bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 and its Cardiac and Neurological Complications among Ontario Visible Minorities
Authors: Chu Joseph Y. , Kaliwal Yosuf , Koh Maria , Chen Robert , Chow Chi-Ming , Ko Dennis T. , Liu Peter P. , Moe Gordon W.
Published: June 2021

Background:

Due to lack of data on the epidemiology, cardiac, and neurological complications among Ontario visible minorities (Chinese and South Asians) affected by coronavirus disease (COVID-19), this population-based retrospective study was undertaken to study them systematically.

Methods:

From January 1, 2020 to September 30, 2020 using the last name algorithm to identify Ontario Chinese and South Asians who were tested positive by PCR for COVID-19, their demographics, cardiac, and neurological complications including hospitalization and emergency visit rates were analyzed compared to the general population.

Results:

Chinese (N = 1,186) with COVID-19 were found to be older (mean age 50.7 years) compared to the general population (N = 42,547) (mean age 47.6 years) (p< 0.001), while South Asians (N = 3,459) were younger (age of 42.1 years) (p< 0.001). The 30-day crude rate for cardiac complications among Chinese was 169/10,000 (p= 0.069), while for South Asians, it was 64/10,000 (p= 0.008) and, for the general population, it was 112/10,000. For neurological complications, the 30-day crude rate for Chinese was 160/10,000 (p< 0.001); South Asians was 40/10,000 (p= 0.526), and general population was 48/10,000. The 30-day all-cause mortality rate was significantly higher for Chinese at 8.1% vs 5.0% for the general population (p< 0.001), while it was lower in South Asians at 2.1% (p< 0.001).

Conclusions:

Chinese and South Asians in Ontario affected by COVID-19 during the first wave of the pandemic were found to have a significant difference in their demographics, cardiac, and neurological outcomes.
Reanalyzing Mandarin V1-V2resultative constructions—A force-theoretic approach
Authors: Han Peng (Benjamin)
Published: June 2021

This study takes a force-theoretic approach to Mandarin V1-V2resultative constructions. Unlike event-based analyses that hold a causing event accountable for a result state, this study attributes a result state to a specific entity involved in the relevant causing event. In this way, V1-V2resultative construction (RC) sentences have the interpretation that through a causing action, one entity relevant to the action caused a change of state to another entity; this causal influence is reconceptualized as a force from the former entity, characterizing the situation change concerning the latter entity. Following Copley and Harley (2015), this conceptual reanalysis is represented structurally, successfully deriving V1-V2RC sentences. V2and the internal argument DP specify the property of a resultant situation and its holder, defining the force; the external argument DP tells about this force's source; V1modifies this force, indicating the causing action through which this force is realized.
Doctrinal Methodology in EU Administrative Law: Confronting the “Touch of Stateness”
Authors: Brito Bastos Filipe
Published: June 2021

From its inception, the academic study of EU administrative law has relied heavily on doctrinal categories, concepts and principles, borrowed from the administrative law of the Member States. It has largely preferred research agendas such as the Europeanisation of national administrative law or the development of common European principles derived from national administrative laws. Legal doctrine has also engaged in the critique of EU administrative law when it fails to account for the normative standards that national administrative law must usually observe. Whereas all these constitute important research agendas, they reproduce in particularly acute terms a familiar paradox. While the existence of a European administration and administrative law beyond the state cannot be seriously disputed today, legal doctrine tends to consider them, implicitly or explicitly, from the perspective of the administrative law of the nation-state. The so-called “touch of stateness” has had a firm grip on EU administrative law, even though it includes unique aspects that lack any precedent in national laws. The article considers, and proposes a methodological approach to address, the ways in which preconceptions and normative expectations originating in national law have conditioned, and indeed prevented, the deeper doctrinal development of EU administrative law.
Abusing Constitutional Identity
Authors: Scholtes Julian
Published: June 2021

Increasingly, populists and authoritarians have discovered for themselves the notion of constitutional identity as a practical excuse to sidestep transnational legal obligations, as well as to vindicate their constitutional projects on the whole from concerns about the rule of law and other shared European values. This has led some scholars to highlight the “dangers of constitutional identity,” brandishing it as an “inherently dangerous concept,” and suggesting that the concept ought to be abandoned. This Article argues that the anti-pluralist critiques of constitutional identity, while rightly criticizing the authoritarian appropriations of constitutional identity, ultimately go too far and draw the wrong conclusions. Simply dismissing the concept of constitutional identity will not lead to the disappearance of the meanings imparted through it. The authoritarian and populist appropriations of constitutional identity must be identified and understood as abuses of the concept. By eliding constitutional identity with its abuse, the anti-pluralist critique sacrifices a more intimate understanding of the realities of constitutional identity abuse to a likely unattainable normative vision of uncontested EU law primacy. In advancing this critique, I will further outline three potential avenues for understanding constitutional identity abuse, differentiating between its substantive, generative, and relational aspects. Constitutional identity claims can be abusive by virtue of their substantive content, how they have come about, as well as how they are advanced.
The Refugees We Are: Solidarity, Asylum, and Critique in the European Constitutional Imagination
Authors: Linden-Retek Paul
Published: June 2021

This Article aims to reimagine post-national legal solidarity. It does so by bringing debates over Habermasian constitutional theory to bear on the evolving use of mutual recognition and mutual trust in the EU’s Area of Freedom, Security, and Justice (AFSJ), particularly in the context of European asylum law and reforms to the Dublin Regulation. Insofar as critiques of Habermasian “constitutional patriotism” apply to the principle of mutual trust, the Article suggests why post-national solidarity requires fallibilism and dynamic responsiveness that exceed formalized rules of forbearance and respect.

