bluuebunny/crossref_metadata_2025 huggingface dataset:
Methodology for integrating artificial intelligence in healthcare systems: learning from COVID-19 to prepare for Disease X
Authors: Radanliev Petar , De Roure David , Maple Carsten , Ani Uchenna
Published: October 2021

Artificial intelligence and edge devices have been used at an increased rate in managing the COVID-19 pandemic. In this article we review the lessons learned from COVID-19 to postulate possible solutions for a Disease X event. The overall purpose of the study and the research problems investigated is the integration of artificial intelligence function in digital healthcare systems. The basic design of the study includes a systematic state-of-the-art review, followed by an evaluation of different approaches to managing global pandemics. The study design then engages with constructing a new methodology for integrating algorithms in healthcare systems, followed by analysis of the new methodology and a discussion. Action research is applied to review existing state of the art, and a qualitative case study method is used to analyse the knowledge acquired from the COVID-19 pandemic. Major trends found as a result of the study derive from the synthesis of COVID-19 knowledge, presenting new insights in the form of a conceptual methodology—that includes six phases for managing a future Disease X event, resulting with a summary map of various problems, solutions and expected results from integrating functional AI in healthcare systems.
The Structural Violence Trap: Disparities in Homicide, Chronic Disease Death, and Social Factors Across San Francisco Neighborhoods
Authors: Boeck Marissa A , Wei Waverly , Robles Anamaria J , Nwabuo Adaobi I , Plevin Rebecca E , Juillard Catherine J , Bibbins-Domingo Kirsten , Hubbard Alan , Dicker Rochelle A
Published: October 2021

BACKGROUND:

On average, a person living in San Francisco can expect to live 83 years. This number conceals significant variation by sex, race, and place of residence. We examined deaths and area-based social factors by San Francisco neighborhood, hypothesizing that socially disadvantaged neighborhoods shoulder a disproportionate mortality burden across generations, especially deaths attributable to violence and chronic disease. These data will inform targeted interventions and guide further research into effective solutions for San Francisco’s marginalized communities.

STUDY DESIGN:

The San Francisco Department of Public Health provided data for the 2010–2014 top 20 causes of premature death by San Francisco neighborhood. Population-level demographic data were obtained from the US American Community Survey 2015 5-year estimate (2011–2015). The primary outcome was the association between years of life loss (YLL) and adjusted years of life lost (AYLL) for the top 20 causes of death in San Francisco and select social factors by neighborhood via linear regression analysis and heatmaps.

RESULTS:

The top 20 causes accounted for N = 15,687 San Francisco resident deaths from 2010–2014. Eight neighborhoods (21.0%) accounted for 47.9% of city-wide YLLs, with 6 falling below the city-wide median household income and many having a higher percent population Black, and lower education and higher unemployment levels. For chronic diseases and homicides, AYLLs increased as a neighborhood’s percent Black, below poverty level, unemployment, and below high school education increased.

CONCLUSIONS:

Our study highlights the mortality inequity burdening socially disadvantaged San Francisco neighborhoods, which align with areas subjected to historical discriminatory policies like redlining. These data emphasize the need to address past injustices and move toward equal access to wealth and health for all San Franciscans.
Stahl's Illustrated Antipsychotics
Authors: Stahl Stephen M. , Mignon Laurence , Muntner Nancy
Published: October 2021

All of the titles in the Stahl's Illustrated series are designed to be fun. Concepts are illustrated by full-color images that will be familiar to all readers of Stahl's Essential Psychopharmacology, 3rd Edition and The Prescriber's Guide. The texts in this user-friendly series can be supplements to figures, images and tables. The visual learner will find that these books make psychopharmacology concepts easy to master, while the non-visual learner will enjoy a shortened text version of complex psychopharmacology concepts. Within each book, each chapter builds on previous chapters, synthesizing information from basic biology and diagnostics to building treatment plans and dealing with complications and comorbidities. Novices may want to approach the Stahl's Illustrated series by first looking through all the graphics and gaining a feel for the visual vocabulary. Readers more familiar with these topics should find that going back and forth between images and text provides an interaction with which to vividly conceptualize complex pharmacologies. And, to help guide the reader toward more in-depth learning about particular concepts, each book ends with a Suggested Reading section.
The Clinical Use of Antipsychotic Plasma Levels
Authors: Meyer Jonathan M. , Stahl Stephen M.
Published: October 2021

Clinicians recognize that monitoring psychotropic levels provides invaluable information to optimize therapy and track treatment adherence, but they lack formal training specifically focused on the use of plasma antipsychotic levels for these purposes. As new technologies emerge to rapidly provide these results, the opportunity to integrate this information into clinical care will grow. This practical handbook clarifies confusing concepts in the literature on use of antipsychotic levels, providing clear explanations for the logic underlying clinically relevant concepts such as the therapeutic threshold and the point of futility, and how these apply to individual antipsychotics. It offers accessible information on the expected correlation between dosages and trough levels, and also provides a clear explanation of how to use antipsychotic levels for monitoring oral antipsychotic adherence, and methods to help clinicians differentiate between poor adherence and variations in drug metabolism. An essential resource for psychiatrists, psychiatric nurse practitioners, and mental health professionals worldwide.
Stahl's Self-Assessment Examination in Psychiatry
Authors: Stahl Stephen M.
Published: October 2021

