bluuebunny/crossref_metadata_2025 huggingface dataset:
The Pirate and the Admiral: Europeanisation and Globalisation of Maritime Conflict Management
Authors: Sicking Louis
Published: January 2021

Piracy holds a special place within the field of international law because of the universal jurisdiction that applies: any state may seize a pirate ship on the high seas and decide upon the penalties to be imposed, as is currently the case with Somali and West African pirates. Unlike today, piracy was the norm in pre-modern times. Maritime trade and piracy went hand in hand. At the same time, kings and emperors recruited their admirals from among pirates. This raises the question of how princes, states and cities distinguished between legal and illegal violence at sea. How did they deal with maritime conflict among themselves and among their respective subjects and citizens? This article puts maritime conflict management in a European, global and long term perspective while avoiding anachronistic and teleological approaches. Finally, it argues that pre-modern conflict management is relevant to understand maritime security in the twenty-first century.
Children sharing Preferences on Contact and Residence Arrangements in Child-inclusive Family Mediation in Norway
Authors: Grape Lovise , Thørnblad Renee , Handegård Bjørn Helge
Published: January 2021

Mediation is mandatory for all separating and divorcing parents in Norway with children under 16 years. The participation of children is voluntary. Living arrangement preferences presented by children attending child-inclusive family mediation in Norway (n = 346, aged 4–18 years) have been examined. 47.1 per cent of children gave a living arrangement preference, and older children were more likely to express a preference for living primarily with the mother compared to an equal time-sharing arrangement. Children very often gave reasoned explanations for their wishes. Children’s utilisation of the potential in their participation supports future inclusion of children in mediation processes. The best interests of the child needs to be examined on an individual basis as children present various preferences that is not in line with a presumption of fixed time-sharing following parental break-up.
Evaluation of the Surface Wind Field over Land in WRF Simulations of Hurricane Wilma (2005). Part I: Model Initialization and Simulation Validation
Authors: Nolan David S. , McNoldy Brian D. , Yunge Jimmy
Published: January 2021

Although global and regional dynamical models are used to predict the tracks and intensities of hurricanes over the ocean, these models are not currently used to predict the wind field and other impacts over land. This two-part study performs detailed evaluations of the near-surface, overland wind fields produced in simulations of Hurricane Wilma (2005) as it traveled across South Florida. This first part describes the production of two high-resolution simulations using the Weather Research and Forecasting (WRF) Model, using different boundary layer parameterizations available in WRF: the Mellor–Yamada–Janjić (MYJ) scheme and the Yonsei University (YSU) scheme. Initial conditions from the Global Forecasting System are manipulated with a vortex-bogusing technique to modify the initial intensity, size, and location of the cyclone. It is found possible through trial and error to successfully produce simulations using both the YSU and MYJ schemes that closely reproduce the track, intensity, and size of Wilma at landfall. For both schemes the storm size and structure also show good agreement with the wind fields diagnosed by H*WIND and the Tropical Cyclone Surface Wind Analysis. Both over water and over land, the YSU scheme has stronger winds over larger areas than does the MYJ, but the surface winds are more reduced in areas of greater surface roughness, particularly in urban areas. Both schemes produced very similar inflow angles over land and water. The overland wind fields are examined in more detail in the second part of this study.
Evaluation of the Surface Wind Field over Land in WRF Simulations of Hurricane Wilma (2005). Part II: Surface Winds, Inflow Angles, and Boundary Layer Profiles
Authors: Nolan David S. , McNoldy Brian D. , Yunge Jimmy , Masters Forrest J. , Giammanco Ian M.
Published: January 2021

This is the second of a two-part study that explores the capabilities of a mesoscale atmospheric model to reproduce the near-surface wind fields in hurricanes over land. The Weather Research and Forecasting (WRF) Model is used with two planetary boundary layer parameterizations: the Yonsei University (YSU) and the Mellor–Yamada–Janjić (MYJ) schemes. The first part presented the modeling framework and initial conditions used to produce simulations of Hurricane Wilma (2005) that closely reproduced the track, intensity, and size of its wind field as it passed over South Florida. This part explores how well these simulations can reproduce the winds at fixed points over land by making comparisons with observations from airports and research weather stations. The results show that peak wind speeds are remarkably well reproduced at several locations. Wind directions are evaluated in terms of the inflow angle relative to the storm center, and the simulated inflow angles are generally smaller than observed. Localized peak wind events are associated with vertical vorticity maxima in the boundary layer with horizontal scales of 5–10 km. The boundary layer winds are compared with wind profiles obtained by velocity–azimuth display (VAD) analyses from National Weather Service Doppler radars at Miami and Key West, Florida; results from these comparisons are mixed. Nonetheless the comparisons with surface observations suggest that when short-term hurricane forecasts can sufficiently predict storm track, intensity, and size, they will also be able to provide useful information on extreme winds at locations of interest.
Longitudinal effect of disease-modifying therapy on tricuspid regurgitant velocity in children with sickle cell anemia
Authors: Rai Parul , Joshi Vijaya M. , Goldberg Jason F. , Yates Amber M. , Okhomina Victoria I. , Penkert Rhiannon , Ataga Kenneth I. , Kang Guolian , Hankins Jane S.
Published: January 2021

