bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of saturable absorber parameters on the operation regimes of a dumbbell-shaped thulium fibre laser
Authors: Zverev A.D. , Kamynin V.A. , Trikshev A.I. , Kovtun E.Yu. , Arutyunyan N.R. , Mastin A.A. , Ryabochkina P.A. , Obraztsova E.D. , Tsvetkov V.B.
Published: May 2021

The influence of saturable absorber parameters on the operation regimes of a dumbbell-shaped thulium fibre laser is studied. As saturable absorbers, polymer films with nanotubes characterised by different transmission coefficients in the saturated and unsaturated states are used. The operation of lasers with absorbers of different configurations used to obtain stable Q-switching and mode-locking regimes in the spectral range 1930 – 1960 nm is demonstrated. The average output power in the single-pulse mode-locking regime is 3.5 mW at a pulse repetition rate of 8.4 MHz and a pulse duration of 1.08 ps.
Investigation of the transition at a wavelength of 506 nm, intended for deep cooling of thulium atoms
Authors: Provorchenko D.I. , Tregubov D.O. , Mishin D.A. , Golovizin A.A. , Fedorova E.S. , Khabarova K.Yu. , Sorokin V.N. , Kolachevsky N.N.
Published: May 2021

A scheme is proposed for the third stage of laser cooling of thulium atoms at a wavelength of 506.2 nm, and a system for stabilising the laser radiation frequency is described, which provides the required characteristics. The transition

at a wavelength of 506.2 nm is detected in a magneto-optical trap with the employment of the developed laser setup. The value of hyperfine splitting of the transition upper level is measured, and the single-dimension cooling at this wavelength is observed for the first time.
Analysis of uncertainties of a cold-ytterbium atomic frequency standard using operational parameters of its optical lattice
Authors: Semenko A.V. , Belotelov G.S. , Sutyrin D.V. , Slyusarev S.N. , Yudin V.I. , Taichenachev A.V. , Ovsiannikov V.D. , Pal’chikov V.G.
Published: May 2021

We have assessed the effect of optical lattice laser field parameters (polarisation, intensity, and wavelength) of a cold-ytterbium atomic frequency standard on the systematic uncertainty of precision clock transition frequency measurements. The spectrum and polarisation of the laser field of the lattice have been investigated in detail directly in the spatial region of interaction of cold ytterbium atoms with the laser field. The Stark shift of the clock transition in the vicinity of the magic wavelength of the laser has been estimated as a function of the experimentally measured laser field intensity in the dipole approximation. The estimates have been used to calculate the residual systematic uncertainty in the light shift of the optical lattice laser frequency.
Objective identification of thunderstorm gust fronts in numerical weather prediction models for fire weather forecasting
Authors: Bresch James F. , Powers Jordan G. , Schwartz Craig S. , Sobash Ryan A. , Coen Janice L.
Published: May 2021

Abrupt changes in wind direction and speed can dramatically impact wildfire development and spread, endangering firefighters. A frequent cause of such wind shifts is outflow from thunderstorms and organised convective systems; thus, their identification and prediction present critical challenges for fire weather forecasters. Here, we develop a methodology and implement it in a software tool that can identify and depict convective outflow boundaries in high-resolution numerical weather prediction (NWP) models to provide guidance for fire weather forecasting. The tool can process model output, objectively identify gust fronts, and graphically display detected gust fronts and similar boundaries in NWP model forecasts. The tool is demonstrated with output from the Weather Research and Forecasting (WRF) model from the operational High-Resolution Rapid Refresh (HRRR) forecasting system and from a WRF ensemble run at the National Center for Atmospheric Research that can provide probabilistic information about model-predicted gust fronts. The tool can identify outflow boundaries in model forecasts of convective events occurring in both simple and complex terrain, both with and without concurrent wildfire activity. With accurate underlying model forecast output, the tool can reliably reveal areas of potential gust front activity and thus provide valuable guidance to incident meteorologists and command personnel.
High energy density and extremely stable supercapacitors based on carbon aerogels with 100% capacitance retention up to 65,000 cycles
Authors: Ma Yu , Chen Ding , Fang Zhi , Zheng Yapeng , Li Weijun , Xu Shang , Lu Xianlu , Shao Gang , Liu Qiao , Yang Weiyou
Published: May 2021

Significance

This work explores carbon aerogels with a three-dimensional interconnected nanofiber network and rationally designed hierarchical porous structures, which endow the supercapacitors (SCs) with both high energy density and long-term stability, with the goal of practical application. The as-constructed SCs have a high specific capacitance of 297 F ⋅ g
–1
at 1 A ⋅ g
–1
and remarkable energy density of 14.83 Wh ⋅ kg
−1
at 0.60 kW ⋅ kg
−1
, both of which are much higher than those of most carbon-based SCs. Significantly, they have an extremely high stability, with capacitance retention of 100% over 65,000 cycles, the best among carbon-based SCs.
Phragmidium nambuanum.
Authors:   USA, USDA-ARS
Published: May 2021

There is little published information on this plant pathogenic fungus, which has a limited geographic distribution. As hosts exist in other regions of the world with similar environmental conditions, this species may pose a threat to native or agricultural plants if introduced.
Heterodera glycines (soybean cyst nematode).
Authors: Hunt David
Published: May 2021

