bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultural sensitivity in brain death determination: a necessity in end-of-life decisions in Japan
Authors: Terunuma Yuri , Mathis Bryan J.
Published: May 2021

Background

In an increasingly globalized world, legal protocols related to health care that are both effective and culturally sensitive are paramount in providing excellent quality of care as well as protection for physicians tasked with decision making. Here, we analyze the current medicolegal status of brain death diagnosis with regard to end-of-life care in Japan, China, and South Korea from the perspectives of front-line health care workers.

Main body

Japan has legally wrestled with the concept of brain death for decades. An inability to declare brain death without consent from family coupled with cultural expectations of family involvement in medical care is mirrored in other Confucian-based cultures (China and South Korea) and may complicate care for patients from these countries when traveling or working overseas. Within Japan, China, and South Korea, medicolegal shortcomings in the diagnosis of brain death (and organ donation) act as a great source of stress for physicians and expose them to potential public and legal scorn. Here, we detail the medicolegal status of brain death diagnosis within Japan and compare it to China and South Korea to find common ground and elucidate the impact of legal ambiguity on health care workers.

Conclusion

The Confucian cultural foundation of multiple Asian countries raises common issues of family involvement with diagnosis and cultural considerations that must be met. Leveraging public education systems may increase awareness of brain death issues and lead to evolving laws that clarify such end-of-life issues while protecting physicians from sociocultural backlash.
Effects of transition on HIV and non-HIV services and health systems in Kenya: a mixed methods evaluation of donor transition
Authors: Rodríguez Daniela C. , Mohan Diwakar , Mackenzie Caroline , Wilhelm Jess , Eze-Ajoku Ezinne , Omondi Elizabeth , Qiu Mary , Bennett Sara
Published: May 2021

Background

In 2015 the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiated its Geographic Prioritization (GP) process whereby it prioritized high burden areas within countries, with the goal of more rapidly achieving the UNAIDS 90–90-90 targets. In Kenya, PEPFAR designated over 400 health facilities in Northeastern Kenya to be transitioned to government support (known as central support (CS)).

Methods

We conducted a mixed methods evaluation exploring the effect of GP on health systems, and HIV and non-HIV service delivery in CS facilities. Quantitative data from a facility survey and health service delivery data were gathered and combined with data from two rounds of interviews and focus group discussions (FGDs) conducted at national and sub-national level to document the design and implementation of GP. The survey included 230 health facilities across 10 counties, and 59 interviews and 22 FGDs were conducted with government officials, health facility providers, patients, and civil society.

Results

We found that PEPFAR moved quickly from announcing the GP to implementation. Despite extensive conversations between the US government and the Government of Kenya, there was little consultation with sub-national actors even though the country had recently undergone a major devolution process. Survey and qualitative data identified a number of effects from GP, including discontinuation of certain services, declines in quality and access to HIV care, loss of training and financial incentives for health workers, and disruption of laboratory testing. Despite these reports, service coverage had not been greatly affected; however, clinician strikes in the post-transition period were potential confounders.

Conclusions

This study found similar effects to earlier research on transition and provides additional insights about internal country transitions, particularly in decentralized contexts. Aside from a need for longer planning periods and better communication and coordination, we raise concerns about transitions driven by epidemiological criteria without adaptation to the local context and their implication for priority-setting and HIV investments at the local level.
Narrowing but persisting gender pay gap among employees of the US Department of Health and Human Services during 2010–2018
Authors: Chen Zhuo , Zhang Yihong , Luo Huabin , Zhang Donglan , Rajbhandari-Thapa Janani , Wang Yuheng , Wang Ruoxi , Bagwell-Adams Grace
Published: May 2021

Background

The gender pay gap in the United States (US) has narrowed over the last several decades, with the female/male earnings ratio in the US increased from about 60% before the 1980s to about 79% by 2014. However, the gender pay gap among the healthcare workforce persists. The objective of this study is to estimate the gender pay gap in the US federal governmental public health workforce during 2010–2018.

Methods

We used an administrative dataset including annual pay rates and job characteristics of employees of the US Department of Health and Human Services. Employees’ gender was classified based on first names. Regression analyses were used to estimate the gender pay gap using the predicted gender.

Results

Female employees of the DHHS earned about 13% less than men in 2010, and 9.2% less in 2018. Occupation, pay plan, and location explained more than half of the gender pay gap. Controlling for job grade further reduces the gap. The unexplained portion of the gender pay gap in 2018 was between 1.0 and 3.5%. Female employees had a slight advantage in terms of pay increase over the study period.

Conclusions

While the gender pay gap has narrowed within the last two decades, the pay gap between female and male employees in the federal governmental public health workforce persists and warrants continuing attention and research. Continued efforts should be implemented to reduce the gender pay gap among the health workforce.
Interprofessional education-relevant accreditation standards in Canada: a comparative document analysis
Authors: Azzam Mohammad , Puvirajah Anton , Girard Marie-Andrée , Grymonpre Ruby E.
Published: May 2021

Background

Increasing evidence suggests that sustainable delivery of interprofessional education (IPE) has the potential to lead to interprofessional collaborative practice (IPCP), which in turn has the potential to lead to enhanced healthcare systems and improved patient-centered care health outcomes. To enhance IPE in Canada, the Accreditation of Interprofessional Health Education (AIPHE) project initiated collaborative efforts among accrediting organizations of six health professions to embed IPE language into their respective accreditation standards. To further understand the impact of the AIPHE project, this study evaluated the accountability of the IPE language currently embedded in Canadian health professions’ accreditation standards documents and examined whether such language spanned the five accreditation standards domains identified in the AIPHE project.

