bluuebunny/crossref_metadata_2025 huggingface dataset:
Not Your Usual Exposure: Tuberculosis Contact Investigation Related to Contaminated Bone Allograft
Authors: Scipione Christy , Washer Laraine , Stoneman Emily , Valyko Amanda , Sweeney Jennifer
Published: September 2024

Background: Mycobacterium tuberculosis transmission through contaminated bone allograft product is unusual and was first described in 2021 with a second outbreak in 2023. In July 2023, Michigan Medicine conducted contact tracing for healthcare personnel (HCP), patients, and visitors following exposure to an immunocompromised patient with surgical site infection and subsequent widely disseminated tuberculosis (bacteremia, pulmonary, lymphadenopathy) following spinal fusion with bone allograft in April 2023. The patient was in the emergency department, operating room (OR), and inpatient units for 9 days prior to initiation of Airborne Precautions (AP). Methods: Michigan Medicine is a 1,107 bed academic hospital. HCP are screened for tuberculosis with interferon-gamma release assay (IGRA) testing upon hire and following tuberculosis exposure. Exposure testing includes baseline IGRA testing and follow-up testing at 10-12 weeks post exposure. Exposure criteria for this investigation was defined as sharing room airspace with the tuberculosis patient prior to initiation of airborne precautions or Central Sterile Processing Department (CSPD) staff involved with instrument decontamination without the use of a respirator. Of note, universal masking with surgical masks was not required during this time for staff and patients/visitors, with the exception of CSPD and OR staff. Contact tracing was performed by Infection Prevention and Occupational Health Services managed all test results and conversions. Results: 176 employees from perioperative care areas (n=30), CSPD (n=7), OR (n=9) and inpatient units (n=130) were IGRA tested. Five employee conversions were identified: one surgeon, one circulating OR nurse, two CSPD decontamination staff, and one respiratory therapist. At time of detection, none of the conversions had evidence of active tuberculosis. Additionally, 46 patients and visitors were tested with zero conversions. HCP compliance with IGRA testing was initially 15% before engagement from hospital and unit leadership and human resources. With intervention, employee compliance reached 100%. Conclusion: Despite standard use of surgical masks for OR and CSPD staff, aerosolization of infected bone graft material played an important role in tuberculosis transmission during surgery and instrument cleaning. Respiratory therapy practices in the ICU setting likely also increased risk for pulmonary tuberculosis transmission. Achieving 100% HCP compliance for baseline and follow-up IGRA testing is challenging and requires engagement of both unit and hospital leadership and human resources to ensure all HCP are tested.
Differential viral load of surgical masks worn by patients infected with respiratory viruses
Authors: Wong Shuk Ching , Cheng Vincent Chi-Chung
Published: September 2024

Background: This study investigated viral load in surgical masks worn by adult patients infected with respiratory viruses. Method: Surgical masks were dissected into eight pieces at pre-selected sites: inner, middle, and outer layers at the nose (N1-N3) and mouth (M1-M3), as well as full-thickness on the right (RS) and left (LS) sides. Viral load was detected, correlated with nasopharyngeal specimens and patients' demographics. Result: Among 230 patients infected with influenza A virus (n=91), respiratory syncytial virus (RSV) (n=61), and SARS-CoV-2 (n=78) from April 1 to August 31, 2023, 90.9% (209/230) were from the medical specialty. Of the 230 surgical masks collected, viral RNA was detected in 79.6% at one or more sites, with 75.7% positive at N1 or M1, 55.2% positive at N3 or M3, and 22.6% exhibiting viral RNA at all sites. Pearson correlation showed viral load correlation between nasopharyngeal specimens and N1 (0.244, p=0.002) and M1 (0.174, p=0.031). The mean viral load at N1 (4.14 ± 1.46 log10 copies/ml) was significantly higher than M1 (3.74 ± 1.32 log10 copies/ml, p=0.014) and N3 (3.58 ± 1.27 log10 copies/ml, p=0.003). Significant differences in viral load were observed across N1-N3 and M1-M3 in RSV patients, but not in influenza A or SARS-CoV-2 patients. SARS-CoV-2 patients exhibited significantly lower viral load at RS and LS sites compared to influenza A or RSV patients. Conclusion: Viral RNA was detected in N3 or M3 sites in our masks, highlighting the potential risk associated in these areas. Differential viral load across various sites in surgical masks worn by patients infected with different respiratory viruses warrants further investigation.
Immediate Use Steam Sterilization and the Effect on Surgical Site Infections in an Acute Care Facility
Authors: Lewis Casey , Crall Victoria , Snyder Graham , Ayres Ashley , Risnear Avisha , Miller Jason , Sherer Joanne
Published: September 2024

