bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving adherence to cholesterol lowering guidelines through an interactive digital tool
Authors: Rashid S , Suero-Abreu G A , Tysarowki M , Um H , Zhang Y , Shah K , Douglas A , Matassa D 
Published: December 2021

Abstract

Background
Statins are the cornerstone of primary and secondary prevention of atheroscleoric cardiovascular disease (ASCVD). Our previous retrospective analysis of 1042 consecutive patient encounters at a large urban academic institution found that one in five patients were not prescribed an appropriate statin therapy. These patients tended to be younger, of Black race, and met statin-eligibility solely via a 10-year ASCVD risk score ≥7.5%. Only one-third of patients had follow-up cholesterol levels ordered to monitor treatment efficacy.

Purpose
To improve adherence to cholesterol guidelines at our academic institution.

Methods
We implemented multiple interventions over a four-month period to support clinical decision making of guideline directed statin therapy: a) development of an online interactive tool, b) physician education on updated cholesterol guidelines and utilization of the tool, c) display of guideline summary in the workspace, and d) a documentation reminder in the electronic health record. We randomly selected encounter dates, from which 622 consecutive patient visits were analyzed. The primary outcome measures were: prescription rates of statins, documentation of a 10-year ASCVD risk score, and follow-up cholesterol levels ordered to monitor treatment efficacy.

Results
Out of the 622 patients, 232 met statin indication. In this post-intervention group, statin prescriptions rates improved when compared to the pre-intervention group (90.5% vs 82.3%, p=0.006). Among the patients who met statin indication solely via a 10-year ASCVD risk score ≥7.5%, there was an increase in documentation of the calculated 10-year ASCVD risk score (72.3% vs 57.8%; p=0.039) and in statin prescription rate (90.8% vs 67.6%; p&lt;0.001). In addition, there was an increase in follow-up cholesterol levels ordered in all patients included in our study who met statin indication (64.1% vs 33.3%; p&lt;0.001).

Conclusion
Our study showed higher rates of statin prescription, 10-year ASCVD risk score documentation, and treatment monitoring after multiple interventions, including an easily accessible online interactive tool, at a large urban academic institution.

Funding Acknowledgement
Type of funding sources: None. Statin Prescription Rates
The feasibility of algorithm-based ECG interpretation in remote monitoring – 53,748 recordings from the Dutch HartWacht program
Authors: Blok S , Slaats B M I , Somsen G A , Tulevski I I , Hofstra L , Winter M M 
Published: December 2021

Abstract

Background
Symptom driven remote monitoring programs for cardiac arrhythmias hold great promise, but scalability is limited due to high additional workload for healthcare providers. The Dutch HartWacht arrhythmia program consists of a connected single lead ECG device operated remotely by the patient, an algorithm for classification and a dedicated team of specialized nurses and cardiologists for additional remote interpretation. Correct classification as sinus rhythm (SR) by the algorithm would reduce workload of the HartWacht team, as it makes double-checking redundant.

Purpose
We investigated agreement of the ECG-classification between the algorithm and the HartWacht team and determined feasibility of the algorithm to classify sinus rhythm (SR).

Methods
We investigated the algorithm accompanying a single lead, handheld ECG-device that is integrated in the Dutch HartWacht program. We retrospectively studied the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the algorithm for classifying SR on home measured 30-second single lead ECGs. We included all recordings that were classified as SR by the algorithm. We used the classification of the HartWacht team as a reference standard.

Results
Between April 2020 and January 2021, 1,671 patients with (suspected) arrhythmias (female = 982 (59%), mean age = 58 (±15) years, participating in the HartWacht program, recorded 53,748 ECGs, of which the algorithm interpreted 35,388 (66%) as SR, 10,899 (20%) as possible AF and 7,461 (14%) as other. All recordings were also interpreted by the HartWacht team. Compared to the classification by the team, the algorithm showed a sensitivity for SR of 0.953, specificity of 0.985, PPV of 0.996 and NPV of 0.841. A total of 137 (0,3%) ECGs from 50 (2,8%) patients showed false positive outcomes, classifying recordings as SR while the HartWacht team detected arrhythmias. In 42 of those patients, arrhythmias were detected by the algorithm in other recordings within the program. The remaining 8 (0,5%) patients made a total of 14 (&lt;0,1%) recordings with false positive outcomes without having any other recordings with arrhythmias within the HartWacht program.

