bluuebunny/crossref_metadata_2025_split huggingface dataset:
Children’s and Parents’ Perspectives on the Effects of Children’s Digital Technology Use
Authors: Žulec Ana , Varga Vanesa , Štefanić Luka 
Published: December 2022

AbstractWith the rapid development of digital technology, examining the effects of digital technology use on children becomes more critical every day. This paper explores the effects of digital technology use on children from children’s and parents’ perspectives. Focus groups with children aged 9 to 15 and their parents were conducted from 30 March to 5 May 2021, via the Zoom platform. Using the thematic analysis approach, we found that both children and parents perceive different positive and negative effects of digital technology use on emotional, behavioral, physical, social and cognitive development and functioning in children, and problematic digital technology use as a general effect of excessive digital technology use in children. These results give insight into different perspectives of digital technology use and allow for encouraging positive effects and intervening in negative ones.
Post-translational modification of lysine residues in erythrocyte α-synuclein
Authors: Amagai Ryosuke , Yoshioka Sakura , Otomo Riki , Nagano Hidekazu , Hashimoto Naoko , Sakakibara Ryuji , Tanaka Tomoaki , Okado-Matsumoto Ayako 
Published: December 2022

Abstractα-Synuclein is a protein linked to various synuclein-associated diseases (‘synucleinopathies’), including Parkinson’s disease, dementia with Lewy Bodies and multiple system atrophy, and is highly expressed in the central nervous system and in erythrocytes. Moreover, α-synuclein-containing erythrocyte-derived extracellular vesicles may be involved in the pathogenesis of synucleinopathies and their progression across the blood–brain barrier. Several post-translational modifications of α-synuclein have been reported in brain inclusions, including S129 phosphorylation, but fewer have been found in erythrocytes. In this study, we analysed the post-translational modifications of erythrocyte α-synuclein using liquid chromatography–mass spectrometry. We found that all lysine residues in the α-synuclein protein could be modified by acetylation, glycation, ubiquitination or SUMOylation but that phosphorylation, nitration and acylation were uncommon minor post-translational modifications in erythrocytes. Since the post-translational modification of lysine residues has been implicated in both membrane association and protein clearance, our findings provide new insight into how synucleinopathies may progress and suggest possible therapeutic strategies designed to target α-synuclein.
Municipal Employees’ Perceptions of Tree Risk and Liability in Alabama
Authors: Judice Abbie , Gordon Jason S , Brodbeck Arnold 
Published: December 2022

Abstract
Research about the broad range of ecological, social, and economic benefits urban forests provide communities trees has expanded significantly and helped provide justification for protecting and enhancing urban forests. However, an empirical understanding of risks and liabilities is limited despite an abundance of risk research in other disciplines. Employing Alabama as a case study, this research examined municipal employees’ perceptions of factors, including legal liability, influencing actions towards urban tree risk mitigation. Qualitative interviews revealed attitudes and practices regarding municipal responsibility towards public tree management. Cities were unlikely to implement risk assessments to provide a foundation for tree maintenance. As a result, there was limited adaptive and integrative governance to handle risk in the community forest. Results are implicated in the broader narrative of community sustainability and resilience, particularly management of complexity, uncertainty, and ambiguity of urban forest risk and benefits.
Study Implications: Large-population cities were equipped to address tree maintenance, implement best management practices, and focus on preventative risk management. However, all cities were limited in capacity to conduct comprehensive tree risk assessments and communicate with residents about proper tree selection and care to reduce risk of failure. Whereas this has negative implications for community resilience, a number of small and medium-sized communities demonstrated opportunities to address urban forest health such as harnessing employee champions, local sources of expertise, and encouraging volunteerism. Municipal tree programs should not overlook community assets and culture in the goal to reduce risk while maximizing tree benefits.
The field of applied mechanics: historical outlook from past to present and its implications for future applications
Authors: Lee Chih-Kung 
Published: December 2022

