bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with the breastfeeding intention
Authors: Marín Leal A , Villegas Domínguez J , Rodriguez Gonzalez RD , Sanchez Rodriguez A , Márquez Celedonio FG
Published: October 2021

Background

In Mexico, 47.7% of newborns are breastfed within the first hour of life and 28.6% are exclusively breastfed until 6 months of age, which does not meet the WHO definition of successful breastfeeding. Attitudes are expressed through beliefs, emotions and intentions wich represent a link between attitude and behavior, that is, a strong predictor of behavior.

Objetive: to determine the factors associated with the intention of breastfeeding in womeńs next pregnancy.

Methods

A cross-sectional, prospective, observational and comparative study was carried out. Women between 18 and 35 years old, residents from Veracruz in Mexico, were between July and December 2020. Virtual surveys were applied through social networks, using a non-probabilistic sampling, evaluating knowledge about breastfeeding through the application of the ‘Breastfeeding knowledge questionnaire' (Cronbach's Alpha 0.722) and social characteristics were also recorded.

Results

1241 participants were included, with a mean age of 22.1 (± 3.5) years. The prevalence of the intention to exclusively breastfeed was 41.2%; the factors that registered a positive association for the intention to grant exclusive breastfeeding were the age between 18 and 25 years (OR 2.0 95%IC 1.4-2.9), high knowledge (OR 2.0 IC95%1.3-2.9), being single (OR 3.7, CI95% 2.4-5.6), studyng high school (OR 1.3, 95%CI 1.05-1.7), being students (OR 2.2, 95%CI 1.7-2.8), have medical service through social security (OR 1.4, 95%CI 1.1-1.7), know what is a breastfeeding room (OR 1.9 95%CI 1.5-2.4), as well as know different points of the law in support of lactation had OR values higher than 1, with p values <0.05 in all cases.

Conclusions

Age, knowledge about breastfeeding, marital status, scholarship, occupation, having medical attention for social security, not having children, knowing the legal aspects about breastfeeding in Mexico and knowing the concept of breastfeeding room are associated with the intention to exclusively breastfeed.

Key messages

Women who receive medical care in the public health system increase their intention to exclusively breastfeed in their next pregnancy. High knowledge about breastfeeding, the laws that support it, being young, single, and knowing what abreastfeeding room is all favor the intentions of giving exclusive breastfeeding.
Underestimation of energy intake in overweight siberian adolescents
Authors: Berezovikova I , Denisova D , Shcherbakova L
Published: October 2021

Background

According to some epidemiological studies, in the Russian Federation the prevalence of overweight in children in different regions of Russia is from 5.5 to 11.8%. The purpose of this study was to evaluate the nutrition of Siberian adolescents with different weight status.

Methods

A cross-sectional population survey (2019) was conducted on a random representative sample of schoolchildren aged 14-18 years of both sexes, 612 people were examined: 249 boys (40.9%), 360 girls (59.1%). To assess levels of overweight and obesity IOTF cut offs were used. The basal metabolic rate (BMR) was calculated using formulas proposed by FAO/WHO/ONU. For evaluation of misreporting of energy intake the equations, proposed by Goldberg G.R. et al were applied to derive cut-offs. Reported Energy Intake should be calculated as average value based on EI estimated for each of non-consecutive days applying 24-h dietary recall. Under-reporters energy intake estimate if EI/BMR < 0,97 for boys and <0,95 for girls.

Results

The prevalence of overweight and obesity among adolescents in Novosibirsk was 22.1% in boys and 14.4% in girls. Quotas of fat energy in general, saturated fatty acids, easily digestible sugars exceed recommended levels in all weight status groups. The fiber content was below the recommended level by more than 2 times. Above 80% of overweight adolescents underestimate energy intake. Percent of under-reporting of energy intake in boys was 45,8% in underweight group; 48,6% in normal weight group; 80,6% in overweight group. In girls - 26,8%, 54,1% and 85,1%, respectively.

Conclusions

Overweight adolescents exceeded the energy of fat, saturated fatty acids, added sugar, protein in the total energy intake. A low intake of total carbohydrates, vegetable protein, and dietary fiber was noted.

Supported by grant No. 19-013-00800 of RFBR.

Key messages

Above 80% of overweight adolescents underestimate energy intake. The results presented that nutritional corrections requires both adolescents with overweight and obesity, as well as with normal weight.
Mother's hesitancy of vaccinating their children in Japan – Text analysis survey
Authors: Tanaka Y , Tsuchiya Y
Published: October 2021

Background

the world is facing a novel coronavirus pandemic, and the role of vaccination and vaccination acceptance is playing an important role under current vaccination deployment. Japan's vaccination system has progressed these days greatly; however, the non-mandatory vaccination rate for children such as mumps, influenza is still low due to mothers' hesitancy. Given this circumstance, we conducted a qualitative analysis using text analysis methods for Japanese mothers with children about their hesitancy to vaccinate their children in Japan.

Methods

We used the data of a questionnaire survey first conducted in 2012, where two hundred and twenty-six mothers participated with an average age of 44.7 years (SD ± 5.02). The questionnaire included open-ended questions, where mothers wrote their opinion freely about vaccination about their children. We conducted text analysis focusing on the keywords of ‘hesitancy' (IBM SPSS Text Analytics for Surveys 4.0).