The soybean cyst nematode H. glycines is a known major pest of soybean in regions of the USA particularly semi-arid areas. The nematode has now been found as a pest of soybean outside the USA in Argentina, Brazil, Colombia, China, Egypt, Indonesia, Iran, Italy, Japan, Korea, Paraguay and the former Soviet Union. Other hosts include Phaseolus beans. It can survive in a semi-dried state and is easily spread in soil or on plant material. It is a pest in temperate areas and does not develop below 15°C or above 33°C. Once introduced, the populations of the nematode can rapidly increase as it will complete 6-7 generations per growing season.
Magnetic coupling across the antiferromagnetic–antiferromagnetic interface
Authors: Jena Bibhuti Bhusan , Kar Arunava , Barman Sukanta , Mandal Suman , Menon Krishnakumar S R
Published: May 2021

We investigate the magnetic coupling across the antiferromagnetic–antiferromagnetic (AFM–AFM) interface for the prototypical CoO-NiO bilayer system where the bulk Néel temperature (T
N
) of NiO is higher than that of CoO. Using the temperature-dependent exchange-scattered electron intensities from the surface AFM lattice, the surface T
N
of CoO was estimated as a function of the CoO/NiO film thicknesses. Our results show that the surface T
N
of CoO layers is enhanced significantly from its bulk T
N
value and approaching the T
N
of the NiO layers, as the thickness of the CoO layers is reduced to the monolayer limit. Thus, thinner CoO layers are found to have higher T
N
than thicker layers on NiO, contrasting with the expected finite-size behavior. In addition to the short-range magnetic exchange coupling at the CoO-NiO interface, we observe the existence of a longer-range magnetic coupling across the interface, mediated by the magnetic correlations. Thus, the magnetic proximity effect is attributed to a combination of a short-range and a weaker long-range magnetic coupling, explaining the long AFM order propagation length in AFM–AFM superlattices and bilayers. Further, our results indicate a new approach to tune the AFM Néel temperature by varying the individual layer thickness of the bilayer system through the magnetic proximity effect.
Bloch oscillations at room temperature in graphene/h-BN electrostatic superlattices
Authors: Dragoman M , Dinescu A , Dragoman D , Comanescu Florin
Published: May 2021

In this manuscript, we report the fabrication and the measurements of Bloch oscillations at room temperature in electrostatic graphene/h-BN superlattices. The electrostatic superlattice consists of an array of tilted metallic electrodes deposited over graphene monolayer/h-BN monolayer grown on 2 inch wafers of doped Si/SiO2. We show the formation of minibands at room temperature, negative differential resistance and the evidence of Bloch oscillations. The experimental results are sustained by numerical modelling of these 2D superlattices. The experimental results are sustained by numerical modelling of these 2D superlattices. At room temperature, we have measured a period of Bloch oscillations of 55 meV which corresponds to a frequency of 13 THz.
Core−shell NiSe/Ni(OH)2 with NiSe nanorods and Ni(OH)2 nanosheets as battery-type electrode for hybrid supercapacitors
Authors: He Leqiu , Wang Yan , Guo Yajie , Li Guobing , Zhang Xubin , Cai Wangfeng
Published: May 2021

Novel core−shell nanostructure electrodes benefit from the excellent properties of their constituent materials, as well as the synergy between them. However, it is challenging to fabricate such structures efficiently. In this study, NiSe nanorods were fabricated using Ni foam as the conductive substrate and reactant via a one-step hydrothermal process, and Ni(OH)2 nanosheets were coated on the surface of the nanorods via one-step electrodeposition. The effect of the structure and morphology on the properties of the material was explored using scanning electron microscopy, x-ray diffraction, and electrochemical technology. The obtained core−shell NiSe/Ni(OH)2 exhibited an areal capacity of 1.89 mAh cm−2 at a current density of 5 mA cm−2. The assembled NiSe/Ni(OH)2//AC hybrid supercapacitor exhibited excellent energy and power densities, indicating that NiSe/Ni(OH)2 has great potential for use as a battery-type electrode in energy storage systems.
Low n electromagnetic modes in spherical tokamaks
Authors: Chowdhury J , McMillan B F
Published: May 2021

The performance of spherical tokamak reactors depends on plasma β, and an upper limit is set by long-wavelength kinetic ballooning modes (KBMs). We examine how these modes become unstable in spherical-tokamak reactor relevant plasmas, which may contain significant fast-ion pressure. In a series of numerically generated equilibria of increasing β, the KBM becomes unstable at sufficiently high plasma β, and for such cases, it is also significantly unstable even in the long-wavelength limit. The β threshold for the KBMs is similar to the ideal Magnetohydrodynamics (MHD) threshold, and in cases without fast ions, their frequencies are as predicted by diamagnetic-drift stabilised MHD. To isolate and explore the KBMs, simulations are performed where the pressure gradient is entirely due to the density profile, or entirely due to the temperature profile; the resulting KBMs have similar properties in the long-wavelength regime. The introduction of energetic ions restricts the KBMs to longer wavelengths, and reduces the β threshold somewhat; for parameter regimes of current-day devices, this is such long wavelength that a global analysis would become necessary. Mode frequencies in plasmas with a significant fast particle population are seen to be controlled by fast particle precession frequencies.
Three-dimensional coherent x-ray diffraction imaging of ferroelastic domains in single CsPbBr3 perovskite nanoparticles
Authors: Dzhigaev D , Zhang Z , Marçal L A B , Sala S , Björling A , Mikkelsen A , Wallentin J
Published: May 2021

