bluuebunny/crossref_metadata_2025 huggingface dataset:
Preconception and Diabetes Information (PADI) App for Women with Pregestational Diabetes: a Feasibility and Acceptability Study
Authors: Nwolise Chidiebere H. , Carey Nicola , Shawe Jill
Published: August 2021

Diabetes mellitus increases the risk of adverse maternal and fetal outcomes. Preconception care is vital to minimise complications; however, preconception care service provision is hindered by inadequate knowledge, resources and care fragmentation. Mobile health technology, particularly smartphone apps, could improve preconception care and pregnancy outcomes for women with diabetes. The aim of this study is to co-create a preconception and diabetes information app with healthcare professionals and women with diabetes and explore the feasibility, acceptability and preliminary effects of the app. A mixed-methods study design employing questionnaires and semi-structured interviews was used to assess preliminary outcome estimates (preconception care knowledge, attitudes and behaviours), and user acceptability. Data analysis included thematic analysis, descriptive statistics and non-parametric tests. Improvements were recorded in knowledge and attitudes to preconception care and patient activation measure following the 3-month app usage. Participants found the app acceptable (satisfaction rating was 72%), useful and informative. The app’s usability and usefulness facilitated usage while manual data input and competing priorities were barriers which participants felt could be overcome via personalisation, automation and use of daily reminders. This is the first study to explore the acceptability and feasibility of a preconception and diabetes information app for women with diabetes. Triangulated data suggest that the app has potential to improve preconception care knowledge, attitudes and behaviours. However, in order for women with DM to realise the full potential of the app intervention, particularly improved maternal and fetal outcomes, further development and evaluation is required.
The NN’s souls-cult: a case study of catholicism and popular religion in Colombia
Authors: Bastidas Meneses Luis , Kaden Tom , Schnettler Bernt
Published: August 2021

This article analyzes the cult of the souls in Purgatory in Puerto Berrío, Colombia, and its relationship with the Catholic Church. Through empirical evidence, it identifies three characteristics of this cult, namely, its relative independence from the Catholic Church, its heterogeneity and its utilitarian character, and compares them with other cases of Latin American popular Catholicism. The particularities of the cult enable an analysis of how popular religion, rather than generating a conflict with the Catholic Church, maintains an ambiguous relationship with it. The case shows that popular religion not only incorporates the symbolic structure of the Catholic Church to legitimize itself, but also that the church tolerates it, contributing to the peaceful coexistence of the popular and the institutionalized. Consequently, this leads believers, instead of adhering to a supposed binary opposition, to shift between popular and institutionalized religion.
Groups' contribution to shaping ethnic residential segregation: a dynamic approach
Authors: Tapia Eduardo
Published: August 2021

Some have argued it is possible to infer different groups’ contributions to ethnic residential segregation from their individual neighborhood preferences. From this perspective, natives tend to be more segregation-promoting than non-natives, since they prefer neighborhoods where they are the majority. It remains unclear, however, whether this holds when one evaluates their contributions to segregation within a dynamic perspective. Using register data from Statistics Sweden, I define and model ten different groups’ residential behavior based on their ethnicity and family composition. I thereby simulate the residential mobility of the full population of Stockholm municipality residents from 1998 to 2012. Even though my results at the micro-level are consistent with previous studies, the simulation results show that foreign singles’ mobility patterns are more segregation-promoting than any other groups, since this group shows a greater in-group feedback effect regarding choice of new neighborhoods, an effect that increases their flow from low-to-high segregated neighborhoods progressively. My results suggest that (1) integration initiatives would be more efficient if focused on this particular group and (2) a proper evaluation of micro-behaviors’ implications for macro-patterns of segregation requires a dynamic approach accounting for groups’ heterogeneous behaviors and their main interdependencies on shaping segregation over time.
Catching Up to America
Authors: Zhu Tian
Published: August 2021

China's rapid rise is doubtless the most significant economic and geopolitical event in the 21st century. What has led to its rise? What does it mean for the rest of the world? When will China overtake the US? Will the conflict between the two superpowers derail its further rise? Can China's development experience be emulated by other countries? These are some of the important questions addressed in this jargon-free, yet rigorous book. It debunks many popular explanations of China's rapid economic growth ranging from abundance of cheap labor, export promotion, demographic dividend, strong government, to mercantilist policies and IP theft. Taking a global comparative approach, this book demonstrates convincingly that the true differentiating factor making China grow faster than other developing countries over the past four decades is the Confucian culture of savings and education. This cultural perspective yields powerful new insights into many questions regarding China's rise.
Using and Abusing Moorean Arguments
Authors: SCARFONE M.
Published: August 2021

Metaethical Mooreanism is the view that without being able to explain how we know certain moral claims we can nevertheless be sure that we do know them. In this article I focus on the Moorean argument against moral error theory. I conclude that it fails. To show this failure, I first distinguish Moorean claims from Moorean arguments, and then so-called presumptive support from dialogical support. With these distinctions in place, I argue that the key Moorean claim requires dialogical support in order to be used within the Moorean argument against moral error theory, but metaethical Mooreans have provided only presumptive support for the Moorean claim. Not only is this presumptive support inadequate for fending off the moral error theory, it is doubtful that Mooreans can actually provide dialogical support for the key Moorean claim.
Conservatism Reconsidered
Authors: O'BRIEN DAVID
Published: August 2021