Elevated tricuspid regurgitant velocity (TRV) ≥2.5 m/s is a predictor of disease severity in adults and children with sickle cell anemia (SCA), but how disease-modifying therapies (DMTs) affect this biomarker is incompletely understood. We investigated the effect of DMTs on TRV elevation in children. In a prospective single-center study, 204 subjects with HbSS or HbSβ0 thalassemia (mean age, 10.6 years; range, 5-18) had echocardiograms with assessment of TRV, with repeat evaluations after 2 years of observation. One-hundred and twelve participants received DMTs (hydroxyurea, n = 72; monthly erythrocyte transfusions, n = 40), 58 did not receive any DMT, and 34 were begun on hydroxyurea during this observation period. In the entire cohort, an increase in hemoglobin of 1.0 g/dL was associated with a 0.03-m/s decrease in TRV (P = .024), and a decrease in absolute reticulocyte count of 1.0 × 106/mL was associated with a 0.34-m/s decrease in TRV (P = .034). Compared with baseline, hydroxyurea exposure (continuous or newly started) was associated with an average 5% decline in mean TRV at the 2-year evaluation. Among participants newly started on hydroxyurea (mean treatment duration 1.2 ± 0.6 years), an increase in hemoglobin of 1.0 g/dL was associated with a 0.06-m/s decrease in TRV (P = .05). We conclude that hydroxyurea therapy may mitigate TRV elevation in children with SCA, possibly as a result of a reduction in hemolysis and improvement in anemia.
A systematic review of antithrombotic treatment of venous thromboembolism in patients with myeloproliferative neoplasms
Authors: Hamulyák Eva N. , Daams Joost G. , Leebeek Frank W. G. , Biemond Bart J. , te Boekhorst Peter A. W. , Middeldorp Saskia , Lauw Mandy N.
Published: January 2021

Patients with myeloproliferative neoplasms (MPNs), polycythemia vera, essential thrombocythemia, and primary myelofibrosis, have an increased risk of thrombosis. Risk of recurrent thrombosis can be reduced with antithrombotic therapy and/or cytoreduction, but the optimal long-term management in patients with MPN with a history of venous thromboembolism (VTE) is unknown, and clinical practice is heterogeneous. We performed a systematic review and meta-analysis of randomized trials and observational studies evaluating anticoagulant and/or antiplatelet therapy, with or without cytoreduction, in MPN patients with a history of VTE. A total of 5675 unique citations were screened for eligibility. No randomized trials were identified. Ten observational studies involving 1295 patients with MPN were included in the analysis. Overall, 23% had an arterial or recurrent venous thrombotic event on follow-up. The recurrence risk was lowest for patients on oral anticoagulation plus cytoreduction (16%); 55 of 313 (18%) with vitamin K antagonists (VKA) and 5 of 63 (8%) with direct oral anticoagulants (DOACs). In 746 analyzed patients, the risk of recurrent VTE ranged up to 33% (median 13%) and was low in 63 DOAC plus cytoreduction-treated patients (3.2%). All types of antithrombotic treatments were associated with a lower risk of recurrent VTE when combined with cytoreduction. Most studies had a high risk of bias, whereas clinical and statistical heterogeneity led to inconsistent and imprecise findings. In summary, evidence on the optimal antithrombotic treatment of VTE in patients with MPN is based on observational studies only with low certainty for all strategies. Our data suggest that a combination of anticoagulation and cytoreduction may provide the lowest recurrence risk.
Influenza virus infection increases ACE2 expression and shedding in human small airway epithelial cells
Authors: Schweitzer Kelly S. , Crue Taylor , Nall Jordan M. , Foster Daniel , Sajuthi Satria , Correll Kelly A. , Nakamura Mari , Everman Jamie L. , Downey Gregory P. , Seibold Max A. , Bridges James P. , Serban Karina A. , Chu Hong Wei , Petrache Irina
Published: January 2021

Background

Patients with coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) demonstrate high rates of co-infection with respiratory viruses, including influenza A (IAV), suggesting pathogenic interactions.

Methods

We investigated how IAV may increase the risk of COVID-19 lung disease, focusing on the receptor angiotensin-converting enzyme (ACE)2 and the protease TMPRSS2, which cooperate in the intracellular uptake of SARS-CoV-2.

Results

We found, using single-cell RNA sequencing of distal human nondiseased lung homogenates, that at baseline, ACE2 is minimally expressed in basal, goblet, ciliated and secretory epithelial cells populating small airways. We focused on human small airway epithelial cells (SAECs), central to the pathogenesis of lung injury following viral infections. Primary SAECs from nondiseased donor lungs apically infected (at the air–liquid interface) with IAV (up to 3×105 pfu; ∼1 multiplicity of infection) markedly (eight-fold) boosted the expression of ACE2, paralleling that of STAT1, a transcription factor activated by viruses. IAV increased the apparent electrophoretic mobility of intracellular ACE2 and generated an ACE2 fragment (90 kDa) in apical secretions, suggesting cleavage of this receptor. In addition, IAV increased the expression of two proteases known to cleave ACE2, sheddase ADAM17 (TACE) and TMPRSS2 and increased the TMPRSS2 zymogen and its mature fragments, implicating proteolytic autoactivation.

