bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterizing environmental geographic inequalities using an integrated exposure assessment
Authors: CAUDEVILLE Julien , REGRAIN Corentin , TOGNET Frederic , BONNARD Roseline , GUEDDA Mohammed , BROCHOT Celine , BEAUCHAMP Maxime , LETINOIS Laurent , MALHERBE Laure , MARLIERE Fabrice , LESTREMAU Francois , CHARDON Karen , BACH Veronique , ZEMAN Florence Anna
Published: May 2021

Background

At a regional or continental scale, the characterization of environmental health inequities (EHI) expresses the idea that populations are not equal in the face of pollution. It implies an analysis be conducted in order to identify and manage the areas at risk of overexposure where an increasing risk to human health is suspected. The development of methods is a prerequisite for implementing public health activities aimed at protecting populations.

Methods

This paper presents the methodological framework developed by INERIS (French National Institute for Industrial Environment and Risks) to identify a common framework for a structured and operationalized assessment of human exposure. An integrated exposure assessment approach has been developed to integrate the multiplicity of exposure pathways from various sources, through a series of models enabling the final exposure of a population to be defined.

Results

Measured data from environmental networks reflecting the actual contamination of the environment are used to gauge the population’s exposure. Sophisticated methods of spatial analysis are applied to include additional information and take benefit of spatial and inter-variable correlation to improve data representativeness and characterize the associated uncertainty. Integrated approaches bring together all the information available for assessing the source-to-human-dose continuum using a Geographic Information System, multimedia exposure and toxicokinetic model.

Discussion

One of the objectives of the integrated approach was to demonstrate the feasibility of building complex realistic exposure scenarios satisfying the needs of stakeholders and the accuracy of the modelling predictions at a fine spatial-temporal resolution. A case study is presented to provide a specific application of the proposed framework and how the results could be used to identify an overexposed population.

Conclusion

This framework could be used for many purposes, such as mapping EHI, identifying vulnerable populations and providing determinants of exposure to manage and plan remedial actions and to assess the spatial relationships between health and the environment to identify factors that influence the variability of disease patterns.
Nahua biocultural richness: an ethnoherpetological perspective
Authors: Linares-Rosas Miriam Itzel , Gómez Benigno , Aldasoro-Maya Elda Miriam , Casas Alejandro
Published: May 2021

Background

Mexico harbours one of the greatest biocultural diversities of the world, where multiple social and natural elements and systems form complex networks of interactions in which both culture and nature are mutually influenced. Biocultural states and processes are studied by ethnosciences, among them ethnoherpetology, which seeks understanding material and non-material expressions of the interactions between humans, amphibians, and reptiles. Herpetofauna has been part of the magic–religious world and source of goods for Mesoamerican cultures. This study aims to document and analyse the complex body of knowledge, beliefs, and practices on these vertebrates in the Nahua culture, the factors that have influenced progressive risk and loss of culture, habitat, and species, and the potential contribution of contemporary Nahua knowledge to biocultural conservation.

Methods

Through 15 workshops with children and young people, and 16 semi-structured interviews to people 27 to 74 years old, we documented the contemporary Nahua knowledge in the communities of Aticpac and Xaltepec in the Sierra Negra, Puebla, central Mexico. Biological and ecological knowledge, use, management practices, legends, and perceptions on herpetofauna were emphasised in the study.

Results

We obtained an ethnoherpetological checklist, grouping species into four general classificatory categories: kohuatl (serpents), kalatl (frogs and toads), ayotsi (turtles), and ketzo (lizards and salamanders), which included 21, 10, 1, and 11 ethnocategories respectively, based on the local Nahua knowledge of herpetofauna. Serpents, used as medicine, are the most culturally relevant. Due to perceptions of danger, beliefs, and actual snake bites, the main interaction with serpents is their elimination; however, some snakes are tolerated and maintained in captivity. The remaining species of local herpetofauna recorded are tolerated. Cultural aspects of reptiles and amphibians in the Nahua worldview were documented to influence the regulation of interactions of people with these vertebrates, but for younger generations, such aspects are less frequent or absent.

Conclusions

Interactions and cultural relationships between the Nahua people, amphibians and reptiles are complex, maintaining some aspects of the local worldview but also influenced by external factors and being constantly recreated and re-signified. Documenting and understanding the contemporary relations is essential to generate strategies in biocultural conservation of herpetofauna.
Implementation fidelity of the Systems for Person-Centered Elder Care (SPEC): a process evaluation study
Authors: Choi Hyoungshim , Jung Young-il , Kim Hongsoo
Published: May 2021

Background

The Systems for Person-Centered Elder Care (SPEC), a complex intervention, was conducted to examine its effectiveness as a technology-enhanced, multidisciplinary, and integrated care model for frail older persons among ten nursing homes (NHs) in South Korea where formal long-term care has recently been introduced. The purpose of this study was to evaluate the implementation fidelity of the SPEC intervention and to identify moderating factors that influence the implementation fidelity.

Methods

This study was a process evaluation based on an evidence-based framework for implementation fidelity using a mixed-methods design. Quantitative data from consultant logbooks, NH documentations, an information and communications technology (ICT) system, and a standardized questionnaire were collected from April 2015 to December 2016 and analyzed by calculating the descriptive statistics. Semi-structured focus group interviews were held with multidisciplinary teams from the participating NHs. Qualitative data from a semi-structured questionnaire and the focus group interviews were analyzed using content analysis.

