bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk of Atherosclerotic Cardiovascular Disease and Nonatherosclerotic Cardiovascular Disease Hospitalizations for Triglycerides Across Chronic Kidney Disease Stages Among 2.9 Million US Veterans
Authors: Soohoo Melissa , Hashemi Leila , Hsiung Jui‐Ting , Moradi Hamid , Budoff Matthew J. , Kovesdy Csaba P. , Kalantar‐Zadeh Kamyar , Streja Elani
Published: November 2021

Background

High triglycerides are associated with atherosclerotic cardiovascular disease (ASCVD) risks. Among patients with advanced chronic kidney disease (CKD), the association of elevated triglycerides with mortality is diminished and, thus, we investigated the relationship of triglycerides with ASCVD and non‐ASCVD hospitalizations across CKD stages.

Methods and Results

The cohort comprised 2 963 176 veterans who received care in 2004 to 2006 (baseline) and were followed up to 2014. Using Cox models, we evaluated baseline and time‐varying triglycerides with time to ASCVD or non‐ASCVD hospitalizations, stratified by baseline CKD stage, and adjusted for demographics and baseline or time‐updated clinical characteristics. The cohort mean±SD age was 63±14 years, with a baseline median (interquartile range) triglycerides level of 127 (87–189) mg/dL, and a quarter had prevalent CKD. There was a linear association between baseline triglycerides and ASCVD risk; however, the risk with high triglycerides ≥240 mg/dL attenuated with worsening CKD stages (reference: triglycerides 120 to <160 mg/dL). Baseline triglycerides were associated with a U‐shaped relationship for non‐ASCVD events in patients with CKD 3A to 3B. Patients with late‐stage CKD had lower to null relationships between baseline triglycerides and non‐ASCVD events. Time‐varying triglycerides associations with ASCVD were similar to baseline analyses. Yet, the time‐varying triglycerides relationship with non‐ASCVD events was inverse and linear, where elevated triglycerides were associated with lower risks.

Conclusions

Associations of higher triglycerides with ASCVD and non‐ASCVD events declined across advancing CKD stages, where a lower to null risk was observed in patients with advanced CKD. Studies are needed to examine the impact of advanced CKD on triglycerides metabolism and its association with outcomes in this high‐risk population.
Less-Affected Hand Function Is Associated With Independence in Daily Living: A Longitudinal Study Poststroke
Authors: Hmaied Assadi Samar , Barel Haim , Dudkiewicz Israel , Gross-Nevo Revital Feige , Rand Debbie
Published: November 2021

Background and Purpose:

The upper extremity (UE) ipsilateral to the brain lesion is mildly affected poststroke. It is unclear whether patients perceive this, and the association between less-affected hand function and independence in activities of daily living (ADL) is unknown. We aimed to (1) assess longitudinal changes in function, dexterity, grip strength, and self-perception of the less-affected UE, (2) compare them to the normative data, and (3) determine the association of both UEs to ADL during the first 6 months poststroke.

Methods:

Consecutive adults following a first stroke were assessed on rehabilitation admission (T1), 6 weeks (T2), and 6 months (T3) poststroke onset. Box and block test assessed function of both UEs. The functional dexterity test (FDT) and Jamar Dynamometer assessed dexterity and grip strength of the less-affected UE. The functional independence measure assessed ADL, and instrumental ADL was assessed at T3. Spearman correlations and multiple regression models were used.

Results:

Participants were assessed at T1 (N=87), T2 (N=82), and T3 (N=68). At T1, less-affected UE deficits were apparent (median [interquartile range] box and block test-45 [35–53] blocks, FDT-44.5 [33.3–60.8] seconds, grip-25.5 [16.2–33.9] kilograms), but only 19.5% of the participants self-perceived this. Less-affected hand function significantly improved with 32% and 33% achieving a minimal clinically important difference for box and block test at T2 and T3, respectively. Dexterity improved significantly between T1 and T2 (
P
<0.001, no established minimal clinically important difference) and grip strength improved significantly between T2 and T3; 3.4% achieving a minimal clinically important difference (
P
<0.01). At T3, most participants did not reach the norms (box and block test-67.4 blocks, FDT-32.2 seconds, grip-40.5 kilograms). Both the less- and more-affected UEs explained a large portion of the variance of ADL at all time-points, after controlling for age, days-since-stroke-onset, stroke type, and cognition.

Conclusions:

Despite some improvement, the less-affected UE at 6 months poststroke remained below norms, explaining difficulties in ADL and instrumental ADL. Further research is needed.
Soybean roots defence against cadmium and its dependence on dose in a non-linear manner
Authors: Mészáros Patrik , Rybanský Ľubomír , Bardáčová Monika , Roszival Marcel , Matušíková Ildikó
Published: November 2021

