bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community development for improved housing, health equity, and education in rural Honduras
Authors: Reifsnider Elizabeth , Packer Phebe W. , Argent‐DeLorme Autumn , Suarez Christina 
Published: April 2021

AbstractThis paper describes an international, long‐term, population health project in rural Honduras among Mayan villagers, focused on collaboration, community building, partnership formation, and improvement of their living situation. Improved housing, health checks, education for their children, and clean water were chosen by the Honduran residents as the projects they thought were most important to improve their health and living conditions. During the short mission trips, the North Americans (NAs) and the villagers worked side‐by‐side on house building and participated in village life. The Hondurans organized into communities that mutually decided on which families received homes and together worked on each other's homes with the NAs' assistance. Nurse‐led health clinics and scholarships for students were provided by the visitors during their time in the villages. Health has improved from better housing and periodic health checks, and most significantly, sustainable community organizing occurred. Public Health Nurses can work towards health equity and population health improvement by basing efforts on what the community partners request and create outcomes through relationships with those who stand to benefit from the improvement.
Wastewater treatment by microalgae
Authors: Plöhn Martin , Spain Olivia , Sirin Sema , Silva Mario , Escudero‐Oñate Carlos , Ferrando‐Climent Laura , Allahverdiyeva Yagut , Funk Christiane 
Published: April 2021

AbstractThe growth of the world's population increases the demand for fresh water, food, energy, and technology, which in turn leads to increasing amount of wastewater, produced both by domestic and industrial sources. These different wastewaters contain a wide variety of organic and inorganic compounds which can cause tremendous environmental problems if released untreated. Traditional treatment systems are usually expensive, energy demanding and are often still incapable of solving all challenges presented by the produced wastewaters. Microalgae are promising candidates for wastewater reclamation as they are capable of reducing the amount of nitrogen and phosphate as well as other toxic compounds including heavy metals or pharmaceuticals. Compared to the traditional systems, photosynthetic microalgae require less energy input since they use sunlight as their energy source, and at the same time lower the carbon footprint of the overall reclamation process. This mini‐review focuses on recent advances in wastewater reclamation using microalgae. The most common microalgal strains used for this purpose are described as well as the challenges of using wastewater from different origins. We also describe the impact of climate with a particular focus on a Nordic climate.
“Out” on the Farm: Queer Farmers Maneuvering Heterosexism and Visibility*
Authors: Hoffelmeyer Michaela 
Published: April 2021

AbstractIn agriculture, heterosexual and cisgender farmers benefit from merging the public and private spheres through the “family farm” model. In comparison, heterosexist expectations relegate queerness to the private sphere and burden queer farmers with the work of gaining acceptance among rural and agrarian communities. Based on interviews with 20 queer farmers in the northeastern United States, this article examines the role of queerness in shaping farmers' participation in agriculture. Findings show that queer farmers actively maneuver their identity based on presumptions of heterosexism, illustrating how queerness, as an aspect of identity, is widely overlooked as a critical vector that influences participation in farming. Through daily interactions with customers, other farmers, and community members, queer farmers develop strategies to mitigate heterosexism's negative implications. Queer farmers participated in alternative agriculture, leveraged the rural politics of recognition, and selectively outed themselves. As a structural issue, however, heterosexism remains an embodied hardship for queer farmers. Queer farmers' experiences offer new pathways for understanding rural community development in the agrarian transition. These results illustrate that agricultural organizations, farm policy, and rural community theorizing would benefit from viewing queerness as a critical axis of consideration in farming rather than a private matter not suitable for farming spaces.
Dynamic Fairness: Mobility, Inequality, and the Distribution of Prospects*
Authors: Peng Baochun , Yuan Haidong 
Published: April 2021

AbstractA society is fairer when the income of the family into which individuals are born, over which they have no control, plays a smaller role in determining their prospects. We examine the nature of dynamic fairness based on the distribution of prospects using a generalized concentration curve. We find that dynamic fairness is jointly determined by inequality and exchange mobility, with inequality reducing fairness and exchange mobility enhancing it. Moreover, any degree of dynamic fairness can be obtained from one of the many pairs of inequality and exchange mobility. Our results can help compare different economic environments through the distribution of their economic opportunities.
Strategic Shirking in Bilateral Trade*
Authors: Lülfesmann Christoph 
Published: April 2021

