bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Vitamin D, Folate and Fatty Acid Levels in Children with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis
Authors: Gallardo-Carrasco Maria Carmen , Jiménez-Barbero José Antonio , Bravo-Pastor María del Mar , Martin-Castillo David , Sánchez-Muñoz María
Published: November 2021

Vitamin and fatty acid deficiency in children diagnosed with autism has been linked to the etiology and course of the disease but the results have been inconsistent. In our work, we present a narrative review, which includes 20 observational studies that provide data on the blood levels of vitamin D, folate, or fatty acids of children diagnosed with ASD (Autism Spectrum Disorder—AG group), and of a control group (children without this disorder—CG group). The main characteristics and results are presented in a summary table. Of the 20 above-mentioned studies, a meta-analysis of vitamin D and folate levels was carried out in 14 of them, with a total of 2269 children (AG = 1159, CG = 1110). Vitamin D levels were lower in AG compared to CG: SMD, 95% CI = − 0.83 [− 1.15, − 0.50]. In terms of folate levels, a total of 299 children (AG = 148, CG = 151) were analyzed, finding no significant differences with the control group: SMD, 95% CI = − 0.16 [− 0.63, 0.32]. Only one study that provided data on fatty acids in children with ASD was included in the review although it was not possible to include it in the meta-analysis. We conclude that the nutritional status (vitamin and fatty acid levels) of patients diagnosed with ASD should be taken into account, as correct adjustment of these levels—may produce an improvement in the course of the disease and could also reduce the risk of its development.
Stringing Together Cowrie Shells in the African Archaeological Record with Special Reference to Southern Africa
Authors: Moffett Abigail Joy , Nyamushosho Robert. Tendai , Bandama Foreman , Chirikure Shadreck
Published: November 2021

Archaeological explorations of the meaning of ‘trade objects’, such as glass beads and cowrie shells, remain hampered by theoretical and methodological limitations in both their analyses and interpretations. In this paper, we develop a methodology for critically engaging in multi-scalar questions of the circulation, exchange, and value of cowrie shells in African archaeological contexts. Species, size, dorsal modifications, and depositional contexts were compared across five sites from South Africa dating between 750 and 1350 CE. These results were positioned within a review of cowries from archaeological sites in the region and compared to the documented distribution of cowries from wider African archaeological contexts.Monetaria annuluswere the prevalent cowrie species in southern African archaeological contexts over the last 2000 years, with a notable absence ofMonetaria moneta, prevalent at contemporaneous sites in West Africa, as well as a variety of endemic southern African species. Breakage patterns on the dorsal surface correspond to different modification techniques, such as chipping and grinding. Combined analyses of modification, use-wear, and depositional patterns show variation, revealing a diversity in the biographies of individual cowries. While a comparison of the distribution of cowries across the continent confirms the circulation of cowries through known trade routes, such as the trans-Saharan trade network and the European mercantile network, they also reveal new pathways for exchange that highlight the need for further exploration of intra African networks. Finally, the breadth of the results of this study demonstrates the value of a focus on a specific artefact to address a wide range of themes, from exchange to the archaeology of everyday life.
Longitudinal measurement invariance of the international spinal cord injury quality of life basic data set (SCI-QoL-BDS) during spinal cord injury/disorder inpatient rehabilitation
Authors: Kunz Simon , Carrard Valerie , Galvis Aparicio Mayra , Scheel-Sailer Anke , Fekete Christine , Lude Peter , Post Marcel W. M. , Westphal Maren
Published: November 2021

Purpose

This study aimed at testing the internal consistency and longitudinal measurement invariance of a brief quality of life questionnaire—the spinal cord injury quality of life basic data set (SCI-QoL-BDS)—among individuals with spinal cord injury/disorder undergoing first inpatient rehabilitation.

Methods

Longitudinal data from the Swiss spinal cord injury inception cohort study were used. Participants (n = 218) completed the SCI-QoL-BDS at one and three months post injury and at discharge. The SCI-QoL-BDS consists of three items assessing satisfaction with life as a whole, physical health, and psychological health. Internal consistency was examined at each time point and longitudinal measurement invariance was tested using longitudinal confirmatory factor analysis.

Results

Internal consistency coefficients ranged between .82 and .90. The confirmatory factor analysis revealed invariance of the factor structure and of all factor loadings across time. Additionally, all item intercepts except the one of satisfaction with physical health were invariant across time, suggesting partial intercept invariance of the SCI-QoL-BDS. Indeed, a response shift was observed in satisfaction with physical health. This item was evaluated more negatively in the early phase of inpatient rehabilitation, indicating the change of the evolving physical situation after the onset of a spinal cord injury.

