bluuebunny/crossref_metadata_2025 huggingface dataset:
Growth of 19 conifer species is highly sensitive to winter warming, spring frost and summer drought
Authors: Song Yanjun , Sass-Klaassen Ute , Sterck Frank , Goudzwaard Leo , Akhmetzyanov Linar , Poorter Lourens
Published: July 2021

Background and Aims

Conifers are key components of many temperate and boreal forests and are important for forestry, but species differences in stem growth responses to climate are still poorly understood and may hinder effective management of these forests in a warmer and drier future.

Methods

We studied 19 Northern Hemisphere conifer species planted in a 50-year-old common garden experiment in the Netherlands to (1) assess the effect of temporal dynamics in climate on stem growth, (2) test for a possible positive relationship between the growth potential and climatic growth sensitivity across species, and (3) evaluate the extent to which stem growth is controlled by phylogeny.

Key results

Eighty-nine per cent of the species showed a significant reduction in stem growth to summer drought, 37 % responded negatively to spring frost and 32 % responded positively to higher winter temperatures. Species differed largely in their growth sensitivity to climatic variation and showed, for example, a four-fold difference in growth reduction to summer drought. Remarkably, we did not find a positive relationship between productivity and climatic sensitivity, but instead observed that some species combined a low growth sensitivity to summer drought with high growth potential. Both growth sensitivity to climate and growth potential were partly phylogenetically controlled.

Conclusions

A warmer and drier future climate is likely to reduce the productivity of most conifer species. We did not find a relationship between growth potential and growth sensitivity to climate; instead, some species combined high growth potential with low sensitivity to summer drought. This may help forest managers to select productive species that are able to cope with a warmer and drier future.
Discovering common pathogenetic processes between COVID-19 and diabetes mellitus by differential gene expression pattern analysis
Authors: Rahman Md Rezanur , Islam Tania , Shahjaman Md , Islam Md Rafiqul , Lombardo Salvo Danilo , Bramanti Placido , Ciurleo Rosella , Bramanti Alessia , Tchorbanov Andrey , Fisicaro Francesco , Fagone Paolo , Nicoletti Ferdinando , Pennisi Manuela
Published: July 2021

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the newly discovered coronavirus, SARS-CoV-2. Increased severity of COVID-19 has been observed in patients with diabetes mellitus (DM). This study aimed to identify common transcriptional signatures, regulators and pathways between COVID-19 and DM. We have integrated human whole-genome transcriptomic datasets from COVID-19 and DM, followed by functional assessment with gene ontology (GO) and pathway analyses. In peripheral blood mononuclear cells (PBMCs), among the upregulated differentially expressed genes (DEGs), 32 were found to be commonly modulated in COVID-19 and type 2 diabetes (T2D), while 10 DEGs were commonly downregulated. As regards type 1 diabetes (T1D), 21 DEGs were commonly upregulated, and 29 DEGs were commonly downregulated in COVID-19 and T1D. Moreover, 35 DEGs were commonly upregulated in SARS-CoV-2 infected pancreas organoids and T2D islets, while 14 were commonly downregulated. Several GO terms were found in common between COVID-19 and DM. Prediction of the putative transcription factors involved in the upregulation of genes in COVID-19 and DM identified RELA to be implicated in both PBMCs and pancreas. Here, for the first time, we have characterized the biological processes and pathways commonly dysregulated in COVID-19 and DM, which could be in the next future used for the design of personalized treatment of COVID-19 patients suffering from DM as comorbidity.
PZLAST: an ultra-fast amino acid sequence similarity search server against public metagenomes
Authors: Mori Hiroshi , Ishikawa Hitoshi , Higashi Koichi , Kato Yoshiaki , Ebisuzaki Toshikazu , Kurokawa Ken
Published: July 2021

: Similarity searches of amino acid sequences against the public metagenomic data can provide users insights about the function of sequences based on the environmental distribution of similar sequences. However, a considerable reduction in the amount of data or the accuracy of the result was necessary to conduct sequence similarity searches against public metagenomic data, because of the vast data size more than Terabytes. Here, we present an ultra-fast service for the highly accurate amino acid sequence similarity search, called PZLAST, which can search the user’s amino acid sequences to several Terabytes of public metagenomic sequences in ∼10–20 min. PZLAST accomplishes its search speed by using PEZY-SC2, which is a Multiple Instruction Multiple Data many-core processor. Results of PZLAST are summarized by the ontology-based environmental distribution of similar sequences. PZLAST can be used to predict the function of sequences and mine for homologs of functionally important gene sequences.

Availability and implementation

PZLAST is freely accessible at https://pzlast.riken.jp/meta without requiring registration.

