bluuebunny/crossref_metadata_2025 huggingface dataset:
Dielectric properties of the Ca0.25Cu0.75-xAlxTiO3 ceramics: experimental and computational investigations
Authors: Boonlakhorn Jakkree , Suksangrat Punpatsorn , Srepusharawoot Pornjuk
Published: February 2024

In this study, we employed a solid-state reaction method to synthesize Ca0.25Cu0.75-xAlxTiO3 ceramics, investigating the impact of Al doping at concentrations of x = 0 and 0.0125. Notably, all ceramics exhibited a primary phase of Ca0.25Cu0.75TiO3. The addition of Al3+ induced a significant increase in grain size. Density functional theory analyses revealed a preferential occupation of Cu sites by Al, leading to liquid-phase sintering processes attributed to excess Cu. Moreover, it was also found from DFT that the Al dopant cannot induce an oxygen vacancy in the lattice. Charge density analysis revealed that Cu+ and Ti3+ observed via XPS originate from the presence of an oxygen vacancy. The Ca0.25Cu0.7375Al0.0125TiO3 ceramic exhibited a very high dielectric permittivity of 9.23 × 104 and a low dielectric loss tangent of 0.057 at 1 kHz and room temperature. Importantly, the dielectric permittivity exhibited impressive stability over a temperature range of −60 °C to 110 °C, perfectly meeting the practical requirements for utilization in X5R ceramic capacitors. Our investigation indicates that the improved dielectric properties may be attributed to enhanced grain boundary responses, influenced by oxygen enrichment and the presence of metastable insulating layers at grain boundaries. Combining experimental findings with theoretical evidence, our study elucidates that the excellent dielectric properties of the Ca0.25Cu0.7375Al0.0125TiO3 ceramic originate from an extrinsic effect arising from grain boundary enhancement. This work not only contributes to advancing the understanding of the underlying mechanisms governing dielectric behavior in doped ceramics, but also emphasizes the potential of Ca0.25Cu0.7375Al0.0125TiO3 as a promising material for applications demanding superior dielectric performance.
Assessing light performance of vertical greenery shading in tropical climate
Authors: Kristanto Luciana , Ekasiwi Sri Nastiti Nugrahani , Dinapradipta Asri
Published: February 2024

Natural light is abundant in tropical climates and advantageous for incorporating daylighting into building designs. However, this daylight intensity often leads to excessive brightness indoors, specifically in high-rise buildings with glass façades. In addressing sustainability concerns, incorporating greenery outside glass façades can effectively shade and alleviate eyestrain for building occupants. Therefore, this study aimed to investigate the effectiveness of plant leaves in reducing the high light intensity on glass facades. An experiment was conducted using the Vernonia elliptica plant, which thrives in medium to high sunlight in tropical climates. Three different leaf area indexes (LAI) were examined in this study as the independent variables, while light illuminance and luminance served as the dependent variables. Two identical box models measuring 1 m × 1 m × 1 m were utilized for the experiment. The two models were oriented towards the west and north, representing intense and longer light exposure. The first, the base case, featured a glass façade without any other additional element, whereas the other incorporated greenery on its glass façade. The obtained results indicated that the impact of leaf density on illuminance and luminance is significant, specifically when the LAI is doubled. It was also found that denser foliage with longer leaf strands produced better results, specifically at low altitudes. These results can be used to implement vertical greenery shading in high-rise office buildings.
Prediction of suitable areas and division of key monitoring zones for Solidago canadensis in Guizhou Province, China
Authors: Zhang Qingqing , Wang Jiaguo , Sun Yan , Wu Jiawei , Long Mengqian , Luo Chong , Li Weijie
Published: February 2024

Comprehending invasive alien species’ potential habitat area and spread trend are of great importance for effective prevention and control strategy and prevention of spread. However, previous studies have mainly been based on large regional scales (national or global level). Research on the smaller regional scale of ecologically fragile karst makes the prevention and control measures more feasible and targeted, it is of great significance to protect mountainous region species diversity and maintain national nature reserves. In this study, based on the distribution point data of Solidago canadensis in Guizhou Province and environmental factors, Pearson correlation analysis and contribution rate analysis of environmental factors were carried out by SPSS and knife cutting method, and current and future potential distribution vector maps were obtained by MaxEnt model, and then imported into ArcGIS for reclassification and visualization. The results show that, (1) the main drivers of S canadensis distribution were precipitation changes and human activities, the total contribution rate more than 70%; (2) S canadensis occurrence probability initially increased, and then decreased with increased precipitation variables, and increased rapidly initially, then gradually with increasing human footprint; (3) under current climate conditions, S canadensis suitable area is 8.13 × 104 km2, with the highly suitable area concentrated in Guiyang, east of Bijie, Zunyi, Anshun and Qiannan. Under climate conditions of the 2050s, the suitable area drops slightly to 8.00 × 104 km2, mainly in the west and north of Zunyi, Anshun and other areas reduced. Under climate conditions of the 2070s, the suitable area expands to 8.31 × 104 km2, it expands in the adjacent areas of Anshun, Qiannan and Qianxinan and the junction of Zunyi, Tongren, Qiannan and Qiandongnan. And move toward the south within the study area; (4) finally, using the spatial optimization software ZONATION, according to the landscape loss proportion curve, the key monitoring area of 79,857 km2 was obtained, including a primary monitoring area mainly distributed in Guiyang, east of Bijie, northeast of Anshun and northwest of Qiannan, a secondary monitoring area mainly outside the primary monitoring area, and a third-level monitoring area widely distributed in Zunyi, Tongren, Qiannan, west of Qiandongnan and Anshun and east of Bijie. Linking our results with this specie’s invasive power, we thus recommended to increase the prevention and control sites in the first-level monitoring area, and continue to pay attention to the risk of the southward spread of this species.
Temperature and hospital admissions in the Eastern Mediterranean: a case study in Cyprus
Authors: Wang Yichen , Achilleos Souzana , Salameh Pascale , Kouis Panayiotis , Yiallouros Panayiotis K , Critselis Elena , Nicolaides Kleanthis , Tymvios Filippos , Savvides Chrysanthos , Vasiliadou Emily , Papatheodorou Stefania I , Koutrakis Petros , Alahmad Barrak
Published: February 2024