Conclusion

The SCI-QoL-BDS is a consistent and valid measure to assess quality of life among individuals undergoing first spinal cord injury/disorder inpatient rehabilitation. However, we recommend using latent variable frameworks instead of mean scores when examining longitudinal changes in the measure to account for potential response shift.
Understanding the Tribological Behavior of Graded (Cr,Al)N + Mo:S in Fluid-Free Friction Regime
Authors: Bobzin K. , Kalscheuer C. , Thiex M.
Published: November 2021

Components running in fluid-free friction regimes are exposed to harsh conditions leading to increased friction and wear. Thereby, the use of the solid lubricant molybdenum disulfide (MoS2) via lacquers, powders or physical vapor deposition (PVD) coatings enables a friction and wear reduction. However, the tribological performance is limited to low mechanical loads. A promising coating concept already proven for high mechanical loads is the incorporation of the triboactive elements Mo and S in wear resistant hard nitride (Cr,Al)N matrix. In this study the supply mechanism and transfer of the tribofilm build out of the toplayer of the triboactive coating graded (Cr,Al)N + Mo:S under high mechanical loads at humid air were analyzed. Here, the chemical composition of the tribofilm was determined by a combination of Raman spectroscopy and X-ray photoelectron spectroscopy (XPS) and correlated with tribological analysis. The results prove a friction and wear reduction independent of Hertzian pressure in the area of 400 MPa ≤ pH ≤ 1300 MPa due to the formation of a MoS2 and molybdenum oxide MoxOy containing tribofilm, whereby the share of MoxOy dominates compared to MoS2. Based on the results the understanding of the effect of the MoS2 + MoxOy containing tribofilm on the tribological behavior is increased.
Role of age, sex, and specific provoking factors on the distal versus proximal presentation of first symptomatic deep vein thrombosis: analysis of the SWIss Venous ThromboEmbolism Registry (SWIVTER)
Authors: Spirk David , Sebastian Tim , Beer Jürg Hans , Mazzolai Lucia , Aujesky Drahomir , Hayoz Daniel , Engelberger Rolf Peter , Korte Wolfgang , Kucher Nils , Barco Stefano
Published: November 2021

We aimed to evaluate the impact of age, sex, and their interactions with provoking risk factors for deep vein thrombosis (DVT). In addition, we intended to provide additional insights on risk factors associated with the isolated distal versus proximal presentation of first symptomatic acute DVT, both being characterized by different prognosis. In the present analysis from the SWIss Venous ThromboEmbolism Registry (SWIVTER), we compared demographic and baseline characteristics in patients with isolated distal (n = 184; 35%) versus proximal (n = 346) DVT of the lower limbs without symptomatic pulmonary embolism, and identified factors related with the presenting thrombosis location. In the overall population, mean age was 59 ± 19 years, 266 (50%) were women, 106 (20%) patients had cancer, 86 (16%) recent surgery, and 52 (10%) acute infection/sepsis. In a multivariable analysis, recent surgery [odds ratio (OR) 2.92, 95% confidence interval (CI) 1.80–4.73] was independently associated with a diagnosis of isolated distal DVT, whereas cancer (OR 2.01, 95% CI 1.20–3.35), male sex aged 41 to 75 years (OR 2.21, 95% CI 1.33–3.67), and acute infection/sepsis (OR 2.71, 95% CI 1.29–5.66) with a diagnosis of proximal DVT. In SWIVTER, age, sex, and several provoking risk factors for VTE appeared to be related with the presenting location of first symptomatic DVT. Cancer, male sex, and acute infection/sepsis were associated with a proximal location of DVT, whereas recent surgery was associated with a distal presentation, likely acting as confounders for the association between thrombosis location and prognosis.
Reducing Sudden Unexpected Death in Epilepsy: Considering Risk Factors, Pathophysiology and Strategies
Authors: Shlobin Nathan A. , Sander Josemir W.
Published: November 2021

Purpose of Review

Sudden Unexpected Death in Epilepsy (SUDEP) is the commonest cause of epilepsy-related premature mortality in people with chronic epilepsy. It is the most devastating epilepsy outcome. We describe and discuss risk factors and possible pathophysiological mechanisms to elucidate possible preventative strategies to avert SUDEP.

Recent Findings

Sudden death accounts for a significant proportion of premature mortality in people with epilepsy compared to the general population. Unmodifiable risk factors include a history of neurologic insult, younger age of seizure-onset, longer epilepsy duration, a history of convulsions, symptomatic epilepsy, intellectual disability, and non-ambulatory status. Modifiable risk factors include the presence of convulsive seizures, increased seizure frequency, timely and appropriate use of antiseizure medications, polytherapy, alcoholism, and supervision while sleeping. Pathophysiology is unclear, but several possible mechanisms such as direct alteration of cardiorespiratory function, pulmonary impairment, electrocerebral shutdown, adenosine dysfunction, and genetic susceptibility suggested.

Methods to prevent SUDEP include increasing awareness of SUDEP, augmenting knowledge of unmodifiable risk factors, obtaining full seizure remission, addressing lifestyle factors such as supervision and prone positioning, and enacting protocols to increase the detection of and intervention for SUDEP. Further studies are required to characterize precisely and comprehensively SUDEP risk factors and pathophysiological drivers and develop evidence-based algorithms to minimize SUDEP in people with epilepsy.
Detection of different chemical binders in coatings using hyperspectral imaging
Authors: Raeissi Bahman , Bashir Muhammad Ahsan , Garrett Joseph L. , Orlandic Milica , Johansen Tor Arne , Skramstad Torbjørn
Published: November 2021