On this revised view, legal solidarity guarantees a particular form of adjudication through which individual litigants in a particular case challenge the transnational structural conditions that give rise to individual harm. Because it acknowledges that violations of individual rights are always potentially or in part the result of a collective systemic failure, this conception of solidarity restores meaning to the transformative “transfer” of sovereignty that post-national law had promised. In the field of asylum law, I detail how this application of solidarity would offer a much-needed corrective to structural imbalances in the existing Dublin regime. I conclude with reflections on the principle’s application in additional fields of EU law, as well.
Use of portable air cleaners to reduce aerosol transmission on a hospital coronavirus disease 2019 (COVID-19) ward
Authors: Buising Kristy L. , Schofield Robyn , Irving Louis , Keywood Melita , Stevens Ashley , Keogh Nick , Skidmore Grant , Wadlow Imogen , Kevin Kevin , Rismanchi Behzad , Wheeler Amanda J. , Humphries Ruhi S. , Kainer Marion , Monty Jason , McGain Forbes , Marshall Caroline
Published: June 2021

Objective:

To study the airflow, transmission, and clearance of aerosols in the clinical spaces of a hospital ward that had been used to care for patients with coronavirus disease 2019 (COVID-19) and to examine the impact of portable air cleaners on aerosol clearance.

Design:

Observational study.

Setting:

A single ward of a tertiary-care public hospital in Melbourne, Australia.

Intervention:

Glycerin-based aerosol was used as a surrogate for respiratory aerosols. The transmission of aerosols from a single patient room into corridors and a nurses’ station in the ward was measured. The rate of clearance of aerosols was measured over time from the patient room, nurses’ station and ward corridors with and without air cleaners [ie, portable high-efficiency particulate air (HEPA) filters].

Results:

Aerosols rapidly travelled from the patient room into other parts of the ward. Air cleaners were effective in increasing the clearance of aerosols from the air in clinical spaces and reducing their spread to other areas. With 2 small domestic air cleaners in a single patient room of a hospital ward, 99% of aerosols could be cleared within 5.5 minutes.

Conclusions:

Air cleaners may be useful in clinical spaces to help reduce the risk of acquisition of respiratory viruses that are transmitted via aerosols. They are easy to deploy and are likely to be cost-effective in a variety of healthcare settings.
Increased rates of blood culture contamination during the coronavirus disease 2019 pandemic
Authors: Esquer Garrigos Zerelda , Wingler Mary Joyce B. , Svoronos Petros A. , Vijayvargiya Prakhar , Goodman-Meza David , O’Horo John C. , Navalkele Bhagyashri D. , Cretella David , Frame Ithiel J. , Parham Jason , Lucar Jose
Published: June 2021

We observed a higher rate of blood-culture contamination during the COVID-19 pandemic at our institution compared to a prepandemic period. Given the potential implications of blood contamination in antibiotic and diagnostic test utilization as well as added cost, it is imperative to continue efforts to minimize these episodes during the pandemic.
Coronavirus disease 2019 (COVID-19) admission screening and assessment of infectiousness at an academic medical center in Iowa, 2020
Authors: Alsuhaibani Mohammed A. , Kobayashi Takaaki , Trannel Alexandra , Holley Stephanie , Abosi Oluchi J. , Jenn Kyle E. , Meacham Holly , Sheeler Lorinda , Etienne William , Dains Angelique , Kukla Mary E. , Ward Emily , Ford Bradley , Edmond Michael B. , Wellington Melanie , Diekema Daniel J. , Salinas Jorge L.
Published: June 2021

Objective:

Patients admitted to the hospital may unknowingly carry severe acute respiratory coronavirus virus 2 (SARS-CoV-2), and hospitals have implemented SARS-CoV-2 admission screening. However, because SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) assays may remain positive for months after infection, positive results may represent active or past infection. We determined the prevalence and infectiousness of patients who were admitted for reasons unrelated to COVID-19 but tested positive for SARS-CoV-2 on admission screening.

Methods:

We conducted an observational study at the University of Iowa Hospitals & Clinics from July 7 to October 25, 2020. All patients admitted without suspicion of COVID-19 were included, and medical records of those with a positive admission screening test were reviewed. Infectiousness was determined using patient history, PCR cycle threshold (Ct) value, and serology.

Results:

In total, 5,913 patients were screened and admitted for reasons unrelated to COVID-19. Of these, 101 had positive admission RT-PCR results; 36 of these patients were excluded because they had respiratory signs/symptoms on admission on chart review. Also, 65 patients (1.1%) did not have respiratory symptoms. Finally, 55 patients had Ct values available and were included in this analysis. The median age of the final cohort was 56 years and 51% were male. Our assessment revealed that 23 patients (42%) were likely infectious. The median duration of in-hospital isolation was 5 days for those likely infectious and 2 days for those deemed noninfectious.

