bluuebunny/crossref_metadata_2025 huggingface dataset:
TOMM20 as a Potential Prognostic Biomarker in Chordoma: Results From a High-Volume, Single-Center Study
Authors: Micaily Ida , Lee Sherry , Basu Mallick Atrayee , Zhan Tingting , O’Neill Raymond , Gargano Stacey , Hozack Bryan , Thapa Sameep , Martinez-Outschoorn Ubaldo , Abraham John , Jiang Wei
Published: March 2023

Objectives

As few large studies identify correlative biomarkers in chordoma, our objective was to use our large, single-center chordoma tumor bank to identify novel signaling pathways.

Methods

Clinical and pathologic data for 73 patients with chordoma were retrospectively collected. Tumor microarrays were built from 61 archived chordoma specimens; immunohistochemistry for TOMM20, TIGAR, and MCT1 were performed; and semiquantitative analysis of staining intensity and percentage of positive tumor cells was performed. Average composite scores of MCT1, TIGAR, and TOMM20 expression were compared by disease status and anatomic location.

Results

Higher expression of TOMM20 was seen in recurrent and metastatic chordomas compared with primary lesions. Comparing composite scores of primary lesions in patients with primary disease only vs those with recurrent disease showed that TIGAR and TOMM20 expressions are significantly higher in primary lesions, followed by a history of recurrence. A TOMM20 composite score of greater than or equal to 3 significantly decreased overall survival (hazard ratio [HR], 5.83) and recurrence-free survival (HR, 8.95).

Conclusions

Identifying novel signaling pathways that promote chordoma growth and recurrence is critical for developing targeted therapy for chordoma. TOMM20 may be a biomarker associated with chordoma disease progression.
Planetary Geopolitics, Space Weaponization and Environmental Harms
Authors: Rothe Dawn L , Collins Victoria E
Published: March 2023

While the militarization of space has been occurring since the 1950s, it was not considered a domain of fighting nor was it being fully weaponized until recently. Yet, there is a glaring absence of research on space weaponization or space environmental harms by criminologists. Here, using a retrospective approach we juxtapose the environmental harms from wars, military weapon development, maintenance and readiness on Earth and known harms that have occurred due to space expansionism and the space arms race. We then use a prospective approach to critically examine anticipated environmental harms of space weaponization. Our goal is to contribute to research in green criminology and to begin a critical dialogue on planetary geopolitics, space weaponization and the space arms race.
Is the Sinaloa Cartel a Mafia?
Authors: Paoli Letizia , Peters Bryan , Reuter Peter
Published: March 2023

Aiming to reduce the conceptual ambiguity surrounding the topic of organized crime, this study assesses the extent to which the Sinaloa Cartel, the most prominent Mexican drug syndicate, has the characteristics of a mafia. The study uses Paoli’s 2020 mafia framework, which identifies seven typifying characteristics of mafias, such as the Sicilian Cosa Nostra or the Japanese Yakuza. It relies on a broad review of the literature, court transcripts and media sources. The Sinaloa Cartel fully meets none of the seven typifying traits of mafias. It comes closest on the last trait, popular legitimacy and power-sharing, but it is properly characterized as a large drug-selling enterprise. Lastly, the study draws (sombre) policy implications from the analysis.
Extremes of baseline cognitive function determine the severity of delirium: a population study
Authors: Tsui Alex , Yeo Natalie , Searle Samuel D , Bowden Helen , Hoffmann Katrin , Hornby Joanne , Goslett Arley , Weston-Clarke Maryse , Lanham David , Hogan Patrick , Seeley Anna , Rawle Mark , Chaturvedi Nish , Sampson Elizabeth L , Rockwood Kenneth , Cunningham Colm , Ely E Wesley , Richardson Sarah J , Brayne Carol , Terrera Graciela Muniz , Tieges Zoë , MacLullich Alasdair M J , Davis Daniel
Published: March 2023

Although delirium is a significant clinical and public health problem, little is understood about how specific vulnerabilities underlie the severity of its presentation. Our objective was to quantify the relationship between baseline cognition and subsequent delirium severity.

We prospectively investigated a population-representative sample of 1510 individuals aged ≥70 years, of whom 209 (13.6%) were hospitalized across 371 episodes (1999 person-days assessment). Baseline cognitive function was assessed using the modified Telephone Interview for Cognitive Status, supplemented by verbal fluency measures. We estimated the relationship between baseline cognition and delirium severity [Memorial Delirium Assessment Scale (MDAS)] and abnormal arousal (Observational Scale of Level of Arousal), adjusted by age, sex, frailty and illness severity. We conducted further analyses examining presentations to specific hospital settings and common precipitating aetiologies.

The median time from baseline cognitive assessment to admission was 289 days (interquartile range 130 to 47 days). In admitted patients, delirium was present on at least 1 day in 45% of admission episodes. The average number of days with delirium (consecutively positive assessments) was 3.9 days. Elective admissions accounted for 88 bed days (4.4%). In emergency (but not elective) admissions, we found a non-linear U-shaped relationship between baseline global cognition and delirium severity using restricted cubic splines. Participants with baseline cognition 2 standard deviations below average (z-score = −2) had a mean MDAS score of 14 points (95% CI 10 to 19). Similarly, those with baseline cognition z-score = + 2 had a mean MDAS score of 7.9 points (95% CI 4.9 to 11). Individuals with average baseline cognition had the lowest MDAS scores. The association between baseline cognition and abnormal arousal followed a comparable pattern. C-reactive protein ≥20 mg/l and serum sodium <125 mM/l were associated with more severe delirium.

