bluuebunny/crossref_metadata_2025 huggingface dataset:
The 1864 Invasion of Missouri
Authors: Beilein Joseph M.
Published: October 2021

In the fall of 1864, Confederate Maj. Gen. Sterling Price led a raid into his beloved state of Missouri that combined the efforts of guerrilla forces with those of his own Army of Missouri. Although the campaign proved disastrous for the Confederacy, it demonstrated the strategic potential of guerrilla and “conventional” troops working in concert with one another, if only for an instant. Missouri’s Southern-sympathizing guerrillas created havoc and served to distract Union troops away from Price’s invasion force. Price, meanwhile, restored some measure of hope to the state’s Southern White populace. By the end, though, it was too little too late: Price was unable to retake St. Louis or any other population center before the presidential election in November of that year, and many of the most powerful guerrilla leaders who came out to support the raid were killed and their supporters’ supplies all but exhausted.
Collective Decision-Making and Administrative Justice
Authors: Sant'Ambrogio Michael , Zimmerman Adam S.
Published: October 2021

This chapter considers how administrative agencies in different countries use aggregate procedures to hear common claims brought by large groups of people. In many countries, administrative agencies promise each individual a ‘day in court’ to appear before a neutral decision-maker and receive a reasoned decision based on the factual record they develop. A handful of US and other countries’ administrative hearing programmes, however, have quietly bucked this trend—using class actions, statistical sampling, agency restitution, public inquiries, ‘test case’ proceedings, and other forms of mass adjudication to resolve disputes involving large groups of people. This chapter examines how administrative agencies can more effectively resolve common disputes with aggregate procedures. Aggregate procedures offer administrative agencies several benefits, including: 1) efficiently creating ways to pool information about recurring problems and enjoin systemic harms; 2) achieving greater equality in outcomes than individual adjudication; and 3) securing legal and expert assistance at critical stages in the process. By charting how administrative systems in different countries aggregate cases, we hope to show that collective hearing procedures can form an integral part of the adjudicatory process, while serving several different models of administrative justice.
Christian-Muslim Relations in the Shadow of Conflict
Authors: Scacco Alexandra , Warren Shana S.
Published: October 2021

In February 2000, large-scale Christian-Muslim riots shook the Nigerian city of Kaduna, killing thousands of people and displacing tens of thousands more. Drawing on original survey data from a random sample of three hundred young men living in particularly conflict-prone neighborhoods in Kaduna, the chapter analyzes patterns of Christian-Muslim relations fifteen years after the February 2000 crisis. The author argues that local exposure to deadly intergroup violence continues to have profoundly negative effects on intergroup relations nearly two decades later. Kaduna residents on either side of the religious divide continue to exhibit high levels of mistrust and prejudice against members of the religious out-group, and demonstrate substantial out-group discrimination in behavioral games with real material stakes. The chapter highlights three interrelated consequences of exposure to large-scale episodes of intercommunal violence, each of which complicates post-conflict reconciliation: (1) the erosion of intergroup trust, (2) the tendency that the violence increases local residential segregation along communal lines, and (3) lasting psychological effects. The chapter offers micro-level evidence on each of these consequences from the Nigerian context, and cautions against expectations that post-conflict communities should quickly bounce back from large-scale interreligious violence.
The Feminization of Social Media Labor
Authors: Bishop Sophie , Duffy Brooke Erin
Published: October 2021

While early techno-utopianists heralded the potential of the internet to challenge social hierarchies, most would concede that today’s digital media landscape is profoundly inequitable. Traditional markers of identity and inequality—including subjectivities of gender and femininity—persist online and are foregrounded across mainstream social media platforms like YouTube, Instagram, Pinterest, and TikTok. Against this backdrop, this chapter explores the ostensible feminization of various modes of social media labor, with particular attention to the cultures and practices of social media production and promotion (i.e., platformed content creation, digital entrepreneurship, social media management). To show how these activities are—much like earlier categories of “women’s work”—rendered socially and/or economically invisible, the authors examine four interrelated features of feminized labor: (1) the demand for emotional and affective expressions, (2) the discipline of aesthetics through the fraught ideal of “visibility,” (3) mandates for various kinds of flexibility, and (4) a deep imbrication with consumer capitalism. In exploring each of these features, the authors show how the patterned devaluation of gender-coded labor is exacerbated along other axes of oppression, including race, class, ethnicity, and sexuality. The authors conclude by calling for future inquiries into other cultures and expressions of social media labor, along with broader interrogations of platform visibility, vulnerability, and governance.
Environment and Development
Authors: Hochstetler Kathryn
Published: October 2021

The divide between developed and developing countries has been a central organizing component of the comparative study of environmental politics and policy. This chapter argues that, much as international climate negotiations have moved away from a hard division, the study of comparative environmental politics should, too. The singling out of developing countries for a distinct treatment has meant overemphasis on a small set of—admittedly very important—topics like natural resource management and underemphasis on classic themes of comparative politics. In addition, it has allowed scholars of environmental politics in developed countries to write as though the range of empirical outcomes on a given topic is much smaller than it actually appears worldwide. Developed countries themselves increasingly act outside their presumed “normal” range, especially as recent populist governments have challenged scientific knowledge and democratic norms. As a result, both sides of the divide need fresh approaches that make fewer assumptions about the nature of environmental politics.
Legal Ethnology and Legal Anthropology in Hungary
Authors: Fekete Balázs
Published: October 2021

