bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymphohistiocytic Myocarditis Possibly Due to Moderna mRNA-1273 Vaccine
Authors: Chow Brandon T , Lai Chi K
Published: February 2022

Objectives

Despite the clear benefits of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in mitigating the impact of the coronavirus disease 2019 pandemic, there are emerging reports of postvaccination myocarditis, the majority of which are diagnosed based on the clinical and radiologic findings without biopsy confirmation. We report a case of biopsy-confirmed lymphohistiocytic myocarditis after Moderna mRNA-1273 vaccination.

Methods

We describe a case of a previously healthy 45-year-old woman who had palpitations, exercise intolerance, and syncope 1 week after her first mRNA-1273 vaccine dose. Laboratory tests and cardiac imaging were compatible with myocarditis. Given her unusual clinical presentation, an endomyocardial biopsy was performed to exclude other potential etiologies.

Results

The endomyocardial biopsy specimen showed patchy endocardial and intramyocardial lymphohistiocytic infiltrates with scattered eosinophils and focal myocyte injury. CD3 and CD68 immunostains confirmed the lymphocytic and histiocytic nature of the infiltrate, respectively. A focal histiocytic collection suggestive of an ill-defined granuloma was present. The histologic and immunohistochemical findings of a lymphohistiocytic myocarditis were highly suggestive of a postvaccination hypersensitivity reaction.

Conclusions

Myocarditis following SARS-CoV-2 vaccination is a rare adverse event. The findings of a lymphohistiocytic myocarditis with scattered eosinophils and a possible ill-defined granuloma are highly suggestive of a hypersensitivity reaction. The mechanism by which this inflammation occurs remains uncertain. Despite our findings, the benefits of SARS-CoV-2 vaccination far outweigh the risks.
Long-Term Mortality in Women With Pregnancy Loss and Modification by Race/Ethnicity
Authors: Grandi Sonia M , Hinkle Stefanie N , Mumford Sunni L , Sjaarda Lindsey A , Grantz Katherine L , Mendola Pauline , Mills James L , Pollack Anna Z , Yeung Edwina , Zhang Cuilin , Schisterman Enrique F
Published: February 2022

Pregnancy loss is a common reproductive complication, but its association with long-term mortality and whether this varies by maternal race/ethnicity is not well understood. Data from a racially diverse cohort of pregnant women enrolled in the Collaborative Perinatal Project (CPP) from 1959 to 1966 were used for this study. CPP records were linked to the National Death Index and the Social Security Death Master File to identify deaths and underlying cause (until 2016). Pregnancy loss comprised self-reported losses, including abortions, stillbirths, and ectopic pregnancies. Among 48,188 women (46.0% White, 45.8% Black, 8.2% other race/ethnicity), 25.6% reported at least 1 pregnancy loss and 39% died. Pregnancy loss was associated with a higher absolute risk of all-cause mortality (risk difference, 4.0 per 100 women, 95% confidence interval: 1.4, 6.5) and cardiovascular mortality (risk difference, 2.2 per 100 women, 95% confidence interval: 0.8, 3.5). Stratified by race/ethnicity, a higher risk of mortality persisted in White, but not Black, women. Women with recurrent losses are at increased risk of death, both overall and across all race/ethnicity groups. Pregnancy loss is associated with death; however, it does not confer an excess risk above the observed baseline risk in Black women. These findings support the need to assess reproductive history as part of routine screening in women.
Cuffless Blood Pressure Devices
Authors: Bradley Corey K , Shimbo Daichi , Colburn David Alexander , Pugliese Daniel N , Padwal Raj , Sia Samuel K , Anstey D Edmund
Published: February 2022

Hypertension is associated with more end-organ damage, cardiovascular events, and disability-adjusted life years lost in the United States compared with all other modifiable risk factors. Several guidelines and scientific statements now endorse the use of out-of-office blood pressure (BP) monitoring with ambulatory BP monitoring or home BP monitoring to confirm or exclude hypertension status based on office BP measurement. Current ambulatory or home BP monitoring devices have been reliant on the placement of a BP cuff, typically on the upper arm, to measure BP. There are numerous limitations to this approach. Cuff-based BP may not be well-tolerated for repeated measurements as is utilized with ambulatory BP monitoring. Furthermore, improper technique, including incorrect cuff placement or use of the wrong cuff size, may lead to erroneous readings, affecting diagnosis and management of hypertension. Compared with devices that utilize a cuff, cuffless BP devices may overcome challenges related to technique, tolerability, and overall utility in the outpatient setting. However, cuffless devices have several potential limitations that limit its routine use for the diagnosis and management of hypertension. The review discusses the different approaches for determining BP using various cuffless devices including engineering aspects of cuffless device technologies, validation protocols to test accuracy of cuffless devices, potential barriers to widespread implementation, and future areas of research. This review is intended for the clinicians who utilize out-of-office BP monitoring for the diagnosis and management of hypertension.
Bioabsorbable Polydioxanone Mesh for Soft Tissue Reinforcement in Revisional Breast Surgery
Authors: Turin Sergey Y , Gutowski Karol
Published: February 2022

Background

The need for revision procedures after breast implant surgery often arises from the failure of soft tissues to provide a stable implant pocket. Meshes or dermal matrices have been used to reinforce the implant’s soft tissue support. Durasorb (Surgical Innovation Associates, Chicago, IL) is a resorbable polydioxanone (PDO) mesh indicated for soft tissue reinforcement. Its monofilament, macroporous design allows for ease of handling and rapid tissue incorporation. The extended timeline of PDO bioabsorption provides support during the critical portions of soft tissue healing while avoiding long-term complications of permanent products.

