bluuebunny/crossref_metadata_2025 huggingface dataset:
A characteristic optical variability time scale in astrophysical accretion disks
Authors: Burke Colin J. , Shen Yue , Blaes Omer , Gammie Charles F. , Horne Keith , Jiang Yan-Fei , Liu Xin , McHardy Ian M. , Morgan Christopher W. , Scaringi Simone , Yang Qian
Published: August 2021

Variability time scales in active galaxies

Active galactic nuclei contain a supermassive black hole (SMBH) surrounded by an accretion disk. As disk material falls toward the SMBH, it heats up enough to emit optical light. Burke
et al
. investigated how such optical emission varies over time in a sample of 67 active galaxies (see the Perspective by Lira and Arevalo). They observed a characteristic variability in timing that scaled with the SMBH mass. The results elucidate the physical processes within accretion disks and provide a method to estimate SMBH mass from optical variability observations. —KTS
Photomediated ring contraction of saturated heterocycles
Authors: Jurczyk Justin , Lux Michaelyn C. , Adpressa Donovon , Kim Sojung F. , Lam Yu-hong , Yeung Charles S. , Sarpong Richmond
Published: August 2021

Shuffling nitrogen with a light push

Manipulation of carbon–nitrogen rings is integral to the synthesis of numerous pharmaceutical and agrochemical compounds. Jurczyk
et al
. report that photoexcitation of carbonyl-substituted cyclic amines can shift the nitrogen from inside to outside the ring framework. The reaction appears to proceed through a 1,5-hydrogen shift to the electronically excited carbonyl, which sets in motion the subsequent carbon–nitrogen and carbon–carbon bonding rearrangements. Several oxygen and sulfur heterocycles were applicable as well. Addition of a chiral phosphoric acid catalyst rendered the reaction asymmetric. —JSY
Structural basis for target site selection in RNA-guided DNA transposition systems
Authors: Park Jung-Un , Tsai Amy Wei-Lun , Mehrotra Eshan , Petassi Michael T. , Hsieh Shan-Chi , Ke Ailong , Peters Joseph E. , Kellogg Elizabeth H.
Published: August 2021

Target site selection in CAST systems

Exciting genomic engineering possibilities exist for natural integration systems called transposons, which have co-opted CRISPR/Cas systems. An unexplained feature of these systems involves how they direct insertions in a single orientation at a precise distance from the programmed target sequence. Park
et al
. show that orientation information is communicated to the transposase, TnsB, using the unidirectional growth of a helical filament made up of an AAA+ protein, TnsC. ATP hydrolysis trims the filament to a minimal unit that is marked by TniQ and defined by the Cas12k protein to provide spacing information. This finding may help future engineering of these systems for therapeutic applications. —DJ
Entanglement transport and a nanophotonic interface for atoms in optical tweezers
Authors: Ðorđević Tamara , Samutpraphoot Polnop , Ocola Paloma L. , Bernien Hannes , Grinkemeyer Brandon , Dimitrova Ivana , Vuletić Vladan , Lukin Mikhail D.
Published: August 2021

Quantum trapping and shuffling

Programmable arrays of atoms or ions trapped in optical potentials have recently emerged as a leading platform for quantum simulation. Being able to interface into these arrays to access the quantum information being processed and pass it along to another module remains a challenge. Ðorđević
et al
. developed a hybrid quantum system that combines atoms held in optical tweezers and a nanophotonic cavity to demonstrate full quantum control, efficient quantum nondestructive readout, and entanglement of atom pairs (see the Perspective by Kaufman). By combining atomic manipulation both inside and away from the cavity field and shuffling the atom qubits into and out of the cavity mode, the authors demonstrate a viable optical interface that could be scaled to larger systems. —ISO
The matter of mind control
Dark Persuasion
Joel E. Dimsdale
Yale University Press, 2021. 304 pp.
Authors: Marks Sarah
Published: August 2021

Brainwashing case studies illuminate the history of coercive persuasion
How massive is that black hole?
Authors: Lira Paulina , Arevalo Patricia
Published: August 2021

The flux of radiation emissions from accretion disks correlates with black hole mass
Taking the long view on metabolism
Authors: Rhoads Timothy W. , Anderson Rozalyn M.
Published: August 2021

Measured energy expenditure across the human life span reveals distinct metabolic phases
Draft Genome Sequences of 10 Bacteria from the Marine
Pseudoalteromonas
Group
Authors: Alker Amanda T. , Gode Bhumika S. , Aspiras Alpher E. , Jones Jeffrey E. , Michael Sama R. , Aguilar David , Cain Audrea D. , Candib Alec M. , Cizmic Julian M. , Clark Elise A. , Cozzo Alyssa C. , Figueroa Laura E. , Garcia Peter A. , Heaney Casey M. , Levy Alexandra T. , Macknight Luke , McCarthy Anna S. , McNamara John P. , Nguyen Kelvin A. , Rollin Kendall N. , Salcedo Gabriella Y. , Showalter Julia A. , Sue Andrew D. , Zamro Tony R. , Dunbar Tiffany L. , Malter Kyle E. , Shikuma Nicholas J.
Published: August 2021

Here, we report the draft genome sequences of 10 marine
Pseudoalteromonas
bacteria which were isolated, assembled, and annotated by undergraduate students participating in a marine microbial genomics course. Genomic comparisons suggest that 7 of the 10 strains are novel isolates, providing a resource for future marine microbiology investigations.
Draft Genome Sequences of Enterobacter spp.,Lelliottiaspp., andSerratiaspp., Coliform Bacteria from Drinking Water Reservoirs and Lakes
Authors: Reitter Carolin , Neuhaus Klaus , Hügler Michael
Published: August 2021