As an excellent source of learning for prescribers specializing in psychiatry, primary care physicians, nurse practitioners, psychologists, and pharmacists, this new edition features approximately 150 questions, divided into ten core areas of psychiatry, helping you to identify areas in which you need further study. The majority of questions are new or updated in their explanations and referencing. Each question is followed by an explanation of the answer and a list of references. After completing the questions you will be better able to: diagnose patients presenting with psychiatric symptoms using accepted diagnostic standards and practices; implement evidence-based psychiatric treatment strategies aligned with the patient's recovery goals; integrate recent advances in diagnostic and treatment strategies into clinical practice according to best practice guidelines. This collection has been approved by the American Board of Psychiatry and Neurology as part of a lifelong learning and self-assessment program and as a component of maintenance of certification.
Stahl's Illustrated Antidepressants
Authors: Stahl Stephen M. , Muntner Nancy
Published: October 2021

All of the titles in the Stahl's Illustrated Series are designed to be fun. Concepts are illustrated by full-color images that will be familiar to all readers of Stahl's Essential Psychopharmacology, 3rd Edition and The Prescriber's Guide. The texts in this user-friendly series can be supplements to figures, images, and tables. The visual learner will find that these books make psychopharmacology concepts easy to master, while the non-visual learner will enjoy a shortened text version of complex psychopharmacology concepts. Within each book, each chapter builds on previous chapters, synthesizing information from basic biology and diagnostics to building treatment plans and dealing with complications and comorbidities. Novices may want to approach Stahl's Illustrated Series by first looking through all the graphics and gaining a feel for the visual vocabulary. Readers more familiar with these topics should find that going back and forth between images and text provides an interaction with which to vividly conceptualize complex pharmacologies. And, to help guide the reader toward more in-depth learning about particular concepts, each book ends with a Suggested Reading section.
Recurrent neural network for end-to-end modeling of laminar-turbulent transition
Authors: Zafar Muhammad I. , Choudhari Meelan M. , Paredes Pedro , Xiao Heng
Published: October 2021

Accurate prediction of laminar-turbulent transition is a critical element of computational fluid dynamics simulations for aerodynamic design across multiple flow regimes. Traditional methods of transition prediction cannot be easily extended to flow configurations where the transition process depends on a large set of parameters. In comparison, neural network methods allow higher dimensional input features to be considered without compromising the efficiency and accuracy of the traditional data-driven models. Neural network methods proposed earlier follow a cumbersome methodology of predicting instability growth rates over a broad range of frequencies, which are then processed to obtain the N-factor envelope, and then, the transition location based on the correlating N-factor. This paper presents an end-to-end transition model based on a recurrent neural network, which sequentially processes the mean boundary-layer profiles along the surface of the aerodynamic body to directly predict the N-factor envelope and the transition locations over a two-dimensional airfoil. The proposed transition model has been developed and assessed using a large database of 53 airfoils over a wide range of chord Reynolds numbers and angles of attack. The large universe of airfoils encountered in various applications causes additional difficulties. As such, we provide further insights on selecting training datasets from large amounts of available data. Although the proposed model has been analyzed for two-dimensional boundary layers in this paper, it can be easily generalized to other flows due to embedded feature extraction capability of convolutional neural network in the model.
Production or Consumption? Glass Beads from the Roman Villa of Aiano, Tuscany
Authors: Boschetti Cristina , Gratuze Bernard , Cavalieri Marco , Lenzi Sara , Schibille Nadine
Published: October 2021

Excavations in the Roman villa of Aiano yielded twenty glass beads, a pendant, and a glass-recycling furnace, originally interpreted as a bead workshop. This article re-assesses the evidence of bead making in light of new data obtained thanks to recent progress in archaeological glass studies. A detailed study of the typology, technology, and chemical composition of the beads clearly excludes local production. Instead, two different forming techniques, four different base glasses (Roman, HIMT, Foy 2.1 and Foy 2.1/HIMT), and numerous colouring and opacifying materials point to a well-established and extensive network of the Roman bead trade, in which Aiano evidently participated. The majority of the beads can be related to the monumentalization of the villa in the fourth to fifth century ad and represent a sample of the ornaments worn by its inhabitants.
The Swedish Covid-19 strategy and voluntary compliance: Failed securitisation or constitutional security management?
Authors: Larsson Oscar Leonard
Published: October 2021

The Covid-19 pandemic that emerged in the spring of 2020 caused severe political, social, and economic turmoil throughout the world. In spite of early warning signals from the World Health Organization, countries struggled to shape their policy responses and countermeasures for curtailing the spread of the virus while also minimising the damage that any restrictions would inflict on the health and well-being of society at large. While some countries have adopted strict regulations and extraordinary measures after declaring ‘states of exception’ and ‘national emergencies’, others have relied upon expert recommendations and individual responsibility. Sweden is viewed as having adopted one of the latter type of approaches in that it places the responsibility for social distancing upon the individual. Is this an instance of a failed ‘securitisation’ process, or rather a sensible constitutional and political response to a severe security event? This article presents an in-depth analysis of the Swedish strategy for coping with Covid-19, arguing that this case illustrates that security management in a democratic state should direct greater attention to rule following in accordance with a logic of appropriateness rather than the rule breaking envisaged by securitisation theory.
Attempted suicide rates before and during the COVID-19 pandemic: interrupted time series analysis of a nationally representative sample
Authors: Travis-Lumer Yael , Kodesh Arad , Goldberg Yair , Frangou Sophia , Levine Stephen Z.
Published: October 2021

Background

To characterize the association between the protracted biopsychosocial coronavirus disease 2019 (COVID-19) pandemic exposures and incident suicide attempt rates.

