bluuebunny/crossref_metadata_2025 huggingface dataset:
The Justification and Critique of Coercion as World Order Politics
Authors: Daase Christopher , Deitelhoff Nicole
Published: April 2021

The present chapter turns from the justification of war (the use of force) to the justification of coercion. It proceeds on the assumption that to stabilize the current international order requires less ‘legitimate force’ and more ‘legitimate coercion’ since in most institutions the enforcement of norms—as the very basis of order—does not only or even primarily rely on physical force but on various forms of political and economic coercion. The chapter distinguishes various forms of coercion and reconstructs debates in International Law and International Relations with regard to their legality, legitimacy, and effectiveness. Doing so, Christopher Daase and Nicole Deitelhoff intend to broaden the debate on world order by redirecting the focus from the use of force to the use of less violent coercive measures. Specifically, the chapter introduces a concept of sanction as a means of communicating normative expectations to the normative community rather than executing punishments.
Part I
Authors: Clark Samuel
Published: April 2021

Part I investigates a wide range of autobiographies, alongside work on the history and literary criticism of autobiography, on narrative, and on the philosophies of the self and of the good life. It works from the point of view of the autobiographer, and considers what she does, what she aims at, and how she achieves her effects, to answer three questions: what is an autobiography? How can we learn about ourselves from reading one? About what subjects does autobiography teach? This part of the book develops, first, an account of autobiography as paradigmatically a narrative artefact in a genre defined by its form: particular diachronic compositional self-reflection. Second, an account of narrative as paradigmatically a generic telling of a connected temporal sequence of particular actions taken by, and particular events which happen to, agents. It defends rationalism about autobiography: autobiography is in itself a distinctive and valuable form of ethical reasoning, and not merely involved in reasoning of other, more familiar kinds. It distinguishes two purposes of autobiography, self-investigation and self-presentation. It identifies five kinds of self-knowledge at which autobiographical self-investigation typically aims—explanation, justification, self-enjoyment, selfhood, and good life—and argues that meaning is not a distinct sixth kind. It then focusses on the book’s two main concerns, selfhood and good life: it sets out the wide range of existing accounts, taxonomies, and tasks for each, and gives an initial characterisation of the self-realization account of the self and its good which is defended in Part II.
Introduction
Authors: O’Flynn. Levy
Published: April 2021

Referendums are now common in ‘conflict societies’—societies where a widespread and concerted campaign of violence between groups recently occurred, is occurring, or is liable to occur. In the ideal case, a peace referendum can secure consent for a new formal peace settlement among warring groups and provide the settlement with a popular mandate. In practice, however, settlements, once attained, may struggle to endure. Some may collapse entirely. Against this background we introduced what we call the ‘Deliberative Peace Referendum’, or ‘DPR’. A DPR is a purpose-designed deliberative referendum held under conditions of conflict. As this chapter recognizes, designing a referendum to be more deliberative is a challenge under any circumstances. It may be hardest of all amid armed intercommunal conflict.
Designing a Deliberative Peace Referendum
Authors: O’Flynn. Levy
Published: April 2021

This chapter outlines the generic Deliberative Peace Referendum model. We introduce key innovations such as a modestly coercive referendum ballot design that encourages public-reason based deliberation. We also point to more established institutional options (eg, mini-publics) and where these may fit the referendum process. The generic Deliberative Peace Referendum model is amendable to modification, especially in light of the various types of conflict in which it may apply.
Conclusion
Authors: O’Flynn. Levy
Published: April 2021

This concluding chapter reprises the book’s content and offers several key lessons. It also proffers predictions about where future work may take studies of deliberative design for peace referendums. Referendums are now part of very many peacemaking efforts. We expect referendums to continue to be used this way. But when this occurs, the success of peace referendums—particularly their capacities to achieve and secure the endurance of constitutional peace settlements—may turn largely on whether institutional supports for deliberation are in place.
A Genetic History of Thought
Authors: Queloz Matthieu
Published: April 2021

This chapter moves into the nineteenth century and brings Friedrich Nietzsche into the fold of the pragmatic genealogical tradition. It is argued that in his Basel years, Nietzsche sketches primarily fictional and vindicatory genealogies of justice and truthfulness which bring him closer to the ‘English’ genealogists than he later cared to admit. Nietzsche’s significance for pragmatic genealogy is shown to be threefold: he diagnoses philosophers’ tendencies to dehistoricize and denaturalize their objects, and envisages, as a remedy for these failings, a systematic application of genealogy across our conceptual practices; he views concepts as growing out of needs, but, under the influence of Darwinism and historicism, he indexes needs to socio-historical perspectives and invites genealogists to think more historically; and he highlights that what has a point under some circumstances might become pointless or dysfunctional once it takes more demanding forms or comes to be applied beyond those circumstances.
The Normative Significance of Pragmatic Genealogies
Authors: Queloz Matthieu
Published: April 2021

