bluuebunny/crossref_metadata_2025 huggingface dataset:
Out-of-Pocket Spending Within 90 Days of Discharge from COVID-19 Hospitalization
Authors: Chua Kao-Ping , Conti Rena M. , Becker Nora V.
Published: June 2021

INTRODUCTION

Millions of U.S. patients have been hospitalized for COVID-19. After discharge, these patients often have extensive health care needs, but out-of-pocket burden for this care is poorly described. We assessed out-of-pocket spending within 90 days of discharge from COVID-19 hospitalization among privately insured and Medicare Advantage patients.

METHODS

In May 2021, we conducted a cross-sectional analysis of the IQVIA PharMetrics® Plus for Academics Database, a national de-identified claims database. Among privately insured and Medicare Advantage patients hospitalized for COVID-19 between March-June 2020, we calculated mean out-of-pocket spending for care within 90 days of discharge. For context, we repeated analyses for patients hospitalized for pneumonia.

RESULTS

Among 1,465 COVID-19 patients included, 516 (35.2%) and 949 (64.8%) were covered by private insurance and Medicare Advantage plans. Among these patients, mean (SD) post-discharge out-of-pocket spending was $534 (1,045) and $680 (1,360); spending exceeded $2,000 for 7.0% and 10.3%. Compared with pneumonia patients, mean post-discharge out-of-pocket spending among COVID-19 patients was higher among the privately insured ($534 vs $445) and lower among Medicare Advantage patients ($680 vs $918).

CONCLUSIONS

For the privately insured, post-discharge out-of-pocket spending was higher among patients hospitalized for COVID-19 than among patients hospitalized for pneumonia. The opposite was true for Medicare Advantage patients, potentially because insurer cost-sharing waivers for COVID-19 treatment covered the costs of some post-discharge care, such as COVID-19 readmissions. Nonetheless, given the high volume of U.S. COVID-19 hospitalizations to date, our findings suggest a large number of Americans have experienced substantial financial burden for post-discharge care.
Coupling of Ca2+-triggered unclamping and membrane fusion during neurotransmitter release
Authors: McDargh Zachary A. , Polley Anirban , Zeng Jin , O’Shaughnessy Ben
Published: June 2021

Neurotransmitter (NT) release is accomplished by a machinery that unclamps fusion in response to calcium and then fuses the synaptic vesicle and plasma membranes. These are often thought of as distinct tasks assigned to non-overlapping components. Vesicle release rates have a power law dependence on [Ca2+] with an exponent of 3-5, long taken to indicate that 3-5 Ca2+ions bind the calcium sensor Synaptotagmin to trigger release. However, dependencies at low [Ca] are inconsistent with simple sequential binding to a single Ca2+sensor followed by a final fusion step. Here we developed coarse-grained molecular dynamics simulations of the NT release machinery accounting for Synaptotagmin-mediated unclamping and SNARE-mediated fusion. Calcium-triggered unclamping and SNARE-mediated fusion emerged from simulations as contemporaneous, coupled processes. Increasing cytosolic [Ca2+], the instantaneous fusion rate increased as SNAREpins were progressively and reversibly released by dissociation of Synaptotagmin-SNAREpin complexes. Simulations reproduced the observed dependence of release rates on [Ca2+], but the power law was unrelated to the number of Ca2+ions required. Action potential-evoked vesicle release probabilities depended on the number of transiently unclamped SNAREpins, explaining experimental dependencies of release probabilities on both unclamping and membrane-fusing machinery components. These results describe a highly cooperative NT release machinery with intrinsically inseparable unclamping and membrane-fusing functionalities.
Tacit curriculum of Black intellectual ineptitude: Black girls' perspectives on Texas school desegregation implementation in the 1970s
Authors: James-Gallaway ArCasia D.
Published: June 2021

Purpose

This paper uses former Black girl students' experiential knowledge as a lens to examine Black students' experiences with formal and informal curriculum; it looks to the 1970s during Waco Independent School District's desegregation implementation process.

Design/methodology/approach

Guided by critical race theory, I used historical and oral history methods to address the question: In newly desegregated schools, what does Black females' experiential knowledge of the academic and social curriculum reveal about Black students' experiences within school desegregation implementation process? Specifically, I drew on oral history interviews with former Black girl students, local newspapers, school board minutes, legal correspondence, memoranda, yearbooks, and brochures.

Findings

Black girls' holistic perspectives, which characterized Black students' experiences more generally, indicate Waco Independent School District's implementation of school desegregation promoted a tacit curriculum of Black intellectual ineptitude.

Originality

My main contribution is the concept of tacit curriculum, which I identified through the lens of former Black girl students, whose experiences spoke to Black students' experiences more widely. It also offers Black females' firsthand perspectives of the school desegregation implementation process in Texas, a perspective, a process, and a place heretofore underexamined in history of education scholarship.
Government regulation and financial support on housing delivery: lessons learned from the Saudi experience
Authors: AlQahtany Ali Muflah
Published: June 2021

Purpose

The purpose of this paper is to study the housing delivery in the Kingdom of Saudi Arabia (KSA) and to discuss the most significant government regulations and financial support that have been applied since the beginning of this century and especially during the past ten years, which constituted a qualitative leap in the housing sector in the country.

