bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Combinations of Behavior Change Techniques That Occur Frequently in Interventions Reflect Underlying Theory?
Authors: Bohlen Lauren Connell , Michie Susan , de Bruin Marijn , Rothman Alexander J , Kelly Michael P , Groarke Hilary N K , Carey Rachel N , Hale Joanna , Johnston Marie
Published: September 2020

Background

Behavioral interventions typically include multiple behavior change techniques (BCTs). The theory informing the selection of BCTs for an intervention may be stated explicitly or remain unreported, thus impeding the identification of links between theory and behavior change outcomes.

Purpose

This study aimed to identify groups of BCTs commonly occurring together in behavior change interventions and examine whether behavior change theories underlying these groups could be identified.

Methods

The study involved three phases: (a) a factor analysis to identify groups of co-occurring BCTs from 277 behavior change intervention reports; (b) examining expert consensus (n = 25) about links between BCT groups and behavioral theories; (c) a comparison of the expert-linked theories with theories explicitly mentioned by authors of the 277 intervention reports.

Results

Five groups of co-occurring BCTs (range: 3–13 BCTs per group) were identified through factor analysis. Experts agreed on five links (≥80% of experts), comprising three BCT groups and five behavior change theories. Four of the five BCT group–theory links agreed by experts were also stated by study authors in intervention reports using similar groups of BCTs.

Conclusions

It is possible to identify groups of BCTs frequently used together in interventions. Experts made shared inferences about behavior change theory underlying these BCT groups, suggesting that it may be possible to propose a theoretical basis for interventions where authors do not explicitly put forward a theory. These results advance our understanding of theory use in multicomponent interventions and build the evidence base for further understanding theory-based intervention development and evaluation.
Effects of Storage Temperature and Media/Buffer for SARS-CoV-2 Nucleic Acid Detection
Authors: Kim Namhee , Kwon Ahrin , Roh Eun Youn , Yoon Jong Hyun , Han Mi Seon , Park Sang-Won , Park Hyunwoong , Shin Sue
Published: September 2020

Objectives

The increase in the number of patients with coronavirus disease 2019 (COVID-19) has delayed real-time reverse transcription–quantitative polymerase chain reaction (RT-qPCR), requiring proper shipping and storage conditions, especially in hot weather. This study aims to assess how some conditions, such as storage period, temperature, media or buffer, and sample types, affect the results of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-qPCR.

Methods

SARS-CoV-2–positive specimens were collected from Boramae Medical Center for 2 months (from May to June 2020) and stored in different media or buffers at different temperatures.

Results

As a result of examining confirmed patient samples, RT-qPCR results were not significantly affected by 2°C to 8°C storage until after 7 days. When stored at 20°C to 22°C or above 35°C, the results were affected negatively even after 1 day. Higher storage temperatures resulted in a lower probability of detecting viral nucleic acids because of degradation. Samples stored in pH-controlled media or buffer were more stable than those stored in nonbuffer states.

Conclusions

These results emphasize the importance of storage temperature and media or buffer and performing RT-qPCR for SARS-CoV-2 nucleic acid detection as soon as possible after sample collection.
Epithelial-Stromal Polyps of the Colon Are Not Perineuriomas
Authors: Hissong Erika , Yantiss Rhonda K
Published: September 2020

Objectives

Some colorectal polyps contain serrated or tubular crypts surrounded by whorls of spindle cells that expand the mucosa. These epithelial-stromal polyps have been termed benign fibroblastic polyps or, more commonly, perineuriomas. We hypothesized that these lesions are pathogenetically heterogeneous polyps that share in common exuberant fibroblastic proliferations derived from the pericryptal sheath.

Methods

Forty-six epithelial-stromal polyps containing serrated crypts (n = 21) and nonserrated crypts (n = 25) were evaluated with epithelial membrane antigen and BRAF V600E immunohistochemical stains, and a subset was subjected to next-generation sequencing for BRAF mutations. Polyp morphology and immunohistochemical results were correlated with clinical information.

Results

Epithelial-stromal polyps containing serrated crypts were significantly associated with other sessile serrated polyps (43%, P = .01) and hyperplastic polyps (29%, P = .006). They also showed BRAF V600E abnormalities (95%) and strong, patchy epithelial membrane antigen staining of spindle cells (95%). In contrast, polyps with nonserrated crypts lacked BRAF alterations and infrequently showed robust EMA staining of stromal cells (16%, P < .01).