Methods

We conducted a comparative content analysis to identify and examine IPE language within the “accountable” statements in the current accreditation standards for 11 Canadian health professions that met our eligibility criteria.

Results and discussion

A total of 77 IPE-relevant accountable statements were identified across 13 accreditation standards documents for the 11 health professions. The chiropractic, pharmacy, and physiotherapy documents represented nearly 50% (38/77) of all accountable statements. The accountable statements for pharmacy, dentistry, dietetics, and nursing (registered) spanned across three-to-four accreditation standards domains. The remaining nine professions’ statements referred mostly to “Students” and “Educational program.” Furthermore, the majority of accreditation standards documents failed to provide a definition of IPE, and those that did, were inconsistent across health professions.

Conclusions

It was encouraging to see frequent reference to IPE within the accreditation standards of the health professions involved in this study. The qualitative findings, however, suggest that the emphasis of these accountable statements is mainly on the students and educational program, potentially compromising the sustainability and development, implementation, and evaluation of this frequently misunderstood pedagogical approach. The findings and exemplary IPE-relevant accountable statements identified in this paper should be of interest to all relevant stakeholders including those countries, where IPE accreditation is still emerging, as a means to accelerate and strengthen achieving desired educational and health outcomes.
Cost-effectiveness of a population-based AAA screening program for men over 65 years old in Iran
Authors: Daroudi Rajabali , Shafe Omid , Moosavi Jamal , Salimi Javad , Bayazidi Yahya , Zafarghandi Mohammad Reza , Maleki Majid , Moini Majid , Farshidmehr Pezhman , Sadeghipour Parham
Published: May 2021

Background

Screening program tend to recognized patients in their early stage and consequently improve health outcomes. Cost-effectiveness of the abdominal aortic aneurysm (AAA) screening program has been scarcely studied in developing countries. We sought to evaluate the cost-effectiveness of a screening program for the abdominal aortic aneurysm (AAA) in men aged over 65 years in Iran.

Methods

A Markov cohort model with 11 mutually exclusive health statuses was used to evaluate the cost-effectiveness of a population-based AAA screening program compared with a no-screening strategy. Transitions between the health statuses were simulated by using 3-month cycles. Data for disease transition probabilities and quality of life outcomes were obtained from published literature, and costs were calculated based on the price of medical services in Iran and the examination of the patients’ medical records. The outcomes were life-years gained, the quality-adjusted life-year (QALY), costs, and the incremental cost-effectiveness ratio (ICER). The analysis was conducted for a lifetime horizon from the payer’s perspective. Costs and effects were discounted at an annual rate of 3%. Uncertainty surrounding the model inputs was tested with deterministic and probabilistic sensitivity analyses.

Results

The mean incremental cost of the AAA screening strategy compared with the no-screening strategy was $140 and the mean incremental QALY gain was 0.025 QALY, resulting in an ICER of $5566 ($14,656 PPP) per QALY gained. At a willingness-to-pay of 1 gross domestic product (GDP) per capita ($5628) per QALY gained, the probability of the cost-effectiveness of AAA screening was about 50%. However, at a willingness-to-pay of twice the GDP per capita per QALY gained, there was about a 95% probability for the AAA screening program to be cost-effective in Iran.

Conclusions

The results of this study showed that at a willingness-to-pay of 1 GDP per capita per QALY gained, a 1-time AAA screening program for men aged over 65 years could not be cost-effective. Nevertheless, at a willingness-to-pay of twice the GDP per capita per QALY gained, the AAA screening program could be cost-effective in Iran. Further, AAA screening in high-risk groups could be cost-effective at a willingness-to-pay of 1 GDP per capita per QALY gained.
Effectiveness and cost-effectiveness of the PLAN-A intervention, a peer led physical activity program for adolescent girls: results of a cluster randomised controlled trial
Authors: Jago Russell , Tibbitts Byron , Willis Kathryn , Sanderson Emily , Kandiyali Rebecca , Reid Tom , Kipping Ruth R , Campbell Rona , MacNeill Stephanie J , Hollingworth William , Sebire Simon J.
Published: May 2021

Background

Physical activity is associated with improved health. Girls are less active than boys. Pilot work showed that a peer-led physical activity intervention called PLAN-A was a promising method of increasing physical activity in secondary school age girls. This study examined the effectiveness and cost-effectiveness of the PLAN-A intervention.

Methods

We conducted a cluster randomised controlled trial with Year 9 (13–14 year old) girls recruited from 20 secondary schools. Schools were randomly assigned to the PLAN-A intervention or a non-intervention control group after baseline data collection. Girls nominated students to be peer leaders. The top 18 % of girls nominated by their peers in intervention schools received three days of training designed to prepare them to support physical activity. Data were collected at two time points, baseline (T0) and 5–6 months post-intervention (T1). Participants wore an accelerometer for seven days to assess the primary outcome of mean weekday minutes of moderate-to-vigorous physical activity (MVPA). Multivariable mixed effects linear regression was used to estimate differences in the primary outcome between the two arms on an Intention-to-Treat (ITT) basis. Resource use and quality of life were measured and a within trial economic evaluation from a public sector perspective was conducted.