This chapter examines how pragmatic genealogy can affect the space of reasons by addressing four objections to this idea: normatively ambitious genealogies commit the genetic fallacy; if not, they founder on failures of continuity in the conditions securing their normative import; if not, this must be because they deal with universal needs, which severely restricts their explanatory scope; and what counts as a need is anyway eagerly contested. In answering these objections, the chapter shows two ways around the genetic fallacy and addresses the problem of Rortyan irony; it offers a need-satisfaction account of functions or pointfulness and discusses the strategies by which genealogies can secure continuity; it shows that the method is not restricted to explaining anthropological universals and that the state of nature can also be used to model local problems; finally, it explores how genealogies help us navigate contestations of certain needs and conceptions of human agents.
Law of Obligations and Contracts
Authors: Oda Hiroshi
Published: April 2021

The Constitution protects property rights, but it is not ‘sacrosanct’. Property rights can be restricted on the ground of public welfare. Real security rights are covered in this part. Although real property rights are to be created by statutes only, in reality, there have been cases where property rights were created by case law on the basis of commercial practice.
The Emotions
Authors: Charles David
Published: April 2021

In De Anima A.1, Aristotle developed an account of certain ‘affections of the soul’ such as anger which is his model for other ‘affections and actions common to body and soul’ such as desire and sense perception. His remarks about anger can be understood in two different ways. According to one account, which I call ‘the Pure Form Interpretation’, anger is essentially a compound made up of two definitionally distinct features, one purely psychological (a desire for revenge: its form) and the other physical (the boiling of the blood: its matter), where the latter in some way ‘underlies’ the former. In the other, described as ‘the Impure Form Interpretation’, the type of desire for revenge referred to in the definition of anger (its form) is inseparable in definition from (and not abstractable from) physical features such as, for example, the boiling blood. The type of desire which defines anger is itself defined as a boiling-of-the-blood-(or hot-) desire for revenge. Aristotle’s comments in De Anima A.1 are, it is argued, best understood in line with the Impure Form Interpretation, as defining anger as an inextricably psycho-physical type of desire for revenge, not decomposable into two definitionally separate features, one purely psychological, one purely physical.
Accommodating England
Authors: Henderson Ailsa
Published: April 2021

Following from these primarily data-driven chapters, Chapter 7 assesses the political challenges that arise in the context of the rise of English nationalism. In particular, we discuss the ways in which three constraints—the pattern of public attitudes in England, the institutional fusion of English and all-UK institutions, as well as the overwhelming size of England relative to the other constituent territories of the union—all serve to shape, limit, or undermine attempts to accommodate England within the post-devolution UK. The chapter then examines in detail the various efforts of political parties to answer ‘the English question’.
Do Androids Dream of Electric Copyright?
Authors: Guadamuz Andres
Published: April 2021

The advent of sophisticated artificial neural networks has opened new artistic opportunities, but also a variety of new legal challenges. Computer programs such as Google’s Deep Dream can take an image and process it in manners that resemble biological networks, producing artwork that is both unique and unpredictable. The law is not unfamiliar with the challenges of artificial intelligence (AI), in the past academics and policymakers have had to deal with the legal implications of autonomous agents in contract formation, to name just one area of interest. However, for the most part the implementation of smart systems has been limited in its reach and scope, and in many instances autonomous agents required quite a lot of direction from the programmer, following a very stringent set of rules. This meant that for the most part all rights, responsibilities, and liabilities arising from artificial agents fell squarely on the program creator. Neural networks are different, these systems have the potential to generate works in which human interaction is minimal. Modern copyright law has been drafted to consider originality as an embodiment of the author’s personality, and originality is one of the main requirements for the subsistence of copyright. So, what happens when you remove personality from the equation? Are machine-created works devoid of copyright? Do we need to change copyright law to accommodate autonomous artists? This chapter will explore this and other questions.
The role of telemedicine in gynecologic healthcare
Authors: Weltin Ann , Etcher LuAnn
Published: April 2021

This article offers a comprehensive narrative literature review on telemedicine use in gynecologic healthcare analyzing current telemedicine integration in the field and outlining innovative and best practices. Telemedicine use in contraceptive care, sexually transmitted infections, acute and chronic gynecologic conditions, and education are discussed. NPs are in a unique position to offer these services to patients in need of women's healthcare services. Barriers, facilitators, clinical implications, and future research are addressed.
Clinical Outcomes for Hemiarthroplasty Versus Total Hip Arthroplasty in Patients With Femoral Neck Fracture Who Meet Published National Criteria for Total Hip Arthroplasty
Authors: Craig Julie , McDonald Jonathon , Cassidy Roslyn , McDonald Sinead , Barr John , Diamond Owen
Published: April 2021

Objectives:

To examine outcome for patients with hip fracture treated by a hemiarthroplasty (HA) but who actually met the United Kingdom, National Institute for Health and Care Excellence (NICE) criteria for receiving a total hip arthroplasty (THA).

Design:

Match cohort study.

Setting:

Level 1, Academic Trauma Centre (UK Major Trauma Centre).

Patients/Participants:

Three hundred ninety-eight patients underwent either a HA or THA for a nonpathological displaced intracapsular fractured neck of the femur [OTA/AO 31 B3 (garden 3–4)], having met the NICE criteria for THA.

Intervention:

HA versus THA. Two analyses were performed, the first comparing the outcome in a cohort of patients who either received a THA or HA but who all had met the NICE criteria to receive a THA (n = 398). The second analysis assessed the outcome of THA versus HA, in a matched cohort of patients who all met the NICE criteria for a THA (n = 44 matched pairs). All patients in the matched cohort were able to walk independently outdoors (WIOs) before injury.