Results

The SPEC program demonstrated good implementation fidelity, and adherence to the SPEC program was strong in all aspects, such as content, coverage, frequency, and duration. Of the participating on-site coordinators, 60% reported that the SPEC model positively impacted needs assessment and the reporting system for resident care. The important facilitating factors were tailored facilitating strategies, assurance of the quality of delivery, and recruitment strategies.

Conclusion

The effectiveness of the SPEC program was driven by good implementation fidelity. The key factors of good implementation fidelity were tailored delivery of evidence-based interventions over process evaluation work, facilitating strategies, and ICT support. Larger implementation studies with a more user-friendly ICT system are recommended.

Trial registration

ISRCTN registry, ISRCTN11972147. Registered on 16 March 2015
Do robot-related complications influence 1 year reoperations and other clinical outcomes after robot-assisted lumbar arthrodesis? A multicenter assessment of 320 patients
Authors: Lee Nathan J. , Buchanan Ian A. , Boddapati Venkat , Mathew Justin , Marciano Gerard , Park Paul J. , Leung Eric , Buchholz Avery L. , Pollina John , Jazini Ehsan , Haines Colin , Schuler Thomas C. , Good Christopher R. , Lombardi Joseph M. , Lehman Ronald A.
Published: May 2021

Background

Robot-assisted platforms in spine surgery have rapidly developed into an attractive technology for both the surgeon and patient. Although current literature is promising, more clinical data is needed. The purpose of this paper is to determine the effect of robot-related complications on clinical outcomes

Methods

This multicenter study included adult (≥18 years old) patients who underwent robot-assisted lumbar fusion surgery from 2012-2019. The minimum follow-up was 1 year after surgery. Both bivariate and multivariate analyses were performed to determine if robot-related factors were associated with reoperation within 1 year after primary surgery.

Results

A total of 320 patients were included in this study. The mean (standard deviation) Charlson Comorbidity Index was 1.2 (1.2) and 52.5% of patients were female. Intraoperative robot complications occurred in 3.4% of patients and included intraoperative exchange of screw (0.9%), robot abandonment (2.5%), and return to the operating room for screw exchange (1.3%). The 1-year reoperation rate was 4.4%. Robot factors, including robot time per screw, open vs. percutaneous, and robot system, were not statistically different between those who required revision surgery and those who did not (P>0.05). Patients with robot complications were more likely to have prolonged length of hospital stay and blood transfusion, but were not at higher risk for 1-year reoperations. The most common reasons for reoperation were wound complications (2.2%) and persistent symptoms due to inadequate decompression (1.5%). In the multivariate analysis, robot related factors and complications were not independent risk factors for 1-year reoperations.

Conclusion

This is the largest multicenter study to focus on robot-assisted lumbar fusion outcomes. Our findings demonstrate that 1-year reoperation rates are low and do not appear to be influenced by robot-related factors and complications; however, robot-related complications may increase the risk for greater blood loss requiring a blood transfusion and longer length of stay.
Investigating health-related quality of life in rare diseases: a case study in utility value determination for patients with CLN2 disease (neuronal ceroid lipofuscinosis type 2)
Authors: Gissen Paul , Specchio Nicola , Olaye Andrew , Jain Mohit , Butt Thomas , Ghosh Wrik , Ruban-Fell Benjamin , Griffiths Annabel , Camp Charlotte , Sisic Zlatko , Schwering Christoph , Wibbeler Eva , Trivisano Marina , Lee Laura , Nickel Miriam , Mortensen Amanda , Schulz Angela
Published: May 2021

Background

Utility studies enable preference-based quantification of a disease’s impact on patients’ health-related quality of life (HRQoL). It is often difficult to obtain utility values for rare, neurodegenerative conditions due to cognitive burden of direct elicitation methods, and the limited size of patient/caregiver populations. CLN2 disease (neuronal ceroid lipofuscinosis type 2) is an ultra-rare, progressive condition, for which there are no published utility data fully capturing all disease stages. This case study demonstrates how utility values can be estimated for ultra-rare paediatric diseases by asking clinicians to complete EQ-5D-5L questionnaires based on vignettes describing the stages of CLN2 disease.

Methods

An indirect elicitation method using proxy-reporting by clinical experts was adopted. Eighteen vignettes were developed, describing nine progressive disease stages as defined by motor and language domain scores of the CLN2 Clinical Rating Scale, in individuals treated with cerliponase alfa or standard care. Eight clinical experts with experience of treating CLN2 disease with cerliponase alfa and current standard care completed the proxy version 2 EQ-5D-5L online after reading these vignettes. Resulting scores were converted to EQ-5D-5L utility values for each disease stage, using UK, German and Spanish value sets.

Results

Utility values, which are typically anchored by 0 (equivalent to death) and 1 (full health), decreased with CLN2 disease progression (results spanned the maximum range of the utility scale). Assigned utility values were consistently higher for patients receiving cerliponase alfa than standard care; differences were statistically significant for the 6 most severe disease stages (p < 0.05). Analysis of the individual dimensions of the EQ-5D-5L showed that greatest differences between patients treated with cerliponase alfa and standard care occurred in the pain dimension (differences in mean scores ranged between no difference and 1.8), with notable differences also observed in the anxiety/depression dimension (differences in mean scores ranged between 0.1 and 1.0).