Design/methodology/approach

In this paper, the desktop study technique was used to review the key related literature, collect the data and analyze secondary data. This study used a mixed approach involving (1) literature search and review, (2) analysis of literature public documents and databases and (3) expert discussions. The content analysis technique was followed for data analysis of gathered documents and secondary data. This study used the three-step iterative process during the use of the content analysis technique.

Findings

The findings reveal that the demand for housing will continue to increase in the coming years with increase in population. The housing supply should not only match the demand but also should develop according to the social and economic characteristics of the population. Besides, the authorities have to both streamline and reinforce regulations pertaining to construction permits and building licenses. Nonetheless, the regulators are suggested to remain vigilant about potential fiscal and financial risks as the housing market develops.

Research limitations/implications

The opinions of policymakers and stakeholders are very important, but because of the time limitation it has not been explicitly addressed. Instead, discussions with select experts were carried out to validate the findings. Future research can assess the housing delivery based on the viewpoints of the policymakers, professionals, academics and stakeholders to have better insights and broaden the boundaries of knowledge in this field.

Originality/value

Similar studies in this field are limited, which makes this paper one of the pioneering attempts to study the current housing situation in the KSA and shed light on the most significant government regulations and financial support for housing delivery in the country.
Women’s experiences of a telemedicine abortion service (up to 12 weeks) implemented during the coronavirus (COVID‐19) pandemic: a qualitative evaluation
Authors: Boydell N , Reynolds‐Wright JJ , Cameron ST , Harden J
Published: June 2021

Objective

To explore the experiences of women in Scotland who accessed medical abortion at home up to 12 weeks’ gestation, delivered via a telemedicine abortion service implemented in response to the coronavirus (COVID‐19) pandemic, to identify areas for improvement and inform service provision.

Design

Qualitative interview study.

Setting

Abortion service in one National Health Service health board in Scotland.

Population or sample

Twenty women who accessed telemedicine abortion services and self‐administered mifepristone and misoprostol at home up to 12 weeks’ gestation.

Methods

Thematic analysis of semi‐structured qualitative interviews, informed by the Framework analytic approach.

Main outcome measures

Women’s experiences of accessing telemedicine for medical abortion at home, specifically: acceptability of the telephone consultation and remote support; views on no pre‐abortion ultrasound scan; and self‐administration of abortion medications at home.

Results

Novel study findings were three‐fold: (1) participants valued the option of accessing abortion care via telemedicine and emphasised the benefits of providing a choice of telephone and in‐person consultation to suit those with different life circumstances; (2) the quality of abortion care was enhanced by the telemedicine service in relation to access, comfort and flexibility, and ongoing telephone support; (3) participants described being comfortable with, and in some cases a preference for, not having an ultrasound scan.

Conclusions

This research demonstrates support for the continuation of telemedicine abortion services beyond the temporary arrangements in place during COVID‐19, and lends weight to the argument that offering the option of telemedicine abortion care can enable women to access this essential health service.

Tweetable abstract

#Telemedicine provision of medical #abortion at home up to 12 weeks’ gestation is acceptable and highly valued by #women #Research #SRHR @nbw80 @doctorjjrw @jeniharden @cameronsharon @mrc_crh @edinuniusher.
Mechanical thrombectomy is efficacious in patients with pre‐stroke moderate disability
Authors: Nababan Tara , Phillips Timothy J. , Hankey Graeme J. , Crockett Matthew T. , Chiu Albert Ho Yuen , Singh Tejinder P. , Blacker David , McAuliffe William
Published: June 2021

Introduction

Patients with ischaemic stroke due to large vessel occlusion (LVO) can be treated successfully with mechanical thrombectomy (MT) and/or intravenous thrombolysis. In the landmark trials, MT was only performed for those with no functional disability prior to stroke (mRS 0–2). There are limited data available regarding clinical outcomes for patients with pre‐stroke moderate disability (mRS ≥ 3). The aims of this study were to analyse the clinical outcomes and financial implications in regard to accommodation costs of performing MT in patients with pre‐stroke mRS = 3.

Methods

An observational cohort study was performed of 802 patients with anterior circulation LVO ischaemic stroke who underwent MT between October 2016 and January 2020 at three tertiary hospitals. Patient demographics, premorbid mRS, stroke and interventional data, 90‐day mRS and accommodation situation were recorded.

Results

Eighty‐two patients with anterior circulation LVO ischaemic stroke were pre‐stroke mRS 3. 38% had a good clinical outcome, as defined by mRS 3 at 90 days. Mortality rate was 38%. The majority of patients presented from home (83%) and greater than one third of those returned home during the 90 days post treatment. 81% of patients had no increase in accommodation cost at 90 days.

Conclusion

Patients with pre‐stroke moderate disability may benefit from MT if they are appropriately selected. This may result in fewer patients requiring nursing home placement and less financial burden on the public health system, indicating significant savings are possible.
Inter‐rater reliability and prospective validation of a clinical prediction rule for SARS‐CoV‐2 infection
Authors: Nevel Adam E. , Kline Jeffrey A.
Published: June 2021

Objectives

Accurate estimation of the risk of SARS‐CoV‐2 infection based on bedside data alone has importance to emergency department (ED) operations and throughput. The 13‐item CORC (COVID [or coronavirus] Rule‐out Criteria) rule had good overall diagnostic accuracy in retrospective derivation and validation. The objective of this study was to prospectively test the inter‐rater reliability and diagnostic accuracy of the CORC score and rule (score ≤ 0 negative, > 0 positive) and compare the CORC rule performance with physician gestalt.

