bluuebunny/crossref_metadata_2025 huggingface dataset:
A warm-front triggered nocturnal tornado outbreak near Kiama, NSW, Australia
Authors: Louis Simon A.
Published: December 2020

This paper documents the case of a nocturnal outbreak of tornadoes on the New South Wales (NSW) south coast on 23 February 2013, and provides an analysis of the conditions that led to the outbreak. These tornadoes were associated with the passage of a warm front which had developed on the eastern flank of a mature extratropical cyclone.The damage from the tornadoes is discussed, and an analysis of the synoptic and mesoscale conditions that led to the event is provided. An analysis of radar at the time of the event shows a series of vortices developing within a zone of horizontal shear just prior to the tornadoes developing. The tornadoes were difficult for operational forecasters to predict, partly due to the infrequent occurrence of nocturnal tornadoes of this type in NSW, and in part due to operational demands from the broader scale severe weather event that resulted from the low-pressure system. This paper presents an analysis of the event that may assist forecasters in identifying similar events in the future.
High-resolution ensemble prediction of the Australian East Coast Low of April 2015
Authors: Zovko-Rajak Dragana , Tory Kevin J. , Fawcett Robert J. B. , Kepert Jeffrey D. , Rikus Lawrence J.
Published: December 2020

An analysis of the East Coast Low (ECL) that affected the eastern coast of Australia between 20 and 23 April 2015 is presented, to get a better understanding of the dynamics of the storm as well as its predictability. For this, an ensemble consisting of 24 high-resolution simulations conducted using the ACCESS model is used. The simulated ensemble-mean forecast rainfall is in good agreement with the observed rainfall and identifies Dungog as the area of highest risk of extreme rainfall. A subset of ensemble members shows very little rain in the Dungog area; instead the high rainfall is located further south or east, indicating that a larger part of the coast was at some risk of significant rain. Ensemble member comparisons show that the strongest surface winds and highest rainfall occur to the south of the main surface low, while the strengthening of an upper-troposphere north-westerly jet and the associated cut-off low occur west of the surface low. However, small synoptic-scale differences between members produce large differences in the location and strength of near-surface extreme winds and highest rainfall, which develop in response to the same dynamic processes in each member. The analysis also showed that the thermal advection rainfall diagnostic is applicable to high-resolution data and could be used for analysing ECL development.
Adequacy of health literacy and its effect on diabetes self-management: a meta-analysis
Authors: Guo Xiu-mei , Zhai Xia , Hou Bo-ru
Published: December 2020

This study evaluated the role of health literacy (HL) in the self-management of diabetes. A literature search was conducted in electronic databases and studies were selected using precise eligibility criteria. A meta-analysis was conducted to estimate the HL adequacy rate, factors affecting the adequacy of HL and correlations between HL and diabetes self-management variables. Thirty-three studies were included in the analysis. The HL adequacy rate was 67% (95% confidence interval (CI) 57, 76). Compared with patients with inadequate HL, patients with adequate HL were younger (mean difference –5.2 years; 95% CI −7.2, −3.2; P<0.00001), more likely to have a high school or higher level of education (odds ratio (OR) 8.39; 95% CI 5.03, 13.99]; P<0.00001) and were less likely to belong to a low-income group (OR 0.36; 95% CI 0.23, 0.56; P<0.00001). HL was positively correlated with self-monitoring (r=0.19; 95% CI 0.11, 0.27; P<0.00001), dietary and physical care (r=0.12; 95% CI 0.07, 0.18; P=0.009), diabetes knowledge (r=0.29; 95% CI 0.09, 0.45; P<0.001), self-efficacy (r=0.28; 95% CI 0.15, 0.41; P<0.00001), self-care (0.24; 95% CI 0.16, 0.31; P<0.00001), formal education (r=0.35; 95% CI 0.18, 0.53; P<0.00001) and social support (r=0.2; 95% CI 0.07, 0.33; P<0.00001). Patient age (r=−0.28; 95% CI −0.39, −0.17; P<0.00001) was inversely correlated with HL. In conclusion, 67% of diabetes patients had adequate HL, with a higher rate among better educated and higher income groups. HL had a statistically significant but weak positive correlation with diabetes self-management variables.
Knowledge and comfort related to palliative care among Indonesian primary health care providers
Authors: Hertanti Nuzul Sri , Huang Mei-Chih , Chang Chia-Ming , Fetzer Susan Jane , Kao Chi-Yin
Published: December 2020

