bluuebunny/crossref_metadata_2025 huggingface dataset:
11. Funding Access to Justice
Authors: Gillespie Alisdair , Weare Siobhan
Published: August 2023

This chapter examines how litigation is funded. It considers the growth, and eventual decline, in legal aid, and how alternative sources of funding have begun to be used. The chapter considers both criminal and civil litigation. It notes how there is an increase in defendants in person before the criminal courts because of restrictions in legal aid. It questions whether this is appropriate, particularly where the loss of liberty is a real possibility. The chapter also considers how civil litigation is now funded. This includes how ‘no win, no fee’ arrangements were at first encouraged, but then subject to restrictions because it was felt the balance of risk vs gain was inappropriate. The chapter charts the growth of before and after the event insurance, and the increase in third-party funding where the litigation is for large sums of money.
12. The Investigation of Crime
Authors: Gillespie Alisdair , Weare Siobhan
Published: August 2023

This chapter examines the investigation of crime. It begins with a discussion of how law enforcement is organized, exploring the role of agencies such as the police, the National Crime Agency, and HM Revenue and Customs, amongst others. It then critically considers police powers around stop and search and arrest and detention, before moving on to examine the rights of suspects in police custody, particularly in relation to interview.
15. The Trials
Authors: Gillespie Alisdair , Weare Siobhan
Published: August 2023

This chapter examines the trial process and identifies the differences between summary trials and trials on indictment. It details who is in court, what their role should be, and how they reach their various decisions. The discussions cover the prosecution case, the defence case, closing speeches, judicial summing-up, reaching a verdict, and youth trials.
17. Civil Litigation
Authors: Gillespie Alisdair , Weare Siobhan
Published: August 2023

This chapter considers the conduct of civil litigation. It discusses how civil litigation is more managed than criminal litigation and the courts seek to assist litigants in finding a compromise. The civil courts have extensive powers over costs and they use this to ensure compliance with their rulings and also to encourage early settlement, reducing the need for litigation. The chapter examines three types of civil litigation; cases relating to the small-claims track (‘small claims court’), judicial review, and private family-law disputes.
In search of markets and technology: the role of cross-border knowledge for domestic productivity
Authors: Arvanitis Spyros , Seliger Florian , Woerter Martin
Published: August 2023

Internationalization of research and development (R&D) is a double-edged sword: on the one hand, it is understood as a driving force of global innovation performance; on the other hand, from a national perspective it is often perceived as a threat to domestic efforts. Against this background, we compare the contribution of domestic and international knowledge sourcing to the productivity of Swiss firms. We find a positive productivity effect of knowledge-sourcing activities in geographically close countries (in the European Union [EU]). Domestic knowledge alone or from other world regions does not yield positive productivity effects. We provide evidence that companies that source international knowledge to generate innovative products benefit disproportionately from knowledge sourcing in the EU and that both knowledge- and market-seeking motives may be relevant to this result.
Coupled lateral and longitudinal trajectory tracking control with a modified vehicle kinematics model for autonomous vehicles
Authors: Li Sijie , Sun Zhanbo , Liu Yafei , Ji Ang , Zhang Shuaifei , Chen Linbin
Published: August 2023

The paper proposes a coupled lateral and longitudinal trajectory tracking control algorithm based on model predictive control (MPC) to enhance the precision and stability of trajectory tracking of autonomous vehicles. The coupled MPC controller is developed based on a modified vehicle kinematics model, which simultaneously takes the steering angle and the longitudinal speed as control variables. The modified vehicle model and the coupled MPC controller are verified by CarSim and MATLAB/Simulink co-simulation experiments. Simulation results demonstrate that, at the cost of 12 percent increase in average computational time, the proposed coupled MPC controller leads to an approximate 48 percent reduction in tracking error compared to the benchmarking coupled lateral and longitudinal MPC controller based on the classic kinematics model.
Patient portal interventions: a scoping review of functionality, automation used, and therapeutic elements of patient portal interventions
Authors: Gleason Kelly T , Powell Danielle S , Wec Aleksandra , Zou Xingyuan , Gamper Mary Jo , Peereboom Danielle , Wolff Jennifer L
Published: August 2023

Objectives

We sought to understand the objectives, targeted populations, therapeutic elements, and delivery characteristics of patient portal interventions.

Materials and Methods

Following Arksey and O-Malley’s methodological framework, we conducted a scoping review of manuscripts published through June 2022 by hand and systematically searching PubMed, PSYCHInfo, Embase, and Web of Science. The search yielded 5403 manuscripts; 248 were selected for full-text review; 81 met the eligibility criteria for examining outcomes of a patient portal intervention.

Results

The 81 articles described: trials involving comparison groups (n = 37; 45.7%), quality improvement initiatives (n = 15; 18.5%), pilot studies (n = 7; 8.6%), and single-arm studies (n = 22; 27.2%). Studies were conducted in primary care (n = 33, 40.7%), specialty outpatient (n = 24, 29.6%), or inpatient settings (n = 4, 4.9%)—or they were deployed system wide (n = 9, 11.1%). Interventions targeted specific health conditions (n = 35, 43.2%), promoted preventive services (n = 19, 23.5%), or addressed communication (n = 19, 23.4%); few specifically sought to improve the patient experience (n = 3, 3.7%). About half of the studies (n = 40, 49.4%) relied on human involvement, and about half involved personalized (vs exclusively standardized) elements (n = 42, 51.8%). Interventions commonly collected patient-reported information (n = 36, 44.4%), provided education (n = 35, 43.2%), or deployed preventive service reminders (n = 14, 17.3%).

