bluuebunny/crossref_metadata_2025 huggingface dataset:
Sasakian Structures on Tangent Sphere Bundles of Compact Rank-One Symmetric Spaces
Authors: González-Dávila J. C.
Published: September 2022

A positive answer is given to the existence of Sasakian structures on the tangent sphere bundle of some Riemannian manifold whose sectional curvature is not constant. Among other results, it is proved that the tangent sphere bundle $$T_{r}(G/K),$$

T
r

(
G
/
K
)

,

for any $$r> 0,$$

r
>
0
,

of a compact rank-one symmetric space G/K,  not necessarily of constant sectional curvature, admits a unique G-invariant K-contact structure whose characteristic vector field is the standard field of T(G/K). Such a structure is in fact Sasakian and it can be expressed as an induced structure from an almost Hermitian structure on the punctured tangent bundle $$T(G/K){\setminus } \{\text{ zero } \text{ section }\}.$$

T
(
G
/
K
)
\
{

zero

section

}
.
Étale Covers and Fundamental Groups of Schematic Finite Spaces
Authors: Sánchez González J. , Tejero Prieto C.
Published: September 2022

We introduce the category of finite étale covers of an arbitrary schematic space X and show that, equipped with an appropriate natural fiber functor, it is a Galois Category. This allows us to define the étale fundamental group of schematic spaces. If X is a finite model of a scheme S, we show that the resulting Galois theory on X coincides with the classical theory of finite étale covers on S, and therefore, we recover the classical étale fundamental group introduced by Grothendieck. To prove these results, it is crucial to find a suitable geometric notion of connectedness for schematic spaces and also to study their geometric points. We achieve these goals by means of the strong cohomological constraints enjoyed by schematic spaces.
Urban–rural disparities in diabetes-related mortality in the USA 1999–2019
Authors: Kobo Ofer , Van Spall Harriette G. C. , Mamas Mamas A.
Published: September 2022

Aims/hypothesis

Our study aimed to examine the trends in diabetes-related mortality in urban and rural areas in the USA over the past two decades.

Methods

We examined the trends in diabetes-related mortality (as the underlying or a contributing cause of death) in urban and rural areas in the USA between 1999 and 2019, using the CDC WONDER Multiple Cause of Death database. We estimated the 20 year trends of the age-adjusted mortality rate (AAMR) per 100,000 population in urban vs rural counties.

Results

The AAMR of diabetes was higher in rural than urban areas across all subgroups. In urban areas, there was a significant decrease in the AAMR of diabetes as the underlying (−16.7%) and contributing (−13.5%) cause of death (ptrend<0.001), which was not observed in rural areas (+2.6%, +8.9%, respectively). AAMRs of diabetes decreased more significantly in female compared with male individuals, both in rural and urban areas. Among people younger than 55 years old, there was a temporal increase in diabetes-related AAMR (+13.8% to +65.2%). While the diabetes-related AAMRs of American Indian patients decreased in all areas (−19.8% to −40.5%, all ptrend<0.001), diabetes-related AAMRs of Black and White patients decreased significantly in urban (−26.6% to −28.3% and −10.7% to −15.4%, respectively, all ptrend<0.001) but not rural areas (−6.5% to +1.8%, +2.4% to +10.6%, respectively, ptrend NS, NS, NS and <0.001).

Conclusions/interpretation

The temporal decrease in diabetes-related mortality in the USA has been observed only in urban areas, and mainly among female and older patients. A synchronised effort is needed to improve cardiovascular health indices and healthcare access in rural areas and to decrease diabetes-related mortality.

Graphical abstract
The incidence of unexpected uterine malignancies in hysterectomies carried out for benign indications
Authors: Ding Yuanyuan , Han Yana , Zhang Sanyuan , Shi Xiaorong
Published: September 2022

Purpose

The aim of the present study was to evaluate the incidence of unexpected uterine malignancies in patients undergoing hysterectomy for benign indications and to evaluate their clinical characteristics.

Methods

We conducted a retrospective review of patients who underwent benign hysterectomy in the Department of Gynecology, the First Hospital of Shanxi Medical University from January 2015 to December 2020. The clinical data of these patients were retrieved and collected.

Results

Their median age was 49.8 years (31–82 years). The mean parity was 1.86 ± 2.54. Their mean BMI was 27.5 ± 7.6 kg/m2. 42.90% were (2438/5683) postmenopausal. The benign indications of procedure were as follows: symptomatic uterine leiomyomas 2218/5683 (39.02%), pelvic organ prolapse 1406/5683 (24.74%), symptomatic endometriosis or adenomyosis 1132/5683 (19.91%), and 927/5683 (16.31%) to treat other benign conditions such as abnormal uterine bleeding, infection, polyps, and endometrial hyperplasia without atypia. In minimally invasive surgery subgroups, 1560/2621 (59.52%) specimens were removed by in-bag manual morcellation through vaginal cuff. The mean operative time of minimally invasive surgery with in-bag morcellation was shorter than abdominal hysterectomy (96.75 ± 35.7 vs. 140 ± 32.6, P < .001), and the estimated blood loss was also less than abdominal hysterectomy (47.35 ± 42.3 vs. 170 ± 60.4, P < .001). A total of 19/5683 (0.33%) unexpected uterine malignancies were recorded, of which 14/5683 (0.26%) were unexpected endometrial carcinomas and 5/5683 (0.08%) were unexpected uterine sarcomas.