Metal pollution represents a serious issue for sustainable agronomy and food safety. Activation of plants’ protective mechanisms has been shown to depend on the extent of soil contamination with metal, but reports on dose-dependent responses (especially to extreme concentrations) are rather rare. In this research we exposed soybean (Glycine max L.) roots at a very early stage to a scale of cadmium concentrations, including doses far exceeding the amounts found in nature. Spectrophotometrical and enzyme in-gel detection assays were used to examine ongoing defence responses. The results confirmed commonly reported findings on inhibited growth and the activation of several superoxide dismutase isoforms in a dose-dependent manner. Contrary to expectations, the hydrogen peroxide levels, proline accumulation and the rate of lipid peroxidation were suppressed with increasing metal doses. More importantly, the linearity of Cd accumulation in soybean roots was interrupted at 200 mg.l-1 of cadmium, which coincides with peculiar responses of several chitinase family members. No such nonlinear response was observable for proline accumulation or any of the SOD isoforms. Possible explanations are provided and the importance of considering the metal stress dose is stressed to avoid false generalizations on plant defence responses.
Paracremonium lepidopterorum, a new insect-associated fungus
Authors: MING DA-QIONG , LUO LING-YAN , HE XIAO-XIA , WANG MING-SHU , FANG WEN-XING , CHEN SHU-FENG , CHEN WAN-HAO , HAN YAN-FENG , LIANG ZONG-QI
Published: November 2021

During a survey of entomopathogenetic fungi from Southwest China, a new species, Paracremonium lepidopterorum was isolated from a pupa. It differs from other Paracremonium species by its shorter cylindrical phialides and absence of slimy head of conidia and chlamydospores. Phylogenetic analyses based on the combined datasets of ITS+LSU+TUB confirmed that P. lepidopterorum is distinct from other species. The new species is formally described and illustrated, and compared to similar species.
Hypodematium chrysolepis comb. nov. from Africa and H. eglandulosum sp. nov. from Asia (Hypodematiaceae)
Authors: FAN XUE-PING , LU NGAN THI , ZHANG LIANG , ZHANG LI-BING
Published: November 2021

A new fern species, Hypodematium eglandulosum, is described and illustrated from southern China and Southeast Asia, and a new combination is made, H. chrysolepis, from Africa. Hypodematium eglandulosum is distinguished from its similar species by plants eglandular, leaves 3-pinnatifid, and stipes upward sparsely covered with acicular hairs or nearly glabrous. The description and photographs of H. eglandulosum are provided. Aspidium chrysolepis is currently treated as a synonym of H. crenatum, but it should be recognized.
Character-state evaluation when discriminating Thysanoptera taxa (Insecta)
Authors: MINAEI KAMBIZ , MOUND LAURENCE
Published: November 2021

Problems are discussed in evaluating character state variation in the insect order Thysanoptera, particularly in the family Phlaeothripidae, illustrated by two such problems in the genus Haplothrips Amyot & Serville. The synonymy of Jironiella Retana-Salazar & Soto-Rodriguez with Haplothrips is reconfirmed, and Haplothrips aliakbarii Mirab-balou & Miri is recognised as a new synonym of H. globiceps Bagnall.
New Species of Entypus (Hymenoptera: Pompilidae) and notes on the natural history of some Atlantic Forest spider wasps
Authors: LOPEZ VINICIUS M. , DE OLIVEIRA ALVES CARDOSO RENAN KOBAL , CEZÁRIO RODRIGO R. , GUILLERMO-FERREIRA RHAINER , SANTOS EDUARDO F. DOS
Published: November 2021

We describe the new species Entypus renata, sp. nov., from the Brazilian Atlantic Forest and report on its host. We also provide the first host records for Ageniella (Priophanes) erythroptera (Banks), Entypus bituberculatus (Guérin-Méneville) and an undetermined species of Poecilopompilus Ashmead. In addition, we report behavioral aspects for these species, including a new ethological sequence for Poecilopompilus.
Contributions of Weakly Coupled Data Assimilation–Based Land Initialization to Interannual Predictability of Summer Climate over Europe
Authors: Shi Pengfei , Wang Bin , He Yujun , Lu Hui , Yang Kun , Xu Shiming , Huang Wenyu , Liu Li , Liu Juanjuan , Li Lijuan , Wang Yong
Published: November 2021

The land surface is a potential source of climate predictability over the Northern Hemisphere midlatitudes but has received less attention than sea surface temperature in this regard. This study quantified the degree to which realistic land initialization contributes to interannual climate predictability over Europe based on a coupled climate system model named FGOALS-g2. The potential predictability provided by the initialization, which incorporates the soil moisture and soil temperature of a land surface reanalysis product into the coupled model with a dimension-reduced projection four-dimensional variational data assimilation (DRP-4DVar)-based weakly coupled data assimilation (WCDA) system, was analyzed first. The effective predictability (i.e., prediction skill) of the hindcasts by FGOALS-g2 with realistic and well-balanced initial conditions from the initialization were then evaluated. Results show an enhanced interannual prediction skill for summer surface air temperature and precipitation in the hindcast over Europe, demonstrating the potential benefit from realistic land initialization. This study highlights the significant contributions of land surface to interannual predictability of summer climate over Europe.
Three Types of Positive Indian Ocean Dipoles and Their Relationships with the South Asian Summer Monsoon
Authors: Jiang Jilan , Liu Yimin , Mao Jiangyu , Li Jianping , Zhao Shuwen , Yu Yongqiang
Published: November 2021