This study investigated Indonesian primary health care providers’ knowledge and comfort towards palliative care. A descriptive cross-sectional design was used. From August 2017 to February 2018, the research team approached 70 primary care centres in the Yogyakarta province of Indonesia and invited health care providers to complete the Palliative Care Quiz for Nursing – Indonesia and describe their comfort in caring for terminally ill patients. Data were obtained from 516 health care providers. The mean (±s.d.) score of palliative care knowledge was low (7.8±3.3 of a possible score of 20). Current comfort level in providing palliative care was also low (1.6±2.7 of a possible score of 10). Only 11.3% of palliative care knowledge was explained by respondents understanding of palliative care definition, their education levels and experience in providing palliative care in hospital. However, 82.9% of provider comfort was explained by their experiences for caring for terminally ill patients in primary healthcare centres, palliative care training and years of work experience in primary healthcare centres. Indonesian evidence-based palliative care standards and guidelines must be established with education offered to all providers.
Why do people with long-term health needs see more than one GP?: a qualitative study
Authors: Cosgriff David , Reath Jenny , Abbott Penelope
Published: December 2020

This study aimed to understand what barriers exist or choices are made by patients who access regular care for long-term health issues from multiple GPs. This was a qualitative interview study in Western Sydney community settings consisting of semi-structured interviews and inductive thematic analysis. Twenty participants who accessed GP care were interviewed. Sixteen had seen multiple GPs over the previous twelve months and all had seen multiple GPs over preceding years. Participants valued interpersonal continuity of care. Nevertheless, they made decisions to meet their needs by seeing multiple GPs. They considered waiting times, preference for an individual GP based on their consultation style or perception of their particular area of expertise, experiences with reception staff and the practice model of care. Participants were aware that interpersonal continuity of care was considered important by GPs and were reticent to be seen as ‘doctor shoppers’. Therefore, they did not usually disclose that they saw multiple doctors and were unlikely to discuss continuity of care with a GP. Participants made considered choices about health care. Despite general practice promoting interpersonal continuity of care, it is not always achievable or desired by patients. GPs can promote care continuity through supportive practice models and dialogue about when continuity is desirable.
Improving quality in general practice using the Primary Care Practice Improvement Tool (PC-PIT) with Primary Health Network support
Authors: Borg Samantha J. , Donald Maria , Totsidis Koula , Quinn Narelle , Jackson Claire L.
Published: December 2020

Optimal primary care sector performance is vital for ensuring the delivery of quality health services and effective clinical management of populations. The Primary Care Practice Improvement Tool (PC-PIT) incorporates subjective staff input and objective indicators to measure 13 elements of organisational performance. This study aimed to measure change in organisational performance for general practices using the PC-PIT with Primary Health Network (PHN) support. A pre-post design was used for changes in PC-PIT subjective and objective scores. Practices used results with PHN support to complete two Plan Do Study Act initiatives and were reassessed 9-months later. PC-PIT scales were dichotomised into lower and higher scores, with odds ratios used to determine effect size. Staff survey response rates were 55.4% at baseline and 50.1% at follow up. There were modest increases in the likelihood of staff rating several elements higher at follow up. When implemented with PHN support staff, the PC-PIT has the potential for effective, focussed and sustained quality improvement, with capacity to support Health Care Home model transition and implementation.
PPP in action
Authors: Bui Trang Le Diem , Newton Jonathan
Published: December 2020

The presentation-practice-production (PPP) approach is used in primary schools in Vietnam to teach speaking skills. However, there is disagreement about the theoretical validity and practical efficacy of PPP (Ellis, 2018;Willis & Willis, 2007) and little research evidence for how teachers actually implement PPP and their views of this approach. The current study addresses this gap. Seven teachers from six primary schools in Vietnam were observed teaching 11 PPP speaking lessons and were then interviewed on their experience of teaching the lessons. Analysis of the observation data showed that all seven teachers followed all three phases of the PPP sequence in their lessons. However, they frequently added interactive activities to the presentation phase and adapted production activities to make them more communicative. The teachers held mixed views of PPP: Three spoke positively of its value for lower level classes, another teacher was somewhat neutral while the remaining three teachers were dismissive of it and actively sought to adopt a more communicative approach. Overall, findings from the study reveal limitations of the PPP approach as it is practiced in this context and highlight affordances for making PPP more communicative, including drawing on principles of effective task design.
A typological perspective on the loss of inflection
Authors: Sims-Williams Helen , Baerman Matthew
Published: December 2020

The loss of inflectional morphology is a diachronic process which has played a major role in shaping our linguistic landscape, but has never been the target of focussed research in the same way that the origin of inflectional morphology has been. We offer here a preliminary typology of the operations involved in inflectional loss, distinguishing three change types: the loss of forms, the loss of features, and loss of both at the same time – that is, the loss of entire paradigm cells. These are illustrated with examples from a typologically, genetically and areally diverse set of languages.
The impersonal construction in the texts of Updated Old English
Authors: Čermák Jan
Published: December 2020

The main focus of this study is the so-adj-a construction seen as an instantiation of grammatical obsolescence in progress. Starting at where Klégr’s (2010) synchronic study of the construction’s local grammar and syntactic functions leaves it, the present work provides a diachronic account of changes in the frequency of use in the last two centuries; their implications; and an overview of possible causes that had led to the situation in which the construction became considerably rare in Present Day English. Methodologically, the paper features quantitative and statistical analyses of corpus data. The work uses the framework for the investigation of grammatical obsolescence designed in the author’s doctoral thesis (Rudnicka 2019). Additionally, the present chapter suggests extravagance as a cognitive motivation behind the emergence of the so-adj-a construction.
Loss or variation? Functional load in morpho-syntax – Three case studies
Authors: Rehn Alexandra
Published: December 2020

