bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distinct brain‐derived TDP‐43 strains from FTLD‐TDP subtypes induce diverse morphological TDP‐43 aggregates and spreading patterns in vitro and in vivo
Authors: Porta Sílvia , Xu Yan , Lehr Tagan , Zhang Bin , Meymand Emily , Olufemi Modupe , Stieber Anna , Lee Edward B. , Trojanowski John Q. , Lee Virginia M.‐Y. 
Published: May 2021

AbstractAimThe heterogeneity in the distribution and morphological features of TAR DNA‐binding protein‐43 (TDP‐43) pathology in the brains of frontotemporal lobar degeneration (FTLD‐TDP) patients and their different clinical manifestations suggest that distinct pathological TDP‐43 strains could play a role in this heterogeneity between different FTLD‐TDP subtypes (A‐E). Our aim was to evaluate the existence of distinct TDP‐43 strains in the brains of different FTLD‐TDP subtypes and characterise their specific seeding properties in vitro and in vivo.Methods and ResultsWe used an inducible stable cell line expressing a mutant cytoplasmic TDP‐43 (iGFP‐NLSm) to evaluate the seeding properties of distinct pathological TDP‐43 strains. Brain‐derived TDP‐43 protein extracts from FTLD‐TDP types A (n = 6) and B (n = 3) cases induced the formation of round/spherical phosphorylated TDP‐43 aggregates that morphologically differed from the linear and wavy wisps and bigger heterogeneous filamentous (skein‐like) aggregates induced by type E (n = 3) cases. These morphological differences correlated with distinct biochemical banding patterns of sarkosyl‐insoluble TDP‐43 protein recovered from the transduced cells. Moreover, brain‐derived TDP‐43 extracts from type E cases showed higher susceptibility to PK digestion of full‐length TDP‐43 and the most abundant C‐terminal fragments that characterise type E extracts.Finally, we showed that intracerebral injections of different TDP‐43 strains induced a distinctive morphological and subcellular distribution of TDP‐43 pathology and different spreading patterns in the brains of CamKIIa‐hTDP‐43NLSm Tg mice.ConclusionsWe show the existence of distinct TDP‐43 strains in the brain of different FTLD‐TDP subtypes with distinctive seeding and spreading properties in the brains of experimental animal models.
New opportunities for institutional analysis in public administration research
Authors: Siddiki Saba , Frantz Christopher K. 
Published: May 2021

AbstractThis Symposium features research that engages an institutional analysis approach, called the Institutional Grammar. Institutional analysis is the study of rules, norms, and strategies (e.g., public policies, organizational bylaws, social conventions) that govern social systems and organizations. The Institutional Grammar is an approach for comprehensively capturing the design of institutions; in particular, for describing the language of directives that comprise them. We posit that the engagement of the Institutional Grammar in public administration research can advance understanding of institutional dynamics of administrative settings and behaviors by lending conceptual and methodological clarity on the definition and measurement of institutions. In support of this position, we (i) provide a brief commentary on institutional analysis in public administration research; (ii) offer a brief overview of the Institutional Grammar; and (iii) highlight how methodological innovations presented in the Symposium articles advance the Institutional Grammar, and present opportunities for advancing institutional analysis in administrative settings.
Symptom scores in the diagnosis of pediatric cow’s milk protein allergy: A systematic review
Authors: Thompson Georgina , Zhelev Zhivko , Peters Jaime , Khalid Sara , Briscoe Simon , Shaw Liz , Nunns Michael , Ludman Sian , Hyde Christopher 
Published: May 2021

AbstractBackgroundCow's milk protein allergy (CMPA) is an immune‐mediated allergic response to proteins in milk that is common in infants. Broad CMPA symptoms make diagnosis a challenge, particularly in primary care. Symptom scores may improve a clinician's awareness of symptoms, indicating a need for further testing. This systematic review examined the development and evaluation of such symptom scores for use in infants.MethodsCENTRAL, MEDLINE, EMBASE and CINAHL databases were searched from inception to 3 December 2019 (Updated 14 November 2020) for diagnostic accuracy studies, randomised controlled trials, observational studies, economic evaluations, qualitative studies and studies reporting development of the tools. Data were not suitable for meta‐analysis due to clinical and methodological heterogeneity, so were narratively synthesised.ResultsWe found two symptom scores evaluated in one and fourteen studies, respectively. Estimated sensitivity and specificity ranged from 37% to 98% and 38% to 93%. The evaluations of each tool were at high risk of bias or failed to address issues such as clinical and cost‐effectiveness.ConclusionsEstimates of accuracy of symptom scores for CMPA offered so far should be interpreted cautiously. Rigorous, conflict‐free research based on well‐defined roles for the tools is urgently required.
The COVID‐19 pandemic first wave in Sweden: A national registry study of the effects on pediatric anesthesia and surgery
Authors: Melander Sixten , Almström Jimmy , Enlund Gunnar , Frykholm Peter 
Published: May 2021