AbstractIn this paper, I study bilateral trade, where the seller can undertake specific investments before the binary trade transaction takes place. I identify a novel reason for hold‐up and contractual inefficiency in this canonical setting. The investing party can shirk for strategic reasons; that is, exert an effort so low that trade becomes inefficient and is being rescinded. Under a fixed‐price contract (the second‐best mechanism in the absence of the shirking problem), strategic shirking can arise regardless of the initially contracted trade price. Moreover, if a fixed‐price contract leads to strategic shirking, there exists no general revelation mechanism to restore equilibrium trade. I show that the shirking problem is more severe when the parties trade after having learned the buyer's valuation, as opposed to the case of an “experience good” where trade is finalized before this information materializes. Finally, when both buyer and seller undertake specific investments, shirking and non‐shirking equilibria are shown to coexist.
Loan Financing as a Tool for Nonincumbent House Candidates
Authors: Baker Anne E. 
Published: April 2021

ObjectiveMore than 50 percent of nonincumbent candidates competing in each of the 2010–2016 election cycles for seats in the House used loans to supplement their campaign revenue streams but their use remains understudied.MethodUsing both summary and quarterly campaign reports from the U.S. Federal Election Commission 2010–2016, I examine the frequency, timing, and the types of loans utilized by nonincumbent House campaigns. I investigate which candidate characteristics and conditions lead to loan financing. And in a matching analysis, I test the impact of loaning financing at different points in time on inexperienced nonincumbent House candidates’ competitiveness.ResultsI find loan financing in the primary election has a greater positive impact on inexperienced House candidates’ vote margins than loan financing later in the election cycle.ConclusionThe results suggest a number of best practices for nonincumbent candidates’ use of loans.
Resolving the ambiguity of random‐effects models with singular precision matrix
Authors: Lee Woojoo , Piepho Hans‐Peter , Lee Youngjo 
Published: April 2021

AbstractRandom walks, intrinsic autoregression, state‐space models, smoothing splines, and so on have been widely used in various areas of statistics. However, practitioners wanting to fit these models using existing packages for random‐effects models are often faced with the difficulty that their covariance matrices are not uniquely determined. Unfortunately, different specifications of the model lead to different covariance structures, giving different analyses. Even if we make a decision on specification it is not immediately obvious how to make inferences from these models. There have been various suggestions on how to overcome such difficulties. However, they differ, implying that there is as yet no agreed remedy. In this article we provide a unified view on these alternatives and show how the analysis can be made invariant with respect to the choice of covariance by inclusion of a suitable set of covariates. Several examples are used to illustrate the approach.
Feeding disorders in children with oesophageal atresia: a cross-sectional study
Authors: Pham Aurélie , Ecochard-Dugelay Emmanuelle , Bonnard Arnaud , Le Roux Enora , Gelas Thomas , Rousseau Véronique , Thomassin Nadège , Cabon-Boudard Isabelle , Nicolas Audrey , Guinot Audrey , Rebeuh Julie , Le Mandat Aurélie , Djeddi Djamal-Dine , Fouquet Virginie , Boucharny Aurélie , Irtan Sabine , Lemale Julie , Comte Aurélie , Bridoux-Henno Laure , Dupont-Lucas Claire , Dimitrov Georges , Turquet Anne , Borderon Corinne , Pelatan Cécile , Chaillou Legault Emilie , Jung Camille , Willot Stéphanie , Montalva Louise , Mitanchez Delphine , Gottrand Frederic , Bellaiche Marc 
Published: April 2021

IntroductionWith advances in surgical and neonatal care, the survival of patients with oesophageal atresia (OA) has improved over time. Whereas a number of OA-related conditions (delayed primary anastomosis, anastomotic stricture and oesophageal dysmotility) may have an impact on feeding development and although children with OA experience several oral aversive events, paediatric feeding disorders (PFD) remain poorly described in this population. The primary aim of our study was to describe PFD in children born with OA, using a standardised scale. The secondary aim was to determine conditions associated with PFD.MethodsThe Feeding Disorders in Children with Oesophageal Atresia Study is a national cohort study based on the OA registry from the French National Network. Parents of children born with OA between 2013 and 2016 in one of the 22 participating centres were asked to complete the French version of the Montreal Children’s Hospital Feeding Scale.ResultsOf the 248 eligible children, 145 children, with a median age of 2.3 years (Q1–Q3 1.8–2.9, min–max 1.1–4.0 years), were included. Sixty-one children (42%) developed PFD; 13% were tube-fed (n=19). Almost 40% of children with PFD failed to thrive (n=23). The presence of chronic respiratory symptoms was associated with the development of PFD. Ten children with PFD (16%) had no other condition or OA-related complication.ConclusionPFD are common in children with OA, and there is no typical profile of patients at risk of PFD. Therefore, all children with OA require a systematic screening for PFD that could improve the care and outcomes of patients, especially in terms of growth.
Development of central precocious puberty following cannabinoid use for paediatric epilepsy: causal or coincidence?
Authors: Krishnan Aditya , Agwu Juliana Chizo , Kallappa Chetana , Pandey Rajesh 
Published: April 2021