Methods

This noninterventional study was conducted at an urban academic ED from February 2021 to March 2021. Two practitioners were approached by research coordinators and asked to independently complete a form capturing the CORC criteria for their shared patient and their gestalt binary prediction of the SARS‐CoV‐2 test result and confidence (0%–100%). The criterion standard for SARS‐CoV‐2 was from reverse transcriptase polymerase chain reaction performed on a nasopharyngeal swab. The primary analysis was from weighted Cohen's kappa and likelihood ratios (LRs).

Results

For 928 patients, agreement between observers was good for the total CORC score, κ = 0.613 (95% confidence interval [CI] = 0.579–0.646), and for the CORC rule, κ = 0.644 (95% CI = 0.591–0.697). The agreement for clinician gestalt binary determination of SARs‐CoV‐2 status was κ = 0.534 (95% CI = 0.437–0.632) with median confidence of 76% (first–third quartile = 66–88.5). For 425 patients who had the criterion standard, a negative CORC rule (both observers scored CORC < 0), the sensitivity was 88%, and specificity was 51%, with a negative LR (LR−) of 0.24 (95% CI = 0.10–0.50). Among patients with a mean CORC score of >4, the prevalence of a positive SARS‐CoV‐2 test was 58% (95% CI = 28%–85%) and positive LR was 13.1 (95% CI = 4.5–37.2). Clinician gestalt demonstrated a sensitivity of 51% and specificity of 86% with a LR− of 0.57 (95% CI = 0.39–0.74).

Conclusion

In this prospective study, the CORC score and rule demonstrated good inter‐rater reliability and reproducible diagnostic accuracy for estimating the pretest probability of SARs‐CoV‐2 infection.
Analysis of Iris volume using swept‐source optical coherence tomography in patients with type 2 diabetes mellitus
Authors: Meng Jie , Han Xiao , Wang Wei , Gong Xia , Li Wangting , Xiong Kun , Li Yuting , Zhang Xiulan , Liang Xiaoling , Huang Jingjing , Huang Wenyong
Published: June 2021

Purpose

To evaluate iris volume before and after pupil dilation using swept‐source anterior segment optical coherence tomography (SS‐ASOCT) and investigate the associated factors of iris volume and iris volume change after pupil dilation in patients with type 2 diabetes mellitus (T2DM).

Methods

A cross‐sectional study was conducted in Zhongshan Ophthalmic Center among T2DM registered patients in the community of Guangzhou, China. Anterior chamber volume (ACV), iris volume, anterior chamber depth (ACD), angle opening distance at 500 μm (AOD 500) and pupil diameter were estimated using SS‐ASOCT (CASIA; Tomey, Nagoya, Japan). Venous blood was taken for the measurement of glycosylated haemoglobin A1c (HbAlc). All biometric measurements were performed before and after pharmacologic pupil dilation.

Results

A total of 117 subjects were included in the analysis. The mean age (±SD) was 64.96 ± 7.75 years, and 62.4% were females. After pupil dilation, iris volume decreased in all eyes. Shorter duration of diabetes (p = 0.035), longer axial length (p < 0.001) and smaller pupil diameter (p < 0.001) were associated with larger iris volume. The change in iris volume per millimetre change in pupil diameter was 1.35mm3/mm. Smaller baseline iris volume (p = 0.002) and higher HbA1c level (p = 0.010) were associated with smaller change in iris volume per millimetre change in pupil diameter, after adjusting for other factors.

Conclusion

Iris volume can be estimated by SS‐ASOCT. Diabetic duration was associated with static anatomy of iris volume, while HbA1c level indicated the dynamic response of iris volume. It is likely that diabetic duration and HbA1c level could affect the macroscopic and microscopic composition of the iris in the diabetic population.
Selected or rejected: Men and women's reactions to affirmative action procedures in hiring
Authors: Carlsson Rickard , Sinclair Samantha
Published: June 2021

Previous research suggests that affirmative action policies tend to be perceived more negatively by men than by women, and by nonbeneficiaries relative to beneficiaries. However, studies focusing on men as beneficiaries are scarce. The present paper reports the results of two preregistered studies conducted in Sweden. Study 1 investigated gender differences in reactions to being selected for a position based on either a strong or weak type of affirmative action policy. The results revealed that men (relative to women) displayed more negative attitudes, but not stronger resentment, and that a procedure using explicit quotas was perceived more negatively than a softer type of preferential treatment. In Study 2, we experimentally manipulated whether participants imagined being selected or rejected due to the same preferential treatment policy. Again, men displayed more negative attitudes than women, but not stronger resentment. The results further showed that attitudes were negative regardless of whether one was selected or rejected. However, those who were rejected felt stronger resentment than those who were selected. This effect was significant for both men and women, but stronger among women. Implications for research, organizations, and policy‐makers are discussed.
Double‐edged effects of tamoxifen‐in‐oil‐gavage on an infectious murine model for multiple sclerosis
Authors: Hülskötter Kirsten , Jin Wen , Allnoch Lisa , Hansmann Florian , Schmidtke Daniel , Rohn Karl , Flügel Alexander , Lühder Fred , Baumgärtner Wolfgang , Herder Vanessa
Published: June 2021