Discussion

This scoping review finds that most patient portal interventions have delivered education or facilitated collection of patient-reported information. Few interventions have involved pragmatic designs or been deployed system wide.

Conclusion

The patient portal is an important tool in real-world efforts to more effectively support patients, but interventions to date rely largely on evidence from consented participants rather than pragmatically implemented systems-level initiatives.
Parasitism by Gryon aetherium (Hymenoptera: Scelionidae) on Bagrada hilaris (Hemiptera: Pentatomidae) eggs in northcentral California
Authors: Hogg Brian N , Grettenberger Ian M , Borkent Christopher J
Published: August 2023

Bagrada bug, Bagrada hilaris (Burmeister) (Hemiptera: Pentatomidae), is an invasive pest of cruciferous crops. The parasitoid Gryon aetherium Talamas (Hymenoptera: Scelionidae) is a promising biological control agent for B. hilaris because it can forage in the soil where B. hilaris deposits most of its eggs. In this study, we assessed parasitism by G. aetherium on B. hilaris eggs in situ in northcentral California, including the Salinas Valley where most cruciferous crops in the United States are grown. Parasitism was documented by leaving soil-filled trays under infested plants for 7–14 days, then removing eggs and holding them for emergence of parasitoids. Gryon aetherium accounted for over 99% of emerged parasitoids, and occurred at 11 of the 12 sampled sites. Of the 17,729 and 31,759 B. hilaris eggs collected in 2021 and 2022, 1,518 (8.84%) and 2,654 (8.36%) were parasitized by G. aetherium, respectively. Parasitism rates were generally higher inland and ranged from 3.64% to 44.93% in 2021 and from 1.01% to 23.04% in 2022, and never exceeded 15% on any sample dates at several coastal sites in the Salinas Valley. Discovery efficiency (a measure of the ability of parasitoids to locate egg patches) reached 80% or higher at all but 1 site, but exploitation efficiency (a measure of the ability of parasitoids to exploit the egg patch after it has been discovered) was generally <20%, suggesting that G. aetherium can locate egg patches efficiently but is less efficient at finding eggs within patches.
Black issue publics online: securing political knowledge through selective exposure
Authors: Kleinberg Mona S
Published: August 2023

Political knowledge is fundamental to democratic politics. I develop a group-centered theory of political knowledge acquisition in the current media environment, which includes both high- and low-choice media, in this article. I argue that group identity prompts selective exposure to media content, which gives rise to specialized group-relevant political knowledge. This specialized knowledge is deeply relevant to the group and cannot be measured with indicators of general political knowledge. I show that selective exposure is the crucial mechanism facilitating specialized knowledge: Both selective exposure to Black-oriented content and use of high-choice media (the Internet) increase group-relevant knowledge among Black issue publics. This research speaks to scholarship examining the role of digital media in democratic politics and illustrates that the affordances of the Internet, and particularly selective exposure, are crucial to marginalized groups, who do not see their interests represented in mainstream media content, but who can access such information online.
Assessing the consistency of fact-checking in political debates
Authors: Lelo Thales
Published: August 2023

In the scholarly literature on journalism and political communication, there has been an expectation that fact-checkers would play an important role in ensuring democratic accountability, especially during pivotal political moments. This piece scrutinizes the level of agreement between five Brazilian fact-checking groups and the reasons for divergences in their verdicts during the presidential debates of the 2022 campaign. The emphasis is on claims checked by two or more organizations. Through a mixed-methods approach, it shows a widespread lack of consistency among fact-checkers, which is explained by their conflicting methods and interpretations of candidates’ words. This study adds to the existing scholarship by challenging the dominant framework on fact-checking, putting into question its democracy-building role in critical circumstances, as well as the epistemology it relies on to assess the veracity of political discourse. Complementary, it introduces a valuable methodology for studying the rationale underlying fact-checking ratings.
Widespread effects of DNA methylation and intra-motif dependencies revealed by novel transcription factor binding models
Authors: Grau Jan , Schmidt Florian , Schulz Marcel H
Published: August 2023

Several studies suggested that transcription factor (TF) binding to DNA may be impaired or enhanced by DNA methylation. We present MeDeMo, a toolbox for TF motif analysis that combines information about DNA methylation with models capturing intra-motif dependencies. In a large-scale study using ChIP-seq data for 335 TFs, we identify novel TFs that show a binding behaviour associated with DNA methylation. Overall, we find that the presence of CpG methylation decreases the likelihood of binding for the majority of methylation-associated TFs. For a considerable subset of TFs, we show that intra-motif dependencies are pivotal for accurately modelling the impact of DNA methylation on TF binding. We illustrate that the novel methylation-aware TF binding models allow to predict differential ChIP-seq peaks and improve the genome-wide analysis of TF binding. Our work indicates that simplistic models that neglect the effect of DNA methylation on DNA binding may lead to systematic underperformance for methylation-associated TFs.
An archaeal transcription factor EnfR with a novel ‘eighth note’ fold controls hydrogen production of a hyperthermophilic archaeon Thermococcus onnurineus NA1
Authors: Bae Da-Woon , Lee Seong Hyuk , Park Ji Hye , Son Se-Young , Lin Yuxi , Lee Jung Hyen , Jang Bo-Ram , Lee Kyu-Ho , Lee Young-Ho , Lee Hyun Sook , Kang Sung Gyun , Kim Byoung Sik , Cha Sun-Shin
Published: August 2023