Methods

Data were from a nationally representative cohort based on electronic health records from January 2013 to February 2021 (N = 852 233), with an interrupted time series study design. For the primary analysis, the effect of COVID-19 pandemic on incident suicide attempts warranting in-patient hospital treatment was quantified by fitting a Poisson regression and modeling the relative risk (RR) and the corresponding 95% confidence intervals (CIs). Scenarios were forecast to predict attempted suicide rates at 10 months after social mitigation strategies. Fourteen sensitivity analyses were performed to test the robustness of the results.

Results

Despite the increasing trend in the unexposed interval, the interval exposed to the COVID-19 pandemic was statistically significant (p < 0.001) associated with a reduced RR of incident attempted suicide (RR = 0.63, 95% CI 0.52–0.78). Consistent with the primary analysis, sensitivity analysis of sociodemographic groups and methodological factors were statistically significant (p < 0.05). No effect modification was identified for COVID-19 lockdown intervals or COVID-19 illness status. All three forecast scenarios at 10 months projected a suicide attempt rate increase from 12.49 (7.42–21.01) to 21.38 (12.71–35.99).

Conclusions

The interval exposed to the protracted mass social trauma of the COVID-19 pandemic was associated with a lower suicide attempt rate compared to the unexposed interval. However, this trend is likely to reverse 10 months after lifting social mitigation policies, underscoring the need for enhanced implementation of public health policy for suicide prevention.
Intelligent cooperative collision avoidance via fuzzy potential fields
Authors: Choi Daegyun , Chhabra Anirudh , Kim Donghoon
Published: October 2021

This paper proposes an intelligent cooperative collision avoidance approach combining the enhanced potential field (EPF) with a fuzzy inference system (FIS) to resolve local minima and goal non-reachable with obstacles nearby issues and provide a near-optimal collision-free trajectory. A genetic algorithm is utilized to optimize parameters of membership function and rule base of the FISs. This work uses a single scenario containing all issues and interactions among unmanned aerial vehicles (UAVs) for training. For validating the performance, two scenarios containing obstacles with different shapes and several UAVs in small airspace are considered. Multiple simulation results show that the proposed approach outperforms the conventional EPF approach statistically.
Crystal structure of osimertinib mesylate Form B (Tagrisso), (C28H34N7O2)(CH3O3S)
Authors: Kaduk James A. , Boaz Nicholas C. , Markun Emma L. , Gindhart Amy M. , Blanton Thomas N.
Published: October 2021

The crystal structure of osimertinib mesylate Form B has been solved and refined using synchrotron X-ray powder diffraction data and optimized using density functional techniques. Osimertinib mesylate Form B crystallizes in space group P-1 (#2) with a = 11.42912(17), b = 11.72274(24), c = 13.32213(22) Å, α = 69.0265(5), β = 74.5914(4), γ = 66.4007(4)°, V = 1511.557(12) Å3, and Z = 2. The crystal structure is characterized by alternating layers of cation–anion and parallel stacking interactions parallel to the ab-planes. The cation is protonated at the nitrogen atom of the dimethylamino group, which forms a strong hydrogen bond between the cation and the anion. That hydrogen atom also participates in a weaker intramolecular hydrogen bond to an amino nitrogen. There are two additional N–H⋅⋅⋅O hydrogen bonds between the cation and the anion. Several C–H⋅⋅⋅O hydrogen bonds also link the cations and anions. The powder pattern has been submitted to ICDD® for inclusion in the Powder Diffraction File™.
A type- and scope-safe universe of syntaxes with binding: their semantics and proofs
Authors: ALLAIS GUILLAUME , ATKEY ROBERT , CHAPMAN JAMES , MCBRIDE CONOR , MCKINNA JAMES
Published: October 2021

The syntax of almost every programming language includes a notion of binder and corresponding bound occurrences, along with the accompanying notions of α-equivalence, capture-avoiding substitution, typing contexts, runtime environments, and so on. In the past, implementing and reasoning about programming languages required careful handling to maintain the correct behaviour of bound variables. Modern programming languages include features that enable constraints like scope safety to be expressed in types. Nevertheless, the programmer is still forced to write the same boilerplate over again for each new implementation of a scope-safe operation (e.g., renaming, substitution, desugaring, printing), and then again for correctness proofs. We present an expressive universe of syntaxes with binding and demonstrate how to (1) implement scope-safe traversals once and for all by generic programming; and (2) how to derive properties of these traversals by generic proving. Our universe description, generic traversals and proofs, and our examples have all been formalised in Agda and are available in the accompanying material available online at https://github.com/gallais/generic-syntax.
Pre-procedural CT imaging aids neonatal PDA stenting for ductal-dependent pulmonary blood flow with reduction in overall procedural morbidity
Authors: Arar Yousef , Dimas V. Vivian , Nugent Alan W. , Hussain Tarique , Kasraie Nima , Reddy Surendranath R. Veeram , Zellers Thomas M. , Herbert Carrie
Published: October 2021