Surface waters are a major source for drinking water production. Therefore, it is essential to examine microbial processes within the water bodies, such as mass proliferations of coliform bacteria. Here, we report the draft genome sequences ofEnterobacterspp.,Lelliottiaspp., andSerratiaspp. isolated from drinking water reservoirs and lakes.
Complete Genome Sequence of a Novel Pseudomonas fluorescens Strain Isolated from the Flower of Kūmarahou (Pomaderris kumeraho)
Authors: Summers Monica C. , Nowak Vincent V. , Fairhurst Michael J. , Owen Jeremy G. , Gerth Monica L. , Patrick Wayne M.
Published: August 2021

Kūmarahou (
Pomaderris kumeraho
) is a shrub endemic to New Zealand used in rongoā (traditional medicine). While studying the antimicrobial properties of kūmarahou, we isolated a new strain of
Pseudomonas fluorescens
, which we designated KF1 (for “kūmarahou flower 1”). Here, we report the complete genome sequence of
P. fluorescens
KF1.
Clear as mud: Clinoform progradation and expanded records of the Paleocene-Eocene Thermal Maximum
Authors: Podrecca Luca G. , Makarova Maria , Miller Kenneth G. , Browning James V. , Wright James D.
Published: August 2021

The mid-Atlantic coastal plain (eastern United States) preserves high-resolution records of the Paleocene-Eocene Thermal Maximum (PETM) and attendant carbon isotope excursion (CIE), though preservation is highly variable from site to site. Here, we use a dip transect of expanded (as much as 15 m thick) PETM sections from the New Jersey coastal plain to build a cross-shelf PETM depositional model that explains the variability of these records. We invoke enhanced delivery of fine-grained sediments, due to the rapid environmental changes associated with this hyperthermal event, to explain relatively thick PETM deposits. We utilize δ13Cbulk, percent CaCO3, and percent coarse fraction (>63 μm) data, supported by biostratigraphic records, to correlate sites along a paleoslope dip transect. Updip cores from Medford, New Jersey, preserve expanded sections of the initiation of the PETM and the earliest portion of the CIE. Medial sites (Wilson Lake, Millville) preserve an expanded CIE body, and downdip Bass River records the CIE recovery. We interpret this pattern to reflect the progradation of clinoform foresets across the paleoshelf via fluid mud, similar to modern high-sediment-supply rivers and adjacent muddy shelves (e.g., the Amazon, Mahakam [Indonesia], and Ayeyarwady [Myanmar] Rivers). Our subaqueous-clinoform delta model explains the pattern of the CIE records and provides a framework for future PETM studies in the region.
Diverse gas composition controls the Moby-Dick gas hydrate system in the Gulf of Mexico
Authors: Portnov Alexey , Cook A.E. , Vadakkepuliyambatta S.
Published: August 2021

In marine basins, gas hydrate systems are usually identified by a bottom simulating reflection (BSR) that parallels the seafloor and coincides with the base of the gas hydrate stability zone (GHSZ). We present a newly discovered gas hydrate system, Moby-Dick, located in the Ship Basin in the northern Gulf of Mexico. In the seismic data, we observe a channel-levee complex with a consistent phase reversal and a BSR extending over an area of ∼14.2 km2, strongly suggesting the presence of gas hydrate. In contrast to classical observations, the Moby-Dick BSR abnormally shoals 150 m toward the seafloor from west to east, which contradicts the northward-shallowing seafloor. We argue that the likely cause of the shoaling BSR is a gradually changing gas mix across the basin, with gas containing heavier hydrocarbons in the west transitioning to methane gas in the east. Our study indicates that such abnormal BSRs can be controlled by gradual changes in the gas mix influencing the shape of the GHSZ over kilometers on a basin scale.
Mentored implementation to initiate a diabetes program in an underserved community: a pilot study
Authors: Vaughan Elizabeth M , Naik Aanand D , Amspoker Amber B , Johnston Craig A , Landrum Joshua D , Balasubramanyam Ashok , Virani Salim S , Ballantyne Christie M , Foreyt John P
Published: August 2021

Introduction

Community clinics often face pragmatic barriers, hindering program initiation and replication of controlled research trial results. Mentoring is a potential strategy to overcome these barriers. We piloted an in-person and telehealth mentoring strategy to implement theTelehealth-supported,Integrated Community Health Workers (CHWs),Medication-access, group visitEducation (TIME) program in a community clinic.

Research design and methods

Participants (n=55) were low-income Latino(a)s with type 2 diabetes. The study occurred in two, 6-month phases. Phase I provided proof-of-concept and an observational experience for the clinic team; participants (n=37) were randomized to the intervention (TIME) or control (usual care), and the research team conducted TIME while the clinic team observed. Phase II provided mentorship to implement TIME, and the research team mentored the clinic team as they conducted TIME for a new single-arm cohort of participants (n=18) with no previous exposure to the program. Analyses included baseline to 6-month comparisons of diabetes outcomes (primary outcome: hemoglobin A1c (HbA1c)): phase I intervention versus control, phase II (within group), and research-run (phase I intervention) versus clinic-run (phase II) arms. We also evaluated baseline to 6-month CHW knowledge changes.