Conclusion

Preoperative examination in the context of benign hysterectomy must be undertaken with care, and patients should be educated about the very slight possibility of a malignant diagnosis.
Extended calculation method for determining the pitting load carrying capacity of bevel and hypoid gears
Authors: Drechsel Alexander , Constien Lorenz , Pellkofer Josef , Boiadjiev Ivan , Stahl Karsten
Published: September 2022

The flank load carrying capacity of bevel and hypoid gears is mainly limited by the failure modes pitting, scuffing, tooth flank fracture and the phenomenon micropitting. By application of a standardized calculation method, e.g. according to the international standard ISO 10300:2014, a first estimation of the flank load carrying capacity can be made based on the macro geometry of the bevel or hypoid gear set. According to method B of ISO 10300:2014 the complexity of the real geometry of bevel and hypoid gears is reduced to a virtual cylindrical gear geometry.

The load carrying capacity regarding scuffing, micropitting and tooth flank fracture can be determined by using the virtual cylindrical gear geometry along the path of contact. However, the determination of the pitting load carrying capacity is carried out on a single representative point on the path of contact of the virtual cylindrical gear.

This paper shows an extended calculation method for the determination of the pitting load carrying capacity of bevel and hypoid gears along the path of contact of the virtual cylindrical gear geometry. Due to the calculation along the path of contact the extended method allows a more precise estimation of the pitting load carrying capacity than the current standard calculation method ISO 10300-2:2014 using the same input data. Within this paper all relevant factors of the extended calculation method are explained in detail. Furthermore, the verification of the extended calculation method with calculation results of an intense validated loaded tooth contact analysis, corresponding to method A of ISO 10300-2:2014, is presented.
Realistic visualization of debris flow type landslides through virtual reality
Authors: Alene Gebray H. , Vicari Hervé , Irshad Shafaq , Perkis Andrew , Bruland Oddbjørn , Thakur Vikas
Published: September 2022

Immersive media technologies, such as virtual and augmented reality, have recently enabled a more holistic way to comprehend natural hazards. In this work, we aim at visualizing the temporal and spatial evolution of a debris flow in a virtual reality environment. We develop a framework to integrate the output results obtained from a debris flow numerical model into virtual reality. To guide the framework, a real debris flow event, which happened in Hunnedalen (Norway) in 2016 and blocked a road network, is considered as a case study. The debris flow is back-calculated using a depth-averaged numerical model and the simulation results are imported into a dedicated game engine to construct a digital model of the debris flow event. The debris flow is visualized using a Head-Mounted Display. We therefore discuss a wide range of potential applications of virtual reality to manage and grasp landslide phenomena: training for rescue operations; improving decision-making; studying early warning systems, and educating communities affected by natural hazards. We finally provide a quantitative evaluation of the hazard perception for a road user. We show that the debris flow movement is perceived at variable delayed times from the triggering of the landslide, depending on the position along the road where the debris flow is observed. Evaluating the realistic perception time of the natural hazard may be fundamental to designing more effective road networks, signs, and mitigation measures.
Antidepressant medication use and prostate cancer recurrence in men with depressive disorders
Authors: Haque Reina , Reading Stephanie , Irwin Michael R. , Chen Lie Hong , Slezak Jeff
Published: September 2022

Purpose

Whether treating prostate cancer survivors with a depressive disorder with antidepressants can affect their cancer outcomes is unknown. We evaluated the association between antidepressant use and prostate cancer recurrence, in survivors with comorbid depressive disorders.

Methods

We conducted a longitudinal cohort study of 10,017 men with prostate cancer (stages I–II) diagnosed who also had a comorbid depressive disorder followed a maximum of 22 years, and examined rates of biochemical recurrence by antidepressant medication use. We conducted multivariable Cox models based on time-dependent antidepressant drug use status, and examined the risk of biochemical recurrence by cumulative duration of antidepressant use.

Results

Of these 10,017 survivors, 1842 (18%) experienced biochemical recurrence over 69,500 person-years of follow-up. The prostate cancer biochemical recurrence rate was greater with antidepressant non-use (31.3/1000 person-years) compared to antidepressant use (23.5/1000 person-years). In Cox proportional hazards multivariable adjusted models, non-use of antidepressants was associated with a 34% increased risk of biochemical recurrence compared to antidepressant use (HR = 1.34, 95% CI: 1.24–1.44). Longer use of antidepressants was associated with a lower biochemical recurrence risk (P trend test < 0.001).

Conclusion

Untreated depressive disorders in prostate cancer patients may be associated with an increased risk of biochemical recurrence.
Initial teacher education (ITE) students’ perceptions of typical engineers: assessing potential for bias in the formative career decision years
Authors: Fox-Turnbull Wendy H. , Docherty Paul D. , Zaka Pinelopi , Impey Tessa
Published: September 2022

There is a recognised lack of women participating in engineering and STEM in most western countries. However, it is desirable for engineering cohorts to have a broad diversity. Hence, girls need to be encouraged into all engineering fields, but especially those traditionally dominated by men such as civil, mechanical and software engineering. A number of factors influence students’ critical career decisions. In particular, teachers influence their students in a number of different ways, some overt and others subliminal, including influencing students’ self-image and belief in capability. Students between the ages of 11–13 years often develop images of themselves that can exclude them from careers in technology related careers such as engineering.

