bluuebunny/crossref_metadata_2025 huggingface dataset:
Cover your assets: non-performing loans and coverage ratios in Europe
Authors: Alessi Lucia , Bruno Brunella , Carletti Elena , Neugebauer Katja , Wolfskeil Isabella
Published: July 2021

We analyse the determinants of coverage ratios and their components [non-performing loans (NPLs) and loss loan reserves] in a large sample of European banks. We find that bank-specific factors, particularly credit risk variables (including forward-looking indicators) and capitalization, matter the most. Coverage ratios adjust insufficiently as asset quality deteriorates, except in high-NPL banks. Capitalization has a positive effect on coverage ratio, pointing to a complementarity between the two buffers. At the country level, specific macroprudential levers and developing NPL secondary markets enhance coverage ratios. Our findings emphasize the importance of micro oversight and call for more stringent macro policies in high-NPL countries.
Cost-effectiveness and return on investment of school-based health promotion programmes for chronic disease prevention
Authors: Ekwaru John P , Ohinmaa Arto , Dabravolskaj Julia , Maximova Katerina , Veugelers Paul J
Published: July 2021

Background

While school-based health prevention programmes are effective in addressing unhealthy diet and physical inactivity, little is known about their economic implications. We conducted an economic evaluation of the programmes that were previously identified as feasible, acceptable, and sustainable in the Canadian context.

Methods

This study builds on a meta-analysis of the effectiveness of feasible, acceptable, and sustainable school-based health promotion programmes. A micro-simulation model incorporated intervention effects on multiple risk factors to estimate incremental cost-effectiveness and return on investment (ROI) of comprehensive school health (CSH), multicomponent, and physical education (PE) curriculum modification programmes. Cost-effectiveness was expressed as the programme costs below which the programme would be cost-effective at a CA$50 000 threshold level.

Results

The estimated costs below which interventions were cost-effective per quality-adjusted life year gained were CA$682, CA$444, and CA$416 per student for CSH, multicomponent, and PE curriculum modification programmes, respectively. CSH programmes remained cost-effective per year of chronic disease prevented for costs of up to CA$3384 per student, compared to CA$1911 and CA$1987 for multicomponent and PE curriculum modification interventions, respectively. If the interventions were implemented at total discounted intervention costs of CA$100 per student, ROI through the avoidance of direct healthcare costs related to the treatment and management of chronic diseases would be 824% for CSH, 465% for multicomponent interventions, and 484% for PE curriculum modification interventions.

Conclusions

Whereas each examined intervention types showed favourable economic benefits, CSH programmes appeared to be the most cost-effective and to have the highest ROI.
The interactions of bacteriophage Ace and Shiga toxin-producingEscherichia coliduring biocontrol
Authors: Pinto Graça , Minnich Scott A , Hovde Carolyn J , Oliveira Hugo , Smidt Hauke , Almeida Carina , Azeredo Joana
Published: July 2021

Strictly lytic phages are considered powerful tools for biocontrol of foodborne pathogens. Safety issues needed to be addressed for the biocontrol of Shiga toxin-producing Escherichia coli (STEC) include: lysogenic conversion, Shiga toxin production through phage induction, and emergence/proliferation of bacteriophage insensitive mutants (BIMs). To address these issues, two new lytic phages, vB_EcoS_Ace (Ace) and vB_EcoM_Shy (Shy), were isolated and characterized for life cycle, genome sequence and annotation, pH stability and efficacy at controlling STEC growth. Ace was efficient in controlling host planktonic cells and did not stimulate the production of the Stx prophage or Shiga toxin. A single dose of phage did not lead to the selection of BIMs. However, when reintroduced, BIMs were detected after 24 h of incubation. The gain of resistance was associated with lower virulence, as a subset of BIMs failed to agglutinate with O157-specific antibody and were more sensitive to human serum complement. BIM's biofilm formation capacity and susceptibility to disinfectants was equal to that of the wild-type strain. Overall, this work demonstrated that phage Ace is a safe biocontrol agent against STEC contamination and that the burden of BIM emergence did not represent a greater risk in environmental persistence and human pathogenicity.
A candidate chromosome inversion in Arctic charr (Salvelinus alpinus) identified by population genetic analysis techniques
Authors: Hale Matthew C , Campbell Matthew A , McKinney Garrett J
Published: July 2021

The “genomics era” has allowed questions to be asked about genome organization and genome architecture of non-model species at a rate not previously seen. Analyses of these genome-wide datasets have documented many examples of novel structural variants (SVs) such as chromosomal inversions, copy number variants, and chromosomal translocations, many of which have been linked to adaptation. The salmonids are a taxonomic group with abundant genome-wide datasets due to their importance in aquaculture and fisheries. However, the number of documented SVs in salmonids is surprisingly low and is most likely due to removing loci in high linkage disequilibrium when analyzing structure and gene flow. Here we re-analyze RAD-seq data from several populations of Arctic charr (Salvelinus alpinus) and document a novel ∼1.2 MB SV at the distal end of LG12. This variant contains 15 protein-coding genes connected to a wide-range of functions including cell adhesion and signal transduction. Interestingly, we studied the frequency of this polymorphism in four disjointed populations of charr—one each from Nunavut, Newfoundland, Eastern Russia, and Scotland—and found evidence of the variant only in Nunavut, Canada, suggesting the polymorphism is novel and recently evolved.
Role-Based Framing of Older Adults Linked to Decreased Ageism Over 210 Years: Evidence From a 600-Million-Word Historical Corpus
Authors: Ng Reuben , Indran Nicole
Published: July 2021