Main Outcome:

Mobility and functional outcome, 1 year after surgery.

Results:

Of the 398 patients who met the criteria for THA, only 78 (19.6%) patients actually received a THA. Within the matched cohort, significantly more THA patients (92.9%, 39/42) maintained the ability to WIOs at 1-year compared with patients with HA (56.4%, 22/39; P = 0.001). There was no difference in mortality, reoperation, or complication rates for our matched population at 1 year.

Conclusions:

Patients who meet the NICE criteria for THA and are able to WIOs preinjury are more likely to have a higher level of independent mobility and a better functional outcome at 1-year if they receive a THA, as opposed to receiving a HA.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Molecular Landscapes and Models of Acute Erythroleukemia
Authors: Fagnan Alexandre , Piqué-Borràs Maria-Riera , Tauchmann Samantha , Mercher Thomas , Schwaller Juerg
Published: April 2021

Malignancies of the erythroid lineage are rare but aggressive diseases. Notably, the first insights into their biology emerged over half a century ago from avian and murine tumor viruses-induced erythroleukemia models providing the rationale for several transgenic mouse models that unraveled the transforming potential of signaling effectors and transcription factors in the erythroid lineage. More recently, genetic roadmaps have fueled efforts to establish models that are based on the epigenomic lesions observed in patients with erythroid malignancies. These models, together with often unexpected erythroid phenotypes in genetically modified mice, provided further insights into the molecular mechanisms of disease initiation and maintenance. Here, we review how the increasing knowledge of human erythroleukemia genetics combined with those from various mouse models indicate that the pathogenesis of the disease is based on the interplay between signaling mutations, impaired TP53 function, and altered chromatin organization. These alterations lead to aberrant activity of erythroid transcriptional master regulators like GATA1, indicating that erythroleukemia will most likely require combinatorial targeting for efficient therapeutic interventions.
Congenital Aberrant Muscular Overgrowth of Hands and Feet in Patients With PIK3CA Overgrowth Spectrum: A Multicentric Study of Case Series
Authors: Delgado-Miguel Carlos , Miguel-Ferrero Miriam , Muñoz-Serrano Antonio J. , Triana Paloma , Martínez-González Víctor , Rodríguez-Laguna Lara , Boente María del Carmen , Torrelo Antonio , López-Gutiérrez Juan C.
Published: April 2021

Background:

The term “congenital muscular hyperplasia of the hand” refers to a distinctive enlargement of the hypothenar eminence associated with ulnar deviation of the metacarpophalangic joints, macrodactyly, and enlargement of the forearm and/or the entire upper extremity. The presence of hyperplastic, aberrant or accessory muscles in the affected areas has been reported.

Methods:

We present a case series of patients diagnosed with aberrant muscular overgrowth of the hands or feet from 3 international institutions between 2008 and 2018.

Results:

Fourteen patients are reported. Hand involvement was observed in 10 patients, and in 4 patients, the lateral side of the foot was involved. Nine patients had a vascular malformation (lymphatic and/or capillary) associated either in the affected limb or elsewhere. In all cases, variable degrees of congenital overgrowth of the ipsilateral limb were observed. Skin punch biopsy (5 mm diameter and 3–5 mm depth) was performed on 7 patients. In all of them, striated muscle hyperplasia and the presence of striated muscular fibers in the dermis and hypodermis, thus revealing ectopic muscle, were observed. A somatic pathogenic variant in phosphatidylinositol-3-kinase catalytic α polypeptide (PIK3CA) was demonstrated in 5 of the 7 biopsied patients, with a 2.7% to 15.7% of mosaicism (His1047Arg in 2 cases, and Cys378Arg, Glu542Lys, and Cys420Arg, 1 case each).

Conclusions:

Our case series supports muscular overgrowth as a distinct phenotype within the PIK3CA-related overgrowth spectrum. Although initially described only in the hands, we have reported foot involvement in 4 cases. The role of PIK3CA in muscle overgrowth is not yet well understood.
Clinical significance of immunohistochemistry to detect BRAF V600E mutant protein in thyroid tissues
Authors: Zhang Yini , Liu Lidan , Liu Ye , Cao Nan , Wang Lifen , Xing Chengjuan
Published: April 2021

This study investigated the feasibility of using immunohistochemistry (IHC) instead of PCR to detect BRAF V600E mutant protein in papillary thyroid carcinoma (PTC), and to determine the value of using preoperative BRAF V600E mutant protein by IHC to assist in the diagnosis of thyroid nodule patients with Hashimoto's thyroiditis (HT).

The expression of BRAFV600E mutant protein was measured in 23 cases of HT+PTC, 31 cases of PTC, and 28 cases of HT by IHC, followed by PCR in the same samples for validation. SPSS 19.0 software was used for statistical analysis.

The sensitivity and specificity of IHC to detect BRAF V600E mutation were 100% and 42.86%, respectively. In addition, the mutation rate of BRAF V600E protein in the HT+PTC group (34.78%, 8/23) was lower than that in the PTC group (80.65%, 25/31).

