bluuebunny/crossref_metadata_2025 huggingface dataset:
The make‐or‐buy decision of feed on livestock farms: Evidence from Ontario swine farms
Authors: Shang Max Zongyuan , McEwan Ken
Published: March 2021

We define the boundary of a livestock farm in terms of corn production as the percentage of homegrown corn in total corn required. A new theoretical model is proposed that explains how farm boundaries are shaped by the relative efficiency of two alternative transaction‐facilitating mechanisms: market and hierarchy. Using tax filer data from swine farms in Ontario, this article analyzes the impact that the mechanism efficiency has on farm boundaries. To identify the potential causal effect, the USD/CAD exchange rate is used as the instrumental variable for corn price in Ontario. The findings support the theoretical model: in‐house corn production expands due to not only higher price but also higher price volatility. The potential causal relationship we identified flowing from the mechanism efficiency to farm boundary may shed light on why swine and other livestock industries are shifting towards nonmarket arrangements.
Is antibiotic prophylaxis expendable in parotid gland surgery? A retrospective analysis of surgical site infection rates
Authors: Hohenberger Ralph , Bremer Isabel , Brinster Regina , Plinkert Peter K. , Federspil Philippe A.
Published: March 2021

Objectives

To evaluate the rate of surgical site infection (SSI) and associated risk factors after parotid gland surgery including the impact of antibiotic prophylaxis.

Design

Retrospective single‐centre clinical study.

Setting

Tertiary referral centre for head and neck surgery.

Participants

Seven hundred and fifty four patients who underwent parotid gland surgery at the University Hospital Heidelberg, Germany, between 2007 and 2014 were enrolled in this study. Data on patient age, American Society of Anesthesiologists (ASA) classification system, smoking status, diabetes mellitus, operation time, and antibiotic prophylaxis were collected. Additionally, the National Healthcare Safety Network (NHSN) risk index was calculated. Association of these factors with SSI was evaluated in univariate analyses and a multivariate logistic regression model.

Main outcome measures

Rate of SSI.

Results

Twenty four patients (3.2%) had an SSI according to the NHSN definition. In univariate analyses, only smokers (P = .048) and male patients (P = .01) had a significantly higher rate of SSI. Since the majority of smokers were men (62.3%), the effect of male gender, smoking, together with the NHSN risk index was further investigated as predictors of SSI within a logistic regression model. All three predictors showed a significant effect on SSI.

Conclusions

Parotid gland surgery has a low rate of SSI. In our cohort, male gender, smoking and high NHSN risk index scores were significantly associated with SSI, whereas antibiotic prophylaxis had no protective effect.
Financial and occupational impact of low anterior resection syndrome in rectal cancer survivors
Authors: Garfinkle Richard , Ky Aurelie , Singh Aashiyan , Morin Nancy , Ghitulescu Gabriela , Faria Julio , Vasilevsky Carol‐Ann , Boutros Marylise
Published: March 2021

Aim

The aim of this study was to assess bowel‐related financial stress and strain and to evaluate its association with global quality of life.

Method

This was a retrospective cohort study with cross‐sectional follow‐up including consecutive patients who underwent restorative proctectomy for neoplastic disease of the rectum at a single university‐affiliated hospital in Montreal, Quebec, Canada. Bowel‐related financial impact and occupational impact were compared between patients with major low anterior resection syndrome (LARS) and those with minor/no LARS. The association between LARS, bowel‐related financial impact and global quality of life (QoL) was then assessed in a multiple logistic regression model.

Results

Of 180 eligible rectal cancer survivors who were contacted, 154 completed the questionnaires (response rate 47.1%) at a median follow‐up of 57.5 months (interquartile range 34.1–98.1) after proctectomy. Individuals with major LARS reported a higher prevalence of bowel‐related financial stress (53.2% vs 5.6%, p < 0.001) and strain (42.2% vs 5.6%, p < 0.001) compared with those with minor/no LARS. Among those who were working preoperatively (n = 100), the majority of participants with major LARS reported an impact of their new bowel function on their ability to work (70.6%), including delayed return to work (44.1%), the need to change schedules (35.3%) or roles (20.6%), and complete long‐term medical absence from work (14.7%). On multiple logistic regression, major LARS with financial impact (OR 4.50, 95% CI 1.57–13.77) was associated with low global QoL compared with minor/no LARS.