Tamoxifen gavage is a commonly used method to induce genetic modifications in cre‐loxP systems. As a selective estrogen receptor modulator (SERM), the compound is known to have immunomodulatory and neuroprotective properties in non‐infectious central nervous system (CNS) disorders. It can even cause complete prevention of lesion development as seen in experimental autoimmune encephalitis (EAE). The effect on infectious brain disorders is scarcely investigated. In this study, susceptible SJL mice were infected intracerebrally with Theiler's murine encephalomyelitis virus (TMEV) and treated three times with a tamoxifen‐in‐oil‐gavage (TOG), resembling an application scheme for genetically modified mice, starting at 0, 18, or 38 days post infection (dpi). All mice developed ‘TMEV‐induced demyelinating disease’ (TMEV‐IDD) resulting in inflammation, axonal loss, and demyelination of the spinal cord. TOG had a positive effect on the numbers of oligodendrocytes and oligodendrocyte progenitor cells, irrespective of the time point of application, whereas late application (starting 38 dpi) was associated with increased demyelination of the spinal cord white matter 85 dpi. Furthermore, TOG had differential effects on the CD4+ and CD8+ T cell infiltration into the CNS, especially a long lasting increase of CD8+ cells was detected in the inflamed spinal cord, depending of the time point of TOG application. Number of TMEV‐positive cells, astrogliosis, astrocyte phenotype, apoptosis, clinical score, and motor function were not measurably affected. These data indicate that tamoxifen gavage has a double‐edged effect on TMEV‐IDD with the promotion of oligodendrocyte differentiation and proliferation, but also increased demyelination, depending on the time point of application. The data of this study suggest that tamoxifen has also partially protective functions in infectious CNS disease. These effects should be considered in experimental studies using the cre‐loxP system, especially in models investigating neuropathologies.
Cutting into wound repair
Authors: Correa‐Gallegos Donovan , Rinkevich Yuval
Published: June 2021

The skin is home to an assortment of fibroblastic lineages that shape the wound repair response toward scars or regeneration. In this review, we discuss the distinct embryonic origins, anatomic locations, and functions of fibroblastic lineages, and how these distinct lineages of fibroblasts dictate the skin's wound response across injury depths, anatomic locations, and embryonic development to promote either scarring or regeneration. We highlight the supportive role of the fascia in dictating scarring outcomes; we then discuss recent findings that indicate fascia mobilization by its resident fibroblasts supersede the classical de novo deposition program of wound matrix formation. These recent findings reconfigure our traditional view of wound repair and present exciting new therapeutic avenues to treat scarring and fibrosis across a range of medical settings.
Innovative in situ investigations using synchrotron‐based micro tomography and molecular dynamics simulation for fouling assessment in ceramic membranes for dairy and food industry
Authors: Mollahosseini Arash , Min Lee Kyu , Abdelrasoul Amira , Doan Huu , Zhu Ning
Published: June 2021

Proteins in dairy streams result in organic fouling and function loss for ceramic membrane's porous structure. Synchrotron‐based X‐ray microtomography (SR‐µCT) is a new method with a high signal to noise ratio and accordingly significant level of accuracy. The goal of this study was to perform an in situ assessment of ceramic membrane fouling in the dairy stream filtration process, using SR‐µCT. This study attempted to assess porosity variation and membrane fouling through different layers from the top, middle, and bottom layers of the ceramic microfiltration membrane before and after skimming milk filtration. Molecular dynamics simulation (MDS) was used for depth understanding of milk protein interactions with the ceramic membrane. Fouling was found to be more intense on the top of the ceramic membrane even though the top layer was slightly more porous, which indicates that top layers were more prone to fouling. A regression model was derived to correlate the porosity loss due to membrane fouling at different membrane thicknesses. The MDS results showed more affinity of the milk proteins to the ceramic membrane compared to water molecules. The MDS studies showed how the presence of the milk's protein macromolecules could change the hydrophilicity trend on the membrane's surface.
Theta‐phase stabilization by rare‐earth and alkali incorporation in sol‐gel derived alumina
Authors: Tian Peijing , Müller Lenka , Zitnan Michal , Sajzew Roman , Wondraczek Lothar
Published: June 2021

Bottom‐up synthesis of alumina suspensions doped with trivalent (Eu3+) or monovalent (K+) ions is reported as a means to generate crystalline transition‐phase alumina with increased thermal stability. Dynamic light scattering was used to track the stability of precursor sols, showing how the dissolved cations contribute to the stabilizing double layer and particle separation in the liquid phase. The incorporation of alkali or rare‐earth dopants into the alumina structure further influences the thermal conversion and crystallization behavior. The Kissinger activation energy of the θ → α phase transition in Al2O3 indicates an inhibitory effect of Eu3+ and K+ on the formation of the stable α phase, also confirmed by X‐ray diffraction. The intensity ratio of the 7F2/7F1 characteristic photoemission bands of Eu3+ was used to probe the local symmetry as a function of calcination temperature to further corroborate this observation.
Wear and marginal quality of aesthetic crowns for primary molars
Authors: Möhn Mirja , Frankenberger Roland , Krämer Norbert
Published: June 2021

Background

Due to limited aesthetics of stainless‐steel crowns, the demand for tooth‐coloured crowns has recently risen. Few studies have investigated the marginal integrity and wear behaviour of tooth‐coloured primary molar crowns under subcritical load in vitro.

