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Background. As cancer survivorship continues to improve, the perioperative morbidity and mortality following surgical treatment of metastatic bone disease become an increasingly important consideration. The objective of this study is to identify risk factors for early postoperative complications and mortality following extremity prophylactic fixation and pathologic fracture stabilization. Methods. A single‐centre retrospective review of 185 patients (226 total surgeries) who underwent prophylactic fixation or pathologic fracture stabilization for extremity metastatic bone disease between 2005 and 2020 was performed. Skull, spine, pelvic, and revision surgeries along with diagnosis of primary bone neoplasm were excluded. Univariate, multivariate, and subgroup analyses were performed to identify predictors and independent risk factors for 30‐day postoperative morbidity and mortality. Results. Primary cancers included lung (n = 41), breast (n = 36), multiple myeloma (n = 35), prostate (n = 16), lymphoma (n = 11), renal cell carcinoma (n = 10), and other (n = 36). The 30‐day postoperative complication and mortality rates were 32.30% (n = 73) and 17.26% (n = 39), respectively. The most common complications were pulmonary‐related, cardiac events, surgical site infection, sepsis, and thromboembolism. Pathologic fracture, presence of extra‐skeletal metastases, longer surgical duration, and blood transfusion requirements were associated with 30‐day postoperative complications overall. A past medical history for cardiac disease was also associated with systemic but not local surgical complications. Pathologic fracture, presence of extra‐skeletal metastases, lung cancer, blood transfusion requirements, and increasing pack‐year smoking history were predictors for 30‐day mortality. In the multivariate analysis, pathologic fracture (p = 0.016) and presence of extra‐skeletal metastases (p = 0.029) were independent predictors of complications. For mortality, pathologic fracture (p = 0.014), presence of extra‐skeletal metastases (p = 0.0085), and increased blood transfusion requirements (p = 0.048) were independent risk factors. Conclusions. The findings of this study provide additional guidance for perioperative risk assessment and patient counselling. Additionally, improving clinical assessment tools to identify and quantify patients at risk of pathologic fractures becomes increasingly important given the significant morbidity and mortality associated with pathologic fracture treatment. [ABSTRACT FROM AUTHOR]

In order to explore the association between meat consumption and gastrointestinal/colorectal cancer (CRC) risk and to estimate the Israeli population attributable fraction (PAF), we conducted a collaborative historical cohort study using the individual participant data of seven nutritional studies from the past 6 decades. We included healthy adult men and women who underwent a nutritional interview. Dietary assessment data, using food‐frequency or 24‐h recall questionnaires, were harmonized. The study file was linked to the National Cancer and death registries. Among 27,754 participants, 1216 (4.4%) were diagnosed with gastrointestinal cancers and 839 (3.0%) with CRC by the end of 2016. Using meta‐analysis methods applied to Cox proportional hazard models (adjusted for daily energy intake, sex, age, ethnic origin, education and smoking),100 g/day increments in beef, red meat and poultry consumption, and 50 g/day increment in processed meat consumption were associated with hazard ratios (HRs) and 95% confidence intervals of 1.46 (1.06–2.02), 1.15 (0.87–1.52), 1.06 (0.89–1.26), and 0.93 (0.76–1.12), respectively, for CRC. Similar results were obtained for gastrointestinal cancer, although red meat consumption reached statistical significance (HR = 1.27; 95%CI: 1.02–1.58). The PAFs associated with a reduction to a maximum of 50 g/day in the consumption of red meat were 2.7% (95%CI: −1.9 to 12.0) and 5.2% (0.3–13.9) for CRC and gastrointestinal cancers, respectively. Reduction of beef consumption to a maximum of 50 g/day will result in a CRC PAF reduction of 7.5% (0.7%–24.3%). While beef consumption was associated with gastrointestinal/CRC excess risk, poultry consumption was not. A substantial part of processed meat consumption in Israel is processed poultry, perhaps explaining the lack of association with CRC. [ABSTRACT FROM AUTHOR]

Background: Collection of detailed dietary data is labor intensive and expensive, harmonization of existing data sets has been proposed as an effective tool for research questions in which individual studies are underpowered. Methods: In this paper, we describe the methodology used to retrospectively harmonize nutritional data from multiple sources, based on the individual participant data of all available studies, which collected nutritional data in Israel between 1963 and 2014. This collaboration was established in order to study the association of red and processed meat with colorectal cancer. Two types of nutritional questionnaires, the Food Frequency Questionnaires (FFQ) and the 24-h dietary recall (24HR recall), and different food composition tables, were used by the participating studies. The main exposure of interest included type of meat (total meat, red meat, and poultry) and level of processing. Results: A total of 29,560 Israeli men and women were enrolled. In studies using FFQ,the weighted mean intakes of total, red, processed meat, and poultry were 95, 27, 37 and 58 gr/day and 92, 25, 10, and 66 gr/day in studies using 24HR recall, respectively.. Despite several methodological challenges, we successfully harmonized nutritional data from the different studies. Conclusions: This paper emphasizes the significance and feasibility of harmonization of previously collected nutritional data, offering an opportunity to examine associations between a range of dietary exposures and the outcome of interest, while minimizing costs and time in epidemiological studies. [ABSTRACT FROM AUTHOR]