Conclusion

Major LARS was associated with considerable financial stress and strain and difficulties in returning to work.
Use of antioxidants to restore bond strength after tooth bleaching with peroxides
Authors: Olmedo Dorcas E. R. P. , Kury Matheus , Resende Bruna A. , Cavalli Vanessa
Published: March 2021

This review compiles the literature on the antioxidants used after tooth bleaching with either low or high‐concentrated carbamide and hydrogen peroxide to recover the bond strength. Antioxidants used in bleached teeth are mainly natural and non‐enzymatic, except for catalase. Commonly, antioxidants are applied to remove any reactive oxygen species (ROS) residues left from bleaching gels, which adversely affect adhesive procedures, such as restorations or orthodontic brackets bonding. Even though sodium ascorbate, the most thoroughly investigated antioxidant, showed the most efficient bond strength recovery at 10% concentration, its performance depends on the type of solution and the application time. Natural extracts, such as proanthocyanidins and green tea, showed satisfactory results in the reversal of bond strength at 5% and 10% concentrations, respectively. Sodium ascorbyl phosphate, α‐tocopherol, and catalase exhibited promising results, but further research is required. The adhesive system type plays an important role in the outcome of enamel bond strength after the antioxidant application. The postponement of either restorations or orthodontic brackets cementation following bleaching procedures seems to be efficiently replaced by antioxidant application prior to bonding procedures. However, the efficacy of using an antioxidant to recover bond strength depends on its type and application time.
Couples' changing work patterns in the United Kingdom and the United States during the COVID‐19 pandemic
Authors: Qian Yue , Hu Yang
Published: March 2021

Going beyond a focus on individual‐level employment outcomes, we investigate couples' changing work patterns in the United Kingdom (UK) and the United States (US) during the COVID‐19 pandemic. Analyzing longitudinal panels of 2186 couples from the Understanding Society COVID‐19 Survey (UK) and 2718 couples from the Current Population Survey (US), we assess whether the pandemic has elevated the importance of human capital vis‐à‐vis traditional gender specialization in shaping couples' work patterns. The UK witnessed a notable increase in sole‐worker families with the better‐educated partner working, irrespective of gender. The impact of the pandemic was similar but weaker in the US. In both countries, couples at the bottom 25% of the prepandemic family income distribution experienced the greatest increase in neither partner working but the least growth in sole‐worker arrangements. Through a couple‐level analysis of changing employment patterns, this study highlights the importance of human capital in shaping couples' paid‐work organization during the pandemic, and it reveals the socioeconomic gradient in such organization.
A retrospective study examining the adverse effect of childhood abuse among adult psychiatric service users in Britain
Authors: Mantovani Nadia , Smith Jared
Published: March 2021

The long‐term effects of childhood abuse have been well studied though the effects of abuse of specific types in adult psychiatric service users are less known. This study aimed to assess the association between childhood abuse and the development of harmful social and behavioural outcomes among adult psychiatric service users. Adult psychiatric service users were accessed from secondary mental health services in South London. A retrospective analysis was conducted of a randomly selected sample of 342 mental health records. Chi‐square tests and logistic regression models were used to examine associations between childhood abuse – sexual abuse, physical abuse and psychological/emotional abuse – and health and behavioural outcomes. This study identified that 109 (31.8%) psychiatric service users had some history of childhood abuse and more often presented with high‐risk or severe behaviours. Sexual abuse in childhood was linked with social isolation related to loss of friends (odds ratio (OR) = 2.68, P < 0.01), risky behaviours such as binge drinking (OR = 2.15, P < 0.05) and self‐harming (OR = 2.86, P < 0.01), while childhood physical abuse was associated with drug abuse in adulthood (OR = 1.88, P < 0.05). Revictimization (adult domestic violence) also impacted on service users’ quality of life in terms of loss of housing (OR = 2.21, P < 0.05) and loss of friends/family contact (OR = 2.73, P < 0.01). These findings suggest childhood abuse may play an important role in shaping risk and vulnerability for mental health problems across a lifespan. In acute mental health services, the incorporation of a trauma‐informed nursing care model is necessary to generate a shift in culture in the delivery of care.
Offspring provisioning by extra‐pair males in blue tits
Authors: Santema Peter , Kempenaers Bart
Published: March 2021

Most birds are socially monogamous with both parents providing offspring care, but sometimes individuals are observed to provision at a nest that is not their own. One possible explanation for this behaviour is that it is a fitness maximising strategy by males who have copulated with the female and hence potentially sired extra‐pair offspring in the focal nest. Over a period of 8 years and among a total of 854 nests, we observed 12 blue tits Cyanistes caeruleus that provisioned at a nest that was not their own. In all cases, the provisioning individual was a male who had no nestlings of its own, either because its breeding attempt had failed (n = 5), because it was a non‐breeder (n = 6) or because the eggs in its own nest had not hatched yet (n = 1). Only two out of the 12 males had sired offspring in the nest where they helped, but most others had had interactions with the female during her presumed fertile period or were close neighbours, and hence may have performed extra‐pair copulations that did not result in fertilisations. In 10 out of the 12 cases, the resident male was not present anymore, either because it had disappeared (n = 7) or because it was socially polygynous and provided care at its other, primary nest (n = 3). Our findings suggest that females can benefit from extra‐pair copulations by obtaining help in raising their brood when they do not receive help from their social mate. Extra‐pair copulations could thus function as an ‘insurance' strategy with a relatively small cost.
High‐mobility group box‐1 promotes vascular calcification in diabetic mice via endoplasmic reticulum stress
Authors: Chen Zheng , Li Ran , Pei Li‐Gang , Wei Zhong‐Hai , Xie Jun , Wu Han , Xu Biao
Published: March 2021