Research suggests a role for cannabidiol oil in managing certain forms of paediatric onset epilepsy. However, studies on the impact of cannabis on the hypothalamo-pituitary-gonadal (HPG) axis have conflicting results. Delta-9-tetrahydrocannabinol (Δ9-THC) acutely inhibits gonadotropin-releasing hormone in the hypothalamus, reducing testosterone levels by 65% in rhesus monkeys. Additionally, there have been reports of pubertal arrest and delayed puberty in male cannabis users. In contrast, other studies have reported higher testosterone levels following long-term cannabis use.A 2-year-old boy presented with testicular enlargement, increased penile length and growth of coarse pubic hair developing over 6 months. His mother procured cannabidiol oil online, which he started taking 7 months earlier for severe epilepsy refractory to medical management. Subsequent investigations confirmed central precocious puberty. While it is unclear whether the precocious puberty is a direct consequence of HPG axis activation by Δ9-THC, this case demonstrates a temporal association between cannabis use and development of precocious puberty.
The effectiveness of maternity waiting homes in reducing perinatal mortality: a case–control study in Ethiopia
Authors: Dalla Zuanna Teresa , Fonzo Marco , Sperotto Milena , Resti Carlo , Tsegaye Ademe , Azzimonti Gaetano , Manenti Fabio , Putoto Giovanni , Bertoncello Chiara 
Published: April 2021

BackgroundThe 2030 Agenda for Sustainable Development aims to reduce neonatal mortality to at least 12 per 1000 live births. Most of the causes can be prevented or cured. Access to quality healthcare during pregnancy and labour is the key to reduce perinatal deaths, and maternity waiting homes (MWHs) may have an impact, especially for women who live far from the healthcare system. We conducted a case–control study to evaluate the effectiveness of MWH in reducing perinatal mortality in a secondary hospital in Ethiopia.MethodsWe did a nested case–control study from January 2014 through December 2017. The enrolled cases were mothers whose childbirth resulted in stillbirth or early neonatal death. The controls were mothers with an alive baby at 7 days or with an alive baby on discharge. We collected demographic, anamnestic, pregnancy-related and obstetric-related data. The effectiveness of the MWH on perinatal death was assessed by a logistic regression model, adjusted for all other variables investigated as potential confounders. We also did a sensitivity analysis to explore the role of twin pregnancies.ResultsWe included 1175 cases and 2350 controls. The crude analysis showed a protective effect of the MWH towards perinatal mortality (OR=0.700; 95% CI: 0.505 to 0.972), even more protective after adjustment for confounders (adjusted OR (AOR)=0.452; 95% CI: 0.293 to 0.698). Sensitivity analyses showed a consistent result, even excluding twin pregnancies (AOR=0.550; 95% CI: 0.330 to 0.917).ConclusionMWHs appear to reduce perinatal mortality by 55%. Our findings support the decision to invest in MWH to support pregnant women with higher quality and more comprehensive healthcare strategy, including quality antenatal care in peripheral primary care clinics, where risk factors can be recognised and women can be addressed for admission to MWH.
Early prediction of serious infections in febrile infants incorporating heart rate variability in an emergency department: a pilot study
Authors: Chong Shu-Ling , Ong Gene Yong-Kwang , Allen John Carson , Lee Jan Hau , Piragasam Rupini , Koh Garion Zhi Xiong , Mahajan Prashant , Liu Nan , Ong Marcus Eng Hock 
Published: April 2021