Exposure to extreme temperatures can trigger a cascade of adverse cardiovascular and respiratory events. However, in Cyprus, a hotspot of climate change in the Eastern Mediterranean region, little is known about the temperature-related cardiorespiratory morbidity risks. We analyzed daily counts of hospital admissions for cardiovascular and respiratory diseases from four general hospitals in three districts in Cyprus from 2000 through 2019. For each district, we fitted time-series quasi-Poisson regression with distributed lag non-linear models to analyze the associations between daily mean temperature (lag 0–21 d) and hospital admissions for cardiorespiratory, cardiovascular, and respiratory diseases. A random-effects meta-analytical model was then applied to pool the district-specific estimates and obtain the national average associations. We analyzed 20 years of cause-specific hospitalization data with a total of 179 988 cardiovascular and respiratory events. The relationships between cardiorespiratory morbidity and temperature were overall U-shaped. During extreme temperature days, 15.85% (95% empirical CI [eCI]: 8.24, 22.40%) excess cardiovascular hospitalizations and 9.59% (95% eCI: −0.66, 18.69%) excess respiratory hospitalizations were attributable to extreme cold days (below the 2.5th percentile). Extreme hot days (above the 97.5th percentile) accounted for 0.17% (95% eCI: 0.03, 0.29%) excess cardiovascular hospitalizations and 0.23% (95% eCI: 0.07, 0.35%) excess respiratory hospitalizations. We found evidence of increased cardiovascular morbidity risk associated with extreme temperatures in Cyprus. Our study highlights the necessity to implement public health interventions and adaptive measures to mitigate the related temperature effects in an understudied region.
Computing nonsurjective primes associated to Galois representations of genus 2 curves
Authors: Banwait Barinder , Brumer Armand , Kim Hyun , Klagsbrun Zev , Mayle Jacob , Srinivasan Padmavathi , Vogt Isabel
Published: February 2024

For a genus

2
2

curve

C
C

over

Q

\mathbb {Q}

whose Jacobian

A
A

admits only trivial geometric endomorphisms, Serre’s open image theorem for abelian surfaces asserts that there are only finitely many primes

ℓ
\ell

for which the Galois action on

ℓ
\ell

-torsion points of

A
A

is not maximal. Building on work of Dieulefait, we give a practical algorithm to compute this finite set. The key inputs are Mitchell’s classification of maximal subgroups of

P
S

p
4

(

F

ℓ

)

PSp_4(\mathbb {F}_\ell )

, sampling of the characteristic polynomials of Frobenius, and the Khare–Wintenberger modularity theorem. The algorithm has been submitted for integration into Sage, executed on all of the genus 

2
2

curves with trivial endomorphism ring in the LMFDB, and the results incorporated into the homepage of each such curve.
Rational points on rank 2 genus 2 bielliptic curves in the LMFDB
Authors: Bianchi Francesca , Padurariu Oana
Published: February 2024

Building on work of Balakrishnan, Dogra, and of the first author, we provide some improvements to the explicit quadratic Chabauty method to compute rational points on genus

2
2

bielliptic curves over

Q

\mathbb {Q}

, whose Jacobians have Mordell–Weil rank equal to

2
2

. We complement this with a precision analysis to guarantee correct outputs. Together with the Mordell–Weil sieve, this bielliptic quadratic Chabauty method is then the main tool that we use to compute the rational points on the

411
411

locally solvable curves from the LMFDB which satisfy the aforementioned conditions.
Modular algorithms for Gross–Stark units and Stark–Heegner points
Authors: Damm-Johnsen Håvard
Published: February 2024

In recent work, Darmon, Pozzi and Vonk explicitly construct a modular form whose spectral coefficients are

p
p

-adic logarithms of Gross–Stark units and Stark–Heegner points. Here we describe how this construction gives rise to a practical algorithm for explicitly computing these logarithms to specified precision, and how to recover the exact values of the Gross–Stark units and Stark–Heegner points from them.

