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, Chun-Fang Chiang, Ming-Jen Lin
Published: 1 December 2021
Abstract:
We use 19 billion likes on the posts of top 2000 U.S. fan pages on Facebook from 2015 to 2016 to measure the dynamic ideological positions for politicians, news outlets, and users at the national and state levels. We then use these measures to derive support rates for 2016 presidential candidates in all 50 states, to predict the election, and to compare them with state-level polls and actual vote shares. We find that: (1) Assuming that users vote for candidates closer to their own ideological positions, support rates calculated using Facebook predict that Trump will win the electoral college vote while Clinton will win the popular vote. (2) State-level Facebook support rates track state-level polling averages and pass the cointegration test, showing two time series share similar trends. (3) Compared with actual vote shares, polls generally have smaller margin of errors, but polls also often overestimate Clinton’s support in right-leaning states. Overall, we provide a method to forecast elections at low cost, in real time, and based on passively revealed preference and little researcher discretion.
, Masuma Pervin Mishu, Mehreen Riaz Faisal, Mohammed Islam, Emily Peckham
Published: 1 December 2021
Abstract:
Background: Those with severe mental illness (SMI) are at greater risk of having poor oral health, which can have an impact on daily activities such as eating, socialising and working. There is currently a lack of evidence to suggest which oral health interventions are effective for improving oral health outcomes for people with SMI. Aims: This systematic review aims to examine the effectiveness of oral health interventions in improving oral health outcomes for those with SMI. Methods: The review protocol was registered with PROSPERO (ID CRD42020187663). Medline, EMBASE, PsycINFO, AMED, HMIC, CINAHL, Scopus and the Cochrane Library were searched for studies, along with conference proceedings and grey literature sources. Titles and abstracts were dual screened by two reviewers. Two reviewers also independently performed full text screening, data extraction and risk of bias assessments. Due to heterogeneity between studies, a narrative synthesis was undertaken. Results: In total, 1462 abstracts from the database search and three abstracts from grey literature sources were identified. Following screening, 12 studies were included in the review. Five broad categories of intervention were identified: dental education, motivational interviewing, dental checklist, dietary change and incentives. Despite statistically significant changes in plaque indices and oral health behaviours as a result of interventions using dental education, motivational interviewing and incentives, it is unclear if these changes are clinically significant. Conclusion: Although some positive results in this review demonstrate that dental education shows promise as an intervention for those with SMI, the quality of evidence was graded as very low to moderate quality. Further research is in this area is required to provide more conclusive evidence.
Published: 1 December 2021
Abstract:
To minimize the curtailment of renewable generation and incentivize grid-scale energy storage deployment, a concept of combining stationary and mobile applications of battery energy storage systems built within renewable energy farms is proposed. A simulation-based optimization model is developed to obtain the optimal design parameters such as battery capacity and power ratings by solving a multi-objective optimization problem that aims to maximize the economic profitability, the energy provided for transportation electrification, the demand peak shaving, and the renewable energy utilized. Two applications considered for the stationary energy storage systems are the end-consumer arbitrage and frequency regulation, while the mobile application envisions a scenario of a grid-independent battery-powered electric vehicle charging station network. The charging stations receive supplies from the energy storage system that absorbs renewable energy, contributing to a sustained DC demand that helps with revenues. Representative results are presented for two operation modes and different sets of weights assigned to the objectives. Substantial improvement in the profitability of combined applications over single stationary applications is shown. Pareto frontier of a reduced dimensional problem is obtained to show the trade-off between design objectives. This work could pave the road for future implementations of the new form of energy storage systems.
, Debasish Saha, Kris Lodroño, Phatu Boonmahittisut, Stephanus Taniwijaya, Ashwini Saha, Selim Badur, Yong Poovorawan
Published: 1 December 2021
Abstract:
Background: A previous review on hepatitis A virus (HAV) seroprevalence in 2005 categorized Southeast Asia as a low HAV endemicity region. In 2010, the World Health Organization modified this from low to low/medium endemicity, pointing out that these estimates were based on limited evidence. Since then, there has been no attempt to review HAV epidemiology from this region. We conducted a systematic review of literature to collect information on HAV incidence and seroprevalence in select countries in the Southeast Asian region, specifically, The Association of Southeast Asian Nations over the last 20 years. Methodology: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. From the relevant articles, we extracted data and conducted a risk of bias assessment of individual studies. Results: The search yielded 22 and 13 publications on HAV seroprevalence and incidence, respectively. Overall, our findings point to a very low HAV endemicity profile in Thailand and Singapore and evidence of a shift towards low HAV endemicity in Indonesia, Lao People’s Democratic Republic, Malaysia, the Philippines, and Vietnam. Only Singapore, Thailand, Malaysia, and the Philippines have existing HAV disease surveillance and reported incidence rates below 1 per 100,000. Several outbreaks with varying magnitude documented in the region provide insights into the evolving epidemiology of HAV in the region. Risk of bias assessment of studies revealed that the individual studies were of low to medium risk. Conclusions/Significance: The available HAV endemicity profiles in Southeast Asian countries, aside from Thailand, are limited and outdated, but suggest an endemicity shift in the region that is not fully documented yet. These findings highlight the need to update information on HAV epidemiology through strengthening of disease surveillance mechanisms to confirm the shift in HAV endemicity in the region.
Published: 1 December 2021
Abstract:
Motivated by the two-decade-long scientific debate over the existence of the ego-depletion effect, our paper contributes to exploring the scope conditions of ego-depletion theory. Specifically, in a randomized experiment, we depleted students’ self-control with a cognitively demanding task that required students’ effort. We measured the effect of depleted self-control on a subsequent task that required self-control to not engage in fraudulent cheating behavior—measured with an incentivized dice-roll task—and tested ego-depletion in a large-scale preregistered field experiment that was similar to real-life situations. We hypothesized that treated students would cheat more. The data confirms the hypothesis and provides causal evidence of the ego-depletion effect. Our results provide new insights into the scope conditions of ego-depletion theory, contribute methodological information for future research, and offer practical guidance for educational policy.
Xiaoye Liang, Tong-Tong Pei, Hao Li, Hao-Yu Zheng, Han Luo, Yang Cui, Ming-Xuan Tang, Ya-Jie Zhao, Ping Xu,
Published: 1 December 2021
Abstract:
The type VI secretion system (T6SS) is a spear-like nanomachine found in gram-negative pathogens for delivery of toxic effectors to neighboring bacterial and host cells. Its assembly requires a tip spike complex consisting of a VgrG-trimer, a PAAR protein, and the interacting effectors. However, how the spike controls T6SS assembly remains elusive. Here we investigated the role of three VgrG-effector pairs in Aeromonas dhakensis strain SSU, a clinical isolate with a constitutively active T6SS. By swapping VgrG tail sequences, we demonstrate that the C-terminal ~30 amino-acid tail dictates effector specificity. Double deletion of vgrG1&2 genes (VgrG3+) abolished T6SS secretion, which can be rescued by ectopically expressing chimeric VgrG3 with a VgrG1/2-tail but not the wild type VgrG3. In addition, deletion of effector-specific chaperones also severely impaired T6SS secretion, despite the presence of intact VgrG and effector proteins, in both SSU and Vibrio cholerae V52. We further show that SSU could deliver a V. cholerae effector VasX when expressing a plasmid-borne chimeric VgrG with VasX-specific VgrG tail and chaperone sequences. Pull-down analyses show that two SSU effectors, TseP and TseC, could interact with their cognate VgrGs, the baseplate protein TssK, and the key assembly chaperone TssA. Effectors TseL and VasX could interact with TssF, TssK and TssA in V. cholerae. Collectively, we demonstrate that chimeric VgrG-effector pairs could bypass the requirement of heterologous VgrG complex and propose that effector-stuffing inside the baseplate complex, facilitated by chaperones and the interaction with structural proteins, serves as a crucial structural determinant for T6SS assembly.
Frank C. Curriero, Cara Wychgram, Alison W. Rebman, , Anton Kvit, Timothy Shields, John N. Aucott
Published: 1 December 2021
Abstract:
With the incidence of Lyme and other tickborne diseases on the rise in the US and globally, there is a critical need for data-driven tools that communicate the magnitude of this problem and help guide public health responses. We present the Johns Hopkins Lyme and Tickborne Disease Dashboard (https://www.hopkinslymetracker.org/), a new tool that harnesses the power of geography to raise awareness and fuel research and scientific collaboration. The dashboard is unique in applying a geographic lens to tickborne diseases, aiming not only to become a global tracker of tickborne diseases but also to contextualize their complicated geography with a comprehensive set of maps and spatial data sets representing a One Health approach. We share our experience designing and implementing the dashboard, describe the main features, and discuss current limitations and future directions.
Marrissa D. Grant, Alexandra Flores, Eric J. Pedersen, David K. Sherman,
Published: 1 December 2021
Abstract:
The present study, conducted immediately after the 2020 presidential election in the United States, examined whether Democrats’ and Republicans’ polarized assessments of election legitimacy increased over time. In a naturalistic survey experiment, people (N = 1,236) were randomly surveyed either during the week following Election Day, with votes cast but the outcome unknown, or during the following week, after President Joseph Biden was widely declared the winner. The design unconfounded the election outcome announcement from the vote itself, allowing more precise testing of predictions derived from cognitive dissonance theory. As predicted, perceived election legitimacy increased among Democrats, from the first to the second week following Election Day, as their expected Biden win was confirmed, whereas perceived election legitimacy decreased among Republicans as their expected President Trump win was disconfirmed. From the first to the second week following Election Day, Republicans reported stronger negative emotions and weaker positive emotions while Democrats reported stronger positive emotions and weaker negative emotions. The polarized perceptions of election legitimacy were correlated with the tendencies to trust and consume polarized media. Consumption of Fox News was associated with lowered perceptions of election legitimacy over time whereas consumption of other outlets was associated with higher perceptions of election legitimacy over time. Discussion centers on the role of the media in the experience of cognitive dissonance and the implications of polarized perceptions of election legitimacy for psychology, political science, and the future of democratic society.