Organic coatings protect metallic structures of significant commercial value. Regular inspections of coatings are required to ensure their integrity and, therefore, to verify their stated performance. However, for metallic structures located in harsh places, coating inspection can pose significant safety and logistical challenges. Near-infrared (NIR) spectroscopy is a rapid, nondestructive and relatively inexpensive analytical technique. It is currently employed to analyze different chemicals in fields like agriculture, food, and pharmaceuticals. Similarly, hyperspectral imaging (HSI) creates a spatial map of spectral information by measuring light reflected from a material. In this work, hyperspectral imaging in the NIR portion of the electromagnetic spectrum (NIR-HSI) is used to accurately distinguish between the chemically different binders employed in commercial organic coatings. In addition, k-means clustering is explored as a tool to provide diagnostic information about the spatial inhomogeneities in the chemical structure of an applied coating, which, if undetected, can lead to coating defects during service life. The results of this work suggest that the NIR-HSI could be used for remote inspections of organic coatings.
Fishing at the Late Islamic settlement in Kharā’ib al-Dasht, Failaka Island, Kuwait
Authors: Iwaszczuk Urszula , Pieńkowska Agnieszka , Wouters Wim , Gręzak Anna , Mierzejewska Marta
Published: November 2021

The Kharā’ib al-Dasht settlement, located on the north-eastern coast of the island of Failaka in Kuwait, has been excavated systematically since 2013 by the Kuwaiti-Polish Archaeological Mission. The investigated area yielded remains dated to the Late Islamic period, from the late seventeenth to the nineteenth century. In the northernmost part of the site, a fish processing area was uncovered, while the remains of residential structures (houses 1 and 2), as well as a mosque, were discovered in the eastern part of the site. Concentrations of fireplaces, hearths and ovens were discovered inside the houses and courtyards of what seems to be the centre of the settlement as well as from the periphery of the site. Fishing was evidenced not only by the presence of fish bones but also by recovered fishing technologies, including the remains of stone fish traps that were discovered in the coastal waters near to the site. The excavations yielded 12,182 bones of marine fishes. Twenty eight families are represented, including six families of cartilaginous fishes. Ariidae bones were most numerous followed by Haemulidae, Sciaenidae and Carcharhinidae. The analysis of the assemblage shows that fishing could have been of great importance to the inhabitants of the settlement. Moreover, we attest different patterns in the fish assemblages between the two different parts of the village. The fish processing area can be seen as a workplace, while the daily activity took place in the village. These differences can also be used to shed light on the fishing techniques these people used.
Recent Advances of Artificial Intelligence in Manufacturing Industrial Sectors: A Review
Authors: Kim Sung Wook , Kong Jun Ho , Lee Sang Won , Lee Seungchul
Published: November 2021

The recent advances in artificial intelligence have already begun to penetrate our daily lives. Even though the development is still in its infancy, it has been shown that it can outperform human beings even in terms of intelligence (e.g., AlphaGo by DeepMind), implying a massive potential for its broader application in various industrial sectors. In particular, the growing public interest in industry 4.0, which focuses on revolutionizing the traditional manufacturing scene, has stimulated a deeper investigation of its possible applications in the related industries. Since it has several limitations that hinder its direct usage, research on the convergence of artificial intelligence with other engineering fields, including precision engineering and manufacturing, is ongoing. This overview looks to summarize some of the important achievements made using artificial intelligence in some of the most influential and lucrative manufacturing industries in hopes of transforming the manufacturing sites.
Queerfeindliche Narrative
Authors: Sehmer Julian
Published: November 2021

Der Beitrag skizziert aktuelle politische Entwicklungen im Kontext von Rechten für LGBTI*Q-Personen sowie daran anknüpfende Diskussionen und verortet diese innerhalb gesellschaftlicher Kultur- und Deutungskämpfe um Gender und Familie. Dabei wird deutlich, wie die Leben von queeren Menschen zunehmend zum Angriffspunkt konservativer und rechter Identitätspolitik werden. Anhand einer umfassenden Analyse einer katholischen Predigt des Vorsitzenden der Jugendkommission der Deutschen Bischofskonferenz wird exemplarisch nachgezeichnet, wie sich tradierte queerfeindliche Ablehnungs- und Abwertungsmuster in scheinbar liberale Narrative einfügen und in Verbindung mit (rechts)populistischen Argumentationsmustern Eingang in hegemoniale Diskurse finden können. Daraus werden Herausforderungen und Prämissen für sozialpädagogische Arbeit (nicht nur) für und mit queeren Jugendlichen skizziert.
Does circulating progesterone mediate the associations of single nucleotide polymorphisms in progesterone receptor (PGR)-related genes with mammographic breast density in premenopausal women?
Authors: Akinjiyan Favour A. , Han Yunan , Luo Jingqin , Toriola Adetunji T.
Published: November 2021