AbstractBackgroundThe COVID‐19 pandemic is pushing healthcare systems to their limits. Dramatic reductions in the adult elective surgery are ubiquitous, but corresponding changes in pediatric services are not well described. The Swedish Perioperative Registry contains data on all anesthetic procedures in Sweden, and therefore, provides a unique opportunity to analyze the effect of the pandemic on the pediatric anesthesia capacity on a national level. We hypothesized that there would be a significant reduction in pediatric elective procedures. The aim was to determine the effects on pediatric surgical and anesthetic services during the first wave of the COVID‐19 pandemic in Sweden.MethodsFor this retrospective registry cohort study, we extracted all procedures performed on patients <18 years of age in 2020 and 2019. Weeks 12 to 26 of 2020 were defined as the first wave, and data were analyzed according to level of care, type of surgery, procedure code, and emergency or elective surgery.ResultsWe found 7015 fewer procedures during the first wave epoch. Elective cases were reduced by 53.7% while emergency surgery was not significantly affected. During the peak of the first wave in April, there was a 72.8% reduction in elective cases; ENT/maxillofacial surgery showed the greatest reduction (86.7%). The surgical and anesthesia capacity recovered to near‐normal levels by the end of June 2020.ConclusionWe conclude that the impact of COVID‐19 on pediatric surgical procedures in Sweden during the first wave of the pandemic was dramatic, but elective services were restored a few months after the peak.
Reproductive justice and black lives: A concept analysis for public health nursing
Authors: Burger Kathryn , Evans‐Agnew Robin , Johnson Susan 
Published: May 2021

AbstractBackgroundInequities in maternal mortality in the United States are a form of structural violence against Black women. The concept of reproductive justice has been employed in the social sciences for almost 30 years, yet nursing has been slow to adopt this concept in promoting maternal‐child health.ObjectiveTo analyze the concept of reproductive justice as used in peer‐reviewed publications with the aim of reframing black maternal health in public health nursing scholarship, research, practice, and advocacy.DesignWe conducted a systematic review of the social science literature. We analyzed selected articles though a principle‐based concept analysis focusing on epistemological, pragmatic, linguistic, and logical principles.SampleEight articles were selected from a pool of 377.ResultsRace was identified as a source of power for understanding reproductive justice through individual knowledge, collective knowledge, and praxis. Pragmatically, reproductive justice is a social justice‐oriented platform that bridges the pro‐choice/pro‐life divide; aids coalition building; and promotes inclusion. Linguistically, the concept is distinct from both reproductive health and reproductive rights. Reproductive justice is logically situated within intersectionality theory and the cumulative embodiment of oppressions Black women experience based on race, class, and gender.ConclusionReproductive justice reframes public health nursing actions for Black women by focusing on uncovering systems of oppression, recognizing past historical injustices, and advancing cultural safety in health promotion. Multilevel interventions are needed to simultaneously address these injustices particularly in the areas of preconception health, maternal health, infant and child health, and Black family well‐being across the reproductive lifespan.
From universal to local: German identity in Nicholas of Cusa’s Catholic Concordance
Authors: Tanaka Julie K. 
Published: May 2021

AbstractNicholas of Cusa’s Catholic Concordance stands as a landmark of fifteenth‐century political thought. Modern scholarship has devoted much attention to Nicholas’s argument about consent in Book Two, but he also develops one of the earliest expressions of German identity. This has not received attention in historical and literary scholarship. Nicholas grounds his conceptualization of a German people and land in the political and ecclesiological debates of his day while tying it to the importance that history plays in defining a people. He establishes a new type of history for them told in terms not of Roman imperial history but of the Germans. His work foreshadows the efforts of German writers in the late fifteenth and sixteenth centuries who composed for the first time histories of Germany devoted to the Germans from their mythical origins to contemporary times and written in their own common language, German.
Joint Equivalence Design and Analysis of a Tensegrity Joint
Authors: Chen Bingxing , Jiang Hongzhou , Liu Jingxuan , Lu Shuaibo 
Published: May 2021