The relationship between the Indian Ocean dipole (IOD) and the South Asian summer monsoon (SASM), which remains a subject of controversy, was investigated using data analyses and numerical experiments. We categorized IOD events according to their sea surface temperature anomaly (SSTA) pattern: type W and type E are associated with stronger SSTA amplitudes in the western and eastern poles of the IOD, respectively, while type C has comparable SSTA amplitudes in both poles during boreal autumn. Type W is associated with a weak SASM from May to summer, which contributes to substantial warming of the western pole in autumn; the east–west SST gradient linked to the warming of the western pole causes weak southeasterly wind anomalies off Sumatra and feeble and cold SSTAs in the eastern pole during the mature phase. Type E is associated with a strong SASM and feeble warming of the western pole; interaction between the strong SASM and cold SSTAs in the eastern pole in summer results in strong southeasterly wind anomalies off Sumatra and substantial cooling of the eastern pole during the mature phase. For type C, warming of the western pole and cooling of the eastern pole develop synchronously without apparent SASM anomalies and reach comparable intensities during the mature phase. Observations and numerical simulation results both indicate the role of disparate SASM anomalies in modulating SSTA patterns during the development of positive IODs. Warming of the tropical Indian Ocean becomes established in the winter and spring following type W and type C IODs but not following type E events.
The Influence of Interannual and Decadal Indo-Pacific Sea Surface Temperature Variability on Australian Monsoon Rainfall
Authors: Heidemann Hanna , Ribbe Joachim , Cowan Tim , Henley Benjamin J. , Pudmenzky Christa , Stone Roger , Cobon David H.
Published: November 2021

Monsoonal rainfall in northern Australia (AUMR) varies substantially on interannual, decadal, and longer time scales, profoundly impacting natural systems and agricultural communities. Some of this variability arises in response to sea surface temperature (SST) variability in the Indo-Pacific linked to both El Niño–Southern Oscillation (ENSO) and the interdecadal Pacific oscillation (IPO). Here we use observations to investigate unresolved issues regarding the influence of the IPO and ENSO on AUMR. Specifically, we show that during negative IPO phases, central Pacific (CP) El Niño events are associated with below-average rainfall over northeast Australia, an anomalous anticyclonic pattern to the northwest of Australia, and eastward moisture advection toward the date line. In contrast, CP La Niña events (distinct from eastern Pacific La Niña events) during negative IPO phases drive significantly wet conditions over much of northern Australia, a strengthened Walker circulation, and large-scale moisture flux convergence. During positive IPO phases, the impact of CP El Niño and CP La Niña events on AUMR is weaker. The influence of central Pacific SSTs on AUMR has been stronger during the recent (post-1999) negative IPO phase. The extent to which this strengthening is associated with climate change or merely natural internal variability is not known.
Biases in the Prediction of Convective Storm Characteristics with a Convection Allowing Ensemble
Authors: Grim Joseph A. , Pinto James O. , Blitz Thomas , Stone Kenneth , Dowell David C.
Published: November 2021

The severity, duration, and spatial extent of thunderstorm impacts are related to convective storm mode. This study assesses the skill of the High-Resolution Rapid Refresh Ensemble (HRRR-E) and its deterministic counterpart (HRRRv4) at predicting convective mode and storm macrophysical properties using 35 convective events observed during the 2020 warm season across the eastern United States. Seven cases were selected from each of five subjectively determined convective organization modes: tropical cyclones, mesoscale convective systems (MCSs), quasi-linear convective systems, clusters, and cellular convection. These storm events were assessed using an object-based approach to identify convective storms and determine their individual size. Averaged across all 35 cases, both the HRRR-E and HRRRv4 predicted storm areas were generally larger than observed, with this bias being a function of storm lifetime and convective mode. Both modeling systems also underpredicted the rapid increase in storm counts during the initiation period, particularly for the smaller-scale storm modes. Interestingly, performance of the HRRRv4 differed from that of the HRRR-E, with the HRRRv4 generally having a larger bias in total storm area than the HRRR-E due to HRRRv4 predicting up to 66% more storm objects than the HRRR-E. The HRRR-E accurately predicted the convective mode 65% of the time, with complete misses being very rare (<5% of the time overall). However, an evaluation of rank histograms across all 35 cases revealed that the HRRR-E tended to be underdispersive when predicting storm size for all but the MCS mode.
Sex and Prediction Error, Part 2: Jouissance and The Free Energy Principle in Neuropsychoanalysis
Authors: Dall’Aglio John
Published: November 2021

Jouissance refers to an excess enjoyment beyond (yet tied to) speech and representation. From the perspective of some Lacanian analysts, jouissance is precisely what testifies against any relationship to the brain— jouissance “slips” out of cognition. On the contrary, it is argued here that jouissance has a central place in contemporary neuropsychoanalysis. In part 1 of this series the metapsychology of jouissance was presented in relation to the real and symbolic registers. Here, in part 2, Mark Solms’s neuropsychoanalytic model of Karl Friston’s free energy principle is summarized. In this model, “predictions” aim to resolve prediction errors—most notably, those signaled by affective consciousness. “Surplus prediction error”—prediction error that arises at the point where the predictive model fails—is proposed to be a neural correlate of jouissance. This limit within prediction is analogous to the real as a structural negativity within the symbolic.
Diversity, Equity, and Inclusion: A Current Analysis of General Surgery Residency Programs
Authors: Kearse LaDonna E. , Jensen Rachel M. , Schmiederer Ingrid S. , Zeineddin Ahmad , Anderson Tiffany N. , Dent Daniel L. , Payne Davis H. , Korndorffer James R.
Published: November 2021

Background

Local, regional, and national diversity, equity, and inclusion (DEI) initiatives have been established to combat barriers to entry and promote retention in surgery residency programs. Our study evaluates changes in diversity in general surgery residency programs. We hypothesize that diversity trends have remained stable nationally and regionally.

