bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple approaches to incorporating scattering states in non-degenerate perturbation theory
Authors: Colladay Don C. , Goff John Eric
Published: August 2020

The second-order perturbative Stark effect on the ground state of hydrogen is a typical example presented in many standard texts on quantum mechanics. Some texts miss the fact that the scattering states are significant contributors to the perturbative energy correction. The inclusion of scattering states has wider applicability than to just the Stark effect. An explicit calculation involving a finite-square well with a perturbation is used to illustrate the importance of including scattering states into the calculation. The second-order correction to the ground-state energy is obtained in three distinct ways. The first involves altering the problem by imposing additional boundary conditions at large distances to make the positive-energy spectrum discrete. The second makes use of the continuum scattering states directly. The third bypasses the use of scattering states by solving a differential equation for the first-order correction to the wave function.
A first-year research experience: The Freshman Project in Physics at Loyola University Chicago
Authors: Bougie Jonathan , Gangopadhyaya Asim , Moses Sherita , Polak Robert D. , Ramsey Gordon P. , Walkosz Weronika
Published: August 2020

Undergraduate research has become an essential mode of engaging and retaining students in physics. At Loyola University Chicago, first-year physics students have been participating in the Freshman Projects program for over twenty years, which has coincided with a period of significant growth for our department. In this paper, we describe how the Freshman Projects program has played an important role in advancing undergraduate research at Loyola and the profound impact it has made on our program. We conclude with suggestions for adoption of similar programs at other institutions.
The paradox of the tight spiral pass in American football: Insights from an analytic approximate solution
Authors: Price Richard H.
Published: August 2020

In a recent paper, Price, Moss, and Gay have given a simple explanation of a paradox in the flight of a football, why the long axis of the football, contrary to intuition but in good agreement with experience, turns so that it is tangent to the path of the football. Here, we add to the analysis the assumption of only first-order differences between the direction of the velocity, the orientation of the long axis, and the direction of the total angular momentum. The result is a closed-form solution that is particularly useful in revealing the way in which nutation and precession are mixed.
Smart covalent organic networks (CONs) with “on-off-on” light-switchable pores for molecular separation
Authors: Liu Jiangtao , Wang Shaofei , Huang Tiefan , Manchanda Priyanka , Abou-Hamad Edy , Nunes Suzana P.
Published: August 2020

2D membrane with azobenzene switches has the photo-responsive pores for nanofiltration.
A brain network supporting social influences in human decision-making
Authors: Zhang Lei , Gläscher Jan
Published: August 2020

Social influence modulates choice and confidence in learning and the interaction between the brain’s reward hub and social hub.
Tough and tunable scaffold-hydrogel composite biomaterial for soft-to-hard musculoskeletal tissue interfaces
Authors: Sun Han Chang Raul A. , Shanley John F. , Kersh Mariana E. , Harley Brendan A.C.
Published: August 2020

A robust multi-tissue biomaterial is fabricated for regeneration of hard-to-soft musculoskeletal tissue interfaces.
High-performance pan-tactic polythioesters with intrinsic crystallinity and chemical recyclability
Authors: Shi Changxia , McGraw Michael L. , Li Zi-Chen , Cavallo Luigi , Falivene Laura , Chen Eugene Y.-X.
Published: August 2020

Circular plastics defy traditional trade-offs in recyclability-performance and structure-property relationships.
Coexistence of a new type of bound state in the continuum and a lasing threshold mode induced by PT symmetry
Authors: Song Qianju , Hu Jiashun , Dai Shiwei , Zheng Chunxiong , Han Dezhuan , Zi Jian , Zhang Z. Q. , Chan C. T.
Published: August 2020

A new type of bound states induced by PT symmetry is found which does not radiate but can be excited from the far field.
An 88-milligram insect-scale autonomous crawling robot driven by a catalytic artificial muscle
Authors: Yang Xiufeng , Chang Longlong , Pérez-Arancibia Néstor O.
Published: August 2020