, Tesfanesh Lemma
Published: 1 December 2021
Abstract:
Background: Maternal satisfaction is an essential indicator of the quality and the efficiency of the health care systems. At a time when efforts are being made globally to reduce maternal and neonatal mortality and morbidity, assessing maternal satisfaction is essential. There is a dearth of studies on maternal satisfaction with intrapartum care, particularly in the study area. This study aimed to assess maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia. Methods: A facility-based cross-sectional study with a systematic random sampling technique was conducted from May1-30/ 2020. Data were entered into EpiData version 4.6 and analyzed using a statistical package for the social sciences version 25. Bivariate and multivariable logistic regression were employed. In multivariable logistic regression analysis, level of statistical significance was declared at variables with p < 0.05 and the strength of the association was measured by an adjusted odds ratio and 95% confidence interval. Result: Of the total 394 participants, 111 (28.2%) [95% CI: 23.9, 32.5] of postpartum women were satisfied with the intrapartum care. Place of residence [AOR: 1.934; 95% CI (1.183, 3.162)], planned status of the pregnancy [AOR: 2.245; 95% CI, (1.212, 4.158)], number of antenatal care visit [AOR: 2.389; 95% (1.437, 3.974)] and duration of labour [AOR: 2.463; 95% (1.378, 4.402)] were factors significantly associated with maternal satisfaction with intrapartum care. Conclusion: The proportion of maternal satisfaction with intrapartum care was low. Therefore, designing strategies to enhance maternal satisfaction by strengthening adherence to antenatal care visits, provision of family planning to prevent unplanned pregnancy, and strict utilization of partograph to prevent prolonged labour and childbirth-related complications are crucial.
, Junya Kusumoto, Naoki Takata, Shungo Furudoi, Akira Tachibana, Masaya Akashi
Published: 1 December 2021
Abstract:
Background: Necrotizing fasciitis (NF) is an acute and life-threatening soft-tissue infection however rarely seen in oro-cervical region. Therefore, the details of oro-cervical NF (OCNF) are not well known. The purpose of this study was to investigate the characteristics of OCNF by comparing it with severe cellulitis of oro-cervical region (OCSC) or NF of other body regions (e.g., limb, perineum, and trunk) (BNF), respectively. Materials and methods: At first, various risk factors for OCNF in oro-cervical severe infection (OCSI; composed of OCNF and OCSC), including neutrophil-to-lymphocyte ratio (NLR) and Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, were investigated by univariate and multivariate analyses. Next, the differences between OCNF and BNF, including inflammatory markers and mortality, were investigated. Results: In the present study, 14 out of 231 OCSI patients had OCNF. Multivariate analyses of OCSI patients showed that NLR ≥15.3 and LRINEC score ≥6 points were significantly related to OCNF. During the same period, 17 patients had BNF. The OCNF group had significantly higher inflammatory markers than the BNF group when diagnosis, but significantly lower clinical stages at the time and mortality as outcomes. Conclusion: We found that compared to BNF, OCNF can be detected at lower clinical stage by using indexes, such as NLR and LRINEC score, besides clinical findings, which may help contributing to patient’s relief.
Published: 1 December 2021
Abstract:
A large variety of misconceptions about learning, teaching, and other educational topics is prevalent in the public but also among educational professionals. Such misconceptions may lead to ill-advised judgments and actions in private life, professional practice, and policymaking. Developing effective correction strategies for these misconceptions hinges on a better understanding of the factors that make individuals susceptible to or resilient against misconceptions. The present study surveyed students from educational and non-educational fields of study to investigate whether the endorsement of four typical educational misconceptions can be predicted by study-related variables (i.e., field of study and study progress) and by students’ cognitive ability (i.e., numeracy), epistemic orientations, general world views (i.e., conservative orientation), and education-related values (i.e., educational goals). A sample of N = 315 undergraduates in teacher education and education- and non-education-related fields of study completed an online survey. Results from structural equation models showed that the pattern of effects strongly varied across the specific misconceptions. The two misconceptions related to teaching factors (i.e., class size and effectiveness of direct instruction as a teaching method) were the most strongly affected by the field of study and had an association with conservative orientation. In contrast, the misconception about the effectiveness of grade retention as an educational intervention was more prevalent among the students emphasizing conventional educational goals, such as discipline. None of the investigated explanatory variables proved predictive of the misconception about the “feminization” of education as an educational-equity topic. Moreover, neither numeracy nor epistemic orientation was found to have any effect on the endorsement of educational misconceptions. These findings emphasize the topic dependency of the factors that make individuals susceptible to misconceptions. Future research and intervention approaches need to consider the topic specificity of educational misconceptions.
, Ulf de Faire, , , Peter Westerholm, Håkan Malmström, ,
Published: 1 December 2021
Abstract:
Background: Elevated apolipoprotein B (apoB) and elevated apoB/apoA-1 ratio increase the risk of myocardial infarction (MI) and stroke, whereas high apoA-1 is protective. We study how these apolipoproteins are associated with major adverse cardiovascular events (MACEs), whether apoA-1 contributes to this association, and whether abnormal values occur decades before such events develop. Methods and findings: In the Swedish AMORIS (Apolipoprotein-related MOrtality RISk) cohort study, 137,100 men and women aged 25–84 years were followed an average 17.8 years. ApoB, apoA-1, and the apoB/apoA-1 ratio were analysed in relation to MACEs (non-fatal MI, stroke, and cardiovascular [CV] mortality), yielding 22,473 events. Hazard ratios (HRs) were estimated using Cox regression. Kaplan–Meier estimates were used to investigate the relationship of MACEs with increasing quintiles of the apoB/apoA-1 ratio in all age groups for both sexes. In nested case–control analyses, cases were randomly matched to age- and sex-matched controls, yielding population trajectories for apolipoproteins. Increased level of apoB and increased apoB/apoA-1 ratio were associated with risk of MACE and all clinical sub-components in both men and women across all ages (10th versus first decile in both sexes combined: HR 1.7 for MACE and 2.7 for non-fatal MI). Decreased values of apoA-1 potentiated the impact of apoB at all levels of apoB (on average across apoB range: 40% increase in HR for MACE and 72% increase in HR for non-fatal MI), indicating that the apoB/apoA-1 ratio covers a broader range of persons with dyslipidaemia at risk than apoB alone. In both men and women, MACEs occurred earlier on average for each increasing quintile of the apoB/apoA-1 ratio. Individuals with the highest levels of apoB/apoA-1 ratio experienced CV events on average several years earlier than those with lower ratios. Higher apoB/apoA-1 ratio in cases of MACE versus controls was seen already about 20 years before the event. A limitation of this study was that adjustment for tobacco smoking and hypertension was only possible in a small validation study. Conclusions: An imbalance between apoB and apoA-1 resulting in an increased apoB/apoA-1 ratio is strongly associated with the outcome MACE and its sub-components, in both men and women of all ages. An increased apoB/apoA-1 ratio already 2 decades before events calls for early recognition and primary prevention. Simple evidence-based cut values should be considered in future cardiovascular guidelines.
, Silvia Schneider,
Published: 1 December 2021
Abstract:
Researcher teams around the globe including the “Project Lightspeed” are intensively working on vaccines to fight the Covid-19 pandemic. However, the availability of effective vaccines does not guarantee the vaccination willingness among the population. In spring 2021, we investigated the vaccination willingness and its potential predictors in representative online samples in nine countries (China, France, Germany, Poland, Russia, Spain, Sweden, U.K., U.S.). Of the 9,264 participants, 79.9% revealed Covid-19 vaccination willingness. The highest willingness was in the U.K., followed by Spain and China, the lowest in Russia. In most countries, the perception of governmental Covid-19 measures as useful and the use of television reports as Covid-19 information source positively predicted the willingness. Further factors such as demographic variables, mental and physical health status, evaluation of governmental communication, social media use, and general adherence to Covid-19 measures showed a country-specific predictive pattern. Recommendations how to increase the vaccination willingness are provided.
, Simon Lai, Marcus Pieterman, Lisa Richardson, Amanda Singh, Jocelynn Peters, Alex Toy, Caroline Piccininni, Taiysa Rouault, Kristie Wong, et al.
Published: 1 December 2021
Abstract:
Background: Computerized algorithms known as symptom checkers aim to help patients decide what to do should they have a new medical concern. However, despite widespread implementation, most studies on symptom checkers have involved simulated patients. Only limited evidence currently exists about symptom checker safety or accuracy when used by real patients. We developed a new prototype symptom checker and assessed its safety and accuracy in a prospective cohort of patients presenting to primary care and emergency departments with new medical concerns. Method: A prospective cohort study was done to assess the prototype’s performance. The cohort consisted of adult patients (≥16 years old) who presented to hospital emergency departments and family physician clinics. Primary outcomes were safety and accuracy of triage recommendations to seek hospital care, seek primary care, or manage symptoms at home. Results: Data from 281 hospital patients and 300 clinic patients were collected and analyzed. Sensitivity to emergencies was 100% (10/10 encounters). Sensitivity to urgencies was 90% (73/81) and 97% (34/35) for hospital and primary care patients, respectively. The prototype was significantly more accurate than patients at triage (73% versus 58%, p<0.01). Compliance with triage recommendations in this cohort using this iteration of the symptom checker would have reduced hospital visits by 55% but cause potential harm in 2–3% from delay in care. Interpretation: The prototype symptom checker was superior to patients in deciding the most appropriate treatment setting for medical issues. This symptom checker could reduce a significant number of unnecessary hospital visits, with accuracy and safety outcomes comparable to existing data on telephone triage.