Background and Objectives

Older adults are exhibiting greater diversity in their aging trajectories. This has led to movements by the World Health Organization and AARP to reframe aging. We compare role-based framing and age-based framing of older adults over 210 years—a time span beyond the reach of traditional methods—and elucidate their respective sentiments and narratives.

Research Design and Methods

We combined the Corpus of Historical American English with the Corpus of Contemporary American English to create a 600-million-word data set—the largest historical corpus of American English with over 150,000 texts collected from newspapers, magazines, fiction, and nonfiction. We compiled the top descriptors of age-based terms (e.g., senior citizen) and role-based terms (e.g., grandparent) and rated them for stereotypic valence (negative to positive) over 21 decades.

Results

Age-based framing evidenced a significantly higher increase in negativity (15%) compared to role-based framing (4%). We found a significant interaction effect between framing (age-based vs. role-based) and stereotypic content across 2 centuries (1800s and 1900s). The percentage of positive topics associated with role-based framing increased from 71% in the 1800s to 89% in the 1900s, with narratives of affection and wisdom becoming more prevalent. Conversely, the percentage of positive topics for age-based framing decreased from 82% to 38% over time, with narratives of burden, illness, and death growing more prevalent.

Discussion and Implications

We argue for a more role-centric approach when framing aging such that age ceases to be the chief determinant in how older adults are viewed in society.
Contested Childhood: Assessing the Age of Young Refugees in the Aftermath of the Second World War
Authors: Burgard Antoine
Published: July 2021

In the immediate aftermath of the Second World War, identity documents and proofs of age were often lost or unavailable, bodies and behaviours had been marked by years of malnourishment and persecution, young people had learned to misrepresent their age for the sake of survival, and administrations routinely doubted age claims. The war had profoundly disrupted the system for knowing age that had become central to Western European regimes of recognition and rights such as citizenship, movement, and welfare. Using the resettlement of young Holocaust survivors to Canada after the war as its core case study, this article examines how state administrations, international organizations, and non-governmental organizations competed and struggled to determine age and consequently who should be considered as a child, and how young people themselves were affected by and navigated these struggles. It foregrounds the necessity to further historicize how power structures increasingly used childhood as a category and chronological age as a supposedly objective criterion to grant some lives more legitimacy than others.
Leptinergic Regulation of Vertebrate Communication Signals
Authors: Nourbakhsh-Rey Mehrnoush , Markham Michael R
Published: July 2021

Animal communication signals are regulated by multiple hormonal axes that ensure appropriate signal targeting, timing, and information content. The regulatory roles of steroid hormones and many peptide hormones are well understood and documented across a wide range of vertebrate taxa. Two recent studies have reported a novel function for leptin, a peptide hormone central to energy balance regulation: regulating communication signals of weakly electric fish and singing mice. With only limited evidence available at this time, a key question is just how widespread leptinergic regulation of communication signals is within and across taxa. A second important question is what features of communication signals are subject to leptinergic regulation. Here, we consider the functional significance of leptinergic regulation of animal communication signals in the context of both direct and indirect signal metabolic costs. Direct costs arise from metabolic investment in signal production, while indirect costs arise from the predation and social conflict consequences of the signal's information content. We propose a preliminary conceptual framework for predicting which species will exhibit leptinergic regulation of their communication signals and which signal features leptin will regulate. This framework suggests a number of directly testable predictions within and across taxa. Accounting for additional factors such as life history and the potential co-regulation of communication signals by leptin and glucocorticoids will likely require modification or elaboration of this model.
Novel FtsZ inhibitor with potent activity against Staphylococcus aureus
Authors: Kumar Manoj , Mathur Tarun , Barman Tarani Kanta , Chaira Tridib , Kumar Ram , Joshi Vattan , Pandya Manisha , Sharma Lalima , Fujii Kunihiko , Bandgar Mahadev , Jadhav Balasaheb , Bambal Ramesh , Upadhyay Dilip , Masuda Nobuhisa , Verma Ashwani Kumar , Bhatnagar Pradip Kumar
Published: July 2021

Objectives

FtsZ is an essential bacterial protein and an unexplored target for the development of antibacterial drugs. The development of a novel inhibitor targeting FtsZ offers a potential opportunity to combat drug resistance. DS01750413, a new derivative of PC190723, is a novel FtsZ inhibitor with improved in vitro and in vivo activity. The objective of this study was to investigate the efficacy of DS01750413 against Staphylococcus spp., including MRSA, in in vitro and in vivo models.