Results

A total of 1558 girls were recruited to the study. At T0, girls in both arms engaged in an average of 51 min of MVPA per weekday. The adjusted mean difference in weekday MVPA at T1 was − 2.84 min per day (95 % CI = -5.94 to 0.25) indicating a slightly larger decline in weekday MVPA in the intervention group. Results were broadly consistent when repeated using a multiple imputation approach and for pre-specified secondary outcomes and sub-groups. The mean cost of the PLAN-A intervention was £2817 per school, equivalent to £31 per girl. Economic analyses indicated that PLAN-A did not lead to demonstrable cost-effectiveness in terms of cost per unit change in QALY.

Conclusions

This study has shown that the PLAN-A intervention did not result in higher levels of weekday MVPA or associated secondary outcomes among Year 9 girls. The PLAN-A intervention should not be disseminated as a public health strategy.

Trial registration

ISRCTN14539759–31 May, 2018.
Lumbar and ventricular CSF concentrations of extracellular matrix proteins before and after shunt surgery in idiopathic normal pressure hydrocephalus
Authors: Minta Karolina , Jeppsson Anna , Brinkmalm Gunnar , Portelius Erik , Zetterberg Henrik , Blennow Kaj , Tullberg Mats , Andreasson Ulf
Published: May 2021

Background

Idiopathic normal pressure hydrocephalus (iNPH) is a reversible CNS disease characterized by disturbed cerebrospinal fluid (CSF) dynamics. Changes in the extracellular matrix (ECM) composition might be involved in the pathophysiology of iNPH. The aim of this study was to explore possible differences between lumbar and ventricular CSF concentrations of the ECM markers brevican and neurocan, matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase-1 (TIMP-1) and their relation to clinical symptoms in iNPH patients before and after shunt surgery.

Methods

Paired lumbar and ventricular CSF was collected from 31 iNPH patients, before and four months after shunt surgery. CSF was analysed for concentrations of tryptic peptides originating from brevican and neurocan using a mass spectrometry-based panel, and for MMP-1, -2, -9, -10 and TIMP-1 using fluorescent or electrochemiluminescent immunoassays.

Results

Brevican and neurocan peptide levels were not influenced by CSF origin, but MMP-1, -2, -10 and TIMP-1 were increased (p ≤ 0.0005), and MMP-9 decreased (p ≤ 0.0003) in lumbar CSF compared with ventricular CSF. There was a general trend of ECM proteins to increase following shunt surgery. Ventricular TIMP-1 was inversely correlated with overall symptoms (rho = − 0.62, p < 0.0001). CSF concentrations of the majority of brevican and neurocan peptides were increased in iNPH patients with a history of cardiovascular disease (p ≤ 0.001, AUC = 0.84–0.94) compared with those without.

Conclusion

Levels of the CNS-specific proteins brevican and neurocan did not differ between the lumbar and ventricular CSF, whereas the increase of several CNS-unspecific MMPs and TIMP-1 in lumbar CSF suggests contribution from peripheral tissues. The increase of ECM proteins in CSF following shunt surgery could indicate disturbed ECM dynamics in iNPH that are restored by restitution of CSF dynamics.
Patients with first versus multiple episodes of self-harm: how do their profiles differ?
Authors: Golay Philippe , Ostertag Louise , Costanza Alessandra , Van der Vaeren Bénédicte , Dorogi Yves , Saillant Stéphane , Michaud Laurent
Published: May 2021

Background

Self-harm (SH) is among the strongest predictors of further episodes of SH, suicide attempt, and death by suicide. People who repeteadly harm themselves are at even higher risk for suicide. Factors influencing the repetition are important to identify when assessing suicidal risk and thereafter to offer specific interventions. Therefore, this study aimed to compare first versus multiple episodes characteristics in a large sample of patients in french-speaking Switzerland.

Method

We used the database from the French-speaking Swiss program for monitoring SH. Data of the psychiatric assessment of all adults admitted for SH were collected in the emergency department of four Swiss city hospitals between December 2016 and October 2019.

Results

1730 episodes of SH were included. Several variables were significantly associated with multiple episodes, including diagnosis (over representation of personality disorders and under representation of anxiety disorders), professional activity (Invalidity insurance more frequent) and prior psychiatry care.

Conclusions

Patients suffering from a personality disorder and those with invalidity insurance are at risk for multiple episodes of SH and should be targeted with specific interventions.
Sonication in the diagnosis of fracture-related infections (FRI)—a retrospective study on 230 retrieved implants
Authors: Bellova Petri , Knop-Hammad Veronika , Königshausen Matthias , Schildhauer Thomas A. , Gessmann Jan , Baecker Hinnerk
Published: May 2021

Background

In fracture-related infections (FRI), both the diagnosis of the infection and the identification of the causative pathogen are crucial to optimize treatment outcomes. Sonication has been successfully used for periprosthetic joint infections (PJI); however, its role in FRI remains unknown. Our aim was to determine the diagnostic accuracy (sensitivity, specificity) of sonicate fluid culture (SFC). The primary objective was to compare SFC with peri-implant tissue culture (PTC) overall and among subgroups using the consensus definition by Metsemakers et al. The secondary objective was to determine the yield of SFC in possible fracture-related infections (PFRI).