Results

Phase I: compared with the control, intervention participants had superior baseline to 6-month improvements for HbA1c (mean change: intervention: −0.73% vs control: 0.08%, p=0.016), weight (p=0.044), target HbA1c (p=0.035), hypoglycemia (p=0.021), medication non-adherence (p=0.0003), and five of six American Diabetes Association (ADA) measures (p<0.001–0.002). Phase II: participants had significant reductions in HbA1c (mean change: −0.78%, p=0.006), diastolic blood pressure (p=0.004), body mass index (0.012), weight (p=0.010), medication non-adherence (p<0.001), and six ADA measures (p=0.007–0.005). Phase I intervention versus phase II outcomes were comparable. CHWs improved knowledge from pre-test to post-tests (p<0.001).

Conclusions

A novel, mentored approach to implement TIME into a community clinic resulted in improved diabetes outcomes. Larger studies of longer duration are needed to fully evaluate the potential of mentoring community clinics.
Persistent neuromuscular junction transmission defects in adults with spinal muscular atrophy treated with nusinersen
Authors: Arnold W David , Severyn Steven , Zhao Songzhu , Kline David , Linsenmayer Matthew , Kelly Kristina , Tellez Marco , Bartlett Amy , Heintzman Sarah , Reynolds Jerry , Sterling Gary , Weaver Tristan , Rajneesh Kiran , Burghes Arthur H M , Kolb Stephen J , Elsheikh Bakri
Published: August 2021

Objective

Spinal muscular atrophy (SMA) is a motor neuron disease caused by low levels of survival motor neuron (SMN) protein. Prior work in models and patients has demonstrated electrophysiological and morphological defects at the neuromuscular junction (NMJ). Therapeutic development has resulted in clinically available therapies to increase SMN protein levels in patients and improve muscle function. Here we aimed to investigate the effect of SMN restoration (via nusinersen) on NMJ transmission in adults with SMA.

Methods

Participants undergoing nusinersen treatment underwent 3 Hz repetitive nerve stimulation (RNS) of the spinal accessory nerve to assess compound muscle action potential amplitude decrement. Maximum voluntary isometric contraction (MVICT), Revised Upper Limb Module (RULM), and 6 min walk test (6MWT) were assessed for correlations with decrement.

Results

Data from 13 ambulatory (7 men/6 women, mean age 40±11 years) and 11 non-ambulatory (3 men/8 women, mean age 38±12 years) participants were analysed. Cross-sectional analyses of RNS decrement were similar at 14 months of nusinersen (−14.2%±11.5%, n=17) vs baseline (−11.9%±8.3%, n=15) (unpaired t-test, p=0.5202). Longitudinal comparison of decrement in eight participants showed no change at 14 months (−13.9%±6.7%) vs baseline (−16.9%±13.4%) (paired t-test, p=0.5863). Decrement showed strong correlations with measures of MVICT, RULM and 6MWT but not age or disease duration.

Conclusion

Adults with SMA had significant NMJ transmission defects that were not corrected with 14 months of nusinersen treatment. NMJ defects were negatively associated with physical function, and thus may represent a promising target for additive or combinatorial treatments.
Revisit the correlates of infant mortality in Bangladesh: findings from two nationwide cross-sectional studies
Authors: Rahman Md Mahabubur , Ara Tasnim , Mahmud Sultan , Samad Nandeeta
Published: August 2021

Objective

The main objective of this study is to investigate how the direction and strength of the association between infant mortality and its predictors are changing over time in Bangladesh using a nationally representative sample for the period 2011–2014.

Design, setting and participants

Data from two repeatedly cross-sectional Bangladesh Demographic and Health Surveys (BDHSs) for the years 2011 and 2014 were used. A total of 7664 (with 312 infant death) and 7048 (with 264 infant death) complete cases, respectively, from BDHS 2011 and 2014 datasets were included in the study.

Methods

Cox’s proportional hazard model with robust standard error (SE) that adjusts for the complex survey design characteristics was implemented to assess how the risk factors associated with infant mortality change their paths.

Results

Results reflected that administrative division remained as a potential risk factor of infant death for both periods. Household’s socioeconomic status, father’s employment status, age difference between parents turned out to be potential risk factors in 2014, though they did not show any significant association with infant death in the year 2011. In contrast to 2011, mothers’ individual-level characteristics such as age at childbirth, education, media exposure, employment status did not remain as significant risk factors for infant death in 2014. Younger fathers increased the burden of death among infants of adolescent mothers. At higher order births, the burden of infant death significantly shifted from rural to urban areas. From the year 2011 to 2014, urban areas achieved socioeconomic equity in infant survival, while the extent of inequity was increased in rural areas.

Conclusion

Community-based programmes should be designed for urban mothers who are expecting higher order births. To eradicate the socioeconomic inequity in infant survival, the government should design strong and sustainable maternal and child healthcare facilities, especially for rural areas.
Do people with mental health problems have lower adherence to precautionary measures in COVID-19 pandemic? A cross-sectional observational study in Hong Kong
Authors: Lee Allen T C , Cheng Gabriel W H , Lin Cuichan , Wong Brian H C , Lam Linda Chiu Wa
Published: August 2021

Objectives

Mental health problems are prevalent during the COVID-19 pandemic, but their effect on adherence to precautionary measures is not well understood. Given that psychological morbidities are associated with lower treatment adherence, and that precautionary measures are important in containing the spread of COVID-19, this study aims to determine if people with mental health problems have lower adherence to precautionary measures against COVID-19.