This study conducted structured interviews with 20 initial teacher education students and two of their lecturers. The interviews considered the students experiences in their own career selection, the reasons one may encourage someone to consider engineering, and the participants of engineering and engineering practice. Interpretation of interview transcriptions indicated that most final year teacher-education students held either limited or stereotypical views of engineering. Participants thought of engineers as mainly for men or “country-type” girls who were good at maths and science. Most recognised the practical nature of engineering, some the academic nature. There was little recognition of the social and empathetic characteristics required.

These outcomes imply a gap in understanding that may cause teachers to rely on their gender prejudice, rather than the skills beneficial in the career when providing career advice to potential engineers.
Links Between Feeding Preferences and Electroantennogram Response Profiles in Dung Beetles: The Importance of Dung Odor Bouquets
Authors: Urrutia Miguel A. , Cortez Vieyle , Verdú José R.
Published: September 2022

The detection of dung odors is a crucial step in the food-searching behavior of dung beetles (Coleoptera: Scarabaeoidea). Yet, whether certain compounds characteristic of a given dung type contribute to a ‘choosy generalism’ behavior proposed for this taxonomic group is unknown. To address this, we analyzed the chemical composition of three types of dung (cow, horse, and rabbit) and conducted behavioral and electroantennogram (EAG) bioassays on 15 species of dung beetles using 19 volatile organic compounds representing the three dung samples. Chemical analyses revealed substantial qualitative and quantitative differences among dung types. When offered these food options in an olfactometer, 14 species exhibited a feeding preference. Surprisingly, all 19 compounds used in the EAG assays elicited antennal responses, with species displaying different olfactory profiles. The relationship between behavioral preferences and electrophysiological profiles highlighted that species with different food preferences had differences in antennal responses. Moreover, a specific set of EAG-active compounds (nonanal, sabinene, acetophenone, ρ-cresol, 2-heptanone, 1H-indole, and 6-methyl-5-hepten-2-one) were the strongest drivers in the distinct sensory profiles of the trophic preference groups. Our results point to the importance of the whole bouquet of dung-emanating compounds in driving food-searching behavior, but specific volatiles could aid in determining highly marked trophic preferences in certain species.
Down a Rabbit Hole: Burrowing Behaviour and Larger Home Ranges are Related to Larger Brains in Leporids
Authors: Todorov Orlin S. , Hird Coen , Kraatz Brian , Sherratt Emma , Hill Narelle , de Sousa Alexandra A. , Blomberg Simone , Weisbecker Vera
Published: September 2022

Studies on the evolution of brain size variation usually focus on large clades encompassing broad phylogenetic groups. This risks introducing ‘noise’ in the results, often obscuring effects that might be detected in less inclusive clades. Here, we focus on a sample of endocranial volumes (endocasts) of 18 species of rabbits and hares (Lagomorpha: Leporidae), which are a discrete radiation of mammals with a suitably large range of body sizes. Using 60 individuals, we test five popular hypotheses on brain size and olfactory bulb evolution in mammals. We also address the pervasive issue of missing data, using multiple phylogenetic imputations as to conserve the full sample size for all analyses. Our analyses show that home range and burrowing behaviour are the only predictors of leporid brain size variation. Litter size, which is one of the most widely reported constraints on brain size, was unexpectedly not associated with brain size. However, a constraining effect may be masked by a strong association of litter size with temperature seasonality, warranting further study. Lastly, we show that unreasonable estimations of phylogenetic signal (Pagel’s lamba) warrant additional caution when using small sample sizes, such as ours, in comparative studies.
Differential diagnosis of infectious diseases, drug-induced lung injury, and pulmonary infiltration due to underlying malignancy in patients with hematological malignancy using HRCT
Authors: Tanaka Nobuyuki , Kunihiro Yoshie , Kawano Reo , Yujiri Toshiaki , Ueda Kazuhiro , Gondo Toshikazu , Kobayashi Taiga , Matsumoto Tsuneo
Published: September 2022

Purpose

To differentiate among infectious diseases, drug-induced lung injury (DILI) and pulmonary infiltration due to underlying malignancy (PIUM) based on high-resolution computed tomographic (HRCT) findings from patients with hematological malignancies who underwent chemotherapy or hematopoietic stem cell transplantation.

Materials and methods

A total of 221 immunocompromised patients with hematological malignancies who had proven chest complications (141 patients with infectious diseases, 24 with DILI and 56 with PIUM) were included. Two chest radiologists evaluated the HRCT findings, including ground-glass opacity, consolidation, nodules, and thickening of bronchovascular bundles (BVBs) and interlobular septa (ILS). After comparing these CT findings among the three groups using the χ2test, multiple logistic regression analyses (infectious vs noninfectious diseases, DILI vs non-DILI, and PIUM vs non-PIUM) were performed to detect useful indicators for differentiation.