Thermococcus onnurineus NA1, a hyperthermophilic carboxydotrophic archaeon, produces H2 through CO oxidation catalyzed by proteins encoded in a carbon monoxide dehydrogenase (CODH) gene cluster. TON_1525 with a DNA-binding helix-turn-helix (HTH) motif is a putative repressor regulating the transcriptional expression of the codh gene cluster. The T55I mutation in TON_1525 led to enhanced H2 production accompanied by the increased expression of genes in the codh cluster. Here, TON_1525 was demonstrated to be a dimer. Monomeric TON_1525 adopts a novel ‘eighth note’ symbol-like fold (referred to as ‘eighth note’ fold regulator, EnfR), and the dimerization mode of EnfR is unique in that it has no resemblance to structures in the Protein Data Bank. According to footprinting and gel shift assays, dimeric EnfR binds to a 36-bp pseudo-palindromic inverted repeat in the promoter region of the codh gene cluster, which is supported by an in silico EnfR/DNA complex model and mutational studies revealing the implication of N-terminal loops as well as HTH motifs in DNA recognition. The DNA-binding affinity of the T55I mutant was lowered by ∼15-fold, for which the conformational change of N-terminal loops is responsible. In addition, transcriptome analysis suggested that EnfR could regulate diverse metabolic processes besides H2 production.
Association between police officers’ stress and perceived health
Authors: Kukić Filip , Streetman Aspen , Heinrich Katie M , Popović-Mančević Marija , Koropanovski Nenad
Published: August 2023

Police experience occupational stress in two categories: operational (i.e. long hours, shift work, crime scenes) and organizational (e.g. favouritism, bureaucratic red tape) stress. High occupational stress may harm officers’ health perceptions, decreasing individual policing capacity. This study surveyed the relationship between operational and organizational stress and perceived health among 1,220 Serbian police officers (female = 232 [19%]; mean age 39.1 ± 8.4 years). Participants answered a single general health question, a 20-question operational police stress questionnaire, and a 20-question organizational police stress questionnaire. Perceived health was negatively associated with operational and organizational stress. Moderate negative associations were found between age and health and obesity status and health. When age groups were analysed separately, older officers with good or great health reported lower operational and organizational stress levels. These results suggest that better-perceived health may be protective against stress for police officers.
Phenotypic and genotypic characterization of Chinese adult patients with NLRP3-associated autoinflammatory disease with hearing loss
Authors: Wu Bingxuan , Luo Yi , Wu Di , Wang Yi , Shen Min
Published: August 2023

Objectives

Nucleotide-binding oligomerization domain-like receptor family, pyrin domain containing 3-associated autoinflammatory disease (NLRP3-AID) is a rare autosomal dominant systemic autoinflammatory disease. We aimed to summarize the phenotypic and genotypic features of Chinese adult NLRP3-AID patients with hearing loss.

Methods

A retrospective cohort study of twenty-one adult patients with NLRP3-AID was conducted in Peking Union Medical College Hospital between July 2015 and March 2023. All patients underwent whole exome sequencing and otorhinolaryngologic assessments. Clinical features and therapeutic data were collected and analysed.

Results

We found that 13/21 (61.90%) of patients had hearing loss with high-frequency impairment in the majority, and most patients presented with vestibular dysfunction as a new finding. The NLRP3-AID patients with early-onset, cold or stress triggered episodes, red eyes, fatigue, hypopsia and mutations located in the NACHT domain of the NLRP3 protein were more likely to suffer from hearing loss, especially sensorineural hearing loss, perhaps as a result of pathogenic variants of high penetrance. By a series of audiological evaluations, TNF-α inhibitors were confirmed to improve or reverse hearing loss.

Conclusions

We reported the first cohort of Chinese adult NLRP3-AID patients with hearing loss and characterized vestibular dysfunction, highlighted the necessity for attention to high-frequency hearing and provided potential alternative treatment.
Hypomethylation of CD3D promoter induces immune cell infiltration and supports malignant phenotypes in uveal melanoma
Authors: Zhang Chao , Wu Shuai
Published: August 2023