Conclusion

These results indicate that IAV amplifies the expression of molecules necessary for SARS-CoV-2 infection of the distal lung. Furthermore, post-translational changes in ACE2 by IAV may increase vulnerability to lung injury such as acute respiratory distress syndrome during viral co-infections. These findings support efforts in the prevention and treatment of influenza infections during the COVID-19 pandemic.
Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults
Authors: Yee Xianyang Sherman , Ng Yee Sien , Allen John Carson , Latib Aisyah , Tay Ee Ling , Abu Bakar Huda Mukhlis , Ho Chien Yee Jolene , Koh Wan Cheen Charissa , Kwek Hwee Heem Theresa , Tay Laura
Published: January 2021

Background

The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants – Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) – with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults.

Methods

This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years. Participants completed a battery of physical fitness tests - 5TSTS, 30CST, grip strength, gait speed, Timed-Up-and-Go (TUG) for dynamic balance and six-minute walk test (6MWT) for cardiorespiratory endurance. Muscle mass was measured using multi-frequency segmental bioelectrical impedance analysis (BIA). We performed correlation analysis between STS performance and other fitness measures and muscle mass, followed by multiple linear regression for the independent determinants of STS performance.

Results

Mean participant age was 67.3±7 years, with female predominance (72.9%). STS tests exhibited weak correlations with grip strength (30CST,r= 0.290; 5TSTS,r= − 0.242; bothp< 0.01), and stronger correlations with gait speed (30CST,r= 0.517; 5TSTS,r= − 0.533; both p< 0.01), endurance (30CST,r= 0.558; 5TSTS,r= − 0.531; bothp< 0.01) and dynamic balance (30CST,r= − 0.501; 5TSTS,r= 0.646; both p< 0.01). Muscle mass correlated with grip strength but not STS. In multiple regression analysis, all fitness measures were independently associated with 30CST performance. Performance in both STS tests remained independent of muscle mass. There was no significant difference in prevalence of possible sarcopenia diagnosis using grip strength or STS (30CST, 25.0%; 5TSTS, 22.1%; grip strength, 22.3%;p= 0.276). When both measures are used, prevalence is significantly higher (42.0%;p= 0.276). Prevalence of confirmed sarcopenia with inclusion of muscle mass was significantly lower using STS compared with grip strength (30CST, 4.6%; 5TSTS, 4.1% vs. grip strength, 7.1%;p< 0.05).

Conclusion

In the sarcopenia construct, STS tests better represents muscle physical performance rather than muscle strength. Different subsets of population with possible sarcopenia are identified depending on the test used. The lack of association of STS performance with muscle mass results in a lower prevalence of confirmed sarcopenia compared with grip strength, but may better reflect changes in muscle quality.
National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis
Authors: Jafari Alireza , Rajabi Abdolhalim , Gholian-Aval Mahdi , Peyman Nooshin , Mahdizadeh Mehrsadat , Tehrani Hadi
Published: January 2021

Background

This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis.

Methods

Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression.

Results

The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively.

Conclusions

The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women.
Acute macular neuroretinopathy in a patient with acute myeloid leukemia and deceased by COVID-19: a case report
Authors: Zamani Ghodsieh , Ataei Azimi; Sajjad , Aminizadeh Ali , Shams Abadi Elham , Kamandi Mostafa , Mortazi Hasan , Shariat Somayeh , Abrishami Mojtaba
Published: January 2021

Purpose

Acute macular neuroretinopathy (AMN) is a visual-deteriorating rare clinical entity with an uncertain etiology. We aimed to report a case of AMN and underlying disease of acute myeloid leukemia (AML).

Case presentation

A thirty-five-year-old female patient with bone marrow biopsy confirmed AML, and bicytopenia, under chemotherapy, complained of sudden paracentral visual field defect in her right eye was referred. Visual acuity was 20/20 in both eyes. Posterior segment evaluation revealed multiple Roth’s spots. Optical coherence tomography (OCT) demonstrated hyper-reflectivity band, in the outer nuclear layer and outer plexiform layer, nasal to the fovea of the right eye, and hyperreflective patch in outer retina segmentation en-face OCT, suggestive of the diagnosis of AMN. Nine days after AMN diagnosis, dyspnea, malaise, and cough was initiated. Ground glass opacities in lung CT scan, beside reverse transcription polymerase chain reaction of severe acute respiratory syndrome coronavirus-2, was conclusive of coronavirus disease 2019 (COVID-19). The patient deceased after 6 days.

