bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timing of Pubertal Development and Midlife Blood Pressure in Men and Women: A Mendelian Randomization Study
Authors: Chan Io Ieong , Kwok Man Ki , Schooling C Mary 
Published: August 2021

Abstract

Introduction
Observational studies suggest earlier puberty is associated with higher adulthood blood pressure (BP), but these findings have not been replicated using Mendelian randomization (MR). We examined this question sex-specifically using larger genome-wide association studies (GWAS) with more extensive measures of pubertal timing.

Methods
We obtained genetic instruments proxying pubertal maturation (age at menarche [AAM] or voice breaking [AVB]) from the largest published GWAS. We applied them to summary sex-specific genetic associations with systolic and diastolic BP z-scores, and self-reported hypertension in women (n = 194 174) and men (n = 167 020) from the UK Biobank, using inverse-variance weighted meta-analysis. We conducted sensitivity analyses using other MR methods, including multivariable MR adjusted for childhood obesity proxied by body mass index (BMI). We used late pubertal growth as a validation outcome.

Results
AAM (beta per 1-year later = -0.030 [95% confidence interval, -0.055 to -0.005] and AVB (beta -0.058 [95% CI, -0.100 to -0.015]) were inversely associated with systolic BP independent of childhood BMI, as were diastolic BP (-0.035 [95% CI, -0.060 to -0.009] for AAM and -0.046 [95% CI, -0.089 to -0.004] for AVB) and self-reported hypertension (odds ratio 0.89 [95% CI, 0.84-0.95] for AAM and 0.87 [95% CI, 0.79-0.96] for AVB). AAM and AVB were positively associated with late pubertal growth, as expected. The results were robust to sensitivity analysis using other MR methods.

Conclusion
Timing of pubertal maturation was associated with adulthood BP independent of childhood BMI, highlighting the role of pubertal maturation timing in midlife BP.
Challenges and Opportunities for Osteoporosis Care During the COVID-19 Pandemic
Authors: Cromer Sara J , Yu Elaine W 
Published: August 2021

AbstractPurposeThe coronavirus disease 2019 (COVID-19) has both directly and indirectly affected osteoporosis diagnosis and treatment throughout the world.MethodsThis mini-review summarizes the available evidence regarding the effects of COVID-19, its treatment, and the consequences of the pandemic itself on bone health. Additionally, we review evidence and expert recommendations regarding putative effects of osteoporosis medications on COVID-19 outcomes and vaccine efficacy and summarize recommendations for continuation of osteoporosis treatment during the pandemic.ResultsThe use of standard screening procedures to assess for osteoporosis and fracture risk declined dramatically early in the pandemic, while rates of fragility fractures were largely unchanged. COVID-19, its treatments, and public health measures to prevent viral spread are each likely to negatively affect bone health. Osteoporosis treatments are not known to increase risk of adverse events from COVID-19, and preclinical data suggest possible beneficial effects of some therapies. Vitamin D deficiency is clearly associated with adverse outcomes from COVID-19, but it remains unclear whether vitamin D supplementation may improve outcomes. Osteoporosis treatment should be continued whenever possible, and recommendations for substituting therapies, if required, are available.ConclusionThe COVID-19 pandemic has decreased screening and disrupted treatment for osteoporosis. Osteoporosis medications are safe and effective during the pandemic and should be continued whenever possible. Further studies are needed to fully understand the impact of the COVID-19 pandemic on long-term bone health.
High-Affinity ZnT8 Autoantibodies by Electrochemiluminescence Assay Improve Risk Prediction for Type 1 Diabetes
Authors: Jia Xiaofan , He Ling , Miao Dongmei , Waugh Kathleen , Rasmussen Cristy Geno , Dong Fran , Steck Andrea K , Rewers Marian , Yu Liping 
Published: August 2021

Abstract

Context
Single ZnT8 autoantibody (ZnT8A) positivity by standard radiobinding assay (RBA) is commonly seen in nondiabetes population-based screening and the risk of progression to type 1 diabetes (T1D) in subjects with single ZnT8A is unknown.

Objective
Identify the risk of progression to T1D in individuals positive only for ZnT8A.

