bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular risks associated with calcium supplementation in patients with osteoporosis: a nationwide cohort study
Authors: Kim Kyoung Jin , Kim Min Sun , Hong Namki , Bae Jae Hyun , Kim Kyeong Jin , Kim Nam Hoon , Rhee Yumie , Lee Juneyoung , Kim Sin Gon 
Published: July 2021

Abstract

Aims
This study aimed to evaluate the real effects of calcium supplementation on cardiovascular outcomes within a population-based cohort.

Methods and results
From a nationwide health screening database in South Korea, a total of 11 297 patients with osteoporosis who had taken calcium supplementation with or without vitamin D for at least 90 days [total calcium group; calcium supplementation only (CaO), n = 567; calcium supplementation in combination with vitamin D (CaD), n = 10 730] were matched at a 1:1 ratio to patients who had not taken calcium supplements (control group) by using propensity scores. The overall mean age was 59.9 ± 8.8 years and the percentage of women was 87.9% in our study population. Over a median follow-up of 54 months, the incidence rate of composite cardiovascular diseases (CVDs) per 1000 person-years was not different between the groups: 9.73 in the total calcium group and 8.97 in the control group [adjusted hazard ratio (HR): 1.12; 95% confidence interval (CI): 0.99–1.28; P = 0.08]. However, calcium supplementation without vitamin D was associated with an increased risk of composite CVD (HR: 1.54; 95% CI: 1.17–2.04; P &lt; 0.01), especially non-fatal myocardial infarction (HR: 1.89; 95% CI: 1.23–2.91; P &lt; 0.01), compared with no calcium supplementation.

Conclusion
Our population-based study supported that taking calcium supplementation combined with vitamin D did not appear to be harmful to cardiovascular health, but reminded that calcium supplementation without vitamin D should be used carefully even in populations with low dietary calcium intake.
Cardiovascular health in emerging adults with type 1 diabetes
Authors: McCarthy Margaret , Yan Joeyee , Jared Mary Christine , You Erica , Ilkowitz Jeniece , Gallagher Mary Pat , Vaughan Dickson Victoria 
Published: July 2021

Abstract

Aims
Individuals with type 1 diabetes (T1D) face increased risk for cardiovascular disease (CVD). Controlling individual cardiovascular risk factors can prevent or slow the onset of CVD. Ideal cardiovascular health is associated with a lower incidence of CVD. Identifying areas of suboptimal cardiovascular health can help guide CVD prevention interventions. To assess cardiovascular health and explore the barriers and facilitators to achieving ideal cardiovascular health in a sample of young adults with T1D.

Methods and results
We used a sequential mixed-method design to assess the seven factors of cardiovascular health according to American Heart Association. Qualitative interviews, guided by Pender’s Health Promotion Model, were used to discuss participant’s cardiovascular health results and the barriers and facilitators to achieving ideal cardiovascular health. We assessed the frequency of ideal levels of each factor. The qualitative data were analysed using content analysis. Qualitative and quantitative data were integrated in the final analysis phase. The sample (n = 50) was majority female (70%), White (86%), with a mean age of 22 ± 2.4 and diabetes duration of 10.7 ± 5.5 years. Achievement of the seven factors of cardiovascular health were: non-smoking (96%); cholesterol &lt;200 mg/dL (76%); body mass index &lt;25 kg/m2 (54%); blood pressure &lt;120/&lt;80 mmHg (46%); meeting physical activity guidelines (38%); haemoglobin A1c &lt;7% (40%); and healthy diet (14%). Emerging qualitative themes related to the perceived benefits of action, interpersonal influences on their diabetes self-management, and perceived self-efficacy.