, Melina Nevoeiro Haik, Larissa Pechincha Ribeiro, Rafaela Firmino de Almeida, Lucas Araújo de Almeida, Carlos Luques Fonseca,
Published: 1 December 2021
Abstract:
Purpose: To verify the measurement properties of the Brazilian versions of Fear-avoidance Beliefs Questionnaire (FABQ) and Tampa Scale of Kinesiophobia (TSK) in individuals with shoulder pain. Methods: Individuals with shoulder pain (>18 years) were included in this study. Structural validity was verified by exploratory factor analysis, which was used to identify dimensionality of the FABQ and TSK. Test-retest reliability was assessed with intraclass correlation coefficient(3,1) and internal consistency with Cronbach’s alpha. Floor or ceiling effects were also investigated. Responsiveness was verified by effect sizes and area under the receiver operating characteristic curve (AUC). Results: Exploratory factor analysis identified two and one factor in the FABQ and TSK, respectively. FABQ and TSK presented moderate to good reliability and adequate internal consistency (Cronbach’s alpha > 0.70). The floor effect was present in one factor of the FABQ. The FABQ and TSK showed small to moderate effect sizes and did not show adequate AUC. Conclusion: FABQ and TSK are multidimensional and unidimensional instruments, respectively. Those instruments presented moderate to good reliability and the responsiveness was considered to be suboptimal in individuals with shoulder pain.
E. Bradshaw, , A. Burston, V. Wylde, R. Gooberman-Hill
Published: 1 December 2021
Abstract:
Background: Patient and public involvement work (PPI) is essential to good research practice. Existing research indicates that PPI offers benefits to research design, conduct, communication, and implementation of findings. Understanding how PPI works and its value helps to provide information about best practice and highlight areas for further development. This study used a values-based approach to reporting PPI at a Research Unit focused on musculoskeletal conditions within a UK medical school. Methods: The study was conducted between October 2019 and January 2020 using Gradinger’s value system framework as a theoretical basis. The framework comprises three value systems each containing five clusters. All PPI members and researchers who had attended PPI groups were invited to participate. Participants completed a structured questionnaire based on the value system framework; PPI members also provided further information through telephone interviews. Data were deductively analysed using a framework approach with data mapped onto value systems. Results: Twelve PPI members and 17 researchers took part. Views about PPI activity mapped onto all three value systems. PPI members felt empowered to provide their views, and that their opinions were valued by researchers. It was important to PPI members that they were able to ‘give back’ and to do something positive with their experiences. Researchers would have liked the groups to be more representative of the wider population, patients highlighted that groups could include more younger members. Researchers recognised the value of PPI, and the study highlighted areas where researchers members might benefit from further awareness. Conclusions: Three areas for development were identified: (i) facilitating researcher engagement in training about the value and importance of PPI in research; (ii) support for researchers to reflect on the role that PPI plays in transparency of healthcare research; (iii) work to further explore and address aspects of diversity and inclusion in PPI.
Xin Jin, Zhen Wang, Zhiyuan Zhang, Hui Wu, Yuhua Ruan, , Ruihua Kang, ,
Published: 1 December 2021
Abstract:
Background: China’s National Free Antiretroviral Treatment Program (NFATP) has substantially reduced morbidity and HIV/AIDS incidence since 2003. However, HIV resistance to antiretroviral drugs (ARVs) has been a major challenge for the current treatment of HIV/AIDS in China. Methods: In the current study, we established a nested dynamic model to predict the multi-drug resistance dynamics of HIV among the heterosexual population and evaluated the impact of intervention measures on the transmission of drug resistance. We obtained an effective reproductive number Red from each sub-model held at different stages of the dynamic model. Meanwhile, we applied Bayesian phylogenetic methods to infer the weighted average effective reproductive number Reg from four HIV subtypes that sampled from 912 HIV-positive patients in China. It is an original and innovative method by fitting Red to Reg by Markov Chain Monte Carlo (MCMC) to generate unknown parameters in Red . Results: By analyzing the HIV gene sequences, we inferred that the most recent common ancestor of CRF01AE, CRF07BC, CRF08BC, and CRFBC dated from 1994, 1990, 1993 and 1990, respectively. The weighted average effective reproductive number Reg dropped from 1.95 in 1994 to 1.73 in 2018. Considering different interventions, we used a macro dynamic model to predict the trend of HIV resistance. The results show that the number of new infections and total drug resistance under the baseline parameter (S1) are 253,422 and 213,250 in 2025, respectively. Comparing with the numbers under the target treatment rate (S2), they were 219,717 and 236,890, respectively. However, under the ideal treatment target (S3, the treatment rate reaches 90% and the treatment success rate reaches 90%), the number of new infections shows a declining trend and will decrease to 46,559 by 2025. Compared with S1 and S2, the total number of resistance also decreased to 160,899 in 2025. Conclusion: With the promotion of NFATP in China, HIV resistance to ARVs is inevitable. The strategy of increasing the treatment rate would not only ineffectively curb the epidemic, but also deteriorate drug resistance issue. Whereas, a combination of intervention strategies (the treatment rate reaches 90% and the treatment success rate reaches 90%) can greatly reduce both infection and drug resistance rate than applying one strategy alone.
, Ana W. Capuano, Robert S. Wilson, David A. Bennett, Lisa L. Barnes
Published: 1 December 2021
Abstract:
Background: The purpose of this study was to identify correlates of perceived stress among older African Americans. Methods and findings: Guided by the National Institute on Aging’s (NIA) Health Disparities Research Framework, we grouped correlates into four levels–environmental, sociocultural, behavioral, and biological, and performed a cross-sectional analysis using ordinal logistic regression models. Participants included 722 African Americans [mean age = 73.61 years (SD = 6.33)] from the Minority Aging Research Study (MARS). Several protective correlates from environmental (e.g., larger life space), sociocultural (e.g., larger social network size), behavioral (e.g., more purpose in life), and biological (e.g., higher global cognition) levels were associated with a lower odds of having higher levels of perceived stress. Conclusions: Perceived stress was associated with established and novel correlates from every level. Future research is needed to examine how changes in these correlates may impact perceived stress in older African Americans.
Published: 1 December 2021
Abstract:
While ensuring employment opportunities is critical for global progress and stability, workers are now subject to several disruptive trends, including automation, rapid changes in technology and skill requirements, and transitions to low-carbon energy production. Yet, these trends seem almost insignificant compared to labor impact of the COVID-19 pandemic. While much has been written about the pandemic’s short-term impacts, this study analyzes anticipated long-term impacts on the labor force of 2029 by comparing original 2029 labor projections to special COVID-adjusted projections recently published by the US Bureau of Labor Statistics. Results show that future demand for nearly every type of labor skill and knowledge will increase, while the nature of work shifts from physical to more cognitive activities. Of the nearly three million jobs projected to disappear by 2029 due to COVID, over 91% are among workers without a bachelor’s degree. Among workers with a degree demand shifts primarily from business-related degrees to computer and STEM degrees. Results further show that the socialness of labor, which is important for both innovation and productivity, increases in many more industries than it decreases. Finally, COVID will likely accelerate the adoption of teleworking and slightly decrease the rate of workforce automation. These impacts, combined with a shift to more cognitive worker activities, will likely impact the nature of workforce health and safety with less focus on physical injuries and more on illnesses related to sedentary lifestyles. Overall, results suggest that future workers will need to engage more often in training and skill acquisition, requiring life-long learning and skill maintenance strategies.
Elif Karaaslan, Nesibe Selma Çetin, Merve Kalkan-Yazıcı, Sevde Hasanoğlu, Faruk Karakeçili, , Ahmet Kalkan, Ali Osman Kılıç,
PLOS Neglected Tropical Diseases, Volume 15; https://doi.org/10.1371/journal.pntd.0009973

Abstract:
In 2019, the World Health Organization declared 3 billion to be at risk of developing Crimean Congo Hemorrhagic Fever (CCHF). The causative agent of this deadly infection is CCHFV. The data related to the biology and immunology of CCHFV are rather scarce. Due to its indispensable roles in the viral life cycle, NP becomes a logical target for detailed viral immunology studies. In this study, humoral immunity to NP was investigated in CCHF survivors, as well as in immunized mice and rabbits. Abundant antibody response against NP was demonstrated both during natural infection in humans and following experimental immunizations in mice and rabbits. Also, cellular immune responses to recombinant NP (rNP) was detected in multispecies. This study represents the most comprehensive investigation on NP as an inducer of both humoral and cellular immunity in multiple hosts and proves that rNP is an excellent candidate warranting further immunological studies specifically on vaccine investigations.