Objectives

Evaluate the efficacy of Durasorb PDO mesh for soft tissue reinforcement in revision breast surgery.

Methods

This is a prospective case series of 17 patients (27 breasts) undergoing revision breast implant surgery with Durasorb PDO mesh.

Results

Five patients (5 breasts) presented for revision after implant placement for breast reconstruction, with the remaining 22 presenting for revision after implant placement for cosmetic indications. Average patient age was 47.9 years, and average BMI 24.3. Indications for surgery were implant malposition (37%), capsular contracture (30%), poor cosmesis/asymmetry (26%), and recurrent soft tissue ptosis (7%). Follow up averaged 355 days (range 174 to 799 days, SD=155). One patient experienced a seroma 2 weeks post-operatively, which resolved after a single aspiration. No infections, wound healing problems, or recurrences of implant malposition/capsular contracture were encountered.

Conclusions

Durasorb PDO mesh appears to be efficacious as a breast implant pocket reinforcement in the reoperative setting with a low complication rate and durable results.

Level of Evidence: 4
Performance optimization in DNA short-read alignment
Authors: Wilton Richard , Szalay Alexander S
Published: February 2022

Over the past decade, short-read sequence alignment has become a mature technology. Optimized algorithms, careful software engineering and high-speed hardware have contributed to greatly increased throughput and accuracy. With these improvements, many opportunities for performance optimization have emerged. In this review, we examine three general-purpose short-read alignment tools—BWA-MEM, Bowtie 2 and Arioc—with a focus on performance optimization. We analyze the performance-related behavior of the algorithms and heuristics each tool implements, with the goal of arriving at practical methods of improving processing speed and accuracy. We indicate where an aligner's default behavior may result in suboptimal performance, explore the effects of computational constraints such as end-to-end mapping and alignment scoring threshold, and discuss sources of imprecision in the computation of alignment scores and mapping quality. With this perspective, we describe an approach to tuning short-read aligner performance to meet specific data-analysis and throughput requirements while avoiding potential inaccuracies in subsequent analysis of alignment results. Finally, we illustrate how this approach avoids easily overlooked pitfalls and leads to verifiable improvements in alignment speed and accuracy.

Contact

richard.wilton@jhu.edu

Supplementary information

Appendices referenced in this article are available at Bioinformatics online.
A reinforcement learning framework for pooled oligonucleotide design
Authors: David Benjamin M , Wyllie Ryan M , Harouaka Ramdane , Jensen Paul A
Published: February 2022

Motivation

The goal of oligonucleotide (oligo) design is to select oligos that optimize a set of design criteria. Oligo design problems are combinatorial in nature and require computationally intensive models to evaluate design criteria. Even relatively small problems can be intractable for brute-force approaches that test every possible combination of oligos, so heuristic approaches must be used to find near-optimal solutions.

Results

We present a general reinforcement learning (RL) framework, called OligoRL, to solve oligo design problems with complex constraints. OligoRL allows ‘black-box’ design criteria and can be adapted to solve many oligo design problems. We highlight the flexibility of OligoRL by building tools to solve three distinct design problems: (i) finding pools of random DNA barcodes that lack restriction enzyme recognition sequences (CutFreeRL); (ii) compressing large, non-degenerate oligo pools into smaller degenerate ones (OligoCompressor) and (iii) finding Not-So-Random hexamer primer pools that avoid rRNA and other unwanted transcripts during RNA-seq library preparation (NSR-RL). OligoRL demonstrates how RL offers a general solution for complex oligo design problems.

Availability and implementation

OligoRL and all simulation codes are available as a Julia package at http://jensenlab.net/tools and archived at https://archive.softwareheritage.org/browse/origin/directory/?origin_url=https://github.com/bmdavid2/OligoRL.

Supplementary information

Supplementary data are available at Bioinformatics online.
Metabolomic profiling in small vessel disease identifies multiple associations with disease severity
Authors: Harshfield Eric L , Sands Caroline J , Tuladhar Anil M , de Leeuw Frank Erik , Lewis Matthew R , Markus Hugh S
Published: February 2022

Cerebral small vessel disease is a major cause of vascular cognitive impairment and dementia. There are few treatments, largely reflecting limited understanding of the underlying pathophysiology. Metabolomics can be used to identify novel risk factors to better understand pathogenesis and to predict disease progression and severity.

We analysed data from 624 patients with symptomatic cerebral small vessel disease from two prospective cohort studies. Serum samples were collected at baseline and patients underwent MRI scans and cognitive testing at regular intervals with up to 14 years of follow-up. Using ultra-performance liquid chromatography–mass spectrometry and nuclear magnetic resonance spectroscopy, we obtained metabolic and lipidomic profiles from 369 annotated metabolites and 54 764 unannotated features and examined their association with respect to disease severity, assessed using MRI small vessel disease markers, cognition and future risk of all-cause dementia.