In this chapter, the history of legal ethnology and of legal anthropology in Hungary are viewed within a common frame. Contemporary Hungarian legal anthropologists see earlier legal ethnologists as important precursors; however, they also recognize that legal ethnology cannot be directly revitalized in the post-transitional period. Four phases of the history of these approaches to law in sociocultural context are discussed: (1) the birth of ethnographic interest in law around 1900; (2) the legislative programme focusing on the in-depth study of folk law at the end of the interwar period; (3) the decline and rehabilitation of legal ethnology in the socialist era; and (4) the emergence of ‘Western-style’ legal anthropology beginning in the 1990s. The chapter concludes with the observation that the conditions for the further development of legal anthropology in Hungary seem to be unfavourable.
The Cultural Defence
Authors: Dundes Renteln Alison
Published: October 2021

This chapter considers how arguments based on cultural traditions and customary law influence the reasoning of judges in various jurisdictions through the use of cultural defences. A survey of cases reveals that judges consistently refuse to allow the introduction of evidence concerning litigants’ cultural backgrounds in legal proceedings. As explained here, the prescriptive version of cultural relativism calls attention to the context in which individuals act under cultural imperatives. It is the underlying theory that justifies culturally specific notions of reasonableness in criminal law and civil litigation. Although the defence is sometimes understood as limited to criminal cases, the chapter demonstrates how cultural factors also figure in cases involving exemptions and calculating damages in civil litigation. The chapter identifies several types of culture conflict, considers a theoretical framework for analysing cultural defences, and discusses practical difficulties associated with the implementation of the cultural defence policy. Anthropologists are often asked to serve as expert witnesses in these cases. How their involvement in the justice system may affect their professional reputations is also assessed. The final section offers suggestions as to likely new areas where cultural defences will be raised, such as military tribunals and educational systems. While proponents of the strategy contend that the courtroom door should be open to cultural argumentation, this does not mean the cultural factors should necessarily influence the disposition of the cases, particularly if the customs central to the dispute involve irreparable harm.
The Greek Crown Games
Authors: Mari Manuela , Stirpe Paola
Published: October 2021

The crowns of the four major Panhellenic crown games reveal the religious and symbolic meaning of the plants of whose leaves they were made. Special attention will also be paid to the historical, political, and socio-economic reasons why these four festivals became the most prestigious and popular in the Greek world from the archaic period onwards. Texts and inscriptions reveal many organizational features of the games. The wider regional function of the festivals is evidenced even in organization. The games were also important occasions for trading, for communicating news of international relevance, for announcing military and political initiatives and building up alliances, or for advertising literary and artistic works. Victor lists, ‘archival documents’, monuments and dedications at the sites preserved public memories and created cultural unities. The prestige of crown games was shared by many local games designated as ‘isolympic’, ‘isopythian’, and so on during the Hellenistic and Roman periods.
Paul and Israel
Authors: Thiessen Matthew , Fredriksen Paula
Published: October 2021

When Paul says ‘Israel’, what or whom does he have in mind? Christian theological tradition has long answered that by ‘Israel’, a universalist Paul means ethnically non-specific ‘Christians’. But a great deal of evidence in Paul’s letters weighs against such an idea. This chapter examines, in turn, the modern myth of a post-ethnic Paul, ancient ideas about divine and human ethnicity, Paul’s language about Jewish and gentile ‘natures’, Paul’s language about Jewish and Gentile kinds of sins, Paul’s application of different Jewish laws to Jews and Gentiles, respectively, and finally Paul’s actual usage of the ethnonyms ‘Jew’ and ‘Israel’. It is concluded that, for Paul, Jews are Israel, and Israel, his own family, is the Jews. God, through Christ, at the end of the ages (mid-first century ce), was graciously calling all humanity into the redemption that he had promised to Israel long ago. Eschatological humanity thus remains two different people groups—Israel and the nations—embraced by a single salvation.
Advances in enzyme-mediated proximity labeling and its potential for plant research
Authors: Mair Andrea , Bergmann Dominique C
Published: October 2021

Cellular processes rely on the intimate interplay of different molecules, including DNA, RNA, proteins, and metabolites. Obtaining and integrating data on their abundance and dynamics at high temporal and spatial resolution are essential for our understanding of plant growth and development. In the past decade, enzymatic proximity labeling (PL) has emerged as a powerful tool to study local protein and nucleotide ensembles, discover protein–protein and protein–nucleotide interactions, and resolve questions about protein localization and membrane topology. An ever-growing number and continuous improvement of enzymes and methods keep broadening the spectrum of possible applications for PL and make it more accessible to different organisms, including plants. While initial PL experiments in plants required high expression levels and long labeling times, recently developed faster enzymes now enable PL of proteins on a cell type-specific level, even with low-abundant baits, and in different plant species. Moreover, expanding the use of PL for additional purposes, such as identification of locus-specific gene regulators or high-resolution electron microscopy may now be in reach. In this review, we give an overview of currently available PL enzymes and their applications in mammalian cell culture and plants. We discuss the challenges and limitations of PL methods and highlight open questions and possible future directions for PL in plants.
DOSE ASSESSMENT WITH DIFFERENT METHODS AFTER EXPOSURE TO 14C-LABELLED COMPOUNDS
Authors: Pántya Annamária , Zagyvai Péter , Remeli Anton , Tyukodi Lajos , Pázmándi Tamás
Published: October 2021

