bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Harmonization and Standardization of Expanded Newborn Screening Results by Optimization of the Legacy Flow Injection Analysis Tandem Mass Spectrometry Methods and Application of a Standardized Calibration Approach
Authors: Carling Rachel S , Whyte Emily , John Catharine , Garstone Rachelle , Goddard Philippa , Greenfield Toby , Hogg Sarah L , Le Masurier Clare , Cowen Simon , Moat Stuart J , Hopley Christopher
Published: April 2022

Background

Newborn screening (NBS) laboratories in the United Kingdom adhere to common protocols based on single analyte cutoff values (COVs); therefore, interlaboratory harmonization is of paramount importance. Interlaboratory variation for screening analytes in UK NBS laboratories ranges from 17% to 59%. While using common stable isotope internal standards has been shown to significantly reduce interlaboratory variation, instrument set-up, sample extraction, and calibration approach are also key factors.

Methods

Dried blood spot (DBS) extraction processes, instrument set-up, mobile-phase composition, sample introduction technique, and calibration approach of flow injection analysis–tandem mass spectrometry (FIA-MS/MS) methods were optimized. Inter- and intralaboratory variation of methionine, leucine, phenylalanine, tyrosine, isovaleryl-carnitine, glutaryl-carnitine, octanoyl-carnitine, and decanoyl-carnitine were determined pre- and postoptimization, using 3 different calibration approaches.

Results

Optimal recovery of analytes from DBS was achieved with a 35-min extraction time and 80% methanol (150 μL). Optimized methodology decreased the mean intralaboratory percentage relative SD (%RSD) for the 8 analytes from 20.7% (range 4.1–46.0) to 5.4% (range 3.0–8.5). The alternative calibration approach reduced the mean interlaboratory %RSD for all analytes from 16.8% (range 4.1–25.0) to 7.1% (range 4.1–11.0). Nuclear magnetic resonance analysis of the calibration material highlighted the need for standardization. The purities of isovaleryl-carnitine and glutaryl-carnitine were 85.13% and 69.94% respectively, below the manufacturer’s stated values of ≥98%.

Conclusions

For NBS programs provided by multiple laboratories using single analyte COVs, harmonization and standardization of results can be achieved by optimizing legacy FIA-MS/MS methods, adopting a common analytical protocol, and using standardized calibration material rather than internal calibration.
Tactics And Techniques Classification In Cyber Threat Intelligence
Authors: Yu Zhongkun , Wang JunFeng , Tang BinHui , Lu Li
Published: April 2022

Completing the classification of tactics and techniques in cyber threat intelligence (CTI) is an important way to obtain tactics, techniques and procedures (TTPs) and portray the behavior of cyber attacks. However, the high level of abstraction of tactics and techniques information and their presence in CTI, usually in the form of natural language text, make it difficult for traditional manual analysis methods and feature engineering-based machine learning methods to complete the classification of tactics and techniques effectively. Meanwhile, flat deep learning methods do not perform well in classifying more fine-grained techniques due to their inability to exploit the hierarchical relationship between tactics and techniques. Therefore, this paper regards the tactics and techniques of TTPs defined in Adversarial Tactics, Techniques and Common Knowledge knowledge base as labels and proposes a Convolutional Neural Network (CNN) model based on hierarchical knowledge migration and attention mechanism for classifying tactics and techniques in CTI, named HM-ACNN (CNN based on hierarchical knowledge migration and attention mechanism). HM-ACNN classifies tactics and techniques into two phases, and the underlying network model for both phases is the Attention-based CNN network. The first step in HM-ACNN is converting the CTI text into a two-dimensional image based on the word embedding model, and then start training the classification of tactics through the CNN structure based on the attention mechanism before the classification of techniques. Secondly, after the tactics classification training is completed, the tactic-to-technique knowledge migration is then completed by transforming the parameters of the CNN layer and the attention layer in the tactics classification process based on the special hierarchical relationship between tactics and techniques. Then, the classification of techniques is finished by fine-tuning. The experimental results show that HM-ACNN performs well in the tactics and techniques classification tasks, and the metric F1 values reach 93.66% and 86.29%, which are better than other models such as CNN, Recurrent Neural Network and CRNN (Recurrent Convolutional Neural Networks).
Survival estimates across five life stages of redfin (Perca fluviatilis) exposed to simulated pumped-storage hydropower stressors
Authors: Doyle Katherine E , Ning Nathan , Silva Luiz G M , Brambilla Eduardo M , Deng Z Daniel , Fu Tao , Boys Craig , Robinson Wayne , du Preez Jan A , Baumgartner Lee J
Published: April 2022