Conclusion
We found areas of needed improvement for cardiovascular health. However, these young adults expressed a strong interest in healthy habits which can be supported by their healthcare providers.
Exploring molecular determinants of polysaccharide lyase family 6–1 enzyme activity
Authors: Violot Sébastien , Galisson Frédéric , Carrique Loïc , Jugnarain Vinesh , Conchou Léa , Robert Xavier , Thureau Aurélien , Helbert William , Aghajari Nushin , Ballut Lionel 
Published: July 2021

Abstract
The polysaccharide lyase family 6 (PL6) represents one of the 41 polysaccharide lyase families classified in the CAZy database with the vast majority of its members being alginate lyases grouped into three subfamilies, PL6_1–3. To decipher the mode of recognition and action of the enzymes belonging to subfamily PL6_1, we solved the crystal structures of Pedsa0632, Patl3640, Pedsa3628 and Pedsa3807, which all show different substrate specificities and mode of action (endo-/exolyase). Thorough exploration of the structures of Pedsa0632 and Patl3640 in complex with their substrates as well as docking experiments confirms that the conserved residues in subsites −1 to +3 of the catalytic site form a common platform that can accommodate various types of alginate in a very similar manner but with a series of original adaptations bringing them their specificities of action. From comparative studies with existing structures of PL6_1 alginate lyases, we observe that in the right-handed parallel β-helix fold shared by all these enzymes, the substrate-binding site harbors the same overall conserved structures and organization. Despite this apparent similarity, it appears that members of the PL6_1 subfamily specifically accommodate and catalyze the degradation of different alginates suggesting that this common platform is actually a highly adaptable and specific tool.
Alternatives to in-person exercise classes and training in Germany during the first COVID-19 lockdown
Authors: Füzéki Eszter , Fischer Martin , Würzberger Laura , Groneberg David A , Banzer Winfried 
Published: July 2021

Summary
COVID-19 containment efforts in most countries included temporary closure of all non-essential services, such as sports and exercise facilities. Also in Germany, sports clubs (SC) had to close for about 2 months starting mid-March 2020. The aim of the present study was to assess what alternatives German SC developed to in-person exercise classes and training. We conducted an anonymous online survey among large German SC. Invitation was sent to 178 SC, 61 data sets could be analyzed. A total of 92% of SC have offered alternatives to in-person exercise classes and training, most of which were digital. Reasons for not offering any alternatives were the lack of financial, personal or technical resources. The large majority (82.1%) of the SC have also allowed non-club members free access to digital alternatives, and 69.6% considered keeping this freely accessible even after the restrictions have been lifted. Almost three quarters (72.3%) of the sport clubs have received no support from their regional umbrella sports organization. In light of the dynamic development of the COVID-19 pandemic, SC must be prepared to offer alternatives to in-person exercise classes and training also on the middle term. These efforts should be supported by sports organizations and communities.
Never-smokers and the fraction of breast cancer attributable to second-hand smoke from parents during childhood: the Norwegian Women and Cancer Study 1991–2018
Authors: Gram Inger T , Wiik Arne Bastian , Lund Eiliv , Licaj Idlir , Braaten Tonje 
Published: July 2021

AbstractBackgroundSecond-hand smoke (SHS) is not an established risk factor for breast cancer. We examined exposure to SHS from parents during childhood and breast-cancer risk overall and by oestrogen- and progesterone-receptor status in the Norwegian Women and Cancer Study. Furthermore, we utilized our nationally representative prospective cohort study to estimate the fraction of breast cancer attributable to parental SHS during childhood.MethodsWe followed 45 923 never-smoking women, aged 34–70 years, who completed a baseline questionnaire between 1991 and 2007 through linkages to national registries through December 2018. We used Cox proportional-hazards models to estimate age-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). We estimated the attributable and the population attributable fraction of breast cancer with 95% CIs.ResultsDuring a mean follow-up of 19.8 (6.8) years, 2185 women developed invasive breast cancer, confirmed by histology. Women exposed to SHS from parents during childhood had an 11% higher (95% CI: 1.02–1.22) risk of breast cancer compared with those who were not. No difference was found for oestrogen (Pheterogeneity = 0.31) and progesterone (Pheterogeneity = 0.95) receptor status. For women exposed, the attributable fraction was 10.3% (95% CI: 1.8–18.0), whereas the population attributable fraction of breast cancer was 7.0% (95% CI: 1.0–13.0).ConclusionsOur results suggest that 1 in 14 breast-cancer cases could have been avoided in the absence of SHS exposure from parents during childhood in a population of never-smoking women. The cancer burden attributable to SHS may be underestimated.
Assessment of Vaccine Herd Protection: Lessons Learned From Cholera and Typhoid Vaccine Trials
Authors: Deen Jacqueline , Clemens John D 
Published: July 2021