Conclusions:

SARS-CoV-2 was infrequent among patients admitted for reasons unrelated to COVID-19. An assessment of the likelihood of infectiousness using clinical history, RT-PCR Ct values, and serology may help in making the determination to discontinue isolation and conserve resources.
Older age, smoking, tooth loss and denture-wearing but neither xerostomia nor salivary gland hypofunction are associated with low intakes of fruit and vegetables in older Danish adults
Authors: Pedersen Anne Marie Lynge , Dynesen Anja Weirsøe , Heitmann Berit Lilienthal
Published: June 2021

Xerostomia and salivary gland hypofunction are prevalent conditions in older people and may adversely influence the intake of certain foods, notably fruit and vegetables. Here, we aimed to investigate whether xerostomia and salivary gland hypofunction were associated with a lower intake of fruit and vegetables. The study included 621 community-dwelling adults, mean age 75⋅2 ± 6⋅4 years, 58⋅9 % female, who had participated in the Copenhagen City Heart Study follow-up, and undergone interviews regarding food intake (preceding month), oral and general health (xerostomia, taste alterations, diseases, medication, alcohol consumption and smoking), clinical oral examination and measurements of unstimulated and chewing-stimulated whole saliva flow rates. The average total energy intake (8⋅4 ± 2⋅7 MJ) and protein energy percentage (14⋅8 ± 3⋅1 %) were slightly below recommendations. The average fruit (234⋅7 ± 201⋅2 g/d) and vegetables (317⋅3 ± 157⋅4 g/d) intakes were within recommendations. Xerostomia and hyposalivation were more prevalent in women than in men (16⋅4 v. 7⋅1 %, P < 0⋅001 and 40⋅7 v. 27⋅5 %, P < 0⋅001). Multiple linear regression analyses revealed that older age (β −0⋅009, se 0⋅003, P = 0⋅005), smoking (β −0⋅212, se 0⋅060, P = 0⋅0005) and wearing complete dentures/being partially or fully edentulous (β −0⋅141, se 0⋅048, P = 0⋅003), but neither xerostomia nor salivary flow rates were associated with an inadequate fruit and vegetable intake, after adjustment for covariates. Older age, smoking, tooth loss and denture-wearing were stronger determinants of low fruit and vegetable intakes than xerostomia and salivary hypofunction supporting the importance of dietary counselling and maintenance of oral health and an adequate masticatory performance.
Algebras with representable representations
Authors: García-Martínez X. , Tsishyn M. , Van der Linden T. , Vienne C.
Published: June 2021

Just like group actions are represented by group automorphisms, Lie algebra actions are represented by derivations: up to isomorphism, a split extension of a Lie algebra $B$ by a Lie algebra $X$ corresponds to a Lie algebra morphism $B\to {\mathit {Der}}(X)$ from $B$ to the Lie algebra ${\mathit {Der}}(X)$ of derivations on $X$. In this article, we study the question whether the concept of a derivation can be extended to other types of non-associative algebras over a field ${\mathbb {K}}$, in such a way that these generalized derivations characterize the ${\mathbb {K}}$-algebra actions. We prove that the answer is no, as soon as the field ${\mathbb {K}}$ is infinite. In fact, we prove a stronger result: already the representability of all abelian actions – which are usually called representations or Beck modules – suffices for this to be true. Thus, we characterize the variety of Lie algebras over an infinite field of characteristic different from $2$ as the only variety of non-associative algebras which is a non-abelian category with representable representations. This emphasizes the unique role played by the Lie algebra of linear endomorphisms $\mathfrak {gl}(V)$ as a representing object for the representations on a vector space $V$.
Awareness of HIV serostatus by sex partners of women living with HIV in North-Central Nigeria: correlates and predictive analyses
Authors: Eboreime Ejemai Amaize , Itanyi Ijeoma Uchenna , Ogidi Amaka Grace , Iheanacho Theddeus , Olayiwola Olanrewaju , Onoka Chima Ariel , Ezeanolue Echezona Edozie
Published: June 2021

Non-communication of HIV status among sex partners is a notable hurdle in halting transmission, largely due to socio-cultural factors. This study aimed to predict the determinants of male partners’ awareness of women’s serostatus. A total of 8825 women of reproductive age living with HIV who were clients at five comprehensive HIV treatment centres in Benue State, North-Central Nigeria were surveyed between June and December 2017, and 6655 reported having a sexual partner at the time of the survey selected for analysis. A regression model was used to estimate the determinants of male partner awareness of serostatus from the perspective of women. Conditional marginal analyses were conducted to evaluate the marginal effects of identified predictors on the probability of outcomes. Partners of married women were found to have greater odds of being aware of their spouse’s serostatus (adjusted OR (aOR): 3.20; 95%CI: 2.13–4.81) than non-married partners. Similarly, the odds of male partner awareness increased with the years women had been on antiretroviral therapy (aOR: 1.13; 95%CI: 1.07–1.20). The probability of partners of married respondents being aware of their spouse’s HIV serostatus was 97%. The conditional marginal effects of being educated to primary or higher level were 1.2 (95% CI: –0.2 to 2.7) and 1.8 (95% CI: 0.09–3.4) percentage points higher respectively when compared with women with no formal education. Being unemployed or being a trader significantly decreased the probability of partners being aware of respondents’ serostatus when compared with farmers; conditional marginal effects of –6.7 (95% CI: –12.0 to –1.4) and –3.9 (95% CI: –5.7 to –2.2) percentage points, respectively. The study found that relationship status and girl-child education are factors that can improve communication of HIV status to sex partners. Policies and interventions aimed at improving the social determinants of health, and social support for healthy communications in relationships, are recommended to reduce HIV transmission between sex partners.
A neurostructural biomarker of dissociative amnesia: a hippocampal study in dissociative identity disorder
Authors: Dimitrova Lora I. , Dean Sophie L. , Schlumpf Yolanda R. , Vissia Eline M. , Nijenhuis Ellert R. S. , Chatzi Vasiliki , Jäncke Lutz , Veltman Dick J. , Chalavi Sima , Reinders Antje A. T. S.
Published: June 2021