Materials and Methods

General surgery residents in all postgraduate years were queried regarding their self-reported sex, race, and ethnicity following the 2020 ABSITE. Residents were then grouped into geographic regions. Data were analyzed utilizing descriptive statistics, Kruskal-Wallis test, and chi-square analyses.

Results

A total of 9276 residents responded. Nationally, increases in female residents were noted from 38.0 to 46.0% ( P < .001) and in Hispanic or Latinx residents from 7.3 to 8.3% ( P = .031). Across geographic regions, a significant increase in female residents was noted in the Northwest (51.9 to 58.3%, P = .039), Midwest (36.9 to 43.3%, P = .006), and Southwest (35.8 to 47.5%, P = .027). A significant increase in black residents was only noted in the Northwest (0 to 15.8%, P = .031). The proportion of white residents decreased nationally by 8.9% and in the Mid-Atlantic, Southeast, and Southwest between 5.5 and 15.9% ( P < .05).

Discussion

In an increasingly diverse society, expanding the numbers of underrepresented surgeons in training, and ultimately in practice, is a necessity. This study shows that there are region-specific increases in diversity, despite minimal change on a national level. This finding may suggest the need for region-specific DEI strategies and initiatives. Future studies will seek to evaluate individual programs with DEI plans and determine if there is a correlation to changing demographics.
The Utility of Serial Hemoglobin Monitoring in Non-Operative Management of Blunt Splenic Injury
Authors: Poupore Nicolas S. , Boswell Nicole D. , Baginski Bryana , Cull John , Pellizzeri Katherine F.
Published: November 2021

Background

The Eastern Association for the Surgery of Trauma (EAST) states there is not enough evidence to recommend a particular frequency of measuring Hgb values for non-operative management (NOM) of blunt splenic injury (BSI). This study was performed to compare the utility of serial Hgb (SHgb) to daily Hgb (DHgb) in this population.

Methods

We conducted a retrospective chart review of patients with BSI between 2013 and 2019. Demographics, comorbidities, lab values, clinical decisions, and outcomes were gathered through a trauma database.

Results

A total of 562 patients arrive in the trauma bay with BSI. In the NOM group, 297 were successful and 37 failed NOM. Of those that failed NOM, 8 (21.6%) changed to OM due to a drop in Hgb. 5 (62.5%) were hypotensive first, 2 (25%) were no longer receiving SHgb, and 1 (12.5%) had a repeat CT scan and was embolized. DHgb patients were not significantly different from SHgb patients in injury severity, length of stay, the largest drop in Hgb, and incidence of failing NOM. Patients taking aspirin were more likely to fall below 7 g/dl at 48 and 72 hours into admission.

Conclusions

These results suggest that that trending SHgb may not influence clinical decision-making in NOM of BSI. Besides taking aspirin, risk factors for who would benefit from SHgb were not identified. Patients who received DHgb had similar injuries and outcomes than patients who received SHgb. Prospective studies are needed to evaluate the clinical utility of SHgb compared to DHgb.
Understanding Health Facility Needs for Human Trafficking Response in Michigan
Authors: Munro-Kramer Michelle L. , Beck Dana C. , Martin Katherine E. , Carr Bridgette A.
Published: November 2021

Objectives

Human trafficking is a public health issue that has substantial health consequences. However, research on the preparedness of health facilities to serve people who have experienced or are experiencing human trafficking is limited. We examined health facility preparedness related to human trafficking in Michigan.

Methods

We used a cross-sectional design to explore health facility preparedness related to human trafficking in Michigan. We sampled 10 prosperity regions according to health facility type (Federally Qualified Health Centers, health departments, and hospitals). An email invitation was sent to identified health facility personnel (eg, administrators, physicians, nurses) from May to June 2019 with a link to a 26-item survey with items about current policies, protocols, and areas for improvement related to human trafficking.

Results

Forty-two Federally Qualified Health Centers, health departments, and hospitals responded to the survey. Most health facilities had screening policies and response protocols related to child maltreatment (screening: 32/41 [78.0%]; response: 38/40 [95.0%]) and intimate partner violence (screening: 33/41 [80.5%]; response: 37/40 [92.5%]). However, fewer facilities had a screening policy (16/41 [39.0%]) and response protocol (25/40 [62.5%]) for human trafficking; more of these facilities focused on sex trafficking than on labor trafficking. The top needs related to human trafficking were (1) individual-level health care provider training, (2) health facility–level screening policies and response protocols, (3) community-level resources, and (4) societal-level awareness, funding allocation, and data.