Methods

From March 2017 to May 2019, 230 cases of retrieved implants were retrospectively reviewed. To perform sonication, explants were placed in sterile polypropylene jars intraoperatively. After treatment in an ultrasonic bath (Bandelin, Berlin, Germany), sonicate fluid was incubated into blood culture bottles, and conventional culturing was eventually performed. Sensitivity and specificity were determined using two-by-two contingency tables. McNemar’s test was used to compare proportions among paired samples while Fisher’s exact test was used for comparison between categorical variables.

Results

Of the 230 cases, 107 were identified as FRI, whereas 123 were aseptic revision cases (ARC). Of the latter, 105 were labeled as PFRI. Sensitivity of SFC was higher in comparison with PTC, although this did not reach statistical significance (90.7% vs. 84.1%; p = .065). The specificity of SFC was significantly lower than that of PTC (73.2% vs. 88.6%; p = .003). In PFRI, SFC yielded significantly more positive results than PTC (33/105 vs. 14/105; p = .003). Overall, 142 pathogens were identified by SFC, whereas 131 pathogens were found by PTC.

Conclusions

We found that sonication of fracture fixation devices may be a useful adjunct in FRI, especially in “low-grade” infections lacking confirmatory clinical criteria. Standardized diagnostic protocols are warranted in order to further optimize the diagnostic accuracy.
Malaria and Cancer: a critical review on the established associations and new perspectives
Authors: Ellis Toby , Eze Elvis , Raimi-Abraham Bahijja Tolulope
Published: May 2021

Objectives

Cancer and malaria both have high incidence rates and are leading causes of mortality worldwide, especially in low and middle-income countries with reduced access to the quality healthcare. The objective of this critical review was to summarize key associations and new perspectives between the two diseases as is reported in existing literature.

Methods

A critical review of research articles published between 1st January 2000 – 1st July 2020 which yielded 1753 articles. These articles were screened based on a precise inclusion criteria. Eighty-nine eligible articles were identified and further evaluated.

Results

Many articles reported anti-cancer activities of anti-malarial medicines, including Artemisinin and its derivatives. Other articles investigated the use of chemotherapy in areas burdened by malaria, treatment complications that malaria may cause for cancer patients as well as ways to circumvent cancer related drug resistance. Potential novel targets for cancer treatment, were identified namely oncofoetal chondroitin sulphate and haem, as well as the use of circumsporozoite proteins. A number of articles also discussed Burkitt lymphoma or febrile neutropenia.

Conclusions

Overall, excluding for Burkitt lymphoma, the relationship between cancer and malaria requires further extensive research in order to define association. There great potential promising new novel anti-cancer therapies using anti-malarial drugs.

Graphical abstract

Created using BioRender
Tick infestation on medium–large-sized mammalian hosts: are all equally suitable to Ixodes ricinus adults?
Authors: Mysterud Atle , Hügli Christian , Viljugrein Hildegunn
Published: May 2021

Background

In Europe, the generalist tick, Ixodes ricinus, is the main vector of several tick-borne pathogens causing diseases in humans and livestock. Understanding how different species of hosts limit the tick population is crucial for management. In general, larger ectoparasites are expected to select hosts with larger body size. Consistent with this, larval and nymphal I. ricinus can feed on a wide range of different-sized vertebrates, while the adult female stage is expected to rely on a medium–large-sized host for reproduction. However, we still have a limited understanding of whether medium-sized hosts other than roe deer can serve as hosts to adult ticks, and other factors than size may also affect host selection.

Methods

To increase our understanding of the suitability of the different species of medium-sized hosts for adult ticks, we sampled mainly roadkill mammals from within the questing season of ticks. We counted life stages of ticks on roe deer (Capreolus capreolus) (n = 29), red fox (Vulpes vulpes) (n = 6), badger (Meles meles) (n = 14) and red squirrel (Sciurus vulgaris) (n = 17) from spatially overlapping populations in Norway, and analysed variation between species across different body parts with a mixed-effects negative binomial model (with and without zero-inflation).

Results

Red squirrel hosted a high density of larval and nymphal I. ricinus, but only one individual had adult female ticks. Roe deer hosted by far the largest number of adult ticks. Badgers had very few ticks, possibly due to their thick skin. Red foxes had intermediate numbers, but a high proportion of subcutaneous, dead ticks (69.3%), suggesting they are not very suitable hosts. Body mass predicted the presence of adult I. ricinus ticks. However, species was a better predictor than body mass for number of ticks, suggesting there was species variation in host suitability beyond body mass per se.

Conclusions

Our study provides evidence that roe deer are indeed the main suitable reproduction host to adult I. ricinus ticks, and are likely a key to host limitation of the tick population in this northern ecosystem.

