bluuebunny/crossref_metadata_2025 huggingface dataset:
6&6: A Transdisciplinary Approach to Art–Science Collaboration
Authors: Clark Sarah E , Magrane Eric , Baumgartner Thomas , Bennett Scott E K , Bogan Michael , Edwards Taylor , Dimmitt Mark A , Green Heather , Hedgcock Charles , Johnson Benjamin M , Johnson Maria R , Velo Kathleen , Wilder Benjamin T
Published: June 2020

Despite an historical connection between the arts and sciences, in the past century, the two disciplines have been greatly siloed. However, there is a renewed interest in collaboration across the arts and sciences to support conservation practice by understanding and communicating complex environmental, social, and cultural challenges in novel ways. 6&6 was created as a transdisciplinary art–science initiative to promote a deeper appreciation of the Sonoran Desert. Six artists and six scientists were paired to create work that explored conservation issues in the Sonoran Desert and the Gulf of California. In-depth interviews were conducted with the artists and scientists throughout the 4-year initiative to understand the impact of 6&6 on their personal and professional behaviors and outlook. The findings from this case study reveal the role that intensive, place-based, and transdisciplinary art–science programs can play in shaping narratives to better communicate the patterns and processes of nature and human–environment interactions.
Modulation of the PD-1/PD-L1 immune checkpoint axis during inflammation-associated lung tumorigenesis
Authors: Narayanapillai Sreekanth Chanickal , Han Yong Hwan , Song Jung Min , Kebede Manaye Ebabu , Upadhyaya Pramod , Kassie Fekadu
Published: June 2020

Chronic obstructive pulmonary disease (COPD) is a significant risk factor for lung cancer. One potential mechanism through which COPD contributes to lung cancer development could be through generation of an immunosuppressive microenvironment that allows tumor formation and progression. In this study, we compared the status of immune cells and immune checkpoint proteins in lung tumors induced by the tobacco smoke carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) or NNK + lipopolysaccharide (LPS), a model for COPD-associated lung tumors. Compared with NNK-induced lung tumors, NNK+LPS-induced lung tumors exhibited an immunosuppressive microenvironment characterized by higher relative abundances of PD-1+ tumor-associated macrophages, PD-L1+ tumor cells, PD-1+ CD4 and CD8 T lymphocytes and FOXP3+ CD4 and CD8 T lymphocytes. Also, these markers were more abundant in the tumor tissue than in the surrounding ‘normal’ lung tissue of NNK+LPS-induced lung tumors. PD-L1 expression in lung tumors was associated with IFNγ/STAT1/STAT3 signaling axis. In cell line models, PD-L1 expression was found to be significantly enhanced in phorbol-12-myristate 13-acetate activated THP-1 human monocytes (macrophages) treated with LPS or incubated in conditioned media (CM) generated by non-small cell lung cancer (NSCLC) cells. Similarly, when NSCLC cells were incubated in CM generated by activated THP-1 cells, PD-L1 expression was upregulated in EGFR- and ERK-dependent manner. Overall, our observations indicate that COPD-like chronic inflammation creates a favorable immunosuppressive microenvironment for tumor development and COPD-associated lung tumors might show a better response to immune checkpoint therapies.
Incidence of Staphylococcus aureus Infections After Elective Surgeries in US Hospitals
Authors: Dreyfus Jill , Yu Holly , Begier Elizabeth , Gayle Julie , Olsen Margaret A
Published: June 2020

Background

Although Staphylococcus aureus is a leading cause of postsurgical infections, national estimates of these infections after elective surgeries based on microbiology data are limited. This study assessed cumulative 180-day postsurgical S. aureus incidence in real-world hospital settings.

Methods

A retrospective study of adults (≥18 years) undergoing inpatient or hospital-based outpatient elective surgeries from 1/7/2010–30/6/2015 at hospitals (N = 181) reporting microbiology results in the Premier Healthcare Database (PHD). 86 surgical categories were identified from the National Healthcare Safety Network procedures. We classified positive S. aureus cultures using a hierarchy (bloodstream [BSI], surgical site [SSI], and all other types [urinary tract, respiratory, other/unknown site]) and calculated incidence (number of infections divided by the number of elective surgery discharges). We estimated national infection case volumes by multiplying incidence by national inpatient elective surgical discharge estimates using the entire PHD and weights based on hospital characteristics.

Results

Following 884 803 inpatient elective surgical discharges, 180-day S. aureus infection incidence was 1.35% (0.30% BSI, 0.74% SSI no BSI, 0.32% all other types only). Among 1 116 994 hospital-based outpatient elective surgical discharges, 180-day S. aureus incidence was 1.19% (0.25% BSI, 0.75% SSI no BSI, 0.19% all other types only). Methicillin resistance was observed in ~45% of the S. aureus infections. We estimated 55 764 S. aureus postsurgical infections occurred annually in the US following 4.2 million elective inpatient surgical discharges.