Background

Little is known about the neural correlates of dissociative amnesia, a transdiagnostic symptom mostly present in the dissociative disorders and core characteristic of dissociative identity disorder (DID). Given the vital role of the hippocampus in memory, a prime candidate for investigation is whether total and/or subfield hippocampal volume can serve as biological markers of dissociative amnesia.

Methods

A total of 75 women, 32 with DID and 43 matched healthy controls (HC), underwent structural magnetic resonance imaging (MRI). Using Freesurfer (version 6.0), volumes were extracted for bilateral global hippocampus, cornu ammonis (CA) 1–4, the granule cell molecular layer of the dentate gyrus (GC-ML-DG), fimbria, hippocampal−amygdaloid transition area (HATA), parasubiculum, presubiculum and subiculum. Analyses of covariance showed volumetric differences between DID and HC. Partial correlations exhibited relationships between the three factors of the dissociative experience scale scores (dissociative amnesia, absorption, depersonalisation/derealisation) and traumatisation measures with hippocampal global and subfield volumes.

Results

Hippocampal volumes were found to be smaller in DID as compared with HC in bilateral global hippocampus and bilateral CA1, right CA4, right GC-ML-DG, and left presubiculum. Dissociative amnesia was the only dissociative symptom that correlated uniquely and significantly with reduced bilateral hippocampal CA1 subfield volumes. Regarding traumatisation, only emotional neglect correlated negatively with bilateral global hippocampus, bilateral CA1, CA4 and GC-ML-DG, and right CA3.

Conclusion

We propose decreased CA1 volume as a biomarker for dissociative amnesia. We also propose that traumatisation, specifically emotional neglect, is interlinked with dissociative amnesia in having a detrimental effect on hippocampal volume.
Dementia in Scottish military veterans: early evidence from a retrospective cohort study
Authors: Bergman B. P. , Mackay D. F. , Pell J. P.
Published: June 2021

Background

Few studies have examined whether UK military veterans are at an increased risk of dementia. We explored the risk of dementia in Scottish military veterans aged up to 73 years in comparison with people who have never served.

Methods

Retrospective cohort study of 78 000 veterans and 253 000 people with no record of service, matched for age, sex and area of residence, with up to 37 years follow-up, using Cox proportional hazard analysis to compare risk of dementia in veterans and non-veterans, overall and by subgroup.

Results

Dementia was recorded in 0.2% of both veterans and non-veterans overall, Cox proportional hazard ratio 0.98, 95% confidence interval (CI) 0.82–1.19, p = 0.879 (landmark age: 50 years), with no difference for men but increased risk in veteran women and Early Service Leavers. Post-traumatic stress disorder (PTSD) was associated with a higher risk of dementia in both veterans and non-veterans, although possibly to a lesser degree in veterans. A history of mood disorder was strongly associated with developing dementia, greater in veterans than in non-veterans, odds ratio 1.54, 95% CI 1.01–2.35, p = 0.045.

Conclusions

There was no evidence to suggest that military service increased the risk of dementia, although this may change as the cohort ages. The well-documented association with PTSD shows no evidence of being stronger in veterans; by contrast, the association of mood disorder with dementia is much stronger in veterans. Healthcare providers should carefully assess the cognitive status of older veterans presenting with depressive illness in order to identify early dementia and ensure optimum management.
Managing Expertise: The Problem of Engineers in the English East India Company, 1668–1764
Authors: Riding Tim
Published: June 2021

This article challenges the assumption that the early modern engineer acted as a reliable agent for colonial authorities. Far from acting as trusted mediators between colony and metropole, experts could exacerbate tensions. The English East India Company knew this, and avoided engineers throughout its early history. This article considers the interplay between authorities in London and their subordinates in Bombay. The company's directors saw engineers as untrustworthy agents who increased expenditure and disrupted the company's system of consultative governance. For much of its early modern history, the company's fortifications and built environments relied on a knowledge network of informal expertise. Examining these experts-in-context reveals how expertise was managed and built environments maintained in colonial settings. When the company did turn to experts in the mid-eighteenth century, it struggled to utilise and incorporate them. This demonstrates that in some colonial contexts experts could be profoundly disruptive.
Systems thinking in health technology assessment: a scoping review
Authors: Richardson Marina , Ramsay Lauren C. , Bielecki Joanna M. , Berta Whitney , Sander Beate
Published: June 2021

Objective

Our objective was to assess how, and to what extent, a systems-level perspective is considered in decision-making processes for health interventions by illustrating how studies define the boundaries of the system in their analyses and by defining the decision-making context in which a systems-level perspective is undertaken.