An accidental intake of 14C-labelled compound has been followed by long-term monitoring of urine samples. First, the intake and the committed effective dose have been calculated by a generally recommended method and as the value exceeded the investigation level, special dose estimation was performed. Recommendations from ICRP Publications were used for analyses but the measurement data did not fit these models, so the recommended parameter values were deemed incorrect for this compound and this exposure situation. With the measurement data, it was possible to set up a case-specific model based on the actual excretion functions. Afterwards, the committed effective dose was obtained from integrating the total number of decays in the body over 50 y. This case shows that 14C-labelled organic compounds could be very unique when they get incorporated into the body and the absorption and deposition parameters should be used with special care when estimating the dose.
Comparing Continuous and Binary Group-based Trajectory Modeling Using Statin Medication Adherence Data
Authors: Hickson Ryan P. , Annis Izabela E. , Killeya-Jones Ley A. , Fang Gang
Published: October 2021

Background:

Of 58 medication adherence group-based trajectory modeling (GBTM) published studies, 74% used binary and 26% used continuous GBTM. Few studies provided a rationale for this choice. No medication adherence studies have compared continuous and binary GBTM.

Objective:

The objective of this study was to assess whether continuous versus binary GBTM: (1) impacts adherence trajectory shapes; and (2) results in the differential classification of patients into adherence groups.

Methods:

Patients were prevalent statin users with myocardial infarction hospitalization, 66+ years old, and continuously enrolled in fee-for-service Medicare. Statin medication adherence was measured 6 months prehospitalization using administrative claims. Final GBTM specifications beyond default settings were selected using a previously defined standardized procedure and applied separately to continuous and binary (proportion of days covered ≥0.80) medication adherence measures. Assignment to adherence groups was compared between continuous and binary models using percent agreement of patient classification and the κ coefficient.

Results:

Among 113,296 prevalent statin users, 4 adherence groups were identified in both models. Three groups were consistent: persistently adherent, progressively nonadherent, and persistently nonadherent. The fourth continuous group was moderately adherent (progressively adherent in the binary model). When comparing patient assignment into adherence groups between continuous and binary trajectory models, only 78.4% of patients were categorized into comparable groups (κ=0.641; 95% confidence interval: 0.638–0.645). The agreement was highest in the persistently adherent group (∼94%).

Conclusions:

Continuous and binary trajectory models are conceptually different measures of medication adherence. The choice between these approaches should be guided by study objectives and the role of medication adherence within the study—exposure, outcome, or confounder.
Flexible Tongue-in-Groove Technique and Its Effectiveness Compared to Classic Tongue-in-Groove and Columellar Strut Graft Techniques: A Retrospective Analysis of 237 Open Rhinoplasty Cases
Authors: Erdal Ayhan Işik , Genç İbrahim Giray , Pasinlioğlu Burak , Findikçioğlu Kemal
Published: October 2021

Background:

The medial crura are almost always supported in tip surgery using columellar strut graft placement or tongue-in-groove suturing to the caudal septum. In this study, the authors present a modified tongue-in-groove (called “flexible tongue-in-groove”) technique.

Methods:

A total of 237 patients who underwent open rhinoplasty between January of 2016 and June of 2018 were included in this retrospective study. The patients were divided into three main groups: (1) flexible tongue-in-groove, (2) classic tongue-in-groove, and (3) columellar strut. Using standardized preoperative and postoperative (1-, 6-, and 12-month) lateral view photographs, the nasolabial angle and Goode ratio were measured for nasal tip rotation and projection, respectively.

Results:

Flexible tongue-in-groove (n = 53) and classic tongue-in-groove (n = 107) techniques showed a significantly smaller decrease in the nasolabial angle from month 1 to month 12 than did the columellar strut technique (n = 77) (p < 0.05). These statistically significant differences were not found when the time intervals were narrowed (p > 0.05). Flexible and classic tongue-in-groove techniques showed significantly higher Goode ratios than did the columellar strut technique at 1, 6, and 12 months (p < 0.05 for all). In various analyses using the nasolabial angle and Goode ratio, no statistically significant difference was found between flexible and classic tongue-in-groove techniques (p > 0.05).

Conclusions:

Flexible and classic tongue-in-groove techniques provide more durable results in nasolabial angle and Goode ratio measurements than does the columellar strut technique in primary open-approach rhinoplasty. The flexible tongue-in-groove technique is as robust as the classic tongue-in-groove technique in appropriate cases.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
A Novel Classification of the Inframammary Fold for Use in Primary Breast Augmentation
Authors: Phillips Nicole A. , Millan Lincoln S. , Miroshnik Michael , Stradwick Luke , Layt Craig
Published: October 2021

Background:

Previous aesthetic breast surgery algorithms have not addressed the importance of evaluating the native inframammary fold before primary breast augmentation. In the authors’ experience, assessment of native inframammary fold anatomy significantly impacts surgical planning and technique. Failure to adequately evaluate and manage the inframammary fold leads to many of the common problems of the lower pole, including double-bubble deformity.