The global prevalence of pumped-storage hydropower (PSH) is expected to grow exponentially as countries transition to renewable energy sources. Compared to conventional hydropower, little is currently known regarding PSH impacts on aquatic biota. This study estimated the survival of five life stages (egg, two larval stages, juvenile and adult) of redfin (European) perch (Perca fluviatilis) following passage through a PSH facility during the pumping phase. This was achieved by simulating the individual stressors expected to occur during passage through a 2000-MW PSH facility using laboratory-simulated (shear strain and extreme compression) and modelling (blade strike, BS) approaches. Our results indicate that redfin could survive the shear, pressure and BS stressors expected within the PSH facility, but impacts varied among life stages. Juvenile survival was >70% across all shear strain rates, while the survival of eggs and larvae declined markedly as strain rate increased. All life stages had high survival when exposed to rapid compression and BS. The high survival of redfin to the stressors tested suggests the PSH facility could facilitate the passage of redfin during the pumping phase from the lower to the higher elevation reservoir. This outcome would be welcomed in situations where the species is native, but could have adverse implications for the conservation of native biota where the species is considered a pest.
Induced bacterial sickness causes inflammation but not blood oxidative stress in Egyptian fruit bats (Rousettus aegyptiacus)
Authors: Costantini David , Weinberg Maya , Jordán Lilla , Moreno Kelsey R , Yovel Yossi , Czirják Gábor Á
Published: April 2022

Bats are particularly interesting vertebrates in their response to pathogens owing to extremes in terms of tolerance and resistance. Oxidation is often a by-product of processes involved in the acute phase response, which may result in antimicrobial or self-damaging effects. We measured the immunological and oxidative status responses of Egyptian fruit bats (Rousettus aegyptiacus) to a simulated bacterial infection using lipopolysaccharide injection. As expected, experimental bats exhibited increases in two humoral immunological markers. However, they surprisingly did not show any effects across two markers of oxidative damage and four antioxidant markers. We propose that this lack of effects on oxidative status may be due to a reduction in cell metabolism through sickness behaviours or given life history traits, such as a long lifespan and a frugivorous diet. Finally, the consistency in the pattern of elevation in haptoglobin and lysozyme between current and previous findings highlights their utility as diagnostic markers for extracellular infections in bats.
Development of an amphibian sperm biobanking protocol for genetic management and population sustainability
Authors: Burger Isabella J , Lampert Shaina S , Kouba Carrie K , Morin Dana J , Kouba Andrew J
Published: April 2022

Sperm cryopreservation is a vital tool in amphibian assisted reproductive technologies that aids in genetic and population management, specifically for at-risk species. Significant advancements have been made in the cryopreservation of amphibian sperm, yet there is little information on how the cryopreservation process influences fertilization and embryonic development. In this study, we tested several cryoprotective agents (CPAs) and freezing rates on sperm recovery, fertilization potential and embryo development using Fowler’s toads (Anaxyrus fowleri) as a model amphibian species for application to at-risk anurans. Three cryoprotectant treatments were tested, which included 10% trehalose + 0.25% bovine serum albumin with (1) 5% N,N-dimethylformamide (DMFA); (2) 10% DMFA; or (3) 10% dimethyl sulfoxide (DMSO). Additionally, sperm in each cryoprotectant was frozen at two different rates, −32 to −45°C/min and −20 to −29°C/min. Post-thaw sperm analysis included motility, morphology, viability, fertilization success and embryo development. Results show that 10% DMFA produced significantly higher (P = 0.005) post-thaw sperm motility than 5% DMFA and was similar to 10% DMSO. Furthermore, sperm frozen at −32 to −45°C/min had significantly higher post-thaw motility (P < 0.001) compared to sperm frozen at −20 to −29°C/min. We also found that embryos fertilized with sperm frozen with 5% DMFA resulted in significantly higher (P = 0.02) cleavage than 10% DMSO, yet there was no other effect of CPA on fertilization or embryo development. Furthermore, embryos fertilized with sperm frozen at −32 to −45°C/min resulted in significantly higher cleavage (P = 0.001), neurulation (P = 0.001) and hatching (P = 0.002) numbers than sperm frozen at a rate of −20 to −29°C/min. Overall, eggs fertilized with frozen–thawed sperm produced 1327 tadpoles. These results provide insight towards a biobanking strategy that can be applied to imperilled species to preserve genetic lineages and bolster offspring genetic diversity for reintroduction.
On the idea of failure in Vergilian translation
Authors: Belle Marie-Alice
Published: April 2022

This article examines the idea of failure (and its corollary, success) in the critical discourse surrounding translations of Vergil’s works in the English-speaking world. Focusing mainly on (early) modern English translations of the Aeneid, with a few inroads into other Vergilian translation traditions, it identifies the main criteria for failure or success and situates them in their historical context. It also discusses the relationship between such judgements of value and the evolving — or, at times, conflicting — linguistic, aesthetic, social, and political norms surrounding the translation of Vergil’s poetry. The essay is an invitation to re-examine our own criteria for failure and success, through an increased awareness of their historical and cultural underpinnings.
TMC-SNPdb 2.0: an ethnic-specific database of Indian germline variants
Authors: Desai Sanket , Mishra Rohit , Ahmad Suhail , Hait Supriya , Joshi Asim , Dutt Amit
Published: April 2022