Our analysis identified 28 metabolites that were significantly associated with small vessel disease imaging markers and cognition. Decreased levels of multiple glycerophospholipids and sphingolipids were associated with increased small vessel disease load as evidenced by higher white matter hyperintensity volume, lower mean diffusivity normalized peak height, greater brain atrophy and impaired cognition. Higher levels of creatine, FA(18:2(OH)) and SM(d18:2/24:1) were associated with increased lacune count, higher white matter hyperintensity volume and impaired cognition. Lower baseline levels of carnitines and creatinine were associated with higher annualized change in peak width of skeletonized mean diffusivity, and 25 metabolites, including lipoprotein subclasses, amino acids and xenobiotics, were associated with future dementia incidence.

Our results show multiple distinct metabolic signatures that are associated with imaging markers of small vessel disease, cognition and conversion to dementia. Further research should assess causality and the use of metabolomic screening to improve the ability to predict future disease severity and dementia risk in small vessel disease. The metabolomic profiles may also provide novel insights into disease pathogenesis and help identify novel treatment approaches.
Influence of NAT2 Genotype and Maturation on Isoniazid Exposure in Low-Birth-Weight and Preterm Infants With or Without Human Immunodeficiency Virus (HIV) Exposure
Authors: Béranger Agathe , Bekker Adrie , Solans Belén P , Cotton Mark F , Mirochnick Mark , Violari Avy , Wang Jiajia , Cababasay Mae , Wiesner Lubbe , Browning Renee , Moye Jack , Capparelli Edmund V , Savic Radojka M
Published: February 2022

Background

Isoniazid (INH) metabolism depends on the N-acetyl transferase 2 (NAT2) enzyme, whose maturation process remains unknown in low birth weight (LBW) and preterm infants. We aimed to assess INH exposure and safety in infants receiving oral tuberculosis prevention.

Methods

This population pharmacokinetics (PK) analysis used INH and N-acetyl-isoniazid (ACL) concentrations in infants (BW ≤ 4 kg), including preterm, with follow-up for 6 months. PK parameters were described using nonlinear mixed effects modeling. Simulations were performed to assess INH exposure and optimal dosing regimens, using 2 targets: Cmax at 3–6 mg/L and area under the curve (AUC) ≥ 10.52 mg h/L.

Results

We included 57 infants (79% preterm, 84% LBW) in the PK analysis, with a median (range) gestational age of 34 (28.7–39.4) weeks. At the time of sampling, postnatal age was 2.3 (0.2–7.3) months and weight (WT) was 3.7 (0.9–9.3) kg. NAT2 genotype was available in 43 (75.4%) patients (10 slow, 26 intermediate, and 7 fast metabolizers). Ninety percent of NAT2 maturation was attained by 4.4 post-natal months. WT, postmenstrual age, and NAT2 genotype significantly influenced INH exposure, with a 5-fold difference in AUC between slow and fast metabolizers for the same dose. INH appeared safe across the broad range of exposure for 61 infants included in the safety analysis.

Conclusions

In LBW/preterm infants, INH dosing needs frequent adjustment to account for growth and maturation. Pharmacogenetics-based dosing regimens is the most powerful approach to deliver safe and equalized exposures for all infants, because NAT2 genotype highly impacts INH pharmacokinetic variability.
Exploring the Natural Origins of SARS-CoV-2 in the Light of Recombination
Authors: Lytras Spyros , Hughes Joseph , Martin Darren , Swanepoel Phillip , de Klerk Arné , Lourens Rentia , Kosakovsky Pond Sergei L , Xia Wei , Jiang Xiaowei , Robertson David L
Published: February 2022

The lack of an identifiable intermediate host species for the proximal animal ancestor of SARS-CoV-2, and the large geographical distance between Wuhan and where the closest evolutionary related coronaviruses circulating in horseshoe bats (members of the Sarbecovirus subgenus) have been identified, is fueling speculation on the natural origins of SARS-CoV-2. We performed a comprehensive phylogenetic study on SARS-CoV-2 and all the related bat and pangolin sarbecoviruses sampled so far. Determining the likely recombination events reveals a highly reticulate evolutionary history within this group of coronaviruses. Distribution of the inferred recombination events is nonrandom with evidence that Spike, the main target for humoral immunity, is beside a recombination hotspot likely driving antigenic shift events in the ancestry of bat sarbecoviruses. Coupled with the geographic ranges of their hosts and the sampling locations, across southern China, and into Southeast Asia, we confirm that horseshoe bats, Rhinolophus, are the likely reservoir species for the SARS-CoV-2 progenitor. By tracing the recombinant sequence patterns, we conclude that there has been relatively recent geographic movement and cocirculation of these viruses’ ancestors, extending across their bat host ranges in China and Southeast Asia over the last 100 years. We confirm that a direct proximal ancestor to SARS-CoV-2 has not yet been sampled, since the closest known relatives collected in Yunnan shared a common ancestor with SARS-CoV-2 approximately 40 years ago. Our analysis highlights the need for dramatically more wildlife sampling to: 1) pinpoint the exact origins of SARS-CoV-2’s animal progenitor, 2) the intermediate species that facilitated transmission from bats to humans (if there is one), and 3) survey the extent of the diversity in the related sarbecoviruses’ phylogeny that present high risk for future spillovers.
Pulmonary Function in Midlife as a Predictor of Later-Life Cognition: The Coronary Artery Risk Development in Adults (CARDIA) Study
Authors: Joyce Brian T , Chen Xuefen , Yaffe Kristine , Henkle Benjamin E , Gao Tao , Zheng Yinan , Kalhan Ravi , Washko George , Kunisaki Ken M , Thyagarajan Bharat , Gross Myron , Jacobs David R , Lloyd-Jones Donald , Liu Kiang , Sidney Stephen , Hou Lifang
Published: February 2022

Background

Studies found associations between pulmonary function (PF) and cognition, but these are limited by mostly cross-sectional design and a single measure of PF (typically forced expiratory volume in 1 second [FEV1]). Our objective was to prospectively analyze the association of repeatedly measured PF with cognition.