In order to get a better understanding of the circumstances under which elements can get lost in the course of their diachronic development, three phenomena of German non-standard varieties will be compared: loss of adnominal genitive, optional realization of adjectival inflection and variation in the choice of relative clause introducers. It will be shown that on the one hand, a substitutional strategy to compensate for the function of the element that undergoes loss is required but that this alone does not necessarily lead to loss. Depending on the functional load of the individual items and the options the syntax provides the availability of a substitutional strategy may result in loss, optionality or variation.
“The next Morning I got a Warrant for the Man and his Wife, but he was fled”
Authors: Hundt Marianne
Published: December 2020

This chapter uses data from the Old Bailey Corpus to study the demise of the English BE-perfect between the 1720s and 1910s. The corpus provides ample evidence on the development in the period that saw the transition from BE to HAVE as perfect auxiliary in constructions with mutative verbs (i.e. intransitive verbs referring to a change of state or place); it also makes it possible to gauge the relative importance that social factors (such as speaker SEX, speaker ROLE or socio-economic background) may have played in the loss of one of the perfect variants. The stages for the development are derived from the data in a bottom-up approach using Variability-based Neighbour Clustering (VNC). In a second step, random forests and conditional inference trees are fitted to the data for each stage. The former provide information on the overall relative importance of predictor variables and the latter on interaction of predictor variables. It turns out that while, overall, social predictors play a far less important role in the process of loss than the predictor lexical VERB, they do show significant interaction with this language-internal variable. The speech-based socio-historical data thus add important details to previous studies on the loss of the BE-perfect, not least by lending support to the fact that this change happened largely below the level of speakers’ awareness.
German so-relatives
Authors: Kempf Luise
Published: December 2020

The paper presents a corpus-based analysis of the loss of the relativizer so in New High German. The corpus data show that the frequencies dropped in the 18th century, with significant differences among regions and genres. The distributions underpin a relation to chancery language (as assumed in the literature), but the particle was also used in all other domains when sophisticated style was aimed at. Since the demise of chancery language does not fully account for the disappearance of so relatives, a broader socio-historical background and general language change of the time needs to be taken into account. Large-scale developments, such as increasing literacy and the Enlightenment, are shown to have induced fundamental language changes. Overall, written German underwent a typological drift to overt, morphosyntax-based complexity. This is evidenced by a number of general grammatical developments. Specifically, the increase of nominal concord conflicted with so relativizers, as they were uninflected. Overall, aggregative and indistinct structures were given up in favor of more integrative and precise constructions. The study reveals the fundamental importance of considering the entire language system and general socio-cultural and socio-linguistic changes in the study of grammatical obsolescence.
Loss of object indexation in verbal paradigms of Koĩc (Tibeto-Burman, Nepal)
Authors: Borchers Dörte
Published: December 2020

Koĩc ([kɔĩts]; English: Sunwar) is a Kiranti language spoken in eastern Nepal. In the past, Koĩc had a biactantial indexing system with transitive verbs indexing subjects and objects, a typical feature of Kiranti languages.1 In modern Koĩc, transitive verbs are not indexed for object. A comparison shows connections in form and function between old and new argument indexes. Now Koĩc has a system of different conjugations, and for the majority of verbs membership in a conjugation is lexically fixed.

Most speakers of Koĩc are bilingual with Nepali (Indo-Iranian), and the longstanding Nepali influence will be discussed as one possible cause of language change.
COVID-19 stokes inflammasomes
Authors: Bryant Clare
Published: December 2020

The poor success rate of treating patients with aggressive sepsis in SARS-CoV-2 infections has highlighted again the challenges of managing systemic inflammatory conditions. In this issue of JEM, Rodrigues et al. (https://doi.org/10.1084/jem.20201707) discuss the role of inflammasome activation in COVID-19 disease severity, opening new possibilities for therapeutic management of sepsis syndromes.
Carrier density oscillation in the photoexcited semiconductor
Authors: Najafi Ebrahim , Jafari Amir , Liao Bolin
Published: December 2020

The perturbation of a semiconductor from the thermodynamic equilibrium often leads to the display of non-linear dynamics and formation of spatiotemporal patterns due to the spontaneous generation of competing processes. Here, we use scanning ultrafast electron microscopy to show that the transport of hot carriers in the strongly excited semiconductor slows down by turning into an oscillatory process; this is evidenced by the expansions and contractions in the second moment of the distribution. We attribute such a response to the electric field generated by the spatial separation of photo-excited electrons and holes under intrinsic and photo-induced fields; we then introduce a transport model that mimics the experimental observation. Our finding provides a direct imaging evidence for the electrostatic oscillation of hot carriers in the highly excited semiconductor and offers new insights into their dynamics in space and time.
Piezoelectric potential enhanced photocatalytic performance based on ZnO with different nanostructures
Authors: Yu Cheng , Yu Xiang-Xiang , Zheng Ding-Shan , Yin Hong
Published: December 2020