Metal halide perovskites attract significant interest due to their remarkable performance in optoelectronic devices. However, the gap in understanding the relationship between their nanoscale structure and properties limits their application towards novel devices. In this work, twinned ferroelastic domains in single 500 nm CsPbBr3 particles are studied with 3D Bragg coherent x-ray diffraction imaging. A preferential double-domain structure is revealed in four identical particles, with one domain oriented along the [110] and the other along the [002] direction. The particles exhibit similar scattering volume ratios of 0.12 ± 0.026 between twin phases, suggesting the possibility of a deterministic formation process. The domains exhibit a difference in lattice tilt of 0.59 degrees, in excellent agreement with calculations of the lattice mismatch at the (112) twin boundary. These results provide important insights both for the fundamental understanding of ferroelastic nanoscale materials and for the performance improvement of perovskite-based devices. Moreover, this work paves the way towards real-time imaging of the domain dynamics in ferroic systems.
Inclusion–exclusion principle for open quantum systems with bosonic bath
Authors: Yang Siyao , Cai Zhenning , Lu Jianfeng
Published: May 2021

We present two fast algorithms which apply inclusion–exclusion principle to sum over the bosonic diagrams in bare diagrammatic quantum Monte Carlo and inchworm Monte Carlo method, respectively. In the case of inchworm Monte Carlo, the proposed fast algorithm gives an extension to the work [2018 Inclusion–exclusion principle for many-body diagrammatics Phys. Rev. B 98 115152] from fermionic to bosonic systems. We prove that the proposed fast algorithms reduce the computational complexity from double factorial to exponential. Numerical experiments are carried out to verify the theoretical results and to compare the efficiency of the methods.
A bird’s eye perspective of the measurement of oxygen reduction reaction in gas diffusion electrode half-cell set-ups for Pt electrocatalysts in acidic media
Authors: Loukrakpam Rameshwori , Ferreira Gomes Bruna , Kottakkat Tintula , Roth Christina
Published: May 2021

Reliable electrochemical testing protocols assessing the catalytic performance of novel materials, such as the rotating disk electrode method to determine the oxygen reduction reaction activity, play an essential role in the knowledge-based design of tailored electrocatalysts. However, these techniques are unable to accurately predict the performance of the developed electrocatalysts in membrane electrode assemblies (MEAs) which are ultimately used in full fuel cell measurements. Half-cell tests of gas diffusion electrodes have been shown to be a good compromise, with economical use of electrocatalysts while also mimicking the three-phase boundary in MEA during the presence of humidified reactant gas. In this review, we aim for a bird’s eye view of the set-ups already reported, how the testing protocols differ and how the protocols can be unified for a more consistent performance evaluation.
Distinct forms of the actin cross-linking protein α-actinin support macropinosome internalization and trafficking
Authors: Burton Kevin M. , Johnson Katherine M. , Krueger Eugene W. , Razidlo Gina L. , McNiven Mark A.
Published: May 2021

Macropinocytosis is an essential mechanism by which pancreatic tumor cells internalize extracellular material to be used as an energy source to fuel proliferation. We describe the mechanism by which the actin cross-linking α-actinin proteins mediate membrane ruffling and macropinosome delivery to the lysosome during this process.
External validation of the Hospital Frailty Risk Score in France
Authors: Gilbert Thomas , Cordier Quentin , Polazzi Stéphanie , Bonnefoy Marc , Keeble Eilìs , Street Andrew , Conroy Simon , Duclos Antoine
Published: May 2021

Background

The Hospital Frailty Risk Score (HFRS) has made it possible internationally to identify subgroups of patients with characteristics of frailty from routinely collected hospital data.

Objective

To externally validate the HFRS in France.

Design

A retrospective analysis of the French medical information database.

Setting

743 hospitals in Metropolitan France.

Subjects

All patients aged 75 years or older hospitalised as an emergency in 2017 (n = 1,042,234).

Methods

The HFRS was calculated for each patient based on the index stay and hospitalisations over the preceding 2 years. Main outcome measures were 30-day in-patient mortality, length of stay (LOS) >10 days and 30-day readmissions. Mixed logistic regression models were used to investigate the association between outcomes and HFRS score.

Results

Patients with high HFRS risk were associated with increased risk of mortality and prolonged LOS (adjusted odds ratio [aOR] = 1.38 [1.35–1.42] and 3.27 [3.22–3.32], c-statistics = 0.676 and 0.684, respectively), while it appeared less predictive of readmissions (aOR = 1.00 [0.98–1.02], c-statistic = 0.600). Model calibration was excellent. Restricting the score to data prior to index admission reduced discrimination of HFRS substantially.