Baseline cognition is a critical determinant of the severity of delirium and associated changes in arousal. Emergency admissions with lowest and highest baseline cognition who develop delirium should receive enhanced clinical attention.
Influenza Vaccination Uptake and Associated Factors Among Adults With and Without Human Immunodeficiency Virus in a Large, Integrated Healthcare System
Authors: Imp Brandon M , Levine Tory , Satre Derek D , Skarbinski Jacek , Luu Mitchell N , Sterling Stacy A , Silverberg Michael J
Published: March 2023

Background

Influenza vaccination is recommended for adults regardless of human immunodeficiency virus (HIV) status. There may be facilitators or barriers to vaccinating people with HIV (PWH) that differ from people without HIV (PWoH). We sought to describe the uptake of influenza vaccination by HIV status and identify factors associated with vaccination.

Methods

We abstracted data from the electronic health records of PWH and PWoH in Kaiser Permanente Northern California during 6 influenza seasons (2013–2018). We determined vaccination uptake and used Poisson regression models to evaluate factors associated with vaccination in PWH and PWoH.

Results

9272 PWH and 194 393 PWoH matched by age, sex, and race/ethnicity were included (mean age: 48 vs 49 years; men: 91% vs 90%; White race: 53% for both groups). PWH were more likely to receive the influenza vaccine (65–69% across years for PWH and 37–41% for PWoH) with an adjusted risk ratio for all years of 1.48 (95% CI: 1.46–1.50). For PWH, lower vaccination uptake was associated with several factors that suggested more complex health needs, such as lower CD4 cell counts, higher HIV viral loads, prior depression diagnoses, having Medicare insurance, and having a higher number of comorbidities. Associations with vaccination uptake were attenuated in PWH, compared with PWoH, for smoking, alcohol, and demographic factors.

Conclusions

PWH had an almost 50% higher uptake of influenza vaccination than PWoH, possibly reflecting greater engagement with the healthcare system. We also found that PWH with more complex health needs had reduced vaccination uptake. Findings may inform outreach strategies to increase influenza vaccination in PWH.
Developing Inclusive High School Team Sports for Adolescents with Disabilities and Neurotypical Students in Underserved School Settings
Authors: Clement Wade , Freeman Stephanny F N
Published: March 2023

The authors investigated the effects of a collaborative after-school inclusive sports program on adolescents with disabilities and neurotypical students in underserved high schools. The program brought together a large urban school district and a private after-school program to provide a service on the school site. The goals were to provide a truly integrated sports environment for adolescents with disabilities and to provide underrepresented minority students an opportunity to gain service learning, improved social–emotional development, and greater self-perceived impact. The project was feasible and indeed continued well beyond the evaluation period. Quantitative results indicated that the neurotypical adolescents felt they had an impact on improving the responsibility of their peer athlete, and they felt they had better perspective taking after participating. Descriptive comments indicated that the children with disabilities enjoyed participation and that this inclusive program may have provided an additional avenue for a subset of the population to engage more in the activities of their school. Program details are presented to encourage further research and replication.
Vascular endothelial growth factor-D plasma levels and VEGFD genetic variants are independently associated with outcomes in patients with cardiovascular disease
Authors: Davidsson Pia , Eketjäll Susanna , Eriksson Niclas , Walentinsson Anna , Becker Richard C , Cavallin Anders , Bogstedt Anna , Collén Anna , Held Claes , James Stefan , Siegbahn Agneta , Stewart Ralph , Storey Robert F , White Harvey , Wallentin Lars
Published: March 2023

Aims

The vascular endothelial growth factor (VEGF) family is involved in pathophysiological mechanisms underlying cardiovascular (CV) diseases. The aim of this study was to investigate the associations between circulating VEGF ligands and/or soluble receptors and CV outcome in patients with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS).

Methods and results

Levels of VEGF biomarkers, including bFGF, Flt-1, KDR (VEGFR2), PlGF, Tie-2, VEGF-A, VEGF-C, and VEGF-D, were measured in the PLATO ACS cohort (n = 2091, discovery cohort). Subsequently, VEGF-D was also measured in the STABILITY CCS cohort (n = 4015, confirmation cohort) to verify associations with CV outcomes. Associations between plasma VEGF-D and outcomes were analysed by multiple Cox regression models with hazard ratios (HR [95% CI]) comparing the upper vs. the lower quartile of VEGF-D. Genome-wide association study (GWAS) of VEGF-D in PLATO identified SNPs that were used as genetic instruments in Mendelian randomization (MR) meta-analyses vs. clinical endpoints. GWAS and MR were performed in patients with ACS from PLATO (n = 10 013) and FRISC-II (n = 2952), and with CCS from the STABILITY trial (n = 10 786). VEGF-D, KDR, Flt-1, and PlGF showed significant association with CV outcomes. VEGF-D was most strongly associated with CV death (P = 3.73e-05, HR 1.892 [1.419, 2.522]). Genome-wide significant associations with VEGF-D levels were identified at the VEGFD locus on chromosome Xp22. MR analyses of the combined top ranked SNPs (GWAS P-values; rs192812042, P = 5.82e-20; rs234500, P = 1.97e-14) demonstrated a significant effect on CV mortality [P = 0.0257, HR 1.81 (1.07, 3.04) per increase of one unit in log VEGF-D].