Aim

This in vitro study evaluated the marginal quality and wear of newly introduced resin composite and hybrid ceramic crowns compared with metal and zirconia crowns.

Design

Metal, resin composite, hybrid ceramic (CAD/CAM), and various zirconia crowns were investigated. After thermomechanical loading (2,500 thermocycles/100,000 × 50N), marginal quality of luting gaps and wear of crowns/antagonists were evaluated using replicas under a light or 3D laser scanning microscope. Results were analysed with the Mann‐Whitney U test or one‐way ANOVA (p < .05).

Results

Marginal quality of the new resin composite and hybrid ceramic crowns performed well in comparison with SSC and zirconia crowns. Adhesive bonding of crowns resulted in superior marginal seal compared with conventional GIC (Mann‐Whitney U test, p < .05). Regarding wear, zirconia crowns exhibited significantly worse results than resin composite or hybrid ceramic crowns and SSCs (ANOVA, p < 0.05).

Conclusion

The new resin composite and hybrid ceramic crown exhibited good performance in comparison with SSCs and zirconia crowns considering both wear and marginal quality after subcritical loading.
Next‐generation sequencing in two cases of de novo acute basophilic leukaemia
Authors: Shimizu Takuya , Kondo Tadakazu , Nannya Yasuhito , Watanabe Mizuki , Kitawaki Toshio , Shindo Takero , Hishizawa Masakatsu , Yamashita Kouhei , Ogawa Seishi , Takaori‐Kondo Akifumi
Published: June 2021

Acute basophilic leukaemia (ABL) is a rare subtype of acute myeloid leukaemia (AML); therefore, few data are available about its biology. Herein, we analysed two ABL patients using flow cytometry and next‐generation sequencing (NGS). Two cell populations were detected by flow cytometry in both patients. In Case no. 1, blasts (CD34+, CD203c−, CD117+, CD123dim+) and basophils (CD34−, CD203c+, CD117±, CD123+) were identified, both of which were found by NGS to harbour the 17p deletion and have loss of heterozygosity of TP53. In Case no. 2, blasts (CD33+, CD34+, CD123−) and basophils (CD33+, CD34+, CD123+) were identified. NGS detected NPM1 mutations in either blasts or basophils, and TET2 in both. These data suggest an overlap of the mutational landscape of ABL and AML, including TP53 and TET2 mutations. Moreover, additional mutations or epigenetic factors may contribute for the differentiation into basophilic blasts.
Turmeric (Curcuma longa) drying in natural circulation solar dryer: An experimental evaluation
Authors: Gill Raminder Singh , Singh Sukhmeet , Hans Vishavjeet Singh , Mittal Tarsem Chand
Published: June 2021

A natural circulation solar dryer has been evaluated for drying differently processed turmeric. The predrying treatments namely, hydrothermal treatment using water boiling and steam boiling; and drying methods namely, drying of sliced and unsliced turmeric rhizomes have been investigated. The open sun drying and untreated unsliced turmeric rhizome was used as control. The maximum thermal efficiency of this passive solar dryer has been obtained as 22.4% for the water boiled sliced turmeric, and while that for the steam boiled unsliced turmeric was 14.1%. The thermal efficiency was comparatively lower for untreated turmeric. The quality parameters namely, polishing loss, curcumin content, volatile oil content, total recovery, and color, were found better for steam boiled unsliced turmeric dried in solar dryer. Based on combined perspective of thermal efficiency and quality, drying of unsliced rhizome pretreated with steam in natural circulation solar dryer is recommended as compared to other processing practices. The dryer is economically feasible as indicated by the cumulative present worth of life cycle savings and payback period.

Practical Applications

In India, turmeric is an essential part of cuisine. The drying operation consumes maximum time and energy in postharvest processing of turmeric. The conventional practice of drying is open sun. The aim of the article was to find the best drying method and pretreatment method for drying in a natural circulation solar dryer, which will also result in saving conventional energy. It was found that the drying in this solar dryer results in lesser drying time and better quality as compared to conventional method of open sun drying.
Building safety cultures at the frontline: An emancipatory Practice Development approach for strengthening nursing surveillance on an acute care ward
Authors: Peet Jacqueline , Theobald Karen A. , Douglas Clint
Published: June 2021

Aim

To evaluate an emancipatory Practice Development approach for strengthening nursing surveillance on a single medical‐surgical ward.

Background

Registered nurses keep patients safe in acute care settings through the complex process of nursing surveillance. Our interest was understanding how frontline teams can build safety cultures that enable proactive nursing surveillance in acute care wards.

Design

A year‐long emancipatory Practice Development project.

Methods

A collaborative relationship was established around a shared interest of nursing surveillance capacity and researcher embedded on a medical‐surgical ward. Critical analysis of workplace observations and reflection with staff generated key sites for collective action. Ward engagement was supported by creative Practice Development methods including holistic facilitation, critical reflection and action learning. An action learning set was established with a group of clinical nurses, facilitating practitioner‐led change initiatives which strengthened nursing surveillance and workplace learning. Evaluation supported an iterative approach, building on what worked in an acute care context. Immersive researcher evaluation, drawing on multiple data sources, generated an analysis of how ward nursing surveillance capacity can be strengthened. COREQ criteria guided reporting.