Conclusions

HFRS can be used in France to determine risks of 30-day in-patient mortality and prolonged LOS, but not 30-day readmissions. Trial registration: Reference ID on clinicaltrials.gov: ID: NCT03905629.
The Association Between Cytomegalovirus and Disability by Race/Ethnicity and Sex: Results From the Health and Retirement Study
Authors: Duchowny Kate A , Noppert Grace A
Published: May 2021

Recent studies have documented a decline in the overall prevalence of disability in the United States; however, racial/ethnic and sex disparities continue to persist. Cytomegalovirus (CMV) infection, a socially patterned exposure, may be a key mechanism in understanding these previously documented disparities. Using data from a nationally representative study, the 2016 Health and Retirement Study, we employed Poisson log-binomial models to estimate the prevalence of disability in a comparison of CMV-seropositive and -seronegative adults and investigated effect modification by race/ethnicity and sex. Among the 9,029 participants (55% women; mean age = 67.4 years), 63% were CMV-seropositive and 15% were disabled. CMV seropositivity was highest among non-Hispanic Black (88%) and Hispanic (92%) adults as compared with non-Hispanic White adults (57%). We found evidence for effect modification in the association between CMV and disability by sex but not race/ethnicity. While the 95% confidence intervals in the fully adjusted models included the null value, in comparison with seronegative women, our results suggest a greater prevalence of disability among CMV-seropositive women (prevalence ratio = 1.16, 95% confidence interval: 0.97, 1.38) but not among men (prevalence ratio = 0.85, 95% confidence interval: 0.69, 1.06). Results provide initial support for the hypothesis that CMV may be an important determinant of sex disparities in disability.
Organ preservation in the multimodality approach to locally advanced oesophageal cancer:festina lente
Authors: Bolger J C , Reynolds J V
Published: May 2021

Morbidity and impacts on quality of life remain significant issues following oesophagectomy for oesophageal cancer. This paper reviews and weighs the current evidence both in favour of and against the adoption of an organ-preserving approach in patients with a complete clinical response to neoadjuvant therapy.
Cardiac risk stratification in emergency resection for colonic tumours
Authors: Bass G A , Forssten M , Pourlotfi A , Ahl Hulme R , Cao Y , Matthiessen P , Mohseni S
Published: May 2021

Background

Despite advances in perioperative care, the postoperative mortality rate after emergency oncological colonic resection remains high. Risk stratification may allow targeted perioperative optimization and cardiac risk stratification. This study aimed to test the hypothesis that the Revised Cardiac Risk Index (RCRI), a user-friendly tool, could identify patients who would benefit most from perioperative cardiac risk mitigation.

Methods

Patients who underwent emergency resection for colonic cancer from 2007 to 2017 and registered in the Swedish Colorectal Cancer Registry (SCRCR) were analysed retrospectively. These patients were cross-referenced by social security number to the Swedish National Board of Health and Welfare data set, a government registry of mortality, and co-morbidity data. RCRI scores were calculated for each patient and correlated with 90-day postoperative mortality risk, using Poisson regression with robust error of variance.

Results

Some 5703 patients met the study inclusion criteria. A linear increase in crude 90-day postoperative mortality was detected with increasing RCRI score (37.3 versus 11.3 per cent for RCRI 4 or more versus RCRI 1; P < 0.001). The adjusted 90-day all-cause mortality risk was also significantly increased (RCRI 4 or more versus RCRI 1: adjusted incidence rate ratio 2.07, 95 per cent c.i. 1.49 to 2.89; P < 0.001).

Conclusion

This study documented an association between increasing cardiac risk and 90-day postoperative mortality. Those undergoing emergency colorectal surgery for cancer with a raised RCRI score should be considered high-risk patients who would most likely benefit from enhanced postoperative monitoring and critical care expertise.
Neuronal SETD2 activity links microtubule methylation to an anxiety-like phenotype in mice
Authors: Koenning Matthias , Wang Xianlong , Karki Menuka , Jangid Rahul Kumar , Kearns Sarah , Tripathi Durga Nand , Cianfrocco Michael , Verhey Kristen J , Jung Sung Yun , Coarfa Cristian , Ward Christopher Scott , Kalish Brian Thomas , Grimm Sandra L , Rathmell W Kimryn , Mostany Ricardo , Dere Ruhee , Rasband Matthew Neil , Walker Cheryl Lyn , Park In Young
Published: May 2021

Gene discovery efforts in autism spectrum disorder have identified heterozygous defects in chromatin remodeller genes, the ‘readers, writers and erasers’ of methyl marks on chromatin, as major contributors to this disease. Despite this advance, a convergent aetiology between these defects and aberrant chromatin architecture or gene expression has remained elusive. Recently, data have begun to emerge that chromatin remodellers also function directly on the cytoskeleton. Strongly associated with autism spectrum disorder, the SETD2 histone methyltransferase for example, has now been shown to directly methylate microtubules of the mitotic spindle. However, whether microtubule methylation occurs in post-mitotic cells, for example on the neuronal cytoskeleton, is not known. We found the SETD2 α-tubulin lysine 40 trimethyl mark occurs on microtubules in the brain and in primary neurons in culture, and that the SETD2 C-terminal SRI domain is required for binding and methylation of α-tubulin. A CRISPR knock-in of a pathogenic SRI domain mutation (Setd2SRI) that disables microtubule methylation revealed at least one wild-type allele was required in mice for survival, and while viable, heterozygous Setd2SRI/wtmice exhibited an anxiety-like phenotype. Finally, whereas RNA-sequencing (RNA-seq) and chromatin immunoprecipitation-sequencing (ChIP-seq) showed no concomitant changes in chromatin methylation or gene expression in Setd2SRI/wtmice, primary neurons exhibited structural deficits in axon length and dendritic arborization. These data provide the first demonstration that microtubules of neurons are methylated, and reveals a heterozygous chromatin remodeller defect that specifically disables microtubule methylation is sufficient to drive an autism-associated phenotype.
The Emergence of Objective Guidelines for Granting Immunity to International Non-Governmental Organizations
Authors: Pavot David , Laperle-Forget Lolita
Published: May 2021