The application of IHC to detect BRAF V600E mutant protein has good sensitivity but not specificity to diagnose PTC. IHC can be used as a preliminary screening method to detect BRAF V600E mutation. The strongly positive (+++) staining of IHC potently indicated BRAF V600E gene mutation. For suspicious thyroid nodules combined with HT, the detection of BRAF V600E mutant protein with IHC alone is not of great significance for differentiating benign and malignant nodules.
Berg balance scale as a tool for choosing the walking aid for patients with Guillain-Barré syndrome or polyneuropathy
Authors: Zupanc Aleksander , Vidmar Gaj
Published: April 2021

Berg balance scale (BBS) is a widely used outcome measure in rehabilitation. We wanted to check if it can discriminate among levels of use of walking aid in patients with Guillain–Barré syndrome or polyneuropathy. A retrospective audit of 109 such patients (aged 16–85 years) who had completed inpatient rehabilitation in the period 2012–2017 was conducted. Receiver operating characteristic curve analysis was used to estimate the thresholds that optimise the prediction of the patient’s walking aid. Statistically, significant threshold BBS score was estimated for the ability to walk without walking aid (≥49 points, yielding 88% sensitivity, 68% specificity and 83% classification accuracy) and the necessity to walk with a walker (≤37 points, yielding 62% sensitivity, 83% specificity and 78% classification accuracy). BBS score thresholds can therefore help clinicians choose the appropriate walking aid for patients with Guillain–Barré syndrome or polyneuropathy undergoing rehabilitation.
Frequency of Anxiety, Depression, and Irritability Symptoms in Children During the COVID-19 Outbreak and Potential Risk Factors Associated With These Symptoms
Authors: Dönmez Yunus Emre , Uçur Ömer
Published: April 2021

The aim of this study was to determine the frequency of anxiety, depression, and irritability symptoms in children during the COVID-19 outbreak and to investigate the associated factors of these symptoms. This study was conducted with 1071 children aged 6 to 17. Results showed that 49.9% of the participants had anxiety symptoms, 29.5% had depression symptoms, and 51.4% had irritability symptoms. Low age was a potential risk factor for anxiety symptoms. Female sex was a potential risk factor for anxiety and depression symptoms. A COVID-19 death in the family or environment was a potential risk factor for depression and irritability symptoms. Exposure to COVID-19 information on television and on the internet was a potential risk factor for anxiety, depression, and irritability symptoms. In conclusion, this study revealed that the COVID-19 outbreak may have serious effects on the mental health of children, and the study highlighted potential risk factors.
Perceptions of Authentic Nurse Leadership and Work Environment and the Pandemic Impact for Nurse Leaders and Clinical Nurses
Authors: Raso Rosanne , Fitzpatrick Joyce J. , Masick Kevin , Giordano-Mulligan Marie , Sweeney Cynthia D.
Published: April 2021

OBJECTIVE

The aim of this study was to determine the pandemic impact on the relationship between nurses' perception of the authentic nurse leadership (ANL) of their manager and their perception of the work environment.

BACKGROUND

Both ANL and healthy work environment (HWE) contribute to staff and patient outcomes. Our 1st study of these 2 variables revealed a positive relationship. Will this be upheld in a pandemic year?

METHODS

More than 5000 nurses from a national sample participated in a cross-sectional, correlational, descriptive study using the Authentic Nurse Leadership Questionnaire, the Critical Elements of a Healthy Work Environment Scale, and a pandemic impact on practice question.

RESULTS

Overall, nurses perceived ANL and HWE were present despite a high level of pandemic impact; however, when clinical nurses were separated from managers/directors, HWE was not present for frontline nurses. The moderate correlation of ANL and HWE was replicated in this larger study.

CONCLUSIONS

This is the 2nd study of the positive relationship between ANL and HWE using these models, supporting ANL as an essential standard of a HWE. ANL was present for clinical nurses in a pandemic year signaling that nurse leaders rose to meet frontline leadership needs. HWE was present overall, but not for clinical nurses. Leadership is essential to work environments and outcomes especially in times of crisis and significant change.
Surgical Outcomes in Urogynecology—Assessment of Perioperative and Postoperative Complications Relative to Preoperative Hemoglobin A1c—A Fellows Pelvic Research Network Study
Authors: Ringel Nancy E. , de Winter K. Lauren , Siddique Moiuri , Marczak Tara , Kisby Cassandra , Rutledge Emily , Soriano Alex , Samimi Parisa , Schroeder Michelle , Handler Stephanie , Zeymo Alexander , Gutman Robert E.
Published: April 2021

Objectives

Poor control of diabetes mellitus is a known predictor of perioperative and postoperative complications. No literature to date has established a hemoglobin A1c (HbA1c) cutoff for risk stratification in the urogynecology population. We sought to identify an HbA1c threshold predictive of increased risk for perioperative and postoperative complications after pelvic reconstructive surgery.

Methods

This multicenter retrospective cohort study involving 10 geographically diverse U.S. female pelvic medicine and reconstructive surgery programs identified women with diabetes who underwent prolapse and/or stress urinary incontinence surgery from September 1, 2013, to August 31, 2018. We collected information on demographics, preoperative HbA1c levels, surgery type, complications, and outcomes. Sensitivity analyses identified thresholds of complications stratified by HbA1c. Multivariate logistic regression further evaluated the association between HbA1c and complications after adjustments.

