bluuebunny/crossref_metadata_2025 huggingface dataset:
Temperature‐dependent effects of house fly proto‐Y chromosomes on gene expression could be responsible for fitness differences that maintain polygenic sex determination
Authors: Adhikari Kiran , Son Jae Hak , Rensink Anna H. , Jaweria Jaweria , Bopp Daniel , Beukeboom Leo W. , Meisel Richard P.
Published: August 2021

Sex determination, the developmental process by which sexually dimorphic phenotypes are established, evolves fast. Evolutionary turnover in a sex determination pathway may occur via selection on alleles that are genetically linked to a new master sex determining locus on a newly formed proto‐sex chromosome. Species with polygenic sex determination, in which master regulatory genes are found on multiple different proto‐sex chromosomes, are informative models to study the evolution of sex determination and sex chromosomes. House flies are such a model system, with male determining loci possible on all six chromosomes and a female‐determiner on one of the chromosomes as well. The two most common male‐determining proto‐Y chromosomes form latitudinal clines on multiple continents, suggesting that temperature variation is an important selection pressure responsible for maintaining polygenic sex determination in this species. Temperature‐dependent fitness effects could be manifested through temperature‐dependent gene expression differences across proto‐Y chromosome genotypes. These gene expression differences may be the result of cis regulatory variants that affect the expression of genes on the proto‐sex chromosomes, or trans effects of the proto‐Y chromosomes on genes elswhere in the genome. We used RNA‐seq to identify genes whose expression depends on proto‐Y chromosome genotype and temperature in adult male house flies. We found no evidence for ecologically meaningful temperature‐dependent expression differences of sex determining genes between male genotypes, but we were probably not sampling an appropriate developmental time‐point to identify such effects. In contrast, we identified many other genes whose expression depends on the interaction between proto‐Y chromosome genotype and temperature, including genes that encode proteins involved in reproduction, metabolism, lifespan, stress response, and immunity. Notably, genes with genotype‐by‐temperature interactions on expression were not enriched on the proto‐sex chromosomes. Moreover, there was no evidence that temperature‐dependent expression is driven by chromosome‐wide cis‐regulatory divergence between the proto‐Y and proto‐X alleles. Therefore, if temperature‐dependent gene expression is responsible for differences in phenotypes and fitness of proto‐Y genotypes across house fly populations, these effects are driven by a small number of temperature‐dependent alleles on the proto‐Y chromosomes that may have trans effects on the expression of genes on other chromosomes.
Respect, cognitive capacity, and profound disability
Authors: Vorhaus John
Published: August 2021

According to one prominent form of moral individualism, how an individual is to be treated is determined, not by considering her group membership, but by considering her own particular characteristics. On this view, so this paper argues, it is not possible to provide an account of why people with profound cognitive disabilities are owed respect. This conclusion is not new, but it has been challenged by writers who are sympathetic to the recommended emphasis. The paper aims to show that the conclusion cannot be avoided, and to look at what is to be learned from an approach that leads us to this point. It suggests that any account of why profoundly disabled people are owed respect will have to supplement discussion of their particular capacities with a normative account of their humanity.
Learning and Teaching Pragmatics in the Globalized World: Commentary
Authors: KRAMSCH CLAIRE
Published: August 2021

This commentary offers comments and critiques on each of the 7 articles included in this special issue and invites further research on the pedagogical implications of these studies for the development of pragmatic competence in second language learning.
Problems for factive accounts of assertion
Authors: Rosenkranz Sven
Published: August 2021

The knowledge account of assertion construes assertion as subject to constitutive norms. In its standard version, it combines a wide scope obligation not to assert p without knowing p, with narrow scope principles specifying conditions under which it is permissible to assert p, where the notions of obligation and permission are duals and behave uniformly for variable p. It is argued that, given natural assumptions about the logic of ‘ought’, the account proves incoherent. The argument generalizes to accounts that substitute other factive notions for knowledge. A recent non‐standard version of the knowledge account employs proposition‐relative norms and circumvents the problem. However, it still leads to intolerable combinations of verdicts. Again, the problem arises because knowledge is factive, and it generalizes to other factive notions. It is shown that non‐factive accounts face none of the diagnosed difficulties and can do much of the explanatory work that the knowledge account is alleged to do.
Arabidopsis cryptochrome 1 undergoes COP1 and LRBs‐dependent degradation in response to high blue light
Authors: Miao Langxi , Zhao Jiachen , Yang Guangqiong , Xu Peng , Cao Xiaoli , Du Shasha , Xu Feng , Jiang Lu , Zhang Shilong , Wei Xuxu , Liu Yao , Chen Huiru , Mao Zhilei , Guo Tongtong , Kou Shuang , Wang Wenxiu , Yang Hong‐Quan
Published: August 2021

Arabidopsis cryptochrome 1 (CRY1) is an important blue light photoreceptor that promotes photomorphogenesis under blue light. The blue light photoreceptors CRY2 and phototropin 1, and the red/far‐red light photoreceptors phytochromes B and A undergo degradation in response to blue and red light, respectively. This study investigated whether and how CRY1 might undergo degradation in response to high‐intensity blue light (HBL).