Results

Significant differences were detected in many HRCT findings by the χ2 test. The results from the multiple logistic regression analyses identified several indicators: nodules without a perilymphatic distribution [p = 0.012, odds ratio (95% confidence interval): 4.464 (1.355–11.904)], nodules with a tree-in-bud pattern [p = 0.011, 8.364 (1.637–42.741)], and the absence of ILS thickening[p = 0.003, 3.621 (1.565–8.381)] for infectious diseases, the presence of ILS thickening [p = 0.001, 7.166 (2.343–21.915)] for DILI, and nodules with a perilymphatic distribution [p = 0.011, 4.256 (1.397–12.961)] and lymph node enlargement (p = 0.008, 3.420 (1.385–8.441)] for PIUM.

Conclusion

ILS thickening, nodules with a perilymphatic distribution, tree-in-bud pattern, and lymph node enlargement could be useful indicators for differentiating among infectious diseases, DILI, and PIUM in patients with hematological malignancies.
The Molecular Effects of Environmental Enrichment on Alzheimer’s Disease
Authors: Liew Anthony Kin Yip , Teo Chuin Hau , Soga Tomoko
Published: September 2022

Environmental enrichment (EE) is an environmental paradigm encompassing sensory, cognitive, and physical stimulation at a heightened level. Previous studies have reported the beneficial effects of EE in the brain, particularly in the hippocampus. EE improves cognitive function as well as ameliorates depressive and anxiety-like behaviors, making it a potentially effective neuroprotective strategy against neurodegenerative diseases such as Alzheimer’s disease (AD). Here, we summarize the current evidence for EE as a neuroprotective strategy as well as the potential molecular pathways that can explain the effects of EE from a biochemical perspective using animal models. The effectiveness of EE in enhancing brain activity against neurodegeneration is explored with a view to differences present in early and late life EE exposure, with its potential application in human being discussed. We discuss EE as one of the non pharmacological approaches in preventing or delaying the onset of AD for future research.
Indocyanine Green to Visualize and Resect Pulmonary Sequestration in Adults
Authors: Ibrahim A. , Murtaja A. , Oberhuber A.
Published: September 2022

Pulmonary sequestration (PS) is a rare congenital pulmonary dysplasia which presents with recurrent chest infections and haemoptysis. Its diagnosis is difficult and suspected on contrast-enhanced chest CT. The definitive treatment of pulmonary sequestration is surgical resection or endoluminal occlusion of the abnormal feeding vessel. Here, we report an innovative technique in which per-operative indocyanine green guided excision of intra-lobar sequestrated lung parenchyma and ligation of abnormal feeding vessel. The first patient was a 44-year-old gentleman with recurrent bouts of cough for 2 years. Courses of antibiotics failed to resolve it. Fibreoptic bronchoscopy and routine blood tests did not show any abnormality. CECT chest showed multiloculated cystic solid and low density mass in the right lower lung. The area of the lesion received its blood supply from anomalous systemic artery originating from coeliac trunk. Intraoperative, indocyanine green was injected into the atypical vessel, and pulmonary sequestration turned green. A sequential atypical lung resection could be completely removed with parenchyma preservation. The second patient was a 53-year-old lady presenting with chest pain, cough and expectoration for 2 years not responding to general management and antibiotics. CECT showed a low-density mass in the right lower lung lobe, with a feeding arterial vessel arising from the abdominal aorta. This was diagnosed as PS and resected using per-operative indocyanine green with parenchymal preservation and ligation of feeding vessel. Both patients have been followed up for at least 1 year and are symptom free. The intraoperative use of indocyanine green could greatly facilitate the presentation of the extent of a lung sequestration and safe resection.
Is Being Funny a Useful Policy? How Local Governments’ Humorous Crisis Response Strategies and Crisis Responsibilities Influence Trust, Emotions, and Behavioral Intentions
Authors: Hämpke Janna , Röseler Stefan , Thielsch Meinald T.
Published: September 2022

This study is the first to investigate how a local government’s humorously framed response strategy on social media to a low-severity crisis influences people’s trust in the local government and their crisis-related behavioral intentions, specifically when considering the government’s responsibility for the crisis. Based on the situational crisis communication theory, we examined the mediating role of experienced positive or negative affect on people’s responses to a local government’s crisis communication strategy. Further, we exploratorily examined the predictive power and moderating role of demographics, sense of humor, disposition to trust, and the respective crisis scenarios. A total of 517 people participated in an online experiment in which they were confronted with three randomly presented fictive crisis scenarios where the local government’s crisis responsibility (high versus low) and the framing of their crisis response strategy (in form of humorous versus rational Twitter posts) were systematically varied between subjects. First, the results mostly corroborate earlier findings about the degree of crisis responsibility (that is, when a government’s crisis responsibility is high, people have less trust and behavioral intentions) and about the mediating role of experienced affect. Second, we found that humorously framed strategies negatively influence trust and positive affect (but not behavioral intentions). In contrast to earlier findings, the crisis responsibility × framing interaction was not significant. Altogether, the results advise against using humor in crisis communications on social media, even in low-severity crisis. Exploratory analyses indicate that further investigations should focus on specific crisis characteristics and potential moderators.
Can Common Elements Support a Public Health Approach to Child Maltreatment?
Authors: Polimeni Melinda , Tan Evelyn , Fang Cheryl Seah Kwee , Lewis Jane , McLeod Bryce D. , Bjorndal Arild
Published: September 2022