Background: Immediate use steam sterilization (IUSS) shortens the time from sterilization to the aseptic transfer onto the surgical sterile field. Published data incompletely defines the extent to which IUSS increases risk of surgical site infection (SSI), compared to standard sterile reprocessing methods. We aimed to measure the association between IUSS use for surgical instrument reprocessing and SSI risk in a facility where IUSS use increased due to staffing constraints and case volumes. Methods: In this retrospective observational study at a tertiary care hospital with a diverse mix of surgery types, we used sterile reprocessing logs and SSI outcomes defined using National Health and Safety Network definitions to compare SSI rates among surgeries using surgical devices sterilized using IUSS compared to standard terminal sterilization methods. We calculated a risk ratio (RR) and 95% confidence interval (95%CI), including stratification by eleven high-volume service lines. Results: Among 23,919 surgical procedures, 416 (1.74%) developed SSIs. IUSS was used to sterilize instruments prior to 1,524 (6.37%) surgical procedures, and of these procedures 39 (2.56%) developed an SSI, compared to 1.68% of non-IUSS procedures (377 SSI in 22,395 procedures; risk ratio [RR] 1.52, 95% confidence interval [95%CI] 1.10-2.11). Two surgical services had statistically significant RRs for SSI development after IUSS: transplant surgery (RR 2.47, 95%CI 1.32-4.60] and plastic surgery (RR 3.64, 95%CI 1.13-11.74; Figure). Conclusion: IUSS is associated with a significant increase in SSIs, including among varied surgery types. IUSS utilization should be minimized.
Bundle Implementation to Prevent Surgical Site Infections - A Study of SRN Hospitals
Authors: Pop-Vicas Aurora , Zimbric Michelle , Schmitz Michelle , Hatas Gabrielle , Safdar Nasia
Published: September 2024

Background: Guidelines recommend bundles with multiple infection control elements to prevent surgical site infections (SSI). Although effective in multiple research studies, little is known about the implementation of such complex bundles in the real-world clinical setting. Methods: A survey was distributed to the SHEA Research Network (SRN) hospitals during November 2022 – December 2023, to assess processes related to the implementation of SSI prevention bundles in colorectal surgery. Results: Of the 93 US and international hospitals within SRN, 49 completed the survey (53% response rate). The mean volume of colorectal surgeries per year was 377 (median 400). Figure 1 shows the individual elements of SSI prevention bundle reported as consistently used in most surgeries. There were no significant differences between hospitals with high vs. low volume (cut-off 400 surgeries), except for wound protectors or retractors, more likely to be used in high-volume hospitals (P = 0.047). A formal process for auditing adherence was reported by 71% of respondents for antibiotic prophylaxis, and 51% for skin prep, with the remaining elements audited < 50% of the time. Feedback of audited adherence to surgeons occurred < 50% of the time for all bundle elements, except antibiotic prophylaxis (59%). Table 1 shows the most common barriers reported as either successfully mitigated or still persistent at the time of the survey. High-volume hospitals were more likely to report persistent clinicians’ low bundle adherence (P = 0.016) and inadequate bundle adherence audit and feedback (P = 0.0016). Conclusion: Implementation of guideline-recommended colorectal SSI Prevention bundles remains highly variable. Further research aiming to develop strategies that optimize implementation and adherence is needed.
Candida auris Screening of High-Risk Patients: A Descriptive Comparison of 2 Strategies.
Authors: Pedersen Laura , Barajas-Ochoa Aldo , Cooper Kaila , Price Jenna , Hannum Kathryn , Major Yvette , Ching Patrick R , Rittmann Barry , Doll Michelle
Published: September 2024

Background: Candida auris infection is associated with high morbidity and mortality. C. auris can persist in the healthcare environment and is associated with outbreaks. We compare screening strategies for C. auris in two high-risk patient populations. Methods: Our center is a tertiary, 865-bed hospital. In the context of known regional outbreaks of C. auris in post-acute care (PAC) facilities, we experienced extended clusters of apparent C. auris acquisition across several hospital units. Hospital acquisition was defined as new C. auris in clinical cultures in patients with no known history of C. auris colonization/infection. We performed point prevalence surveys (PPS) on affected units weekly until all tests were negative for two consecutive weeks. We also initiated admission screening for C. auris for patients admitted from PAC. All screening swabs were collected per CDC’s procedure. Tests were performed either by RT-PCR or Chromagar C. auris media, depending on availability. We compared the overall positivity rates of exposure PPS versus PAC admission screenings using Z-test for two proportions with statistical significance set at p < 0 .05 Results: From 2/2023-12/2023, a total of 533 tests on 367 unique patients were processed during PPS; 512 tests were negative and 21 were positive (3.9% positivity rate). Three additional samples were either unable to be processed or indeterminate. There were 68 patients who had repeat testing weekly for ≥2 weeks. Most remained negative, but 5 tested positive after variable amounts of negative-week intervals: 3 patients at week 2, 1 patient at week 4 and 1 patient at week 5. From 8/2023 to 12/2023, a total of 89 patients admitted from 35 different PAC facilities underwent admission screening for C. auris. Only three patients were positive (3.4%), each from a different facility. The difference in the positivity rates between PPS and PAC was not statistically significant (Z-score 0.25, p = 0.79). Discussion: Our C. auris screening strategies found similar positivity rates for patients admitted to the hospital from PACs compared to targeted PPS in the setting of apparent hospital acquisition events. These strategies may be considered as complementary. Facilities experiencing apparent acquisition events should consider screening high-risk admissions to identify and isolate colonized patients, particularly if standard infection prevention practices are being performed with high fidelity.
Comparison of COVID-19 Sentinel Surveillance and COVID-19 School Absentee Surveillance in Japan
Authors: Tanabe Masaki , Ito Shiho , Hara Yasuyuki , Ogura Takahiro , Ichikawa Makoto , Fukuta Miwa , Iwade Yoshito
Published: September 2024