Abstract
The focus of this paper is to look at the development of the field of Applied Mechanics from past to present. With a historical perspective, we can better understand the important contributions and achievements that the field of Applied Mechanics has played in our society. The paper will begin by reviewing the history of Applied Mechanics over the past 400 years, followed by looking at engineering education in the 19th and 20th centuries, and then examining the evolution of Applied Mechanics in society today. We will discuss some of today's interdisciplinary developments in Applied Mechanics such as the buckling of ferromagnetic materials in strong magnetic fields, mechanics-based nanoscale measurement instruments, radio frequency microelectromical systems, biochips and nanotechnology. Finally, we will conclude by looking at Maslow's Five-level Theory of Human Needs and provide several innovative examples to further implement innovative models of Applied Mechanics research to teach more advanced knowledge in today's artificial intelligence and information technology based society.
Lamp-post with an outflow and the hard state of Cyg X-1
Authors: Klepczarek Łukasz , Niedźwiecki Andrzej , Szanecki Michał 
Published: December 2022

ABSTRACT
Relativistic reflection observed in the hard states of accreting black holes (BH) often shows a weak amplitude relative to the main Comptonization component, which may result from either a disc truncation or a non-isotropy of the X-ray source, e.g. due to a motion away from the reflector. We investigate here the latter case, assuming that the X-ray source is located on the symmetry axis of the Kerr BH. We discuss effects relevant to a proper computation of the reflected radiation, and we implement them in the model for data analysis, reflkerrv. We apply it to the simultaneous Suzaku and NuSTAR observation of Cyg X-1 in the hard state, and we find a good fit for an untruncated disc irradiated by the source moving away from it at 0.36 c. However, we find a slightly better solution in a geometry closely approximating the truncated disc irradiated by an inner hot flow. In this solution, we either still need a subrelativistic outflow or the source opposite to the observer must contribute to the directly observed radiation. We also discuss differences between the implementation of the outflow effect in reflkerrv and in relxilllpcp.
Evolution and Diversity of TGF-β Pathways are Linked with Novel Developmental and Behavioral Traits
Authors: Lo Wen-Sui , Roca Marianne , Dardiry Mohannad , Mackie Marisa , Eberhardt Gabi , Witte Hanh , Hong Ray , Sommer Ralf J , Lightfoot James W 
Published: December 2022

AbstractTransforming growth factor-β (TGF-β) signaling is essential for numerous biologic functions. It is a highly conserved pathway found in all metazoans including the nematode Caenorhabditis elegans, which has also been pivotal in identifying many components. Utilizing a comparative evolutionary approach, we explored TGF-β signaling in nine nematode species and revealed striking variability in TGF-β gene frequency across the lineage. Of the species analyzed, gene duplications in the DAF-7 pathway appear common with the greatest disparity observed in Pristionchus pacificus. Specifically, multiple paralogues of daf-3, daf-4 and daf-7 were detected. To investigate this additional diversity, we induced mutations in 22 TGF-β components and generated corresponding double, triple, and quadruple mutants revealing both conservation and diversification in function. Although the DBL-1 pathway regulating body morphology appears highly conserved, the DAF-7 pathway exhibits functional divergence, notably in some aspects of dauer formation. Furthermore, the formation of the phenotypically plastic mouth in P. pacificus is partially influenced through TGF-β with the strongest effect in Ppa-tag-68. This appears important for numerous processes in P. pacificus but has no known function in C. elegans. Finally, we observe behavioral differences in TGF-β mutants including in chemosensation and the establishment of the P. pacificus kin-recognition signal. Thus, TGF-β signaling in nematodes represents a stochastic genetic network capable of generating novel functions through the duplication and deletion of associated genes.
Publics and their health: 50 years of continuity and change
Authors: Mold Alex 
Published: December 2022

