bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of flow of chorioretinal capillaries in healthy black and white subjects using optical coherence tomography angiography
Authors: Massamba Nathalie , Mackin Anna G. , Chun Lindsay Y. , Rodriguez Sarah , Dimitroyannis Rose C. , Bodaghi Bahram , Hariprasad Seenu M. , Skondra Dimitra
Published: November 2021

This study compared macular capillary parameters between healthy black and white subjects using optical coherence tomography angiography (OCTA). We measured vessel density (VD) of superficial (SCP), intermediate (ICP), and deep (DCP) capillary plexuses and choriocapillaris blood flow area (BFA) of the fovea, parafovea and total 3 mm-diameter circular area centered on the fovea, as well as the foveal avascular zone (FAZ) parameters, controlling for axial length. Black subjects had lower foveal and parafoveal VD in the SCP (p = 0.043 and p = 0.014) and the ICP (p = 0.014 and p = 0.002). In the DCP, black subjects had a trend toward lower foveal and parafoveal VD. Black subjects had decreased choriocapillaris BFA in the total 3 mm area (p = 0.011) and the parafovea (p = 0.033), larger FAZ area (p = 0.006) and perimeter (p = 0.014), and a higher capillary density in a 300 μm wide region around the FAZ (FD-300) (p = 0.001). There was no significant difference in FAZ acircularity index. To our knowledge, this is the first report analyzing the three distinct retinal capillary plexuses and identifying differing baseline VD, choriocapillaris and FAZ parameters in healthy young black compared to white subjects. Larger studies are needed to validate these findings and better understand racial differences in vulnerability to ocular diseases.
Protective effects of low-molecular-weight components of adipose stem cell-derived conditioned medium on dry eye syndrome in mice
Authors: Lee Yuan-Chieh , Sun Li-Yi , Zhang Jia-Rong
Published: November 2021

The present study demonstrated the protective effects of low-molecular-weight adipose-derived stem cell-conditioned medium (LADSC-CM) in a mouse model of dry eye syndrome. Mice subjected to desiccating stress and benzalkonium chloride had decreased tear secretion, impaired corneal epithelial tight junction with microvilli, and decreased conjunctival goblet cells. Topical application of adipose-derived stem cell-conditioned medium (ADSC-CM) stimulated lacrimal tear secretion, preserved tight junction and microvilli of the corneal epithelium, and increased the density of goblet cells and MUC16 expression in the conjunctiva. The low-molecular-weight fractions (< 10 kDa and < 3 kDa) of ADSC-CM (LADSC-CM) provided better protections than the > 10 kDa or > 3 kDa fractions of ADSC-CM. In the in vitro study, desiccation for 10 min or hyperosmolarity (490 osmols) for 24 h caused decreased viability of human corneal epithelial cells, which were reversed by LADSC-CM. The active ingredients in the LADSC-CM were lipophobic and stable after heating and lyophilization. Our study demonstrated that LADSC-CM had beneficial effects on experimental dry eye. It is worthy of further exploration for the active ingredient(s) and the mechanism.
Switching of easy-axis to easy-plane anisotropy in cobalt(ii) complexes
Authors: Wu Yuewei , Xi Jing , Xiao Tongtong , Ferrando-Soria Jesús , Ouyang Zhongwen , Wang Zhenxing , Luo Shuchang , Liu Xiangyu , Pardo Emilio
Published: November 2021

In situmicrocalorimetry monitored assembly and coligand induced switching of the magnetic anisotropy sign have been observed in a β-diketonate-Co(ii) system.
The Behavior of a Strengthened Steel Beam Section Under Eccentric Loadings
Authors: Rasheed Mohammed M. , Mahmoud Kamal Sh. , Mohaisen Saad Khalaf , Yousif Mohammed Z.
Published: November 2021

Thirteen simply supported steel samples have been tested to explain the effects of strengthening steel beams using an external prestressing strand. The samples have the same cross-sectional dimensions and overall length. One steel beam without strengthening was taken as a reference, while the other twelve of them had been strengthening by two external strands at various eccentricity locations and jacking stresses. The strengthening by external prestressing strands is sub-divided into two series according to jacking stress. Each series consists of six steel samples divided according to the eccentricity location of prestressing strand. During tests, it was found that the Load deflection response for the strengthened samples is stiffer as compared with the reference. The increasing percentage in ultimate load capacity was increased to 0.347, 2.758, 3.921, 8.898, 9.326, and 10.256% for beams under jacking stress of 1120 MPa, while increasing percentage in ultimate load capacity were increased to 0.17, 26, 33, 48.5, 13.7, and 69.56% for beams under jacking stress of 815 MPa. On the other hand, the maximum percentages of deflection were decreased to 4.88, 2.44, 20.62, 15, and 9.7% when the jacking stress increase from 815 to 1120 MPa and the ratio of the quarter to mid-span deflection (δ quarter / δ mid) is about 0.528 and 0.497 when jacking stress is 1120 and 815 MPa respectively. So, the increase in jacking stresses from 815 to 1120 MPa will not be preferable because it has a little increasing percentage in stiffening and behaviors compared with other tested beams at the same condition.
Investigation of acoustic fields in the arctic zone with uneven ice cover
Authors: Korochentsev Vladimir , Wenjian Сhen , Petrosyants Victor , Lobova Tatiana , Shpak Julia
Published: November 2021