G. A. Cohen has argued that there is a surprising truth in conservatism—namely, that there is a reason for some valuable things to be preserved, even if they could be replaced with other, more valuable things. This conservative thesis is motivated, Cohen suggests, by our judgments about a range of hypothetical cases. After reconstructing Cohen's conservative thesis, I argue that the relevant judgments about these cases do not favor the conservative thesis over standard, nonconservative axiological views. But I then argue that there is a Mirrored Histories case that is such that, if one shares Cohen's conservative attitude, judgments about this case favor Cohen's conservative thesis over a wide range of non-conservative axiological views. Reflection on this case also suggests a different explanation of apparently conservative judgments that merits consideration in its own right.
Follow-up blood cultures in Pseudomonas aeruginosa bacteremia: A potential target for diagnostic stewardship
Authors: Green Alexis L. , Liang Yuanyuan , O’Hara Lyndsay M. , Pineles Lisa , Sorongon Scott , Harris Anthony D. , Baghdadi Jonathan D.
Published: August 2021

Objectives:

Evidence supporting collection of follow-up blood cultures for Gram-negative bacteremia is mixed. We sought to understand why providers order follow-up blood cultures when managing P. aeruginosa bacteremia and whether follow-up blood cultures in this context are associated with short- and long-term survival.

Methods:

We conducted a retrospective cohort study of adult inpatients with P. aeruginosa bacteremia at the University of Maryland Medical Center in 2015–2020. Kaplan-Meier survival curves and Cox regression with time-varying covariates were used to evaluate the association between follow-up blood cultures and time to mortality within 30 days of first positive blood culture. Provider justifications for follow-up blood cultures were identified through chart review.

Results:

Of 159 eligible patients, 127 (80%) had follow-up blood cultures, including 9 (7%) that were positive for P. aeruginosa and 10 (8%) that were positive for other organisms. Follow-up blood cultures were typically collected “to ensure clearance” or “to guide antibiotic therapy.” Overall, 30-day mortality was 25.2%. After risk adjustment for patient characteristics, follow-up blood cultures were associated with a nonsignificant reduction in mortality risk (hazard ratio, 0.43; 95% confidence interval, 1.08; P = .071). In exploratory analyses, the potential mortality reduction from follow-up blood cultures was driven by their use in patients with Pitt bacteremia scores >0.

Conclusions:

Follow-up blood cultures are commonly collected for P. aeruginosa bacteremia but infrequently identify persistent bacteremia. Targeted use of follow-up blood cultures based on severity of illness may reduce unnecessary culturing.
Learning stable reduced-order models for hybrid twins
Authors: Sancarlos Abel , Cameron Morgan , Le Peuvedic Jean-Marc , Groulier Juliette , Duval Jean-Louis , Cueto Elias , Chinesta Francisco
Published: August 2021

The concept of “hybrid twin” (HT) has recently received a growing interest thanks to the availability of powerful machine learning techniques. This twin concept combines physics-based models within a model order reduction framework—to obtain real-time feedback rates—and data science. Thus, the main idea of the HT is to develop on-the-fly data-driven models to correct possible deviations between measurements and physics-based model predictions. This paper is focused on the computation of stable, fast, and accurate corrections in the HT framework. Furthermore, regarding the delicate and important problem of stability, a new approach is proposed, introducing several subvariants and guaranteeing a low computational cost as well as the achievement of a stable time-integration.
A randomized-controlled trial of community-based transdiagnostic psychotherapy for veterans and internally displaced persons in Ukraine
Authors: Bogdanov Sergiy , Augustinavicius Jura , Bass Judith K. , Metz Kristie , Skavenski Stephanie , Singh Namrita S. , Moore Quincy , Haroz Emily E. , Kane Jeremy , Doty Ben , Murray Laura , Bolton Paul
Published: August 2021

Background

There is limited research on community-based mental health interventions in former Soviet countries despite different contextual factors from where most research has been conducted. Ongoing military conflict has resulted in many displaced persons and veterans and their families with high burdens of mental health problems. Lack of community-based services and poor uptake of existing psychiatric services led to the current trial to determine the effectiveness of the common elements treatment approach (CETA) on anxiety, depression, and posttraumatic stress symptoms (PTS) among conflict affected adults in Ukraine.

Methods

We conducted a three-armed randomized-controlled trial of CETA delivered in its standard form (8–12 sessions), a brief form (five-sessions), and a wait-control condition. Eligible participants were displaced adults, army veterans and their adult family members with elevated depression and/or PTS and impaired functioning. Treatment was delivered by community-based providers trained in both standard and brief CETA. Outcome data were collected monthly.

Results

There were 302 trial participants (n = 117 brief CETA, n = 129 standard CETA, n = 56 wait-controls). Compared with wait-controls, participants in standard and brief CETA experienced clinically and statistically significant reductions in depression, anxiety, and PTS and dysfunction (effect sizes d = 0.46–1.0–6). Comparing those who received standard CETA with brief CETA, the former reported fewer symptoms and less dysfunction with small-to-medium effect sized (d = 0.20–0.55).