Conclusions

This study demonstrates a feasible methodology for eliciting utility values in CLN2 disease, indicating HRQoL declines with disease progression. Vignettes describing patients receiving cerliponase alfa were consistently assigned higher utility values for the same disease state, suggesting this treatment improves HRQoL compared with standard care.

Trial registration NCT01907087, NCT02485899.
Vaccination strategy and anti - SARS-CoV-2 S titers in healthcare workers of the INT – IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy)
Authors: Cavalcanti Ernesta , Isgrò Maria Antonietta , Rea Domenica , Di Capua Lucia , Trillò Giusy , Russo Luigi , Botti Gerardo , Miscio Leonardo , Buonaguro Franco Maria , Bianchi Attilio Antonio Montano
Published: May 2021

Background

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and the resulting disease, coronavirus disease 2019 (COVID-19), have spread to millions of people globally, requiring the development of billions of different vaccine doses. The SARS-CoV-2 spike mRNA vaccine (named BNT162b2/Pfizer), authorized by the FDA, has shown high efficacy in preventing SARS-CoV-2 infection after administration of two doses in individuals 16 years of age and older.

In the present study, we retrospectively evaluated the differences in the SARS-CoV-2 humoral immune response after vaccine administration in the two different cohorts of workers at the INT - IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy): previously infected to SARS-CoV-2 subjects and not infected to SARS-CoV-2 subjects.

Methods

We determined specific anti-RBD (receptor-binding domain) titers against trimeric spike glycoprotein (S) of SARS-CoV-2 by Roche Elecsys Anti-SARS-CoV-2 S immunoassay in serum samples of 35 healthcare workers with a previous documented history of SARS-CoV-2 infection and 158 healthcare workers without, after 1 and 2 doses of vaccine, respectively. Moreover, geometric mean titers and relative fold changes (FC) were calculated.

Results

Both previously infected and not infected to SARS-CoV-2 subjects developed significant immune responses to SARS-CoV-2 after the administration of 1 and 2 doses of vaccine, respectively. Anti-S antibody responses to the first dose of vaccine were significantly higher in previously SARS-CoV-2-infected subjects in comparison to titers of not infected subjects after the first as well as the second dose of vaccine. Fold changes for subjects previously infected to SARS-CoV-2 was very modest, given the high basal antibody titer, as well as the upper limit of 2500.0 BAU/mL imposed by the Roche methods. Conversely, for naïve subjects, mean fold change following the first dose was low ($$ \overline{x} $$

x
¯

=1.6), reaching 3.8 FC in 72 subjects (45.6%) following the second dose.

Conclusions

The results showed that, as early as the first dose, SARS-CoV-2-infected individuals developed a remarkable and statistically significant immune response in comparison to those who did not contract the virus previously, suggesting the possibility of administering only one dose in previously SARS-CoV-2-infected subjects. FC for previously infected subjects should not be taken into account for the generally high pre-vaccination values. Conversely, FC for not infected subjects, after the second dose, were = 3.8 in > 45.0% of vaccinees, and ≤ 3.1 in 19.0%, the latter showing a potential susceptibility to further SARS-CoV-2 infection.
Exploring the use of musculoskeletal ultrasound imaging by podiatrists: an international survey
Authors: Dando Charlotte , Ellis Richard , Carroll Matthew , Molyneux Prue , Gijon‐Nogueron Gabriel , Siddle Heidi J. , Cherry Lindsey , Gatt Alfred , Bowen Catherine
Published: May 2021

Background

Podiatrists, in musculoskeletal services, are demonstrating an expansion of their practice skills through the use of ultrasound imaging. There is an assumption that this practice is beneficial within the context of patient care and health systems. The aim of this research was to further investigate the use of musculoskeletal ultrasound (MSUS) by podiatrists within their clinical setting and gain additional insights into the impact that they perceive use of MSUS has on their approaches to management of musculoskeletal foot and ankle problems.

Method

An international study utilising a cross‐sectional design and an internet‐based platform was undertaken. The survey was developed and implemented through three phases: 1. survey development, 2. face validity agreement via questionnaire review, and 3. survey distribution and data collection. Twenty‐two survey questions were developed and set as a two‐step approach collecting quantitative data (part 1) and qualitative free text data (part 2). Data was exported from SurveyMonkey and analysed using Microsoft Excel software. Counts and frequencies were calculated for responses to all twenty closed questions. Responses to the two final open‐ended questions were analysed using thematic analysis to search for patterns related to podiatrists' perceptions of impact.

Results

Two hundred and thirty‐two eligible participants consented to complete the survey. The majority (n = 159) of respondents were from the UK and Spain. Commonly MSUS has been used in practice for (i) diagnosing pathology, (ii) supporting rehabilitation, (iii) supporting interventions or (iv) research purposes. Most frequently, MSUS was used to assist in the diagnosis of injury/pathology (84%). A range of free text comments were received from the participants in response to the question relating to their thoughts on the impact of using MSUS imaging in their practice (n = 109) and on their perceptions of how the use of MSUS has influenced their approaches to management of their patients' musculoskeletal foot and ankle problems (n = 108). Thematic analysis of the free text comments generated four themes: (i) diagnosis, (ii) delivery and access of care, (iii) patient education and engagement, and (iv) patient empowerment.