Several studies reported the role of endoplasmic reticulum stress (ERS) in vascular calcification. High‐mobility group box‐1 (HMGB‐1) plays a substantial role in diabetes and its complications. However, relatively little information is available regarding the association between HMGB‐1 and calcification, and the underlying mechanism has still remained elusive. Therefore, in the present study, we attempted to indicate whether HMGB‐1 could promote vascular calcification via ERS in diabetes. After induction of diabetes by Streptozotocin (STZ), mice were treated with glycyrrhizin (Gly) or 4‐phenylbutyrate (4‐PBA). Mineral deposition was confirmed by reverse transcription‐polymerase chain reaction (RT‐PCR) and calcium assay. In cell experiments, calcification of vascular smooth muscle cells (VSMCs) was performed with Alizarin Red staining, alkaline phosphatase (ALP) activity and RT‐PCR. Expression and location of HMGB‐1 in aortic tissue were detected by Western blotting, immunocytochemistry (ICC) and immunohistochemistry (IHC). Diabetic mice demonstrated increased HMGB‐1 expression, ERS and vascular calcification. However, inhibition of HMGB‐1 with Gly or inhibition of ERS with 4‐PBA ameliorated the enhanced vascular calcification and ERS in diabetic mice. In vitro experiments unveiled that inhibition of HMGB‐1 attenuated advanced glycation end products (AGEs)‐induced ERS in VSMCs. In addition, AGEs promoted translocation and secretion of HMGB‐1 in VSMCs, which was reversed by 4‐PBA. Moreover, VSMCs exhibited increased mineralization and osteogenic gene expressions in response to HMGB‐1 and AGEs. However, inhibition of ERS with 4‐PBA partially, although noticeably, attenuated VSMC calcification induced by HMGB‐1. Thus, diabetes induced translocation and secretion of HMGB‐1 via ERS, which resulted in calcification in diabetic mice and in AGEs‐treated VSMCs.
Procedural Politics Revisited: Institutional Incentives and Jurisdictional Ambiguity in EU Competence Disputes
Authors: Ovádek Michal
Published: March 2021

Over 15 years ago Joseph Jupille articulated the conditions under which actors clash over, rather than merely within, political institutions. He showed that between 1987 and 1997 the theory of procedural politics helped explain why and when EU institutions contested the legal basis of EU legislation. The two key determinants in the theory are jurisdictional ambiguity and actors' desire to maximize their own procedural influence. This article examines the theory's ongoing relevance by putting it through a fresh test with 20 years' worth of new data. Although I find robust evidence of the theory's explanatory value beyond 1997, the phenomenon of procedural politics appears currently at its tail end, largely consistent with Jupille's prediction that treaty change increases the probability of institutional contestation.
Does Alice Target Patent Trolls?
Authors: Lemley Mark A. , Zyontz Samantha
Published: March 2021

The five years since Alice Corp. v. CLS Bank International, 573 U.S. 208 (2014) have witnessed an explosion in patentable subject matter decisions ‐‐ and in political controversy over the doctrine. To its critics, Alice renders important inventions in medical diagnostics, biotechnology, and information technology unpatenable and therefore discouraging investment in critical market sector innovation. To its defenders, Alice offers a reliable, quick, and cheap way to invalidate weak patents owned by patent trolls, reducing patent holdup and protecting innovators. In response to these debates, we explore how the courts actually use Alice. We construct a unique dataset of every district court and federal circuit decision on patentable subject matter from July 2014 through June 2019 and categorize the patent plaintiffs in each case using the Stanford NPE Litigation Database. Once in court, patentable subject matter challenges are far more common in software/IT cases, and biotech/life science innovations are more likely to survive. Surprisingly, the entities most likely to lose their patents are not patent trolls but individual inventors and inventor‐started companies. Our findings have important implications for current legislative and judicial disputes over patent reform as some of the patent owners most impacted may be overlooked.
Role of immunotherapy in gastro‐enteropancreatic neuroendocrine neoplasms (gep‐nens): Current advances and future directions
Authors: Fang Liu , Arvind Dasari , Dowlati Afshin , Mohamed Amr
Published: March 2021

Neuroendocrine neoplasms (NENs) are heterogeneous tumours originating from neuroendocrine cells (Pearse & Polak, Gut, 1971, 12,783). They were once considered as rare tumours, although their annual incidence has increased significantly and now exceeds seven cases in 100 000 in the USA (Dasari, et al., JAMA oncology, 2017, 3, 1335). They are a group of highly diverse neoplasms and can be classified into the spectrum of well‐differentiated neuroendocrine tumours to poorly differentiated neuroendocrine carcinomas. This is entirely based on the tumour differentiation and grade (low, intermediate, high), which is determined by the Ki‐67/mitotic index. The lower grades (G1/2) of the well‐differentiated group are characterised by a relative indolent clinical course and the ability to secrete a variety of peptide hormones (Kloppel, Visceral medicine, 2017, 33, 324). Higher grades and poorly differentiated tumours tend to be more aggressive and have limited therapeutic options (Sorbye et al., Neuroendocrinology, 2019, 108, 54). In the modern era of immuno‐oncology, immune checkpoint inhibitors (ICPIs) that target programmed cell death 1 (pembrolizumab, nivolumab), programmed cell death‐ligand1 (avelumab, atezolizumab and durvalumab) or cytotoxic T‐lymphocyte‐associated protein 4 (ipilimumab) have revolutionised the management of many solid tumours. In patients with gastro‐enteropancreatic (GEP)‐NENs, there is a limited data regarding the role of ICPIs either as a single agent or in combination regimens. Here, we review the current advances for ICPIs and where they fit in the management of GEP‐NENs.
Herlyn–Werner–Wunderlich syndrome: Report of a delayed diagnosed case with video presentation of the operative technique of vaginal septum resection
Authors: Pittokopitou Savia , Kathopoulis Nikolaos , Protopapas Athanasios , Domali Ekaterini
Published: March 2021