Conclusions

Standard CETA is more effective than brief CETA, but brief CETA also had significant effects compared with wait-controls. Given demonstrated effectiveness, CETA could be scaled up as an effective community-based approach.
Impact of weekly asymptomatic testing for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in inpatients at an academic hospital
Authors: Smith Leigh , Pau Sara , Fallon Susan , Cosgrove Sara E. , Curless Melanie S. , Fabre Valeria , Karaba Sara M. , Maragakis Lisa L. , Milstone Aaron M. , Sick-Samuels Anna C. , Trexler Polly , Rock Clare ,   for the CDC Prevention Epicenter Program
Published: August 2021

We analyzed the impact of a 7-day recurring asymptomatic SARS-CoV-2 testing protocol for all patients hospitalized at a large academic center. Overall, 40 new cases were identified, and 1 of 3 occurred after 14 days of hospitalization. Recurring testing can identify unrecognized infections, especially during periods of elevated community transmission.
Bubble behaviour in a horizontal high-speed solid-body rotating flow
Authors: Rodgar Majid , Scolan Hélène , Marié Jean-Louis , Doppler Delphine , Matas Jean-Philippe
Published: August 2021

We study experimentally the behaviour of a bubble injected into a horizontal liquid solid-body rotating flow, in a range of rotational velocities where the bubble is close to the axis of rotation. We first study the stretching of the bubble as a function of its size and of the rotation of the cell. We show that the bubble aspect ratio can be predicted as a function of the bubble Weber number by the model of Rosenthal (J. Fluid Mech., vol. 12, 1962, 358–366) provided an appropriate correction due to the impact of buoyancy is included. We next deduce the drag and lift coefficients from the mean bubble position. For large bubbles straddling the axis of rotation, we show that the drag coefficient $C_D$ is solely dependent on the Rossby number $Ro$, with $C_D \approx 1.5/Ro$. In the same limit of large bubbles, we show that the lift coefficient $C_L$ is controlled by the shear Reynolds number $Re_{shear}$ at the scale of the bubble. For $Re_{shear}$ larger than 3000 we observe a sharp transition, wherein large fluctuations in the bubble aspect ratio and mean position occur, and can lead to the break-up of the bubble. We interpret this regime as a resonance between the periodic forcing of the rotating cell and the eigenmodes of the stretched bubble.
Effect of dehydration during pregnancy on birth weight and length in West Jakarta
Authors: Mulyani Erry Y. , Hardinsyah  , Briawan Dodik , Santoso Budi I. , Jus'at Idrus
Published: August 2021

Nutrition and maternal behavior are critical factors in fetal development. Maternal water intake is necessary to regulate metabolism and may influence fetal growth. This study aims to determine the effect of dehydration during pregnancy on birth weight and length. This cohort-prospective study took place in the area of Kebon Jeruk District Health Centre. A total of 38 subjects of pregnant women in their second trimester were examined. Subject characteristics were collected through direct measurements and interviews. Urine and blood samples were collected at the sixth trimester (32–34 and 35–37 weeks) to determine hydration status. Nutritional status was collected through food recall, while birth weight and length were obtained from the anthropometric measurements 30 min after birth. From a total of 38 subjects, 20 were dehydrated, and 18 were well hydrated. There was a significant relationship between hydration status and water intake, birth weight and length, head circumference, and chest circumference. After being corrected to the level of water intake, the difference in birth weight and length between the two groups were 500⋅6 g and 0⋅4 cm, and 0⋅8 cm and 1⋅4 cm for the head circumference and chest circumference (P < 0⋅05). It is recommended for mothers to monitor their weight and ensure fluid intake of 3⋅0 l per day. Further research requires more subjects to observe the effects of chronic maternal dehydration on pregnancy output and a cohort study that monitors infant development in the first six months of life.
Methodologies to measure the coverage of vitamin A supplementation: a systematic review
Authors: Miglietta Alessandro , Imohe Annette , Hasman Andreas
Published: August 2021

Countries are increasingly transitioning from event-based vitamin A supplementation (VAS) distribution to delivery through routine health system contacts, shifting also to administrative, electronic-based monitoring tools, a process that brings certain limitations affecting the quality of administrative VAS coverage. At present, there is no standardised methodology for measuring the coverage of VAS delivered through routine health services. To address this gap, we conducted a systematic review of the literature to identify and recommend methods to measure VAS coverage, with the aim of providing guidance to countries on the collection of consistent data for planning, monitoring and evaluating VAS programmes integrated into routine health systems. We searched the PubMed®, Embase®, Scopus, Google Scholar and World Health Organization (WHO) Global Index Medicus databases for studies published from 1 January 2000 to 1 January 2021, reporting original data on VAS coverage and methodologies used for measurement. We screened 2371 original titles and abstracts, assessed twenty-seven full-text articles and ultimately included eighteen studies. All but two studies used a coverage cluster survey (CCS) design to measure VAS coverage, adapting the WHO Vaccination Coverage Cluster Surveys methodology, by modifying sample size and sampling parameters. Annual two-dose VAS coverage was reported from only four studies. Until electronic-based systems to collect and analyse VAS data are equipped to measure routine two-dose VAS coverage using administrative data, CCSs that comply with the 2018 WHO Vaccination Coverage Cluster Surveys Reference Manual represent the gold-standard method for effective VAS programme monitoring.
Quantifying heterogeneous monsoonal melt on a debris-covered glacier in Nepal Himalaya using repeat uncrewed aerial system (UAS) photogrammetry
Authors: Mishra Niti B. , Miles Evan S. , Chaudhuri Gargi , Mainali Kumar P. , Mal Suraj , Singh Paras B. , Tiruwa Babulal
Published: August 2021