Patent ductus arteriosus stenting for ductal-dependent pulmonary blood flow is a technically challenging neonatal procedure to maintain a stable pulmonary circulation. Pre-procedural computed tomography imaging aids in outlining ductal origin, insertion, size, course and curvature. Computed tomography imaging may add value to procedural outcomes and reduce overall procedural morbidity in neonatal patent ductus arteriosus stenting. We conducted a single centre retrospective chart review of neonates with ductal-dependent pulmonary blood flow who underwent patent ductus arteriosus stenting between January 1, 2014 and June 31, 2020. We compared patients variables between patients who underwent pre-procedural computed tomography imaging to those who did not. A total of 64 patients were referred for patent ductus arteriosus stenting with 33 (52%) obtaining pre-procedural computed tomography imaging. Average age [19 days; range 1–242 days (p = 0.85)] and weight [3.3 kg (range 2.2–6.0 kg; p = 0.19)] was not significantly different between the groups. A diagnosis of pulmonary atresia was made in 42 out of 64 (66%) patients prior to patent ductus arteriosus stenting. The cohort with pre-intervention computed tomography imaging had a significant reduction in the total number of access sites (1.2 versus 1.5; p = 0.03), contrast needed (5.9 versus 8.2 ml/kg; p = 0.008), fluoroscopy (20.7 versus 38.8 minutes; p = 0.02) and procedural time (83.4–128.4 minutes; p = 0.002) for the intervention. There was no significant difference in radiation burden between the groups (p = 0.35). Pre-procedural computed tomography imaging adds value by aiding interventional planning for neonatal patent ductus arteriosus stenting. A statistically significant reduction in the number of access sites, contrast exposure, as well as fluoroscopic and procedural time was noted without significantly increasing the cumulative radiation burden.
Children’s Health Care in Mass-Casualty Incidents: A Systematic Literature Review
Authors: Costa Victor S.L.P. , Stéfani Giovanna M. , Ferenhof Helio A. , Lima Fabiana S. , Cola Maíra
Published: October 2021

Objectives:

Considering the pediatric peculiarities and the difficulty of assisting this population in mass-casualty situations, this study aims to identify the main topics regarding children’s health care in mass-casualty incidents (MCIs) that are discussed in the Emergency Medicine area.

Methods:

This systematic review was performed according to the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered with the PROSPERO database of systematic reviews with the number CRD42021229552. The last update of the search in the databases was on May 27, 2021 and resulted in 45 documents to be analyzed. The inclusion criteria included the peer-reviewed academic papers in English, Portuguese, Spanish, and Italian languages; the databases used were PubMed, Scopus, MEDLINE/Bireme (Virtual Library of Health - VLH), and Web of Science, which execute the query on the topic, keywords, or abstracts. Also, to be included, documents that were available with full-text access through CAPES, Google, or Google Scholar. Books, non-academic research, and content in languages other than the presented ones were represented as exclusion criteria.

Results:

From the resulting papers, 21 articles served as the basis for this analysis. Revealed were the year of publication, the first author’s institution nationality, topic, and disaster management phase for each study, which allow other researchers to understand the main topics regarding children’s health care in MCIs.

Conclusions:

The topics regarding child’s health care in MCIs found in the primary studies of this review, in order of frequency, were: Disaster Response (including the following sub-topics: simulation, education, quality of care, use of technological tools, and damage analysis); Triage; and Disaster Planning. The Emergency Medicine operation was focused on harm reduction after the occurrence of an MCI. Further studies focusing on the pre-disaster and post-disaster phases are needed.
An Investigation of the Validity of the Edinburgh Social Cognition Test (ESCoT) in Acquired Brain Injury (ABI)
Authors: Poveda Blanca , Abrahams Sharon , Baksh R. Asaad , MacPherson Sarah E. , Evans Jonathan J.
Published: October 2021

Objectives:

Social cognition is frequently impaired following an acquired brain injury (ABI) but often overlooked in clinical assessments. There are few validated and appropriate measures of social cognitive abilities for ABI patients. The current study examined the validity of the Edinburgh Social Cognition Test (ESCoT, Baksh et al., 2018) in measuring social cognition following an ABI.

Methods:

Forty-one patients with ABI were recruited from a rehabilitation service and completed measures of general ability, executive functions and social cognition (Faux Pas; FP, Reading the Mind in the Eyes; RME, Social Norms Questionnaire; SNQ and the ESCoT). Forty-one controls matched on age, sex and years of education also performed the RME, SNQ and ESCoT.

Results:

A diagnosis of ABI was significantly associated with poorer performance on all ESCoT measures and RME while adjusting for age, sex and years of education. In ABI patients, the ESCoT showed good internal consistency with its subcomponents and performance correlated with the other measures of social cognition demonstrating convergent validity. Better Trail Making Test performance predicted better ESCoT total, RME and SNQ scores. Higher TOPF IQ was associated with higher RME scores, while higher WAIS-IV working memory predicted better FP performance.