, , Unai Ayala, Marian Acera, Mónica Fernández, Beatriz Tijero, Mar Carmona, Tamara Fernández, Iñigo Gabilondo, Juan Carlos Gómez-Esteban
Published: 1 December 2021
Abstract:
Objective: To prospectively evaluate nocturnal sleep problems and excessive daytime sleepiness (EDS) in Parkinson’s disease (PD) patients, and analyze the influence of motor symptoms, treatment, and sex differences on sleep problems in PD. Methods: Sleep disturbances of 103 PD patients were assessed with Parkinson’s Disease Sleep Scale (PDSS) and the Epworth Sleepiness Scale (ESS). Student’s t-test for related samples, one-way ANOVA with Tukey’s HSD post hoc test were used to assess group differences. Bivariate correlations and mixed-effects linear regression models were used to analyze the association between clinical aspects and sleep disturbances over time. Results: At baseline, 48.5% of PD patients presented nocturnal problems and 40% of patients presented EDS. The PDSS and ESS total score slightly improve over time. Nocturnal problems were associated with age and motor impartment, explaining the 51% of the variance of the PDSS model. Males presented less nocturnal disturbances and more EDS than females. Higher motor impairment and combined treatment (L-dopa and agonist) were related to more EDS, while disease duration and L-dopa in monotherapy were related to lower scores, explaining the 59% of the model. Conclusions: Sleep disturbances changed over time and age, diseases duration, motor impairment, treatment and sex were associated with nocturnal sleep problems and EDS. Agonist treatment alone or in combination with L-dopa might predict worse daytime sleepiness, while L-dopa in monotherapy is related to lower EDS, which significantly affects the quality of life of PD patients.
, , Darren M. Green, , Mike R. Hutchings, Glenn Marion
PLOS Computational Biology, Volume 17; https://doi.org/10.1371/journal.pcbi.1009652

Abstract:
Variants of the susceptible-infected-removed (SIR) model of Kermack & McKendrick (1927) enjoy wide application in epidemiology, offering simple yet powerful inferential and predictive tools in the study of diverse infectious diseases across human, animal and plant populations. Direct transmission models (DTM) are a subset of these that treat the processes of disease transmission as comprising a series of discrete instantaneous events. Infections transmitted indirectly by persistent environmental pathogens, however, are examples where a DTM description might fail and are perhaps better described by models that comprise explicit environmental transmission routes, so-called environmental transmission models (ETM). In this paper we discuss the stochastic susceptible-exposed-infected-removed (SEIR) DTM and susceptible-exposed-infected-removed-pathogen (SEIR-P) ETM and we show that the former is the timescale separation limit of the latter, with ETM host-disease dynamics increasingly resembling those of a DTM when the pathogen’s characteristic timescale is shortened, relative to that of the host population. Using graphical posterior predictive checks (GPPC), we investigate the validity of the SEIR model when fitted to simulated SEIR-P host infection and removal times. Such analyses demonstrate how, in many cases, the SEIR model is robust to departure from direct transmission. Finally, we present a case study of white spot disease (WSD) in penaeid shrimp with rates of environmental transmission and pathogen decay (SEIR-P model parameters) estimated using published results of experiments. Using SEIR and SEIR-P simulations of a hypothetical WSD outbreak management scenario, we demonstrate how relative shortening of the pathogen timescale comes about in practice. With atttempts to remove diseased shrimp from the population every 24h, we see SEIR and SEIR-P model outputs closely conincide. However, when removals are 6-hourly, the two models’ mean outputs diverge, with distinct predictions of outbreak size and duration.
Quansheng Wu, Xiaofeng Yin, Wenbo Zhao, Wenli Xu,
Published: 1 December 2021
Abstract:
Secreted frizzled-related protein 2 (SFRP2) is a glycoprotein with frizzled-like cysteine-rich domain that binds with Wnt ligands or frizzled receptors to regulate Wnt signaling. SFRP2 is frequently hypermethylated in glioma patients, and analysis of TCGA data indicates that SFRP2 is one of the most downregulated genes in radiotherapy treated glioma patients. In the present study, we aimed to explore the potential function of SFRP2 in tumorigenesis and radioresistance of glioma. The RNA sequencing data of TCGA glioma samples were downloaded and analyzed. SFRP2 expression in 166 glioma patients was evaluated by qRT-PCR. The potential functions of SFRP2 in glioma were evaluated by loss-of-function assays and gain-of-function assays in glioma cell lines. We found that SFRP2 was downregulated in radiotherapy-treated glioma patients, and low SFRP2 expression was correlated with advanced tumor stage and poor prognosis. CRISP/Cas9-meidated SFRP2 knockdown promoted soft agar colony formation, cancer stemness and radioresistance of glioma cells, while enforced SFRP2 expression exhibited opposite effects. Moreover, Wnt/β-catenin signaling was activated in radiotherapy treated glioma patients. SFRP2 knockdown activated Wnt/β-catenin signaling in glioma cell lines, while overexpression of SFRP2 inhibited Wnt/β-catenin activation. Besides, pharmacological inhibition of Wnt/β-catenin signaling by XAV-939 abrogated the effects of SFRP2 knockdown on cancer stemness and radioresistance of glioma cells. Our data for the first time demonstrated a role of SFRP2 in radioresistance of glioma cells, and suggested that inhibition of Wnt/β-catenin signaling might be a potential strategy for increasing radiosensitivity of glioma patients.
Daphné Coache, Mihaela Friciu, V. Gaëlle Roullin, Marianne Boulé, Jean-Marc Forest,
Published: 30 November 2021
Abstract:
The present study aimed to assess the stability of clonidine hydrochloride oral liquids (20-μg/mL) prepared from two different generic tablets in Ora-Blend and stored in amber plastic bottles. Physical and chemical stabilities were evaluated over a period of 90 days at 25°C. Analytical challenges were overcome with the development of a new extraction procedure based on solid phase extraction to ensure efficient clonidine hydrochloride quantification. The absence of physical instabilities, evaluated by qualitative and quantitative measurements (static multiple light scattering), as well as the absence of chemical instabilities, evidenced by a stability-indicating HPLC-UV method, confirmed that a beyond-use date of 90 days was appropriate for these compounded oral liquids.
Samanta Ferraresi Brighente, , Ana Luiza Rodrigues Louzada, Gabriela Marchisio Giordani, Helena Fussiger, Marco Antonnio Rocha dos Santos, Diana Maria Cubillos-Arcila, Pablo Brea Winckler,
Published: 30 November 2021
Abstract:
Introduction: The Hereditary Spastic Paraplegias (HSP) are a group of genetic diseases that lead to slow deterioration of locomotion. Clinical scales seem to have low sensitivity in detecting disease progression, making the search for additional biomarkers a paramount task. This study aims to evaluate the role of evoked potentials (EPs) as disease biomarkers of HSPs. Methods: A single center cross-sectional case-control study was performed, in which 18 individuals with genetic diagnosis of HSP and 21 healthy controls were evaluated. Motor evoked potentials (MEP) obtained with transcranial magnetic stimulation and somatosensory evoked potentials (SSEP) were performed in lower (LL) and upper limbs (UL). Results: Central motor conduction time in lower limbs (CMCT-LL) was prolonged in HSP subjects, with marked reductions in MEP-LL amplitudes when compared to the control group (p<0.001 for both comparisons). CMCT-UL was 3.59ms (95% CI: 0.73 to 6.46; p = 0.015) prolonged and MEP-UL amplitudes were reduced (p = 0.008) in the HSP group. SSEP-LL latencies were prolonged in HSP subjects when compared to controls (p<0.001), with no statistically significant differences for upper limbs (p = 0.147). SSEP-UL and SSEP-LL latencies presented moderate to strong correlations with age at onset (Rho = 0.613, p = 0.012) and disease duration (Rho = 0.835, p<0.001), respectively. Similar results were obtained for the SPG4 subgroups of patients. Conclusion: Motor and somatosensory evoked potentials can adequately differentiate HSP individuals from controls. MEP were severely affected in HSP subjects and SSEP-LL latencies were prolonged, with longer latencies being related to more severe disease. Future longitudinal studies should address if SSEP is a sensitive disease progression biomarker for HSP.
Sungmin Moon, Mallory A. Jackson, , Mary Pat Wenderoth
Published: 30 November 2021
Abstract:
Evidence-based teaching practices are associated with improved student academic performance. However, these practices encompass a wide range of activities and determining which type, intensity or duration of activity is effective at improving student exam performance has been elusive. To address this shortcoming, we used a previously validated classroom observation tool, Practical Observation Rubric to Assess Active Learning (PORTAAL) to measure the presence, intensity, and duration of evidence-based teaching practices in a retrospective study of upper and lower division biology courses. We determined the cognitive challenge of exams by categorizing all exam questions obtained from the courses using Bloom’s Taxonomy of Cognitive Domains. We used structural equation modeling to correlate the PORTAAL practices with exam performance while controlling for cognitive challenge of exams, students’ GPA at start of the term, and students’ demographic factors. Small group activities, randomly calling on students or groups to answer questions, explaining alternative answers, and total time students were thinking, working with others or answering questions had positive correlations with exam performance. On exams at higher Bloom’s levels, students explaining the reasoning underlying their answers, students working alone, and receiving positive feedback from the instructor also correlated with increased exam performance. Our study is the first to demonstrate a correlation between the intensity or duration of evidence-based PORTAAL practices and student exam performance while controlling for Bloom’s level of exams, as well as looking more specifically at which practices correlate with performance on exams at low and high Bloom’s levels. This level of detail will provide valuable insights for faculty as they prioritize changes to their teaching. As we found that multiple PORTAAL practices had a positive association with exam performance, it may be encouraging for instructors to realize that there are many ways to benefit students’ learning by incorporating these evidence-based teaching practices.