Methods

We studied 3 499 participants in the Coronary Artery Risk Development in Young Adults cohort with cognition measured at year 25 (Y25) and Y30, and PF (FEV1 and forced vital capacity [FVC], reflecting better PF) measured up to 6 times from Y0 to Y20. Cognition was measured via Stroop test, Rey-Auditory Verbal Learning Test [RAVLT], and digit symbol substitution test [DSST], which capture executive function, verbal learning and memory, and attention and psychomotor speed, respectively; lower Stroop, and higher RAVLT and DSST scores indicate better cognition. We modeled linear, cross-sectional associations between cognition and PF at Y30 (mean age 55), and mixed models to examine associations between cognition at Y25–Y30 and longitudinal PF (both annual rate of change, and cumulative PF from Y0 to Y20).

Results

At Y30, FEV1 and FVC were cross-sectionally associated with all 3 measures of cognition (β = 0.08–0.12, p < .01–.02). Annual change from peak FEV1/FVC ratio was associated with Stroop and DSST (β = 18.06, 95% CI = 7.71–28.40; β = 10.30, 95% CI = 0.26–20.34, respectively), but not RAVLT. Cumulative FEV1 and FVC were associated with Stroop and DSST (β = 0.07–0.12, p < .01–.02), but only cumulative FEV1 was associated with RAVLT (β = 0.07, 95% CI = 0.00–0.14).

Conclusions

We identified prospective associations between measures of PF and cognition even at middle ages, adding evidence of a prospective association between reduced PF and cognitive decline.
A GNSS velocity field for crustal deformation studies: The influence of glacial isostatic adjustment on plate motion models
Authors: Vardić Katarina , Clarke Peter J , Whitehouse Pippa L
Published: February 2022

The two main causes of global-scale secular deformation of the Earth are tectonic plate motion and glacial isostatic adjustment (GIA). We create a bespoke global 3D GNSS surface velocity field ‘NCL20’ to investigate tectonic plate motion and the effect of GIA on plate motion models (PMMs), drawing on a set of 1D and 3D GIA model predictions. The main motivation for creating NCL20 is to include a larger number of GNSS sites in the most GIA-affected areas of investigation, namely North America, Europe, and Antarctica. We do this using the IGS repro2 data and other similarly processed GNSS data sets. Our final GNSS velocity field has horizontal uncertainties mostly within ±0.5 mm yr–1 and vertical uncertainties mostly within ±1 mm yr–1 (at 95 per cent confidence), which make it suitable for testing GIA models. We generate a suite of 117 global GIA model predictions by combining three different ice history models (ICE-5G, ICE-6G and W12) with a range of 1D and 3D Earth models. By subtracting this ensemble from the GNSS velocity field, we identify and compare a range of PMMs which are expected to be unaffected by GIA. Our method allows us to include GNSS sites that are typically excluded from PMM estimations due to their location in GIA-affected regions. We demonstrate that significant GIA-related horizontal motion outside of the rapidly uplifting regions may bias PMMs if left uncorrected. Based on their ability to explain the observed surface velocity field, a group of best-performing GIA models is selected for three regions of interest: North America, Europe and Antarctica. The range of GIA predictions in each best-performing group is assumed to represent the uncertainty in regional GIA modelling insofar as it can be constrained by present-day geodetic velocities. In the horizontal component, we note that 3D GIA models show more variation in the direction of predicted velocities than 1D GIA models, confirming that horizontal velocities are strongly sensitive to lateral variations in Earth structure. Furthermore, for Antarctica the variation in predicted GIA vertical velocities suggests that the total GIA contribution to annual gravimetric mass change ranges from –3 to 22 Gt yr–1 depending on which of the best-performing GIA models is used.
‘I shall paint my nails with the blood of those that covet me’: Kashmir’s Women’s Militia and Independence-era Nationalism
Authors: Whitehead Andrew
Published: February 2022

Towards the close of 1947, amid increasing turbulence and conflict in Kashmir, women activists established their own militia and were trained to use rifles – a rare initiative in South Asia even amid the turmoil of Partition and independence. The women were aligned with radical Kashmiri nationalism. Their militia was a self-defence force as well as a demonstration of support for Indian rule in Kashmir and for a democratic dispensation to replace the autocratic maharaja. Although the militia was short-lived and never saw active service, the sight of women drilling in the Kashmiri capital with rifles on their shoulders was a powerful demonstration of a change of regime. The testimony of former members of the women's militia emphasizes the sense of empowerment they gained – though the subsequent trajectory of the unresolved Kashmir conflict has clouded over this episode of women's political activism.
Total arch replacement using frozen elephant trunk technique with Frozenix for distal aortic arch aneurysms
Authors: Tokunaga Chiho , Kumagai Yu , Chubachi Fumiya , Hori Yuto , Takazawa Akitoshi , Hayashi Jun , Asakura Toshihisa , Ishii Ryota , Nakajima Hiroyuki , Yoshitake Akihiro
Published: February 2022

OBJECTIVES

Total arch replacement (TAR) using an endovascular approach has been initially introduced as the frozen elephant trunk technique (FET). In our institute, TAR using the FET with Frozenix has been used as the first-line treatment for distal aortic arch aneurysms since 2014. This study aimed to evaluate the early and long-term outcomes and demonstrate the efficacy of this procedure.