Methods
We developed an electrochemiluminescence (ECL) assay to detect high-affinity ZnT8A and validated it in 3 populations: 302 patients newly diagnosed with T1D, 135 nondiabetic children positive for ZnT8A by RBA among 23 400 children screened by the Autoimmunity Screening for Kids (ASK) study, and 123 nondiabetic children multiple autoantibody positive or single ZnT8A positive by RBA participating in the Diabetes Autoimmunity Study in the Young (DAISY).

Results
In 302 patients with T1D at diagnosis, the positivity for ZnT8A was 62% both in RBA and ECL. Among ASK 135 participants positive for RBA-ZnT8A, 64 were detected ZnT8A as the only islet autoantibody. Of these 64, only 9 were confirmed by ECL-ZnT8A, found to be of high affinity with increased T1D risk. The overall positive predictive value of ECL-ZnT8A for T1D risk was 87.1%, significantly higher than that of RBA-ZnT8A (53.5%, P &lt; .001). In DAISY, 11 of 2547 children who had no positivity previously detected for other islet autoantibodies were identified as single ZnT8A by RBA; of these, 3 were confirmed positive by ECL-ZnT8A and all 3 progressed to clinical T1D.

Conclusion
A large proportion of ZnT8A by RBA are single ZnT8A with low T1D risk, whereas ZnT8A by ECL was of high affinity and high prediction for T1D development.
Spontaneity of nuclear fusion: a qualitative analysis via classical thermodynamics
Authors: Tosti Silvano 
Published: August 2021

Background: So far the feasibility of nuclear reactions has been studied only through the evaluation of the reaction rate, which gives us information about the kinetics, while the thermodynamic analysis has been limited to evaluations of the change in enthalpy without any consideration of the change in entropy. Methods: This work examines the thermodynamics of nuclear fusion reactions through a simplified approach. The analysis introduces the thermodynamic study of fission and fusion reactions through their comparison with a chemical process. Results: The main result is that fission reactions are always spontaneous (ΔG < 0) since a lot of energy is released in the form of heat and the system moves spontaneously towards a more disordered state. In contrast, fusion reactions are spontaneous only when the enthalpic contribution of the change in Gibbs free energy overcomes the entropic contribution. This condition is verified when the temperature of the process is below a characteristic value T*, calculated as the ratio between the energy corresponding to the mass defect and the change of entropy of the fusion reaction. Conclusions: Due to the unavailability of data related to entropy changes in fusion reactions, only a qualitative thermodynamic analysis has been carried out. Through such analysis, the influence of the operating conditions over the spontaneity of fusion processes has been discussed. The final considerations emphasize the role of the thermodynamics analysis that should be implemented in the current studies that, so far, have been mainly based on the assessment of the reaction rate and exothermicity of fusion reactions.
Conductors of care: exploring the role of the multiple sclerosis nurse in Australasia, phase 2
Authors: Burke Therese , Patching Joanna 
Published: August 2021

Background: Despite tremendous growth and change in the speciality of multiple sclerosis (MS) nursing in the last decade, there is a dearth of research aimed at defining the role of the MS nurse. This article explores phase 2 of a two-part study to define the MS nurse role in Australasia. Methods: Qualitative inquiry and a form of focused ethnography, called life history, were used to explore the experiences of 25 MS nurses. Semi-structured, one-on-one interviews were analysed using thematic analysis to explore the role and develop a role definition. Findings: The findings reveal five key themes and 21 subthemes to tell the story of a conductor of care. The key themes of holistic healers, sources of support, disease and symptom educators and managers, medication managers and professional development advancers highlights the complex skillset of MS nurses. Conclusion: Awareness of the scope and responsibility of the MS nurse role brings understanding and structure to modern MS care. Additionally, this may improve collaborations, relationships and acknowledgement of the role of the MS nurse among healthcare professionals, patients and the wider MS community.
Improving the cementation of the tibial component in knee arthroplasty
Authors: Rodríguez-Collell Juan Ramón , Mifsut Damian , Ruiz-Sauri Amparo , Rodríguez-Pino Luis , González-Soler Eva María , Valverde-Navarro Alfonso Amador 
Published: August 2021