Progesterone is a proliferative hormone in the breast but the associations of genetic variations in progesterone-regulated pathways with mammographic breast density (MD) in premenopausal women and whether these associations are mediated through circulating progesterone are not clearly defined. We, therefore, investigated these associations in 364 premenopausal women with a median age of 44 years. We sequenced 179 progesterone receptor (PGR)-related single nucleotide polymorphisms (SNPs). We measured volumetric percent density (VPD) and non-dense volume (NDV) using Volpara. Linear regression models were fit on circulating progesterone or VPD/NDV separately. We performed mediation analysis to evaluate whether the effect of a SNP on VPD/NDV is mediated through circulating progesterone. All analyses were adjusted for confounders, phase of menstrual cycle and the Benjamini–Hochberg false discovery (FDR) adjusted p-value was applied to correct for multiple testing. In multivariable analyses, only PGR rs657516 had a direct effect on VPD (averaged direct effect estimate = − 0.20, 95%CI = − 0.38 ~ − 0.04, p-value = 0.02) but this was not statistically significant after FDR correction and the effect was not mediated by circulating progesterone (mediation effect averaged across the two genotypes = 0.01, 95%CI = − 0.02 ~ 0.03, p-value = 0.70). Five SNPs (PGR rs11571241, rs11571239, rs1824128, rs11571150, PGRMC1 rs41294894) were associated with circulating progesterone but these were not statistically significant after FDR correction. SNPs in PGR-related genes were not associated with VPD, NDV and circulating progesterone did not mediate the associations, suggesting that the effects, if any, of these SNPs on MD are independent of circulating progesterone.
Contrast-Enhanced Mammography: Technique, Indications, and Review of Current Literature
Authors: Hannsun Gemmy , Saponaro Stephen , Sylvan Paul , Elmi Azadeh
Published: November 2021

Purpose of Review

To provide an update on contrast-enhanced mammography (CEM) regarding current technique and interpretation, the performance of this modality versus conventional breast imaging modalities (mammography, ultrasound, and MRI), existing clinical applications, potential challenges, and pitfalls.

Recent Findings

Multiple studies have shown that the low-energy, non-contrast-enhanced images obtained when performing CEM are non-inferior to full-field digital mammography with the added benefit of recombined post-contrast images, which have been shown to provide comparable information compared to MRI without sacrificing sensitivity and negative predictive values. While CEMs' usefulness for further diagnostic characterization of indeterminate breast findings is apparent, additional studies have provided strong evidence of potential roles in screening intermediate to high-risk populations, evaluation of disease extent, and monitoring response to therapy, particularly in patients in whom MRI is either unavailable or contraindicated. Others have shown that some patients prefer CEM over MRI given the ease of performance and patient comfort. Additionally, some health systems may find significantly reduced costs compared to MRI. Currently, CEM is hindered by the limited availability of CEM-guided tissue sampling and issues of intravenous contrast administration. However, commercially available CEM-guided biopsy systems are on the horizon, and small changes in practice workflow can be quickly adopted. As of now, MRI remains a mainstay of high-risk screening, evaluation of the extent of disease, and monitoring response to therapy, but smaller studies have suggested that CEM may be equivalent to MRI for these indications, and larger confirmatory studies are needed.

CEM is an emerging problem-solving breast imaging modality that provides complementary information to conventional imaging modalities and may potentially be used in place of MRI for specific indications and/or patient populations.
Sturm. Nie war mehr Hermeneutik in der Korpuslinguistik (gefragt)
Authors: Wilk Nicole M.
Published: November 2021

Der Beitrag plädiert für eine höhere Sichtbarkeit und gezieltere Modellierung der qualitativ-hermeneutischen (Vor‑)Entscheidungen, die in die Anwendung korpuslinguistischer Standardverfahren eingelassen sind. Anhand verschiedener Fallbeispiele wird die datengeleitete, nicht intentionalistische Zusammenstellung von Belegsammlungen als Vorzug quantitativer Verfahren erkannt. Die Verbindung von Kollokationsnetzen mit Deutungsmustern, von Wortverbindungen mit Verstehenshorizonten, an deren Schnittstellen zentrale sprachliche Einheiten als Knotenpunkte liegen, wird mithilfe verschiedener korpus- und soziolinguistischer Ansätze modelliert. In der Frage, wie korpushermeneutisch das Herausbilden verschiedener Lesarten im Diskurs (Diskurssalienzen) begründet und erfasst werden kann, liegt das Hauptaugenmerk auf dem Prozess der Ko-Konstruktion zwischen Algorithmus und menschlicher Interpretationsinstanz als eine Art Anti-Hermeneutik ohne vorgängigen Code oder Symbolismus.
Angeborene Stoffwechselerkrankungen – Orphan Diseases aus der Sicht der Pädiatrie
Authors: Konstantopoulou Vassiliki
Published: November 2021

Orphan Diseases, die „Waisenkrankheiten“, sind seltene oder ultraseltene Erkrankungen (SE), die gemäß einer EU-weiten Definition mit einer Prävalenz von unter 5 Individuen in 10.000 Einwohnern auftreten. Somit gibt es in Österreich geschätzt ca. 400.000 Personen, die an einer SE leiden. Geschätzt gibt es 6000–8000 Krankheiten, von denen ca. 80 % einen genetischen Ursprung (mono- oder polygenetische Ursache) haben. Ca. 50–75 % davon manifestieren sich schon im Kindesalter.