Crohn disease (CD) burden has increased with globalization/urbanization, and the rapid rise is attributed to environmental changes rather than genetic drift. The Study Of Urban and Rural CD Evolution (SOURCE, n = 380) has considered diet-omics domains simultaneously to detect complex interactions and identify potential beneficial and pathogenic factors linked with rural-urban transition and CD. We characterize exposures, diet, ileal transcriptomics, metabolomics, and microbiome in newly diagnosed CD patients and controls in rural and urban China and Israel. We show that time spent by rural residents in urban environments is linked with changes in gut microbial composition and metabolomics, which mirror those seen in CD. Ileal transcriptomics highlights personal metabolic and immune gene expression modules, that are directly linked to potential protective dietary exposures (coffee, manganese, vitamin D), fecal metabolites, and the microbiome. Bacteria-associated metabolites are primarily linked with host immune modules, whereas diet-linked metabolites are associated with host epithelial metabolic functions. Exposures rather than genetics likely contribute to the worldwide increased prevalence of Crohn Disease (CD). Here, the authors constructed the Study Of Urban and Rural Crohn disease Evolution (SOURCE), a multicenter and multi-omics cross-sectional study, to identify that time spent by rural residents in urban environments is linked with changes in gut microbial composition and metabolomics, which mirrored those seen in CD. Reviewer recognition: [ABSTRACT FROM AUTHOR]

Background Dalbavancin has been used off-label to treat invasive bacterial infections in vulnerable populations like people who use drugs (PWUD) because of its broad gram-positive coverage and unique pharmacological properties. This retrospective, multisite study examined clinical outcomes at 90 days in PWUD versus non-PWUD after secondary treatment with dalbavancin for bacteremia, endocarditis, osteomyelitis, septic arthritis, and epidural abscesses. Methods Patients at 3 teaching hospitals who received dalbavancin for an invasive infection between March 2016 and May 2022 were included. Characteristics of PWUD and non-PWUD, infection highlights, hospital stay and treatment, and outcomes were compared using χ2 for categorical variables, t test for continuous variables, and nonparametric tests where appropriate. Results There were a total of 176 patients; 78 were PWUD and 98 were non-PWUD. PWUD were more likely to have a patient-directed discharge (26.9% vs 3.1%; P <.001) and be lost to follow-up (20.5% vs 7.14%; P <.01). Assuming loss to follow-up did not achieve clinical cure, 73.1% of PWUD and 74.5% of non-PWUD achieved clinical cure at 90 days (P =.08). Conclusions Dalbavancin was an effective treatment option for invasive gram-positive infections in our patient population. Despite higher rates of patient-directed discharge and loss to follow-up, PWUD had similar rates of clinical cure at 90 days compared to non-PWUD. [ABSTRACT FROM AUTHOR]

To summarize the research on the effectiveness of virtual reality (VR) therapy for the management of phantom limb pain (PLP). Three databases (SCOPUS, Ovid Embase, and Ovid MEDLINE) were searched for studies investigating the use of VR therapy for the treatment of PLP. Original research articles fulfilling the following criteria were included: (i) patients 18 years and older; (ii) all etiologies of amputation; (iii) any level of amputation; (iv) use of immersive VR as a treatment modality for PLP; (v) self-reported objective measures of PLP before and after at least one VR session; (vi) written in English. A total of 15 studies were included for analysis. Fourteen studies reported decreases in objective pain scores following a single VR session or a VR intervention consisting of multiple sessions. Moreover, combining VR with tactile stimulation had a larger beneficial effect on PLP compared with VR alone. Based on the current literature, VR therapy has the potential to be an effective treatment modality for the management of PLP. However, the low quality of studies, heterogeneity in subject population and intervention type, and lack of data on long-term relief make it difficult to draw definitive conclusions. Virtual reality (VR) therapy has emerged as a new potential treatment option for phantom limb pain (PLP) that circumvents some limitations of mirror therapy. VR therapy was shown to decrease PLP following a single VR session as well as after an intervention consisting of multiple sessions. The addition of vibrotactile stimuli to VR therapy may lead to larger decreases in PLP scores compared with VR therapy alone. [ABSTRACT FROM AUTHOR]

Building on original research and dialoguing with scholarly works on Portugal, France and the United Kingdom, this article argues that decolonisation and migrations from the (former) colonies triggered and moulded a new, post-imperial nation-building in Western Europe. Analysing the highly significant but hitherto much-neglected case of Portugal in its broader Western European context, this claim is substantiated by surveying how these migrations affected citizenship and notions of the national community, the welfare state and public memories. Comparative and relational in its approach, the article links the histories of white 'returnees' from Portugal's African colonies after the 1974 Carnation Revolution to those of non-white 'immigrants', arguing that we must situate in the same analytical field all those who migrated from (formerly) colonised territories to the metropole during the drawn-out end of empire. [ABSTRACT FROM AUTHOR]

The descendants of immigrants have become increasingly successful in Western European education systems and labor markets, which in principle supports Richard Alba's new assimilation theory (NAT). Still, acceptance and recognition on the part of the mainstream has not kept pace. We have suggested outgroup mobility threat (OMT), the fear of being overtaken by intergenerational mobility, as one possible explanation. However, Richard Alba has argued that demographic changes widely lead to a non-zero-sum mobility and do not necessarily cause competition threat. In this paper, we relate Richard Alba's reasoning to the concept of OMT, focusing on the German immigration context. We bring together the arguments by distinguishing between realistic and symbolic threat and by differentiating between occupations and groups. We measure OMT and test our hypotheses using a vignette study that we recently conducted as part of the kick-off survey of the new National Discrimination and Racism Monitor (NaDiRa) in Germany. Our results confirm that Richard Alba's argument is superior to the simple competitive threat perspective. However, we also show that it is still insufficient, and OMT comes into play when immigrant groups move up into value-based occupations that are assumed to normatively shape society. Moreover, we demonstrate that this threat is felt particularly when Muslims ascend to these types of occupations. [ABSTRACT FROM AUTHOR]