Cancer is a somatic disease. The lack of Indian-specific reference germline variation resources limits the ability to identify true cancer-associated somatic variants among Indian cancer patients. We integrate two recent studies, the GenomeAsia 100K and the Genomics for Public Health in India (IndiGen) program, describing genome sequence variations across 598 and 1029 healthy individuals of Indian origin, respectively, along with the unique variants generated from our in-house 173 normal germline samples derived from cancer patients to generate the Tata Memorial Centre-SNP database (TMC-SNPdb) 2.0. To show its utility, GATK/Mutect2-based somatic variant calling was performed on 224 in-house tumor samples to demonstrate a reduction in false-positive somatic variants. In addition to the ethnic-specific variants from GenomeAsia 100K and IndiGenomes databases, 305 132 unique variants generated from 173 in-house normal germline samples derived from cancer patients of Indian origin constitute the Indian specific, TMC-SNPdb 2.0. Of 305 132 unique variants, 11.13% were found in the coding region with missense variants (31.3%) as the most predominant category. Among the non-coding variations, intronic variants (49%) were the highest contributors. The non-synonymous to synonymous SNP ratio was observed to be 1.9, consistent with the previous version of TMC-SNPdb and literature. Using TMC SNPdb 2.0, we analyzed a whole-exome sequence from 224 in-house tumor samples (180 paired and 44 orphans). We show an average depletion of 3.44% variants per paired tumor and significantly higher depletion (P-value < 0.001) for orphan tumors (4.21%), demonstrating the utility of the rare, unique variants found in the ethnic-specific variant datasets in reducing the false-positive somatic mutations. TMC-SNPdb 2.0 is the most exhaustive open-source reference database of germline variants occurring across 1800 Indian individuals to analyze cancer genomes and other genetic disorders. The database and toolkit package is available for download at the following:

Database URL  http://www.actrec.gov.in/pi-webpages/AmitDutt/TMCSNPdb2/TMCSNPdb2.html
Working Memory-Based Cognitive Rehabilitation: Spoken Language of Deaf and Hard-of-Hearing Children
Authors: Ashori Mohammad
Published: April 2022

This research examined the effect of the Working Memory-based Cognitive Rehabilitation (WMCR) intervention on the spoken language development of deaf and hard-of-hearing (DHH) children. In this clinical trial study, 28 DHH children aged between 5 and 6 years were selected by random sampling method. The participants were randomly assigned to experimental and control groups. The experimental group participated in the WMCR intervention involving 11 sessions. All participants were assessed pre-and postintervention. Data were collected by the Newsha Development Scale and analyzed through MANCOVA. The results revealed a significant difference between the scores of the receptive and expressive language of the experimental group that were exposed to the WMCR intervention compared with the control group. The receptive and expressive language skills of the experimental group indicated a significant improvement after the intervention. Therefore, the WMCR intervention is an effective method that affects the spoken language skills of DHH children. These findings have critical implications for teachers, parents, and therapists in supporting DHH young children to develop their language skills.
Chromosomal-level genome assembly of the orchid tree Bauhinia variegata (Leguminosae; Cercidoideae) supports the allotetraploid origin hypothesis of Bauhinia
Authors: Zhong Yan , Chen Yong , Zheng Danjing , Pang Jingyi , Liu Ying , Luo Shukai , Meng Shiyuan , Qian Lei , Wei Dan , Dai Seping , Zhou Renchao
Published: April 2022

Cercidoideae, one of the six subfamilies of Leguminosae, contains one genus Cercis with its chromosome number 2n = 14 and all other genera with 2n = 28. An allotetraploid origin hypothesis for the common ancestor of non-Cercis genera in this subfamily has been proposed; however, no chromosome-level genomes from Cercidoideae have been available to test this hypothesis. Here, we conducted a chromosome-level genome assembly of Bauhinia variegata to test this hypothesis. The assembled genome is 326.4 Mb with the scaffold N50 of 22.1 Mb and contains 37,996 protein-coding genes. The Ks distribution between gene pairs in the syntenic regions indicates two whole-genome duplications (WGDs): one is B. variegata-specific, and the other is shared among core eudicots. Although Ks between gene pairs generated by the recent WGD in Bauhinia is greater than that between Bauhinia and Cercis, the WGD was not detected in Cercis, which can be explained by an accelerated evolutionary rate in Bauhinia after divergence from Cercis. Ks distribution and phylogenetic analysis for gene pairs generated by the recent WGD in Bauhinia and their corresponding orthologs in Cercis support the allopolyploidy origin hypothesis of Bauhinia. The genome of B. variegata also provides a genomic resource for dissecting genetic basis of its ornamental traits.
Long-term outcome of minimally invasive thymectomy versus open thymectomy for locally advanced cases
Authors: Hwang Su Kyung , Lee Gun Dong , Kang Chang Hyun , Cho Jong Ho , Choi Yong Soo , Lee Jin Gu , Kim Dong Kwan
Published: April 2022

OBJECTIVES

Our goal was to compare the oncological outcomes and efficacy between minimally invasive thymectomy (MIT) and open thymectomy (OT) in patients with early or locally advanced thymoma using a multicentre study database.

METHODS

We retrospectively collected data from 1,239 patients who underwent thymectomy between January 2000 and December 2013, as recorded in the database of the Korean Association for Research on Thymus. We compared the postoperative outcomes of the MIT and OT groups using unmatched and propensity score (PS) matched data.