We demonstrated that CRY1 is ubiquitinated and degraded through the 26S proteasome pathway in response to HBL. We found that the E3 ubiquitin ligase constitutive photomorphogenic 1 (COP1) is involved in mediating HBL‐induced ubiquitination and degradation of CRY1. We also found that the E3 ubiquitin ligases LRBs physically interact with CRY1 and are also involved in mediating CRY1 ubiquitination and degradation in response to HBL.

We further demonstrated that blue‐light inhibitor of cryptochromes 1 interacts with CRY1 in a blue‐light‐dependent manner to inhibit CRY1 dimerization/oligomerization, leading to the repression of HBL‐induced degradation of CRY1.

Our findings indicate that the regulation of CRY1 stability in HBL is coordinated by COP1 and LRBs, which provides a mechanism by which CRY1 attenuates its own signaling and optimizes photomorphogenesis under HBL.
The Impact of Uncertainty Shocks: Evidence from Geopolitical Swings on the Korean Peninsula*
Authors: Ha Jongrim , Lee Seohyun , So Inhwan
Published: August 2021

Using a novel set of instrumental variables in a structural VAR framework, we investigate the economic impact of uncertainty shocks from geopolitical swings on the Korean Peninsula over 2003–17. We construct robust instrumental variables for these shocks based on high‐frequency changes in financial asset returns and their volatilities around the geopolitical events. The empirical results suggest that heightened geopolitical uncertainty has negative impacts on macroeconomic outcomes in South Korea. We provide evidence that financial and capital markets play a key role in the transmission of geopolitical uncertainty shocks.
A proof of concept pilot trial of probiotics in symptomatic oral lichen planus (CABRIO)
Authors: Marlina Erni , Goodman Richard N. , Mercadante Valeria , Shephard Martina , McMillan Roddy , Hodgson Tim , Leeson Rachel , Porter Stephen , Barber Julie A. , Fedele Stefano , Smith Andrew M.
Published: August 2021

Objective

To preliminary evaluate the clinical effects of probiotics in individuals with symptomatic oral lichen planus and the possible mechanisms of action.

Subjects and Methods

A group of 30 individuals with symptomatic oral lichen planus were recruited in a randomised double‐blind parallel group controlled (1:1) proof‐of‐concept pilot trial of probiotic VSL#3 vs placebo. Efficacy outcomes included changes in pain numeric rating scale, oral disease severity score and the chronic oral mucosal disease questionnaire. Adverse effects, home diary and withdrawals were assessed as feasibility outcomes. Mechanistic outcomes included changes in salivary and serum levels of CXCL10 and IFN‐γ and in oral microbial composition.

Results

The probiotic VSL#3 was safe and well tolerated. We observed no statistically significant change in pain, disease activity, quality of life, serum/salivary CXCL10 or oral microbial composition with respect to placebo. Salivary IFN‐γ levels demonstrate a trend for a reduced level in the active group (p = 0.082) after 30 days of probiotic consumption.

Conclusions

The present proof‐of‐concept study provides some weak not convincing indication of biological and clinical effects of probiotic VSL#3 in individuals with painful oral lichen planus. Further research in this field is needed, with the current study providing useful information to the design of future clinical trials.
A validated finite element model to reproduce Helmholtz’s theory of accommodation: a powerful tool to investigate presbyopia
Authors: Cabeza‐Gil Iulen , Grasa Jorge , Calvo Begoña
Published: August 2021

Purpose

To reproduce human in vivo accommodation numerically. For that purpose, a finite element model specific for a 29‐year‐old subject was designed. Once the proposed numerical model was validated, the decrease in accommodative amplitude with age was simulated according to data available in the literature.

Methods

In contrast with previous studies, the non‐accommodated eye condition was the reference configuration. Consequently, two aspects were specifically highlighted: contraction of the ciliary muscle, which was simulated by a continuum electro‐mechanical model and incorporation of initial lens capsule stresses, which allowed the lens to become accommodated after releasing the resting zonular tension.

Results

The morphological changes and contraction of the ciliary muscle were calibrated accurately according to the experimental data from the literature. All dynamic optical and biometric lens measurements validated the model. With the proposed numerical model, presbyopia was successfully simulated.

Conclusions

The most widespread theory of accommodation, proposed by Helmholtz, was simulated accurately. Assuming the same initial stresses in the lens capsule over time, stiffening of the lens nucleus is the main cause of presbyopia.
Oral microbiome shifts during pregnancy and adverse pregnancy outcomes: Hormonal and Immunologic changes at play
Authors: Ye Changchang , Kapila Yvonne
Published: August 2021

Because of hormonal and immunologic changes, there are significant changes in the oral microbiome that emerge during pregnancy. Recent evidence further suggests that there is an association between the presence of periodontal disease and a pregnancy‐associated oral dysbiosis. Although this oral dysbiosis and pathogenic periodontal bacteria are considered to be associated with adverse pregnancy outcomes, it is still not clear how an oral dysbiosis during pregnancy can modulate oral diseases and birth outcomes. To develop preventive or therapeutic interventions, it is critical to understand the oral microbiome changes that emerge during pregnancy and their association with adverse pregnancy outcomes. In the present review, we summarize the current literature on normal changes in the oral microbiome that occur during pregnancy; the pathogenic changes in the oral microbiome believed to occur in association with adverse pregnancy outcomes; and the association between the placental microbiome and the oral microbiome.
Transient Thermo-Acoustic Responses of Methane/Hydrogen Flames in a Pressurized Annular Combustor
Authors: Ahn Byeonguk , Indlekofer Thomas , Dawson James , Worth Nicholas
Published: August 2021