The ablation zones of debris-covered glaciers in Himalaya exhibit heterogeneous processes and melt patterns. Although sub-debris melt is measured at ablation stakes, the high variability of debris thickness necessitates distributed melt measurements at the glacier scale. Focusing on Annapurna III Glacier, we used uncrewed aerial system (UAS) photogrammetry to estimate total volume loss and slope-perpendicular glacier melt between May and November 2019 using flow-corrected point clouds. Results indicated the average elevation change was −1.10 ± 0.19 m, while the mean melt was −0.87 m w.e., equating to a mean melt rate of −0.47 cm w.e. d−1. However, the spatial pattern was highly variable due to complex local processes necessitating future study over short intervals. The evaluation of specific areas showed the interplay of debris thickness variability, subseasonal debris redistribution, supraglacial channel reconfiguration and the imprint of relict ice cliffs in leading to contemporary melt rates. Ice cliffs had higher melt distances (mean −3.9 ± 0.19 m) compared to non-cliff areas (mean −0.75 ± 0.19 m) and were the predominant control on the spatial patterns of seasonal melt rates. Crucially, the definition of ice cliff areas from thinning data has a profound impact on derived melt rates and melt enhancement. Our study demonstrates the possibility and utility of deriving fully-distributed slope-perpendicular melt measurements.
From Host Country Nationals to Entrepreneurs: Insights from Professional Service Ventures in Vietnam
Authors: Tran Yen , Michailova Snejina , Nguyen Huong
Published: August 2021

Working for multinational companies (MNCs) is often viewed as a privilege for host country nationals (HCNs) in emerging economies. This raises the question: Why do HCNs leave their jobs to pursue the hardship of establishing their own business? This article addresses this question by adopting a phenomenon-based approach to study 12 professional service firms in Vietnam. We explorewhyHCNs initially become entrepreneurs and identifyhowthey make this transition. We reveal several idiosyncratic motivations and identify four types of migration pathways: MNC returnee, committed hybrid, transitional hybrid, and direct spin-off. Our findings address the shortcomings of the existing HCNs literature that centers on MNCs’ view and employee entrepreneurship literature that overlooks the context of emerging markets. We find evidence that institutional voids often promote, rather than suppress, entrepreneurship in emerging markets. Importantly, by taking a local perspective, our findings help MNCs increase their awareness that in the fast-growing market of Vietnam, a brain drain might occur as a result of HCNs becoming entrepreneurs.
The Elite–Citizen Gap in International Organization Legitimacy
Authors: DELLMUTH LISA , SCHOLTE JAN AART , TALLBERG JONAS , VERHAEGEN SOETKIN
Published: August 2021

Scholars and policy makers debate whether elites and citizens hold different views of the legitimacy of international organizations (IOs). Until now, sparse data has limited our ability to establish such gaps and to formulate theories for explaining them. This article offers the first systematic comparative analysis of elite and citizen perceptions of the legitimacy of IOs. It examines legitimacy beliefs toward six key IOs, drawing on uniquely coordinated survey evidence from Brazil, Germany, the Philippines, Russia, and the United States. We find a notable elite–citizen gap for all six IOs, four of the five countries, and all of six different elite types. Developing an individual-level approach to legitimacy beliefs, we argue that this gap is driven by systematic differences between elites and citizens in characteristics that matter for attitudes toward IOs. Our findings suggest that deep-seated differences between elites and general publics may present major challenges for democratic and effective international cooperation.
Agenda Control and Timing of Bill Initiation: A Temporal Perspective on Coalition Governance in Parliamentary Democracies
Authors: KÖNIG THOMAS , LIN NICK , LU XIAO , SILVA THIAGO N. , YORDANOVA NIKOLETA , ZUDENKOVA GALINA
Published: August 2021

Although democratic governance imposes temporal constraints, the timing of government policy making activities such as bill initiation is still poorly understood. This holds especially under coalition governments, in which government bills need to find approval by a partner party in parliament. We propose a dynamic temporal perspective in which ministers do not know whether they face a cooperative or competitive partner at the beginning of a term, but they learn this over time and use their agenda control to time further bill initiation in response. A circular regression analysis using data on more than 25,000 government bills from 11 parliamentary democracies over 30 years supports this temporal perspective, showing that ministers initiate bills later in the term when their previous bills have experienced greater scrutiny. Ministers further delay bill initiation when coalition parties’ incentives to deviate from compromise increase and when they have less power to constrain their bills’ scrutiny.
MOLINACO, the Comorian Diaspora, and Decolonisation in East Africa's Indian Ocean
Authors: Roberts George
Published: August 2021

The marginal case of the decolonisation of Comoros has gained little attention from historians of Africa. By tracing the evolution of the Mouvement de libération nationale des Comores (MOLINACO) around East Africa's Indian Ocean basin, this article explores the possibilities and constraints of anticolonial organisation among a diaspora population whose own existence was threatened by the more exclusive political order that emerged from the process of decolonisation. In Tanganyika, Zanzibar, Kenya, and Madagascar, MOLINACO's activities were shaped and limited by contested issues of racial identity, island genealogy, partisan alignment, and international priorities among both the Comorian diaspora and their ‘host’ governments. Through a transterritorial approach, this article examines the difficulties for minority communities in navigating the transition from empire to nation-state, while also illustrating the challenges MOLINACO faced in its ultimately unsuccessful attempt to impose that same normative model onto the archipelago.
Substance use and misuse of older adults living in residential care facilities: a scoping review from a person-centred care approach
Authors: de Graaf Lisette , Janssen Meriam , Roelofs Tineke , Luijkx Katrien
Published: August 2021