Aims The main objective of this study is to analyze the penetration of bone cement in four different full cementation techniques of the tibial tray. Methods In order to determine the best tibial tray cementation technique, we applied cement to 40 cryopreserved donor tibiae by four different techniques: 1) double-layer cementation of the tibial component and tibial bone with bone restrictor; 2) metallic cementation of the tibial component without bone restrictor; 3) bone cementation of the tibia with bone restrictor; and 4) superficial bone cementation of the tibia and metallic keel cementation of the tibial component without bone restrictor. We performed CT exams of all 40 subjects, and measured cement layer thickness at both levels of the resected surface of the epiphysis and the endomedular metaphyseal level. Results At the epiphyseal level, Technique 2 gave the greatest depth compared to the other investigated techniques. At the endomedular metaphyseal level, Technique 1 showed greater cement penetration than the other techniques. Conclusion The best metaphyseal cementation technique of the tibial component is bone cementation with cement restrictor. Additionally, if full tibial component cementation is to be done, the cement volume used should be about 40 g of cement, and not the usual 20 g. Cite this article: Bone Joint Res 2021;10(8):467–473.
Post-fabrication tuning of microring resonators using 3D-printed microfluidics
Authors: Larson Kevin , Hammond Alec , Carver Christian , Anderson Derek , Viglione Matthew , Boaks Mawla , Nordin Greg , Camacho Ryan M. 
Published: August 2021

We demonstrate a method of tuning the resonant frequencies of silicon microring resonators using a 3D-printed microfluidic chip overlaid directly on the photonic circuit with zero energy consumption following the initial tuning. Aqueous solutions with different concentrations of NaCl are used in experimentation. A shift of a full free spectral range is observed at a concentration of 10% NaCl. On a 60 µm microring resonator, this equals a resonant wavelength shift of 1.514 nm when the index of the cladding changes by 0.017 refractive index units (RIUs), or at a rate of 89.05 nm/RIU.
Levels of pneumococcal conjugate vaccine coverage and indirect protection against invasive pneumococcal disease and pneumonia hospitalisations in Australia: An observational study
Authors: Chan Jocelyn , Gidding Heather F. , Blyth Christopher C. , Fathima Parveen , Jayasinghe Sanjay , McIntyre Peter B. , Moore Hannah C. , Mulholland Kim , Nguyen Cattram D. , Andrews Ross , Russell Fiona M. 
Published: August 2021

Background
There is limited empiric evidence on the coverage of pneumococcal conjugate vaccines (PCVs) required to generate substantial indirect protection. We investigate the association between population PCV coverage and indirect protection against invasive pneumococcal disease (IPD) and pneumonia hospitalisations among undervaccinated Australian children.

Methods and findings
Birth and vaccination records, IPD notifications, and hospitalisations were individually linked for children aged <5 years, born between 2001 and 2012 in 2 Australian states (New South Wales and Western Australia; 1.37 million children). Using Poisson regression models, we examined the association between PCV coverage, in small geographical units, and the incidence of (1) 7-valent PCV (PCV7)-type IPD; (2) all-cause pneumonia; and (3) pneumococcal and lobar pneumonia hospitalisation in undervaccinated children. Undervaccinated children received <2 doses of PCV at <12 months of age and no doses at ≥12 months of age. Potential confounding variables were selected for adjustment a priori with the assistance of a directed acyclic graph.
There were strong inverse associations between PCV coverage and the incidence of PCV7-type IPD (adjusted incidence rate ratio [aIRR] 0.967, 95% confidence interval [CI] 0.958 to 0.975, p-value < 0.001), and pneumonia hospitalisations (all-cause pneumonia: aIRR 0.991 95% CI 0.990 to 0.994, p-value < 0.001) among undervaccinated children. Subgroup analyses for children <4 months old, urban, rural, and Indigenous populations showed similar trends, although effects were smaller for rural and Indigenous populations. Approximately 50% coverage of PCV7 among children <5 years of age was estimated to prevent up to 72.5% (95% CI 51.6 to 84.4) of PCV7-type IPD among undervaccinated children, while 90% coverage was estimated to prevent 95.2% (95% CI 89.4 to 97.8). The main limitations of this study include the potential for differential loss to follow-up, geographical misclassification of children (based on residential address at birth only), and unmeasured confounders.