The present article experimentally investigates the triggering and transient growth of azimuthal instabilities in a pressurized laboratory-scale annular combustor featuring 12 methane/hydrogen flames, as the equivalence ratio is ramped up and down. The ramping rate of equivalence ratio is varied to examine its effect on the transient thermo-acoustic response and the driving mechanisms, highlighting a number of previously unseen features. As the equivalence ratio is dynamically increased, all cases were observed to feature a distinct modal trajectory, during the onset of high-amplitude instabilities. Strongly spinning counterclockwise modes are first excited before a dynamic transition to strongly spinning clockwise modes occurs. Furthermore, the strength of the spinning mode (quantified through the spin ratio or nature angle) was shown to feature a local minima before the spinning mode stabilized in the system, which corresponds to an almost pure spinning state. Hysteresis behavior was observed in both the amplitude and nature of the mode, resulting in different thresholds for the onset and decay of the instability, depending on the time history of the combustor. Increasing the ramping rate was found to reduce the amount of hysteresis in the system. Furthermore, the high amplitude of the instability resulted in significant harmonic components. The behavior of the harmonics generally resembles the fundamental component, albeit with some notable exceptions.
Relative Effects of Velocity- and Mixture-Coupling in a Thermoacoustically Unstable, Partially Premixed Flame
Authors: Karmarkar Ashwini , Boxx Isaac , O'Connor Jacqueline
Published: August 2021

Combustion instability, which is the result of a coupling between combustor acoustic modes and unsteady flame heat release rate, is a severely limiting factor in the operability and performance of modern gas turbine engines. This coupling can occur through different pathways, such as flow-field fluctuations or equivalence ratio fluctuations. In realistic combustor systems, there are complex hydrodynamic and thermo-chemical processes involved, which can lead to multiple coupling pathways. In order to understand and predict the mechanisms that govern the onset of combustion instability in real gas turbine engines, we consider the influences that each of these coupling pathways can have on the stability and dynamics of a partially premixed, swirl-stabilized flame. In this study, we use a model gas turbine combustor with two concentric swirling nozzles of air, separated by a ring of fuel injectors, operating at an elevated pressure of 5 bar. The flow split between the two streams is systematically varied to observe the impact on the flow and flame dynamics. High-speed stereoscopic particle image velocimetry, OH planar laser-induced fluorescence, and acetone planar laser-induced fluorescence are used to obtain information about the velocity field, flame, and fuel-flow behavior, respectively. Depending on the flow conditions, a thermoacoustic oscillation mode or a hydrodynamic mode, identified as the precessing vortex core, is present. The focus of this study is to characterize the mixture coupling processes in this partially premixed flame as well as the impact that the velocity oscillations have on mixture coupling. Our results show that, for this combustor system, changing the flow split between the two concentric nozzles can alter the dominant harmonic oscillation modes in the system, which can significantly impact the dispersion of fuel into air, thereby modulating the local equivalence ratio of the flame. This insight can be used to design instability control mechanisms in real gas turbine engines.
Balanced Energy/Time Optimal Defibrillation
Authors: Barbieri Enrique , Muzdeka Slobodanka
Published: August 2021

The synthesis of a cardiac defibrillating pulse is cast as a standard optimal feedback control problem that minimizes a weighted measure of consumed energy and elapsed time to reach a nominal defibrillated state. The solution is developed for a general first-order system that includes the widely used parallel resistor/capacitor circuit and energy source as a special case. The novel optimal pulse comprises an exponentially ascending and a rectangular component; it is agile and energy conscious; and it therefore outperforms the waveforms developed thus far that minimize energy or time expenditures alone. Explicit time-domain expressions are derived which may be used for comparing against other commonly studied defibrillating functions. The analytic formulas and computer simulations may be useful to implement performance improvements in defibrillating devices.
Adapted Physical Education Teachers’ Job Satisfaction
Authors: Kim Minhyun , Santiago José A. , Woong Park Chan , Roper Emily A.
Published: August 2021

Grounded in occupational socialization theory, the authors examined adapted physical education (APE) teachers’ job satisfaction. Twelve (nine female and three male) APE teachers who had 3–43 years of teaching experience participated in the study. A semistructured interview was employed. The interviews focused on the participants’ roles and responsibilities. The following questions guided this study: (a) What social agents positively impact APE teachers’ job satisfaction? (b) what APE teachers’ roles and responsibilities are related to job satisfaction? and (c) what type of working conditions are linked to APE teachers’ job satisfaction? Thematic analysis was employed to analyze the data. The following four themes emerged from the analysis: (a) support from administrators, physical education teachers, and colleagues; (b) relevant and meaningful professional development; (c) itinerant working conditions; and (d) seeing students’ progress and achievement. The results of this study provide several implications to enhance APE teachers’ job satisfaction.
The Association Between Objectively Measured Vision Impairment and Self-Reported Physical Activity Among 34,129 Adults Aged ≥50 Years in Six Low- and Middle-Income Countries
Authors: Smith Lee , Pardhan Shahina , Gorely Trish , Barnett Yvonne , Jacob Louis , López-Sánchez Guillermo F. , Tully Mark A. , Veronese Nicola , Shin Jae Il , Koyanagi Ai
Published: August 2021