Background: Reduction of Tanzania's neonatal mortality rate has lagged behind that for all under-fives, and perinatal mortality has remained stagnant over the past two decades. We conducted a national verbal and social autopsy (VASA) study to estimate the causes and social determinants of stillbirths and neonatal deaths with the aim of identifying relevant health care and social interventions. Methods: A VASA interview was conducted of all stillbirths and neonatal deaths in the prior 5 years identified by the 2015-16 Tanzania Demographic and Health Survey. We evaluated associations of maternal complications with antepartum and intrapartum stillbirth and leading causes of neonatal death; conducted descriptive analyses of antenatal (ANC) and delivery care and mothers' careseeking for complications; and developed logistic regression models to examine factors associated with delivery place and mode. Results: There were 204 stillbirths, with 185 able to be classified as antepartum (88 [47.5%]) or intrapartum (97 [52.5%]), and 228 neonatal deaths. Women with an intrapartum stillbirth were 6.5% (adjusted odds ratio (aOR) = 1.065, 95% confidence interval (CI) 1.002, 1.132) more likely to have a C-section for every additional hour before delivery after reaching the birth attendant. Antepartum hemorrhage (APH), maternal anemia, and premature rupture of membranes (PROM) were significantly positively associated with early neonatal mortality due to preterm delivery, intrapartum-related events and serious infection, respectively. While half to two-thirds of mothers made four or more ANC visits (ANC4+), a third or fewer received quality ANC (Q-ANC). Women with a complication were more likely to deliver at hospital only if they received Q-ANC (neonates: aOR = 4.5, 95% CI 1.6, 12.3) or ANC4+ (stillbirths: aOR = 11.8, 95% CI 3.6, 38.0). Nevertheless, urban residence was the strongest predictor of hospital delivery. Conclusions: While Q-ANC and ANC4 + boosted hospital delivery among women with a complication, attendance was low and the quality of care is critical. Quality improvement efforts in urban and rural areas should focus on early detection and management of APH, maternal anemia, PROM, and prolonged labor, and on newborn resuscitation. [ABSTRACT FROM AUTHOR]

Purpose: Minimizing complications is an important focus in hip hemiarthroplasty (HHA) for femoral neck fracture (FNF) patients given the associated high morbidity and mortality rates. This systematic review and meta-analysis aimed to compare the clinical and functional outcomes associated with the direct anterior approach (DAA) compared to other surgical approaches used for HHA. Methods: Studies evaluating HHA-treated FNFs using the DAA were compared through meta-analysis to all other surgical approaches combined and as distinct subgroups. Outcomes included overall complication rate, mortality rate, dislocation rate, reoperation rate, periprosthetic fracture rate, infection rate, length of stay (LOS), mobility, perioperative blood loss, operative time, and postoperative pain. Results: Nineteen studies met the inclusion criteria, totaling 2,018 HHAs. DAA significantly reduced the overall complication rate (odds ratio (OR) = 0.73, 95% confidence interval (CI) 0.57 to 0.94, p = 0.01), dislocation rate (OR = 0.34, 95% CI 0.15 to 0.77, p = 0.01), and LOS (mean difference (MD) = −1.31 days, 95% CI − 2.12 to − 0.50, p = 0.002). Findings from studies that were not appropriate for meta-analysis were qualitatively summarized and suggested improved mobility and reduced postoperative pain with the DAA. Significant differences were not detected in any of the remaining outcomes. Conclusion: The DAA HHA appears to be safer, reduces hospital stay, and may improve early functional recovery. This article supports the DAA HHA as a safe option for the management of displaced intracapsular FNFs. [ABSTRACT FROM AUTHOR]

Nutrition-related chronic diseases are a major problem among Indigenous populations. Appropriate dietary intake assessment tools are needed for nutritional surveillance and intervention; however, tools designed to measure the habitual dietary intake of Indigenous persons are largely lacking. We developed a digital food frequency questionnaire (FFQ) to measure habitual consumption among Australian Aboriginal adults and support personalized nutrition counseling. The primary contributors to energy, select nutrients, and inter-person variation (83 food groups) were identified from nationally representative 24 h recall (24HR) data, and they accounted for >80% of the total intake and inter-person variation of the nutrients of interest. Based on community input, a meal-based FFQ format was adopted, with a main food/beverage list of 81 items and the capacity to report on >300 additional items via the digital platform. The nutrient database was based on the Australian Food and Nutrient Database. Data for the first 60 study participants (70% female; median age: 48 years) were used to assess the FFQ's utility. The participants' median [IQR] reported energy intake (10,042 [6968–12,175] kJ/day) was similar to their median [IQR] estimated energy expenditure (10,197 [8636–11,551] kJ/day). Foods/beverages on the main FFQ list accounted for between 66% and 90% of the participants' reported energy and nutrient intakes; the remainder came from participant-selected extra items. The digital FFQ platform provides a potentially valuable resource for monitoring habitual dietary intake among Aboriginal adults and supporting chronic disease prevention and management interventions. [ABSTRACT FROM AUTHOR]