Despite ongoing reforms to child protection systems and calls for a greater focus on prevention and early intervention, demand on statutory services continues to grow across developed countries. The reasons for this are multiple and complex and include: (1) barriers that exist within service systems themselves; (2) the entrenched and interwoven nature of the drivers of child maltreatment and (3) limited access to programs that can be implemented at scale. This means that empirically supported interventions that can address child maltreatment are not widely available to support a public health response. Several innovations to address the aforementioned challenges draw on ‘common elements’ approaches. Common elements are the discrete techniques commonly found in programs supported by evidence. Over the last 30 years, the evidence base regarding therapeutic techniques for child maltreatment has remained relatively stable, yet there has been a significant increase in the number of evidence-based programs or protocols available. Many of these protocols consist of different combinations of the same therapeutic elements. The Institute of Medicine in the USA has recently called for further research into common elements for psychosocial interventions as an approach to widening access to empirically supported techniques. This article will explore whether common elements may assist in overcoming some of the challenges we are facing in ‘realising’ a public health response to child maltreatment. The potential benefits and limitations of the approach will be outlined, as well as the existing evidence base, and future directions for research and evaluation.
What do climate impacts, health, and migration reveal about vulnerability and adaptation in the Marshall Islands?
Authors: Krzesni David , Brewington Laura
Published: September 2022

Climate change is impacting public health in the Republic of the Marshall Islands (RMI). Meanwhile, migration within the RMI and abroad is driven, in part, by access to better healthcare, and migration is also expected to be accelerated by climate change. Based on a survey of 199 RMI households, this study used logistic regression and hierarchical clustering to analyze the relationships between climate stressors, climate-related health impacts, and migration outcomes and identify vulnerable segments of the population. Climate stressors were experienced by all respondents but no significant correlations were found between stressors, health impacts, and expectation to migrate. When grouped according to the climate stressors they faced, however, one group was characterized by low stressors, high wealth, and a low expectation to migrate, whereas another experienced very high climate stressors, low wealth, and a high expectation to migrate. Only the first exhibited a statistically significant relationship between climate-related health impacts and migration; however, for the second, climate stressors were significantly related to proximate determinants of health, and there was no association with migration. To create equitable adaptation outcomes across diverse society, policies should expand economic and education prospects and reduce vulnerability to the direct and indirect health impacts of climate change.

Graphical Abstract

Households that were surveyed in the Marshall Islands have experienced many climate stressors and direct impacts to health, as well as the determinants of health, in recent years.
Survival After Being Wedged in a Crevasse for 16 Hours in Alaska
Authors: Giesbrecht Gordon G. , Zafren Ken , Anderson Jaime , Erickson Chris
Published: September 2022

We present a case of an un-roped mountaineer who fell into a crevasse during descent from the summit of Denali (Mount McKinley). He was wedged about 20 m deep in the crevasse for a total of 16 h; this included 4.5 h waiting for a rescue team to arrive, and an 11.5 h extrication process. His condition deteriorated and he eventually lost consciousness. Even though the rescue team collectively felt there was little or no chance of survival, they continued until the victim was extricated from the crevasse. He was almost immediately placed in a hypothermia wrap with active warming, loaded on a rescue helicopter, and transported for 1 h 40 min to a hospital in Fairbanks, Alaska. During the flight, he was placed on supplemental oxygen. He was cold to the touch; respiration was detectable, but a pulse was not, and he was responsive to verbal stimuli. Initial bladder temperature in hospital was 26.1°C. He was released from hospital after 14 d and made a full recovery. This case highlights an important mix of preventative and resuscitative lessons regarding crevasse rescue in an isolated location. The lessons include the dangers of travelling un-roped on a crevassed glacier, the challenges of extrication from a confined space, the fact that respirations are often more easily detected than pulses, an extended transport time to medical facilities, and the necessity of trying unorthodox extrication methods. This case emphasized the need to continue extrication and treatment efforts for a cold patient even when survival with hypothermia seems impossible.
Audit and feedback as a tool to increase compliance with carbapenemase-producing Enterobacteriaceae (CPE) screening and decrease CPE transmission in the hospital
Authors: Ben Natan Orna , Stein Michal , Reisfeld Sharon
Published: September 2022

Objective:

To increase compliance with carbapenemase-producing Enterobacteriaceae (CPE) screening through real-time audit and feedback in our hospital and decrease CPE transmissions.

Design:

A before-and-after trial, using active enhanced surveillance of CPE carriers.

Setting:

A 500-bed, secondary, university-affiliated hospital that serves a population of 450,000 in a northern district in Israel.

Methods:

The study was conducted during 2016–2019 and included patients who were admitted to the hospital and fulfilled CPE screening criteria upon admission and during prolonged hospitalizations. On January 1, 2017, the infection control team implemented a new strategy of real-time feedback toward compliance with in-hospital screening guidelines. Other infection control measurements were performed without interventions. The primary outcome was compliance with appropriate CPE screening. Secondary outcomes included CPE acquisition and compliance with hand hygiene and contact precaution practices. Data were analyzed to calculate differences between compliance with CPE screening during the study period and to test the correlation between contact precautions and hand hygiene practices according to compliance with CPE screening.