Out of thousands of international non-governmental organizations (INGOs), only five benefit from immunities from jurisdiction and execution: the International Committee of the Red Cross (ICRC), the International Union for Conservation of Nature (IUCN), the Global Fund to Fight AIDS, Tuberculosis, and Malaria; Gavi, the Vaccine Alliance (Gavi), and the World Anti-Doping Agency (WADA). Based on empirical research, this article argues that there is an emerging State practice in granting immunity only to INGOs that meet two cumulative criteria: a hybridity character and a mission of international interest, formally recognized in a source of international law. This article proposes a new approach based on both Functionalism and Institutionalism that addresses the specificities of INGOs and thus shows that international law provides guidance on the granting of immunities.
Patient Adherence to Fecal Calprotectin Testing Is Low Compared to Other Commonly Ordered Tests in Patients With Inflammatory Bowel Disease
Authors: Khakoo Nidah S , Lewis Ayanna , Roldan Giovanni A , Al Khoury Alex , Quintero Maria A , Deshpande Amar R , Kerman David H , Damas Oriana M , Abreu Maria T
Published: May 2021

Background

Limited data exist on adherence to fecal calprotectin (FCP) testing in patients with inflammatory bowel disease.

Methods

Completion rates for patients who had at least one FCP test ordered (n = 3082) and a subgroup with C-reactive protein, complete blood count, and Clostridium difficile tests also ordered (n = 1563) were analyzed.

Results

More patients completed blood than stool tests, with FCP having the poorest adherence of all tests analyzed. Older patients had higher FCP completion rates. No differences were noted in completion rates across age, gender, or ethnicity for blood tests.

Conclusions

Further studies are needed to develop strategies that improve the uptake of FCP.
Epidemiology of dementia onset captured in Canadian primary care electronic medical records
Authors: Pham Anh N Q , Voaklander Don , Wagg Adrian , Drummond Neil
Published: May 2021

Background

Dementia is an increasing concern in many countries, especially in those experiencing rapid growth in the proportion of older adults in their population.

Objective

This study aims to describe trends and demographic characteristics of incident dementia cases in community-dwelling older adults managed by primary care physicians.

Methods

We used electronic medical records from the Canadian Primary Care Sentinel Surveillance Network database to conduct a retrospective analysis to determine the number of, and trends for, incident diagnoses of dementia. Age-standardized annual incidence rates were calculated. Participants in our cohort are Canadian community dwelling seniors aged 65+ years who were not diagnosed with dementia before baseline with at least six years of record at their primary care clinics.

Results

The cohort consisted of 39 067 patients of whom 57% were females; the mean (SD) follow-up was 8.4 (1.5) years. During follow-up, 4935 patients were diagnosed with dementia. The risk for dementia diagnosis increased with increasing age but decreased in the last four years among people aged 80 and older at baseline (P < 0.001). People with dementia were more likely to be females (P = 0.001) and urban residents (P < 0.001), they are less likely to be classified into the least deprived group (P = 0.012).

Conclusions

The incidence of dementia diagnosis increased with age except in the oldest old in both sexes. This may be attributed to the effect of mortality competing risk. Future research on the association between risk factors and dementia should consider studying dementia among the oldest old separately to minimize bias.
Exemption for the poor or the rich? An assessment of socioeconomic inequalities in Ghana’s national health insurance exemption policies
Authors: Novignon Jacob , Atakorah Yaw Boateng , Chijere Chirwa Gowokani
Published: May 2021

Out-of-pocket payments for health are considered a major limitation to universal health coverage (UHC). Policymakers across the globe are committed to achieving UHC through the removal of financial barriers to health care. In Ghana, a national health insurance scheme was established for this purpose. A unique feature of the scheme is its premium exemption policies for vulnerable groups. In this article, we access the nature of socioeconomic inequality in these exemption policies. We used data from the Ghana Living Standards Survey rounds six and seven. Socioeconomic inequality was assessed using concentration curves and indices. Real household annual total consumption expenditure adjusted by adult equivalence scale was used as a wealth indicator. Four categories of exemption were used as outcome variables. These were exemptions for indigents, individuals <18 years, the aged and free maternal service. The analysis was also disaggregated by rural and urban locations of individuals. We found that while overall national health insurance scheme (NHIS) coverage was concentrated among the wealthy, all categories of premium exemption were concentrated among the poor. There was also evidence of a general decline in the magnitude of inequality over the survey years. With the specific exemptions, inequalities in exemption for indigents and maternal services were most relevant in rural locations, while inequalities in exemption for individuals <18 years and the aged were significant in urban areas. The findings suggest that the exemption policies under the NHIS are generally progressive and achieve the objective of inclusion for the underprivileged. However, it also provides lessons for better targeting and effective implementation. There may be a need for separate efforts to better target individuals in rural and urban locations to improve enrolment.
Rethinking sustainability in childhood obesity prevention interventions: learning from South Australia’s Obesity Prevention and Lifestyle (OPAL) Programme
Authors: Jones Michelle G , Verity Fiona
Published: May 2021