Conclusion

This is the first large-scale cohort study to demonstrate that both VEGF-D plasma levels and VEGFD genetic variants are independently associated with CV outcomes in patients with ACS and CCS. Measurements of VEGF-D levels and/or VEGFD genetic variants may provide incremental prognostic information in patients with ACS and CCS.
Surgical and percutaneous left atrial appendage intervention: silent cerebral embolism considerations
Authors: Wang Zidun , Wang Kexin , Lu Shanshan , Zhang Lian , Li Mingfang , Ju Weizhu , Ni Buqing , Gu Weidong , Shao Yongfeng , Chen Minglong
Published: March 2023

OBJECTIVES

Left atrial appendage intervention is an alternative to oral anticoagulation for thromboprophylaxis in atrial fibrillation. The aim of our study was to compare the incidence of silent cerebral embolisms after surgical and percutaneous intervention and to identify the risk factors for procedure-related silent cerebral embolisms after intervention.

METHODS

This prospective observational study included consecutive atrial fibrillation patients from 2 independent cohorts (left atrial appendage excision (LAAE) cohort and left atrial appendage occlusion cohort) between September 2018 and December 2020. All patients underwent cerebral magnetic resonance imaging before and after the procedure. Silent cerebral embolism was defined as new focal hyperintense lesions detected only on postprocedural sequence.

RESULTS

Thirty-two patients from the LAAE cohort and 42 patients from the occlusion cohort were enrolled. A significantly lower incidence of silent cerebral embolism was observed in the LAAE cohort as compared with occlusion (6.3% vs 54.8%, P < 0.001). In the left atrial appendage occlusion cohort, patients who developed silent cerebral embolism after the procedure had significantly higher CHA2DS2-VASc scores [odds ratio (OR) 2.172; 95% confidence interval (CI) 1.149–4.104; P = 0.017], longer occlusion placement time (OR 1.067; 95% CI 1.018–1.118; P = 0.006) and lower peak activated clotting time level after transseptal puncture (OR 0.976; 95% CI 0.954–0.998; P = 0.035).

CONCLUSIONS

The incidence of procedure-related silent cerebral embolism was strikingly lower in patients with LAAE than in patients with occlusion. More cardiovascular comorbidities, longer occlusion placement time and lower activated clotting time level were significantly associated with the development of procedure-related silent cerebral embolism.
Effectiveness of intraoperative use of dexmedetomidine in reducing the incidence of tachyarrhythmia after congenital cardiac surgery in neonates and infants: a doubly robust method estimation analysis
Authors: Bourgoin Pierre , Jegard Julien , Joram Nicolas , Fox Sylvain , Biard Marc , Fernandez Modesto , Baruteau Alban Elouen , Dejoie Thomas , Ferdynus Cyril , Chenouard Alexis
Published: March 2023

OBJECTIVES

The antiarrhythmic effects of dexmedetomidine (DEX) have been suggested, but there are controversial reports on the effectiveness of intraoperative use of DEX to reduce the incidence of postoperative tachyarrhythmia (POT).

METHODS

From a local European Congenital Heart Surgery Association database, we included patients operated for congenital heart diseases under cardiopulmonary bypass within a 5-year period (2017–2021), during which intraoperative use of high dose of DEX (1–1.4 µg/kg/h) was implemented. A doubly robust matching estimation of the causal effect of DEX on the incidence of POT was conducted. We combined a multimodal estimation model in patients not exposed to DEX (disease risk score) as well as a regression analysis in a matched cohort for patients exposured to DEX.

RESULTS

From a cohort of 593 surgeries (514 patients) occurring during the study period, doubly matched analysis consisted of the analysis of 426 surgeries conducted under DEX or not (213 per group). The probability of developing POT in patients exposed to DEX was 6.6% (95% confidence interval 0.032–0.099) vs 14.5% (95% confidence interval 0.098–0.193) in the group of patients not exposed to DEX. The doubly robust matched estimation method showed a mean reduction of 8.8% (95% confidence interval −0.137 to −0.023) of POT when DEX is used for intraoperative anaesthesia.

CONCLUSIONS

The use of high doses of DEX during anaesthesia for congenital heart surgery in neonates and infants is associated with a moderate but significant reduction of POT.
Outcome after pediatric craniopharyngioma: the role of age at diagnosis and hypothalamic damage
Authors: Beckhaus Julia , Friedrich Carsten , Boekhoff Svenja , Calaminus Gabriele , Bison Brigitte , Eveslage Maria , Timmermann Beate , Flitsch Jörg , Müller Hermann L
Published: March 2023

Objective

Craniopharyngiomas (CP) are rare malformational tumors. Clinical presentation and outcome of pediatric patients with CP with specific regard to age at diagnosis is not clear. The aim of this cohort study was to determine clinical presentation and outcome in these patients diagnosed at different ages at diagnosis.

Design

Seven hundred and nine patients diagnosed with CP were recruited from 1999 to 2021 in HIT-Endo and KRANIOPHARYNGEOM 2000/2007/Registry 2019 and prospectively observed.

Methods

Age at diagnosis was categorized as infants and toddlers (<2 years), early childhood (2-6 years), middle childhood (6-12 years), and early adolescence (12-18 years). Overall and event-free survival (EFS), functional capacity (FMH), and quality of life (QoL) (PEDQOL) were assessed.