Conclusions

Facility-level resources are needed to ensure that health care providers have adequate training and support to address human trafficking in the health care system.
Reciprocity of Cognitive and Emotional Antecedents to Bullying: Bidirectional Relations Between Cognitive Impulsivity and Anger
Authors: Walters Glenn D. , Espelage Dorothy L.
Published: November 2021

The purpose of this study was to investigate the possibility that cognitive and affective variables form a reciprocal relationship when it comes to predicting future bullying perpetration. To this end, the bidirectional relationship between cognitive impulsivity and anger was evaluated in an effort to determine whether both cross-lagged pathways contributed to a rise in bullying behavior. The reciprocal hypothesis was tested in a sample of 1,160 early adolescents (567 boys, 593 girls) from the Illinois Study of Bullying and Sexual Violence (ISBSV). Cognitive impulsivity and anger were cross-lagged at Waves 1 and 2 of the ISBSV, after which they were correlated with bullying perpetration at Wave 3 in a three-wave longitudinal path analysis. Results from the path analysis identified the presence of a significant bidirectional association between Cognitive Impulsivity-1 and Anger-2 and between Anger-1 and Cognitive Impulsivity-2, with both cross-lags effectively predicting future bullying behavior.
Investigation of Regression-Based Effect Size Methods Developed in Single-Subject Studies
Authors: Sen Nihal
Published: November 2021

The purpose of this study is to provide a brief introduction to effect size calculation in single-subject design studies, including a description of nonparametric and regression-based effect sizes. We then focus the rest of the tutorial on common regression-based methods used to calculate effect size in single-subject experimental studies. We start by first describing the difference between five regression-based methods (Gorsuch, White et al., Center et al., Allison and Gorman, Huitema and McKean). This is followed by an example using the five regression-based effect size methods and a demonstration how these methods can be applied using a sample data set. In this way, the question of how the values obtained from different effect size methods differ was answered. The specific regression models used in these five regression-based methods and how these models can be obtained from the SPSS program were shown. R2 values obtained from these five methods were converted to Cohen’s d value and compared in this study. The d values obtained from the same data set were estimated as 0.003, 0.357, 2.180, 3.470, and 2.108 for the Allison and Gorman, Gorsuch, White et al., Center et al., as well as for Huitema and McKean methods, respectively. A brief description of selected statistical programs available to conduct regression-based methods was given.
Spontaneous Primary Pleural Mesothelioma in Fischer 344 (F344) and Other Rat Strains: A Retrospective Review
Authors: Tokarz Debra A. , Gruebbel Margarita M. , Willson Gabrielle A. , Hardisty Jerry F. , Pearse Gail , Cesta Mark F.
Published: November 2021

Spontaneous primary pleural mesotheliomas in Fischer 344 (F344) or other rat strains have rarely been reported. The objectives of this retrospective study were to develop historical incidence data and better characterize the light-microscopic morphology of these naturally occurring neoplasms in a large cohort of rats of several strains. A retrospective review was performed of National Toxicology Program (NTP) studies in rats conducted between 1980 and 2019 and comprising a total of 104,029 rats (51,326 males, 52,703 females), predominantly (90%) of the F344 strain. Of the 94,062 F344 rats surveyed, there were 30 cases of primary pleural mesotheliomas (22 males, 8 females). Of the 2998 Wistar Han rats surveyed, primary pleural mesotheliomas were present in 2 male rats. No primary pleural mesotheliomas were noted in male and female rats of other strains (6669 Sprague Dawley; 300 Osborne-Mendel). All primary pleural mesotheliomas in control and treated F344 and Wistar Han rats were considered spontaneous and unrelated to treatment. Based on light-microscopic evaluation of paraffin-embedded hematoxylin and eosin stained sections, only epithelioid and biphasic histologic subtypes were observed: 18 and 12 in F344 rats, respectively, and one each in Wistar Han rats. No sarcomatoid subtype cases were noted in any strain of rat.
Setting meaningful goals in rehabilitation: A qualitative study on the experiences of clients and clinicians in working with a practical tool
Authors: Littooij Elsbeth , Doodeman Suzan , Holla Jasmijn , Ouwerkerk Maaike , Post Lenneke , Satink Ton , ter Steeg Anne Marie , Vloothuis Judith , Dekker Joost , de Groot Vincent
Published: November 2021

Objective

To evaluate the experience of clients and clinicians in working with a tool to help set goals that are personally meaningful to rehabilitation clients.

Design

We have applied the tool in the outpatient rehabilitation setting. Clients’ and clinicians’ experiences in working with the tool were evaluated in individual, semi-structured interviews and focus group interviews, respectively. Thematic analysis was used to analyze the data.

Setting

A university medical center and a rehabilitation center.

Subjects

Clients with a first-time stroke ( n = 8) or multiple sclerosis ( n = 10), and clinicians ( n = 38).

Intervention

The tool to help set meaningful goals consisted of a session (i) to explore the client's fundamental beliefs, goals and attitudes and (ii) to identify a meaningful overall rehabilitation goal. The results of that session were used by the multidisciplinary rehabilitation team (iii) to help the client to set specific rehabilitation goals that served to achieve the meaningful overall rehabilitation goal.

Results

Both clients and clinicians reported that the tool helped to set a meaningful overall rehabilitation goal and specific goals that became meaningful as they served to achieve the overall goal. This contributed to clients’ intrinsic rehabilitation motivation. In some clients, the meaningfulness of the rehabilitation goals facilitated the process of behavior change. Both clients and clinicians made suggestions on how the tool could be further improved.