BackgroundEarly differentiation of febrile young infants with from those without serious infections (SIs) remains a diagnostic challenge. We sought to (1) compare vital signs and heart rate variability (HRV) parameters between febrile infants with versus without SIs, (2) assess the performance of HRV and vital signs with reference to current triage tools and (3) compare HRV and vital signs to HRV, vital signs and blood biomarkers, when predicting for the presence of SIs.MethodsUsing a prospective observational design, we recruited patients <3 months old presenting to a tertiary paediatric ED in Singapore from December 2018 through November 2019. We obtained patient demographic characteristics, triage assessment (including the Severity Index Score (SIS)), HRV parameters (time, frequency and non-linear domains) and laboratory results. We performed multivariable logistic regression analyses to predict the presence of an SI, using area under the curve (AUC) with the corresponding 95% CI to assess predictive capability.ResultsAmong 203 infants with a mean age of 38.4 days (SD 27.6), 67 infants (33.0%) had an SI. There were significant differences in the time, frequency and non-linear domains of HRV parameters between infants with versus without SIs. In predicting SIs, gender, temperature and the HRV non-linear parameter Poincaré plot SD2 (AUC 0.78, 95% CI 0.71 to 0.84) performed better than SIS alone (AUC 0.61, 95% CI 0.53 to 0.68). Model performance improved with the addition of absolute neutrophil count and C reactive protein (AUC 0.82, 95% CI 0.76 to 0.89).ConclusionAn exploratory prediction model incorporating HRV and biomarkers improved prediction of SIs. Further research is needed to assess if HRV can identify which young febrile infants have an SI at ED triage.Trial registration numberNCT04103151.
Actinic keratoses contiguous with squamous cell carcinomas are mostly non-hyperkeratotic and with severe dysplasia
Authors: Heerfordt Ida M , Poulsen Thomas , Wulf Hans Christian 
Published: April 2021

AimsActinic keratosis (AK) is a precursor of cutaneous squamous cell carcinoma (SCC). No validated parameters can predict which AKs will progress into SCCs, but especially thick AKs are under suspicion. The clinical and histopathological thickness of AKs is strongly correlated. This study aimed to investigate the thicknesses and degree of dysplasia of AKs contiguous with SCCs assuming these AKs represent the AKs that have undergone malignant transformation.MethodsFiles of the Pathology Department, Hospital of Southern Jutland, Denmark, were reviewed. 111 cases met the inclusion criteria: a skin biopsy containing an invasive SCC. All SCCs merged with an AK at the edge. Degree of dysplasia, epidermal thickness and stratum corneum thicknesses of AKs were measured.ResultsAll AKs showed severe dysplasia. Most AKs had a stratum corneum thickness under 0.1 mm and an epidermal thickness under 0.5 mm, corresponding to clinically thin and non-hyperkeratotic AKs.ConclusionsOur result suggests malignant progression potential of AKs regardless of thickness.
Effect of nurse-led care on outcomes in patients with ACPA/RF-positive rheumatoid arthritis with active disease undergoing treat-to-target: a multicentre randomised controlled trial
Authors: Hoeper Juliana Rachel , Zeidler Jan , Meyer Sara Eileen , Gauler Georg , Steffens-Korbanka Patricia , Welcker Martin , Wendler Jörg , Schuch Florian , von Hinüber Ulrich , Schwarting Andreas , Witte Torsten , Meyer-Olson Dirk , Hoeper Kirsten 
Published: April 2021

ObjectiveTo determine the non-inferiority of nurse-led care (NLC) in patients with anticitrullinated protein antibody (ACPA)-positive and/or rheumatoid factor (RF)-positive rheumatoid arthritis (RA) with active disease who are starting disease-modifying antirheumatic drug therapy, following treat-to-target (T2T) recommendations.MethodsA multicentre, pragmatic randomised controlled trial was conducted to assess clinical effectiveness, anxiety, depression and patient satisfaction following a non-inferiority design. The participants were 224 adults with ACPA/RF-positive RA who were randomly assigned to either NLC or rheumatologist-led care (RLC). The primary outcome was the Disease Activity Score in 28 Joints measured with C reactive protein (DAS28-CRP) assessed at baseline and after 3, 6, 9 and 12 months. A DAS28-CRP difference of 0.6 was set as the non-inferiority margin. Mean differences between the groups were assessed following per-protocol and intention-to-treat strategies.ResultsDemographic data and baseline characteristics of patients in the NLC group (n=111) were comparable to those of patients in the RLC group (n=113). The improvement in disease activity (change in DAS28-CRP, primary outcome) over the course of 12 months was significant in both groups (p<0.001). No significant differences were observed between the NLC and RLC groups (p=0.317). Non-inferiority of NLC was shown for the primary outcome and all secondary outcomes.ConclusionThis study supported the non-inferiority of NLC in managing T2T and follow-up care of patients with RA with moderate to high disease activity and poor prognostic factors in addition to RLC.Trial registration numberDRKS00013055.
Attributable mortality of acute respiratory distress syndrome: a systematic review, meta-analysis and survival analysis using targeted minimum loss-based estimation
Authors: Torres Lisa K , Hoffman Katherine L , Oromendia Clara , Diaz Ivan , Harrington John S , Schenck Edward J , Price David R , Gomez-Escobar Luis , Higuera Angelica , Vera Mayra Pinilla , Baron Rebecca M , Fredenburgh Laura E , Huh Jin-Won , Choi Augustine M K , Siempos Ilias I 
Published: April 2021