Conclusions

The high burden of S. aureus infections after both inpatient and outpatient elective surgeries highlights the continued need for surveillance and novel infection prevention efforts.
Statewide Interventions and Coronavirus Disease 2019 Mortality in the United States: An Observational Study
Authors: Yehya Nadir , Venkataramani Atheendar , Harhay Michael O
Published: June 2020

Background

Social distancing is encouraged to mitigate viral spreading during outbreaks. However, the association between distancing and patient-centered outcomes in coronavirus disease 2019 (COVID-19) has not been demonstrated. In the United States, social distancing orders are implemented at the state level with variable timing of onset. Emergency declarations and school closures were 2 early statewide interventions.

Methods

To determine whether later distancing interventions were associated with higher mortality, we performed a state-level analysis in 55 146 COVID-19 nonsurvivors. We tested the association between timing of emergency declarations and school closures with 28-day mortality using multivariable negative binomial regression. Day 1 for each state was set to when they recorded ≥ 10 deaths. We performed sensitivity analyses to test model assumptions.

Results

At time of analysis, 37 of 50 states had ≥ 10 deaths and 28 follow-up days. Both later emergency declaration (adjusted mortality rate ratio [aMRR] 1.05 per day delay; 95% confidence interval [CI], 1.00–1.09; P = .040) and later school closure (aMRR 1.05; 95% CI, 1.01–1.09; P = .008) were associated with more deaths. When assessing all 50 states and setting day 1 to the day a state recorded its first death, delays in declaring an emergency (aMRR 1.05; 95% CI, 1.01–1.09; P = .020) or closing schools (aMRR 1.06; 95% CI, 1.03–1.09; P < .001) were associated with more deaths. Results were unchanged when excluding New York and New Jersey.

Conclusions

Later statewide emergency declarations and school closure were associated with higher Covid-19 mortality. Each day of delay increased mortality risk 5 to 6%.
Microhabitat Variation in Egg Diapause Incidence in Summer Within a Local Population: An Adaptation to Decline in Host-Plant Suitability in Trigonotylus caelestialium (Hemiptera: Miridae)
Authors: Shintani Yoshinori , Nagamine Keisuke
Published: June 2020

Diapause induction in multivoltine insects is an ecophysiological event that is generally triggered by seasonal cues such as photoperiod and temperature. The rice leaf bug, Trigonotylus caelestialium (Kirkaldy), feeds on various Poaceae grasses and produces several generations a year. Previous studies have shown that adults produce diapause and nondiapause eggs under short-day and long-day conditions, respectively. However, there is a distinct mid-summer peak in diapause incidence before an autumnal increase in diapause incidence in the field, which cannot be explained by the laboratory results. The present study was performed to examine the environmental factors affecting the diapause incidence in mid-summer and the adaptive significance of this phenomenon. Seasonal trends in diapause incidence differed significantly among three sites located 150–400 m apart from each other and with different host plants. The suitability of host plants differs depending on species and seasonally. Therefore, the microhabitat difference in diapause trend is believed to be due to the difference in host plants. When field-collected female adults laying diapause eggs in late June were fed a seasonally deteriorating host (the orange foxtail, Alopecurus aequalis Sobol. [Poales: Poaceae]), they kept laying diapause eggs, whereas when fed a suitable host (the wheat, Triticum aestivum L. [Poales: Poaceae]) for 5 d, they changed oviposition mode to lay nondiapause eggs. These results indicate that host-plant suitability affects the oviposition mode of T. caelestialium. Diapause-egg oviposition in mid-summer in T. caelestialium has adaptive significance as a bet-hedging strategy against unpredictable dietary conditions.
A Randomized Comparison Study of Lyophilized Nile Tilapia Skin and Silver-Impregnated Sodium Carboxymethylcellulose for the Treatment of Superficial Partial-Thickness Burns
Authors: Lima Júnior Edmar Maciel , de Moraes Filho Manoel Odorico , Costa Bruno Almeida , Fechine Francisco Vagnaldo , Rocha Marina Becker Sales , Vale Mariana Lima , Diógenes Ana Kely de Loyola , Uchôa Alex Marques do Nascimento , Silva Júnior Francisco Raimundo , Martins Camila Barroso , Bandeira Tereza de Jesus Pinheiro Gomes , Rodrigues Felipe Augusto Rocha , Paier Carlos Roberto Koscky , de Moraes Maria Elisabete Amaral
Published: June 2020

Glycerolized Nile tilapia skin (NTS) showed promising results when used for burn treatment in phases II and III randomized controlled trials. This pilot study aims to evaluate the effectiveness of lyophilized NTS (LNTS) as a temporary skin substitute for superficial partial-thickness burns by comparing it with silver-impregnated sodium carboxymethylcellulose dressing. This was a randomized, prospective, open-label, and controlled pilot study conducted in Fortaleza, Brazil, from April 2019 to December 2019. The 24 participants had ≥18 and ≤70 years of age and superficial partial-thickness burns affecting up to 10% of TBSA. Primary outcomes were the number of dressings performed and pain intensity, assessed via the Visual Analogue Scale and the Electronic von Frey. Secondary outcomes were the level of pain-related anxiety, assessed via the Burns Specific Pain Anxiety Scale, and analgesic consumption. In the test group, the number of dressings and the patient-reported pain after dressing-related procedures were lower. Analgesic intake, pain-related anxiety, and both patient-reported and objectively measured pain before dressing-related procedures were similar for the treatment groups. No adverse effects were detected. LNTS shares the same characteristics of an “‘ideal’” wound dressing demonstrated by glycerolized NTS in previous studies. Also, it demonstrated noninferiority for burn management when compared with silver-impregnated sodium carboxymethylcellulose dressing. The safety and efficacy of LNTS demonstrated in this pilot study may allow the development of larger phases II and III RCTs in a near future.
A Novel Head Capsule Labial Gland Lobe in the Black Field Cricket (Orthoptera: Gryllidae)
Authors: Pereira Monique Campos , Cooper Paul D
Published: June 2020