Results

Eight hundred seven charts were identified. In this diabetic cohort, the rate of overall complications was 44.1%, and severe complications were 14.9%. Patients with an am HbA1c value of 8% or greater (reference HbA1c, <8%) had an increased rate of both severe (27.1% vs 12.8%, P < 0.001) and overall complications (57.6% vs 41.8%, P = 0.002) that persisted after multivariate logistic regression (odds ratio, 2.618; 95% confidence interval, 1.560–4.393 and odds ratio, 1.931; 95% confidence interval, 1.264–2.949, respectively). Mesh complications occurred in 4.6% of sacrocolpopexies and 1.7% of slings. The average HbA1c in those with mesh exposures was 7.5%.

Conclusions

Preoperative HbA1c of 8% or higher was associated with a 2- to 3-fold increased risk of overall and severe complications in diabetic patients undergoing pelvic reconstructive surgery that persisted after adjustments.
Universality in biodiversity patterns: Variation in species-temperature and species-productivity relationships reveals a prominent role of productivity in diversity gradients
Authors: Bohdalková Eliška , Toszogyova Anna , Šímová Irena , Storch David
Published: April 2021

Temperature and productivity appear as universal positive correlates of species richness. However, the strength and the shape of species-temperature (STR) and species-productivity (SPR) relationships vary widely, and the causes of this variation are poorly known. We analysed (1) published species richness data for multiple taxa sampled in various regions and (2) different clades within vertebrate classes globally, to test for the effects of spatial scale and characteristics of examined taxa and regions on the strength and direction of STRs and SPRs. There are striking differences in the variation of the relationships among types of data, between ectotherms and endotherms and also between STRs and SPRs. Some sources of this variation are of statistical nature (e.g. the relationships are stronger if the range of temperature or productivity variation is wider), but non-statistical sources are more important and illuminate the processes responsible for the origin of biodiversity patterns. The SPRs are generally stronger and less variable than STRs, and SPR variation is weakly related to the explored factors – the SPRs are stronger in warmer regions in ectotherms, while clade size is the only factor consistently affecting the strength of the SPR in endotherms. In contrast, STRs are weaker and more variable, and this variation is linked to region characteristics - most importantly, STRs are stronger in the regions where temperature positively correlates with productivity, indicating that productivity plays a role even in the STRs. The effect of temperature on species richness is thus complex and context-dependent, while productivity is a more universal driver of species richness patterns, largely independent of particular characteristics of given region or taxon. Productivity thus appears as the main proximate driver of species richness patterns, probably due to its effect on the limits of the number of viable populations which can coexist in a given environment.
Physical activity, sedentary behaviour, and sleep on Twitter: A labelled dataset for public health research
Authors: Hossein Abad Zahra Shakeri , Butler Gregory P. , Thompson Wendy , Lee Joon
Published: April 2021

Advances in automated data processing, together with the unprecedented growth in user-generated social media (SM) content, have made public health surveillance (PHS) one of the long-lasting SM applications. However, the existing PHS systems feeding on SM data have not been widely deployed in national surveillance systems, which appears to stem from the lack of practitioners’ trust in SM data. More robust datasets over which machine learning (ML) models can be trained/tested reliably is a significant step toward overcoming this hurdle. The health implications of physical activity, sedentary behaviour, and sleep (PASS) are widely studied through traditional data sources, which are often out-of-date, costly to collect, and thus limited in quantity and coverage. We present LPHEADA, a multicountry and fully Labelled digital Public HEAlth DAtaset of tweets originated in Australia/Canada/United Kingdom/United States between November 2018-June 2020. LPHEADA contains 366,405 labels for 122,135 PASS-related tweets and provides details about the place/time/demographics associated with each tweet. LPHEADA is publicly available and can be utilized to develop (un)supervised ML models for digital PASS surveillance.
Choosing the right tool for the job: A comprehensive assessment of serological assays for SARS-CoV-2 as surrogates for authentic virus neutralization
Authors: Wohlgemuth Nicholas , Whitt Kendall , Cherry Sean , Roubidoux Ericka Kirkpatrick , Lin Chun-Yang , Allison Kim J. , Gowen Ashleigh , Freiden Pamela , Allen E. Kaitlynn ,   St. Jude Investigative Team, Gaur Aditya H. , Estepp Jeremie H. , Tang Li , Mori Tomi , Hijano Diego R. , Hakim Hana , McGargill Maureen A. , Krammer Florian , Whitt Michael A. , Wolf Joshua , Thomas Paul G. , Schultz-Cherry Stacey
Published: April 2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019 and has since caused a global pandemic resulting in millions of cases and deaths1-4. Diagnostic tools and serological assays are critical for controlling the outbreak5-7, especially assays designed to quantitate neutralizing antibody levels, considered the best correlate of protection8-11. As vaccines become increasingly available12, it is important to identify reliable methods for measuring neutralizing antibody responses that correlate with authentic virus neutralization but can be performed outside of biosafety level 3 (BSL3) laboratories. While many neutralizing assays using pseudotyped virus have been developed, there have been few studies comparing the different assays to each other as surrogates for authentic virus neutralization9,10,13,14. Here we characterized three enzyme-linked immunosorbent assays (ELISAs) and three pseudotyped VSV virus neutralization assays and assessed their concordance with authentic virus neutralization. The most accurate assays for predicting authentic virus neutralization were luciferase and secreted embryonic alkaline phosphatase (SEAP) expressing pseudotyped virus neutralizations, followed by GFP expressing pseudotyped virus neutralization, and then the ELISAs.
Geographic and demographic heterogeneity of SARS-CoV-2 diagnostic testing in Illinois, USA, March to December 2020
Authors: Holden Tobias M , Richardson Reese A.K. , Arevalo Philip , Duffus Wayne A. , Runge Manuela , Whitney Elena , Wise Leslie , Ezike Ngozi O. , Patrick Sarah , Cobey Sarah , Gerardin Jaline
Published: April 2021