METHODS

Between 2014 and 2021, 121 consecutive patients were treated with TAR using the FET with Frozenix for distal aortic arch aneurysms. Early and long-term outcomes were retrospectively analysed.

RESULTS

The 30-day mortality rate was 2.5% (3/121). Of postoperative complications, paraplegia due to spinal cord injury occurred in 2 (1.7%) patients, stroke in 12 (9.9%) and acute renal failure in 10 (8.3%). At follow-up, 23 secondary aortic interventions were required and 8 (6.6%) patients underwent intended secondary thoracic endovascular aortic repair for residual descending aortic aneurysm. Late and aortic-related deaths occurred in 16 (13.2%) and 4 (3.3%) patients, respectively. The overall long-term survival rates at 1, 3 and 5 years were 87.6%, 83.1% and 65.4%, respectively, while the rates of freedom from aortic-related death at 1, 3 and 5 years were 95.7%, 95.7% and 84.8%, respectively.

CONCLUSIONS

TAR using the FET with Frozenix for distal aortic arch aneurysms has acceptable early mortality and morbidity. Spinal cord injury and paraplegia occur less frequently than previously reported. The technique has satisfactory long-term survival and freedom from aortic-related death.
Heart disease among Greenlandic children and young adults: a nationwide cohort study
Authors: Tindborg Marie , Koch Anders , Andersson Mikael , Juul Klaus , Geisler Uka Wilhjelm , Soborg Bolette , Michelsen Sascha Wilk
Published: February 2022

Background

The incidences of heart disease (HD) and congenital heart disease (CHD) among Inuit in Greenland (GL) and Denmark (DK) are unknown. This study aims to estimate incidence rates (IRs) of HD and CHD among the young Inuit populations in Greenland and Denmark compared with rates among young non-Inuit populations in the same countries.

Methods

A register-based nationwide cohort including all individuals living in Greenland and Denmark from birth to age <40 years through 1989–2014 was formed. Ethnicity was considered Inuit/mixed if at least one parent was registered as being born in Greenland. Information on HD and CHD hospitalization was obtained from national inpatient registers using ICD-8 and ICD-10 codes.

Results

HD IR was lower among individuals living in Greenland compared with those living in Denmark, [73.35GL (95% confidence interval (CI) 68.07 to 79.03)] vs [88.07DK (95% CI 87.38 to 88.76)], whereas CHD IRs were almost similar in the two countries [IR 34.44GL (95% CI 30.89 to 38.40) vs IR 34.67DK (95% CI 34.24 to 35.10)]. Being of Inuit/mixed ethnicity was associated with an increased risk of both HD and CHD compared with non-Inuit in Greenland and Denmark [adjusted hazard ratio HD 2.07GL (95% CI 1.25 to 3.42)] and CHD [2.92GL (95% CI 1.34 to 6.38)].

Conclusion

HD IR was lower in individuals living in Greenland compared with individuals living in Denmark, whereas the CHD IRs were almost the same for both countries. However, the risk of HD including CHD was higher among individuals of Inuit/mixed ethnicity compared with non-Inuit in both countries, suggesting a role of ethnicity among children and younger adults.
Pharmaceutical services in public hospitals in Mexico: a cross-sectional study
Authors: Vargas López Laura C , Wirtz Veronika J , Reich Michael R
Published: February 2022

Objective

To describe the provision of pharmaceutical services within Ministry of Health hospitals in Mexico and identify the main factors that affect their implementation.

Methods

Between November 2018 and April 2019, we conducted telephone interviews with the heads of pharmacy departments of 413 state and federal Ministry of Health hospitals in Mexico. Responses were analyzed with descriptive and inferential statistics to determine the main factors influencing the implementation of pharmaceutical services within these public hospitals.

Key findings

Of the 413 hospitals, a total of 96 hospitals in 27 states reported the provision of at least one pharmaceutical service. The most frequently reported services were: patient education on the correct use of medications (23%), provision of information to other health professionals on the rational use of medications (21%), and participation in the hospital´s pharmacovigilance system (19%). The main factors associated with the implementation of HPS were the number of pharmacists (46%, n = 215, p=0.001) and the pharmaceutical- or health sciences-oriented education of the head of the pharmacy department of the hospital (46%, n = 215, P = 0.001).

Conclusions

Hiring more pharmacists and ensuring the appropriate professional education of the head of the pharmacy department are key factors to expanding the implementation of pharmaceutical services in Mexico’s public hospitals.
The Enduring Role of Sector: Citizen Preferences in Mixed Markets
Authors: Witesman Eva M , Silvia Chris , Child Curtis
Published: February 2022

What role does sector play in citizens’ perceptions of products or services in mixed-market settings where governments compete with for-profit and nonprofit vendors or when governments partner or contract with private-sector providers? Do the public and nonprofit sectors have an advantage over for-profit providers? Using choice-based conjoint analysis with a nationally representative paid consumer panel, we examine the relevance of sector to consumers and compare it other signals of quality; namely, price, third-party certifications, and consumer ratings. Of these, subjects are most sensitive to information from consumer ratings. Regarding sector, we find that subjects generally prefer nonprofit to government providers and government to for-profit providers. Sector is most relevant to consumers in low-information environments when the quality of a product or service is otherwise unclear. We extend theory by proposing four possible mechanisms for the differential value of sector to consumers (process quality, product quality, expertise quality, and moral quality).
Picky Eating in Childhood: Associations With Obsessive-Compulsive Symptoms
Authors: Schwarzlose Rebecca F , Hennefield Laura , Hoyniak Caroline P , Luby Joan L , Gilbert Kirsten E
Published: February 2022

Objective

To test whether childhood picky eating (PE)—a behavior previously linked to many forms of psychopathology—is specifically associated with symptoms of obsessive-compulsive disorder (OCD).