We describe a pair of labial gland lobes on either side of the retrocerebral complex in the head of the Australian black field cricket, Teleogryllus commodus Walker. As the retrocerebral complex includes the corpora cardiaca and corpora allata, hormones secreted by these glands can be absorbed by these lobes. These lobes of the labial gland are connected to the thoracic lobes via a relatively long duct that enters the main duct draining the thoracic lobes. Measurement of the flow rate of dye from head to thorax in the ducts is rapid, suggesting that these glands may serve as a transport system into the thoracic region. Both serotonin and adipokinetic hormone are shown to be present in the lobes near the retrocerebral complex and the ducts of the thoracic lobes, but whether this connection between the head and thorax acts as a hormone transporter is still unclear.
It’s...Complicated: A Theoretical Model of Music-Induced Harm
Authors: Silverman Michael J , Gooding Lori F , Yinger Olivia
Published: June 2020

While literature exists supporting the use of music for health promotion, scholars have also noted the potential for music-induced harm and other maladaptive effects of music. Harm is a multifaceted construct that can include affective, behavioral, cognitive, identity, interpersonal, physical, and spiritual aspects. As music also represents a multifaceted experience, the relationship between music and harm is complex and can include numerous contextual-, deliverer-, music-, and recipient-based factors. Music-induced harm (MIH) also needs to be clearly defined to understand and protect against it. Therefore, the purpose of this article was to explore the numerous factors influencing how music can result in harm and develop a theoretical model that could be used to inform safe music practices. Drawing from existing models of emotional responses to music, music intervention reporting guidelines, therapeutic functions of music, and holistic wellness, we explored how the interplay between the deliverer, music, and recipient can result in various types of MIH in diverse contexts. We then developed the MIH model to integrate these factors and connect the model with the existing literature. The MIH model highlights the relevance of academic and clinical training, credentialing, occupational regulation, continuing education, and professional organizations that provide accredited curricular oversight to protect people from MIH. Implications for clinical application, limitations, and suggestions for future research are provided.
Triad of meningothelial meningioma, rhabdoid meningioma and ependymoma: successful management of an extremely rare case
Authors: Du Hoang Gia , Phuoc Vu Xuan , Hoang Nguyen Duc , Tan Le Dang , Van Trung Nguyen
Published: June 2020

An 8-year-old girl was admitted with four limb weakness for 2 months. Hyperactive reflexes were observed in all four limbs, and positive Hoffmann’s signs were revealed. An MRI spine with the coronal slide detected two tumors, first in the intradural and intramedullary space at the C2–C4 level and the second in the intradural and extramedullary space at the C5–C7 level. Axial T1W contrast MRI brain showed a tumor in the left parietal region. The patient underwent spine surgery first and following by brain surgery. No invasive lesions were remarked during surgery. Histological findings showed meningothelial meningioma and ependymoma from the spine and rhabdoid meningioma from the brain. Two months after the second surgery, the patient recovered fully with no symptoms and was able to participate in all regular activities in life. This work is the first report of a mixed tumor with distinct spinal meningioma and ependymoma components occurring in the cervical spinal cord at the C2–C7 level and coexisting with cranial meningioma. The remarkable result was that the patient fully recovered without any symptoms after receiving two surgeries.
Biomarkers, Creatine Kinase, and Kidney Function of Special Operation Candidates During Intense Physiological Training
Authors: Shumway Joshua , Irvin Adam , Shia Regina , Goodyear Charles D
Published: June 2020

Introduction

The purpose of this pilot study was to assess for biomarkers indicative of passing intense physical training and establishing normative values within the tactical athlete population. Unfortunately, none of the biomarkers assessed were indicative of passing training, however, glucose, blood urea nitrogen, and creatine kinase (CK) levels stood out as abnormal. CK levels are commonly used in conjunction with muscle pain and/or myoglobinurea to diagnose exertional rhabdomyolysis (ER) in athletes and the military population. However, research shows that high CK levels may not correlate with acute kidney failure in ER.

Materials and Methods

After IRB approval and informed consent, blood samples were obtained from 21 volunteers during two phases of the combat control training pipeline: the first phase (12 participants) was 2 hours of daily physical training followed by 8 hours of academics, and the second phase (nine volunteers) a grueling, 72 hour, intense training cycle (stress inoculation training, SIT) with a historic pass rate of only 50%. Biomarkers were also tracked 48 hours after cessation of SIT.