Methods

In vitro activities of DS01750413 and standard-of-care antibiotics were evaluated against clinical isolates of Gram-positive pathogens. The in vivo efficacy was evaluated in a murine systemic infection model caused by MRSA.

Results

DS01750413 showed potent in vitro activity against MRSA clinical isolates with MIC ranges of 0.5–1 mg/L and also demonstrated concentration-dependent bactericidal killing. In the murine bacteraemia infection model of MRSA, treatment with DS01750413 resulted in prolonged survival of animals compared with placebo-treated animals and exhibited a significant reduction in the bacterial load in liver, spleen, lungs and kidneys.

Conclusions

DS01750413 showed encouraging in vitro and in vivo activity against MRSA. As a novel chemical class, DS01750413 has the potential to become clinically viable antibiotics to address the drug resistance problem by its unique novel targeting mechanism of action.
Comparison of Breath- and Blood-Alcohol Concentrations in a Controlled Drinking Study
Authors: Skaggs Lindsey , Heizler Amy , Kalscheur Diane , Miles Amy , Barkholtz Heather M
Published: July 2021

In this work, 114 volunteers were dosed with 80-proof liquor to produce peak blood-alcohol concentration (BAC) or breath-alcohol concentration (BrAC) of 0.040–0.080 g/100 mL blood or g/210 L breath. This was followed by a 30 minute deprivation period before simultaneous blood and breath samples were collected and the alcohol concentration quantified. BAC was determined by gas chromatography with flame ionization detection and BrAC by a dual-sensor Intox EC/IR II instrument. Paired Student t-tests showed that differences between paired blood- and breath-alcohol results differed significantly. Results from these two measurement methods are highly correlated and, on average, measured BAC was 11.3% greater than BrAC. There were 10 instances of BrAC being greater than the corresponding BAC, and the average difference between these two values was 0.0059 g/100 mL. Agreement plots of coupled BAC and BrAC revealed a mean bias of 0.00754 g/100 mL and 95% limits of agreement (LOA) at −0.00705 and 0.0221 g/100 mL. Once BrAC values were truncated to the hundredths place as required by Wisconsin state statute, only three participants had greater BrAC than corresponding BAC, with an average difference between these values of 0.008 g/100 mL. Agreement plots with truncated BrAC values gave a mean bias of 0.0120 g/100 mL and 95% LOA at −0.00344 and 0.0275 g/100 mL. Data showed that typically, blood samples had greater alcohol concentrations than corresponding breath values. Differences were exacerbated by Wisconsin’s statutory requirement that reported breath alcohol measurements be truncated to the hundredths place, whereas blood has no corresponding mandate.
Design process of patient-specific osteosynthesis plates using topology optimization
Authors: Park Si-Myung , Park Soyeon , Park Jieun , Choi Minwook , Kim Laehyun , Noh Gunwoo
Published: July 2021

To reduce complications related to the osteosynthesis plating system, the use of a patient-specific plate design was proposed. However, the issue of associated complications is still critical. Because existing patient-specific plate designs have mainly relied on parametric studies, a design method is needed that considers the complex factors influencing the performance of the reconstruction and that can be generalized for various patients. The goal of this study was to propose a design process that can strengthen the advantages of a customized plate to reduce patient discomfort and ensure the stability of surgery. We applied topology optimization to design a plate for a case of mandibular condyle fracture. The optimization problem was set to maximize the plate stiffness and minimize its volume. The performance of the designed plate was evaluated using finite element simulations, which approximated the various mastication states. Plate performance was then compared with the performance of two conventional plating systems: bent plates and computerized numerical control-machined plates. The conventional plate models used a pair of mini-plates, and the bent plate was modeled by conducting bending simulation. Each finite element model was appraised via masticatory simulations under static molar-jaw-closing conditions. Differences in stress concentration were noted between the model with bent plates and the model with computerized numerical control-machined plates. The most severe stress concentration occurred in the bent plate, which was affected by the residual stress from the bending process. In comparison with the two conventional plates, the newly designed plate exhibited significantly improved biomechanical stability in terms of stress and stiffness and had approximately twice the endurance capability against fractured bone separation. The newly designed plate was designed to have a balance between volume and plate stiffness, and it showed superior stability over the conventional plates. The proposed plate design process using topology optimization is an effective method not only because it enhances the advantages of the patient-specific plate but also because it can be applied in various reconstruction cases.
Auctioning Class Action Representation
Authors: Klement Alon , Neeman Zvika , Ofir Moran
Published: July 2021

Class actions feature severe agency problems, resulting from the divergence of interests between class members and the class attorney. This article proposes a novel mechanism for selecting the class attorney and aligning her interests with those of the represented class. The mechanism applies a combined percentage and hourly litigation fee structure, suggested by Polinsky, Mitchell A., and Daniel L. Rubinfeld. 2003. “Aligning the Interests of Lawyers and Clients,” 5 Am Law Econ Rev 165, in which lawyers earn a percentage of the class’ common fund, and bear the same percentage over their time investment. To maximize the expected payoff for the class, we supplement this fee structure with a preliminary two stages auction, in which the role of the lawyer is tendered using competitive bidding. We prove that the proposed auction approximates the highest possible net payoff for the class as the number of lawyers who compete for the right to represent the class increases. The percentage taken by the lawyer would be the lowest possible, and the winning lawyer would be the one who produces the highest expected net payoff for the class. We then extend the model to cases where the attorney files the class action is compensated for her pre-filing investment, and to settlements (JEL K41, K22)
COVID-19, Telehealth, and Pediatric Integrated Primary Care: Disparities in Service Use
Authors: Chakawa Ayanda , Belzer Leslee Throckmorton , Perez-Crawford Trista , Yeh Hung-Wen
Published: July 2021