Design

We conducted a cross-sectional territory-wide online survey between 17 June and 31 July 2020 during the COVID-19 pandemic. Clinically significant mental health problems, adherence to precautionary behaviours, and confounding factors such as sociodemographic factors and self-reported physical health were assessed.

Setting

The link to the questionnaire was disseminated to the general population in all 18 districts of Hong Kong using various social media platforms.

Participants

1036 individuals completed the survey. Of them, 1030 met the inclusion criteria of being adult Hong Kong residents.

Primary outcome

Adherence to precautionary measures against COVID-19, including wearing face mask, frequent handwashing, household disinfection, social distancing, minimising unnecessary travel, and stocking up on food and daily essentials.

Results

Of the 1030 participants, 166 (16.1%) had clinically significant mental health problems. Interestingly, they were more likely to stock up on food and daily essentials during the pandemic (7 (4.2%) vs 15 (1.7%), p=0.04; unadjusted OR=2.49, 95% CI=1.00 to 6.21, p<0.05) and had a lesser tendency to stop social distancing even if the pandemic subsides (86 (51.8%) vs 513 (59.4%), p=0.07; unadjusted OR=0.74, 95% CI=0.53 to 1.03, p=0.07). The latter association remained significant after adjusting for the confounding factors (adjusted OR=0.68, 95% CI=0.48 to 0.96, p=0.03).

Conclusions

Contrary to our hypothesis, people who are mentally unwell might go beyond the recommended precautionary measures. Our findings highlight the need to identify mental health problems and provide care and support for those who might go too far with precautionary measures.

Trial registration number

ChiCTR 2000033936.
What to measure in biliary atresia research: study protocol for developing a core outcome set
Authors: Maguire Christopher , Tyack Zephanie , Kimble Roy M , Griffin Bronwyn Ruth , Yesberg Helen Joanna , Choo Fang Ming , McBride Craig Antony
Published: August 2021

Aim

Extrahepatic biliary atresia is a rare disorder. This creates challenges in the quality and quantity of research conducted. This issue is exacerbated by the potential heterogeneity in the reported outcomes in research examining the management of biliary atresia. A core outcome set is required to standardise reporting on the management of biliary atresia in research, facilitate systematic reviews that include outcomes of greatest importance to patients and clinicians, and to evaluate the quality of the existing evidence base on the management of biliary atresia.

Methods

A list of all potential outcomes will be developed through a systematic review of the literature. This list will be refined through a three-stage Delphi approach, involving key stakeholders in the management of biliary atresia. This will include patients and their parents, clinicians, nurses and allied health professionals. In this way, outcomes will be prioritised into a set of consensus core outcomes.

Conclusion

The development of a core outcome set in biliary atresia management is needed to guide future research and assist in evaluating the quality of existing research.

Ethics and dissemination

Ethical approval has been granted by the Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC), Ref: HREC/20/QCHQ/62448. Results of the study will be published in an open access format.
Response strategies for promoting gender equality in public health emergencies: a rapid scoping review
Authors: Steinert Janina I , Alacevich Caterina , Steele Bridget , Hennegan Julie , Yakubovich Alexa R
Published: August 2021

Objectives

The COVID-19 pandemic threatens to widen existing gender inequities worldwide. A growing body of literature assesses the harmful consequences of public health emergencies (PHEs) for women and girls; however, evidence of what works to alleviate such impacts is limited. To inform viable mitigation strategies, we reviewed the evidence on gender-based interventions implemented in PHEs, including disease outbreaks and natural disasters.

Methods

We conducted a rapid scoping review to identify eligible studies by systematically searching the databases MEDLINE, Global Health and Web of Science with the latest search update on 28 May 2021. We used the Sustainable Development Goals as a guiding framework to identify eligible outcomes of gender (in)equality.

Results

Out of 13 920 records, 16 studies met our eligibility criteria. These included experimental (3), cohort (2), case–control (3) and cross-sectional (9) studies conducted in the context of natural disasters (earthquakes, droughts and storms) or epidemics (Zika, Ebola and COVID-19). Six studies were implemented in Asia, seven in North/Central America and three in Africa. Interventions included economic empowerment programmes (5); health promotion, largely focused on reproductive health (10); and a postearthquake resettlement programme (1). Included studies assessed gender-based outcomes in the domains of sexual and reproductive health, equal opportunities, access to economic resources, violence and health. There was a dearth of evidence for other outcome domains relevant to gender equity such as harmful practices, sanitation and hygiene practices, workplace discrimination and unpaid work. Economic empowerment interventions showed promise in promoting women’s and girls’ economic and educational opportunities as well as their sexual and reproductive health during PHEs. However, some programme beneficiaries may be at risk of experiencing unintended harms such as an increase in domestic violence. Focused reproductive health promotion may also be an effective strategy for supporting women’s sexual and reproductive health, although additional experimental evidence is needed.

Conclusions

This study identified critical evidence gaps to guide future research on approaches to alleviating gender inequities during PHEs. We further highlight that interventions to promote gender equity in PHEs should take into account possible harmful side effects such as increased gender-based violence.