Die angeborenen Stoffwechselerkrankungen („inborn errors of metabolism“ – IEM) gehören zu der Gruppe der seltenen Krankheiten (SE) oder „rare diseases“. IEM treten mit einer geschätzten Häufigkeit von 1:500–1000 Individuen auf. Ca. 80 % der IEM treten bereits im Kindesalter auf, sofern eine frühsymptomatische Form vorliegt. Aufgrund von milden Manifestationsformen wird der Rest erst im Adoleszenten- oder auch später im Erwachsenenalter entdeckt. Es ist auch möglich, dass asymptomatische Formen nie erkannt werden.

Je früher eine Krankheit diagnostiziert wird, am besten bevor sie symptomatisch wird, desto früher kann eine vorhandene, oft nur symptomatische, Therapie eingesetzt werden. Existiert eine effiziente Therapie, sind die Chancen für eine verbesserte Lebensqualität, sowohl für die Patienten als auch für die betroffenen Familien, groß.

Die Entdeckung einer seltenen Erkrankung bedeutet jedoch eine diagnostische Herausforderung, weshalb die betroffenen Patienten oft eine lange Diagnoseodyssee erleben.

Nachdem ca. 80 % der IEM im Kindesalter auftreten, sich aber auch später in der Adoleszenz manifestieren können, sind auch die Pädiater gefordert, ihr medizinisches Wissen auf diesem Feld zu erweitern.
Mobile robot with failure inspection system for ferromagnetic structures using magnetic memory method
Authors: Montes de Oca-Mora N. J. , Woo-Garcia R. M. , Juarez-Aguirre R. , Herrera-May A. L. , Sanchez-Vidal A. , Ceron-Alvarez C. A. , Restrepo J. , Algredo-Badillo I. , Lopez-Huerta F.
Published: November 2021

Flaws or cracks are one of the major failures in oil and gas pipeline networks. The early detection of these failures is very important for the safety of the industry, and this last requires of analysis for non-destructive testing (NDT), which is reliable, inexpensive and easy to implement. In this paper, we propose the development of an embedded prototype mounted on a mobile robot for the inspection of defects in ferromagnetic plates. This prototype has two embedded systems (control and data acquisition), which are based on a microcontroller of 8 and 32 bits, respectively. On the one hand, the first system for control has the logic to govern the sensors and motors that will allow to the robot moves with autonomous way during 45 min. While, the second system presents an algorithm for storing, processing and sending the data obtained from the sensors, being able to measure variations in the magnetic field in the order of 0.1 µT. Magnetic-field reading tests have been carried out on control ASTM A-27 ferromagnetic plates, obtaining experimental response in the 3 axes of the magnetic domains, which is very close to the expected results by the magnetic-flux density model that is calculated from the fields E and B derived from the equations of a Hertz dipole, and developed in the high-level Python programming language. The prototype proposed for NDT can detect geometric defects in the range of millimeters, producing changes in the density of the magnetic field in the order of thousands of µT.
222 nm ultraviolet radiation C causes more severe damage to guard cells and epidermal cells of Arabidopsis plants than does 254 nm ultraviolet radiation
Authors: Otake Momo , Okamoto Yoshiyama Kaoru , Yamaguchi Hiroko , Hidema Jun
Published: November 2021

Lamps that emit 222 nm short-wavelength ultraviolet (UV) radiation can be safely used for sterilization without harming human health. However, there are few studies on the effects of 222 nm UVC (222-UVC) radiation exposure on plants compared with the effects of germicidal lamps emitting primarily 254 nm UVC (254-UVC) radiation. We investigated the growth inhibition and cell damage caused by 222-UVC exposure to Arabidopsis plants, especially mitochondrial dynamics, which is an index of damage caused by UVB radiation. Growth inhibition resulted from 254-UVC or 222-UVC exposure depending on the dose of UVC radiation. However, with respect to the phenotype of 222-UVC-irradiated plants, the leaves curled under 1 kJ m−2 and were markedly bleached under 10 kJ m−2 compared with those of plants irradiated with 254-UVC. The cellular state, especially the mitochondrial dynamics, of epidermal and mesophyll cells of Arabidopsis leaves exposed to 254-UVC or 222-UVC radiation was investigated using Arabidopsis plants expressing mitochondrial matrix-targeted yellow fluorescent protein (MT-YFP) under the control of Pro35S to visualize the mitochondria. 222-UVC (1 or 5 kJ m−2) severely damaged the guard cells within the epidermis, and YFP signals and chloroplast autofluorescence in guard cells within the epidermis exposed to 222-UVC (1 or 5 kJ m−2) were not detected compared with those in cells exposed to 254-UVC radiation. In addition, 222-UVC irradiation led to mitochondrial fragmentation in mesophyll cells, similar to the effects of 254-UVC exposure. These results suggest that 222-UVC severely damages guard cells and epidermal cells and that such damage might have resulted in growth inhibition.
Improving antibiotic prescribing for pediatric acute respiratory tract infections: A cluster randomized trial to evaluate individual versus clinic feedback
Authors: Clegg Herbert W. , Ezzo Stephen J. , Flett Kelly B. , Anderson William E.
Published: November 2021

Objective:

To assess the effect of individual compared to clinic-level feedback on guideline-concordant care for 3 acute respiratory tract infections (ARTIs) among family medicine clinicians caring for pediatric patients.

Design:

Cluster randomized controlled trial with a 22-month baseline, 26-month intervention period, and 12-month postintervention period.