Supplementary information

Supplementary data are available at Bioinformatics online.
Professional Identity and Turnover Intention amongst Chinese Social Workers: Roles of Job Burnout and a Social Work Degree
Authors: Hu Hongwei , Wang Enjian , Si Jiacheng , Sui Xudong , Yi Zhiqi , Zheng Ziye , Liu Hongting
Published: July 2021

The turnover rate of social workers is extremely high and the predictive roles of professional identity and job burnout on turnover intention have not been explored in China. The study examined the relationship between professional identity and turnover intention, mediated by job burnout and moderated by a social work degree, amongst social workers in China. Based on a sample of 829 participants and the structural equation model method, the findings confirmed that professional identity per se was not related to turnover intention, and a mediating role of job burnout and a moderating role of a social work degree were identified.
Heparin resistance in severe thermal injury: a prospective cohort study
Authors: Cato Liam D , Bailiff Benjamin , Price Joshua , Ermogeneous Christos , Hazeldine Jon , Lester William , Lowe Gillian , Wearn Christopher , Bishop Jonathan R B , Lord Janet M , Moiemen Naiem , Harrison Paul
Published: July 2021

Background

Low molecular-weight heparin (LMWH) is routinely administered to burn patients for thromboprophylaxis. Some studies have reported heparin resistance, yet the mechanism(s) and prevalence have not been systematically studied. We hypothesized that nucleosomes, composed of histone structures with associated DNA released from injured tissue and activated immune cells in the form of neutrophil extracellular traps (NETs or NETosis), neutralize LMWH resulting in suboptimal anticoagulation, assessed by reduction in anti-factor Xa activity.

Methods

Blood was sampled from >15% total body surface area (TBSA) burn patients receiving LMWH on days 5, 10 and 14. Peak anti-factor Xa (AFXa) activity, anti-thrombin (ATIII) activity, cell-free DNA (cfDNA) levels and nucleosome levels were measured. Mixed effects regression was adjusted for multiple confounders, including injury severity and ATIII activity, and was used to test the association between nucleosomes and AFXa.

Results

A total of 30 patients with severe burns were included. Mean TBSA 43% (SD 17). Twenty-three (77%) patients were affected by heparin resistance (defined by AFXa activity <0.2 IU/mL). Mean peak AFXa activity across samples was 0.18 IU/mL (SD 0.11). Mean ATIII was 81.9% activity (SD 20.4). Samples taken at higher LWMH doses were found to have significantly increased AFXa activity, though the effect was not observed at all doses, at 8000 IU no samples were heparin resistant. Nucleosome levels were negatively correlated with AFXa (r = −0.29, p = 0.050) consistent with the hypothesis. The final model, with peak AFXa as the response variable, was adjusted for nucleosome levels (p = 0.0453), ATIII activity (p = 0.0053), LMWH dose pre-sample (p = 0.0049), drug given (enoxaparin or tinzaparin) (p = 0.03), and other confounders including severity of injury, age, gender, time point of sample.

Conclusions

Heparin resistance is a prevalent issue in severe burns. Nucleosome levels were increased post-burn, and showed an inverse association with AFXa consistent with the hypothesis that they may interfere with the anticoagulant effect of heparin in vivo and contribute to heparin resistance. Accurate monitoring of AFXa activity with appropriate therapy escalation plans are recommended with dose adjustment following severe burn injury.
Evaluation of Radioactivity in Patient Specimens Received in the Core Laboratory at a National Cancer Institute (NCI) Designated Cancer Center
Authors: Suciu Christopher G , Amurao Max , Luechtefeld David , Marko Areti , Ashby Lori , Gronowski Ann M
Published: July 2021

Background

Biological specimens from patients who have received radiopharmaceuticals are often collected for diagnostic testing and sent to clinical laboratories. Residual radiation has long been assumed to be minimal. However, literature is sparse and may not represent the specimen volumes or spectrum of radionuclides currently seen at National Cancer Institute (NCI)–designated cancer centers. This study examined the radiopharmaceuticals associated with patient specimens received in the hospital core laboratory and assessed the potential risk of external radiation exposure to laboratory personnel.

Methods

The types and amounts of radiopharmaceuticals administered in a large metropolitan hospital system were retrospectively examined over a 20-month study period. The associated biological specimens sent to the largest core laboratory in the system for testing were evaluated. In addition, manual survey meter assessment of random clinical specimens and weekly wipe tests were performed for 44 weeks, and wearable and environmental dosimeters were placed for 6 months.

Results

Over 11 000 specimens, collected within 5 physical half-lives of radiopharmaceutical administration, were processed by our laboratory. Manual survey meter assessment of random clinical specimens routinely identified radioactive specimens. If held in a closed palm for >2 min, many samples could potentially deliver a 0.02 mSv effective dose of radiation.

Conclusions

The laboratory regularly receives radioactive patient specimens without radioactive labels. Although the vast majority of these are blood specimens associated with low-dose diagnostic radiopharmaceuticals, some samples may be capable of delivering a significant amount of radiation. Recommendations for laboratories associated with NCI cancer centers are given.
The discerning ear: cardiac auscultation in the era of artificial intelligence and telemedicine
Authors: Jani Vivek , Danford David A , Thompson W Reid , Schuster Andreas , Manlhiot Cedric , Kutty Shelby
Published: July 2021

