bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with poor oral health‐related quality of life among non‐institutionalized Brazilian older adults
Authors: Tenani Carla Fabiana , De Checchi Maria Helena Ribeiro , da Cunha Inara Pereira , Mendes Karine Laura Cortellazzi , Soares Gustavo Hermes , Michel‐Crosato Edgard , Jamieson Lisa , Ju Xiangqun , Mialhe Fábio Luiz
Published: March 2021

Aims

To investigate the factors associated with poor oral health‐related quality of life (OHRQoL) in a sample of Brazilian older adults.

Methods and Results

A cross‐sectional study was conducted with 535 non‐institutionalized elders aged 60 years or older from Piracicaba, São Paulo, Brazil. OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). Data on sociodemographic characteristics, self‐perceived general health status, and health‐related behaviors were obtained through a structured questionnaire. Data on chronic diseases were obtained from health records. Associations between exploratory factors and low OHRQoL (% GOHAI score <30) were evaluated using multivariate Poisson regression models to estimate adjusted prevalence ratios (PRs) and confidence intervals. The mean OHRQoL score was 30 (± 4.4). In bivariate analysis, being not married, smoking, and self‐rated “fair/poor” general health status were associated with lower OHRQoL. In the adjusted model, self‐rated “fair/poor” general health (PR: 1.25; 95% CI: 1.05–1.48), presence of chronic diseases (PR: 1.88; 95% CI: 1.37–2.58), smoking (PR: 1.25; 95% CI: 1.02–1.53), and reason for last dental appointment (PR: 1.34; 95% CI: 1.13–1.59) were associated with poor OHRQoL.

Conclusion

Non‐institutionalized older adults with a history of chronic diseases, who smoke, have a negative perception of their general health, and had the last dental appointment motivated by pain present significantly higher prevalence rates of poor OHRQoL.
Factors determining nurses’ knowledge of evidence‐based pressure ulcer prevention practices in Finland: a correlational cross‐sectional study
Authors: Parisod Heidi , Holopainen Arja , Koivunen Marita , Puukka Pauli , Haavisto Elina
Published: March 2021

Background

Pressure ulcers cause economic burden, human suffering, pain and decreased health‐related quality of life in patients. Pressure ulcers are preventable in most cases, and nursing staff knowledge is a key factor in successful pressure ulcer prevention. Further evidence is needed to better tailor pressure ulcer prevention training programmes to the nursing staff.

Aim

To evaluate the level of nursing staff knowledge about evidence‐based pressure ulcer prevention practices in both primary and specialised care, and to identify what factors determine nurses’ knowledge levels.

Methods

A correlational, cross‐sectional study was conducted from 2018 to 2019 in two hospital districts in Finland. The Pressure Ulcer Prevention Knowledge test was used to collect data, and the Attitude towards Pressure ulcer Prevention (APuP) instrument was used as a background variable. The data were statistically analysed with Wilcoxon and Kruskal–Wallis tests, Spearman correlations and multiple linear regression.

Results

The pressure ulcer prevention knowledge of the participating registered nurses, practical nurses and ward managers (N = 554) was on average 24.40 (max. 35.00). There was no difference in the participants’ knowledge based on the type of unit in which they were working (primary or specialised care). The participants’ attitudes (p < 0.0001), current position (p = 0.0042), frequency of taking care of patients with pressure ulcers (p = 0.0001) and self‐evaluated training needs (p < 0.0001) independently explained the variation in the knowledge scores.

Conclusions

Special attention needs to be paid to the knowledge of those nurses working in positions that require lower levels of education and those who rarely take care of patients with pressure ulcers. Supporting nurses’ positive attitudes towards pressure ulcer prevention should be an essential part of pressure ulcer prevention training. Nurses’ self‐evaluations of their training needs can be used to target training. The limitations of the study should be considered when generalising the results.
Older hospitalised patients’ experience of involvement in discharge planning
Authors: Schjødt Karina , Erlang Anne Snoghøj , Starup‐Linde Jakob , Jensen Annesofie Lunde
Published: March 2021

Introduction

Worldwide healthcare policy highlights patient involvement and participation. Older people with chronic diseases and comorbidities are in need of complex healthcare. Even though these issues have been highlighted, there is a need to investigate older patients’ perspective on discharge planning in order to ensure quality in the healthcare system.

Aim

The aim was to explore how older medical patients experience their own involvement in discharge planning from a medical department.

Methodological design

A qualitative study using semi‐structured interviews with 20 patients aged 60+. Interviews were conducted 1 week after discharge in the patients’ homes.

Ethical approval

The study was approved by the Danish Data Protection Agency, and ethical principles were applied while the study was being conducted. All participants provided informed consent.

Results

The participants had individual needs and various experiences of being involved in their discharge planning. One main category emerged from the study, “Different levels of rapport,” as well as three subcategories, “A lot of information—mostly from healthcare professionals to patients,” “The distribution of roles between healthcare professionals and patients” and “The meaning of having relatives.”