RESULTS

We excised the thymoma using MIT and OT in 455 and 784 patients, respectively. We matched 378 patients with Masaoka-Koga stage I or II thymoma by their PS. The operative time, duration of hospital stay and complications were significantly shorter in the MIT group than in the OT group (all P < 0.005). In the PS matched data, the groups did not show significant differences in the 10-year survival rate (87.7% in OT vs 85.5% in MIT, stage II, mean follow-up duration: 12.9 years in OT vs 11.1 years in MIT), recurrence-free survival (94.0% in OT vs 86.4% in MIT) and R0 resection (97.35% in OT and MIT, P = 0.59).

CONCLUSIONS

Compared with OT, MIT was associated with shorter operative times, shorter durations of hospital stay and fewer complications. Long-term survival, recurrence-free survival and complete resection were not significantly different between the OT and MIT groups. Our findings may help physicians track the progress of patients with early or locally advanced thymomas and design treatment plans for them.
Patient risk factors for conversion during video-assisted thoracic surgery—the Epithor conversion score
Authors: Fourdrain Alex , Georges Olivier , Gossot Dominique , Falcoz Pierre-Emmanuel , Jougon Jacques , Baste Jean-Marc , Marty-Ane Charles-Henri , Berna Pascal
Published: April 2022

OBJECTIVES

Intraoperative conversion from video-assisted thoracic surgery (VATS) to thoracotomy may occur during anatomical lung resection. The objectives of the present study were to identify risk factors for intraoperative conversion and to develop a predictive score.

METHODS

We performed a multicentre retrospective analysis of French thoracic surgery departments that contributed data on anatomical lung resections to the Epithor database over a 10-year period (from January-2010 to December-2019). Using univariate and multivariate logistic regression analyses, we determined risk factors for intraoperative conversion and elaborated the Epithor conversion score (ECS). The ECS was then validated in a cohort of patients operated on between January- and June-2020.

RESULTS

From January-2010 to December-2019, 210,037 patients had been registered in the Epithor database. Of these, 55,030 had undergone anatomical lung resection. We excluded patients who had upfront a thoracotomy or robotic-assisted thoracoscopic surgery (n = 40,293) and those with missing data (6,794). Hence, 7943 patients with intent-to-treat VATS were assessed: 7100 with a full VATS procedure and 843 patients with intraoperative conversion to thoracotomy (conversion rate: 10.6%). Thirteen potential risk factors were identified among patients’ preoperative characteristics and planned surgical procedures and were weighted accordingly to give the ECS. The score showed acceptable discriminatory power (area under the curve: 0.62 in the development cohort and 0.64 in the validation cohort) and good calibration (P = 0.23 in the development cohort and 0.30 in the validation cohort).

CONCLUSIONS

Thirteen potential preoperative risk factors were identified, enabling us to develop and validate the ECS—an easy-to-use, reproducible tool for estimating the risk of intraoperative conversion during VATS.
At Which Age is Education the Great Equalizer? A Causal Mediation Analysis of the (In-)Direct Effects of Social Origin over the Life Course
Authors: Kratz Fabian , Pettinger Bettina , Grätz Michael
Published: April 2022

The mechanisms linking parental resources to their children’s opportunities are of fundamental interest to sociologists. This study is the first to provide a dynamic life course assessment of the origin–education–destination triangle using causal mediation analysis. While the age-as-equalizer hypothesis suggests that for the highly educated, direct effects of social origin are high at young ages and decrease over the life course, the age-as-stratifier hypothesis suggests that for individuals with low educational attainment, direct effects of social origin are low at young ages and increase over the life course. Findings using panel data from the German Socio-Economic Panel Study are largely consistent with these hypotheses for various measures of social origin and social destination. Overall, this study demonstrates how causal mediation analysis provides precise effect definitions that allow scholars to assess mechanisms when status transmission processes depend on educational attainment.
Lung function impairment and risk of incident heart failure: the NHLBI Pooled Cohorts Study
Authors: Eckhardt Christina M , Balte Pallavi P , Barr Robert Graham , Bertoni Alain G , Bhatt Surya P , Cuttica Michael , Cassano Patricia A , Chaves Paolo , Couper David , Jacobs David R , Kalhan Ravi , Kronmal Richard , Lange Leslie , Loehr Laura , London Stephanie J , O’Connor George T , Rosamond Wayne , Sanders Jason , Schwartz Joseph E , Shah Amil , Shah Sanjiv J , Smith Lewis , White Wendy , Yende Sachin , Oelsner Elizabeth C
Published: April 2022

Aims

The aim is to evaluate associations of lung function impairment with risk of incident heart failure (HF).