Objective

The coronavirus disease 2019 pandemic (COVID-19) may increase pediatric mental health needs due to its social, economic, and public health threats, especially among Black, Indigenous, and People of Color and those served within disadvantaged communities. COVID-19 protocols have resulted in increased provision of telehealth in integrated primary care (IPC) but little is known about pediatric telehealth IPC utilization during the pandemic for diverse and traditionally underserved groups.

Methods

A comparative study was conducted to explore variability between in-person (pre-COVID-19; n = 106) and telehealth (mid-COVID-19; n = 120) IPC consultation utilization among children 1–19 years old served through a large, inner-city primary care clinic. Logistic regression modeling was used to examine the association between service delivery modality (i.e., in-person vs. telehealth) and attendance, referral concerns, and several sociodemographic variables.

Results

Service delivery modality and attendance, referral concerns, and race/ethnicity were significantly associated. The odds of non-attendance were greater for children scheduled for telehealth, the odds of children with internalizing problems being scheduled for telehealth were greater than those with externalizing problems, and the odds of Black children being scheduled for telehealth were less compared to White children.

Conclusion

Though telehealth has helped provide IPC continuity during COVID-19, findings from this study show troubling preliminary data regarding reduced attendance, increased internalizing concerns, and disparities in scheduling for Black patients. Specific actions to monitor and address these early but alarming indications of telehealth and Covid-19 related behavioral health disparities are discussed.
Idiopathic pleuroparenchymal fibroelastosis: first case report in Lebanon
Authors: Dbouk Samer , Bazzi Nagham , Mansour Sally , Masry Aly , Mansour Bassam
Published: July 2021

Idiopathic pleuroparenchymal fibroelastosis (IPPFE) was initially described by Amitani et al. in Japan. It is characterized by visceral pleural fibrosis and adjacent lung parenchymalfibroelastosis with striking upper lobe predominance. Because of its rarity and the lack of clear diagnostic criteria, the prevalence of the disease is still unclear. We report the first case of IPPFE in Lebanon and the second one in the Arab World. A 37-year-old Iraqi man was admitted to the hospital with progressive dyspnea on exertion occurring since 2 years and associated with dry cough. Histo-pathologic results reported a prominent interstitial fibrosis mainly in upper parts, and no granulomatous tissue was detected. Therefore, the diagnosis of IPPFE was made. The IPPFE is a distinct entity that requires meticulous clinico-pathological correlation for an adequate diagnosis and a close follow-up as this entity can progress into more advanced stages.
Detecting optical transients using artificial neural networks and reference images from different surveys
Authors: Wardęga Katarzyna , Zadrożny Adam , Beroiz Martin , Camuccio Richard , Díaz Mario C
Published: July 2021

We present a technique to detect optical transients based on an artificial neural networks method. We describe the architecture of two networks capable of comparing images of the same part of the sky taken by different telescopes. One image corresponds to the epoch in which a potential transient could exist; the other is a reference image of an earlier epoch. We use data obtained by the Dr. Cristina V. Torres Memorial Astronomical Observatory and archival reference images from the Sloan Digital Sky Survey. We trained a convolutional neural network and a dense layer network on simulated source samples and then tested the trained networks on samples created from real image data. Autonomous detection methods replace the standard process of detecting transients, which is normally achieved by source extraction of a difference image followed by human inspection of the detected candidates. Replacing the human inspection component with an entirely autonomous method would allow for a rapid and automatic follow-up of interesting targets of opportunity. The toy-model pipeline that we present here is not yet able to replace human inspection, but it might provide useful hints to identify potential candidates. The method will be further expanded and tested on telescopes participating in the Transient Optical Robotic Observatory of the South Collaboration.
The UV-brightest Lyman continuum emitting star-forming galaxy
Authors: Marques-Chaves R , Schaerer D , Álvarez-Márquez J , Colina L , Dessauges-Zavadsky M , Pérez-Fournon I , Saldana-Lopez A , Verhamme A
Published: July 2021

