bluuebunny/crossref_metadata_2025 huggingface dataset:
The rural identity scale: Development and validation
Authors: Oser Carrie B. , Strickland Justin , Batty Evan J. , Pullen Erin , Staton Michele
Published: March 2021

Purpose

The purpose of this study was to conduct a psychometric evaluation of a new 35‐item survey developed in the United States to measure rural identity.

Methods

Factor structure, reliability, convergent validity, and incremental validity of the Rural Identity Scale (RIS) were examined using two datasets. Study 1 examined RIS psychometric properties using survey data collected from substance use treatment counselors in a southeastern state (n = 145), while Study 2 used data collected from women incarcerated in rural jails (n = 400).

Findings

A one‐factor structure containing 15 items was identified in the RIS, with acceptable internal reliability (α = .72–.83). In Study 1, participants from rural counties had significantly higher RIS scores than their urban counterparts. In both studies, convergent validity was evaluated and the RIS scores were significantly associated with other measures relevant to identity and rurality at the bivariate level. Incremental validity was supported in multivariable models as the RIS scores were significantly and uniquely associated with primary rural place variables in each sample.

Conclusions

This study is an initial step toward a reliable, valid scale measuring rural identity. RIS may be especially beneficial to health research as a methodological tool that can contextualize health behaviors among rural populations and highlight potential interventions to promote health equity.
Behavioural biometrics: Using smartphone keyboard activity as a proxy for rest–activity patterns
Authors: Druijff‐van de Woestijne Gerrieke B. , McConchie Hannah , de Kort Yvonne A. W. , Licitra Giovanni , Zhang Chao , Overeem Sebastiaan , Smolders Karin C. H. J.
Published: March 2021

Rest–activity patterns are important aspects of healthy sleep and may be disturbed in conditions like circadian rhythm disorders, insomnia, insufficient sleep syndrome, and neurological disorders. Long‐term monitoring of rest–activity patterns is typically performed with diaries or actigraphy. Here, we propose an unobtrusive method to obtain rest–activity patterns using smartphone keyboard activity. The present study investigated whether this proposed method reliably estimates rest and activity timing compared to daily self‐reports within healthy participants. First‐year students (n = 51) used a custom smartphone keyboard to passively and objectively measure smartphone use behaviours and completed the Consensus Sleep Diary for 1 week. The time of the last keyboard activity before a nightly absence of keystrokes, and the time of the first keyboard activity following this period were used as markers. Results revealed high correlations between these markers and user‐reported onset and offset of resting period (r ranged from 0.74 to 0.80). Linear mixed models could estimate onset and offset of resting periods with reasonable accuracy (R2 ranged from 0.60 to 0.66). This indicates that smartphone keyboard activity can be used to estimate rest–activity patterns. In addition, effects of chronotype and type of day were investigated. Implementing this method in longitudinal studies would allow for long‐term monitoring of (disturbances to) rest–activity patterns, without user burden or additional costly devices. It could be particularly interesting to replicate these findings in studies amongst clinical populations with sleep‐related problems, or in populations for whom disturbances in rest–activity patterns are secondary complaints, such as neurological disorders.
Projecting Religious Demographics: The Case of Jews in the United States
Authors: Pinker Edieal J.
Published: March 2021

Drawing upon the comprehensive survey of the American Jewish population conducted in 2013 by the Pew Research Center, we estimate the trajectory of the population and its denominational segments, 50 years into the future. Our analysis relies upon estimates of the population in 2013, fertility rates, marriage behaviors, and denominational switching patterns as inputs into a model of population demographics. We project that over the next 50 years, the demographics of U.S. Jews are likely to change dramatically, with the share of the population that is Orthodox rising from 12 percent to 29 percent, with their share of the child population increasing from 22 percent to 51 percent. Among Reform and Conservative Jews, the number of 30‐ to 69‐year‐olds is projected to drop by approximately 46 percent over this period. We also project a slight drop in the total Jewish population followed by a recovery propelled by the growing Orthodox population.
How does spatial micro‐environmental heterogeneity influence seedling recruitment in ironstone outcrops?
Authors: Dayrell Roberta L. C. , Fuzessy Lisieux Franco , Azevedo Luísa O. , Lambers Hans , Veneklaas Erik J. , Silveira Fernando A. O.
Published: March 2021

Questions

Environmental filters limit the set of potentially coexisting species in plant communities. Paradoxically, some of the world's most biodiverse communities are subjected to strong abiotic filters. We explored how environmental heterogeneity provides conditions for niche segregation in a harsh megadiverse ecosystem, focusing on fine‐scale factors that drive seedling recruitment. Due to the environmental stress (mainly nutrient and water scarcity), we expected the prevalence of positive plant interactions over negative ones to contribute to species coexistence.

Location

Ironstone outcrop (canga) at Serra da Calçada, southeast Brazil.

Methods

We characterised microhabitats with one or neither of two dominant shrubs Mimosa calodendron (Fabaceae) and Lychnophora pinaster (Asteraceae), and assessed which micro‐environmental attributes affect seedling survival, growth, and abundance, as well as adult richness in the ecosystem.