Abstract
Vaccine herd protection is the extension of the defense conferred by immunization beyond the vaccinated to unvaccinated persons in a population, as well as the enhancement of the protection among the vaccinated, due to vaccination of the surrounding population. Vaccine herd protection has traditionally been inferred from observations of disease trends after inclusion of a vaccine in national immunization schedules. Rather than awaiting outcomes of widescale vaccine deployment, earlier-stage evaluation of vaccine herd protection during trials or mass vaccination projects could help inform policy decisions about potential vaccine introduction. We describe the components, influencing factors, and implications of vaccine herd protection and discuss various methods for assessing herd protection, using examples from cholera and typhoid vaccine studies.
Factors Associated With Self-Reported Medical Errors Among Healthcare Workers: A Cross-Sectional Study From Oman
Authors: Al Balushi Amal Ahmed , Alameddine Mohamad , Fai Chan Moon , Al Sadoon Muna , Bou-Karroum Karen , Al-Adawi Samir 
Published: July 2021

Abstract

Background
Despite efforts to improve patient safety, medical errors remain prevalent among healthcare workers. The aim of this study is to investigate the relationships between self-reported medical errors, occupational outcomes and socio-demographic variables.

Methods
The study employed a cross-sectional design to survey healthcare workers at a large tertiary hospital in Muscat, Oman. The survey questionnaire included socio-demographic variables, a self-assessment of medical errors, work-life balance, occupational burnout, and work-related bullying.

Results
A total of 297 healthcare workers participated in this study. In this sample, the average self-reported medical errors was 5.4±3.3. The prevalence of work-life imbalance, bullying, and moderate/high burnout was 90.2%, 31.3%, and 19.5%, respectively. Multivariate analysis showed that gender, nationality, age, profession, occupational burnout, and bullying were significantly associated with self-reported medical error. Being male was associated with higher self-reported medical errors compared to female workers (ß=1.728, p&lt;.001). Omani workers reported higher medical errors compared to their non-Omani colleagues (ß=2.668, p&lt;.001). Similarly, healthcare workers in a younger age group reported higher medical errors compared with those in the older age group (ß=-1.334, p&lt;.001). Physicians reported higher medical error than nurses (ß=3.126, p&lt;.001). Among occupational outcomes, self-reported medical errors increased with higher burnout rates (ß=1.686, p=0.003) and frequent exposure to bullying (ß=1.609, p&lt;.001).

Conclusion
Improving patient safety has become paramount in the modern age of quality improvement. In this study, medical errors reported by healthcare workers were strongly related to their degree of burnout and exposure to work-related bullying practice. This study makes a unique and tangible contribution to the current knowledge of medical errors among healthcare workers in Oman.
Added value of rapid respiratory syndromic testing at point of care versus central laboratory testing: a controlled clinical trial
Authors: Bouzid Donia , Casalino Enrique , Mullaert Jimmy , Laurent Odile , Duval Xavier , Lescure François Xavier , Peiffer Smadja Nathan , Tubiana Sarah , Armand Lefèvre Laurence , Descamps Diane , Fidouh Nadhira , Choquet Christophe , Lucet Jean-Christophe , Visseaux Benoit 
Published: July 2021

Abstract

Background
Virus-associated respiratory infections are in the spotlight with the emergence of SARS-CoV-2 and the expanding use of multiplex PCR (mPCR). The impact of molecular testing as a point-of-care test (POCT) in the emergency department (ED) is still unclear.

Objectives
To compare the impact of a syndromic test performed in the ED as a POCT and in the central laboratory on length of stay (LOS), antibiotic use and single-room assignment.

Methods
From 19 November 2019 to 9 March 2020, adults with acute respiratory illness seeking care in the ED of a large hospital were enrolled, with mPCR performed with a weekly alternation in the ED as a POCT (week A) or in the central laboratory (week B).

Results
474 patients were analysed: 275 during A weeks and 199 during B weeks. Patient characteristics were similar. The hospital LOS (median 7 days during week A versus 7 days during week B, P = 0.29), the proportion of patients with ED-LOS &lt;1 day (63% versus 60%, P = 0.57) and ED antibiotic prescription (59% versus 58%, P = 0.92) were not significantly different. Patients in the POCT arm were more frequently assigned a single room when having a positive PCR for influenza, respiratory syncytial virus and metapneumovirus [52/70 (74%) versus 19/38 (50%) in the central testing arm, P = 0.012].