A mathematical model for elastic wave propagation in an ice cover with uneven relief (hummock) has been developed. The theoretical model is based on the application of “directed” Green’s functions. We obtained numerical results for different distances between radiating and receiving antennas installed inside the ice layer and in water medium. An information-measuring system was created to investigate elastic acoustic waves along ice surface based on electo-hydraulic generator. Experiments of high-frequency acoustic signal propagation from electro-hydraulic generator in water-ice-air system were carried out. We illustrated the model validity for the investigation of hydroacoustic wave propagation in real ice conditions.
Operation of a multi-frequency parametric sidescan sonar in an ice waveguide
Authors: Pivnev Petr , Tarasov Sergey , Jianjun Zhu , Voronin Vasily
Published: November 2021

Hydroacoustic systems for mineral exploration, solving engineering problems and monitoring the ecological state of the world’s oceans are currently being intensively developed. However, the practical use of hydroacoustic systems for solving the problems under consideration, operating in the traditional mode, has some significant limitations. These restrictions are largely related to the state of the marine areas in which such work is carried out. Especially little is known about the patterns of propagation and interaction of acoustic waves in marine basins with ice cover. These areas are rich in minerals and intensive shipping is developing in them. Therefore, an important place in acoustic research is occupied by the study of the acoustic properties of the ice cover of the polar regions of the Earth. This is determined by the fact that the ice sheet is a unique constantly collapsing and renewable natural system. In this regard, the conditions for the propagation of acoustic waves are changing. More than 70% of the Arctic basin is covered with ice, the lower boundary of which has significant irregularities with a standard deviation of up to 3 m, so the scattering of acoustic waves at such a boundary is significant and different at different frequencies. The formation of the acoustic field of the hydroacoustic systems used in these conditions is quite complex. Therefore, the task of assessing changes in the characteristics of the field and the use of appropriate hydroacoustic systems for their effective use is urgent.
On the dynamics of the electromagnetic parameters of the Northern Tien Shan lithosphere
Authors: Bataleva Elena
Published: November 2021

The results of geophysical monitoring of seismically hazardous regions are of undoubted interest for studying the deep structure of the lithosphere, regional seismicity, modern geodynamics, etc. The work used experimental material, including the results of magnetotelluric monitoring and the catalogs of the KNET (Kyrgyzstan Telemetered Network), KRNET (Kyrgyz Republic Digital Network) and ISC (International Seismological Center) networks obtained in the seismically active zones of the Bishkek Geodynamic Proving Ground (Northern Tien Shan). The analysis of electromagnetic monitoring results of the Northern Tien Shan seismic generating zone was carried out in a wide frequency range. The data on the parameters of the electromagnetic field of the Earth’s crust in the Northern Tien Shan are generalized and systematized. Based on the analysis of these data, the dependence of the response of seismic events in electromagnetic parameters on the distance of earthquake epicenters was studied. The most likely reason for the occurrence of anomalous changes in the electromagnetic field is the activation of deformation processes during the preparation of strong earthquakes. The results of the time-frequency analysis are presented and the features of manifestation are considered depending on the location of the hypoand epicenters of seismic events and their magnitude. Regularities have been established in the behavior of tipper variations for remote and regional earthquakes for the first quarter of 2016 with an energy class from 6 to 10.
Digitale Transformation und psychische Gesundheit – DGPPN
2021
Authors: Karow Anne
Published: November 2021

Die Aufgabe der digitalen Transformation wird mit allen Chancen und Risiken als eine
der größten Herausforderungen für unsere künftige
gesellschaftliche Entwicklung benannt und beeinflusst auch beschleunigt und
intensiviert durch die Pandemieerfahrungen alle Bereiche der Medizin. Insofern ist
es nur konsequent, dass das Leitthema der diesjährigen DGPPN vom
24.–27. November 2021 „Digitale Transformation und psychische
Gesundheit“ heißt. Der DGPPN Vorstand stellt in den Mittelpunkt des
Kongresses zentrale Fragen nach einem direkten Einfluss der Digitalisierung und den
Auswirkungen technischer Innovationen auf psychische Erkrankungen, als auch auf die
Diagnostik und Behandlung von psychischen Erkrankungen und auf die Menschen, die
jetzt oder künftig mit Hilfe digitaler Anwendungen ihre Patienten in ihrem
Krankheitsprozess behandeln und bei ihrer Genesung begleiten. Es werden wichtige
Themenfelder wie die Rolle der therapeutischen Beziehung im digitalen Raum oder die
Vorteile und Risiken einer frühen Vorhersage von Krankheitsentwicklungen
durch große Datenanalysen mit Konsequenzen für die Betroffenen und
ihre Familien und datenschutzrechtlichen und ethischen Fragestellungen benannt.
Statin Therapy in Patients Undergoing Thoracic Aorta Replacement for Aortic Aneurysms
Authors: Kindzelski Bogdan A. , Hanick Andrea L. , Miletic Kyle G. , Lowry Ashley M. , Van Wagoner David , Blackstone Eugene H. , Roselli Eric E.
Published: November 2021

Background Patients undergoing surgery for thoracic aortic aneurysms receive statin therapy out of proportion to cardiovascular comorbidity. We sought to determine the prevalence of statin use among patients presenting for thoracic aortic aneurysm surgery and investigate its effect on outcomes.