Results

Spatial heterogeneity in the community was mostly driven by differences in substrate properties, and plots with Mimosa calodendron and Lychnophora pinaster exhibited different biotic and abiotic conditions from those lacking these species. Microhabitats under both shrubs had greater adult richness, and those occupied by Mimosa calodendron had greater seedling abundance, suggesting positive effects of environmental conditions associated with these plants. Nevertheless, we identified two potential negative plant–plant interactions: larger crown area of the two dominant shrubs was associated with lower species richness, and greater understorey plant cover with lower seedling abundance. Over one year, 63% of the recorded seedlings survived, but measured attributes failed to predict survival. Seedling relative growth rates were species‐specific and lower in microsites where the rocky substrate is fragmented. The most abundant seedling taxa occurred in association with specific microhabitats.

Conclusions

Our study suggested that fine‐scale spatial heterogeneity determines the outcome of plant–plant interactions in a stressful ecosystem. Micro‐environmental heterogeneity allows for the spatial segregation of species recruitment, thereby broadening the range of viable strategies within a harsh megadiverse ecosystem.
Pharmacologic manipulation of skin pigmentation
Authors: Kindl Gabriel H. , D’Orazio John A.
Published: March 2021

Skin complexion is among the most recognizable phenotypes between individuals and is mainly determined by the amount and type of melanin pigment deposited in the epidermis. Persons with dark skin complexion have more of a brown/black pigment known as eumelanin in their epidermis whereas those with fair skin complexions have less. Epidermal eumelanin acts as a natural sunblock by preventing incoming UV photons from penetrating into the skin and therefore protects against UV mutagenesis. By understanding the signaling pathways and regulation of pigmentation, strategies can be developed to manipulate skin pigmentation to improve UV resistance and to diminish skin cancer risk.
Visible light regulates anthocyanin synthesis via malate dehydrogenases and the ethylene signaling pathway in plum (Prunus salicina L.)
Authors: Zhang Guojing , Cui Xiaohui , Niu Junping , Ma Fengwang , Li Pengmin
Published: March 2021

Light regulates anthocyanins synthesis in plants. Upon exposure to visible light, the inhibition of photosynthetic electron transfer significantly lowered the contents of anthocyanins and the expression levels of key genes involved in anthocyanins synthesis in plum fruit peel. Meanwhile, the expression levels of PsmMDH2 (encoding the malate dehydrogenase in mitochondria) and PschMDH (encoding the malate dehydrogenase in chloroplasts) decreased significantly. The contents of anthocyanins and the levels of the key genes involved in anthocyanin synthesis decreased significantly with the treatment of 1‐MCP (an inhibitor of ethylene perception) but were enhanced by the exogenous application of ethylene. The ethylene treatment could also recover the anthocyanin synthesis capacity lowered by the photosynthetic electron transfer inhibition. Silencing PsmMDH2 and PschMDH significantly lowered the contents of anthocyanins in plum fruit. At low temperature, visible light irradiation induced anthocyanin accumulation in Arabidopsis leaves. However, the mmdh, chmdh, and etr1‐1 mutants had significantly lower anthocyanins content and expressions of the key genes involved in anthocyanins synthesis compared to wild type. Overall, the present study demonstrates that both photosynthesis and respiration were involved in the regulation of anthocyanin synthesis in visible light. The visible light regulates anthocyanin synthesis by controlling the malate metabolism via MDHs and the ethylene signaling pathway.
ABO blood type association with SARS‐CoV‐2 infection mortality: A single‐center population in New York City
Authors: Szymanski James , Mohrmann Laurel , Carter Jamal , Nelson Randin , Chekuri Sweta , Assa Andrei , Spund Brian , Reyes‐Gil Morayma , Uehlinger Joan , Baron Sarah , Paroder Monika
Published: March 2021

Background

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has a variable clinical course with significant mortality. Early reports suggested higher rates of SARS‐CoV‐2 infection in patients with type A blood and enrichment of type A individuals among COVID‐19 mortalities.

Study Design and Methods

The study includes all patients hospitalized or with an emergency department (ED) visit who were tested for SARS‐CoV‐2 between March 10, 2020 and June 8, 2020 and had a positive test result by nucleic acid test (NAT) performed on a nasopharyngeal swab specimen. A total of 4968 patients met the study inclusion criteria, with a subsequent 23.1% (n = 1146/4968) all‐cause mortality rate in the study cohort. To estimate overall risk by ABO type and account for the competing risks of in‐hospital mortality and discharge, we calculated the cumulative incidence function (CIF) for each event. Cause‐specific hazard ratios (csHRs) for in‐hospital mortality and discharge were analyzed using multivariable Cox proportional hazards models.

Results

Type A blood was associated with the increased cause‐specific hazard of death among COVID‐19 patients compared to type O (HR = 1.17, 1.02–1.33, p = .02) and type B (HR = 1.32,1.10–1.58, p = .003).