Key tools are overconvergent modular forms, reduction theory of quadratic forms and Newton polygons. As an application, we tabulate Gross–Stark units in narrow Hilbert class fields of real quadratic fields with discriminants up to

10000
10000

, for primes less than

20
20

, as well as Stark–Heegner points on elliptic curves.
A new puzzle for limited aggregation
Authors: Kowalczyk Kacper
Published: February 2024

This paper presents a new puzzle for limited aggregation. Unlike other recent puzzles, this one arises independently of the issue of rational aversion to risk. Some possible responses are laid out and explored.
Inappropriate Identities: Racialized Language Ideologies and Sociolinguistic Competence in a Study Abroad Context
Authors: Grammon Devin
Published: February 2024

This article examines cases where two study abroad students—Rita and Jack—problematized the normative use of specific dialectal variants by local native speakers at the end of their Spanish immersion program in Peru. Specifically, it explores what these cases reveal about second language learners’ sociolinguistic competence in a study abroad context involving their knowledge of native speaker norms and the contextual appropriateness of target language variation. An analysis of ethnographic data suggests that Rita and Jack interpreted the appropriate use of sociolinguistic variation from the local variety of Andean Spanish by drawing on prevalent racialized language ideologies in the host community that link non-standard variants to an indigenous identity imagined as incompetent in Spanish. These findings validate a need for alternative analytic frameworks that conceptualize second language learners’ development of sociolinguistic competence in terms of language ideologies rather than objective sets of normative native speaker practices. This study advances calls to develop L2 learners’ critical language awareness through curricular innovation and critical pedagogies in study abroad programs.
mBARq: a versatile and user-friendly framework for the analysis of DNA barcodes from transposon insertion libraries, knockout mutants, and isogenic strain populations
Authors: Sintsova Anna , Ruscheweyh Hans-Joachim , Field Christopher M , Feer Lilith , Nguyen Bidong D , Daniel Benjamin , Hardt Wolf-Dietrich , Vorholt Julia A , Sunagawa Shinichi
Published: February 2024

Motivation

DNA barcoding has become a powerful tool for assessing the fitness of strains in a variety of studies, including random transposon mutagenesis screens, attenuation of site-directed mutants, and population dynamics of isogenic strain pools. However, the statistical analysis, visualization, and contextualization of the data resulting from such experiments can be complex and require bioinformatic skills.

Results

Here, we developed mBARq, a user-friendly tool designed to simplify these steps for diverse experimental setups. The tool is seamlessly integrated with an intuitive web app for interactive data exploration via the STRING and KEGG databases to accelerate scientific discovery.

Availability and implementation

The tool is implemented in Python. The source code is freely available (https://github.com/MicrobiologyETHZ/mbarq) and the web app can be accessed at: https://microbiomics.io/tools/mbarq-app.
Actioning the findings of hard endpoint clinical trials as they emerge in the realm of chronic kidney disease care: a review and a call to action
Authors: Strippoli Giovanni F M , Green Suetonia C
Published: February 2024

Fewer than half of patients treated with hemodialysis survive 5 years. Multiple therapeutics are used to address the complications of advanced chronic kidney disease but most have not been found to improve clinical outcomes. Clinical trials of treatment innovations for chronic kidney diseases and dialysis care have been suboptimal in number and quality. Recent trials are changing this trend. Practice and policy change when new evidence emerges remains frequently impeded by resource and organizational constraints and accordingly, clinical practice guidelines are updated years or decades after definitive evidence is produced. Ultimately, practice change in health systems is slow, leading to impaired uptake of effective medical interventions and lower value healthcare, although innovations in rapid guideline production are emerging. What can be done to ensure that conclusive evidence is taken up in practice, policy and healthcare funding? We use the example of the recently published hard endpoint study “Comparison of high-dose HDF with high-flux HD” (CONVINCE) (hemodiafiltration versus hemodialysis), to explain how a new trial can impact on medical knowledge and change in practices. We (i) assess how the trial can be placed in the context of the totality of the evidence, (ii) define whether or not further trials of convective dialysis therapies are still needed and (iii) examine whether the evidence for convective therapies is now ready to inform practice, policy and funding change. When looking at CONVINCE in the context of the totality of evidence, we show that it addresses dialysis quality improvement priorities and is consistent with other trials evaluating convective dialysis therapies, and that the evidence for convective dialysis therapies is now definitive. Once updated evidence for cost-effectiveness in specific healthcare settings and patient-reported outcomes become available, we should therefore determine whether or not clinical practice guidelines should recommend uptake of convective dialysis therapies routinely, and move on to evaluating other treatments.
Large pericardial effusion in a woman in the second trimester of pregnancy: a case report
Authors: Rammos Aidonis , Papaioannou Eftychia , Lazaros George , Siminelakis Stavros , Naka Katerina K
Published: February 2024

Background

Pericardial effusion is common in pregnancy, with causes similar to the general population. Usually, it is found in the third trimester and disappears spontaneously after labour; however, there is a risk of progression to tamponade. Management is based on expert opinion, since few studies have been published.