Heart murmur, a thoracic auscultatory finding of cardiovascular origin, is extremely common in childhood and can appear at any age from premature newborn to late adolescence. The objective of this review is to provide a modern examination and update of cardiac murmur auscultation in this new era of artificial intelligence (AI) and telemedicine. First, we provide a comprehensive review of the causes and differential diagnosis, clinical features, evaluation, and long-term management of paediatric heart murmurs. Next, we provide a brief history of computer-assisted auscultation and murmur analysis, along with insight into the engineering design of the digital stethoscope. We conclude with a discussion of the paradigm shifting impact of deep learning on murmur analysis, AI-assisted auscultation, and the implications of these technologies on telemedicine in paediatric cardiology. It is our hope that this article provides an updated perspective on the impact of AI on cardiac auscultation for the modern paediatric cardiologist.
Sporulation environment drives phenotypic variation in the pathogen Aspergillus fumigatus
Authors: Earl Kang S , Celia Brandi N , Bensasson Douda , Momany Michelle
Published: July 2021

Aspergillus fumigatus causes more than 300,000 life-threatening infections annually and is widespread across varied environments with a single colony producing thousands of conidia, genetically identical dormant spores. Conidia are easily wind-dispersed to new environments where they can germinate and, if inhaled by susceptible hosts, cause disease. Using high-throughput single-cell analysis via flow cytometry we analyzed conidia produced and germinated in nine environmentally and medically relevant conditions (complete medium, minimal medium, high temperature, excess copper, excess iron, limited iron, excess salt, excess reactive oxygen species, and limited zinc). We found that germination phenotypes vary among genetically identical individuals, that the environment of spore production determines the size of spores and the degree of germination heterogeneity, and that the environment of spore production impacts virulence in a Galleria mellonella host.
Testing the Feasibility of Virtual Reality With Older Adults With Cognitive Impairments and Their Family Members Who Live at a Distance
Authors: Afifi Tamara , Collins Nancy L , Rand Kyle , Fujiwara Ken , Mazur Allison , Otmar Chris , Dunbar Norah E , Harrison Kathryn , Logsdon Rebecca
Published: July 2021

Background and Objectives

This study tests the feasibility of using virtual reality (VR) with older adults with mild cognitive impairment (MCI) or mild-to-moderate dementia with a family member who lives at a distance.

Research Design and Methods

21 residents in a senior living community and a family member (who participated in the VR with the older adult from a distance) engaged in a baseline telephone call, followed by 3 weekly VR sessions.

Results

Residents and family members alike found the VR safe, extremely enjoyable, and easy to use. The VR was also acceptable and highly satisfying for residents with MCI and dementia. Human and automated coding revealed that residents were more conversationally and behaviorally engaged with their family member in the VR sessions compared to the baseline telephone call and in the VR sessions that used reminiscence therapy. The results also illustrate the importance of using multiple methods to assess engagement. Residents with dementia reported greater immersion in the VR than residents with MCI. However, the automated coding indicated that residents with MCI were more kinesically engaged while using the VR than residents with dementia.

Discussion and Implications

Combining networking and livestreaming features in a single VR platform can allow older adults in senior living communities to still travel, relive their past, and engage fully with life with their family members, despite geographical separation and physical and cognitive challenges.
Protection of Personal Rights in Poland on the Basis of the Judgment of the Polish Supreme Court – The Tiger Case
Authors: Buchalska Joanna
Published: July 2021

The protection of personal rights in Poland is currently one of the fastest developing areas of law. Each year it is noted that the number of cases in this area is growing, mostly because people are looking to protect their rights, such as freedom, name, pseudonym, image, health or another right on the basis of the Polish Civil Code. It allows them to receive financial compensation where their, mostly, immaterial rights were infringed or when they feel injured. This is also why the open catalogue of the values protected by personal rights is increasing rapidly, and now one can observe that such values as national identity, a sense of belonging to a gender or dignity are protected by these rights. The subject matter of this article is an opinion on the Polish Supreme Court case where the Court decided that the nickname ‘Tiger’ used by a Polish boxer cannot be protected as a personal right on the bases of the Civil Code. This article presents basic information about protecting personal rights in Polish law and sets out the author’s opinion on this case.**
Environmental effects onCalanus finmarchicusabundance and depth distribution in the Barents Sea
Authors: Kvile Kristina Ø , Prokopchuk Irina P , Stige Leif C
Published: July 2021

The vertical migrations performed by zooplankton at daily and seasonal scales are important for marine ecosystem dynamics and biogeochemical cycles. We analysed associations between seasonal variation in abundance and depth distribution of the copepod Calanus finmarchicus and temperature and predation pressure from visual (capelin and herring) and non-visual (ctenophores) predators, using data from a > 30-year survey in the southwestern Barents Sea. Calanus finmarchicus abundances were significantly reduced in upper waters with increased capelin biomass, possibly due to a combination of predation mortality and active avoidance of the upper layer. The weighted mean depth of Calanus finmarchicus tended to become shallower, and abundances in deeper layers lower, with a high probability of ctenophore occurrence, possibly due to a predation effect at depth. Temperature influenced the seasonal timing of Calanus finmarchicus, but appeared less important for depth distribution. This study illustrates how climate-driven changes in the physical and biological environment can influence the seasonal and vertical distribution of zooplankton, which has major implications for the flow of energy and nutrients in marine ecosystems.
Shifting meanings of fazhi and China’s journey toward socialist rule of law
Authors: Ye Ruiping
Published: July 2021