Conclusions

Our study shows that ABO histo‐blood group type is associated with the risk of in‐hospital death in COVID‐19 patients, warranting additional inquiry. Elucidating the mechanism behind this association may reveal insights into the susceptibility and/or immunity to SARS‐CoV‐2.
Descripción de los resultados de las pruebas neuropsicológicas en el diagnóstico diferencial de los pacientes con Alzheimer
Authors: Hackspiel María Mercedes , Paredes Garavito Olga
Published: March 2021

Introducción: el deterioro cognitivo en las demencias es una de las dimensiones que requieren ser evaluadas de forma eficaz en los pacientes que acuden a los servicios especializados. Por décadas el Mini Mental (MMSE) y la evaluación cognitiva Monterreal (MoCA) se han constituido en los instrumentos más utilizados, sin embargo, la complejidad del diagnóstico ha dado origen a nuevas pruebas como la batería de evaluación frontal (FAB). Objetivo: describir los resultados de las pruebas neuropsicológicas aplicadas a los pacientes con demencias. Método: diseño: Estudio descriptivo transversal con 19 pacientes con demencias de diversas índoles, quienes diligenciaron pruebas psicológicas de tamizaje. El encuadre fue el de la bioética, especialmente con la visión de la dignidad y autonomía de los pacientes. Resultados:los puntajes evidencian deterioro cognitivo moderado y la presencia del diagnóstico de Alzheimer, adicionalmente, el FAB evidencia cortes para diagnóstico de Alzheimer. Conclusiones: a pesar de que cada instrumento evidencia puntos de corte más sensibles a cada tipo de demencia, las dos pruebas evidencian similitudes en cuanto a curva de puntuación en cada criterio de evaluación. Es importante que los pacientes con deterioro cognitivo tengan acceso a pruebas que permitan realizar un diagnóstico diferencial adecuado pues de este dependerá no solo la intervención y tratamiento sino el cuidado que recibirá en el proceso de la enfermedad.
¿Tratamiento penitenciario a domicilio?
Authors: Ariza Higuera Libardo José , Romero David Ricardo
Published: March 2021

La crisis del hacinamiento en el sistema penitenciario local ha sido enfrentada a través de estrategias de descongestión basadas en la flexibilización del régimen de subrogados penales. No obstante, estas medidas han sido adoptadas sin tener en cuenta las implicaciones de la Relación Especial de Sujeción (RES) en el caso de las personas sometidas al régimen de domiciliarias. Este artículo es resultado de una investigación más amplia sobre las penas y medidas domiciliarias en Colombia, y muestra cómo los elementos esenciales de la RES sufren una transformación importante, afectando las doctrinas constitucionales clásicas que han sido creadas para la definición del contenido y alcance de los derechos fundamentales de los reclusos.
Closed-Form Synthesis of Force-Generating Planar Four-Bar Linkages
Authors: Soper R. Randall , Scardina Michael , Tidwell Paul , Reinholtz Charles , Lo Presti Michael A.
Published: March 2021

This paper presents a technique for synthesizing four-bar linkages to produce a specified resisting force or torque. The resisting energy is provided by a weight acting on the other grounded link. The linkage serves as a nonlinear mechanical advantage function generator.

Force and velocity synthesis methods have been extensively discussed in the literature. The general approach, however, has been to assume that the specified force or velocity occurs at a prescribed position. This results in the loss of design parameters that are being used unnecessarily to control position. In this application, force input to the linkage is specified as a function of only the input link position and the magnitude and direction of the weight force.

Mechanical advantage synthesis can be achieved at as many as seven precision points. The method presented in this paper allows free selection of two parameters and viewing one infinity of solutions.
A Multi-Field Space-Time Finite Element Method for Structural Acoustics
Authors: Thompson Lonny L.
Published: March 2021

A Computational Structural Acoustics (CSA) capability for solving scattering, radiation, and other problems related to the acoustics of submerged structures has been developed by employing some of the recent algorithmic trends in Computational Fluid Dynamics (CFD), namely time-discontinuous Galerkin Least-Squares finite element methods. Traditional computational methods toward simulation of acoustic radiation and scattering from submerged elastic bodies have been primarily based on frequency domain formulations. These classical time-harmonic approaches (including boundary element, finite element, and finite difference methods) have been successful for problems involving a limited range of frequencies (narrow band response) and scales (wavelengths) that are large compared to the characteristic dimensions of the elastic structure. Attempts at solving large-scale structural acoustic systems with dimensions that are much larger than the operating wavelengths and which are complex, consisting of many different components with different scales and broadband frequencies, has revealed limitations of many of the classical methods. As a result, there has been renewed interest in new innovative approaches, including time-domain approaches. This paper describes recent advances in the development of a new class of high-order accurate and unconditionally stable space-time methods for structural acoustics which employ finite element discretization of the time domain as well as the usual discretization of the spatial domain. The formulation is based on a space-time variational equation for both the acoustic fluid and elastic structure together with their interaction. Topics to be discussed include the development and implementation of higher-order accurate non-reflecting boundary conditions based on the exact impedance relation through the. Dirichlet-to-Neumann (DtN) map, and a multi-field representation for the acoustic fluid based on independent pressure and velocity potential variables. Numerical examples involving radiation and scattering of acoustic waves are presented to illustrate the high-order accuracy achieved by the new methodology for CSA.
A Practical Algorithm for the Efficient Computation of Eigenvector Derivatives
Authors: Lin R. M. , Wang Z. , Lim M. K.
Published: March 2021