We report the discovery of J0121+0025, an extremely luminous and young star-forming galaxy (MUV = −24.11, log[$L_{\rm Ly \alpha } / \rm erg~s^{-1}] = 43.8$) at z = 3.244 showing copious Lyman continuum (LyC) leakage ($f_{\rm esc, abs} \approx 40{{\ \rm per\ cent}}$). High signal-to-noise ratio rest-frame UV spectroscopy with the Gran Telescopio Canarias reveals a high significance (7.9σ) emission below the Lyman limit (<912 Å), with a flux density level f900 = 0.78 ± 0.10μJy, and strong P-Cygni in wind lines of O vi 1033 Å, N v 1240 Å, and C iv 1550 Å that are indicative of a young age of the starburst (<10 Myr). The spectrum is rich in stellar photospheric features, for which a significant contribution of an AGN at these wavelengths is ruled out. Low-ionization interstellar medium (ISM) absorption lines are also detected, but are weak ($EW_{0} \rm \simeq 1$ Å) and show large residual intensities, suggesting a clumpy geometry of the gas with a non-unity covering fraction or a highly ionized ISM. The contribution of a foreground and AGN contamination to the LyC signal is unlikely. Deep optical to Spitzer/IRAC 4.5 μm imaging show that the spectral energy distribution of J0121+0025 is dominated by the emission of the young starburst, with log($M_{\star }^{\rm burst}/M_{\odot }) = 9.9\pm 0.1$ and $\rm SFR = 981\pm 232$ M⊙ yr−1. J0121+0025 is the most powerful LyC emitter known among the star-forming galaxy population. The discovery of such luminous and young starburst leaking LyC radiation suggests that a significant fraction of LyC photons can escape in sources with a wide range of UV luminosities and are not restricted to the faintest ones as previously thought. These findings might shed further light on the role of luminous starbursts to the cosmic reionization.
Redshift evolution of the hot intracluster gas metallicity in the C-EAGLE cluster simulations
Authors: Pearce Francesca A , Kay Scott T , Barnes David J , Bahé Yannick M , Bower Richard G
Published: July 2021

The abundance and distribution of metals in galaxy clusters contain valuable information about their chemical history and evolution. By looking at how metallicity evolves with redshift, it is possible to constrain the different metal production channels. We use the C-EAGLE clusters, a sample of 30 high-resolution (mgas ≃ 1.8 × 106 M⊙) cluster zoom simulations, to investigate the redshift evolution of metallicity, with particular focus on the cluster outskirts. The early enrichment model, in which the majority of metals are produced in the core of cluster progenitors at high redshift, suggests that metals in cluster outskirts have not significantly evolved since z = 2. With the C-EAGLE sample, we find reasonable agreement with the early enrichment model as there is very little scatter in the metallicity abundance at large radius across the whole sample, out to at least z = 2. The exception is Fe for which the radial dependence of metallicity was found to evolve at low redshift as a result of being mainly produced by Type Ia supernovae, which are more likely to be formed at later times than core-collapse supernovae. We also found considerable redshift evolution of metal abundances in the cores of the C-EAGLE clusters that has not been seen in other simulations or observation-based metallicity studies. Since we find this evolution to be driven by accretion of low-metallicity gas, it suggests that the interaction between outflowing, AGN-heated material and the surrounding gas is important for determining the core abundances in clusters.
Towards robust determination of non-parametric morphologies in marginal astronomical data: resolving uncertainties with cosmological hydrodynamical simulations
Authors: Thorp Mallory D , Bluck Asa F L , Ellison Sara L , Maiolino Roberto , Conselice Christopher J , Hani Maan H , Bottrell Connor
Published: July 2021

Quantitative morphologies, such as asymmetry and concentration, have long been used as an effective way to assess the distribution of galaxy starlight in large samples. Application of such quantitative indicators to other data products could provide a tool capable of capturing the two-dimensional distribution of a range of galactic properties, such as stellar mass or star-formation rate maps. In this work, we utilize galaxies from the Illustris and IllustrisTNG simulations to assess the applicability of concentration and asymmetry indicators to the stellar mass distribution in galaxies. Specifically, we test whether the intrinsic values of concentration and asymmetry (measured directly from the simulation stellar mass particle maps) are recovered after the application of measurement uncertainty and a point spread function (PSF). We find that random noise has a non-negligible systematic effect on asymmetry that scales inversely with signal-to-noise ratio (S/N), particularly at an S/N less than 100. We evaluate different methods to correct for the noise contribution to asymmetry at very low S/N, where previous studies have been unable to explore due to systematics. We present algebraic corrections for noise and resolution to recover the intrinsic morphology parameters. Using Illustris as a comparison data set, we evaluate the robustness of these fits in the presence of a different physics model, and confirm these correction methods can be applied to other data sets. Lastly, we provide estimations for the uncertainty on different correction methods at varying S/N and resolution regimes.
Adaptive Introgression Facilitates Adaptation to High Latitudes in European Aspen (Populus tremula L.)
Authors: Rendón-Anaya Martha , Wilson Jonathan , Sveinsson Sæmundur , Fedorkov Aleksey , Cottrell Joan , Bailey Mark E S , Ruņǵis Dainis , Lexer Christian , Jansson Stefan , Robinson Kathryn M , Street Nathaniel R , Ingvarsson Pär K
Published: July 2021

