD. Over a median follow-up of 3.7 years, linear progressors reached ESRD sooner whilst those with non-linear progression faced significantly higher rates of mortality prior to ESRD.

Conclusions

Patients with rapid eGFR decline have high rates of adverse outcomes that are differentially expressed in those progressing linearly and non-linearly as a result of differing phenotypic profiles. Consequently, addressing individual risk factor profiles is important to deliver optimal personalised patient care.
The impact of betamethasone on fetal pulmonary, umbilical and middle cerebral artery Doppler velocimetry and its relationship with neonatal respiratory distress syndrome
Authors: Vafaei Homeira , Kaveh Baghbahadorani Fahimeh , Asadi Nasrin , Kasraeian Maryam , Faraji Azam , Roozmeh Shohreh , Zare Marjan , Bazrafshan Khadije
Published: March 2021

Background

Prenatal corticosteroid administration is known to be an effective strategy in improving fetal pulmonary maturity. This study aimed to evaluate the impact of maternal betamethasone administration on fetal pulmonary and other arteries Doppler velocity and the correlation between RDS development and Doppler indices results.

Methods

Fifty one singleton pregnancies between 26 and 34 gestational weeks with a diagnosis of preterm labor were included in the exposed group and received betamethasone. Fifty one uncomplicated pregnancies were included in the non-exposed group. Fetal pulmonary, umbilical and middle cerebral arteries Doppler parameters were evaluated before and 24 to 48 h after steroid administration in the exposed group and two times at same intervals in the non-exposed group. Maternal records were matched to neonatal charts if delivery happened, and demographic and outcome data were abstracted.

Results

When compared with the nonexposed group, fetuses treated with corticosteroids demonstrated significantly decreased umbilical artery Pulsatility index (PI) and significantly increased the middle cerebral artery PI, pulmonary artery Acceleration time (AT) and pulmonary artery AT/ET (Ejection time), while all other indices remained similar. We found significantly decreased pulmonary artery AT in the fetuses with respiratory distress syndrome (RDS) compared to those that did not.

Conclusions

The results of our study showed that maternal antenatal betamethasone administration caused significant changes in the fetus blood velocity waveforms and also affected the blood flow in the pulmonary artery which led to an increase in the pulmonary artery AT and AT/ET. Among those fetuses with RDS, we found a significant decrease in the pulmonary artery AT, but we did not observe any pulmonary artery AT/ET differences.
Validating a generic cancer consumer quality index in eight European countries, patient reported experiences and the influence of cultural differences
Authors: Wind A. , Hartman E. D. , Van Eekeren R. R. J. P. , Wijn R. P. W. F. , Halámková J. , Mattson J. , Siesling S. , van Harten W. H.
Published: March 2021

Background

Taking patient centeredness into account is important in healthcare. The European Cancer Consumer Quality Index (ECCQI) is a validated tool for international benchmarking of patient experiences and satisfaction.

This study aimed to further validate the ECCQI in larger and more uniform groups of high volume tumours such as breast and prostate cancer. A second objective was the verification of the influence of cultural factors of the country to determine its possible use in international benchmarking.

Methods

Data from two survey studies in eight European countries were combined. Socio-demographic correlations were analysed with Kruskall-Wallis and Mann-Whitney tests. Cronbach’s alpha was calculated to validate internal consistency. Influences of masculinity (MAS), power distance (PD) and uncertainty avoidance (UA) were determined by linear regression analysis in a general model and subgroup models.

Results

A total of 1322 surveys were included in the analysis (1093 breast- and 348 prostate cancer patients). Cronbach’s alpha was good (α ≥ 0.7) or acceptable (0.5 ≤ α ≤ 0.7) in 8 out of 9 questionnaire categories, except in the category ‘Safety’ (α = 0.305). Overall ECCQI scores ranged from 22.1 to 25.1 between countries on a 1–35 scale (categories had a 1–4 scale). In certain subcategories such as ‘Organisation’ (range 2.2 vs 3.0) and ‘Supervision & Support’ (range 3.0 vs 3.8) a large difference was observed between countries. Differences in ‘Overall opinion’ were however small: mean scores of 3.7 vs 3.9, whereas median scores were all the maximum of 4.0. Power distance was positively associated with higher patient satisfaction scores whereas Uncertainty avoidance was negatively associated with these scores. Masculinity was only associated with patient satisfaction scores in lower educated patients. We found the highest impact of culture on overall scores in Hungary and Portugal and the lowest in Romania.