Conclusions
In this study, we observed substantial indirect protection at lower levels of PCV coverage than previously described—challenging assumptions that high levels of PCV coverage (i.e., greater than 90%) are required. Understanding the association between PCV coverage and indirect protection is a priority since the control of vaccine-type pneumococcal disease is a prerequisite for reducing the number of PCV doses (from 3 to 2). Reduced dose schedules have the potential to substantially reduce program costs while maintaining vaccine impact.
How relevant for you is to be a moral person? Polish validation of the Self-Importance of Moral Identity Scale
Authors: Paruzel-Czachura Mariola , Blukacz Mateusz 
Published: August 2021

Objective
The Self-Importance of Moral Identity Scale (SMIS) was developed by Aquino and Reeds with the purpose of measuring how people evaluate their private (Internalization subscale) and public (Symbolization subscale) moral identity. SMIS has become commonly and broadly used in many studies. The aim of this paper is to validate the Polish version of SMIS by analyzing its structure and relation to similar measures (such as The Moral Self-Concept Scale developed by Stake and The Moral Self-Image Scale created by Jordan, Leliveld and Tenbrunsel), declared past prosocial behaviors and readiness to donate money.

Methods
The translation-back-translation procedure was used to maintain semantic, idiomatic, and conceptual equivalence of the original scale. Throughout four separate studies the psychometric properties of the Polish version of the scale were assessed: Study 1 (N = 529) was carried out to derive the factor structure using the exploratory factor analysis (EFA) and cross-validate it; Study 2 (N = 602) and Study 3 (N = 899) were performed to confirm and replicate the structure with the confirmatory factor analysis (CFA); gender-balanced Study 4 (N = 862) was conducted to assess measurement invariance over gender using multigroup CFA, and to normalize the scale. Validity of the scale was assessed based on each study.

Results
A stable two-factor structure using 10 items was replicated in four different samples. The results showed that reliability (α) was between 0.71 and 0.81 for Internalization, and 0.76 and 0.81 for Symbolization. Validity was confirmed in terms of the expected pattern of correlations with morality measures and factorial structure. Metric invariance across gender was confirmed with possible exception of factor loadings on two items regarding communication of values. Polish normalization for men and women was constructed.

Conclusions
Polish validation of SMIS proved to be a structurally consistent and valid measure.
Prevalence and risk factors for antimicrobial resistance among newborns with gram-negative sepsis
Authors: Solomon Semaria , Akeju Oluwasefunmi , Odumade Oludare A. , Ambachew Rozina , Gebreyohannes Zenebe , Van Wickle Kimi , Abayneh Mahlet , Metaferia Gesit , Carvalho Maria J. , Thomson Kathryn , Sands Kirsty , Walsh Timothy R. , Milton Rebecca , Goddard Frederick G. B. , Bekele Delayehu , Chan Grace J. 
Published: August 2021

Introduction
Newborn sepsis accounts for more than a third of neonatal deaths globally and one in five neonatal deaths in Ethiopia. The first-line treatment recommended by WHO is the combination of gentamicin with ampicillin or benzylpenicillin. Gram-negative bacteria (GNB) are increasingly resistant to previously effective antibiotics.

Objectives
Our goal was to estimate the prevalence of antibiotic-resistant gram-negative bacteremia and identify risk factors for antibiotic resistance, among newborns with GNB sepsis.

Methods
At a tertiary hospital in Ethiopia, we enrolled a cohort pregnant women and their newborns, between March and December 2017. Newborns who were followed up until 60 days of life for clinical signs of sepsis. Among the newborns with clinical signs of sepsis, blood samples were cultured; bacterial species were identified and tested for antibiotic susceptibility. We described the prevalence of antibiotic resistance, identified newborn, maternal, and environmental factors associated with multidrug resistance (MDR), and combined resistance to ampicillin and gentamicin (AmpGen), using multivariable regression.

Results
Of the 119 newborns with gram-negative bacteremia, 80 (67%) were born preterm and 82 (70%) had early-onset sepsis. The most prevalent gram-negative species were Klebsiella pneumoniae 94 (79%) followed by Escherichia coli 10 (8%). Ampicillin resistance was found in 113 cases (95%), cefotaxime 104 (87%), gentamicin 101 (85%), AmpGen 101 (85%), piperacillin-tazobactam 47 (39%), amikacin 10 (8.4%), and Imipenem 1 (0.8%). Prevalence of MDR was 88% (n = 105). Low birthweight and late-onset sepsis (LOS) were associated with higher risks of AmpGen-resistant infections. All-cause mortality was higher among newborns treated with ineffective antibiotics.