Case summary

A woman with enlargement of a known, chronic, presumably idiopathic pericardial effusion, in the 17th gestation week, presented with mild dyspnoea, without specific echocardiographic signs of cardiac tamponade. She received double antithrombotic treatment with aspirin 100 mg, started before conception, and a prophylactic dose of tinzaparin 4500 IU, started at the beginning of the pregnancy due to obstetrical antiphospholipid syndrome. A multidisciplinary team consisting of the treating obstetrician–gynaecologist, haematologist, cardiothoracic surgeon, and cardiologist discussed the management, taking into account the large size of the effusion and the significant increase during pregnancy, the possibility of further increase during the third trimester, the antiplatelet and antithrombotic treatment, which increased the haemorrhagic risk, and the difficulty and risk to intervene later in pregnancy. A surgical pericardial window was proposed to the patient and family and was performed uneventfully.

Discussion

This case demonstrates the importance of a multidisciplinary team approach and shared decision-making in the management of these complex cardio-obstetric patients in order to achieve optimal therapeutic results.
Acute radiation-induced pericarditis complicated by polymicrobial infectious pericarditis in a patient with mediastinal sarcoma: a case report
Authors: Yan Kimberly L , Lee Yoo Jin , Baik Alan H
Published: February 2024

Background

Acute pericarditis is often caused by viral infections, autoimmune diseases, and radiation therapy (RT). Infectious pericarditis is rare and associated with high morbidity and mortality. We present a case of acute RT-induced pericarditis complicated by bacterial pericarditis and cardiac tamponade due to oesophageal bacterial translocation.

Case summary

A 65-year-old man with a recurrent mediastinal sarcoma complicated by oesophageal compression and recent oesophageal stenting presented with shortness of breath. Electrocardiogram showed diffuse ST elevations, and he was diagnosed with presumed RT-induced pericarditis. Despite anti-inflammatory therapy, he developed haemodynamic instability and clinical tamponade, with transthoracic echocardiogram showing a large circumferential pericardial effusion. He underwent emergent pericardiocentesis, and pericardial fluid cultures grew polymicrobial species. Anti-inflammatories were held, and he was started on broad spectrum intravenous antibiotics and antifungals. Due to clinical decompensation and repeat computed tomography imaging demonstrating worsening pericardial disease, he underwent pericardial irrigation and subxiphoid pericardial window. The patient died from hypoxaemic and hypercapnic respiratory failure. Autopsy revealed constrictive pericarditis and no bacterial organisms in the pericardium.

Discussion

Anti-inflammatories are standard treatment for viral and RT-induced pericarditis. Purulent, bacterial pericarditis is rare and an uncommon complication of RT-induced pericarditis. Polymicrobial infectious pericarditis is often refractory to intravenous antibiotics, requiring surgical intervention. This case highlights the importance of maintaining a high index of suspicion of various potential aetiologies of pericarditis in order to tailor medical and surgical therapies especially in high-risk, immunosuppressed cancer patients.
Sociodemographic inequalities of suicide: a population-based cohort study of adults in England and Wales 2011–21
Authors: Ward Isobel L , Finning Katie , Ayoubkhani Daniel , Hendry Katie , Sharland Emma , Appleby Louis , Nafilyan Vahé
Published: February 2024

Background

The risk of suicide is complex and often a result of multiple interacting factors. Understanding which groups of the population are most at risk of suicide is important to inform the development of targeted public health interventions.

Methods

We used a novel linked dataset that combined the 2011 Census with the population-level mortality data in England and Wales. We fitted generalized linear models with a Poisson link function to estimate the rates of suicide across different sociodemographic groups and to identify which characteristics are independent predictors of suicide.

Results

Overall, the highest rates of suicide were among men aged 40–50 years, individuals who reported having a disability or long-term health problem, those who were unemployed long term or never had worked, and those who were single or separated. After adjusting for other characteristics such as employment status, having a disability or long-term health problem, was still found to increase the incidence of suicide relative to those without impairment [incidence rate ratio minimally adjusted (women) = 3.5, 95% confidence interval (CI) = 3.3–3.6; fully adjusted (women) 3.1, 95% CI = 3.0–3.3]. Additionally, while the absolute rate of suicide was lower in women compared with men, the relative risk in people reporting impairments compared with those who do not was higher in women compared with men.

Conclusions

The findings of this work provide novel population-level insights into the risk of suicide by sociodemographic characteristics in England and Wales. Our results highlight several sociodemographic groups who may benefit from more targeted suicide prevention policies and practices.
Interpretation issues with “genomic vulnerability” arise from conceptual issues in local adaptation and maladaptation
Authors: Lotterhos Katie E
Published: February 2024

As climate change causes the environment to shift away from the local optimum that populations have adapted to, fitness declines are predicted to occur. Recently, methods known as genomic offsets (GOs) have become a popular tool to predict population responses to climate change from landscape genomic data. Populations with a high GO have been interpreted to have a high “genomic vulnerability” to climate change. GOs are often implicitly interpreted as a fitness offset, or a change in fitness of an individual or population in a new environment compared to a reference. However, there are several different types of fitness offset that can be calculated, and the appropriate choice depends on the management goals. This study uses hypothetical and empirical data to explore situations in which different types of fitness offsets may or may not be correlated with each other or with a GO. The examples reveal that even when GOs predict fitness offsets in a common garden experiment, this does not necessarily validate their ability to predict fitness offsets to environmental change. Conceptual examples are also used to show how a large GO can arise under a positive fitness offset, and thus cannot be interpreted as a population vulnerability. These issues can be resolved with robust validation experiments that can evaluate which fitness offsets are correlated with GOs.
Anelloviruses versus human immunity: how do we control these viruses?
Authors: Timmerman Anne L , Schönert Antonia L M , van der Hoek Lia
Published: February 2024