The authors investigated the association between vision impairment and physical activity among older adults from low- and middle-income countries. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better seeing eye. Physical activity was assessed by the Global Physical Activity Questionnaire. Multivariable logistic regression and meta-analysis were conducted to assess associations. The sample included 34,129 individuals aged 50–114 years (mean [SD] age 62.4 [16.0] years; 47.9% male). After adjustment for confounders, near vision impairment was not significantly associated with low physical activity, but far vision impairment showed a significant association (odds ratio = 1.32; 95% confidence interval [1.17, 1.49], I2 = 0.0%). Far vision impairment was dose-dependently associated with low physical activity (e.g., severe [<6/10] vs. no [≥6/12] far vision impairment; odds ratio = 1.80; 95% confidence interval [1.03, 3.15]). Interventions to address low levels of physical activity in the visually impaired in low- and middle-income countries should target those with far vision impairment.
Deep learning-based carotid plaque vulnerability classification with multicentre contrast-enhanced ultrasound video: a comparative diagnostic study
Authors: Guang Yang , He Wen , Ning Bin , Zhang Hongxia , Yin Chen , Zhao Mingchang , Nie Fang , Huang Pintong , Zhang Rui-Fang , Yong Qiang , Guo Yanli , Yuan Jianjun , Wang Yicheng , Yuan Lijun , Ruan Litao , Yu Tengfei , Song Haiman , Zhang Yukang
Published: August 2021

Objectives

The aim of this study was to evaluate the performance of deep learning-based detection and classification of carotid plaque (DL-DCCP) in carotid plaque contrast-enhanced ultrasound (CEUS).

Methods and analysis

A prospective multicentre study was conducted to assess vulnerability in patients with carotid plaque. Data from 547 potentially eligible patients were prospectively enrolled from 10 hospitals, and 205 patients with CEUS video were finally enrolled for analysis. The area under the receiver operating characteristic curve (AUC) was used to evaluate the effectiveness of DL-DCCP and two experienced radiologists who manually examined the CEUS video (RA-CEUS) in diagnosing and classifying carotid plaque vulnerability. To evaluate the influence of dynamic video input on the performance of the algorithm, a state-of-the-art deep convolutional neural network (CNN) model for static images (Xception) was compared with DL-DCCP for both training and holdout validation cohorts.

Results

The AUCs of DL-DCCP were significantly better than those of the experienced radiologists for both the training and holdout validation cohorts (training, DL-DCCP vs RA-CEUS, AUC: 0.85 vs 0.69, p<0.01; holdout validation, DL-DCCP vs RA-CEUS, AUC: 0.87 vs 0.66, p<0.01), that is, also better than the best deep CNN model Xception we had performed, for both the training and holdout validation cohorts (training, DL-DCCP vs Xception, AUC:0.85 vs 0.82, p<0.01; holdout validation, DL-DCCP vs Xception, AUC: 0.87 vs 0.77, p<0.01).

Conclusion

DL-DCCP shows better overall performance in assessing the vulnerability of carotid atherosclerotic plaques than RA-CEUS. Moreover, with a more powerful network structure and better utilisation of video information, DL-DCCP provided greater diagnostic accuracy than a state-of-the-art static CNN model.

Trial registration number

ChiCTR1900021846,
Translational deep phenotyping of deaths related to the COVID-19 pandemic: protocol for a prospective observational autopsy study
Authors: Henningsen Mikkel Jon , Khatam-Lashgari Apameh , Olsen Kristine Boisen , Jacobsen Christina , Brøchner Christian Beltoft , Banner Jytte
Published: August 2021

Introduction

The COVID-19 pandemic is an international emergency with an extreme socioeconomic impact and a high mortality and disease burden. The COVID-19 outbreak is neither fully understood nor fully pictured. Autopsy studies can help understand the pathogenesis of COVID-19 and has already resulted in better treatment of patients. Structured and systematic autopsy of COVID-19-related deaths will enhance the mapping of pathophysiological pathways, not possible in the living. Furthermore, it provides an opportunity to envision factors translationally for the purpose of disease prevention in this and future pandemics. This is the protocol for an autopsy study that offers an umbrella for deep and diverse investigations of COVID-19-related deaths, including a systematic investigation of ‘long’ COVID-19 by means of extensive and systematic tissue sampling.

Methods and analysis

A COVID-19-specific autopsy algorithm has been created to cover all cases undergoing clinical or forensic autopsy in Denmark. The algorithm describes advanced tissue sampling and a translational analytical follow-up for deep phenotyping. The translational approach covers registry data, postmortem imaging, gross autopsy findings, microscopic organ changes, postmortem toxicology, postmortem biochemical investigation, microbiological profiling and immunological status at the time of death, and future research projects covering genetics and epigenetics on an organ level.

Ethics and dissemination

This study has been approved by the Regional Ethics Committee of the Region of Greater Copenhagen (No: H-20078436) and the Danish Data Protection Agency (No: 2002-54-1080). Next of kin gave informed consent to research. The study results will be published in peer-reviewed journals.