Herlyn–Werner–Wunderlich (HWW) syndrome is a rare congenital anomaly of Mullerian duct development characterized by uterus didelphys with blind hemivagina and ipsilateral renal agenesis. We present a case of a 29‐year‐old nulliparous woman, who was referred to our hospital complaining of chronic pelvic pain, dyspareunia, and a palpable mass in her vagina. At the age of 12, she underwent surgery because of a didelphys uterus diagnosis. Subsequently, she was operated on twice for endometriomas. At our institution, clinical and imaging findings revealed an obstructed hemivagina setting the diagnosis of HWW syndrome. Some of the various syndrome types may go unnoticed for months or even years after the onset of menstruation. Early diagnosis, followed by proper surgical treatment, is the key to avoid potentially severe complications.
Is there an ethnicity bias in Catalan secessionism? Discourses and political actions
Authors: Vergés‐Gifra Joan , Serra Macià
Published: March 2021

Many charges have been made against Catalan secessionism from a normative or ideological point of view. In this article we would like to focus on the accusation that the secessionist movement is xenophobic, racist or ethnicist. Between 2017 and 2019, and particularly since Quim Torra was named president of the Generalitat, this has been the dominant criticism in the arguments set out against secessionism. We are interested in evaluating the strength of this accusation in this contribution. In this respect, we focus on the discourse and the main legislative actions adopted by the Catalan institutions since embarking on a determined bid for sovereignty, popularly called the Process, in 2010. Our conclusion is that both from discursive and legislative points of view, it can be concluded that Catalan secessionism cannot be considered as an ethnicist movement.
Rewiring of interactions in a changing environment: nettle‐feeding butterflies and their parasitoids
Authors: Audusseau Hélène , Ryrholm Nils , Stefanescu Constanti , Tharel Suzanne , Jansson Camilla , Champeaux Lucile , Shaw Mark R. , Raper Chris , Lewis Owen T. , Janz Niklas , Schmucki Reto
Published: March 2021

Climate and land use change can alter the incidence and strength of biotic interactions, with important effects on the distribution, abundance and function of species. To assess the importance of these effects and their dynamics, studies quantifying how biotic interactions change in space and time are needed.

We studied interactions between nettle‐feeding butterflies and their shared natural enemies (parasitoids) locally and across 500 km latitudinal gradient in Sweden. We also examined the potential impact of the range‐expansion of the butterflyAraschnia levanaon resident butterflies via shared parasitoids, by studying how parasitism in resident butterflies covaries with the presence or absence of the newly‐established species. We collected 6777 larvae of four nettle‐feeding butterfly species (Aglais urticae,Aglais io,Ar. levanaandVanessa atalanta), over two years, at 19 sites distributed along the gradient. We documented the parasitoid complex for each butterfly species and measured their overlap, and analysed how parasitism rates were affected by butterfly species assemblage, variations in abundance, time, and the arrival ofAr. levana. Parasitoids caused high mortality, with substantial overlap in the complex of parasitoids associated with the four host butterflies. Levels of parasitism differed significantly among butterflies and were influenced by the local butterfly species assemblage. Our results also suggest that parasitism in resident butterflies is elevated at sites whereAr. levanahas been established for a longer period.

In our study system, variations in butterfly species assemblages were associated in a predictable way with substantial variations in rates of parasitism. This relationship is likely to affect the dynamics of the butterfly host species, and potentially cascade to the larger number of species with which they interact. These results highlight the importance of indirect interactions and their potential to reorganise ecological communities, especially in the context of shifts in species distributions in a warmer world.
Staging the prince and the people: Kairós in James Shirley’s The Politician
Authors: Zirak‐Schmidt David Hasberg
Published: March 2021

This article examines the temporal dynamics of James Shirley's The Politician, and how they relate to the play's staging of the people and the prince. More specifically, I am interested in analysing The Politician through the lens of the ancient Greek notion of kairós (καιρός). By examining the kairotic temporality of The Politician, it becomes possible to analyse how Shirley balances the doctrine of divine right and Machiavellianism while simultaneously healing the strained relationship between the king and the people.
Community‐driven post‐fire restoration initiatives in Central Chile: when good intentions are not enough
Authors: Morales Narkis S. , Fernández Ignacio C. , Duran Leonardo P. , Venegas‐González Alejandro
Published: March 2021