In this paper, two novel nanostructures with ZnO nanowire and nanosheet arrays vertically growing on the FTO and Al foil have been synthesized by a hydrothermal method, which exhibit both the piezoelectric and photocatalytic properties. These nanostructures have typical wurtzite structures based on the XRD results. From the SEM results, the average diameter and length of nanowire have been measured to be about 150 nm and 4.5 μm, the thickness of ZnO nanosheet is about 50 nm and the width is about 5 μm. In the photocatalytic test, the photodegradation of RhB under 365 nm illumination for nanowire and nanosheet is about 25% and 37% in 80 min reaction. With stirring, the degradation rate is increased to 61% and 85%. Finally, the photocurrent test and finite element method were used to analyze the piezo-photodegradation mechanism.
How to switch between relational quantum clocks
Authors: Höhn Philipp A , Vanrietvelde Augustin
Published: December 2020

Every clock is a physical system and thereby ultimately quantum. A naturally arising question is thus how to describe time evolution relative to quantum clocks and, specifically, how the dynamics relative to different quantum clocks are related. This is a particularly pressing issue in view of the multiple choice facet of the problem of time in quantum gravity, which posits that there is no distinguished choice of internal clock in generic general relativistic systems and that different choices lead to inequivalent quantum theories. Exploiting a recent unifying approach to switching quantum reference systems [Vanrietvelde et al 2020 Quantum
4 225; Vanrietvelde et al 2018 arXiv:1809.05093[quant-ph])], we exhibit a systematic method for switching between different clock choices in the quantum theory. We illustrate it by means of the parametrized particle, which, like gravity, features a Hamiltonian constraint. We explicitly switch between the quantum evolution relative to the non-relativistic time variable and that relative to the particle’s position, which requires carefully regularizing the zero-modes in the so-called time-of-arrival observable. While this toy model is simple, our approach is general and, in particular, directly amenable to quantum cosmology. It proceeds by systematically linking the reduced quantum theories relative to different clock choices via the clock-choice-neutral Dirac quantized theory, in analogy to coordinate changes on a manifold. This method suggests a new perspective on the multiple choice problem, indicating that it is rather a multiple choice feature of the complete relational quantum theory, taken as the conjunction of Dirac quantized and quantum deparametrized theories. Precisely this conjunction permits one to consistently switch between different temporal reference systems, which is a prerequisite for a quantum notion of general covariance. Finally, we show that quantum uncertainties generically lead to a discontinuity in the relational dynamics when switching clocks, in contrast to the classical case.
Numerical study of radiative impacts on a magneto-convective flow confined an inclined two-sided wavy enclosure using hybrid nanofluid
Authors: Rashed Z Z , Mansour M A , Attia M A , Ahmed Sameh E
Published: December 2020

Numerical simulations are carried out for a buoyancy-driven flow of hybrid nanofluids within an inclined two-sided wavy enclosure. The vertical wavy walls are mentioned to a relatively low temperature while two heated sections are placed in the top and bottom walls. An inclined electromagnetic force is considered together with impacts of the thermal radiation in the vertical direction. Method of the solution is consisting of two steps, namely, the first step is mapping the irregular domain to regular computational domain and the second step is discretization the resulting domain equations using the finite difference method. It is focused on influences of the radiation, magnetic field, undulation number, lengths and locations of the active sections. The main outcomes disclosed that an alteration in the radiation parameter enhances the rate of the heat transfer while various configurations of the hybrid nanofluid flow are obtained as the undulation number and the cavity inclination angle are varied.
Magnetic properties and critical behavior of magnetically intercalated WSe2: a theoretical study
Authors: Reyntjens Peter D , Tiwari Sabyasachi , Van de Put Maarten L , Sorée Bart , Vandenberghe William G
Published: December 2020

Transition metal dichalcogenides, intercalated with transition metals, are studied for their potential applications as dilute magnetic semiconductors. We investigate the magnetic properties of WSe2 doped with third-row transition metals (Co, Cr, Fe, Mn, Ti and V). Using density functional theory in combination with Monte Carlo simulations, we obtain an estimate of the Curie or Néel temperature. We find that the magnetic ordering is highly dependent on the dopant type. While Ti and Cr-doped WSe2 have a ferromagnetic ground state, V, Mn, Fe and Co-doped WSe2 are antiferromagnetic in their ground state. For Fe doped WSe2, we find a high Curie-temperature of 327 K. In the case of V-doped WSe2, we find that there are two distinct magnetic phase transitions, originating from a frustrated in-plane antiferromagnetic exchange interaction and a ferromagnetic out-of-plane interaction. We calculate the formation energy and reveal that, in contrast to earlier reports, the formation energy is positive for the intercalated systems studied here. We also show that in the presence of W-vacancies, it becomes favorable for Ti, Fe, and Co to intercalate in WSe2.
Assessment of the impact of an opioid-specific education series on rates of medication-assisted treatment for opioid use disorder in veterans
Authors: Kirby Taylor , Connell Robert , Linneman Travis
Published: December 2020

Purpose

The impact of a focused inpatient educational intervention on rates of medication-assisted therapy (MAT) for veterans with opioid use disorder (OUD) was evaluated.