Conclusion

We report a rare case of AMN following AML. Our findings support the role of ischemia in the outer retina, of which AML may contributed to the pathophysiological process. The patient has deceased less than 2 weeks from AMN initiation.
Genome-wide identification of the 14–3-3 gene family and its participation in floral transition by interacting with TFL1/FT in apple
Authors: Zuo Xiya , Wang Shixiang , Xiang Wen , Yang Huiru , Tahir Muhammad Mobeen , Zheng Shangong , An Na , Han Mingyu , Zhao Caiping , Zhang Dong
Published: January 2021

Background

Apple (Malus domestica Borkh.) is a popular cultivated fruit crop with high economic value in China. Apple floral transition is an important process but liable to be affected by various environmental factors. The 14–3-3 proteins are involved in regulating diverse biological processes in plants, and some 14–3-3 members play vital roles in flowering. However, little information was available about the 14–3-3 members in apple.

Results

In the current study, we identified eighteen 14–3-3 gene family members from the apple genome database, designated MdGF14a to MdGF14r. The isoforms possess a conserved core region comprising nine antiparallel α-helices and divergent N and C termini. According to their structural and phylogenetic features, Md14–3-3 proteins could be classified into two major evolutionary branches, the epsilon (ɛ) group and the non-epsilon (non-ɛ) group. Moreover, expression profiles derived from transcriptome data and quantitative real-time reverse transcription PCR analysis showed diverse expression patterns of Md14–3-3 genes in various tissues and in response to different sugars and hormone treatments during the floral transition phase. Four Md14–3-3 isoforms (MdGF14a, MdGF14d, MdGF14i, and MdGF14j) exhibiting prominent transcriptional responses to sugars and hormones were selected for further investigation. Furthermore, yeast two-hybrid and bimolecular fluorescence complementation experiments showed that the four Md14–3-3 proteins interact with key floral integrators, MdTFL1 (TERMINAL FLOWER1) and MdFT (FLOWERING LOCUS T). Subcellular localization of four selected Md14–3-3 proteins demonstrated their localization in both the cytoplasm and nucleus.

Conclusion

We identified the Md14–3-3 s family in apple comprehensively. Certain Md14–3-3 genes are expressed predominantly during the apple floral transition stage, and may participate in the regulation of flowering through association with flower control genes. Our results provide a preliminary framework for further investigation into the roles of Md14–3-3 s in floral transition.
The role of older patients’ goals in GP decision-making about medicines: a qualitative study
Authors: Weir Kristie Rebecca , Naganathan Vasi , Carter Stacy M. , Tam Chun Wah Michael , McCaffery Kirsten , Bonner Carissa , Rigby Debbie , McLachlan Andrew J. , Jansen Jesse
Published: January 2021

Background

To optimise medication use in older people, it is recommended that clinicians evaluate evidence on potential benefits and harms of medicines in light of the patients’ overall health, values and goals. This suggests general practitioners (GPs) should attempt to facilitate patient involvement in decision-making. In practice this is often challenging. In this qualitative study, we explored GPs’ perspectives on the importance of discussing patients’ goals and preferences, and the role patient preferences play in medicines management and prioritisation.

Methods

Semi-structured interviews were conducted with GPs from Australia (n = 32). Participants were purposively sampled to recruit GPs with variation in experience level and geographic location. Transcribed audio-recordings of interviews were coded using Framework Analysis.

Results

The results showed that most GPs recognised some value in understanding older patients’ goals and preferences regarding their medicines. Most reported some discussions of goals and preferences with patients, but often this was initiated by the patient. Practical barriers were reported such as limited time during busy consultations to discuss issues beyond acute problems. GPs differed on the following main themes: 1) definition and perception of patients’ goals, 2) relationship with the patient, 3) approach to medicines management and prioritisation. We observed that GPs preferred one of three different practice patterns in their approach to patients’ goals in medicines decisions: 1) goals and preferences considered lower priority – ‘Directive’; 2) goals seen as central – ‘Goal-oriented’; 3) goals and preferences considered but not explicitly elicited – ‘Tacit’.

Conclusions

This study explores how GPs differ in their approach to eliciting patients’ goals and preferences, and how these differences are operationalised in the context of older adults taking multiple medicines. Although there are challenges in providing care that aligns with patients’ goals and preferences, this study shows how complex decisions are made between GPs and their older patients in clinical practice. This work may inform future research that investigates how GPs can best incorporate the priorities of older people in decision-making around medicines. Developing practical support strategies may assist clinicians to involve patients in discussions about their medicines.
The developing family doctor system: evidence from the progress of the family doctor signing service from a longitudinal survey (2013–2016) in Pudong New Area, Shanghai
Authors: Liu Shanshan , Liu Yan , Zhang Tao , Wang Luan , Huang Jiaoling , Liang Hong , Chen Gang , Liu Chengjun , Zhang Yimin
Published: January 2021

Background

The family doctor system is a vital part of China’s national medical and health system reform. Evidence of the degree of implementation of the family doctor system is required to assist managers and policy makers in Pudong with resource allocation planning. This study analyzed changes in indicators (family doctor team construction, contracted medical services, health management services and so on) over time to evaluate the progress of the family doctor system in Pudong.

Methods

We used a cross-sectional design with an online questionnaire survey to collect 3-year (2013–2016) consecutive data. The online questionnaires were completed by the doctors responsible for information reporting in each community health service center of Pudong. The data were sorted, and the indices calculated and analyzed using descriptive statistics and statistical tests.