Background Incidence of end-stage renal disease (ESRD) is higher in Israel than the European average. Socio-economic differences in ESRD have been reported globally, but many countries lack a national register. Using national data, we assessed which socio-demographic factors are associated with 5-year incidence of ESRD in Israel, where there is universal access to renal replacement therapy (RRT). Methods Data on all incident ESRD cases aged ≥20 years receiving chronic RRT between 1 January 2014 and 31 December 2018 (N  = 7883) were collected from Israel's National Dialysis & Renal Transplant Register. Individual-level data on ESRD cases requiring RRT included residential area, age, gender, ethnicity (Jewish or Arab) and ESRD cause (diabetes, other, unknown/missing). Area-level data included age and sex distribution, socio-economic status (SES) and proportion of Arab population. The associations between individual-level socio-demographic characteristics and ESRD cause were tested in bivariate comparisons. The risk of developing ESRD during the study period (from all and specific causes) was estimated using multiple Poisson regression models with negative binomial distribution, using four parameters, namely sex, ethnicity, SES category and age strata, based on area-level distribution of these parameters, and with the whole population (aged ≥20 years) as the denominator. Results A socio-economic gradient was seen for ESRD from all causes, more marked for diabetic aetiology [rate ratio (RR)=0.45, 95% CI: 0.39–0.52 highest vs lowest SES categories] than from other (RR = 0.64, 95% CI: 0.55–0.75) or unknown cause (RR = 0.79, 95% CI: 0. 62–0.99). Based on population area-level data, predominantly Arab neighbourhoods showed higher risk for ESRD requiring RRT for all causes, with the strongest association for diabetes (RR = 1.69, 95% CI: 1.53–1.86) adjusted for SES, age and sex. Conclusions A strong socio-economic gradient was demonstrated for ESRD requiring RRT. Arab ethnicity was associated with higher risk for ESRD, especially due to diabetes. Our findings suggest the need for allocation of health resources according to needs and culturally appropriate interventions for improving control of modifiable risk factors for chronic renal failure. [ABSTRACT FROM AUTHOR]

Genome engineering via targeted nucleases, specifically CRISPR-Cas9, has revolutionized the field of gene therapy research, providing a potential treatment for diseases of the blood and immune system. While numerous genome editing techniques have been used, CRISPR-Cas9 homology-directed repair (HDR)-mediated editing represents a promising method for the site-specific insertion of large transgenes for gene knock-in or gene correction. Alternative methods, such as lentiviral/gammaretroviral gene addition, gene knock-out via non-homologous end joining (NHEJ)-mediated editing, and base or prime editing, have shown great promise for clinical applications, yet all possess significant drawbacks when applied in the treatment of patients suffering from inborn errors of immunity or blood system disorders. This review aims to highlight the transformational benefits of HDR-mediated gene therapy and possible solutions for the existing problems holding the methodology back. Together, we aim to help bring HDR-based gene therapy in CD34+ hematopoietic stem progenitor cells (HSPCs) from the lab bench to the bedside. [ABSTRACT FROM AUTHOR]

Among its many global impacts, decolonization triggered the migration of several million 'repatriates' — white settlers or others associated with the imperial power — who left Asia and Africa and 'returned' to their European 'motherlands'. This article explores the arrival of several thousand Anglo-Egyptians into Britain in 1957 following the Suez crisis, the one million pieds-noirs who left Algeria for France in 1962, and the 500,000 retornados who entered Portugal amidst the 1975 Carnation Revolution. Offering an integrated comparison of these three key moments of decolonization via the migrations they triggered, it underscores the importance of citizenship, understood here as both a 'hard' legal category and a set of 'soft' social practices. The comparison equally demonstrates how, across different national contexts, citizenship was unevenly applied. Despite holding the same rights, returnee-citizens faced discrimination from resident-citizens in subtle (and sometimes less subtle) ways. Moreover, subgroups of returnee-citizens were treated differently by the state, in a process that amounted at times to their physical and social segregation and a racialization of welfare. This unevenness of treatment illuminates how the British, French, and Portuguese national communities were reimagined in the era of decolonization, and the crucial role 'repatriated' citizens played in that process. [ABSTRACT FROM AUTHOR]

Cryogenic liquids such as liquid nitrogen are of relevance for numerous processes in engineering, and the food and pharmaceutical industries. However, as a result of its strong evaporation at ambient conditions, its handling for laboratory purposes and experimentation is so far cumbersome. In the present work an original design approach for a supply device for liquid nitrogen is developed and characterized in detail. With the device pure liquid nitrogen is supplied from a pressurized dewar flask to a hypodermic needle without contamination of the liquid with its own vapor or frost, finally enabling to generate a free liquid jet or single droplets in a way comparable to the handling of non-cryogenic liquids using a syringe and a hypodermic needle. Compared to previous approaches for the generation of liquid nitrogen droplets in scientific studies which mostly rely on a reservoir for liquid nitrogen from which droplets form at a bottom outlet due to gravity, the present design allows generation of droplets and free liquid jets in a significantly better controlled and more flexible way. The device is experimentally characterized for varying operational conditions during generation of a free liquid jet, and its versatility for laboratory research purposes is further briefly demonstrated. [ABSTRACT FROM AUTHOR]