Methods

A retrospective cohort analysis compared rates of MAT, along with rates of OUD-related emergency department (ED) visits and/or hospital admission within 1 year, between veterans with a diagnosis of OUD who completed inpatient rehabilitation prior to implementation of a series of group sessions designed to engage intrinsic motivation to change behavior surrounding opioid abuse and provide education about MAT (the control group) and those who completed rehabilitation after implementation of the education program (the intervention group). A post hoc, multivariate analysis was performed to evaluate possible predictors of MAT use and ED and/or hospital readmission, including completion of the opioid series, gender, age (>45 years), race, and specific prior substance(s) of abuse.

Results

One hundred fifty-eight patients were included: 95 in the control group and 63 in the intervention group. Rates of MAT were 25% (24 of 95 veterans) and 75% (47 of 63 veterans) in control and intervention groups, respectively (P < 0.01). Gender, completion of the opioid series, prior heroin use, and marijuana use met prespecified significance criteria for inclusion in multivariate regression modeling of association with MAT utilization, with participation in the opioid series (odds ratio [OR], 9.56; 95% confidence interval [CI], 4.36-20.96) and prior heroin use (OR, 3.26; 95% CI, 1.18-9.01) found to be significant predictors of MAT utilization on multivariate analysis. Opioid series participation and MAT use were independently associated with decreased rates of OUD-related ED visits and/or hospital admission (hazard ratios of 0.16 [95% CI, 0.06-0.44] and 0.32 [95% CI, 0.14-0.77], respectively) within 1 year after rehabilitation completion.

Conclusion

Focused OUD-related education in a substance abuse program for veterans with OUD increased rates of MAT and was associated with a decrease in OUD-related ED visits and/or hospital admission within 1 year.
Genetic insights into the globally invasive and taxonomically problematic tree genusProsopis
Authors: Castillo María L , Schaffner Urs , van Wilgen Brian W , Montaño Noé Manuel , Bustamante Ramiro O , Cosacov Andrea , Mathese Megan J , Le Roux Johannes J
Published: December 2020

Accurate taxonomic identification of alien species is crucial to detect new incursions, prevent or reduce the arrival of new invaders and implement management options such as biological control. Globally, the taxonomy of non-native Prosopis species is problematic due to misidentification and extensive hybridization. We performed a genetic analysis on several Prosopis species, and their putative hybrids, including both native and non-native populations, with a special focus on Prosopis invasions in Eastern Africa (Ethiopia, Kenya and Tanzania). We aimed to clarify the taxonomic placement of non-native populations and to infer the introduction histories of Prosopis in Eastern Africa. DNA sequencing data from nuclear and chloroplast markers showed high homology (almost 100 %) between most species analysed. Analyses based on seven nuclear microsatellites confirmed weak population genetic structure among Prosopis species. Hybrids and polyploid individuals were recorded in both native and non-native populations. Invasive genotypes of Prosopis juliflora in Kenya and Ethiopia could have a similar native Mexican origin, while Tanzanian genotypes likely are from a different source. Native Peruvian Prosopis pallida genotypes showed high similarity with non-invasive genotypes from Kenya. Levels of introduced genetic diversity, relative to native populations, suggest that multiple introductions of P. juliflora and P. pallida occurred in Eastern Africa. Polyploidy may explain the successful invasion of P. juliflora in Eastern Africa. The polyploid P. juliflora was highly differentiated from the rest of the (diploid) species within the genus. The lack of genetic differentiation between most diploid species in their native ranges supports the notion that hybridization between allopatric species may occur frequently when they are co-introduced into non-native areas. For regulatory purposes, we propose to treat diploid Prosopis taxa from the Americas as a single taxonomic unit in non-native ranges.
Optimizing Screening for Anorectal, Pharyngeal, and Urogenital Chlamydia trachomatis and Neisseria gonorrhoeae Infections in At-Risk Adolescents and Young Adults in New Orleans, Louisiana and Los Angeles, California, United States
Authors: Man Olivia M , Ramos Wilson E , Vavala Gabriella , Goldbeck Cameron , Ocasio Manuel A , Fournier Jasmine , Romero-Espinoza Adriana , Fernandez M Isabel , Swendeman Dallas , Lee Sung-Jae , Comulada Scott , Rotheram-Borus Mary Jane , Klausner Jeffrey D
Published: December 2020

Background

Public health organizations have inconsistent recommendations for screening adolescents and young adults for Chlamydia trachomatis and Neisseria gonorrhoeae infections. Guidelines suggest different combinations of anorectal, pharyngeal, and urogenital testing based on age, sex, and sexual activity. Further evaluation of how identity and behaviors impact the anatomic distribution of C. trachomatis and N. gonorrhoeae infection is needed to optimize future screening practices.