BackgroundAlthough acute respiratory distress syndrome (ARDS) is associated with high mortality, its direct causal link with death is unclear. Clarifying this link is important to justify costly research on prevention of ARDS.ObjectiveTo estimate the attributable mortality, if any, of ARDS.DesignFirst, we performed a systematic review and meta-analysis of observational studies reporting mortality of critically ill patients with and without ARDS matched for underlying risk factor. Next, we conducted a survival analysis of prospectively collected patient-level data from subjects enrolled in three intensive care unit (ICU) cohorts to estimate the attributable mortality of critically ill septic patients with and without ARDS using a novel causal inference method.ResultsIn the meta-analysis, 44 studies (47 cohorts) involving 56 081 critically ill patients were included. Mortality was higher in patients with versus without ARDS (risk ratio 2.48, 95% CI 1.86 to 3.30; p<0.001) with a numerically stronger association between ARDS and mortality in trauma than sepsis. In the survival analysis of three ICU cohorts enrolling 1203 critically ill patients, 658 septic patients were included. After controlling for confounders, ARDS was found to increase the mortality rate by 15% (95% CI 3% to 26%; p=0.015). Significant increases in mortality were seen for severe (23%, 95% CI 3% to 44%; p=0.028) and moderate (16%, 95% CI 2% to 31%; p=0.031), but not for mild ARDS.ConclusionsARDS has a direct causal link with mortality. Our findings provide information about the extent to which continued funding of ARDS prevention trials has potential to impart survival benefit.PROSPERO Registration NumberCRD42017078313
Pulse arrival time, a novel sleep cardiovascular marker: the multi-ethnic study of atherosclerosis
Authors: Kwon Younghoon , Wiles Christopher , Parker B Eugene , Clark Brian R , Sohn Min-Woong , Mariani Sara , Hahn Jin-Oh , Jacobs David R , Stein James H , Lima Joao , Kapur Vishesh , Wellman Andrew , Redline Susan , Azarbarzin Ali 
Published: April 2021

BackgroundPulse arrival time (PAT) is commonly used to estimate blood pressure response. We hypothesised that PAT response to obstructive respiratory events would be associated with increased cardiovascular risk in people with obstructive sleep apnoea.MethodsPAT, defined as the time interval between electrocardiography R wave and pulse arrival by photoplethysmography, was measured in the Multi-Ethnic Study of Atherosclerosis Sleep study participants. The PAT response to apnoeas/hypopnoeas was defined as the area under the PAT waveform following respiratory events. Cardiovascular outcomes included markers of subclinical cardiovascular disease (CVD): left ventricular mass, carotid plaque burden score and coronary artery calcification (CAC) (cross-sectional) and incident composite CVD events (prospective). Multivariable logistic and Cox proportional hazard regressions were performed.ResultsA total of 1407 participants (mean age 68.4 years, female 47.5%) were included. Higher PAT response (per 1 SD increase) was associated with higher left ventricular mass (5.7 g/m2 higher in fourth vs first quartile, p<0.007), higher carotid plaque burden score (0.37 higher in fourth vs first quartile, p=0.02) and trended to greater odds of CAC (1.44, 95% CI 0.98 to 2.15, p=0.06). A total of 65 incident CVD events were observed over the mean of 4.1 (2.6) years follow-up period. Higher PAT response was associated with increased future CVD events (HR: 1.20, 95% CI 1.02 to 1.42, p=0.03).ConclusionPAT is independently associated with markers of subclinical CVD and incident CVD events. Respiratory-related PAT response is a novel and promising polysomnography metric with cardiovascular implications.