Conclusion
For classifying SR in home measured single lead ECGs, the algorithm and the HartWacht team showed a nearly perfect agreement. The recordings without agreement did not lead to relevant individual changes in diagnostic or therapeutic strategy for the patient. Therefore, the algorithm is feasible as standalone classification. With 66% of the recordings within the HartWacht program showing SR, a corresponding workload reduction can be achieved which importantly increases scalability and cost-effectiveness of remote monitoring of arrhythmia patients.

Funding Acknowledgement
Type of funding sources: None.
Cesarean section and breastfeeding outcomes in an Indigenous Qom community with high breastfeeding support
Authors: Martin Melanie , Keith Monica , Olmedo Sofía , Edwards Deja , Barrientes Alicia , Pan Anwesha , Valeggia Claudia 
Published: December 2021

Abstract

Background and objectives
Cesarean section may lead to suboptimal breastfeeding outcomes, though evidence has been mixed. Factors, such as premature birth, birth weight and maternal age may independently increase risk of cesarean and hinder breastfeeding initiation, while maternal preferences, support and sociostructural barriers may influence breastfeeding practices beyond the immediate postpartum period.

Methodology
We assessed impacts of cesarean section and gestational factors on breastfeeding duration among Indigenous Qom mothers in Argentina who have strong traditional breastfeeding support. We modeled transitions from exclusive breastfeeding to complementary feeding and from complementary feeding to full weaning in a Bayesian time-to-event framework with birth mode and gestational covariates (n = 89 infants).

Results
Estimated median time to full weaning was 30 months. Cesarean-delivered babies were weaned an average of 5 months later adjusting for gestational age, maternal parity and infant sex. No factors were associated with time-to-complementary feeding, and time-to-complementary feeding was not associated with time-to-full weaning.

Conclusions and implications
Among Indigenous Qom mothers in Argentina, cesarean section was not associated with suboptimal breastfeeding outcomes. Although some Qom mothers do experience early breastfeeding problems, particularly following first birth, problems are not more frequent following cesarean delivery. Traditional postpartum kin and community support during prolonged postpartum periods may be instrumental in helping mothers to overcome early breastfeeding problems due to cesarean or other risk factors.
Early Exposure to County Income Mobility and Adult Individual Health in the United States
Authors: Daza Sebastian , Palloni Alberto 
Published: December 2021

Abstract

Objectives
Previous research in the United States suggests contextual income mobility may play a role in explaining the disparities between life expectancy in the United States and peer countries. This article aims to extend previous research by estimating the consequences of average individual exposure to mobility regimes during childhood and adolescence on adult health.

Methods
This study draws its data from two longitudinal datasets that track the county of residence of respondents during childhood and adolescence, the Panel Study of Income Dynamics and the National Longitudinal Survey of Youth 1997. We implement marginal structural models to assess the association of the average exposure to county income mobility on five health outcomes and behaviors.

Results
The results are only partially consistent with a systematic association between exposure to income mobility and health outcomes. Evidence obtained from the National Longitudinal Survey of Youth suggests less income mobility might increase the probability of smoking by age 30.

Discussion
The paper provides a precise assessment of the hypothesis that childhood exposure to income mobility regimes may influence health status through behavior later in life and contribute to longevity gaps. Only partial evidence on smoking suggests an association between income mobility and health, so we discuss potential reasons for the disparities in results with previous research.
Intersectoral collaboration in a Dutch community health promotion programme: building a coalition and networks
Authors: de Jong Marja , Tijhuis Yvon , Koelen Maria , Wagemakers Annemarie 
Published: December 2021