Setting and participants:

In total, 26 family medicine practices (39 clinics) caring for pediatric patients in Virginia, North Carolina, and South Carolina were selected based upon performance on guideline-concordance for 3 ARTIs, stratified by practice size. These were randomly allocated to a control group (17 clinics in 13 practices) or to an intervention group (22 clinics in 13 practices).

Interventions:

All clinicians received an education session and baseline then monthly clinic-level rates for guideline-concordant antibiotic prescribing for ARTIs: upper respiratory tract infection (URI), acute bacterial sinusitis (ABS), and acute otitis media (AOM). For the intervention group only, individual clinician performance was provided.

Results:

Both intervention and control groups demonstrated improvement from baseline, but the intervention group had significantly greater improvement compared with the control group: URI (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.37–1.92; P < 0.01); ABS (OR, 1.45; 95% CI, 1.11–1.88; P < 0.01); and AOM (OR, 1.59; 95% CI, 1.24–2.03; P < 0.01). The intervention group also showed significantly greater reduction in broad-spectrum antibiotic prescribing percentage (BSAP%): odds ratio 0.80, 95% CI 0.74-0.87, P < 0.01. During the postintervention year, gains were maintained in the intervention group for each ARTI and for URI and AOM in the control group.

Conclusions:

Monthly individual peer feedback is superior to clinic-level only feedback in family medicine clinics for 3 pediatric ARTIs and for BSAP% reduction.

Trial registration:

ClinicalTrials.gov identifier: NCT04588376, Improving Antibiotic Prescribing for Pediatric Respiratory Infection by Family Physicians with Peer Comparison.
Analysis and Critique of the Advocacy Paper Towards Inclusive Education: A Necessary Process of Transformation
Authors: Stephenson Jennifer , Ganguly Rahul
Published: November 2021

The increasing inclusion of students with disabilities in regular classes still leads to debate and many advocate for full inclusion of all students. Arguments for full inclusion are generally rights-based, but proponents also claim research supports the effectiveness of full inclusion over specialist provision for all students with disabilities. In this article, we analyse and critique the use of the research literature in an Australian advocacy paper as an example of the broad claims made concerning full inclusion. We examine the extent to which the sources used provide conclusive evidence about the merits of full inclusion. We find the advocacy paper relies heavily on opinion and non-peer-reviewed literature, with little use of quantitative research that compares outcomes for students in different settings. We suggest that policymakers should treat the conclusions drawn in this paper cautiously and give due consideration to the literature that is not supportive of full inclusion.
Two-week-wait referrals in otolaryngology in a tertiary centre: cross-sectional study of benign outcomes, with a systematic review
Authors: Mettias B , Charlton A , Ashokkumar S
Published: November 2021

Objective

The two-week-wait referral is designed to improve early detection in cancer patients. This retrospective study analysed those ENT two-week-wait referrals to out-patient clinics in a tertiary head and neck oncology centre, from January to June 2018, which were not compliant with National Institute for Health and Care Excellence guidelines (2015 update).

Methods

Referral symptoms were statistically analysed against National Institute for Health and Care Excellence guidelines, with detailed analysis of reasons for non-compliance. In addition, a systematic review of similar previously published articles was conducted.

Results

There were 1107 patients referred through the two-week-wait pathway. Of these referrals, 52 per cent were compliant with National Institute for Health and Care Excellence 2015 guidelines. Six errors were identified for non-compliant referrals, most commonly inconsistencies in referral (e.g. globus sensation) and intermittent disease course (e.g. intermittent hoarseness). Of all patients referred, 93 per cent were diagnosed with benign conditions, with laryngopharyngeal reflux being the commonest. Twenty-two per cent of referred patients were discharged after the first visit.

Conclusion

Two-week-wait referral is inappropriately overused. There are many non-compliant referrals, and most of the outcomes are benign.
Weak Alfvénic turbulence in relativistic plasmas.
Part 2. current sheets and dissipation
Authors: Ripperda B. , Mahlmann J.F. , Chernoglazov A. , TenBarge J.M. , Most E.R. , Juno J. , Yuan Y. , Philippov A.A. , Bhattacharjee A.
Published: November 2021

Alfvén waves as excited in black hole accretion disks and neutron star magnetospheres are the building blocks of turbulence in relativistic, magnetized plasmas. A large reservoir of magnetic energy is available in these systems, such that the plasma can be heated significantly even in the weak turbulence regime. We perform high-resolution three-dimensional simulations of counter-propagating Alfvén waves, showing that an

