bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and risk factors for umbilical cord prolapse in labor when amniotomy is used and with spontaneous rupture of membranes: A Swedish nationwide register study
Authors: Tallhage Sofia , Årestedt Kristofer , Schildmeijer Kristina , Oscarsson Marie
Published: November 2023

Introduction

Umbilical cord prolapse (UCP) is a rare but severe obstetric complication in the presence of a rupture of the membranes. Although it is not possible to prevent a spontaneous rupture of the membranes (SROM), it is possible to prevent an amniotomy, which is a commonly used intervention in labor. This study aimed to explore the incidence and risk factors that are associated with UCP in labor when amniotomy is used vs SROM.

Material and methods

A retrospective nationwide register study was conducted of all births in Sweden from January 2014 to June 2020 that were included in the Swedish Pregnancy Register (n = 717 336). The main outcome, UCP, was identified in the data by the International Classification of Diseases (ICD‐10) diagnosis code O69.0. Multiple binary logistic regression analysis was used to identify the risk factors.

Results

Amniotomy was performed in 230 699 (43.6%) of all pregnancies. A UCP occurred in 293 (0.13%) of these cases. SROM occurred in 298 192 (56.4%) of all cases, of which 352 (0.12%) were complicated by UCP. Risk factors that increased the odds of UCP for both amniotomy and SROM were: higher parity, non‐cephalic presentation and an induction of labor. Greater gestational age reduced the odds of UCP. Risk factors associated with only amniotomy were previous cesarean section and the presence of polyhydramnios. Identified risk factors for UCP in labor with SROM were a higher maternal age and maternal origin outside of the EU.

Conclusions

UCP is a rare complication in Sweden. Beyond confirming the previously recognized risk factors, this study found induction of labor and previous cesarean section to be risk factors in labor when amniotomy is used.
Low liver fat in non‐alcoholic steatohepatitis‐related significant fibrosis and cirrhosis is associated with hepatocellular carcinoma, decompensation and mortality
Authors: Lee Sung Won , Huang Daniel Q. , Bettencourt Ricki , Ajmera Veeral , Tincopa Monica , Noureddin Nabil , Amangurbanova Maral , Siddiqi Harris , Madamba Egbert , Majzoub Abdul M. , Nayfeh Tarek , Tamaki Nobuharu , Izumi Namiki , Nakajima Atsushi , Yoneda Masato , Idilman Ramzan , Gumussoy Mesut , Oz Digdem Kuru , Erden Ayse , Loomba Rohit
Published: November 2023

Background

Progression to cirrhosis in non‐alcoholic steatohepatitis (NASH) is associated with a decrease in liver fat. However, the prognostic significance of liver fat content in NASH‐related significant fibrosis and cirrhosis is unclear.

Aim

To investigate the risk of decompensation, hepatocellular carcinoma (HCC) and mortality stratified by liver fat content in NASH‐related significant fibrosis and cirrhosis.

Methods

In this meta‐analysis of individual participant data, 456 patients with both magnetic resonance elastography (MRE) and MRI‐derived protein density fat fraction (MRI‐PDFF) were enrolled, and 296 patients with longitudinal follow‐up were analysed. MRE combined with fibrosis‐4 (MEFIB‐index), and MRI‐PDFF were used to measure liver fibrosis and fat, respectively. MEFIB‐negative, MEFIB‐positive+ MRI‐PDFF ≥5% and MEFIB‐positive+ MRI‐PDFF <5% were defined as no significant liver fibrosis, NASH with significant fibrosis and higher liver fat content, and NASH with significant fibrosis and low liver fat content groups, respectively. The primary outcome was hepatic decompensation, HCC and death.

Results

The rates of decompensation, HCC and mortality were highest in the NASH with significant fibrosis and low liver fat group (33%, 17% and 17%, respectively), followed by the NASH with significant fibrosis and higher liver fat group (18%, 13% and 13% respectively), and lowest in the no significant fibrosis (MEFIB‐negative) group (0%, 1% and 2% respectively). In multivariable‐adjusted analysis, low liver fat content was strongly associated (HR = 42.2 [95% CI: 7.5–235.5, p < 0.0001]) with HCC, decompensation and death. Sensitivity analyses for patients with cirrhosis (MRE ≥5 kPa) determined consistent findings.

Conclusions

Low liver fat content in patients with burnt‐out NASH‐related significant fibrosis and cirrhosis is associated with an increase in hepatic decompensation, HCC and mortality.
Concurrent lithium and haemodialysis treatment: Clinical recommendations based on the literature and a multicentre survey
Authors: Kuiper Wytse J. , Grootens Koen P. , Kerckhoffs Angèle P. M.
Published: November 2023

Introduction

Lithium has an irreplaceable role in the treatment of severe mood disorders, but declining renal function associated with its use leads to clinical dilemmas. Although not often applied, and requiring close monitoring and multidisciplinary actions, concurrent lithium and haemodialysis treatment (CLHT) is a feasible option. To our knowledge, however, there are no detailed consensus‐ or evidence‐based treatment guidelines or directives on its delivery.

Methods

To fill this gap, we reviewed the literature and surveyed psychiatrists and nephrologists with experience in CLHT using a self‐designed questionnaire. Our goal was to form an integrated picture of the current knowledge and clinical practices of CLHT and formulate practical recommendations for colleagues being confronted with patients with renal dysfunction requiring lithium to help manage their mood disorder.