Results

The keywords that extracted frequently included; vaccination (n = 160), hesitancy (n = 66), difficulty in access to vaccination (n = 57), knowledge/information scarcity (n = 31), fear for side effect (n = 30), complexity of vaccination schedule (n = 23) and government subsidies (n = 20). The most related keyword with hesitancy was; side effect (n = 20), expensive cost (n = 12), and non-mandatory (n = 10). A keyword of having natural immunity was also closely connected (n = 8).

Discussion and Conclusions

To ameliorate hesitancy among mothers against vaccination of their children, local government notification and subsidy as mandatory vaccination, providing the correct information about diseases and side effects of vaccinations would work as plus factors.

Key messages

For pandemic preparedness, it is necessary to research vaccine acceptance among children. This research is to explore vaccine hesitancy among mothers and factors related to their unwillingness.
Mental health needs assessment in the time of covid-19 pandemic: the Delphi study based consensus
Authors: Makivić I , Selak Š , Švab V
Published: October 2021

Backgrounds

The COVID-19 pandemic affected mental health of population around the world. To be able to address mental health field effectively evidence based solutions through needs assessment with inclusion of all stakeholders - politicians, service providers, users and caregivers is needed.

Methods

The first group of priority activities was listed within two professional groups. Additional 129 participants of all stakeholder groups were invited to participate in the Delphi study consequently. After the first round activities were meaningfully formed into set of activities. In the second round, participants rated the importance on a scale of 1 to 5 (5 means very important activity).

Results

Among the participants in the Delphi study (response rate 37.9%), half of them were professionals and the other half equally distributed among policy- or decision-makers and services' users or carers. The average score of activities was 4.3 (important) with high consensus level (84.3%). The study provided a list of important activities including COVID 19 pandemic in Slovenia recognised in the system and service levels. These are single entry point, establishment of appropriate and accessible psychological assistance to most exposed individuals and to infected ones, continuously implemented destigmatization campaigns, regular consultations among professionals in health, social and educational services also for needs assessment, strengthened services addressing domestic violence, strengthen advocacy and representation services for people with mental health disorders and others.

Conclusions

The Delphi study provided consensus based list of activities at the system and service levels, important in the time of COVID-19 epidemics that are in line with international standards. These measures are also in line with several already launched preventive measures in Slovenia that were established also regarding detected needs.

Work was supported by Slovenian Research Agency, project No.: Z3-2652.

Key messages

Delphi study achieved civil society’s influence and co-design of emergency activities. According to recognized needs establishment of additional services is needed, especially for vulnerable groups.
Wellbeing and anxiety among students during COVID-19 crisis: results from an initial survey in Israel
Authors: Bashkin O , Faingersch E , Abramov L , Shapovalov N
Published: October 2021

Background

The COVID-19 crisis that has burdened the world for the past year posed a life threat and caused psychological implications for public well-being. Well-being is an essential element of mental health that affects learning and productivity. Students are vulnerable to suffering from low well-being and developing mental problems caused by various stressors such as the ongoing COVID-19 health crisis. In addition, the spread of the epidemic, quarantine requirements, and the delayed academic year have had significant psychological impacts on students. The purpose of the study was to evaluate anxiety and well-being among college students at the end of the first year of the COVID-19 epidemic.

Methods

On January 2021, during the third lockdown in Israel, 366 college students responded to an online survey that included demographics, 7-item Generalized Anxiety Disorder Scale (GAD-7), and a 14-item Mental Health Continuum-Short Form (MHC-SF) measuring emotional, psychological, and social well-being.

Results

Findings revealed low self-rated well-being compared to the general population. The mean anxiety level was 8.89. 39% showed moderate to severe anxiety. Negative correlations were found between anxiety and well-being. Women expressed low levels of well-being and higher anxiety compared to men. A regression model showed that students living with parents diagnosed with Covid-19 and having low emotional well-being are at risk of suffering from anxiety (R2=0.32, F = 53, p < 0.001).

Conclusions

The mental health of college students is significantly affected by the pandemic, therefore should be monitored and requires attention:

Further investigation of factors influencing mental health and well-being of students. Detecting students with a higher risk of developing mental health problems and providing timely psychological support. Develop initiatives to raise awareness among students and interventions to prevent negative implications of the COVID-19 crisis on mental health.

Key messages

Students report low well-being and show high risk of developing anxiety disorder during COVID-19 crisis. It is crucial to detect students with a higher risk of developing mental health problems and provide timely psychological support.
Contribution of Postjunctional M2 Muscarinic Receptors to Cholinergic Nerve-Mediated Contractions of Murine Airway Smooth Muscle
Authors: Alkawadri Tuleen , McGarvey Lorcan P , Mullins N D , Hollywood Mark A , Thornbury Keith D , Sergeant Gerard P
Published: October 2021