Conclusions:

The ESCoT is a brief, valid and internally consistent assessment tool able to detect social cognition deficits in neurological patients. Given the prevalence of social cognition deficits in ABI and the marked impact these can have on an individual’s recovery, this assessment can be a helpful addition to a comprehensive neuropsychological assessment.
Visibility and Apparent Size of Néel-Type Magnetic Skyrmions in Fresnel Defocus Images of Multilayer Films
Authors: Denneulin Thibaud , Caron Jan , Müller-Caspary Knut , Boulle Olivier , Kovács András , Dunin-Borkowski Rafal E
Published: October 2021

Multilayers that comprise thin films of heavy metals and ferromagnets have been shown to host Néel-type magnetic skyrmions at room temperature. Fresnel defocus imaging in Lorentz transmission electron microscopy is a widely used technique for recording magnetic information about skyrmions. However, the visibility of Néel-type skyrmions in Fresnel defocus images is typically low, both because only a small component of their magnetic field contributes to the signal and because of the presence of diffraction contrast from the polycrystalline multilayer structure. Here, we take advantage of the out-of-plane hysteresis in such samples to record background-subtracted Fresnel defocus images. We demonstrate an improvement in magnetic signal-to-noise ratio and spatial resolution by a factor of 3 for a (Pt/Co/NiFe)×5 multilayer. We also use simulated Fresnel defocus images of Néel-type magnetic skyrmions to understand the influence of defocus on apparent skyrmion size.
The Roth score as a triage tool for detecting hypoxaemia in general practice: a diagnostic validation study in patients with possible COVID-19
Authors: ten Broeke Charlotte E.M. , Himmelreich Jelle C.L. , Cals Jochen W.L. , Lucassen Wim A.M. , Harskamp Ralf E.
Published: October 2021

Aim:

To validate the Roth score as a triage tool for detecting hypoxaemia.

Backgrounds:

The virtual assessment of patients has become increasingly important during the corona virus disease (COVID-19) pandemic, but has limitations as to the evaluation of deteriorating respiratory function. This study presents data on the validity of the Roth score as a triage tool for detecting hypoxaemia remotely in potential COVID-19 patients in general practice.

Methods:

This cross-sectional validation study was conducted in Dutch general practice. Patients aged ≥18 with suspected or confirmed COVID-19 were asked to rapidly count from 1 to 30 in a single breath. The Roth score involves the highest number counted during exhalation (counting number) and the time taken to reach the maximal count (counting time).

Outcome measures were (1) the correlation between both Roth score measurements and simultaneous pulse oximetry (SpO2) on room air and (2) discrimination (c-statistic), sensitivity, specificity and predictive values of the Roth score for detecting hypoxaemia (SpO2 < 95%).

Findings:

A total of 33 physicians enrolled 105 patients (52.4% female, mean age of 52.6 ± 20.4 years). A positive correlation was found between counting number and SpO2 (rs = 0.44, P < 0.001), whereas only a weak correlation was found between counting time and SpO2 (rs = 0.15, P = 0.14). Discrimination for hypoxaemia was higher for counting number [c-statistic 0.91 (95% CI: 0.85–0.96)] than for counting time [c-statistic 0.77 (95% CI: 0.62–0.93)]. Optimal diagnostic performance was found at a counting number of 20, with a sensitivity of 93.3% (95% CI: 68.1–99.8) and a specificity of 77.8% (95% CI: 67.8–85.9). A counting time of 7 s showed the best sensitivity of 85.7% (95% CI: 57.2–98.2) and specificity of 81.1% (95% CI: 71.5–88.6).

Conclusions:

A Roth score, with an optimal counting number cut-off value of 20, maybe of added value for signalling hypoxaemia in general practice. Further external validation is warranted before recommending integration in telephone triage.
General practitioners’ knowledge of gout and its management: a case study in Beijing
Authors: Liu Min , Gao Zhenlei , Zhang Xuelei , Yuan Xiaoxu , Lu Yuewu , Meng Juan
Published: October 2021

Background:

The incidence of gout has increased rapidly in recent years, and the suspected lack of awareness of gout among general practitioners may lead to misdiagnosis and inappropriate treatment.

Aim:

To assess general practitioners’ management of gout at community health service clinics in the Tongzhou district of Beijing, as well as the factors that contributed to optimal decision making.

Methods:

A survey based on current guidelines for assessment and management of gout was sent to 245 general practitioners at community health service clinics in the Tongzhou district of Beijing. The questionnaire included personal information of general practitioners and ten items that addressed knowledge of gout. Our questionnaire was self-administered and distributed electronically via WeChat, and data were collected on a platform called ‘Wenjuanwang’. Statistical analysis was performed using SPSS version 19.0 software.

Results:

Totally, 216 general practitioners responded to the survey. About three-quarters (71.8%) reported having received Continuing Medical Education (CME) about gout. More than half (54.6%) reported an awareness of treat to target (T2T) for gout. However, the overall rate of good understanding of gout was only 6.5%, a basic knowledge of gout was 55.6%, and understanding about gout diagnosis and treatment was only 11.1%. The general practitioners’ understanding of basic concepts related to gout indicated that CME could improve their understanding (P < 0.05). An analysis of the general practitioners’ rate of comprehension of gout diagnosis and treatment showed that education level, CME, and familiarity with T2T could improve understandings of gout diagnosis and treatment (P < 0.05).