Trial registration number

This study is purely observational and, as such, does not meet the criteria of the International Committee of Medical Journal Editors for clinical trials; thus, there is no need for registration in a database of research trials, such as clinical trials. To facilitate cooperation in research, provide transparency on case recruitment for publications to come and to avoid unnecessary duplicate work, we nevertheless wish to publish our protocol.
Treatment of hallux rigidus (HARD trial): study protocol of a prospective, randomised, controlled trial of arthrodesis versus watchful waiting in the treatment of a painful osteoarthritic first metatarsophalangeal joint
Authors: Miettinen Mikko , Rämö Lasse , Lähdeoja Tuomas , Sirola Timo , Sandelin Henrik , Ponkilainen Ville , Repo Jussi P
Published: August 2021

Introduction

Hallux rigidus is a common problem of pain and stiffness of the first metatarsophalangeal joint (MTPJ) caused mainly by degenerative osteoarthritis. Several operative techniques have been introduced for the treatment of this condition without high-quality evidence comparing surgical to non-surgical care. In this trial, the most common surgical procedure, arthrodesis, will be compared with watchful waiting in the management of hallux rigidus.

Methods and analysis

Ninety patients (40 years or older) with symptomatic first MTPJ osteoarthritis will be randomised to arthrodesis or watchful waiting in a ratio of 1:1. The primary outcome will be pain during walking, assessed using the 0–10 Numerical Rating Scale (NRS) at 1 year after randomisation. The secondary outcomes will be pain at rest (NRS), physical function (Manchester-Oxford Foot Questionnaire), patient satisfaction in terms of the patient-acceptable symptom state, health-related quality of life (EQ-5D-5L), activity level (The Foot and Ankle Ability Measure Sports subscale), use of analgesics or orthoses and the rate of complications. Our null hypothesis is that there will be no difference equal to or greater than the minimal important difference of the primary outcome measure between arthrodesis and watchful waiting. Our primary analysis follows an intention-to-treat principle.

Ethics and dissemination

The study protocol has been approved by the Ethics Committee of Helsinki and Uusimaa Hospital District, Finland. Written informed consent will be obtained from all the participants. We will disseminate the findings of this study through peer-reviewed publications and conference presentations.

Protocol version

21 June 2021 V.2.0.

Trial registration number

NCT04590313.
UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study
Authors: Sharp Marie-Louise , Serfioti Danai , Jones Margaret , Burdett Howard , Pernet David , Hull Lisa , Murphy Dominic , Wessely Simon , Fear Nicola T
Published: August 2021

Objective

To investigate the impact of the COVID-19 pandemic on the health and well-being of UK ex-service personnel (veterans) before and during the pandemic, and to assess associations of COVID-19 experiences and stressors with mental health, alcohol use and loneliness.

Design

An additional wave of data was collected from a longitudinal cohort study of the UK Armed Forces.

Setting

Online survey June–September 2020.

Participants

Cohort members were included if they had completed a questionnaire at phase 3 of the King’s Centre for Military Health Research health and well-being study (2014–2016), had left the Armed Forces after regular service, were living in the UK, had consented to follow-up and provided a valid email address. Invitation emails were sent to N=3547 with a 44% response rate (n=1562).

Primary outcome measures

Common mental health disorders (CMDs) (measured using the General Health Questionnaire, 12 items—cut-off ≥4), hazardous alcohol use (measured using the Alcohol Use Disorder Identification Test, 10 items—cut off ≥8) and loneliness (University of California, Los Angeles, Loneliness Scale— 3 items-cut-off ≥6).

Results

Veterans reported a statistically significant decrease in hazardous drinking of 48.5% to 27.6%, while CMD remained stable (non-statistically significant increase of 24.5% to 26.1%). 27.4% of veterans reported feelings of loneliness. The COVID-19 stressors of reporting difficulties with family/social relationships, boredom and difficulties with health were statistically significantly associated with CMD, hazardous drinking and loneliness, even after adjustment for previous mental health/hazardous alcohol use.

Conclusions

Our study suggests a COVID-19 impact on veterans’ mental health, alcohol use and loneliness, particularly for those experiencing difficulties with family relationships. Veterans experienced the pandemic in similar ways to the general population and in some cases may have responded in resilient ways. While stable levels of CMD and reduction in alcohol use are positive, there remains a group of veterans who may need mental health and alcohol treatment services.
Workforce safety in the remote health sector of Australia: a scoping review
Authors: Wright Laura Kimberly , Jatrana Santosh , Lindsay David
Published: August 2021

Objectives

To scope the evidence surrounding workplace health and safety risks for the remote health workforce in Australia and to collate the recommendations to address those risks.

Design

A five-stage scoping review framework refined by Cooperet alwas used for this review. Informit Health Collection, Ovid Emcare, Medline, Web of Science Core Collection, ProQuest and the grey literature were searched in October 2020 using a combination of key words derived from the eligibility criteria. No date restriction was placed on the search. Title and abstract screening, full-text review and data extraction were performed by three reviewers. Data were analysed by the lead author using qualitative thematic analysis.

Eligibility criteria

Articles were eligible for inclusion if they were published research or industry reports, focused on safety for the remote health workforce in Australia, identified hazards/safety risks or recommendations to reduce risk, and were written in English.