Conclusion

In the opinion of both clients and clinicians, the tool does indeed result in goal setting that is personally meaningful. Further development, implementation and evaluation of the tool is warranted.
DNAJB11 predicts a poor prognosis and is associated with immune infiltration in thyroid carcinoma: a bioinformatics analysis
Authors: Sun Rongxin , Yang Longyan , Wang Yan , Zhang Yuanyuan , Ke Jing , Zhao Dong
Published: November 2021

Objective

To investigate the prognostic value of the co-chaperone protein DnaJ Heat Shock Protein Family (Hsp40) Member B11 (DNAJB11) in thyroid carcinoma (THCA).

Methods

This bioinformatics analysis study evaluated the prognostic value of DNAJB11 mRNA levels in THCA based on data from The Cancer Genome Atlas (TCGA). The levels of DNAJB11 mRNA in THCA and normal tissues were compared with Wilcoxon signed rank test. Kaplan–Meier survival curve analysis and Cox regression analysis were performed to evaluate the correlation between DNAJB11 mRNA levels and survival. Gene Ontology (GO) enrichment analysis was used to elucidate the functional enrichment difference.

Results

Data from the 502 patients with THCA from the TCGA database were analysed. DNAJB11 mRNA was downregulated in THCA tissues compared with normal tissues. Decreased levels of DNAJB11 mRNA were significantly correlated with T stage, N stage, pathological stage, histological type, extrathyroidal extension and BRAF gene status. The low levels of DNAJB11 mRNA were associated with a shorter progression-free interval. GO enrichment analysis showed that DNAJB11 was involved in immune-related biological processes.

Conclusion

Low levels of DNAJB11 mRNA were associated with poor prognosis in THCA.
An analytical parametric method for force analysis of planar mechanisms with sliding frictions
Authors: Abhary Kazem
Published: November 2021

A purely analytical method for parametric force analysis of planar mechanisms with sliding friction, as well as frictionless planar mechanisms, has been developed herein. The method uses the well-known vectorial illustration of mechanisms, which is also widely used for the kinematic analysis of mechanisms. In this method, a joint force is either decomposed into components along the direction of its adjacent links and determined via the moment equilibrium equation of links; or can be vectorially determined from the force equilibrium equations of one of the adjacent links. Unlike the common analytical method which leads to a system of simultaneous equations, this method leads to a set of algebraic and vectorial equations of only one unknown each. Force analysis of planar mechanisms has always been cumbersome and time consuming, but this method has proved to be simple, straightforward and quick. As per the author's experience who has been teaching the subject for many years, this is the most suitable tool for teaching and learning the topic as it makes the user needless of graphical solution or lengthy matrix calculations both of which solve a mechanism for just one position, and must be fully repeated for any other position. This method generates a parametric solution applicable to the whole cycle of the mechanism and easily lends itself to automation. The advantage of the method over the common one has been demonstrated in an example.
Research on Non-hyperelastic Mechanical Model of EMU Rubber Spring Based on Experimental Data
Authors: Xu Chuanbo , Chi Maoru , Liang Shulin , Dai Liangcheng , Jiang Yiping
Published: November 2021

The dynamic mechanical properties of rubber spring have great influence on the vehicle dynamic performance, so the accurate description of the mechanical properties of rubber spring has always been the focus of the train dynamics. Among the mechanical properties of rubber springs, the study of non-hyperelastic properties are the most difficult and complex. Therefore, this paper mainly studies non-hyperelastic forces. Based on the experimental data of rubber springs, an elliptic analysis model is derived to describe the non-hyperelastic properties of rubber springs. On the basis of this model, a modified model based on time change and a modified model based on displacement change are also proposed. The results show that the ellipse analysis model is simple, but the error of calculation is large; the calculation precision of time correction model is high, but the calculation process is complex; the displacement correction model is between the previous two models, with both accuracy and convenience. Compared with other models, the displacement correction model has great advantages, which can improve the accuracy of the calculation of train dynamics. It is suggested to adopt the rubber spring displacement correction model in engineering application.
Linkage Between 2 Information Systems: Combined Live Births and Food and Nutrition Surveillance as a Public Health Tool for Investigation of the Determinants of Obesity Among Children and Adolescents in Southern Brazil
Authors: Mariante Giesta Juliana , Dihl Schiffner Mariana , Boklis Mirena , Schuch Ilaine , Bosa Vera Lúcia , Homrich da Silva Clécio
Published: November 2021

Background:

Childhood obesity has been growing steadily, at an earlier age, and currently comprises a public health issue. A number of studies have pointed to perinatal factors as possible determinants in the development of childhood obesity.

Objective:

To evaluate the influence of perinatal factors on the development of obesity in children and adolescents in southern Brazil.

Design:

Retrospective cohort study in which a linkage was made between anthropometric data of children and adolescents aged 0 to 15 years who had been registered in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2016 and their perinatal data registered in the Live Birth Information System (SINASC) from 2000 to 2014. The SINASC was used to extract maternal covariables (age, schooling, marital status), prenatal variables (parity and number of prenatal visits), and perinatal variables (type of delivery, sex, and birth weight). Variables such as age, inclusion in the Bolsa Família income transfer program, and the number of anthropometric evaluations were extracted from SISVAN.

Results:

The sample comprised 537 children and adolescents. The median age was 8 years (interquartile range: 2-11 years). The prevalence of obesity was 15.1%. Poisson regression revealed a higher risk of obesity in children born via cesarean delivery (relative risk [RR] = 1.48; 95% CI: 1.01-2.17), children of primiparous mothers (RR = 1.72; 95% CI: 1.16-2.53), girls (RR = 1.77; 95% CI:1.21-2.60), and those aged between 5 and 9 years (RR = 26.8; 95% CI: 3.75-191.55) and older than 10 years (RR = 20.74; 95% CI: 2.89-148.61).