Methods:

The authors assessed the inframammary fold preoperatively in 2192 consecutive patients undergoing primary breast augmentation between June of 2014 and December of 2018. A novel classification of inframammary fold morphology was devised based on review of standardized preoperative photographs. Outcome assessment was performed postoperatively at 3-month intervals.

Results:

The authors identified four clear inframammary fold subtypes based on their clinical appearance, ranging from the nonexistent type F0 to the well-formed and fixed type F3. The key outcome measure examined was the presence of double-bubble deformity postoperatively. There were three total cases of double-bubble deformity identified in our cohort (<1 percent of patients). All cases of double-bubble deformity occurred in patients with a type 3 fold.

Conclusions:

The inframammary fold defines the inferior boundary of the lower pole of the breast and is a critical landmark to the aesthetic breast surgeon. The authors describe a unique and simple inframammary fold classification system that assists in selection of the appropriate approach to the inframammary fold in addition to implant dimensional planning. The authors have found that this system—in particular, the identification of the type F3 inframammary fold—has minimized the risk of inframammary fold–associated complications in over 2000 cases.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
The Prevalence of Adverse Childhood Experiences, Body Shame, and Revision Request Rate in 218 Plastic Surgery Patients: What Drives Postoperative Dissatisfaction?
Authors: Constantian Mark B. , Zaborek Nick
Published: October 2021

Background:

What drives patients who are unhappy despite good results? Adverse childhood experiences are common, can impair adult health, and can cause body shame. Neither adverse childhood experiences nor body shame has been studied in surgical patients. The authors report adverse childhood experience prevalences in a plastic surgical population and investigate associations from adverse childhood experiences to body shame and to postoperative dissatisfaction.

Methods:

Two hundred eighteen consecutive patients (86 percent aesthetic and 14 percent reconstructive) completed the Adverse Childhood Experiences Survey and the Experience of Shame Scale. A one-sample test of proportions, logistic regression, and mediation analysis assessed outcomes.

Results:

Compared to the Kaiser/Centers for Disease Control and Prevention medical population, our patients had higher overall adverse childhood experience prevalences (79.8 percent versus 64 percent), emotional abuse (41 percent versus 11 percent), emotional neglect (38 percent versus 15 percent), family substance abuse (36 percent versus 27 percent), and family mental illness (29 percent versus 19 percent, all p < 0.001). Fifty-two percent of our patients had body shame. Adverse Childhood Experiences score predicted body shame (OR, 1.22; p = 0.003). Compared to unshamed patients, body shame was associated with more adverse childhood experiences (85 percent versus 72 percent), higher median Adverse Childhood Experiences score (3.5 versus 2), more cosmetic operations (three versus zero), more health problems (three versus two), higher antidepressant use (39 percent versus 19 percent), substance abuse history (16 percent versus 5 percent), and demands for additional pain medication (18 percent versus 5 percent). Body shame predicted requests for surgical revision (49 percent versus 17 percent; OR, 4.61; all p ≤ 0.0001).

Conclusions:

Adverse childhood experience were common in our patients. Adverse Childhood Experiences score predicted body shame, which predicted revision requests. If body shame preceded and drove surgery, revision requests were likely. Patients desiring revisions had recognizable characteristics.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.
Flying Without a Net: Space Radiation Cancer Risk Predictions without a Gamma-Ray Basis
Authors: Cucinotta Francis A.
Published: October 2021

It is well known that the spatial distribution of ionization in cells and tissue from heavy ions and other high linear energy transfer (LET) radiation leads to qualitative and quantitative differences in biological effects compared to low LET radiation such as gamma-rays. However, models used to estimate risks involve extensive use of gamma-ray data, including low LET radiation epidemiology, the role of gamma-rays in estimates of quality factors (QF), and the dose and dose-rate reduction effectiveness factor (DDREF). In tumor induction studies, high LET radiation typically have demonstrable dose responses in many animal strains and tissue, while gamma-ray exposures often lead to a weak or poorly determined dose response at low to moderate doses (<2 Gy) leading to large uncertainties in QF estimates. Here we consider an alternate risk prediction approach, avoiding low epidemiology, the QF and DDREF, by formulating a fluence based track structure model of excess relative risk (ERR) with parameters estimated from animal studies with heavy ions and neutrons for the induction for lung and breast cancer in females and liver cancer in males. The ERR model is applied directly with cancer rates for the US population to predict lifetime risks to astronauts at solar minimum. Results for male liver and female breast cancer risk show that the ERR model agrees fairly well with estimates of a QF model with estimates of non-targeted effects (NTE), and is about 2-fold higher than the QF model that ignores NTE. The effective damage area derived by the ERR model for breast and liver tumors is several times that of a mammalian cell nucleus, which suggests NTE likely contribute to cancer risk. For female lung cancer risk, the ERR model predicts 2-fold and 5-fold lower risk compared to the QF models with or without NTE, respectively. We suggest that the direct ERR approach when coupled with improved experimental models of tissue specific cancers representing human risks would lead to large reductions in the uncertainties in space radiation risk projections by avoiding low LET uncertainties.
Antimicrobial consumption in pediatric intensive care units during the first year of COVID-19 pandemic
Authors: Porto MFM , de Oliveira CSM , Pires MEO , Santos RRQ , Teixeira CH , Souza CV , Araujo da Silva AR
Published: October 2021

Introduction

The absence of standardized treatment for critical children admitted in pediatric intensive care units (PICUs) with COVID could lead to an increase in antimicrobial consumption, as indirect effect.