Understanding local adaptation has become a key research area given the ongoing climate challenge and the concomitant requirement to conserve genetic resources. Perennial plants, such as forest trees, are good models to study local adaptation given their wide geographic distribution, largely outcrossing mating systems, and demographic histories. We evaluated signatures of local adaptation in European aspen (Populus tremula) across Europe by means of whole-genome resequencing of a collection of 411 individual trees. We dissected admixture patterns between aspen lineages and observed a strong genomic mosaicism in Scandinavian trees, evidencing different colonization trajectories into the peninsula from Russia, Central and Western Europe. As a consequence of the secondary contacts between populations after the last glacial maximum, we detected an adaptive introgression event in a genome region of ∼500 kb in chromosome 10, harboring a large-effect locus that has previously been shown to contribute to adaptation to the short growing seasons characteristic of Northern Scandinavia. Demographic simulations and ancestry inference suggest an Eastern origin—probably Russian—of the adaptive Nordic allele which nowadays is present in a homozygous state at the north of Scandinavia. The strength of introgression and positive selection signatures in this region is a unique feature in the genome. Furthermore, we detected signals of balancing selection, shared across regional populations, that highlight the importance of standing variation as a primary source of alleles that facilitate local adaptation. Our results, therefore, emphasize the importance of migration–selection balance underlying the genetic architecture of key adaptive quantitative traits.
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Perioperative Spine: Preoperative Opioid Evaluation
Authors: Wang Marjorie C , Harrop James S , Bisson Erica F , Dhall Sanjay , Dimar John , Mohamed Basma , Mummaneni Praveen V , Hoh Daniel J
Published: July 2021

BACKGROUND

Opioid use disorders in the United States have rapidly increased, yet little is known about the relationship between preoperative opioid duration and dose and patient outcomes after spine surgery. Likewise, the utility of preoperative opioid weaning is poorly understood.

OBJECTIVE

The purpose of this evidence-based clinical practice guideline is to determine if duration and dose of preoperative opioids or preoperative opioid weaning is associated with patient-reported outcomes or adverse events after elective spine surgery for degenerative conditions.

METHODS

A systematic review of the literature was performed using the National Library of Medicine/PubMed database and Embase for studies relevant to opioid use among adult patients undergoing spine surgery. Clinical studies evaluating preoperative duration, dose, and opioid weaning and outcomes were selected for review.

RESULTS

A total of 41 of 845 studies met the inclusion criteria and none were Level I evidence. The use of any opioids before surgery was associated with longer postoperative opioid use, and longer duration of opioid use was associated with worse outcomes, such as higher complications, longer length of stay, higher costs, and increased utilization of resources. There is insufficient evidence to support the efficacy of opioid weaning on postoperative opioid use, improving outcome, or reducing adverse events after spine surgery.

CONCLUSION

This evidence-based clinical guideline provides Grade B recommendations that preoperative opioid use and longer duration of preoperative opioid use are associated with chronic postoperative opioid use and worse outcome after spine surgery. Insufficient evidence supports the efficacy of an opioid wean before spine surgery (Grade I).

The full guidelines can be accessed at https://www.cns.org/guidelines/browse-guidelines-detail/1-preoperative-opioid-evaluation.
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Perioperative Spine: Preoperative Nutritional Assessment
Authors: Bisson Erica F , Dimar John , Harrop James S , Hoh Daniel J , Mohamed Basma , Mummaneni Praveen V , Wang Marjorie C , Dhall Sanjay
Published: July 2021

BACKGROUND

Preoperative malnutrition has been implicated in adverse events after elective surgery, potentially impacting patient outcomes.

OBJECTIVE

As a potentially modifiable risk factor, we sought to determine which assessments of nutritional status were associated with specific adverse events after spine surgery. In addition, we explored if a preoperative nutritional improvement intervention may be beneficial in lowering the rates of these adverse events.

METHODS

The literature search yielded 115 abstracts relevant to the PICO (patient/population, intervention, comparison, and outcomes) questions included in this chapter. The task force selected 105 articles for full text review, and 13 met criteria for inclusion in this systematic review.

RESULTS

Malnutrition, assessed preoperatively by a serum albumin <3.5 g/dL or a serum prealbumin <20 mg/dL, is associated with a higher rate of surgical site infections (SSIs), other wound complications, nonunions, hospital readmissions, and other medical complications after spine surgery. A multimodal nutrition management protocol decreases albumin and electrolyte deficiencies in patients with normal preoperative nutritional status. It also improves overall complication rates but does not specifically impact SSIs.

CONCLUSION

It is recommended to assess nutritional status using either serum albumin or prealbumin preoperatively in patients undergoing spine surgery.

The full guidelines can be accessed at https://www.cns.org/guidelines/browse-guidelines-detail/4-preoperative-nutritional-assessment.
Neighbourhood walkability and obesity among adults in rural Japan: results from a Japanese health database
Authors: Koh Grace , Sekine Michikazu , Yamada Masaaki , Fujimura Yuko , Tatsuse Takashi
Published: July 2021

Background

Walkable neighbourhoods promote physical activity and prevent obesity, but there is limited evidence to inform urban planning strategies for public health within the context of rural Japan. This study describes associations between neighbourhood walkability and obesity in Toyama, a regional municipality in Japan.