Results

None of the biomarkers assessed showed a correlation with passing SIT, but high CK levels were well above the diagnostic threshold for ER—as high as 28,000 u/L. At a single point in time, a significant correlation did not exist between CK and others markers associated with rhabdomyolysis. Across time, partial correlations controlling for subject did exist between CK and other markers.

Conclusions

In our low-powered case control study (pilot study), a nonpathologic elevation of CK is prevalent in high-intensity military training, but not shown to correlate with values associated with acute kidney injury. We assume that real-time collection of these markers could be used once sensors are capable of real-time collection and have the potential for diagnostic affordance. When measured in a between subjects design, our study showed a lack of significance when correlating markers of acute renal injury and elevation of CK. However, when utilized for tracking purposes (within subjects design), the results do show a positive correlation between CK and renal failure biomarkers—specifically only at high physiological stress points.
Attendance and Quality and Quantity of Research Presentations at an Obstetrics and Gynecology Regional Meeting Pre- and Postchanges in Federal Funding
Authors: Thagard Andrew S , Poole Aaron T , Greer Joy A , Ennen Christopher S
Published: June 2020

Introduction

Participating in scientific meetings offers value to physician trainees and faculty. In 2012, the U.S. Government (including the Department of Defense) instituted restrictions on conference travel, requiring central approval to attend. Hence, our objective was to determine the academic impact of research presented at the American College of Obstetricians and Gynecologists (ACOG) Armed Forces District Meeting and the effect of this federally mandated policy change on attendance and the quality and quantity of research.

Materials and Methods

Attendance logs and meeting programs were reviewed for the 3 years immediately before and after institution of travel regulations. A PubMed search of each abstract was performed to determine if it resulted in publication and the mean duration in months from presentation to publication was calculated and compared between oral and poster presentations. The top journals accepting manuscripts were noted along with the corresponding impact factor.

Results

The overall meeting publication rate was 22%. Oral presentations were significantly more likely than posters to achieve publication (P < 0.001). Following implementation of travel regulations, mean faculty attendance declined from 130 per year to 105 (P < 0.05). Declines in resident attendance and publication rates were not statistically significant. The top journals publishing investigations included Obstetrics and Gynecology (n = 15), Military Medicine (n = 12), and Fertility and Sterility and Gynecologic Oncology (tied, both n = 11).

Conclusion

Approximately one in five presentations at the ACOG Armed Forces District Meeting are published, many in high impact journals within the specialty. Implementation of stricter travel regulations adversely impacted faculty physician attendance, but not trainee participation or the publication rate.
Host Immune Response to Enterovirus and Parechovirus Systemic Infections in Children
Authors: Sasidharan Anjana , Hassan Wail M , Harrison Christopher J , Hassan Ferdaus , Selvarangan Rangaraj
Published: June 2020

Background

Enterovirus (EV) and parechovirus type A3 (PeV-A3) cause infections ranging from asymptomatic to life-threatening. Host immune responses in children, particularly innate responses to PeV-A3, remain largely unknown. The aim of this study was to determine aspects of the cytokine/chemokine responses to EV and PeV-A3 in cerebrospinal fluid (CSF) and plasma obtained from children with systemic/central nervous system infection.

Methods

A total of 74 salvaged CSF samples (27 with EV, 23 with PeV-A3, and 24 with neither EV nor PeV-A3) and 35 paired blood samples (10 with EV, 14 with PeV-A3, and 11 with neither) were studied. Concentrations of cytokines and chemokines were measured using a customized 21-plex MILLIPLEX MAP Human Cytokine/Chemokine Magnetic Bead Panel. Additionally, clinical characteristics data for all the patients were collected from electronic medical records to evaluate the potential association between the immune response and presentations.

Results

We demonstrate that EV and PeV-A3 infections induce different cytokine/chemokine immune responses in children. EV induces more robust responses in CSF with significantly elevated levels of fractalkine, interferon (IFN)-α2, IFN-γ, interleukin (IL)-1Rα, IL-4, IL-8, and tumor necrosis factor α; PeV-A3 induces less robust or absent responses in CSF but robust responses in plasma, with significantly higher concentrations of IFN-α2, IL-15, IL-1Rα, interferon-γ-inducible protein–10, and monocyte chemoattractant protein–1.

Conclusions

High cytokine/chemokine concentrations in the plasma of PeV-A3 patients compared with EV patients could explain higher/more prolonged fever in PeV-A3 patients, whereas relatively low cytokine/chemokine concentrations in PeV-A3 CSF might explain the absence of CSF pleocytosis.
Symptoms of COVID-19 Outpatients in the United States
Authors: Pullen Matthew F , Skipper Caleb P , Hullsiek Kathy H , Bangdiwala Ananta S , Pastick Katelyn A , Okafor Elizabeth C , Lofgren Sarah M , Rajasingham Radha , Engen Nicole W , Galdys Alison , Williams Darlisha A , Abassi Mahsa , Boulware David R
Published: June 2020

Background

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel pathogen causing the current worldwide coronavirus disease 2019 (COVID-19) pandemic. Due to insufficient diagnostic testing in the United States, there is a need for clinical decision-making algorithms to guide testing prioritization.