Results

We identified 14 case reports and case series describing CLHT and one systematic review concluding CLHT to be effective. Ten nephrologists and six psychiatrists practising in the Netherlands completed our questionnaire, providing details on collaboration, lithium dosing regimens, serum level evaluations and additional amenities and services they deemed necessary during CLHT delivery.

Discussion

We found that CLHT appears to be safe and effective and argue that delivery is a shared responsibility and needs continuous multidisciplinary finetuning. To facilitate delivery, we provide a flowchart for the initiation or reinstatement of lithium therapy in haemodialysis patients and a practical guide for CLHT, including an easy‐to‐use rule of thumb for calculating the lithium target dose.
Health care use and health consequences of geographic lack of access to abortion and maternity care
Authors: Wallace Maeve E. , Vilda Dovile , Dyer Lauren , Johnson Iman , Funke Lillian
Published: November 2023

Background

Recent years have brought substantial declines in geographic access to abortion facilities and maternity care across the US. The purpose of this study was to identify the reproductive health consequences of living in a county without access to comprehensive reproductive health care services.

Methods

We analyzed National Center for Health Statistics data on all live births occurring in the US in 2020. We used data on locations of abortion facilities and availability of maternity care in order to classify counties by level of access to comprehensive reproductive health care services and defined comprehensive reproductive health care deserts as counties that did not have an abortion facility in the county or in any neighboring county and did not have any maternity care practitioners. We fit modified Poisson regression models with generalized estimating equations to estimate the degree to which living in a comprehensive reproductive health care desert was associated with receipt of timely and adequate prenatal care and risk of preterm birth, controlling for individual‐level and county‐level characteristics.

Results

In 2020, one third of counties in the US were comprehensive reproductive health care deserts (n = 1082), and 136,272 births occurred in these counties. In adjusted models, there was no difference in prenatal health care use (timeliness or adequacy of care) between persons in comprehensive reproductive health care deserts and those with full access to care, but the risk of preterm birth was significantly elevated (aRR =1.09, 95% CI = 1.06, 1.13).

Conclusions

Lack of access to comprehensive reproductive health care services may increase the incidence of preterm birth.
Parents' experiences of receiving their child's diagnosis of congenital heart disease: A systematic review and meta‐synthesis of the qualitative literature
Authors: Dandy Shannon , Wittkowski Anja , Murray Craig D.
Published: November 2023

Purpose

This systematic review aimed to synthesize qualitative research on parents' psychological experiences following their child's diagnosis of congenital heart disease (CHD).

Methods

A systematic search of six electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, PubMed and Web of Science) was completed, inclusive of all years up to May 2022. Any included articles were synthesized using thematic synthesis and appraised using the Critical Appraisal Skills Programme Qualitative Checklist.

Results

Twenty‐six articles were included. Four main themes, and 11 subthemes, emerged from the synthesis. Theme 1 (unpreparedness for the diagnosis) concerned parents' shock, guilt and anger regarding the diagnosis. Theme 2 (the overwhelming reality of CHD) described parental fear about decision‐making and the child's prognosis, and the influence of professionals on parents' well‐being. Theme 3 (mourning multiple losses) detailed parents' sadness at losing their envisioned pregnancy, birth and parenthood experiences. Theme 4 (redefining hopes to reach an acceptance of CHD) described parents' adjustment to the diagnosis.

Conclusions

Receiving a child's CHD diagnosis was a uniquely challenging situation for parents. The findings provided insight into the emotions parents experienced and how they adjusted to the diagnosis psychologically. As parents' experiences were significantly influenced by their interactions with professionals, clinicians should offer compassion, validation and clear information throughout the diagnosis process.
The oral health landscape in Singapore: A commentary on key features, challenges and future policies
Authors: Lee Gabriel Keng Yan , Wong Kuan Yee , Lee Wan Zhen , Chng Chai Kiat
Published: November 2023

Over the last decade, Singapore has grappled with substantial healthcare challenges, chiefly a bourgeoning aging population and a mounting burden of chronic diseases. The oral health landscape has also changed, with the Ministry of Health placing a greater focus on a life‐course approach supported by policies that facilitate Singaporeans to receive dental care appropriately and affordably. A pivotal oral health policy is the National Dental Strategy, a comprehensive framework governing dental services in the public sector. This strategy encompasses aspects such as financing, workforce management, and capacity considerations. To facilitate affordability and accessibility to dental services in the public sector, the government extends subsidies to reduce out‐of‐pocket costs. Those attending private dental clinics also benefit from the Community Health Assist Scheme, introduced in 2012, which alleviates treatment costs for enrolled Singaporeans. Furthermore, additional age‐banded subsidies have been introduced for older Singaporeans born before 1960, enhancing financial support when accessing dental services in both private and public sectors. In 2019, a national adult oral health survey was commissioned to gauge the oral health status of Singaporeans aged 21 and above. The findings reported 34.8% having untreated dental caries, and 15.7% and 41.2% experiencing moderate and severe periodontitis, respectively. While over half (53.9%) of respondents visited the dentist at least annually, about 60% of eligible individuals did not utilize their government dental subsidies. In response, the Ministry of Health is committed to strengthening oral disease prevention, integrating oral health into general healthcare services, expanding dental financing schemes to enhance service utilization, improving the quality and transparency of dental care, and leveraging advancements in tele‐dentistry and other modes of dental services. It is imperative to adapt Singapore's oral health policies and service delivery models to meet the evolving needs of the population and ensure a sustainable, equitable and resilient oral healthcare system.
Insulin independence following islet transplantation improves long‐term metabolic outcomes
Authors: Stanley Adam K. , Duncan Kirsty , Anderson Debbie , Irvine Lora , Sutherland Andrew , Forbes Shareen , Casey John
Published: November 2023