Review registration

DOI 10.17605/OSF.IO/8HKFD.
Determinants of dispensing antibiotics without prescription in Eritrea: a mixed-method qualitative study on pharmacy professionals’ perspective
Authors: Bahta Merhawi , Weldemariam Dawit G , Tesfamariam Sirak , Tesfamariam Eyasu H , Russom Mulugeta
Published: August 2021

Objective

Antimicrobial resistance is a global public health challenge. Dispensing of antibiotics without prescription (DAWP), a major contributor to antibiotic resistance, is extensive in Eritrea. This study was, therefore, aimed at deeply understanding, qualitatively, the pharmacy professionals’ perspective on the factors that trigger DAWP and how this practice could be mitigated.

Design

A qualitative exploratory study design was employed.

Setting

Drug retail outlets of Asmara, capital of Eritrea, and pharmaceutical services of Eritrea.

Participants

Thirty pharmacy professionals who were owners and employees of the drug retail outlets stationed in Asmara and six key informants from the pharmaceutical services of all administrative regions of Eritrea, selected purposively, were the study participants.

Data collection and analysis

The data were collected using focus group discussions and key informant interviews between March and September 2020. The collected data were transcribed verbatim, translated to English and finally thematically analysed using an inductive approach.

Results

The main triggering factors were related to the drug retail outlet owners, dispensers, healthcare system and patients. Knowledge and attitude-based motivation, economic interest, inadequate services in health facilities, weak regulatory enforcement, inadequate training, trust and satisfaction of patients, previous successful experience, seriousness of a condition and saving time and money were reported among others as determinants of DAWP.

Conclusions

The triggering factors to DAWP were found to be very complex and some of them were important that might require immediate attention from policymakers. Ensuring readily available and accessible healthcare services, empowering medicines regulation and continuing sensitisation of dispensers are highly recommended to minimise DAWP.
Implementation of a provincial acute stroke pathway and its impact on access to advanced stroke care in Saskatchewan
Authors: Holodinsky Jessalyn K , Onaemo Vivian N , Whelan Ruth , Hunter Gary , Graham Brett R , Hamilton Jessica , Schwartz Laura , Latta Lori , Peeling Lissa , Kelly Michael E
Published: August 2021

Background

For ischaemic stroke, outcome severity is heavily time dependent. Systems of care need to be in place to ensure that patients with stroke are treated quickly and appropriately across entire health regions. Prior to this study, the province of Saskatchewan, Canada did not have a provincial stroke strategy in place.

Methods

A quality improvement project was undertaken to create and evaluate a provincial stroke strategy. The Saskatchewan Acute Stroke Pathway was created using a multidisciplinary team of experts, piloted at five stroke centres and then implemented provincially. The number of stroke alerts, door-to-imaging, door-to-needle, door-to-groin puncture times and treatment rates were collected at all centres. Improvements over time were analysed using run charts and individuals control charts.

Results

The number of stroke alerts province-wide trended upwards in the last 6 months of the study. There were no clear trends or shifts in the proportion of stroke alerts treated with alteplase or endovascular therapy. Across the province, the weighted mean door-to-imaging time decreased from 21 to 15 min, the weighted mean door-to-needle time decreased from 62 to 47 min and the mean door-to-groin puncture time decreased from 83 to 70 min. There was high variability in the degree of improvement from centre to centre.

Conclusions

The implementation of a province wide acute stroke pathway has led to improvement in stroke care on a provincial basis. Further work addressing intercentre variability is ongoing.
Strategies to reduce the caesarean section rate in a private hospital and their impact
Authors: Negrini Romulo , D’Albuquerque Izabella Mikaella Souza Campos , de Cássia Sanchez e Oliveira Rita , Ferreira Raquel Domingues da Silva , De Stefani Luciana Francine Bocchi , Podgaec Sergio
Published: August 2021

There is a concern around the world of an increasing caesarean section rate. It was estimated that between 2010 and 2015, caesarean section rates increased by almost 50%. There are several implications for this, considering that caesarean sections are associated with higher costs and worse clinical outcomes. In this context, several interventions have been considered to increase vaginal delivery rates, including the Adequate Childbirth Project (PPA) in Brazil. This study aimed to verify the impact of the strategies adopted internally in the Hospital Israelita Albert Einstein (HIAE) located in São Paulo, Brazil, regarding the reduction of caesarean sections and their perinatal results. Actions to support our study were implemented in two phases based on the PPA schedule. These actions involved three axes: a multidisciplinary team, pregnant women and facility improvements. All pregnant women admitted for childbirth at the HIAE between 2014 and 2019 were included in this study. The overall rate of vaginal delivery in this study population and among primiparous women and the percentage of admissions to the neonatal intensive care unit (NICU) were analysed in three periods: before the implementation of PPA actions (period A), after the first phase of the project (period B) and after its second phase (period C). The results showed an increase in the average vaginal delivery rate from 23.57% in period A to 27.88% in period B, and to 30.06% in period C (AxB, p<0.001; BxC, p=0.004). There was a decrease in the average of NICU admissions over the periods (period A 19.22%, period B 18.71% and period C 13.22%); a significant reduction was observed when periods B and C (p<0.001) were compared.
Goldilocks Days: optimising children’s time use for health and well-being
Authors: Dumuid Dorothea , Olds Timothy , Lange Katherine , Edwards Ben , Lycett Kate , Burgner David P , Simm Peter , Dwyer Terence , Le Ha , Wake Melissa
Published: August 2021

Background

One size rarely fits all in population health. Differing outcomes may compete for best allocations of time. Among children aged 11–12 years, we aimed to (1) describe optimal 24-hour time use for diverse physical, cognitive/academic and well-being outcomes, (2) pinpoint the ‘Goldilocks Day’ that optimises all outcomes and (3) develop a tool to customise time-use recommendations.