Conclusions:

The linkage between SINASC and SISVAN allowed identification of prenatal and perinatal risk factors for the development of childhood obesity. These findings should contribute to the development of health promotion and prevention policies.
Kinship Ties to Government Staff and Local Political Trust: Evidence from Rural China
Authors: Hu Anning , Yin Chen
Published: November 2021

Drawing on the Rural Socioeconomic Survey in China, we for the first time present descriptive information about Chinese citizens’ kinship ties to local government staff in rural areas, where around 40 percent of the respondents have at least one close relative in the family working in the local government. On average, such kinship ties have a significant but negative correlation with both the trust in staff of local township and county governments, and the trust in staff of judicial, legislative, and public security agencies. This negative effect, however, is not linearly additive with the number of kinship ties. Taken together, these findings lend support to the negative association between local kinship embeddedness and confidence in local official staff, highlighting a relational approach to understanding political trust in Chinese society.
Public Knowledge and Perceptions About Unsubmitted and Untested Sexual Assault Kits
Authors: Pinchevsky Gillian M. , Sousa William H.
Published: November 2021

Large numbers of unsubmitted and untested sexual assault kits have been uncovered across the country. Although increased criminal justice, empirical, and legislative attention have been given to better understanding this issue, the extent to which the public is aware of unsubmitted and untested kits and how the public feels about the subject has not been explored. Assessing the public's knowledge of this topic is important considering that public awareness of criminal justice issues can ultimately influence policy decisions. This study, therefore, explores the publics’ knowledge and perceptions about the issue of unsubmitted and untested sexual assault kits. We found that roughly 74% of the sample had heard of the term “sexual assault kit,” and a little over half (60%) of those persons were aware of the magnitude of the issue surrounding unsubmitted and untested kits. Few (30%) respondents who were aware of the problem knew that it was an issue in their own communities. Further, the public was generally supportive of testing kits and saw the utility of kits, but nuances in the data emerged.
Gonococcal bacterial load in PrEP users with Mycoplasma genitalium coinfection
Authors: Van Dijck Christophe , De Baetselier Irith , Cuylaerts Vicky , Buyze Jozefien , Laumen Jolein , Vuylsteke Bea , Kenyon Chris
Published: November 2021

Objectives

Gonococcal infections with a higher bacterial load may pose a higher risk of transmission. We assessed the association between gonococcal bacterial load and coinfection with Mycoplasma genitalium.

Methods

From September 2015 until May 2018, 200 men and transgender women who have sex with men participated in an HIV pre-exposure prophylaxis (PrEP) demonstration trial in Antwerp, Belgium. They underwent 3-monthly 3-site (anus, urine, and pharynx) molecular testing for N. gonorrhoeae and C. trachomatis and M. genitalium, irrespective of symptoms. Gonococcal bacterial load was determined on remnant DNA extracts using an in-house quantitative PCR. Results were expressed as log10 transformed copies/mL and analyzed with a linear regression model.

Results

Gonococcal bacterial load could be determined for 82 (80.4%) of 102 anal, 17 (73.9%) of 23 urine, and 64 (90.1%) of 71 pharyngeal samples. M. genitalium was detected in five of these anal, two urine, and two pharyngeal samples and C. trachomatis was detected in 16 anal, one urine, and two pharyngeal samples. Gonococcal bacterial load was significantly higher in the presence of M. genitalium (difference 0.92 log copies/mL, 95% CI 0.16–1.67).

Conclusions

Gonococcal bacterial load was higher with M. genitalium coinfection. M. genitalium may thus be a cofactor in gonococcal transmission.
A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam
Authors: Li Li , Lin Chunqing , Liang Li-Jung , Song Weilu , Pham Loc Quang , Le Tuan Anh , Nguyen Tuan Anh
Published: November 2021

Background

People living with HIV who use drugs (PLHWUD) face enormous challenges to access antiretroviral therapy (ART), addiction treatment, and other healthcare services. This study evaluated the effect of a community capacity-building approach on PLHWUD’s access to healthcare services.

Methods

A cluster randomized controlled trial was conducted in four provinces of Vietnam. Trained commune health workers in the intervention condition were encouraged to provide services to PLHWUD in the community and engage them in HIV/addiction treatment and care using learned knowledge and skills. A total of 241 PLHWUD participated in surveys at the baseline and every three months for one year. The primary outcome was PLHWUD’s reported barriers to seeking healthcare. A linear mixed-effects regression model with a difference in difference approach was used to estimate the intervention effect on the primary outcome.

Results

Adjusted analyses indicated that significant intervention effects were observed at the Sixth and ninth month follow-ups for those on ART at the baseline and increased motivation to engage in treatment at the 3-month follow-up (60.2% vs 34.4% for the intervention and control groups, respectively).

Conclusions

The community capacity-building intervention had shown promising yet limited outcomes among a subset of PLHWUD in the community, that is, PLHWUD who had already initiated ART.
Impact of profession and wards on moral distress in a community hospital
Authors: Bayanzay Karim , Amoozgar Behzad , Kaushal Varun , Holman Alissa , Som Valentina , Sen Shuvendu
Published: November 2021

Background:

Recently, a singular survey titled “Measure of Moral Distress—Healthcare Professionals,” which addresses shortcomings of previous instruments, has been validated.