Results

The proportion of registered general practitioners increased each year, from 50.8% in 2013 to 66.5% in 2016; this difference was statistically significant (P = 0.000). The number of family doctors per 10,000 permanent residents rose each year, from 1.7 in 2013 to 2.1 in 2016. The rate of contracted household residents was 55.7% in 2013 and increased to 71.7% in 2016, with the difference being significant in different years (P = 0.012). Analysis of referral services showed the people times of contracted residents transferring to higher-level hospitals from family doctors increased each year, from 172,734 in 2013 to 341,615 in 2016; differences among different regions were statistically significant for 2013–2016. The rate of health screening for contracted residents also increased each year, with statistically significant differences in different years (P = 0.000). The rate of health assessment interventions for contracted residents rose each year, with statistically significant differences in different years (P = 0.003).

Conclusions

The family doctor signing service in Pudong made headway in general practitioner availability, contract service rate of household residents, and providing health management services. However, problems included family doctor shortages and limited supporting policies, especially in rural and suburban areas compared with urban divisions. Increasing the enrollment rate of family doctors and speeding up the implementation of “contract service fees” are key tasks for the sustainable development of the family doctor system in Pudong.
Conservative versus surgical management for patients with rotator cuff tears: a systematic review and META-analysis
Authors: Longo Umile Giuseppe , Risi Ambrogioni Laura , Candela Vincenzo , Berton Alessandra , Carnevale Arianna , Schena Emiliano , Denaro Vincenzo
Published: January 2021

Background

This study aims to compare conservative versus surgical management for patients with full-thickness RC tear in terms of clinical and structural outcomes at 1 and 2 years of follow-up.

Methods

A comprehensive search of CENTRAL, MEDLINE, EMBASE, CINAHL, Google Scholar and reference lists of retrieved articles was performed since the inception of each database until August 2020. According to the Cochrane Handbook for Systematic Reviews of Interventions, two independent authors screened all suitable studies for the inclusion, extracted data and assessed risk of bias. Only randomised controlled trials comparing conservative and surgical management of full-thickness RC tear in adults were included. The primary outcome measure was the effectiveness of each treatment in terms of Constant-Murley score (CMS) and VAS pain score at different time points. The secondary outcome was the integrity of the repaired tendon evaluated on postoperative MRI at different time points. The GRADE guidelines were used to assess the critical appraisal status and quality of evidence.

Results

A total of six articles met the inclusion criteria. The average value of CMS score at 12 months of follow-up was 79.2 ± 13.7 in the surgery group and 72.7 ± 17.2 in the conservative group. The average value of CMS score at 24 months of follow-up was 80 ± 15 in the surgery group and 77 ± 15 in the conservative group. Results showed statistically significant differences between the CMS measured at one year of follow-up in favour of surgical RC repair compared with patients treated conservatively (P= 0.003). No significant differences were demonstrated in terms of CMS at 24 months of follow-up (P= 0.15). The mean of VAS pain score at 12 months of follow-up was 1.4 ± 1.6 in the surgery group and 2.4 ± 1.9 in the conservative group. Quantitative synthesis showed better results in favour of the surgical group in terms of VAS pain score one year after surgery (− 1.08, 95% CI − 1.58 to − 0.58;P < 0.001).

Conclusions

At a 2-year follow-up, shoulder function evaluated in terms of CMS was not significantly improved. Further high-quality level-I randomised controlled trials at longer term follow-up are needed to evaluate whether surgical and conservative treatment provide comparable long-term results.
Defining the role of TT-TG and TT-PCL in the diagnosis of lateralization of the Tibial tubercle in recurrent patellar dislocation
Authors: Su Peng , Jian Nengri , Mao Beini , Zhang Zhong , Li Jian , Fu Weili
Published: January 2021

Background

The radiological indicators can help doctors determine whether to make tibial tubercle transfer. But which indicator is better is still in question.

Methods

117 knees in 103 patients who had undergone patellar surgery and 60 knees in 58 patients who had no history of patellar dislocation from 2014 to 2019 were analyzed. Significant differences of tibial tubercle–trochlear groove (TT-TG) on CT and tibial tubercle–posterior cruciate ligament (TT-PCL) on MRI between the case group and the control group were estimated by an unpaired t test. Significant differences between TT-TG on CT and TT-TG on MRI were estimated by a paired t test. The correlation between TT-PCL on MRI and tibial width was estimated by Pearson test. Receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were measured to assess the diagnostic accuracy of TT-TG and TT-PCL on MRI.

Results

The intraclass correlation coefficient (ICC) for TT-TG between CT and MRI evaluated by two raters was were 0.566. When comparing TT-TG on CT with that on MRI, the mean difference was 2.5 mm (p< 0.001). The mean TT-TG difference on CT between the case group and the control group was 5.3 mm, which was significantly bigger than the mean TT-PCL difference on MRI of 1.2 mm(p< 0.001). AUC of TT-TG on CT and TT-PCL were 0.838 and 0.580 (P< 0.001). TT-PCL correlated with tibial width (r=0.450, P< 0.001).