Background

Availability of SARS-CoV-2 testing in the United States (U.S.) has fluctuated through the course of the COVID-19 pandemic, including in the U.S. state of Illinois. Despite substantial ramp-up in test volume, access to SARS-CoV-2 testing remains limited, heterogeneous, and insufficient to control spread.

Methods

We compared SARS-CoV-2 testing rates across geographic regions, over time, and by demographic characteristics (i.e., age and racial/ethnic groups) in Illinois during March through December 2020. We compared age-matched case fatality ratios and infection fatality ratios through time to estimate the fraction of SARS-CoV-2 infections that have been detected through diagnostic testing.

Results

By the end of 2020, initial geographic differences in testing rates had closed substantially. Case fatality ratios were higher in non-Hispanic Black and Hispanic/Latino populations in Illinois relative to non-Hispanic White populations, suggesting that tests were insufficient to accurately capture the true burden of COVID-19 disease in the minority populations during the initial epidemic wave. While testing disparities decreased during 2020, Hispanic/Latino populations consistently remained the least tested at 1.87 tests per 1000 population per day compared with 2.58 and 2.87 for non-Hispanic Black and non-Hispanic White populations, respectively, at the end of 2020. Despite a large expansion in testing since the beginning of the first wave of the epidemic, we estimated that over half (50-80%) of all SARS-CoV-2 infections were not detected by diagnostic testing and continued to evade surveillance.

Conclusions

Systematic methods for identifying relatively under-tested geographic regions and demographic groups may enable policymakers to regularly monitor and evaluate the shifting landscape of diagnostic testing, allowing officials to prioritize allocation of testing resources to reduce disparities in COVID-19 burden and eventually reduce SARS-CoV-2 transmission.
Expectant parents’ perceptions of healthcare and support during COVID-19 in the UK: A thematic analysis
Authors: Aydin Ezra , Glasgow Kevin A. , Weiss Staci M. , Austin Topun , Johnson Mark , Barlow Jane , Lloyd-Fox Sarah
Published: April 2021

Background

In response to the COVID-19 pandemic, expectant parents experienced changes in the availability and uptake of both NHS community and hospital-based healthcare.

Objective

To examine how COVID-19 and its societal related restrictions have impacted the provision of healthcare support for pregnant women during the COVID-19 pandemic.

Method

A thematic analysis using an inductive approach was undertaken of data from open-ended responses using data from the national COVID in Context of Pregnancy, Infancy and Parenting (CoCoPIP) Study online survey (N = 507 families).

Results

The overarching theme identified was the way in which the changes to healthcare provision increased parents’ anxiety levels, and feelings of not being supported. Five sub-themes, associated with the first wave of the pandemic, were identified: (1) rushed and/or fewer antenatal appointments, (2) lack of sympathy from healthcare workers, (3) lack of face-to-face appointments, (4) requirement to attend appointments without a partner, and (5) requirement to use PPE. A sentiment analysis, that used quantitative techniques, revealed participant responses to be predominantly negative (50.1%), with a smaller proportion of positive (21.8%) and neutral (28.1%) responses found.

Conclusion

This study provides evidence indicating that the changes to healthcare services for pregnant women during the pandemic increased feelings of anxiety and have left women feeling inadequately supported. Our findings highlight the need for compensatory social and emotional support for new and expectant parents while COVID-19 related restrictions continue to impact on family life and society.
The COvid-19 Pandemic and Exercise (COPE) Trial: A multi-group randomized controlled trial comparing effects of an app-based, at-home exercise program to waitlist control on depressive symptoms
Authors: Puterman Eli , Hives Benjamin A. , Mazara Nicole , Grishin Nikol , Webster Joshua , Hutton Stacey , Koehle Michael , Liu Yan , Beauchamp Mark R
Published: April 2021

Background

The number of adults across the globe with significant depressive symptoms has grown substantially during the COVID-19 pandemic. The extant literature supports exercise as a potent behavior that can significantly reduce depressive symptoms in clinical and non-clinical populations.

Objective

Using a suite of mobile applications, at-home exercise, including high intensity interval training (HIIT) and/or yoga, was completed to reduce depressive symptoms in the general population in the early months of the pandemic.

Methods

A 6-week, parallel, multi-arm, randomized controlled trial was completed with 4 groups: [1] HIIT, [2] Yoga, [3] HIIT+Yoga, and [4] waitlist control (WLC). Low active, English-speaking, non-retired Canadians aged 18-64 years were included. Depressive symptoms were measured at baseline and weekly following randomization.