Jefferson F. Cordeiro, Mariana C. Sanches, Elidiane Rusch, Nathalia V. Xavier, Ana Angélica Cassoli, Åsa Fahlman,
Published: 30 November 2021
Abstract:
Capybara (Hydrochoerus hydrochaeris) is the main host of tick-borne pathogens causing Brazilian spotted fever; therefore, controlling its population is essential, and this may require chemical restraint. We assessed the impact of chemical restraint protocols on the partial pressure of arterial oxygen (PaO2) and other blood variables in 36 capybaras and the effect of different flows of nasal oxygen (O2) supplementation. The capybaras were hand-injected with dexmedetomidine (5 μg/kg) and midazolam (0.1 mg/kg) and butorphanol (0.2 mg/kg) (DMB, n = 18) or methadone (0.1 mg/kg) (DMM, n = 18). One-third of the animals were maintained in ambient air throughout the procedure, and one-third were administered intranasal 2 L/min O2 after 30 min whereas the other third were administered 5 L/min O2. Arterial blood gases, acid-base status, and electrolytes were assessed 30 and 60 min after drug injection. The DMB and DMM groups did not vary based on any of the evaluated variables. All animals developed hypoxaemia (PaO2 44 [30; 73] mmHg, SaO2 81 [62; 93] %) 30 min before O2 supplementation. Intranasal O2 at 2 L/min improved PaO2 (63 [49; 97] mmHg and SaO2 [92 [85; 98] %), but 9 of 12 capybaras remained hypoxaemic. A higher O2 flow of 5 L/min was efficient in treating hypoxaemia (PaO2 188 [146; 414] mmHg, SaO2 100 [99; 100] %) in all the 12 animals that received it. Both drug protocols induced hypoxaemia, which could be treated with intranasal oxygen supplementation.
, Xiaofang Zhang, Fang Peng, Jing Zhao, Haijun Deng
Published: 30 November 2021
Abstract:
This study investigates international students’ acculturation attitude preference and the influence factors (i.e., gender, duration in China, host and English proficiency, adult attachment style and social ties) on each acculturation attitude (i.e, integration, assimilation, separation and marginalization attitude) in China. A group of 229 international students within China responded online. Results from cluster analysis based on process model of acculturation revealed that, integration was the most prevalent acculturation attitude of international students in China. Additionally, logistic regressions analysis indicated that duration in China was negatively associated with adoption of separation and marginalization attitude also higher level of English proficiency predicted the preference of marginalization attitude. However, Chinese proficiency was positively associated with integration attitude adoption, host ties were positively and significantly associated with adoption of assimilation and integration attitude, but negatively associated with the usage of marginalization attitude. Lastly, avoidance attachment was found negatively associating with the integration attitude. This study provides valuable insights for international student education policymakers to assist international students in order to adapt to a new environment quickly and effectively.
, Kensuke Matsushita, , Adrien Carmona, Sébastien Hess, Marion Kibler, Joé Heger, Antje Reydel, , Lelia Grunebaum, et al.
Published: 30 November 2021
Abstract:
Background: Bleeding following transcatheter aortic valve replacement (TAVR) has important prognostic implications. This study sought to evaluate the impact of baseline mean platelet volume (MPV) on bleeding events after TAVR. Methods and results: Patients undergoing TAVR between February 2010 and May 2019 were included. Low MPV (L-MPV) was defined as MPV ≤10 fL and high MPV (H-MPV) as MPV >10 fL. The primary endpoint was the occurrence of major/life-threatening bleeding complications (MLBCs) at one-year follow-up. Among 1,111 patients, 398 (35.8%) had L-MPV and 713 (64.2%) had H-MPV. The rate of MLBCs at 1 year was higher in L-MPV patients compared with H-MPV patients (22.9% vs. 17.7% respectively, p = 0.034). L-MPV was associated with vascular access-site complications (36.2% vs. 28.9%, p = 0.012), early (<30 days) major bleeding (15.6% vs. 9.4%, p2 units (23.9% vs. 17.5%, p = 0.01). No impact of baseline MPV on overall death, cardiovascular death and ischemic events (myocardial infarction and stroke) was evidenced. Multivariate analysis using Fine and Gray model identified preprocedural hemoglobin (sHR 0.84, 95%CI [0.75–0.93], p = 0.001), preprocedural L-MPV (sHR 1.64, 95%CI [1.16–2.32], p = 0.005) and closure time adenosine diphosphate post-TAVR (sHR 2.71, 95%CI [1.87–3.95], p<0.001) as predictors of MLBCs. Conclusions: Preprocedural MPV was identified as an independent predictor of MLBCs one year after TAVR, regardless of the extent of platelet inhibition and primary hemostasis disorders.
, Tais De Campos Moreira, Daniel Sganzerla, Ana Maria Frölich Matzenbacher, Amanda Gomes Faria, Lucas Matturro, Felipe Cezar Cabral, Dimitris Rucks Varvaki Rados, Anelise Decavata Szortyka, Maicon Falavigna, et al.
Published: 30 November 2021
Abstract:
Telemedicine can be used to conduct ophthalmological assessment of patients, facilitating patient access to specialist care. Since the teleophthalmology models require data collection support from other health professionals, the purpose of our study was to assess agreement between the nursing technician and the ophthalmologist in acquisition of health parameters that can be used for remote analysis as part of a telemedicine strategy. A cross-sectional study was conducted with 140 patients referred to an ophthalmological telediagnosis center by primary healthcare doctors. The health parameters evaluated were visual acuity (VA), objective ophthalmic measures acquired by autorefraction, keratometry, and intraocular pressure (IOP). Bland-Altman plots were used to analyze agreement between the nursing technician and the ophthalmologist. The Bland-Altman analysis showed a mean bias equal to zero for the VA measurements [95%-LoA: -0.25–0.25], 0.01 [95%-LoA: -0.86–0.88] for spherical equivalent (M), -0.08 [95%-LoA: -1.1–0.95] for keratometry (K) and -0.23 [95%-LoA: -4.4–4.00] for IOP. The measures had a high linear correlation (R [95%CI]: 0.87 [0.82–0.91]; 0.97 [0.96–0.98]; 0.96 [0.95–0.97] and 0.88 [0.84–0.91] respectively). The results observed demonstrate that remote ophthalmological data collection by adequately trained health professionals is viable. This confirms the utility and safety of these solutions for scenarios in which access to ophthalmologists is limited.
Nithiwat Suntichaikamolkul, Lalida Sangpong, Hubert Schaller,
Published: 30 November 2021
Abstract:
Durian (Durio zibethinus L.) is a major economic crop native to Southeast Asian countries, including Thailand. Accordingly, understanding durian fruit ripening is an important factor in its market worldwide, owing to the fact that it is a climacteric fruit with a strikingly limited shelf life. However, knowledge regarding the molecular regulation of durian fruit ripening is still limited. Herein, we focused on cytochrome P450, a large enzyme family that regulates many biosynthetic pathways of plant metabolites and phytohormones. Deep mining of the durian genome and transcriptome libraries led to the identification of all P450s that are potentially involved in durian fruit ripening. Gene expression validation by RT-qPCR showed a high correlation with the transcriptome libraries at five fruit ripening stages. In addition to aril-specific and ripening-associated expression patterns, putative P450s that are potentially involved in phytohormone metabolism were selected for further study. Accordingly, the expression of CYP72, CYP83, CYP88, CYP94, CYP707, and CYP714 was significantly modulated by external treatment with ripening regulators, suggesting possible crosstalk between phytohormones during the regulation of fruit ripening. Interestingly, the expression levels of CYP88, CYP94, and CYP707, which are possibly involved in gibberellin, jasmonic acid, and abscisic acid biosynthesis, respectively, were significantly different between fast- and slow-post-harvest ripening cultivars, strongly implying important roles of these hormones in fruit ripening. Taken together, these phytohormone-associated P450s are potentially considered additional molecular regulators controlling ripening processes, besides ethylene and auxin, and are economically important biological traits.
Arzoo Ahad, Roohi Aslam, , Rabia Amir, Faiza Munir, Tuba Sharf Batool, Mahnoor Ilyas, Muhammad Sarwar, Muhammad Azhar Nadeem, , et al.
Published: 30 November 2021
Abstract:
Transcription factors are regulatory proteins known to modulate gene expression. These are the critical component of signaling pathways and help in mitigating various developmental and stress responses. Among them, bZIP, BBR, and BZR transcription factor families are well known to play a crucial role in regulating growth, development, and defense responses. However, limited data is available on these transcription factors in Triticum aestivum. In this study, bZIP, BBR, and BZR sequences from Brachypodium distachyon, Oryza sativa, Oryza barthii, Oryza brachyantha, T. aestivum, Triticum urartu, Sorghum bicolor, Zea mays were retrieved, and dendrograms were constructed to analyze the evolutionary relatedness among them. The sequences clustered into one group indicated a degree of evolutionary correlation highlighting the common lineage of cereal grains. This analysis also exhibited that these genes were highly conserved among studied monocots emphasizing their common ancestry. Furthermore, these transcription factor genes were evaluated for envisaging conserved motifs, gene structure, and subcellular localization in T. aestivum. This comprehensive computational analysis has provided an insight into transcription factor evolution that can also be useful in developing approaches for future functional characterization of these genes in T. aestivum. Furthermore, the data generated can be beneficial in future for genetic manipulation of economically important plants.
Maria Memtsa, Venetia Goodhart, Gareth Ambler, Peter Brocklehurst, Edna Keeney, Sergio A. Silverio, Zacharias Anastasiou, Jeff Round, Nazim Khan, Jennifer Hall, et al.