Aims

Pancreatic islet allotransplantation is an effective therapy for type 1 diabetes mellitus, restoring glycaemic control and hypoglycaemic awareness in patients with recurrent severe hypoglycaemia. Insulin independence following transplant is being increasingly reported; however, this is not a primary endpoint in the UK. Having surpassed 10 years of islet transplantation in Scotland, we aimed to evaluate the impact of insulin independence following transplant on metabolic outcomes and graft survival.

Methods

We conducted a retrospective analysis on data collected prospectively between 2011 and 2022. Patients who underwent islet transplantation in Scotland up to the 31st January 2020 were included. Primary endpoint was graft survival (stimulated C‐peptide >50 pmol/L). Secondary endpoints included GOLD score, HbA1c, C‐peptide and insulin requirement. Outcomes were compared between patients who achieved insulin independence at any point following transplant versus those who did not.

Results

60 patients were included. 74.5% experienced >50 severe hypoglycaemic episodes in the year preceding transplant. There was a 55.0% decrease in insulin requirement following transplant and 30.0% achieved insulin independence. Mean graft survival time was 9.0 years (95% CI 7.2–10.9) in patients who achieved insulin independence versus 4.4 years (95% CI 3.4–5.3) in patients who did not. Insulin independence was associated with significantly improved graft function, glycaemic control and hypoglycaemic awareness at 1 year.

Conclusions

This is the largest UK single‐centre study on islet transplant to date. Our findings demonstrate significantly improved outcomes in patients who achieved insulin independence following islet transplantation.
Lessons from the field: Isn't it just common sense? Naïve realism as a barrier to learning
Authors: Dyer Kathleen D.
Published: November 2023

Objective

The goal was to determine whether or not there is an association between the belief that human development and family science (HDFS) is “just common sense” and academic performance in a rigorous research methods class in HDFS.

Background

Naïve realism is a cognitive bias that creates a belief in common sense that is difficult to challenge. It is unknown whether student commitment to common sense impedes students' ability to learn.

Method

Students (N = 112) in an HDFS research methods class were followed for a semester. Potential barriers to learning were measured through a self‐report survey before the start of the semester. The outcome variable was objective performance in the course as measured by exam scores.

Results

Exam scores were positively correlated with prior academic achievement and negatively correlated with student belief that the discipline is just common sense.

Conclusion

Naïve realism, expressed as the belief that HDFS is just common sense, predicts poor performance in a research methods class.

Implications

Higher education faculty in HDFS must directly confront the problem that our discipline is perceived as just common sense. Naïve realism must be challenged directly in coursework if students are to learn about the science of HDFS.
Tumor immune evasion: insights from CRISPR screens and future directions
Authors: Djajawi Tirta Mario , Wichmann Johannes , Vervoort Stephin J. , Kearney Conor J.
Published: November 2023

Despite the clinical success of cancer immunotherapies including immune checkpoint blockade and adoptive cellular therapies across a variety of cancer types, many patients do not respond or ultimately relapse; however, the molecular underpinnings of this are not fully understood. Thus, a system‐level understating of the routes to tumor immune evasion is required to inform the design of the next generation of immunotherapy approaches. CRISPR screening approaches have proved extremely powerful in identifying genes that promote tumor immune evasion or sensitize tumor cells to destruction by the immune system. These large‐scale efforts have brought to light decades worth of fundamental immunology and have uncovered the key immune‐evasion pathways subverted in cancers in an acquired manner in patients receiving immune‐modulatory therapies. The comprehensive discovery of the main pathways involved in immune evasion has spurred the development and application of novel immune therapies to target this process. Although successful, conventional CRISPR screening approaches are hampered by a number of limitations, which obfuscate a complete understanding of the precise molecular regulation of immune evasion in cancer. Here, we provide a perspective on screening approaches to interrogate tumor‐lymphocyte interactions and their limitations, and discuss further development of technologies to improve such approaches and discovery capability.
DNA double‐strand breaks regulate the cleavage‐independent release of Rec8‐cohesin during yeast meiosis
Authors: Fajish Ghanim , Challa Kiran , Salim Sagar , VP Ajith , Mwaniki Stephen , Zhang Ruihao , Fujita Yurika , Ito Masaru , Nishant Koodali T. , Shinohara Akira
Published: November 2023