Aim:

To determine how moral distress affects nurses and physicians differently across the various wards of a community hospital.

Participant and research context:

We distributed a self-administered, validated survey titled “Measure of Moral Distress—Healthcare Professionals” to all nurses and physicians in the medical/surgical ward, telemetry ward, intensive care units, and emergency rooms of a community hospital.

Findings:

A total of 101 surveys were included in the study. The mean Measure of Moral Distress—Healthcare Professionals score for all respondents was 143.0 (standard deviation = 79.8). The mean Measure of Moral Distress—Healthcare Professionals score was 1.75 greater for nurses than for physicians (92.5 vs 161.5, p < .001), and nurses were 2.52 times more likely to consider leaving their position due to moral distress (68% vs 27%). The mean Measure of Moral Distress—Healthcare Professionals score for moral distress was least prevalent in the medical/surgical ward (92.5, SD = 38.2) and highest in the telemetry ward (197.7, SD = 83.6). The intensive care unit ward had a mean Measure of Moral Distress—Healthcare Professionals score mildly greater than the emergency room.

Ethical considerations:

No participant identifying information or information connecting a survey response to an individual was collected. This study was approved by the Raritan Bay Medical Center’s Institutional Review Board.

Discussion:

This study provides insight into the level of moral distress in the community hospital setting. Telemetry nurses experience significantly more than nurses in other wards. Telemetry nurses typically manage patients sicker than medical/surgical wards, however do not have the resources of the critical care units. This scenario presents challenges for telemetry nurses and may explain their elevated moral distress.

Conclusion:

In community hospitals, telemetry nurses experience a considerably greater amount of moral distress compared to their colleagues in other wards. As measured by the Measure of Moral Distress—Healthcare Professionals questionnaire, moral distress continues to be higher among nurses compared to physicians.
Shadow Economy and Environmental Pollution in West African Countries: The Role of Institutions
Authors: Dada James Temitope , Ajide Folorunsho Monsur , Adeiza Adams
Published: November 2021

This study deviates from extant studies by examining the effect of shadow economy (SE) on environmental pollution, and the role institutional indicators play in moderating the effect in West Africa between 1992 and 2015. Specifically, the study employed three institutional indicators (corruption control [COR], law and order [LAW], and bureaucratic quality [BUQ]) to mediate the effect and also determine its threshold values. SE is measured using Multiple Indicators Multiple Causes (MIMIC) while environmental pollution is proxy by carbon dioxide (CO2) per capita. Two step system Generalized Method of Moments (GMM) is used to drive out the conclusions of the study. The findings reveal that SE, COR and LAW contribute significantly to environmental pollution, while BUQ though not significant, reduces environmental pollution in the region. Further, the interactive effect of SE with all the institutional indicators shows that strong institutional indicators abate environmental pollution through reduction in the presence of SE. The threshold value of institutional indicators, which reduces SE and abates environmental pollution, are 3.8 and 3.7 for COR, and LAW, respectively, on an ordinary scale of 0–6, while 2.8 for BUQ on an ordinary scale of 0–4. Nevertheless, most of the countries in the region operate below the threshold level of institutional indicators in the region. The results are robust to different proxies of environmental pollution. The implications of the study are discussed.
Association Between SNPs in 1q32.2 and NSCL ± P in Han Chinese Population
Authors: Yin Bin , Shi Jia-Yu , Shi Bing , Zheng Qian , Jia Zhong-Lin
Published: November 2021

Objectives

Non-syndromic cleft lip with or without cleft palate (NSCL ±  P) is one of the most common birth malformations. Currently, numerous susceptibility SNPs have been reported by GWA studies, however, the replications of them among NSCL ±  P from Han Chinese were very limited.

Design

In this study, we selected 16 SNPs around 1q32.2 based on the published GWA studies and replicated them among 302 trios with NSCL ±  P from Han Chinese Population. The genotypic data was analyzed with FBAT, PLINK and R package.

Setting

The study was conducted in a tertiary medical center.

Patients, participants

302 patients with CL ±  P and their parents.

Main outcome measures

To ascertain the genetic variants in 1q32.2 in patients with CL ±  P in Han Chinese Population.

Interventions

Blood samples were collected.

Results

We found T allele ( Z = 4.26, p = 0.00002) and T/T homozygotes ( Z = 4.4, p = 0.000011) at rs12063989 was significantly over-transmitted among non-syndromic cleft lip with or without cleft palate (NSCL ±  P).

Conclusions

We found rs12063989 exhibited significant association with the occurrence of NSCL ±  P, which would provide new evidence for the future study in the etiology of NSCL ±  P.
Unilateral Palatal Hypoplasia: A Case Report With a Long-Term Follow-Up
Authors: Masuoka Hiromu , Takai Yumi , Kusumoto Kenji
Published: November 2021

Isolated unilateral palatal hypoplasia is an extremely rare congenital disorder that usually causes velopharyngeal incompetence. We herein report a case with isolated unilateral palatal hypoplasia that was treated and followed up over nine years. No hypernasality or articulation errors were observed through the postoperative period. Here the intraoperative and postoperative findings are described.