Method

We conducted a scoping review following the Joanna Briggs Institute methodology. MEDLINE, EMBASE, Cochrane Library, and EconLit were searched and key search concepts included decision making, system, and integration. Studies were classified according to an interpretation of the “system” of analysis used in each study based on a four-level model of the health system (patient, care team, organization, and/or policy environment) and using categories (based on intervention type and system impacts considered) to describe the decision-making context.

Results

A total of 2,664 articles were identified and 29 were included for analysis. Most studies (16/29; 55%) considered multiple levels of the health system (i.e., patient, care team, organization, environment) in their analysis and assessed multiple classes of interventions versus a single class of intervention (e.g., pharmaceuticals, screening programs). Approximately half (15/29; 52%) of the studies assessed the influence of policy options on the system as a whole, and the other half assessed the impact of interventions on other phases of the disease pathway or life trajectory (14/29; 48%).

Conclusions

We found that systems thinking is not common in areas where health technology assessments (HTAs) are typically conducted. Against this background, our study demonstrates the need for future conceptualizations and interpretations of systems thinking in HTA.
Developing a sense of self-reliance: caregivers of infants with single-ventricle heart disease during the interstage period
Authors: Imperial-Perez Flerida , Heilemann MarySue V. , Doering Lynn V. , Eastwood Jo-Ann , Pike Nancy A.
Published: June 2021

Background:

Caring for infants after the first-stage palliative surgery for single-ventricle heart disease bring challenges beyond the usual parenting responsibilities. Current studies fail to capture the nuances of caregivers’ experiences during the most critical “interstage” period between the first and second surgery.

Objectives:

To explore the perceptions of caregivers about their experiences while transitioning to caregiver roles, including the successes and challenges associated with caregiving during the interstage period.

Methods:

Constructivist Grounded Theory methodology guided the collection and analysis of data from in person or telephonic interviews with caregivers after their infants underwent the first-stage palliative surgery for single-ventricle heart disease, and were sent to home for 2–4 months before returning for their second surgery. Symbolic interactionism informed data analyses and interpretation.

Results:

Our sample included 14 parents, who were interviewed 1–2 times between November, 2019 and July, 2020. Most patients were mothers (71%), Latinx (64%), with household incomes <$30K (42%). Data analysis led to the development of a Grounded Theory called Developing a Sense of Self-Reliance with three categories: (1) Owning caregiving responsibilities despite grave fears, (2) Figuring out how “to make it work” in the interstage period, and (3) Gaining a sense of self-reliance.

Conclusions:

Parents transitioned to caregiver roles by developing a sense of self-reliance and, in the process, gained self-confidence and decision-making skills. Our study responded to the key research priority from the AHA Scientific Statement to address the knowledge gap in home monitoring for interstage infants through qualitative research design.
ARMED to ESCAPE COVID-19: the impact of COVID-19 on a mixed methods feasibility study of a weight management, education and physical function programme for patients with knee osteoarthritis at the primary/secondary care interface
Authors: Monaghan Brenda , Bourton Cassidy Lara , Glynn Aaron A. , Hurley M.V. , Kacprzak Pauline , Kelly Maria , O’ Connor Keelan , Flynn Jane O. , Keelan Fiona , Reidy Ruth , Rodgers Sarah Jane , Cusack Tara
Published: June 2021

Objectives:

This study was designed to test the feasibility of running a trial to compare the effectiveness of a combined weight management and physical function programme for patients with knee osteoarthritis ARMED (Arthritis Rehabilitation through the Management of Exercise and Diet) with usual care ESCAPE pain (Enabling Self-management and Coping with Arthritic Pain using Exercise). The COVID-19 pandemic interruption allowed additional measurement of the qualitative ‘lived in’ experiences of this patient group during the pandemic and also their appetite for virtual health.

Participants:

Thirty-two patients with knee osteoarthritis were recruited from a combined primary/secondary care waiting list and were allocated to either a six-week intervention group (ARMED) or to the six-week usual care ESCAPE pain group (Enabling Self-management and Coping with Arthritic Pain using Exercise) group.

Results:

The intervention programme was interrupted after three weeks by COVID-19. Fifteen patients were reassessed after the first stage. The average attendance was 92% with 6 patients attending all sessions, 5 attending 5/6, 1 attending 4/6 and 2 attending 3/6. One subject dropped out and 15/16 patients completed all outcome measurements. All patients completed the KOOS knee score and the Short Warwick-Edinburgh Mental Well Being Scale to evaluate anxiety and depression. There was a statistically significant improvement in pain, activities of daily living, quality of life and mental health and well-being scores from time one to time 2. The mean weight, BMI and waist measurements were reduced also from time one to time 2, but these failed to reach significance. The semi-structured interviews provided rich information on enablers and barriers to coping in lockdown, benefits of the ARMED programme to increasing physical activity and weight management and enablers and barriers to redesigning the programme for online delivery.