Results:

During the study period, 3,131 patients were eligible for CPE screening. We detected a statistically significant increase in compliance to CPE screening from 74% during 2017 to 92% in 2018 and 95% in 2019 (P < .0001 for both comparisons). We detected a decrease in CPE transmission from 12% in 2017 to 2% in 2019 (P < .0001). We did not find any correlation between other infection control interventions and CPE screening and acquisition.

Conclusion:

Audit and feedback can improve appropriate CPE screening and may reduce CPE transmission in the hospital.
Patients‘ Attitudes Towards Medical Student Presence in Psychiatric Consultations
Authors: Kolshus E. M. , Akinmoluwa S. , Sloan D. , MacSuibhne S. , Kolshus E. H.
Published: September 2022

Objectives:

Studies on patient-student relationships have to date largely focused on student attitudes. This study explores attitudes of patients with psychiatric illness in Ireland, towards medical students. Patients’ experience of consent for student involvement is an area of concern in previous studies and is also quantified here.

Methods:

This was a mixed-methods cross-sectional survey of Irish adult psychiatric patients. Quantitative analysis was carried out using SPSS 22 (Statistical Product and Service Solutions, Version 22, IBM). Differences on Likert score between groups (male/female, hospital site, past experience with students/ no experience) were analysed using ordinal logistic regression with a p-value below 0.05 being significant. Qualitative data were analysed by thematic analysis using OpenCode 4.03

Results:

A total of 340 patients completed the survey. The mean age (sd) was 44.8 (16.3). 52.8% were female, 75.2% were outpatients. 24.3% had never met a medical student. Most patients were comfortable seeing students, but preferred students being passive observers. Patients with previous student experience had higher comfort levels and more positive attitudes. Although most patients (63.7%) strongly agreed they had been asked for consent, only 49.3% felt they had been given sufficient information. Qualitative data revealed preference for adequate information and notice of involvement. Patients felt pressured by student presence in certain circumstances.

Conclusions:

Psychiatric patients are comfortable with students but many feel inadequately informed. Patients recognise the benefits of interacting with students. More information is needed regarding circumstances in which patients give consent to involvement with students
Effect of waveform on turbulence transition in pulsatile pipe flow
Authors: Morón Daniel , Feldmann Daniel , Avila Marc
Published: September 2022

Pulsatile flow in a straight pipe is a model system for unsteady internal flows in industrial engineering and physiology. In some parameter regimes, the laminar flow is susceptible to helical perturbations, whose transient energy growth scales exponentially with the Reynolds number (Re). In this paper, we link the transient growth of these perturbations to the instantaneous linear instability of the laminar flow. We exploit this link to study the effect of the waveform on turbulence transition by performing linear stability and transient growth analyses of flows driven with different waveforms. We find a higher-energy growth in flows driven with longer low-velocity phases as well as with steeper deceleration and acceleration phases. Finally, we perform direct numerical simulations and show that cases with larger transient growth transition faster to turbulence and exhibit larger turbulence intensities. However, these same cases are also more prone to relaminarisation once turbulence has been established. This highlights that, in pulsatile flows, the linear mechanisms responsible for turbulence transition are distinctly different from the nonlinear mechanisms sustaining turbulence.
Review of the parasitic nematodes of marine fishes from off the American continent
Authors: Pereira Felipe B. , González-Solís David
Published: September 2022

The ichthyofauna of the Atlantic and Pacific coasts off the American continent is very rich. Consequently, a high biodiversity of nematodes parasitizing these vertebrates is also expected. Currently, data on nematode parasites of marine fish off the Americas are fragmented. A review of all adult nematode species reported parasitizing marine fish from off the American continent is herein presented, as well as comments on their patterns of diversity, life cycles and advances in the taxonomic and phylogenetic knowledge. A total of 209 valid species, 19species inquirendaeand 6 dubious records have been recorded, the majority from the fish taxa Eupercaria and Perciformes. The families Sciaenidae, Serranidae and Lutjanidae, as well as the tropical and temperate Atlantic waters, exhibited the highest records of parasitic nematodes. The Cucullanidae, Philometridae and Cystidicolidae were the most speciose families of nematodes, which may be related to technological advances and relatively recent efforts of taxonomists, resulting in description of new taxa and the resolution of taxonomic problems. Numerous taxonomic questions still need resolution and, even though genetic data have been important for this process, the database is very scarce. This is the first review on all currently known nematode species parasitizing marine fish off the Americas and may serve as an important basis of reference for future approaches on these organisms.
Unravelling the trophic interaction between a parasitic barnacle (Anelasma squalicola) and its host Southern lanternshark (Etmopterus granulosus) using stable isotopes
Authors: Sabadel A. J. M. , Cresson P. , Finucci B. , Bennett J.
Published: September 2022

The parasitic barnacle, Anelasma squalicola, is a rare and evolutionary fascinating organism. Unlike most other filter-feeding barnacles, A. squalicola has evolved the capability to uptake nutrient from its host, exclusively parasitizing deepwater sharks of the families Etmopteridae and Pentanchidae. The physiological mechanisms involved in the uptake of nutrients from its host are not yet known. Using stable isotopes and elemental compositions, we followed the fate of nitrogen, carbon and sulphur through various tissues of A. squalicola and its host, the Southern lanternshark Etmopterus granulosus, to better understand the trophic relationship between parasite and host. Like most marine parasites, A. squalicola is lipid-rich and clear differences were found in the stable isotope ratios between barnacle organs. It is evident that the deployment of a system of ‘rootlets’, which merge with host tissues, allows A. squalicola to draw nutrients from its host. Through this system, proteins are then rerouted to the exterior structural tissues of A. squalicola while lipids are used for maintenance and egg synthesis. The nutrient requirement of A. squalicola was found to change from protein-rich to lipid-rich between its early development stage and its definitive size.
Systemic and Structural Injustice: Is There a Difference?
Authors: Haslanger Sally
Published: September 2022