Conclusions

Benign epithelial-stromal polyps with serrated epithelium are biologically similar to sessile serrated polyps and should be classified as such to ensure appropriate clinical surveillance. The nature of polyps without serrated crypts is less clear, but evidence that they are perineuriomas is circumstantial at best.
Long-term observations reveal the formation process of branching systems of the genus Sasa in Bambusoideae
Authors: Niimiya Hiroko (Kawabata) , Kawabata Kazushige
Published: September 2020

Clarifying the endogenous processes that construct gross aerial shapes such as branching architecture in plants is crucial to understanding how branching contributes to plant adaptation to environments. Architectural analysis is powerful in decomposing the branching process, by comparing observations of plant growth among closely related taxa. The genus Sasa (Gramineae: Bambusoideae) contains three major sections Crassinodi, Sasa and Macrochlamys. These sections exhibit characteristic branching architectures and are distributed separately across the Japanese archipelago, in relation to macroclimatic conditions such as snow accumulation. Our study aimed to quantitatively reveal the endogenous processes underlying branching architectures in the three sections of Sasa. Long-term observations were carried out branch architectural development on Hokkaido Island from 1979 to 2012, which corresponded to the flowering interval of the genus. The results revealed that the three characteristic branching systems of the genus arise mainly from four endogenous processes (distribution of lateral buds on a culm, internode length arrangement along a culm, determination of the fate of lateral buds, development of branching with culm fragility due to ageing) and their interactions with environmental conditions, especially snow accumulation. These processes are coordinated with each other over the life span of a single shoot in developing branching architecture.
Cloud 3D-QSAR: a web tool for the development of quantitative structure–activity relationship models in drug discovery
Authors: Wang Yu-Liang , Wang Fan , Shi Xing-Xing , Jia Chen-Yang , Wu Feng-Xu , Hao Ge-Fei , Yang Guang-Fu
Published: September 2020

Effective drug discovery contributes to the treatment of numerous diseases but is limited by high costs and long cycles. The Quantitative Structure–Activity Relationship (QSAR) method was introduced to evaluate the activity of a large number of compounds virtually, reducing the time and labor costs required for chemical synthesis and experimental determination. Hence, this method increases the efficiency of drug discovery. To meet the needs of researchers to utilize this technology, numerous QSAR-related web servers, such as Web-4D-QSAR and DPubChem, have been developed in recent years. However, none of the servers mentioned above can perform a complete QSAR modeling and supply activity prediction functions. We introduce Cloud 3D-QSAR by integrating the functions of molecular structure generation, alignment, molecular interaction field (MIF) computing and results analysis to provide a one-stop solution. We rigidly validated this server, and the activity prediction correlation was R2 = 0.934 in 834 test molecules. The sensitivity, specificity and accuracy were 86.9%, 94.5% and 91.5%, respectively, with AUC = 0.981, AUCPR = 0.971. The Cloud 3D-QSAR server may facilitate the development of good QSAR models in drug discovery. Our server is free and now available at http://chemyang.ccnu.edu.cn/ccb/server/cloud3dQSAR/ and http://agroda.gzu.edu.cn:9999/ccb/server/cloud3dQSAR/.
InstaDock: A single-click graphical user interface for molecular docking-based virtual high-throughput screening
Authors: Mohammad Taj , Mathur Yash , Hassan Md Imtaiyaz
Published: September 2020

Exploring protein–ligand interactions is a subject of immense interest, as it provides deeper insights into molecular recognition, mechanism of interaction and subsequent functions. Predicting an accurate model for a protein–ligand interaction is a challenging task. Molecular docking is a computational method used for predicting the preferred orientation, binding conformations and the binding affinity of a ligand to a macromolecular target, especially protein. It has been applied in ‘virtual high-throughput screening’ of chemical libraries containing millions of compounds to find potential leads in drug design and discovery. Here, we have developed InstaDock, a free and open access Graphical User Interface (GUI) program that performs molecular docking and high-throughput virtual screening efficiently. InstaDock is a single-click GUI that uses QuickVina-W, a modified version of AutoDock Vina for docking calculations, made especially for the convenience of non-bioinformaticians and for people who are not experts in using computers. InstaDock facilitates onboard analysis of docking and visual results in just a single click. To sum up, InstaDock is the easiest and more interactive interface than ever existing GUIs for molecular docking and high-throughput virtual screening. InstaDock is freely available for academic and industrial research purposes via https://hassanlab.org/instadock.
Elevation as a selective force on mitochondrial respiratory chain complexes of thePhrynocephaluslizards in the Tibetan plateau
Authors: Jin Yuanting , Y C Brandt Débora , Li Jiasheng , Wo Yubin , Tong Haojie , Shchur Vladimir
Published: September 2020

Animals living in extremely high elevations have to adapt to low temperatures and low oxygen availability (hypoxia), but the underlying genetic mechanisms associated with these adaptations are still unclear. The mitochondrial respiratory chain can provide >95% of the ATP in animal cells, and its efficiency is influenced by temperature and oxygen availability. Therefore, the respiratory chain complexes (RCCs) could be important molecular targets for positive selection associated with respiratory adaptation in high-altitude environments. Here, we investigated positive selection in 5 RCCs and their assembly factors by analyzing sequences of 106 genes obtained through RNA-seq of all 15 Chinese Phrynocephalus lizard species, which are distributed from lowlands to the Tibetan plateau (average elevation >4,500 m). Our results indicate that evidence of positive selection on RCC genes is not significantly different from assembly factors, and we found no difference in selective pressures among the 5 complexes. We specifically looked for positive selection in lineages where changes in habitat elevation happened. The group of lineages evolving from low to high altitude show stronger signals of positive selection than lineages evolving from high to low elevations. Lineages evolving from low to high elevation also have more shared codons under positive selection, though the changes are not equivalent at the amino acid level. This study advances our understanding of the genetic basis of animal respiratory metabolism evolution in extreme high environments and provides candidate genes for further confirmation with functional analyses.
Abandoning resectional intent in patients initially deemed suitable for esophagectomy: a nationwide study of risk factors and outcomes
Authors: Edholm David , Lindblad Mats , Linder Gustav
Published: September 2020