Scholars disagree over the nature, extent, and direction of the rule of law in China. Unlike researchers who see China’s rule of law situation as either static or steadily improving, this article traces the use, meaning, and implementation of fazhi (法治, literally “law governs,” usually translated as “rule of law”) at different stages in China since 1978. It argues that the real meaning of fazhi has changed over the past forty years. Correspondingly, China’s journey towards the socialist rule of law experienced some turns. China went from laying down a foundation for the rule of law in the late 1970s and 1980s, to turning to rule by law in the 1990s and 2000s, and then to using law to legitimize the rule of the Communist Party in the 2010s as the legal system became more mature and more sophisticated. This article further argues that, despite significant improvements in the legal system, socialist rule of law turns out to be the rule of man, with tightened legal institutions and sharpened legal tools, although it is also hoped that the key principles laid down in the 1980s and increased awareness of rights may bring about transformation in the future.
Knowledge and perceptions about antibiotic resistance and prudent antibiotic prescribing among final year medical students in two African countries
Authors: Augie Bashar M , van Zyl Robyn L , McInerney Patricia A , Miot Jacqui
Published: July 2021

Objectives

The objectives of this study were to assess the knowledge and perceptions of final year medical students about antibiotic resistance and antibiotic use to assist in the development of an antibiotic stewardship curriculum for teaching medical students in South Africa and Nigeria and the principles of prudent antibiotic prescribing.

Methods

A cross-sectional study was conducted to determine the knowledge and perceptions of final year medical students in one South African and three Nigerian universities about prudent antibiotic use, antibiotic resistance and antibiotic stewardship. A 26-item questionnaire was administered electronically to students in three medical schools and a paper-based copy in the fourth.

Key findings

A difference in the gap in knowledge between the two countries was identified; however, respondents from both countries had a similar understanding of antibiotic use and antibiotic resistance. Most respondents in South Africa (94.8%) and Nigeria (91.4%) agreed that antibiotics are overused in their countries. There was a significant difference between the number of respondents in the two countries who thought that there are new antibiotics available to treat resistant pathogens; 45.4% of Nigerian respondents agreed with the statement as compared to 9.6% of the South African respondents. Of the 10 vignettes answered correctly, South African respondents scored an average of 62.4% in the knowledge segment compared to 31.9% scored by the Nigerian respondents (P = 0.001). All of the South African (100%) and 98.3% of the Nigerian respondents indicated their desire for more education on appropriate antibiotic use.

Conclusions

Although students from both countries had the same perception of antibiotic resistance, there was, however, a difference in their level of knowledge, which could have been improved in both countries. This should be addressed at an undergraduate curriculum level; as well as with continued education to reinforce antibiotic knowledge.
Determinants of the choice of provisionally registered pharmacist (PRP) training in Malaysia: a qualitative insight
Authors: Ooi Guat See , Ong Siew Chin , Kwan Shin May
Published: July 2021

Objective

In Malaysia, due to provisional registered pharmacist (PRP) training places in government hospitals being oversubscribed, pharmacy graduates wait for about a year before starting their training. Therefore, a policy was implemented to allow pharmacy graduates to select their preferred areas of PRP training. This study was conducted to explore the perception and preferences of final year pharmacy students on the current PRP training system.

Methods

This qualitative interview study was conducted among final year pharmacy students. Participants were recruited using convenience sampling until data saturation (i.e., when additional interviews didn’t lead to any new themes). All interviews were audio-recorded, transcribed verbatim, and evaluated by thematic analysis.

Key findings

Twenty-two final year pharmacy students were interviewed. Fifteen of them preferred the government sector as their choice training, three chose the community sector, two preferred private hospitals and another two preferred the pharmaceutical industry. The majority of the students gave positive feedback towards the liberalization of PRP training sites. Most of them chose clinical pharmacy as their preferred training site despite knowing of the saturation issue in government hospitals. This was mainly due to the opportunity to gain clinical experience and knowledge from the government sector. A small number of students preferred the pharmaceutical industry based on their personal interests and opportunities for career advancement.

Conclusion

Pharmacy students generally chose their PRP training site based on personal interest, future career advancement and working environment. A better understanding of career pathways and opportunities in the pharmaceutical industry by the students is required.
Clinical pharmacy services provided in public sector hospitals in Nigeria: a national survey
Authors: Udoh Arit , Akpan Mary , Ibrahim Umar Idris , Lawal Basira Kankia , Labaran Kamilu Sarki , Ndem Ekpedeme , Amorha Kosisochi , Matuluko Ayodeji , Tikare Olubukola , Ohabunwa Unoma , Kpokiri Eneyi
Published: July 2021

Objectives

Studies show that clinical pharmacy services are effective in optimizing medicines use and patients' outcomes. This study aimed to determine the clinical pharmacy services provided in public sector hospitals in Nigeria.

Methods

This was an online survey of 296 primary, secondary and tertiary care hospitals sampled purposively across the 36 States and Federal Capital Territory in Nigeria. Data analysis was conducted descriptively via χ 2 test and multivariate analysis of variance (MANOVA).