Graphical Abstract
Correction to: Weak faults at megathrust plate boundary respond to tidal stress
Authors: Tonegawa Takashi , Kimura Toshinori , Shiraishi Kazuya , Yabe Suguru , Fukao Yoshio , Araki Eiichiro , Kinoshita Masataka , Sanada Yoshinori , Miura Seiichi , Nakamura Yasuyuki , Kodaira Shuichi
Published: May 2021

An amendment to this paper has been published and can be accessed via the original article.
The effects of repetition frequency on the illusory truth effect
Authors: Hassan Aumyo , Barber Sarah J.
Published: May 2021

Repeated information is often perceived as more truthful than new information. This finding is known as the illusory truth effect, and it is typically thought to occur because repetition increases processing fluency. Because fluency and truth are frequently correlated in the real world, people learn to use processing fluency as a marker for truthfulness. Although the illusory truth effect is a robust phenomenon, almost all studies examining it have used three or fewer repetitions. To address this limitation, we conducted two experiments using a larger number of repetitions. In Experiment 1, we showed participants trivia statements up to 9 times and in Experiment 2 statements were shown up to 27 times. Later, participants rated the truthfulness of the previously seen statements and of new statements. In both experiments, we found that perceived truthfulness increased as the number of repetitions increased. However, these truth rating increases were logarithmic in shape. The largest increase in perceived truth came from encountering a statement for the second time, and beyond this were incrementally smaller increases in perceived truth for each additional repetition. These findings add to our theoretical understanding of the illusory truth effect and have applications for advertising, politics, and the propagation of “fake news.”
Long-ranged velocity correlations in dense systems of self-propelled particles
Authors: Szamel Grzegorz , Flenner Elijah
Published: May 2021

Model systems of self-propelled particles reproduce many phenomena observed in laboratory active matter systems that defy our thermal equilibrium-based intuition. In particular, in stationary states of self-propelled systems, it is recognized that velocities of different particles exhibit non-trivial equal-time correlations. Such correlations are absent in equivalent equilibrium systems. Recently, researchers found that the range of the velocity correlations increases with increasing persistence time of the self-propulsion and can extend over many particle diameters. Here we review the initial studies of long-ranged velocity correlations in solid-like systems of self-propelled particles. Then, we demonstrate that the long-ranged velocity correlations are also present in dense fluid-like systems. We show that the range of velocity correlations in dense systems of self-propelled particles is determined by the combination of the self-propulsion and the virial bulk modulus that originates from repulsive interparticle interactions.
How we are leading a 3-XORSAT challenge: From the energy landscape to the algorithm and its efficient implementation on GPUs
(a)
Authors: Bernaschi M. , Bisson M. , Fatica M. , Marinari E. , Martin-Mayor V. , Parisi G. , Ricci-Tersenghi F.
Published: May 2021

A recent 3-XORSAT challenge required to minimize a very complex and rough energy function, typical of glassy models with a random first-order transition and a golf-course–like energy landscape. We present the ideas beyond the quasi-greedy algorithm and its very efficient implementation on GPUs that are allowing us to rank first in such a competition. We suggest a better protocol to compare algorithmic performances and we also provide analytical predictions about the exponential growth of the times to find the solution in terms of free-energy barriers.
Decoupling redshift: The key to conciliate global and local estimates of the Universe expansion rate
Authors: Barboza Edésio M. , Abreu Everton M. C. , Ananias Neto Jorge
Published: May 2021

To explain the

discrepancy between the local

and the global

estimates of the Universe expansion rate, H
0, becomes one of the most challenging problems in contemporary cosmology. Underestimated systematic errors as well as new physics beyond the standard ΛCDM model, has been invoked to solve, or at least alleviate, this problem. In this paper we show that we can conciliate the local measurement of the Hubble constant with its global estimate in a very simple way without making any of these assumptions. This is achieved if we deal with the decoupling redshift,

, as a free parameter. By noting that the dependence of the cosmic microwave background (CMB) observables on H
0 comes from the decoupling redshift

we show that, by incorporating a missing parameter, the electron fraction

, to the

functional form, local and global estimates of H
0 agree with each other perfectly. The effect of introducing

is the same that treat

as free parameter which should be fitted along with the model parameters. The CMB data and the local estimates of H
0 are reconciled if

, a value

higher than the value obtained from the usual calculations.
Periodontitis and Risk of Diabetes in the Atherosclerosis Risk In Communities (ARIC) Study: A BMI-Modified Association
Authors: Zhang Shaoping , Philips Kamaira H , Moss Kevin , Wu Di , Adam Hamdi S , Selvin Elizabeth , Demmer Ryan T , Norby Faye L , Mustapha Indra Z , Beck James D
Published: May 2021

Purpose

To determine whether periodontal disease is positively associated with incident diabetes across the continuum of body mass levels (BMI) and test the hypothesis that the periodontal risk for incident diabetes is modified by BMI.

Methods

We included 5569 diabetes-free participants from Visit 4 (1996-1998) of the Atherosclerosis Risk in Communities study and followed them until 2018. Periodontal disease status was classified by periodontal profile class (PPC)-Stages , and incident diabetes was based on participant report of physician diagnosis. We estimated the hazard ratios (HR) for diabetes using a competing risk model for each PPC-Stage. We assessed multiplicative interactions between periodontal disease and BMI (as a continuous variable) on risk of diabetes.

Results

During a median time of 19.4 years of follow-up, 1348 incident diabetes cases and 1529 deaths occurred. Compared to the “Health/Incidental Disease” stage, participants with PPC “Severe Periodontal Disease” or “Severe Tooth Loss” stage and lower BMI had elevated risk for diabetes adjusting for demographic, smoking, education, and biological variables when accounting for death as a competing risk with HRs of 1.76 (95% CI 1.10-2.80) and 2.11 (95% CI 1.46-3.04), respectively. The interaction between PPC-Stages and BMI was significant (P = 0.01). No significant associations of PPC-Stages with incident diabetes were present when BMI was above 31 kg/m2.