Background: In Japan, notifiable infectious disease surveillance ended and was replaced by sentinel surveillance following the COVID-19 reclassification in May 2023. Since COVID-19 sentinel surveillance is integrated into seasonal influenza surveillance, the number of reported cases varies depending on the extent to which sentinel facilities provide COVID-19 care. Therefore, we compared COVID-19 sentinel surveillance with school absentee surveillance, which is limited to high school equivalent age or younger, but provides reliable information on absences in the target population. Method: The 17-week period from week 23 (June 5 to June 11) to week 39 (September 25 to October 1) of 2023 was used as the target period. The number of weekly COVID-19 reports from 72 sentinel sites in Mie Prefecture (Population 1.7 million) as for sentinel surveillance and the number of COVID-19 absentees at a total of 998 facilities (401 kindergartens and nursery schools, and 597 elementary, junior high, and senior high schools) registered for school absentee surveillance in Mie Prefecture as for school absentee surveillance were compared across Mie Prefecture and eight health centers (Fig 1). Result: Except for the summer vacation period from week 29 to 35, sentinel surveillance and school absentee surveillance showed a significant positive correlation. During the summer vacation period, a decrease in the number of COVID-19 absentees was observed, especially in the elementary, junior high, and senior high school groups of the school absentee surveillance, compared to the sentinel surveillance (Fig 2 and 3). When compared by health center, no regional differences were observed in school absentee surveillance, but in sentinel surveillance, some health centers reported significantly more cases than others. Conclusion: The results of this study suggest that although COVID-19-based school absentee surveillance has some drawbacks, such as the limited number of subjects and the difficulty of evaluation during the summer vacation when schools are closed, it has the advantage of being able to evaluate the entire community without being affected by medical institution practice bias, and can be used to monitor trends in infectious diseases. It was considered important to combine and evaluate multiple surveillance indicators in order to accurately monitor epidemiologic trends of infectious disease over time.
Variability of MDRO Reporting Across Tennessee Microbiology Laboratories
Authors: Lokant Matthew , Wilson Christopher , Talbot Tom , Pineda Priscilla , Hitchingham Erin , Harriott Melphine , Villegas Raquel , Wolfe Kaleb , Owens Staub Milner
Published: September 2024

Background: Identification and timely reporting of multi-drug resistant organisms (MDROs) drives efficacy of infection prevention efforts. Data on MDRO reporting timeliness and inter-facility variability are limited. Facility-dependent variability in MDRO reporting across Tennessee was examined to identify opportunities for MDRO surveillance improvement. Methods: Data for reported Tennessee MDROs including carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Acinetobacter baumannii (CRAB), Carbapenem-resistant Pseudomonas aeruginosa (CRPA) and Candida auris, were obtained from the southeast regional Antibiotic Resistance Laboratory Network (ARLN) from 2018-2022, excluding screening and colonization specimens. Variance in days accrued from specimen collection to ARLN receipt was analyzed using one-way analysis of variance (ANOVA) with Tukey’s test (SAS 9.4). Facilities were categorized as fast (1-10 days), slow (11-20 days), or delayed (21-100 days) reporters. Results: There were 9,569 MDRO isolates reported. CRPA was reported faster than other MDROs (p < 0.001), while specimens from West Tennessee compared to other regions (p < 0.001) (Figure) and blood cultures compared to other specimens were reported more slowly (p < 0.001) (Table). There was no difference in reporting times for facilities using on-site microbiology laboratories versus reference laboratories (P = 0.062). Conclusion: MDRO reporting times varied across Tennessee by region, specimen, and organism. Future work to elucidate drivers of variability will consist of surveys and focused interviews with laboratory personnel to identify shared and unique barriers and opportunities for improvement.
Are there risk factors commonly observed on Australian farms where the welfare of livestock is poor?
Authors: Williams Natarsha , Hemsworth Lauren , Chaplin Sarah , Shephard Richard , Fisher Andrew
Published: September 2024