Methods

We assessed the positivity of C. trachomatis and N. gonorrhoeae infections at different anatomic sites in a cohort of at-risk sexually active adolescents and young adults aged 12–24 years in New Orleans, Louisiana and Los Angeles, California. Participants were tested for C. trachomatis and N. gonorrhoeae at 3 sites (anorectum, pharynx, and urethral/cervix) every 4 months using self-collected swabs. We stratified anatomic distributions of infection into 4 gender and sexual behavior categories: (1) cisgender men who have sex with men and transgender women (MSMTW); (2) cisgender heterosexual males; (3) cisgender heterosexual females; and (4) gender minorities assigned female at birth.

Results

While three-site testing detected all infections, two-site (anorectum and urethra/cervix) testing identified 92%–100% of C. trachomatis or N. gonorrhoeae infections in participants assigned female at birth and cisgender heterosexual males. For MSMTW, two-site anorectal and pharyngeal testing vs single-site anorectal testing increased the proportion of individuals with either infection from 74% to 93%.

Conclusions

Sexual behavior and gender identity may influence detection of C. trachomatis and N. gonorrhoeae infections at specific anatomic testing sites. Testing guidelines should incorporate sexual behavior and gender identity.

Clinical Trials Registration

NCT03134833.
Civic Learning and Self-Determination: A Model of User-Generated Content and Civic Readiness Among Actualizing Citizens
Authors: Gotlieb Melissa R , Sarge Melanie A
Published: December 2020

Participation in user-generated content (UGC) consistently relates to participation in various forms of online and offline politics, suggesting that it is likely to complement or even serve as a gateway to instrumental engagement. Yet, there has been little attempt to offer a comprehensive account of the mechanisms that explain these relationships. We address this gap in the literature by theorizing how participation in UGC contributes to civic readiness. Specifically, we advance a conceptual model relating the attributes of UGC involvement to civic readiness through two concurrent processes: a civic learning process that relates the attributes to civic ability and a self-determination process that relates them to civic motivation. In doing so, we suggest that in addition to the development of civic skills, participation in UGC also contributes to civic readiness by promoting the perception that such participation is self-determined. The result is the development of competent and engaged citizens.
Differential susceptibility to endocrine disruptor-induced epimutagenesis
Authors: Lehle Jake D , McCarrey John R
Published: December 2020

There is now considerable evidence indicating the potential for endocrine disrupting chemicals to alter the epigenome and for subsets of these epigenomic changes or “epimutations” to be heritably transmitted to offspring in subsequent generations. While there have been many studies indicating how exposure to endocrine disrupting chemicals can disrupt various organs associated with the body’s endocrine systems, there is relatively limited information regarding the relative susceptibility of different specific organs, tissues, or cell types to endocrine disrupting chemical-induced epimutagenesis. Here we review available information about different organs, tissues, cell types, and/or cell lines which have been shown to be susceptible to specific endocrine disrupting chemical-induced epimutations. In addition, we discuss possible mechanisms that may be involved, or impacted by this tissue- or cell type-specific, differential susceptibility to different endocrine disrupting chemicals. Finally, we summarize available information indicating that certain periods of development display elevated susceptibility to endocrine disrupting chemical exposure and we describe how this may affect the extent to which germline epimutations can be transmitted inter- or transgenerationally. We conclude that cell type-specific differential susceptibility to endocrine disrupting chemical-induced epimutagenesis is likely to directly impact the extent to, or manner in, which endocrine disrupting chemical exposure initially induces epigenetic changes to DNA methylation and/or histone modifications, and how these endocrine disrupting chemical-induced epimutations can then subsequently impact gene expression, potentially leading to the development of heritable disease states.
Metabolic diseases affect male reproduction and induce signatures in gametes that may compromise the offspring health
Authors: Pereira Sara C , Crisóstomo Luís , Sousa Mário , Oliveira Pedro F , Alves Marco G
Published: December 2020