Methods

We recruited participants nationwide for a randomized clinical trial. We categorized participants into 3 groups: (1) those with confirmed SARS-CoV-2 infection, (2) those with probable SARS-CoV-2 infection (pending test or not tested but with a confirmed COVID-19 contact), and (3) those with possible SARS-CoV-2 infection (pending test or not tested and with a contact for whom testing was pending or not performed). We compared the frequency of self-reported symptoms in each group and categorized those reporting symptoms in early infection (0–2 days), midinfection (3–5 days), and late infection (>5 days).

Results

Among 1252 symptomatic persons screened, 316 had confirmed, 393 had probable, and 543 had possible SARS-CoV-2 infection. In early infection, those with confirmed and probable SARS-CoV-2 infection shared similar symptom profiles, with fever most likely in confirmed cases (P = .002). Confirmed cases did not show any statistically significant differences compared with unconfirmed cases in symptom frequency at any time point. The most commonly reported symptoms in those with confirmed infection were cough (82%), fever (67%), fatigue (62%), and headache (60%), with only 52% reporting both fever and cough.

Conclusions

Symptomatic persons with probable SARS-CoV-2 infection present similarly to those with confirmed SARS-CoV-2 infection. There was no pattern of symptom frequency over time.
The Starting at Home Principle: On Ritual Animal Slaughter, Male Circumcision and Proportionality
Authors: Porat Iddo
Published: June 2020

Abstract—

Many argue that ritual animal slaughter and male circumcision should be banned using a balancing and proportionality approach: freedom of religion considerations are outweighed by the infringements of the rights of children and animals. I argue that the proportionality approach to the problem is misguided and suggest applying an approach that I term starting at home: members of a minority have a right not to be subjected to more stringent moral criteria than the majority is willing to subject itself to. There is, in other words, a right given to the minority that the majority start with its own moral rectitude before taking care of the minority’s. Applying this principle to ritual animal slaughter and male circumcision, I argue that banning these practices in Europe is wrong.
Influence of water and rock particle contents on the shear behaviour of a SRM
Authors: Liu Longqi , Mao Xuesong , Xiao Yajun , Wang Tiequan , Nie Menglan
Published: June 2020

The contents of both water and rock particles are important factors affecting the mechanical strength of a soil–rock mixture (SRM) filled subgrade in the western mountainous area of China. Therefore, the purpose of this paper is to study the mechanisms of reconstituted landslide deposit samples with different water and rock particle contents by analysing the characteristics of shear strength, volumetric strain and ‘jumping’ phenomenon via large-scale direct shear tests. The results show that the influence of water content on shear strength is greater than the influence of rock particle content under a lower normal stress, and the results are reversed in the case of a higher normal stress. The effect of water content on the equivalent cohesion is bigger, especially for the sample with a high rock particle content. The friction angle of the specimen with same water content increases with the increasing rock particle content, but when the number of rock particles increases to a certain extent, there is a little effect on the friction angle. However, the friction angle decreases with increasing water content at the same rock particle content. Specimens with the same rock particle content change from dilation to compression with increasing water content. Finally, the continuous stage of the ‘intense jumping’ at different water content has been analysed. The ‘jumping’ phenomenon of samples with low water and rock particle content will first strengthen and then weaken the samples with increasing normal stress.
Using portable falling weight deflectometer to determine treatment depth of subgrades in highway reconstruction of Southern China
Authors: Zhang Junhui , Ding Le , Zeng Ling , Gao Qianfeng , Gu Fan
Published: June 2020

Based on a highway reconstruction project in southern China, this study aims to put forward a method to determine the proper treatment depth of the existing subgrade. First, some field tests including the Beckman beam deflection test and portable falling weight deflectometer (PFWD) test were carried out. The results showed that there was a good correlation between the Beckman beam deflection (L) and PFWD modulus (Ep). Subsequently, a subgrade section was excavated and backfilled with cement-stabilized soil in layers. Compaction test, dynamic cone penetrometer rate test, plate load test and Beckman beam deflection test were performed to evaluate the treatment effect. To make sure, the subgrade was treated deeply enough, the Beckman beam deflection (L) was used as the controlled indicator among all the measured indexes for it was the hardest metric to meet. According to the design deflection and decreasing law of the measured deflections with the different number of the stabilized layers, the treatment depth was finally determined. As the PFWD test is superior to the deflection test in the detection efficiency, and the deflection value can be calculated from PFWD modulus by correlation formulas, thus the latter index can be used as a more suitable parameter for estimating the treatment depth instead of the former. Consequently, based on the measured PFWD moduli of the existing subgrade, six treatment schemes considering different treatment depths were proposed. It was confirmed that the method developed from this study is feasible and worth being extensively applied.
Pulsed Water Mists for Suppression of Strawberry Powdery Mildew
Authors: Asalf Belachew , Onofre Rodrigo B. , Gadoury David M. , Peres Natalia A. , Stensvand Arne
Published: June 2020