Postjunctional M2Rs on airway smooth muscle (ASM) outnumber M3Rs by a ratio of 4:1 in most species, however, it is the M3Rs that are thought to mediate the bronchoconstrictor effects of acetylcholine. In this study, we describe a novel and profound M2R-mediated hypersensitization of M3R-dependent contractions of ASM at low stimulus frequencies.. Contractions induced by 2Hz EFS were augmented by > 2.5-fold when the stimulus interval was reduced from 100 to 10 s. This effect was reversed by the M2R antagonists, methoctramine, and AFDX116, and was absent in M2R null mice. The M3R antagonist 4-DAMP abolished the entire response in both WT and M2R KO mice. The M2R-mediated potentiation of EFS-induced contractions was not observed when the stimulus frequency was increased to 20 Hz. A subthreshold concentration of carbachol enhanced the amplitude of EFS-evoked contractions in WT, but not M2R null mice. These data highlight a significant M2R-mediated potentiation of M3R-dependent contractions of ASM at low frequency stimulation that could be relevant in diseases such as asthma and COPD.
Cost–Benefit Analysis of the COPE Program for Persons Living With Dementia: Toward a Payment Model
Authors: Pizzi Laura T , Jutkowitz Eric , Prioli Katherine M , Lu Ember (Yiwei) , Babcock Zachary , McAbee-Sevick Heather , Wakefield Dorothy B , Robison Julie , Molony Sheila , Piersol Catherine V , Gitlin Laura N , Fortinsky Richard H
Published: October 2021

Background and Objectives

There is a critical need for effective interventions to support quality of life for persons living with dementia and their caregivers. Growing evidence supports nonpharmacologic programs that provide care management, disease education, skills training, and support. This cost–benefit analysis examined whether the Care of Persons with Dementia in their Environments (COPE) program achieves cost savings when incorporated into Connecticut’s home- and community-based services (HCBS), which are state- and Medicaid-funded.

Research Design and Methods

Findings are based on a pragmatic trial where persons living with dementia and their caregiver dyads were randomly assigned to COPE with HCBS, or HCBS alone. Cost measures included those relevant to HCBS decision makers: intervention delivery, health care utilization, caregiver time, formal care, and social services. Data sources included care management records and caregiver report.

Results

Per-dyad mean cost savings at 12 months were $2 354 for those who received COPE with a mean difference-in-difference of −$6 667 versus HCBS alone (95% CI: −$15 473, $2 734; not statistically significant). COPE costs would consume 5.6%–11.3% of Connecticut’s HCBS annual spending limit, and HCBS cost-sharing requirements align with participants’ willingness to pay for COPE.

Discussion and Implications

COPE represents a potentially cost-saving dementia care service that could be financed through existing Connecticut HCBS. HCBS programs represent an important, sustainable payment model for delivering nonpharmacological dementia interventions such as COPE.
Crust and upper-mantle seismic anisotropy variations from the coast to inland in central and Southern Mexico (2): correlations with tectonic tremor
Authors: Husker Allen , Castellanos Jorge C , Pérez-Campos Xyoli , Valenzuela Raúl W , Frank William B
Published: October 2021

Seismic anisotropy in the flat slab region of Mexico is compared with tectonic tremor (TT) activity. The anisotropy is observed in three separate horizontal layers using a novel technique with receiver functions. Those layers are identified as the continental crust and the subducted flat oceanic slab and a thin (∼10 km thick) remnant mantle wedge between those two layers. The TT is located in two zones: (1) the Sweet Spot where most of the tremor is observed (∼160–180 km from the coast) and (2) the Transient Zone (∼80–110 km from the coast). Anisotropy within each layer is observed to be different within each of the tremor zones than just outside them. The changes are explained as due to hydration within those zones. Water releasing phase changes have previously been modelled to occur within those two zones in the subducted slab (Manea & Manea). Water rising through each of the layers should generate the observed differences in anisotropy in those zones as the fast polarization direction and split times can differ between dry and hydrated material. This observation also correlates with the many observations of high pore fluid pressure associated with TT.
Implementation of in vitro glycoengineering of monoclonal antibodies into downstream processing of industrial production
Authors: Malik Sebastian , Grunert Ingrid , von Roman Matthias Freiherr , Walch Heiko , Dams Thomas , Thomann Marco , Falkenstein Roberto
Published: October 2021

In vitro glycoengineering using exoenzymes for specific modification is recognized as appropriate method to tailor sugar moieties of glycan structures during the recombinant production of monoclonal antibodies (mAbs). This report describes enhanced in vitro glycoengineering approaches using β1,4-galactosyltransferase and α2,6-sialyltransferase to improve the efficiency of galactosylation and sialylation with the aim to implement in vitro glycoengineering into common mAb purification processes. Feasibility studies tested the potential of different in vitro glycoengineering protocols (two-step vs. one-step) to facilitate the overall procedure. Scalability of the reactions was demonstrated for mAb amounts ranging from 1 mg to 1 g. Additionally, the reactions of β1,4-galactosyltransferase and α2,6-sialyltransferase were shown to work on column during affinity chromatography using Protein A or KappaSelect, the latter providing more efficient galactosylation and sialylation of IgG1 and IgG4 mAbs. Performing in vitro glycoengineering on column enabled the use of cell culture harvest that yielded results comparable to those of purified bulk. Based thereon, an optimized two-step mixed mode approach was found most appropriate to integrate in vitro glycoengineering of the IgG1 mAb into the overall manufacturing process. Using harvest for on-column reaction of β1,4-galactosyltransferase combined with in-solution reaction of α2,6-sialyltransferase, this approach yielded 100% biantennary galactosylation and 61% biantennary sialylation. Moreover, the enzymes applied in in vitro glycoengineering could be separated, recycled and reused in further reactions to improve economic efficiency. Overall, the study provides a toolbox for in vitro glycoengineering and presents an optimized easy-to-handle workflow to implement this method into the downstream processing of industrial mAb production.
Breaking the “Virtuous Circle”: How Partisan Communication Flows Can Erode Social Trust but Drive Participation
Authors: Suk Jiyoun , Shah Dhavan V , McLeod Douglas M
Published: October 2021