The most prevalent diseases worldwide are non-communicable such as obesity and type 2 diabetes. Noteworthy, the prevalence of obesity and type 2 diabetes is expected to steadily increase in the next decades, mostly fueled by bad feeding habits, stress, and sedentarism. The reproductive function of individuals is severely affected by abnormal metabolic environments, both at mechanical and biochemical levels. Along with mechanical dysfunctions, and decreased sperm quality (promoted both directly and indirectly by metabolic abnormalities), several studies have already reported the potentially harmful effects of metabolic disorders in the genetic and epigenetic cargo of spermatozoa, and the epigenetic inheritance of molecular signatures induced by metabolic profile (paternal diet, obesity, and diabetes). The inheritance of epigenetic factors towards the development of metabolic abnormalities means that more people in reproductive age can potentially suffer from these disorders and for longer periods. In its turn, these individuals can also transmit this (epi)genetic information to future generations, creating a vicious cycle. In this review, we collect the reported harmful effects related to acquired metabolic disorders and diet in sperm parameters and male reproductive potential. Besides, we will discuss the novel findings regarding paternal epigenetic inheritance, particularly the ones induced by paternal diet rich in fats, obesity, and type 2 diabetes. We analyze the data attained with in vitro and animal models as well as in long-term transgenerational population studies. Although the findings on this topic are very recent, epigenetic inheritance of metabolic disease has a huge societal impact, which may be crucial to tackle the ‘fat epidemic’ efficiently.
Primary cardiac sarcoma: a case report of a therapeutic challenge
Authors: Andrei Valentina , Scheggi Valentina , Stefàno Pier Luigi , Marchionni Niccolò
Published: December 2020

Background

Primary cardiac sarcomas are very rare and the prognosis is poor both because the diagnosis is typically made at an advanced stage of the disease and because data are insufficient to identify a standard treatment. Surgical resection is the cornerstone of therapy with the need to develop new therapeutic strategies.

Case summary

We present a case of a young man admitted to the emergency department due to worsening dyspnoea. A left-sided sarcoma was diagnosed and treated with surgery, chemo- and radiation therapy, and subsequently with heart transplant for local recurrence of the disease. Endomyocardial biopsy made during the routine follow-up period was complicated by pericardial tamponade and cardiogenic shock and the patient was managed with veno-arterial extracorporeal membrane oxygenation, until recovery of left ventricular function (left ventricular ejection fraction of 55%). After 1 year a kidney transplant was performed. After 42 months from diagnosis, the patient is in good general condition.

Discussion

Primary cardiac sarcomas are treated with surgery to reach R0 (free resection margins) and with chemo- and radiation therapy with adjuvant purposes. Auto-transplantation is also performed, while conventional heart transplant must be customized on an individual basis, after excluding metastases. A multidisciplinary assessment should be performed and the single patient treated with a personalized approach, in relation to his performance status, location of the mass, and stage of the disease.
Evaluation of two thioesterases from Marinobacter aquaeolei VT8: relationship to wax ester production
Authors: Lijewski Amelia M , Knutson Carolann M , Lenneman Eric M , Barney Brett M
Published: December 2020

The biosynthesis of lipid-based biofuels is an important aspect of developing sustainable alternatives to conventional oils derived from fossil fuel reserves. Many biosynthetic approaches to biodiesel fuels and oils involve fatty acid derivatives as a precursor, and thioesterases have been employed in various strategies to increase fatty acid pools. Thioesterases liberate fatty acids from fatty acyl-coenzyme A or fatty acyl-acyl carrier protein substrates. The role played by thioesterases has not been extensively studied in model bacteria that accumulate elevated levels of biological oils based on fatty acid precursors. In this report, two primary thioesterases from the wax ester accumulating bacterium Marinobacter aquaeolei VT8 were heterologously expressed, isolated and characterized. These genes were further analyzed at the transcriptional level in the native bacterium during wax ester accumulation, and their genes were disrupted to determine the effect these changes had on wax ester levels. Combined, these results indicate that these two thioesterases do not play an integral role in wax ester accumulation in this natural lipid-accumulating model bacterium.
Equity and economic evaluation of system-level health interventions: A case study of Brazil's Family Health Program
Authors: Love-Koh James , Mirelman Andrew , Suhrcke Marc
Published: December 2020

Distributional economic evaluation estimates the value for money of health interventions in terms of population health and health equity impacts. When applied to interventions delivered at the population and health system-level interventions (PSIs) instead of clinical interventions, additional practical and methodological challenges arise. Using the example of the Programme Saúde da Familia (PSF) in Brazil, a community-level primary care system intervention, we seek to illustrate these challenges and provide potential solutions. We use a distributional cost-effectiveness analysis (DCEA) approach to evaluate the impact of the PSF on population health and between-state health inequalities in Brazil. Data on baseline health status, disease prevalence and PSF effectiveness are extracted from the literature and incorporated into a Markov model to estimate the long-term impacts in terms of disability-adjusted life years. The inequality and average health impacts are analysed simultaneously using health-related social welfare functions. Uncertainty is computed using Monte Carlo simulation. The DCEA encountered several challenges in the context of PSIs. Non-randomized, quasi-experimental methods may not be powered to identify treatment effect heterogeneity estimates to inform a decision model. PSIs are more likely to be funded from multiple public sector budgets, complicating the calculation of health opportunity costs. We estimate a cost-per-disability-adjusted life years of funding the PSF of $2640. Net benefits were positive across the likely range of intervention cost. Social welfare analysis indicates that, compared to gains in average health, changes in health inequalities accounted for a small proportion of the total welfare improvement, even at high levels of social inequality aversion. Evidence on the population health and health equity impacts of PSIs can be incorporated into economic evaluation methods, although with additional complexity and assumptions. The case study results indicate that the PSF is likely to be cost-effective but that the inequality impacts are small and highly uncertain.
Reflection on modern methods: good practices for applied statistical learning in epidemiology
Authors: Nunez Yanelli , Gibson Elizabeth A , Tanner Eva M , Gennings Chris , Coull Brent A , Goldsmith Jeff , Kioumourtzoglou Marianthi-Anna
Published: December 2020