AbstractBackgroundThis article explores a set of changes and continuities in relation to public health and its publics in the UK since the establishment of the Faculty of Public Health in 1972.MethodsThe article draws on historical research to produce a synthetic analysis of key changes and continuities in British public health since 1972.ResultsThree key areas are identified. The first centres on the issue of who has responsibility for public health. The second examines the persistence of social and racial inequalities in population health. The third considers the ‘return’ of infectious disease as a threat to public health.ConclusionsDespite the trend to place more responsibility for individual and collective health on the public itself, there was a proliferation in the actors and authorities involved in securing and protecting the health of the public. The strong linkages between health and structural inequality, and the challenges of addressing these, demonstrate that public health never was (and never can be) solely an individual matter. The appearance of new diseases, such as HIV/AIDS and the return of ones thought to have been conquered, like tuberculosis, raised profound questions for public health authorities and the people they cared for.
Creating a robust multidisciplinary public health workforce — almost there?
Authors: Sim Fiona , Wright Jenny , Ferguson Katie 
Published: December 2022

Abstract
From 1972 to 2001, membership of the Faculty of Public Health (FPH) was only open to medical practitioners with recognised specialist experience or training in public health. In 2001, the Faculty became multidisciplinary at the specialist level, a rare achievement in a medical specialty in the UK. 1 Specialists from backgrounds other than medicine were accepted as Members and Fellows of the Faculty provided they met the required standards. They were eligible for Consultant and Director of Public Health (DPH) posts, initially in England and Wales. A multidisciplinary higher specialist training scheme was established and, over time, rolled out systematically across the UK. These changes later led to limited developments for public health practitioners filling roles distinct from those in the specialist workforce. Reviewing this history reminds current and future generations of the struggles to reach the unique model we have today. The article teases out the key factors leading to the changes, summarises the somewhat bumpy journey over five decades and, in the shadow of the pandemic, reflects on the contemporary situation for the UK’s public health workforce.
Public health women doctors in England: from backwater to strategic roles in 20 years
Authors: Wright Jenny 
Published: December 2022

Abstract
Women doctors in public health were able to achieve consultant status, and major strategic leadership roles, well ahead of female colleagues in other areas of medical and, especially, surgical practice. This development was bound up with the struggles in the early days of the Faculty of Community Medicine to achieve its status as a separate Faculty of the Royal College of Physicians, raise standards and encourage able and committed doctors to join the specialty. This paper outlines the history of public health medicine in England between 1974 and the 1990s when, through a combination of design, and happenstance in response to organizational changes, a gender-neutral specialty was created, benefiting both men and women, and enabling the latter, in particular, to flourish.
Unmet need for gender-affirming care as a social determinant of mental health inequities for transgender youth in Aotearoa/New Zealand
Authors: Tan Kyle K H , Byrne Jack L , Treharne Gareth J , Veale Jaimie F 
Published: December 2022

AbstractBackgroundPast studies have demonstrated better mental health and well-being among transgender youth who had accessed gender-affirming care. However, few existing studies have assessed unmet need for gender-affirming care as a social determinant of mental health inequities.MethodsData on unmet need for gender-affirming care, distress and suicidality were analysed from the 2018 Counting Ourselves nationwide community-based survey of transgender people in Aotearoa/New Zealand. Associations between unmet need for gender-affirming care and mental health indicators were tested for transgender youth within the sample (aged 14–26 years; n = 608; Mage = 20.5).ResultsTransgender youth reported unmet needs ranging from 42% for gender-affirming hormone to 100% for feminizing surgeries and voice surgeries. Overall unmet need for gender-affirming care was associated with worse mental health. Trans men with an unmet need for chest reconstruction (84%) scored an average of 7.13 points higher on the K10 Psychological Distress Scale relative to those whose need had been met. Participants reporting unmet need for hormones (42%) had twice the odds (adjusted odds ratios = 2.01; CI = 1.02–3.98) of having attempted suicide in the last 12 months.ConclusionsDismantling barriers to accessing gender-affirming care could play a crucial role in reducing mental health inequities faced by transgender youth.
Optimizing antibiotic use in culture-negative healthcare-associated infection with a ‘stop’ policy: a descriptive analytical study
Authors: Sathyan Sajina , Pournami Femitha , Prithvi Ajai Kumar , Nandakumar Anand , Prabhakar Jyothi , Jain Naveen 
Published: December 2022

Abstract

Background and objectives
Many sick neonates receive antibiotics for the clinical diagnosis of probable/possible sepsis. Reports suggest rampant antibiotic use in culture-negative sepsis. We introduced an antibiotic stop policy (ASP), by defining ‘completed course duration of antibiotics’ in the setting of culture-negative suspected healthcare-associated infection (HAI). Antibiotic overuse days (AOD) before antibiotic stop policy (BASP) and after antibiotic stop policy (AASP) were compared.