Conclusion

The perceived benefit podiatrists indicated in using MSUS as part of their practice is the perceived improvement in patient journeys through tighter, focused management plans and reduced waiting times. An additional novel finding was that MSUS provided the capacity for podiatrists to better inform patients of their diagnosis, which they believed led to improved engagement and consequent empowerment of patients in their treatment plans. We propose further investigation of patient experiences as well as testing of the model that embeds podiatrists' use of MSUS as a key skill in musculoskeletal foot and ankle services.
Effect of combined contraceptive pill on immune cell of ovarian endometriotic tissue
Authors: Waiyaput Wanwisa , Wattanakamolchai Keerati , Tingthanatikul Yada , Lertvikool Srithean , Tantanavipas Siriluk , Dittharot Kanthanadon , Sroyraya Morakot , Sophonsritsuk Areepan
Published: May 2021

Background

Dysregulation of immune response is associated with development of endometriosis. The study aim was to evaluate effect of combined oral contraceptive pills (COCs) consisting of ethinyl estradiol (EE) and desogestrel on the expression of macrophage, natural killer cells, and regulatory T cells of ovarian endometriotic cysts.

Methods

Endometriotic cyst wall tissues were collected from women with endometriosis who were treated (n = 22) with COCs (one table per day of EE 0.03 mg and desogestrel 0.15 mg administered for 28 to 35 days before surgery) or untreated (n = 22). The tissues were collected from endometriotic cyst wall during laparoscopic or laparotomy ovarian cystectomy. Immunohistochemistry for anti-CD68, anti-CD56, and anti-forkhead–winged helix transcription factor (FoxP3), a marker for macrophages, natural killer cells, and regulatory T cells, respectively, were investigated.

Results

The median (interquartile range [IQR]) number of anti-CD68 positive cells in the COC group was significantly lower than in the untreated group (12.7; 4.9–19.3) versus 45.7 (26.0–70.7), p < 0.001). Tissue infiltration of anti-CD56 positive cells in endometriotic cyst was significantly higher after the treatment when compared with tissue from untreated group (42.9, 27.4–68.9 versus 25.3 (14.1–37.3; p = 0.009). The number of regulatory T cells was also significantly increased in the COC group (6.3, 2.8–15.5) versus 0 (0–1.8; p < 0.001).

Conclusions

The effects of COC, containing EE 0.30 mg with desogestrel 0.15 mg, on the immune system was demonstrated by a significant decrease in the number of macrophages and an increase in natural killer and regulatory T cells.
Towards fungal sensing skin
Authors: Adamatzky Andrew , Gandia Antoni , Chiolerio Alessandro
Published: May 2021

A fungal skin is a thin flexible sheet of a living homogeneous mycelium made by a filamentous fungus. The skin could be used in future living architectures of adaptive buildings and as a sensing living skin for soft self-growing/adaptive robots. In experimental laboratory studies we demonstrate that the fungal skin is capable for recognising mechanical and optical stimulation. The skin reacts differently to loading of a weight, removal of the weight, and switching illumination on and off. These are the first experimental evidences that fungal materials can be used not only as mechanical ‘skeletons’ in architecture and robotics but also as intelligent skins capable for recognition of external stimuli and sensorial fusion.
Conditions influencing the choice between direct shipment and transshipment in maritime shipping network
Authors: Tagawa Hoshi , Kawasaki Tomoya , Hanaoka Shinya
Published: May 2021

This study examines the conditions that influence the choice between direct shipment and transshipment, focusing on two factors: geographical distance and demand. We develop a two-stage model comprising shipping lines and shippers, and apply it to a virtual maritime network with one origin, two destination ports, and one hub port. The generalized costs of shippers in the optimum direct shipment and in transshipment for the shipping lines model are compared to evaluate the choice between direct shipment and transshipment. We find that competitiveness of the port as a hub, indicating the cargo volume aggregated in transshipment, is essential for examining the cost-effectiveness of direct shipment and transshipment. The comparison between the cost-effectiveness of direct shipment and transshipment is based on the configuration of each network, especially in terms of frequency and the vessel size deployed. Direct shipment can be more cost-effective for short distances.
The key role of 3D printing and the new medical sterilizable threads in the development of the translaryngeal Tracheostomy Needle Introducer
Authors: Terrani Alessandro , Bassi Enrico , Ornaghi Alberto , Bellani Giacomo , Foti Giuseppe
Published: May 2021

Background

Percutaneous tracheostomy is frequently performed in intensive care units in patients who require prolonged mechanical ventilation. The first crucial step for the physician in these procedures is the precise needle insertion into the trachea. The primary aim of this technical note was to test the new filament and share our experiences in the implementation of the new device. The secondary aim was to show how a physician with basic training in computer-aided design and three-dimensional (3D) printing could independently create useful devices for clinical practice.

Methods

To simplify this referred clinical procedure and increase its safety, 3D printing and a new medical filament were used to develop a new translaryngeal Tracheostomy Needle Introducer (tTNI) for use in conjunction with the Fantoni’s method of percutaneous tracheostomy. The tTNI is composed of three parts: a support to fit on the rigid endotracheal tube of the Fantoni kit, an external particular shaped arm, and an introducer for the needle. The latest version of the device used a new filament based on a polyester matrix certified for skin contact that was sterilizable in a standard autoclave. Post-printing, minor technical interventions were required to correct small material deformities.