A fundamental pillar of community‐driven restoration projects is motivation, without which initiatives are doomed to fail. However, technical knowledge and funding are also important factors for success. In this work, we present three case studies of post‐fire restoration projects driven by local communities in Central Chile to assess whether motivation and proactive actions were sufficient to carry out successful restoration projects. We found that while in the three cases motivation was essential for starting restoration actions, the level of technical knowledge, the ability to connect with academic institutions, and the capability to secure funding played key roles in the projects' results. We identified three key factors that should be present to increase community‐driven restoration success: (1) appropriate technical knowledge and expertise to set suitable restoration objectives and activities; (2) adequate capabilities and networks for procuring financial and technical resources; and (3) capacity to apply for available funding to ensure resources for later phases. Ensuring the concurrence of these three factors cannot be the sole responsibility of local communities. Instead, it should be a shared responsibility between government agencies and academic institutions to develop strategies that help develop links between experts and local communities.
Distributional effects of nonresident investors on the housing market and welfare
Authors: Germaschewski Yin , Wang Shu‐Ling
Published: March 2021

This paper studies the distributional effects of nonresident housing investment on residents' consumption and welfare in a dynamic stochastic general equilibrium model with two types of agents: savers and borrowers. The model is estimated with Bayesian methods applied to Taiwan. Three main results emerge. First, nonresident housing investment raises house prices and rent, validating policymakers' concerns about housing affordability. Second, higher house prices boost homeowners' property values, which strongly promotes consumption. Third, higher investment by nonresidents increases government tax revenues, the allocation of which has important welfare consequences across agents. Using tax revenues to subsidize residents through income tax reduction produces the largest welfare improvement, followed by a provision of public goods. Increasing the tax deductibility of mortgage interest is beneficial to borrowers, while allotting tax revenues to supply public capital results in the greatest welfare losses to savers.
Darboux transformations and solutions of nonlocal Hirota and Maxwell–Bloch equations
Authors: An Ling , Li Chuanzhong , Zhang Lixiang
Published: March 2021

In this paper, based on the Hirota and Maxwell–Bloch (H‐MB) system and its application in the theory of the femtosecond pulse propagation through an erbium doped fiber, we define two kinds of nonlocal Hirota and Maxwell–Bloch (NH‐MB) systems, namely, ‐symmetric NH‐MB system and reverse space‐time NH‐MB system. Then, we construct the Darboux transformations of these NH‐MB systems. Meanwhile, we derive the explicit solutions by the Darboux transformations.
Integrating communal content into science lessons: An investigation of the beliefs and attitudes of preservice teachers
Authors: Fuesting Melissa A. , Diekman Amanda B. , Bautista Nazan
Published: March 2021

Developing student capacity for the science, technology, engineering, and math (STEM) workforce requires not only better preparation in specific content and skills but also better preparation in understanding the goals that STEM fields can afford. In particular, stereotypic views that STEM fields lack communal opportunities to work with and help others dampen interest in pursuing STEM careers. This research project investigated preservice science teachers' (PST) beliefs about whether science careers afford communal goals, and then employed experimental methodology to assess reactions to science lessons that integrate communal content. PSTs perceived STEM fields as less likely than other fields to fulfill communal goals. Yet lesson plans that integrated communal applications were perceived as more likely to engage students. The communally‐oriented lesson plans were then further developed for dissemination. We discuss the opportunities and obstacles to integrating communal content into science education instruction.
Cognitive Effects of Inattentive Responding in an MTurk Sample
Authors: Pyo Jimin , Maxfield Michael G.
Published: March 2021

Objective

Mechanical Turk (MTurk) has become an increasingly valuable sampling tool for social scientists. At the same time, concern has emerged about the quality of responses obtained from MTurk workers. This article demonstrates several screening practices for identifying problematic or inattentive MTurk participants. The study also examines how inattentive responding affects psychometric properties of measures and relationships between substantive variables.

Method

A sample of 498 MTurk workers participated in an experimental study for developing and validating scales of public confidence in the criminal justice system. Multiple screening procedures were used to identify inattentive participants and their potential effects on study measures and hypothesis testing.

Results

Results reveal adverse impacts on psychometric properties of measures as well as inflated observed relationships between substantive variables.

Conclusion

Screeners used in this study work well in identifying attention problems among MTurk participants. The present study expands guidance for improving quality of responses from MTurk participants for social science research.
A nait‐associated and previously unreported mutation in the ITGB3 gene with a low frequency in the local population
Authors: Norrenbrock Stefan , Müller Thomas H. , Mayer Christiane , Doescher Andrea
Published: March 2021

Background

Neonatal alloimmune thrombocytopenia is a rare but potentially severe postnatal complication caused by maternal allo‐antibodies against platelet antigens of the newborn. In relatively few cases, immunisation against low‐frequency antigens has been reported.