Alterations in DNA methylation in malignant diseases have been heralded as promising targets for diagnostic, prognostic, and predictive values. This study was based on epigenetic alterations and immune cell infiltration analysis to investigate the mechanism of CD3D methylation in uveal melanoma (UM). Bioinformatics analysis was performed on transcriptome data, 450 K methylation data, and clinical information of UM patients from the TCGA database. Stromal and immune cell infiltration was evaluated by calculating the StromalScore and ImmuneScore of UM samples. UM samples were divided into high and low StromalScore and ImmuneScore groups, followed by differential and enrichment analyses. PPI network construction and correlation analysis was used to identify the core prognosis‐related genes. The bioinformatics analysis results were confirmed in UM cell experiments. StromalScore and ImmuneScore were significantly associated with the prognosis of UM patients. CD3D, IRF1, CCL3, and FN1 were identified as core genes driven by methylation that affected the prognosis of UM patients. CD3D expression showed the highest correlation with its methylation and was closely related to the four key immune cells in UM development. CD3D was hypomethylated and abundantly expressed in UM cells, while silencing of CD3D inhibited the proliferation, migration, and invasion of UM cells in vitro. In summary, this study identifies hypomethylation of CD3D promoter in UM, which was associated with immune cell infiltration of UM.
Corrective Maneuvers Used in Different Scoliosis Deformities With the Experience of 72 Operated Patients
Authors: Bayram Yusuf , Polat Ömer , Karataş Muhammed E. , Günaydin Fatih , Kesebir Enes , Çaçan Mehmet A. , Uçar Bekir Y.
Published: August 2023

Purpose:

This study aimed to show the correction maneuvers used in scoliosis surgery and give hints and tips on achieving optimal correction with the help of visual content.

Materials and Methods:

Seventy-two scoliosis patients with 96 major curves operated between 2011 and 2018 evaluated retrospectively. Seven different correction maneuvers (Ucar convex rod rotation technique, cantilever technique, convex double-rod rotation technique, convex double-rod translation technique, double-rod rotation with coronal bending, convex rod rotation with coronal bending, direct vertebral rotation) were used in these surgeries alone or together. Each method is explained with figures and videos. Type of scoliosis, follow-up time, age, preoperative and postoperative degree of curvature, amount of correction, surgical time, amount of transfusion, hemoglobin level, and hospital stay were evaluated.

Results:

The mean follow-up was 42.5 (24–108) months, and the mean age was 15.8 (12–29) years. The mean preoperative scoliosis angle of the patients was 75.9 (50–139) degrees, and the final follow-up was 15.6 (5–40) degrees. The scoliotic deformity correction rate was 79.3%. The mean preoperative thoracic kyphosis of the patients was 58.7 (12–110) degrees, and the final follow-up was 41.2 (25–62) degrees. The mean surgical time was 293 (160–440) minutes. The mean hospitalization length was 5.8 (2–21) days. The blood delivered to patients during surgery and postoperative was 715 (300–1800) mL. There was a statistically significant difference between the preoperative and final follow-up scoliosis angle (P=0.000).

Conclusions:

Providing an ideal correction without damaging the spinal cord depends on correctly applying the correction maneuvers. The use of correction maneuvers alone or in combination in the appropriate order will shorten the duration of the case, decrease the amount of bleeding, shorten the hospital stay, increase the amount of correction, and reduce complications.
Biomechanical Study of Horizontal Screw-screw Crosslink in C1–2 Pedicle Screw-rod Fixation
Authors: Ouyang Beiping , Zou Xiaobao , Luo Chunshan , Lu Tingsheng , Ma Xiangyang
Published: August 2023

Study Design:

This is a biomechanical study in vitro.

Objective:

To investigate the biomechanical differences between horizontal rod-rod crosslink (hR-R CL) and the horizontal screw-screw crosslink (hS-S CL) implementation in C1–2 pedicle screw-rod (C1–2 PSR) fixation.

Summary of Background:

To improve internal fixation stability, transverse connector (TC) is used in C1-2 PSR to increase torsional stiffness. The connection mode of horizontal connection includes hR-R CL and hS-S CL. hS-S CL adopted in C1–2 PSR was rarely reported and its biomechanics are still unclear.

Materials and Methods:

Six fresh cadaveric cervical spine specimens were each tested as an Intact model, then modified and tested as an Instability model (unstable odontoid fractures), and then as 3 internal fixation models, including C1–2 PSR, C1–2 pedicle screw-rod+horizontal rod-rod crosslink (C1–2 PSR+ hR-R CL), C1–2 pedicle screw-rod+horizontal screw-screw crosslink (C1–2 PSR+ hS-S CL). The ROM of the C1–2 segments was measured by applying 1.5 nm load in 6 loading conditions, including flexion-extension (FE), left and right lateral bending (LB), and left and right axial rotation (AR).

Results:

The C1–2 PSR+hR-R CL and C1–2 PSR+hS-S CL models, respectively, showed 60% and 75% lower ROM than the C1–2 PSR model in LB and AR conditions (P<0.05). ROM was comparable between the C1–2 PSR+hR-R CL and the C1–2 PSR+hS-S CL models in all loading conditions (P>0.05).

Conclusion:

Both types of crosslinks showed superior C1–2 stability under LB and AR conditions than PSR without crosslinks. The C1–2 segment stability was comparable between the 2 types of crosslinks themselves.
Pilot Study on Percutaneous Delivery of Recombinant Human Bone Morphongenetic Protein-2 Augments Fusion in a Nicotine-impaired Rabbit Fusion Model
Authors: Virk Sohrab , Vaishnav Avani , Kumagai Hiroshi , Yao Yu-Cheng , Dowdell James , Sandhu Harvinder , Schwab Frank , Qureshi Sheeraz
Published: August 2023

Study Design:

A nicotine-impaired spinal fusion rabbit model.