Methods
This descriptive analytical study was conducted to measure the change in AOD after implementing ASP in culture-negative HAI. We also sought to evaluate situations in which antibiotic overuse is likely (lower gestation, ventilation, central lines) and safety of the ASP, measured as not having to restart antibiotics in the week following completed course.

Results
A total of 126 neonates were initiated on a new antibiotic (started or changed) for suspected HAI. Of these, 43 were excluded. Patient days of 5175 and 5208 were analyzed in BASP and AASP, respectively. Implementation of an ASP reduced AOD (from 14.49 to 3.26 AOD per 1000 patient days; p value &lt;0.01). Safety was ensured; the number of babies who had to be restarted on antibiotics within 1 week of stopping therapy was similar in both groups. All-cause mortality and relevant morbidities were comparable between groups.

Conclusions
A significant decrease in AOD after the introduction of an ASP was noted, in neonates with culture-negative suspected HAI. This difference was noted even in the most vulnerable extreme preterm babies and those requiring ventilation and central lines.
Long Stay and Frequent Readmission in the Pediatric Intensive Care in The Netherlands; 15-Year Time Trends
Authors: van de Riet Liz , Otten Marieke H. , van Karnebeek Clara D. , van Woensel Job B. M. ,   on behalf of the PICE study group
Published: December 2022

OBJECTIVES:
To describe time trends and the burden of long-stay patients (LSP) and frequent-readmission patients (FRP) in the PICUs in The Netherlands.

DESIGN:
Retrospective analysis of data from the nationwide Pediatric Intensive Care Evaluation registry including all PICU admissions in The Netherlands.

SETTING:
All PICUs in The Netherlands.

PATIENTS:
All PICU patients less than 18 years old admitted between 2003 and 2017. Two groups of patients were identified: LSP (admitted ≥30 d) and FRP (≥3 readmissions within the first year after their first admission).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
A total of 47,424 children were admitted on 59,759 occasions. LSP (3.3% of total cohort) and FRP (2.1%) accounted for 37.5% and 14.5% of cumulative admission days, respectively. Patients fulfilling both LSP and FRP criteria (0.6%) accounted for 9.9% of cumulative admission days. No significant time trends were observed between 2003 and 2017 for the number of LSP and FRP, nor for accounted cumulative admission days. Age and disease severity-adjusted mortality was significantly higher for LSP (odds ratio [OR], 2.16; 95% CI, 1.66–2.82; p < 0.001) and FRP OR 1.40 (95% CI, 0.97–2.01; p = 0.069) compared with the general PICU population. Overall PICU mortality decreased significantly between 2003 (6.5%) and 2017 (3.7%; p = 0.004), but remained constant over time for both LSP (17.2%) and FRP (6.3%).

CONCLUSIONS:
The proportion of LSP and FRP and their burden on PICU capacity are considerable and remained constant between 2003 and 2017. Whereas age and disease severity-adjusted mortality decreased in the general PICU population, it did not change in LSP and FRP.
Age and Comorbidities Predict COVID-19 Outcome, Regardless of Innate Immune Response Severity: A Single Institutional Cohort Study
Authors: Mohan Aditya A. , Olson Lyra B. , Naqvi Ibtehaj A. , Morrison Sarah A. , Kraft Bryan D. , Chen Lingye , Que Loretta G. , Ma Qing , Barkauskas Christina E. , Kirk Allan , Nair Smita K. , Sullenger Bruce A. , Kasotakis George 
Published: December 2022

OBJECTIVES:
The COVID-19 pandemic has claimed over eight hundred thousand lives in the United States alone, with older individuals and those with comorbidities being at higher risk of severe disease and death. Although severe acute respiratory syndrome coronavirus 2–induced hyperinflammation is one of the mechanisms underlying the high mortality, the association between age and innate immune responses in COVID-19 mortality remains unclear.