We examine how individuals’ interactions with the shifting contemporary communication ecology—either by seeking information selectively from partisan sources or immersing themselves in a broad range of partisan communications — relate to shifting levels of social trust and online engagement. Using national panel surveys of young adults (i.e., millennials age 18–34) collected over the 2016 U.S. presidential election, we find that individuals’ partisan communication flows—calculated by algorithmically combining patterns of news consumption, social media use, and political talk—explain: (a) polarized shifts in levels of trust towards people of other nationalities, religions, races, and ethnicities and (b) increases in levels of online political engagement. By elaborating the relationship between citizens’ communication patterns and their levels of trust and participation, this research forces a reconsideration of theoretical traditions in the field of communication, especially those linking mass and interpersonal processes in the study of social capital.
10. Privacy, Personality, and Publicity
Authors: Aplin Tanya , Davis Jennifer
Published: October 2021

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. This chapter examines the protection of privacy, personality, and publicity interests. It considers: the law of privacy and the extent to which individuals can control the use or disclosure of their personal and private information; character and personality merchandising and the ways in which the law of registered and unregistered trade marks protects these interests; and the controversial question of whether individuals can and should be able to prevent the commercial exploitation of their personality and image through a separate publicity right.
11. Patents I: Justifications, Registration, Patentable Subject Matter, and Industrial Application
Authors: Aplin Tanya , Davis Jennifer
Published: October 2021

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. This chapter begins with an overview of the history of UK patent law. It then discusses: justifications in support of patent rights; sources of patent law; obtaining a patent; patentable subject matter; exclusions from patentability relevant to biotechnological inventions (e.g. plant and animal varieties and non-microbiological processes for their production; software and business methods; and inventions that are contrary to ordre public or morality); industrial application requirements for patentability; and methods of medical and veterinary treatment.
A heuristic model for health-related autonomy based on health promotion ideas: the ‘Health–Autonomy Interaction Model’
Authors: Farinatti Paulo
Published: October 2021

Autonomy and health are central concepts in health promotion literature. Operational frameworks explaining their relationship are important to support health-related autonomy actions. This study presents a heuristic model describing the ‘health–autonomy relationship’ based on health promotion ideas, particularly Antonovsky’s and Nordenfeldt’s works. Central to the ‘Health–Autonomy Interaction Model’ is the existence of inter-related dimensions of autonomy: thought, intention and action, all influenced by negative and positive factors of physical and social environments (extrinsic factors) and personal resources to cope with life needs (intrinsic factors). Intrinsic factors comprise elements often included in definitions of negative (ill-health) and positive health (well-being and fitness), therefore establishing a bridge between conceptions of health and autonomy. Unique to this biopsychosocial framework is the differentiation between the potential for being autonomous and the degree of autonomy effectively achieved—the potential autonomy reflects the individual set of abilities to accomplish any task, while the expressed autonomy results from the extent to which this satisfies the demands of the environment and vital goals. Conceptualizing autonomy in this manner highlights that it is a multi-factorial capability referred to external conditions, reflecting a cluster of abilities to be and do things indicative of a self-empowered life. Concluding, our model moves the concept of health-related autonomy from a focus on ‘disease’ and ‘incapacity’ to a broader view in which the meaning of ‘capacity’ depends on the achievement of ‘self-fulfillment’ in given circumstances. The notion of autonomy is regarded as a precondition for health and an essential priority in health promotion.
Temperature-dependent effects on fecundity in a serial broadcast spawning fish after whole-life high CO2 exposure
Authors: Concannon Callie A , Cross Emma L , Jones Lucas F , Murray Christopher S , Matassa Catherine M , McBride Richard S , Baumann Hannes
Published: October 2021

Experiments examining fish sensitivities to future oceanic CO2 levels have greatly expanded over past decades and identified many potentially affected traits. Curiously, data on reproductive trait responses to high CO2 are still scarce, despite their strong link to Darwinian fitness and thus to population vulnerability to ocean acidification. We conducted two rearing experiments on the first broadcast-spawning marine fish model (Atlantic silverside, Menidia menidia) to examine how long-term and novel whole life-cycle exposures to predicted future CO2 levels (∼2,000 µatm) affect laboratory spawning, temperature-specific reproductive investment, fecundity, and size distributions of maturing oocytes. At low temperatures (17°C), female body size and therefore potential fecundity (FPot, oocytes/female) slightly increased with CO2, while relative fecundity (FRel, oocytes/g female) remained unaffected. At high temperatures (24°C), high CO2 substantially reduced both FPot (−19%) and FRel (−28%) relative to control treatments. Irrespective of CO2, females at 24°C grew larger and heavier than those at 17°C, and although larger females produced larger oocytes at some developmental stages, they also had lower gonadosomatic indices and lower FRel. Our findings contrast with most previous studies and thus highlight the need to investigate reproductive impacts of increasing CO2 on multiple fish species with contrasting life history strategies.
Phi thickenings in Brassica oleracea roots are induced by osmotic stress and mechanical effects, both involving jasmonic acid
Authors: Aleamotuʻa Maketalena , Baker Jaime K , McCurdy David W , Collings David A
Published: October 2021