Results

A total of 334 participants were randomized to one of four groups. No differences in depressive symptoms were evident at baseline. The results of latent growth modeling showed significant treatment effects for each active group compared to the WLC, with small effect sizes in the community-based sample of participants. Treatment groups were not significantly different from each other. Effect sizes were very large when restricting analyses only to participants with high depressive symptoms at baseline.

Conclusions

At-home exercise is a potent behavior to improve mental health in adults during the pandemic, especially in those with increased levels of depressive symptoms. Promotion of at-home exercise may be a global public health target with important personal, social, and economic implications as the world emerges scathed by the pandemic.

Trial registration number

clinicaltrials.gov #NCT04400279

Summary Box

This randomized controlled trial provides strong evidence suggesting that at-home app-based exercise in various forms (high intensity interval training or yoga or their combination) can significantly improve depression symptoms over a 6-week period in community adults during the pandemic. When the sample was restricted to only those with high baseline depression symptoms, the weekly effects were substantially large. At-home exercise during the COVID-19 pandemic proved to be an impactful and affordable health behavior in which community living adults, especially those with high depression symptoms, can engage to bolster their mental health. In light of the long-term mental health consequences of COVID-19 with which many adults are expected to struggle, even after a return to normal, promoting and supporting programming in communities at the individual level will emerge as a necessary health policy initiative.
Emergence of the SARS-CoV-2 B.1.1.7 lineage and its characteristics at an outpatient testing site in Berlin, Germany, January-March 2021
Authors: van Loon Welmoed , Rössig Heike , Burock Susen , Hofmann Jörg , Bernhardt Julian , Linzbach Elizabeth , Pettenkofer Domenika , Schönfeld Christian , Gertler Maximilian , Seybold Joachim , Kurth Tobias , Mockenhaupt Frank P.
Published: April 2021

Within five weeks in early 2021, B.1.1.7 became the dominant SARS-CoV-2 lineage at an outpatient testing site in Berlin. Characteristics including Ct-values of 193 and 125 recently ill outpatients with B.1.1.7 and wildtype virus, respectively, were similar, except for more commonly reported sore throat and travel, and less frequently stated loss of smell and taste in the former.
Access to palivizumab among children at high risk of respiratory syncytial virus complications in English hospitals
Authors: Zylbersztejn Ania , Almossawi Ofran , Gudka Nikesh , Tompsett Daniel , De Stavola Bianca , Standing Joseph F , Smyth Rosalind , Hardelid Pia
Published: April 2021

Objectives

Palivizumab is a monoclonal antibody which can prevent infection with respiratory syncytial virus (RSV). Due to its high cost, it is recommended for high-risk infants only. We aimed to determine the proportion of infants eligible for palivizumab treatment in England who receive at least one dose.

Methods

We used the Hospital Treatment Insights database containing hospital admission records linked to hospital pharmacy dispensing data for 43/153 hospitals in England. Infants born between 2010 and 2016 were considered eligible for palivizumab if their medical records indicated chronic lung disease (CLD), congenital heart disease (CHD), or severe immunodeficiency (SCID), and they met additional criteria based on gestational age at birth and age at start of the RSV season (beginning of October). We calculated the proportion of infants who received at least one dose of palivizumab in their first RSV season, and modelled the odds of treatment according to multiple child characteristics using logistic regression models.

Results

We identified 3,712 eligible children, of whom 2,479 (67%) had complete information on all risk factors. Palivizumab was prescribed to 832 of eligible children (34%). Being born at <30 weeks’ gestation, aged <6 months at the start of RSV season, and having two or more of CLD, CHD or SCID were associated with higher odds of treatment.

Conclusion

In England, palivizumab is not prescribed to the majority of children who are eligible to receive it. Doctors managing these infants might be unfamiliar with the eligibility criteria or are constrained by other considerations, such as cost.
Classifying Drug Ratings Using User Reviews with Transformer-Based Language Models
Authors: Shiju Akhil , He Zhe
Published: April 2021

Drugs.com provides users’ textual reviews and numeric ratings of drugs. However, text reviews may not always be consistent with the numeric ratings. Overly positive or negative rating may be misleading. In this project, to classify user ratings of drugs with their textual reviews, we built classification models using traditional machine learning and deep learning approaches. Machine learning models including Random Forest and Naive Bayesian classifiers were built using TF-IDF features as input. Also, transformer-based neural network models including BERT, BioBERT, RoBERTa, XLNet, ELECTRA, and ALBERT were built using the raw text as input. Overall, BioBERT model outperformed the other models with an overall accuracy of 87%. We further identified UMLS concepts from the postings and analyzed their semantic types in the postings stratified by the classification result. This research demonstrated that transformer-based models can be used to classify drug reviews and identify reviews that are inconsistent with the ratings.
Evaluation of the Nutritional Quality of Ultra-Processed Foods (Ready to Eat + Fast Food): Fatty Acid Composition
Authors: Maldonado-Pereira Lisaura , Barnaba Carlo , De los Campos Gustavo , Medina-Meza Ilce Gabriela
Published: April 2021