Increases in childhood obesity have occurred across a relatively short time-period, yet childhood obesity prevention is a longer-term game. Programmes have only identified population-level changes after 12 years of on-the-ground activity [Romon et al.]. Community stakeholders can impact the success of public health interventions [Ganter et al.; Lee et al.] and they have been identified as a critical success factor for programme sustainability [Schell et al.]. Qualitative research with stakeholders (n = 59) provides their insights and understandings of the sustainability of OPAL, a South Australian childhood obesity prevention programme. Stakeholders identified activities that they thought contributed to improved sustainability of action such as embedding obesity prevention into organizational policy and plans; and installation of infrastructure within communities to modify physical environments. In contrast, there was little appetite for sustaining OPAL or other formulations of a childhood obesity prevention programme. This research has implications for planning and implementation of community-based childhood obesity prevention initiatives when considering the balance of the portfolio of activities for implementation.
The effects of smoking on pregnancy risks in women with polycystic ovary syndrome: a population-based study
Authors: Feferkorn I , Badeghiesh A , Mills G , Baghlaf H , Dahan M
Published: May 2021

STUDY QUESTION

Is there is an association between smoking and pregnancy complications in pregnant women with polycystic ovarian syndrome (PCOS)?

SUMMARY ANSWER

There is an increased risk of developing gestational diabetes mellitus (GDM) among women with PCOS who smoke.

WHAT IS KNOWN ALREADY

Smokers are at increased risk of developing Type 2 Diabetes Mellitus (DM). Given the common pathophysiology and shared risk factors between type 2 DM and GDM, we sought to assess whether an association between smoking and the development of GDM exists.

STUDY DESIGN, SIZE, DURATION

This is a retrospective population-based study utilizing data from the HCUP-NIS over 11 years from 2004 to 2014. Pregnant women with PCOS who did smoke were compared to pregnant women with PCOS who did not smoke. A second comparison was made between pregnant smokers with and without PCOS. Of the 443 590 women who smoked during pregnancy and the 14 882 women with PCOS, 631 women were both smokers and diagnosed with PCOS.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The Healthcare Cost and Utilization Project—Nationwide Inpatient Sample (HCUP-NIS) is the largest inpatient sample database in the USA and is composed of hospital inpatient stays submitted by hospitals throughout the entire country. Each year, the database provides information relating to 7 million inpatient stays, including patient characteristics, diagnosis and procedures. The data are representative of ∼20% of admissions to US hospitals across 48 states and the District of Columbia.

MAIN RESULTS AND THE ROLE OF CHANCE

There were no differences in the risks of preterm delivery (aOR1.2; CI 0.8–1.9), placental abruption (aOR1.1; CI 0.4–3.2), pregnancy induced hypertension (aOR1.0; CI 0.7–1.5), rate of operative vaginal delivery (aOR1.5; CI 0.9–2.5) and rates of cesarean section (C/S) (aOR1.0; CI 0.7–1.3) between smoking and non-smoking women with PCOS. A significant association between smoking and GDM was observed in women with PCOS (aOR1.5; CI1.01–2.1).

LIMITATIONS, REASONS FOR CAUTION

The limitations of our study are its retrospective nature and the fact that it relies on an administrative database. Data regarding smoking and PCOS diagnosis could be skewed due to patients’ underreporting, lack of documentation and documentation differences.

WIDER IMPLICATIONS OF THE FINDINGS

The public health implications of confirming smoking as a risk for GDM among women with PCOS are many. This can lead to earlier screening in pregnancy of smokers for GDM. Earlier initiation of interventions could decrease fetal complications and possibly have an impact on the life and long-term health of the offspring. Future studies are needed in order to assess whether smoking cessation during pregnancy decreases the risk of GDM in that gestation.

STUDY FUNDING/COMPETING INTEREST(S)

No external funding was used. The authors report no competing interests.

TRIAL REGISTRATION NUMBER

N/A.
Applying health-six-sigma principles helps reducing the variability of length of stay in the emergency department
Authors: KOBO-GREENHUT Ayala , HOLZMAN Keren , RAVIV Osnat , ARAD Jakov , BEN SHLOMO Izhar
Published: May 2021

Background

Reducing length of stay (LOS) is one of the urgent problems in healthcare systems worldwide. Popular methods that are used to reduce LOS are the Lean and the 6 Sigma, which in practice result in limited improvements. In this paper, we introduce and test a tailored method for implementing the 6 Sigma principles in healthcare (we call H-6S).

Objective

To reduce the variability in the time between admission and discharge of patients in the emergency department.