Phi thickenings are peculiar secondary cell wall thickenings found in radial walls of cortical cells in plant roots. However, while thickenings are widespread in the plant kingdom, research into their development has been lacking. Here, we describe a simple system for rapid induction of phi thickenings in primary roots of Brassica. Four-day-old seedlings were transferred from control agar plates to new plates containing increased levels of osmotica. Phi thickening development occurred within a narrow region of the differentiation zone proportional to osmolarity, with cellulose deposition and lignification starting after 12h and 15h, respectively. However, osmoprotectants not only failed to induce phi thickenings, but inhibited induction when tested in combination with thickening-inducing osmotica. An independent, biomechanical pathway exists regulating phi thickening induction, with root growth rates and substrate texture being important factors in determining thickening induction. Phi thickening development is also controlled by stress-related plant hormones, most notably jasmonic acid, but also abscisic acid. Our research not only provides the first understanding of the developmental pathways controlling phi thickening induction, but also provides tools with which the functions of these enigmatic structures might be clarified.
Aspergillosis: Emerging risk groups in critically ill patients
Authors: Kluge Stefan , Strauß Richard , Kochanek Matthias , Weigand Markus A , Rohde Holger , Lahmer Tobias
Published: October 2021

Information on invasive aspergillosis (IA) and other invasive filamentous fungal infections is limited in non-neutropenic patients admitted to the intensive care unit (ICU) and presenting with no classic IA risk factors. This review is based on the critical appraisal of relevant literature, on the authors' own experience and on discussions that took place at a consensus conference. It aims to review risk factors favoring aspergillosis in ICU patients, with a special emphasis on often overlooked or neglected conditions. In the ICU patients, corticosteroid use to treat underlying conditions such as chronic obstructive pulmonary disease (COPD), sepsis, or severe COVID-19, represents a cardinal risk factor for IA. Important additional host risk factors are COPD, decompensated cirrhosis, liver failure, and severe viral pneumonia (influenza, COVID-19). Clinical observations indicate that patients admitted to the ICU because of sepsis or acute respiratory distress syndrome are more likely to develop probable or proven IA, suggesting that sepsis could also be a possible direct risk factor for IA, as could small molecule inhibitors used in oncology. There are no recommendations for prophylaxis in ICU patients; posaconazole mold-active primary prophylaxis is used in some centers according to guidelines for other patient populations and IA treatment in critically ill patients is basically the same as in other patient populations. A combined evaluation of clinical signs and imaging, classical biomarkers such as the GM assay, and fungal cultures examination, remain the best option to assess response to treatment.

Lay summary

The use of corticosteroids and the presence of co-morbidities such as chronic obstructive pulmonary disease, acute or chronic advanced liver disease, or severe viral pneumonia caused by influenza or Covid-19, may increase the risk of invasive aspergillosis in intensive care unit patients.
First extragalactic measurement of the turbulence driving parameter: ALMA observations of the star-forming region N159E in the Large Magellanic Cloud
Authors: Sharda Piyush , Menon Shyam H , Federrath Christoph , Krumholz Mark R , Beattie James R , Jameson Katherine E , Tokuda Kazuki , Burkhart Blakesley , Crocker Roland M , Law Charles J , Seta Amit , Gaetz Terrance J , Pingel Nickolas M , Seitenzahl Ivo R , Sano Hidetoshi , Fukui Yasuo
Published: October 2021

Studying the driving modes of turbulence is important for characterizing the impact of turbulence in various astrophysical environments. The driving mode of turbulence is parameterized by b, which relates the width of the gas density PDF to the turbulent Mach number; b ≈ 1/3, 1, and 0.4 correspond to driving that is solenoidal, compressive, and a natural mixture of the two, respectively. In this work, we use high-resolution (sub-pc) ALMA 12CO (J = 2–1), 13CO (J = 2–1), and C18O (J = 2–1) observations of filamentary molecular clouds in the star-forming region N159E (the Papillon Nebula) in the Large Magellanic Cloud (LMC) to provide the first measurement of turbulence driving parameter in an extragalactic region. We use a non-local thermodynamic equilibrium (NLTE) analysis of the CO isotopologues to construct a gas density PDF, which we find to be largely log-normal in shape with some intermittent features indicating deviations from lognormality. We find that the width of the log-normal part of the density PDF is comparable to the supersonic turbulent Mach number, resulting in b ≈ 0.9. This implies that the driving mode of turbulence in N159E is primarily compressive. We speculate that the compressive turbulence could have been powered by gravo-turbulent fragmentation of the molecular gas, or due to compression powered by H I1.2ex flows that led to the development of the molecular filaments observed by ALMA in the region. Our analysis can be easily applied to study the nature of turbulence driving in resolved star-forming regions in the local as well as the high-redshift Universe.
COVID-19 in patients with Behçet’s disease: Outcomes and rate of Behçet’s exacerbations in a retrospective cohort
Authors: Polat Bünyamin , Erden Abdulsamet , Güven Serdar Can , Armağan Berkan , Karakaş Özlem , Özdemir Bahar , Apaydın Hakan , Usul Eren , Ateş İhsan , Küçükşahin Orhan , Omma Ahmet
Published: October 2021

Objectives

The aim of this study is to investigate the outcomes of coronavirus disease 2019 (COVID-19) in our cohort of Behçet’s disease (BD) patients and to reveal the rate of BD exacerbations due to COVID-19.