Conclusion

The participants had various experiences and preferences based on their involvement in discharge planning. In general, older people wished to be involved in discharge planning. Healthcare professionals should thus be aware of the involvement levels of such patients and adjust nursing to these levels during hospitalisation.
Recognition of a novel HLA‐B*13 allele, HLA‐B*13:153, in a Russian individual
Authors: Loginova Maria , Makhova Olga , Smirnova Daria , Kutyavina Svetlana , Paramonov Igor
Published: March 2021

One nucleotide replacement in codon 144 of HLA‐B*13:45 results in a novel allele, HLA‐B*13:153.
Cryopreservation of platelets treated with riboflavin and UV light and stored at −80°C for 1 year
Authors: Jimenez‐Marco Teresa , Ballester‐Servera Carme , Quetglas‐Oliver Miguel , Morell‐Garcia Daniel , Torres‐Reverte Natalia , Bautista‐Gili Antonia M. , Serra‐Ramon Neus , Girona‐Llobera Enrique
Published: March 2021

Background

The combination of pathogen reduction technologies (PRTs) and cryopreservation can contribute to building a safe and durable platelet (PLT) inventory. Information about cryopreserved riboflavin and UV light‐treated PLTs is scarce.

Study Design and Methods

Twenty‐four buffy coat (BC) PLT concentrates were grouped into 12 type‐matched pairs, pooled, and divided into 12 non‐PRT‐treated control units and 12 riboflavin and UV light PRT‐treated test units. Both were cryopreserved with 5% DMSO and stored at −80°C for 1 year. The cryopreservation method used was designed to avoid the formation of aggregates. PLT variables (PLT recovery, swirling, pH, MPV, and LDH) and hemostatic function measured by thromboelastography (TEG) were analyzed before cryopreservation (day 1) and post‐cryopreservation at day 14 and months 3, 6, and 12 of storage at −80°C. The analyses were carried out within 1‐h post‐thaw.

Results

No aggregates were found in either PLT group at any time. Swirling was observed in both groups. MPV increased and mean pH values decreased over time (p < .001), but the mean pH value was never below 6.4 in either group after 12 months of storage at −80°C. PLT recovery was good and clotting time became significantly shorter over the storage period in both groups (p < .001).

Conclusion

Our cryopreservation and thawing method prevented aggregate formation in cryopreserved riboflavin‐UV‐light‐treated PLTs, which exhibited good recovery, swirling, pH > 6.4, and procoagulant potential, as evidenced by a reduced clotting time after 12 months of storage at −80°C. The clinical relevance of these findings should be further investigated in clinical trials.
A simplified CD34+ based preharvest prediction tool for HPC(A) collection
Authors: Jacob Reuben P. , Walsh Eileen M. , Maslak Peter G. , Giralt Sergio A. , Avecilla Scott T.
Published: March 2021

Background

Hematopoietic stem cell transplantation is an important treatment that is dependent on the collection of sufficient CD34+ hematopoietic progenitor cells. The peripheral blood CD34 count (PB CD34+ counts) measured by flow cytometry can be used in predicting CD34+ stem cell yields hours before the completion of collection. Previously described formulas to predict the yield have used many different variables. As such, there is currently no consensus on an industry‐standard algorithm or formula.

Study Design and Methods

Retrospective reviews of same‐day PB CD34+ counts and the ensuing absolute CD34+ yields of mobilized donors (allogeneic and autologous) were used to develop and validate a formula using regression analysis to predict the CD34+ stem cell yield. A metric of prediction correlation, using root mean square error (RMSE), was used to assess the robustness of our prediction formula in addition to comparisons with two other published formulas, as well as subset analysis.

Results

A formula in the form of y = mxb with r = 0.95 and 95% confidence intervals was generated and validated. The ratio of actual to predicted yield demonstrated a high correlation coefficient (r = 0.96) with linear regression and overall RMSE of 228.4, which was lower than the two prior studies (calculated RMSE = 330.8 and 405.2). Subset analyses indicated male patients, lymphoma patients, and patients >60 years of age demonstrated lower RMSEs.