Results

Severe obesity (body mass index [BMI] >3 standard deviation score [SDS]) was prevalent in 45.4% at last visit. A lower EFS but better QoL was observed in children with age at diagnosis <6 years compared with ≥6 years. Reduced functional capacity percentiles were associated with increased BMI-SDS at last visit (rho = −0.125, 95% confidence interval [CI; −0.21; −0.04]) and age at diagnosis <2 years. Posterior hypothalamic involvement and hypothalamic lesion (HL) were independent risk factors for reduced EFS (hazard ratio = 1.59, 95% CI [1.12-2.26]) and obesity at last visit (odds ratio = 2.94, 95% CI [1.73-5.08]). Age at diagnosis did not contribute to severe obesity and reduced QoL.

Conclusions

Diagnosis of CP at age <6 years may help patients to adapt early to disabilities but may lead to a higher probability of CP relapse. Not age at diagnosis but posterior HL may be the contributing factor to severe obesity and a reduced QoL.

Clinical trial registration numbers

NCT00258453; NCT01272622; NCT04158284.
Prognostic impact of hypercoagulability and impaired fibrinolysis in acute myocardial infarction
Authors: Lee Seung Hun , Kim Hyun Kuk , Ahn Jong-Hwa , Kang Min Gyu , Kim Kye-Hwan , Bae Jae Seok , Cho Sang Young , Koh Jin-Sin , Park Yongwhi , Hwang Seok Jae , Gorog Diana A , Tantry Udaya S , Bliden Kevin P , Gurbel Paul A , Hwang Jin-Yong , Jeong Young-Hoon
Published: March 2023

Aims

Atherothrombotic events are influenced by systemic hypercoagulability and fibrinolytic activity. The present study evaluated thrombogenicity indices and their prognostic implications according to disease acuity.

Methods and results

From the consecutive patients undergoing percutaneous coronary intervention (PCI), those with thrombogenicity indices (n = 2705) were grouped according to disease acuity [acute myocardial infarction (AMI) vs. non-AMI]. Thrombogenicity indices were measured by thromboelastography (TEG). Blood samples for TEG were obtained immediately after insertion of the PCI sheath, and TEG tracing was performed within 4 h post-sampling. Major adverse cardiovascular events (MACE, a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke) were evaluated for up to 4 years. Compared with non-AMI patients, AMI patients had higher platelet-fibrin clot strength [maximal amplitude (MA): 66.5 ± 7.8 vs. 65.3 ± 7.2 mm, P < 0.001] and lower fibrinolytic activity [clot lysis at 30 min (LY30): 0.9 ± 1.8% vs. 1.1 ± 1.9%, P < 0.001]. Index AMI presentation was associated with MA [per one-mm increase: odds ratio (OR): 1.024; 95% confidence interval (CI): 1.013–1.036; P < 0.001] and LY30 (per one% increase: OR: 0.934; 95% CI: 0.893–0.978; P = 0.004). The presence of high platelet-fibrin clot strength (MA ≥68 mm) and low fibrinolytic activity (LY30 < 0.2%) was synergistically associated with MACE occurrence. In the multivariable analysis, the combined phenotype of ‘MA ≥ 68 mm’ and ‘LY30 < 0.2%’ was a major predictor of post-PCI MACE in the AMI group [adjusted hazard ratio (HR): 1.744; 95% CI: 1.135–2.679; P = 0.011], but not in the non-AMI group (adjusted HR: 1.031; 95% CI: 0.499–2.129; P = 0.935).

Conclusion

AMI occurrence is significantly associated with hypercoagulability and impaired fibrinolysis. Their combined phenotype increases the risk of post-PCI atherothrombotic event only in AMI patients. These observations may support individualized therapy that targets thrombogenicity for better outcomes in patients with AMI.

Clinical Trial Registration

Gyeongsang National University Hospital (G-NUH) Registry, NCT04650529.
Fate of the unoperated ascending thoracic aortic aneurysm: three-decade experience from the Aortic Institute at Yale University
Authors: Wu Jinlin , Zafar Mohammad A , Liu Yiwei , Chen Julia Fayanne , Li Yupeng , Ziganshin Bulat A , Ellauzi Hesham , Mukherjee Sandip K , Rizzo John A , Elefteriades John A
Published: March 2023

Aims

This study aims to outline the ‘true’ natural history of ascending thoracic aortic aneurysm (ATAA) based on a cohort of patients not undergoing surgical intervention.

Methods and results

The outcomes, risk factors, and growth rates of 964 unoperated ATAA patients were investigated, over a median follow-up of 7.9 (maximum of 34) years. The primary endpoint was adverse aortic events (AAE), including dissection, rupture, and aortic death. At aortic sizes of 3.5–3.9, 4.0–4.4, 4.5–4.9, 5.0–5.4, 5.5–5.9, and ≥6.0 cm, the average yearly risk of AAE was 0.2%, 0.2%, 0.3%, 1.4%, 2.0%, and 3.5%, respectively (P < 0.001), and the 10-year survival free from AAE was 97.8%, 98.2%, 97.3%, 84.6%, 80.4%, and 70.9%, respectively (P < 0.001). The risk of AAE was relatively flat until 5 cm of aortic size, at which it began to increase rapidly (P for non-linearity <0.001). The mean annual growth rate was estimated to be 0.10 ± 0.01 cm/year. Ascending thoracic aortic aneurysms grew in a very slow manner, and aortic growth over 0.2 cm/year was rarely seen. Multivariable Cox regression identified aortic size [hazard ratio (HR): 1.78, 95% confidence interval (CI): 1.50–2.11, P < 0.001] and age (HR: 1.02, 95% CI: 1.00–1.05, P = 0.015) as significant independent risk factors for AAE. Interestingly, hyperlipidemia (HR: 0.46, 95% CI: 0.23–0.91, P = 0.025) was found to be a significant protective factor for AAE in univariable Cox regression.