Objective:

To examine whether controlled delivery of morselized absorbable collagen sponge recombinant human bone morphogenetic protein-2 (rhBMP2) in a delayed manner postsurgery would allow for improved bone healing.

Summary of Background Data:

The current delivery method of rhBMP-2 during surgery causes a burst of rhBMP-2, which is not sustained. Given that bone morphogenetic protein 2 (BMP-2) expression peaks later in the fusion process, there may be the benefit of delivery of rhBMP-2 later in the healing process.

Methods:

Sixteen male 1-year-old rabbits underwent a posterolateral spinal fusion with iliac crest bone graft at L5–L6 while being given nicotine to prevent spinal fusion as previously published. Eight were controls, whereas 8 had morselized rhBMP-2 (4.2 mg) injected at the fusion site at 4 weeks postoperatively. Histologic, radiologic, and palpation examinations were performed at 12 weeks to determine fusion status and the volume of bone formed. Hematoxylin and eosin stains were used for histology. A Student t test was used to compare the computed tomography scan measured volume of bone created between the control cohort (CC) and rhBMP-2 delayed delivery cohort (BMP-DDC).

Results:

Of the total, 7/8 rabbits in the BMP-DDC and 5/8 rabbits in the CC formed definitive fusion with a positive palpation examination, bridging bone between transverse processes on computed tomography scan, and an x-ray showing fusion. Histologic analysis revealed newly remodeled bone within the BMP-DDC. There was an increased average volume of bone formed within the BMP-DDC versus the CC (22.6 ± 13.1 vs 11.1 ± 3.6 cm3, P = 0.04).

Conclusion:

Our study shows that injectable morselized absorbable collagen sponge/rhBMP-2 can create twice as much bone within a nicotine-impaired rabbit spine fusion model when delivered 4 weeks out from the time of surgery.
Telomere length is associated with increased risk of cutaneous melanoma: a Mendelian randomization study
Authors: Liu Mingjuan , Lan Yining , Zhang Hanlin , Zhang Xinyi , Wu Mengyin , Yang Leyan , Zhou Jia , Tong Meiyi , Leng Ling , Zheng Heyi , Li Jun , Mi Xia
Published: August 2023

The objective was to investigate the causal association between genetically predicted telomere length (TL) and cutaneous melanoma (CM) risk using Mendelian randomization (MR). This study utilized a two-sample MR and two large genome-wide association studies (GWAS) were used for instrumental variable (IV) selection to select single nucleotide polymorphisms at the genome-wide significance threshold (P < 5E-08) for TL. The IVs were then pruned for linkage disequilibrium and weak instrument bias. Summary statistics from a GWAS meta-analysis of CM were used as the outcome variable. The inverse variance weighted (IVW) method was used as the primary approach for overall causal estimation in MR, with sensitivity analyses performed to assess robustness. All statistical analyses were conducted in R studio.

Results

The MR analysis using two TL GWAS datasets revealed strong and consistent evidence that long TL is causally associated with an increased risk of CM. The analysis of the Codd et al. dataset found that long TL significantly predicted an elevated risk of CM (IVW OR = 2.411, 95% CI 2.092–2.780, P = 8.05E-34). Similarly, the analysis of the Li et al. dataset yielded consistent positive results across all MR methods, providing further robustness to the causal relationship (IVW OR = 2.324, 95% CI 1.516–3.565, P = 1.11E-04). The study provides evidence for a causal association between TL and CM susceptibility, indicating that longer TL increases the risk of developing CM and providing insight into the unique telomere biology in melanoma pathogenesis. Telomere maintenance pathways may be a potential target for preventing and treating CM.
Noninvasive Prenatal Screening for Single-Gene Disorders
Authors: GONSALVES ZENOBIA , KLUGMAN SUSAN
Published: August 2023

Single-gene disorders (SGDs), also known as monogenic disorders, are caused by pathogenic variants at individual loci. Prenatal cell-free DNA screening for SGDs has been investigated for decades. Detecting paternal and de novo variants may be somewhat straightforward, whereas detecting maternally inherited variants poses a significant challenge. Although commercially available in both high-risk and low-risk patients, many limitations exist. The use of SGDs is not supported by professional medical societies.
Advanced practice nursing in France: Social capital assessment
Authors: Brandman J. D. Wailua , Sato Randall M.
Published: August 2023

France is in the initial stage of development of the advanced practice nursing role. Social capital is essential to move this development forward, as evidenced by similar global movements resulting in the establishment of the advanced practice role of nurses. A pilot project examined the general response of French citizens (social capital) to the idea of advanced nursing practice in their country. The overwhelming majority of participants were in support of advanced nursing practice, with 90% of the participants answering “Yes” to the question “Would you trust and feel safe having a Nurse Practitioner (APRN) provide your primary care instead of a physician?” Social capital is needed in many areas of health care and may be enhanced by strong social capital within the citizenry.
“Scaling out” evidence-informed antenatal care to support healthy pregnancy weight gain: a context assessment using the Consolidated Framework for Implementation Research
Authors: Meloncelli Nina , James Sarah , Riggs Kristen , de Jersey Susan
Published: August 2023

Introduction and aims:

Excess gestational weight gain is a challenge within antenatal care. Low-intensity interventions that offer opportunities for individualization, such as pregnancy weight-gain charts (PWGCs) combined with brief advice, have been a promising strategy but scaling out such interventions requires planning. The aim of this study was to examine current practices and conduct a context assessment using the Consolidated Framework for Implementation Research (CFIR) to guide implementation of PWGCs and brief intervention advice to support healthy pregnancy weight gain in two hospitals that provide antenatal care.