Methods

We investigated the relationship between PE and symptoms of several forms of psychopathology in two separate observational samples: a sample of 110 children (5 and 6 years old) and a sample of 210 children (8 and 9 years old) drawn from a longitudinal study. In each sample, regression models based on psychiatric symptoms or diagnoses were used to assess the specificity of PE associations while accounting for cooccurring symptoms or comorbidities.

Results

Although bivariate associations emerged between PE and multiple forms of psychopathology, multivariate analyses revealed these associations were driven by a strong and specific association between PE and symptoms of OCD in both samples. Moreover, PE among 8- and 9-year-olds in the longitudinal study predicted emergence of additional later psychopathology, specifically attention-deficit/hyperactivity disorder (ADHD).

Conclusions

Findings suggest that PE, an easily identifiable clinical presentation, is also a specific marker for obsessive-compulsive symptomatology in school-age children and may impart risk for ADHD later in childhood.
Exploring Adjustment and Parent–Infant Relations in Mothers of Premature Infants: Thematic Analysis Using a Multisensory Approach
Authors: Suarez Catalina , Adair Pauline , Doherty Nicola , McCormack David
Published: February 2022

Objective

The aim of the study was to explore mothers’ experiences of having an infant born prematurely (28–32 weeks gestation). In particular, the study aimed to explore the developing parent–infant relationship 12–30 months since birth and the developing parental identity during hospitalization and discharge.

Methods

Twelve mothers, aged between 22 and 43, participated in the semi-structured interviews. The mean age of infants was 19 months. Interviews comprised open-ended questions and visual stimuli consisting of photographs brought by participants, word selection, and card sorting techniques. Data were analyzed using Braun and Clarke’s thematic analysis (Braun & Clarke, 2013).

Results

Three themes arose from a clustering of 10 subthemes: (a) Emotional Impact, (b) Searching for Parent Identity, and (c) Moving Beyond Adversity. Participants expressed experiencing heightened emotional distress during the time of their infants’ birth and hospitalization and initially not feeling like parents. Their parental identity strengthened as they became more involved in the care of their infant and began to accept the situation. Participants described parenting their premature infants differently compared with parents of full-term infants, and described adjusting to this difference over time.

Conclusions

The findings highlight the emotional experience and adjustment of mothers of premature infants, from hospital and postdischarge. The need for psycho-educational interventions postdischarge and parent-partnered models during hospitalization is discussed. In addition, the study demonstrates the use of integrating visual stimuli in qualitative data collection procedures, to elicit further meaning and interaction from participants with the interview process.
Can we improve the chilling tolerance of maize photosynthesis through breeding?
Authors: Burnett Angela C , Kromdijk Johannes
Published: February 2022

Chilling tolerance is necessary for crops to thrive in temperate regions where cold snaps and lower baseline temperatures place limits on life processes; this is particularly true for crops of tropical origin such as maize. Photosynthesis is often adversely affected by chilling stress, yet the maintenance of photosynthesis is essential for healthy growth and development, and most crucially for yield. In this review, we describe the physiological basis for enhancing chilling tolerance of photosynthesis in maize by examining nine key responses to chilling stress. We synthesize current knowledge of genetic variation for photosynthetic chilling tolerance in maize with respect to each of these traits and summarize the extent to which genetic mapping and candidate genes have been used to understand the genomic regions underpinning chilling tolerance. Finally, we provide perspectives on the future of breeding for photosynthetic chilling tolerance in maize. We advocate for holistic and high-throughput approaches to screen for chilling tolerance of photosynthesis in research and breeding programmes in order to develop resilient crops for the future.
Comparison of Musculoskeletal Injury and Behavioral Health Diagnoses Among U.S. Army Active Duty Servicewomen in Ground Combat and Non-Ground Combat Military Occupational Specialties
Authors: Phillips Kimberley J , Banaag Amanda , Lynch LeeAnne C , Wu Hongyan , Janvrin Miranda , Koehlmoos Tracey Perez
Published: February 2022

Introduction

The U.S. Army’s Soldier 2020 program, which started in January 2016, was designed to achieve full integration of women in all military occupational specialties. This study was undertaken to determine differences in risk of musculoskeletal injury and behavioral health (BH) disorders among U.S. Army Active Duty Servicewomen (ADSW) in ground combat military occupational specialties (MOS) versus those in non-ground combat MOS since the start of the program until January 2019.

Materials and Methods

Using healthcare claims data from the Military Health System’s Data Repository we conducted a cross-sectional study on ADSW from January 1, 2016 to January 1, 2019 and categorized them as either ground combat specialists (GCSs) or non-ground combat specialists (NGCSs). We identified all female soldiers in our cohort with a musculoskeletal injury (MSKI) and/or BH diagnosis during the study period. A multivariable logistic regression, adjusted by pregnancy or delivery status, was used to assess risk factors associated with GCS and included soldier age, race, body mass index (BMI), tobacco use, alcohol/substance use, and MSKI and BH status as predictor variables.