Derivatives of eigenvalues and eigenvectors have become increasingly important in the development of modern numerical methods for areas such as structural design optimization, dynamic system identification and dynamic control, and the development of effective and efficient methods for the calculation of such derivatives has remained to be an active research area for several decades. In this paper, a practical algorithm has been developed for efficiently computing eigenvector derivatives of generalized symmetric eigenvalue problems. For eigenvector derivative of a separate mode, the computation only requires the knowledge of eigenvalue and eigenvector of the mode itself and an inverse of system matrix accounts for most computation cost involved. In the case of two close modes, the modal information of both modes is required and the eigenvector derivatives can be accurately determined simultaneously at minor additional computational cost. Further, the method has been extended to the case of practical structural design where structural modifications are made locally and the eigenvalues and eigenvectors and their derivatives are of interest. By combining the proposed algorithm together with the proposed inverse iteration technique and singular value decomposition theory, eigenproperties and their derivatives can be very efficiently computed. Numerical results from a practical finite element model have demonstrated the practicality of the proposed method. The proposed method can be easily incorporated into commercial finite element packages to improve the computational efficiency of eigenderivatives needed for practical applications.
Different Relationships Between Steps and Movements and Healthy Biomarkers in People With and Without Disability
Authors: Chiu Chungyi , Covello-Jones Alicia R. , Montenegro Esteban , Brooks Jessica M. , Shen Sa
Published: March 2021

Background: Physical activity benefits have been extensively studied. However, the public health guidelines seem unclear about the relationships between steps and movements with healthy biomarkers for people with (PWD) and without disabilities (PWOD), respectively. While public health guidelines illustrate types of exercise (eg, running, swimming), it is equally important to provide data-driven recommended amounts of daily steps or movements to achieve health biomarkers and further promote a physically active lifestyle. Methods: Data from the National Health and Nutrition Examination Survey 2003–2006 were used. The authors conducted sensitivity, specificity, and receiver-operating-characteristic curve analyses regarding cut points from ActiGraph 7164 of daily steps and movements for health biomarkers (eg, body mass index, cholesterol) in PWD (2178 participants) and PWOD (4414 participants). The authors also examined the dose relationships of steps, movements, and healthy biomarkers in each group. Results: The authors found significant differences in the cut points of daily steps and movement for health biomarkers in PWD and PWOD. For daily steps, cut points of PWD were ranged from 3222 to 8311 (area under the receiver-operating-characteristic curve [AUC] range = 0.52–0.93) significantly lower than PWOD’s daily steps (range = 5455–14,272; AUC = 0.58–0.87). For daily movement, cut points of PWD were ranged from 115,451 to 430,324 (AUC = 0.53–0.91) significantly lower than the PWOD’s daily movements (range = 215,288–282,307; AUC = 0.60–0.88). The authors found strong but different dose relationships of many biomarkers in each group. Conclusions: PWD need fewer daily steps or movement counts to achieve health biomarkers than PWOD. The authors provided data-driven, condition-specific recommendations on promoting a physically active lifestyle.
An early warning approach to monitor COVID-19 activity with multiple digital traces in near real time
Authors: Kogan Nicole E. , Clemente Leonardo , Liautaud Parker , Kaashoek Justin , Link Nicholas B. , Nguyen Andre T. , Lu Fred S. , Huybers Peter , Resch Bernd , Havas Clemens , Petutschnig Andreas , Davis Jessica , Chinazzi Matteo , Mustafa Backtosch , Hanage William P. , Vespignani Alessandro , Santillana Mauricio
Published: March 2021

Multiple digital data streams forecast COVID-19 activity weeks before traditional epidemiological surveillance.
Nicotinic regulation of local and long-range input balance drives top-down attentional circuit maturation
Authors: Falk Elisa N. , Norman Kevin J. , Garkun Yury , Demars Michael P. , Im Susanna , Taccheri Giulia , Short Jenna , Caro Keaven , McCraney Sarah E. , Cho Christina , Smith Milo R. , Lin Hung-Mo , Koike Hiroyuki , Bateh Julia , Maccario Priscilla , Waltrip Leah , Janis Meaghan , Morishita Hirofumi
Published: March 2021

Nicotinic signaling regulates top-down circuit maturation and restores attention deficits in mouse model of fragile X syndrome.
Trans-synaptic assemblies link synaptic vesicles and neuroreceptors
Authors: Martinez-Sanchez Antonio , Laugks Ulrike , Kochovski Zdravko , Papantoniou Christos , Zinzula Luca , Baumeister Wolfgang , Lučić Vladan
Published: March 2021

Tripartite trans-synaptic assemblies directly link pre- and postsynaptic complexes crucial for synaptic transmission.
On secondary atomization and blockage of surrogate cough droplets in single- and multilayer face masks
Authors: Sharma Shubham , Pinto Roven , Saha Abhishek , Chaudhuri Swetaprovo , Basu Saptarshi
Published: March 2021

Large-sized cough droplets can penetrate and atomize through single-layer masks, while triple-layer masks effectively block them.
Prefusion structure of human cytomegalovirus glycoprotein B and structural basis for membrane fusion
Authors: Liu Yuhang , Heim Kyle P. , Che Ye , Chi Xiaoyuan , Qiu Xiayang , Han Seungil , Dormitzer Philip R. , Yang Xinzhen
Published: March 2021

Prefusion human cytomegalovirus glycoprotein B structure reveals the structural basis for membrane fusion.
Application of a Chlamydia trachomatis Expression System To Identify Chlamydia pneumoniae Proteins Translocated into Host Cells
Authors: Yanatori Izumi , Miura Koshiro , Chen Yi-Shan , Valdivia Raphael H. , Kishi Fumio
Published: March 2021