Methods:

Retrospective chart audits and surveys of staff and women were used to understand current practice as well as barriers and enablers to implementing change according to the domains and constructs reported in the CFIR.

Results:

Forty-eight percent (site A) and 46% (site B) of pregnant women who were audited (n = 180, site A; n = 176, site B) gained weight above recommendations. Most women were unable to accurately report their recommended weight gain for pregnancy (93% site A, 94% site B). Although more than 50% of women reported discussions about weight gain during pregnancy, advice about physical activity and healthy eating (in the context of helping women to achieve healthy gestational weight gain) was low. Mapping barriers and enablers to the CFIR helped guide the selection of implementation strategies, including audit and feedback, informing local opinion leaders, obtaining consensus, identifying champions, and building a coalition.

Conclusion:

Scaling out of interventions can be enhanced by undertaking a detailed context assessment guided by implementation frameworks.
Prediction models for adverse drug reactions during tuberculosis treatment in Brazil
Authors: Ridolfi Felipe , Amorim Gustavo , Peetluk Lauren S. , Haas David W. , Staats Cody , Araújo-Pereira Mariana , Cordeiro-Santos Marcelo , Kritski Afrânio L. , Figueiredo Marina C. , Andrade Bruno B. , Rolla Valeria C. , Sterling Timothy R. ,   Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil consortium
Published: August 2023

Background

Tuberculosis (TB) treatment-related adverse drug reactions (TB-ADR) can negatively affect adherence and treatment success rates.

Methods

We developed two prediction models for TB-ADR. We included drug-susceptible pulmonary TB participants who initiated standard TB therapy. TB-ADR were determined by physician-assigned attributions of causality, and described according to affected organ system, timing, and grade. Potential predictors of TB-ADR included concomitant medication (CM) use, HIV-status, glycated hemoglobin (HbA1c), age, body mass index (BMI), sex, substance use, and TB drug metabolism variables (e.g.,NAT2acetylator profile). Bootstrapped backwards selection was used to develop the models. Cox proportional hazards regression was used to evaluate TB-ADR risk.

Results

There were 156 TB-ADR among 102 (11%) of the 945 participants included. Most TB-ADR were hepatic (n=82;53%), grade 2 (n=121;78%), and occurred inNAT2slow acetylators (n=62;61%). The main prediction model included CM use, HbA1c, alcohol-use, HIV-infection, BMI, and age. The alternative model included the same variables, except replaced BMI withNAT2. Both models had good performance and fit. CM use and HIV-infection increased TB-ADR risk.

Conclusions

The model with only clinical variables and that withNAT2were highly predictive of TB-ADR. TheNAT2model provides rationale to evaluate isoniazid dose adjustment and ADR risk.
Co-existence of negative and positive associations between cognition and intergenerational psychiatric symptoms reveal necessity of socioeconomic and clinical enrichment
Authors: Pines Adam , Tozzi Leonardo , Bertrand Claire , Keller Arielle S. , Zhang Xue , Whitfield-Gabrieli Susan , Hastie Trevor , Larsen Bart , Leikauf John , Williams Leanne M.
Published: August 2023

Background

Mental illnesses are a leading cause of disability globally. Across 17 psychiatric disorders, functional disability is often in part caused by cognitive impairments. However, cognitive heterogeneity in mental health is poorly understood, particularly in children.

Methods

We used generalized additive models (GAMs) to reconcile discrepant reports of cognitive impairment across classes of psychiatric symptoms in 4,782 children and their parents. Specifically, we derive relationships between cognition and psychopathology across different ranges and classes of symptom burdens. We additionally evaluate generalizability across sex-assigned-at-birth (SAAB) and federal poverty status. Finally, we incorporate a measure of scholastic performance as a real-world measure of functional ability. Associations were tested at the 99% confidence level.

Results

We demonstrate that the previously-reported, weak, negative, and linear relationship between general cognition and general psychopathology consists of several stronger but opposed relationships. Externalizing symptoms are negatively associated with cognition, but internalizing symptoms are positively associated with cognition at low symptom burdens. This phenomenon holds across parental and child symptoms. Finally, we provide evidence that, compared to laboratory measures of cognition, school grades are more accurate and generalizable indicators of psychopathological burden in children.

Discussion

The most common approach to quantifying the relationship between cognition and psychopathology systematically underestimates the strength and complexity of this relationship. Grades may represent a more accurate and generalizable marker of mental illness. Developmental studies incorporating clinical enrichment, parental mental health, and socioeconomically diverse samples may provide deeper and more generalizable insight into neurocognitive impairment and psychopathology.
A mathematical model for velocity-selective arterial spin labeling
Authors: Liu Thomas T. , Wong Eric C. , Bolar Divya S. , Chen Conan , Barnes Ryan A.
Published: August 2023

Purpose

To present a theoretical framework that rigorously defines and analyzes key concepts and quantities for velocity selective arterial spin labeling (VSASL).