Key findings

Responses were obtained from 272 hospitals in the country with a survey completion rate of 88%. This included 55 tertiary, 72 secondary and 145 primary healthcare centres (PHCs). Pharmacists provided pharmaceutical care services in all the tertiary care hospitals, 94% of the secondary and in only 6% of the PHCs surveyed. Most of the secondary and tertiary care hospitals provided medicines information, patient education and counselling, and in-patient dispensing services [n = 97 (79%), 116 (94%), 88 (72%)], respectively. However, fewer than a third reported involvement in multidisciplinary ward rounds, medication chart review and antibiotic stewardship programmes [n = 18 (15%), 33 (27%), 22 (18%), respectively]. Furthermore, medication error reporting and pharmacovigilance services were each routinely provided in only about half of the secondary and tertiary care hospitals [n = 62 (50%)], and this was not associated with the level of care (P > 0.05).

Conclusions

The findings of this study demonstrate disparity in clinical pharmacy service availability across the various levels of care in Nigeria and emphasize the need to prioritize their integration within the primary care sector.
Competitive balance measures and the uncertainty of outcome hypothesis in European football
Authors: Manasis V , Ntzoufras I , Reade J J
Published: July 2021

Competitive balance is an important issue in professional sport in general and European football in particular. However, competitive balance is difficult to quantify because competitiveness is multi-dimensional and particular sports are distinctive. We aim to identify the most appropriate index for a holistic view of competitive balance in European football. We use data from eight domestic European football leagues over a time span of 60 years. The indices we consider are specifically designed to capture competitiveness at different levels of performance and in this way reflect the peculiarities of European football leagues. Our findings support the longstanding uncertainty of outcome hypothesis. A bivariate index that captures competitiveness in the top K places is shown to have the highest association with attendance. A seasonal index of champions’ domination is also found to have a large association with attendance. Finally, ranking mobility is found to have a slightly higher association with attendance than seasonal performance. These results imply that sports policy makers should use these indices to assess strategic decisions that may influence competitive balance.
Antibiotic stewardship in French nursing homes: a 2019 regional survey
Authors: Belan Martin , Agrinier Nelly , Gonthier Damien , Boivin Jean-Marc , Charmillon Alexandre , Chopard Virginie , Dif Claudine , Hansmann Véronique , Pereira Ouarda , Thilly Nathalie , Pulcini Céline
Published: July 2021

Background

Antibiotic resistance is a growing issue in nursing homes (NHs). Antibiotic stewardship (ABS) programmes can reduce antibiotic use in NHs, but few studies have assessed to what extent they are implemented in NHs.

Objectives

To describe ABS current practices and describe the opinion of NH stakeholders regarding ABS and opportunities for improvement in one French region.

Methods

We invited by e-mail the medical and nurse coordinators of all NHs of the Grand Est region, France, to participate in our survey in 2019. The online questionnaire included 35 questions covering four topics: NH characteristics, current ABS practices, attitudes towards ABS and opinions on strategies to promote ABS. A score evaluating implementation of core ABS elements was calculated using the current ABS practice responses.

Results

Out of 417 NHs, 75 (18%) participated in our survey. The three most implemented ABS activities were antibiotic consumption monitoring (65%), antibiotic plan documentation (56%) and antibiotic prescription guide distribution (54%). Audit and feedback, training sessions or identification of a local ABS leader ranged from 13% to 29%. Participants positively perceived ABS and most suggestions to improve ABS programmes in NH, with maximal interest in training, audit and feedback interventions. The median score for implementation of core ABS elements was 3.3 (IQR = 2.3–5.4; theoretical range 0–11), and the score distribution was not associated with any NH characteristic.

Conclusions

While there is still room for improvement, NHs had a positive attitude towards ABS strategies. Some regional and national initiatives to promote ABS in NHs exist and should be actively promoted.
Falling through the cracks no more? Article 102 TFEU and sustainability: the relation between dominance, environmental degradation, and social injustice
Authors: Iacovides Marios C , Vrettos Christos
Published: July 2021

EU competition law has a sustainability gap, particularly when it comes to enforcing Article 102 TFEU as a ‘sword’ to prohibit dominant undertakings’ unsustainable conduct. In this article, we ask whether EU competition law can and should be part of a holistic EU solution to the climate crisis and how it can contribute to ensuring that our social, economic, and ecological systems are not entrenched into further perpetuating and mutually reinforcing crises. By using EU constitutional theories of ‘mainstreaming’, we argue for the inclusion of environmental and social sustainability goals in those that are pursued by EU competition law. With research that cuts across law and socioecological studies, we offer an original and unique perspective that identifies a relation between market power and business practices that harm people and planet. We do this by demonstrating empirically that undertakings that have in the past been found to be dominant, also engage in unsustainable business practices. This relation is significant, as it demonstrates that addressing unsustainable business practices through Article 102 TFEU is not only a theoretical possibility mandated by EU constitutional law. It is a real opportunity to address environmental and social injustices and thereby contribute to tackling the most important existential threat facing humanity, climate change.
Incorporating broadband durability in measuring geographic access to health care in the era of telehealth: A case example of the 2-step virtual catchment area (2SVCA) Method
Authors: Alford-Teaster Jennifer , Wang Fahui , Tosteson Anna N A , Onega Tracy
Published: July 2021