One continuous companion and one of the major players in the human blood virome are members of the Anelloviridae family. Anelloviruses are probably found in all humans, infection occurs early in life and the composition (anellome) is thought to remain stable and personal during adulthood. The stable anellome implies a great balance between the host immune system and the virus. However, the lack of a robust culturing system hampers direct investigation of interactions between virus and host cells. Other techniques, however, including next generation sequencing, AnelloScan-antibody tests, evolution selection pressure analysis, and virus protein structures, do provide new insights into the interactions between anelloviruses and the host immune system. This review aims at providing an overview of the current knowledge on the immune mechanisms acting on anelloviruses and the countering viral mechanisms allowing immune evasion.
Effects of China’s Clean Air Act on Frailty Levels Among Middle-Aged and Older Adults: A Population-Based Quasi-Experimental Study
Authors: Guo Yujia , Yang Fan
Published: February 2024

Background

Air pollution is a frailty risk factor, yet the frailty-related health benefits of China’s air pollution control policy, the Clean Air Action (CCAA), are unclear. Frailty progression and transitions differ among robust, prefrail, and frail adults. This study aimed to evaluate the CCAA’s effect on frailty levels among robust, prefrail, and frail Chinese adults.

Methods

Using propensity score matching with difference-in-differences analysis, we studied 9 788 adults aged ≥45 from the 2011 and 2018 China Health and Retirement Longitudinal Study. The Frailty Index (FI), summarizing 32 health deficits, quantifies frailty level (range: 0–1 scores). Frailty was defined as FI ≥ 0.25, prefrailty as FI 0.10–0.25, and robust as FI ≤ 0.10. We examined frailty transitions between these states (robust, prefrail, and frail) from 2011 to 2018. Based on provincial particulate matter reduction targets, participants were assigned to intervention (>10% reduction) or control (≤10%) groups and categorized as robust, prefrail, or frail pre-CCAA implementation.

Results

The CCAA significantly reduced FI scores among preimplementation robust individuals by 0.0205 and among prefrail individuals by 0.0114, with no significant changes in frail individuals. Frailty transition analyses confirmed specific benefits of the CCAA, which significantly reduced worsening from robust to prefrail or frail by 7.0% and prefrail to frail by 3.9%. However, it did not facilitate the improvement from frail to prefrail/robust or from prefrail back to robust. No significant subgroup differences were observed across age, gender, Hukou, education, and social participation.

Conclusions

CCAA has been associated with a reduction in frailty deterioration in robust and prefrail populations.
The Impact of the Older Person’s Grant Expansion on Hypertension Among Older Men in Rural South Africa: Findings From the HAALSI Cohort
Authors: Chang Haeyoon , Jock Janet , Rosenberg Molly S , Li Chihua , Cho Tsai-Chin , Gaziano Thomas A , Lisabeth Lynda , Kobayashi Lindsay C
Published: February 2024

Background and Objectives

Hypertension is a major modifiable contributor to disease burden in sub-Saharan Africa. We exploited an expansion to age eligibility for men in South Africa’s noncontributory public pension to assess the impact of pension eligibility on hypertension in a rural, low-income South African setting.

Research Design and Methods

Data were from 1 247 men aged ≥60 in the population-representative Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa in 2014/2015. We identified cohorts of men from 0 (controls, aged ≥65 at pension expansion) through 5 years of additional pension eligibility based on their birth year. Using the modified Framingham Heart Study hypertension risk prediction model, and the Wand et al. model modified for the South African population, we estimated the difference in the probabilities of hypertension for men who benefitted from the pension expansion relative to the control. We conducted a negative control analysis among older women, who were not eligible for pension expansion, to assess the robustness of our findings.

Results

Older men with 5 additional years of pension eligibility had a 6.9–8.1 percentage point greater probability of hypertension than expected without the pension expansion eligibility. After accounting for birth cohort effects through a negative control analysis involving older women reduced estimates to a 3.0–5.2 percentage point greater probability of hypertension than expected. We observed a mean 0.2 percentage point increase in the probability of hypertension per additional year of pension eligibility, but this trend was not statistically significant.