Aim

To describe trends of antimicrobial consumption in two PICUs before and during the COVID pandemic year.

Methods

We did a retrospective study in children admitted in two PICUs of Rio de Janeiro city, between March 2019 and March 2021. The first year represented the pre-pandemic period and the last one the pandemic period. Trends of antimicrobial consumption were measured by days of therapy (DOT/1000 patient-days) and analyzed by linear regression for antibiotics, antivirals and antifungals

Results

Number of patients-days in the PICU 1 was 3495 in the pre-pandemic period and 3600 in the pandemic period. The overall DOT/1000 PD of antibiotics, antivirals and antifungal was 15,308.1, 942.8 and 1,691.1, respectively in the pre-pandemic period and 13,481.5, 1,335.4 and 1,243.7, respectively in pandemic period. It was verified trend of reduction of antibiotic and antifungals and increase in antivirals consumption. Number of patients-days in the PICU 2 was 5029 in the pre-pandemic period and 4557 in the pandemic period and the overall DOT/1000 PD of antibiotics, antivirals and antifungal was 16,668.5, 1,385 and 1,966.7, respectively in the pre-pandemic period and 10,896.5, 830.7 and 677.3 in pandemic period. It was verified trend of reduction of antibiotic, antivirals and antifungals consumption.

Conclusion

Trends of antimicrobial consumption reduction were verified for antibiotics and antifungals in two PICUs and reduction for antiviral in one of them
Trans-ancestry genome-wide association study of gestational diabetes mellitus highlights genetic links with type 2 diabetes
Authors: Pervjakova Natalia , Moen Gunn-Helen , Borges Maria-Carolina , Ferreira Teresa , Cook James P , Allard Catherine , Beaumont Robin N , Canouil Mickaël , Hatem Gad , Heiskala Anni , Joensuu Anni , Karhunen Ville , Kwak Soo Heon , Lin Frederick TJ , Liu Jun , Rifas-Shiman Sheryl , Thorleifsson Gudmar , Andrew Toby , Auvinen Juha , Bhowmik Bishwajit , Bonnefond Amélie , Delahaye Fabien , Demirkan Ayse , Froguel Philippe , Haller-Kikkatalo Kadri , Hardardottir Hildur , Hummel Sandra , Hussain Akhtar , Kajantie Eero , Keikkala Elina , Khamis Amna , Lahti Jari , Lekva Tove , Mustaniemi Sanna , Sommer Christine , Tagoma Aili , Tzala Evangelia , Uibo Raivo , Vääräsmäki Marja , Villa Pia M , Birkeland Kåre I , Bouchard Luigi , Duijn Cornelia M , Finer Sarah , Groop Leif , Hämäläinen Esa , Hayes Geoffrey M , Hitman Graham A , Jang Hak C , Järvelin Marjo-Riitta , Jenum Anne Karen , Laivuori Hannele , Melander Olle , Oken Emily , Park Kyong Soo , Perron Patrice , Prasad Rashmi B , Qvigstad Elisabeth , Sebert Sylvain , Stefansson Kari , Steinthorsdottir Valgerdur , Tuomi Tiinamaija , Hivert Marie-France , Franks Paul W , McCarthy Mark I , Lindgren Cecilia M , Freathy Rachel M , Lawlor Deborah A , Morris Andrew P , Mägi Reedik
Published: October 2021

Gestational diabetes mellitus (GDM) is associated with increased risk of pregnancy complications and adverse perinatal outcomes. GDM often reoccurs and is associated with increased risk of subsequent diagnosis of type 2 diabetes (T2D). To improve our understanding of the aetiological factors and molecular processes driving the occurrence of GDM, including the extent to which these overlap with T2D pathophysiology, the GENetics of Diabetes In Pregnancy (GenDIP) Consortium assembled genome-wide association studies (GWAS) of diverse ancestry in a total of 5,485 women with GDM and 347,856 without GDM. Through trans-ancestry meta-analysis, we identified five loci with genome-wide significant association (p<5×10−8) with GDM, mapping to/nearMTNR1B(p=4.3×10−54),TCF7L2(p=4.0×10−16),CDKAL1(p=1.6×10−14),CDKN2A-CDKN2B(p=4.1×10−9) andHKDC1(p=2.9×10−8). Multiple lines of evidence pointed to genetic contributions to the shared pathophysiology of GDM and T2D: (i) four of the five GDM loci (notHKDC1) have been previously reported at genome-wide significance for T2D; (ii) significant enrichment for associations with GDM at previously reported T2D loci; (iii) strong genetic correlation between GDM and T2D; and (iv) enrichment of GDM associations mapping to genomic annotations in diabetes-relevant tissues and transcription factor binding sites. Mendelian randomisation analyses demonstrated significant causal association (5% false discovery rate) of higher body mass index on increased GDM risk. Our results provide support for the hypothesis that GDM and T2D are part of the same underlying pathology but that, as exemplified by theHKDC1locus, there are genetic determinants of GDM that are specific to glucose regulation in pregnancy.
Nutrition Policies in Germany: A Systematic Assessment with the Food Environment Policy Index (Food-EPI)
Authors: von Philipsborn Peter , Geffert Karin , Klinger Carmen , Hebestreit Antje , Stratil Jan , Rehfuess Eva ,   for the PEN Consortium
Published: October 2021

Objective

To systematically assess Germany’s nutrition policies, to benchmark them against international best practices, and to identify priority policy actions to improve population-level nutrition in Germany.