The COVID-19 (coronavirus disease 2019) pandemic has expanded telehealth utilization in unprecedented ways and has important implications for measuring geographic access to healthcare services. Established measures of geographic access to care have focused on the spatial impedance of patients in seeking health care that pertains to specific transportation modes and do not account for the underlying broadband network that supports telemedicine and e-health. To be able to measure the impact of telehealth on healthcare access, we created a pilot augmentation of existing methods to incorporate measures of broadband accessibility to measure geographic access to telehealth. A reliable measure of telehealth accessibility is important to enable policy analysts to assess whether the increasing prevalence of telehealth may help alleviate the disparities in healthcare access in rural areas and for disadvantaged populations, or exacerbate the existing gaps as they experience “double burdens.”
Accumulation of Nε-(carboxyethyl) lysine in Caenorhabditis elegans is correlated with the formation of ketone body
Authors: Sugawa Hikari , Yachi Ayuka , Fujimoto Yuki , Nagai Ryoji
Published: July 2021

Advanced glycation end-products (AGEs) are formed when proteins react with carbonyl compounds, and they gradually accumulate with age. However, AGE accumulation with ageing is not fully understood because longevity studies in mammals are time-consuming. Therefore, we used Caenorhabditis elegans to evaluate the correlation between ageing and AGE accumulation. Age-synchronized C.elegans nematodes were cultured for 3 and 12 days. The levels of Nε-(carboxymethyl) lysine, Nω-(carboxymethyl) arginine, Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl) ornithine and Nε-(carboxyethyl) lysine (CEL) were compared. Glucose, methylglyoxal and acetol were incubated with human serum albumin, and CEL formation was evaluated. The levels of methylglyoxal and ketone bodies in C.elegans were quantified. CEL accumulation increased significantly with culture duration. Methylglyoxal and ketone bodies—possible forerunners of AGE accumulation—were also quantified with respect to culture duration. The levels of ketone bodies increased significantly during culture, and correlated closely with CEL accumulation (R2 = 0.72, P = 0.0008), whereas the levels of methylglyoxal did not increase over time. CEL was formed in vitro in a time-dependent manner from methylglyoxal and acetol when incubated with human serum albumin (HSA) at the same temperature as C.elegans culture, suggesting that increased levels of CEL in C.elegans are attributable to ketone bodies.
An Examination of Employee Immunization Policies Among Colorado Child Care Providers
Authors: Dullea Elizabeth J , Abbott Elizabeth K , O’Leary Sean T , Wasserman Stephanie , Cataldi Jessica R
Published: July 2021

Background

Child care employee vaccination policies can protect children and adults from vaccine-preventable diseases (VPDs) in child care programs. We aimed to understand the prevalence and characteristics of employee immunization policies at child care facilities and support among child care administrators for statewide employee vaccination regulations.

Methods

A postal mail survey was distributed to a cross-sectional sample of 300 center-based and 300 home-based child care programs in Colorado. Programs were asked to report whether they had any type of policy requiring employee immunizations and if they would support statewide regulations mandating employee immunizations for influenza, pertussis, and measles.

Results

The response rate was 48% (288/600). About 55% of child care programs reported having an employee immunization policy. Child care centers (73%) were more likely than home-based child care programs (30%, P < .001) to report having a policy. Overall, 62% of respondents reported that they would support one or more statewide regulations requiring child care employees to be vaccinated. Home-based programs (71%) were more likely than center-based programs (53%, P = .001) to support one or more statewide child care employee immunization regulations.

Conclusions

Our findings demonstrate the variability of employee immunization policies at child care programs across Colorado. These results may be used to inform strategies to increase employee immunization uptake and reduce the incidence of VPDs, including developing comprehensive employee immunization policies at the facility and state level. Future research is needed to understand vaccination knowledge, attitudes, and behaviors among child care employees including their perspectives on employee vaccination policies and regulations.
Feasibility of intensity modulated radiotherapy with involved field radiotherapy for Japanese patients with locally advanced non-small cell lung cancer
Authors: Abe Takanori , Iino Misaki , Saito Satoshi , Aoshika Tomomi , Ryuno Yasuhiro , Ohta Tomohiro , Igari Mitsunobu , Hirai Ryuta , Kumazaki Yu , Miura Yu , Kaira Kyoichi , Kagamu Hiroshi , Noda Shin-ei , Kato Shingo
Published: July 2021

The feasibility of intensity modulated radiotherapy (IMRT) with involved field radiotherapy (IFRT) for Japanese patients with locally advanced non-small cell lung cancer (LA-NSCLC) remains unclear. Here we reviewed our initial experience of IMRT with IFRT for Japanese patients with LA-NSCLC to evaluate the feasibility of the treatment. Twenty LA-NSCLC patients who were treated with IMRT with IFRT during November 2019 to October 2020 were retrospectively analyzed. All patients received 60 Gy in 30 fractions of IMRT and were administered concurrent platinum-based chemotherapy. The median patient age was 71 years old and the group included 15 men and 5 women. The patient group included 2 patients with stage IIB, 11 patients with stage IIIA, 5 patients with stage IIIB, and 2 patients with stage IIIC disease. Histological diagnosis was squamous cell carcinoma in 14 patients, adenocarcinoma in 5 patients, and non-small cell lung cancer in 1 patient. The median follow-up period was 8 months. The incidence of grade 3 or greater pneumonitis was 5%, and grade 3 or greater esophagitis was not observed. None of the patients developed regional lymph node, with only recurrence reported so far. These findings indicate that IMRT with IFRT for Japanese patients with LA-NSCLC is feasible in terms of acute toxicity. Further study with a larger number of patients and longer follow-up to clarify the effect of treatment on patient prognosis is required.
Risk factors for acute mountain sickness in travellers to Cusco, Peru: coca leaves, obesity and sex
Authors: Caravedo Maria A , Mozo Karen , Morales Maria L , Smiley Hunter , Stuart Jared , Tilley Drake H , Cabada Miguel M
Published: July 2021