Methods From January 1, 2005 to January 1, 2011, 1,839 consecutive patients underwent aortic replacement for degenerative thoracic aortic aneurysm at Cleveland Clinic. Of these, 771 (42%) were on statins preoperatively. Statin users (vs. nonstatin users) were older (65 ± 11 vs. 56 ± 16 years) and had more hypertension (78 vs. 59%). Propensity matching based on 56 preoperative variables other than lipid levels was used to compare outcomes among 570 matched patient pairs (74% of possible pairs).

Results Propensity-matched statin and nonstatin users were aged 64 ± 11 years, 394 (69%) versus 387 (68%) were male, and 437 (77%) versus 442 (78%) had ascending aortic aneurysms, respectively. Overall, 25% of patients were followed for more than 8.2 years and 10% for more than 10 years. Perioperative outcomes were similar, including hospital mortality (11 [1.9%] vs. 5 [0.88%]) and stroke (22 [3.9%] vs. 13 [2.3%]), but 16 statin users (2.8%) versus 5 nonstatin users (0.88%) required temporary dialysis after surgery (p = 0.02). At 6 years, 3.7% of statin users versus 5.1% of nonstatin users (p[log-rank] = 0.5) underwent further aortic surgery, and at 10 years, mortality was 25% in both groups (p > 0.5).

Conclusion Patients presenting for thoracic aortic aneurysm surgery frequently receive unnecessary statins. Additionally, statin use was associated with more postoperative renal failure, but not less intermediate-term risk for aortic reintervention or all-cause mortality after surgery. Therefore, presence of a thoracic aortic aneurysm should not be considered an indication for statin therapy in the absence of well-established indications.
Diagnostic Performance of Digital Radiograph and Low-Dose Computed Tomography for the Diagnosis of Fishbone Retention in the Oropharynx
Authors: Chansangrat Jirapa
Published: November 2021

Introduction Fishbone foreign body retention is one of the most common problem with various clinical manifestations from asymptomatic, abscess formation, and perforation to mediastinitis with subsequence morbidity and mortality. Accurately identifying the location of the fishbone leads to precise removal, which, in turn, prevents serious consequences. Digital radiographs have been widely used for diagnosis, but many studies show poor sensitivity.

Object The present study was designed to compare the diagnostic performances of digital radiograph and low-dose computed tomography (CT) for fishbone retention and to demonstrate the radiation dose of the two modalities.

Methods We collected 2 pieces of fishbone from each of the 15 species commonly eaten in Southeast Asia. We embedded each fishbone in a fresh pig's neck, then subjected the pig's neck to lateral soft tissue neck digital radiograph. The locations to embed included tonsil, base of tongue, and upper esophagus. Then, we subjected the same specimen to a CT scan. Two experienced radiologists interpreted each image.

Results Visibility in the digital radiograph group was 13%, and in CT images group, it was 87% regardless of the locations. The average radiation dose from digital radiographs was 0.4 mGy (radiation dose field), while from CT images it was 8.6 mGy (CT dose index).

Conclusion Most of the common fishbones in Southeast Asia could not be visualized by digital radiograph when embedded in the neck. Computed tomography scans demonstrated better diagnostic performance of fishbone retention compared to digital radiographs, regardless of the embedded location.
Information sharing to mitigate delays in port: the case of the Port of Rotterdam
Authors: Nikghadam Shahrzad , Molkenboer Kim F. , Tavasszy Lori , Rezaei Jafar
Published: November 2021

Reliability of service times has long been a concern of many ports around the world. This paper presents an approach to mitigate delays in service times through improved information sharing in ports. The approach is based on a mapping of information sharing links and their association to the root causes of frequently occurring delays. We identify the kind of information which is critical in mitigating delays. Critical information links are then re-ordered to create an information sharing arrangement between the actors, which further condenses and simplifies the required information sharing actions. We apply the proposed approach to the Port of Rotterdam. Quantitative data of 28,000 port calls is complemented by qualitative data collected through direct observations and expert interviews with port actors, including the pilot organization, a tugboat company, the boatmen organization, the harbour master, a terminal and a vessel agent. Besides the suggested arrangement for information sharing, the case reveals the critical position of pilots, a vulnerable position of tugboat companies and the minimal contribution made by the terminal towards information sharing. The increased pressure on ports by ever larger vessels seems to bear its fair share for delays and bottlenecks in the smooth execution of port operations.
Surface reconstruction of tetragonal methylammonium lead triiodide
Authors: Seidu Azimatu , Dvorak Marc , Järvi Jari , Rinke Patrick , Li Jingrui
Published: November 2021

We present a detailed first-principles analysis of the (001) surface of methylammonium lead triiodide (MAPbI3). With density functional theory, we investigate the atomic and electronic structure of the tetragonal (I4cm) phase of MAPbI3. We analyzed surface models with MAI-termination (MAI-T) and PbI2-termination (PbI2-T). For both terminations, we studied the clean surface and a series of surface reconstructions. We find that the clean MAI-T model is more stable than its counterpart, PbI2-T. For the MAI-T, reconstructions with added or removed units of nonpolar MAI and PbI2 are most stable. The corresponding band structures reveal surface states originating from the conduction band. Despite the presence of such additional surface states, our stable reconstructed surface models do not introduce new states within the bandgap.
Synthesis and anisotropic magnetism in quantum spin liquid candidates AYbSe2 (A = K and Rb)
Authors: Xing Jie , Sanjeewa Liurukara D. , May Andrew F. , Sefat Athena S.
Published: November 2021