Methods

Platelet antigens of a newborn with severe thrombocytopenia and his family members were investigated by serological and molecular biological methods. A real‐time PCR assay was developed to reliably detect this mutation in pools of DNA from up to seven individuals.

Results

Serological testing showed positive reactions of maternal plasma with paternal platelets but not with conventional platelet donor panels. Sequencing of the ITGB3 gene revealed a G > A polymorphism in position c.1915 of exon 12 for the father, the newborn and three of four paternal relatives. Screening of samples from a local population of 1575 Caucasian blood donors identified only a single individual with this mutation.

Conclusion

This finding of a previously unreported private platelet antigen demonstrates that the identification of the target glycoprotein by MAIPA assay followed by sequencing of the affected gene can be combined with an efficient population screening by real‐time PCR with pooling of DNA samples.
Training Non-Directiveness? A Transdisciplinary Survey of Medical Students' Perspective Towards Prenatal Counseling and Down Syndrome
Authors: Dilen Thomas , Lefevre Thomas , Mariën Bram , Munster Benjamin , Neven Fran , Van Deursen Gaëtan , Van In Jill , Verberckmoes Marie , van Uffelen Nynke , Zenner Eline
Published: March 2021

The non-invasive prenatal test (NIPT) is a highly sensitive blood analysis tool that allows for the early detection of multiple chromosomal abnormalities, including Down syndrome. Prenatal testing in general and a positive test outcome in particular leave pregnant parents facing difficult
ethical decisions and life-changing dilemmas. The language used by medical practitioners in this context has the potential to exert a strong influence on parents in their decision-making process. During counseling, health care professionals (HCPs) are expected to encourage parents to make
an informed yet autonomous decision, which hinges on maximally unbiased, clear and consistent communication from the HCP. It is still unclear whether medical students are aware of this importance of unbiased communication, how they perceive the role of HCPs in the prenatal counseling process,
and what perspectives they have regarding the disabilities screened for. Our research project aims to address this gap, presenting the results of a transdisciplinary survey completed by 245 medical students at KU Leuven. In particular, the survey investigates: (1) the students' view on the
ideal prenatal counseling process; (2) their knowledge of NIPT and Down syndrome (the most prevalent disability NIPT screens for); and (3) their general attitudes towards disabilities. Results reveal that more than 50% of medical students do not feel prepared for genetic counseling. The survey
further shows a lack of knowledge and some clearly negative attitudes towards life with disability; 20% of medical students agree that a life with Down syndrome should be avoided. Overall, results indicate fairly heterogeneous distribution of knowledge and fairly diverse attitudes of the students,
suggesting revisions in the current curriculum might be needed to increase the homogeneity towards counseling and disabilities in the medical student population.
¿Buscar el bienestar de la ciudad, o marcharse mientras ella se quema? Lectura política e intertextual de Jr 29 y Lc 17 en relación con las crisis migratorias del siglo XXI
Authors: Hays Christopher Michael
Published: March 2021

Este artículo fusiona la exégesis crítica con la reflexión sociopolítica para mostrar cómo una tensión desafiante en las Escrituras puede nutrir respuestas matizadas a crisis sociales. Al comenzar con un estudio intertextual, se identifica que Lc 17,27-28 hace alusión y subvierte a Jr 29,5-7. Se nota que las actividades que Jr 29 encomienda a los exiliados en Babilonia (plantar, edificar, casar y dar en casamiento) son las mismas actividades criticadas por Lc 17, y que hay otras similitudes entre Lc 17 y Jr 32 y 35, todo lo cual revela que Lucas pretende contrastar la situación de su audiencia con la de los exiliados en Babilonia, y propone así una ética distinta para los discípulos de su época. Aunque el profeta animó a sus lectores exiliados a entregarse al desarrollo económico y familiar en Babilonia, el evangelista advierte en contra de preocupaciones mundanas que estorban su compromiso con el Reino. Se propone que esta tensión intracanónica facilita un acercamiento diferenciado a dos crisis migratorias actuales, aplicando la perspectiva de Jeremías para animar a las víctimas del desplazamiento forzoso en Colombia a echar raíces en sus sitios de llegada, y recurriendo a Lc 17 para criticar la deportación estadounidense de los migrantes indocumentados. Se justifica este acercamiento hermenéutico diferenciado por medio de un estudio de la actividad redaccional de Lucas (transformando las enseñanzas de Mt 24 y Mc 13 sobre el evento de la parusía a exhortaciones sobre cómo vivir de manera ética antes de la parusía) y de la polifonía ética de Jeremías (la cual se nota en los divergentes estilos de vida afirmados por Jr 16,2-4; 29,6; 35,6-7). Se argumenta que esta moralidad multifacética cuadra con una visión neotestamentaria equilibrada que caracteriza a los cristianos como exiliados y a la vez ciudadanos (Hb 11,13-14; 1P 2,1).
A New Approach to the Modeling of Magnetorheological Dampers and Application to Resonance Control
Authors: Siginer Dennis A. , Letelier Mario F. , Stockle Juan
Published: March 2021