The main curative treatment modality for esophageal cancer is resection. Patients initially deemed suitable for resection may become unsuitable, most commonly due to signs of generalized disease or having become unfit for surgery. The aim was to assess risk factors for abandoning esophagectomy and its impact on survival. All patients diagnosed with an esophageal or gastroesophageal junction cancer in the Swedish National Register for Esophageal and Gastric Cancer from 2006–2016 were included and risk factors associated with becoming ineligible for resection were analyzed in multivariable logistic regression analysis. Overall survival was explored by multivariable Cox regression models. Among 1,792 patients planned for resection, 189 (11%) became unsuitable for resection before surgery and 114 (6%) had exploratory surgery without resection. Intermediate and high educational levels were associated with an increased probability of resection (odds ratio (OR) 1.46, 95% CI 1.05–2.05, OR 1.92, 95% CI 1.28–2.87, respectively) as was marital status (married: OR 1.37, 95% CI 1.01–1.85). Clinically advanced disease (cT4: OR 0.38, 95% CI 0.16–0.87; cN3: OR 0.27, 95% CI 0.09–0.81) and neoadjuvant treatment were associated with a decreased probability of resection (OR 0.62, 95% CI 0.46–0.88).

Five-year survival for non-resected patients was only 4.5% although neoadjuvant treatment was associated with improved survival (HR 0.75, 95% CI 0.56–0.99). Non-resected patients with squamous cell carcinoma had comparatively reduced survival (HR 1.64, 95% CI 1.10–2.43). High socioeconomic status was associated with an increased probability of completing the plan to resect whereas clinically advanced disease and neoadjuvant treatment were independent factors associated with increased risk of abandoning resectional intent.
Optimal selection of endoscopic resection in patients with esophageal squamous cell carcinoma: endoscopic mucosal resection versus endoscopic submucosal dissection according to lesion size
Authors: Kawashima Kazumasa , Abe Seiichiro , Koga Masakazu , Nonaka Satoru , Suzuki Haruhisa , Yoshinaga Shigetaka , Oda Ichiro , Hikichi Takuto , Ohira Hiromasa , Saito Yutaka
Published: September 2020

En bloc resection is essential for accurate pathological evaluation in patients with superficial esophageal squamous cell carcinoma (SESCC). This retrospective study aimed to clarify optimal treatment selection of endoscopic resection according to lesion size. A total of 760 patients underwent endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) between January 2011 and December 2015. Among them, this retrospective study included 196 solitary index SESCC lesions ≤20 mm, with the deepest invasion to the mucosa or superficial submucosa endoscopically. The lesions were classified according to size measured via endoscopy as follows; group A: lesions ≤10 mm, group B: lesions ≥11 mm but ≤15 mm, and group C: lesions ≥16 mm but ≤20 mm. The short- and long-term outcomes were investigated for EMR and ESD subgroups. In patients undergoing EMR and ESD, en bloc resection rates for group A and B were not different (98.8 vs. 100%, 93.3 vs. 100%, respectively). However, the en bloc resection rate was significantly lower in EMR than that in ESD for group C (64.3 vs. 100%, P < 0.001). Furthermore, the use of adjunctive ablative therapy rate was significantly higher in EMR than that in ESD in group C (35.7 vs. 0%, P < 0.001). The 5-year cumulative local recurrence rate of group C was significantly higher than that of group A + B after EMR (P < 0.01). EMR was an adequate treatment for SESCC lesions ≤15 mm. On the other hand, ESD could be necessary to achieve en bloc resection for lesions ≥16 mm to avoid local recurrence.
Fit-for-Discharge Criteria after Esophagectomy: An International Expert Delphi Consensus
Authors: Müller P C , Kapp J R , Vetter D , Bonavina L , Brown W , Castro S , Cheong E , Darling G E , Egberts J , Ferri L , Gisbertz S S , Gockel I , Grimminger P P , Hofstetter W L , Hölscher A H , Low D E , Luyer M , Markar S R , Mönig S P , Moorthy K , Morse C R , Müller-Stich B P , Nafteux P , Nieponice A , Nieuwenhuijzen G A P , Nilsson M , Palanivelu C , Pattyn P , Pera M , Räsänen J , Ribeiro U , Rosman C , Schröder W , Sgromo B , van Berge Henegouwen M I , van Hillegersberg R , van Veer H , van Workum F , Watson D I , Wijnhoven B P L , Gutschow C A
Published: September 2020