Theory and Methods

An expression for the VSASL arterial delivery function is derived based on (1) labeling and saturation profiles as a function of velocity and (2) physiologically plausible approximations of changes in acceleration and velocity across the vascular system. The dependence of labeling efficiency on the amplitude and effective bolus width of the arterial delivery function is defined. Factors that affect the effective bolus width are examined, and timing requirements to minimize quantitation errors are derived.

Results

The model predicts that a flow-dependent negative bias in the effective bolus width can occur when velocity selective inversion (VSI) is used for the labeling module and velocity selective saturation (VSS) is used for the vascular crushing module. The bias can be minimized by choosing a nominal labeling cutoff velocity that is lower than the nominal cutoff velocity of the vascular crushing module.

Conclusion

The elements of the model are specified in a general fashion such that future advances can be readily integrated. The model can facilitate further efforts to understand and characterize the performance of VSASL and provide critical theoretical insights that can be used to design future experiments and develop novel VSASL approaches.
Health factors associated with development and severity of post-stroke dysphagia: an epidemiological investigation
Authors: Krekeler Brittany N , Schieve Heidi J P , Khoury Jane , Ding Lili , Haverbusch Mary , Alwell Kathleen , Adeoye Opeolu , Ferioloi Simona , Mackey Jason , Woo Daniel , Flaherty Matthew , De Los Rios La Rosa Felipe , Demel Stacie , Star Michael , Coleman Elisheva , Walsh Kyle , Slavin Sabreena , Jasne Adam , Mistry Eva , Kleindorfer Dawn , Kissela Brett
Published: August 2023

Background and Purpose

Dysphagia is a common post-stroke occurrence and has been shown to impact patients’ morbidity and mortality. The purpose of this study was to use a large population-based dataset to determine specific epidemiological and patient health risk factors that impact development and severity of dysphagia after acute stroke.

Methods

Using data from the Greater Cincinnati Northern Kentucky Stroke Study, GCNKSS, involving a representative sample of approximately 1.3 million people from Southwest Ohio and Northern Kentucky of adults (age ≥18), ischemic and hemorrhagic stroke cases from 2010 and 2015 were identified via chart review. Dysphagia status was determined based on bedside and clinical assessments, and severity by necessity for alternative access to nutrition via nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tube placement. Comparisons between patients with and without dysphagia were made to determine differences in baseline characteristics and pre-morbid conditions. Multivariable logistic regression was used to determine factors associated with increased risk of developing dysphagia.

Results

Dysphagia status was ascertained from 4139 cases (1709 with dysphagia). Logistic regression showed: increased age, Black race, higher NIHSS score at admission, having a hemorrhagic stroke (vs infarct), and right hemispheric stroke increased risk of developing dysphagia after stroke. Factors associated with reduced risk included history of high cholesterol, lower pre-stroke mRS score, and white matter disease.

Conclusions

This study replicated many previous findings of variables associated with dysphagia (older age, worse stroke, right sided hemorrhagic lesions), while other variables identified were without clear biological rationale (e.g. Black race, history of high cholesterol and presence of white matter disease). These factors should be investigated in future, prospective studies to determine biological relevance and potential influence in stroke recovery.
Individual differences in wellbeing are supported by separable sets of co-active self- and visual-attention-related brain networks
Authors: Ma Yumeng , Skipper Jeremy I
Published: August 2023

How does the brain support ‘wellbeing’? Because it is a multidimensional construct, it is likely the product of multiple co-active brain networks that vary across individuals. This is perhaps why prior neuroimaging studies have found inconsistent anatomical associations with wellbeing. Furthermore, these used ‘laboratory-style’ or ‘resting-state’ methods not amenable to finding manifold networks. To address these issues, we had participants watch a full-length romantic comedy-drama film during functional magnetic resonance imaging. We hypothesised that individual differences in wellbeing measured before scanning would be correlated with individual differences in brain networks associated with ‘embodied’ and ‘narrative’ self-related processing. Indeed, searchlight spatial inter-participant representational similarity and subsequent analyses revealed seven sets of co-activated networks associated with individual differences in wellbeing. Two were ‘embodied self’ related, including brain regions associated with autonomic and affective processing. Three sets were ‘narrative self’ related, involving speech, language, and autobiographical memory-related regions. Finally, two sets of visual-attention-related networks emerged. These results suggest that the neurobiology of wellbeing in the real world is supported by diverse but functionally definable and separable sets of networks. This has implications for psychotherapy where individualised interventions might target, e.g., neuroplasticity in language-related narrative over embodied self or visual-attentional related processes.
SSVEPs reveal dynamic (re-)allocation of spatial attention during maintenance and utilization of visual working memory
Authors: Chota Samson , Bruat Arnaud , Van der Stigchel Stefan , Strauch Christoph
Published: August 2023

Visual Working Memory (VWM) allows us to temporarily store goal-relevant information to guide future behavior. Prior work has established that VWM and spatial attention are intrinsically connected – even if location is irrelevant for responses: behavioral and neural correlates of attention show spatial biases, specific to the location at which memory items were encoded. This suggests that VWM is spatially organized and that maintaining information might rely on the allocation of spatial attention towards the location of memory items. Importantly, attention often needs to be dynamically redistributed between several locations, e.g. in preparation for an upcoming probe. Very little is known about how attentional resources are distributed between multiple locations during a VWM task and even less about the dynamic changes governing such attentional shifts over time. This is largely due to the inability to use behavioral outcomes to reveal fast dynamic changes within trials.