Methods

In 2004, the Longitudinal Study of Australian Children recruited a nationally-representative cohort of 5107 infants with biennial follow-up waves. We used data from the cross-sectional Child Health CheckPoint module (2015–2016, n=1874, 11–12 years, 51% males). Time use was from 7-day 24-hour accelerometry. Outcomes included life satisfaction, psychosocial health, depressive symptoms, emotional problems, non-verbal IQ; vocabulary, academic performance, adiposity, fitness, blood pressure, inflammatory biomarkers, bone strength. Relationships between time use and outcomes were modelled using compositional regression.

Results

Optimal daily durations varied widely for different health outcomes (sleep: 8.3–11.4 hours; sedentary: 7.3–12.2 hours; light physical activity: 1.7–5.1 hours; moderate-to-vigorous physical activity (MVPA): 0.3–2.7 hours, all models p≤0.04). In general, days with highest physical activity (predominantly MVPA) and low sedentary time were optimal for physical health, while days with highest sleep and lowest sedentary time were optimal for mental health. Days with highest sedentary time and lowest physical activity were optimal for cognitive health. The overall Goldilocks Day had 10 hours 21 min sleep, 9 hours 44 min sedentary time, 2 hours 26 min light physical activity and 1 hour 29 min MVPA. Our interactive interface allows personalisation of Goldilocks Days to an individual’s outcome priorities.

Conclusion

‘Goldilocks Days’ necessitate compromises based on hierarchies of priorities for health, social and economic outcomes.
Do expert clinicians make the best managers? Evidence from hospitals in Denmark, Australia and Switzerland
Authors: Bäker Agnes , Goodall Amanda H
Published: August 2021

Introduction

Hospital quality rests on the morale and productivity of those who work in them. It is therefore important to try to understand the kinds of team leaders that create high morale within hospitals.

Methods

This study collects and examines data on 3000 physicians in hospitals from Denmark, Australia and Switzerland. It estimates regression equations to study the statistical predictors of levels of doctors’ job satisfaction, their intentions to quit or stay in their current hospital and their assessment of the leadership quality of their immediate manager. A particular concern of this study is to probe the potential role played by clinical expertise among those in charge of other physicians.

Results

When led by managers with high clinical expertise, hospital physicians are (1) more satisfied with their jobs, (2) more satisfied with their supervisors’ effectiveness and (3) less likely to wish to quit their current job. These findings are robust to adjustment for potential confounders, including age and job seniority, and pass a variety of statistical checks (including clustering of SEs and checking for omitted variable bias). They are replicated in each of the three nations.

Conclusion

Physicians are happier with their jobs when led by outstanding clinical experts. It is not sufficient, it appears from this evidence, for leaders merely to be clinicians. This suggests that—though only an idealised and presumably infeasible randomised experiment could allow complete certainty—there is a natural case for managers within a hospital hierarchy to be drawn from the ranks of those who are themselves outstanding clinicians.
Efficacy and safety of filgotinib in methotrexate-naive patients with rheumatoid arthritis with poor prognostic factors: post hoc analysis of FINCH 3
Authors: Aletaha Daniel , Westhovens René , Gaujoux-Viala Cecile , Adami Giovanni , Matsumoto Alan , Bird Paul , Messina Osvaldo Daniel , Buch Maya H , Bartok Beatrix , Yin Zhaoyu , Guo Ying , Hendrikx Thijs , Burmester Gerd R
Published: August 2021

Objective

This analysis evaluated efficacy and safety of filgotinib, a Janus-associated kinase 1-preferential inhibitor, in methotrexate (MTX)-naive patients with rheumatoid arthritis (RA) with multiple poor prognostic factors (PPFs).

Methods

This was a post hoc analysis of the phase III, randomised, double-blind, active-controlled, FINCH 3 study (clinicaltrials.govNCT02886728). Patients received once-daily oral filgotinib 200 or 100 mg plus once-weekly oral MTX ≤20 mg (FIL200 + MTX and FIL100 + MTX), filgotinib 200 mg monotherapy (FIL200), or oral MTX monotherapy (MTX-mono) for up to 52 weeks. PPFs investigated were seropositivity for rheumatoid factor or anticyclic citrullinated peptide antibodies, high-sensitivity C reactive protein (CRP) ≥4 mg/L, Disease Activity Score in 28 joints with CRP (DAS28(CRP)) >5.1, and presence of erosions. Filgotinib efficacy and safety in patients with all four PPFs at baseline were explored versus MTX-mono within this subgroup and compared informally with the overall population.

Results

Of 1249 patients in FINCH 3, 510 (40.8%) had all PPFs. Efficacy of FIL200 + MTX among these patients was comparable to the overall population, with higher rates of 20%/50%/70% improvement from baseline by American College of Rheumatology criteria, DAS28(CRP) <2.6, and remission; greater improvement in physical function and pain; and better inhibition of structural damage relative to MTX-mono. FIL100 + MTX and FIL200 were not consistently more efficacious versus MTX-mono. Safety of filgotinib in patients with PPFs was comparable to the overall population; no new safety signals were observed.