Abstract
We propose a method to design a tensegrity joint, making its elastic deformation an accurate joint-like motion, such as a rotation around the designed rotational center. The tensegrity joint can be a revolute, universal, and ball joint through this method. Axis drift is presented as a design criterion to describe the rotational center’s deviation degree with respect to the compliance center since the rotational center is not fixed to one point for different positions of the tensegrity joint. The axis drift is designed to be in a prescribed range so that the tensegrity joint is approximately equivalent to a rigid joint. In other words, the tensegrity joint’s elastic response under external torque and force becomes precise rigid joint-like kinematics and can replace rigid joints to transfer motion, force, and energy. A large-size tensegrity rotational joint is developed to verify the joint equivalence experimentally. The experimental results show that the tensegrity joint achieved maximum dimensionless axis drift of less than 2%, which indicates an excellent joint equivalence. The tensegrity joints’ ability to replace rigid joints as modular joints to construct a hyper redundant serial structure is demonstrated using a tensegrity robotic arm. The proposed compliant tensegrity joint has notable benefits of tensegrity structure, such as high mechanical efficiency, modularity, and scalability. It can be extended to many robotic applications, such as large-size serial robotic arms and snake-like robots.
Multicentre, open-label, randomised, controlled clinical trial comparing
2% chlorhexidine–70% isopropanol and 5% povidone iodine–69% ethanol for skin
antisepsis in reducing surgical-site infection after cardiac surgery: the
CLEAN 2 study protocol
Authors: Boisson Matthieu , Corbi Pierre , Kerforne Thomas , Camilleri Lionel , Debauchez Mathieu , Demondion Pierre , Eljezi Vedat , Flecher Erwan , Lepelletier Didier , Leprince Pascal , Nesseler Nicolas , Nizou Jacques Yves , Roussel Jean Christian , Rozec Bertrand , Ruckly Stéphane , Lucet Jean-Christophe , Timsit Jean-François , Mimoz Olivier 
Published: May 2021

Introduction
Surgical-site infection (SSI) is the second most frequent cause of
healthcare-associated infection worldwide and is associated with
increased morbidity, mortality and healthcare costs. Cardiac surgery is
clean surgery with low incidence of SSI, ranging from 2% to 5%, but with
potentially severe consequences.
Perioperative skin antisepsis with an alcohol-based antiseptic
solution is recommended to prevent SSI, but the superiority of
chlorhexidine (CHG)–alcohol over povidone iodine (PVI)–alcohol, the two
most common alcohol-based antiseptic solutions used worldwide, is
controversial. We aim to evaluate whether 2% CHG–70% isopropanol is more
effective than 5% PVI–69% ethanol in reducing the incidence of
reoperation after cardiac surgery.

Methods and analysis
The CLEAN 2 study is a multicentre, open-label, randomised,
controlled clinical trial of 4100 patients undergoing cardiac surgery.
Patients will be randomised in 1:1 ratio to receive either 2% CHG–70%
isopropanol or 5% PVI–69% ethanol for perioperative skin preparation.
The primary endpoint is the proportion of patients undergoing any
re-sternotomy between day 0 and day 90 after initial surgery and/or any
reoperation on saphenous vein/radial artery surgical site between day 0
and day 30 after initial surgery. Data will be analysed on the
intention-to-treat principle.

Ethics and dissemination
This protocol has been approved by an independent ethics committee
and will be carried out according to the principles of the Declaration
of Helsinki and the Good Clinical Practice guidelines. The results of
this study will be disseminated through presentation at scientific
conferences and publication in peer-reviewed journals.