Powdery mildew (Podosphaera aphanis) is a destructive and widespread disease of strawberry (Fragaria × ananassa), especially when susceptible cultivars are grown in high plastic tunnels or glasshouses. Many powdery mildews thrive in humid environments but free water films on plant surfaces can inhibit conidial germination of some species. We hypothesized that P. aphanis might be directly suppressed by rain through the action of water films and meteoric water. In repeated experiments, the hydrophobic conidia of P. aphanis collected on the surface of water droplets, resulting in their removal when the droplets rolled over the leaf surfaces and fell to the ground. Meteoric water and water films also damaged conidiophores. Brief midday water mists applied in pulses lasting 1 min each four times per day were as effective as multiple fungicide treatments in suppressing powdery mildew. Rapid drying of the pulsed mists resulted in effective suppression of powdery mildew without consequent increases of fungal pathogens that might benefit from water films. The timing and duration of water sprinkling has been refined to the point where it can provide a commercially relevant degree of suppression of powdery mildew on strawberry in a high-tunnel production system.
Characterization of Colletotrichum spp. Sensitivity to Carbendazim for Isolates Causing Strawberry Anthracnose in China
Authors: Zhong Shan , Miao Jianqiang , Liu Xili , Zhang Guozhen
Published: June 2020

Strawberry anthracnose caused by Colletotrichum species is an important disease that may cause significant economic losses. Based on multilocus sequence analyses and morphological characteristics, 64 isolates from strawberry anthracnose samples collected from nine Chinese provinces and municipalities were identified as three species: Colletotrichum fructicola (29 isolates), Colletotrichum siamense (23 isolates), and Colletotrichum nymphaeae (12 isolates). Isolates of C. siamense showed strong aggressiveness to fruit and leaves. Isolates of C. fructicola showed strong aggressiveness to crowns. Isolates of C. nymphaeae were weakly or not pathogenic to fruit, leaves, or crowns. Sensitivity to carbendazim was determined for a total of 75 isolates, including 11 previously preserved. Two isolates of C. siamense were highly resistant (HR) and 21 were moderately resistant (MR). Nine isolates of C. fructicola were sensitive (S), 24 were HR, and four were MR. All 15 isolates of C. nymphaeae were insensitive, and their mycelial growth was not completely inhibited on potato dextrose agar amended with 500 μg/ml carbendazim. Beta-tubulin (TUB2) of representative isolates was amplified and sequenced, revealing a glutamic acid substituted by alanine at codon 198 in HR isolates of C. siamense and C. fructicola. MR isolates of C. siamense and C. fructicola had a point mutation at codon 200, causing a replacement of phenylalanine acid by tyrosine. No point mutation was detected at codons 50, 167, 198, 200, or 240 in TUB2 of C. nymphaeae insensitive isolates. Overall, this study revealed that C. fructicola was the dominant species causing anthracnose on strawberry and could improve the understanding of the management of fungicide resistance in Colletotrichum species on strawberry in China.
An Interprofessional Approach to Assessing Research Ethics Capacity in Vietnam: Implications for Nursing Education
Authors: Upvall Michele , Thao Nguyen Thanh , Beever Jonathan , Huy Nguyen Vu Quoc
Published: June 2020

This study assessed the knowledge, practices, attitudes, and educational needs related to research ethics across health professions faculty, including nursing, in a university located in Vietnam. Consistent themes across five focus groups and two interviews included promoting knowledge of research ethics, ethics in context, and the value of international partnerships to promote ongoing knowledge of research ethics. Results from this study can be used to strengthen the university’s curriculum reform efforts for nursing programs and other health profession curricula across the university. Research partnership opportunities may further the development of research ethics among nursing faculty and students.
New Simulation Orientation for Sophomore Nursing Students: Continuous Quality Improvement
Authors: Porembski Lauren , Fletcher Linnea , King Tara Spalla
Published: June 2020

This quality improvement project focused on reducing simulation-related anxiety and stress and building confidence in nursing students. The authors evaluated two methods to provide orientation to simulation on the first simulation day: the traditional faculty-led orientation and interactive orientation led by a high-fidelity simulator. Given the small sample size, there was no statistical difference in student-reported anxiety or stress; there was one significant difference in confidence. Qualitative data provided valuable qualitative feedback about the simulation experience that will be used to enhance future simulations.
Using the CNE as an Innovative Strategy to Support Junior Nursing Faculty Transitioning From Clinical Practice
Authors: Kinneary Patricia , Sutton Elizabeth
Published: June 2020

For new nurse educators, the certified nurse educator credential can be more than a mark of expertise. This article explains how two junior nurse faculty discovered that preparation for certification facilitated the change process from clinician to academic nurse educator. We describe barriers overcome on the path to certification and highlight key factors for attaining success. The important fruits of certification are explored, and recommendations for professional development for new nurse educators are offered.
Resurrecting Philosophers in an Online Doctoral Philosophy Course in Nursing
Authors: Volkert Delene , Castleberry Jennifer , Fellows Bonnie J. , Goodreau Meredythe , Hesser Lisa , Whitley Catherine
Published: June 2020

Philosophy courses are hallmarks for research-focused doctoral nursing programs. They help students develop inductive reasoning to build critical thinking skills, but students often find them dry and boring and have difficulty developing enthusiasm for the material. Students in an online EdD in Nursing Education program were able to engage with philosophical topics meaningfully by designing and facilitating creative peer-learning activities. To assess the realization of learning outcomes, participating students completed a survey at the end of the module. Five of the six participants (83 percent) indicated they agreed or strongly agreed that the activities helped meet course learning outcomes.
Interventional radiology for the obstetric patient
Authors: Lambrecht Sigrid , Van De Velde Marc
Published: June 2020

Purpose of review

To discuss the recent results of the use of interventional radiology modalities treating postpartum hemorrhage (PPH).