Conclusion:

There are serious deficits in understandings about gout among general practitioners in the Tongzhou district of Beijing. Quality CME is needed to improve Chinese general practitioners’ management of gout.
The Partisanship of Protestant Clergy in the 2016 Presidential Election
Authors: Guth James L. , Smidt Corwin E.
Published: October 2021

Given their strategic position within American society, clergy continue to remain important actors in American politics. This article examines the partisan identifications and electoral behavior of American Protestant clergy in the 2016 presidential election. Although clergy partisanship may be of interest in any election, the 2016 contest, given the milieu of political polarization and the presence of the Trump candidacy, provides an intriguing context for assessing the profession's electoral behavior, particularly among Republican clergy. Based on survey results from over 2,500 clergy drawn from ten Protestant (five mainline and five evangelical) denominations, the study finds that, during the early stages of the 2016 nomination process, only a small percentage of Republican clergy supported Trump and that, despite the high level of political polarization, a sizable segment of Republican clergy resisted partisan pressures and refused to vote for Trump in the general election. The propensity of both independent and Republican clergy to vote for the GOP nominee varied largely with the level of perceived “threats”: to the Christian heritage of the nation, from Islam, and from the process of “globalization.”
The impact a Mediterranean Diet in the third trimester of pregnancy has on neonatal body fat percentage
Authors: Ashwin D. , Gibson L. , Hagemann E. , D’Vaz N. , Bear N. , Silva D.
Published: October 2021

Maternal diet during pregnancy has long been recognised as an important determinant of neonatal outcomes and child development. Infant body composition is a potentially modifiable risk factor for predicting future health and metabolic disease. Utilising the Mediterranean Diet Score, this study focused on how different levels of Mediterranean Diet adherence (MDA) in pregnancy influence body fat percentage of the infant. Information on 458 pregnant women in their third trimester of pregnancy and their infants was obtained from The ORIGINS Project. The data included MDA score, body composition measurements using infant air displacement plethysmography (PEA POD), pregnancy, and birth information. Infants born to mothers with high MDA had a body fat percentage of 11.3%, whereas infants born to mothers with low MDA had a higher body fat percentage of 13.3% (p = 0.010). When adjusted for pre-pregnancy body mass index and infant sex, a significant result remained between high vs. low MDA and infant fat mass (FM) (2.5% less FM p = 0.016). This study suggests that high MDA in pregnancy was associated with a reduced body fat percentage in the newborn. Future studies are needed to understand whether small but significant changes in FM persist throughout childhood.
The Validity of the Enns and Koch, and Berry et al. Measures of State Policy Mood: Continuing the Debate
Authors: Berry William D. , Fording Richard C. , Hanson Russell L. , Crofoot Justin K.
Published: October 2021

Enns and Koch question the validity of the Berry, Ringquist, Fording, and Hanson measure of state policy mood and defend the validity of the Enns and Koch measure on two grounds. First, they claim policy mood has become more conservative in the South over time; we present empirical evidence to the contrary: policy mood became more liberal in the South between 1980 and 2010. Second, Enns and Koch argue that an indicator’s lack of face validity in cross-sectional comparisons is irrelevant when judging the measure’s suitability in the most common form of pooled cross-sectional time-series analysis. We show their argument is logically flawed, except under highly improbable circumstances. We also demonstrate, by replicating several published studies, that statistical results about the effect of state policy mood can vary dramatically depending on which of the two mood measures is used, making clear that a researcher’s measurement choice can be highly consequential.
The Effect of Ballot Characteristics on the Likelihood of Voting Errors
Authors: Bernardo Nicholas D. , Pearson-Merkowitz Shanna , Macht Gretchen A.
Published: October 2021

In the United States, people are asked to vote on a myriad of candidates, offices, and ballot questions. The result is lengthy ballots that are time intensive and complicated to fill out. In this paper, we utilize a new analytical technique harnessing ballot scanner data from a statewide midterm election to estimate the effects of ballot complexity on voting errors. We find that increases in ballot length, increases in the number of local ballot questions, and increases in the number of candidates listed for single offices significantly increase the odds of encountering ballot marking and scanning errors. Our findings indicate that ballots’ characteristics can help election administrators make Election Day planning and resource allocation decisions that decrease ballot errors and associated wait times to vote while increasing the reliability of election results and voter confidence in the electoral process.
Ten new insights in climate science 2021: a horizon scan
Authors: Martin Maria A. , Sendra Olga Alcaraz , Bastos Ana , Bauer Nico , Bertram Christoph , Blenckner Thorsten , Bowen Kathryn , Brando Paulo M. , Rudolph Tanya Brodie , Büchs Milena , Bustamante Mercedes , Chen Deliang , Cleugh Helen , Dasgupta Purnamita , Denton Fatima , Donges Jonathan F. , Donkor Felix Kwabena , Duan Hongbo , Duarte Carlos M. , Ebi Kristie L. , Edwards Clea M. , Engel Anja , Fisher Eleanor , Fuss Sabine , Gaertner Juliana , Gettelman Andrew , Girardin Cécile A.J. , Golledge Nicholas R. , Green Jessica F. , Grose Michael R. , Hashizume Masahiro , Hebden Sophie , Hepach Helmke , Hirota Marina , Hsu Huang-Hsiung , Kojima Satoshi , Lele Sharachchandra , Lorek Sylvia , Lotze Heike K. , Matthews H. Damon , McCauley Darren , Mebratu Desta , Mengis Nadine , Nolan Rachael H. , Pihl Erik , Rahmstorf Stefan , Redman Aaron , Reid Colleen E. , Rockström Johan , Rogelj Joeri , Saunois Marielle , Sayer Lizzie , Schlosser Peter , Sioen Giles B. , Spangenberg Joachim H. , Stammer Detlef , Sterner Thomas N.S. , Stevens Nicola , Thonicke Kirsten , Tian Hanqin , Winkelmann Ricarda , Woodcock James
Published: October 2021