Methods

The study took place within the emergency department (ED) of Josephtal Medical Center in Eilat, Israel. Our analysis focused on the processes of examining and treating patients from admission to ED until discharge home. The analysis was done during the second quarter of 2018. The implementation of the recommendations took place during Q3 2018. The reported results are from Q3 2018 to Q2 2019, compared to the corresponding period in 2017 (experienced team).

Results

In Q2 2017, LOS was 2.42 ± 2.07 h (experienced team, n = 9928). In Q2 2018, the LOS was 2.62 ± 7.04 h (before the H-6S, inexperienced team, n = 9484). In Q2 2019 following the intervention, it reached 2.3 ± 1.74 h (n = 7647). The differences between the standard deviations of the three periods are significant.

Conclusion

Implementing H-6S dropped the variance of LOS within 3 months and remained low for the whole year. Each new team of physicians who enter the ED should be thoroughly instructed as to the routines and expectations of the system from them, which should narrow the differences of previous education between them.
Epigenetic approaches to crop breeding: current status and perspectives
Authors: Dalakouras Athanasios , Vlachostergios Dimitrios
Published: May 2021

In order to tackle the cumulative adverse effects of global climate change, reduced farmland, and heightened needs of an ever-increasing world population, modern agriculture is in urgent search of solutions that can ensure world food security and sustainable development. Classical crop breeding is still a powerful method to obtain crops with valued agronomical traits, but its potential is gradually being compromised by the menacing decline of genetic variation. Resorting to the epigenome as a source of variation could serve as a promising alternative. Here, we discuss current status of epigenetics-mediated crop breeding (epibreeding), highlight its advances and limitations, outline currently available methodologies, and propose novel RNA-based strategies to modify the epigenome in a gene-specific and transgene-free manner.
UK Listing, Prospectus, and Disclosure Regime
Authors: Pearce Will
Published: May 2021

This chapter talks about the current UK listing regime that stems from the EU legislation that was enacted as part of the European Commission's action plan for the Capital Markets Union (CMU) and Financial Services Action Plan (FSAP). It describes the aims of the CMU and the FSAP in order to achieve a single financial services market with no obstacles to cross—border activity and a sound supervisory structure. It also highlights the key EU legislation that governs the UK listing regime, which includes the prospectus regulation that regulates the prospectus to be published when a company's securities are to be offered to the public or admitted to trading on a regulated market in the European Economic Area (EEA). This chapter discusses the Market Abuse Regulation (MAR), which covers the disclosure and control of inside information and the offences of market manipulation and insider dealing. It also mentions the Transparency Directive that harmonizes transparency requirements for issuers whose securities are admitted to trading on a regulated market.
Credit Rating Agencies
Authors: Eborall Charlotte
Published: May 2021

This chapter concentrates on credit rating agencies (CRAs), which play a key role in financial markets. It explains how CRAs help reduce information asymmetry between investors and issuers by providing an independent assessment of the relative creditworthiness of countries or companies. It also describes how CRA's role has expanded significantly in recent decades with financial globalization, such as the introduction of references to credit ratings in regulations and the embedding by market participants of ratings in their operating procedures, investment decisions, and contracts. This chapter identifies the heavy reliance on CRAs as one of the main contributors to the global financial crisis in 2008. It also talks about the efficacy of CRAs' credit ratings after 2008, in which regulators in the United States (US) and Europe introduced new regulations intended to address the reliability of CRAs' predictions of probability of default.
OHADA
Authors: Monsenepwo Justin
Published: May 2021

This chapter describes the relationship between the Organisation pour l’Harmonisation en Afrique du Droit des Affaires (OHADA; the Organization for the Harmonization of Business Law in Africa) and the Hague Principles. OHADA is an African supranational organization which was created on October 17, 1993. As per the Preamble and Article 1 of the OHADA Treaty, OHADA aims at creating simple, modern, and harmonized business law rules in Africa. To achieve this goal, OHADA has five institutions: (i) the Conference of Heads of State and Government; (ii) the Council of Ministers; (iii) the Common Court of Justice and Arbitration; (iv) the Regional Training Centre for Legal Officers; and (v) the Permanent Secretariat. Uniform Acts are the main instrument of OHADA. To understand the rules governing choice of law in commercial international contracts under OHADA law, it is important to examine the relation between the acts of OHADA (Uniform Acts and regulations) and the domestic law of the Member States. Meanwhile, there is no uniform codification of private international law under OHADA law. The chapter then explains that the Working Group on the Preliminary Draft Uniform Act on the Law of Obligations in the OHADA Region in 2015 did not use the Hague Principles, and why this omission should be reversed.
Common Law Africa
Authors: Oppong Richard Frimpong
Published: May 2021

This chapter studies the common law African countries Gambia, Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia. Their main source of private international law rules is judicial decisions or case law. Because of the relatively underdeveloped nature of their private international law regimes, foreign case law often serves as an important source of persuasive authority. In this regard, the jurisprudence of the English courts is particularly persuasive and is often referred to by the courts. In general, an international convention or treaty does not have the force of law in the legal systems of the countries under study, unless it is expressly incorporated into national law. In essence, they are dualist countries. However, courts in some of the countries under study have demonstrated a willingness to seek guidance from international treaties that are not yet domestically in force, if the circumstances are appropriate. Thus, it is possible, that courts in the countries under study may be receptive to the Hague Principles, especially if argued by counsel.
Tunisia
Authors: Elbalti Béligh
Published: May 2021