Conclusion

A statistically significance and a fair ICC proved that TT-TG could not be used interchangeably. The bigger mean difference between the case group and the control group and better AUC proved that TT-TG on CT might be an indicator more suitable for measuring the lateralization of the tibial tubercle. And TT-PCL should be considered as an individual parameter because of the significant correlation between TT-PCL and tibial width.
Perceptions of firearms in a cohort of women exposed to intimate partner violence (IPV) in Central Pennsylvania
Authors: Leuenberger Laura , Lehman Erik , McCall-Hosenfeld Jennifer
Published: January 2021

Background

Almost one-half of U.S. women will experience intimate partner violence (IPV), defined as physical, sexual, or psychological harm by a current or former partner. IPV is associated with an increased risk of homicide, with firearms as the most commonly used weapon. We designed this study to better understand the correlation of interpersonal trauma exposures and demographic factors on firearm perceptions among a cohort of IPV-exposed women.

Methods

Two hundred sixty-seven women in central Pennsylvania with exposure to IPV were surveyed about perceptions of gun access, safety, and gun presence in the home. Trauma variables included IPV type, IPV recency, unwanted sexual exposure, and adverse childhood experiences (ACEs). Multivariable analyses examined three questions examining firearm perceptions controlling for trauma exposures and demographics.

Results

Ease of firearm acquisition: Women who were older (mean 44.92 years +/− SD 12.05), compared to women who were younger (40.91 +/− SD 11.81 years) were more likely to describe it as easy or very easy to acquire a gun (aOR 1.05, 95%CI 1.004, 1.10).

Perceived safety in the proximity of a gun: Women with the highest ACE score were less likely to feel safe with a gun nearby (aOR 0.31, 95%CI 0.14, 0.67).

Odds of guns in the home: Women who were divorced or separated (aOR 0.22, 95%CI 0.09, 0.54), women were widowed or single (aOR0.23, 95%CI 0.08, 0.67), and women who were partnered (aOR 0.45 95%CI 0.20, 0.97) had lower odds of having a gun in the home, compared to married women. There was no significant effect of the trauma variables on the odds of having a gun at home.

Conclusions

Women with more severe childhood trauma felt less safe around firearms, but trauma exposures did not predict the perception of gun prevalence in the local community or gun ownership. Instead, demographic factors of marriage predicted presence of a gun in the home.
The impact of integrating environmental health into medical school curricula: a survey-based study
Authors: Kligler Benjamin , Pinto Zipp Genevieve , Rocchetti Carmela , Secic Michelle , Ihde Erin Speiser
Published: January 2021

Background

Inclusion of environmental health (EH) in medical education serves as a catalyst for preparing future physicians to address issues as complex as climate change and health, water pollution and lead contamination. However, previous research has found EH education to be largely lacking in U.S. medical education, putting future physicians at risk of not having the expertise to address patients’ environmental illnesses, nor speak to prevention.

Methods

Environmental health (EH) knowledge and skills were incorporated into the first-year medical school curriculum at Hackensack Meridian School of Medicine (Nutley, New Jersey), via a two-hour interactive large group learning module with follow up activities. Students completed the Environmental Health in Med School (EHMS) survey before and after the year 1 EH module. This survey evaluates medical students’ attitudes, awareness and professionalism regarding environmental health. In year 2, students completed the Environmental Health Survey II, which measured students’ perceptions of preparedness to discuss EH with future patients. The research team created both surveys based upon learning objectives that broadly aligned with the Institute of Medicine six competency-based environmental health learning objectives.

Results

36 year 1 students completed both the pre and post EHMS surveys. McNemar’s test was used for paired comparisons. Results identified no statistically significant changes from pre to post surveys, identifying a dramatic ceiling.

When comparing year 2, EHS II pre-survey (n = 84) and post-survey (n = 79) responses, a statistically significant positive change in students’ self-reported sense of preparedness to discuss environmental health with their patients following the curriculum intervention was noted.

Conclusions

Our conclusion for the EHMS in Year 1 was that the current generation of medical students at this school is already extremely aware of and concerned about the impact of environmental issues on health.

Through the EHS II in Year 2, we found that the six-week environmental health module combining didactic and experiential elements significantly increased medical students’ self-reported sense of preparedness to discuss environmental health issues, including climate change, with their patients.
The impact of research intercalation during medical school on post-graduate career progression
Authors: Sorial Antony K. , Harrison-Holland Morgan , Young Helen S.
Published: January 2021

Background

Medical students at The University of Manchester have the option of research intercalation on the Master of Research programme. There is a paucity of evidence for the benefits of research intercalation. However, we hypothesised that research intercalation would accelerate post-graduate career progression and aimed to objectively measure the career enhancing impact, quantify the benefits and determine the alumni perception of research intercalation.

Methods

Data was collected retrospectively by electronic questionnaire (in 2018) from those commencing research intercalation between 2005 and 2012.