Conclusions

The ECCQI shows high internal consistency in all categories except ‘Safety’. Especially in separate categories and overall ECCQI scores the questionnaire showed discriminative value. This study showed a positive correlation of power distance and a negative correlation for uncertainty avoidance in some countries. When using the ECCQI for international benchmarking these two dimensions of culture should be taken into account.
Body composition in term offspring after maternal gestational diabetes does not predict postnatal hypoglycemia
Authors: Wiechers Cornelia , Balles Lena S. , Kirchhof Sara , Weber Romy , Avellina Vanessa , Pauluschke-Fröhlich Jan , Hallschmid Manfred , Fritsche Louise , Preißl Hubert , Fritsche Andreas , Poets Christian F. , Franz Axel R.
Published: March 2021

Background

Offspring of mothers with gestational diabetes mellitus (GDM) have an increased risk of neonatal complications like birth trauma due to macrosomia or postnatal hypoglycemia, as well as long-term metabolic sequelae. Neonatal body composition may be a sensitive marker of metabolic effects on the fetus caused by suboptimal glycemic control during pregnancy.

Objective

To determine body composition in offspring of mothers with GDM compared to a reference cohort of healthy term neonates and to assess whether increased body fat would be associated with postnatal hypoglycemia.

Methods

This prospective, observational, cross-sectional study included 311 full-term, singleton infants born between June 2014 and July 2015. Body composition was measured within 96 h of birth using air displacement plethysmography. Results are indicated as median (1st Quartile – 3rd Quartile).

Results

Of 311 infants, 40 (12.9%) were born to mothers with GDM. Birth weight standard deviation scores (SDS) (0.24 vs. − 0.07,p = 0.04), fat mass (370 g vs. 333 g,p = 0.02) as well as fat mass/total body mass (BF%; 11.4% vs. 10.8%,p = 0.03) were significantly higher in infants following maternal GDM than in controls. In GDM offspring, anthropometric parameters, fat mass or BF% did not differ between infants with or without postnatal hypoglycemia. In this cohort, SDS for birth weight, fat mass, fat free mass, BF% or postnatal hypoglycemia were not associated with maternal blood glucose levels measured at an oral glucose tolerance test.

Conclusions

SDS for birth weight, neonatal fat mass, and BF% were significantly higher in newborns following maternal GDM. In these infants born to mothers with GDM, body composition did not differ between those with or without postnatal hypoglycemia.
Parental appearance teasing in adolescence and associations with eating problems: a systematic review
Authors: Dahill Lucy M. , Touyz Stephen , Morrison Natalie M. V. , Hay Phillipa
Published: March 2021

Background

The adolescent years see significant physical and emotional development that lay foundations for patterns of behaviour that can continue into adult life, including the shaping of eating behaviours. Given parents are key socio-environmental drivers and influencers of adolescent behaviours around physical health and wellbeing, it is critical to consider if specific forms of parental communication are potentially contributing to the associated emotional difficulties experienced in the adolescent years. The aim of this research was to systematically review the myriad of literature pertaining to the prevalence of parental weight or appearance-based teasing and adolescent eating problems to examine how the scientific and clinical community currently understands the relationship between these domains.

Methods

A systematic search of the literature, using the SCOPUS, APA PsycINFO, Medline, CINAHL databases, reference lists and Google Scholar, was undertaken to identify relevant literature for parental teasing and problem eating in adolescents aged 10–19 years, published between January 1980 to October 2020, in English or French.

Results

Six studies met criteria for inclusion, all were cross-sectional studies and two included additional prospective data. Although parents were not the most common perpetrators of teasing, often subsidiary to that of peers and siblings, the influence and impact of parental teasing remained significant, and in some cases, appeared to interact with sibling-based teasing. This teasing was associated with problem eating behaviours for adolescents.

Conclusions

There is evidence in the literature to suggest the existence of an association between ‘eating problems’ amongst adolescents and exposure to parental appearance or weight teasing. Parents are unlikely to be aware of the perception or impact of the words they use or the wider influence these words may have. Future research should employ representative longitudinal designs to develop a greater understanding of the relationships between parental communications around their adolescent’s appearance or weight and how that communication is perceived by adolescents within complex family processes.