The mitotic cohesin complex necessary for sister chromatid cohesion and chromatin loop formation shows local and global association to chromosomes in response to DNA double‐strand breaks (DSBs). Here, by genome‐wide binding analysis of the meiotic cohesin with Rec8, we found that the Rec8‐localization profile along chromosomes is altered from middle to late meiotic prophase I with cleavage‐independent dissociation. Each Rec8‐binding site on the chromosome axis follows a unique alternation pattern with dissociation and probably association. Centromeres showed altered Rec8 binding in late prophase I relative to mid‐prophase I, implying chromosome remodeling of the regions. Rec8 dissociation ratio per chromosome is correlated well with meiotic DSB density. Indeed, the spo11 mutant deficient in meiotic DSB formation did not change the distribution of Rec8 along chromosomes in late meiotic prophase I. These suggest the presence of a meiosis‐specific regulatory pathway for the global binding of Rec8‐cohesin in response to DSBs.
Environmental correlates of aquatic macroinvertebrate diversity in garden ponds: Implications for pond management
Authors: Hill Matthew J. , Wood Paul J. , White James C. , Thornhill Ian , Fairchild Win , Williams Penny , Nicolet Pascale , Biggs Jeremy
Published: November 2023

Garden ponds are a ubiquitous feature of urban landscapes and have the potential to be an important resource for biodiversity. However, the environmental and spatial factors influencing ecological communities within garden ponds have been poorly quantified to date, despite such evidence being critical to the development of effective management strategies that support biodiversity.

This study aims to identify the environmental and spatial factors influencing macroinvertebrate richness, abundance and compositional variation among garden ponds and provide management recommendations at the local and landscape scale. In total, 99 macroinvertebrate taxa were recorded from 30 garden ponds.

A negative association was recorded between ecological uniqueness (measured as the Local Contribution to Beta‐Diversity) and taxonomic richness among the garden ponds, and those ponds with high ecological uniqueness typically displayed high replacement (turnover) values. Surface area, total plant richness and non‐native plant richness were positively associated with macroinvertebrate richness. Taxonomic richness and abundance predominantly displayed a negative association with conductivity levels.

Current management practices for garden ponds are highly variable, often focussed on individual ponds. Based on the findings of this study, we recommend that management should focus on making garden pond surface areas as large as possible, ensure that there is a wide variety of native aquatic plant species present and manage conductivity levels. Garden ponds likely comprise a significant component of the urban freshwater network, and considering their management at both local and landscape scales will ensure that biotic communities inhabiting urban landscapes can be more effectively supported.
Grain morphology‐dependent dielectric and piezoelectric properties of lead‐free KBT ceramics
Authors: Badole Manish , Vasavan Hari Narayanan , Saxena Samriddhi , Das Asish Kumar , Gami Pratiksha , Kumar Sunil
Published: November 2023

K0.5Bi0.5TiO3 ceramics with cuboid (KBT‐C), rod (KBT‐R), and plate (KBT‐P)‐shaped grains were fabricated via solid‐state reaction and reactive template grain growth (using K2Ti6O13 and K0.5Bi4.5Ti4O15) methods, and the strong dependence of electrical properties on the grain morphology was demonstrated. The average grain sizes of KBT‐R, KBT‐P, and KBT‐C were ∼30 ± 10 μm, 7 ± 1 μm, and 350 ± 50 nm, respectively. While the room temperature dielectric constant decreased for KBT‐R (∼240) and KBT‐P (∼230) from ∼500 for KBT‐C, a significant enhancement in the piezoelectric charge coefficient (d33) was noticed for KBT‐R (∼95 pC/N) and KBT‐P (∼105 pC/N) samples compared to that of KBT‐C ceramic (∼60 pC/N). Accordingly, a large improvement in piezoelectric voltage coefficient (g33) of almost 300% in poled KBT‐R (∼45 × 10−3 Vm/N) and 400% in KBT‐P (∼54 × 10−3 Vm/N) samples over the KBT‐C ceramic was obtained. Interestingly, a significantly lower activation energy (Ea) for KBT‐C (∼0.71 eV) below the temperature of the dielectric maximum (Tm) was noticed compared to KBT‐R (∼1.07 eV) and KBT‐P (∼1.00 eV), suggesting a strong dependence of DC conduction on grain morphology. Furthermore, chronoamperometry measurements confirmed a mixed electronic and ionic conduction at higher temperatures in all samples.
Improvement of τf in HfTiO4 microwave dielectric ceramics with Zr‐ and Sn‐substitution
Authors: Ding Yi Han , Wang Xi , Guo Rui Ze , Li Lei , Chen Xiang Ming
Published: November 2023

(Hf1‐xZrx)TiO4 and (Hf1‐xSnx)TiO4 ceramics were prepared through a standard solid‐state reaction route, and the microwave dielectric characteristics were determined together with the microstructures. The single‐phase solid solution in space group Pbcn was obtained in (Hf1‐xZrx)TiO4, while the two‐phase structure with (HfTiO4(s.s.) major phase in space group Pbcn and Sn0.3Ti0.7O2 secondary phase in space group P42/mnm) was determined in (Hf1‐xSnx)TiO4. The temperature coefficient of resonant frequency τf could be significantly improved to near‐zero in both systems, and the best combination of microwave dielectric characteristic was achieved at x = 0.5 in (Hf1‐xZrx)TiO4: εr = 39.0, Qf = 43,150 GHz at 5.3 GHz and τf = 3 ppm/°C, and at x = 0.225 in (Hf1‐xSnx)TiO4: εr = 37.2, Qf = 52,600 GHz at 5.5 GHz and τf = ‐6 ppm/°C. In the solid solutions, the obvious improvement of τf could be deeply linked with the degree of covalency and the restoring forces of structure. While, the intermediate near‐zero τf is achieved by mixing the phases with opposite τf in multiphase materials. The present work provided an effective way to modify the temperature coefficient of resonant frequency in microwave dielectric ceramics.
Analysing students' self‐assessment practice in a distance education environment: Student behaviour, accuracy, and task‐related characteristics
Authors: Radović Slaviša , Seidel Niels , Haake Joerg M. , Kasakowskij Regina
Published: November 2023