Results

The ward moved through a turbulent and transformative process of resistance and retreat towards a new learning culture where nursing surveillance was visible and valued. Staff developed and sustained innovations including the ‘My MET Call series’, a ‘Shared GCS initiative’, an enhanced ‘Team Safety Huddle’, and staff‐led Practice Development workshops. These new practices affirmed nurses’ agency, asserted nurses’ clinical knowledge, positioned nurses to participate in team decision‐making and humanised care.

Conclusion

Working collaboratively with frontline staff enabled bottom‐up sustainable innovation to strengthen nursing surveillance capacity where it mattered most, at the point of care.

Relevance to clinical practice

Emancipatory Practice Development enables the profound impact of small‐scale, microsystem level practice transformation. It is an accessible methodology for clinical teams to develop effective workplace cultures.
Food Literacy Interventions in Elementary Schools: A Systematic Scoping Review*
Authors: Kelly Rebecca K. , Nash Rosie
Published: June 2021

BACKGROUND

Childhood is a critical period for developing food‐related skills and knowledge, known as food literacy (FL). Schools may be an important setting for interventions aiming to improve FL in children. This systematic scoping review aimed to characterize food literacy interventions in elementary schools.

METHODS

Databases (PubMed, Web of Science, and EBSCO) were searched for FL interventions in elementary schools (students aged 4‐12 years). Studies were assessed according to design, duration, theoretical underpinning, and ascertainment of FL outcome(s). Interventions were assessed according to FL competencies (functional, interactive, and critical).

RESULTS

After exclusions, 116 studies were eligible for review, including 105 original interventions. Interventions ranged from 45 minutes to 4 years. Social cognitive theory was the most referenced theory and common interventions included; classroom lessons, games, school gardens, food preparation, and cooking classes. Most studies measured FL outcomes quantitatively (96%, N = 111). All studies addressed functional FL (N = 116), while 77% (N = 89) addressed interactive FL and 28% (N = 32) addressed critical FL.

CONCLUSIONS

This first international review of FL programs in elementary schools found great heterogeneity in school‐based FL intervention design and measurement of FL. Few interventions addressed critical FL, which should be a focus for future interventions.
Heeding to the Losers: Legislators' Trade‐Policy Preferences and Legislative Behavior
Authors: Murillo María Victoria , Pinto Pablo M.
Published: June 2021

Electoral incentives affect legislators' responsiveness to voters, parties, and other stakeholders. Proportional representation (PR) electoral systems with party control over nominations foster party discipline and reduce legislators' responsiveness to local constituents when at odds with the party. Yet, even under closed‐list PR regimes policymakers have incentives to respond to local interests who help advance their political careers. We illustrate this argument using evidence from a survey of Argentine legislators and a roll‐call vote on a salient export tax bill. Despite the incentives created by the electoral regime, we find that legislators' trade‐policy preferences and legislative behavior reflect the expected consequences of trade on local constituents. Our evidence suggests that catering to voters, rather than organized interests, are more likely to motivate legislators to defy their parties. These findings underscore the importance of understanding when and how catering to local constituents can affect politicians’ trade policy choices.
Nanotextures and formation process of coesite in silica glass from the Xiuyan impact crater
Authors: Yin Feng , Sharp Thomas G. , Chen Ming
Published: June 2021

Coesite embedded in silica glass in suevite from the Xiuyan crater has been studied by scanning and transmission electron microscopy to better understand the mechanisms at formation of coesite. Coesite grains in this study mainly occur as vein‐like aggregates (10–40 μm in width) and irregular aggregates (IAs; <40 μm in size). Both aggregate types are composed of subhedral to anhedral coesite crystals with random orientations. Most of the crystals are 100–1000 nm in size, and some display twinning. The shape, twinning, and random orientation of coesite crystals suggest rapid crystallization in amorphous silica that became supercooled. The center of vein‐like aggregates crystallized from localized silica melt within diaplectic silica glass, whereas the rim of vein‐like aggregates and IAs crystallized from diaplectic silica glass. The size and amount of coesite crystals in the vein‐like aggregate vary greatly from the rim to the center of such veins. Microstructures suggest that the crystals nucleated heterogeneously at the outer rim of the vein and nucleated homogeneously within the vein. IAs do not show any changes in size and amount of coesite crystals from the rim to core of such aggregates. Coesite crystals in IAs primarily nucleate heterogeneously in diaplectic silica glass. It can be concluded that vein‐like coesite aggregates are mainly formed by crystallization from silica melt, and irregular coesite aggregates should be formed by solid‐state transformation of diaplectic silica glass.
Learning networks in pediatric heart failure and transplantation
Authors: O’Connor Matthew J. , Lorts Angela , Kwiatkowski David , Butts Ryan , Barnes Aliessa , Jeewa Aamir , Knoll Christopher , Fenton Matthew , McQueen Melissa , Cousino Melissa K. , Shugh Svetlana , Rosenthal David N.
Published: June 2021

Background

Learning networks have emerged in medicine as a novel organizational structure that contains elements of quality improvement, education, and research with the goal of effecting rapid improvements in clinical care. In this article, the concept of a learning network is defined and highlighted in the field of pediatric heart failure and transplantation.

Methods

Learning networks are defined, with particular attention paid to the recent creation of the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) for children with heart failure and those being supported with ventricular assist devices (VAD).

Results

The mission, goals, and organizational structure of ACTION are described, and recent initiatives promoted by ACTION are highlighted, such as stroke reduction initiatives, practice harmonization protocols, and use of ACTION data to support the recent US Food and Drug Administration approval of newer VAD for pediatric patients.