Chlamydia
sp. injects numerous effector proteins into host cells to manipulate cellular functions important for bacterial survival. Based on findings in
Chlamydia trachomatis
, it has been proposed that between 5% and 10% of the
Chlamydia pneumoniae
genome, a related respiratory pathogen, encodes secreted effectors.
Portable RT-PCR System: a Rapid and Scalable Diagnostic Tool for COVID-19 Testing
Authors: Zowawi Hosam M. , Alenazi Thamer H. , AlOmaim Waleed S. , Wazzan Ahmad , Alsufayan Abdullah , Hasanain Rihab A. , Aldibasi Omar S. , Althawadi Sahar , Altamimi Sarah A. , Mutabagani Maysoon , Alamri Maha , Almaghrabi Reem S. , Al-Abdely Hail M. , Memish Ziad A. , Alqahtani Saleh A.
Published: March 2021

Combating the ongoing coronavirus disease 2019 (COVID-19) pandemic demands accurate, rapid, and point-of-care testing with fast results to triage cases for isolation and treatment. The current testing relies on reverse transcriptase PCR (RT-PCR), which is routinely performed in well-equipped laboratories by trained professionals at specific locations.
Evaluating the Antimicrobial Properties of Commercial Hand Sanitizers
Authors: Chojnacki M. , Dobrotka C. , Osborn R. , Johnson W. , Young M. , Meyer B. , Laskey E. , Wozniak R. A. F. , Dewhurst S. , Dunman P. M.
Published: March 2021

In response to the coronavirus disease 2019 (COVID-19) pandemic, hand hygiene has taken on a prominent role in efforts to mitigate SARS-CoV-2 transmission and infection, which has led to a radical increase in the number and types of hand sanitizers manufactured to meet public demand. To our knowledge, no studies have evaluated or compared the antimicrobial performance of hand sanitizers that are being produced under COVID-19 emergency authorization.
Single perineal opening with ‘H-type’ cecovesical fistula and blind-ending foreshortened distal colon: a new variant of persistent cloaca
Authors: Saxena Rahul , Pathak Manish , Sinha Arvind , Thummalapati Jayakumar Kesavulu
Published: March 2021

Persistent cloaca is a rare and severe variety of anorectal malformation, which is more common in females and includes a spectrum of abnormalities. The urinary tract, genital tract and rectum open into a common channel, which exteriorises as a single perineal opening. We are reporting a patient with a novel variation in the classical anatomy of the cloaca. The child has a short blind-ending colon with a cecovesical fistula associated with mullerian agenesis and lipomyelomeningocoele. The child is being managed in a stepwise approach and she has completed the anal reconstruction. Here, we discuss this novel variation in anatomy and challenges in its management.
Splenic artery pseudoaneurysm and resultant haematosuccus pancreaticus
Authors: Sonanis Shwetambari , Layton Benjamin , Nicholson Oliver , Subar DA
Published: March 2021

Splenic artery pseudoaneurysm (SAP) is a rare and dangerous diagnosis with a high risk of rupture and death. It is the most common cause of main pancreatic duct haematoma—haematosuccus pancreaticus (HP). Neither SAP nor HP have specific clinical features that allow diagnosis without cross-sectional imaging. Upper gastrointestinal haemorrhage and a history of pancreatitis should raise clinical suspicion but ultimately endoscopy and CT are required. We report a case of a 51-year-old man without clinical symptoms in whom cross-sectional imaging was undertaken for incidental severe acute anaemia. This demonstrated stigmata of chronic pancreatitis and the main pancreatic duct was distended with dense material in keeping with haematoma. The diagnosis of a SAP bleeding into the main pancreatic duct was made radiologically. A subsequent oesophago-gastro-duodenoscopy confirmed the diagnosis. The imaging appearances, pathophysiology and management are discussed.
Nephrotic syndrome secondary to alpha-1 antitrypsin deficiency
Authors: Santos Gabriela F , Ellis Paul , Farrugia Daniela , Turner Alice M
Published: March 2021

We report a 64-year-old caucasian woman diagnosed with membranous nephropathy secondary to alpha-1 antitrypsin deficiency (AATD). AATD is a rare autosomal codominant genetic disorder. Its clinical manifestations are mostly observed in the lungs, with early-onset emphysema. Nephropathy due to AATD is still very rare and only a few cohort studies have been reported. It has been recognised that alpha-1 antitrypsin has a protective role in the kidneys which enhances the possibility of development of kidney failure, such as nephrotic syndrome, in cases of AATD. Further clinical investigation is needed to understand the relationship between the development of nephropathy, namely membranous nephropathy, and AATD.
Factors associated with missed appointments by adults with type 2 diabetes mellitus: a systematic review
Authors: Sun Chun-An , Taylor Kathryn , Levin Scott , Renda Susan M , Han Hae-Ra
Published: March 2021