Background

Self‐assessment serves to improve learning through timely feedback on one's solution and iterative refinement as a way to improve one's competence. However, the complexity of the self‐assessment process is widely recognized, as well as that students can benefit from it only if their assessment is accurate enough.

Objectives

In order to gain more insight into the self‐assessment process we analysed students' behaviour, accuracy, and question‐related characteristics that influence the capability of self‐assessment in two studies.

Methods

The initial study examined 131 undergraduate students using voluntary self‐assessment questions in an online course in a B.Sc. Computer Science program while a year later a replication study with the same research settings was applied to a different cohort of 264 undergraduate students with minor modifications to the question design, in the light of the original findings.

Results and Conclusions

Results from both studies show that similar patterns could be observed for usage and of accuracy and score distribution for almost all questions. Item difficulty and comprehensiveness of the sample solution were identified as features of self‐assessment questions affecting student's self‐assessment capability. The replication study showed that task design can be modified to affect students' accuracy. Recommendations to make self‐assessment tasks effective and efficient for learning are provided.
Intermittent hypoxia increased the expression of ESM1 and ICAM‐1 in vascular endothelial cells via the downregulation of microRNA‐181a1
Authors: Takasawa Shin , Makino Mai , Yamauchi Akiyo , Sakuramoto‐Tsuchida Sumiyo , Hirota Rina , Fujii Ryusei , Asai Keito , Takeda Yoshinori , Uchiyama Tomoko , Shobatake Ryogo , Ota Hiroyo
Published: November 2023

Sleep apnea syndrome (SAS) exposes cells throughout the body to intermittent hypoxia (IH). Intermittent hypoxia is a risk factor not only for hypertension and insulin resistance but also for vascular dysfunction. We have reported correlations between IH, insulin resistance and hypertension. However, the details of why IH leads to vascular dysfunction remain unclear. In this study, we investigated inflammation‐related transcripts in vascular endothelial cells (human HUEhT‐1 and mouse UV2) exposed to IH by real‐time RT‐PCR and found that intercellular adhesion molecule‐1 (ICAM‐1) and endothelial cell‐specific molecule‐1 (ESM1) mRNAs were significantly increased. ELISA confirmed that, in the UV2 cell medium, ICAM‐1 and ESM1 were significantly increased by IH. However, the promoter activities of ICAM‐1 and ESM1 were not upregulated. On the other hand, IH treatment significantly decreased microRNA (miR)‐181a1 in IH‐treated cells. The introduction of miR‐181a1 mimic but not miR‐181a1 mimic NC abolished the IH‐induced upregulation of Ican‐1 and ESM1. These results indicated that ICAM‐1 and ESM1 were upregulated by IH via the IH‐induced downregulation of miR‐181a1 in vascular endothelial cells and suggested that SAS patients developed atherosclerosis via the IH‐induced upregulation of ICAM‐1 and ESM1.
Money Makes the World Go Round: How Much Difference Do Recovery and Resilience Plans Make to EU Reform Governance?
Authors: Miró Joan , Natili Marcello , Schelkle Waltraud
Published: November 2023

The Next Generation EU (NGEU) package transformed European economic governance. This article examines the implications of this change in terms of EU polity formation and in terms of social policy content. It asks whether the temporary availability of large funds increases the leverage of the Commission in the European Semester and how this innovation affects sensitive policies. In the tradition of Stein Rokkan, the article advances a conception of the EU as a compound polity that needs to reconcile dispersed authority with second‐order loyalty. We then contrast our theoretical expectations with traditional reform surveillance and experimentalist governance theories. The drafting of Recovery and Resilience Plans for Italy and Spain provides the empirical basis for assessing these expectations. The analysis shows a dual effect: adding fiscal capacity to the European Semester enhances the Commission's hierarchical power whilst the need to ensure member states' loyalty leaves room for national executives to insist on their priorities.
Sexual Minorities, Religion, and Self‐Rated Health in the United States
Authors: Cranney Stephen
Published: November 2023

While religiosity has generally been found to be associated with health, sexual minority individuals are a theoretically unique population in the literature. Because of sample size issues, the extent to which sexual minority individuals differ from nonsexual minority individuals in the health and religion relationship has been difficult to comprehensively test; additionally, the theoretically germane but often hypothesized distinction between affirming and nonaffirming religions has remained largely untested. This study draws on the Cooperative Election Study, a nationally representative survey with a relatively large sexual minority sample (∼6600), and finds that (1) sexual minority individuals are less likely to affiliate with a religion; (2) sexual minority individuals report poorer health; (3) sexual minority individuals do enjoy an overall health benefit from religiosity, but this benefit is attenuated (compared to nonsexual minority individuals) in the case of affiliation; and (4) there is some ambiguous evidence for an affirming religiosity effect.
Ontological unpredictability: what can realists say about unpredictability, contingency and catastrophe?
Authors: Al‐Amoudi Ismael
Published: November 2023