Discussion and Implications

Although the Older Person’s Grant is important for improving the financial circumstances of older adults and their families in South Africa, expanded pension eligibility may have a small, negative short-term effect on hypertension among older men in this rural, South African setting.
Research Centers Collaborative Network Workshop on Digital Health Approaches to Research in Aging
Authors: Fanning Jason , Brinkley Tina E , Campbell Laura M , Colon-Semenza Cristina , Czaja Sara J , Moore Raeanne C , Pajewski Nicholas M , Kritchevsky Stephen
Published: February 2024

Digital health technologies are ubiquitous in the healthcare landscape. Older adults represent an important user group who may benefit from improved monitoring of physical and cognitive health and in-home access to care, but there remain many barriers to widespread use of digital health technologies in gerontology and geriatric medicine. The National Institute on Aging Research Centers Collaborative Network convened a workshop wherein geriatricians and gerontological researchers with expertise related to mHealth and digital health applications shared opportunities and challenges in the application of digital health technologies in aging. Discussion broadly centered on 2 themes: promises and challenges in (i) the use of ecological momentary assessment methodologies in gerontology and geriatric medicine, and (ii) the development of health promotion programs delivered via digital health technologies. Herein, we summarize this discussion and outline several promising areas for future research.
Caregiving While Black: A Novel, Online Culturally Tailored Psychoeducation Course for Black Dementia Caregivers
Authors: Alexander Karah , Cave Nkosi , Oliver Sloan , Bennett Stephanie , Higgins Melinda , Hepburn Ken , Clevenger Carolyn , Epps Fayron
Published: February 2024

Background and Objectives

Psychoeducation interventions using distance learning modalities to engage caregivers in active learning environments have demonstrated benefits in enhancing caregiving mastery. However, few of these programs have been specifically adapted to develop mastery in Black caregivers.

Research Design and Methods

A multimethod approach was carried out to assess Caregiving While Black (CWB), including pre–post surveys and in-depth interviews. This psychoeducation course addresses the cultural realities of caring for a person living with dementia as a Black American. Caregivers engaged in online asynchronous education related to healthcare navigation, home life management, and self-care. Primary (caregiving mastery) and secondary outcomes (anxiety, depression, perceived stress, burden, perceived ability to manage behavioral and psychological symptoms) were assessed at baseline and post-course (10 weeks).

Results

Thirty-two Black caregivers from across the United States completed the course within the allotted time frame. Paired sample t test analyses revealed significant reductions in caregiver burden and role strain. Caregiver mastery from baseline to completion increased by 0.45 points with an effect size of 0.26 (Cohen’s d). Twenty-nine caregivers participated in an optional post-course interview, and thematic analysis led to the construction of 5 overarching themes: Comfortability with a Culturally Tailored Course; Experiences Navigating the Course Platform; Utility of Course Resources; Time as a Barrier and Facilitator; Familial and Community Engagement.

Discussion and Implications

Pilot findings convey a need to continue creating and receiving feedback on culturally tailored psychoeducation programs for dementia caregivers. The next steps include applying results to fuel the success of the next iteration of CWB.
Thrombocytosis and Transaminitis in Infants Born to Women With Inflammatory Bowel Disease Is Associated With Exposure to Maternal Inflammation In Utero
Authors: Prentice Ralley , Flanagan Emma , Wright Emily , Hardikar Winita , Ross Alyson , Burns Megan , Prideaux Lani , Connell William , Sparrow Miles , De Cruz Peter , Lust Mark , Goldberg Rimma , Vogrin Sara , Greeve Tessa , Bell Sally
Published: February 2024

Background

Despite reassuring clinical safety data, thrombocytosis, anemia, lymphopenia, and liver function derangements have been observed in infants born to women with inflammatory bowel disease (IBD) treated with thiopurines and biologics. We aimed to define the prevalence, course, associations, and clinical impact of hematological and biochemical abnormalities in such infants.

Methods

This multicenter prospective cohort study assessed clinical, hematologic, and biochemical outcomes of infants exposed to thiopurines or biologics in utero for management of maternal IBD. Liver transaminases, full blood examination, and infant thiopurine metabolites (where exposed) were taken at delivery and 6 weeks of age. Abnormal results were repeated until normalization. Infants were followed clinically by a pediatric gastroenterologist up to 2 years of age.

Results

A total of 130 infants were included. Thrombocytosis and elevated alanine transaminase (ALT) were seen in over half of infants up to 6 months of age with no significant clinical impact. Elevated ALT was associated with increasing maternal C-reactive protein in second trimester, while thrombocytosis was associated with increasing maternal C-reactive protein and fecal calprotectin in third trimester. Preceding infection and vaccination were associated with an increased risk of elevated alkaline phosphatase at 3 months. In those exposed to thiopurines, increasing maternal 6-methylmercaptopurine at delivery was associated with increased ALT to 6 months.

Conclusions

Infants born to women with IBD commonly developed thrombocytosis, elevated alkaline phosphatase, and elevated ALT. These findings were associated with exposure to maternal inflammation, elevated 6-methylmercaptopurine at delivery, and infant vaccinations and infections, and had minimal clinical consequence.
Physical Activity and IBD: State of Art and Knowledge, Patients and Healthcare Professionals Points of View, A French Multicenter Cross Sectional Study
Authors: Derbey Lea , Charlois Anne Laure , Buisson Anthony , Roblin Xavier , Mathieu Nicolas , Danion Pauline , Gay Claire , Nancey Stéphane , Boschetti Gilles
Published: February 2024

Background

Several studies have reported low levels of physical activity (PA) in patients with inflammatory bowel diseases (IBD), possibly related to a lack of information and support, despite the many recognized benefits such as cardiovascular prevention or quality of life (QoL) improvement.