Conclusion

We have demonstrated a simple yet robust formula that can be used prospectively to accurately predict the CD34+ stem cell yield in both autologous and allogeneic donors, which also accounts for recipient weight.
Pregnancy‐induced changes in β‐cell function: what are the key players?
Authors: Salazar‐Petres Esteban Roberto , Sferruzzi‐Perri Amanda Nancy
Published: March 2021

Maternal metabolic adaptations during pregnancy ensure appropriate nutrient supply to the developing fetus. This is facilitated by reductions in maternal peripheral insulin sensitivity, which enables glucose to be available in the maternal circulation for transfer to the fetus for growth. To balance this process and avoid excessive hyperglycaemia and glucose intolerance in the mother during pregnancy, maternal pancreatic β‐cells undergo remarkable changes in their function including increasing their proliferation and glucose‐stimulated insulin secretion. In this review we examine how placental and maternal hormones work cooperatively to activate several signalling pathways, transcription factors and epigenetic regulators to drive adaptations in β‐cell function during pregnancy. We also explore how adverse maternal environmental conditions, including malnutrition, obesity, circadian rhythm disruption and environmental pollutants, may impact the endocrine and molecular mechanisms controlling β‐cell adaptations during pregnancy. The available data from human and experimental animal studies highlight the need to better understand how maternal β‐cells integrate the various environmental, metabolic and endocrine cues and thereby determine appropriate β‐cell adaptation during gestation. In doing so, these studies may identify targetable pathways that could be used to prevent not only the development of pregnancy complications like gestational diabetes that impact maternal and fetal wellbeing, but also more generally the pathogenesis of other metabolic conditions like type 2 diabetes.

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Corridos del destierro
Authors: Torres Lavao Juan Sebastián
Published: March 2021

Corridos del destierro nace a cinco horas de San José del Guaviare, en el pueblo Jaime Pardo Leal, que en ese tiempo era zona veredal. Este libro tiene el objetivo de acercar al lector las vidas de algunos guerrilleros que conformaban las FARC-EP, mediante una puesta en escena sensible que se encargará de sumergir al lector en un viaje. Esta apuesta literaria busca desestabilizar las representaciones hegemónicas y, en cambio, quiere mostrar un crisol de emociones, de sentires y motivos presentes en el escenario de la guerra. En definitiva, lo que se busca es generar una memoria de los movimientos del destierro y del temple que se necesita para sobrevivir en las entrañas de un Estado que gobierna con el miedo y la incertidumbre.
Geometrical and Metallurgical Changes in Steel Surfaces Under Conditions of Boundary Lubrication
Authors: Sakmann B. W.
Published: March 2021

Changes taking place in metal surfaces during running-in tests are reported. The surfaces were lubricated during the tests which simulated conditions encountered in industrial practice. In all tests the geometry of the surfaces was changed. Furthermore, under certain conditions, metallurgical changes could be observed. The material of the transformation was considerably harder than the martensitic steel of the test samples, and the etching characteristics of the transformed material were markedly different from those of the underlying steel. For initially smooth surfaces, the metallurgical transformations had the form of ridgelike eruptions protruding over the surface of the test specimen by several microns. Different tests for the identification of the nature of the transformation are discussed. Heat-conductivity calculations made it possible to estimate the temperature reached during running-in. A tentative explanation of the origin of the transformations is presented.
The Shape and Tension of a Light Flexible Cable in a Uniform Current
Authors: Landweber L. , Protter M. H.
Published: March 2021

The authors consider the several cases of a towing cable in which the frictional forces as well as the normal forces are taken into account in determining the shape of the cable, the weight of the cable being neglected. Equations and curves are derived by means of which any problem of this type, involving towing cables or loops, can be treated. Examples are given which illustrate solutions to various towline problems.
Method of Characteristics for Two-Dimensional Supersonic Flow—Graphical and Numerical Procedures
Authors: Shapiro Ascher H. , Edelman Gilbert M.
Published: March 2021

The method of characteristics for two-dimensional supersonic flow is reviewed and summarized. A characteristics chart is presented for use with the graphical procedure of Prandtl and Busemann. A new numerical procedure is described which eliminates graphical operations and which allows of more accurate solutions. To facilitate the numerical method, a table of useful functions is included.
Calculation of Diffuser Efficiency for Two-Dimensional Flow
Authors: Binder R. C.
Published: March 2021

A method is presented for calculating the efficiency of a diffuser for two-dimensional, steady, incompressible flow without separation. The method involves a combination of organized boundary-layer data and frictionless potential-flow relations. The potential velocity and pressure are found after the boundary-layer growth is determined by a trial-and-check calculation.
On the Use of Power Laws in Stress Analysis Beyond the Elastic Range
Authors: Winzer Alice , Prager W.
Published: March 2021

In a recent paper A. A. Ilyushin drew attention to the remarkable simplicity which the theory of plastic deformation assumes when the secant shear modulus is taken as a power of the octahedral shearing stress. In the present paper Ilyushin’s results are discussed in connection with a specific example and it is shown that great caution is indicated in the use of such power laws.
The Mechanics and Thermodynamics of Steady One-Dimensional Gas Flow
Authors: Shapiro Ascher H. , Hawthorne W. R.
Published: March 2021