Methods and results

Data were pooled across eight US population-based cohorts that enrolled participants from 1987 to 2004. Participants with self-reported baseline cardiovascular disease were excluded. Spirometry was used to define obstructive [forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) <0.70] or restrictive (FEV1/FVC ≥0.70, FVC <80%) lung physiology. The incident HF was defined as hospitalization or death caused by HF. In a sub-set, HF events were sub-classified as HF with reduced ejection fraction (HFrEF; EF <50%) or preserved EF (HFpEF; EF ≥50%). The Fine–Gray proportional sub-distribution hazards models were adjusted for sociodemographic factors, smoking, and cardiovascular risk factors. In models of incident HF sub-types, HFrEF, HFpEF, and non-HF mortality were treated as competing risks. Among 31 677 adults, there were 3344 incident HF events over a median follow-up of 21.0 years. Of 2066 classifiable HF events, 1030 were classified as HFrEF and 1036 as HFpEF. Obstructive [adjusted hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.07–1.27] and restrictive physiology (adjusted HR 1.43, 95% CI 1.27–1.62) were associated with incident HF. Obstructive and restrictive ventilatory defects were associated with HFpEF but not HFrEF. The magnitude of the association between restrictive physiology and HFpEF was similar to associations with hypertension, diabetes, and smoking.

Conclusion

Lung function impairment was associated with increased risk of incident HF, and particularly incident HFpEF, independent of and to a similar extent as major known cardiovascular risk factors.
The moderating role of caregiver preparedness on the relationship between depression and stroke-specific quality of life in stroke dyads: a longitudinal study
Authors: Petrizzo Antonello , Lyons Karen S , Bartoli Davide , Simeone Silvio , Alvaro Rosaria , Lee Christopher S , Vellone Ercole , Pucciarelli Gianluca
Published: April 2022

Aims

To examine the moderating role of caregiver preparedness on the association between stroke survivors’ depression and stroke-specific quality of life dimensions.

Methods and results

We used a multilevel modelling approach to analyse trajectories of change in the eight Stroke Impact Scale 3.0 subscales [i.e. strength, communication, mobility, activities of daily living (ADL)/instrumental activities of daily living (IADL), memory, emotion, hand function, participation] using Hierarchical Linear Modeling. Caregiver preparedness significantly moderated the association between survivor depressive symptoms and survivor communication (B = −0.95, P < 0.01), mobility (B = −0.60, P < 0.05), and ADL/IADL (B = −0.73, P < 0.01) at baseline; linear change for strength (B = 0.83, P < 0.05) and communication (B = 0.66, P < 0.05); and quadratic change for strength (B = −0.19, P < 0.01). Although caregiver preparedness did not significantly moderate the association between survivor depressive symptoms and strength at baseline, there was a significant moderating effect for change over time. Higher levels of caregiver preparedness were significantly associated with higher survivor scores of emotion, hand function, and participation at baseline.

Conclusions

Including immediate caregivers in the care process, through a psycho-educational training, would mean having better-prepared caregivers and consequently more-healthy stroke survivors. Given that preparedness includes coping with stress, responding and managing emergencies, assessing help and information may require tailored interventions aimed at improving the caregivers’ skills and knowledge about stroke survivors’ management.
Long-term trends in psychosocial working conditions in Europe—the role of labor market policies
Authors: Rigó Mariann , Dragano Nico , Wahrendorf Morten , Siegrist Johannes , Lunau Thorsten
Published: April 2022

Background

Employees have witnessed rising trend in work stress over the last few decades. However, we know a little about country differences in those trends. Our article fills this gap in the literature by examining heterogeneities in trends in working conditions by country groups defined by their amount of investment into labor market policy (LMP) programs. Additionally, we provide findings on differences in occupational inequalities between country groups.

Methods

We use comparative longitudinal data of the European Working Conditions Surveys including cross-sectional information on employees from 15 countries surveyed in Waves 1995, 2000, 2005, 2010 and 2015. Estimation results are provided by three-way multilevel models with employees nested within country-years nested within countries. Our work stress measure is the proxy version of job strain based on the demand-control model.

Results

Our regression results indicate that for employees in countries with the least LMP spending job strain increased by 10% from 1995 to 2015 compared to a smaller and insignificant change in middle- and high-LMP countries. In low-LMP countries, inequalities in job strain also widened during the studied period: the gap in job strain between the highest- and lowest-skilled increased by 60% from 1995 to 2015. This contrasts a stable gap in middle- and high-LMP countries.

Conclusions

Our results direct the attention to the vulnerable position of the least skilled and highlight that LMP investments may buffer some of the adverse impacts of globalization and technological changes and effectively improve the labor market situation of the least skilled.
A qualitative study of patient perspectives of care management services in Comprehensive Primary Care Plus
Authors: Lechner Amanda , Williams Nyna , Kogan Rachel , Hays Burke , Feeley-Summerl Theresa , Chen Tammy
Published: April 2022

Background

Care management has the potential to improve quality of care and health outcomes for chronic conditions, but questions remain about how patients perceive care management. Understanding patient perceptions is critical for ensuring care management can successfully engage patients and improve management of chronic conditions.

Objective

To understand high-risk patients’ experiences and perceptions of care management.

Methods

We conducted 1-h phone interviews with 40 patients receiving care management at 12 practices participating in the Centers for Medicare & Medicaid Services Comprehensive Primary Care Plus model. Interviews were transcribed verbatim and analysed using a thematic approach.

Results

Most patients reported discussing health goals with their providers that aligned with their values and care preferences; a few reported that goal setting did not result in desired action steps. Most reported positive experiences receiving behavioural health support; a few reported unmet behavioural health needs that they had not expressed to their practice. Patients reported financial and transportation barriers to following care managers’ recommendations. Care managers’ active listening skills, accessibility, and caring personalities facilitated patient engagement.