Conclusion

An aortic size of 5 cm, rather than 5.5 cm, may be a more appropriate intervention criterion for prophylactic ATAA repair. Aortic growth may not be an applicable indicator for intervention.
Metabolic engineering ofSaccharomyces cerevisiaefor glycerol utilization
Authors: Yu Ziqian , Chang Zhao , Lu Yinhua , Xiao Han
Published: March 2023

Due to its wide availability, glycerol is considered as a promising alternative feedstock for microbial fermentation. As a model eukaryote, Saccharomyces cerevisiae is commonly adopted for bioproduction of various bulk and value-added chemicals, but it does not efficiently utilize glycerol. In this review, the metabolic pathway of glycerol and its regulation in S. cerevisiae are first introduced. Then, strategies, including metabolic engineering of the endogenous pathway, introduction of exogenous pathways, adaptive evolution, and reverse metabolic engineering, are summarized for improving the glycerol utilization in S. cerevisiae. Finally, methods for further improving glycerol utilization by S. cerevisiae are proposed. This review provides insights for designing engineered S. cerevisiae for efficient utilization of glycerol.
Promotive and risk factors for children’s mental health—Finnish municipal policymakers’ and leading officeholders’ views
Authors: Savolainen Outi , Sormunen Marjorita , Turunen Hannele
Published: March 2023

Findings on children’s mental health promotion at the policy level are scarce, and the perceptions of the municipal administration on factors affecting children’s mental health have not been reported. This study describes the perspectives of policymakers and leading officeholders on promotive and risk factors for children’s mental health in a socioecological context. The perspectives of Finnish policymakers (n = 15) and officeholders (n = 10) in municipalities were examined using semi-structured interviews. The data were analyzed using inductive content analysis and were categorized according to the five levels of a socioecological model of health promotion: public policy, community, organizational, interpersonal and individual levels. The public policy level emerged strongly in the findings, specifically strategic planning and implementation challenges related to the promotion of children’s mental health in the municipality and state administration. At the community level, environmental factors promoting children’s mental health as well as risk factors were described. The organizational level consisted of support, requirements and development needs in children’s services. The importance of family and close networks at the interpersonal level, as well as the individual basis of mental health, were also evident. The integration and better collaboration of child and family services, the use of child rights impact assessment in political decision-making, and financial support from the state could contribute to improving strategic planning to support children’s mental health at the municipal level.
The insurance role in workplace health promotion: a comparative analysis of the United States and the Philippines
Authors: Mendoza Roger Lee
Published: March 2023

There is a void in the health promotion literature concerning the role of health insurance. This study offers a comparative analysis of employee health insurance in the United States and the Philippines. As the first study of its kind, it examines insurance as an instrument of health promotion policy for improving population health and reducing healthcare costs. The following questions guide this study: (i) How has insurance coverage of employee healthcare in these two countries evolved and changed over time, and why? (ii) What factors incentivize payers (employers and insurers) to incorporate health promotion into their health plans, even if health promotion does not fall within the traditional ambit of insurance? and (iii) How does health promotion through the insurance vehicle operate cost-efficiently and within the Global Health Promotion framework of the World Health Organization (WHO)? US and Philippine public-use datasets were gathered and disaggregated to address these questions. The Affordable Care Act (ACA) in the US and universal healthcare legislation leading to the Universal Healthcare Act (UHC) in the Philippines initiated major paradigmatic shifts in insurance coverage. Health literacy, behavioral change and social equity are objectives pursued in both countries by mandating and/or nudging payers to offer health screenings, wellness and fitness programs and primary preventive and diagnostic services. By providing a means to finance access to promotive health and encourage individual responsibility for risk prevention (‘healthism’), insurance influences social attitudes about health. However, our findings indicate that outcomes and relative success vary depending on a country’s insurance environment, its regulation and the economic, political and socio-cultural forces that affect or shape it (e.g. private markets vs. multi-payer system). Contextual realities also drive incentives and rewards to payers and users of promotive health benefits against the backdrop of financial risk or exposure.
Microscopic and metabolic investigations disclose the factors that lead to skin cracking in chili-type pepper fruit varieties
Authors: Marinov Ofir , Nomberg Gal , Sarkar Sutanni , Arya Gulab Chand , Karavani Eldad , Zelinger Einat , Manasherova Ekaterina , Cohen Hagai
Published: March 2023