Background Three-quarters of births in Indonesia occur in a health facility, yet the neonatal mortality rate remains high at 15 per 1000 live births. The Pathway to Survival (P-to-S) framework of steps needed to return sick neonates and young children to health focuses on caregiver recognition of and care-seeking for severe illness. In view of increased institutional delivery in Indonesia and other low- and middle-income countries, a modified P-to-S is needed to assess the role of maternal complications in neonatal survival. Methods We conducted a retrospective cross-sectional verbal and social autopsy study of all neonatal deaths from June through December 2018, identified by a proven listing method in two districts of Java, Indonesia. We examined care-seeking for maternal complications, delivery place, and place and timing of neonatal illness onset and death. Results The fatal illnesses of 189/259 (73%) neonates began in their delivery facility (DF), 114/189 (60%) of whom died before discharge. Mothers whose neonate's illness started at their delivery hospital and lower-level DF were more than six times (odds ratio (OR)=6.5; 95% confidence interval (CI)=3.4-12.5) and twice (OR=2.0; 95% CI=1.01-4.02) as likely to experience a maternal complication as those whose neonates fell fatally ill in the community, and illness started earlier (mean=0.3 vs 3.6 days; P<0.001) and death came sooner (3.5 vs 5.3 days; P=0.06) to neonates whose illness started at any DF. Despite going to the same number of providers/facilities, women with a labour and delivery (L/D) complication who sought care from at least one other provider or facility on route to their DF took longer than those without a complication to reach their DF (median= 3.3 vs 1.3 hours; P=0.01). Conclusions Neonates' fatal illness onset in their DF was strongly associated with maternal complications. Mothers with a L/D complication experienced delays in reaching their DF, and nearly half the neonatal deaths occurred in association with a complication, suggesting that mothers with complications first seeking care at a hospital providing emergency maternal and neonatal care might have prevented some deaths. A modified P-to-S highlights the importance of rapid access to quality institutional delivery care in settings where many births occur in facilities and/or there is good care-seeking for L/D complications. [ABSTRACT FROM AUTHOR]

In this paper, we study the deployment potential of automated minibuses (AmBs) on the first-mile part of public transport (PT) trips or short (sub)urban commutes by comparing "regular" (fixed route and fixed schedule) and "flexible" (door-to-door and on-demand) service types. For reaching that goal, we run a stated choice experiment in the Netherlands. The participants have assessed the referred two AmB alternatives compared to their current travel mode (car, PT, or active modes (AM) – bicycle and walking) used as the main mode for unimodal travellers or as access travel mode to transit lines for multimodal travellers. The results of a joint mixed logit model estimation based on data obtained from Dutch travellers show that there are similarities and differences in the preferences for the AmBs service type within and between the segments of travellers (car, PT, and AM) and that these are mostly in instrumental variables (cost and time) and attitudes. Current PT users prefer the flexible service to regular service based on their perception of in-vehicle travel time and waiting time, while current users of car and AM do not show a difference in preference between the two services concerning these variables. Moreover, their perception of in-vehicle travel time and waiting time is not significantly different from PT users' perception of those variables in the regular service. This may mean that for non-PT users (car and AM), AmB's flexibility of door-to-door transport is not seen as offering a significant advantage over what they think about public transport. When looking at the preferences of potential users explained by underlying psychological factors, we conclude that a positive attitude towards riding in AmBs is a significant factor in all three segments of travellers. Trust, usefulness, and enjoyment in using AmBs are important prerequisites for car and PT users to choose either service type. The experience with technology positively influences the preferences of current PT users for both AmB services. [ABSTRACT FROM AUTHOR]

In this paper, we study the deployment potential of automated minibuses (AmBs) on the first-mile part of public transport (PT) trips or short (sub)urban commutes by comparing "regular" (fixed route and fixed schedule) and "flexible" (door-to-door and on-demand) service types. For reaching that goal, we run a stated choice experiment in the Netherlands. The participants have assessed the referred two AmB alternatives compared to their current travel mode (car, PT, or active modes (AM) – bicycle and walking) used as the main mode for unimodal travellers or as access travel mode to transit lines for multimodal travellers. The results of a joint mixed logit model estimation based on data obtained from Dutch travellers show that there are similarities and differences in the preferences for the AmBs service type within and between the segments of travellers (car, PT, and AM) and that these are mostly in instrumental variables (cost and time) and attitudes. Current PT users prefer the flexible service to regular service based on their perception of in-vehicle travel time and waiting time, while current users of car and AM do not show a difference in preference between the two services concerning these variables. Moreover, their perception of in-vehicle travel time and waiting time is not significantly different from PT users' perception of those variables in the regular service. This may mean that for non-PT users (car and AM), AmB's flexibility of door-to-door transport is not seen as offering a significant advantage over what they think about public transport. When looking at the preferences of potential users explained by underlying psychological factors, we conclude that a positive attitude towards riding in AmBs is a significant factor in all three segments of travellers. Trust, usefulness, and enjoyment in using AmBs are important prerequisites for car and PT users to choose either service type. The experience with technology positively influences the preferences of current PT users for both AmB services. [ABSTRACT FROM AUTHOR]