Statistical learning includes methods that extract knowledge from complex data. Statistical learning methods beyond generalized linear models, such as shrinkage methods or kernel smoothing methods, are being increasingly implemented in public health research and epidemiology because they can perform better in instances with complex or high-dimensional data—settings in which traditional statistical methods fail. These novel methods, however, often include random sampling which may induce variability in results. Best practices in data science can help to ensure robustness. As a case study, we included four statistical learning models that have been applied previously to analyze the relationship between environmental mixtures and health outcomes. We ran each model across 100 initializing values for random number generation, or ‘seeds’, and assessed variability in resulting estimation and inference. All methods exhibited some seed-dependent variability in results. The degree of variability differed across methods and exposure of interest. Any statistical learning method reliant on a random seed will exhibit some degree of seed sensitivity. We recommend that researchers repeat their analysis with various seeds as a sensitivity analysis when implementing these methods to enhance interpretability and robustness of results.
Protracted Abstinence From Extended Cocaine Self-Administration Is Associated With Hypodopaminergic Activity in the VTA but Not in the SNc
Authors: Salin Adélie , Lardeux Virginie , Solinas Marcello , Belujon Pauline
Published: December 2020

The chronic relapsing nature of cocaine addiction suggests that chronic cocaine exposure produces persistent neuroadaptations that may be temporally and regionally dynamic in brain areas such as the dopaminergic (DA) system. We have previously shown altered metabolism of DA-target structures, the ventral and dorsal striatum, between early and late abstinence. However, specific changes within the midbrain DA system were not investigated. Here, we investigated potential time- and region-specific changes of activity in the ventral tegmental area (VTA) and the substantia nigra pars compacta (SNc) in rats that had extended or limited access to cocaine and later underwent a period of abstinence. We found that DA activity is decreased only in the VTA in rats with extended access to cocaine, with no changes in SNc DA activity. These changes in VTA DA activity may participate in the negative emotional state and the incubation of drug seeking that occur during abstinence from cocaine.
Perceptions of Adequacy of Breast Imaging Training in the United States among Breast Radiologists
Authors: Fragomeni Roberto A Salas , Ambinder Emily B , Myers Kelly , Sohn Young-Jin , Miles Randy , Oluyemi Eniola
Published: December 2020

Objective

To evaluate the perceptions of breast imaging training in the United States among practicing breast radiologists.

Methods

An anonymous electronic survey was sent to physician members of the Society of Breast Imaging. Study participants were queried about why they practice breast imaging, what percentage of their clinical practice consists of breast imaging, details about their breast imaging training, and how well their training prepared them for their breast imaging practice. Results were stratified by whether respondents completed a breast imaging fellowship and length of time practicing breast imaging. Results were compared using the Chi-squared test or Fisher’s exact test.

Results

We received 271 completed survey responses. Of the survey respondents, 52.4% (141/269) were employed in private practice, 24.2% (65/269) in academic practice, and 23.4% (63/269) in a mixed/hybrid practice. Overall, 46.6% (125/268) of respondents reported practicing a greater proportion of breast imaging than anticipated during training and 18.7% (50/268) had not anticipated that their future practice would include breast imaging at all. The 62.3% (167/268) of survey respondents who had completed a breast or women’s imaging fellowship were significantly more likely to report sufficient training in screening mammography, diagnostic mammography, breast procedures, and MRI interpretation.

Conclusion

Our study highlights perceived areas of insufficiency in breast imaging training. These were most notable among those who did not complete a breast imaging fellowship. These insufficiencies may be considered when updating the next version of the residency training curriculum.
Beliefs about Whether Spending Implies Wealth
Authors: Kappes Heather Barry , Gladstone Joe J , Hershfield Hal E
Published: December 2020

Spending is influenced by many factors. One that has received little attention is the meaning that people give to the act of spending. Spending money might imply that someone is relatively wealthy—since they have money to spend—or relatively poor—since spending can deplete assets. We show that people differ in the extent to which they believe that spending implies wealth (SIW beliefs). We develop a scale to measure these beliefs and find that people who more strongly believe that SIW spend their own money relatively lavishly and are, on average, more financially vulnerable. We find correlational evidence for these relationships using objective financial-transaction data, including over 2 million transaction records from the bank accounts of over 2,000 users of a money management app, as well as self-reported financial well-being. We also find experimental evidence by manipulating SIW beliefs and observing causal effects on spending intentions. These results show how underlying beliefs about the link between spending and wealth play a role in consumption decisions, and point to beliefs about the meaning of spending as a fruitful direction for further research.