Design

We applied the Food Environment Policy Index (Food-EPI), a methodological framework developed by the INFORMAS network. Qualitative content analysis of laws, directives and other documents formed the basis of a multi-staged, structured consultation process.

Setting

Germany.

Participants

The expert consultation process included 55 experts from academia, public administration, and civil society.

Results

Germany lags behind international best practices in several key policy areas. For 18 policy indicators, the degree of implementation compared to international best practices was rated as very low, for 21 as low, for 8 as intermediate, and for none as high. In particular, indicators on food taxation, regulation of food marketing, and retail and food service sector policies were rated as very low to low. Identified priority actions included the binding implementation of nutrition standards for schools and kindergartens, a reform of the value added tax on foods and beverages, a sugar-sweetened beverage tax and stricter regulation of food marketing directed at children.

Conclusions

The results show that Germany makes insufficient use of the potential of evidence-informed health-promoting nutrition policies. Adopting international best practices in key policy areas could help to reduce the burden of nutrition-related chronic disease and related inequalities in nutrition and health in Germany. Implementation of relevant policies requires political leadership, a broad societal dialogue, and evidence-informed advocacy by civil society, including the scientific community.
Impact of Recent Job Loss on Sleep, Energy Consumption and Diet
Authors: Batool-Anwar Salma , Mayer Candace , Haynes Patricia L. , Liu Yilin , Thomson Cynthia A. , Quan Stuart F.
Published: October 2021

To examine how sleep quality and sleep duration affect caloric intake among those experiencing involuntary job loss.

Methods

Adequate sleep and self reported dietary recall data from the Assessing Daily Activity Patterns through Occupational Transitions (ADAPT) study was analysed. Primary sleep indices used were total sleep time, time spent in bed after final awakening, and sleep quality as measured by the Daily Sleep Diary (DSD). Mean Energy consumption (MEC) was the primary nutritional index. Secondary indices included diet quality using the Health Eating Index 2015 (HEI), and self-reported intake of protein, carbohydrates and fats.

Results

The study participants were comprised mainly of women (61%) and non-Hispanic white. The participants had at least 2 years of college education and mean body mass index of 30.2±8.08 (kg/m 2). The average time in bed was 541.8±77.55 minutes and total sleep time was 461.1±56.49 minutes. Mean sleep efficiency was 91±6%, self-reported sleep quality was 2.40±0.57 (0-4 scale, 4 = very good), and minutes earlier than planned morning awakening were 14.36±24.15. Mean HEI score was 47.41±10.92. Although the MEC was below national average for both men and women, male sex was associated with higher MEC. In a fully adjusted model sleep quality was positively associated with MEC.

Conclusion

Daily overall assessments of sleep quality among recently unemployed persons were positively associated with mean energy consumption. Additionally, the diet quality of unemployed persons was found to unhealthier than the average American and consistent with the relationship between poor socioeconomic status and lower diet quality.
Comparison of endoscopic activity before and during the covid pandemic at a tertiary care hospital in South Punjab
Authors: Din Chaudhary Farooq Mohyud , Gul Muhammad Asif , Hameed Nouman , Hameed Rizwan , Zaidi Yasir , Kanju Shehryar , Tameez-ud-din Ahsan , Altaf Syeda Manal , Ud Din Asma Tameez
Published: October 2021

Introduction

Coronavirus disease 2019 (COVID-19) has resulted in dramatic changes to health-care delivery. Endoscopic activity has had frequent disruptions during this pandemic. The objective of the study was to see the influence of pandemic over the endoscopic activity.

Methods

This retrospective analysis of endoscopic activity was undertaken at Nishtar Hospital Multan. Procedural analysis was done in the three months immediately after covid lockdown (1st April till 30th June 2020) and was compared to a similar period one year back.

Results

Five hundred and fifty-four (68.5%) patients underwent endoscopic procedures during the three months of pre-COVID era, while this number reduced to half (n=255, 31.5%) patients during the covid pandemic. Even though the absolute number of Esophagogastroduodenoscopies (EGDs) reduced during the pandemic, patients were more likely to undergo EGDs during the COVID pandemic in contrast to the era before the pandemic (79% versus 66%, p = 0.002). The most common indication for EGD was upper gastrointestinal bleeding (UGIB). The percentage of EGDs done for UGIB rose from almost 60% to 80% during the covid pandemic (p < 0.001). The most common findings were esophageal varices and portal gastropathy (non-significant difference during and before the pandemic). Percentage of ERCPs done for obstructive jaundice doubled during the COVID pandemic (33% versus 65%, p = 0.002).The most common indication for sigmoidoscopy or colonoscopy was lower gastrointestinal bleeding. However, no significant difference was found before and during the covid pandemic (41.7% and 45.8% respectively, p=0.72). Internal hemorrhoids were the most common endoscopic finding. Colon cancer diagnosis reduced from 10% to undetected during the pandemic period.