DESIGN:
Flow cytometry of fresh blood and multiplexed inflammatory chemokine measurements of sera were performed on samples collected longitudinally from our cohort. Aggregate impact of comorbid conditions was calculated with the Charlson Comorbidity Index, and association between patient factors and outcomes was calculated via Cox proportional hazard analysis and repeated measures analysis of variance.

SETTING:
A cohort of severely ill COVID-19 patients requiring ICU admission was followed prospectively.

PATIENTS:
In total, 67 patients (46 male, age 59 ± 14 yr) were included in the study.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Mortality in our cohort was 41.8%. We identified older age (hazard ratio [HR] 1.09 [95% CI 1.07–1.11]; p = 0.001), higher comorbidity index (HR 1.24 [95% CI 1.14–1.35]; p = 0.039), and hyponatremia (HR 0.90 [95% CI 0.82–0.99]; p = 0.026) to each independently increase risk for death in COVID-19. We also found that neutrophilia (R = 0.2; p = 0.017), chemokine C-C motif ligand (CCL) 2 (R = 0.3; p = 0.043), and C-X-C motif chemokine ligand 9 (CXCL9) (R = 0.3; p = 0.050) were weakly but significantly correlated with mortality. Older age was associated with lower monocyte (R = –0.2; p = 0.006) and cluster of differentiation (CD) 16+ cell counts (R = –0.2; p = 0.002) and increased CCL11 concentration (R = 0.3; p = 0.050). Similarly, younger patients (< 65 yr) demonstrated a rise in CD4 (b-coefficient = 0.02; p = 0.036) and CD8 (0.01; p = 0.001) counts, as well as CCL20 (b-coefficient = 6.8; p = 0.036) during their ICU stay. This CD8 count rise was also associated with survival (b-coefficient = 0.01; p = 0.023).

CONCLUSIONS:
Age, comorbidities, and hyponatremia independently predict mortality in severe COVID-19. Neutrophilia and higher CCL2 and CXCL9 levels are also associated with higher mortality, while independent of age.
Catastrophic COVID-19 Delta Variant Surge in French West Indies: Report of an ICU Triage Policy*
Authors: Pommier Jean-David , Martino Frederic , Delamare Floran , Jarrige Bruno , Foucan Tania , Markowicz Samuel , Valette Marc , Demoule Alexandre , Camous Laurent 
Published: December 2022

OBJECTIVES:
Here, we report the management of a catastrophic COVID-19 Delta variant surge, which overloaded ICU capacity, using crisis standards of care (CSC) based on a multiapproach protocol.

DESIGN:
Retrospective observational study.

SETTING:
University Hospital of Guadeloupe.

PATIENTS:
This study retrospectively included all patients who were hospitalized for COVID-19 pneumonia between August 11, 2021, and September 10, 2021, and were eligible for ICU admission.

Intervention:
Based on age, comorbidities, and disease severity, patients were assigned to three groups: Green (ICU admission as soon as possible), Orange (ICU admission after the admission of all patients in the Green group), and Red (no ICU admission).

MEASUREMENTS AND MAIN RESULTS:
Among the 328 patients eligible for ICU admission, 100 (30%) were assigned to the Green group, 116 (35%) to the Orange group, and 112 (34%) to the Red group. No patient in the Green group died while waiting for an ICU bed, whereas 14 patients (12%) in the Orange group died while waiting for an ICU bed. The 90-day mortality rates were 24%, 37%, and 78% in the Green, Orange, and Red groups, respectively. A total of 130 patients were transferred to the ICU, including 79 from the Green group, 51 from the Orange group, and none from the Red group. Multivariate analysis revealed that among patients admitted to the ICU, death was independently associated with a longer time between ICU referral and ICU admission, the Sequential Organ Failure Assessment score, and the number of comorbidities, but not with triage group.

CONCLUSIONS:
CSC based on a multiapproach protocol allowed admission of all patients with a good prognosis. Higher mortality was associated with late admission, rather than triage group.