There are no internationally recognized criteria available to determine preparedness for hospital discharge after esophagectomy. This study aims to achieve international consensus using Delphi methodology. The expert panel consisted of 40 esophageal surgeons spanning 16 countries and 4 continents. During a 3-round, web-based Delphi process, experts voted for discharge criteria using 5-point Likert scales. Data were analyzed using descriptive statistics. Consensus was reached if agreement was ≥75% in round 3. Consensus was achieved for the following basic criteria: nutritional requirements are met by oral intake of at least liquids with optional supplementary nutrition via jejunal feeding tube. The patient should have passed flatus and does not require oxygen during mobilization or at rest. Central venous catheters should be removed. Adequate analgesia at rest and during mobilization is achieved using both oral opioid and non-opioid analgesics. All vital signs should be normal unless abnormal preoperatively. Inflammatory parameters should be trending down and close to normal (leucocyte count ≤12G/l and C-reactive protein ≤80 mg/dl). This multinational Delphi survey represents the first expert-led process for consensus criteria to determine ‘fit-for-discharge’ status after esophagectomy. Results of this Delphi survey may be applied to clinical outcomes research as an objective measure of short-term recovery. Furthermore, standardized endpoints identified through this process may be used in clinical practice to guide decisions regarding patient discharge and may help to reduce the risk of premature discharge or prolonged admission.
The consolidation of royal control: evidence from northern Castile, 1352–1787
Authors: Figueroa Valentín
Published: September 2020

Rulers of modern states consolidated control over territories that were previously complicated mosaics of private political jurisdictions. Systematic information about this process is sparse. This article analyzes village-level transition paths between jurisdictions—royal, seigneurial, and ecclesiastical—in northern Castile in the period 1352–1787. It quantifies how much power different types of lords preserved or lost to the Crown in the long run and also offers conjectural estimates showing that exposure to opportunities for trade led to more resilient and larger royal domains—at the expense of secular lords, but not of the Catholic Church.
Impaired Myocardial Energetics Causes Mechanical Dysfunction in Decompensated Failing Hearts
Authors: Lopez Rachel , Marzban Bahador , Gao Xin , Lauinger Ellen , Van den Bergh Françoise , Whitesall Steven E , Converso-Baran Kimber , Burant Charles F , Michele Daniel E , Beard Daniel A
Published: September 2020

Cardiac mechanical function is supported by ATP hydrolysis, which provides the chemical-free energy to drive the molecular processes underlying cardiac pumping. Physiological rates of myocardial ATP consumption require the heart to resynthesize its entire ATP pool several times per minute. In the failing heart, cardiomyocyte metabolic dysfunction leads to a reduction in the capacity for ATP synthesis and associated free energy to drive cellular processes. Yet it remains unclear if and how metabolic/energetic dysfunction that occurs during heart failure affects mechanical function of the heart. We hypothesize that changes in phosphate metabolite concentrations (ATP, ADP, inorganic phosphate) that are associated with decompensation and failure have direct roles in impeding contractile function of the myocardium in heart failure, contributing to the whole-body phenotype. To test this hypothesis, a transverse aortic constriction (TAC) rat model of pressure overload, hypertrophy, and decompensation was used to assess relationships between metrics of whole-organ pump function and myocardial energetic state. A multiscale computational model of cardiac mechanoenergetic coupling was used to identify and quantify the contribution of metabolic dysfunction to observed mechanical dysfunction. Results show an overall reduction in capacity for oxidative ATP synthesis fueled by either fatty acid or carbohydrate substrates as well as a reduction in total levels of adenine nucleotides and creatine in myocardium from TAC animals compared to sham-operated controls. Changes in phosphate metabolite levels in the TAC rats are correlated with impaired mechanical function, consistent with the overall hypothesis. Furthermore, computational analysis of myocardial metabolism and contractile dynamics predicts that increased levels of inorganic phosphate in TAC compared to control animals kinetically impair the myosin ATPase crossbridge cycle in decompensated hypertrophy/heart failure.
Older People’s Nonphysical Contacts and Depression During the COVID-19 Lockdown
Authors: Arpino Bruno , Pasqualini Marta , Bordone Valeria , Solé-Auró Aïda
Published: September 2020

Background and Objectives

With the goal of slowing down the spread of the SARS-CoV-2 virus, restrictions to physical contacts have been taken in many countries. We examine to what extent intergenerational and other types of nonphysical contacts have reduced the risk of increased perceived depressive feelings during the lockdown for people aged 50+.

Research Design and Methods

We implemented an online panel survey based on quota sampling in France, Italy, and Spain in April 2020, about 1 month after the start of the lockdown. Our analyses are based on logistic regression models and use post-stratification weights.

Results

About 50% of individuals aged 50+ felt sad or depressed more often than usual during the lockdown in the 3 considered countries. Older people who increased or maintained unchanged nonphysical contacts with noncoresident individuals during the lockdown were at a lower risk of increased perceived depressive feelings compared to those who experienced a reduction in nonphysical contacts. The beneficial effect of nonphysical contacts was stronger for intergenerational relationships. The effects were similar by gender and stronger among individuals aged 70+, living in Spain and not living alone before the start of the lockdown.