Conclusion

Periodontal disease was associated with incident diabetes, especially in nonobese participants. Dentists should be aware that periodontal disease is associated with incident diabetes but the association may be modified for patient’s at higher BMI levels.
Causal Effects of N-6 Polyunsaturated Fatty Acids on Age-related Macular Degeneration: A Mendelian Randomization Study
Authors: Wang Kai , Zhong Yueyang , Yang Fangkun , Hu Chenyang , Liu Xin , Zhu Yanan , Yao Ke
Published: May 2021

Context

Although the role of n-6 polyunsaturated fatty acids (PUFAs) in age-related macular degeneration (AMD) has been studied in previous observational studies, the precise manner in which 1 or more n-6 PUFAs account for this relationship remains unclear.

Objective

Using genetic instruments for n-6 PUFAs traits implemented through mendelian randomization (MR), we aimed to study possible causal associations between n-6 PUFAs and AMD.

Methods

The 2-sample MR method was used to obtain unconfounded causal estimates. We selected genetic variants strongly associated (P < 5 × 10–8) with circulating linoleic acid (LA) and arachidonic acid (AA) from a study involving 8 631 individuals and applied to an AMD case–control study (33 526 participants and 16 144 cases). The weighted median and MR Egger methods were used for the sensitivity analysis.

Results

Our MR analysis suggested that circulating LA was a causal protective factor for AMD, with an odds ratio (OR) estimate of 0.967 (95% CI 0.945 to 0.990; P = .005) per percentage in total fatty acid increase in LA. In contrast, higher genetically predicted circulating AA causally increased the AMD risk (OR = 1.034; 95% CI 1.012 to 1.056; P = .002). Sensitivity analysis provided no indication of unknown pleiotropy. The findings from different single-nucleotide polymorphism selections and analytic methods were consistent, suggesting the robustness of the causal associations.

Conclusion

Our study provided genetic evidence that circulating LA accounted for protective effects of n-6 PUFAs against the risk of AMD, whereas AA was responsible for deleterious effects on higher AMD risk.
“For a Few Months of Peace”
Authors: Bhaman Salonee
Published: May 2021

This article explores the interrelated struggles for housing and HIV/AIDS care during the first decades of the epidemic in New York City. It follows municipal and activist responses to a growing homeless population alongside the work of tenants’ rights advocates to explore the complex dynamics of care, displacement, and austerity that gave shape to the struggles of people living with HIV/AIDS. This article places the 1989 New York State Supreme Court case Braschi v. Stahl, concerning lease succession rights for same-sex partners, as a central text alongside Callahan v. Carey and Mixon v. Grinker litigation to illustrate the possibilities and limitations within coalitions formed between antipoverty activists and LGBTQ rights groups.
The Case of Linwood Boyette and Transatlantic Imaginaries of AIDS, Race, and Carcerality
Authors: Huebenthal Jan
Published: May 2021

In November 1987, Linwood Boyette, an African American man and retired US army sergeant, became one of the first people in West Germany to be jailed for alleged HIV transmission, following charges brought under a legal Maßnahmenkatalog (catalog of measures) in the state of Bavaria. Boyette stood accused of having knowingly exposed three white male sexual partners to HIV and bringing them into “danger of death.” Boyette’s racial and national “otherness” underscored the widespread West German perception of AIDS as a racialized threat linked to the United States. With his example, this article frames early West German criminalization of HIV/AIDS as a transatlantic spectacle of carceral discipline and racialized punishment. The article concludes that the US-inspired Bavarian response mirrors an ongoing carceral racialization of HIV that systemically harms individuals and communities of color in the United States today.
First record of the weevil Otiorhynchus armadillo (Coleoptera:Curculionidae) in Greece
Authors: Mpamnaras Athanasios , Eliopoulos Panagiotis
Published: May 2021

An entimine weevil is recorded for the first time in Greece. Around the year 2000, Otiorhynchus armadillo (Rossi, 1792) was found in the district of Larisa. Images of the species (of the original specimen collected in Greece) and information on its distribution, ecology and biology, are presented.
Α new tropical invader in Greece: The lantana plume moth Lantanophaga pusillidactylus (Lepidoptera: Pterophoridae)
Authors: Demetriou Jakovos , Kazilas Christos , Koutsoukos Evangelos , Kalaentzis Konstantinos
Published: May 2021

This study documents the first known record of the lantana plume moth Lantanophaga pusillidactylus (Walker, 1864) in Greece. The moth was observed in four localities from April 2018 to November 2019, and four individuals were collected and deposited in the Zoological Museum of the University of Athens (ZMUA). All specimens were identified as L. pusillidactylus, an alien species in Europe, that has been recently introduced in Spain, Italy (Sicily), Portugal, and Malta. The possible pathways of its introduction, as well as potential ecological implications, are discussed.
On track to becoming a cosmopolitan invasive species: First record of the box tree moth Cydalima perspectalis (Lepidoptera: Crambidae) in the African continent
Authors: Haddad Karim , Kalaentzis Konstantinos , Demetriou Jakovos
Published: May 2021