Results

The search yielded 312 articles, of which 18 met the inclusion criteria. A wide range of hazards/safety risks and recommendations were identified within the literature, which related to safety culture, isolation, safe environment, and education and training. Some recommendations, such as the use of a risk management approach, good post-incident support, safer clinics and accommodation, and improved access to education and training, had been discussed in the literature for over a decade, with a high level of agreement regarding their importance. Two articles briefly evaluated the impact of some recommendations.

Conclusion

While many recommendations have been developed to improve the safety of the remote health workforce in Australia, there is little evidence of their implementation and evaluation. As many remote health professionals report ongoing or worsening workplace safety issues, there is an urgent need for the implementation and evaluation of the workforce safety strategies recommended in the literature and required by legislation.
Preventing adverse cardiac events (PACE) in chronic obstructive pulmonary disease (COPD): study protocol for a double-blind, placebo controlled, randomised controlled trial of bisoprolol in COPD
Authors: Martin Allison , Hancox Robert J , Chang Catherina L , Beasley Richard , Wrobel Jeremy , McDonald Vanessa , Dobler Claudia C , Yang Ian A , Farah Claude S , Cochrane Belinda , Hillis Graham S , Scowcroft Caroline Polak , Aggarwal Ashutosh , Di Tanna Gian Luca , Balicki Grace , Galgey Shane , Jenkins Christine
Published: August 2021

Introduction

Heart disease in chronic obstructive pulmonary disease (COPD) is a common but neglected comorbidity. Patients with COPD are frequently excluded from clinical trials of treatments aimed at reducing cardiac morbidity and mortality, which has led to undertreatment of cardiovascular disease in patients with COPD. A particular concern in COPD is the underuse of beta (β)-blockers. There is observational evidence that cardioselective β-blockers are safe and may even reduce mortality risk in COPD, although some evidence is conflicting. There is an urgent need to answer the research question: Are cardioselective β-blockers safe and of benefit in people with moderately severe COPD? The proposed study will investigate whether cardioselective β-blocker treatment in patients with COPD reduces mortality and cardiac and respiratory morbidity.

Methods and analyses

This is a double-blind, randomised controlled trial to be conducted in approximately 26 sites in Australia, New Zealand, India, Sri Lanka and other countries as required. Participants with COPD will be randomised to either bisoprolol once daily (range 1.25–5 mg, dependent on tolerated dose) or matched placebo, in addition to receiving usual care for their COPD over the study duration of 24 months.

The study will enrol 1164 participants with moderate to severe COPD, aged 40–85 years. Participants will be symptomatic from their COPD and have a postbronchodilator forced expiratory volume in 1 s (FEV1) ≥30% and ≤70% predicted and a history of at least one exacerbation requiring systemic corticosteroids, antibiotics or both in the prior 24 months.

Ethics and dissemination

The study protocol has been approved by the Sydney Local Health District Human Research Ethics Committee at The Concord Repatriation General Hospital.

Trial registration numbers

NCT03917914; CTRI/2020/08/027322.
Determining the skills needed by frontline NHS staff to deliver quality improvement: findings from six case studies
Authors: Wright David , Gabbay John , Le May Andrée
Published: August 2021

Background

Previous studies have detailed the technical, learning and soft skills healthcare staff deploy to deliver quality improvement (QI). However, research has mainly focused on management and leadership skills, overlooking the skills frontline staff use to improve care. Our research explored which skills mattered to frontline health practitioners delivering QI projects.

Study design

We used a theory-driven approach, informed by communities of practice, knowledge-in-practice-in-context and positive deviance theory. We used case studies to examine skill use in three pseudonymised English hospital Trusts, selected on the basis of Care Quality Commission rating. Seventy-three senior staff orientation interviews led to the selection of two QI projects at each site. Snowball sampling obtained a maximally varied range of 87 staff with whom we held 122 semistructured interviews at different stages of QI delivery, analysed thematically.

Results

Six overarching ‘Socio-Organisational Functional and Facilitative Tasks’ (SOFFTs) were deployed by frontline staff. Several of these had to be enacted to address challenges faced. The SOFFTs included: (1) adopting and promulgating the appropriate organisational environment; (2) managing the QI rollercoaster; (3) getting the problem right; (4) getting the right message to the right people; (5) enabling learning to occur; and (6) contextualising experience. Each task had its own inherent skills.

Conclusion

Our case studies provide a nuanced understanding of the skills used by healthcare staff. While technical skills are important, the ability to judge when and how to use wider skills was paramount. The provision of QI training and fidelity to the improvement programme may be less of a priority than the deployment of SOFFT skills used to overcome barriers. QI projects will fail if such skills and resources are not accessed.
Contribution of men who have sex with men (MSM) attending due to contact tracing to the diagnoses of HIV, syphilis and gonorrhoea in MSM from a clinic-based population
Authors: Samarasekara Keshinie , Ringshall Miriam , Parashar Kuhuk , Pickering Alice , Buss Zoe , Nichols Kayleigh , Devlin John , Fitzpatrick Colin , Williams Deborah , Richardson Daniel
Published: August 2021

Objectives

Rates of HIV, syphilis and gonorrhoea have increased over the past 20 years in men who have sex with men (MSM). Contact tracing strategies have increased the number of MSM attending clinics as sexual contacts. Understanding the outcomes of contact tracing could inform future public health policies to reduce the burden of STIs in MSM.