Conclusions

Our experiences with the thread and the technical features of the material were reported herein in conjunction with some suggestions on how to solve the most frequently encountered problems. The 3D printing technique allows physicians to directly manage the prototyping process of new medical devices, making this process completely independent. The speed of the prototyping process and the testing of each piece allow faster creation of a prototype than with traditional industrial methods. Finally, the new biomedical filaments offer endless possibilities of creation and modelling.
Do Islamic versus conventional banks progress or regress in productivity level?
Authors: Jubilee Ribed Vianneca W. , Kamarudin Fakarudin , Latiff Ahmed Razman Abdul , Hussain Hafezali Iqbal , Tan Khar Mang
Published: May 2021

This study assesses the differences between Islamic and conventional bank’s productivity. Earlier studies on bank productivity focused on conventional banks, but few have been done on Islamic banks. Therefore, the present study attempts to close the gap in the literature by investigating the productivity of Islamic and conventional banks in the context of the Middle East, Southeast Asia and South Asia regions. The sample is comprised of 385 banks (66 Islamic banks and 319 conventional banks) from 18 countries with data observations from 2008 to 2017. Panel data techniques with DEA-based MPI will be employed to investigate the impact of selected important factor and bank productivity as indicated by total factor productivity changes (TFPCH). Based on the results, Islamic banks are more productive than conventional banks and the results from t test are further confirmed by the results from nonparametric tests. These results are attributed to the progress in EFFCH. However, the mean difference between Islamic and conventional banks TFPCH is not statistically significant in all regions. The main benefit is that this work will hopefully provide additional insight and complement the existing studies on bank productivity of Islamic and conventional banks that are important to the banks, regulations, investors and researchers.
Estimating the Productivity Impact of Acute Myeloid Leukemia in Australia Between 2020 and 2029, Using a Novel Work Utility Measure: The Productivity-Adjusted Life Year (PALY)
Authors: Parker Catriona , Liew Danny , Ademi Zanfina , Owen Alice J. , Ayton Darshini , Wei Andrew , Zomer Ella
Published: May 2021

PURPOSE:

Acute myeloid leukemia (AML) is a rare hematologic malignancy accounting for 0.8% of new cancer diagnoses in Australia. High mortality and morbidity affect work productivity through workforce dropout and premature death. This study sought to estimate the productivity loss attributable to AML in the Australian population over 10 years and to estimate the costs of this productivity loss. Productivity was measured using productivity-adjusted life years (PALYs), a similar concept to quality-adjusted life years, but adjusts for the productivity loss attributable to disease, rather than impaired health.

MATERIALS AND METHODS:

Dynamic life tables modeled the Australian working population (age 15-65 years) between 2020 and 2029. The model population had two cohorts: those with and without AML. Differences in life years, PALYs, and costs represented the health and productivity impact of AML. Secondary analyses evaluated the impact of different scenarios.

RESULTS:

Over the next 10 years, there will be 7,600 years of life lost and 7,337 PALYs lost because of AML, amounting to Australian dollars (AU$) 1.43 billion in lost gross domestic product ($971 million in US dollars). Secondary analyses highlight potential savings of approximately AU$52 million if survival rates were improved by 20% and almost AU$118 million in savings if the return-to-work rates increased by 20% on the current estimates.

CONCLUSION:

Our study demonstrates that even in low-incidence cancer, high mortality and morbidity translate to profound impacts on years of life, productivity, and the broader economy. Better treatment strategies are likely to result in significant economic gains. This highlights the value of investing in research for improved therapies.
The Duration of Denosumab Treatment and the Efficacy of Zoledronate to Preserve Bone Mineral Density After Its Discontinuation
Authors: Makras Polyzois , Appelman-Dijkstra Natasha M , Papapoulos Socrates E , van Wissen Sandra , Winter Elizabeth M , Polyzos Stergios A , Yavropoulou Maria P , Anastasilakis Athanasios D
Published: May 2021

Context

Zoledronate is used to prevent bone loss following denosumab discontinuation but its efficacy differs among studies.

Objective

To test if the duration of denosumab treatment affects the efficacy of subsequent zoledronate infusion.

Methods

This multicenter, prospective cohort study, conducted at 2 Greek and 1 Dutch bone centers, included 47 postmenopausal women (n = 47) who received a single zoledronate infusion 6 months after the last denosumab injection and then were followed for 1 year. Twenty-seven women received ≤ 6 denosumab injections (≤ 6 Group) and 20 received > 6 denosumab injections (> 6 Group). The main outcome measure was changes in lumbar spine (LS) bone mineral density (BMD).

Results

At 12 months LS-BMD values were maintained in the ≤ 6 Group (0.98 ± 0.10 to 0.99 ± 0.9 g/cm2, P = 0.409) but decreased significantly in the > 6 Group (1.0 ± 0.11 to 0.93 ± 0.12 g/cm2, P < 0.001). The percent change of LS-BMD of the ≤ 6 Group (+1.0%) was significantly different (P < 0.001) from the change of the > 6 Group (−7.0%). In the whole cohort, the duration of denosumab treatment was negatively correlated with the percentage change of LS-BMD (rs = −0.669, P < 0.001) but not with the change of femoral neck (FN)-BMD. Bone turnover markers increased in all patients 6 months following zoledronate administration with no difference between the 2 groups.