Recent developments in the fields of propulsion, flow machinery, and high-speed flight have emphasized the need for an improved understanding of the characteristics of compressible flow. A one-dimensional analysis for flow without shocks is presented which takes into account the simultaneous effects of area change, wall friction, drag of internal bodies, external heat exchange, chemical reaction, change of phase, injection of gases, and changes in molecular weight and specific heat. The method of selecting independent and dependent variables, and the organization of the working equations, leads, it is believed, to a better understanding of the influence of the foregoing effects, and also simplifies greatly the analytical treatment of particular problems. Examples are given first of several simple types of flow, including (a) area change only; (b) heat transfer only; (c) wall friction only; and (d) gas injection only. In addition, examples of flow with combined effects are given, including (a) simultaneous friction and area change; (b) simultaneous friction and heat transfer; and (c) simultaneous liquid injection and evaporation. A one-dimensional analysis for flow through a discontinuity is presented, allowing for energy, shock, drag, and gas-injection effects, and for changes in gas properties. This analysis is applicable to such processes as: (a) the adiabatic normal shock; (b) combustion; (c) moisture condensation shocks; and (d) steady explosion waves.
The Permanent Strain in a Uniform Bar Due to Longitudinal Impact
Authors: White M. P. , Griffis LeVan
Published: March 2021

A method is presented for predicting the final strained state of a long uniform bar or wire of ductile material that is subjected to a longitudinal impact of finite duration during which the impact stress is constant and exceeds the yield strength. It is shown that for a long specimen this corresponds to giving the point of impact a constant velocity during the impact interval. (After this interval the stress at the end of the member is zero, but not its particle velocity.) It is also shown that the final unit strains are greatest immediately adjacent to the impact point and are constant over a finite length of specimen. Following this region of constant residual strain is a region, also of finite length, in which the permanent strain decreases steadily with distance from the end of the specimen. At the end of this there is another zone of constant permanent strain, which is followed by one of decreasing permanent strain, and so on. It is shown that there is a definite relation between the stress history at a point of a specimen and the velocity of that point—this relation is given. It is demonstrated that in tensile impact a critical velocity of impact can be defined, corresponding to the ultimate strength of the material. At impact velocities greater than this critical velocity, rupture occurs quickly and close to the point of impact so that the remainder of the specimen does not receive large deformations. Thus the energy required to break a specimen in tension is less at supercritical than at subcritical impact velocities.
A Reduced-Order Computational Model of a Semi-Active Variable-Stiffness Foot Prosthesis
Authors: McGeehan Michael A. , Adamczyk Peter G. , Nichols Kieran M. , Hahn Michael E.
Published: March 2021

Passive energy storage and return (ESR) feet are current performance standard in lower limb prostheses. A recently developed semi-active variable-stiffness foot (VSF) prosthesis balances the simplicity of a passive ESR device with the adaptability of a powered design. The purpose of this study was to model and simulate the ESR properties of the VSF prosthesis. The ESR properties of the VSF were modeled as a lumped parameter overhung beam. The overhung length is variable, allowing the model to exhibit variable ESR stiffness. Foot-ground contact was modeled using sphere-to-plane contact models. Contact parameters were optimized to represent the geometry and dynamics of the VSF and its foam base. Static compression tests and gait were simulated. Simulation outcomes were compared to corresponding experimental data. Stiffness of the model matched that of the physical VSF (R2: 0.98, root-mean-squared error (RMSE): 1.37 N/mm). Model-predicted resultant ground reaction force (GRFR) matched well under optimized parameter conditions (R2: 0.98, RMSE: 5.3% body weight,) and unoptimized parameter conditions (R2: 0.90, mean RMSE: 13% body weight). Anterior–posterior center of pressure matched well with R2 > 0.94 and RMSE < 9.5% foot length in all conditions. The ESR properties of the VSF were accurately simulated under benchtop testing and dynamic gait conditions. These methods may be useful for predicting GRFR arising from gait with novel prostheses. Such data are useful to optimize prosthesis design parameters on a user-specific basis.
Analysis of Reachable Workspace for Spatial Three-Cable Under-Constrained Suspended Cable-Driven Parallel Robots
Authors: Peng Yijia , Bu Wanghui
Published: March 2021

The workspace is an important reference for designs of cable-driven parallel robots (CDPRs). Most current researches focus on calculating the workspace of redundant CDPRs. However, few literature study the workspaces of under-constrained CDPRs. In this paper, the static equilibrium reachable workspaces (SERWs) of spatial 3-cable under-constrained CDPRs are solved numerically since expressions describing workspace boundaries cannot be obtained in closed forms. The steps to solve the SERWs are as follows. First, expressions that describe the SERWs and their boundaries are proposed. Next, these expressions are instantiated through a novel anchor points model composed of linear equations, quadratic equations, and tension limits in cables. Then, based on the reformulated linearization technique (RLT), the constraints system is transformed into a system containing only linear equality constraints and linear inequality constraints. Finally, the framework of the branch-and-prune (BP) algorithm is adopted to solve this system. The effect of the algorithm is verified by two examples. One is searching the SERWs boundaries of a special three-cable-driven parallel robot (CDPR) whose anchor points layouts both on the moving platform (MP) and on the base are equilateral triangles, followed by a method to extract the SERW boundary where cables do not interfere with each other. The other is searching the SERWs boundaries of a general three-cable CDPR with randomly selected geometry arrangement. The presented method in this paper is universal for calculating the SERWs of spatial three-cable CDPRs with arbitrary geometry parameters.
A Novel Nonlinear Disturbance Observer Embedded Second-Order Finite Time Tracking-Based Controller for Robotic Manipulators
Authors: Ren Bin , Wang Yao , Chen Jiayu , Chen Silu
Published: March 2021