Summary
In health promotion programmes (HPP), it is crucial to have intersectoral collaboration within coalitions and to build networks between health and other societal sectors. A health broker role is recognized as being helpful in connecting the coalition with the broader network, and participatory action research (PAR) is deemed supportive because it facilitates evaluation, reflection, learning and action. However, there is a lack of insight into how processes that affect collaboration develop over time. Therefore, this study aimed to provide insights into the coalition’s processes that facilitate building and maintaining intersectoral collaboration within a HPP coalition and network and how these processes contribute to the coalition’s ambitions. As part of PAR, the coalition members used the coordinated action checklist (CAC) and composed network analysis (CNA) in 2018 and 2019. The CAC and CNA results were linked back into the coalition in five group sessions and used for reflection on pro-gress and future planning. Coalition governance, interaction with the context, network building and brokerage, and generating visibility emerged as the most prominent processes. Important insights concerned the health broker’s role and positioning, the programme coordinator’s leadership and the importance of visibility and trust leading to investment in continuation. The combined research instruments and group sessions supported discussion and reflection, sharing visions and adjusting working strategies, thereby strengthening the coalition’s capacity. Thus, PAR was useful for evaluating and simultaneously facilitating the processes that affect collaboration.
Systematic identification of genomic elements that regulateFCGR2Aexpression and harbor variants linked with autoimmune disease
Authors: Dahlqvist Johanna , Fulco Charles P , Ray John P , Liechti Thomas , de Boer Carl G , Lieb David J , Eisenhaure Thomas M , Engreitz Jesse M , Roederer Mario , Hacohen Nir 
Published: December 2021

AbstractBackground: FCGR2A binds antibody–antigen complexes to regulate the abundance of circulating and deposited complexes along with downstream immune and autoimmune responses. Although the abundance of FCRG2A may be critical in immune-mediated diseases, little is known about whether its surface expression is regulated through cis genomic elements and non-coding variants. In the current study, we aimed to characterize the regulation of FCGR2A expression, the impact of genetic variation and its association with autoimmune disease. Methods: We applied CRISPR-based interference and editing to scrutinize 1.7 Mb of open chromatin surrounding the FCGR2A gene to identify regulatory elements. Relevant transcription factors (TFs) binding to these regions were defined through public databases. Genetic variants affecting regulation were identified using luciferase reporter assays and were verified in a cohort of 1996 genotyped healthy individuals using flow cytometry. Results: We identified a complex proximal region and five distal enhancers regulating FCGR2A. The proximal region split into subregions upstream and downstream of the transcription start site, was enriched in binding of inflammation-regulated TFs, and harbored a variant associated with FCGR2A expression in primary myeloid cells. One distal enhancer region was occupied by CCCTC-binding factor (CTCF) whose binding site was disrupted by a rare genetic variant, altering gene expression. Conclusions: The FCGR2A gene is regulated by multiple proximal and distal genomic regions, with links to autoimmune disease. These findings may open up novel therapeutic avenues where fine-tuning of FCGR2A levels may constitute a part of treatment strategies for immune-mediated diseases.
Convergence of Lagrange finite elements for the Maxwell eigenvalue problem in two dimensions
Authors: Boffi Daniele , Guzmán Johnny , Neilan Michael 
Published: December 2021

AbstractWe consider finite element approximations of the Maxwell eigenvalue problem in two dimensions. We prove, in certain settings, convergence of the discrete eigenvalues using Lagrange finite elements. In particular, we prove convergence in three scenarios: piecewise linear elements on Powell–Sabin triangulations, piecewise quadratic elements on Clough–Tocher triangulations and piecewise quartics (and higher) elements on general shape-regular triangulations. We provide numerical experiments that support the theoretical results. The computations also show that, on general triangulations, the eigenvalue approximations are very sensitive to nearly singular vertices, i.e., vertices that fall on exactly two ‘almost’ straight lines.
Balanced Curves and Minimal Rational Connectedness on Fano Hypersurfaces
Authors: Ran Ziv 
Published: December 2021