Conclusion

The duration of denosumab treatment significantly affects the efficacy of subsequent zoledronate infusion to maintain BMD gains. Frequent follow-up of patients treated with denosumab longer than 3 years is advisable as additional therapeutic interventions may be needed.
The Impact of the COVID-19 Pandemic on Consumption: Learning from High-Frequency Transaction Data
Authors: Chen Haiqiang , Qian Wenlan , Wen Qiang
Published: May 2021

We use daily transaction data in 214 cities to study the impact of COVID-19 on consumption after China's outbreak in late January 2020. Based on difference-in-difference estimation, daily offline consumption--via bank card and mobile Quick Response code transactions--fell by 32 percent, or 18.57 million renminbi (RMB) per city, during the 12-week period. The effect is prevalent across cities and is more pronounced in the dining-and-entertainment and travel categories. We infer that China's offline consumption decreased by over 1.22 trillion RMB, or 1.2 percent of China's 2019 GDP, in the 3-month postoutbreak period.
Maintaining and Enhancing Labor Statistics during the COVID-19 Pandemic
Authors: Beach William W.
Published: May 2021

The US Bureau of Labor Statistics (BLS) continued to produce key employment statistics while reengineering operations as a result of the COVID-19 pandemic. In-person data collection moved to electronic, deadlines were adjusted, and flexibilities were implemented to get the job done, all while maintaining confidentiality and data quality. Opportunities arose, such as collection of new information from households and businesses on changes that resulted from the pandemic. This is a story that continues to unfold and will transform the way BLS moves forward. This paper focuses on changes in BLS operations and in the economy as reflected in BLS data.
High-Frequency Data and a Weekly Economic Index during the Pandemic
Authors: Lewis Daniel J. , Mertens Karel , Stock James H. , Trivedi Mihir
Published: May 2021

This paper describes a weekly economic index (WEI) developed to track the rapid economic developments associated with the onset of and policy response to the novel coronavirus in the United States. The WEI, with its ten component series, tracks the overall economy. Comparing the contributions of the WEI's components in the 2008 and 2020 recessions reveals differences in how the two events played out at a high frequency. During the 2020 collapse and recovery, it provides a benchmark to interpret similarities and differences of novel indicators with shorter samples and/or nonstationary coverage, such as mobility indexes or credit card spending.
Homefront: Black Veterans and Black Voters in the Civil Rights Era
Authors: Koch Thomas , Logan Trevon D. , Parman John M.
Published: May 2021

While the role of World War II veterans in the civil rights movement has been well documented, debate about the causal effect of military service remains. Combining detailed information on World War II enlistments and Civil Rights Commission data on voter registration, we present the first causal estimates of the role of Black veterans in high-risk political participation in the US South. Each Black enlistee increased Black voter registration by more than two additional Black registrants after the Voting Rights Act of 1965. We find similar effects on the presence of Black rights groups and, in response, White nationalist organizations.
Product Proliferation under Rational Inattention: Application to Health Insurance
Authors: Brown Zach Y. , Jeon Jihye
Published: May 2021

In markets with complicated products such as insurance, why do firms offer many products even when consumers appear to receive little benefit? We show that when consumers face information acquisition costs, firms may have an incentive to introduce many undifferentiated products. This allows firms to gain market share and increase markups. We document initial evidence consistent with the model using data from Medicare prescription drug insurance. Insurers that offer more duplicate or similar plans have higher-cost plans. These results suggest a role for policymakers to restrict product proliferation in markets with complicated products.
Custom Elections and Local Policies: The Case of Canada’s First Nations
Authors: Aragón Fernando M. , Kessler Anke S.
Published: May 2021

We examine the effect of community-designed electoral codes on Canadian First Nation communities. Adopting a custom code for local elections allows for changes such as increasing term duration, creating appeal and supervisory bodies, and incorporating traditional governance elements. To reduce biases due to selective opt-in, we exploit the timing of the electoral reform and a rich set of controls. We find that bands using the custom systems pay lower remunerations to their chiefs, spend more on education and training and less on band development, and have better wastewater services but show no sizable differences in income, population, or employment.
Keynesian Production Networks and the COVID-19 Crisis: A Simple Benchmark
Authors: Baqaee David , Farhi Emmanuel
Published: May 2021

The COVID-19 crisis is a seemingly all-encompassing shock to supply and demand. These negative shocks affected industries differently: some switched to remote work, maintaining employment and production, while others reduced capacity and shed workers. We consider a stripped-down version of the model in Baqaee and Farhi (2020). The model allows for an arbitrary input-output network, complementarities, incomplete markets, downward wage rigidity, and a zero lower bound. Nevertheless, the model has a stark property: factor income shares at the initial equilibrium are global sufficient statistics for the production network, clarifying assumptions that must be broken if the network is to matter.
The Family Origin of the Math Gender Gap Is a White Affluent Phenomenon
Authors: Dossi Gaia , Figlio David , Giuliano Paola , Sapienza Paola
Published: May 2021