$E_{B_{\perp }}(k_{\perp }) \propto k_{\perp }^{-2}$

energy spectrum develops as a result of the weak turbulence cascade in relativistic magnetohydrodynamics and its infinitely magnetized (force-free) limit. The plasma turbulence ubiquitously generates current sheets, which act as locations where magnetic energy dissipates. We show that current sheets form as a natural result of nonlinear interactions between counter-propagating Alfvén waves. These current sheets form owing to the compression of elongated eddies, driven by the shear induced by growing higher-order modes, and undergo a thinning process until they break-up into small-scale turbulent structures. We explore the formation of current sheets both in overlapping waves and in localized wave packet collisions. The relativistic interaction of localized Alfvén waves induces both Alfvén waves and fast waves, and efficiently mediates the conversion and dissipation of electromagnetic energy in astrophysical systems. Plasma energization through reconnection in current sheets emerging during the interaction of Alfvén waves can potentially explain X-ray emission in black hole accretion coronae and neutron star magnetospheres.
Schistosomiasis in the People's Republic of China – down but not out
Authors: Gordon Catherine A. , Williams Gail M. , Gray Darren J. , Clements Archie C. A. , Zhou Xiao-Nong , Li Yuesheng , Utzinger Jürg , Kurscheid Johanna , Forsyth Simon , Addis Alene Kefyalew , Zhou Jie , Li Zhaojun , Li Guangpin , Lin Dandan , Lou Zhihong , Li Shengming , Ge Jun , Xu Jing , Yu Xinling , Hu Fei , Xie Shuying , Chen Jie , Shi Tao , Li Chong , Zheng Huajun , McManus Donald P.
Published: November 2021

Schistosomiasis has been subjected to extensive control efforts in the People's Republic of China (China) which aims to eliminate the disease by 2030. We describe baseline results of a longitudinal cohort study undertaken in the Dongting and Poyang lakes areas of central China designed to determine the prevalence of Schistosoma japonicum in humans, animals (goats and bovines) and Oncomelania snails utilizing molecular diagnostics procedures. Data from the Chinese National Schistosomiasis Control Programme (CNSCP) were compared with the molecular results obtained.

Sixteen villages from Hunan and Jiangxi provinces were surveyed; animals were only found in Hunan. The prevalence of schistosomiasis in humans was 1.8% in Jiangxi and 8.0% in Hunan determined by real-time polymerase chain reaction (PCR), while 18.3% of animals were positive by digital droplet PCR. The CNSCP data indicated that all villages harboured S. japonicum-infected individuals, detected serologically by indirect haemagglutination assay (IHA), but very few, if any, of these were subsequently positive by Kato-Katz (KK).

Based on the outcome of the IHA and KK results, the CNSCP incorporates targeted human praziquantel chemotherapy but this approach can miss some infections as evidenced by the results reported here. Sensitive molecular diagnostics can play a key role in the elimination of schistosomiasis in China and inform control measures allowing for a more systematic approach to treatment.
Provider insights on shared decision-making with families affected by CHD
Authors: Pinto Nelangi M. , Patel Angira , Delaney Rebecca K. , Donofrio Mary T. , Marino Bradley S. , Miller Stephen , Ozanne Elissa M. , Zickmund Susan L. , Karasawa Michelle H. , Pershing Mandy L. , Fagerlin Angela
Published: November 2021

Background and Objectives:

Little data exist on provider perspectives about counselling and shared decision-making for complex CHD, ways to support and improve the process, and barriers to effective communication. The goal of this qualitative study was to determine providers’ perspectives regarding factors that are integral to shared decision-making with parents faced with complex CHD in their fetus or newborn; and barriers and facilitators to engaging in effective shared decision-making.

Methods:

We conducted semi-structured interviews with providers from different areas of practice who care for fetuses and/or children with CHD. Providers were recruited from four geographically diverse centres. Interviews were recorded, transcribed, and analysed for key themes using an open coding process with a grounded theory approach.

Results:

Interviews were conducted with 31 providers; paediatric cardiologists (n = 7) were the largest group represented, followed by nurses (n = 6) and palliative care providers (n = 5). Key barriers to communication with parents that providers identified included variability among providers themselves, factors that influenced parental comprehension or understanding, discrepant expectations, circumstantial barriers, and trust/relationship with providers. When discussing informational needs of parents, providers focused on comprehensive short- and long-term outcomes, quality of life, and breadth and depth that aligned with parental goals and needs. In discussing resources to support shared decision-making, providers emphasised the need for comprehensive, up-to-date information that was accessible to parents of varying situations and backgrounds.

Conclusions:

Provider perspectives on decision-making with families with CHD highlighted key communication issues, informational priorities, and components of decision support that can enhance shared decision-making.
Assessing food and nutrition literacy in children and adolescents: a systematic review of existing tools
Authors: Carroll Nicholas , Perreault Maude , Ma David WL , Haines Jess
Published: November 2021

Objective:

Food literacy (FL) and nutrition literacy (NL) are concepts that can help individuals to navigate the current food environment. Building these skills and knowledge at a young age is important for skill retention, confidence in food practices and supporting lifelong healthy eating habits. The objectives of this systematic review were to: (i) identify existing tools that measure FL and NL among children and/or adolescents and (ii) describe the psychometric properties.

Design:

A 4-phase protocol was used to systematically retrieve articles. The search was performed in May 2021. Study characteristics and psychometric properties were extracted, and a narrative synthesis was used to summarise findings. Risk of bias was assessed using the COSMIN checklist.

Setting:

Six databases were searched to identify current tools.

Participants:

Children (2–12 years) and adolescents (13–18 years) participated in this study.