Methods

The purpose of our study was to identify challenges faced by patients and to evaluate IBD impact on PA and QoL by using the International Physical Activity Questionnaire short form and the 32-item Inflammatory Bowel Disease Questionnaire (IBDQ-32) questionnaire, respectively. We also assessed the expectations and knowledge of patients and healthcare professionals using the MICI-Active questionnaire that we developed.

Results

We included 298 IBD patients in 4 French hospitals, with a mean age of 38 years. We found a decrease in training frequency since IBD diagnosis, regardless of age, gender, symptom intensity, or type of disease. Moreover, there was an increase in low intensity activities like walking and a decrease in competitions and sports club registrations. Intensity of symptoms has a negative impact on QoL, as evidenced by the worsening of IBDQ score. Conversely, a higher PA intensity was correlated with a higher IBDQ score, regardless of symptoms intensity. The main barrier to PA was fatigue (56%), and the main fear was diarrhea (42%). Furthermore, 75% of patients did not feel sufficiently informed, and 61% were interested in coaching. A total of 112 healthcare professionals were interviewed, 62.5% said they had already discussed of PA with their patients, but 98% felt that they lacked knowledge.

Conclusions

Inflammatory bowel disease constraints and symptoms have a strong impact on PA. Work needs to be done to better train practitioners to improve IBD patient management, who have much to gain from better PA.
Predictors of Complicated Disease Course in Adults and Children With Crohn’s Disease: A Nationwide Study from the epi-IIRN
Authors: Atia Ohad , Lujan Rona , Buchuk Rachel , Greenfeld Shira , Kariv Revital , Loewenberg Weisband Yiska , Ledderman Natan , Matz Eran , Ledder Oren , Zittan Eran , Yanai Henit , Shwartz Doron , Dotan Iris , Nevo Daniel , Turner Dan
Published: February 2024

Background

Since data on predictors of complicated Crohn’s disease (CD) from unselected populations are scarce, we aimed to utilize a large nationwide cohort, the epi-IIRN, to explore predictors of disease course in children and adults with CD.

Methods

Data of patients with CD were retrieved from Israel’s 4 health maintenance organizations, whose records cover 98% of the population (2005-2020). Time-to-event modeled a complicated disease course, defined as CD-related surgery, steroid-dependency, or the need for >1 class of biologics. Hierarchical clustering categorized disease severity at diagnosis based on available laboratory results.

Results

A total of 16 659 patients (2999 [18%] pediatric-onset) with 121 695 person-years of follow-up were included; 3761 (23%) had a complicated course (750 [4.5%] switched to a second biologic class, 1547 [9.3%] steroid-dependency, 1463 [8.8%] CD-related surgery). Complicated disease was more common in pediatric- than adult-onset disease (26% vs 22%, odds ratio, 1.3; 95% confidence interval [CI], 1.2-1.4). In a Cox multivariate model, complicated disease was predicted by induction therapy with biologics (hazard ratio [HR], 2.1; 95% CI, 1.2-3.6) and severity of laboratory tests at diagnosis (HR, 1.7; 95% CI, 1.2-2.2), while high socioeconomic status was protective (HR, 0.94; 95% CI, 0.91-0.96). In children, laboratory tests predicted disease course (HR, 1.8; 95% CI, 1.2-2.5), as well as malnutrition (median BMI Z score −0.41; 95% CI, −1.42 to 0.43 in complicated disease vs −0.24; 95% CI, −1.23 to 0.63] in favorable disease; P < .001).

Conclusions

In this nationwide cohort, CD course was complicated in one-fourth of patients, predicted by laboratory tests, type of induction therapy, socioeconomic status, in addition to malnutrition in children.
Enhanced SARS-CoV-2 case prediction using public health data and machine learning models
Authors: Price Bradley S , Khodaverdi Maryam , Hendricks Brian , Smith Gordon S , Kimble Wes , Halasz Adam , Guthrie Sara , Fraustino Julia D , Hodder Sally L
Published: February 2024

Objectives

The goal of this study is to propose and test a scalable framework for machine learning (ML) algorithms to predict near-term severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases by incorporating and evaluating the impact of real-time dynamic public health data.

Materials and Methods

Data used in this study include patient-level results, procurement, and location information of all SARS-CoV-2 tests reported in West Virginia as part of their mandatory reporting system from January 2021 to March 2022. We propose a method for incorporating and comparing widely available public health metrics inside of a ML framework, specifically a long-short-term memory network, to forecast SARS-CoV-2 cases across various feature sets.

Results

Our approach provides better prediction of localized case counts and indicates the impact of the dynamic elements of the pandemic on predictions, such as the influence of the mixture of viral variants in the population and variable testing and vaccination rates during various eras of the pandemic.

Discussion

Utilizing real-time public health metrics, including estimated Rt from multiple SARS-CoV-2 variants, vaccination rates, and testing information, provided a significant increase in the accuracy of the model during the Omicron and Delta period, thus providing more precise forecasting of daily case counts at the county level. This work provides insights on the influence of various features on predictive performance in rural and non-rural areas.