Trial registration

PROSPERO 2018CRD42018109623. Prospectively registered 15th October 2018.
Examining the news media reaction to a national sugary beverage tax in South Africa: a quantitative content analysis
Authors: Essman Michael , Stoltze Fernanda Mediano , Carpentier Francesca Dillman , Swart Elizabeth C. , Taillie Lindsey Smith
Published: March 2021

Background

South Africa was the first sub-Saharan African country to implement a sugar-sweetened beverage (SSB) tax called the Health Promotion Levy (HPL) in April 2018. Given news media can increase public awareness and sway opinions, this study analyzed how the media represented the HPL, including expressions of support or challenge, topics associated with the levy, and stakeholder views of the HPL.

Methods

We performed a quantitative content analysis of online South African news articles related to the HPL published between January 1, 2017 and June 30, 2019. We coded the presence or absence of mentions related to health and economic effects of the HPL and HPL support or opposition. Prevalence of these mentions, overall and by source (industry, government, academics, other), were analyzed with Pearson χ2and post-hoc Fisher exact tests.

Results

Across all articles, 81% mentioned health, and 65% mentioned economics topics. 54% of articles expressed support, 26% opposition, and 20% a balanced view of the HPL. All sources except industry expressed majority support for the HPL. Health reasons were the most common justifications for support, and economic harms were the most common justifications for opposition. Statements that sugar intake is not related to obesity, the HPL will not reduce SSB intake, and the HPL will cause industry or economic harm were all disproportionately high in industry sources (92, 80, and 81% vs 25% prevalence in total sample) (p < 0.001). Statements that sugar intake is related to obesity and non-communicable diseases were disproportionately high in both government (46 and 54% vs 31% prevalence in total sample) (p < 0.001) and academics (33 and 38% vs 25% prevalence in total sample) (p < 0.05). Statements that the HPL will improve health and the HPL will reduce health care costs were disproportionately high in government (47% vs 31% prevalence in total sample) (p < 0.001) and academics (44% vs 25% prevalence in total sample) (p < 0.05), respectively.

Conclusions

Industry expressed no support for the HPL, whereas academics, government, and other sources mainly expressed support. Future studies would be improved by linking news media exposure to SSB intake data to better understand the effects news media may have on individual behavior change.
Self-reported suboptimal sleep and receipt of sleep assessment and treatment among persons with and without a mental health condition in Australia: a cross sectional study
Authors: Metse Alexandra P. , Fehily Caitlin , Clinton-McHarg Tara , Wynne Olivia , Lawn Sharon , Wiggers John , Bowman Jenny A.
Published: March 2021

Background

Poor sleep and poor mental health go hand in hand and, together, can have an adverse impact on physical health. Given the already disproportionate physical health inequities experienced by people with a mental health condition worldwide, the need to consider and optimise sleep has been highlighted as a means of improving both physical and mental health status.

Sleep recommendations recently developed by the United States’ National Sleep Foundation incorporate a range of sleep parameters and enable the identification of ‘suboptimal’ sleep. Among community-dwelling persons with and without a 12-month mental health condition in Australia, this study reports: [1] the prevalence of ‘suboptimal’ sleep and [2] rates of sleep assessment by a health care clinician/service and receipt of and desire for sleep treatment.

Methods

A descriptive study (N = 1265) was undertaken using self-report data derived from a cross-sectional telephone survey of Australian adults, undertaken in 2017.

Results

Fifteen per cent (n = 184) of participants identified as having a mental health condition in the past 12 months. Across most (7 of 8) sleep parameters, the prevalence of suboptimal sleep was higher among people with a mental health condition, compared to those without (all p < 0.05). The highest prevalence of suboptimal sleep for both groups was seen on measures of sleep duration (36–39% and 17–20% for people with and without a mental health condition, respectively). In terms of sleep assessment and treatment, people with a mental health condition were significantly more likely to: desire treatment (37% versus 16%), have been assessed (38% versus 12%) and have received treatment (30% versus 7%).