Results:

Twelve tools were identified. Three tools measured FL, 1 tool measured NL, 4 tools measured both FL and NL, and 4 tools measured subareas of NL—more specifically, critical NL, food label and menu board literacy. Most tools were self-reported, developed based on a theoretical framework and assessed some components of validity and/or reliability for a specific age and ethnic group. The majority of tools targeted older children and adolescents (9–18 years of age), and one tool targeted preschoolers (3–6 years of age).

Conclusions:

Most widely used definitions of FL and NL do not acknowledge life-stage specific criterion. Continued efforts are needed to develop a comprehensive definition and framework of FL and NL appropriate for children, which will help inform future assessment tools.
Translating fathers’ support for breastfeeding into practice
Authors: Baldwin Sharin , Bick Debra , Spiro Alison
Published: November 2021

Breastfeeding has numerous health benefits for the mother and child. For breastfeeding to be successful and continue for longer, women need adequate support. Fathers/partners play an important role in providing this support to women, but research suggests that fathers/partners often feel inadequately informed and supported by health professionals. Midwives and health visitors are in ideal positions to offer women and their partner’s timely and relevant breastfeeding information and support throughout the perinatal period. This article discusses the benefits of breastfeeding, presents research evidence of the crucial role fathers/partners play in promoting and supporting breastfeeding, and recommends ways in which health professionals can provide breastfeeding information and support to fathers/partners.
Coethnicity Beyond Clientelism: Insights from an Experimental Study of Political Behavior in Lebanon
Authors: Cammett Melani , Kruszewska-Eduardo Dominika , Parreira Christiana , Atallah Sami
Published: November 2021

A large literature finds that coethnicity primarily shapes voter behavior through material exchanges, particularly clientelism. Yet identity groups provide distinct psychological and social benefits that also compel people to vote based on coethnicity. Does coethnicity matter for vote choice, net of instrumental considerations? We address this question using a conjoint experiment in Lebanon, which asked a nationally representative sample of citizens to choose between potential candidates in national elections. We find that coethnicity is the single strongest predictor of electoral support, more important than party affiliation, provision of clientelism, or programmatic platform. Coethnicity does not significantly alter perceptions of candidates who provide clientelism, including high-value goods like patronage employment. Furthermore, citizens who feel closer to their ethnic group are more likely to vote on the basis of coethnicity, as are those with lower levels of trust in state institutions. Collectively, these findings suggest that coethnic voting in diverse polities is not driven solely by clientelism, but also by less immediately material concerns about security and belonging.
Dynamic Hillslope Soil Moisture in a Mediterranean Montane Watershed
Authors: Dymond Salli F. , Wagenbrenner Joseph W. , Keppeler Elizabeth T. , Bladon Kevin D.
Published: November 2021

Variations in hillslope soil moisture control forest hydrologic fluxes and storage pools, yet sparse observations combined with the complexity and heterogeneity of water movement and storage in the vadose zone can make temporal and spatial patterns and processes difficult to predict. We used two years of field observations of volumetric soil moisture at three depths (15, 30, and 100 cm) across five topographic positions (riparian, toeslope, sideslope, shoulder, and ridge) along three hillslope transects to better understand how soil moisture changes with hillslope position and through time. As expected, we found higher values of soil moisture at all depths at the riparian and toeslope positions. Unexpectedly, we found that ridges were particularly wet during the wet winter months and dried quickly during the summer months, indicating that topography alone cannot account for mean wet season soil moisture in our Mediterranean climate field site. The variability in soil moisture across all soil depths and topographic positions was greatest when soils were dry and decreased under wet soil conditions; this variability remained high in the deeper soil horizons, regardless of season. Lastly, event analysis suggests that the response to early season rainfall was highly variable along the hillslopes and was likely dominated by localized controls such as microtopography and vegetation as well as soil texture, antecedent moisture conditions, and rainfall characteristics. Our results suggest that the drivers of wet and dry season soil moisture dynamics can vary across topographic positions along a hillslope and do not always follow topographic controls.
Inferring the Horizontal Speed of an Ionospheric Irregularity From a Single GPS Scintillation Receiver at High Latitudes
Authors: Hong Junseok , Chung Jong‐Kyun , Ham Young‐Bae , Kwak Young‐Sil , Kim Yong Ha
Published: November 2021

We propose a new technique to infer the horizontal speed of ionospheric irregularity at high latitudes from the refractive components of the global positioning system (GPS) L1 (1575.42 MHz) and L2 (1227.60 MHz) carrier phases using only a single ground‐based receiver that can log measurements at 50–100 Hz. The test data at Jang Bogo Station (geographic: 74.6°S and 164.2°E; geomagnetic: 77.2°S) in Antarctica and at Sachs Harbor (geographic: 71.9°N and 234.7°E; geomagnetic: 75.6°N) in the Arctic were analyzed for a one‐year period in 2019. The results were compared with data from ground‐based radar observations, the Vertical Incidence Pulsed Ionospheric Radar (VIPIR) in Antarctica and the Canadian Advanced Digital Ionosonde (CADI) in the Arctic, which measures the ion drift velocity at the apex. Although it is difficult to directly compare GPS and radar measurements due to the steep gradient of fast plasma motion in narrow regions at high latitudes, the probability density of the ionospheric irregularity speeds from the two different instruments were consistent with the correlation coefficients of 0.81 and 0.85 in the Southern and Northern hemispheres.