Published: 30 November 2021
Abstract:
Objective: To determine whether the participation of consultant gynaecologists in delivering early pregnancy care results in a lower rate of acute hospital admissions. Design: Prospective cohort study and emergency hospital care audit; data were collected as part of the national prospective mixed-methods VESPA study on the “Variations in the organization of EPAUs in the UK and their effects on clinical, Service and PAtient-centred outcomes”. Setting: 44 Early Pregnancy Assessment Units (EPAUs) across the UK randomly selected in balanced numbers from eight pre-defined mutually exclusive strata. Participants: 6606 pregnant women (≥16 years old) with suspected first trimester pregnancy complications attending the participating EPAUs or Emergency Departments (ED) from December 2016 to July 2017. Exposures: Planned and actual senior clinician presence, unit size, and weekend opening. Main outcome measures: Unplanned admissions to hospital following any visit for investigations or treatment for first trimester complications as a proportion of women attending EPAUs. Results: 205/6397 (3.2%; 95% CI 2.8–3.7) women were admitted following their EPAU attendance. The admission rate among 44 units ranged from 0% to 13.7% (median 2.8). Neither planned senior clinician presence (p = 0.874) nor unit volume (p = 0.247) were associated with lower admission rates from EPAU, whilst EPAU opening over the weekend resulted in lower admission rates (p = 0.027). 1445/5464 (26.4%; 95%CI 25.3 to 27.6) women were admitted from ED. There was little evidence of an association with planned senior clinician time (p = 0.280) or unit volume (p = 0.647). Keeping an EPAU open over the weekend for an additional hour was associated with 2.4% (95% CI 0.1% to 4.7%) lower odds of an emergency admission from ED. Conclusions: Involvement of senior clinicians in delivering early pregnancy care has no significant impact on emergency hospital admissions for early pregnancy complications. Weekend opening, however, may be an effective way of reducing emergency admissions from ED.
Published: 30 November 2021
Abstract:
Objective: Availability of safe and effective vaccines against COVID-19 is critical for controlling the pandemic, but herd immunity can only be achieved with high vaccination coverage. The present research examined psychological factors associated with intentions to receive COVID-19 vaccination and whether reluctance towards novel pandemic vaccines are similar to vaccine hesitancy captured by a hypothetical measure used in previous research. Method: Study 1 was administered to undergraduate students when COVID-19 was spreading exponentially (February-April 2020). Study 2 was conducted with online panel workers toward the end of the first U.S. wave (July 2020) as a pre-registered replication and extension of Study 1. In both studies, participants (total N = 1,022) rated their willingness to receive the COVID-19 vaccination and to vaccinate a hypothetical child for a fictitious disease, and then responded to various psychological measures. Results: In both studies, vaccination intentions were positively associated with past flu vaccine uptake, self-reported vaccine knowledge, vaccine confidence, and sense of collective responsibility. Complacency (not perceiving disease as high-risk), anti-vaccine conspiracy beliefs, perceived vaccine danger, and mistrust in science/scientists were negative correlates of vaccination intentions. Constraints (psychological barriers), calculation (extensive information-searching), analytical thinking, perceived disease vulnerability, self-other overlap, and conservatism were weakly associated with vaccination intentions but not consistently across both studies or vaccine types. Additionally, similar factors were associated with both real and hypothetical vaccination intentions, suggesting that conclusions from pre-COVID vaccine hesitancy research mostly generalize to the current pandemic situation. Conclusion: Encouraging flu vaccine uptake, enhancing confidence in a novel vaccine, and fostering a sense of collective responsibility are particularly important as they uniquely predict COVID-19 vaccination intentions. By including both actual pandemic-related hesitancy measures and hypothetical hesitancy measures from past research in the same study, this work provides key context for the generalizability of earlier non-pandemic research.
Sorawit Boonyathee, Katekaew Seangpraw, , Nisarat Auttama, Prakasit Tonchoy, Supakan Kantow, Sasivimol Bootsikeaw, Monchanok Choowanthanapakorn, Pitakpong Panta, Dech Dokpuang
Published: 30 November 2021
Abstract:
Hypertension is becoming increasingly prevalent among the elderly. Family caregivers play an important role in caring for elderly people and empowering them to care for themselves. This study’s goal was to see how social support training for family caregivers affected changes in hypertension, total cholesterol, and high-density lipoprotein (HDL), and how such support led to the prevention of hypertension behaviors among the elderly in rural areas. This was a quasi-experimental study with 268 elderly people at risk of hypertension and their caregivers. Sixty seven pairs of elderly people and their caregivers were assigned to the intervention and control groups. Baseline data were collected in November 2020. The intervention group received the Social Support Family Caregiver Training Program (SSFCTP), while the control group received a regular program from the local health authority. The activity lasted 12 weeks, with home visits and telephone check-ups along the way, and data collection took place after the program ended. The final data were collected three months after the end of the intervention. An analysis of repeated measures ANOVA showed the overall effect of the SSFCTP on knowledge, self-efficacy, health care behaviors, and blood pressure among elderly people during three different time periods (p<0.05). Furthermore, the intervention program had a time-dependent effect on knowledge, blood pressure, and total cholesterol levels (p<0.05). In terms of caregiver outcomes, there was an overall difference among the degrees of knowledge, self-efficacy, and behaviors toward health care displayed by elderly hypertensive patients during the three different time periods (p<0.05). The average knowledge and self-efficacy of the participants improved after the intervention. As a result, better self-care behaviors and lower blood pressure and total cholesterol levels were observed among the elderly participants after the intervention. The programs emphasized the importance of caregivers’ roles in providing social support, boosting confidence, and encouraging participation in caring, monitoring, and assisting the elderly in controlling blood pressure and other health issues.
, Aran Mooney, Russel Andrews, Stacy Deruiter, Wu-Jung Lee, Megan Ferguson, Paul Wade
Published: 30 November 2021
Abstract:
Cook Inlet, Alaska, is home to an endangered and declining population of 279 belugas (Delphinapterus leucas). Recovery efforts highlight a paucity of basic ecological knowledge, impeding the correct assessment of threats and the development of recovery actions. In particular, information on diet and foraging habitat is very limited for this population. Passive acoustic monitoring has proven to be an efficient approach to monitor beluga distribution and seasonal occurrence. Identifying acoustic foraging behavior could help address the current gap in information on diet and foraging habitat. To address this conservation challenge, eight belugas from a comparative, healthy population in Bristol Bay, Alaska, were instrumented with a multi-sensor tag (DTAG), a satellite tag, and a stomach temperature transmitter in August 2014 and May 2016. DTAG deployments provided 129.6 hours of data including foraging and social behavioral states. A total of 68 echolocation click trains ending in terminal buzzes were identified during successful prey chasing and capture, as well as during social interactions. Of these, 37 click trains were successfully processed to measure inter-click intervals (ICI) and ICI trend in their buzzing section. Terminal buzzes with short ICI (minimum ICI <8.98 ms) and consistently decreasing ICI trend (ICI increment range <1.49 ms) were exclusively associated with feeding behavior. This dual metric was applied to acoustic data from one acoustic mooring within the Cook Inlet beluga critical habitat as an example of the application of detecting feeding in long-term passive acoustic monitoring data. This approach allowed description of the relationship between beluga presence, feeding occurrence, and the timing of spawning runs by different species of anadromous fish. Results reflected a clear preference for the Susitna River delta during eulachon (Thaleichthys pacificus), Chinook (Oncorhynchus tshawytscha), pink (Oncorhynchus gorbuscha), and coho (Oncorhynchus kisutch) salmon spawning run periods, with increased feeding occurrence at the peak of the Chinook and pink salmon runs.
Alla Revittser, Ivan Selin, Yuri Negulyaev, Vladislav Chubinskiy-Nadezhdin
Published: 30 November 2021
Abstract:
The actin cytoskeleton is indispensable for the motility and migration of all types of cells; therefore, it plays a crucial role in the ability of the tissues to repair. Mesenchymal stem cells are intensively used in regenerative medicine, but usually relatively low percent of transplanted cells reaches the injury. To overcome this evident limitation, researchers try to enhance the motility and migration rate of the cells. As one of the approaches, co-cultivation and preconditioning of stem cells with biologically active compounds, which can cause actin cytoskeleton rearrangements followed by an increase of migratory properties of the cells, could be applied. The observed changes in F-actin structure induced by the compounds require quantitative estimation, and measurement of fluorescence intensity of the F-actin image captured by various microscopic techniques is commonly used nowadays. However, this approach could not always accurately detect the observed changes in the shape and structure of actin cytoskeleton. At this time, the image of F-actin has an irregular geometric pattern, and thus could be considered and characterized as a fractal object. To quantify the re-organization of cellular F-actin in terms of fractal geometry Minkovsky’s box-counting method is suitable, but it is not widely used nowadays. We modified and improved the previously described method for fractal dimension measurement, and successfully applied it for the quantification of the F-actin structures of human mesenchymal stem cells.
Declan Williams, Mohadeseh Mehrabian, Hamza Arshad, Shehab Eid, Christopher Sackmann, Wenda Zhao, Xinzhu Wang, Farinaz Ghodrati, Claire E. Verkuyl, Joel C. Watts, et al.
Published: 30 November 2021
Abstract:
The prion protein (PrP) is best known for its ability to cause fatal neurodegenerative diseases in humans and animals. Here, we revisited its molecular environment in the brain using a well-developed affinity-capture mass spectrometry workflow that offers robust relative quantitation. The analysis confirmed many previously reported interactions. It also pointed toward a profound enrichment of Na,K-ATPases (NKAs) in proximity to cellular PrP (PrPC). Follow-on work validated the interaction, demonstrated partial co-localization of the ATP1A1 and PrPC, and revealed that cells exposed to cardiac glycoside (CG) inhibitors of NKAs exhibit correlated changes to the steady-state levels of both proteins. Moreover, the presence of PrPC was observed to promote the ion uptake activity of NKAs in a human co-culture paradigm of differentiated neurons and glia cells, and in mouse neuroblastoma cells. Consistent with this finding, changes in the expression of 5’-nucleotidase that manifest in wild-type cells in response to CG exposure can also be observed in untreated PrPC-deficient cells. Finally, the endoproteolytic cleavage of the glial fibrillary acidic protein, a hallmark of late-stage prion disease, can also be induced by CGs, raising the prospect that a loss of NKA activity may contribute to the pathobiology of prion diseases.