Conclusions:

Evaluation of preliminary data from this feasibility study supports the three-week intervention combining education, exercise and weight management in this patient group even during a pandemic. Based on the results of the qualitative interviews, we have now redesigned our programme to present it virtually. We hope to present the results of our virtual feasibility study later in 2021.
Brief cognitive behavioural therapy for binge-eating disorder: clinical effectiveness in a routine clinical setting
Authors: Moore Elana , Hinde Michelle , Waller Glenn
Published: June 2021

Brief cognitive behavioural therapy (CBT) is effective in working with non-underweight eating disorder patients across transdiagnostic groups. However, it is not clear whether it will be as effective in the treatment of binge-eating disorder, where emotional eating is likely to play a larger role than starvation-driven eating. This case series tested whether brief, 10-session CBT (CBT-T) would be effective in a case series of 53 patients with binge-eating disorder. Attrition rates were comparable to previous research. Eating attitudes, binge frequency, anxiety and depression were measured. Remission was measured comparing different categorical methods: ‘cut-off’; reliable change index (RCI); and clinically significant change (CSC). CBT-T was effective for binge-eating disorder patients, at comparable levels to other non-underweight patients. All measures of pathology were significantly reduced, with large to moderate effect sizes. When categorical changes were used to indicate remission, RCI and CSC levels were more appropriate than existing cut-off methods, potentially because of the lower levels of initial restrained eating in this clinical group. CBT-T’s effectiveness in transdiagnostic groups is replicated in binge-eating disorder patients, despite their greater level of emotionally driven eating. More stringent definitions of remission (CSC and RCI) should be used more widely, to ensure realistic estimates.

Key learning aims

(1)

What is necessary for brief CBT to be effective for binge-eating disorder (BED)?

(2)

Is CBT for BED effective in the absence of purging behaviours?

(3)

What is the most appropriate way to measure remission in CBT for BED?
Complex Network for Solar Protons and Correlations With Flares
Authors: Mohammadi Z. , Alipour N. , Safari H. , Zamani Farhad
Published: June 2021

We study the properties of the complex network for solar proton flux (SPF) at six integral energy channels (>1, >5, >10, >30, >50, and >100 MeV). We construct a growing visibility network based on the SPF time series for proton for each channel, which observed by Geostationary Operational Environmental Satellites from April 14, 2010 to May 9, 2018. The clustering coefficient values for SPF networks are much larger than those of the equivalent random network. The logarithmic behavior of the characteristic path length refers to the characteristics of the small‐world network. The degree distribution of nodes obeys the power‐law behavior with certain exponents that reflects the scale‐free nature of the networks. For the constructed SPF networks, the average clustering coefficient shows a jump when the large flares occurred. We show that both western solar longitude large flares (X‐class, M‐class) and flares associated with coronal mass ejections (with speed greater than 500 km s−1) are relatively more related to the peaks (more than the median) of both SPF time series and PageRank of the networks. We conclude that both the PageRank and clustering coefficient of the SPF network are useful indicators to identify the source of SPFs related to flares and flares associated with coronal mass ejections.
Effects of Typhoon Mujigae on the Biogeochemistry and Ecology of a Semi‐Enclosed Bay in the Northern South China Sea
Authors: Zhou Xin , Jin Guangzhe , Li Jiacheng , Song Zhiguang , Zhang Shuwen , Chen Chunqing , Huang Chao , Chen Fajin , Zhu Qingmei , Meng Yafei
Published: June 2021

Typhoons frequently induce algal blooms in the open ocean based on the satellite remote sensing data. However, the effects of typhoons on nearshore areas are not fully clarified due to the inaccessibility of in situ sampled data and the low accuracy of satellite data in the nearshore areas. To understand the biogeochemical and ecological changes in semi‐enclosed bays under the influence of typhoons, physicochemical parameters and isotopic compositions of surface water were measured in Zhanjiang Bay during the super Typhoon Mujigae and nontyphoon periods. The results show that the chlorophyll a (Chl a) concentrations inside and outside the bay during these two periods were considerably different. During typhoon periods, the positive apparent oxygen utilization and unsaturated dissolved oxygen (DO) values suggested significant biological degradation in Zhanjiang Bay, rather than the algal blooms reported by previous studies. In contrast, during nontyphoon periods, particulate organic matter (POM: POC and PN) was mainly generated by in situ phytoplankton production, as indicated by a low POC/Chl a ratio (<99), low C/N ratio, and positive correlations between PN, POC, and Chl a. Isotopic analysis of the particulate N (PN) and nitrate (NO3−) indicated that the 15N‐enriched PN in both periods originally came from sewage‐dissolved inorganic N. These results suggest that the typhoon‐induced decomposition processes, rather than algal blooms, in this semi‐enclosed bay in the northern South China Sea, providing new understanding of the impact of the typhoons on marine biogeochemistry and ecology.
Estimating Bioturbation From Replicated Small‐Sample Radiocarbon Ages
Authors: Dolman Andrew M. , Groeneveld Jeroen , Mollenhauer Gesine , Ho Sze Ling , Laepple Thomas
Published: June 2021