Non-technical summary

We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding about the remaining options to achieve the Paris Agreement goals, through overcoming political barriers to carbon pricing, taking into account non-CO2factors, a well-designed implementation of demand-side and nature-based solutions, resilience building of ecosystems and the recognition that climate change mitigation costs can be justified by benefits to the health of humans and nature alone. We consider new insights about what to expect if we fail to include a new dimension of fire extremes and the prospect of cascading climate tipping elements.

Technical summary

A synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.

Social media summary

How do we limit global warming to 1.5 °C and why is it crucial? See highlights of latest climate science.
Fibrinolytic nanocages dissolve clots in the tumor microenvironment, improving the distribution and therapeutic efficacy of anticancer drugs
Authors: Seo Junyoung , Do Yoo Jae , Kim Minseong , Shim Gayong , Oh Yu-Kyoung , Park Rang-Woon , Lee Byungheon , Kim In-San , Kim Soyoun
Published: October 2021

Fibrin, one of the components of the extracellular matrix (ECM), acts as a transport barrier within the core of tumors by constricting the blood vessels and forming clots, leading to poor intratumoral distribution of anticancer drugs. Our group previously developed a microplasmin-based thrombolytic ferritin nanocage that efficiently targets and dissolves clots without causing systemic fibrinolysis or disrupting hemostatic clots. We hypothesized that the thrombolytic nanocage-mediated degradation of fibrin clots in the tumor ECM can lead to enhanced intratumoral drug delivery, especially for nanosized anticancer drugs. Fibrin clot deposition worsens after surgery and chemotherapy, further hindering drug delivery. Moreover, the risk of venous thromboembolism (VTE) also increases. Here, we used thrombolytic nanocages with multivalent clot-targeting peptides and fibrin degradation enzymes, such as microplasmin, to dissolve fibrin in the tumor microenvironment and named them fibrinolytic nanocages (FNCs). These FNCs target tumor clots specifically and effectively. FNCs efficiently dissolve fibrin clots inside of the tumor vessels, suggesting that they can mitigate the risk of VTE in cancer patients. Coadministration of FNC and doxorubicin led to improved chemotherapeutic activity in a syngeneic mouse melanoma model. Furthermore, the FNCs increased the distribution of Doxil/doxorubicin nanoparticles within mouse tumors. These results suggest that fibrinolytic cotherapy might help improve the therapeutic efficacy of anticancer nanomedicines. Thus, microplasmin-based fibrinolytic nanocages are promising candidates for this strategy due to their hemostatic safety and ability to home in on the tumor.
Factors influencing participation and long-term commitment to self-monitoring of blood pressure in a large remote clinical trial: The treatment in morning versus evening (TIME) study
Authors: Vickneson Keeran , Rogers Amy , Anbarasan Thineskrishna , Rorie David A. , MacDonald Thomas M. , Mackenzie Isla S.
Published: October 2021

This study investigates factors associated with active participation, and long-term commitment, to home blood pressure monitoring (HBPM) in the TIME study, a remote clinical trial assessing the effectiveness of morning vs. evening dosing of antihypertensive medications on cardiovascular outcomes in adults with hypertension. Participants reporting HBPM ownership were invited to submit blood pressure (BP) measurements three-monthly. Factors associated with active participation (submitting at least one set of BP measurements), and longer-term commitment (at least six sets of BP measurements), were analysed using multivariable logistic regression. 11,059 participants agreed to provide BP measurements, of whom 7646 submitted. Active participation was associated with age (adjusted odds ratio (AOR) per decade, 1.29; 95% CI 1.23–1.36), positive family history of hypertension (AOR 1.11; 95% CI 1.01–1.21), number of antihypertensive medications (AOR, 1.10; 95% CI 1.04–1.16), and lower deprivation (AOR per decile, 1.03; 95% CI 1.01–1.05). People with higher body mass index (BMI) and smokers were less likely to participate (AOR, 0.91 (per increase of 5.0 kg/m2) and 0.63 respectively; all p < 0.001). 3,655 participants (47.8%) submitted measurements beyond one year. Non-modifiable risk factors – age (AOR per decade, 1.29; 95% CI 1.21–1.37) and positive family history of hypertension (AOR, 1.15; 95% CI 1.03–1.27) – were positively associated with longer-term commitment. Higher BMI (AOR per 5.0 kg/m2, 0.89; 95% CI 0.85–0.93), smoking (AOR 0.60, 95% CI 0.44–0.82) and higher baseline systolic blood pressure (AOR per mmHg, 0.99; 95% CI 0.98–0.99) were negatively associated. This study provides insight into factors that influence HBPM use.
Phosphoglycerate kinase 1 silencing by a novel microRNA microRNA-4523 protects human osteoblasts from dexamethasone through activation of Nrf2 signaling cascade
Authors: Liang Jin-qian , Zhou Zhen-tao , Bo Lin , Tan Hai-ning , Hu Jian-hua , Tan Ming-sheng
Published: October 2021