The hydrophobic cuticle encasing the fruit skin surface plays critical roles during fruit development and post-harvest. Skin failure often results in the fruit surface cracking and forming a wound-periderm tissue made of suberin and lignin. The factors that make the fruit skin susceptible to cracking have yet to be fully understood. Herein, we investigated two varieties of chili peppers (Capsicum annuum L.), Numex Garnet, whose fruit has intact skin, and Vezena Slatka, whose fruit has cracked skin. Microscopical observations, gas chromatography–mass spectrometry, biochemical and gene expression assays revealed that Vezena Slatka fruit form a thicker cuticle with greater levels of cutin monomers and hydroxycinnamic acids, and highly express key cutin-related genes. The skin of these fruit also had a lower epidermal cell density due to cells with very large perimeters, and highly express genes involved in epidermal cell differentiation. We demonstrate that skin cracking in the Vezena Slatka fruit is accompanied by a spatial accumulation of lignin-like polyphenolic compounds, without the formation of a typical wound-periderm tissues made of suberized cells. Lastly, we establish that skin cracking in chili-type pepper significantly affects fruit quality during post-harvest storage in a temperature-dependent manner. In conclusion, our data highlight cuticle thickness and epidermal cell density as two critical factors determining fruit skin susceptibility to cracking in chili-type pepper fruit.
Remote Work, Work Measurement and the State of Work Research in Human-Centred Computing
Authors: Gould Sandy J. J. , Rudnicka Anna , Cook Dave , Cecchinato Marta E. , Newbold Joseph W. , Cox Anna L.
Published: March 2023

Over the past few decades, a small but growing group of people have worked remotely from their homes. With the arrival of the coronavirus pandemic, millions of people found themselves joining this group overnight. In this position paper, we examine the kinds of work that ‘went remote’ in response to the pandemic, and consider the ways in which this transition was influenced by (and in turn came to influence) contemporary trends in digital workplace measurement and evaluation. We see that employers appeared reluctant to let certain classes of employee work remotely. When the pandemic forced staff home, employers compensated by turning to digital surveillance tools, even though, as we argue, these tools seem unable to overcome the significant conceptual barriers to understanding how people are working. We also observed that, in the United Kingdom context, the pandemic didn’t mean remote work for a significant proportion of the population. We assert that, to maximize its impact, ‘future of work’ research in human-centred computing must be more inclusive and representative of work, rather than focusing on the experiences of knowledge workers and those involved in new forms of work.
Using electronic health record data to link families: an illustrative example using intergenerational patterns of obesity
Authors: Krefman Amy E , Ghamsari Farhad , Turner Daniel R , Lu Alice , Borsje Martin , Wood Colby Witherup , Petito Lucia C , Polubriaginof Fernanda C G , Schneider Daniel , Ahmad Faraz , Allen Norrina B
Published: March 2023

Objective

Electronic health record (EHR) data are a valuable resource for population health research but lack critical information such as relationships between individuals. Emergency contacts in EHRs can be used to link family members, creating a population that is more representative of a community than traditional family cohorts.

Materials and Methods

We revised a published algorithm: relationship inference from the electronic health record (RIFTEHR). Our version, Pythonic RIFTEHR (P-RIFTEHR), identifies a patient’s emergency contacts, matches them to existing patients (when available) using network graphs, checks for conflicts, and infers new relationships. P-RIFTEHR was run on December 15, 2021 in the Northwestern Medicine Electronic Data Warehouse (NMEDW) on approximately 2.95 million individuals and was validated using the existing link between children born at NM hospitals and their mothers. As proof-of-concept, we modeled the association between parent and child obesity using logistic regression.

Results

The P-RIFTEHR algorithm matched 1 157 454 individuals in 448 278 families. The median family size was 2, the largest was 32 persons, and 247 families spanned 4 generations or more. Validation of the mother–child pairs resulted in 95.1% sensitivity. Children were 2 times more likely to be obese if a parent is obese (OR: 2.30; 95% CI, 2.23–2.37).

Conclusion

P-RIFTEHR can identify familiar relationships in a large, diverse population in an integrated health system. Estimates of parent–child inheritability of obesity using family structures identified by the algorithm were consistent with previously published estimates from traditional cohort studies.
Gene expression reveals immune response strategies of naïve Hawaiian honeycreepers experimentally infected with introduced avian malaria
Authors: Paxton Kristina L , Cassin-Sackett Loren , Atkinson Carter T , Videvall Elin , Campana Michael G , Fleischer Robert C
Published: March 2023

The unprecedented rise in the number of new and emerging infectious diseases in the last quarter century poses direct threats to human and wildlife health. The introduction to the Hawaiian archipelago of Plasmodium relictum and the mosquito vector that transmits the parasite has led to dramatic losses in endemic Hawaiian forest bird species. Understanding how mechanisms of disease immunity to avian malaria may evolve is critical as climate change facilitates increased disease transmission to high elevation habitats where malaria transmission has historically been low and the majority of the remaining extant Hawaiian forest bird species now reside. Here, we compare the transcriptomic profiles of highly susceptible Hawai‘i ‘amakihi (Chlorodrepanis virens) experimentally infected with P. relictum to those of uninfected control birds from a naïve high elevation population. We examined changes in gene expression profiles at different stages of infection to provide an in-depth characterization of the molecular pathways contributing to survival or mortality in these birds. We show that the timing and magnitude of the innate and adaptive immune response differed substantially between individuals that survived and those that succumbed to infection, and likely contributed to the observed variation in survival. These results lay the foundation for developing gene-based conservation strategies for Hawaiian honeycreepers by identifying candidate genes and cellular pathways involved in the pathogen response that correlate with a bird’s ability to recover from malaria infection.
Subjects, disciplines, and practices
Authors: Winch Christopher
Published: March 2023