Recent findings

PPH still is a leading cause of maternal morbidity and mortality. An important risk factor for the development of PPH is the placenta accreta spectrum. In patients with placenta accreta, we can use prophylactic balloon occlusion of the common or internal iliac artery or abdominal aorta to prevent PPH. Balloon occlusion of the abdominal aorta seems to ensure better results than balloon occlusion of the iliac artery in terms of blood loss, transfusion rate and hysterectomy rate reduction with a minimal risk of complications. To treat PPH uterine artery embolization can be effective and potentially fertility-sparing, while having a low complication rate.

The use of aortic balloon occlusion catheters for the prevention of PPH and uterine artery embolization for the treatment of PPH are well tolerated and feasible options for patients with placenta accreta spectrum.
Is there a place for regional anesthesia in nonoperating room anesthesia?
Authors: Faddoul Annibal , Bonnet Francis
Published: June 2020

Purpose of review

General anesthesia and monitored anesthesia care (MAC) are the most widely used techniques in nonoperating room anesthesia (NORA). However, regional anesthesia is slowly finding viable applications in this field. This review aims at providing an update on the current practice of regional anesthesia techniques outside of the operating theatre.

Recent findings

Some anesthetic departments have implemented the use of regional anesthesia in novel applications outside of the operating room. In most cases, it remains an adjunct to general anesthesia but is sometimes used as the sole anesthetic technique. The use of the paravertebral block during radiofrequency ablation of different tumors is a recent application in interventional radiology. In emergency medicine, regional anesthesia is gaining traction in analgesia for trauma patients.

Regional anesthesia is finding its way into broader applications every day, offering a range of potential benefits in anesthetic care. Its implementation in NORA is promising and may aid in decreasing patient morbidity. However, great care should be taken in applying the recommended safety precautions for regional anesthesia in any setting.
Implementing a Skin-to-Skin Care and Parent Touch Initiative in a Tertiary Cardiac and Surgical Neonatal Intensive Care Unit
Authors: Levesque Valerie , Johnson Krystal , McKenzie Amy , Nykipilo Andrea , Taylor Barbara , Joynt Chloe
Published: June 2020

Background

Skin-to-skin care (SSC) has been integrated as an essential component of developmental care for preterm infants. Despite documented benefits, SSC is not routinely practiced in the cardiac and surgical neonatal intensive care unit, with a predominantly term population, due to staff apprehension, patient factors and acuity, and environmental constraints.

Purpose:

The purpose of this quality improvement project was to increase SSC, parental holds, and parent touch events for infants in our cardiac and surgical neonatal intensive care unit. When traditional SSC was not possible, alternative holds and alternative parent touch (APT) methods were encouraged.

Methods:

Quality improvement and qualitative descriptive methodology were utilized to assess baseline, develop education and practice changes, and evaluate the use of SSC, holds, and APT methods at 12 and 18 months postintervention. Implementation included educational tools and resource development, simulations, peer champions, in-class teaching, and team huddles. Decisions around the type of hold and parent touch were fluid and reflected complex infant, family, staff, and physical space needs.

Findings:

Given its initial scarcity, there was an increased frequency of SSC and variety of holds or APT events. Staff survey results indicated support for the practice and outlined persistent barriers.

Implications for Practice:

Skin-to-skin care, holds, and APT practices are feasible and safe for term and preterm infants receiving highly instrumented and complex cardiac and surgical care.

Implications for Research:

Future research regarding the intervention's impact on neurodevelopmental outcomes of infants and on parent resilience in the surgical and cardiac neonatal intensive care unit is warranted.
Remodeling of Sagittal Plane Malunion After Pediatric Supracondylar Humerus Fractures
Authors: Gamble James G. , Vorhies John S.
Published: June 2020

Background:

Pediatric supracondylar humeral fractures (SCHFs) can heal in hyperextension malunion after casting or surgical treatment. Here the authors present quantitative evidence concerning the ability of children to remodel sagittal plane malunion. Their null hypothesis was that like varus and valgus malunion, children have little capacity to remodel sagittal plane malunion after SCHFs.

Methods:

The authors performed a prospective longitudinal radiographic study of 41 children, aged 22 to 126 months, who were registered during the study interval. They calculated the percent displacement of the center of the capitellum behind the anterior humeral line (AHL) as the distance of the midpoint of the capitellum from the AHL, divided by the diameter of the capitellum, multiplied by 100. Longitudinal measurements were made using the embedded software on our institution’s digital radiographic system. The primary outcome focus was the percent displacement of the center of the capitellum relative to AHL on the initial and on the latest radiograph.

Results:

The average initial displacement (hyperextension) of the capitellum behind the AHL for all patients was 61% (range, 23% to 134%). At an average follow-up of 21 months, 24 children (60%) had remodeled 100% the sagittal plane malunion, 12 children (30%) had remodeled such that the AHL passed through the central third of the capitellum, and 5 children (10%) had minimal or no remodeling.