A subgram fully autonomous insect-sized crawling robot called RoBeetle is powered by the controlled catalytic combustion of fuel.
Pathophysiological regulation of lung function by the free fatty acid receptor FFA4
Authors: Prihandoko Rudi , Kaur Davinder , Wiegman Coen H. , Alvarez-Curto Elisa , Donovan Chantal , Chachi Latifa , Ulven Trond , Tyas Martha R. , Euston Eloise , Dong Zhaoyang , Alharbi Abdulrahman Ghali M. , Kim Richard Y. , Lowe Jack G. , Hansbro Philip M. , Chung Kian Fan , Brightling Christopher E. , Milligan Graeme , Tobin Andrew B.
Published: August 2020

FFA4 receptor agonism corrects dysfunctional lung responses and inflammation in models and is a potential target for inflammatory lung disease.
Artery to vein configuration of arteriovenous fistula improves hemodynamics to increase maturation and patency
Authors: Bai Hualong , Sadaghianloo Nirvana , Gorecka Jolanta , Liu Shirley , Ono Shun , Ramachandra Abhay B. , Bonnet Sophie , Mazure Nathalie M. , Declemy Serge , Humphrey Jay D. , Dardik Alan
Published: August 2020

Radial artery deviation and reimplantation exhibits improved patency rates in both sexes and is associated with improved hemodynamics in a rat model.
Targeting acid ceramidase inhibits YAP/TAZ signaling to reduce fibrosis in mice
Authors: Alsamman Sarah , Christenson Stephanie A. , Yu Amy , Ayad Nadia M. E. , Mooring Meghan S. , Segal Joe M. , Hu Jimmy Kuang-Hsien , Schaub Johanna R. , Ho Steve S. , Rao Vikram , Marlow Megan M. , Turner Scott M. , Sedki Mai , Pantano Lorena , Ghoshal Sarani , Ferreira Diego Dos Santos , Ma Hsiao-Yen , Duwaerts Caroline C. , Espanol-Suner Regina , Wei Lan , Newcomb Benjamin , Mileva Izolda , Canals Daniel , Hannun Yusuf A. , Chung Raymond T. , Mattis Aras N. , Fuchs Bryan C. , Tager Andrew M. , Yimlamai Dean , Weaver Valerie M. , Mullen Alan C. , Sheppard Dean , Chen Jennifer Y.
Published: August 2020

Acid ceramidase inhibition promotes YAP/TAZ degradation to inactivate fibroblasts, decrease matrix stiffness, and reduce fibrosis in mice.
An affinity for pure drugs
Authors: Rodell Christopher B.
Published: August 2020

High-affinity supramolecular interactions improve the purification of recombinant therapeutic proteins, simplifying their production.
Draft Genome Sequence of 2-Methylpyridine-, 2-Ethylpyridine-, and 2-Hydroxypyridine-Degrading
Arthrobacter
sp. Strain ATCC 49987
Authors: Gupta Nidhi , Skinner Kelly A. , Summers Zarath M. , Edirisinghe Janaka N. , Faria José P. , Marshall Christopher W. , Sharma Anukriti , Gottel Neil R. , Gilbert Jack A. , Henry Christopher S. , O’Loughlin Edward J.
Published: August 2020

Here, we report the draft genome sequence of
Arthrobacter
sp. strain ATCC 49987, consisting of three contigs with a total length of 4.4 Mbp. Based on the genome sequence, we suggest reclassification of
Arthrobacter
sp. strain ATCC 49987 as
Pseudarthrobacter
sp. strain ATCC 49987.
Complete Genome Sequence of Bartonella alsatica Strain IBS 382 (CIP 105477)
Authors: Thibau Arno , Schultze Tilman G. , Ballhorn Wibke , Kempf Volkhard A. J.
Published: August 2020

Bartonella alsatica
causes bacteremia in rabbits and, rarely, human infections. Here, we announce the complete and closed genome of
B. alsatica
IBS 382 (CIP 105477), generated by long-read Pacific Biosciences single-molecule real-time (SMRT) sequencing. The availability of this genome sequence allows future work on understanding the zoonotic potential of this pathogen.
Draft Genome Sequence of Ligilactobacillus salivarius FFIG58, Isolated from the Intestinal Tract of Wakame-Fed Pig
Authors: Zhou Binghui , Albarracin Leonardo , Masumizu Yuki , Indo Yuhki , Islam M. Aminul , Garcia-Castillo Valeria , Ikeda-Ohtsubo Wakako , Suda Yoshihito , Aso Hisashi , Villena Julio , Kitazawa Haruki
Published: August 2020