Previous research has shown that norms around the role of women in society could help explain the gender gap in mathematics and that these norms could be transmitted within the family. Using data from the Florida Department of Education combined with birth certificates, we uncover important heterogeneity in the transmission of gender biases within the family. We find that gender role norms can explain the lower performance of girls in mathematics only in relatively affluent White families, whereas they do not apparently matter for the performance of Black girls.
PARA ALÉM DOS FUNDAMENTOS DA DECISÃO JUDICIAL: ANÁLISE EMPÍRICA DA INFLUÊNCIA DO PERFIL DO RÉU SOBRE A DECISÃO QUE DISPENSA AS AUDIÊNCIAS OBRIGATÓRIAS DE CONCILIAÇÃO E MEDIAÇÃO NO INÍCIO DO PROCESSO (ART. 334, CPC)
Authors: Paula Filho Alexandre Moura Alves de , Gomes Neto José Mário Wanderley
Published: May 2021

Objetivo: O perfil do réu influencia na dispensa das audiências previstas no art. 334, CPC, em feitos que tramitam pelo rito do procedimento comum nas varas cíveis da comarca de Recife/PE? Alguns juízes vêm dispensando de modo contra legem essas audiências, que são, salvo poucas exceções, obrigatórias. Com esse problema de pesquisa, o objetivo geral deste trabalho é identificar se, para além das justificativas dadas pelos juízes para dispensar um ato processual quase sempre obrigatório, um fator processual que aparentemente não está relacionado à dispensa da audiência, que é o perfil do litigante, pode apresentar correlação com a não designação contra legem do ato processual em questão.Metodologia: Para responder ao problema de pesquisa proposto, utilizou-se de metodologia empírica quantitativa, consistente em análise estatística por regressão logística, por meio da qual se testou a força da associação entre a não designação da audiência e quatro perfis de réus distinguidos pela quantidade de ações a que respondem.Resultados: Ao testar empiricamente a hipótese de que a variação da natureza da parte ré (entre as categorias raro, eventual, contumaz e habitual) produziria variação nas chances do juiz marcar (ou não) a audiência prévia, verificou-se que, na comarca de Recife/PE, há uma tendência a designar a audiência quando há litigantes raros no polo passivo (pessoas físicas, microempreendedores individuais, microempresas e pessoas jurídicas de pequeno porte, via de regra) e há, no sentido contrário, um aumento na tendência de não designação à medida que o réu se torna mais habitual na justiça comum cível da localidade onde foi realizada a pesquisa.Contribuições: Com este trabalho, é possível identificar que há fatores para além dos diversos mencionados nas decisões que dispensam as audiências que influenciam na decisão de não as realizar de modo contra legem. Apresentando esse dado, é possível se pensar em propostas de lege ferenda mais realistas, isto é, que considerem o comportamento judicial mediante sua verificação empírica, e não em deduções de natureza unicamente dogmática, especialmente quando a norma em questão é suscitada como potencialmente cooperativa para uma “mudança de cultura” – no caso, da litigiosidade.
Η σχέση εθνικής και ευρωπαϊκής ταυτότητας στο ενωσιακό δίκαιο
Authors: Γεράσιμος Ιωάννης
Published: May 2021

Παρά τη σημαντική δυναμική που έχει αναπτύξει και το επιστημονικό ενδιαφέρον που έχει προσελκύσει κατά τη διάρκεια της τελευταίας δεκαετίας η έννοια της εθνικής συνταγματικής ταυτότητας αυτή συνιστά μια σχετικά νέα έννοια του ευρωπαϊκού δικαίου. Έτσι, στο πλαίσιο αυτό αντικείμενο διερεύνησης της παρούσας υπό εκπόνηση διδακτορικής διατριβής, η οποία εντάσσεται στο επιστημονικό αντικείμενο του ευρωπαϊκού συνταγματικού δικαίου , συνιστά το ζήτημα της σχέσης της εθνικής συνταγματικής ταυτότητας των κρατών μελών της Ευρωπαϊκής Ένωσης με μια υπό ανάδυση κοινή ευρωπαϊκή συνταγματική ταυτότητα. Στο πλαίσιο αυτό ιδιαίτερη έμφαση δίνεται στον τρόπο χρησιμοποίησης της έννοιας από το ΔΕΕ και στη νομολογία που έχει ήδη αναπτύξει σχετικά με το σεβασμό της πολιτισμικής πολυμορφίας, της γλωσσικής πολυμορφίας, με τη σχέση του Χάρτη Θεμελιωδών Δικαιωμάτων της ΕΕ και εθνικών συνταγματικών διατάξεων περί συνταγματικών δικαιωμάτων(άρθρο 53 Χάρτη), με το υποεθνικό επίπεδο διακυβέρνησης στο πλαίσιο των κρατών μελών, καθώς και με τη νέα οικονομική διακυβέρνηση. Παράλληλα, αναδεικνύεται η συμβολή της έννοιας της εθνικής συνταγματικής ταυτότητας μέσω των θεμελιωδών συνταγματικών δομών στην ενίσχυση ενός κοινού ευρωπαικού συνταγματικού προτύπου και μιας κοινότητας ευρωπαικής συνταγματικής παράδοσης.
Exploring barriers and facilitators of physical distancing in the context of the COVID-19 pandemic: a qualitative interview study
Authors: Farrell Karen , Durand Hannah , McSharry Jenny , Meade Oonagh ,   The Health Psychology Public Advisory Panel, Kenny Eanna , Noone Chris , O'Connor Laura L. , Lavoie Kim L. , Byrne Molly , Mooney Robert , McGuire Brian E. , Molloy Gerard J.
Published: May 2021

Background: Physical distancing measures (e.g., keeping a distance of two metres from others, avoiding crowded areas, and reducing the number of close physical contacts) continue to be among the most important preventative measures used to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID -19). Therefore, it is important to understand barriers and facilitators of physical distancing to help inform future public health campaigns.