The quantum spin liquid (QSL) state in rare-earth triangular lattices has attracted much attention recently due to its potential application in quantum computing and communication. Here, we report the single-crystal growth synthesis, crystal structure characterizations, and magnetic properties of AYbSe2 (A = K and Rb) compounds. The x-ray diffraction analysis shows that AYbSe2 (A = K and Rb) crystallizes in a trigonal space group, R-3m (No. 166) with Z = 3. AYbSe2 possesses a two-dimensional (2D) Yb–Se–Yb layered structure formed by edged-shared YbSe6 octahedra. The magnetic properties are highly anisotropic for both title compounds, and no long-range order is found down to 0.4 K, revealing the possible QSL ground state in these compounds. The isothermal magnetization exhibits a one-third magnetization plateau when the magnetic fields are applied in the ab-plane. Heat capacity is performed along both ab-plane and c axis and features the characteristic dome for triangular magnetic lattice compounds as a function of magnetic fields. Due to the change in the interlayer and intralayer distance of Yb3+, the dome shifts to low fields from KYbSe2 to RbYbSe2. All these results indicate that the AYbSe2 family presents unique frustrated magnetism close to the possible QSL and noncollinear spin states.
Effect of a state hospital formulary on medicines utilisation in Australia
Authors: Iedema Joel
Published: November 2021

Objective The provision of medicines through state public hospitals is comparatively restrictive compared with the federally funded Pharmaceutical Benefits Scheme (PBS). Individual states are progressively moving towards statewide medicines formularies. Although a statewide formulary has existed in Queensland for some time. The effects of hospital formularies on medicines utilisation and policy in Australia has not been quantified. Thus, the aim of the present study was to quantify the effects of the Queensland Health List of Approved Medicines (LAM) on medicines utilisation in Queensland at a state and PBS-purchasing level and describe the implications for medicines policy. Methods This study used a quasi-experimental design with an interrupted time series (with control for PBS) examining utilisation effects of medicines within the therapeutic classes of proton pump inhibitors and non-vitamin K oral anticoagulants with LAM listing or delisting. Results The LAM was demonstrated to be highly effective at controlling utilisation within Queensland Health purchasing. Effects on PBS utilisation were evident, resulting in increases in generic utilisation (where available) and associated reduced total costs both within Queensland Health and to the PBS. The full benefit is likely underestimated due to limitations in the PBS datasets. Conclusion The LAM is a highly effective state medicines policy tool with demonstrable effects on PBS utilisation. With increased use of statewide medicines formularies, this will be an increasingly relevant aspect of Australia’s overall medicines policy. What is known about the topic? State medicines policy is comparatively restrictive compared with the federal PBS. Most Australian states have, or are developing, statewide medicines formularies. What does this paper add? By examining several classes of medicines, a substantial quantitative effect of the Queensland state formulary on both state and PBS medicines utilisation can be demonstrated. Increased use of generic medicines and reduced costs are seen. What are the implications for practitioners? With increased use of state medicines formularies, state medicines formularies will become increasingly relevant to medicines policy makers and advocates at both the state and federal level.
Integrative taxonomy reveals an even greater diversity within the speciose genus
Authors: Pinacho-Pinacho Carlos D. , Sereno-Uribe Ana L. , Hernández-Orts Jesús S. , García-Varela Martín , Pérez-Ponce de León Gerardo
Published: November 2021

Phyllodistomum is one of the most species-rich genera of parasitic platyhelminths, with 120 species described worldwide; they infect the urinary bladder of marine and freshwater fishes. As the number of new species within the genus has increased, morphological conservatism, and the lack of reliable diagnostic traits make the separation of species a challenging task. The increase of genetic data for Phyllodistomum species has permitted the use of an integrative taxonomy approach as a framework for species discovery and delimitation. DNA sequences (28S rRNA and COI mtDNA) were obtained from individuals of Phyllodistomum sampled in 29 locations across Middle America, and used in combination with morphology, host association and geographic distribution to uncover five new congeneric species. Morphologically, the new species are relatively similar; there are no unique morphological traits to readily distinguish them. We first investigated species boundaries through phylogenetic analyses of the independent and concatenated datasets; analyses recognised five candidate species showing reciprocal monophyly and strong clade support, particularly for COI data. The interspecific 28S rRNA and COI sequence divergence among the new species from 0.4 to 18.4% and from 5.1 to 27% respectively. These results were further validated by a Bayesian species delimitation approach. The five new species are well supported by molecular data used in combination with other sources of information such as host association and geographical distribution and are described herein as Phyllodistomum romualdae sp. nov., P. virmantasi sp. nov., P. isabelae sp. nov., P. scotti sp. nov., and P. simonae sp. nov.
A multifaceted approach in leveraging electronic health record tools for safe inpatient use of concentrated U-500 insulin
Authors: Willner Marc A , Ketz Jeffrey , Davis Ramona A , Yaniv Angela W , Bulgar-Grozav Alina , Wang Weishi , Shah Sneha , Pang Bob , Hesketh Alexandria
Published: November 2021

Purpose

The Institute for Safe Medication Practices classifies subcutaneous insulin as a high-risk medication. Concentrated U-500 insulin carries additional risks in comparison to conventional U-100 insulin, as the 5-fold more concentrated nature of this product, limitations to insulin pen dosing, and various devices for dose measurement may lead to miscommunication of patient-reported doses, resulting in downstream errors in ordering, verification, or administration. We describe a multifaceted approach to leveraging technical tools within the electronic health record (EHR) for U-500 insulin use.