Background

Acute mountain sickness (AMS) may occur after rapid ascents to altitudes >2500 m. Cusco (3350 m) in Peru is a popular destination for altitude inexperienced travellers. This study aimed at evaluating the incidence and risk factors for AMS among a cohort of foreign Spanish language students in Cusco.

Methods

We performed a cohort study among young healthy foreign Spanish language students arriving to Cusco between 2012 and 2016. Consenting students answered an enrollment questionnaire on demographics, travel history and intended AMS preventive behaviour within 48 h of arrival. At 4–5 days after enrollment participants answered a second questionnaire about actual preventive behaviour before symptoms and the development of symptoms compatible with AMS during their first 48 h in Cusco. We used the 2018 Lake Louise Scoring System for AMS diagnosis. Participants with headache and a score ≥ 3 were considered to have AMS.

Results

We enrolled 142 language students, the median age was 21 years (interquartile range 20–25) and 57% were female. Participants decreased physical activity (38%), increased fluid intake (34%), drank coca leaf tea (34%), took acetazolamide (16%) and acclimatized at a lower altitude (6%) to prevent AMS. Thirty-nine percent had AMS. In the multivariate analysis, obesity [odds ratio (OR) 14.45 (2.33–89.6)] and female sex [OR 4.32 (1.81–10.28)] were associated with increased risk of AMS. Taking acetazolamide [OR 0.13 (0.03–0.56)] was associated with decreased AMS risk. Consumption of coca leaf tea was not associated with decreased risk of AMS.

Conclusions

In our cohort, AMS affected two out of five travellers. Obesity and female sex were associated with increased risk. Drinking coca leaf tea for prevention did not decrease the risk of AMS. Acetazolamide prophylaxis was associated with decreased risk of AMS.
Corporate social responsibility and joint venture governance—the forgotten issues
Authors: Fowler Reg
Published: July 2021

Corporate social responsibility is moving from a ‘soft law’ phase when international companies are expected to develop and follow voluntary codes of good practice on issues such as human rights, modern slavery, environmental protection and climate change, and into a phase of ‘hard law’ and enforceable duties of care. This article looks ahead to the issues that such new laws will create for unincorporated joint ventures in the oil and gas sector. The legislation will intentionally get around the principle of corporate separateness with the result that every joint venture participant, the operator and their respective parent companies will have a greater or lesser duty of care to check for and eliminate the same abuses. Will the legislation allow the joint venture participants to rely upon the operator to fulfil those duties for them and how will liability cascade if the duty of care is breached? And what of the state’s liability if it also had an obligation not to cause, or to eliminate, the abuses which the joint venture failed to spot and/or remediate? Can the joint venture seek a contribution from the state?

These Guiding Principles are grounded in recognition of:

(a) States’ existing obligations to respect, protect and fulfil human rights and fundamental freedoms;

(b) The role of business enterprises as specialized organs of society performing specialized functions, required to comply with all applicable laws and to respect human rights;

(c) The need for rights and obligations to be matched to appropriate and effective remedies when breached.

‘Guiding Principles on Business and Human Rights—Implementing the United Nations “Protect, Respect and Remedy” Framework’
A Descriptive Analysis of Pediatric Transports Throughout the U.S. Indo-Pacific Command
Authors: Sam Ashley E , Hamele Mitchell T , Matos Renée I , Fagiana Angela M , Borgman Matthew A , Maddry Joseph K , Schauer Steven G
Published: July 2021

Background

The U.S. Indo-Pacific Command (INDOPACOM) has over 375,000 military personnel, civilian employees, and their dependents. Routine pediatric care is available in theater, but pediatric subspecialty, surgical, and intensive care often require patient movement. Transfer is frequently performed by military air evacuation teams and intermittently augmented by civilian services. Pediatric care requires special training and equipment, yet most transports are staffed by non-pediatric specialists. We seek to describe the epidemiology of pediatric transport missions in INDOPACOM.

Methods

A retrospective review of all patients less than 18 years old transported within INDOPACOM and logged into the Transportation Command Regulating and Command and Control Evacuation System (TRAC2ES) database from June 2008 through June 2018 was conducted. Data are reported using descriptive statistics. Patients were categorized into four age groups: neonatal (<31 days), infant (31-364 days), young children (1 to <8 years), and older children (8-17 years).

Results

During the study period, 687 out of 4,217 (16.3%) transports were children. Median age was 4 years (interquartile range 6 months to 8 years) and 654 patients (95.2%) were transported via military fixed-wing aircraft. There were 219 (31.9%) neonates, 162 (23.6%) infants, 133 (19.4%) young children, and 173 (25.2%) older children. Most common diagnoses encountered were respiratory, cardiac, or abdominal, although older children had a higher percentage of psychiatric diagnoses (28%). Mechanical ventilation was used in 118 (17.2%) patients, and 75 (63.6%) of these patients were neonates.