AbstractOn a general hypersurface $X$ of degree $n$ (resp. $&lt;n$) in ${\mathbb {P}}^n$ and any $e\geq n-1$ (resp. arbitrarily large $e$), we construct families of rational curves of degree $e$ going through the maximal number of general points. This solves in many cases the problem of rational curve interpolation on $X$.
Structural and biochemical elements of efficiently degradable proteasome substrates
Authors: Tomita Takuya 
Published: December 2021

AbstractMost regulated proteolysis in cells is conducted by the ubiquitin-proteasome system (UPS), in which proteins to be eliminated are selected through multiple steps to achieve high specificity. The large protease complex proteasome binds to ubiquitin molecules that are attached to the substrate and further interacts with a disordered region in the target to initiate unfolding for degradation. Recent studies have expanded our view of the complexity of ubiquitination as well as the details of substrate engagement by the proteasome and at the same time have suggested the characteristics of substrates that are susceptible to proteasomal degradation. Here, I review some destabilizing elements of proteasome substrates with particular attention to ubiquitination, initiation region and stability against unfolding and discuss their interplay to determine the substrate stability. A spatial perspective is important to understand the mechanism of action of proteasomal degradation, which may be critical for drug development targeting the UPS including targeted protein degradation.
Pontonia margaritaVerrill, 1869 (Decapoda: Caridea: Palaemonidae) as a symbiont ofPinna rugosaSowerby, 1835 (Mollusca: Bivalvia) on both coasts of the Baja California Peninsula, Mexico
Authors: Vélez-Arellano Nurenskaya , Medina-Gómez Sandra P , Magaña Joaquín D , Camacho-Mondragón Marian A , Rábago-Quiroz Carlos H 
Published: December 2021

AbstractMany caridean shrimps live in symbiosis with bivalves, the shrimps finding refuge and food in the mucus in their host’s mantle cavity. We report for the first time the presence of Pontonia margarita Verrill, 1869 on both coasts of Baja California Peninsula, Mexico, as a symbiont of the pen shell Pinna rugosa Sowerby, 1835. The symbiont was found in Laguna Ojo de Liebre (LOL), which faces the Pacific Ocean, and in Bahía Concepción (BC), on the eastern coast facing the Gulf of California. A total of 569 specimens of Pinna rugosa were studied, 472 from LOL (104–277 mm shell length (SL)) and 97 from BC (130–234 mm SL). A total of 376 Pontonia margarita individuals were extracted in LOL (19–41 mm total length (TL)) and 41 in BC (20–48 mm TL). The prevalence of Pontonia margarita was 46% in LOL and 28% in BC. The regression analyses for both sexes of Pontonia margarita showed a high correlation between TL and total weight and abdominal length and TL. The data showed a moderate correlation between TL and the length of the major and minor chelae, and TL and length of the minor chela. There was no significant relationship between biometric parameters of the host and the symbiont. The presence of gravid females of Pontonia margarita (52% in LOL and 39% in BC) in shells suggests reproduction during autumn.
Too Vulnerable to Participate? A Systematic Literature Review of the Gap between a Right to Participate and Participation, in Welfare Services
Authors: Strømland Monica , Bahus Marianne K , Andersen Anders J W 
Published: December 2021

AbstractThere is a need to reconceptualize children as competent and reflective actors in their own lives, acknowledging their right to be heard and to participate in meaningful ways. This article explores and suggests the means to overcome the gap between the formal right to participate and meaningful participation in welfare services that involve evaluating a child’s family environment. For this purpose, we conducted a systematic literature review to synthesize the qualitative literature on how children and young people who have been in contact with child welfare services experience participation in the making of decisions that affect their well-being. The articles collected from eight scientific databases indicate that despite a growing general emphasis on the importance of child participation over the past 25 years, the operationalization of children’s right to be heard is challenging in child welfare services. There are challenges at both the organizational level, with the failure to fully acknowledge and operationalize children’s right to be heard in a sufficient manner, and at the individual level, with a need to improve opportunities for communication that facilitate trustful relationships between child welfare social workers and children in need. Based on previous studies of participation in a child welfare context at different levels, we conclude that a legally clear framework in combination with the realization of Skivenes and Strandbu’s definition of participation would increase the chances that children’s interests and right to be heard are respected, protected, and implemented.
The kinematic properties of Milky Way stellar halo populations
Authors: Lane James M M , Bovy Jo , Mackereth J Ted 
Published: December 2021