At Cleveland Clinic, the U-500 insulin use process evolved in a number of phases using EHR tools. Phase 1 included new clinical decision support and documentation tools during order entry, including a customized alert that fired during order entry recommending that the prescriber order a consult with endocrinology and requiring the prescriber to provide the patient’s home insulin measuring device and the source of the patient’s reported home dose. In order verification, a customized alert fired directing the pharmacist to contact the patient or patient’s nurse and validate the information provided by the prescriber. Phase 2 involved transitioning dispensing of patient-specific doses from tuberculin syringes to U-500 insulin syringes. Phase 3 transitioned to use of U-500 insulin pens and included automatic dose rounding of ordered doses down to the nearest 5 units, and an additional customized pharmacist alert intended for cost conservation was added to fire if the patient had a recent administration of U-500 insulin documented, directing the pharmacist to determine whether the nurse needed a new pen dispensed.

Conclusion

Cleveland Clinic successfully implemented customized tools and processes within the EHR pertaining to the prescribing, verification, dispensing, and administration of U-500 insulin.
A case of spontaneous idiopathic tension pneumoperitoneum successfully managed with bedside pig-tail catheter
Authors: Chang Wendy , Udo Mieko , Schulze Bettina
Published: November 2021

We present a 67-year-old gentleman with a high perioperative mortality and morbidity risk who presented with spontaneous idiopathic tension pneumoperitoneum that was successfully managed with bedside pig-tail catheter insertion. Here we also discuss other potential non-surgical aetiologies of pneumoperitoneum.
Incorporating Faith into Ethics Education
Authors: Smith Diane L.
Published: November 2021

Preparing students for ethical situations they will face in practice should be incorporated into nursing curricula, especially programs with a Christian focus. Linking ethical concepts with tenets from Scripture can increase students' confidence in their ability to respond through a biblical worldview to ethical dilemmas in nursing practice. Specific assignments can be geared to help students think critically about the Code of Ethics for Nurses with Interpretive Statements (Code) and biblical responses to ethical situations. Sample assignments are presented for the nine provisions of the Code.
Single-cell metabolomics reveals the metabolic heterogeneity among microbial cells
Authors: Meng Xuanlin , Tao Fei , Xu Ping
Published: November 2021

In microbial research, the heterogeneity phenomenon is closely associated with microbial physiology in multiple dimensions. For now, A few studies were proposed in transcriptome and proteome analysis to discover the heterogeneity among single cells. However, microbial single cell metabolomics has not been possible yet. Herein, we developed a method, RespectM, based on discontinuous mass spectrometry imaging, which can detect more than 700 metabolites at a rate of 500 cells per hour. While ensuring the high throughput of RespectM, it integrates matrix sublimation, QC-based peak filtering, and batch correction strategies to improve accuracy. The results show that RespectM can distinguish single microbial cells from the blank matrix with an accuracy of 98.4%, depending on classification algorithms. Furthermore, to verify the accuracy of RespectM for distinguishing different single cells, we performed a classification test on Chlamydomonas reinhardtii single cells among allelic strains. The results showed an accuracy of 93.1%, which provides RespectM with enough confidence to perform microbial single cell metabolomics analysis. As we expected, untreated microbial cells will spontaneously undergo metabolic grouping coherence with genetic and biochemical similarities. Interestingly, the pseudo-time analysis also provided intuitive evidence on the metabolic dimension, indicating the cell grouping is based on microbial population heterogeneity. We believe that the RespectM can offer a powerful tool in the microbial study. Researchers can now directly analyze the changes in microbial metabolism at a single-cell level with high efficiency.
Determinants of healthy diet choices during austerity in Greece
Authors: Koulierakis George , Dermatis Anastasia , Vassilakou Nair-Tonia , Pavi Elpida , Zavras Dimitris , Kyriopoulos John
Published: November 2021

Purpose

The purpose of this paper is to investigate the key determinants of dietary choices of the Greek population during a period of financial austerity.

Design/methodology/approach

Data from the 2016 “Health and Welfare” Greek national cross-sectional survey, in a representative sample of 2,003 individuals, were examined. The survey was conducted via computer-assisted telephone interviews. Sociodemographic characteristics and diet knowledge were examined as potential determinants of four dietary behaviours (fruit, fish, red meat and fast food consumption).

Findings

Findings showed significant gender differences against men (64.4% were overweight and obese; 57.6% and 18.4% reported red meat and fast food consumption more than twice a week, respectively). Age and financial affordability were the most significant determinants of fruit consumption. Fish consumption was determined by age, financial affordability, and family status (unmarried, living with the parents). Gender, age, family status (unmarried, living alone), employment status (unemployed) and social support affected red meat consumption. Finally, factors influencing fast food consumption were gender, age and employment status (unemployed).