Discussion and Implications

In the next phases of the COVID-19 pandemic, or during any future similar pandemic, policy makers may implement measures that balance the need to reduce the spread of the virus with the necessity of allowing for limited physical contacts. Social contacts at a distance may be encouraged as a means to keep social closeness, while being physically distant.
The limited contribution from outer core dynamics to global deformations at the Earth’s surface
Authors: Gillet N , Dumberry M , Rosat S
Published: September 2020

Planetary scale interannual deformations of the Earth’s surface, of millimetric amplitude, have recently been related to both geomagnetic field changes and motion within the fluid outer core. We calculate the temporal variations of the dynamical pressure at the surface of the core associated with core flow models inverted from geomagnetic observations. From these we compute predictions of the changes in Earth’s topography in response to elastic deformations in the mantle. We show that at decadal periods, the predicted changes in Earth’s topography are at most of the order of 0.3 mm. Focused at interannual periods between 4 and 9.5 yr, the predicted topography variations are smaller than 0.05 mm, at least an order of magnitude smaller than the reported observations. These amplitudes are only weakly sensitive to the choice of hypothesis used to reconstruct fluid motions at the core surface. We conclude that surface deformations induced by dynamical pressure changes in the core are below the detection level at present-day. Alternative geophysical sources must be sought to explain the observed millimetric interannual variations of the planetary scale topography, and its associated gravity variations. We currently see no justification for a physical relationship between interannual fluctuations of the geomagnetic field and of Earth’s observed deformations. We conjecture that the largest gravity signal of core origin is potentially associated with decadal longitudinal oscillations of the inner core. It might be detectable as longer series will become available.
Application of a convolutional neural network for seismic phase picking of mining-induced seismicity
Authors: Johnson Sean W , Chambers Derrick J A , Boltz Michael S , Koper Keith D
Published: September 2020

Monitoring mining-induced seismicity (MIS) can help engineers understand the rock mass response to resource extraction. With a thorough understanding of ongoing geomechanical processes, engineers can operate mines, especially those mines with the propensity for rockbursting, more safely and efficiently. Unfortunately, processing MIS data usually requires significant effort from human analysts, which can result in substantial costs and time commitments. The problem is exacerbated for operations that produce copious amounts of MIS, such as mines with high-stress and/or extraction ratios. Recently, deep learning methods have shown the ability to significantly improve the quality of automated arrival-time picking on earthquake data recorded by regional seismic networks. However, relatively little has been published on applying these techniques to MIS. In this study, we compare the performance of a convolutional neural network (CNN) originally trained to pick arrival times on the Southern California Seismic Network (SCSN) to that of human analysts on coal-mine-related MIS. We perform comparisons on several coal-related MIS data sets recorded at various network scales, sampling rates and mines. We find that the Southern-California-trained CNN does not perform well on any of our data sets without retraining. However, applying the concept of transfer learning, we retrain the SCSN model with relatively little MIS data after which the CNN performs nearly as well as a human analyst. When retrained with data from a single analyst, the analyst-CNN pick time residual variance is lower than the variance observed between human analysts. We also compare the retrained CNN to a simpler, optimized picking algorithm, which falls short of the CNN's performance. We conclude that CNNs can achieve a significant improvement in automated phase picking although some data set-specific training will usually be required. Moreover, initializing training with weights found from other, even very different, data sets can greatly reduce the amount of training data required to achieve a given performance threshold.
Improving offset detection algorithm of GNSS position time-series using spline function theory
Authors: Khazraei S M , Amiri-Simkooei A R
Published: September 2020

It is well known that unmodelled offsets in Global Navigation Satellite System (GNSS) position time-series can introduce biases into the station velocities. Although large offsets are usually reported or can be visually detected, automated offset detection algorithms require further investigation. This problem is still challenging as (small) geophysical offsets are usually covered by coloured noise and remain undetected. An offset detection algorithm has recently been proposed, which can detect and estimate offsets in both univariate and multivariate analyses. Although efficient in truly detecting offsets, this method still suffers from a high rate of detected fake offsets. To improve the offset detection performance, we attempt to stabilize the offset power spectrum to reduce the number of false detections. The spline function theory is adopted in the smoothness process of the power spectrum. The algorithm modified using the spline functions, referred to as As-mode, is compared with its original counterpart, called A-mode. The GNSS position time-series consisting of a linear trend, seasonal signals, offsets, and white plus coloured noise are simulated for the numerical comparison. The overall performance of the algorithm is significantly improved using the As-mode algorithm. The multivariate analysis shows that the truly detected offsets' percentage (true positive) increases from 52.9 per cent for A-mode to 61.1 per cent for As-mode. Further, the falsely detected offsets' percentage (false positive) is reduced from 40.6 per cent to 29.8 per cent. The algorithm was also tested on the DOGEx data set. The results indicate that the proposed method outperforms the existing solutions, with TP, FP and FN being 33.3 per cent, 32.3 per cent and 34.4 per cent, respectively. Also, in 90 per cent of the station, velocities are estimated at a 0.8 mm yr−1 distance from the simulated values.
Power, policy and abortion care in Uganda
Authors: Kagaha Alexander , Manderson Lenore
Published: September 2020