Robotic manipulators are complex and dynamic nonlinear mechanical systems subject to numerous uncertainties, such as payload variations, frictions, and unmodeled dynamics. To mitigate the uncertainty caused by these disturbances and minimize the tracking errors of the controllers, this study proposed a finite time tracking-based controller (FTC) that embeds a (NDO) and a second-order sliding-mode modifier (SOSM). The NDO was incorporated to compensate for the system’s global bounded uncertainty and the SOSM used a robust nonsingular terminal sliding-mode modifier to stabilize the controller. The theoretical analysis showed that the tracking error could quickly converge in finite time. Simulation on a typical robotics manipulator demonstrated the practical appeal of the proposed scheme.
Assisted Spatial Sit-to-Stand Prediction—Part 2: Virtual Injured Elderly Individuals
Authors: Ozsoy Burak , Yang James
Published: March 2021

Sit-to-stand (STS) is a challenging task, especially for injured elderly in their daily life. This paper presents Part 2 of the assisted spatial STS computational motion prediction to investigate the effect of a unilateral grab-rail bar placed on the right-hand side on STS motion performance for injured virtual individuals (computational digital human model-DHM) with either right or left knee injury. The motion prediction formulation was constructed as a nonlinear optimization and validated in Part 1 of the assisted spatial STS motion prediction (Yang, J., and Ozsoy, B., 2021, “Assisted Spatial Sit-to-Stand Prediction—Part 1: VirtualHealthy Elderly Individuals,” ASME J. Comput. Inf. Sci. Eng., 21(4), p. 041002). Injuries are implemented into the formulation with reduction rates of 75% in a single knee‘s extension torque limits. Two different objective functions are tested: The first one is just minimizing the dynamic effort where the second one is minimizing the difference between right and left side support reaction forces in addition to the dynamic effort. Computational simulations resulted in that systematic changes are seen in the joint coordination better with the first objective function for the elderly group with either right or left knee injury. Since only one of the knees is modeled to experience a strength loss, virtual-individuals tend to flex their trunk to the intact side whilst rotating the upper-body to the right side with both objective functions due to holding the grab-rail bar, which was placed to the right side of the biomechanical model. Based on the peak values of the center of mass velocity and displacement profiles in both the medial-lateral axis, virtual-individuals prefer to use lateral plane motions less and transverse plane motions more to minimize the difference between right and left side-vertical support reaction forces with the second objective function.
Thermoeconomic Analysis of Vapor Compression Refrigeration System With Dedicated Subcooler for High-Temperature Lift Applications
Authors: Roy Ranendra , Bhowal Arup Jyoti , Mandal Bijan Kumar
Published: March 2021

A single-stage vapor compression refrigeration system becomes inefficient and impractical when the temperature lift between the evaporator and the condenser becomes large. Under the high-temperature lift, different losses in the system increase, and more refrigerant vapor is formed at the end of the throttling process. The authors have attempted to analyze a vapor compression refrigeration system with a dedicated subcooler for high-temperature lift applications using R134a in the main cycle and four low global warming potential (GWP) refrigerants in the subcooler cycle. The modeling of the proposed system has been carried out in Engineering Equation Solver (EES) considering the energy, exergy, and economic aspects for the simulation of the system. The predicted results show that the use of the proposed system is more beneficial from both performance and economic point of view for high-temperature lift. Nearly 27% improvement in both energetic and exergetic performances are noted whereas cost is reduced by 2% when the proposed system is used instead of a typical refrigeration system. Finally, the present investigation concludes that the use of refrigerant R1234ze is much efficient than the other investigated refrigerants due to its low GWP and compressor discharge temperature, in spite of achieving better thermo-economic performances using R152a as subcooler refrigerant.
Longitudinal Relationships Between Maturation, Technical Efficiency, and Performance in Age-Group Swimmers: Improving Swimmer Evaluation
Authors: Abbott Shaun , Yamauchi Goshi , Halaki Mark , Castiglioni Marcela Torres , Salter James , Cobley Stephen
Published: March 2021