Person-centred care (PCC) in residential care facilities (RCFs) is valuable but creates challenges for care professionals balancing involvement and a partnership approach for residents while considering the health and safety outcomes of all residents. This review evaluates what is known about the substance use and misuse of residents living in RCFs and what is important to study in future research to enhance PCC, especially in cases in which residents wish to choose unhealthy behaviours. A scoping review was conducted and exclusion criteria were set. The included papers were assessed on methodological quality using the Mixed Methods Appraisal Tool and the results were qualitatively analysed. The included papers consisted of studies regarding alcohol, tobacco and illicit drugs. The results showed that care professionals are involved in facilitating and regulating alcohol and tobacco. The focus of the included papers is on alcohol and tobacco. Five of the 16 papers assessed the residents’ perspective. This review highlights the importance of incorporating the perspectives of residents, care professionals and the organisation to enhance PCC and enable residents to make shared and well-informed decisions in dialogue with care professionals. Future research should also assess the distinction between substance use and misuse, and how this affects implementing PCC in RCFs.
Re-engaging in Aging and Mobility Research in the COVID-19 Era: Early Lessons from Pivoting a Large-Scale, Interdisciplinary Study amidst a Pandemic
Authors: Vrkljan Brenda , Beauchamp Marla K. , Gardner Paula , Fang Qiyin , Kuspinar Ayse , McNicholas Paul D. , Newbold K. Bruce , Richardson Julie , Scott Darren , Zargoush Manaf , Gruppuso Vincenza
Published: August 2021

In the wake of the COVID-19 pandemic, those planning and conducting research involving older adults have faced many challenges, in part because of the public health measures in place. This article details the early steps and corresponding strategies implemented by our multidisciplinary team to pivot our large-scale aging and mobility study. Based on the premise that all current and emerging research in aging has been impacted by the pandemic, we propose a continuum approach whereby the research question, analysis, and interpretation are situated in accordance with the stage of the pandemic. Using examples from our own study, we outline potential ways to partner with older adults and other stakeholders as well as to encourage collaboration beyond disciplinary silos even under the current circumstances. Finally, we suggest the formation of a Canadian-led consortium that leverages cross-disciplinary expertise to address the complexities of our aging population in the COVID-19 era and beyond.
Towards a credibility revolution in bilingualism research: Open data and materials as stepping stones to more reproducible and replicable research
Authors: Bolibaugh Cylcia , Vanek Norbert , Marsden Emma J.
Published: August 2021

The extent to which findings in bilingualism research are contingent on specific analytic choices, experimental designs, or operationalisations, is currently unknown. Poor availability of data, analysis code, and materials has hindered the development of cumulative lines of research. In this review, we survey current practices and advocate a credibility revolution in bilingualism research through the adoption of minimum standards of transparency. Full disclosure of data and code is necessary not only to assess the reproducibility of original findings, but also to test the robustness of these findings to different analytic specifications. Similarly, full provision of experimental materials and protocols underpins assessment of both the replicability of original findings, as well as their generalisability to different contexts and samples. We illustrate the review with examples where good practice has advanced the agenda in bilingualism research and highlight resources to help researchers get started.
Impact of elevated BMI and types of comorbid conditions on health-related quality of life in a nationally representative US sample
Authors: Le Quang A , Delevry Dimittri
Published: August 2021

Objective:

Elevated BMI is associated with multiple chronic conditions including diabetes and CVD. Patients with overweight or obesity may also suffer from comorbidities not directly related to the pathophysiology of elevated BMI. The current study sought to determine the impact of BMI and different types of chronic conditions on health-related quality of life (HRQoL) outcomes.

Design:

Six weight categories by BMI were identified: underweight, normal weight, overweight, Class-I obesity, Class-II obesity and Class-III obesity. Twenty chronic conditions were considered and categorised as elevated BMI-related (concordant) or -unrelated (discordant) conditions. HRQoL outcomes were measured using Short Form-6 Dimensions (SF-6D). Multivariable regression models were performed to examine the impact of type, number of comorbid conditions and BMI categories on SF-6D scores.

Setting:

Medical Expenditure Panel Survey (2013–2015).

Participants:

Nationally representative sample of US population; 18 years or older (n 58 960).

Results:

Of the sample, 1·7 %, 32·9 %, 34·0 % and 31·4 % were classified as underweight, normal weight, overweight and obese, respectively. The SF-6D scores were significantly decreased across all obesity classes, with the largest reduction in Class-III obesity (0·033; P < 0·001). Additionally, individuals with obesity having one or more concordant or discordant comorbidities further reduced SF-6D scores between 0·031 and 0·148 (P-values < 0·001) or between 0·080 and 0·212 (P-values < 0·001), respectively.