Results

A total of 92,443 U.S. Army ADSW were identified, of whom 3,234 (3.5%) were GCS (infantry, field artillery, cavalry/armor, and air defense) and 89,209 (96.5%) were in non-ground combat billets. A large difference was observed when comparing the age of the population by occupation; GCS women were predominantly between the ages of 18-23 years (71.9%), compared to NGCS women aged 18-23 (41.0%). Top MSKI and BH diagnoses for both occupations were joint pain (44.9% GCS, 50.2% NGCS) and adjustment disorders (26.2% GCS, 28.0% NGCS). GCS women had lower odds for musculoskeletal injury (0.86 AOR, 0.79-0.93 CI, P = 0.0002), obesity per BMI classification (0.82 AOR, 0.70-0.97 CI, P = 0.0214), and BH disorders (0.87 AOR, 0.80-0.95 CI, P = 0.0019); and higher odds for tobacco use (1.44 AOR, 1.27-1.63 CI, P < 0.0001), substance use (1.36 AOR, 1.04-1.79 CI, P = 0.0257), and alcohol use (1.18 AOR, 1.02-1.38 CI, P = 0.0308) when compared to NGCS women.

Conclusions

With the increasing focus on soldier medical readiness in today’s U.S. Army, the health of all soldiers is of paramount concern to command groups, unit leaders, and individual soldiers. The integration of women into ground combat military occupational specialties is a relatively new program; further longitudinal research of these groups should follow, focusing on their progression and improvement in soldier readiness, overall health, and the well-being of all servicewomen.
Detailed analysis on the reflection component for the black hole candidate MAXI J1348-630
Authors: Jia Nan , Zhao Xueshan , Gou Lijun , García Javier A , Liao Zhenxuan , Feng Ye , Li Yufeng , Wang Yuan , Li Huixian , Wu Jianfeng
Published: February 2022

The black hole candidate MAXI J1348-630 was discovered in 2019 January 26, with the Gas Slit Camera (GSC) on-board MAXI. We report a detailed spectral analysis of this source by using the archived data of NuSTAR. A total of nine observations covered the complete outburst evolution of MAXI J1348-630 from the hard state to the soft state and finally back to the hard state. Additionally, the intermediate state is found in the transition from the hard state to the soft state. We use the state-of-the-art reflection model relxill family to fit all the nine spectra, and the spectra from two focal plane module detectors of NuSTAR are jointly fitted for each observation. In particular, we concentrate on the results of the black hole spin parameter and the inclination of the accretion disc. Based on the analysis of the inner radius of the accretion disc, we obtain the spin parameter $a_* =0.78_{-0.04}^{+0.04}$, and the inclination angle of the inner disc $i = 29.2_{-0.5}^{+0.3}$°. Furthermore, we also find that when the black hole is in the hard state, the accretion disc would show a significant truncation. The high iron abundance and ionization of the accretion disc obtained in the fitting results can be possibly explained by the high density of the accretion disc.
Exploring the connection between ultraviolet/optical variations and radio emission in radio-quiet quasars: clues about the origin of radio emission
Authors: Liao Mai , Wang Junxian , Kang Wenyong , Zhou Minhua
Published: February 2022

Radio emission in radio-quiet quasars (RQQs) has long been a mystery and its physical origin remains unclear. In previous work, we have found that quasars that are more variable in ultraviolet (UV)/optical have stronger X-ray emission, indicating a link between disc turbulence and X-ray corona heating. In this work, for the first time, we investigate the relation between UV/optical variability and the radio emission in RQQs selected from the Sloan Digital Sky Survey Stripe 82 survey and the Faint Images of the Radio Sky at Twenty-Centimeters (FIRST) survey. We median stack the FIRST images and detect clear signals from RQQs in the co-added images of individually radio non-detected sources. Controlling the effects of other parameters, including redshift, black hole mass, bolometric luminosity and Eddington ratio, we find more variable RQQs, which are known to be relatively brighter in X-ray, and show tentatively weaker radio emission, contrary to the linear X-ray/radio correlation if the radio emission is from, or driven by, the corona. This discovery also suggests that if the radio emission in RQQs is driven by AGN activity (such as a weak jet), the underlying driving process is independent of the disc turbulence, which drives UV/optical variability and probably also corona heating. Alternatively, the radio emission could be a result of star formation in the host galaxies.
A broad-band X-ray study of the asynchronous polar CD Ind
Authors: Dutta Anirban , Rana Vikram
Published: February 2022