Results

Participants (n=52) returned questionnaires (68% response), demonstrating that the cohort had completed 67 postgraduate qualifications, published 304 manuscripts (median 3 publications per person (PP); range: 0–53) and made 430 presentations (median 7 PP; range: 0–37). Alumni had been awarded 49 research grants; funding disclosed on 43% totalled £823,000. Career progression of 73% of alumni had taken the minimum number of years; 27% took longer due to time spent working abroad or to gain additional experience prior to specialty training. Fifty-five publications and 71 presentations were directly related to MRes projects.

Conclusion

Research intercalation provides graduates with an opportunity to learn valuable transferrable skills, contribute to translational research, and objectively enhances medical career progression.
Evaluation of a training program for life skills education and financial literacy to community health workers in India: a quasi-experimental study
Authors: Sharma Shantanu , Arora Kanishtha , Chandrashekhar  , Sinha Rajesh Kumar , Akhtar Faiyaz , Mehra Sunil
Published: January 2021

Background

Accredited Social Health Activists (ASHA) are community health workers responsible for improving the health status of people by facilitating their access to healthcare services. The life skills of ASHA are known to be effective in negotiating behaviour change in the community; however, there has been a meagre focus towards improving them. Considering this gap, we adopted a comprehensive training program, known as Personal Advancement and Career Enhancement (P.A.C.E.), to empower ASHAs on life skills and financial literacy. The present study intends to assess the training program in two districts of Uttar Pradesh, India, by examining changes in knowledge, perceptions, and practices of ASHAs about life skills and financial literacy.

Methods

We conducted a quasi-experimental, non-randomized, controlled study with pre-and post-test assessments. Data were collected on socio-demographic characteristics, knowledge, and practices related to life skills (communication skills, self-confidence, problem–solving and decision-making skills, time and stress management skills) and financial literacy. Additionally, change perceptions on gender-, life skills-, and savings-related practices at the personal, community, and workplace levels were assessed in the intervention group. Factor analysis was performed to obtain the change patterns by assessing the degree to which the four life skills, financial literacy, and change perceptions on practices were correlated. A general linear regression model was performed to assess associations among change pattern scores and socio-demographic variables.

Results

We analyzed the data of 171 ASHAs (intervention group:86 and control group:85). There was a significant improvement in the average post-test scores of all the life skills and financial literacy in the intervention group (p < 0.001). Three distinct change patterns were found post-training in the intervention group. Factor 1 (high loadings for change perceptions on practices) was positively associated with ASHAs aged 38 and above and with experience of ≤12 years. On the contrary, the change in financial literacy and self-confidence scores was common among ASHAs with more than 12 years of experience.

Conclusions

The P.A.C.E training program was found effective in improving the life skills and financial literacy of ASHAs in India.
Dietary patterns and chronic kidney disease risk: a systematic review and updated meta-analysis of observational studies
Authors: He Ling-Qiong , Wu Xu-Hong , Huang Yi-Qian , Zhang Xiao-Yan , Shu Long
Published: January 2021

Background

A number of studies have reported the association between dietary patterns and the risk of chronic kidney disease (CKD), however a consistent perspective hasn’t been established to date. Herein, we conducted this systematic review and meta-analysis of observational studies to assess the association between dietary patterns and CKD.

Methods

MEDLINE, EBSCO and references from eligible studies were searched for relevant articles published up to 9 May 2020 that examined the association of common dietary patterns and CKD. The heterogeneity among studies was assessed by Cochran’s Q test and I2 methods.

Results

Seventeen eligible studies, involving 149,958 participants, were included in our systematic review and meta-analysis. The highest compared with the lowest category of healthy dietary pattern was significantly associated with a lower risk of CKD (OR=0.69; CI: 0.57, 0.84; P=0.0001). A higher risk of CKD was shown for the highest compared with the lowest categories of Western-type dietary pattern (OR=1.86; CI: 1.21, 2.86; P=0.005). There were evidence of a lower risk of CKD in the highest compared with the lowest categories of light-moderate drinking pattern (OR=0.76; CI: 0.71, 0.81; P< 0.0001) and heavy drinking pattern (OR=0.67; CI: 0.56, 0.80; P< 0.0001).

Conclusions

The results of this systematic review and meta-analysis show that a healthy dietary pattern and alcohol drinking were associated with lower risk of CKD, whereas a Western-type dietary pattern was associated with higher risk of CKD.
Tailoring interventions for social isolation among older persons during the COVID-19 pandemic: challenges and pathways to healthcare equity
Authors: Dassieu Lise , Sourial Nadia
Published: January 2021

Background

Social isolation among older adults raises major issues for equity in healthcare in the context of the COVID-19 pandemic.

Main text

This commentary describes current challenges in preventing social isolation among older adults and proposes pathways to develop inclusive approaches to intervention in this vulnerable population. Building interventions that take account of structural inequities among older persons, as well as their subjective experiences, expectations and perspectives, appears fundamental to improve their health and quality of life in pandemic and post-pandemic contexts.