Keeping regular medical appointments is a key indicator of patient engagement in diabetes care. Nevertheless, a significant proportion of adults with type 2 diabetes mellitus (T2DM) miss their regular medical appointments. In order to prevent and delay diabetes-related complications, it is essential to understand the factors associated with missed appointments among adults with T2DM. We synthesized evidence concerning factors associated with missed appointments among adults with T2DM. Using five electronic databases, including PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Web of Science, a systematic literature search was done to identify studies that describe factors related to missed appointments by adults with T2DM. A total of 18 articles met the inclusion criteria. The majority of studies included in this review were cohort studies using medical records. While more than half of the studies were of high quality, the operational definitions of missed appointments varied greatly across studies. Factors associated with missed appointments were categorized as patient characteristics, healthcare system and provider factors and interpersonal factors with inconsistent findings. Patient characteristics was the most commonly addressed category, followed by health system and provider factors. Only three studies addressed interpersonal factors, two of which were qualitative. An increasing number of people live with one or more chronic conditions which require more careful attention to patient-centered care and support. Future research is warranted to address interpersonal factors from patient perspectives to better understand the underlying causes of missed appointments among adults with T2DM.
What factors explain the much higher diabetes prevalence in Russia compared with Norway? Major sex differences in the contribution of adiposity
Authors: Iakunchykova Olena , Averina Maria , Wilsgaard Tom , Malyutina Sofia , Kudryavtsev Alexander V , Cook Sarah , Wild Sarah , Eggen Anne Elise , Hopstock Laila Arnesdatter , Leon David A
Published: March 2021

Introduction

Compared with many other countries Russia has a high prevalence of diabetes in men and women. However, contrary to what is found in most other populations, the risk is greater among women than men. The reasons for this are unclear.

Research design and methods

Prevalence and risk factors for diabetes at ages 40–69 years were compared in two population-based studies: Know Your Heart (KYH) (Russia, 2015–2018, n=4121) and the seventh wave of the Tromsø Study (Tromsø 7) (Norway, 2015–2016, n=17 649). Diabetes was defined by the level of glycated hemoglobin and/or self-reported diabetes and/or diabetes medication use. Marginal structural models were used to estimate the role of key risk factors for diabetes in differences between the studies.

Results

Age-standardized prevalence of diabetes was higher in KYH compared with Tromsø 7 in men (11.6% vs 6.2%) and in women (13.2% vs 4.3%). Age-adjusted ORs for diabetes in KYH compared with Tromsø 7 were 2.01 (95% CI 1.68 to 2.40) for men and 3.66 (95% CI 3.13 to 4.26) for women. Adiposity (body mass index and waist circumference) explained none of this effect for men but explained 46.0% (39.6, 53.8) for women. Addition of smoking and C reactive protein, as further mediators, slightly increased the percentage explained of the difference between studies to 55.5% (46.5, 66.0) for women but only to 9.9% (−0.6, 20.8) for men.

Conclusions

Adiposity is a key modifiable risk factor that appears to explain half of the almost threefold higher female prevalence of diabetes in Russia compared with Norway, but none of the twofold male difference.
Evaluation of the feasibility and impacts of in situ simulation in emergency medicine—a mixed-method study protocol
Authors: Truchot Jennifer , Boucher Valérie , Raymond-Dufresne Éliane , Malo Christian , Brassard Éric , Marcotte Jean , Martel Guillaume , Côté Geneviève , Garneau Christian , Bouchard Gino , Emond Marcel
Published: March 2021

Introduction

In situ simulation (ISS) consists of performing a simulation in the everyday working environment with the usual team members. The feasibility of ISS in emergency medicine is an important research question, because ISS offers the possibility for repetitive, regular simulation training consistent with specific local needs. However, ISS also raises the issue of safety, since it might negatively impact the care of other patients in the emergency department (ED). Our hypothesis is that ISS in an academic high-volume ED is feasible, safe and associated with benefits for both staff and patients.

Methods

A mixed-method, including a qualitative method for the assessment of feasibility and acceptability and a quantitative method for the assessment of patients’ safety and participants’ psychosocial risks, will be used in this study.

Two distinct phases are planned in the ED of the CHU de Québec-Université Laval (Hôpital de l’Enfant-Jésus) between March 2021 and October 2021. Phase 1: an ISS programme will be implemented with selected ED professionals to assess its acceptability and safety and prove the validity of our educational concept. The number of cancelled sessions and the reasons for cancellation will be collected to establish feasibility criteria. Semistructured interviews will evaluate the acceptability of the intervention. We will compare unannounced and announced ISS. Phase 2: the impact of the ISS programme will be measured with validated questionnaires for the assessment of psychosocial risks, self-confidence and perceived stress among nonselected ED professionals, with comparison between those exposed to ISS and those that were not.

Ethics and dissemination

The CHU de Québec-Université Laval Research ethics board has approved this protocol (#2020–5000). Results will be presented to key professionals from our institution to improve patient safety. We also aim to publish our results in peer-reviewed journals and will submit abstracts to international conferences to disseminate our findings.
Content analysis of reported activities of the United Nations Road Safety Collaboration Members during the Decade of Action for Road Safety 2011–2020
Authors: Flannigan Sean Alan , Khayesi Meleckidzedeck
Published: March 2021

Objective

Several activities were planned for the Decade of Action (DOA) for Road Safety 2011–2020, covering key policies and interventions on road safety. Knowledge of the activities implemented by key actors is currently lacking in the literature. This study answers the question: what activities were implemented during the DOA by the United Nations Road Safety Collaboration (UNRSC) members?

Design

The study used content analysis techniques to extract and analyse information from five United Nations Secretary General’s reports, which summarise the activities reported by UNRSC members.

Setting

The primary setting for this study are 116 countries in which activities supporting the DOA were conducted.