Conclusions

The prevalence of suboptimal sleep among persons with a mental health condition in Australia is significantly higher than those without such a condition, and rates of assessment and treatment are low for both groups, but higher for people with a mental health condition. Population health interventions, including those delivered as part of routine health care, addressing suboptimal sleep are needed.
Multidisciplinary programme for rehabilitation of chronic low back pain – factors predicting successful return to work
Authors: Leung Gabriel Ching Ngai , Cheung Prudence Wing Hang , Lau Gareth , Lau Sin Ting , Luk Keith Dip Kei , Wong Yat Wa , Cheung Kenneth Man Chee , Koljonen Paul Aarne , Cheung Jason Pui Yin
Published: March 2021

Background

There are no clear indicators for predicting return to work for patients with chronic low back pain (LBP). We aim to report the outcomes of a 14-week multidisciplinary programme targeting patients with chronic LBP who failed conventional physiotherapy to provide functional rehabilitation. Also, this study will identify factors predicting successful return to work (RTW).

Methods

A collected cohort of patients with chronic LBP was consecutively enrolled into the programme from 1996 to 2014. All recruited patients failed to RTW despite at least 3 months of conservative treatment. Patient underwent weekly multidisciplinary sessions with physiotherapists, occupational therapists and clinical psychologists. Patient perceived function was considered the primary outcome of the programme. Patients were assessed for their sitting, standing and walking tolerance. Oswestry Disability Index (ODI) and Spinal Function Sort Score (SFSS) were used to assess patient perceived disability.

Results

One hundred and fifty-eight patients were recruited. After the programme, statistically significant improvement was found in ODI (47.5 to 45.0, p = 0.01) and SFSS (98.0 to 109.5, p <  0.001). There was statistically significant improvement (p <  0.01) in sitting, standing, walking tolerance and straight leg raise tests. 47.4% of the patients were able to meet their work demand. Multivariate logistic regression model (R2 = 59.5%, χ2 (9) = 85.640, p <  0.001) demonstrated that lower initial job demand level and higher patient-perceived back function correlated with greater likelihood of returning to work.

Conclusion

The results of this study may support the use of this multidisciplinary programme to improve patient function and return to work.
Further understanding on osteopetrotic femoral fractures: a case report and literature review
Authors: Ding Haiqi , Chen Hongjiang , Lin Haiming , Xu Jiankun , Huang Zhonglian , Li Wensheng , Hu Jun
Published: March 2021

Background

Osteopetrosis is a genetic disease characterized by defects in osteoclast formation and function. There were a few cases of subtrochanteric femur fractures treated with dynamic hip screw (DHS) in patients with osteopetrosis, but unfortunately the healing outcome was rather poor.

Case presentation

We present our experience for treating a patient with intermediate autosomal recessive osteopetrosis (IRO) suffering from subtrochanteric femur fracture. In this case, we successfully used dynamic hip screw (DHS) internal fixation through meticulous preoperative planning and postoperative care, as well as application of surgical techniques. The patient displayed stable internal fixation with no limitation of activities during follow-up for 15 months. In addition to this case, a review of previous case reports showed an increasing number of case reports demonstrating that surgical treatment-related complications could be avoided preoperatively, intraoperatively, and postoperatively.

Conclusion

DHS for this patient, who suffered from subtrochanteric fractures with osteopetrosis, was successfully implemented. In the light of a comprehensive literature review, preoperative planning, surgical techniques, and postoperative rehabilitation care can significantly reduce the complications.
Context matters when implementing patient centred rehabilitation models for persons with cognitive impairment: a case study
Authors: McGilton Katherine S. , Cumal Alexia , Corsi Dana , Gingrich Shaen , Zheng Nancy , Escrig-Pinol Astrid
Published: March 2021

Background

There is a growing number of older adults with cognitive impairment (CI) that require inpatient rehabilitation, and as such patient centred rehabilitation models have been developed. However, implementing evidence-based models without attending to the fit of the model to the new context could lead to an unsuccessful outcome. Researchers collaborated with administrators and staff in one rural site to adapt a patient centred rehabilitation model of care in the Canadian province of Ontario. This paper reports on the contextual factors that influenced the implementation of the model of care.

Methods

The study takes a case study approach. One rural facility was purposefully selected for its interest in offering rehabilitation to persons with CI. Four focus group discussions were conducted to explore healthcare professionals’ perceptions on the contextual factors that could affect the implementation of the rehabilitation model of care in the facility. Twenty-seven professionals with various backgrounds were purposively sampled using a maximum diversity sampling strategy. A hybrid inductive-deductive approach was used to analyze the data using the Context and Implementation of Complex Interventions (CICI) Framework.