Originality/value

This research incorporates unique and original insight in the determinants of healthy dietary choices during the austerity measures in Greece. Findings could contribute to a better understanding of the main factors that influence healthy eating and help develop policies to encourage healthy dietary lifestyles for the general public.
Real‐world, long‐term treatment patterns of commonly used biologics in Canadian patients with moderate‐to‐severe chronic plaque psoriasis
Authors: Gooderham Melinda J. , Lynde Charles , Turchin Irina , Avadisian Miriam , Labelle Melanie , Papp Kim A.
Published: November 2021

Real‐world and long‐term data on biologic treatment changes – including switching, discontinuation, dose escalation, and interval change (both increasing and decreasing) – are required to understand treatment patterns for psoriasis (PsO) in Canada. The study objectives were to evaluate the time to first biologic treatment change and to document these changes in Canadian patients with moderate‐to‐severe chronic plaque PsO. Charts from 13 Canadian sites were queried retrospectively (2005–2019); a period covering all biologic classes commonly used for PsO in Canada. Included were patients diagnosed with, and currently using biologics for, moderate‐to‐severe chronic plaque PsO. Time to first treatment change, nature of treatment change, number of lines of treatment, proportion of patients on each drug, and drug survival were collected. Based on 1149 medical charts, adalimumab had the longest time to first treatment change (49.3 months; 95% confidence interval, 37.4–67.4). Approximately half of the patients had a treatment change, and nearly 75% of these changes were either an interval change or a biologic switch. Lack of efficacy was the most prevalent primary reason for biologic switch (67.3%), whereas 6.7% of patients switched due to adverse events. Drug survival for etanercept and infliximab was approximately twice as long for patients who had dose optimization (i.e., dose escalation or interval change) than patients without dose optimization. The survival curve of adalimumab was similar to the one of ustekinumab after 48 months of treatment, showing approximately 60% of patients remaining on treatment after 132 months, with or without dose optimization. Assessing treatment patterns of all commonly used biologics for moderate‐to‐severe chronic plaque PsO in Canada between 2005 and 2019 showed that approximately half of the patients required a treatment change (mainly interval change or biologic switch) while the other half remained on treatment.
A soil‐nesting invasive ant disrupts carbon dynamics in saplings of a foundational ant–plant
Authors: Milligan Patrick D. , Martin Timothy A. , Pringle Elizabeth G. , Riginos Corinna , Mizell Gabriella M. , Palmer Todd M.
Published: November 2021

Nearly every terrestrial ecosystem hosts invasive ant species, and many of those ant species construct underground nests near roots and/or tend phloem‐feeding hemipterans on plants. We have a limited understanding of how these invasive ant behaviours change photosynthesis, carbohydrate availability and growth of woody plants.

We measured photosynthesis, water relations, carbohydrate concentrations and growth for screenhouse‐reared Acacia drepanolobium saplings on which we had manipulated invasive Pheidole megacephala ants and native Ceroplastes sp. hemipterans to determine whether and how soil nesting and hemipteran tending by ants affect plant carbon dynamics. In a field study, we also compared leaf counts of vertebrate herbivore‐excluded and ‐exposed saplings in invaded and non‐invaded savannas to examine how ant invasion and vertebrate herbivory are associated with differences in sapling photosynthetic crown size.

Though hemipteran infestations are often linked to declines in plant performance, our screenhouse experiment did not find an association between hemipteran presence and differences in plant physiology. However, we did find that soil nesting by P. megacephala around screenhouse plants was associated with >58% lower whole‐crown photosynthesis, >31% lower pre‐dawn leaf water potential, >29% lower sucrose concentrations in woody tissues and >29% smaller leaf areas. In the field, sapling crowns were 29% smaller in invaded savannas than in non‐invaded savannas, mimicking screenhouse results.

Synthesis. We demonstrate that soil nesting near roots, a common behaviour by Pheidole megacephala and other invasive ants, can directly reduce carbon fixation and storage of Acacia drepanolobium saplings. This mechanism is distinct from the disruption of a native ant mutualism by P. megacephala, which causes similar large declines in carbon fixation for mature A. drepanolobium trees. Acacia drepanolobium already has extremely low natural rates of recruitment from the sapling to mature stage, and we infer that these negative effects of invasion on saplings potentially curtail recruitment and reduce population growth in invaded areas. Our results suggest that direct interactions between invasive ants and plant roots in other ecosystems may strongly influence plant carbon fixation and storage.
Trust, affect, and choice in parents’ vaccination decision‐making and health‐care provider selection in Switzerland
Authors: Deml Michael J. , Buhl Andrea , Huber Benedikt M. , Burton‐Jeangros Claudine , Tarr Philip E.
Published: November 2021

This article examines the relationships between biomedicine, complementary and alternative medicine (CAM) and parents’ vaccination decision‐making in Switzerland. Our empirical evidence sheds light on an understudied phenomenon—parents switching from one doctor to another provider (often one offering CAM services) around issues that arise during vaccination consultations. This is important to understand since CAM is used by 25%–50% of the Swiss population and is integrated into the Swiss health‐care system when offered by biomedically trained medical doctors with additional CAM training. Qualitative data gathered from in‐depth semi‐structured interviews with parents (N = 30) and ethnographic observations of vaccination consultations (N = 16 biomedical consultations, N = 18 CAM consultations) demonstrate how there was not always a clear‐cut, direct relationship between (non)vaccination and parents’ use of CAM and/or biomedicine. Borrowing from Hirschman (Exit, voice, and loyalty: Responses to decline in firms, organizations, and states, Harvard Univ. Press, 1970), we frame our analysis by using the concepts of exit, voice and loyalty to describe parents’ provider selection and vaccination decision‐making process, although only four families in the sample described switching solely because of vaccination‐related issues. Findings add to vaccine decision‐making literature by describing and analysing the underdiscussed provider‐switching phenomenon and by demonstrating the importance of parents’ experiences of trust, affect and choice in vaccination consultations as they pursue the best health outcomes for their children.
Changing landscape of nursing homes serving residents with dementia and mental illnesses
Authors: Xu Huiwen , Intrator Orna , Culakova Eva , Bowblis John R.
Published: November 2021