Unsafe abortion practices remain the major contributor to maternal death in Uganda, impeding the achievement of universal health coverage and quality of maternal health care. Using an ethnographic design and critical discourse analysis, we explored the operations of power in setting maternal healthcare priorities, as evident at the 2018 Reproductive, Maternal, Neonatal, Child and Adolescents Health Conference. Observational data were collected of the policy-making activities, processes and events and key informant interviews were conducted with 27 participants. We describe how neoliberal and state governance through the structure and organization of policy-making, epistemic governance and universal concepts of ‘high-impact’ interventions, results-based financing, cost-effectiveness and accountability converge to suppress the articulation of local conditions associated with unsafe and risky abortion. By defining maternity along the continuum of birth and emphasizing birthing women, priority-setting was directed towards interventions promoting women’s normative role as mothers while suppressing unmet abortion care needs. Finally, discursive and communicative materials controlled how women of reproductive age in Uganda managed reproduction.
Effect of publicly funded assisted reproductive technology on maternal and infant outcomes: a pre- and post-comparison study
Authors: Wei Shu Qin , Bilodeau-Bertrand Marianne , Lo Ernest , Auger Nathalie
Published: September 2020

STUDY QUESTION

Does publicly funded assisted reproductive technology result in improved maternal and infant outcomes?

SUMMARY ANSWER

Publicly funded ART in Quebec was associated with reduced risks of preeclampsia, cesarean delivery, preterm birth, low birth weight and other adverse outcomes.

WHAT IS KNOWN ALREADY

Publicly funded ART programs that provide free access to single embryo transfer are known to decrease the rate of multiple pregnancy, but the impact on other pregnancy outcomes is unknown.

STUDY DESIGN, SIZE, DURATION

We conducted a pre- and post-comparison study of 597 416 pregnancies conceived between July 2008 and September 2015 in Quebec, Canada, a region where public funding of ART began in August 2010.

PARTICIPANTS/MATERIALS, SETTING, METHODS

We included all pregnant women who conceived by ART (n = 14 309) or spontaneously (n = 583 107) and delivered a live or stillborn infant in hospitals of Quebec. The main exposure measure was conception before versus during the publicly funded ART program. Outcomes included measures of maternal and infant morbidity and mortality. We estimated risk ratios (RR) and 95% confidence intervals for the association of publicly funded ART with maternal and infant outcomes using log-binomial regression models adjusted for maternal characteristics.

MAIN RESULTS AND THE ROLE OF CHANCE

In this study, 2638 pregnancies were conceived by ART before, and 11 671 were conceived by ART, during public funding. Compared with no public funding, ART funding was associated with reduced risks of severe maternal morbidity (RR 0.64, 95% CI 0.50–0.83), preeclampsia (RR 0.55, 95% CI 0.44–0.68), cesarean delivery (RR 0.83, 95% CI 0.77–0.89), preterm birth (RR 0.67, 95% CI 0.60–0.75), low birth weight (RR 0.63, 95% CI 0.55–0.72), severe neonatal morbidity (RR 0.75, 95% CI 0.57–0.99) and neonatal intensive care unit admission (RR 0.65, 95% CI 0.53–0.78). When multiple pregnancies were excluded, ART funding continued to be associated with a lower risk of preeclampsia (RR 0.61, 95% CI 0.48–0.79) and preterm birth (RR 0.85, 95% CI 0.73–0.99). However, ART funding was associated with increased risk of gestational diabetes.

LIMITATIONS, REASONS FOR CAUTION

We had no information on the type of ART, number of in-vitro fertilization cycles or number of embryos transferred. We lacked data on body mass index, ethnicity and smoking and cannot rule out residual confounding.

WIDER IMPLICATION OF THE FINDINGS

Our findings suggest that publicly funded ART programs that encourage single embryo transfer may have substantial benefits for a range of maternal and infant outcomes, beyond prevention of multiple births.

STUDY FUNDING/COMPETING INTEREST(S)

This study was supported by grant 6D02363004 from the Public Health Agency of Canada. N.A. acknowledges a career award from the Fonds de recherche du Québec-Santé (34695). The authors declare no competing interests.

TRIAL REGISTRATION NUMBER

N/A
Hypothermia for cardiogenic encephalopathy in neonates with dextro-transposition of the great arteries
Authors: Boos Vinzenz , Bührer Christoph , Photiadis Joachim , Berger Felix
Published: September 2020

OBJECTIVES

Neonates with dextro-transposition of the great arteries (d-TGA) may experience rapid haemodynamic deterioration and profound hypoxaemia after birth. We report on d-TGA patients with severe acidosis, encephalopathy and their treatment with systemic hypothermia.

METHODS

This study is a single-centre retrospective cohort analysis of newborns with d-TGA.

RESULTS

Ninety-five patients (gestational age ≥35 weeks) with d-TGA and intended arterial switch operation were included. Ten infants (10.5%) with umbilical arterial blood pH > 7.10 experienced profound acidosis (pH < 7.00) within the first 2 h of life. Six of these patients displayed signs of encephalopathy and received therapeutic hypothermia. Apgar scores at 5 min independently predicted the development of neonatal encephalopathy during postnatal transition (unit Odds Ratio 0.17, 95% confidence interval 0.06–0.49, P = 0.001). Infants treated with hypothermia had a more severe preoperative course and required more often mechanical ventilation (100% vs 35%, P = 0.003), treatment with inhaled nitric oxide (50% vs 2.4%, P = 0.002) and inotropic support (67% vs 3.5%, P < 0.001), as compared to non-acidotic controls. The median age at cardiac surgery was 12 (range 6–14) days in cooled infants and 8 (4–59) days in controls (P = 0.088). Postoperative morbidity and total duration of hospitalization were not increased in infants receiving preoperative hypothermia. Mortality in newborns with severe preoperative acidosis was zero.