Conclusion
There was significant resistance to current first-line antibiotics and cephalosporins. Additional data are needed from primary care and community settings. Amikacin and piperacillin-tazobactam had lower rates of resistance; however, context-specific assessments of their potential adverse effects, their local availability, and cost-effectiveness would be necessary before selecting a new first-line regimen to help guide clinical decision-making.
Excess mortality due to Covid-19? A comparison of total mortality in 2020 with total mortality in 2016 to 2019 in Germany, Sweden and Spain
Authors: Kowall Bernd , Standl Fabian , Oesterling Florian , Brune Bastian , Brinkmann Marcus , Dudda Marcel , Pflaumer Peter , Jöckel Karl-Heinz , Stang Andreas 
Published: August 2021

Introduction
Excess mortality is a suitable indicator of health consequences of COVID-19 because death from any cause is clearly defined contrary to death from Covid-19. We compared the overall mortality in 2020 with the overall mortality in 2016 to 2019 in Germany, Sweden and Spain. Contrary to other studies, we also took the demographic development between 2016 and 2020 and increasing life expectancy into account.

Methods
Using death and population figures from the EUROSTAT database, we estimated weekly and cumulative Standardized Mortality Ratios (SMR) with 95% confidence intervals (CI) for the year 2020. We applied two approaches to calculate weekly numbers of death expected in 2020: first, we used mean weekly mortality rates from 2016 to 2019 as expected mortality rates for 2020, and, second, to consider increasing life expectancy, we calculated expected mortality rates for 2020 by extrapolation from mortality rates from 2016 to 2019.

Results
In the first approach, the cumulative SMRs show that in Germany and Sweden there was no or little excess mortality in 2020 (SMR = 0.976 (95% CI: 0.974–0.978), and 1.030 (1.023–1.036), respectively), while in Spain the excess mortality was 14.8% (1.148 (1.144–1.151)). In the second approach, the corresponding SMRs for Germany and Sweden increased to 1.009 (1.007–1.011) and 1.083 (1.076–1.090), respectively, whereas results for Spain were virtually unchanged.

Conclusion
In 2020, there was barely any excess mortality in Germany for both approaches. In Sweden, excess mortality was 3% without, and 8% with consideration of increasing life expectancy.
Parent reports of children’s emotional and behavioral problems in a low- and middle- income country (LMIC): An epidemiological study of Nepali schoolchildren
Authors: Ma Jasmine , Mahat Pashupati , Brøndbo Per Håkan , Handegård Bjørn H. , Kvernmo Siv , Javo Anne Cecilie 
Published: August 2021

BackgroundAs epidemiological data on child mental health in low- and middle-income countries are limited, a large-scale survey was undertaken to estimate the prevalence and amount of child emotional and behavioral problems (EBP) in Nepal as reported by the parents.Methods3820 schoolchildren aged 6–18 years were selected from 16 districts of the three geographical regions of Nepal, including rural, semi-urban and urban areas. We used the Nepali version of the Child Behavior Checklist (CBCL)/6-18 years as screening instrument. Comparisons of child problems between genders and between the seven largest castes and ethnic groups were carried out by analysis of variance. Prevalence was computed based on American norms.ResultsAdjusted prevalence of Total Problems was 18.3% (boys: 19.1%; girls:17.6%). The prevalence of internalizing problems was higher than externalizing problems. The mean scores of Total, Externalizing, and Internalizing problems were 29.7 (SD 25.6), 7.7 (SD 8.0), and 9.1 (SD 8.1), respectively. The Khas Kaami (Dalit) group scored the highest, and the indigenous Tharu group scored the lowest on all scales. In the Mountains and Middle Hills regions, problem scores were higher in the rural areas, whereas in the Tarai region, they were higher in the urban areas.ConclusionThe prevalence and magnitude of emotional and behavioral problems in Nepali children were found to be high compared to findings in meta-analyses worldwide. Problem scores varied according to gender, castes /ethnic groups, and living areas. Our findings highlight the need for a stronger focus on child mental problems in a low-and middle-income country like Nepal.