A predetermined flow pattern in a magnetorheological damper providing continuously variable resistance to flow is required for efficient damping of a given load. The required predetermined flow pattern rests on the a priori determination of the constitutive properties of the magnetorheological (MR) fluid determined to generate variable resistance to flow. The inverse problem of constructing the predetermined response of the damper with a specific displacement pattern of the piston in the damper for efficient damping of a given load is solved. The MR fluid in the damper is modeled as a Bingham phase change material with time-dependent yield stress offering continuously variable resistance to the flow in the piston to achieve the required specific displacement pattern. The governing equations are solved for any time history of the dimensionless yield stress of the fluid which in turn is determined from the imposed response of the damper. Analytical tools developed can be used in optimizing damper performance. The application of the method to resonance mitigation is illustrated.
Development and Verification of an Enhanced Equation of State in TOUGH2
Authors: An Cheng , Han Yanhui , Liu Hui-Hai , Sun Zhuang
Published: March 2021

A reservoir-geomechanics coupled simulation tool is required in the interpretation and prediction of stimulation and production performance of unconventional reservoirs in a physically rigorous manner. One such a coupled simulation tool developed at Lawrence Berkeley National Laboratory (LBNL), TOUGH2-FLAC3D, has been extensively adopted in many scientific research and practical application projects in last two decades. In TOUGH2's most often used equation of state (EOS), EOS4, the vapor pressure is used as a primary variable, however, the vapor pressure lowering effect is not the primary interest in a typical reservoir flow simulation. Instead, the temperature should be a natural and physically correct primary variable, considering the convenience of model input, and the understanding and interpretation of simulation results. In this work, the vapor pressure is replaced by temperature in the EOS implementation. To be consistent with the change of primary variable, the Jacobian matrix is modified correspondingly and illustrated using a case of two-phase flow in one grid block. The development work was verified in three well-defined problems that are related to fluid diffusion, thermal conduction, thermal fluid conduction and convection, respectively, through comparing the modeling results with the corresponding analytical solutions.
Investigation of Particle Loading on the Turbulent Flow Over a Deep Cavity
Authors: Bluestein Andrew M. , Bohl Douglas
Published: March 2021

Turbulent particle-laden flows are of interest due to their presence in many industrial and natural flows. The effect that the particles have on the turbulence of the fluid is referred to as turbulence modulation. Experimental data is lacking at Reynolds numbers (Re) greater than 100,000, and at dense loadings (ΦV > 1%). In this work, turbulent particle-laden flow over a deep cavity with an aspect ratio of 1, was studied at Re of 11,500 and 115,000, and particle loadings of 0%, 1%, 3%, and 5% by weight/volume using neutrally buoyant particles (solid-phase specific gravity = 1). Super absorbent particles were used to create an index-matched environment with water as the working fluid. Data were acquired using two-dimensional planar particle image velocimetry along the center span of the geometry. Mean and root-mean-square velocities were calculated for the fluid phase. The flow structures were identified and located using the gamma criteria. The results showed that the particle loading changed the locations of the recirculation regions within the cavity. The mean velocities were nominally unaffected by loading for a respective Re case. Prior literature suggested that the particles would attenuate the turbulence, however, the current data showed no single trend. Turbulence modulation of the flow was found to be sensitive to the Re and location within the flow field. The changes in the turbulence appeared to be primarily due to the differences in the location of the flow structures.
Atypical Genetic Basis of Pyrazinamide Resistance in Monoresistant Mycobacterium tuberculosis
Authors: Modlin Samuel J. , Marbach Tyler , Werngren Jim , Mansjö Mikael , Hoffner Sven E. , Valafar Faramarz
Published: March 2021

Pyrazinamide (PZA) is a widely used antitubercular chemotherapeutic. Typically, PZA resistance (PZA-R) emerges in
Mycobacterium tuberculosis
strains with existing resistance to isoniazid and rifampin (i.e., multidrug resistance [MDR]) and is conferred by loss-of-function
pncA
mutations that inhibit conversion to its active form, pyrazinoic acid (POA).
Pathogenesis of Gram-Negative Bacteremia
Authors: Holmes Caitlyn L. , Anderson Mark T. , Mobley Harry L. T. , Bachman Michael A.
Published: March 2021

Gram-negative bacteremia is a devastating public health threat, with high mortality in vulnerable populations and significant costs to the global economy. Concerningly, rates of both Gram-negative bacteremia and antimicrobial resistance in these species are increasing.
Living in Your Skin: Microbes, Molecules, and Mechanisms
Authors: Swaney Mary Hannah , Kalan Lindsay R.
Published: March 2021

Human skin functions as a physical, chemical, and immune barrier against the external environment while also providing a protective niche for its resident microbiota, known as the skin microbiome. Cooperation between the microbiota, host skin cells, and the immune system is responsible for maintenance of skin health, and a disruption to this delicate balance, such as by pathogen invasion or a breach in the skin barrier, may lead to impaired skin function.
A holistic approach to promoting early child development: a cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh
Authors: Pitchik Helen O , Tofail Fahmida , Rahman Mahbubur , Akter Fahmida , Sultana Jesmin , Shoab Abul Kasham , Huda Tarique Md. Nurul , Jahir Tania , Amin Md Ruhul , Hossain Md Khobair , Das Jyoti Bhushan , Chung Esther O , Byrd Kendra A , Yeasmin Farzana , Kwong Laura H , Forsyth Jenna E , Mridha Malay K , Winch Peter J , Luby Stephen P , Fernald Lia CH
Published: March 2021

Introduction

In low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention.