Conclusions:

Individuals with obesity had a significant reduction in HRQoL outcomes compared to those with normal BMI. Importantly, discordant comorbidity resulted in greater reduction in HRQoL outcomes compared to concordant comorbidity in subjects with elevated BMI.
Household-level double burden of malnutrition in Ethiopia: a comparison of Addis Ababa and the rural district of Kersa
Authors: Bliznashka Lilia , Blakstad Mia M , Berhane Yemane , Tadesse Amare W , Assefa Nega , Danaei Goodarz , Canavan Chelsey R , Hemler Elena C , Fawzi Wafaie W
Published: August 2021

Objective:

To examine the prevalence of and factors associated with different forms of household-level double burden of malnutrition (DBM) in Ethiopia.

Design:

We defined DBM using anthropometric measures for adult overweight (BMI ≥ 25 kg/m2), child stunting (height-for-age Z-score <-2 sd) and overweight (weight-for-height Z-score ≥2 sd). We considered sixteen biological, environmental, behavioural and socio-demographic factors. Their association with DBM forms was assessed using generalised linear models.

Setting:

We used data from two cross-sectional studies in an urban (Addis Ababa, January–February 2018), and rural setting (Kersa District, June–September 2019).

Participants:

Five hundred ninety-two urban and 862 rural households with an adult man, adult woman and child <5 years.

Results:

In Addis Ababa, overweight adult and stunted child was the most prevalent DBM form (9 % (95 % CI 7, 12)). Duration of residence in Addis Ababa (adjusted OR (aOR) 1·03 (95 % CI 1·00, 1·06)), Orthodox Christianity (aOR 1·97 (95 % CI 1·01, 3·85)) and household size (aOR 1·24 (95 % CI 1·01, 1·54)) were associated factors. In Kersa, concurrent child overweight and stunting was the most prevalent DBM form (11 % (95 % CI 9, 14)). Housing quality (aOR 0·33 (95 % CI 0·20, 0·53)), household wealth (aOR 1·92 (95 % CI 1·18, 3·11) and sanitation (aOR 2·08 (95 % CI 1·07, 4·04)) were associated factors. After adjusting for multiple comparisons, only housing quality remained a significant factor.

Conclusions:

DBM prevalence was low among urban and rural Ethiopian households. Environmental, socio-economic and demographic factors emerged as potential associated factors. However, we observed no common associated factors among urban and rural households.
Entwicklungs- und spielbasierte Förderung früher arithmetischer Konzepte
Authors: Herzog Moritz , Fritz Annemarie
Published: August 2021

Zusammenfassung. Hintergrund: Die Subjektwissenschaftliche Lerntheorie betrachtet Lernprozesse vom Standpunkt des Subjektes. Dabei wird ein besonderer Fokus auf Begründungsstrukturen für gelingende oder nicht gelingende Lernhandlungen gelegt. Die subjektwissenschaftliche Perspektive scheint gerade für die Betrachtung von Lernprozessen in der Alphabetisierung und Grundbildung gewinnbringend, da bisherige (negative) Lernerfahrungen, unterschiedlich zusammengesetzte Kompetenzen sowie spezifische Bildungsziele (wie z.B. gesellschaftliche Teilhabe) auf besondere Weise das Lernen beeinflussen können. Grundbildungszentren (GBZen) können als regionale Anlaufstellen für unterschiedliche Fragestellungen bezüglich der Grundbildung und Alphabetisierung Erwachsener Lernenden gelten. Dabei halten GBZen sowohl niedrigschwellige Lernangebote für Menschen mit Alphabetisierungs- und Grundbildungsbedarfen vor, als auch regionale Netzwerk- und Kooperationsstrukturen, um das Umfeld der Lernenden zu sensibilisieren. Methoden: Anhand von zwölf Interviews und vier Selbstberichten, die im Rahmen einer Evaluationsstudie generiert wurden, wurde folgende Fragestellung sekundäranalytisch beantwortet: Welches Potential haben die GBZen Lernprozesse subjektorientiert zu gestalten? Ergebnisse und Diskussion: Die Ergebnisdarstellung erfolgt anhand einer institutionellen, interaktionellen sowie individuellen Ebene. Die Ergebnisse zeigen, dass die Struktur der GBZen eine wesentliche Vorbedingung darstellt, Lernenden subjektorientiert zu unterstützen, sich das Potenzial in vollem Umfang aber nur durch das Zusammenwirken aller drei Ebenen entfalten kann.
The Influence of Chemical and Mineral Compositions on the Parameterization of Immersion Freezing by Volcanic Ash Particles
Authors: Umo N. S. , Ullrich R. , Maters E. C. , Steinke I. , Benker N. , Höhler K. , Wagner R. , Weidler P. G. , Hoshyaripour G. A. , Kiselev A. , Kueppers U. , Kandler K. , Dingwell D. B. , Leisner T. , Möhler O.
Published: August 2021