We present a simultaneous broad-band analysis of X-ray data obtained with the XMM–Newton and the Nuclear Spectroscopic Telescope Array (NuSTAR) for the asynchronous polar source, CD Ind. The spin-folded light curve in the soft 0.3–3.0 keV band shows a single broad hump-like structure superimposed with occasional narrow dips, indicating a single-pole accretion model with a complex intrinsic absorber. Lack of strong modulation in the folded light curve above 3 keV reveals that emission from the corresponding zone of the post-shock region (PSR) remains in view throughout the spin phase. The broad-band spectrum is modelled with a three-component absorbed plasma emission model and absorbed isobaric cooling flow model, both of which fit the data well with similar statistical significance. The presence of a partial covering absorber is evident in the spectra with equivalent column density ${\sim}7\times 10^{22}\, \text{cm}^{-2}$ and a covering fraction of ~25 per cent. Strong ionized oxygen Kα line emission is detected in the spectra. We notice spectral variability during the spin phase 0.75–1.05, when there is a considerable increase in the column density of the overall absorber (from ${\sim}1 \times 10^{20}\, \text{cm}^{-2}$ to ${\sim}9 \times 10^{20}\, \text{cm}^{-2}$). We required at least three plasma temperatures to describe the multitemperature nature of the PSR. The shock temperature ${\sim}43.3_{-3.4}^{+3.8}$ keV, represented by the upper temperature of the cooling flow model, implies a white dwarf mass of ${\sim}0.87^{+0.04}_{-0.03}\, \mathrm{M}_{\odot }$. The iron Kα line complex show strong He-like and weak neutral fluorescence lines. We could not unambiguously detect the presence of Compton reflection in the spectra, which is probably very small and signifies a tall shock height.
The impact and mitigation of broad-absorption-line quasars in Lyman α forest correlations
Authors: Ennesser Lauren , Martini Paul , Font-Ribera Andreu , Pérez-Ràfols Ignasi
Published: February 2022

Correlations in and with the flux transmission of the Lyman α (Ly α) forest in the spectra of high-redshift quasars are powerful cosmological tools, yet these measurements can be compromised if the intrinsic quasar continuum is significantly uncertain. One particularly problematic case is broad-absorption-line (BAL) quasars, which exhibit blueshifted absorption associated with many spectral features that are consistent with outflows of up to ∼0.1c. As these absorption features can both fall in the forest region and be difficult to distinguish from Ly α absorption, cosmological analyses eliminate the ∼12–16 per cent of quasars that exhibit BALs. In this paper, we explore an alternate approach that includes BALs in the Ly α autocorrelation function, with the exception of the expected locations of the BAL absorption troughs. This procedure returns over 95 per cent of the path-length that is lost by the exclusion of BALs, as well as increasing the density of sightlines. We show that including BAL quasars reduces the fractional uncertainty in the covariance matrix and correlation function by 12 per cent and does not significantly change the shape of the correlation function relative to analyses that exclude BAL quasars. We also evaluate different definitions of BALs, masking strategies, and potential differences in the quasar continuum in the forest region for BALs with different amounts of absorption.
The photo-astrometric vertical tracer density of the Milky Way – II. Results from Gaia
Authors: Everall Andrew , Belokurov Vasily , Evans N Wyn , Boubert Douglas , Grand Robert J J
Published: February 2022

We use Gaia photometry and astrometry to estimate the vertical spatial structure of the Milky Way at the Solar radius, formally accounting for sample incompleteness (the selection function) and parallax measurement uncertainty. Our results show impressive precision demonstrating the power of the Gaia data. However, systematic errors dominate the parameter value uncertainties. We thoroughly test and quantify the impacts of all systematic uncertainties. The vertical tracer density is modelled as a sum of two exponential profiles for the thin and thick discs, together with a spherically symmetric power law for the stellar halo. We constrain the thin disc scale height as ${h_\mathrm{Tn}=260 \pm 3\, (\mathrm{stat}) \pm 26\, \mathrm{pc}\, (\mathrm{sys})}$ and thick disc ${h_\mathrm{Tk}=693 \pm 7 \, (\mathrm{stat}) \pm 121\, \mathrm{pc}\, (\mathrm{sys})}$. For the halo, we obtain a power-law profile with $n_\mathrm{H}=3.543\pm 0.023 \, (\mathrm{stat}) \pm 0.259\, (\mathrm{sys})$. We infer a local stellar mass density for non-compact object stars of ${\rho _\mathrm{local}^{*} = 3.66\pm 0.03\, (\mathrm{stat})\pm 0.52 \times 10^{-2}\, \mathrm{M}_\odot \, \mathrm{pc}^{-3}\, (\mathrm{sys})}$ and surface density of ${\Sigma _\mathrm{local}^{*} = 23.17\pm 0.08\, (\mathrm{stat})\pm 2.43\, \mathrm{M}_\odot \, \mathrm{pc}^{-2}\, (\mathrm{sys})}$. We find asymmetries above and below the disc with longer disc scale heights in the north but a flatter halo in the south at the ≲ 10 per cent level.
Enhancement of double-close-binary quadruples
Authors: Fezenko Gavin B , Hwang Hsiang-Chih , Zakamska Nadia L
Published: February 2022

Double-close-binary quadruples (2 + 2 systems) are hierarchical systems of four stars where two short-period binary systems move around their common centre of mass on a wider orbit. Using Gaia Early Data Release 3, we search for comoving pairs where both components are eclipsing binaries. We present eight 2 + 2 quadruple systems with inner orbital periods of <0.4 d and with outer separations of ≳1000 au. All of these systems but one are newly discovered by this work, and we catalogue their orbital information measured from their light curves. We find that the occurrence rate of 2 + 2 quadruples is 7.3 ± 2.6 times higher than what is expected from random pairings of field stars. At most a factor of ∼2 enhancement may be explained by the age and metallicity dependence of the eclipsing binary fraction in the field stellar population. The remaining factor of ∼3 represents a genuine enhancement of the production of short-period binaries in wide-separation (>103 au) pairs, suggesting a close-binary formation channel that may be enhanced by the presence of wide companions.