Conclusion

FIL200 + MTX efficacy and safety in patients with multiple PPFs were similar to the overall population.
Réponse au déficit hydrique progressif chez la lentille : vers une différentiation morpho-physiologique entre des accessions sauvages (Lens orientalis), populations locales et lignées avancées (Lens culinaris)
Authors: Ben Ghoulam Said , Zeroual Abdelmonim , Baidani Aziz , Idrissi Omar
Published: August 2021

La lentille (Lens culinaris Medik.) contribue à la sécurité alimentaire et à la durabilité des systèmes agricoles. La tolérance à la sécheresse est un objectif majeur pour la création variétale. Cette étude visait la comparaison des réponses des populations locales, accessions sauvages Lens orientalis et des lignées avancées au stress hydrique progressif sous conditions contrôlées. Les accessions sauvages ont démontré une grande tolérance au stress hydrique par rapport aux lignées avancées et populations locales. Elles avaient un rapport (biomasse racinaire/biomasse aérienne), un contenu relatif en eau des feuilles, une dépression de la température du couvert et une stabilité de la membrane cellulaire plus élevés ainsi qu’une sévérité de flétrissement et un taux de perte d’eau des feuilles plus faible. Une différentiation génétique claire pour la tolérance à la sécheresse entre les 3 groupes génétiques a été montrée. Différentes réponses morpho-physiologiques du matériel génétique ont été observées, correspondant à différents mécanismes de tolérance à la sécheresse. Les accessions sauvages, les lignées avancées et les nouvelles variétés améliorées de l’Institut National de Recherche Agronomique (INRA) du Maroc A3, A4, A5, A6 et A7 ainsi que la lentille de Zaer, une population locale bénéficiant d’un label de qualité connue dans le pays, ont été identifiées comme les plus tolérantes à la sécheresse parmi le matériel génétique étudié. Ces accessions pourraient être utilisées dans les programmes d’amélioration génétique dans la perspective de développer des variétés tolérantes à la sécheresse.
The consequences of dam passage for downstream-migrating American eel in the Penobscot River, Maine
Authors: Mensinger Matthew A. , Blomberg Erik J. , Zydlewski Joseph D.
Published: August 2021

American eel (Anguilla rostrata) often pass hydropower dams during adult spawning migrations. We conducted a 4-year acoustic telemetry study that characterized passage risks through two dams (West Enfield and Milford) in the Penobscot River, Maine, USA. We released tagged fish (n = 355) at two sites, estimated survival and delay under variable river conditions, and compared performance among dammed and free-flowing river sections. Survival rates (standardized per river kilometre, rkm) were lower at West Enfield (Φrkm = 0.984 ± 0.006 SE) and Milford (Φrkm = 0.966 ± 0.007 SE) compared with undammed River sections (Φrkm = 0.998 ± 0.0003 SE). Cumulative mortality was 8.7% (4.4 km) and 14.2% (5.5 km) through dammed sections and 8.7% throughout the rest of the river (58.1 km). Fish that already passed an upstream dam incurred higher downstream mortality compared with individuals without passage experience. Additionally, fish endured long delays at dams, and >10% of fish were delayed >24 h. Low flows exacerbated the risk of mortality and delay. These results offer evidence for direct, latent, and sublethal consequences of dam passage for migrating eels.
Hand and Upper Limb Malformations in Italy: A Multicentric Study
Authors: Senes Filippo M. , Calevo Maria Grazia , Adani Roberto , Baldrighi Carla , Bassetto Franco , Corain Massimo , Landi Antonio , Lando Mario , Monticelli Andrea , Novelli Chiara , Pajardi Giorgio , Rosanda Elisa , Rossello Mario Igor , Santecchia Luigino , Zoccolan Andrea , Catena Nunzio
Published: August 2021

Background: Although hand and upper limb malformations are quite frequent, up to now very few reports have been published on epidemiology. The aim of this study is to evaluate the number of infants who presented with hand and upper limb malformations from 2010 to 2015 in Italy.

Methods: A retrospective analysis of a pediatric population presenting with hand and upper extremity malformations was carried out, gathering reports achieved from eight Italian Centers of pediatric hand surgery. Other factors such as gender, date and region of birth, family distribution of malformations and associated syndromes, were analysed.

Results: Out of 3,100,421 live births, 765 children presented with hand and upper limb malformations. The incidence was 2,5/10,000 live births with a predominance of males and the right side. Radial polydactyly was the anomaly with the highest percentage, closely followed by simple syndactyly, simbrachidactyly and complex syndactyly. Less common conditions were the triphalangic thumb, thumb in palm, proximal radioulnar synostosis and Sprengel deformity. Inheritance of and familial predisposition to those malformations was recorded in 25 cases, while 84 children presented with syndromes related to hand anomalies.

Conclusions: In conclusion the incidence of hand and upper extremity malformations in Italy is lower than that registered in other countries. The retrospective nature of the study combined with the fact that some defects frequently evade pediatric hand surgeon consultations are some possible limitations of the study. However, our data confirmed that, in spite of the decrease in the birth rate in Italy, the trend of congenital hand disorders maintained a stable trend. We aim to integrate this study with a prospective analysis and to involve the institutional health authorities in other countries so as to register the correct incidence of hand and upper extremity defects.
Non-Vascularized Tri-Cortical Iliac Crest Graft–A Reliable Option in the Management of Scaphoid Waist Non-Unions
Authors: Singh Vivek , Moger Nagaraj Manju , Jaisankar Pragadeeshwaran , Rajkumar Surjala , Chaudhary Sunny , Azam Quamar
Published: August 2021

Background: Scaphoid non-union often leads to a change in biomechanics of the wrist joint. Various types of bone grafts and different sites of harvest have been described in the literature for scaphoid reconstruction. This study was conducted to assess the clinical and radiological outcome after non-vascularised tri-cortical iliac crest bone graft for non-union of scaphoid waist fractures.