Conclusion

Our proposed framework incorporates available public health metrics with operational data on the impact of testing, vaccination, and current viral variant mixtures in the population to provide a foundation for combining dynamic public health metrics and ML models to deliver forecasting and insights in healthcare domains. It also shows the importance of developing and deploying ML frameworks in rural settings.
Dietary encapsulated fennel seed (Foeniculum vulgare Mill.) essential oil supplementation improves performance, modifies the intestinal microflora, morphology, and transcriptome profile of broiler chickens
Authors: İpçak Hasan Hüseyin , Alçiçek Ahmet , Denli Muzaffer
Published: February 2024

Global antimicrobial resistance has led to a ban on the use of antibiotics as growth promoters (AGPs) in poultry farming, encouraging the use of natural phytogenic feed additives that provide similar effects to AGPs without causing resistance. The aim of this study was to determine the effects of the addition of encapsulated fennel seed (Foeniculum vulgare Mill.) essential oil (FEO) into the diets on the performance, intestinal microflora, morphology, and transcriptomic profiling of broiler chickens. In the study, 400 one-d-old male chicks of the Ross-308 genotype were randomly distributed into five groups, each with 16 replicates of five birds. The experiment included a control group fed on basal diets without the addition of FEO and treatment groups supplemented with 50 (FEO50), 100 (FEO100), 200 (FEO200), or 400 (FEO400) mg of encapsulated FEO/kg. Body weight and the European Production Efficiency Factor values were higher in the FEO100, FEO200, and FEO400 groups (P < 0.05). The feed conversion ratio significantly improved at all FEO levels (P < 0.05). FEO supplementation improved duodenum, jejunum, and ileum morphologies. It enhanced mucosal layer thickness in the duodenum and jejunum, and muscular layer thickness in the jejunum and ileum (P < 0.05). It also increased the number of Lactobacillus spp. in the jejunum and ileum (P < 0.05). According to the transcriptome profile obtained from the microarray analysis of samples taken from small intestine tissues, the mRNA expression levels of 261 genes in the FEO50 group (206 upregulated and 55 downregulated), 302 genes in the FEO100 group (218 upregulated and 84 downregulated), 292 genes in the FEO200 group (231 upregulated and 61 downregulated), and 348 genes in the FEO400 group (268 upregulated and 80 downregulated) changed compared to the control group. Most upregulated genes were associated with catalytic activity, binding, transcription regulators and transcription factors, anatomical structure and cellular development, and protein binding activity modulators. The downregulated genes mostly belonged to the transporter, carrier, and protein-modifying enzyme classes. Besides, the anti-inflammatory IL-10 gene (4.41-fold) increased significantly in the FEO100 group compared to the control group (P < 0.05). In conclusion, FEO improved the performance of broiler chickens by regulating biological processes such as performance and intestinal health, with the 100 mg FEO/kg supplementation being the most prominent.
Factors Contributing to Disproportionate Burnout in Women Breast Imaging Radiologists: A Review
Authors: Dodelzon Katerina , Milch Hannah S , Mullen Lisa A , Dialani Vandana , Jacobs Sarah , Parikh Jay R , Grimm Lars J
Published: February 2024

Physician burnout continues to increase in prevalence and disproportionately affects women physicians. Breast imaging is a woman-dominated subspeciality, and therefore, worsening burnout among women physicians may have significant repercussions on the future of the breast imaging profession. Systemic and organizational factors have been shown to be the greatest contributors to burnout beyond individual factors. Based on the Mayo Model, we review the evidence regarding the 7 major organizational contributors to physician burnout and their potential disproportionate impacts on women breast radiologists. The major organizational factors discussed are work–life integration, control and flexibility, workload and job demands, efficiency and resources, finding meaning in work, social support and community at work, and organizational culture and values. We also propose potential strategies for institutions and practices to mitigate burnout in women breast imaging radiologists. Many of these strategies could also benefit men breast imaging radiologists, who are at risk for burnout as well.
What’s Wrong with Annuity Markets?
Authors: Verani Stéphane , Yu Pei Cheng
Published: February 2024

We show that the supply of U.S. life annuities is constrained by interest rate risk. We identify this effect using annuity prices offered by life insurers from 1989 to 2019 and exogenous variations in contract-level regulatory capital requirements. The cost of interest rate risk management—conditional on the effect of adverse selection—accounts for about half of annuity markups, or 8 percentage points. The contribution of interest rate risk to annuity markups sharply increased after the Global Financial Crisis, suggesting new retirees’ opportunities to transfer their longevity risk are unlikely to improve in a persistently low interest rate environment.
Resisting Education
Authors: Carvalho Jean-Paul , Koyama Mark , Williams Cole
Published: February 2024

Educational institutions not only build human capital; they also shape culture. We present a model of cultural dynamics produced by cultural transmission through the education system. Groups that are culturally marginalized become economically disadvantaged and exhibit various forms of resistance to education. First, individuals may drop out of education to avoid its cultural content. Second, individuals may invest in other forms of socialization to tune out the cultural content of education. Finally, cultural communities may collectively resist mainstream education by turning out to change curricula or establish their own schools. We show that resistance to education can make it impossible for a policymaker to eliminate alternative cultural traits from the population. In fact, a policymaker may have to moderate the cultural content of education or else face a backlash which increases the spread of alternative cultural traits. Our analysis unifies a growing body of empirical work on the effects of cultural policies and makes new predictions regarding the effect of socializing institutions on cultural dynamics.