Ligilactobacillus salivarius
FFIG58 was isolated from the intestine of a wakame-fed pig and sequenced with an Illumina HiSeq system. FFIG58 genome sequencing revealed a genome size of 1,984,180 bp, with 1,994 protein-coding genes and a GC content of 32.9%. This draft genome sequence will contribute to a better understanding of the porcine gut microbiome.
Breadcrust bubbles: Ash particles recording post-fragmentation brittle-ductile deformation
Authors: Quane Steven L. , Andrews Benjamin J.
Published: August 2020

Breadcrust bubbles are a previously undescribed pyroclast providing unique insights into post-fragmentation conduit dynamics. We describe these particles from the ca. 7 Ma Rattlesnake Tuff deposits (Oregon, USA) and ca. 15 ka deposits at Laguna del Maule (Chile). The clasts comprise discrete, ∼1-mm-diameter, fully intact hollow spheroids composed of high-silica rhyolite glass with a series of cross-cutting cracks on the shell exterior akin to breadcrust texture on volcanic bombs. We interpret the spheroids as resulting from fragmentation of a thick-walled magmatic foam. As the pyroclasts accelerated up the conduit, breadcrust textures recorded cycles of brittle and ductile deformation to relieve overpressure. We exploit this texture to quantify parameters inaccessible through direct observation including strain accommodation and the time scale necessary for it to accrue. Breadcrust bubbles have additional potential to better describe and quantify the nature of fragmentation and transport conditions in high-silica rhyolite eruptions.
Simultaneous Middle Pleistocene eruption of three widespread tholeiitic basalts in northern California (USA): Insights into crustal magma transport in an actively extending back arc
Authors: Downs Drew T. , Champion Duane E. , Muffler Patrick , Christiansen Robert L. , Clynne Michael A. , Calvert Andrew T.
Published: August 2020

Mapping and chronology are central to understanding spatiotemporal volcanic trends in diverse tectonic settings. The Cascades back arc in northern California (USA) hosts abundant lava flows and normal faults, but tholeiitic basalts older than 200 ka are difficult to discriminate by classic mapping methods. Paleomagnetism and chemistry offer independent means of correlating basalts, including the Tennant, Dry Lake, and Hammond Crossing basalt fields. Paleomagnetic analysis of these chemically similar basalts yield notable overlap, with statistical analysis yielding 7 chances in 1,000,000 that their similar mean remanent directions are random. These basalts also have overlapping 40Ar/39Ar ages of 272.5 ± 30.6 ka (Tennant), 305.8 ± 23.9 ka (Dry Lake), and 300.4 ± 15.2 and 322.6 ± 17.4 ka (Hammond Crossing). Chemical and paleomagnetic analyses indicate that these spatially distributed basalts represent simultaneous (<100 yr uncertainty) eruptions, and thus we use 305.5 ± 9.8 ka (weighted mean) as the eruption age. Their vents align on a N25°W trend over a distance of 39 km. Tennant erupted the largest volume (3.55 ± 0.75 km3) at the highest elevation; both factors decay to the south-southeast at Dry Lake (0.75 ± 0.15 km3) and Hammond Crossing (0.15 ± 0.05 km3). We propose vertical magma ascent beneath the Tennant vent area, where the most evolved, high-SiO2 magma erupted, with lateral dike propagation in the brittle crust. Propagation was near orthogonal to east-west extension (0.3–0.6 mm/yr) along north-northwest–trending normal faults.
P16 CEASE: deprescribing on discharge from PICU
Authors: Hayes Charlotte , Brooks Teresa
Published: August 2020

Aim

To develop a screening tool for prescribers to aid desprescribing on discharge from paediatric intensive care (PICU). Deprescribing is defined as ‘the process of withdrawal of an inappropriate medication supervised by a healthcare professional with the goal of managing polypharmacy and improving outcomes’.1 On the subject of deprescribing in paediatrics there is currently a lack of published literature however it is thought that we will be able to rationalise medicine use by being able to identify and document their indications.2

Method

An audit was completed of twenty-five paediatric patients following discharge from PICU. Data was collected on which medicines were not appropriately stopped by PICU prescribers when patients were stepped down to the ward. These medicines were categorised by their indication and this information was used to create a deprescribing screening tool. Prescribers on PICU were educated on this new tool and a further audit is currently underway to assess the impact of this.