Methods: 12 adult patients who underwent reconstruction of scaphoid waist non-union with tricortical iliac crest grafting and internal fixation with headless compression screws (11 cases) and k-wires (1 case) were prospectively analysed. There were 11 males and 1 female (mean age 23.9 years). The mean duration of presentation was 5.7 months following injury. Outcome following surgery were analyzed clinically by range of movements (ROM) and functional scores like DASH and modified Mayo wrist score and radiologically by X-rays and Non contrast CT of the wrist. Radiological assessment included scaphoid length, radio-lunate (RL) angle and scapho-lunate (SL) angle at latest 6 months follow up.

Results: Bony union was achieved in 10 cases (union rate 83%). All the cases which achieved union had a significant improvement in radiological and clinical outcome criterias at 6-month follow-up interval. 1 patient had persistent non-union and 1 had k-wire back out with fixation failure.

Conclusions: It is important to restore scaphoid length and to correct flexion deformity for a successful outcome. This can reliably be acheived by a carefully planned wedge-shaped iliac crest graft along with secure fixation with a headless compression screw.
Artery-Only Fingertip Replantation Distal to the Lunula: A Retrospective Analysis of Clinical Results
Authors: Kaneshiro Yasunori , Yano Koichi , Hyun Seungho , Sakanaka Hideki , Hidaka Noriaki
Published: August 2021

Background: Both arterial and venous repair are crucial for optimal results in digital replantation. However, anastomosis of veins becomes challenging in very distal fingertip amputation. This study aimed to report the clinical results of an artery-only replantation without vein repair for a distal fingertip amputation and to analyze the survival rate and clinical outcomes based on the amputation level.

Methods: We performed a retrospective review of 47 digits in 38 patients who had undergone fingertip replantation with a mean follow-up period of 12 months. All patients had complete fingertip amputation distal to the lunula. Only one central artery repair distal to the arch was performed. All patients received the postoperative protocol including external bleeding and anticoagulation therapy.

Results: By Ishilawa’s classification, 12 digits in subzone I, and 35 digits in subzone II. 31 of the 47 fingertip replantations (66%) were successful, and a significantly higher survival rate was observed in subzone I than in subzone II. The mean total active motion of surviving digits was 86% of normal side. The mean grip strength was 82% of normal side. The sensory recovery according to modified Highet and Saunders’ classification was S4, S3+, S3, and S2 in fingers 19, 2, 5 and 3, respectively.

Conclusions: 66% of survival rate was achieved in fingertip replantation distal to lunula which including large number of crushing/avulsion injury. The result of comparison for the survival rate based on amputation level, a significantly higher survival rate was observed in subzone I compared to subzone II. Therefore, the artery-only fingertip replantation had a better indication for distal amputation, and an aggressive attempt for venous anastomosis or drainage, including a secondary surgery for proximal amputation could be attributed to a higher success rate.
An Adaptive Material Interpolation for the Reconstruction of P-Wave Velocity Models with Sharp Interfaces using the Topology Optimization Method
Authors: Gonçalves Juliano F. , Silva Emílio C. N.
Published: August 2021

A topology optimization (TO) approach is used to reconstruct P-wave velocity models with sharp interfaces. The concept of material model (interpolation), usually applied in TO to design structures and multi-physics devices, is explored in this work to solve this inverse problem. An adaptive interpolation rule is proposed to deal with the reconstruction problem as a transition from a single- to a multi-material approach combining the Solid Isotropic Material with Penalization (SIMP) and peak function material models. Data collected during the optimization process is used to find material candidates by means of a curve fitting strategy based on generalized simulated annealing (GSA), if this information is not available. The numerical analysis is carried out using a finite element (FE) approach in the frequency domain. Both forward and adjoint problems are solved aided by an open source Domain-Specific Language (DSL) framework and automated derivation tool, while the optimization problem is solved by using a BFGS algorithm. Numerical results for 2D examples demonstrated that proposed material interpolation can lead to solutions with sharper interfaces and improved resolution without including any type of regularization or extra constraint in the optimization problem.
Linking Multiple User Identities of Multiple Services from Massive Mobility Traces
Authors: Wang Huandong , Li Yong , Wang Gang , Jin Depeng
Published: August 2021

Understanding the linkability of online user identifiers (IDs) is critical to both service providers (for business intelligence) and individual users (for assessing privacy risks). Existing methods are designed to match IDs across
two services
but face key challenges of matching multiple services in practice, particularly when users have multiple IDs per service. In this article, we propose a novel system to link IDs across multiple services by exploring the spatial-temporal features of user activities, of which the core idea is that the same user's online IDs are more likely to repeatedly appear at the same location. Specifically, we first utilize a
contact graph
to capture the “co-location” of all IDs across multiple services. Based on this graph, we propose a set-wise matching algorithm to discover candidate ID sets and use Bayesian inference to generate confidence scores for candidate ranking, which is proved to be optimal. We evaluate our system using two real-world ground-truth datasets from an Internet service provider (4 services, 815K IDs) and Twitter-Foursquare (2 services, 770 IDs). Extensive results show that our system significantly outperforms the state-of-the-art algorithms in accuracy (AUC is higher by 0.1–0.2), and it is highly robust against data quality, matching order, and number of services.