Methods

A cross-sectional analysis of the Toyama Prefecture National Health Insurance data (n = 3454) in 2016 using Analysis of Covariance (ANCOVA) and binary logistic regression. Walk Score® was used to estimate neighbourhood walkability.

Results

Residents from highly walkable neighbourhoods generally had lower mean body mass index (BMI), but significant associations between neighbourhood walkability and BMI and prevalence of obesity were only observed in women (adjusted OR: 0.46, 95% CI: 0.26–0.80). Men below 65 years old had higher obesity prevalence (adjusted OR: 1.76, 95% CI: 1.34–2.30). Daily alcohol consumption was associated with lower odds of being obese among men (adjusted OR: 0.72, 95% CI: 0.55–0.95). Hypertension, diabetes mellitus and dyslipidaemia were associated with higher obesity prevalence among residents, regardless of gender.

Conclusions

Walkable environment may improve health outcomes for rural communities in Japan. Further studies are required to create equitable and inclusive living spaces for men and women to access healthier lifestyle choices.
The Alien Citizen: Social Distance and the Economic Returns to Naturalization in the Southwest
Authors: Catron Peter
Published: July 2021

Citizenship acquisition is often promoted as one factor that can facilitate the economic integration of immigrants. However, not all individuals and groups experience positive benefits from naturalization. This article argues that social distance from the native-born is an important factor that influences who does and does not benefit from citizenship acquisition. Specifically, I create a new continuous measure of social distance for immigrants during the age of mass migration. I show that the relationship between social distance and the economic returns to citizenship takes an inverted U-shape. Those considered closest and furthest away in social distance to the native-born report little to no advantages to citizenship, while those in the middle report larger returns. I then focus on the Mexican population in the historical Southwest and take advantage of a unique enumeration in the complete count 1930 U.S. census that coded Mexicans as either white or Mexican. Mexicans coded as white report economic differences between citizenship statuses, while Mexicans coded as nonwhite report no difference between citizenship statuses. The results suggest that citizenship may not be beneficial to all individuals and groups, depending on where they fall in the ethnoracial hierarchy.
Development and Application of an Interactive Physiologically Based Pharmacokinetic (iPBPK) Model to Predict Oxytetracycline Tissue Distribution and Withdrawal Intervals in Market-Age Sheep and Goats
Authors: Riad Mahbubul H , Baynes Ronald E , Tell Lisa A , Davis Jennifer L , Maunsell Fiona P , Riviere Jim E , Lin Zhoumeng
Published: July 2021

Oxytetracycline (OTC) is a widely used antibiotic in food-producing animals. Extralabel use of OTC is common and may lead to violative residues in edible tissues. It is important to have a quantitative tool to predict scientifically based withdrawal intervals (WDIs) after extralabel use in food animals to ensure human food safety. This study focuses on developing a physiologically based pharmacokinetic (PBPK) model for OTC in sheep and goats. The model included 7 compartments: plasma, lung, liver, kidneys, muscle, fat, and rest of the body. The model was calibrated with serum and tissue (liver, muscle, kidney, and fat) concentration data following a single intramuscular (IM, 20 mg/kg) and/or intravenous (IV, 10 mg/kg) administration of a long-acting formulation in sheep and goats. The model was evaluated with independent datasets from Food Animal Residue Avoidance Databank (FARAD). Results showed that the model adequately simulated the calibration datasets with an overall estimated coefficient of determination (R2) of 0.95 and 0.92, respectively, for sheep and goat models and had acceptable accuracy for the evaluation datasets. Monte Carlo sampling technique was applied to predict the time needed for drug concentrations in edible tissues to fall below tolerances for the 99th percentiles of the population. The model was converted to a web-based interactive PBPK (iPBPK) interface to facilitate model applications. This iPBPK model provides a useful tool to estimate WDIs for OTC after extralabel use in small ruminants to ensure food safety and serves as a basis for extrapolation to other tetracycline drugs and other food animals.
Mucocutaneous Findings of Multisystem Inflammatory Syndrome in Children: A Single-Center Experience
Authors: Böncüoğlu Elif , Kıymet Elif , Şahinkaya Şahika , Cem Ela , Yılmaz Çelebi Miray , Düzgöl Mine , Besin Dorukhan , Arıkan Kamile Ötiken , Akaslan Kara Aybüke , Bayram Nuri , Devrim İlker
Published: July 2021

This descriptive study aimed to evaluate the frequency and the types of mucocutaneous manifestations associated with multisystem inflammatory syndrome in children (MIS-C). A cohort of 49 patients was reviewed. There were 6 patients (12.2%) whose mucocutaneous findings were observed by the clinicians on admission, whereas 26 (53%) patients had at least one of the histories of rash or desquamation associated with fever before the admission. Exanthems in our experience demonstrated a variety of morphologies, including morbilliform, urticarial, petechial, and maculopapular forms. Mucosal involvement (conjunctivitis and strawberry tongue) was observed only in 2/6 (34%) patients. In the coronavirus disease 2019 pandemic era, while evaluating the criteria for MIS-C, the history of previous cutaneous findings given by parents/caregivers is also important. There was no pathognomonic rash for MIS-C and a variety of cutaneous findings with a short lifespan can be associated with MIS-C.
Baccalaureate Nursing Program Admission Requirements and Predictors of Success
Authors: McKnight Heather M. , Moore Sheila M.
Published: July 2021