This paper introduces the original research articles that constitute the present Forum issue on unpredictability, contingency and catastrophe. In doing so, it also identifies and discusses the specificity of realist approaches to the above questions. It is argued that attentiveness to the ontological dimension of (un)predictability opens promising avenues for reflexive approaches to social science and collective action.
Management of type 2 diabetes, obesity, or nonalcoholic steatohepatitis with high‐dose GLP‐1 receptor agonists and GLP‐1 receptor‐based co‐agonists
Authors: Goldenberg Ronald M. , Gilbert Jeremy D. , Manjoo Priya , Pedersen Sue D. , Woo Vincent C. , Lovshin Julie A.
Published: November 2023

Type 2 diabetes (T2D), obesity, and nonalcoholic fatty liver disease/nonalacoholic steatohepatitis (NAFLD/NASH) share mutual causalities. Medications that may offer clinical benefits to all three conditions are being developed. Glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) are approved for the management of T2D and obesity and there is great interest in evaluating higher doses of available GLP‐1RAs and developing novel GLP‐1RA‐based co‐agonists to provide greater reductions in glycated hemoglobin (HbA1c) and body weight as well as modifying NAFLD/NASH complications in clinically meaningful ways. High‐dose GLP‐1RAs and multi‐hormonal strategies including GLP‐1R agonism have either already been approved or are in development for managing T2D, obesity, or NASH. We provide a mechanistic outline with a detailed summary of the available clinical data and ongoing trials that are adjudicating the impact of high‐dose GLP‐1RAs, unimolecular, and multimolecular GLP‐1R‐based co‐agonists in populations living with T2D, obesity, or NASH. The available trial findings are aligned with preclinical observations, showing clinical efficacy and safety thus providing optimism for the expansion of GLP‐1R‐based drug classes for managing the triad of T2D, obesity and NASH. Development, access, and wide‐spread utilization of these new therapeutic approaches will offer important opportunities to markedly improve the collective global burden of T2D, obesity, and NASH.
Uncovering the secrets of monoculture yield decline: trade‐offs between leaf and root chemical and physical defence traits in a grassland experiment
Authors: Bassi Leonardo , Hennecke Justus , Albracht Cynthia , Bröcher Maximilian , Solbach Marcel Dominik , Schaller Jörg , Doan Van Cong , Wagner Heiko , Eisenhauer Nico , Ebeling Anne , Meyer Sebastian T. , van Dam Nicole M. , Weigelt Alexandra
Published: November 2023

Plant monocultures growing for extended periods face severe losses of productivity. This phenomenon, known as ‘yield decline', is often caused by the accumulation of above‐ and below‐ground plant antagonists. The effectiveness of plant defences against antagonists might help explain differences in yield decline among species. Using a trait‐based approach, we studied the role of 20 physical and chemical defence traits of leaves and fine roots on yield decline of 4‐ and 18‐year‐old monocultures of 27 grassland species. We hypothesized that yield decline is lower for species with high defences, that root defences are better predictors of yield decline than leaf defences, and that in roots, physical defences better predict yield decline than chemical defences, while the reverse is true for leaves. We additionally hypothesized that the relationship between defences and yield decline increases with time and that species increasing the expression of defence traits after long‐term monoculture growth would suffer less yield decline. We summarized leaf and fine root defence traits using principal component analyses and analysed the relationship between the most informative components along with their temporal changes and monoculture yield decline. The significant predictors of yield decline were traits related to the so‐called collaboration gradient of the root economics space (specific root length and root diameter) as well as their temporal changes and traits related to the leaf physical vs chemical defence tradeoff (leaf dry matter, silicon and cellulose content, toughness and phytochemical diversity). We were unable to unequivocally identify the mechanisms relating the effect of those traits to yield decline as they could mediate plant responses to several stressors such as antagonist accumulation, nutrient depletion or drought. Further studies are needed to differentiate between these alternative mechanisms and to gain a comprehensive understanding of the drivers of yield decline in relation to root and leaf defence traits.
Comparison of very high‐power short‐duration, high‐power short‐duration, and low‐power long‐duration radiofrequency ablation for atrial fibrillation: A systematic review and network meta‐analysis
Authors: Junarta Joey , Rodriguez Sebastian , Ullah Waqas , Siddiqui Muhammad U. , Riley Joshua M. , Patel Anjani , O'Neill Parker , Dikdan Sean J. , Fradin James J. , Rosen Jake L. , Frisch Daniel R.
Published: November 2023

Background

The optimal power and duration settings for radiofrequency (RF) atrial fibrillation (AF) ablation to improve efficacy and safety is unclear. We compared low‐power long‐duration (LPLD), high‐power short‐duration (HPSD), and very HPSD (vHPSD) RF settings for AF ablation.