, , Kathy Briffa
Published: 30 November 2021
Abstract:
Introduction: Research with a focus on sleep posture has been conducted in association with sleep pathologies such as insomnia and positional obstructive sleep apnoea. Research examining the potential role sleep posture may have on waking spinal symptoms and quality of sleep is however limited. The aims of this research were to compare sleep posture and sleep quality in participants with and without waking spinal symptoms. Methods: Fifty-three participants (36 female) were, based on symptoms, allocated to one of three groups; Control (n = 20, 16 female), Cervical (n = 13, 10 female) and Lumbar (n = 20, 10 female). Participants completed an online survey to collect general information and patient reported outcomes and were videoed over two consecutive nights to determine sleep posture using a validated classification system including intermediate sleep postures. Results: Participants in the symptomatic groups also reported a lower sleep quality than the Control group. Compared to Control group participants, those in the Cervical group had more frequent posture changes (mean (SD); 18.3(6.5) versus 23.6(6.6)), spent more time in undesirable/provocative sleep postures (median IQR; 83.8(16.4,105.2) versus 185.1(118.0,251.8)) minutes and had more long periods of immobility in a provocative posture, (median IQR: 0.5(0.0,1.5) versus 2.0 (1.5,4.0)). There were no significant differences between the Control and Lumbar groups in the number of posture changes (18.3(6.5) versus 22.9(9.1)) or the time spent in provocative sleep postures (0.5(0.0,1.5) versus 1.5(1.5,3.4)) minutes. Discussion: This is the first study using a validated objective measure of sleep posture to compare symptomatic and Control group participants sleeping in their home environment. In general, participants with waking spinal symptoms spent more time in provocative sleep postures, and experienced poorer sleep quality.
Jorge A. Barraza, Xinbo Hu, Elizabeth T. Terris, Chuan Wang,
Published: 30 November 2021
Abstract:
Humans express loyalty to consumer brands much like they do in human relationships. The neuroactive chemical oxytocin is an important biological substrate of human attachment and this study tested whether consumer-brand relationships can be influenced by oxytocin administration. We present a mathematical model of brand attachment that generates empirically-testable hypotheses. The model is tested by administering synthetic oxytocin or placebo to male and female participants (N = 77) who received information about brands and had an opportunity to purchase branded products. We focused on two brand personality dimensions: warmth and competence. Oxytocin increased perceptions of brand competence but not brand warmth relative to placebo. We also found that participants were willing to pay more for branded products through its effect on brand competence. When writing about one’s favorite brands, oxytocin enhanced the use of positive emotional language as well as words related to family and friends. These findings provide preliminary evidence that consumers build relationships with brands using the biological mechanisms that evolved to form human attachments.
Yi-Hsuan Lin, Jeng-Min Chiou, Ta-Fu Chen, Liang-Chuan Lai, Jen-Hau Chen,
Published: 30 November 2021
Abstract:
Objectives: To examine the association between metabolic syndrome (MetS) and successful aging among community-dwelling older adults. Methods: Adults aged ≥ 65 years who participated in the senior health checkup program at National Taiwan University Hospital during 2011–2013 were recruited (N = 467 at baseline). The participants were followed after 4 years and 6 years. MetS was assessed at baseline. Successful aging was evaluated at baseline, 4-year follow-up, and 6-year follow-up. We adopted an extended definition of successful aging, which was defined as three major domains: physiological, psychological, and sociological and economic domains. Generalized linear mixed models were used to assess the association between MetS and successful aging adjusting for time (follow-up years), age, sex, years of education, alcohol consumption and MetS×time interaction term. Results: The mean age of the study population was 72.9 (SD 5.5) years. The absence of baseline MetS had a positive effect on the probability of successful aging over six years. The absences of abdominal obesity, hyperglycemia, reduced high-density lipoprotein cholesterol, and hypertension were associated with the physiological successful aging. The absence of hypertension was the most significant predictor of physiological successful aging [aOR (95% CI) = 2.76 (1.67–4.58), p<0.001]. Significant increased trend was found in the overall and physiological successful aging across MetS status (No MetS, pre MetS, MetS; Ptrend<0.001). Conclusions: We found that MetS is a risk factor of successful aging among community-dwelling older adults. Public health policy should aim at avoidance of MetS in order to facilitate successful aging in older population.
, Matej Kucera, Pavla Cermakova
Published: 30 November 2021
Abstract:
Background: A wide range of potentially modifiable risk factors, indicating that the onset of neurocognitive disorders can be delayed or prevented, have been identified. The region of Central and Eastern Europe has cultural, political and economic specifics that may influence the occurrence of risk factors and their link to the cognitive health of the population. Objective: We aimed to systematically review population-based studies from Central and Eastern Europe to gather evidence on risk and protective factors for neurocognitive disorders. Methods: We searched the electronic databases PubMed, Cochrane Database of Systematic Reviews, PsycINFO, Web of Science, and Embase. The search was performed on 26th of February 2020 and repeated at the end of the review process on 20th May 2021. Results: We included 25 papers in a narrative synthesis of the evidence describing cardiovascular risk factors (n = 7), social factors (n = 5), oxidative stress (n = 2), vitamins (n = 2), genetic factors (n = 2) and other areas (n = 7). We found that there was a good body of evidence on the association between neurocognitive disorders and the history of cardiovascular disease while there were gaps in research of genetic and social risk factors. Conclusion: We conclude that the epidemiological evidence from this region is insufficient and population-based prospectively followed cohorts should be established to allow the development of preventive strategies at national levels.
Shiran Lacham-Hartman, Yulia Shmidov, Evette S. Radisky, Ronit Bitton, ,
Published: 30 November 2021
Abstract:
Although myriad protein–protein interactions in nature use polyvalent binding, in which multiple ligands on one entity bind to multiple receptors on another, to date an affinity advantage of polyvalent binding has been demonstrated experimentally only in cases where the target receptor molecules are clustered prior to complex formation. Here, we demonstrate cooperativity in binding affinity (i.e., avidity) for a protein complex in which an engineered dimer of the amyloid precursor protein inhibitor (APPI), possessing two fully functional inhibitory loops, interacts with mesotrypsin, a soluble monomeric protein that does not self-associate or cluster spontaneously. We found that each inhibitory loop of the purified APPI homodimer was over three-fold more potent than the corresponding loop in the monovalent APPI inhibitor. This observation is consistent with a suggested mechanism whereby the two APPI loops in the homodimer simultaneously and reversibly bind two corresponding mesotrypsin monomers to mediate mesotrypsin dimerization. We propose a simple model for such dimerization that quantitatively explains the observed cooperativity in binding affinity. Binding cooperativity in this system reveals that the valency of ligands may affect avidity in protein–protein interactions including those of targets that are not surface-anchored and do not self-associate spontaneously. In this scenario, avidity may be explained by the enhanced concentration of ligand binding sites in proximity to the monomeric target, which may favor rebinding of the multiple ligand binding sites with the receptor molecules upon dissociation of the protein complex.
, Ryo Furue
Published: 30 November 2021
Abstract:
The size distribution of marine microplastics provides a fundamental data source for understanding the dispersal, break down, and biotic impacts of the microplastics in the ocean. The observed size distribution at the sea surface generally shows, from large to small sizes, a gradual increase followed by a rapid decrease. This decrease has led to the hypothesis that the smallest fragments are selectively removed by sinking or biological uptake. Here we propose a new model of size distribution, focusing on the fragmentation of marine plastics. The model is inspired by ideas from statistical mechanics. In this model, the original large plastic piece is broken into smaller pieces once by the application of “energy” or work by waves or other processes, under two assumptions, one that fragmentation into smaller pieces requires larger energy and the other that the occurrence probability of the “energy” exponentially decreases toward larger energy values. Our formula well reproduces observed size distributions over wide size ranges from micro- to mesoplastics. According to this model, the smallest fragments are fewer because large “energy” required to produce such small fragments occurs more rarely.
, Sanne Rasing, Rian Van Den Boogaart, Wendy Rongen, Twan van der Steen, Daan Creemers, Rutger Engels, Filip Smit
Published: 30 November 2021
Abstract:
Background: Stigma and limited mental health literacy impede adolescents getting the help they need for depressive symptoms. A serious game coupled with a classroom session led by lived experience workers (LEWs) might help to overcome these barriers. The school-based Strong Teens and Resilient Minds (STORM) preventive program employed this strategy and offered a serious game, Moving Stories. The current study was carried out to assess inhibiting and promoting factors for scaling up Moving Stories once its effectiveness has been ascertained. Methods: Moving Stories was offered in three steps: (1) introductory classroom session, (2) students playing the game for five days, (3) debriefing classroom session led by lived experience worker. Data was collected on the number of participating students, costs of offering Moving Stories, and was further based on the notes of the debriefing sessions to check if mental health first aid (MHFA) strategies were addressed. Results: Moving Stories was offered in seven high-schools. Coverage was moderate with 982 participating students out of 1880 (52%). Most participating students (83%) played the Moving Stories app three out of the five days. Qualitative data showed that the MHFAs were discussed in all debriefing sessions. Students showed great interest in lived experience workers’ stories and shared their own experiences with depression. Conclusions: Bringing Moving Stories to scale in the high-school setting appears feasible, but will remain logistically somewhat challenging. Future implementation and scale-up of Moving Stories could benefit from improved selection and training of LEWs that played such an important role in grabbing the full attention of students and were able to launch frank discussions about depressive disorder and stigma in classrooms. Trial registration: The study is registered in the Dutch Trial Register: Trial NL6444 (NTR6622: https://www.trialregister.nl/trial/6444).