CONCLUSIONS

Newborn infants with d-TGA have a substantial risk for profound acidosis during the first hours of life. Systemic hypothermia for encephalopathic patients may delay corrective surgery without compromising perioperative outcomes.
Passivity-based control of islanded microgrids with unknown power loads
Authors: Avila-Becerril Sofía , Espinosa-Pérez Gerardo , Montoya Oscar Danilo , Garces Alejandro
Published: September 2020

In this paper, the control problem of microgrids (MGs)operating in islanded mode is approached from a passivity-based control perspective. A control scheme is proposed that, relying only on local measurements for the power converters included in the network representation, achieves both voltage regulation and power balance in the network through the generation of grid-forming and grid-following nodes. From the mathematical perspective, the importance of the contribution lies in the feature that, exploiting a port-controlled Hamiltonian representation of the MG, the closed-loop system’s stability properties are formally proved using arguments from the theory of non-linear dynamical systems. Fundamental for this achievement is the decomposition of the system into subsystems that require a control law and another whose variables can evolve in a free way. From the practical viewpoint, the advantage of the proposed controller lies in the feature that the power demanded by the loads is satisfied without neither computing its specific value nor solving the non-linear algebraic equations given by the power flow, avoiding the computational burden associated with this task. The usefulness of the scheme is illustrated via a numerical simulation that includes practical considerations.
A Zero-One Law for Uniform Diophantine Approximation in Euclidean Norm
Authors: Kleinbock Dmitry , Rao Anurag
Published: September 2020

We study a norm-sensitive Diophantine approximation problem arising from the work of Davenport and Schmidt on the improvement of Dirichlet’s theorem. Its supremum norm case was recently considered by the 1st-named author and Wadleigh [ 17], and here we extend the set-up by replacing the supremum norm with an arbitrary norm. This gives rise to a class of shrinking target problems for one-parameter diagonal flows on the space of lattices, with the targets being neighborhoods of the critical locus of the suitably scaled norm ball. We use methods from geometry of numbers to generalize a result due to Andersen and Duke [ 1] on measure zero and uncountability of the set of numbers (in some cases, matrices) for which Minkowski approximation theorem can be improved. The choice of the Euclidean norm on $\mathbb{R}^2$ corresponds to studying geodesics on a hyperbolic surface, which visit a decreasing family of balls. An application of the dynamical Borel–Cantelli lemma of Maucourant [ 25] produces, given an approximation function $\psi $, a zero-one law for the set of $\alpha \in \mathbb{R}$ such that for all large enough $t$ the inequality $\left (\frac{\alpha q -p}{\psi (t)}\right )^2 + \left (\frac{q}{t}\right )^2 < \frac{2}{\sqrt{3}}$ has non-trivial integer solutions.
Budget Depreciation: When Budgeting Early Increases Spending
Authors: Choe Yuna , Kan Christina
Published: September 2020

While budgeting in advance is seen as a good practice to control spending, this research shows that budgeting too early for a specific purchase may increase spending. We argue that as the temporal separation between budget setting and actual purchase increases, consumers become more willing to overspend because of what we term “budget depreciation.” Consumers adapt to the reference point set by the budget such that, over time, the budgeted level becomes the status-quo spending. Thus, as more time passes, pain of payment from the budgeted amount decreases, and the willingness-to-spend increases. Across a secondary dataset of real estate purchases, one field study, and three experiments, we find evidence that consumers who set a budget in the distant (vs. near) past are more likely to overspend relative to their budget. The effect emerges for single purchase occasions rather than a category of purchases over multiple occasions. It emerges because of the hypothesized pain-of-payment process (e.g., effect is stronger among tightwads, who feel greater pain from spending; effect is mitigated under budget reassessment, which prevents pain adaptation). Our work contributes to the mental budgeting literature by invoking a role for temporal separation and draws a novel connection to prior work on payment depreciation.
The poet’s skull
Authors: Mencfel Michał
Published: September 2020

This essay discusses collections of historical memorabilia assembled in Poland at the end of the eighteenth and the beginning of the nineteenth century, which contained the physical remains (bones and hair) of historical figures. An analysis is offered of the traditions and circumstances that made it acceptable and possible for Polish antiquaries and collectors to open the tombs of eminent historical figures and to remove the contents of graves to private collections. Emphasis is placed on the role of national trauma, brought about by the crisis of the partition of Poland, culminating in 1795 in the demise of Poland as an independent state, which provided an impetus for the development of a distinctive historical consciousness. It is argued that while objects of this kind would cause moral and other dilemmas in other countries in Europe, such concerns were absent in Poland owing to its unique situation. Attention is also paid to changing attitudes throughout the nineteenth century, which influenced both the shape of historical collections and the manner of examining the corpses of historical figures. An explanation is offered for why, in the second half of the nineteenth century, despite the continuing exploration of tombs, the practice of collecting and displaying human remains and grave goods never gained wide public approval.
Challenge Trials: What Are the Ethical Problems?
Authors: Hausman Daniel M
Published: September 2020