This article attempts to show how Hirst’s earlier work on forms of knowledge, and his later work on education as an inculcation into practices, have close connections, closer than those made explicit in his own writings. In fact, it can be argued that, in some sense, the idea of a practice is fundamental to understanding the ways in which knowledge is organized, and thus to the epistemic claim that knowledge is organized differently according to the various ways in which it is acquired and evaluated. This approach allows us to make a distinction between disciplines and subjects that in turn allow us to distinguish knowledge-seeking from knowledge-transmitting activities, particularly in the context of school subjects and thus to bring out more clearly the relationship between the practical side of knowledge acquisition and evaluation, on the one hand, and the structure of the knowledge thus acquired, on the other. By doing this, we can see an underlying unity in Hirst’s concerns that is not so obvious at first sight.
Quasi-experimental Controlled Study on the Effect of Autism Resource Clinic Guardian Attendance at a Military Treatment Facility
Authors: Hensley Jennifer L , Beydoun Hind A
Published: March 2023

Introduction

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that requires multidisciplinary care. Evidence-based practice indicates that early intervention may improve long-term ASD outcomes. The Autism Resource Clinic (ARC) provides an educational session for guardians empowering them to build a personalized ASD team for their child. We examined the impact of guardian attendance of an ARC at a Military Treatment Facility on time to initiation of patient services and guardian stress level.

Materials and Methods

A quasi-experimental controlled study was conducted comparing a group of guardians attending the ARC with a group of guardians not attending the ARC following a child’s initial ASD diagnosis. ARC speakers included medical, county/state, community/military, and advocacy experts. Surveys were completed at diagnosis, 1, 2, and 3 mo postdiagnosis. Initiation of patient services and Parental Stress Scale scores were compared between groups using independent samples t-test, chi-square tests, or nonparametric tests, as appropriate.

Results

Use of Applied Behavioral Analysis was significantly higher among ARC attendees vs. nonattendees (73.3% vs. 33.3%, P = 0.028). County early intervention was more frequent among ARC attendees versus nonattendees (40% vs. 13.3%, P = 0.09). Of borderline significance, median time to initiation of genetics services was greater in ARC attendees vs. nonattendees (106 vs. 65.5, P = 0.10). The two groups did not differ on changes in Parental Stress Scale score from baseline to follow-up months 1, 2, or 3.

Conclusions

Although ARC did not influence time to initiation of patient services or guardian stress level, attendance of ARC was associated with more frequent use of Applied Behavioral Analysis services and county early intervention services. This pilot study is unique as it targets guardians of ASD patients within military treatment facilities. Study limitations include data collection during the coronavirus disease 2019 pandemic, sequential evaluation of experimental and control groups, sample size and generalizability. A large, multicenter, randomized controlled trial is required to better assess the impact of this educational opportunity among military populations.
Assessing model-based carbon and oxygen abundance derivation from ultraviolet emission lines in AGNs
Authors: Pérez-Montero E , Amorín R , Pérez-Díaz B , Vílchez J M , García-Benito R
Published: March 2023

We present an adapted version of the code HII-CHI-mistry-UV to derive chemical abundances from emission lines in the ultraviolet, for use in narrow line regions (NLR) of active galactic nuclei (AGN). We evaluate different ultraviolet emission line ratios and how different assumptions about the models, including the presence of dust grains, the shape of the incident spectral energy distribution, or the thickness of the gas envelope around the central source, may affect the final estimates as a function of the set of emission lines used. We compare our results with other published recipes for deriving abundances using the same emission lines and show that deriving the carbon-to-oxygen abundance ratio using C iii] λ 1909 Å and O iii] λ 1665 Å emission lines is a robust indicator of the metal content in AGN that is nearly independent of the model assumptions, similar to the case of star-forming regions. Moreover, we show that a prior determination of C/O allows for a much more precise determination of the total oxygen abundance using carbon UV lines, as opposed to assuming an arbitrary relationship between O/H and C/O, which can lead to non-negligible discrepancies.
An umbrella review of the acceptability of fiscal and pricing policies to reduce diet-related noncommunicable disease
Authors: Barry Luke E , Kee Frank , Woodside Jayne , Cawley John , Doherty Edel , Clarke Mike , Crealey Grainne E , Duggan Jim , O’Neill Ciaran
Published: March 2023

Context

Poor diet has been implicated in a range of noncommunicable diseases. Fiscal and pricing policies (FPs) may offer a means by which consumption of food and non-alcoholic beverages with links to such diseases can be influenced to improve public health.

Objective

To examine the acceptability of FPs to reduce diet-related noncommunicable disease, based on systematic review evidence.

Data Sources

MEDLINE, EMBASE, PsychInfo, SCI, SSCI, Web of Science, Scopus, EconLit, the Cochrane Library, Epistemonikos, and the Campbell Collaboration Library were searched for relevant studies published between January 1, 1990 and June 2021.

Data Extraction

The studies included systematic reviews of diet-related FPs and: used real-world evidence; examined real or perceived barriers/facilitators; targeted the price of food or non-alcoholic beverages; and applied to entire populations within a jurisdiction. A total of 9996 unique relevant records were identified, which were augmented by a search of bibliographies and recommendations from an external expert advisory panel. Following screening, 4 systematic reviews remained.

Data Analysis

Quality appraisal was conducted using the AMSTAR 2 tool. A narrative synthesis was undertaken, with outcomes grouped according to the WHO-INTEGRATE criteria. The findings indicated a paucity of high-quality systematic review evidence and limited public support for the use of FPs to change dietary habits. This lack of support was related to a number of factors that included: their perceived potential to be regressive; a lack of transparency, ie, there was mistrust around the use of revenues raised; a paucity of evidence around health benefits; the deliberate choice of rates that were lower than those considered necessary to affect diet; and concerns about the potential of such FPs to harm economic outcomes such as employment.