Marine sedimentary records are a key archive when reconstructing past climate; however, mixing at the seabed (bioturbation) can strongly influence climate records, especially when sedimentation rates are low. By commingling the climate signal from different time periods, bioturbation both smooths climate records, by damping fast climate variations, and creates noise when measurements are made on samples containing small numbers of individual proxy carriers, such as foraminifera. Bioturbation also influences radiocarbon‐based age‐depth models, as sample ages may not represent the true ages of the sediment layers from which they were picked. While these effects were first described several decades ago, the advent of ultra‐small‐sample 14C dating now allows samples containing very small numbers of foraminifera to be measured, thus enabling us to directly measure the age‐heterogeneity of sediment for the first time. Here, we use radiocarbon dates measured on replicated samples of 3–30 foraminifera to estimate age‐heterogeneity for five marine sediment cores with sedimentation rates ranging from 2 to 30 cm kyr−1. From their age‐heterogeneities and sedimentation rates we infer mixing depths of 10–20 cm for our core sites. Our results show that when accounting for age‐heterogeneity, the true error of radiocarbon dating can be several times larger than the reported measurement. We present estimates of this uncertainty as a function of sedimentation rate and the number of individuals per radiocarbon date. A better understanding of this uncertainty will help us to optimize radiocarbon measurements, construct age models with appropriate uncertainties and better interpret marine paleo records.
Better Subseasonal-to-Seasonal Forecasts for Water Management
Authors: DeFlorio Michael , Ralph F. , Waliser Duane , Jones Jeanine , Anderson Michael
Published: June 2021

Emerging methods that improve precipitation forecasting over weeks to months could support more informed resource management and increase lead times for responding to droughts and floods.
Sedimentary Processes Within the Canadian Arctic Archipelago: Relationships Among Sedimentological, Geochemical, and Magnetic Sediment Properties
Authors: Letaïef Sarah , Montero‐Serrano Jean‐Carlos , St‐Onge Guillaume
Published: June 2021

The sedimentological, geochemical, physical and magnetic properties of 40 surface and basal sediment samples of box cores collected throughout the Canadian Arctic Archipelago (CAA) from the Canadian Beaufort Shelf to Lancaster Sound were analyzed to determine the sedimentary processes that operate within the CAA during the pre‐ and post‐industrial periods (i.e., before and after 1900 Common Era or CE). In addition, the chronology of seven selected regional cores was established using 210Pb measurements, where the base is dated between 1550 and 1820 CE. These cores provide an opportunity to robustly compare post‐1900 sedimentary conditions with those of the colder Little Ice Age period (LIA; ∼1500–1900 CE). The different properties combined with multivariate statistical analyses result in the identification of three regional provinces with distinct sedimentary characteristics: (a) the West province (Mackenzie Shelf/Slope, west Banks Island and M'Clure Strait) typified by detrital associations (Fe‐Rb‐Ti‐Zn), high organic matter inputs, dominance of magnetite and low‐coercivity minerals and high aluminosilicate contents; (b) the Intermediate Zone (Amundsen and Coronation gulfs) distinguished by Si‐Al‐Zr‐Sr‐K associations, Mn oxyhydroxides precipitation, constant high magnetic grain concentrations and a mixture between marine and terrigenous organic matter; and (c) the East Province (Queen Maud Gulf, Victoria and Barrow straits, and Lancaster and Eclipse sounds) described by high detrital carbonate inputs, marine organic matter, a dominance of high‐coercivity minerals and high magnetic concentrations in pre‐industrial samples. Our results confirm that the pre‐ and post‐industrial sedimentary dynamics are controlled by sediment supplies from the river discharges in the West and Intermediate provinces, whereas the East province is more influenced by sea ice and coastal erosion. Basal sediment samples from the seven 210Pb‐dated cores suggest an intensification of the Mackenzie, Coppermine, and Ellice rivers runoff, extensive sea‐ice cover and consequently sediment transport by the latter during the LIA period.
An Extended Rheological Map of Pāhoehoe—‘A‘ā Transition
Authors: Di Fiore F. , Vona A. , Kolzenburg S. , Mollo S. , Romano C.
Published: June 2021

The pāhoehoe—‘a‘ā morphological transition involves a change in the rheological response of the magmatic suspension from pure viscous to complex rheological behavior, resulting in the development of tear‐apart features. Here, we present a suite of concentric cylinder experiments aimed at studying the effects of cooling and shear rates on the rheology of a phonotephrite melt in response to crystallization. Experiments were conducted at: (a) isothermal subliquidus temperatures of 1,167–1,189°C and shear rates of 1–3 s−1; (b) constant cooling rates of 1–10°C/min and shear rates of 1–20 s−1. We defined the viscosity‐temperature‐time window of lava solidification, as well as the transition from coherent flow to shear localization and physical separation (i.e., viscous rupture). Through this approach, we mapped the processes and timescales affecting pāhoehoe—‘a‘ā transition in natural lavas at variable cooling and shear rates. Under disequilibrium conditions, as the cooling rate increases, both crystallization onset and viscous rupture occur at lower temperature and earlier in time. Moreover, the time to reach the crystallization onset and viscous rupture also decreases with increasing shear rate. Both increasing cooling and shear rate reduces the critical crystallinity required for viscous rupture, a consequence of the non‐linear interplay between temperature, crystallization kinetics, and melt viscosity. This outcome expands our knowledge on compositional, thermal, and rheological changes in phonotephritic systems. In addition to shear rate and apparent viscosity, comparison with previous measurements on basaltic systems indicates that the pāhoehoe—‘a‘ā transition is sensitive to the composition and cooling path of lavas.
Dynamics of Episodic Magma Injection and Migration at Yellowstone Caldera: Revisiting the 2004–2009 Episode of Caldera Uplift With InSAR and GPS Data
Authors: Delgado Francisco , Grandin Raphaël
Published: June 2021