Trial registration number
EudraCT 2017-005169-33 and NCT03560193.
Geriatric fracture centre vs usual care after proximal femur fracture in older patients: what are the benefits? Results of a large international prospective multicentre study
Authors: Blauth Michael , Joeris Alexander , Rometsch Elke , Espinoza-Rebmann Kathrin , Wattanapanom Pannida , Jarayabhand Rahat , Poeze Martijn , Wong Merng K , Kwek Ernest B. K. , Hegeman Johannes H , Perez-Uribarri Carlos , Guerado Enrique , Revak Thomas J , Zohner Sebastian , Joseph David , Gosch Markus 
Published: May 2021

ObjectiveThe aim of this study was to determine the effect of treatment in geriatric fracture centres (GFC) on the incidence of major adverse events (MAEs) in patients with hip fractures compared with usual care centres (UCC). Secondary objectives included hospital-workflow and mobility-related outcomes.DesignCohort study recruiting patients between June 2015 and January 2017. Follow-up was 1 year.SettingInternational (six countries, three continents) multicentre study.Participants281 patients aged ≥70 with operatively treated proximal femur fractures.InterventionsTreatment in UCCs (n=139) or GFCs (n=142), that is, interdisciplinary treatment including regular geriatric consultation and daily physiotherapy.Outcome measuresPrimary outcome was occurrence of prespecified MAEs, including delirium. Secondary outcomes included any other adverse events, time to surgery, time in acute ward, 1-year mortality, mobility, and quality of life.ResultsPatients treated in GFCs (n=142) had a mean age of 81.9 (SD, 6.6) years versus 83.9 (SD 6.9) years in patients (n=139) treated in UCCs (p=0.013) and a higher mean Charlson Comorbidity Index of 2.0 (SD, 2.1) versus 1.2 (SD, 1.5) in UCCs (p=0.001). More patients in GFCs (28.2%) experienced an MAE during the first year after surgery compared with UCCs (7.9%) with an OR of 4.56 (95% CI 2.23 to 9.34, p<0.001). Analysing individual MAEs, this was significant for pneumonia (GFC: 9.2%; UCC: 2.9%; OR, 3.40 (95% CI 1.08 to 10.70), p=0.027) and delirium (GFC: 11.3%; UCC: 2.2%, OR, 5.76 (95% CI 1.64 to 20.23), p=0.002).ConclusionsContrary to our study hypothesis, the rate of MAEs was higher in GFCs than in UCCs. Delirium was revealed as a main contributor. Most likely, this was based on improved detection rather than a truly elevated incidence, which we interpret as positive effect of geriatric comanagement.Trial registration numberClinicalTrials.gov:NCT02297581.
Music intervention for sleep quality in critically ill and surgical patients: a meta-analysis
Authors: Kakar Ellaha , Venema Esmée , Jeekel Johannes , Klimek Markus , van der Jagt Mathieu 
Published: May 2021

ObjectiveSleep disruption occurs frequently in hospitalised patients. Given the potential of music intervention as a non-pharmacological measure to improve sleep quality, we aimed to assess and quantify current literature on the effect of recorded music interventions on sleep quality and quantity in the adult critical care and surgical populations.DesignSystematic review and meta-analysis.Data sourcesEmbase, MEDLINE Ovid, Cochrane Central, Web of Science and Google Scholar.Eligibility criteria for studiesRandomised controlled trials assessing the effect of music on sleep quality in critically ill and surgical patients.MethodsThe electronic databases were systematically searched from 1 January 1981 to 27 January 2020. Data were screened, extracted and appraised by two independent reviewers. Primary outcomes were sleep quality and quantity, assessed with validated tools. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Random effects meta-analysis was performed, and pooled standardised mean differences (SMDs) with 95% CIs were reported.ResultsFive studies (259 patients) were included in qualitative (risk of bias) and quantitative analysis (meta-analysis). Pooled data showed a significant effect of recorded music on subjective sleep quality in the critical care and surgical population (SMD=1.21 (95% CI 0.50 to 1.91), p<0.01, excluding one non-English study; SMD=0.87 (95% CI 0.45 to 1.29), p<0.01). The SMD of 1.21 corresponded to a 27.1% (95% CI 11.2 to 42.8) increase in subjective sleep quality using validated questionnaires. A significant increase in subjective sleep quantity of 36 min was found in one study. Objective measurements of sleep assessed in one study using polysomnography showed significant increase in deeper sleep stage in the music group.ConclusionsRecorded music showed a significant improvement in subjective sleep quality in some critical care and surgical populations. Therefore, its use may be relevant to improve sleep, but given the moderate potential for bias, further research is needed.PROSPERO registration numberCRD42020167783.
Long-chain omega-3 fatty acid serum concentrations across life stages in the USA: an analysis of NHANES 2011–2012
Authors: Murphy Rachel A , Devarshi Prasad P , Ekimura Shauna , Marshall Keri , Hazels Mitmesser Susan 
Published: May 2021