Conclusions

Within TRAC2ES, nearly one in six encounters were patients aged <18 years, with neonates or infants representing nearly one of three pediatric encounters. Slightly more than one in six pediatric patients required intubation for transport. The data suggest the need for appropriately trained transport teams and equipment be provided to support these missions.
Room-temperature coherent manipulation of single-spin qubits in silicon carbide with a high readout contrast
Authors: Li Qiang , Wang Jun-Feng , Yan Fei-Fei , Zhou Ji-Yang , Wang Han-Feng , Liu He , Guo Li-Ping , Zhou Xiong , Gali Adam , Liu Zheng-Hao , Wang Zu-Qing , Sun Kai , Guo Guo-Ping , Tang Jian-Shun , Li Hao , You Li-Xing , Xu Jin-Shi , Li Chuan-Feng , Guo Guang-Can
Published: July 2021

Spin defects in silicon carbide (SiC) with mature wafer-scale fabrication and micro/nano-processing technologies have recently drawn considerable attention. Although room-temperature single-spin manipulation of colour centres in SiC has been demonstrated, the typically detected contrast is less than 2$\%$, and the photon count rate is also low. Here, we present the coherent manipulation of single divacancy spins in 4H-SiC with a high readout contrast ($-30\%$) and a high photon count rate (150 kilo counts per second) under ambient conditions, which are competitive with the nitrogen-vacancy centres in diamond. Coupling between a single defect spin and a nearby nuclear spin is also observed. We further provide a theoretical explanation for the high readout contrast by analysing the defect levels and decay paths. Since the high readout contrast is of utmost importance in many applications of quantum technologies, this work might open a new territory for SiC-based quantum devices with many advanced properties of the host material.
The Impact of COVID-19 on UNAIDS 90–90–90 Targets: Calls for New HIV Care Models
Authors: Guaraldi Giovanni , Borghi Vanni , Milic Jovana , Carli Federica , Cuomo Gianluca , Menozzi Marianna , Santoro Antonella , Orlando Gabriella , Puzzolante Cinzia , Meschiari Marianna , Franceschini Erica , Bedini Andrea , Ferrari Filippo , Gennari William , Sarti Mario , Mussini Cristina
Published: July 2021

We compared 90–90–90 targets in 2020, during the coronavirus disease 2019 (COVID-19) pandemic, with the targets across the period 2017–2019 in people with HIV. We observed a significant loss in the 90–90–90 objectives in 2020 when compared with 2017–2019 that might be attributable to the COVID-19 crisis.
Forgiveness of Dolutegravir-Based Triple Therapy Compared With Older Antiretroviral Regimens: A Prospective Multicenter Cohort of Adherence Patterns and HIV-RNA Replication
Authors: Parienti Jean-Jacques , Fournier Anna L , Cotte Laurent , Schneider Marie-Paule , Etienne Manuel , Unal Guillemette , Perré Philippe , Dutheil Jean-Jacques , Morilland-Lecoq Elodie , Chaillot Fabien , Bangsberg David R , Gagneux-Brunon Amandine , Prazuck Thierry , Cavassini Matthias , Verdon Renaud , Hocqueloux Laurent
Published: July 2021

Background

For many people with HIV (PWH), taking antiretroviral therapy (ARV) every day is difficult.

Methods

Average adherence (Av-Adh) and log-transformed treatment interruption (TI) to ARV were prospectively measured over 6 months using electronic drug monitoring (EDM) in several cohorts of PWH. Multivariate linear regression models including baseline confounders explored the influence of EDM-defined adherence (R2) on 6-month log10 HIV-RNA. Multivariate logistic regression models were used to compare the risk of HIV-RNA detection (VR) within subgroups stratified by lower (≤95%) and higher (>95%) Av-Adh.

Results

Three hundred ninety-nine PWH were analyzed with different ARVs: dolutegravir (n = 102), raltegravir (n = 90), boosted PI (bPI; n = 107), and NNRTI (n = 100). In the dolutegravir group, the influence of adherence pattern measures on R2 for HIV-RNA levels was marginal (+2%). Av-Adh, TI, and Av-Adh × TI increased the R2 for HIV-RNA levels by 54% and 40% in the raltegravir and bPI treatment groups, respectively. TI increased the R2 for HIV-RNA levels by 36% in the NNRTI treatment group. Compared with the dolutegravir-based regimen, the risk of VR was significantly increased for raltegravir (adjusted odds ratio [aOR], 45.6; 95% CI, 4.5–462.1; P = .001), NNRTIs (aOR, 24.8; 95% CI, 2.7–228.4; P = .005), and bPIs (aOR, 28.3; 95% CI, 3.4–239.4; P = .002) in PWH with Av-Adh ≤95%. Among PWH with >95% Av-Adh, there were no significant differences in the risk of VR among the different ARVs.

Conclusions

These findings support the concept that dolutegravir in combination with 2 other active ARVs achieves greater virological suppression than older ARVs, including raltegravir, NNRTI, and bPI, among PWH with lower adherence.