Conclusions

Practices should consider patient perspectives as they improve care management activities. Future research is needed to confirm our findings about patient perspectives regarding goal setting, behavioural health support, and barriers and facilitators to engagement.
Surrealizing Wifredo Lam?
Authors: Adamowicz Elza
Published: April 2022

In their writings on the Cuban artist Wifredo Lam, Surrealists and the related avant-garde forge a fictional construct, ‘Wifredo Lam.’ Their texts are explored in relation to what André Breton identified as the two approaches to the artwork: a subjective approach expressed through poetic language; and an interpretation based on objective knowledge expressed through rational language. An overview of Lam’s artistic activities focuses on his participation in Surrealist activities and his affinities with its principles. Breton goes further, appropriating the artist for Surrealism, attributing poetic, mythical and primitivizing qualities to the paintings. His interpretation contrasts with Leiris’s ethnographic approach to Lam as ‘un homme métis’ [a man of mixed ethnicity], corresponding to the second ‘temptation’ proposed by Breton. Finally, it will be argued that the two discourses often cohabit and merge, notably in texts on the artist by Aimé Césaire, for whom Lam was a political companion in their shared commitment to political liberation and the recognition of a Caribbean identity.
Being in Place: Toward a Situational Perspective on Care
Authors: Rhodus Elizabeth K , Rowles Graham D
Published: April 2022

An optimum focus in any care situation is creating and sustaining environments that facilitate an ongoing sense of “being in place” for all involved. Using this rationale, we propose a Situational Model of Care for exploring dynamic relationships among aging persons receiving care, the convoy of persons offering this care and support, and the place where this occurs, as evolving situations throughout the course of a disease. The model is grounded in extant literature and illustrated through a case study derived from in-home observations and interviews. Emphasizing an underlying goal of fostering a sense of being in place as a desirable outcome facilitates situationally nuanced directions in research and clinical care.
Developments and perspectives in high-throughput protein glycomics: enabling the analysis of thousands of samples
Authors: de Haan Noortje , Pučić-Baković Maja , Novokmet Mislav , Falck David , Lageveen-Kammeijer Guinevere , Razdorov Genadij , Vučković Frano , Trbojević-Akmačić Irena , Gornik Olga , Hanić Maja , Wuhrer Manfred , Lauc Gordan ,   the The Human Glycome Project, Guttman Andras , Cummings Richard , Mora Samia , Rombouts Yoann , Mehta Andad
Published: April 2022

Glycans expand the structural complexity of proteins by several orders of magnitude, resulting in a tremendous analytical challenge when including them in biomedical research. Recent glycobiological research is painting a picture in which glycans represent a crucial structural and functional component of the majority of proteins, with alternative glycosylation of proteins and lipids being an important regulatory mechanism in many biological and pathological processes. Since interindividual differences in glycosylation are extensive, large studies are needed to map the structures and to understand the role of glycosylation in human (patho)physiology. Driven by these challenges, methods have emerged, which can tackle the complexity of glycosylation in thousands of samples, also known as high-throughput (HT) glycomics. For facile dissemination and implementation of HT glycomics technology, the sample preparation, analysis, as well as data mining, need to be stable over a long period of time (months/years), amenable to automation, and available to non-specialized laboratories. Current HT glycomics methods mainly focus on protein N-glycosylation and allow to extensively characterize this subset of the human glycome in large numbers of various biological samples. The ultimate goal in HT glycomics is to gain better knowledge and understanding of the complete human glycome using methods that are easy to adapt and implement in (basic) biomedical research. Aiming to promote wider use and development of HT glycomics, here, we present currently available, emerging, and prospective methods and some of their applications, revealing a largely unexplored molecular layer of the complexity of life.
Health literacy interventions in the hospital setting: an overview
Authors: Larrotta-Castillo Diego , Moreno-Chaparro Jaime , Amaya-Moreno Alejandra , Gaitán-Duarte Hernando , Estrada-Orozco Kelly
Published: April 2022

Health Literacy (HL) is the degree to which an individual has the ability to find, understand and use information and services to inform health-related decisions and actions. These decisions and actions take place mainly in hospitals, so in this setting, HL has a higher impact on the health status and prognosis of patients. The objective of this study was to identify HL interventions implemented in the hospital care setting and describe the characteristics of their implementation, as well as their impact on health outcomes and care processes of these patients. An overview of systematic reviews published from 2015 to 2020 in MEDLINE (Ovid), Embase, Scopus, Cochrane Database (Ovid), PsyArticles, LILACS (Bvs) and Epistemonikos was conducted. The synthesis of the results was carried out narratively and the methodological quality of the reviews was evaluated using the AMSTAR II tool. A total of 16 reviews were included for full analysis, of which 68.5% were assessed as having high or moderate quality. HL interventions were based on single or multifaceted strategies, including the use of brochures, visual aids, digital tools, multimedia resources (videos) and group and personalized counseling sessions. Despite the high heterogeneity of data, HL interventions seem to have a positive impact on improving health-related knowledge levels and some health-related behaviors and attitudes. In conclusion, it was evidenced that HL interventions implemented in the hospital setting are widely varied. These interventions can be used to improve health-related knowledge levels and promote health-related behavioral changes in inpatients. However, it is necessary to standardize the reporting of both the characteristics and outcomes of these interventions to favor their replicability.
Gaps in hygiene promotion at schools in Pakistan: qualitative descriptive research
Authors: Pradhan Nousheen Akber , Haider Fatima , Khudadad Umerdad , Zahidie Aysha , Asim Muhammed , Ladak Asma Akbar , Iqbal Shagufta , Mevawalla Areesh , Siddiqi Uswah , Ali Tazeen Saeed , Karmaliani Rozina
Published: April 2022