Purpose: The study aimed to (1) accurately examine longitudinal relationships between maturity status and both technical skill indices and performance in Australian male (N = 64) age-group Front-crawl swimmers (10–15 y) and (2) determine whether individual differences in maturation influenced relationships between technical skill level and swimming performance. Methods: A repeated-measures design was used to assess maturity status and performance on 200-m Front-crawl trial across 2 competition seasons (2018–2020). Assessments were made on 3 to 5 occasions (median = 3) separated by approximately 4 months. Average horizontal velocity and stroke frequency were used to calculate technical skill indices, specifically stroke index, and arm propelling efficiency. Relationships between variables were assessed using linear mixed models, identifying fixed, and random effect estimates. Results: Curvilinear trends best described significant longitudinal relationships between maturity status with horizontal velocity (F = 10.33 [1, 233.77]; P = .002) and stroke index (F = 5.55 [1, 217.9]; P = .02) during 200-m Front-crawl trials. Maturity status was not significantly related to arm propelling efficiency (P = .08). However, arm propelling efficiency was an independent predictor of Front-crawl velocity (F = 55.89 [1, 210.45]; P < .001). Conclusions: Maturity status predicted assessment of swimmer technical skill (stroke index) and swimming performance. However, technical skill accessed via arm propelling efficiency was independent of maturation and was predictive of performance. Maturity status influences performance evaluation based on technical skill and velocity. Findings highlight the need to account for maturation and technical skill in age-group swimmers to better inform swimmer evaluation.
Ancient Earth was a water world
Authors: Voosen Paul
Published: March 2021

Life and plate tectonics may have emerged on a planet drowned in water that was rejected by the mantle.
Genomic, epigenomic, and biophysical cues controlling the emergence of the lung alveolus
Authors: Zepp Jarod A. , Morley Michael P. , Loebel Claudia , Kremp Madison M. , Chaudhry Fatima N. , Basil Maria C. , Leach John P. , Liberti Derek C. , Niethamer Terren K. , Ying Yun , Jayachandran Sowmya , Babu Apoorva , Zhou Su , Frank David B. , Burdick Jason A. , Morrisey Edward E.
Published: March 2021

Transitioning lung for postnatal life

The lung is a complex organ composed of multiple cell types, and its alveolus serves as the functional unit of gas exchange. The alveolar type 1 cell (AT1) serves as an active signaling hub in the developing and postnatal mouse and human lung. Zepp
et al.
generated a comprehensive single-cell atlas of the developing murine lung and identified cell differentiation and cell-to-cell communication as the lung transitions to air breathing. The AT1 cells spatially aligned with stromal progenitors and formed a signaling hub that preferentially communicated with a transient, force-exerting, myofibroblast through signaling factors including Shh and Wnts to actively remodel the alveolus after the transition to air breathing.

Science
, this issue p.
eabc3172
Structure of the human Mediator-bound transcription preinitiation complex
Authors: Abdella R. , Talyzina A. , Chen S. , Inouye C. J. , Tjian R. , He Y.
Published: March 2021

Mediating transcription

The Mediator complex is recruited by transcription factors to all protein-coding genes in eukaryotes and helps to assemble the machinery necessary to transcribe the gene. Abdella
et al.
present the cryo–electron microscopy structure of the human Mediator-bound preinitiation complex (Med-PIC). The structure shows how Mediator positions the long, flexible C-terminal domain of RNA polymerase II to be phosphorylated by the kinase CDK7, a crucial step for further processing of the RNA into a mature RNA. Most sites where transcription factors bind to Mediator are flexibly tethered to the complex, allowing the large Med-PIC to assemble at any gene.

Science
, this issue p.
52
Dispatches from life's blurry boundaries
Life's Edge: The Search for What It Means to Be Alive
Carl Zimmer
Dutton, 2021. 368 pp.
Authors: Dunn Rob
Published: March 2021

How we think about what it means to be alive will always depend on what questions we ask
Magic, symmetry, and twisted matter
Authors: Yazdani Ali
Published: March 2021

Alternating magic-angle twist induces unconventional superconductivity
“Birth” of the modern ocean twilight zone
Authors: Bopp Laurent
Published: March 2021

The recently evolved mesopelagic zone faces an uncertain future
Fungi prevent intestinal healing
Authors: Chiaro Tyson , Round June L.
Published: March 2021

Antibiotics open niches for fungi with detrimental consequences to wound healing
COVID-19 lessons for research
Authors: Collins Francis S.
Published: March 2021

As we mark the 1-year anniversary of the declaration by the World Health Organization (WHO) of COVID-19 as a global pandemic, the world has suffered a staggering and tragic human toll. During this dark time, the scientific community has been called to rise to the occasion in unprecedented ways. The intensity of the work and the sense of urgency have been unremitting and exhausting. As we sort out the triumphs and frustrations, we can begin to reflect on what we have learned.
Behind the scenes of the CRISPR story
Authors: Thorp H. Holden
Published: March 2021