Objective

Nursing homes (NHs) are serving an increasing proportion of residents with cognitive issues (e.g., dementia) and mental health conditions. This study aims to: (1) implement unsupervised machine learning to cluster NHs based on residents' dementia and mental health conditions; (2) examine NH staffing related to the clusters; and (3) investigate the association of staffing and NH quality (measured by the number of deficiencies and deficiency scores) in each cluster.

Data sources

2009–2017 Certification and Survey Provider Enhanced Reporting (CASPER) were merged with LTCFocUS.org data on NHs in the United States.

Study design

Unsupervised machine learning algorithm (K‐means) clustered NHs based on percent residents with dementia, depression, and serious mental illness (SMI, e.g., schizophrenia, anxiety). Panel fixed‐effects regressions on deficiency outcomes with staffing‐cluster interactions were conducted to examine the effects of staffing on deficiency outcomes in each cluster.

Data extraction methods

We identified 110,463 NH‐year observations from 14,671 unique NHs using CASPER data.

Principal findings

Three clusters were identified: low dementia and mental illnesses (Postacute Cluster); high dementia and depression, but low SMI (Long‐stay Cluster); and high dementia and mental illnesses (Cognitive‐mental Cluster). From 2009 to 2017, the number of Postacute Cluster NHs increased from 3074 to 5719, while the number of Long‐stay Cluster NHs decreased from 6745 to 3058. NHs in Long‐stay/Cognitive‐mental Clusters reported slightly lower nursing staff hours in 2017. Regressions suggested the effect of increasing staffing on reducing deficiencies is statistically similar across NH clusters. For example, 1 hour increase in registered nurse hours per resident day was associated with −0.67 (standard error [SE] = 0.11), −0.88 (SE = 0.12), and −0.97 (SE = 0.15) deficiencies in Postacute Cluster, Long‐stay Cluster, and Cognitive‐mental Cluster, respectively.

Conclusions

Unsupervised machine learning detected a changing landscape of NH serving residents with dementia and mental illnesses, which requires assuring staffing levels and trainings are suited to residents' needs.
Empirical underidentification in estimating random utility models: The role of choice sets and standardizations
Authors: Olschewski Sebastian , Sirotkin Pavel , Rieskamp Jörg
Published: November 2021

A standard approach to distinguishing people’s risk preferences is to estimate a random utility model using a power utility function to characterize the preferences and a logit function to capture choice consistency. We demonstrate that with often‐used choice situations, this model suffers from empirical underidentification, meaning that parameters cannot be estimated precisely. With simulations of estimation accuracy and Kullback–Leibler divergence measures we examined factors that potentially mitigate this problem. First, using a choice set that guarantees a switch in the utility order between two risky gambles in the range of plausible values leads to higher estimation accuracy than randomly created choice sets or the purpose‐built choice sets common in the literature. Second, parameter estimates are regularly correlated, which contributes to empirical underidentification. Examining standardizations of the utility scale, we show that they mitigate this correlation and additionally improve the estimation accuracy for choice consistency. Yet, they can have detrimental effects on the estimation accuracy of risk preference. Finally, we also show how repeated versus distinct choice sets and an increase in observations affect estimation accuracy. Together, these results should help researchers make informed design choices to estimate parameters in the random utility model more precisely.
Restrictive versus liberal transfusion in patients with diabetes undergoing cardiac surgery: An open‐label, randomized, blinded outcome evaluation trial
Authors: Mistry Nikhil , Shehata Nadine , Carmona Paula , Bolliger Daniel , Hu Raymond , Carrier François M. , Alphonsus Christella S. , Tseng Elaine E. , Royse Alistair G. , Royse Colin , Filipescu Daniela , Mehta Chirag , Saha Tarit , Villar Juan C. , Gregory Alexander J. , Wijeysundera Duminda N. , Thorpe Kevin E. , Jüni Peter , Hare Gregory M. T. , Ko Dennis T. , Verma Subodh , Mazer C. David ,   TRICS Investigators
Published: November 2021

Aim

To characterize the association between diabetes and transfusion and clinical outcomes in cardiac surgery, and to evaluate whether restrictive transfusion thresholds are harmful in these patients.

Materials and Methods

The multinational, open‐label, randomized controlled TRICS‐III trial assessed a restrictive transfusion strategy (haemoglobin [Hb] transfusion threshold <75 g/L) compared with a liberal strategy (Hb <95 g/L for operating room or intensive care unit; or <85 g/L for ward) in patients undergoing cardiac surgery on cardiopulmonary bypass with a moderate‐to‐high risk of death (EuroSCORE ≥6). Diabetes status was collected preoperatively. The primary composite outcome was all‐cause death, stroke, myocardial infarction, and new‐onset renal failure requiring dialysis at 6 months. Secondary outcomes included components of the composite outcome at 6 months, and transfusion and clinical outcomes at 28 days.