Conclusions
Syndromic testing performed in the ED compared with the central laboratory failed to reduce the LOS or antibiotic consumption in patients with acute respiratory illness, but was associated with an increased single-room assignment among patients in whom a significant respiratory pathogen was detected.
PrEP monitoring and HIV incidence after PrEP initiation in France: 2016–18 nationwide cohort study
Authors: Tassi Marc-Florent , Laurent Emeline , Gras Guillaume , Lot Florence , Barin Francis , de Gage Sophie Billioti , Stefic Karl , Grammatico-Guillon Leslie 
Published: July 2021

Abstract

Background
Clinical trials have demonstrated that oral pre-exposure prophylaxis (PrEP) has high efficacy in preventing HIV transmission. In many countries, HIV testing is recommended prior to PrEP initiation, 1 month after and quarterly thereafter. We assessed the uptake of HIV testing and estimated the incidence of HIV infections after oral PrEP initiation, by using the French national health database (SNDS).

Methods
A historic cohort study included every adult person who started oral PrEP between 1 January 2016 and 30 June 2018 in France. HIV infection was tracked in the follow-up, from first PrEP dispensation up to 31 December 2018. Factors associated with adherence to HIV testing in PrEP follow-up were analysed using a generalized linear mixed model.

Results
PrEP users (9893) were followed for a median duration of 551 days (IQR 350–769). The first HIV test, 1 month after PrEP initiation, was performed by 64% of users. For subsequent tests, this rate exceeded 81% and remained stable over time. HIV testing was lower among PrEP users without prescription refill (OR 0.15; 99% CI 0.12–0.20), but higher if the last prescription was made by a hospital practitioner (OR 2.03; 99% CI 1.69–2.45). Twenty-nine HIV infections were identified, leading to an incidence of 0.19 cases per 100 person-years (99% CI 0.12–0.30).

Conclusions
We confirmed good adherence to HIV testing and efficacy of PrEP in users, which should help in decreasing HIV incidence in France. This study also revealed that SNDS could be a powerful automated tool for the epidemiological monitoring of PrEP users.
Regulation of polyphosphate glucokinase gene expression through cotranscriptional processing in Mycobacterium tuberculosis H37Rv
Authors: Bokolia Naveen Prakash , Khan Inshad Ali 
Published: July 2021

Abstract
Transcription is a molecular process that involves the synthesis of RNA chain into the 5ʹ–3ʹ direction, and simultaneously nascent RNA chain tends to form geometric structures, known as cotranscriptional folding. This folding determines the functional properties of RNA molecules and possibly has a critical role during the synthesis. This functioning includes the characterized properties of riboswitches and ribozymes, which are significant when the transcription rate is comparable to the cellular environment. This study reports a novel noncoding region important in the genetic expression of polyphosphate glucokinase (ppgk) in Mycobacterium tuberculosis. This noncoding element of ppgk gene undergoes cleavage activity during the transcriptional process in M.tuberculosis. We revealed that cleavage occurs within the nascent RNA, and the resultant cleaved 3ʹRNA fragment carries the Shine–Dalgarno (SD) sequence and expression platform. We concluded cotranscriptional processing at the noncoding region as the required mechanism for ppgk expression that remains constitutive within the bacterial environment. This study defines the molecular mechanism dependent on the transient but highly active structural features of the nascent RNA.
The Symptoms and Factors Associated With Posttraumatic Stress Disorder for Burns Nurses: A Cross-Sectional Study From Guangdong Province in China
Authors: Zhu Piao-Piao , Chen Li-Ying , Pan Jian-Hua , Kang Chan-Juan , Ye Xue-Mei , Ye Jie-Yu , Li Hai-Yan , Huang Miao , Li Ping , Tan Hui-Yi 
Published: July 2021