ObjectiveTo determine reference ranges of circulating long-chain (LC) omega-3 fatty acids: eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) in a nationally representative population of Americans. To provide context, serum concentrations of LC omega-3 were compared with concentrations associated with consuming the recommended amount of EPA and DHA by the Dietary Guidelines for Americans (DGA) and the Omega-3 Index (EPA+DHA).DesignCross-sectional population-based study.SettingThe National Health and Nutrition Examination Survey 2011–2012 cycle.ParticipantsParticipants with fatty acids measured in serum: 945 children, age 3–19 years, and 1316 adults, age 20 and older.Main measureSerum EPA, DPA, DHA and sum of LC omega-3 fatty acids expressed as per cent of total fatty acids.ResultsAmong children, mean (SE) serum concentrations of EPA, DHA and omega-3s were 0.28% (0.01), 1.07% (0.02) and 1.75% (0.03). Among adults, mean (SE) of EPA, DHA and omega-3s were 0.61% (0.02), 1.38% (0.05) and 2.43% (0.08), all of which were significantly higher than corresponding serum fatty acid concentrations in children (p<0.001). Despite recommendations for higher intake, pregnant and/or breastfeeding women had mean (SE) EPA, DHA and LC omega-3 concentrations of 0.34% (0.07), 1.52% (0.08) and 2.18% (0.15), which were comparable to women of childbearing age; p=0.17, p=0.10 and p=0.73. Over 95% of children and 68% of adults had LC omega-3 concentrations below those associated with the DGA recommendation. Approximately 89% of adults had an Omega-3 Index in the high cardiovascular risk category.ConclusionsContemporary reference ranges for circulating LC omega-3s are critical for setting public health recommendations. Our findings show the need for continued emphasis on regular consumption of LC omega-3s among Americans, particularly considering the importance of LC omega-3s in cardiovascular health, brain health and development throughout life.
Are weak or negative clinical recommendations associated with higher geographical variation in utilisation than strong or positive recommendations? Cross-sectional study of 24 healthcare services
Authors: Ulyte Agne , Wei Wenjia , Gruebner Oliver , Bähler Caroline , Brüngger Beat , Blozik Eva , von Wyl Viktor , Schwenkglenks M , Dressel Holger 
Published: May 2021

ObjectivesWhen research evidence is lacking, patient and provider preferences, expected to vary geographically, might have a stronger role in clinical decisions. We investigated whether the strength or the direction of recommendation is associated with the degree of geographic variation in utilisation.DesignIn this cross-sectional study, we selected 24 services following a comprehensive approach. The strength and direction of recommendations were assessed in duplicate. Multilevel models were used to adjust for demographic and clinical characteristics and estimate unwarranted variation.SettingObservational study of claims to mandatory health insurance in Switzerland in 2014.ParticipantsEnrolees eligible for the 24 healthcare services.Primary outcome measuresThe variances of regional random effects, also expressed as median odds ratios (MOR). Services grouped by strength and direction of recommendations were compared with Welch’s t-test.ResultsThe sizes of the eligible populations ranged from 1992 to 409 960 patients. MOR ranged between 1.13 for aspirin in secondary prevention of myocardial infarction to 1.68 for minor surgical procedures performed in inpatient instead of outpatient settings. Services with weak recommendations had a negligibly higher variance and MOR (difference in means (95% CI) 0.03 (−0.06 to 0.11) and 0.05 (−0.11 to 0.21), respectively) compared with strong recommendations. Services with negative recommendations had a slightly higher variance and MOR (difference in means (95% CI) 0.07 (−0.03 to 0.18) and 0.14 (−0.06 to 0.34), respectively) compared with positive recommendations.ConclusionsIn this exploratory study, the geographical variation in the utilisation of services associated with strong vs weak and negative vs positive recommendations was not substantially different, although the difference was somewhat larger for negative vs positive recommendations. The relationships between the strength or direction of recommendations and the variation may be indirect or modified by other characteristics of services. As initiatives discouraging low-value care are gaining attention worldwide, these findings may inform future research in this area.