School health remains an ignored domain in Pakistan. This article presents gaps in understanding hygiene promotion efforts in school settings in urban squatter settlements by exploring perspectives of the key stakeholders and undertaking a review of the education curriculum. Using qualitative methodology, 13 in-depth interviews were held with the key informants (teachers, health and education officers) and three focus group discussions were conducted with 36 mothers. The study setting includes three schools located in a semi-urban area in the province of Sindh, Pakistan. The semi-structured guide was utilized to obtain perspectives of key stakeholders on factors constraining hygiene promotion efforts in school settings. The primary education curriculum was reviewed using the content analysis approach to assess the integration of hygiene concepts into the curriculum. Analysis of qualitative interviews and curriculum review resulted in five categories under a theme that addressed multiple factors constraining hygiene promotion in the school settings. These include (i) Gaps in the school curriculum, (ii) Poor accountability of the local administration in the upkeep of schools, (iii) Parent’s negligence toward children’s hygiene, (iv) Inadequate training of school teachers on hygiene concepts, and (v) Lack of interdepartmental coordination between health and education sectors. Hygiene promotion at schools has been deterred by multiple factors at the selected primary schools in Pakistan. Recommended actions include integration of health and hygiene concepts into the education curriculum, capacity building of teachers, reviving water, sanitation and hygiene infrastructure, coordination among Education and Health Departments and ownership among the local government to ensure cleanliness at schools.
Parents’ age at birth and daughters’ time to pregnancy: a study within the Norwegian Mother, Father and Child Cohort
Authors: Basso Olga , Magnus Maria C , Arge Lise A , Håberg Siri E
Published: April 2022

STUDY QUESTION

Is parents’ age at birth associated with daughters’ fecundability?

SUMMARY ANSWER

Daughters born to mothers <25 years or fathers ≥35 years had slightly lower fecundability.

WHAT IS KNOWN ALREADY

Two recent studies reported lower fecundability in women born to mothers <20 years, which may be partly due to daughters of young mothers being less likely to plan their pregnancies.

STUDY DESIGN, SIZE, DURATION

A retrospective cohort study of 58 496 pregnancy planners (4290 of whom conceived with treatment) and 14 194 non-planners enrolled in the Norwegian Mother, Father and Child Cohort Study (MoBa) between 2000 and 2008, linked with the Medical Birth Registry of Norway.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Participants were born in Norway between 1967 and 1990. We estimated fecundability ratios (FRs) and 95% CI as a function of both parents’ (F1) age at the daughter’s (F2) birth among non-treated planners and the relative risk of time to pregnancy (TTP) ≥12 months or treatment among all planners. We explored whether daughters of young mothers were under-represented among planners, compared with the underlying population. Finally, we estimated FRs after adding non-planners, randomly assigned to conceiving in the first cycle with probabilities of 0.60 and 0.70.

MAIN RESULTS AND THE ROLE OF CHANCE

For both mother and father, the reference category was 25–29 years. Fecundability was slightly lower among daughters of older fathers (FRs (95% CI): 0.95 (0.92, 0.98) for F1 father’s age 35–39 years and 0.93 (0.89, 0.97) for ≥40 years) and daughters of young mothers (0.92 (0.89, 0.96) for F1 mother’s age <20 years and 0.97 (0.95, 0.99) for 20–24 years). Results were similar for the composite outcome TTP ≥ 12 months or treatment, although driven by TTP ≥ 12. Compared with Norwegian-born women with ≥1 pregnancy, planners born to mothers <20 years were underrepresented. Including non-planners with very high fecundability weakened the association with mother’s age <20 years.

LIMITATIONS, REASONS FOR CAUTION

This was a pregnancy cohort with retrospectively reported information on planning and TTP. Selection bias appears unlikely to fully explain the association with mother’s age <20 years.

WIDER IMPLICATIONS OF THE FINDINGS

Daughters of young mothers or older fathers may have slightly lower fecundability. If corroborated, the finding about older paternal age is relevant, given the widespread tendency to delay childbearing.

STUDY FUNDING/COMPETING INTEREST(S)

This work was partly funded by the Research Council of Norway (project no. 320656), and through its Centres of Excellence funding scheme (project no. 262700). M.C.M. has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 947684). No competing interests.