Up to the 60% of the Western diet is characterized by consumption of high amounts of Ultra-processed foods (UPFs). From a nutritional standpoint, the high consumption of UPFs, including Fast-foods and Ready-to-Eat (RTE), emerges as a critical topic for public health linking nutritional quality and food safety. In the present work, we provide a systematic database of fatty acids composition of the most consumed UPFs in the US mid-western region. Saturate (SFA) and monounsaturated (MUFA) fatty acids were predominant in both FF and RTE, while health-beneficial polyunsaturated (PUFA) fatty acids were abundant only in seafood meals. Nutritional and non-nutritional attributes were correlated, finding positive correlation between caloric and sodium content. The significance of this study relies on providing new quantitative data for the most consumed UPFs, with the opportunity to define priority interventions for more advanced precision nutrition, especially for vulnerable populations.
A cross-sectional study of infection control measures against COVID-19 and psychological distress among Japanese workers
Authors: Yasuda Yoshino , Ishimaru Tomohiro , Nagata Masako , Tateishi Seiichiro , Eguchi Hisashi , Tsuji Mayumi , Ogami Akira , Matsuda Shinya , Fujino Yoshihisa ,   for the CORoNaWork project
Published: April 2021

Objectives

This study examined the relationship between the status of infection control efforts against COVID-19 in the workplace and workers’ mental health using a large-scale Internet-based study.

Methods

This cross-sectional study was based on an Internet monitoring survey conducted during the third wave of the COVID-19 epidemic in Japan. Of the 33,302 people who participated in the survey, 27,036 were included in the analyses. Participants answered whether or not each of 10 different infection control measures were in place at their workplace (e.g. wearing masks at all times during working hours). A Kessler 6 (K6) score of ≥13 was defined as mild psychological distress. The odds ratios (ORs) of psychological distress associated with infection control measures at the workplace were estimated using a multilevel logistic model nested in the prefectures of residence.

Results

The OR of subjects working at facilities with 4 or 5 infection control measures for psychological distress was 1.19 (95% confidence interval [CI]: 1.05-1.34, p=0.010), that in facilities with 2 or 3 infection control measures was 1.43 (95% CI: 1.25-1.64, p<0.001), and that in facilities with 1 or no infection control measures was 1.87 (95% CI: 1.63-2.14, p<0.001) compared to subjects whose workplaces had ≥6 infection control measures.

Conclusion

Our findings suggest that proactive COVID-19 infection control measures can influence the mental health of workers.
The bundle sheath of rice is conditioned to play an active role in water transport as well as sulfur assimilation and jasmonic acid synthesis
Authors: Hua Lei , Stevenson Sean R. , Reyna-Llorens Ivan , Xiong Haiyan , Kopriva Stanislav , Hibberd Julian M.
Published: April 2021

Leaves comprise multiple cell types but our knowledge of the patterns of gene expression that underpin their functional specialization is fragmentary. Our understanding and ability to undertake rational redesign of these cells is therefore limited. We aimed to identify genes associated with the incompletely understood bundle sheath of C3plants, which represents a key target associated with engineering traits such as C4photosynthesis into rice. To better understand veins, bundle sheath and mesophyll cells of rice we used laser capture microdissection followed by deep sequencing. Gene expression of the mesophyll is conditioned to allow coenzyme metabolism and redox homeostasis as well as photosynthesis. In contrast, the bundle sheath is specialized in water transport, sulphur assimilation and jasmonic acid biosynthesis. Despite the small chloroplast compartment of bundle sheath cells, substantial photosynthesis gene expression was detected. These patterns of gene expression were not associated with presence/absence of particular transcription factors in each cell type, but rather gradients in expression across the leaf. Comparative analysis with C3Arabidopsisidentified a small gene-set preferentially expressed in bundle sheath cells of both species. This included genes encoding transcription factors from fourteen orthogroups, and proteins allowing water transport, sulphate assimilation and jasmonic acid synthesis. The most parsimonious explanation for our findings is that bundle sheath cells from the last common ancestor of rice and Arabidopsis was specialized in this manner, and since the species diverged these patterns of gene expression have been maintained.

Significance statement

The role of bundle sheath cells in C4species have been studied intensively but this is not the case in leaves that use the ancestral C3pathway. Here, we show that gene expression in the bundle sheath of rice is specialized to allow sulphate and nitrate reduction, water transport and jasmonate synthesis, and comparative analysis with Arabidopsis indicates ancient roles for bundle sheath cells in water transport, sulphur and jasmonate synthesis.
Correlated Functional Connectivity and Glucose Metabolism in Brain White Matter Revealed by Simultaneous MRI/PET
Authors: Guo Bin , Zhou Fugen , Li Muwei , Gore John C. , Ding Zhaohua
Published: April 2021

Blood oxygenation level-dependent (BOLD) signals in white matter (WM) have usually been ignored or undetected, consistent with the lower vascular density and metabolic demands in WM than in gray matter (GM). Despite converging evidence demonstrating the reliable detection of BOLD signals in WM evoked by neural stimulation and in a resting state, few studies have examined the relationship between BOLD functional signals and tissue metabolism in WM. By analyzing simultaneous recordings of MRI and PET data, we found that the correlations between low frequency resting state BOLD signals in WM are spatially correlated with local glucose uptake, which also covaried with the amplitude of spontaneous low frequency fluctuations in BOLD signals. These results provide further evidence that BOLD signals in WM reflect variations in metabolic demand associated with neural activity, and suggest they should be incorporated into more complete models of brain function.