If, as is alleged, challenge trials of vaccines against COVID-19 are likely to save thousands of lives and vastly diminish the economic and social harms of the pandemic while subjecting volunteers to risks that are comparable to kidney donation, then it would seem that the only sensible objection to such trials would be to deny that they have low risks or can be expected to have immense benefits. This essay searches for a philosophical rationale for rejecting challenge trials while supposing that they have huge benefits and relatively low risks. Although it finds some force in objections to challenge trials grounded in the obligations of researchers to limit the harms imposed on some individuals for the benefit of others, it argues that there is no compelling objection to challenge trials of vaccines for COVID-19—if they have the benefits and risks that have been claimed.
“When Offered to Participate”: A Systematic Review and Meta-Analysis of Patient Agreement to Participate in Cancer Clinical Trials
Authors: Unger Joseph M , Hershman Dawn L , Till Cathee , Minasian Lori M , Osarogiagbon Raymond U , Fleury Mark E , Vaidya Riha
Published: September 2020

Background

Patient participation in clinical trials is vital for knowledge advancement and outcomes improvement. Few adult cancer patients participate in trials. Although patient decision-making about trial participation has been frequently examined, the participation rate for patients actually offered a trial is unknown.

Methods

A systematic review and meta-analysis using 3 major search engines was undertaken. We identified studies from January 1, 2000, to January 1, 2020, that examined clinical trial participation in the United States. Studies must have specified the numbers of patients offered a trial and the number enrolled. A random effects model of proportions was used. All statistical tests were 2-sided.

Results

We identified 35 studies (30 about treatment trials and 5 about cancer control trials) among which 9759 patients were offered trial participation. Overall, 55.0% (95% confidence interval [CI] = 49.4% to 60.5%) of patients agreed to enroll. Participation rates did not differ between treatment (55.0%, 95% CI = 48.9% to 60.9%) and cancer control trials (55.3%, 95% CI = 38.9% to 71.1%; P = .98). Black patients participated at similar rates (58.4%, 95% CI = 46.8% to 69.7%) compared with White patients (55.1%, 95% CI = 44.3% to 65.6%; P = .88). The main reasons for nonparticipation were treatment choice or lack of interest.

Conclusions

More than half of all cancer patients offered a clinical trial do participate. These findings upend several conventional beliefs about cancer clinical trial participation, including that Black patients are less likely to agree to participate and that patient decision-making is the primary barrier to participation. Policies and interventions to improve clinical trial participation should focus more on modifiable systemic structural and clinical barriers, such as improving access to available trials and broadening eligibility criteria.
The close binary fraction as a function of stellar parameters in APOGEE: a strong anticorrelation with α abundances
Authors: Mazzola Christine N , Badenes Carles , Moe Maxwell , Koposov Sergey E , Kounkel Marina , Kratter Kaitlin , Covey Kevin , Walker Matthew G , Thompson Todd A , Andrews Brett , Freeman Peter E , Anguiano Borja , Carlberg Joleen K , De Lee Nathan M , Frinchaboy Peter M , Lewis Hannah M , Majewski Steven , Nidever David , Nitschelm Christian , Price-Whelan Adrian M , Roman-Lopes Alexandre , Stassun Keivan G , Troup Nicholas W
Published: September 2020

We use observations from the Apache Point Observatory Galactic Evolution Experiment (APOGEE) survey to explore the relationship between stellar parameters and multiplicity. We combine high-resolution repeat spectroscopy for 41 363 dwarf and subgiant stars with abundance measurements from the APOGEE pipeline and distances and stellar parameters derived using Gaia DR2 parallaxes from Sanders & Das to identify and characterize stellar multiples with periods below 30 yr, corresponding to ΔRVmax ≳ 3 km s−1, where ΔRVmax is the maximum APOGEE-detected shift in the radial velocities. Chemical composition is responsible for most of the variation in the close binary fraction in our sample, with stellar parameters like mass and age playing a secondary role. In addition to the previously identified strong anticorrelation between the close binary fraction and [Fe/H], we find that high abundances of α elements also suppress multiplicity at most values of [Fe/H] sampled by APOGEE. The anticorrelation between α abundances and multiplicity is substantially steeper than that observed for Fe, suggesting C, O, and Si in the form of dust and ices dominate the opacity of primordial protostellar discs and their propensity for fragmentation via gravitational stability. Near [Fe/H] = 0 dex, the bias-corrected close binary fraction (a < 10 au) decreases from ≈100 per cent at [α/H] = −0.2 dex to ≈15 per cent near [α/H] = 0.08 dex, with a suggestive turn-up to ≈20 per cent near [α/H] = 0.2. We conclude that the relationship between stellar multiplicity and chemical composition for sun-like dwarf stars in the field of the Milky Way is complex, and that this complexity should be accounted for in future studies of interacting binaries.