Methods: The current study aimed to qualitatively explore barriers and facilitators of physical distancing in the context of the COVID-19 pandemic using a qualitative interpretative design. Semi-structured one-to-one phone interviews were conducted with 25 participants aged 18+ years and living in the Republic of Ireland between September and October 2020. A purposive sampling strategy was used to maximise diversity in terms of age, gender, and socioeconomic status. Interviews were transcribed verbatim and analysed using inductive thematic analysis.

Results: Analysis resulted in the development of six main themes related to barriers and facilitators of physical distancing: (1) Maintaining and negotiating close relationships; (2) Public environments support or discourage physical distancing; (3) Habituation to threat; (4) Taking risks to maintain well-being; (5) Personal responsibility to control the “controllables”; and (6) Confusion and uncertainty around government guidelines.

Conclusions: Our study found that physical distancing measures are judged to be more or less difficult based on a number of internal and external psychosocial factors, including maintaining and negotiating close relationships, habituation to threat, risk compensation, structure of public environments, personal responsibility, and confusion or uncertainty around government guidelines. Given the diversity in our sample, it is clear that the identified barriers and facilitators vary depending on context and life stage. Messaging that targets sub-groups of the population may benefit from considering the identified themes in this analysis.
Application of paste-type acellular dermal matrix in hard-to-heal wounds
Authors: Kim Sang Wha , Shim Hyung Sup , Lee Jihye , Kim Youn Hwan
Published: May 2021

Objective:

The extracellular matrix (ECM) is one of the most important elements in wound healing. Absence or dysfunction of the ECM may impair wound healing. The application of acellular dermal matrix (ADM) as a substitute for ECM has been suggested. This study investigated the clinical application and wound healing effects of a paste-type ADM in patients presenting with hard-to-heal wounds due to various causes.

Method:

Patients with a hard-to-heal wound for >1 month, from September 2017 to February 2019, were included in this study. After debridement, the paste-type ADM was applied, at zero (baseline), two and four weeks. After application of the paste-type ADM, a conventional dressing was applied using polyurethane foam. Wound size, the formation of granulation tissue, re-epithelialisation, complete healing and adverse events were recorded at zero (baseline), one, two, four, eight and 12 weeks after the initial treatment.

Results:

A total of 18 patients took part (eight male, 10 female, mean age of 56±16.16 years). The mean wound area decreased from 17.42±10.04cm2 to 12.73±7.60cm2 by week one (p<0.05), to 10.16±7.00 by week two (p<0.0005), to 5.56±5.25 by week four (p<0.0001), to 2.77±5.15 by week eight (p<0.0001) and to 2.07±4.78 by week 12 (p<0.0001). The number of patients with >75% re-epithelialisation increased from two (11.1%) at two weeks to five (27.8%) at four weeks, to 11 (61.1%) at eight weeks and to 13 (72.2%) at 12 weeks. The number of patients showing complete wound healing was two (11.1%) at four weeks, nine (50.0%) at eight weeks and 12 (66.7%) at 12 weeks. No adverse events were reported during treatment.

Conclusion:

The paste-type ADM used in this study is a viable option for facilitating wound healing; it can shorten hospitalisation, and promote a faster recovery and return to normal life activities.
Molecular Mechanisms Underlying Salt Stress Tolerance in Jojoba (Simmondsia Chinensis)
Authors: Alghamdi Budour A. , Bafeel Sameera O. , Edris Sherif , Atef Ahmed , Al-Matary Mohammed , Bahieldin Ahmed
Published: May 2021

The aim of this study was todetect the expression profiles of salt-related genes in the leaf transcriptome of Jojoba (Simmondsia chinensis) to decipher the molecular mechanisms underlying salt stress tolerance in this plant species. The analyzed RNA-Seq data identified numerous differentially expressed genesthat were mostly upregulated under salt (NaCl) stress conditions. The genes varied in their ability to limit cellular damage under stress conditions by regulatingthe production of reactive oxygen species (ROS). Some genes demonstrated the use of methylation/demethylation followed by intergenerational transmission of a “stress memory”. Other genes are known for their potential to produce proteins with superoxide dismutase (SOD) activity, the ability to detoxify metal ions and to produce molecular chaperones. Additional activities include regulating signal transductionandthe ion transport processes, the reprogramming of selective gene expression andthe maintenance of balanced sucrose content, ethylene signaling and homeostasis, the regulating of plasmodesmal permeability, ubiquitination,and selective protein degradation. Moreover, genes were also identified to be associated with cell wall remodeling, alleviating chlorophyll content, and accumulatinglower levels of sodium (Na+) and chloride (Cl-), as well as increased levels of lignin that function to support a plant’s integrity under salt stress. Overall, these data provide new insights into the molecular mechanisms at play during conditions of salt stress. These mechanisms ensure a plant’s survival and help to maintain its natural chemical compounds. These findings may be beneficial in furthering the use of this economically important plant.