Conclusions

We argue that equity-based and person-centered approaches are critical to counter the negative outcomes of social isolation in the vulnerable older population.
Ratatosk: hybrid error correction of long reads enables accurate variant calling and assembly
Authors: Holley Guillaume , Beyter Doruk , Ingimundardottir Helga , Møller Peter L. , Kristmundsdottir Snædis , Eggertsson Hannes P. , Halldorsson Bjarni V.
Published: January 2021

A major challenge to long read sequencing data is their high error rate of up to 15%. We present Ratatosk, a method to correct long reads with short read data. We demonstrate on 5 human genome trios that Ratatosk reduces the error rate of long reads 6-fold on average with a median error rate as low as 0.22 %. SNP calls in Ratatosk corrected reads are nearly 99 % accurate and indel calls accuracy is increased by up to 37 %. An assembly of Ratatosk corrected reads from an Ashkenazi individual yields a contig N50 of 45 Mbp and less misassemblies than a PacBio HiFi reads assembly.
The morphological and molecular characterization of Baylisascaris devosi Sprent, 1952 (Ascaridoidea, Nematoda), collected from Pine marten (Martes martes) in Iran
Authors: Sharifdini Meysam , Heckmann Richard A. , Mikaeili Fattaneh
Published: January 2021

Background

Baylisascaris devosiis an intestinal nematode found in several carnivores including fisher, wolverine, Beech marten, American marten and sable in different parts of the world, but this nematode has not been reported from Pine marten. Therefore, this study aimed to identifyBaylisascarisisolated from a Pine marten in Iran using morphological and molecular approaches.

Methods

Specimens ofB. devosiwere collected from one road-killed Pine marten in northern Iran. Morphological features were evaluated using scanning electron microscopy, energy dispersive x-ray analysis and ion sectioning. The molecular characterization was carried out using partialCox1, LSU rDNA and ITS-rDNA genes.

Results

The nematodes isolated from the Pine marten were confirmed to beB. devosibased on the morphological features and the sequence of ribosomal and mitochondrial loci. X-ray scans (EDAX) were completed on gallium cut structures (papillae, eggs, male spike and mouth denticles) ofB. devosiusing a dual-beam scanning electron microscope. The male spike and mouth denticles had a high level of hardening elements (Ca, P, S), helping to explain the chemical nature and morphology of the worm. Based on these genetic marker analyses, our sequence had the greatest similarity with RussianB. devosiisolated from sable.

Conclusions

In this study, to our knowledge, the occurrence ofB. devosiinfection in Pine marten is reported for the first time. Molecular analysis showed that these three genes are suitable molecular markers for identification and inferring phylogenetic relationships ofBaylisascarisspecies. Furthermore, the high divergence ofCox1betweenBaylisascarisspecies indicates thatCox1could be used for their phylogenetic and taxonomic studies.

Graphical Abstract
Association between polygenic risk score of Alzheimer’s disease and plasma phosphorylated tau in individuals from the Alzheimer’s Disease Neuroimaging Initiative
Authors:   the Alzheimer’s Disease Neuroimaging Initiative*, Zettergren Anna , Lord Jodie , Ashton Nicholas J. , Benedet Andrea L. , Karikari Thomas K. , Lantero Rodriguez Juan , Snellman Anniina , Suárez-Calvet Marc , Proitsi Petroula , Zetterberg Henrik , Blennow Kaj
Published: January 2021

Background

Recent studies suggest that plasma phosphorylated tau181 (p-tau181) is a highly specific biomarker for Alzheimer’s disease (AD)-related tau pathology. It has great potential for the diagnostic and prognostic evaluation of AD, since it identifies AD with the same accuracy as tau PET and CSF p-tau181 and predicts the development of AD dementia in cognitively unimpaired (CU) individuals and in those with mild cognitive impairment (MCI). Plasma p-tau181 may also be used as a biomarker in studies exploring disease pathogenesis, such as genetic or environmental risk factors for AD-type tau pathology. The aim of the present study was to investigate the relation between polygenic risk scores (PRSs) for AD and plasma p-tau181.

Methods

Data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) was used to examine the relation between AD PRSs, constructed based on findings in recent genome-wide association studies, and plasma p-tau181, using linear regression models. Analyses were performed in the total sample (n = 818), after stratification on diagnostic status (CU (n = 236), MCI (n = 434), AD dementia (n = 148)), and after stratification on Aβ pathology status (Aβ positives (n = 322), Aβ negatives (n = 409)).

Results

Associations between plasma p-tau181 and APOE PRSs (p = 3e−18–7e−15) and non-APOE PRSs (p = 3e−4–0.03) were seen in the total sample. The APOE PRSs were associated with plasma p-tau181 in all diagnostic groups (CU, MCI, and AD dementia), while the non-APOE PRSs were associated only in the MCI group. The APOE PRSs showed similar results in amyloid-β (Aβ)-positive and negative individuals (p = 5e−5–1e−3), while the non-APOE PRSs were associated with plasma p-tau181 in Aβ positives only (p = 0.02).

Conclusions

Polygenic risk for AD including APOE was found to associate with plasma p-tau181 independent of diagnostic and Aβ pathology status, while polygenic risk for AD beyond APOE was associated with plasma p-tau181 only in MCI and Aβ-positive individuals. These results extend the knowledge about the relation between genetic risk for AD and p-tau181, and further support the usefulness of plasma p-tau181 as a biomarker of AD.