Conclusions

The learning network, exemplified by ACTION, is distinguished from traditional clinical research collaboratives by contributions in research, quality improvement, patient‐reported outcomes, and education, and serves as an effective vehicle to drive clinical improvement in the care of children with advanced heart failure.
Development, nutrition, and rearing practices of relevant catfish species (Siluriformes) at early stages
Authors: Gisbert Enric , Luz Ronald Kennedy , Fernández Ignacio , Pradhan Pravata K. , Salhi Maria , Mozanzadeh Mansour T. , Kumar Aditya , Kotzamanis Yannis , Castro‐Ruiz Diana , Bessonart Martin , Darias Maria J.
Published: June 2021

Catfish (Siluriformes) are important species for aquaculture worldwide, with an annual production in 2018 of ca. 6 million t. This review focuses on reassessing larval development, first feeding, and early rearing practices of the most important farmed catfish species, along with some candidate species for aquaculture diversification: Pangasianodon hypophthalmus (Pangasiidae), Clarias gariepinus (Clariidae), Ictalurus punctatus (Ictaluridae), Pseudoplatystoma spp. (Pimelodidae), Heteropneustes fossilis (Heteropneustidae), Rhamdia quelen (Heptapteridae), Ompok bimaculatus (Siluridae), and Lophiosilurus alexandri (Pseudopimelodidade). These species are initially reared indoors from one day to two weeks and are then transferred to fertilised outdoor ponds where they either feed on natural zooplankton or compound feeds. With the exception of C. gariepinus, I. punctatus, R. quelen and P. hypophthalmus, consistent and reliable fry production is a bottleneck that limits the expansion of farming of other species, such as Pseudoplatystoma spp., H. fossilis, O. bimaculatus, and L. alexandri. Rearing systems (extensive, semi‐extensive, intensive) and feeding protocols vary with species and geographical regions. Cannibalism and size heterogeneity are common, and these features create problems for larval and fry rearing of catfish species. Information about their nutritional requirements is required for the formulation of compound feeds that can guarantee high survival and good growth of catfish fries. However, such knowledge for most species is scarce, although some data are available for I. punctatus. Further genomic resources might allow fine‐tuning rearing success. This review describes some successes in this field, and also highlights gaps in knowledge to guide future research that can promote the development of catfish aquaculture.
Threshold concepts in religious studies: A qualitative and theoretical exploration of threshold concepts in a “nodal” curriculum
Authors: Mosurinjohn Sharday C.
Published: June 2021

This article explores “threshold concepts” in North American religious studies undergraduate education. The threshold concepts approach concentrates on how certain concepts or learning experiences can act like the threshold of a doorway that opens onto a new perspective for the learner. Crucially, they come into play in learning to think like a professional within a discipline. Little work has been done on threshold concepts in religious studies. In this article I explore what threshold concepts might be central to it. I also distinguish religious studies as a “nodal” discipline, in contrast to “sequential” ones, and describe how threshold concepts function in a nodal curriculum differently than they do in a sequential one. Drawing on the Scholarship of Teaching and Learning literature, plus my own focus group data from religious studies faculty and students, I argue that the threshold concepts approach is useful for religious studies professors examining what concepts should be at the heart of our curricula and what it means to “think like a religious studies scholar.”
Smoothing Calabi–Yau toric hypersurfaces using the Gross–Siebert algorithm
Authors: Prince Thomas
Published: June 2021

We explain how to form a novel dataset of Calabi–Yau threefolds via the Gross–Siebert algorithm. We expect these to degenerate to Calabi–Yau toric hypersurfaces with certain Gorenstein (not necessarily isolated) singularities. In particular, we explain how to ‘smooth the boundary’ of a class of four-dimensional reflexive polytopes to obtain polarised tropical manifolds. We compute topological invariants of a compactified torus fibration over each such tropical manifold, expected to be homeomorphic to the general fibre of the Gross–Siebert smoothing. We consider a family of examples related to products of reflexive polygons. Among these we find $14$ topological types with $b_2=1$ that do not appear in existing lists of known rank-one Calabi–Yau threefolds.
Bending of an Elastically Restrained Circular Plate Under Normal Loading Over a Sector
Authors: Bassali W. A. , Dawoud R. H.
Published: June 2021

The complex variable method is used to find the deflection, bending and twisting moments, and shearing forces at any point of a thin circular plate normally loaded over a sector and supported at its edge under a general boundary condition including the usual clamped and simply supported boundaries. In this way separate treatments for these two cases are avoided and a single treatment is available.
Natural Frequencies of Nonuniform Beams on Multiple Elastic Supports
Authors: Di Taranto R. A.
Published: June 2021

A method is presented for the determination of the natural frequencies of nonuniform beams on two or more torsionally and linearly elastic supports, including the effect of rotary mass moment of inertia. The method employed is an extension of the Myklestad method. The cases of two supports with varied end conditions and three supports with a torsional and linear restraint at each support are formulated. It is indicated how this method may be used for problems concerning forced vibrations of beams on multiple elastic supports and for the determination of critical rotor speeds including gyroscopic effects.
Ring Damping of Free Surface Oscillations in a Circular Tank
Authors: Miles J. W.
Published: June 2021