Methods

We conducted a 9-month, parallel, multiarm, cluster-randomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers.

Results

In July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (age-adjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54).

Conclusion

Our findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.

Trial registration number

The trial is registered in ISRCTN (ISRCTN16001234).
Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review
Authors: Moynihan Ray , Sanders Sharon , Michaleff Zoe A , Scott Anna Mae , Clark Justin , To Emma J , Jones Mark , Kitchener Eliza , Fox Melissa , Johansson Minna , Lang Eddy , Duggan Anne , Scott Ian , Albarqouni Loai
Published: March 2021

Objectives

To determine the extent and nature of changes in utilisation of healthcare services during COVID-19 pandemic.

Design

Systematic review.

Eligibility

Eligible studies compared utilisation of services during COVID-19 pandemic to at least one comparable period in prior years. Services included visits, admissions, diagnostics and therapeutics. Studies were excluded if from single centres or studied only patients with COVID-19.

Data sources

PubMed, Embase, Cochrane COVID-19 Study Register and preprints were searched, without language restrictions, until 10 August, using detailed searches with key concepts including COVID-19, health services and impact.

Data analysis

Risk of bias was assessed by adapting the Risk of Bias in Non-randomised Studies of Interventions tool, and a Cochrane Effective Practice and Organization of Care tool. Results were analysed using descriptive statistics, graphical figures and narrative synthesis.

Outcome measures

Primary outcome was change in service utilisation between prepandemic and pandemic periods. Secondary outcome was the change in proportions of users of healthcare services with milder or more severe illness (eg, triage scores).

Results

3097 unique references were identified, and 81 studies across 20 countries included, reporting on >11 million services prepandemic and 6.9 million during pandemic. For the primary outcome, there were 143 estimates of changes, with a median 37% reduction in services overall (IQR −51% to −20%), comprising median reductions for visits of 42% (−53% to −32%), admissions 28% (−40% to −17%), diagnostics 31% (−53% to −24%) and for therapeutics 30% (−57% to −19%). Among 35 studies reporting secondary outcomes, there were 60 estimates, with 27 (45%) reporting larger reductions in utilisation among people with a milder spectrum of illness, and 33 (55%) reporting no difference.

Conclusions

Healthcare utilisation decreased by about a third during the pandemic, with considerable variation, and with greater reductions among people with less severe illness. While addressing unmet need remains a priority, studies of health impacts of reductions may help health systems reduce unnecessary care in the postpandemic recovery.

PROSPERO registration number

CRD42020203729.
Web-based physical activity intervention for people with progressive multiple sclerosis: application of consensus-based intervention development guidance
Authors: Busse Monica , Latchem-Hastings Julie , Button Kate , Poile Vince , Davies Freya , O' Halloran Rhian , Stensland Barbara , Tallantyre Emma , Lowe Rachel , Wood Fiona , Dawes Helen , Edwards Adrian , Jones Fiona
Published: March 2021

Objectives

People with progressive multiple sclerosis (PwPMS) report that they recognise the benefits of activity on their physical and psychological health but need support to achieve their physical activity goals. We aimed to systematically develop a theoretically informed intervention that would enable PwPMS to more readily engage in regular physical activity.

Design

We used an intervention mapping approach to inform intervention development.

Setting

We conducted semistructured interviews with PwPMS and their families/carers and physiotherapists recruited from secondary care settings.

Participants

Fourteen PwPMS with an Expanded Disability Status Scale score of between 6 and 8 and 7 of their families/carers and 13 physiotherapists and 1 physiotherapy technician participated.

Results

Interview data suggested that the development of supportive coaching relationships with physiotherapists could promote the ability of PwPMS to achieve a desirable and achievable physical activity plan. These interview data informed the prototype ‘Lifestyle Exercise and Activity Package for Multiple Sclerosis’ (LEAP-MS) consisting of a secure multiuser web-based platform (with an education and activity suite, interactive components enabling selection of exercises, goal setting and activity logging), up to six flexible face-to-face or web-based physiotherapy coaching sessions and remote support via an embedded web-based messaging function that all together draw on specific theory-based methods to achieve physical activity behaviour change, namely active learning, reinforcement, modelling, feedback, facilitation, goal setting and guided practice. Implementation is within a multiuser platform accessible to participants, trained physiotherapists and researchers.

Conclusions

We have followed an inclusive, systematic and transparent process to develop the LEAP-MS intervention that enables detailed description of components, context and guiding principles to inform ongoing evaluation. Importantly, PwPMS expressed the need for autonomy in developing physical activity plans. This has been achieved through the embedding of self-management principles in the design and delivery of the LEAP-MS intervention.