The objective of this study was to identify factors more commonly observed on farms with poor livestock welfare compared to farms with good welfare. Potentially, these factors may be used to develop an animal welfare risk assessment tool (AWRAT) that could be used to identify livestock at risk of poor welfare. Identifying livestock at risk of poor welfare would facilitate early intervention and improve strategies to promptly resolve welfare issues. This study focuses on cattle, sheep and goats in non-dairy extensive farming systems in Australia. To assist with identifying potential risk factors, a survey was developed presenting 99 factors about the farm, farmers, animals and various aspects of management. Based on their experience, key stakeholders, including veterinarians, stock agents, consultants, extension and animal welfare officers were asked to consider a farm where the welfare of the livestock was either high or low and rate the likelihood of observing these factors. Of the 141 responses, 65% were for farms with low welfare. Only 6% of factors had ratings that were not significantly different between high and low welfare surveys, and these were not considered further. Factors from poor welfare surveys with median ratings in the lowest 25% were considered potential risks (n = 49). Considering correlation, ease of verification and the different livestock farming systems in Australia, 18 risk factors relating to farm infrastructure, nutrition, treatment and husbandry were selected. The AWRAT requires validation in future studies.
Practical, effective and safer: Placing traps above ground is an improved capture method for the critically endangered ngwayir (western ringtail possum; Pseudocheirus occidentalis)
Authors: Corsetti Sara , Yokochi Kaori , Webb Evan , Urso Arianna , Bencini Roberta
Published: September 2024

The capture of wild-living animals can provide valuable information that is critical in developing and implementing effective conservation actions. These capture procedures, however, often require direct handling of individuals by researchers, and conservationists should constantly seek to improve capture methods so that the impacts on animal welfare are minimised. The ngwayir (western ringtail possum; Pseudocheirus occidentalis) is a critically endangered arboreal marsupial in need of effective conservation. It is, however, not amenable to conventional trapping, leading to the use of methods such as nest robbing and tranquilisation using dart guns or pole syringes, which involve potentially serious animal welfare risks and longer exposure of animals to humans as compared to conventional trapping. In pursuit of an improved capture method, we investigated opportunistically whether placing traps above the ground would increase the capture success rate of the species, using wire cage traps baited with universal bait and fruit. Between 2010 and 2019, we deployed trapping grids in Locke Nature Reserve and adjacent campsites near Busselton, WA, Australia, with traps placed on the ground for 1,985 trap nights and traps placed on horizontal tree branches, fallen trees or fences, 1–2 m above ground for 694 trap nights. With the above ground traps we trapped 82 ngwayirs out of 694 trap nights, 27 in autumn and 55 in spring. We also captured eleven common brushtail possums (Trichosurus vulpecula; 1.6% trap success rate), 12 King’s skinks (Egernia kingii; 1.7%) and five black rats (Rattus rattus; 0.7%). Trapping success rate was higher in elevated traps (up to 18.3%) compared to traps on the ground (0.5%) and using fruit as bait increased the trap success rate. These results suggest that using elevated traps baited with fruit is a practical, effective method to capture the ngwayir.
Comparing emergency department versus high school-based recruitment for a hypertension research study with adult–youth dyads
Authors: Heinert Sara W. , Salvatore Ryan , Thompson Kelsey M. , Krishna Divya , Pena Kayla , Ohman-Strickland Pamela , Greene Kathryn , Heckman Carolyn J. , Crabtree Benjamin F. , Levy Phillip , Hudson Shawna V.
Published: September 2024

Dyads can be challenging to recruit for research studies, but detailed reporting on strategies employed to recruit adult–adolescent dyads is rare. We describe experiences recruiting adult–youth dyads for a hypertension education intervention comparing recruitment in an emergency department (ED) setting with a school-based community setting. We found more success in recruiting dyads through a school-based model that started with adolescent youth (19 dyads in 7 weeks with < 1 hour recruitment) compared to an ED-based model that started with adults (2 dyads in 17 weeks with 350 hours of recruitment). These findings can benefit future adult–youth dyad recruitment for research studies.
Evaluation of a peer-led research best practices training for community health workers and promotoras
Authors: Murphy Susan L. , Harper Alexandra E. , Jay Gina M. , Trujillo Vanessa I. , Weeks-Norton Kristen , Samuels Elias , Troost Jonathan P. , Eakin Brenda , Piatt Gretchen , Striley Catherine , Perez Analay , McIntosh Shannen , Watkins Daphne C. , Aguilar-Gaxiola Sergio , Cottler Linda
Published: September 2024

Introduction:

Community health workers and promotoras (CHW/Ps) increasingly support research conducted in communities but receive variable or no training. We developed a culturally and linguistically tailored research best practices course for CHW/Ps that can be taken independently or in facilitated groups. The purpose of this study was to evaluate the facilitated training.

Methods:

CHW/Ps were recruited from communities and partners affiliated with study sites in Michigan, Florida, and California. They participated in virtual or in-person training facilitated by a peer in English or Spanish and then completed a survey about their abilities (i.e., knowledge and skills for participating in research-related work) and perceptions of the training. Linear regression analyses were used to examine differences in training experience across several factors.

Results:

A total of 394 CHW/Ps, mean age 41.6 ± 13.8 years, completed the training and survey (n = 275 English; 119 Spanish). Most CHW/Ps were female (80%), and 50% identified as Hispanic, Latino, or Spanish. Over 95% of CHW/Ps rated their abilities as improved after training; 98% agreed the course was relevant to their work and felt the training was useful. Small differences were observed between training sites.