Outcome measures

Frequency of themes and subthemes that emerged from reported activities are identified and cross-tabulated by year of report, country level of income, geographical region and organisation type.

Results

Over the entire DOA, establishment of institutions and lead agencies as well as the development of national strategies featured prominently under the theme of management. This theme was steadily reported across regions, country income level and organisation type. Workshops, training and major events regarding road safety increased in frequency of reporting throughout the decade as did developing and promoting the basic road and vehicle systems supportive of road safety. It is further noted that other key activities like infrastructure and behaviour change that are required for a balanced approach to road safety policy were also attended to by various organisations. Activities related to road safety enforcement and post-crash response as well as activities in low-income countries appeared to be less reported.

Conclusion

The wide range of activities reported by UNRSC members over the entire DOA need to be sustained and evaluated in years to come if they are to have a significant impact on reducing road traffic deaths and injuries at national and international levels.
Mediators and theories of change in psychotherapy with adolescents: a systematic review protocol
Authors: Taubner Svenja , Saliba Andrea , Heinonen Erkki , Protić Sonja , Volkert Jana , Adler Asta , Barkauskiene Rasa , Conejo Cerón Sonia , Di Giacomo Dina , Ioannou Yianna , Mestre Jose M , Moreno-Peral Patricia , Mucha Vieira Filipa , Mota Catarina Pinheiro , Raleva Marija , Rangel Santos Henriques Margarida Isabel , Røssberg Jan Ivar , Schmidt Stefanie J. , Stepišnik Perdih Tjaša , Ulberg Randi , Sales Célia M D
Published: March 2021

Introduction

Approximately 75% of mental disorders emerge before the age of 25 years but less than half receive appropriate treatment. Little is known about the mechanisms underlying the therapeutic change of adolescents in psychotherapy. The ‘European Network of Individualised Psychotherapy Treatment of Young People with Mental Disorders’, funded by the European Cooperation in Science and Technology, will conduct the first systematic review to summarise the existing knowledge on mediators and theories of change in psychotherapy for adolescents.

Method

A systematic review will be conducted, conforming to the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement recommendations. Electronic databases (PubMed and PsycINFO) have been systematically searched on 23 February 2020, for prospective, longitudinal and case-control designs which examine mediators of change. Participants will be adolescents between 10 and 19 years of age who suffer from a mental disorder or psychological difficulties and receive an intervention that aims at preventing, ameliorating and/or treating psychological problems.

Ethics and dissemination

Ethical approval is not required for this systematic review as no primary data will be collected. The results will be published in a peer-reviewed journals and at conference presentations and will be shared with stakeholder groups. The whole data set will be offered to other research groups following recommendations of the open science initiative. Databases with the systematic search will be made openly available following open science initiatives.

PROSPERO registration number

CRD42020177535.
Systematic review of endovascular stent grafting versus open surgical repair for the elective treatment of arch/descending thoracic aortic aneurysms
Authors: McCarthy Andrew , Gray Joanne , Sastry Priya , Sharples Linda , Vale Luke , Cook Andrew , Mcmeekin Peter , Freeman Carol , Catarino Pedro , Large Stephen
Published: March 2021

Objective

To review comparisons of the effectiveness of endovascular stent grafting (ESG) against open surgical repair (OSR) for treatment of chronic arch or descending thoracic aortic aneurysms (TAA).

Design

Systematic review and meta-analysis

Data sources

MEDLINE, EMBASE, CENTRAL, WHO International Clinical Trials Routine data collection, current controlled trials, clinical trials and the NIHR portfolio were searched from January 1994 to March 2020.

Eligibility criteria for selective studies

All identified studies that compared ESG and OSR, including randomised controlled trials (RCTs), quasi-randomised and non-RCTs, comparative cohort studies and case–control studies matched on main outcomes were sought. Participants had to receive elective treatments for arch/descending (TAA). Studies were excluded where other thoracic aortic conditions (eg, rupture or dissection) were reported, unless results for patients receiving elective treatment for arch/descending TAA reported separately.

Data extraction and synthesis

Data were extracted by one reviewer and checked by another. Risk of Bias was assessed using the ROBINS-I tool. Meta-analysis was conducted using random effects. Where meta-analysis not appropriate, results were reported narratively.

Results

Five comparative cohort studies met inclusion criteria, reporting 3955 ESG and 21 197 OSR patients. Meta-analysis of unadjusted short-term (30 day) all-cause mortality favoured ESG (OR 0.75; 95% CI 0.55 to 1.03)). Heterogeneity identified between larger and smaller studies. Sensitivity analysis of four studies including only descending TAA showed no statistical significance (OR 0.73, 95% CI 0.45 to 1.18)), moderate heterogeneity. Meta-analysis of adjusted short-term all-cause mortality favoured ESG (OR 0.71, 95% CI 0.51 to 0.98)), no heterogeneity. Longer-term (beyond 30 days) survival from all-cause mortality favoured OSR in larger studies and ESG in smaller studies. Freedom from reintervention in the longer-term favoured OSR. Studies reporting short-term non-fatal complications suggest fewer events following ESG.

Conclusions

There is limited and increasingly dated evidence on the comparison of ESG and OSR for treatment of arch/descending TAA.