Results

Across the domains of the CICI framework, three domains (political, epidemiological, and geographical) and seven corresponding sub-domains of the context were found to have a major influence on the implementation process. Key elements within the political domain included effective teamwork, facilitation, adequate resources, effective communication strategies, and a vision for change. Within the epidemiological domain, a key element was knowing how to tailor rehabilitation approaches for persons with CI. Infrastructure, an aspect of the geographical domain, focused on the facility’s physical layout that required attention.

Conclusions

The CICI framework was a useful guide to identify key factors within the context that existed and were required to fully support the implementation of the model of care in a new environment. The findings suggest that when implementing a new program of care, strong consideration should be paid to the political, epidemiological, and geographical domains of the context and how they interact and influence one another.
Sex-specific differences in left ventricular mass and myocardial energetic efficiency in non-diabetic, pre-diabetic and newly diagnosed type 2 diabetic subjects
Authors: Succurro Elena , Miceli Sofia , Fiorentino Teresa Vanessa , Sciacqua Angela , Perticone Maria , Andreozzi Francesco , Sesti Giorgio
Published: March 2021

Background

Women with type 2 diabetes (T2DM) have a higher excess risk for cardiovascular disease (CVD) than their male counterparts. However, whether the risk for CVD is higher in prediabetic women than men is still debated. We aimed to determine whether sex-related differences exist in left ventricular mass index (LVMI), and myocardial mechano-energetic efficiency (MEEi) in with normal glucose tolerant (NGT), pre-diabetic and newly diagnosed type 2 diabetic subjects.

Methods

Sex-related differences in LVMI and myocardial MEEi, assessed by validated echocardiography-derived measures, were examined among 1562 adults with NGT, prediabetes, and newly diagnosed T2DM, defined according to fasting glucose, 2-h post-load glucose, or HbA1c.

Results

Worsening of glucose tolerance in both men and women was associated with an increase in age-adjusted LVMI and myocardial MEEi. Women with newly diagnosed T2DM exhibited greater relative differences in LVMI and myocardial MEEi than diabetic men when compared with their NGT counterparts. Prediabetic women exhibited greater relative differences in myocardial MEEi, but not in LVMI, than prediabetic men when compared with their NGT counterparts. The statistical test for interaction between sex and glucose tolerance on both LVMI (P < 0.0001), and myocardial MEEi (P < 0.0001) was significant suggesting a sex-specific association.

Conclusions

Left ventricle is subject to maladaptive changes with worsening of glucose tolerance, especially in women with newly diagnosed T2DM. The sex-specific increase in LVM and decrease in MEEi, both being predictors of CVD, may have a role in explaining the stronger impact of T2DM on the excess risk of CVD in women than in men.
Clinical profiles and quality of care of subjects with type 2 diabetes according to their cardiovascular risk: an observational, retrospective study
Authors: Pintaudi Basilio , Scatena Alessia , Piscitelli Gabriella , Frison Vera , Corrao Salvatore , Manicardi Valeria , Graziano Giusi , Rossi Maria Chiara , Gallo Marco , Mannino Domenico , Di Bartolo Paolo , Nicolucci Antonio
Published: March 2021

Background

The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 2 diabetes (T2D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care, with particular regard to cardiovascular risk factors.

Methods

The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD Annals initiative. Patients with T2D were stratified by cardiovascular risk. General descriptive indicators, measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated.

Results

Overall, 473,740 subjects with type 2 diabetes (78.5% at very high cardiovascular risk, 20.9% at high risk and 0.6% at moderate risk) were evaluated. Among people with T2D at very high risk: 26.4% had retinopathy, 39.5% had albuminuria, 18.7% had a previous major cardiovascular event, 39.0% had organ damage, 89.1% had three or more risk factors. The use of DPP4-i markedly increased as cardiovascular risk increased. The prescription of secretagogues also increased and that of GLP1-RAs tended to increase. The use of SGLT2-i was still limited, and only slightly higher in subjects with very high cardiovascular risk. The overall quality of care, as summarized by the Q score, tended to be lower as the level of cardiovascular risk increased.

Conclusions

A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction. Several actions are necessary to improve the quality of care.