Discussion:

Most CHW/Ps rated the training positively and noted improved knowledge and skills for engaging in research-related work. Despite slight site differences, the training was well received, and CHW/Ps appreciated having a facilitator with experience working in community-based settings. This course offers a standard and scalable approach to training the CHW/P workforce. Future studies can examine its uptake and effect on research quality.
Aerosol optical depth disaggregation: toward global aerosol vertical profiles
Authors: Bouabid Shahine , Watson-Parris Duncan , Stefanović Sofija , Nenes Athanasios , Sejdinovic Dino
Published: September 2024

Aerosol-cloud interactions constitute the largest source of uncertainty in assessments of anthropogenic climate change. This uncertainty arises in part from the difficulty in measuring the vertical distributions of aerosols, and only sporadic vertically resolved observations are available. We often have to settle for less informative vertically aggregated proxies such as aerosol optical depth (AOD). In this work, we develop a framework for the vertical disaggregation of AOD into extinction profiles, that is, the measure of light extinction throughout an atmospheric column, using readily available vertically resolved meteorological predictors such as temperature, pressure, or relative humidity. Using Bayesian nonparametric modeling, we devise a simple Gaussian process prior over aerosol vertical profiles and update it with AOD observations to infer a distribution over vertical extinction profiles. To validate our approach, we use ECHAM-HAM aerosol-climate model data which offers self-consistent simulations of meteorological covariates, AOD, and extinction profiles. Our results show that, while very simple, our model is able to reconstruct realistic extinction profiles with well-calibrated uncertainty, outperforming by an order of magnitude the idealized baseline which is typically used in satellite AOD retrieval algorithms. In particular, the model demonstrates a faithful reconstruction of extinction patterns arising from aerosol water uptake in the boundary layer. Observations however suggest that other extinction patterns, due to aerosol mass concentration, particle size, and radiative properties, might be more challenging to capture and require additional vertically resolved predictors.
Broadening participation in environmental data science: Insights from practitioners
Authors: Fong Caitlin R. , Galaz García Carmen , Abbasi Emman , Gubbins Nick , Jouzi Zeynab
Published: September 2024

Environmental data science (EDS) is a nascent STEM sub-discipline where we have the opportunity to shape the culture, to work to create an environment that welcomes broad participation, and to build a culture of inclusivity. Like many STEM disciplines, some may be excluded from participating in EDS due to historical legacies, systemic barriers, and social prejudices that create unequal opportunities and access. To better understand barriers to participation, and to identify solutions and priorities, we conducted a survey of the participants of the first Environmental Data Science Summit. We identified three barriers to participation that matched with three solutions and priorities for the field. The most commonly identified barrier was an unsupportive work environment for minorities and a male-dominated culture; creating a supportive community and work environment, particularly for minorities, was identified as both a solution and a priority for broadening participation in EDS. The second most commonly identified barrier pertained to training and maintaining relevance— specifically, late or informal training experiences and time constraints limiting time to upskill. The solution and priority proposed included access to good mentors and teachers, open data and educational materials, and increased applicability of projects. Finally, the third most commonly identified barrier, solution, and priority relate to financial concerns and the funding landscape, with both the solution and priority identified as improving funding and salary conditions. The results of this study identify the key barrier to participation in EDS and highlight potential solutions to lower these barriers to build a more equitable future.
Retreat of the Greenland Ice Sheet leads to divergent patterns of reconfiguration at its freshwater and tidewater margins
Authors: Ryan Jonathan , Ross Theo , Cooley Sarah , Fahrner Dominik , Abib Nicole , Benson Victoria , Sutherland David
Published: September 2024

Greenland's marine- and land-terminating glaciers are retreating inland due to climate warming, reconfiguring the way the ice sheet interacts with its proglacial environment. Here we use three decades of satellite imagery to determine whether the ice-sheet margin is becoming more or less exposed to marine and lacustrine processes. During our 1990–2019 study period, we find that the length of ice-sheet perimeter in contact with the ocean shrank by 12.3 ± 3.8% (196.2 ± 10.4 km), due to the retreat of marine-terminating glaciers into narrower fjords. On the other hand, we find that the length of the ice-sheet perimeter in contact with freshwater lakes exhibited more divergent trends that is better explored at regional scales. The length of ice–lake boundaries increased in southwest, north and northwest Greenland but declined in southeast and central east Greenland. The magnitude of change we document during our study period leads us to conclude that the ice sheet is poised for further, substantial reconfiguration in the coming decades with consequences for the flux of fresh water, nutrients and primary productivity in Greenland's terrestrial and oceanic environment.
Saturated fatty acids and total and CVD mortality in Norway: a prospective cohort study with up to 45 years of follow-up
Authors: Arnesen Erik Kristoffer , Laake Ida , Veierød Marit B. , Retterstøl Kjetil
Published: September 2024