The terms ‘structural injustice’ and ‘systemic injustice’ are commonly used, but their meanings are elusive. In this paper, I sketch an ontology of social systems that embeds accounts of social structures, relations, and practices. On this view, structures may be intrinsically problematic, or they may be problematic only insofar as they interact with other structures in the system to produce injustice. Because social practices that constitute structures set the backdrop for agency and identity, socially fluent agents reproduce the systems, often unknowingly and unintentionally. The account aims to capture how agents both depend on and enact structures, and do so in ways that, as Ta-Nehisi Coates says, ‘land on the body’.
Treating postpartum insomnia: a three arm randomised controlled trial of cognitive behavioural therapy and light dark therapy
Authors: Verma Sumedha , Quin Nina , Astbury Laura , Wellecke Cornelia , Wiley Joshua F. , Davey Margot , Rajaratnam Shantha M. W. , Bei Bei
Published: September 2022

Background

Insomnia symptoms are common during the postpartum period, yet interventions remain scarce. This trial aimed to simultaneously examine the efficacy of cognitive behavioural therapy (CBT) and light dark therapy (LDT), targeting different mechanisms, against treatment-as-usual (TAU), in reducing maternal postpartum insomnia symptoms.

Methods

This three-arm randomised controlled trial recruited from the general community in Australia. Nulliparous females 4–12 months postpartum with self-reported insomnia symptoms [Insomnia Severity Index (ISI) scores >7] were included; severe medical/psychiatric conditions were excluded. Participants were randomised 1:1:1 to CBT, LDT, or TAU stratified by ISI (< or ⩾14) and infant age (< or ⩾8 months). Participants and principal investigators were unblinded. Six-week interventions were delivered via digital materials and telephone. The primary outcome was insomnia symptoms (ISI), assessed pre-, midpoint-, post- (primary endpoint), and one-month post-intervention. Analyses were intention-to-treat using latent growth models.

Results

114 participants (CBT = 39, LDT = 36, TAU = 39; Mage = 32.20 ± 4.62 years) were randomised. There were significantly greater reductions in ISI scores in CBT and LDT (effect sizes −2.01 and −1.52 respectively, p < 0.001) from baseline to post-intervention compared to TAU; improvements were maintained at follow-up. Similar effects were observed for self-reported sleep disturbance. There were greater reductions in fatigue in CBT (effect size = 0.85, p < 0.001) but not LDT (p = 0.11) compared to TAU. Changes in sleepiness, depression, and anxiety were non-significant compared to TAU (all p > 0.08). Four participants (11%) in the LDT group reported headaches, dizziness, or nausea; no others reported adverse events.

Conclusions

Therapist-assisted CBT and LDT were feasible during the first postpartum year; data at post-intervention and 1-month follow-up support their safety and efficacy in reducing postpartum insomnia symptoms.
The incidence rate of planned and emergency physical health hospital admissions in people diagnosed with severe mental illness: a cohort study
Authors: Launders Naomi , Hayes Joseph F. , Price Gabriele , Marston Louise , Osborn David P. J.
Published: September 2022

Background

People with severe mental illness (SMI) have more physical health conditions than the general population, resulting in higher rates of hospitalisations and mortality. In this study, we aimed to determine the rate of emergency and planned physical health hospitalisations in those with SMI, compared to matched comparators, and to investigate how these rates differ by SMI diagnosis.

Methods

We used Clinical Practice Research DataLink Gold and Aurum databases to identify 20,668 patients in England diagnosed with SMI between January 2000 and March 2016, with linked hospital records in Hospital Episode Statistics. Patients were matched with up to four patients without SMI. Primary outcomes were emergency and planned physical health admissions. Avoidable (ambulatory care sensitive) admissions and emergency admissions for accidents, injuries and substance misuse were secondary outcomes. We performed negative binomial regression, adjusted for clinical and demographic variables, stratified by SMI diagnosis.

Results

Emergency physical health (aIRR:2.33; 95% CI 2.22–2.46) and avoidable (aIRR:2.88; 95% CI 2.60–3.19) admissions were higher in patients with SMI than comparators. Emergency admission rates did not differ by SMI diagnosis. Planned physical health admissions were lower in schizophrenia (aIRR:0.80; 95% CI 0.72–0.90) and higher in bipolar disorder (aIRR:1.33; 95% CI 1.24–1.43). Accident, injury and substance misuse emergency admissions were particularly high in the year after SMI diagnosis (aIRR: 6.18; 95% CI 5.46–6.98).