Walter Isaacson, one of America's foremost biographers, recently told me that he sees three fundamental units as the cornerstones of 20th-century innovation: the bit, the atom, and the gene. Having written about Steve Jobs and Albert Einstein—embodiments of the first two—in previous works, in his latest book,
The Code Breaker
, reviewed in this issue of
Science
(see page 1213), Isaacson's focus turns to the gene. His story centers on the life of biochemist Jennifer Doudna, who, together with Emmanuelle Charpentier, won the 2020 Nobel Prize in Chemistry for their pioneering work on the gene editing technology known as CRISPR-Cas9. The book is an extraordinarily detailed and revealing account of scientific progress and competition that grants readers behind-the-scenes access to the scientific process, which the COVID-19 pandemic has taught us remains opaque to the wider public. It also provides lessons in science communication that go beyond the story itself.
Coronavirus-Specific Antibody Cross Reactivity in Rhesus Macaques following SARS-CoV-2 Vaccination and Infection
Authors: Jacob-Dolan Catherine , Feldman Jared , McMahan Katherine , Yu Jingyou , Zahn Roland , Wegmann Frank , Schuitemaker Hanneke , Schmidt Aaron G. , Barouch Dan H.
Published: March 2021

The rapid development and deployment of SARS-CoV-2 vaccines has been unprecedented. In this study, we explore the cross-reactivity of SARS-CoV-2-specific antibody responses to other coronaviruses.
Supplemental Material: Curation and analysis of global sedimentary geochemical data to inform Earth history
Authors: Mehra Akshay
Published: March 2021

Table of valid lithologies; map depicting sample locations; crossplot illustrating analytical uncertainty; flowchart of the proposed workflow; histograms showing the effects of progressive filtering, the distribution of spatial and age scales, and proximity and probability values; and results of parameters sensitivity tests.
Measuring safety in older adult care homes: a scoping review of the international literature
Authors: Rand Stacey , Smith Nick , Jones Karen , Dargan Alan , Hogan Helen
Published: March 2021

Background

Safety is a key concern in older adult care homes. However, it is a less developed concept in older adult care homes than in healthcare settings. As part of study of the collection and application of safety data in the care home sector in England, a scoping review of the international literature was conducted.

Objectives

The aim of the review was to identify measures that could be used as indicators of safety for quality monitoring and improvement in older adult residential or nursing care homes.

Sources of evidence

Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019.

Eligibility criteria

Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria.

Charting methods

Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps.

Results and conclusions

Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019. Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home.

A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria. Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps.

The findings indicate that there are a range of available safety measures used for quality monitoring and improvement in older adult care homes. These cover all five domains of safety in the SMMF. However, there are potential gaps. These include user experience, psychological harm related to the care home environment, abusive or neglectful care practice and the processes for integrated learning. Some of these gaps may relate to challenges and feasibility of measurement in the care home context.
Link between COVID-19-related in-hospital mortality in continental France administrative areas and weather: an ecological study
Authors: Mejdoubi Mehdi , Djennaoui Mehdi , Kyndt Xavier
Published: March 2021

Objective

To assess the effect of a weather index on in-hospital COVID-19-linked deaths.

Design

Ecological study.

Setting

Continental France administrative areas (départements; henceforth counties). The study period, from 18 March to 30 May 2020, corresponds to the main first outbreak period in France.

Population

COVID-19-linked in-hospital deaths.

Main outcome measures

In-hospital deaths and demographics (population, human density, male sex and population percentage >59 years old) were obtained from national and centralised public databases. County weather indexes were calculated by the French National Meteorological Agency.

Methods

In this observational ecological study, the relationship between in-hospital COVID-19-related mortality and climate zones in continental French counties were analysed, by comparing the cumulative in-hospital death tolls in France by county to other factors (population density, climate, age and sex). The study period lasted from 18 March to 30 May 2020. A multivariate linear-regression analysis of in-hospital mortality included climate zones, population density, population >59 years old and percentages of males as potential predictors. The significance level was set at 5%.

Results

Weather indicators and population density were factors independently associated with the COVID-19 death toll. Colder counties had significantly higher mortality rates (p<0.00001). Percentages of males and population >59 years old in counties did not affect COVID-19 in-hospital mortality.

Conclusions

Many parameters influence COVID-19 outbreak-severity indicators. Population density is a strong factor but its exact importance is difficult to discern. Weather (mainly cold winter temperatures) was independently associated with mortality and could help explain outbreak dynamics, which began and were initially more severe in the coldest counties of continental France. Weather partly explains fatality-rate discrepancies observed worldwide.
A qualitative exploration of patients’ experiences, needs and expectations regarding online access to their primary care record
Authors: McMillan Brian , Davidge Gail , Brown Lindsey , Lyons Moira , Atherton Helen , Goulding Rebecca , Mold Freda , Morris Rebecca L , Sanders Caroline
Published: March 2021

Objectives

Primary care records have traditionally served the needs and demands of clinicians rather than those of the patient. In England, general practices must promote and offer registered patients online access to their primary care record, and research has shown benefits to both patients and clinicians of doing so. Despite this, we know little about patients’ needs and expectations regarding online access to their record. This study explored what patients and carers want from online access to their electronic primary care health record, their experiences of using it, how they would like to interact with their record and what support they may need.