Results

Of the 5092 patients analysed, 1396 (27.4%) had diabetes (restrictive, n = 679; liberal, n = 717). Patients with diabetes had more cardiovascular disease than patients without diabetes. Neither the presence of diabetes (OR [95% CI] 1.10 [0.93‐1.31]) nor the restrictive strategy increased the risk for the primary composite outcome (diabetes OR [95% CI] 1.04 [0.68‐1.59] vs. no diabetes OR 1.02 [0.85‐1.22]; Pinteraction = .92). In patients with versus without diabetes, a restrictive transfusion strategy was more effective at reducing red blood cell transfusion (diabetes OR [95% CI] 0.28 [0.21‐0.36]; no diabetes OR [95% CI] 0.40 [0.35‐0.47]; Pinteraction = .04).

Conclusions

The presence of diabetes did not modify the effect of a restrictive transfusion strategy on the primary composite outcome, but improved its efficacy on red cell transfusion. Restrictive transfusion triggers are safe and effective in patients with diabetes undergoing cardiac surgery.
The impact of knowledge base on technological innovation of emerging industries from the perspective of related variety: A case study of China’s fuel cell industry
Authors: Mi Zefeng , Shang Yongmin , Zeng Gang
Published: November 2021

The location of emerging industries has been hotly debated in the field of economic geography. While the concept of Windows of Locational Opportunity proposes that new industries emerge with relative freedom in space, the literature on Regional Branching has been underlining the importance of existing knowledge base. The concept of related variety provides us with a new way to handle this ongoing debate. By dividing technological knowledge base of a region into related and unrelated knowledge bases, this study empirically examines the impact of knowledge base on technological innovation of emerging industries by utilizing patent data of China’s fuel cell industry from 2000 to 2016. The empirical findings clearly confirm the stable and positive impact of related technological knowledge base on the emergence and development of emerging industries. However, the direction of the impact of unrelated technological knowledge base changes from negative to positive with the maturity of the industry. To an increasing extent, emerging industries tend to be less free in space and prefer to locate in developed regions with related and unrelated knowledge.
Functional and taxonomic responses of tropical moth communities to deforestation
Authors: Correa‐Carmona Yenny , Rougerie Rodolphe , Arnal Pierre , Ballesteros‐Mejia Liliana , Beck Jan , Dolédec Sylvain , Ho Chris , Kitching Ian J. , Lavelle Patrick , Le Clec'h Solen , Lopez‐Vaamonde Carlos , Martins Marlúcia B. , Murienne Jérôme , Oszwald Johan , Ratnasingham Sujeevan , Decaëns Thibaud
Published: November 2021

Global insect decline has recently become a cause for major concern, particularly in the tropics where the vast majority of species occurs. Deforestation is suggested as being a major driver of this decline, but how anthropogenic changes in landscape structure affect tropical insect communities has rarely been addressed.

We sampled Saturniidae and Sphingidae moths on 27 farms located in Brazilian Amazonia (Pará state) and characterised by different deforestation histories. We used functional traits (forewing length, body mass, wing load, trophic niche breadth and resource use strategy), analysed by combining RLQ and null model analyses, to investigate the responses of their taxonomic and functional diversity to landscape change dynamics and current structure.

We found that communities had a higher proportion of large and polyphagous species with low wing load in landscapes with low forest quality and relative cover and high land use turnover. This was mainly due to a significant response to deforestation by saturniids, whereas the more mobile sphingids showed no significant landscape‐related pattern. We also observed an overall increase of species richness and functional dispersion in landscapes that have been deforested for a long time when compared with more recent agricultural settlements.

Our results highlight the complex way in which landscape structure and historical dynamics interact to shape Neotropical moth communities and that saturniid moths respond clearly to the structure of the surrounding landscape, confirming their potential use as an indicator group for environmental monitoring programmes.
Research gaps and new insights in the evolution of Drosophila seminal fluid proteins
Authors: Hurtado Juan , Almeida Francisca Cunha , Belliard Silvina Anahí , Revale Santiago , Hasson Esteban
Published: November 2021

While the striking effects of seminal fluid proteins (SFPs) on females are fairly conserved among Diptera, most SFPs lack detectable homologues among the SFP repertoires of phylogenetically distant species. How such a rapidly changing proteome conserves functions across taxa is a fascinating question. However, this and other pivotal aspects of SFPs' evolution remain elusive because discoveries on these proteins have been mainly restricted to the model Drosophila melanogaster. Here, we provide an overview of the current knowledge on the inter‐specific divergence of the SFP repertoire in Drosophila and compile the increasing amount of relevant genomic information from multiple species. Capitalizing on the accumulated knowledge in D. melanogaster, we present novel sets of high‐confidence SFP candidates and transcription factors presumptively involved in regulating the expression of SFPs. We also address open questions by performing comparative genomic analyses that failed to support the existence of many conserved SFPs shared by most dipterans and indicated that gene co‐option is the most frequent mechanism accounting for the origin of Drosophila SFP‐coding genes. We hope our update establishes a starting point to integrate further data and thus widen the understanding of the intricate evolution of these proteins.