We here demonstrate EEG Steady-State Visual Evoked Potentials (SSVEPs) to successfully track the dynamic allocation of spatial attention during a VWM task. Participants were presented with to-be-memorized gratings and distractors at two distinct locations. During maintenance and retrieval, each location was tagged with a disk flickering at either 10 or 13 Hz. This allowed us to dynamically track attention allocated to memory and distractor items via their coupling with space by quantifying the amplitude and coherence of SSVEP responses in the EEG signal to flickering stimuli at the former memory and distractor locations.

SSVEP responses at memory locations did not differ from distractor locations during early parts of the maintenance window. However, shortly before probe comparison, we observed a decrease in SSVEP coherence over distractor locations indicative of a reallocation of spatial attentional resources. Reaction times were shorter when preceded by stronger decreases in SSVEP coherence at distractor locations, reflecting the reallocation of attention from the distractor location to the memory location or towards the distinct upcoming probe location.

Broader SignificanceWe demonstrate that SSVEPs can inform about dynamic processes in VWM, even if location does not have to be reported by participants. This finding not only supports the notion of a spatially organized VWM, but also reveals that SSVEPs betray a dynamic prioritization process of working memory items and locations over time that is directly predictive of memory performance.
Sex- versus apomictic-specific polymorphisms in the 5’UTR of APOLLO fromBoecherashift gene expression from somatic to reproductive tissues inArabidopsis
Authors: Honari Maryam , Ashnest Joanne R. , Sharbel Timothy F.
Published: August 2023

Among candidate genes underlying the control components of apomixis, APOLLO is known for its strong linkage to apomeiosis in the genusBoechera. The gene has “apo-alleles”, which are characterized by a set of linked apomixis-specific polymorphisms, and “sex-alleles”. All apomictic□Boecheragenotypes are heterozygous for the apo/sex-alleles, while all sexual genotypes are homozygous for sex-alleles. In this study, native and synthetic APOLLO promoters were characterized by detecting the expression level of the β-glucuronidase (GUS) gene inArabidopsis. Comparing various flower developmental stages in transgenic lines containing different constructs with 2 kb native transgenic lines revealed that changes to the APOLLO promoter causes shifts in tissue- and developmental-stage specificity of GUS expression. Importantly, several apomixis-specific polymorphisms in the 5’UTR change the timing and location of GUS activity from somatic to reproductive tissues. These synthetic data simulate a plausible evolutionary process whereby apomixis-specific gene activity can be achieved.
A distinct class of hematopoietic stem cells develop from the human yellow bone marrow
Authors: Nguyen Tammy T. , Loureiro Zinger Yang , Desai Anand , DeSouza Tiffany , Joyce Shannon , Khair Lyne , Samant Amruta , Cirka Haley , Solivan-Rivera Javier , Ziegler Rachel , Brehm Michael , Messina Louis M. , Corvera Silvia
Published: August 2023

Aging and metabolic diseases are accompanied by systemic inflammation, but the mechanisms that induce this state are not known. We developed a human bone-marrow organoid system to explore mechanisms underlying metabolic-disease associated systemic inflammation. We find that a distinct type of hematopoietic stem cell (HSC) develops in the adipose-rich, yellow bone marrow, which is known to gradually replace the hematopoietic red marrow as we age and during metabolic disease. Unlike HSCs derived from the red bone marrow, HSCs derived from the yellow bone marrow have higher proliferation rates, increase myeloid differentiation, skew towards pro-inflammatory M1 macrophage differentiation, and express a distinct transcriptomic profile associated with responsiveness to wounding. Yellow marrow-derived HSCs express higher levels of the leptin receptor, which we find to be further increased in patients with type 2 diabetes. Our work demonstrates that the human long bone yellow marrow is a niche for a distinct class of HSCs which could underlie hematopoietic dysfunction during aging and metabolic disease processes suggesting a shared inflammaging mechanism.
Costs of resistance limit the effectiveness of cooperation enforcement
Authors: Miller M.E. , Sidell S. , Ostrowski E.A.
Published: August 2023

Cooperative groups are susceptible to invasion by cheaters that reap the benefits but fail to pay the costs. Both theory and experimental work have shown that cheating can select for counter-adaptations to resist cheating. But then why is cheating so common? One key hypothesis is that trade-offs prevent resistors from taking over, but evidence to support the trade-off model is lacking. Here we evolved resistance to different cheaters and tested for trade-offs. Improvements against one cheater frequently entailed correlated improvements against novel cheaters. However, direct responses to selection were typically stronger than correlated responses to selection, resulting in a pattern of local adaptation of resistance. Control populations, evolved in the absence of a cheater, showed improvements in spore germination, whereas cheater-evolved populations did not, suggesting that the evolution of resistance retards or prevents other fitness improvements. Taken together, our findings suggest that, although cheater resistance can evolve rapidly, it may also involve subtle trade-offs that can help to explain the maintenance of polymorphism in cheating and resistance in nature.