Jonathan N. Thomas, Joanna Roopkumar,
Published: 30 November 2021
Abstract:
Disease-related effects on hepatic metabolism can alter the composition of chemicals in the circulation and subsequently in breath. The presence of disease related alterations in exhaled volatile organic compounds could therefore provide a basis for non-invasive biomarkers of hepatic disease. This study examined the feasibility of using global volatolomic profiles from breath analysis in combination with supervised machine learning to develop signature pattern-based biomarkers for cirrhosis. Breath samples were analyzed using thermal desorption-gas chromatography-field asymmetric ion mobility spectroscopy to generate breathomic profiles. A standardized collection protocol and analysis pipeline was used to collect samples from 35 persons with cirrhosis, 4 with non-cirrhotic portal hypertension, and 11 healthy participants. Molecular features of interest were identified to determine their ability to classify cirrhosis or portal hypertension. A molecular feature score was derived that increased with the stage of cirrhosis and had an AUC of 0.78 for detection. Chromatographic breath profiles were utilized to generate machine learning-based classifiers. Algorithmic models could discriminate presence or stage of cirrhosis with a sensitivity of 88–92% and specificity of 75%. These results demonstrate the feasibility of volatolomic profiling to classify clinical phenotypes using global breath output. These studies will pave the way for the development of non-invasive biomarkers of liver disease based on volatolomic signatures found in breath.
Fernando De La Garza Salazar, , José Ramón Azpiri López,
Published: 30 November 2021
Abstract:
Background: Left ventricular hypertrophy detected by echocardiography (Echo-LVH) is an independent predictor of mortality. Integration of the Philips DXL-16 algorithm into the electrocardiogram (ECG) extensively analyses the electricity of the heart. Machine learning techniques such as the C5.0 could lead to a new decision tree criterion to detect Echo-LVH. Objectives: To search for a new combination of ECG parameters predictive of Echo-LVH. The final model is called the Cardiac Hypertrophy Computer-based model (CHCM). Methods: We extracted the 458 ECG parameters provided by the Philips DXL-16 algorithm in patients with Echo-LVH and controls. We used the C5.0 ML algorithm to train, test, and validate the CHCM. We compared its diagnostic performance to validate state-of-the-art criteria in our patient cohort. Results: We included 439 patients and considered an alpha value of 0.05 and a power of 99%. The CHCM includes T voltage in I (≤0.055 mV), peak-to-peak QRS distance in aVL (>1.235 mV), and peak-to-peak QRS distance in aVF (>0.178 mV). The CHCM had an accuracy of 70.5% (CI95%, 65.2–75.5), a sensitivity of 74.3%, and a specificity of 68.7%. In the external validation cohort (n = 156), the CHCM had an accuracy of 63.5% (CI95%, 55.4–71), a sensitivity of 42%, and a specificity of 82.9%. The accuracies of the most relevant state-of-the-art criteria were: Romhilt-Estes (57.4%, CI95% 49–65.5), VDP Cornell (55.7%, CI95%47.6–63.7), Cornell (59%, CI95%50.8–66.8), Dalfó (62.9%, CI95%54.7–70.6), Sokolow Lyon (53.9%, CI95%45.7–61.9), and Philips DXL-16 algorithm (54.5%, CI95%46.3–62.5). Conclusion: ECG computer-based data and the C5.0 determined a new set of ECG parameters to predict Echo-LVH. The CHCM classifies patients as Echo-LVH with repolarization abnormalities or LVH with increased voltage. The CHCM has a similar accuracy, and is slightly more sensitive than the state-of-the-art criteria.
, Jesse M. Rubenstein, John G. Hampton, M. Philip Rolston
Published: 30 November 2021
Abstract:
When successful, the operation of local and international networks of crop seed distribution or “seed systems” ensures farmer access to seed and impacts rural livelihoods and food security. Farmers are both consumers and producers in seed systems and benefit from access to global markets. However, phytosanitary measures and seed purity tests are also needed to maintain seed quality and prevent the spread of costly weeds, pests and diseases, in some countries regulatory controls have been in place since the 1800s. Nevertheless, seed contaminants are internationally implicated in between 7% and 37% of the invasive plant species and many of the agricultural pests and diseases. We assess biosecurity risk across international seed trade networks of forage crops using models of contaminant spread that integrate network connectivity and trade volume. To stochastically model hypothetical contaminants through global seed trade networks, realistic dispersal probabilities were estimated from quarantine weed seed detections and incursions from border security interception data in New Zealand. For our test case we use contaminants linked to the global trade of ryegrass and clover seed. Between 2014 and 2018 only four quarantine weed species (222 species and several genera are on the quarantine schedule) warranting risk mitigation were detected at the border. Quarantine weeds were rare considering that average import volumes were over 190 tonnes for ryegrass and clover, but 105 unregulated contaminant species were allowed in. Ryegrass and clover seed imports each led to one post-border weed incursion response over 20 years. Trade reports revealed complex global seed trade networks spanning >134 (ryegrass) and >110 (clover) countries. Simulations showed contaminants could disperse to as many as 50 (clover) or 80 (ryegrass) countries within 10 time-steps. Risk assessed via network models differed 18% (ryegrass) or 48% (clover) of the time compared to risk assessed on trade volumes. We conclude that biosecurity risk is driven by network position, the number of trading connections and trade volume. Risk mitigation measures could involve the use of more comprehensive lists of regulated species, comprehensive inspection protocols, or the addition of field surveillance at farms where seed is planted.
, John M. Vierling, Wayne Gosbee, Gabriella A. Wan, May-Linh Hyunh, Henry E. Chang
Published: 30 November 2021
Abstract:
The screening for undiagnosed non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (SUNN) study was a population-based screening study that aimed to provide proof of concept to encourage community-level screening and detection for this non-communicable disease. Current screening guidelines do not recommend the routine screening of nonalcoholic fatty liver disease (NAFLD) for asymptomatic populations, so providers are not encouraged to actively seek disease, even in high-risk patients. This study sought to determine whether a self-selecting cohort of asymptomatic individuals would have scores based on vibration controlled transient elastography (VCTE) and controlled attenuation parameter (CAP) significantly correlated to risk factors to suggest that routine screening for high-risk patients should be recommended. The study recruited 1,070 self-selected participants in Houston and Galveston County, Texas, 940 of which were included in final analysis. A pre-screening survey was used to determine eligibility. VCTE-based scores analyzed steatosis and fibrosis levels. Fifty-seven percent of the study population demonstrated steatosis without fibrosis, suggesting NAFLD, while 16% demonstrated both steatosis and fibrosis, suggesting NASH. Statistically significant risk factors included factors related to metabolic syndrome, race, and age, while statistically significant protective factors included consumption of certain foods and exercise. The findings of this study suggest that high-risk individuals should be screened for NAFLD even in the absence of symptoms and that community-based screenings are an effective tool, particularly in the absence of proactive guidelines for providers.
, Lam Tran,
Published: 30 November 2021
Abstract:
Objectives: To conduct a cross-sectional nationwide study examining how exclusion of nursing home COVID-19 cases influences the association between county level social distancing behavior and COVID-19 cases throughout the US during the early phase of the pandemic (February 2020-May 2020). Methods: Using county-level COVID-19 data and social distancing metrics from tracked mobile devices, we investigated the impact social distancing had on a county’s total COVID-19 cases (cases/100,000 people) between when the first COVID-19 case was confirmed in a county and May 31st, 2020 when most statewide social distancing measures were lifted, representing the pandemic’s exponential growth phase. We created a mixed-effects negative binomial model to assess how implementation of social distancing measures when they were most stringent (March 2020-May 2020) influenced total COVID-19 cases while controlling for social distancing and COVID-19 related covariates in two scenarios: (1) when COVID-19 nursing home cases are not excluded from total COVID-19 cases and (2) when these cases are excluded. Model findings were compared to those from February 2020, a baseline when social distancing measures were not in place. Marginal effects at the means were generated to further isolate the influence of social distancing on COVID-19 from other factors and determine total COVID-19 cases during March 2020-May 2020 for the two scenarios. Results: Regardless of whether nursing home COVID-19 cases were excluded from total COVID-19 cases, a 1% increase in average % of mobile devices leaving home was significantly associated with a 5% increase in a county’s total COVID-19 cases between March 2020-May 2020 and about a 2.5% decrease in February 2020. When the influence of social distancing was separated from other factors, the estimated total COVID-19 cases/100,000 people was comparable throughout the range of social distancing values (25%-45% of mobile phone devices leaving home between March 2020-May 2020) when nursing home COVID-19 cases were not excluded (25% of mobile phones leaving home: 163.84 cases/100,000 people (95% CI: 121.81, 205.86), 45% of mobile phones leaving home: 432.79 cases/100,000 people (95% CI: 256.91, 608.66)) and when they were excluded (25% of mobile phones leaving home: 149.58 cases/100,000 people (95% CI: 111.90, 187.26), 45% of mobile phones leaving home: 405.38 cases/100,000 people (95% CI: 243.14, 567.62)). Conclusions: Exclusion of nursing home COVID-19 cases from total COVID-19 case counts has little impact when estimating the relationship between county-level social distancing and preventing COVID-19 cases with additional research needed to see whether this finding is also observed for COVID-19 growth rates and mortality.
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