Design

Focus groups and semistructured interviews using purposive sampling to achieve a good sociodemographic spread. Interviews were digitally audiorecorded, transcribed and coded using an established thematic approach.

Setting

Focus groups and interviews were conducted in community settings in the UK.

Participants

Fifty-four individuals who were either eligible for the National Health Service Health Check, living with more than one long-term condition or caring for someone else.

Results

Participants views regarding online access were categorised into four main themes: awareness, capabilities, consequences and inevitability. Participants felt online access should be better promoted, and suggested a number of additional functions, such as better integration with other parts of the healthcare system. It was felt that online access could improve quality of care (eg, through increased transparency) but also have potential negative consequences (eg, by replacing face to face contact). A move towards more online records access was considered inevitable, but participants noted a need for additional support and training in using the online record, especially to ensure that health inequalities are not exacerbated.

Conclusions

Discussions with patients and carers about their views of accessing online records have provided useful insights into future directions and potential improvements for this service.
International assessment of the link between COVID-19 related attitudes, concerns and behaviours in relation to public health policies: optimising policy strategies to improve health, economic and quality of life outcomes (the iCARE Study)
Authors: Bacon Simon L , Lavoie Kim L , Boyle Jacqueline , Stojanovic Jovana , Joyal-Desmarais Keven
Published: March 2021

Introduction

In the context of a highly contagious virus with only recently approved vaccines and no cure, the key to slowing the spread of the COVID-19 disease and successfully transitioning through the phases of the pandemic, including vaccine uptake, is public adherence to rapidly evolving behaviour-based public health policies. The overall objective of the iCARE Study is to assess public awareness, attitudes, concerns and behavioural responses to COVID-19 public health policies, and their impacts, on people around the world and to link behavioural survey data with policy, mobility and case data to provide behavioural science, data-driven recommendations to governments on how to optimise current policy strategies to reduce the impact of the COVID-19 pandemic.

Methods and analyses

The iCARE study (www.icarestudy.com) uses a multiple cross-sectional survey design to capture self-reported information on a variety of COVID-19 related variables from individuals around the globe. Survey data are captured using two data capture methods: convenience and representative sampling. These data are then linked to open access data for policies, cases and population movement.

Ethics and dissemination

The primary ethical approval was obtained from the coordinating site, the Centre intégré universitaire de santé et de services sociaux du Nord-de-l’Île-de-Montréal (REB#: 2020–2099/03–25–2020). This study will provide high-quality, accelerated and real-time evidence to help us understand the effectiveness of evolving country-level policies and communication strategies to reduce the spread of the COVID-19. Due to the urgency of the pandemic, results will be disseminated in a variety of ways, including policy briefs, social media posts, press releases and through regular scientific methods.
Prolonged grief disorder prevalence in adults 65 years and over: a systematic review
Authors: Thiemann Pia , Street Anna Naomi , Heath Sarah Eleanor , Quince Thelma , Kuhn Isla , Barclay Stephen
Published: March 2021

Background

Prolonged grief disorder (PGD) is a recently recognised mental health disorder with an estimated prevalence of 10% in the bereaved adult population. This review aims to appraise and summarise evidence relating to PGD in older adults (≥65 years), a growing population group, most likely to experience bereavement and often assumed to cope well.

Method

Literature from Medline, PsycINFO, CINAHL, Cochrane Library and Web of Science was searched. Epidemiological and non-epidemiological studies including data on frequency of PGD in older adults bereaved by mainly natural causes were included and a descriptive analysis undertaken.

Results

From 2059 records, three epidemiological and six non-epidemiological studies were included. Most studies had good internal but not external validity. Conditional prevalence for PGD ranged between 3.2% and 48.8%. Heterogeneity in sample characteristics and study methodology contributed to this variability resulting in a descriptive analysis. The prevalence rate of 9.1% by Kerstinget alwas the best available estimate for PGD in older adults for western countries. The small number of epidemiological studies and the use of varying PGD-constructs which did not match International Classification of Diseases 11th Revision and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria were the main limiting factors.

Conclusion

This first review on PGD prevalence in older adults suggests that, despite studies’ methodological short comings, a similar proportion of older adults experience PGD as the general bereaved adult population (1:10). With older adults forming the largest subgroup among the bereaved, health and social care systems need to adapt their provision of care to address the specific needs of older adults.