Conclusion

COVID pandemic resulted in considerable reduction in all type of endoscopic procedures. Majority of procedures were done for emergency indications like gastrointestinal bleeding. Rates of cancer detection was significantly reduced.
SPECIFIC DETECTION OF SARS-COV-2 VARIANTS B.1.1.7 (ALPHA) AND B.1.617.2 (DELTA) USING A ONE-STEP QUANTITATIVE PCR ASSAY
Authors: Erster Oran , Mendelson Ella , Kabat Areej , Levy Virginia , Menasheh Batya , Asraf Hadar , Azar Roberto , Ali Yaniv , Bucris Efrat , Bar-Ilan Dana , Mor Orna , Elul Michal , Mandelboim Michal , Sofer Danit , Fleishon Shai , Zuckerman Neta S , Bar-Or Itay
Published: October 2021

In this report, we describe the development of an RT-qPCR assay, termed Alpha Delta assay, which can detect SARS-COV-2 (SC-2) and distinguish between the Alpha (B.1.1.7) and Delta (B.1.617.2) variants. The Alpha- and Delta-specific reactions in the assay target mutations that are strongly linked to the target variant. The Alpha reaction targets the D3L substitution in N gene, and the Delta reaction targets the spike gene 156-158 mutations. Additionally, we developed a second Delta-specific assay, used as a confirmatory test for the Alpha Delta assay that targets the 119-120 deletion in the Orf8 gene. Both reactions have similar sensitivities of 15-25 copies per reaction, similar to the sensitivity of commercial SC-2 detection tests. The Alpha Delta assay and the Orf8-119del assay were successfully used to classify clinical samples that were subsequently analyzed by whole genome sequencing. Lastly, we show that the Alpha Delta and Orf8-119del assays correctly identified the presence of Alpha and Delta lineages RNA in wastewater samples. This study provides a rapid, sensitive and cost-effective tool for detecting and classifying two worldwide dominant SC-2 variants. It also highlights the importance of a timely diagnostic response to the emergence of new SC-2 variants with significant consequences on global health.
The GenoDiabMar registry. A collaborative research platform of “real world” type 2 diabetes patients
Authors: Sierra Adriana , Otero Sol , Rodríguez Eva , Faura Anna , Vera María , Riera Marta , Palau Vanesa , Durán Xavier , Costa-Garrido Anna , Sans Laia , Márquez Eva , Poposki Vladimir , Franch-Nadal Josep , Mundet Xavier , Oliveras Anna , Crespo Marta , Pascual Julio , Barrios Clara
Published: October 2021

The GenoDiabMar registry is a prospective study aims to provide data on demographic, biochemical and clinical changes, from a “real-world” population of Type 2 DM (T2D) patients. This registry is addressed to find new biomarkers related to the micro and macrovascular complications of T2D, especially focused on diabetic nephropathy. The registry includes longitudinal serum and urine samples, DNA bank, as well as data on 227 metabolomics profiles, 77 Immunoglobulin G glycomics traits and others emerging biomarkers. 650 patients aged 69.56 ±9.31 with different grades of chronic kidney disease; (G1-2 50.3%, G3 31.4%, G4 10.8% and G5 7.5%) were followed up for 4.96 (±0.43) years. Regardless of albuminuria, women lost 0.93 (0.40-1.46) glomerular filtration units per year less than men. 17% of the participant experienced rapid progression of renal function, 75.2% men, with differential risk factors between sexes; severe macroalbuminuria >300mg/g for men OR[IQ] 2.40 [1.29:4.44] and concomitant peripheral vascular disease 3.32 [1.10:9.57] for women. An overall mortality of 23% was detected (38% due to Cardiovascular aetiology).

This cohort is postulated as a great tool for scientific collaboration for studies, whether they are focused on T2D, or whether they are interested in comparing differential markers between diabetic and non-diabetic populations.
COVID-19 and Mental Health: Predicted Mental Health Status is Associated with Clinical Symptoms and Pandemic-Related Psychological and Behavioral Responses
Authors: Chung Joyce Y. , Gibbons Alison , Atlas Lauren , Ballard Elizabeth , Ernst Monique , Japee Shruti , Farmer Cristan , Shaw Jacob , Pereira Francisco
Published: October 2021

Background

The COVID-19 pandemic led to dramatic threats to health and social life. Study objectives - develop a prediction model leveraging subsample of known Patient/Controls and evaluate the relationship of predicted mental health status to clinical outcome measures and pandemic-related psychological and behavioral responses during lockdown (spring/summer 2020).

Methods

Online cohort study conducted by National Institute of Mental Health Intramural Research Program. Convenience sample of English-speaking adults (enrolled 4/4–5/16/20; n=1,992). Enrollment measures: demographics, clinical history, functional status, psychiatric and family history, alcohol/drug use. Outcome measures (enrollment and q2 weeks/6 months): distress, loneliness, mental health symptoms, and COVID-19 survey. NIMH IRP Patient/Controls survey responses informed assignment of Patient Probability Scores (PPS) for all participants. Regression models analyzed the relationship between PPS and outcome measures.