This chapter focuses on Tunisian perspectives on the Hague Principles. The main source of private international law in Tunisia is the 1998 Code of private international law (CPIL). Tunisia has not signed any convention on choice of law in international contractual matters. However, it is worth mentioning that, in the field of international arbitration, some conventions to which Tunisia is party include an express reference to party autonomy. As a matter of principle, Tunisian courts are bound only by Tunisian law and other international instruments duly ratified by Tunisia. Nevertheless, it is not uncommon that Tunisian courts refer to foreign laws, international conventions not ratified by Tunisia, model laws, foreign case law, or even foreign legal literature when such reference is deemed persuasive. Therefore, it can be safely said that nothing prevents Tunisian courts from referring to the persuasive authority of the Hague Principles. This would be the case if the parties invoked the Principles in support of their arguments in the case where a clear solution is lacking under Tunisian law.
Japan
Authors: Nishitani Yuko
Published: May 2021

This chapter discusses Japanese perspectives on the Hague Principles. Japan belongs to the civil law system, although some legal institutions grounded in common law also exist. At the end of the nineteenth century, Japan transplanted Western legal systems. Along with the codification of the Civil Code and other statutes, the Private International Law Act, Hôrei, was adopted in 1898, which was modernized and substituted by the Japanese Act on General Rules for Application of Laws (AGRAL) in 2006. The AGRAL designates, out of several conflicting laws, the law which has the closest connection with the legal relationship concerned. This value-neutral, multilateral method consists in localizing the legal relationship in a certain jurisdiction, grounded on the equality and interchangeability of domestic law and foreign law. While the judge does not have the authority to directly apply the Hague Principles instead of the AGRAL in litigation, the judge can certainly refer to the Hague Principles in seeking guidance for interpretation or filling gaps of the AGRAL, same as for other international, regional, or domestic conflicts rules, including the relevant Hague Conventions.
Macau
Authors: Tu Guangjian
Published: May 2021

This chapter focuses on Macau perspectives on the Hague Principles. It clarifies a few points before examining the contractual choice of law rules in Macau in detail. First, the Macau Civil Code that is the most important source for conflict of laws rules was derived from the 1966 Portuguese Civil Code. Second, due to the fact that Macau is a jurisdiction belonging to the civil law family, court decisions in Macau, theoretically, are not a source of law and do not formally have binding legal effects. Third, while legal doctrine developed by scholars in Macau is not a formal source of law, it may have influence on legislation and provide guidance for court decisions. Fourth, although some revision has been made for the Macau Civil Code since its entry into force in 1999, so far there has not been any initiative to revise its conflicts system, let alone its contractual conflicts rules. Unfortunately, the Hague Principles as a whole or any part therein cannot be incorporated into Macau’s legislation in the near future. Nevertheless, theoretically speaking, broadly accepted international customs and usages could be resorted to as ‘persuasive authority’ by Macau judges in judicial practice. The chapter then provides a comparison between the Hague Principles and Macau law.
Singapore
Authors: Yeo Tiong Min
Published: May 2021

This chapter describes Singaporean perspectives on the Hague Principles. Party autonomy is recognized as a very important principle in the private international law of Singapore. The primacy given to the role of party autonomy is evidenced by the adoption of the New York Convention and UNCITRAL Model Law for international arbitration, the adoption of the Convention on Choice of Court Agreements for international litigation, and the palpable support of the UNCITRAL Convention on International Settlement Agreements Resulting from Mediation. Most of private international law in Singapore is sourced in judge-made law. In the absence of direct Singapore authority, Singapore courts have traditionally looked to English case law for guidance, but increasingly, the courts have looked to the laws of other jurisdictions, and indeed international instruments which do not have binding force in Singapore law. Given the level of sophistication of existing common law contract choice of law rules, it is unlikely that Singapore will engage in radical law reform. However, it is likely that the Singapore courts will continue to look to the Hague Principles for guidance in areas where the common law is unclear or where there is a gap or strong imperative for change.
United Arab Emirates
Authors: Bälz Kilian
Published: May 2021

This chapter presents Emirati perspectives on the Hague Principles. The United Arab Emirates (UAE) are a federal State that was established in 1971. Private international law, civil procedure, and arbitration all are federal matters that are covered by federal laws. Private international law is codified in a section of the UAE Civil Code (Federal Law No 5 of 1985) that deals in Articles 10 to 28 with ‘The application of the law regarding the place’. The section also contains the conflict of law rules applicable to international commercial contracts. The statutory provisions of the Civil Code are, in practical terms, the most important source of law when determining the law applicable to an international contract in the UAE. According to Article 22 of the Civil Code, international treaties, to the extent they apply, override the provisions of municipal law. Moreover, Article 23 of the Civil Code provides that in the absence of any statutory provision, ‘the [general] principles of private international law’ shall apply. This provides the UAE courts with the option to make reference to international standards such as the Hague Principles.