Native to E. Asia, the box tree moth Cydalima perspectalis (Walker, 1859) has managed to establish itself, and gradually expand its distribution, across Europe, Asia and recently America. This publication documents the first known record of the invasive species in Africa. The moth was observed in Constantine, Algeria in 2018 and was later identified as C. perspectalis. Possible scenarios of its introduction on the continent, as well as potential ecological implications, are discussed.
Leveraging the trust of nurses to advance a digital agenda in Europe: a critical review of health policy literature
Authors: De Raeve Paul , Davidson Patricia M. , Shaffer Franklin A. , Pol Eric , Pandey Amit Kumar , Adams Elizabeth
Published: May 2021

This article is a critical and integrative review of health policy literature examining artificial intelligence (AI) and its implications for healthcare systems and the frontline nursing workforce. A key focus is on co-creation as essential for the deployment and adoption of AI. Our review hinges on the European Commission’s White Paper on Artificial Intelligence from 2020, which provides a useful roadmap. The value of health data spaces and electronic health records (EHRs) is considered; and the role of advanced nurse practitioners in harnessing the potential of AI tools in their practice is articulated. Finally, this paper examines “trust” as a precondition for the successful deployment and adoption of AI in Europe.

AI applications in healthcare can enhance safety and quality, and mitigate against common risks and challenges, once the necessary level of trust is achieved among all stakeholders. Such an approach can enable effective preventative care across healthcare settings, particularly community and primary care. However, the acceptance of AI tools in healthcare is dependent on the robustness, validity and reliability of data collected and donated from EHRs. Nurse stakeholders have a key role to play in this regard, since trust can only be fostered through engaging frontline end-users in the co-design of EHRs and new AI tools. Nurses hold an intimate understanding of the direct benefits of such technology, such as releasing valuable nursing time for essential patient care, and empowering patients and their family members as recipients of nursing care.

This article brings together insights from a unique group of stakeholders to explore the interaction between AI, the co-creation of data spaces and EHRs, and the role of the frontline nursing workforce. We identify the pre-conditions needed for successful deployment of AI and offer insights regarding the importance of co-creating the future European Health Data Space.
Las figuras femeninas en La mujer del animal
Authors: Cano Guarín Laura
Published: May 2021

El presente artículo aborda el asunto de las representaciones femeninas en el filme La mujer del animal del director de cine colombiano Víctor Gaviria, quien en general retrata paisajes citadinos referentes a las problemáticas y miseria de las clases sociales más bajas. En primera instancia se enmarca el contexto en el que se desarrolla la historia, la ciudad de Medellín, los acontecimientos históricos que han propiciado dichas realidades y el estilo narrativo de su autor. A continuación, a la luz de las bases teóricas provistas por los estudios de género, se hace un breve resumen y análisis de la producción fílmica en cuestión, con el fin descubrir cómo se percibe, se concibe y se proyecta el universo femenino en su obra. A través del análisis propuesto se hará una revisión del complejo rol que cumplen las mujeres en un entorno desafortunado de abandono e indiferencia del estado, en una ciudad segregada en cuyas periferias la violencia es el pan de cada día y de las historias que protagonizan a través de las cuales pueden o bien reforzar o bien resistirse a las construcciones sociales.
Análisis de terminología especializada para la traducción interdisciplinar de un webinario de temática médica: el caso de Rheumatoid Arthritis Pathophysiology (signs and symptoms)
Authors: Carmona Ruiz Manuel
Published: May 2021

La traducción interdisciplinar audiovisual-médica es un campo de la traducción poco explorado hasta el momento. Si bien es cierto que la traducción audiovisual es relativamente joven, la médica no lo es tanto. Es obvio que se necesitan ciertas habilidades y conocimientos para traducir un texto especializado: si es médico, conocimientos en traducción médica; si es jurídico, en traducción jurídica. Para su labor, el traductor necesitará, entre otros, analizar la terminología especializada presente en el texto. En el presente artículo se presenta un modelo de clasificación de términos que organiza la terminología y facilita su correcto análisis. Con este artículo se pretende, también, dar visibilidad a la traducción de webinarios, pues pueden aportar información y conocimientos muy beneficiosos para la sociedad.
El esplendor de la producción del libro en la Edad Media. Del manuscrito al incunable. ¿Cómo de oscura era la Edad Media?
Authors: Classen Albrecht
Published: May 2021

Abstract: In this study I pursue once again the development of the medieval manuscript to the incunabulum, focusing in particular on the progress of German medieval literature. The question being pursued here focuses on how much the manuscript tradition can tell us something about the popularity of individual works. Manuscript studies thus promote a literary-historical analysis Keywords: manuscripts, incunabula, medieval German literature, Codex Manesse, Ambraser Heldenbuch, Oswald von Wolkenstein,
Retos terminológicos y traductológicos en el atentado contra Charlie Hebdo: el lenguaje eufemístico (inglés-español)
Authors: Montes Sánchez Alba
Published: May 2021