The contribution of dietary saturated fatty acids (SFA) to cardiovascular disease (CVD) and mortality remains debated after decades of research. Few previous studies had repeated dietary assessments and power to assess mortality. Evidence for individual SFA is limited. In this large population-based cohort study, we investigated associations between intake of total and individual SFA and risk of total and CVD mortality. Adult residents (mean 41·1 years at baseline) in three Norwegian counties were invited to repeated health screenings between 1974 and 1988 (> 80 % attendance). We calculated cumulative average intakes of macronutrients from semi-quantitative FFQ. Median (interquartile range) intake of SFA was 14·6 % (12·8–16·6 %) of total energy (E%). Hazard ratios (HR) and 95 % CI were estimated using multivariable Cox regression models to assess total, CVD, ischaemic heart disease (IHD) and acute myocardial infarction (AMI) mortality. Among 78 725 participants, 28 555 deaths occurred during a median follow-up of 33·5 years, with 9318 deaths due to CVD. Higher intake of SFA (replacing carbohydrates) was positively associated with all mortality endpoints, including total (HR per 5 E% increment, 1·18; 95 % CI 1·13, 1·23) and CVD mortality (1·16; 95 % CI 1·07, 1·25). Theoretical isoenergetic substitution of SFA with carbohydrates or MUFA was associated with lower risk. Of individual SFA, myristic (14:0) and palmitic acid (16:0) were positively associated with mortality. In summary, dietary SFA intake was strongly associated with higher total and CVD mortality in this long-term cohort study. This supports policies implemented to reduce SFA consumption in favour of carbohydrates and unsaturated fats.
Iodine nutrition among pregnant women in the Faroe Islands
Authors: Johannesen Herborg Líggjasardóttir , Andersen Stig , Andersen Stine Linding , Hansen Solrunn , Petursdóttir Jóhanna , Weihe Pál , Strøm Marin , Petersen Maria Skaalum , Veyhe Anna Sofía
Published: September 2024

Ensuring adequate iodine nutrition during pregnancy is crucial for fetal brain development. Thus, the WHO recommend monitoring iodine nutrition in pregnant women. With changing dietary habits and declining iodine intake in coastal populations, iodine nutrition in pregnant Faroese women was a focus in newly established pregnancy cohorts. This study aimed to monitor the iodine status of pregnant women in the Faroe Islands by assessing urinary iodine concentration (UIC) and maternal iodine intake. For 2 years, all pregnant women were invited to participate in a nationwide study. Participants completed questionnaires addressing personal and lifestyle factors, supplement intake and dietary habits, Additionally, they provided spot urine samples for UIC measurements. Iodine was measured spectrophotometrically using the ceri/arsen method after alkaline-ashing. Among the 1030 invited, 654 participated and 647 provided a spot-urine sample. The average age was 30·4 years (18–47 years). The overall median UIC was 110 µg/l, declined from 117 to 101 µg/l over 2 years (P = 0·004). UIC was significantly impacted by diet. Women consuming fish and eggs had a higher median UIC compared with those whose primary iodine source was dairy: fish-dinner, 151 µg/l; dairy products, 112 µg/l (P < 0·001). Furthermore, there was a positive association between maternal age, reported intake of iodine-containing supplements and the UIC. This nationwide study of pregnant Faroese women found UIC below the WHO-recommended cut-off for pregnant women and decreasing with time. This decline highlights the importance of continuous monitoring to prompty identify shifts in iodine status, enabling timely intervention to address emerging deficiencies.
Variation in bovine milk stability according to lactational stage and genetic group
Authors: Schmitz Bruna , Costa Olmar Antônio Denardin , Fluck Ana Carolina , de Borba Leonardo Piffer , Rangel Adriano Henrique do Nascimento , Fischer Vivian
Published: September 2024

We address the hypothesis that at early and late lactation milk presents low ethanol stability due to high acidity and ionic calcium values. Our aim was to evaluate the functional traits of milk (milk ethanol stability: MES, acidity and ionic calcium: iCa) according to lactation stage in different genetic groups. Raw milk samples were collected from Jersey (n = 271), Holstein (n = 248) and Jersey × Holstein crossbred cows (n = 82), raised on five commercial farms located in the state of Paraná, Brazil. Milk composition, somatic cell count (SCC), milk urea nitrogen (MUN), MES, pH, acidity and iCa were determined. Days in milk (DIM) were categorized into four classes: 1–60, 61–150, 151–305 and over 305 DIM. Data were submitted to analysis of variance. Fixed and random effects were incorporated into the model, in a repeated measures in time arrangement using the mixed models methodology. Significant interactions between DIM class and genetic groups were detected. The comparison between each combination of genetic group and DIM class showed that at the beginning of lactation, Holsteins produced milk with higher MES than Jersey and crossbreds. At 105–305 DIM Holstein milk presented higher MES than Jersey, while beyond 305 DIM Holstein milk showed higher MES than crossbred cows. At the beginning of lactation acidity was higher in Holstein milk and crossbreds compared with Jersey, while acidity was lower in Holstein milk compared with Jersey and crossbreds in the other lactation stages. Ionic calcium was highest after lactation peak for Holstein, but did not vary between lactation stages for Jersey and crossbreds. Functional characteristics of bovine raw milk such as MES, iCa and acidity varied between lactation stages in a distinct manner according to genetic groups. Early and end lactation stages are challenging in terms of low stability, especially for Jersey and crossbreds.
Characterizing Veteran suicide decedents that were not classified as high-suicide-risk
Authors: Levis Maxwell , Dimambro Monica , Levy Joshua , Dufort Vincent , Fraade Abby , Winer Max , Shiner Brian
Published: September 2024