Volcanic ash (VA) from explosive eruptions contributes to aerosol loadings in the atmosphere. Aside from the negative impact of VA on air quality and aviation, these particles can alter the optical and microphysical properties of clouds by triggering ice formation, thereby influencing precipitation and climate. Depending on the volcano and eruption style, VA displays a wide range of different physical, chemical, and mineralogical properties. Here, we present a unique data set on the ice nucleation activity of 15 VA samples obtained from different volcanoes worldwide. The ice nucleation activities of these samples were studied in the Aerosol Interaction and Dynamics in the Atmosphere (AIDA) cloud simulation chamber as well as with the Ice Nucleation Spectrometer of the Karlsruhe Institute of Technology (INSEKT). All VA particles nucleated ice in the immersion freezing mode from 263 to 238K with ice nucleation active site (INAS) densities ranging from ∼105 to 1011 m−2, respectively. The variabilities observed among the VA samples, at any given temperature, range over 3.5 orders of magnitude. The ice‐nucleating abilities of VA samples correlate to varying degrees with their bulk pyroxene and plagioclase contents as a function of temperature. We combined our new data set with existing literature data to develop an improved ice nucleation parameterization for natural VA in the immersion freezing mode. This should be useful for modeling the impact of VA on clouds.
Chemical Evolution of the Exceptional Arctic Stratospheric Winter 2019/2020 Compared to Previous Arctic and Antarctic Winters
Authors: Wohltmann I. , von der Gathen P. , Lehmann R. , Deckelmann H. , Manney G. L. , Davies J. , Tarasick D. , Jepsen N. , Kivi R. , Lyall N. , Rex M.
Published: August 2021

The winter 2019/2020 showed the lowest ozone mixing ratios ever observed in the Arctic winter stratosphere. It was the coldest Arctic stratospheric winter on record and was characterized by an unusually strong and long‐lasting polar vortex. We study the chemical evolution and ozone depletion in the winter 2019/2020 using the global Chemistry and Transport Model ATLAS. We examine whether the chemical processes in 2019/2020 are more characteristic of typical conditions in Antarctic winters or in average Arctic winters. Model runs for the winter 2019/2020 are compared to simulations of the Arctic winters 2004/2005, 2009/2010, and 2010/2011 and of the Antarctic winters 2006 and 2011, to assess differences in chemical evolution in winters with different meteorological conditions. In some respects, the winter 2019/2020 (and also the winter 2010/2011) was a hybrid between Arctic and Antarctic conditions, for example, with respect to the fraction of chlorine deactivation into HCl versus ClONO2, the amount of denitrification, and the importance of the heterogeneous HOCl + HCl reaction for chlorine activation. The pronounced ozone minimum of less than 0.2 ppm at about 450 K potential temperature that was observed in about 20% of the polar vortex area in 2019/2020 was caused by exceptionally long periods in the history of these air masses with low temperatures in sunlight. Based on a simple extrapolation of observed loss rates, only an additional 21–46 h spent below the upper temperature limit for polar stratospheric cloud formation and in sunlight would have been necessary to reduce ozone to near zero values (0.05 ppm) in these parts of the vortex.
A Numerical Study of the Sensitivity of Typhoon Track and Convection Structure to Cloud Microphysics
Authors: Hsu Li‐Huan , Su Shih‐Hao , Kuo Hung‐Chi
Published: August 2021

Typhoon Saola affected Taiwan from July 30, 2012, to August 03, 2012. It started in a northwestward track, and it was weakening to Category 1 storm and had a sharp cyclonic deflection track when it was about to made landfall in Taiwan on August 02. After the deflection, the typhoon moved northward and then northwestward across northern Taiwan. The cyclonic southward deflection and the northward motion constituted 12 h of looping motion which increase both the typhoon duration time and the rainfall in northeastern Taiwan. This research is to study the looping motion by the Weather Research and Forecasting model for this very weak typhoon. The model is able to reproduce the looping motion similar to that of observation. The model shows a strong asymmetry of precipitation and cross‐mountain downslope wind near the typhoon center while the typhoon track is looping toward the southwest. The potential vorticity (PV) tendency diagnosis confirms that diabatic heating and downslope wind vertical stretching are the major contributors to tropical cyclone southwestward motion, rather than the commonly referred channeling effect. The asymmetric rainfall disappears when the tropical cyclone starts moving northward in its end‐stage of looping. The northward motion is dominated by horizontal advection of PV tendency. The results highlight the influence of convection and downslope wind near steep terrain on the initial southward motion in the looping track. The model sensitivity study indicates that a large part of track uncertainty resides in the interaction of model internal dynamics and model cloud microphysics.
Significant Contribution of Stratospheric Water Vapor to the Poleward Expansion of the Hadley Circulation in Autumn Under Greenhouse Warming
Authors: Xia Yan , Wang Yuwei , Huang Yi , Hu Yongyun , Bian Jianchun , Zhao Chuanfeng , Sun Cheng
Published: August 2021

Widening of the Hadley circulation and associated poleward shifts of subtropical dry zones have drawn extensive studies in the past decade. It is found that the poleward expansion of the Hadley circulation has strong seasonality and peaks in autumn in both Hemispheres in response to quadrupling CO2. Here we find that the poleward expansion in autumn is closely related to the increase of stratospheric water vapor (SWV). The SWV increase radiatively cools the stratosphere especially in the polar lower stratosphere, which consequently leads to widening of the Hadley cell in autumn. The SWV effect is affirmed in a set of “SWV‐locking” experiments. It is found that the SWV increase leads to a poleward expansion of the Hadley circulation in autumn in both Hemispheres, which contributes about 30% of the total expansion due to quadrupling CO2 in autumn.
Influence of Fault Zone Maturity on Fully Dynamic Earthquake Cycles
Authors: Thakur Prithvi , Huang Yihe
Published: August 2021