PROSPERO registration number

CRD42017054565.
Implementation of a care manager organisation and its association with antidepressant medication patterns: a register-based study of primary care centres in Sweden
Authors: Sandheimer Christine , Björkelund Cecilia , Hensing Gunnel , Mehlig Kirsten , Hedenrud Tove
Published: March 2021

Objective

To evaluate the implementation of a care manager organisation for common mental disorders and its association with antidepressant medication patterns on primary care centre (PCC) level, compared with PCCs without this organisation. Moreover, to determine whether a care manager organisation is associated with antidepressant medication patterns that is more in accordance with treatment guidelines.

Design

Register-based study on PCC level.

Setting

Primary care in Region Västra Götaland, Sweden.

Participants

All PCCs in the region. PCCs were analysed in three subgroups: PCCs with a care manager organisation during 2015 and 2016 (n=68), PCCs without the organisation (n=92) and PCCs that shifted to a care manager organisation during 2016 (n=42).

Outcome measures

Proportion of inadequate medication users, defined as number of patients >18 years with a common mental disorder diagnosis receiving care at a PCC in the region during the study period and dispensed 1–179 defined daily doses (DDD) of antidepressants of total patients with at least 1 DDD. The outcome was analysed through generalised linear regression and a linear mixed-effects model.

Results

Overall, all PCCs had about 30%–34% of inadequate medication users. PCCs with a care manager organisation had significantly lower proportion of inadequate medication users in 2016 compared with PCCs without (−6.4%, p=0.02). These differences were explained by higher proportions in privately run PCCs. PCCs that shifted to a care manager organisation had a significant decrease in inadequate medication users over time (p=0.01).

Conclusions

Public PCCs had a more consistent antidepressant medication pattern compared with private PCCs that gained more by introducing a care manager organisation. It was possible to document a significant decrease in inadequate medication users, notwithstanding that PCCs in the region followed the guidelines to a comparatively high extent regardless of present care manager organisation.
New poetics of postcolonial relations: global genetic kinship in Zadie Smith’sWhite Teethand Amitav Ghosh’sThe Calcutta Chromosome
Authors: Hamann-Rose Paul
Published: March 2021

Conceptions of genetic kinship have recently emerged as a powerful new discourse through which to trace and imagine connections between individuals and communities around the globe. This article argues that, as a new way to think and represent such connections, genetic discourses of relatedness constitute a new poetics of kinship. Discussing two exemplary contemporary novels, Amitav Ghosh’sThe Calcutta Chromosome(1995) and Zadie Smith’sWhite Teeth(2000), this article argues further that literary fiction, and postcolonial literary fiction in particular, is uniquely positioned to critically engage this new biomedical discourse of global and interpersonal relations. Ghosh’s and Smith’s novels illuminate and amplify the concept of a cultural poetics of genetic kinship by aesthetically transcending the limits of genetic science to construct additional genetic connections between the West and the Global South on the level of metaphor and analogy. As both novels oscillate spatially between the West and a postcolonial Indian subcontinent, the texts’ representations of literal and figurative genetic relations become a vehicle through which the novels test and reconfigure postcolonial and diasporic identities, as well as confront Western genetic science with alternative forms of knowledge. The emerging genetic imaginary highlights—evoking recent sociological and anthropological work—that meaningful kinship relations rely on biological as much as on cultural discourses and interpretations, especially in postcolonial and migrant contexts where genetic markers become charged with conflicting notions of connection and otherness.
Correlation between intracranial pressure and venous sinus pressures in patients undergoing cerebral venography and manometry
Authors: Lee Katriel , Kittel Carol , Aldridge Jennifer Bernhardt , Wolfe Stacey Q , Brown Patrick , Fargen Kyle M
Published: March 2021

Background

The pathophysiology of idiopathic intracranial hypertension (IIH) is complex but is directly related to cerebral venous hypertension. Few studies have simultaneously recorded venous sinus pressures and lumbar puncture (LP) opening pressure (OP) to understand the relationship between these factors without temporal confounding.

Methods

A retrospective review was performed of patients with a known or suspected diagnosis of IIH who underwent cerebral venography with manometry followed immediately by LP.

Results

47 patients aged 16–68 years met inclusion criteria. 91.5% were female. Mean body mass index (BMI) was 33.3 kg/m2. Of the included patients, median OP was 21 cm H2O (IQR (15.5, 26.5)). Mean (SD) recorded superior sagittal sinus (SSS) and torcular pressures were 25.5 (16.5) mm Hg and 23.8 (16.6) mm Hg, respectively. Twenty patients (42.6%) were discovered to have a trans-stenosis gradient of 8 mm Hg or greater. Transverse sinus, torcula, and SSS pressures were all significantly predicted by OP. On regression analysis, torcular pressures were best predicted by OP of the three measured sites. For 17 patients with OP <20 cm H2O (36.2%), mean (SD) SSS and torcular pressures were 13.5 (4.2) mm Hg and 15.4 (6.7) mm Hg, respectively, suggesting that normally SSS pressures should measure <18 mm Hg (80th percentile) in non-pathologic conditions.

Conclusions

This is the first study to correlate venous sinus pressures and OP in patients with IIH with LP performed directly after manometry. In 47 patients, LP OP significantly predicted transverse sinus, torcula, and SSS pressures. Torcular pressures (mm Hg) were most accurately predicted by OP (cm H2O) in a nearly one-to-one relationship.