Conclusion

We found twice the incidence of emergency physical health admissions in patients with SMI compared to those without SMI. Avoidable admissions were particularly elevated, suggesting interventions in community settings could reduce hospitalisations. Importantly, we found underutilisation of planned inpatient care in patients with schizophrenia. Interventions are required to ensure appropriate healthcare use, and optimal diagnosis and treatment of physical health conditions in people with SMI, to reduce the mortality gap due to physical illness.
Crystal structure of aminopentamide hydrogen sulfate, (C19H25N2O)(HSO4)
Authors: Kaduk James A. , Gindhart Amy M. , Gates-Rector Stacy , Blanton Thomas N.
Published: September 2022

The crystal structure of aminopentamide hydrogen sulfate has been solved and refined using synchrotron X-ray powder diffraction data, and optimized using density functional techniques. Aminopentamide hydrogen sulfate crystallizes in space group P21/c (#14) with a = 17.62255(14), b = 6.35534(4), c = 17.82499(10) Å, β = 96.4005(6)°, V = 1983.906(14) Å3, and Z = 4. The structure consists of layers parallel to the bc-plane with hydrogen sulfate anions at the core and aminopentamide cations on the outside. There is a strong charge-assisted O49–H53⋯O52 hydrogen bond between the hydrogen sulfate anions. This hydrogen bond links the anions in a chain parallel to the b-axis. The cation forms a discrete N–H⋯O hydrogen bond to the anion. The amide group also forms two weaker discrete hydrogen bonds to the anion. The three N–H⋯O hydrogen bonds link the cations and anions into columns parallel to the b-axis. This commercial material from USP contained an unidentified impurity, the powder pattern of which could be indexed on a monoclinic unit cell. The powder pattern has been submitted to ICDD for inclusion in the Powder Diffraction File™ (PDF®).
Bovine ICSI: limiting factors, strategies to improve its efficiency and alternative approaches
Authors: Fuentes Fernanda , Muñoz Erwin , Contreras María José , Arias María Elena , Felmer Ricardo
Published: September 2022

Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technique mainly used to overcome severe infertility problems associated with the male factor, but in cattle its efficiency is far from optimal. Artificial activation treatments combining ionomycin (Io) with 6-dimethylaminopurine after piezo-ICSI or anisomycin after conventional ICSI have recently increased the blastocyst rate obtained. Compounds to capacitate bovine spermatozoa, such as heparin and methyl-β-cyclodextrin and compounds to destabilize sperm membranes such as NaOH, lysolecithin and Triton X-100, have been assessed, although they have failed to substantially improve post-ICSI embryonic development. Disulfide bond reducing agents, such as dithiothreitol (DTT), dithiobutylamine and reduced glutathione, have been assessed to decondense the hypercondensed head of bovine spermatozoa, the two latter being more efficient than DTT and less harmful. Although piezo-directed ICSI without external activation has generated high fertilization rates and modest rates of early embryo development, other studies have required exogenous activation to improve the results. This manuscript thoroughly reviews the different strategies used in bovine ICSI to improve its efficiency and proposes some alternative approaches, such as the use of extracellular vesicles (EVs) as ‘biological methods of oocyte activation’ or the incorporation of EVs in thein vitromaturation and/or culture medium as antioxidant defence agents to improve the competence of the ooplasm, as well as a preincubation of the spermatozoa in estrous oviductal fluid to induce physiological capacitation and acrosome reaction before ICSI, and the use of hyaluronate in the sperm immobilization medium.
Enhancing member engagement in a Tier 3 personality disorder service during COVID-19: evaluation of a virtual group programme
Authors: Smith Emma , Papastavrou Brooks Cat , Clifford Emma , Giles Emily , Dring Jessica , Startup Helen
Published: September 2022

Background:

Drop-out rates from evidence-based interventions for people with a diagnosis of personality disorder (PD) are high. The COVID-19 pandemic has likely exacerbated barriers to engagement with the introduction of virtual working. Virtual therapy has a good evidence-base for Axis I disorders, but limited research for Axis II disorders.

Aims:

To investigate facilitators and barriers to engagement in a Tier 3 PD service virtual group programme.

Method:

A virtual group programme was developed in collaboration with service members, and analysed members’ attendance rates over a 5-month period pre- and post-COVID-19. Thematic analysis of semi-structured telephone interviews with 38 members is reported, describing their experience of the virtual group programme.

Results:

Attendance rates were significantly higher pre-COVID (72%) than post-COVID (50%). Thematic analysis highlighted key barriers to attendance were: practical issues, low motivation, challenges of working in a group online and feeling triggered at home. Main promoters of engagement were: feeling valued, continued sense of connection and maintaining focus on recovery.

Discussion:

The results suggest that the pandemic has exacerbated relational and practical barriers to engagement in a Tier 3 PD service. Ways of enhancing engagement are discussed, as well as preliminary recommendation for services offering virtual therapy to people with a diagnosis of PD.
Insurers’ hidden risk from reinsurance recaptures
Authors: Ugono Mudi , Ashton Brad , Brauch Nora , Drew Adél , Funnell Jamie , Healey Martin , Notani Raj
Published: September 2022

There is a lack of publicly available information covering the practices insurers employ to manage their exposure to reinsurance recapture risk. A working party was set-up to shed light on the different approaches insurers use to mitigate this complicated to manage risk. This report is intended to form part of a publicly available information repository that market practitioners can refer to and reflect on as best practice evolves and develops.