Gobiernos y organizaciones internacionales contemplan el terrorismo como un problema de repercusión mundial, un factor complejo que se ha abordado desde numerosos ámbitos de estudio. En cierto modo, el tipo de terrorismo perpetrado en la actualidad logra sus objetivos gracias, en gran parte, a la información facilitada a través de los medios de comunicación, pues otorgan cobertura inmediata sobre sus actuaciones a nivel planetario, lo que da a entender que la relación entre el terrorismo y los medios de comunicación está cada vez más reforzada, puesto que, si cierta información no resulta publicada, los actos terroristas parecer no ser noticia. La presente investigación plantea un acercamiento a la terminología del campo del terrorismo a través de los eufemismos. Para ello, en primer lugar, este estudio presenta la relación existente entre los medios de comunicación y el terrorismo desde un enfoque lingüístico. En este sentido, esta investigación parte de un corpus comparable (inglés-español) constituido por textos periodísticos sobre el atentado terrorista contra Charlie Hebdo. Con ello, se pretende analizar y resolver las cuestiones lingüísticas que se originan en inglés y español desde una perspectiva traductológica, con el objetivo fundamental de evidenciar el volumen de eufemismos que emplea la prensa española e inglesa en este campo de especialidad. Finalmente, se observa cómo los resultados arrojados por el análisis podrían redundar en beneficio de los profesionales que trabajan en la investigación o en la transferencia de información sobre contenidos terroristas, como periodistas, lingüistas y traductores e intérpretes
Alto y bajo: de lo dimensional a lo cualitativo. Propuesta lexicográfica
Authors: Ynduráin Carlos
Published: May 2021

En torno a los valores prototípicos de los adjetivos alto y bajo (relacionados, en principio, con las dimensiones de una entidad física) existe una serie de significados de origen metafórico que vinculan estas palabras con los conceptos de CANTIDAD (altas dosis), INTENSIDAD (alta tensión) y FRECUENCIA (ventas altas). El objetivo de este artículo es analizar la base cognitiva de estas extensiones semánticas y clasificar los sentidos que resulta apropiado diferenciar de cara a su posterior tratamiento lexicográfico.
N-acetylcysteine+nimesulide: An association strategy aiming to prevent nimesulide-induced hepatotoxicity
Authors: Elias Amanda G. , Silva Julia S. da , Klein Rafaela L. , Amaral Francieli U. I. , Arbo Marcelo D. , Conte Fernanda M. , Garcia Solange C. , Dallegrave Eliane , Martins Janaine R. , Bertol Charise D. , Setim Diorges H. , Da Motta Adriana C. , Barcelos Romulo P. , Grando Luciana G. R.
Published: May 2021

Introduction: Nimesulide is a potent anti-inflammatorywith rapid and long-lasting effects, but also with a high riskof hepatotoxicity. Objective: This work aimed to preventnimesulide-induced hepatotoxicity through the associationof nimesulide with a hepatoprotective agent. Materials andMethods: First, we tested three hepatoprotective agents:N-acetylcysteine, L-carnitine, and Gingko biloba extract inan in vitro hepatic cell model. Both N-acetylcysteine and G.biloba showed promisor results. We selected N-acetylcysteineto continue the studies in an animal model. In vivo study wasperformed using male Wistar rats divided in 4 groups: control,nimesulide (100mg/kg/day), nimesulide (100mg/kg/day) +N-acetylcysteine (100mg/kg/day) and N-acetylcysteine alone(100mg/kg/day). Treatments were given by gavage, daily, for15 days. Results: Animals receiving nimesulide alone showedlower body weight gain compared to control. Body weightgain in the nimesulide + N-acetylcysteine group was higherthan nimesulide alone, evidencing lower toxicity. However,the body weight gain of the nimesulide + N-acetylcysteinegroup was still lower than the control animals. Animals treatedwith nimesulide alone presented an increased relative mass ofheart, liver, and spleen and significant hepatic damage seen inmicroscopy when compared to other groups. N-acetylcysteineco-administered with nimesulide prevented the increasedheart mass, but the same was not true with liver and spleen.Conclusions: This work evidence partial protection elicitedby the association of N-acetylcysteine and nimesulide againstnimesulide-induced hepatotoxicity.
The effect of long-term whole-body vibration on muscular performance
Authors: Haleva Yossef , Dunsky Ayelet , Meckel Yoav , Kleinöder Heinz , Bar-Eli Michael , Mester Joachim
Published: May 2021

Introduction: The whole-body vibration (WBV) approachis considered to be a unique training method for physicalrehabilitation, injury preventions, and improving physicalperformance in athlete. The scientific literature about WBV iswell documented and presents different vibration protocols,different measurements and, as a consequence - differentresults. Objectives: To explore the effect of a strengtheningprogram with WBV on several muscular strength variablesamong physical education students in comparison to a controlpassive group of students. Methods: Thirty-eight healthymale physical education students were randomly allocatedinto Vibration Group (VG, n=13) - who underwent strengtheningprogram with WBV and external load, and Control Group(CG, n=25), that received no treatment. The study includedpre-test assessments, 4-week intervention phase and post-testassessments. During the intervention phase VG performedthree training sessions per week that included six sets of 30sec squats with external loads on a WBV platform. Assessmentsincluded maximal muscle strength, power, reactivestrength and endurance. Results: Significant improvementswere shown in all components among the VG from pre topost-tests (p<0.001), with no significant change among theCG. Conclusions: A 4-week strengthening program with WBVand medium external load improves different components ofstrength among healthy physical education students.