Methods

This network meta‐analysis (NMA) was structured according to the Preferred Reporting Items for Systematic Review and Meta‐Analyses guidelines. Medline, Scopus and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. Observational and randomized studies were included. Eligible studies compared outcomes in AF patients who underwent first‐time RF ablation with the following settings: vHPSD (70–90 W, 3–10 s), HPSD (45–60 W, 5–10 s), or LPLD (20–40 W, 20–60 s).

Results

Thirty‐six studies comprising 10,375 patients were included (33% female). Frequentist NMA showed LPLD tended toward a lower odds of freedom from arrhythmia (FFA) versus HPSD (OR 0.93, 95% CI 0.86–1.00). There was no difference in FFA between vHPSD versus HPSD. Splitwise interval estimates showed a lower odds of FFA in LPLD versus vHPSD on direct (OR 0.78, 95% CI 0.65–0.93) and network estimates (OR 0.85, 95% CI 0.73–0.98). Frequentist NMA showed less total procedural (TP) time with HPSD versus LPLD (generic variance 1.06, 95% CI 0.83 to 1.29) and no difference between HPSD versus vHPSD.

Conclusion

This NMA shows improved procedural times in HPSD and vHPSD versus LPLD. Although HPSD tended toward improved odds of FFA compared to LPLD, the overall result was not statistically significant. The odds of FFA in LPLD was lower versus vHPSD on direct and network estimates on splitwise interval analysis. Large prospective head‐to‐head randomized trials are needed to validate HPSD and vHPSD settings.
History of multifetal gestation and long‐term maternal mortality
Authors: Mitro Susanna D. , Sundaram Rajeshwari , Qiao Yan , Gleason Jessica L. , Yeung Edwina , Hinkle Stefanie N. , Mendola Pauline , Mills James L. , Grandi Sonia M. , Mumford Sunni L. , Schisterman Enrique F. , Zhang Cuilin , Grantz Katherine L.
Published: November 2023

Background

Multifetal gestation could be associated with higher long‐term maternal mortality because it increases the risk of pregnancy complications such as preeclampsia and preterm birth, which are in turn linked to postpartum cardiovascular risk.

Objectives

We examined whether spontaneously conceived multifetal versus singleton gestation was associated with long‐term maternal mortality in a racially diverse U.S. cohort.

Methods

We ascertained vital status as of 2016 via linkage to the National Death Index and Social Security Death Master File of 44,174 mothers from the Collaborative Perinatal Project (CPP; 1959–1966). Cox proportional hazards models with maternal age as the time scale assessed associations between history of spontaneous multifetal gestation (in the last CPP observed pregnancy or prior pregnancy) and all‐cause and cardiovascular mortality, adjusted for demographics, smoking status, and preexisting medical conditions. We calculated hazard ratios (HR) for all‐cause and cause‐specific mortality over the study period and until age 50, 60, and 70 years (premature mortality).

Results

Of eligible participants, 1672 (3.8%) had a history of multifetal gestation. Participants with versus without a history of multifetal gestation were older, more likely to have a preexisting condition, and more likely to smoke. By 2016, 51% of participants with and 38% of participants without a history of multifetal gestation had died (unadjusted all‐cause HR 1.14, 95% confidence interval [CI] 1.07, 1.23). After adjustment for smoking and preexisting conditions, a history of multifetal gestation was not associated with all‐cause (adjusted HR 1.00, 95% CI 0.93, 1.08) or cardiovascular mortality (adjusted HR 0.99, 95% CI 0.87, 1.11) over the study period. However, history of multifetal gestation was associated with an 11% lower risk of premature all‐cause mortality (adjusted HR 0.89, 95% CI 0.82, 0.96).

Conclusions

In a cohort with over 50 years of follow‐up, history of multifetal gestation was not associated with all‐cause mortality, but may be associated with a lower risk of premature mortality.
Past the saturation point: Why voters switch from mainstream to niche parties and vice‐versa
Authors: van de Wardt Marc , Rooduijn Matthijs
Published: November 2023

When do voters switch from mainstream to niche parties and vice‐versa? To understand these switches, we focus on the saturation of the party system. We theorize that when a party system is oversaturated – i.e. when a higher effective number of parties contests elections than predicted based on socio‐political contextual characteristics (the system's ‘carrying capacity’) – it becomes increasingly likely that: (1) mainstream party voters defect to niche parties; and (2) niche party voters refrain from switching to mainstream parties. Based on vote‐switching patterns in 15 countries and 53 elections, we find that oversaturation increases shifts from mainstream to niche parties. Further analyses show that this holds for shifts from mainstream to radical left and right parties, but not for shifts to green parties. This has important consequences for research on vote switching, the electoral consequences of policy differentiation and the competition between niche and mainstream parties.
An improved hierarchical clustering method based on the k‐NN and density peak clustering
Authors: Shi Zhicheng , Guo Renzhong , Zhao Zhigang
Published: November 2023