AbstractThe symptoms of posttraumatic stress disorder (PTSD) among medical staff have become a significant issue. Environments related to burns are highly stressful for nurses and can lead to PTSD, thus affecting their mental health. It is vital to consider that the quality of burns care, and the outcomes of such treatments, may be threatened if nurses experience PTSD. We evaluated PTSD symptoms in burns nurses and explored the correlations between demographic characteristics, work-related characteristics, professional identity, turnover intention, and PTSD symptoms. This was a cross-sectional study involving 273 nurses working in the burns unit from Guangdong, China, between July and August 2019. Nurses were recruited from 30 hospitals and completed three validated psychological questionnaires: Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Professional Identity Scale (PIS) for nurses, and Turnover Intention Questionnaire (TIQ). We also collated information relating to sociodemographic and work-related characteristics. The cutoff point for the PCL-C was defined as 38 points; 17.22% (n = 47) of participants scored higher than or equal to 38. The PCL-C score was negatively correlated with professional identity level (P &lt; .01) and positively correlated with turnover intention (P &lt; .01). The workplace, mean monthly income, experience of workplace violence, and professional identity level were important factors and all associated with the severity of PTSD. PTSD symptoms were common in burns nurses. Attention should be paid to the mental well-being of these staff. Screening processes need to be initiated to identify individuals suffering from PTSD and take appropriate early interventional action.
Electoral Competition, Voter Bias, and Women in Politics
Authors: Le Barbanchon Thomas , Sauvagnat Julien 
Published: July 2021

Abstract
We quantify the implications of voter bias and electoral competition for politicians’ gender composition. Unfavorable voters’ attitudes toward women and local gender earnings gap correlate negatively with the share of female candidates in Parliamentary elections. Using within-candidate variation across the different polling stations of an electoral district in a given election year, we find that female candidates obtain fewer votes in municipalities with higher gender earnings gaps. We show theoretically that when voters are biased against women, parties facing gender quotas select male candidates in the most contestable districts. We find empirical support for such a strategic party response to voter gender bias. Simulating our calibrated model confirms that competition significantly hinders the effectiveness of gender quotas.
Redshift-space distortions in simulations of the 21-cm signal from the cosmic dawn
Authors: Ross Hannah E , Giri Sambit K , Mellema Garrelt , Dixon Keri L , Ghara Raghunath , Iliev Ilian T 
Published: July 2021

ABSTRACT
The 21-cm signal from the Cosmic Dawn (CD) is likely to contain large fluctuations, with the most extreme astrophysical models on the verge of being ruled out by observations from radio interferometers. It is therefore vital that we understand not only the astrophysical processes governing this signal, but also other inherent processes impacting the signal itself, and in particular line-of-sight effects. Using our suite of fully numerical radiative transfer simulations, we investigate the impact on the redshifted 21-cm from the CD from one of these processes, namely the redshift-space distortions (RSDs). When RSDs are added, the resulting boost to the power spectra makes the signal more or equally detectable for our models for all redshifts, further strengthening hopes that a power spectra measurement of the CD will be possible. RSDs lead to anisotropy in the signal at the beginning and end of the CD, but not while X-ray heating is underway. The inclusion of RSDs, however, decreases detectability of the non-Gaussianity of fluctuations from inhomogeneous X-ray heating as measured by the skewness and kurtosis. On the other hand, mock observations created from all our simulations that include telescope noise corresponding to 1000 h of observation with the Square Kilometre Array telescope show that we may be able to image the CD for all heating models considered and suggest RSDs dramatically boost fluctuations coming from the inhomogeneous Ly α background.
Inferring time-dependent distribution functions from kinematic snapshots
Authors: Darling Keir , Widrow Lawrence M 
Published: July 2021

ABSTRACT
We propose a method for constructing the time-dependent phase space distribution function (DF) of a collisionless system from an isolated kinematic snapshot. In general, the problem of mapping a single snapshot to a time-dependent function is intractable. Here, we assume a finite series representation of the DF, constructed from the spectrum of the system’s Koopman operator. This reduces the original problem to one of mapping a kinematic snapshot to a discrete spectrum rather than to a time-dependent function. We implement this mapping with a convolutional neural network. The method is demonstrated on two example models: the quantum simple harmonic oscillator and a self-gravitating isothermal plane. The latter system exhibits phase space spiral structure similar to that observed in Gaia Data Release 2.