Background

Although the Department of Veterans Affairs (VA) has made important suicide prevention advances, efforts primarily target high-risk patients with documented suicide risk, such as suicidal ideation, prior suicide attempts, and recent psychiatric hospitalization. Approximately 90% of VA patients that go on to die by suicide do not meet these high-risk criteria and therefore do not receive targeted suicide prevention services. In this study, we used national VA data to focus on patients that were not classified as high-risk, but died by suicide.

Methods

Our sample included all VA patients who died by suicide in 2017 or 2018. We determined whether patients were classified as high-risk using the VA's machine learning risk prediction algorithm. After excluding these patients, we used principal component analysis to identify moderate-risk and low-risk patients and investigated demographics, service-usage, diagnoses, and social determinants of health differences across high-, moderate-, and low-risk subgroups.

Results

High-risk (n = 452) patients tended to be younger, White, unmarried, homeless, and have more mental health diagnoses compared to moderate- (n = 2149) and low-risk (n = 2209) patients. Moderate- and low-risk patients tended to be older, married, Black, and Native American or Pacific Islander, and have more physical health diagnoses compared to high-risk patients. Low-risk patients had more missing data than higher-risk patients.

Conclusions

Study expands epidemiological understanding about non-high-risk suicide decedents, historically understudied and underserved populations. Findings raise concerns about reliance on machine learning risk prediction models that may be biased by relative underrepresentation of racial/ethnic minorities within health system.
Incipient fault diagnosis for robot manipulators based on evolution of friction characteristics in transmission components
Authors: Zhou Xing , Huang Shifeng , Xian Yaoqi , Zhou Huicheng , Deng Wenbin , Zhou Jian
Published: September 2024

The tribological behavior can be informative about the incipient faults of robot manipulators. This study explores the evolution of friction characteristics from cold start to thermal equilibrium through a series of steady-state friction experiments. Based on these experimental observations, a friction-based fault diagnosis framework is proposed. The fault diagnosis process primarily involves defining the healthy state, decomposing friction curves and their features, and anomaly detection. Given the dependence of friction characteristics on different sources of faults, the parameters of steady-state experimental friction model are divided into two categories: one associated with contact interactions and the other related to non-contact regimes. Subsequently, confidence regions corresponding to distinguishable friction characteristics are independently constructed. These regions encapsulate the statistical description of the healthy state, characterized by mean values and the covariance of the friction characteristic parameter vectors during the unloaded state. In addition, we conduct experiments that consider the influence of applied loads on friction behavior. These experiments serve as a test set for comparison against nominal statistics. Leveraging the similarity between the effects of wear and load on friction, we introduce equivalent load thresholds to assess the severity of joint degradation. The results demonstrate the feasibility of employing confidence region views based on friction characteristic classification for fault detection and isolation.
The Councils and their Significance
Authors: Hill Edmund
Published: September 2024

The Council of Florence, about which I have recently been reading Fr
Gill's monumental work, is surely one of the more poignant, and I would say
gallant failures of history. I feel also that it has a special interest for
me as a Dominican, since the chief spokesman on the Latin Side in the
theological debates was the Dominican John Montenero; a Greek Dominican
bishop, Andrew Chrysoberges, played a prominent part in the negotiations
that preceded and followed the Council; and finally the patriarch Joseph II,
who died a few weeks before the union was proclaimed, was buried in the
Dominican church of S. Maria Novella.

But for two more substantial reasons it is also of particular
significance for subject this evening; it did achieve a union, however
precarious and short-lived, between the Latins and the Greeks, and a union
elicited from genuine hard discussion of the points at issue between the two
Churches; and secondly it really settled once and for all the issue that Was
dividing the Latin Church on whether or not a council has authority over the
pope.
Devotion to the Holy Name
Authors: Haines I. M.
Published: September 2024

Christian worship began with the bestowal of a Name. It ends with the
adoration of that Name. When the angel Gabriel told the Virgin Mother what
her little son should be called he started a devotion that has run like a
red thread through all the worship of the Church and seems destined to last
while time shall last and till time shall be no more. One surmises if among
the things the wondering shepherds and the adoring magi asked was the name
by which he should be called, and if the Virgin Mother in her graciousness
entrusted to them that high secret which they carried so joyously back with
them as they returned to their own fields or their own country by another
way. Anyway, eight days after he was born, he was publicly given that Name
which is above every name and before which every knee shall bow, of things
in heaven and of things on earth and things under the earth.
The Culture War and Partisan Polarization: State Political Parties, 1960–2018
Authors: Gamm Gerald , Phillips Justin H. , Carr Matthew , Auslen Michael
Published: September 2024