Clustering is one of the most prevalent and important data mining algorithms ever developed. Currently, most clustering methods are divided into distance‐based and density‐based. In 2014, the fast search and find of density peaks clustering method was proposed, which is simple and effective and has been extensively applied in several research domains. However, the original version requires manually assigning a cut‐off distance and selecting core points. Therefore, this article improves the density peak clustering method from two aspects. First, the Gaussian kernel is substituted with a k‐nearest neighbors method to calculate local density. This is important as compared with selecting a cut‐off distance, calculating the k‐value is easier. Second, the core points are automatically selected, unlike the original method that manually selects the core points regarding local density and distance distribution. Given that users' selection influences the clustering result, the proposed automatic core point selection strategy overcomes the human interference problem. Additionally, in the clustering process, the proposed method reduces the influence of manually assigned parameters.
Estudiantes-profesores de lenguas: identidades emergentes en la práctica docente
Authors: Aguirre-Garzón Edgar Augusto , Ubaque-Casallas Diego , Salazar-Sierra Adriana
Published: November 2023

La práctica docente ha sido un escenario clave en la construcción de identidades profesionales.Este estudio busca indagar la forma en que cinco estudiantes-profesores de inglés construyen su identidad profesional en la práctica docente.Para ello se utilizó una metodología de investigación narrativa, con el fin de analizar realidades vividas por los participantes. Los resultados sugieren que dimensiones como la de violencia en el aula y los discursos de docentes, alumnos y estudiantesprofesores, emergen para la construcción de identidades. Estas construcciones retan formas dominantes de enseñanza del inglés, y confrontan a los estudiantes-profesores con su yo humano y tolerante en el aula.
3D Printed Bioinspired Hierarchical Surface Structure With Tunable Wettability
Authors: Rahman M. M. Towfiqur , Joyee Erina Baynojir
Published: November 2023

Nature has examples of impressive surfaces and interfaces with diverse wettability stemming from superhydrophilicity to superhydrophobicity. The multiscale surface structures found in biological systems generally have high geometric complexity, which makes it challenging to replicate their characteristics, especially using traditional fabrication techniques. It is even more challenging to fabricate such complex microstructures with tunable wettability. In this paper, we propose a method to tune the wettability of a microscale surface by changing the geometrical parameters of embedded microstructures in the surface. By taking inspiration from an insect (springtails), we designed micropillar arrays with different roughness by adjusting geometric parameters such as reentrant angle, pitch distance, and the number of spikes and pillars. This study shows that, by changing geometrical parameters in microscale, the apparent contact angle, and hence the surface wettability can be calibrated. The microscale pillars were fabricated using a precise microdirect light processing (μDLP) three-dimensional (3D) printer. Different printing parameters were studied to optimize the geometric parameters to fabricate 3D hierarchical structures with high accuracy and resolution. The largest apparent contact angle in our experiments is up to 160 deg, with pillars of 0.17 mm height and 0.5 mm diameter, 55 deg reentrant angle, and a spacing of 0.36 mm between pillars. The lowest contact angle is ∼35 deg by reducing the pillar size and spacing. By controlling the size of different features of the pillar, pillar number, and layout of the mushroom-shaped micropillars, the wettability of the surface is possible to be tuned from a highly nonwetting liquid/material combination to highly wetting material. Such wettability tuning capability expands the design space for many biomedical and thermofluidic applications.
Estimating the Thermal Conductivity of Thin Films: A Novel Approach Using the Transient Plane Source Method
Authors: Landry David , Flores Renzo , Goodman Renée B.
Published: November 2023

The conventional transient plane source (TPS) method for thin films is used for films and adhesives with thicknesses between 50 and 200 μm. Measurements with the conventional TPS method are usually inaccurate due to thermal contact resistance between the insulating sensor layers, the film and the sensor, and the film and the background material. A new approach to measuring thin films with the TPS is introduced, where the heat flow is constrained to one dimension, and a slab layer made from the same background material is introduced between the thin film and the TPS sensor. This decouples the effects of the thermal contact resistance (TCR) of the sensor to the thermal resistance of the film. The new approach is tested on four different thin films with stainless steel as the background material. The results are compared to guarded heat flowmeter measurements. Excellent agreement (< 12% error) between the two methods is achieved, showing that the new method proposed is fast, accurate, and convenient alternative for determining the thermal conductivity of thin films.
Influence of vacuum annealing on mechanical characteristics of focused ion beam fabricated silicon nanowires
Authors: Ando Hiromichi , Namazu Takahiro
Published: November 2023

This paper describes the influence of vacuum annealing on the mechanical characteristics of silicon (Si) nanowires (NWs) fabricated using focused ion beam (FIB) technologies. Two types of Si NWs having a cross-sectional one-side length or diameter ranging from 19 to 447 nm are prepared using the direct milling and Ga ion doping functions of FIB. The Si NWs prepared are annealed at 400–700 °C in high vacuum for 10 min, followed by quasi-static uniaxial tensile testing using a microelectromechanical system based tensile test system in a scanning electron microscope. All the Si NWs fracture in a brittle manner. Young's modulus of submicrometer-sized Si NWs shows both annealing and specimen size influences in the range from 120 to 170 GPa, whereas that of nano-sized Si NWs shows only annealing influence in the range from 60 to 110 GPa. Tensile strength scatters greatly, ranging from 1.0 to 7.2 GPa, which increases with increasing the NW size. A transmission electron microscope and an atomic force microscope suggest that, by annealing, recrystallization happens in the damaged layer introduced by FIB milling and the NW surface morphology changes due to its recrystallization and gallium (Ga) ion evaporation. Fracture origin is discussed through the comparison between surface roughness and crack length estimated by the Griffith theory of brittle fracture.