TRIAL REGISTRATION NUMBER

N/A.
Dystopian legalities: A reply to Nico Krisch
Authors: Klabbers Jan
Published: April 2022

As its title indicates, this is a reply of sorts to recent work by Nico Krisch, published in this issue. The notion of entangled legalities, I argue, shows considerable analytical promise, much like the notion of inter-legality as developed by my colleague Gianluigi Palombella and myself a few years ago. Both may help us understand how large chunks of contemporary law works. Where Krisch’s approach departs from ours is in his background assumptions and his chosen actorial perspective: his interest resides mainly with the regulator. In this reply, I zoom in on some of the consequences this may have.
Global capitalism and law, and where to find them: Afterword to the Foreword by Karen Alter
Authors: Tzouvala Ntina
Published: April 2022

In her Foreword, Karen J. Alter paints an elaborate picture of the multilayered relationship between law and capitalism, while at the same time offering important insights into recent developments in international law, international relations, and international history. In this brief Afterword, I will take a step back and reflect on the often-unarticulated theoretical assumptions of Alter’s conceptualization of both law and capitalism. Situating this account within the broader trend of “law and political economy” and “new histories of capitalism,” I argue that understanding the juridical and bureaucratic underpinnings of capitalism does not require us to reduce the latter to the former. In fact, I posit that the centering of lawyers, bureaucrats, and administrators—instead of workers, peasants, or Indigenous peoples—in these new histories of capitalism leads to both theoretical and political impasses.
Robotic-assisted beating heart surgery provides precise repair of periprosthetic mitral valvular leak
Authors: Kocyigit Muharrem , Gullu Ahmet Umit , Senay Sahin , Alhan Cem
Published: April 2022

The prosthetic paravalvular leak is a rare but important complication following mitral valve replacement. Determining the location of the leak is almost always dependent on perioperative transoesophageal echocardiography and the considerable expertise of echo operators. Acoustic shadowing due to the prosthetic valve may create another important difficulty. In this report, we present a case with a paravalvular leak diagnosed 1 year after mitral valve replacement. Beating heart surgery and robotic 3D/high-resolution camera provided to localize the direct location of leak coherent with perioperative echocardiography and precise repair. The robotic approach prevented the potential complications of aortic cross-clamp and resternotomy.
Comparative analysis of the hydrogen sulphide pathway in internal thoracic artery and radial artery
Authors: Kang Yoonjin , Kim Jun Sung , Cui Huixing , Jang Myoung-Jin , Zhang Yin Hua , Hwang Ho Young
Published: April 2022

OBJECTIVES

The molecular basis supporting the superiority of the left internal thoracic artery (LITA) as a bypass conduit is limited. This study was conducted to compare the expression and localization of hydrogen sulphide synthesizing enzymes in LITA and radial artery (RA).

METHODS

Nineteen patients who underwent coronary artery bypass grafting using LITA and RA were enrolled. The remnant LITA and RA were collected to measure the expression levels of 3 hydrogen sulphide-producing enzymes: cystathionine β-synthase, cystathionine γ-lyase and 3-mercaptopyruvate sulphurtransferase using quantitative real-time polymerase chain reaction. Expression levels of these enzymes in the LITA and RA were compared in each subject. The expression and localization patterns of the enzymes were also analysed by immunohistochemistry.

RESULTS

The mRNA expression of the cystathionine β-synthase was greater in the LITA than in the RA (P = 0.033), whereas the expression levels of the other 2 enzymes did not significantly differ between the 2 arteries. The immunohistochemistry analysis demonstrated greater expression of the cystathionine β-synthase in the LITA than in the RA (P = 0.006). This protein was present in both tunica intima and tunica media of the LITA, although it was present only in the tunica media of the RA. Localization patterns of the other 2 enzymes were not different between LITA and RA.

CONCLUSIONS

Expression levels of the mRNA and protein of cystathionine β-synthase were significantly greater in LITA than in the RA. These findings might be a factor that affects the superior patency rate of LITA.
E-values for effect heterogeneity and approximations for causal interaction
Authors: Mathur Maya B , Smith Louisa H , Yoshida Kazuki , Ding Peng , VanderWeele Tyler J
Published: April 2022

Background

Estimates of effect heterogeneity (i.e. the extent to which the causal effect of one exposure varies across strata of a second exposure) can be biased if the exposure–outcome relationship is subject to uncontrolled confounding whose severity differs across strata of the second exposure.

Methods

We propose methods, analogous to the E-value for total effects, that help to assess the sensitivity of effect heterogeneity estimates to possible uncontrolled confounding. These E-value analogues characterize the severity of uncontrolled confounding strengths that would be required, hypothetically, to ‘explain away’ an estimate of multiplicative or additive effect heterogeneity in the sense that appropriately controlling for those confounder(s) would have shifted the effect heterogeneity estimate to the null, or alternatively would have shifted its confidence interval to include the null. One can also consider shifting the estimate or confidence interval to an arbitrary non-null value. All of these E-values can be obtained using the R package EValue.

Results

We illustrate applying the proposed E-value analogues to studies on: (i) effect heterogeneity by sex of the effect of educational attainment on dementia incidence and (ii) effect heterogeneity by age on the effect of obesity on all-cause mortality.

Conclusion

Reporting these proposed E-values could help characterize the robustness of effect heterogeneity estimates to potential uncontrolled confounding.