ABSTRACT
In the Gaia era, stellar kinematics are extensively used to study Galactic halo stellar populations, to search for halo structures, and to characterize the interface between the halo and hot disc populations. We use distribution function-based models of modern data sets with 6D phase space data to qualitatively describe a variety of kinematic spaces commonly used in the study of the Galactic halo. Furthermore, we quantitatively assess how well each kinematic space can separate radially anisotropic from isotropic halo populations. We find that scaled action space (the ‘action diamond’) is superior to other commonly used kinematic spaces at this task. We present a new, easy to implement selection criterion for members of the radially anisotropic Gaia–Enceladus merger remnant. Assuming a 1:1 ratio of Gaia–Enceladus stars to more isotropic halo, we find our selection achieves a sample purity of 86 per cent in our models with respect to contamination from the more isotropic halo. We compare this criterion to literature criteria, finding that it produces the highest purity in the resulting samples, at the expense of a modest reduction in completeness. We also show that selection biases that underlie nearly all contemporary spectroscopic data sets can noticeably impact the E−Lz distribution of samples in a manner that may be confused for real substructure. We conclude by providing recommendations for how authors should use stellar kinematics in the future to study the Galactic stellar halo.
Adolescents on the Autism Spectrum: Music Therapists’ Work with Speech-Language Pathologists
Authors: Guerriero Angela , Culp Mara E , Pierce-Goldstein Lisa 
Published: December 2021

Abstract
Adolescents on the autism spectrum may experience challenges with multiple domains of communication that impact their quality of life. Both music therapists and speech-language pathologists (SLPs) implement activities to address these challenges. Empirical evidence suggests that incorporating music into treatment can be an effective way to improve communication. The purpose of this article is to provide suggestions for music therapists assisting adolescents on the autism spectrum to improve their communication skills and ways to collaborate with SLPs in doing so. In this paper, we discuss interprofessional collaborative models (e.g., interdisciplinary, transdisciplinary) and competencies (e.g., coordination, adaptability), as well as music-based clinical experiences that appeal to adolescents, and target improvement of communication skills for learners with complex communication needs.
The nucleotide messenger (p)ppGpp is an anti-inducer of the purine synthesis transcription regulator PurR inBacillus
Authors: Anderson Brent W , Schumacher Maria A , Yang Jin , Turdiev Asan , Turdiev Husan , Schroeder Jeremy W , He Qixiang , Lee Vincent T , Brennan Richard G , Wang Jue D 
Published: December 2021

AbstractThe nucleotide messenger (p)ppGpp allows bacteria to adapt to fluctuating environments by reprogramming the transcriptome. Despite its well-recognized role in gene regulation, (p)ppGpp is only known to directly affect transcription in Proteobacteria by binding to the RNA polymerase. Here, we reveal a different mechanism of gene regulation by (p)ppGpp in Firmicutes: (p)ppGpp directly binds to the transcription factor PurR to downregulate purine biosynthesis gene expression upon amino acid starvation. We first identified PurR as a receptor of (p)ppGpp in Bacillus anthracis. A co-structure with Bacillus subtilis PurR reveals that (p)ppGpp binds to a PurR pocket reminiscent of the active site of phosphoribosyltransferase enzymes that has been repurposed to serve a purely regulatory role, where the effectors (p)ppGpp and PRPP compete to allosterically control transcription. PRPP inhibits PurR DNA binding to induce transcription of purine synthesis genes, whereas (p)ppGpp antagonizes PRPP to enhance PurR DNA binding and repress transcription. A (p)ppGpp-refractory purR mutant in B. subtilis fails to downregulate purine synthesis genes upon amino acid starvation. Our work establishes the precedent of (p)ppGpp as an effector of a classical transcription repressor and reveals the key function of (p)ppGpp in regulating nucleotide synthesis through gene regulation, from soil bacteria to pathogens.