This data brief introduces the Friendship and Identity in School (FIS) dataset. The FIS data are school-based longitudinal social network data, which have become increasingly important in recent years. Including information on 2,500 adolescents in nine secondary schools in the German federal state of North Rhine-Westphalia, the FIS data have four important key features that make them uniquely suited for studying the co-evolution of friendship networks and group identities or other time-varying individual characteristics. Specifically, the data include (i) fine-grained multidimensional measures of youth' ethnic, national, and religious identities, (ii) comparatively large social networks that span multiple classrooms, (iii) up to six waves over four and a half years, and (iv) an ethnoreligiously diverse sample. Besides friendship and identity, the data include other network dimensions such as romantic relations or dislike as well as repeated measurements of various individual attributes ranging from perceived discrimination over intergroup attitudes and religion to leisure time activities and students' perceptions of parents' identities and attitudes. In combination, the FIS data provide rich longitudinal information that allows researchers to study the development, change, and interplay of youth' group identities and friendship networks as well as broader questions concerning intergroup relations, network formation, and peer influence. [ABSTRACT FROM AUTHOR]

Background Data suggest lower coronavirus disease-2019 (COVID-19) vaccination coverage among minority and disadvantaged groups. We aimed to identify interactions between sociodemographic factors associated with vaccination gaps. Methods This population study used Israeli National COVID-19 data (extracted: 10 May 2021). The analysis comprised 6   478   999 individuals age ≥15 years with aggregated area-level data on sex and age distribution and no COVID-19 history. We estimated vaccination hazard and cumulative incidence using the Fine and Gray competing risk model. Results Older age and higher socioeconomic status (SES) were associated, with stepwise higher cumulative vaccination rates (age 20–24: 67%, age ≥ 75: 96%; SES 1–3: 61%, 4–5: 74.2%, 6–7: 82%, 8–10: 87%). We found the lowest vaccination rates in Arab (65%) and Ultra-Orthodox Jewish (54%) areas. SES modified the association in Arab neighbourhoods, with higher coverage than in the non-Orthodox Jewish reference group in SES 1–3 [adjusted hazard ratio (HR) = 1.06; 95% confidence interval (CI): 1.02–1.11], and gradually lower coverage in higher SES classes (SES 6–7: HR = 0.83; 95% CI: 0.79–0.87). Vaccination rates were also higher among younger Arabs (≤45 years) compared with age counterparts in the reference population group (age 25–34: HR = 1.18; 95% CI: 1.12–1.28) and lower than the reference group among Arabs age ≥45 years. Among Ultra-Orthodox Jews, vaccination HRs remained below one across age and SES classes. Conclusions Age and SES modified the association between population group and vaccination coverage. Identifying the interplay between sociodemographic characteristics and the underlying explanations may improve targeted efforts, aimed at closing vaccination coverage gaps and mitigating COVID-19. [ABSTRACT FROM AUTHOR]

Background: Despite the increased access to facility-based delivery in Indonesia, the country's maternal mortality remains unacceptably high. Reducing maternal mortality requires a good understanding of the care-seeking pathways for maternal complications, especially with the government moving toward universal health coverage. This study examined care-seeking practices and health insurance in instances of pregnancy-related deaths in Jember District, East Java, Indonesia. Methods: This was a community-based cross-sectional study to identify all pregnancy-related deaths in the district from January 2017 to December 2018. Follow-up verbal and social autopsy interviews were conducted to collect information on care-seeking behavior, health insurance, causes of death, and other factors. Findings: Among 103 pregnancy-related deaths, 40% occurred after 24 hours postpartum, 36% during delivery or within the first 24 hours postpartum, and 24% occurred while pregnant. The leading causes of deaths were hemorrhage (38.8%), pregnancy-induced hypertension (20.4%), and sepsis (16.5%). Most deaths occurred in health facilities (81.6%), primarily hospitals (74.8%). Nearly all the deceased sought care from a formal health provider during their fatal illness (93.2%). Seeking any care from an informal provider during the fatal illness was more likely among women who died after 24 hours postpartum (41.0%, OR 7.4, 95% CI 1.9, 28.5, p = 0.049) or during pregnancy (29.2%, OR 4.4, 95% CI 1.0, 19.2, p = 0.003) than among those who died during delivery or within 24 hours postpartum (8.6%). There was no difference in care-seeking patterns between insured and uninsured groups. Conclusions: The fact that women sought care and reached health facilities regardless of their insurance status provides opportunities to prevent deaths by ensuring that every woman receives timely and quality care. Accordingly, the increasing demand should be met with balanced readiness of both primary care and hospitals to provide quality care, supported by an effective referral system. [ABSTRACT FROM AUTHOR]

Multiple methodologies have been developed to identify and predict adverse events (AEs); however, many of these methods do not consider how patient population characteristics, such as diseases, age, and gender, affect AEs seen. In this study, we evaluated the utility of collecting and analyzing AE data related to hydroxychloroquine (HCQ) and chloroquine (CQ) from US Prescribing Information (USPIs, also called drug product labels or package inserts), the FDA Adverse Event Reporting System (FAERS), and peer-reviewed literature from PubMed/EMBASE, followed by AE classification and modeling using the Ontology of Adverse Events (OAE). Our USPI analysis showed that CQ and HCQ AE profiles were similar, although HCQ was reported to be associated with fewer types of cardiovascular, nervous system, and musculoskeletal AEs. According to EMBASE literature mining, CQ and HCQ were associated with QT prolongation (primarily when treating COVID-19), heart arrhythmias, development of Torsade des Pointes, and retinopathy (primarily when treating lupus). The FAERS data was analyzed by proportional ratio reporting, Chi-square test, and minimal case number filtering, followed by OAE classification. HCQ was associated with 63 significant AEs (including 21 cardiovascular AEs) for COVID-19 patients and 120 significant AEs (including 12 cardiovascular AEs) for lupus patients, supporting the hypothesis that the disease being treated affects the type and number of certain CQ/HCQ AEs that are manifested. Using an HCQ AE patient example reported in the literature, we also ontologically modeled how an AE occurs and what factors (e.g., age, biological sex, and medical history) are involved in the AE formation. The methodology developed in this study can be used for other drugs and indications to better identify patient populations that are particularly vulnerable to AEs. [ABSTRACT FROM AUTHOR]