Conclusions:

The authors rejected their null hypothesis. Children do have the capacity to remodel radiographically measurable sagittal plane malunion of SCHFs. Children younger than 5 years of age can remodel 100% displacement of the center of the capitellum, whereas those over 8 years of age have minimal remodeling capacity.
3D-printed Patient-specific Spine Implants
Authors: Wallace Nicholas , Schaffer Nathaniel E. , Aleem Ilyas S. , Patel Rakesh
Published: June 2020

Study Design:

Systematic review.

Objective:

To review the current clinical use of 3-dimensional printed (3DP) patient-specific implants in the spine.

Summary of Background Data:

Additive manufacturing is a transformative manufacturing method now being applied to spinal implants. Recent innovations in technology have allowed the production of medical-grade implants with unprecedented structure and customization, and the complex anatomy of the spine is ideally suited for patient-specific devices. Improvement in implant design through the process of 3DP may lead to improved osseointegration, lower subsidence rates, and faster operative times.

Methods:

A comprehensive search of the literature was conducted using Ovid MEDLINE, EMBASE, Scopus, and other sources that resulted in 1842 unique articles. All manuscripts describing the use of 3DP spinal implants in humans were included. Two independent reviewers (N.W. and N.E.S.) assessed eligibility for inclusion. The following outcomes were collected: pain score, Japanese Orthopedic Association (JOA) score, subsidence, fusion, Cobb angle, vertebral height, and complications. No conflicts of interest existed. No funding was received for this work.

Results:

A total of 17 studies met inclusion criteria with a total of 35 patients. Only case series and case reports were identified. Follow-up times ranged from 3 to 36 months. Implant types included vertebral body replacement cages, interbody cages, sacral reconstruction prostheses, iliolumbar rods, and a posterior cervical plate. All studies reported improvement in both clinical and radiographic outcomes. 11 of 35 cases showed subsidence >3 mm, but only 1 case required a revision procedure. No migration, loosening, or pseudarthrosis occurred in any patient on the basis of computed tomography or flexion-extension radiographs.

Conclusions:

Results of the systematic review indicate that 3DP technology is a viable means to fabricate patient-matched spinal implants. The effects on clinical and radiographic outcome measures are still in question, but these devices may produce favorable subsidence and pseudoarthrosis rates. Currently, the technology is ideally suited for complex tumor pathology and atypical bone defects. Future randomized controlled trials and cost analyses are still needed.

Level of Evidence: IV—systematic review.
Evaluating the Clinical Impact of Rapid Response Electroencephalography: The DECIDE Multicenter Prospective Observational Clinical Study*
Authors: Vespa Paul M. , Olson DaiWai M. , John Sayona , Hobbs Kyle S. , Gururangan Kapil , Nie Kun , Desai Masoom J. , Markert Matthew , Parvizi Josef , Bleck Thomas P. , Hirsch Lawrence J. , Westover M. Brandon
Published: June 2020

Objectives:

To measure the diagnostic accuracy, timeliness, and ease of use of Ceribell rapid response electroencephalography. We assessed physicians’ diagnostic assessments and treatment plans before and after rapid response electroencephalography assessment. Primary outcomes were changes in physicians’ diagnostic and therapeutic decision making and their confidence in these decisions based on the use of the rapid response electroencephalography system. Secondary outcomes were time to electroencephalography, setup time, ease of use, and quality of electroencephalography data.

Design:

Prospective multicenter nonrandomized observational study.

Setting:

ICUs in five academic hospitals in the United States.

Subjects:

Patients with encephalopathy suspected of having nonconvulsive seizures and physicians evaluating these patients.

Interventions:

Physician bedside assessment of sonified electroencephalography (30 s from each hemisphere) and visual electroencephalography (60 s) using rapid response electroencephalography.

Measurements and Main Results:

Physicians (29 fellows or residents, eight attending neurologists) evaluated 181 ICU patients; complete clinical and electroencephalography data were available in 164 patients (average 58.6 ± 18.7 yr old, 45% females). Relying on rapid response electroencephalography information at the bedside improved the sensitivity (95% CI) of physicians’ seizure diagnosis from 77.8% (40.0%, 97.2%) to 100% (66.4%, 100%) and the specificity (95% CI) of their diagnosis from 63.9% (55.8%, 71.4%) to 89% (83.0%, 93.5%). Physicians’ confidence in their own diagnosis and treatment plan were also improved. Time to electroencephalography (median [interquartile range]) was 5 minutes (4–10 min) with rapid response electroencephalography while the conventional electroencephalography was delayed by several hours (median [interquartile range] delay = 239 minutes [134–471 min] [p < 0.0001 using Wilcoxon signed rank test]). The device was rated as easy to use (mean ± sd: 4.7 ± 0.6 [1 = difficult, 5 = easy]) and was without serious adverse effects.

Conclusions:

Rapid response electroencephalography enabled timely and more accurate assessment of patients in the critical care setting. The use of rapid response electroencephalography may be clinically beneficial in the assessment of patients with high suspicion for nonconvulsive seizures and status epilepticus.