This study aimed to determine if correlations existed between overall science prerequisite grade point average (GPA) and successful completion of pathophysiology and overall science GPA and the Test of Essential Academic Skills Version V (TEAS V) science subscore. The quantitative study design was used with 73 students who were conditionally admitted to the baccalaureate nursing program. No statistically significant correlation was found between overall science GPA and successful completion of pathophysiology; a weak low correlation was found between overall science GPA and TEAS V science subscore. These findings suggest that TEAS V science subscores used as a standalone assessment do not predict success in pathophysiology.
New developments in rare vulvar and vaginal cancers
Authors: Garganese Giorgia , Romito Alessia , Scambia Giovanni , Fagotti Anna
Published: July 2021

Purpose of review

To provide the latest insight on the rare vulvar and vaginal malignancies, able to impact on clinical practice, and to outline new potential research developments.

Recent findings

Many efforts are being made to produce technical and scientific advances in the fields of vulvar and vaginal carcinoma, including imaging work-up, interventional procedures and minimally invasive surgical approach, as well as molecular profiling and identification of new target treatments.

In the evaluation of lymph node status, ultrasound has demonstrated promising results because of high predictive value, low risk and low cost. Positron Emission Tomography-Computed Tomography is confirmed to be reliable and should be prospectively investigated for its potential applications in radiomics, whilst Fusion-US could allow a precision guidance in diagnostics and interventional procedures. Regarding interventional procedure, surgery is becoming less invasive with the aim to increase quality of life; in carefully selected patients it would be possible to overcome the current strict criteria in the use of sentinel node biopsy. Future research should focus on potential target therapy, on the basis of tumor-specific biological features.

Rare cancers should be referred to experienced centers with a high case flow, able to offer a full range of diagnostic and therapeutical options and a multidisciplinary approach. Networking should be encouraged to promote research opportunities and enable data sharing and multicenter trials.
Comparative effectiveness and safety of 32 pharmacological interventions recommended by guidelines for coronavirus disease 2019: a systematic review and network meta-analysis combining 66 trials
Authors: Wu Shan-Shan , Zhou Qing-Xin , Zeng Xue-Yang , Zhang Jing-Xue , Yang Zhi-Rong , Yang Qing-Qing , Zhang Zi-Lu , Chen Ya-Hong , Sun Feng , Zhan Si-Yan
Published: July 2021

Background:

The global pandemic coronavirus disease 2019 (COVID-19) has become a major public health problem and presents an unprecedented challenge. However, no specific drugs were currently proven. This study aimed to evaluate the comparative efficacy and safety of pharmacological interventions in patients with COVID-19.

Methods:

Medline, Embase, the Cochrane Library, and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/SARS-CoV. Random-effects network meta-analysis within the Bayesian framework was performed, followed by the Grading of Recommendations Assessment, Development, and Evaluation system assessing the quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion, and overall adverse events (OAEs). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.

Results:

Sixty-six RCTs with 19,095 patients were included, involving standard of care (SOC), eight different antiviral agents, six different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids (COR), and other treatments. Compared with SOC, a significant reduction of mortality was observed for TCM (OR = 0.34, 95% CI: 0.20–0.56, moderate quality) and COR (OR = 0.84, 95% CI: 0.75–0.96, low quality) with improved cure rate (OR = 2.16, 95% CI: 1.60–2.91, low quality for TCM; OR = 1.17, 95% CI: 1.05–1.30, low quality for COR). However, an increased risk of mortality was found for CQ_HD vs. SOC (OR = 3.20, 95% CI: 1.18–8.73, low quality). TCM was associated with decreased risk of OAE (OR = 0.52, 95% CI: 0.38–0.70, very low quality) but CQ_HD (OR = 2.51, 95% CI: 1.20–5.24) and interferons (IFN) (OR = 2.69, 95% CI: 1.02–7.08) vs. SOC with very low quality were associated with an increased risk.

Conclusions:

COR and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN, and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low-quality and further high-quality trials are needed.
Clozapine metabolism may be affected by Gilbert’s syndrome: case report and discussion
Authors: Stanbridge Andrea J , Cranshaw Thomas , Paul Meethu M
Published: July 2021

A 34-year-old man with treatment-resistant schizophrenia and Gilbert’s syndrome was treated with clozapine and found to have unusually slow and fluctuating metabolism of clozapine, resulting in difficulty achieving a well-tolerated and stable plasma clozapine level. Gilbert’s syndrome is a relatively common (3–10% prevalence) genetic condition which results in altered hepatic metabolism. This case report demonstrates in vivo the finding of previous in-vitro research suggesting that the UGT1A1 7/7 mutation most commonly associated with Gilbert’s syndrome may result in decreased clozapine excretion. Given evidence of an increased prevalence of Gilbert’s syndrome in patients with schizophrenia, further investigation into this possible correlation may improve understanding and prediction of clozapine dosage.