Background: The Government of Indonesia is determined to follow global commitments to reduce the neonatal mortality rate. Yet, there is a paucity of information on contributing factors and causes of neonatal deaths, particularly at the sub-national level. This study describes care-seeking during neonates' fatal illnesses and their causes of death. Methods: We conducted a cross-sectional community-based study to identify all neonatal deaths in Serang and Jember Districts, Indonesia. Follow-up interviews were conducted with the families of deceased neonates using an adapted verbal and social autopsy instrument. Cause of death was determined using the InSilicoVA algorithm. Results: The main causes of death of 259 neonates were prematurity (44%) and intrapartum-related events (IPRE)-mainly birth asphyxia (39%). About 83% and 74% of the 259 neonates were born and died at a health facility, respectively; 79% died within the first week after birth. Of 70 neonates whose fatal illness began at home, 59 (84%) sought care during the fatal illness. Forty-eight of those 59 neonates went to a formal care provider; 36 of those 48 neonates (75%) were moderately or severely ill when the family decided to seek care. One hundred fifteen of 189 neonates (61%) whose fatal illnesses began at health facilities were born at a hospital. Among those 115, only 24 (21%) left the hospital alive–of whom 16 (67%) were referred by the hospital. Conclusions: The high proportion of deaths due to prematurity and IPRE suggests the need for improved management of small and asphyxiated newborns. The moderate to severe condition of neonates at the time when care was sought from home highlights the importance of early illness recognition and appropriate management for sick neonates. Among deceased neonates whose fatal illness began at their delivery hospital, the high proportion of referrals may indicate issues with hospital capability, capacity, and/or cost. [ABSTRACT FROM AUTHOR]

Art exposure can influence children's emotional growth, but little is known about tools that aid emotional development in art museums. We implemented attentional and social manipulations to test whether (1) modifications to unscripted instructions and (2) caregiver prompts shape children's attentional focus towards either the emotional or elemental content (e.g., colour andmedium) of paintings. Thesemanipulations occurred within an on-going art museum education programme. Afterwards, children's (N = 60; ages 3-13 years) attentional focus towards emotions or elements was assessed by asking them to select words that best described the art. Children focused on emotion more, but the instructional manipulation successfully influenced word choices towards the targeted focus. Caregiver prompts also influenced focus towards the elements and away from emotions. These findings highlight that children's attention to art's emotional content can be altered by social context, which here was demonstrated within a museum programme. [ABSTRACT FROM AUTHOR]

Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a 'deficit-based' discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants' knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men's, 5 women's) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants' communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09–4.63), people with disabilities (OR: 2.43; 95% CI: 1.28–4.64), and unemployed people (OR: 2.64; 95% CI: 1.28–5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25–4.09), unemployment (OR: 4.07; 95% CI: 1.64–10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03–1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants' knowledge, experience, and strengths has the potential to improve individuals' diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths. [ABSTRACT FROM AUTHOR]

Upwelling of nutrient-rich deep waters make eastern boundary upwelling systems (EBUSs), such as the Humboldt Current system, hot spots of marine productivity. Associated settling of organic matter to depth and consecutive aerobic decomposition results in large subsurface water volumes being oxygen depleted. Under these circumstances, organic matter remineralisation can continue via denitrification, which represents a major loss pathway for bioavailable nitrogen. Additionally, anaerobic ammonium oxidation can remove significant amounts of nitrogen in these areas. Here we assess the interplay of suboxic water upwelling and nitrogen cycling in a manipulative offshore mesocosm experiment. Measured denitrification rates in incubations with water from the oxygen-depleted bottom layer of the mesocosms (via 15 N label incubations) mostly ranged between 5.5 and 20 nmol N 2 L -1 h -1 (interquartile range), reaching up to 80 nmol N 2 L -1 h -1. However, actual in situ rates in the mesocosms, estimated via Michaelis–Menten kinetic scaling, did most likely not exceed 0.2–4.2 nmol N 2 L -1 h -1 (interquartile range) due to substrate limitation. In the surrounding Pacific, measured denitrification rates were similar, although indications of substrate limitation were detected only once. In contrast, anammox (anaerobic ammonium oxidation) made only a minor contribution to the overall nitrogen loss when encountered in both the mesocosms and the Pacific Ocean. This was potentially related to organic matter C / N stoichiometry and/or process-specific oxygen and hydrogen sulfide sensitivities. Over the first 38 d of the experiment, total nitrogen loss calculated from in situ rates of denitrification and anammox was comparable to estimates from a full nitrogen budget in the mesocosms and ranged between ∼ 1 and 5.5 µ mol N L -1. This represents up to ∼ 20 % of the initially bioavailable inorganic and organic nitrogen standing stocks. Interestingly, this loss is comparable to the total amount of particulate organic nitrogen that was exported into the sediment traps at the bottom of the mesocosms at about 20 m depth. Altogether, this suggests that a significant portion, if not the majority of nitrogen that could be exported to depth, is already lost, i.e. converted to N 2 in a relatively shallow layer of the surface ocean, provided that there are oxygen-deficient conditions like those during coastal upwelling in our study. Published data for primary productivity and nitrogen loss in all EBUSs reinforce such conclusion. [ABSTRACT FROM AUTHOR]