A rough analysis of the effect of an annular ring on the sloshing oscillations of liquid in a cylindrical tank is carried out. The damping per cycle (logarithmic decrement) for moderate amplitudes is predicted as proportional to the square root of the amplitude and the three-halves power of the ring area. The corresponding force on the ring also is calculated.
Criterion for Flow of a Bingham Plastic Between Two Cylinders Loaded by Torque and Pressure Gradient
Authors: Paslay P. R. , Slibar A.
Published: June 2021

The criterion for the initiation of flow of a Bingham material between two concentric circular cylinders is considered. An external torque and an axial pressure gradient are acting on the plastic. For three values of the ratio of outer to inner radii of the cylinders the solutions are presented graphically.
The End Problem of Cylinders
Authors: Horvay G. , Mirabal J. A.
Published: June 2021

When self-equilibrating rotationally symmetric normal and shear tractions sk(r), tk(r) act on an end face of a cylinder, stresses ensue which decay with distance from the loaded end as e−αk2, where αk is the real part of an eigenvalue parameter γk. The analysis is carried out in a variational approximation; the method is based on Sadowsky-Sternberg stress functions Φk(z, r) which are so modified as to identically satisfy the equilibrium equations. The factors Fk(r) of the functions Φk = Gk(z) Fk(r) or Φk = Hk(z)Fk(r) (k = 2, 4, 6, …) are polynomials of degree k + 2, which are orthogonal in a “generalized sense”; their appropriate derivatives constitute sk(r) and tk(r). The polynomials sk(r), tk(r), of degrees k and k + 1, respectively, form two complete sets of tractions in terms of which arbitrary rotationally symmetric self-equilibrating end tractions may be expanded. The factors Gk(z), Hk(z) of the stress functions Φk are exponentially decaying sinusoidals; Gk(z) is appropriate for the normal load problem, Hk(z) for the shear-load problem. The function Φ2 leads, for ν = 0.3, to the fundamental variational eigenvalue γ2 = 2.69 + i 1.34, as contrasted with the rigorous value γ2 = 2.72 + i 1.35.
Sulfurization of dissolved organic matter in the anoxic water column of the Black Sea
Authors: Gomez-Saez Gonzalo V. , Dittmar Thorsten , Holtappels Moritz , Pohlabeln Anika M. , Lichtschlag Anna , Schnetger Bernhard , Boetius Antje , Niggemann Jutta
Published: June 2021

Sulfurization of DOM in the Black Sea highlights an additional mechanism for organic carbon sequestration in O
2
-limited basins.
m
6
A demethylase ALKBH5 controls CD4
+
T cell pathogenicity and promotes autoimmunity
Authors: Zhou Jing , Zhang Xingli , Hu Jiajia , Qu Rihao , Yu Zhibin , Xu Hao , Chen Huifang , Yan Lichong , Ding Chenbo , Zou Qiang , Ye Youqiong , Wang Zhengting , Flavell Richard A. , Li Hua-Bing
Published: June 2021

ALKBH5 maintains CD4
+
T cell pathogenicity during autoimmune disease via regulating IFN-γ and CXCL2.
Addressing the human cost in a changing climate
Authors: Desai Bina , Bresch David N. , Cazabat Christelle , Hochrainer-Stigler Stefan , Mechler Reinhard , Ponserre Sylvain , Schewe Jacob
Published: June 2021

Displacement costs remain largely invisible, hindering effective action
Simultaneous multifocal intracranial haemorrhage (ICH) and subarachnoid haemorrhage (SAH) in the setting of long-term cocaine usage
Authors: Al-Khafaji Minnan , Podbicanin Sabina , Ghaghda Deep , Basi Saajan , Punekar Shuja
Published: June 2021

A 45-year-old Caucasian man was admitted to hospital following a collapse at home. On admission, this patient was noted to have a Glasgow Coma Scale (GCS) Score of 9 out of 15, fever and tachypnoea. The patient was identified to have bilateral limb weakness, predominately on the left side, with associated dysphagia. Radiological imaging demonstrated bilateral multifocal intracranial haemorrhage and subarachnoid haemorrhage. Neurosurgical input was sought; the outcome of this was a decision to manage the patient conservatively, without surgical intervention. Of note, his urine drug testing revealed a positive result for a cocktail of drugs including cocaine, benzoylecgonine (cocaine metabolite), methadone, heroin, norbuprenorphine and benzodiazepine. Throughout the admission, the patient was monitored in an intensive care setting. The patient received support with feeding, speech and mobilisation. The patients’ GCS improved throughout the admission. Following a 30-day admission, the patient walked home.
Treatment refractoryStenotrophomonas maltophiliabacteraemia and pneumonia in a COVID-19-positive patient
Authors: Pek Zachary , Cabanilla Maria Gabriela , Ahmed Shozab
Published: June 2021

Stenotrophomonas maltophiliais an opportunistic pathogen that most often infects patients requiring mechanical ventilation, indwelling central venous catheters and broad-spectrum antibiotics. The reported incidence ofS. maltophiliainfection has increased over the past two decades, and many of its risk factors are commonly seen in patients with severe COVID-19 infection. Our case regards a patient with severe COVID-19 pneumonia, who subsequently developed disseminatedS. maltophiliainfection, refractory to first-line treatment and optimal medical management. This case highlights the high index of suspicion required for diagnosing secondary complications in patients with COVID-19 infection and highlights the difficulty in treating disseminatedS. maltophiliainfection in critically ill patients.