Methods

Patients who have been followed with a diagnosis of BD were retrospectively investigated for a positive severe acute respiratory syndrome–coronavirus 2 polymerized chain reaction (PCR) test. Data regarding demographics, clinical features and COVID-19 outcomes were collected from medical records for patients with a positive PCR. PCR-positive patients were reached via phone numbers, and ‘Behçet’s Disease Current Activity Form’ (BDCAF) scores for pre- and post-COVID-19 BD symptoms were calculated.

Results

Out of a total 648 BD patients, 59 were detected to have a positive PCR test. Three of the 59 patients (5.0%) were found to be hospitalized, none of them was admitted to the ICU or died. An increasing trend in the frequency of comorbid diseases and older age was observed in hospitalized patients. 32.2% of BD patients suffered from exacerbation of at least one symptom related to BD.

Conclusions

We observed no ICU admission or mortality with COVID-19 in our BD patient cohort. A substantial number of patients suffered from exacerbation of BD symptoms.
Impact of age on the efficacy and safety of peficitinib (ASP015K) for the treatment of rheumatoid arthritis
Authors: Tanaka Yoshiya , Takeuchi Tsutomu , Kato Daisuke , Kaneko Yuichiro , Fukuda Musashi , Miyatake Daisuke
Published: October 2021

Objectives

To evaluate peficitinib efficacy and safety in Asian patients with rheumatoid arthritis (RA), stratified by age (≥20–<50, ≥50–<65, and ≥65 years).

Methods

Efficacy data from two Phase 3 studies were analysed. Safety data from one Phase 2, two Phase 3, and one open-label extension study were pooled. Incidence rates per 100 patient-years of adverse events of special interest were calculated, and Cox proportional hazard analysis was conducted.

Results

1052 patients received peficitinib for 2 years (median). Peficitinib demonstrated efficacy improvements versus placebo across all age categories. Incidence rates (95% confidence interval) per 100 patient-years for ≥20–<50, ≥50–<65, and ≥65 years were 0.8 (0.4, 1.9), 2.6 (1.8, 3.7), and 4.7 (3.1, 7.0) for serious infections and 3.7 (2.5, 5.4), 6.4 (5.0, 8.2), and 11.2 (8.5, 14.7) for herpes zoster–related disease, respectively. Twenty patients reported malignancies in pooled Phase 2/3 studies. Incidences of serious infections and herpes zoster–related disease increased significantly with age, but there was no association with baseline estimated glomerular filtration rate.

Conclusions

Peficitinib was efficacious in adult Asian RA patients of all ages. Age, but not estimated glomerular filtration rate, was associated with serious infections and herpes zoster–related disease, demonstrating the importance of an appropriate RA treatment strategy in older patients.
High incidence of serious infections requiring hospitalisation in human T-cell leukaemia virus type 1-positive rheumatoid arthritis: A case-controlled observational study
Authors: Hashiba Yayoi , Umekita Kunihiko , Kimura Masatoshi , Iwao Chihiro , Iwao Kosho , Kariya Yumi , Kubo Kazuyoshi , Miyauchi Shunichi , Kudou Risa , Rikitake Yuki , Kawaguchi Takeshi , Matsuda Motohiro , Takajo Ichiro , Inoue Eisuke , Hidaka Toshihiko , Okayama Akihiko
Published: October 2021

Objectives

We aimed to assess the clinical features of human T-cell leukaemia virus type 1 (HTLV-1)-positive rheumatoid arthritis (RA) patients. Furthermore, we investigated the impact of HTLV-1 infection on incidences of serious infections requiring hospitalisation (SIH) and malignancies.

Methods

A total of 150 sex- and age-matched HTLV-1-negative and 50 HTLV-1-positive RA patients were enrolled from the HTLV-1 RA Miyazaki Cohort Study. Clinical and laboratory data were collected from this cohort database. The incidence rate (IR) for SIH and malignancies from 2015 to 2020 was analysed.

Results

The median age and female ratio in the study population were 70 years old and 80%, respectively. Although no differences were found in inflammatory marker values between the two groups, the patient global assessment and Health Assessment Questionnaire scores were higher in HTLV-1-positive RA patients. In HTLV-1-negative RA patients, the IR for SIH was 6.37/100 person-years (PY) and 1.32/100 PY for malignancies. In HTLV-1-positive RA patients, SIH occurred in 11.1/100 PY and malignancies in 2.46/100 PY. The crude IR ratio comparing SIH between two groups was 1.74 (95% confidence interval, 1.04–2.84), which was a significant increase.

Conclusions

HTLV-1-positive RA patients may worsen RA symptoms. HTLV-1 may be a risk factor for SIH.
Effect of administration of immunoglobulin preparations on the results of tests for autoantibodies
Authors: Yasuda Naomi , Nishikawa Masako , Shimosaka Hironori , Ono Yoshikazu , Yatomi Yutaka
Published: October 2021

Objectives

We encountered the case in whom the results of autoantibodies tests became transiently positive after high-dose immunoglobulin therapy and investigated the effect of administration of these preparations on autoantibodies tests in subjects with autoimmune diseases who had received high-dose immunoglobulin therapy.