Outcomes

Mean age 46.0 (±14.7), female (82.4%), white (88.9 %). PPS correlated with distress, loneliness, depression, and mental health factors. PPS associated with negative psychological responses to COVID-19. Worry about mental health (OR 1.46) exceeded worry about physical health (OR 1.13). PPS not associated with adherence to social distancing guidelines but was with stress related to social distancing and worries about infection of self/others.

Interpretation

Mental health status (PPS) was associated with concurrent clinical ratings and COVID-specific negative responses. A focus on mental health during the pandemic is warranted, especially among those with mental health vulnerabilities. We will include PPS when conducting longitudinal analyses of mental health trajectories and risk and resilience factors that may account for differing clinical outcomes.

Funding

NIMH (ZIAMH002922); NCCIH (ZIAAT000030)
Alkyne modified purines for assessing activation of Plasmodium vivax hypnozoites and growth of pre-erythrocytic and erythrocytic stages in Plasmodium spp
Authors: Botnar Alona , Lawrence Grant , Maher Steven P. , Vantaux Amélie , Witkowski Benoît , Shiau Justine C. , Merino Emilio F. , De Vore David , Yang Christian , Murray Cameron , Cassera Maria B. , Leahy James W. , Kyle Dennis E.
Published: October 2021

Malaria is a major global health problem which predominantly afflicts developing countries. Although many antimalarial therapies are currently available, the protozoan parasite causing this disease, Plasmodium spp., continues to evade eradication efforts. One biological phenomenon hampering eradication efforts is the parasite’s ability to arrest development, transform into a drug-insensitive form, and then resume growth post-therapy. Currently, the mechanisms by which the parasite enters arrested development, or dormancy, and later recrudesces or reactivates to continue development, are unknown and the malaria field lacks techniques to study these elusive mechanisms. Since Plasmodium spp. salvage purines for DNA synthesis, we hypothesized that alkyne-containing purine nucleosides could be used to develop a DNA synthesis marker which could be used to investigate mechanisms behind dormancy. Using copper-catalyzed click chemistry methods, we observe incorporation of alkyne modified adenosine, inosine, and hypoxanthine in actively replicating asexual blood stages of P. falciparum and incorporation of modified adenosine in actively replicating liver stage schizonts of P. vivax. Notably, these modified purines were not incorporated in dormant liver stage hypnozoites, suggesting this marker could be used as a tool to differentiate replicating and non-replicating liver forms and, more broadly, a tool for advancing our understanding Plasmodium dormancy mechanisms.
TheLegionellaLqs-LvbR regulatory network controls temperature-dependent growth onset and bacterial cell density
Authors: Hochstrasser Ramon , Hilbi Hubert
Published: October 2021

Legionellaspecies are facultative intracellular pathogens, which can cause a life-threatening pneumonia termed Legionnaires’ disease.Legionella pneumophilaemploys theLegionellaquorum sensing (Lqs)-LvbR network to regulate virulence and motility, but its role for growth in media is ill-defined. Compared to the parentalL. pneumophilastrain JR32, a ΔlqsRmutant showed a reduced lag phase at 30°C and reached a higher cell density at 45°C, while the ΔlqsA, ΔlqsSand ΔlqsTmutants exhibited a longer lag phase and reached only a lower cell density. A ΔlvbRmutant resumed growth like the parental strain at 30°C, but exhibited a substantially reduced cell density at 45°C. Thus, LvbR is an important cell density regulator at elevated temperatures. A quantitative analysis of temperature-dependent growth characteristics of environmental and clinical strains revealed thatL. pneumophilastrains grew in AYE medium after distinct lag phases with similar rates at 30°C, reached different cell densities at the optimal growth temperature of 40°C, and no longer grew at 50°C.Legionella longbeachaereached a rather low cell density at 40°C and did not grow at and beyond 45°C. Genes encoding components of the Lqs-LvbR network were present in the genomes of the environmental and clinicalL. pneumophilaisolates, and the PlqsR, PlqsA, PlqsSand PlvbRpromoters from strain JR32 were active in these strains. Taken together, our results indicate that the Lqs-LvbR network governs the temperature-dependent growth onset and cell density of theL. pneumophilareference strain JR32, and possibly also of environmental and clinicalL. pneumophilaisolates.

Importance

Environmental bacteria of the genusLegionellaare the causative agents of the severe pneumonia Legionnaires’ disease, the incidence of which is worldwide on the rise.Legionella pneumophilaandLegionella longbeachaeare the clinically most relevant species. The opportunistic pathogens are inhaled through contaminated aerosols and replicate in human lung macrophages with a similar mechanism as in their natural hosts, free-living amoebae. Given their prevalence in natural and technical water systems, an efficient control ofLegionellaspp. by physical, chemical or biological means will reduce the incidence of Legionnaires’ disease. Here we report that theLegionellaquorum sensing (Lqs) system and the pleiotropic transcription factor LvbR govern the temperature-dependent growth onset and cell density of bacterial cultures. Hence, the growth ofL. pneumophilain water systems is not only determined by the temperature and nutrient availability, but also by quorum sensing, i.e., density- and signaling molecule-dependent gene regulation.