Method

We aimed to describe the contribution of MSM attending as notified sexual contacts of patients with HIV, syphilis and gonorrhoea to the overall diagnoses of HIV, syphilis and gonorrhoea in MSM in a cross-sectional study. We collected data on all MSM diagnosed with HIV, syphilis and gonorrhoea in 2019 and evaluated which of these MSM were tested due to attending as a sexual contact.

Results

Sexual contacts of HIV, syphilis and gonorrhoea contributed to 20% (95% CI=17.3% to 23.7%) of all diagnoses of HIV (3 of 30, 10%), syphilis (28 of 183, 15%) or gonorrhoea (98 of 420, 23%) in the study period. Asymptomatic sexual contacts contributed to 12% (95% CI=9.6% to 14.9%) of all diagnoses of HIV (3 of 30, 10%), syphilis (16 of 183, 9%) and gonorrhoea (57 of 420, 14%). The proportion of MSM diagnosed with gonorrhoea attending as sexual contacts of gonorrhoea (21%) was significantly greater than MSM diagnosed with HIV, attending as sexual contacts of HIV (3%) or MSM diagnosed with syphilis, attending as a sexual contact of syphilis (4%) (p<0.001). Furthermore, the proportion of MSM diagnosed with syphilis, attending as a sexual contact of another STI (11%) was significantly greater than MSM diagnosed with HIV, attending as a contact of another STI (7%) or MSM diagnosed with gonorrhoea, attending as a sexual contact of another STI (2%) (p<0.001).

Conclusion

Contact tracing contributes significantly to the overall diagnoses of HIV, syphilis and gonorrhoea including asymptomatic sexual contacts in our population. Further efforts to increase the yield from contact tracing may continue to reduce the burden of HIV, syphilis and gonorrhoea within sexual networks of MSM.
NINE HISTORICAL VIEWS OF THE PHILLIPS CURVE: EIGHT AUTHENTIC AND ONE INAUTHENTIC
Authors: FORDER JAMES
Published: August 2021

There is a widely believed but entirely mythical story to the effect that the discovery of ‘the Phillips curve’ was, in the 1960s and 1970s, an inspiration of inflationist policy. One aspect of the explanation of how that myth came to be widely believed is considered in this paper. It is noted that the expression ‘Phillips curve’ was applied in a number of quite distinct and inconsistent ways, and as a result there was, by about 1980, an enormous confusion as to what that label meant. This confusion, as well as the multiplicity of possible meanings, it is suggested, provides part, although only part, of the explanation of the myth’s acceptance.
A semilinear parabolic predator–prey system with time delay and habitat complexity effect
Authors: Liu Haicheng , Ge Bin , Chen Jiaqi , Liang Qiyuan
Published: August 2021

Based on the research on the predator–prey model with Holling type response function, a delayed predator–prey system with diffusion term and habitat complexity effect is established, and the effects of time delay and diffusion on dynamical behavior of the system are studied. First, taking habitat complexity as the parameter, the dynamical properties of the system without time delay are studied. By eigenvalue analysis, the sufficient conditions for locally asymptotic stability of the positive equilibrium and globally asymptotic stability of the boundary equilibrium are given, the existence conditions of Hopf bifurcation induced by diffusion term are discussed. In an appropriate range, diffusion makes a family of spatially homogeneous and inhomogeneous periodic solutions bifurcate from the positive equilibrium. Second, taking production delay as the bifurcation parameter, the existence conditions of Hopf bifurcation are given, the method to determine the bifurcation direction and the stability of bifurcating periodic solutions is given by using the center manifold theory and normal form method. Finally, the biological interpretations of the results are given, and some numerical simulations are given to verify the theoretical analysis results.
Comprehension of defect states induced by fluorine ions substituting for oxygen ions in Sr3MgSi2O8−δF2δ by first principles calculation
Authors: Zhang Meng , Song Ting , Zhu Hancheng , Zhang Xinyang
Published: August 2021

Study of the defect states in the luminescent host materials has always been a significant point in improving the light emitting devices performances. To afford candidate luminescence host materials, defect states in Sr3MgSi2O[Formula: see text]F[Formula: see text] induced by substitution of fluorine ions (F[Formula: see text] substituting for oxygen ions (O[Formula: see text] have been studied through first principles calculation and the related results are presented in this work. First, chemical formulas have been confirmed to be Sr3MgSi2O[Formula: see text]F[Formula: see text] through calculations of the possible crystal structures with increasing F[Formula: see text] substituting for O[Formula: see text] concentrations while band gap values decrease from 5.889 eV to 5.328 eV. When the fluorine ion substituting concentration [Formula: see text] reached 0.5, a new defect state near 3.002 eV in the band gap appeared and it can be concluded that the defect state originates from the two fluorine ions bonding to the same Si–O–F2 group. In addition, there arose a new absorption band in the visible region and it can also be attributed to the introduced color [Formula: see text] center in Sr3MgSi2O[Formula: see text]F. The aforementioned results show that tiny doping amounts of fluorine ions could make Sr3MgSi2O[Formula: see text]F[Formula: see text] suitable for luminescence host materials.
Pre-Hospital First Aid Strategy for Highway Traffic Accident
Authors: Guo Shuzhang , Liu Zhi
Published: August 2021