Emotions play a central role in the process of conflict and resolution. For a mediator, it is important to recognize emotions correctly and act upon them. Whether interventions are appropriate depends to a large extent on the ability of mediators to accurately perceive the emotions of conflict parties. Particularly in hierarchical labor conflicts, this can be challenging, since subordinates tend to hide emotions while supervisors tend to express them. In this study, we investigated if subordinates and supervisors differ in their emotional experience during mediation and whether mediators perceive these emotions accurately. To this end, we compared the extent to which disputants experienced certain emotions with the extent to which mediators perceived these emotions. Data were collected through surveys of mediation clients and mediators in hierarchical labor conflicts in the Netherlands. As expected, subordinates experienced a higher level of negative emotions during the mediation than supervisors did. Positive emotions, however, were experienced to a similar extent by both supervisors and subordinates in mediation. Mediators perceived supervisors' emotions more accurately than they did subordinates' emotions. While supervisors' emotions were positively related with mediators' perceptions, this was not the case for subordinates' emotions. Furthermore, mediators were more accurately perceiving supervisors' negative emotions than their positive emotions. Implications for mediation theory and practice are discussed. [ABSTRACT FROM AUTHOR]

An international diagnostic criterion for amniotic fluid embolism (AFE) diagnosis has recently been published. Data regarding subsequent pregnancies is scarce. We sought to implement recent diagnostic criteria and detail subsequent pregnancies in survivors. A case series of all suspected AFE cases at a tertiary medical center between 2003 and 2018 is presented. Cases meeting the diagnostic criteria for AFE were included. Clinical presentation, treatment, and outcomes described. Pregnancy outcomes in subsequent pregnancies in AFE survivors detailed. Between 2003 and 2018 14 women were clinically suspected with AFE and 12 of them (85.71%) met the diagnostic criteria for AFE. Three cases occurred during midtrimester dilation and evacuation procedures, and the remaining occurred in the antepartum period. Of the antepartum cases, mode of delivery was cesarean delivery or vacuum extraction for expedited delivery due to presentation of AFE in 8/9 cases (88.88%). Clinical presentation included cardiovascular collapse, respiratory distress and disseminated intravascular coagulopathy (DIC). Heart failure of varying severity was diagnosed in 75% (9/12) cases. Composite maternal morbidity was 5/12 (41.66%), without cases of maternal mortality. 11 subsequent pregnancies occurred in four AFE survivors. Pregnant women were followed by a high-risk pregnancy specialist and multidisciplinary team if pregnancy continued beyond the early second trimester. Six pregnancies resulted in a term delivery. No recurrences of AFE were documented. Use of a diagnostic criterion for diagnosis of AFE results in a more precise diagnosis of AFE. Nevertheless, the accuracy of clinical diagnosis is still high. Subsequent pregnancies were not associated with AFE recurrence. [ABSTRACT FROM AUTHOR]

Upwelling of nutrient-rich deep waters make Eastern Boundary upwelling systems (EBUS), such as the Humboldt Current System, hotspots of marine productivity. Associated settling of organic matter to depth and consecutive aerobic decomposition results in large sub-surface water volumes being oxygen-depleted. Under these circumstances organic matter remineralisation can continue via denitrification which represents a major loss pathway of bioavailable nitrogen. Another process removing significant amounts of nitrogen in these areas is anaerobic ammonium oxidation. Here we assess the interplay of suboxic water upwelling and nitrogen cycling in a manipulative off-shore mesocosm experiment. Measured denitrification rates in the oxygen-depleted bottomlayer of themesocosms mostly ranged between 5.5–20 (interquartile range), reaching up to 80 nmol N2 L-1h-1. However, realised in-situ rates did most likely not exceed 0.6–1.6 nmolN2 L-1h-1 (interquartile range), due to substrate limitation in the mesocosms. This was in contrast to realised rates in the surrounding Pacific. Both in the mesocosms and the Pacific Ocean anammox made only a minor contribution to overall nitrogen loss when encountered. Over the first 38 days of the experiment, total nitrogen loss calculated from denitrification and anammox rates was comparable to estimates from a full nitrogen budget in the mesocosms and ranged between ~ 2–6 µmolNL-1 . This represents up to ~ 20% of the initially bioavailable inorganic and organic nitrogen standing stocks. Interestingly, this loss is comparable to the total amount of particulate organic nitrogen that was exported into the sediment traps at the bottom of the mesocosms in about 20 metres depth. Altogether, this suggests that a significant portion, if not the majority of nitrogen that could be exported to depth, is already lost, i.e. converted to N2 in a relatively shallow layer of the surface ocean, provided oxygen-deficient conditions like during coastal upwelling in our study. [ABSTRACT FROM AUTHOR]