The 2004–2009 caldera uplift is the largest instrumentally recorded episode of unrest at Yellowstone caldera. We use GPS and Interferometric Synthetic Aperture Radar (InSAR) time series spanning 2004–2015, with a focus in the aforementioned event to understand the mechanisms of unrest. InSAR data recorded ∼25 and ∼20 cm of uplift at the Sour Creek (SCD) and Mallard Lake (MLD) resurgent domes during 2004–2009, and ∼8 cm of subsidence at the Norris Geyser Basin (NGB) during 2004–2008. The SCD/MLD uplift was followed by subsidence across the caldera floor with a maximum at MLD of ∼1.5–2.5 cm/yr, and no deformation at NGB. The best‐fit source models for the 2004–2009 period are two horizontal sills at depths of ∼8.7 and 10.6 km for the caldera source and NGB, respectively, with volume changes of 0.354 and −0.121 km3, and an overpressure of ∼0.1 MPa. The InSAR and GPS time series record exponentially increasing followed by exponentially decreasing uplift between 2004 and 2009, which is indicative of magma injection into the caldera reservoir, with no need for other mechanisms of unrest. However, magma extraction from NGB to the caldera is unable to explain the subsidence coeval with the caldera uplift. Models of magma injection can also explain other episodes of caldera uplift like that in 2014–2015. Distributed sill opening models show that magma is stored across the caldera source with no clear boundary between MLD and SCD. Since the magma overpressure is orders of magnitude below the tensile strength of the encasing rock, historical episodes of unrest like these are very unlikely to trigger an eruption.
Plain Language Summaries to be Required for Submission to Journal of Geophysical Research: Earth Surface
Authors: Attal Mikael , East Amy E. , Finnegan Noah J. , Hoitink A. J. F. (Ton) , Sergienko Olga V.
Published: June 2021

Manuscripts submitted to the Journal of Geophysical Research: Earth Surface will require a Plain Language Summary beginning in July 2021.
Diabetes and COVID19: a bidirectional relationship
Authors: Unnikrishnan Ranjit , Misra Anoop
Published: June 2021

The advent and rapid spread of the coronavirus disease-2019 (COVID19) pandemic across the world has focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course and outcomes of this infection. While diabetes does not seem to be associated with an increased risk of COVID19 infection per se, it has been clearly demonstrated that the presence of hyperglycemia of any degree predisposes to worse outcomes, such as more severe respiratory involvement, ICU admissions, need for mechanical ventilation and mortality. Further, COVID19 infection has been associated with the development of new-onset hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic damage by the virus, body’s stress response to infection (including cytokine storm) and use of diabetogenic drugs such as corticosteroids in the treatment of severe COVID19. In addition, public health measures taken to flatten the pandemic curve (such as lockdowns) can also adversely impact persons with diabetes by limiting their access to clinical care, healthy diet, and opportunities to exercise. Most antidiabetic medications can continue to be used in patients with mild COVID19 but switching over to insulin is preferred in severe disease.
Serum BCMA levels predict outcomes in MGUS and smoldering myeloma patients
Authors: Visram A. , Soof C. , Rajkumar S. V. , Kumar S. K. , Bujarski S. , Spektor T. M. , Kyle R. A. , Berenson J. R. , Dispenzieri A.
Published: June 2021

Soluble BCMA (sBCMA) levels are elevated in monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). However, the association between sBCMA levels and prognosis in MGUS and SMM has not been studied. We retrospectively analyzed sBCMA levels in stored samples from 99 MGUS and 184 SMM patients. Baseline sBCMA levels were significantly higher in MGUS and SMM patients progressing to MM during clinical follow up. When stratified according to the median baseline sBCMA level for each cohort, higher levels were associated with a shorter PFS for MGUS (HR 3.44 comparing sBCMA ≥77 vs <77 ng/mL [95% CI 2.07–5.73, p < 0.001] and SMM (HR 2.0 comparing sBCMA ≥128 vs <128 ng/mL, 95% 1.45–2.76, p < 0.001) patients. The effect of sBCMA on PFS was similar even after adjusting for the baseline MGUS or SMM risk stratification. We evaluated paired serum samples and found that sBCMA increased significantly in MGUS and SMM patients who eventually progressed to MM, whereas among MGUS non-progressors the sBCMA level remained stable. While our results require independent validation, they suggest that sBCMA may be a useful biomarker to identify MGUS and SMM patients at increased risk of progression to MM independent of the established risk models.