Methods

We measured the autoantibodies in residual serum samples after routine clinical testing from eight subjects with autoimmune diseases who had received high-dose immunoglobulin therapy. We also measured the autoantibodies in available immunoglobulin preparations.

Results

Tests for autoantibodies conducted before and after immunoglobulin therapy revealed a positive conversion of the results for anti-Sjogren’s syndrome antigen A (SS-A) antibody, anti-glutamic acid decarboxylase (GAD) antibody, anti-thyroglobulin (Tg) antibody, and anti-thyroid peroxidase (TPO) antibody. In five cases in which changes in the antibody titres of anti-SS-A antibody after the high-dose immunoglobulin administration, it was found that the titres decreased by about 50% from 10 to 20 days after and the test result became negative 25– 30 days later.

Conclusions

In patients receiving high-dose immunoglobulin therapy, there appears to be a high likelihood of positive conversion of tests for anti-SS-A antibody, GAD antibody, Tg antibody, and TPO antibody after the treatment, so that cautious interpretation of the results is of importance.
Elevated 2HG does not cause features of tumorigenesis
Authors: Adam Julie , Finch Alina , Sepulveda Catarina , Ducker Martin , Torroba Maria Blanca , Krell Daniel , Kriaucionis Skirmantas , Szele Francis , Ratcliffe Peter , Soga Tomoyoshi , Kranc Kamil , Tomlinson Ian , Bardella Chiara
Published: October 2021

Aims

Gliomas are the most frequent brain tumours, representing 75% of all primary malignant brain tumours in adults. IDH1 (and IDH2) driver mutations occur in >80% of low grade gliomas and secondary GBMs, in <10% of primary GBMs and other cancers. How IDH1/2 mutations contribute to tumorigenesis is mostly unknown. IDH1/2 convert isocitrate to α-ketoglutarate, but when mutated possess a novel enzymatic function that reduces α-ketoglutarate to D2-hydroxyglutarate (2HG). Indeed 2HG accumulates in IDH1/2-mutant tumours, and this discovery suggested that 2HG may have a role in IDH1/2-mutant tumours onset and progression, possibly by causing dysregulations of various enzymes in the cells. Studies are undergoing to clarify the causative role of 2HG in IDH1/2-mutant tumours, but it is still not clear whether 2HG is the driver/oncometabolite. Our aim is to understand the role of 2HG in developing and adult mouse tissues and whether its accumulation might cause features of gliomagenesis.

Method

A constitutive D2hgdh Knock-out mouse (D2hgdh KO) was generated and the relative molecular and cellular analysis were performed.

Results

Brains dissected from D2hgdh KO mice appeared to be histologically normal. No differences were found in the proliferation and labelling retaining capacity of neural stem and progenitors cells (NSC/NPC) of the D2hgdh KO mice compared to controls. A comprehensive metabolites analysis showed that D2hgdh KO mouse accumulated 2HG in various organs and tissues, included total brains and in the NSC/NPC microdissected from the subventricular zone, the site of origin of many human gliomas. The DNA amount of 5mC and 5hmC extracted from brains of D2hgdh KO mice was similar to controls. A normal number of haematopoietic progenitors was also found.

Conclusion

Although D2hgdh KO mice accumulated 2HG in all tissues analysed, they did not develop any abnormalities and remained completely asymptomatic. This suggests that a mere increment of 2HG in developing and adult tissues may be not sufficient to cause tumorigenesis (and gliomagenesis), leading some doubts on the oncogenic roles of the 2HG in IDH1/2-mutant tumours.
Effects of the tumour microenvironment on protoporphyrin IX accumulation in glioblastoma
Authors: Walker Paul , Finch Alina , Wykes Victoria , Watts Colin , Tennant Dan
Published: October 2021

Aims

Glioblastoma is the most common primary brain tumour and has a poor prognosis. Standard clinical intervention involves the resection of the tumour volume, chemotherapy and radiotherapy. However, achieving gross-total resection is challenging due to poorly defined boundaries as a result of tumour infiltration. Fluorescence-guided surgery (FGS) utilises an apparently selective accumulation of protoporphyrin IX (PPIX) that occurs in areas of glioblastoma after systemic administration of the metabolite 5-aminolevulinic acid (5-ALA). We have investigated the metabolic basis for the heterogeneity of the PPIX fluorescent signal, and its implications for glioma biology.

Method

Using glioblastoma cell lines and patient-derived primary cells, we have monitored the uptake of 5-ALA and conversion to the fluorescent molecule PPIX. Stable isotope tracing coupled with GCMS and LCMS was used to analyse intra- and extracellular metabolite levels arising from exogenous 5-ALA administration under both normoxic (21% O2) and hypoxic (1% O2) conditions.

Results

Uptake of exogenous 5-ALA from culture media and conversion to PPIX is observed in a time and dose-dependent manner in both normoxia and hypoxia. High levels of PPIX accumulation are associated with reduced cell proliferation despite the majority of the PPIX synthesised not being retained within the tumour cell, but exported into the medium. Under hypoxic conditions, reduced fluorescence is observed as a result of the decrease in oxygen availability likely affecting the oxygen-dependent enzymes. Stable isotope tracing experiments indicate an increase in the glutamine-derived succinate pool in response to exogenous 5-ALA, which is dependent on flux through the heme pathway.