Nuclear-factor-E2-related factor 2 (Nrf2) cascade activation can ameliorate dexamethasone (DEX)-induced oxidative injury and death in human osteoblasts. Phosphoglycerate kinase 1 (PGK1) depletion is shown to efficiently activate Nrf2 signaling by inducing methylglyoxal modification of Kelch-like ECH-associated protein 1 (Keap1). We here identified a novel PGK1-targeting microRNA: microRNA-4523 (miR-4523). RNA fluorescent in situ hybridization, RNA pull-down, and Argonaute-2 RNA immunoprecipitation results confirmed a direct binding between miR-4523 and PGK1 mRNA in primary human osteoblasts and hFOB1.19 osteoblastic cells. Forced overexpression of miR-4523, using a lentiviral construct, robustly decreased PGK1 3′-UTR (untranslated region) luciferase activity and downregulated its expression in human osteoblasts and hFOB1.19 cells. Furthermore, miR-4523 overexpression activated the Nrf2 signaling cascade, causing Keap1–Nrf2 disassociation, Nrf2 protein stabilization, and its nuclear translocation as well as transcription activation of Nrf2-dependent genes (NQO1, GCLC, and HO1) in human osteoblasts. By expressing a UTR-null PGK1 construct, miR-4523 overexpression-induced Nrf2 cascade activation was however largely inhibited. Importantly, DEX-induced reactive oxygen species production, oxidative injury, and cell apoptosis were significantly attenuated by miR-4523 overexpression in human osteoblasts and hFOB1.19 cells. Such actions by miR-4523 were abolished by Nrf2 shRNA or knockout, but mimicked by PGK1 knockout (using CRISPR/Cas9 method). In PGK1 knockout human osteoblasts, miR-4523 overexpression failed to further increase Nrf2 cascade activation and offer osteoblast cytoprotection against DEX. Significantly, miR-4523 is downregulated in human necrotic femoral head tissues of DEX-taking patients. Together, PGK1 silencing by miR-4523 protected human osteoblasts from DEX through activation of the Nrf2 signaling cascade.
Cryo-EM structure of human Pol κ bound to DNA and mono-ubiquitylated PCNA
Authors: Lancey Claudia , Tehseen Muhammad , Bakshi Souvika , Percival Matthew , Takahashi Masateru , Sobhy Mohamed A. , Raducanu Vlad S. , Blair Kerry , Muskett Frederick W. , Ragan Timothy J. , Crehuet Ramon , Hamdan Samir M. , De Biasio Alfredo
Published: October 2021

Y-family DNA polymerase κ (Pol κ) can replicate damaged DNA templates to rescue stalled replication forks. Access of Pol κ to DNA damage sites is facilitated by its interaction with the processivity clamp PCNA and is regulated by PCNA mono-ubiquitylation. Here, we present cryo-EM reconstructions of human Pol κ bound to DNA, an incoming nucleotide, and wild type or mono-ubiquitylated PCNA (Ub-PCNA). In both reconstructions, the internal PIP-box adjacent to the Pol κ Polymerase-Associated Domain (PAD) docks the catalytic core to one PCNA protomer in an angled orientation, bending the DNA exiting the Pol κ active site through PCNA, while Pol κ C-terminal domain containing two Ubiquitin Binding Zinc Fingers (UBZs) is invisible, in agreement with disorder predictions. The ubiquitin moieties are partly flexible and extend radially away from PCNA, with the ubiquitin at the Pol κ-bound protomer appearing more rigid. Activity assays suggest that, when the internal PIP-box interaction is lost, Pol κ is retained on DNA by a secondary interaction between the UBZs and the ubiquitins flexibly conjugated to PCNA. Our data provide a structural basis for the recruitment of a Y-family TLS polymerase to sites of DNA damage.
Boride-derived oxygen-evolution catalysts
Authors: Wang Ning , Xu Aoni , Ou Pengfei , Hung Sung-Fu , Ozden Adnan , Lu Ying-Rui , Abed Jehad , Wang Ziyun , Yan Yu , Sun Meng-Jia , Xia Yujian , Han Mei , Han Jingrui , Yao Kaili , Wu Feng-Yi , Chen Pei-Hsuan , Vomiero Alberto , Seifitokaldani Ali , Sun Xuhui , Sinton David , Liu Yongchang , Sargent Edward H. , Liang Hongyan
Published: October 2021

Metal borides/borates have been considered promising as oxygen evolution reaction catalysts; however, to date, there is a dearth of evidence of long-term stability at practical current densities. Here we report a phase composition modulation approach to fabricate effective borides/borates-based catalysts. We find that metal borides in-situ formed metal borates are responsible for their high activity. This knowledge prompts us to synthesize NiFe-Boride, and to use it as a templating precursor to form an active NiFe-Borate catalyst. This boride-derived oxide catalyzes oxygen evolution with an overpotential of 167 mV at 10 mA/cm2 in 1 M KOH electrolyte and requires a record-low overpotential of 460 mV to maintain water splitting performance for over 400 h at current density of 1 A/cm2. We couple the catalyst with CO reduction in an alkaline membrane electrode assembly electrolyser, reporting stable C2H4 electrosynthesis at current density 200 mA/cm2 for over 80 h.