We study the mechanical response of two‐dimensional vertical strike‐slip fault to coseismic damage evolution and interseismic healing of fault damage zones by simulating fully dynamic earthquake cycles. Our models show that fault zone structure evolution during the seismic cycle can have pronounced effects on mechanical behavior of locked and creeping fault segments. Immature fault damage zone models exhibit small and moderate subsurface earthquakes with irregular recurrence intervals and abundance of slow‐slip events during the interseismic period. In contrast, mature fault damage zone models host pulse‐like earthquake ruptures that can propagate to the surface and extend throughout the seismogenic zone, resulting in large stress drop, characteristic rupture extents, and regular recurrence intervals. Our results suggest that interseismic healing and coseismic damage accumulation in fault zones can explain the observed differences of earthquake behaviors between mature and immature fault zones and indicate a link between regional seismic hazard and fault structural maturity.
Tracing Earth's Volatile Delivery With Tin
Authors: Kubik E. , Siebert J. , Mahan B. , Creech J. , Blanchard I. , Agranier A. , Shcheka S. , Moynier F.
Published: August 2021

Earth's accretion history for volatile elements, and the origin of their depletions with respect to the Sun and primitive meteorites, continue to be debated. Two end‐member scenarios propose either that volatile elements were delivered during the main phases of accretion and differentiation, or that the Earth accreted from materials largely devoid of volatiles with late addition of volatile‐rich materials. Experiments evaluating the effect of metal–silicate equilibrium on elemental and isotopic distribution of volatile and siderophile elements such as Sn can help to distinguish between these scenarios. In this study, we have systematically investigated the relative influence of temperature, pressure, oxygen fugacity, and metal and silicate composition on the metal–silicate partioning behavior of Sn, from 2 to 20 GPa and 1,700 to 2,573 K, indicating that Sn siderophility noticeably decreases with temperature and S content of the metal but increases dramatically with pressure. A resolvable isotopic fractionation factor between metal and silicate suggests that core–mantle equilibrium temperatures (∼3,000 K) could potentially generate a Sn isotopic composition of the mantle lighter than the core by 150–200 ppm/amu. Core formation modeling shows that the volatiles were added during the last 10% of the accretion history. A final core containing 2.5 to 3.5 wt.% S is required. Furthermore, modeling of the BSE isotopic composition argues for a late Sn delivery on Earth with carbonaceous chondrite‐like material as the most likely source of volatiles. Therefore, both elemental and isotopic approaches converge toward an identical volatile accretion scenario, involving a late volatile delivery.
Preliminary Evaluation of Hai‐Nan Lightning Detection Network (HNLDN)
Authors: Yang Qingliu , Wang Jiaquan , Zhou Xiao , Yuan Shangbo , Meng Xiaoyang , Xiao Fang , Jin Hongling , Xue Weiqing , Ma Qiming
Published: August 2021

Hai‐Nan Lightning Detection Network (HNLDN) is composed of seven sites that accept very low frequency/low frequency (VLF/LF) signals. A total of seven sites are evenly distributed on Hai‐Nan Island. The baseline distance is between 50 and 150 km, which is about five times longer than in typical short‐baseline VLF/LF imaging networks. Each detection station uses zero‐phase digital filtering to avoid the phase deviation caused by filtering. HNLDN uses an improved peak search method to increase the number of detected of lightning waveforms, applies a One‐dimensional convolutional neural network (1D‐CNN) to identify and classify the waveforms, and to the increase the detection efficiency of intracloud lightning. This article analyzes three typical thunderstorm processes. From inside to outside the network, the detection efficiency of HNLDN relative to the advanced direction‐time lightning detection system (ADTD) is 239%, 181%, and 19%, respectively. It can be seen that the detection efficiency is negatively correlated with the distance from the thunderstorm to HNLDN. The average location error of HNLDN inside the network is 190 m.
Whole exome and transcriptome sequencing reveal clonal evolution and exhibit immune-related features in metastatic colorectal tumors
Authors: Li Chunxue , Xu Juan , Wang Xiangfeng , Zhang Chao , Yu Zicheng , Liu Jiucheng , Tai Zaixian , Luo Ziwen , Yi Xin , Zhong Zhaoyang
Published: August 2021

Liver is the most common site where metastatic lesions of colorectal cancer (CRC) arise. Although researches have shown mutations in driver genes, copy number variations (CNV) and alterations in relevant signaling pathways promoted the tumor evolution and immune escape during colorectal liver metastasis (CLM), the underlying mechanism remains largely elusive. Tumor and matched metastatic tissues were collected from 16 patients diagnosed with colorectal cancer and subjected to whole-exome sequencing (WES) and RNA sequencing (RNA-seq) for studying colorectal cancer clonal evolution and immune escape during CLM. Shared somatic mutations between primary and metastatic tissues with a commonly observed subclonal-clonal (S-C) changing pattern indicated a common clonal origin between two lesions. The recurrent mutations with S-C changing pattern included those in KRAS, SYNE1, CACNA1H, PCLO, FBXL2, and DNAH11. The main CNV events underwent clonal-clonal evolution (20q amplification (amp), 17p deletion (del), 18q del and 8p del), subclonal-clonal evolution (8q amp, 13q amp, 8p del) and metastasis-specific evolution (8q amp) during the process of CLM. In addition, we revealed a potential mechanism of tumor cell immune escape by analyzing human leukocytes antigens (HLA) related clonal neoantigens and immune cell components in CLM. Our study proposed a novel liver metastasis-related evolutionary process in colorectal cancer and emphasized the theory of neo-immune escape in colorectal liver metastasis.