Partisan polarization on “culture war” issues has become a defining feature of contemporary American politics. This was not always the case; for the first two-thirds of the twentieth century, social issues such as abortion and LGBTQ rights played no role in politics. Where and when did the partisan divide begin? Did the initiative come from state or national parties? Was there a critical moment, or was position change incremental? We have constructed an original database of nearly 2,000 state party platforms from 1960 to 2018. These platforms allow us to trace position-taking on these issues and generate estimates of platform ideology. By the time national parties took positions, we show, they lagged state-level position-taking. Contrary to long-held assumptions, we show that state party system polarization did not occur around any critical moment but rather was incremental.
What is the dietary intake and nutritional status of defence members: a systematic literature review
Authors: Bayes Jessica , Burch Emily , Lauche Romy , Wardle Jon
Published: September 2024

Optimal diet and nutrition is vital for military readiness, performance and recovery. Previous research on military diets has primarily focused on the nutritional composition of field/combat rations and dietary intake during deployment. There is accumulating research exploring the usual free-living dietary intake and nutritional status of defence members in garrison (i.e. military bases on which personnel are stationed). However, no comprehensive review has been conducted to assess the overall dietary quality of defence members internationally. Therefore, this review assessed the diets of military populations against national nutritional guidelines and Military Dietary Reference Intakes (MDRI). A systematic literature review of original research was conducted. CINAHL, Medline (EBSCO), Scopus (Elsevier), PubMed and AMED databases were searched up to the 20/02/2023. A total of thirty-six studies met the inclusion criteria. The overall quality of included studies was high, with a low risk of bias. The diet quality scores indicate poor to fair diet quality among defence members. Defence members display low intakes of fruits, vegetables, wholegrains, seafood, plant protein and nuts and high intakes of added sugars, trans fat and processed meat. Results also indicated suboptimal intake of fibre, essential fatty acids, vitamin A, vitamin E, folate, Mg, Zn and iodine. This may lead to reduced performance, increased risk of chronic diseases and mental health disorders. More research is needed to assess the long-term consequences of poor diet quality in defence members. These results require the attention of policymakers to ensure that military education and food environment is supportive of healthy eating.
Traumatic stress in parents of children with congenital heart disease: a scoping review
Authors: Jones Melissa B. , Cameron Vanessa K. , Lee Sura , McNelis Angela M.
Published: September 2024

Congenital heart disease is the most common birth defect in the United States, with many of the affected infants requiring surgical and/or interventional procedures within their first year of life. The parental impacts of a child’s diagnosis, subsequent hospitalization, and transition to home after discharge are numerous and burdensome, and many experience symptoms of traumatic stress along this trajectory. The purpose of this scoping review was to summarize current available literature related to the traumatic stress experienced by parents of children with heart disease to better understand the prevalence, related factors, and consequences. The Joanna Briggs Institute Scoping Review Framework was implemented to identify 31 relevant peer-reviewed articles published between 2000 and early 2024, including 25 quantitative studies, 3 qualitative studies, and 3 systematic reviews or meta-analyses. This scoping review provides an overview of parent traumatic stress for clinicians caring for children with heart disease at every stage of their clinical course.
A Modal Heterotopia: Rethinking Makam Modality and Chordal Harmony in Interwar Rebetiko
Authors: DELEGOS SPIROS
Published: September 2024

This article revisits the concepts of makam modality and chordal harmony, and argues for viewing interwar rebetiko as a musico-cultural amalgamation. I explore the transcendence of the theoretical incompatibility beyond the East–West dichotomy by employing the Foucauldian concept of heterotopia as a de-ideologised analytical tool. I conduct a case study of makam Sabâ and pertinent harmonisation on the guitar, by analysing two representative historical recordings from the 1930s and interpreting them within the contemporaneous musico-cultural context. As a result, I contend that the terms “equal-tempered makam” and “idiosyncratic harmonisation” mirror expressions of modal heterotopia within interwar rebetiko.
A Model‐Based Investigation of the Recent Rebound of Shelf Water Salinity in the Ross Sea
Authors: Zhang Jingwei , Zhang Xuebin , King Matt A. , Lyu Kewei
Published: September 2024

Intense atmosphere‐ocean‐ice interactions in the Ross Sea play a vital role in global overturning circulation by supplying saline and dense shelf waters. Since the 1960s, freshening of the Ross Sea shelf water has led to a decline in Antarctic Bottom Water formation. However, during 2012–2018, salinity of the western Ross Sea has rebounded. This study adopts a global ocean‐sea ice model to investigate the causes of this salinity rebound. Model‐based surface salinity budget analysis indicates that the salinity rebound was driven by increased brine rejection from sea ice formation, triggered by nearly equal effects of local anomalous winds and surface heat flux. The local divergent wind anomalies promoted local sea ice formation by creating a thin ice area, while cooling heat flux anomaly decreased the surface temperature, increasing sea ice production as well. This highlights the importance of understanding local climate variability in projecting future dense shelf water change.