Conclusion

Our data suggest that different microenvironments within the tumour alter the activity of the heme biosynthetic pathway, resulting in differential fluorescence in glioblastoma. It paves the way by which we could work to alter the glioblastoma microenvironment in order to further improve the use of FGS in guiding surgery across these devastating tumours.
Inequitable Distribution of FTP Marketing by Neighborhood Characteristics: Further Evidence for Targeted Marketing
Authors: Rose Shyanika W , Anesetti-Rothermel Andrew , Westneat Susan , van de Venne Judy , Folger Shanell , Rahman Basmah , Azam Tofial , Zhou Yitong , Debnam Charles , Ribisl Kurt , Cohn Amy M
Published: October 2021

Introduction

Flavored tobacco products (FTPs) are disproportionately used among young people and racial/ethnic minority populations. However, few studies have examined the retail distribution of such product marketing beyond menthol cigarettes. This study created geographic-based predictions about marketing of FTPs (overall, cigarettes, cigars, e-cigarettes, and smokeless) in stores across Washington, DC neighborhoods. We examined neighborhood-level demographic correlates of the amount of FTP and non-FTP marketing.

Methods

We conducted photographic audits of interior and exterior tobacco marketing in 96 Washington, DC tobacco retailers visited by 149 young adult respondents between 2018–2019. We created a geographic predictive surface of overall and product-specific tobacco marketing and then estimated the average predicted amount of marketing at the census-tract level using zonal statistics. Using linear regression, we examined neighborhood demographic correlates (race/ethnicity, family poverty, and youth population under 18) of FTP and non-FTP marketing.

Results

The predicted amount of non-FTP ads/displays were evenly distributed with no neighborhood variability (Range 8.46–8.46). FTP marketing overall was geographically concentrated with greater range across neighborhoods (Range 6.27–16.77). Greater FTP marketing overall and flavored cigar marketing was available in neighborhoods with higher percentages of Black residents. Flavored cigar marketing was less available in neighborhoods with more Hispanic residents, but there was greater flavored smokeless tobacco marketing. Nonflavored marketing overall and by product did not vary across neighborhoods.

Conclusions

This study provides evidence of disproportionate distribution of FTP marketing in Black neighborhoods, especially for flavored cigars, at the point-of-sale. Policies that restrict the sale of FTPs may enhance health equity.

Implications

Tobacco marketing has frequently been shown to be more prevalent in neighborhoods with lower household income and more Black residents. Using geographic-based predictions, we find that greater flavored tobacco marketing in these neighborhoods, not decreased marketing for nonflavored tobacco, is driving this disparity. Targeting Black neighborhoods with increased marketing of flavored tobacco products, which has been found to be more appealing, easier to use, and harder to quit is a social justice issue.
Novel System of Simulation Models for Aneurysm Clipping Training: Description of Models and Assessment of Face, Content, and Construct Validity
Authors: Belykh Evgenii , Giovani Andrei , Abramov Irakliy , Ngo Brandon , Bardonova Liudmila , Zhao Xiaochun , Loymak Thanapong , Mooney Michael A , Sheehy John P , McBryan Sarah , Tanikawa Rokuya , Lawton Michael T , Preul Mark C
Published: October 2021

BACKGROUND

Aneurysm clipping simulation models are needed to provide tactile feedback of biological vessels in a nonhazardous but surgically relevant environment.

OBJECTIVE

To describe a novel system of simulation models for aneurysm clipping training and assess its validity.

METHODS

Craniotomy models were fabricated to mimic actual tissues and movement restrictions experienced during actual surgery. Turkey wing vessels were used to create aneurysm models with patient-specific geometry. Three simulation models (middle cerebral artery aneurysm clipping via a pterional approach, anterior cerebral artery aneurysm clipping via an interhemispheric approach, and basilar artery aneurysm clipping via an orbitozygomatic pretemporal approach) were subjected to face, content, and construct validity assessments by experienced neurosurgeons (n = 8) and neurosurgery trainees (n = 8).

RESULTS

Most participants scored the model as replicating actual aneurysm clipping well and scored the difficulty of clipping as being comparable to that of real surgery, confirming face validity. Most participants responded that the model could improve clip-applier-handling skills when working with patients, which confirms content validity. Experienced neurosurgeons performed significantly better than trainees on all 3 models based on subjective (P = .003) and objective (P < .01) ratings and on time to complete the task (P = .04), which confirms construct validity. Simulations were used to discuss clip application strategies and compare them to prototype clinical cases.

CONCLUSION

This novel aneurysm clipping model can be used safely outside the wet laboratory; it has high face, content, and construct validity; and it can be an effective training tool for microneurosurgery training during aneurysm surgery courses.
Defining Temptation
Authors: Henking Susan
Published: October 2021

In this chapter Susan Henking and Anne Koch debate the utility of definitions. Koch argues in her initial definition that the moment we attempt to define religion—by making it into “this” or “that” (e.g., the social, the political, and so on)—we automatically mislabel it. Such mislabeling, she adds, creates all sorts of epistemological and categorical confusion. Henking argues that, even though problematic, we must persevere in the task to define religion since all we have at our disposal is words. The subsequent debate is indicative of two radically different approaches to the study of religion—one that seeks to question normativity and one that ultimately seeks to reaffirm it.