Conclusion

The findings underscore the need for high-quality systematic review evidence on this topic, and the importance of responding to public concerns and putting in place mechanisms to address these when implementing FPs. This study was funded by Safefood [02A-2020].

Systematic Review Registration

PROSPERO registration no. CRD42021274454.
Invoking self-related and social thoughts impacts online information sharing
Authors: Scholz Christin , C. Baek Elisa , Falk Emily B
Published: March 2023

Online sharing impacts which information is widely available and influential in society. Yet, systematically influencing sharing behavior remains difficult. Past research highlights two factors associated with sharing: the social and self-relevance of the to-be-shared content. Based on this prior neuroimaging work and theory, we developed a manipulation in the form of short prompts that are attached to media content (here health news articles). These prompts encourage readers to think about how sharing the content may help them to fulfill motivations to present themselves positively (self-relevance) or connect positively to others (social relevance). Fifty-three young adults completed this pre-registered experiment while undergoing functional magnetic resonance imaging. Ninety-six health news articles were randomly assigned to three within-subject conditions that encouraged self-related or social thinking or a control. Invoking self-related or social thoughts about health-related news (vs control) (i) causally increased brain activity in a priori regions of interest chosen for their roles in processing social and self-relevance and (ii) causally impacted self-reported sharing intentions. This study provides evidence corroborating prior reverse inferences regarding the neural correlates of sharing. It further highlights the feasibility and utility of targeting neuropsychological processes to systematically facilitate online information spread.
Soybean Cyst Nematode Management Is Improved by Combining Native and Transgenic Resistance
Authors: McCarville Michael T. , Daum Julia , Xing Liqun , Moser Hal
Published: March 2023

Field trials were conducted to assess the benefit of combining a transgenic soybean cyst nematode (SCN) resistance trait, Cry14Ab-1 expressed by the event GMB151, with the native resistance allele rhg1b from PI 88788. The GMB151 event and rhg1b were crossed into common genetic backgrounds and segregated out to create four genetically related lines within each background. The lines created contained both native and transgenic resistance (rhg1b + GMB151), only native resistance (rhg1b alone), only transgenic resistance (GMB151 alone), or neither resistance type (susceptible). The benefit of GMB151 and rhg1b for SCN management was evaluated by measuring SCN control and yield protection. Soybean cyst nematode control was assessed by counting the number of females and cysts on roots early in the season and measuring the change in SCN egg population density over the entire season. The GMB151 transgenic event and the native resistance allele rhg1b both reduced early season SCN reproduction and contributed to significantly higher soybean yield. Compared to susceptible lines, the rhg1b allele improved yield by 33%, while GMB151 improved yield by 13%. Combining the GMB151 event and rhg1b allele resulted in greater SCN control and yield improvement than either provided alone. The combination of GMB151 and rhg1b reduced season-long SCN reproduction by 50% and resulted in 44% greater yield than the susceptible lines. Soybean cyst nematode virulence to rhg1b continues to increase due to the continuous planting of PI 88788-derived resistant cultivars. Pyramiding GMB151 with rhg1b provides a new management option to improve SCN control and soybean yield.
Intracavernous injection of platelet‐rich plasma reverses erectile dysfunction of chronic cavernous nerve degeneration through reduction of prostate hyperplasia evidence from an aging‐induced erectile dysfunction rat model
Authors: Tai Huai‐Ching , Tsai Wei‐Kung , Chang Meng‐Lin , Praveen Rajneesh Chellappan , Tseng Xiao‐Wen , Hsu Wen‐Chun , Wu Yi‐No , Chiang Han‐Sun
Published: March 2023

Age‐induced erectile dysfunction (ED) is a convoluted medical condition, and restoring erectile function (EF) under geriatric conditions is highly complicated. Platelet‐rich plasma (PRP) treatment is an inexpensive cell‐based therapeutic strategy. We have aimed to restore EF in aged‐ED rats with PRP as a therapeutic tool. Male rats were grouped into aged and young according to age. The young rats were considered as normal control (NC) and treated with saline. Aged were further divided into 2 groups and treated with intracavernous (IC) PRP and saline. Treatment was scheduled at the 9th and 10th week for NC and 41th and 42th week for aged‐ED rats, with EF analysis scheduled on the 12th week for NC and 44th week for aged‐ED rats, respectively. Erectile response, immunofluorescence staining, and electron microscopic analyses were performed. IC PRP treatment effectively reduced prostate hyperplasia (PH). EF response indicated a significant increase in crucial EF parameters in PRP‐treated aged‐ED rats. Histological evidence denoted a rigid and restored development of tunica adventitia of the dorsal artery, decreased vacuolation of the dorsal penile nerve, and structural expansion of the epineurium. Masson's trichrome and immunostaining results affirmed an elevated expression of α‐smooth muscle actin (α‐SMA) in the corpus cavernosum (CC). Ultrastructure findings revealed that PRP effectively rejuvenated degenerating nerves, preserved endothelium and adherent junctions of corporal smooth muscle, and restored the axonal scaffolds by upregulating neurofilament‐H (NF‐H) expression. Finally, PRP enhanced neural stability by enhancing the axonal remyelination processes in aged‐ED rats. Hence, PRP treatment was proven to restore EF in aged‐ED rats, which was considered a safe, novel, cost‐effective, and hassle‐free strategy for EF restoration in geriatric patients.