Road traffic accidents have become an enormous global public health problem. Traffic accident injuries on highways can cause severe trauma. The death rate of the injured is very high within 30[Formula: see text]min after injury. According to statistics, about 75–95% of the people with fatal traffic injuries died before being taken to the hospital. If these casualties can be effectively treated, about 1/3 can be prevented from death. Therefore, pre-hospital first aid plays a very important role in the treatment of major traffic accident injuries. Paying attention to the pre-hospital emergency treatment is crucial to ensure the success of a major accident damage, and to improve treatment results and reduce mortality and morbidity. A good relationship between the doctor and ambulance officers is essential for efficient team work. All emergency surgical procedures in the case of severely injured patients are generally performed in accordance with the Damage Control Orthopedics (DCO) principle. In order to improve the pre-hospital rapid response and first aid capabilities, the government should establish independent trauma disciplines and trauma specialist training systems, and must build the regional trauma care system as well as the standards for graded treatment, thus establishing a multi-disciplinary team (MDT) for severe trauma. In this way, we can reduce the mortality and disability risks of severe trauma, improve the quality of patients’ life and save more lives.
Distinct time courses and mechanics of right ventricular hypertrophy and diastolic stiffening in a male rat model of pulmonary arterial hypertension
Authors: Kwan Ethan D. , Vélez-Rendón Daniela , Zhang Xiaoyan , Mu Hao , Patel Megh , Pursell Erica , Stowe Jennifer , Valdez-Jasso Daniela
Published: August 2021

Using a novel combination of hemodynamic and morphological measurements over 10 wk in a male rat model of PAH and a mathematical model of RV mechanics, we found that compensated systolic function was almost entirely explained by RV hypertrophy, but subsequently altered RV end-diastolic mechanics were primarily explained by passive myocardial stiffening that was not associated with significant collagen extracellular matrix accumulation.
Myocardial adaptation and exercise performance in patients with pulmonary arterial hypertension assessed with patient-specific computer simulations
Authors: Olsen Niels Thue , Göransson Christoffer , Vejlstrup Niels , Carlsen Jørn
Published: August 2021

Computer simulations of the myocardial mechanics and hemodynamics of rest and exercise were performed in nine patients with pulmonary arterial hypertension and 10 control subjects, with the use of data from invasive catheterization and from cardiac magnetic resonance. This approach allowed a detailed analysis of myocardial adaptation to pulmonary arterial hypertension and showed how reduction in right ventricular inotropic reserve is the important limiting factor for an increase in cardiac output during exercise.
Angiotensin II biphasically regulates cell differentiation in human iPSC-derived kidney organoids
Authors: Yanofsky Stacy M. , Dugas Courtney M. , Katsurada Akemi , Liu Jiao , Saifudeen Zubaida , El-Dahr Samir S. , Satou Ryousuke
Published: August 2021

This study demonstrates angiotensin II exertion of biphasic effects on cell differentiation through distinct mediatory roles of angiotensin II type 1 receptor and type 2 receptor in human induced pluripotent stem cell-derived kidney organoids, providing a novel strategy to establish and further characterize the developmental potential of the human kidney organoids.
Experimental Research on the Impact of Interface Temperature on the Adhesion Properties of Clay under the Condition of Different Contacting Time
Authors: Qiu Tao , Zhang Yonggang
Published: August 2021

Mud cakes are very likely to occur at the shield cutter when the shield machine passes through a clay stratum, which adhere to the cutter and reduce the excavation efficiency. Due to the thrust of the cutter, the mud cakes are compacted and cause friction at the soil-structure interface, which results in high temperature and aggravates the adhesion, and the effect tends to become stronger as the heating process lasts. In this paper, the effects of the interface temperature and the contacting time between the soil and the hot surface on the adhesion properties of the soil were studied by a self-made adhesion test device. According to the findings, at low interfacial temperature (≤40°C), both the adhesion force and the amount of adhered soil were insignificant in a short term, and the effects were found to be strengthened as the contacting time went on; at the high interfacial temperature (≥50°C), very significant soil adhesion occurred at the structure surface within a short time, and as the contacting time increased, the amount of the adhered soil decreased rapidly while the adhesion force kept increasing, and both tended to remain a constant and become independent with the temperature after a long-term contact. This study is of guiding significance for understanding the formation and development of the shield mud cakes during shield construction.
A Neural Recording and Stimulation Chip with Artifact Suppression for Biomedical Devices
Authors: Liu Xu , Li Juzhe , Chen Tao , Wang Wensi , Je Minkyu
Published: August 2021

This paper presents chip implementation of the integrated neural recording and stimulation system with stimulation-induced artifact suppression. The implemented chip consists of low-power neural recording circuits, stimulation circuits, and action potential detection circuits. These circuits constitute a closed-loop simultaneous neural recording and stimulation system for biomedical devices, and a proposed artifact suppression technique is used in the system. Moreover, this paper also presents the measurement and experiment results of the implemented 4-to-4 channel neural recording and stimulation chip with 0.18 µm CMOS technology. The function and efficacy of simultaneous neural recording and stimulation is validated in both in vivo and animal experiments.