Results

Twenty-five children were discharged from PICU to wards within the hospital over a four week period. Of these all twenty-five had two medicines or more that should have been deprescribed or a plan documented for before stepping down. A total of 110 medicines could have been deprescribed (median 4 per patient, range 2–8). These medicines were categorised by their indication: sedation 38.2% (n=42), electrolytes 33.6% (n=37), additional charts 18.2% (n=20), gastro-protection 4.5% (n=5), antibiotics 2.7% (n=3), other 2.7% (n=3).

We found that these medicines included high risk critical care only medicines that were unsafe to be administered on a ward such as high strength potassium infusions or inotropes, oral and IV sedative agents and antibiotics with no documented plan. Based on this information the following ‘CEASE’ screening tool was created:

Charts - are additional charts still in use and appropriate?

Electrolytes - have all PICU only electrolytes been stopped?

Antibiotics - do all antibiotics have a documented plan?

Sedation - has all sedation been stopped or if not is there a documented plan of when and how to stop?

Enteral - if enteral feeds have started has all gastro-protection been stopped?

A further audit is currently underway to assess the impact of the ‘CEASE’ tool.

Conclusion

The audit has shown that a range of different medicines were inappropriately continued outside of PICU, this includes high risk medicines not suitable for use on the ward. The development of the ‘CEASE’ tool has been created to aid prescribers in the identification of medicines which should be deprescribed. This should help to provide better treatment, improve patient safety and promote antimicrobial stewardship.

References

Reeve E, Gnjidic D, et al. A systematic review of the emerging definition of ‘deprescribing’ with network analysis: implications for future research and clinical practice. Br J Clin Pharmacol 2015;80:1254–68.

Begum R, Tomlin S. Deprescribing in paediatrics. Eur J Hosp Pharm 2017;24:70.
P31 Improving paracetamol safety in a tertiary paediatric hospital
Authors: McCann Joe , Copeland Rachel , Keaney Aideen , Laverty Leanne , Marcus Simon
Published: August 2020

Aims

Medication errors are perhaps the most common threat to patient safety.1 Children are particularly at risk because of variations in age and weight necessitating individual dose calculation for each patient; doses that are ten times the correct amount are occasionally given and can be life-threatening.2 Since 2015 the hospital has been seeking, as part of a Regional Quality initiative, to improve safety related to paracetamol.

Methods

Previous work involved clarification of IV paracetamol dosing for neonates and children under 10 kg with procurement of 100 mg in 10 ml vials, as well as introduction of a ‘ready-reckoner’ reference chart for prescribing, preparation and administration inserted into each BNFC across the hospital. In September 2018, we implemented a new prescribing aide sticker into kardexes in an effort to reduce IV administration errors. We then audited whether these interventions had led to an overall reduction in adverse incidents related to paracetamol.

Results

We demonstrated a progressive reduction in adverse incidents over the past four years; it has now been more than 1000 days since the last reported serious adverse incident related to paracetamol. A snapshot audit of prescribing showed that 100% of patients were prescribed a safe dose of paracetamol by either age or weight. There was however considerable variation in dosing for enteral prescribing (8.2–18.8 mg/kg), with the majority of children (74%) being dosed according to age, despite weight being available at time of prescription. Introduction of the paracetamol prescribing aide sticker received overwhelmingly positive feedback from both medical and nursing staff, and has now been implemented for all children requiring regular IV paracetamol.

Conclusions

Anaesthetics were the most commonly implicated specialty in paracetamol errors in our institution. Enteral dosing by age banding in hospital carries the potential for some children to be significantly under-dosed leading to sub-therapeutic drug levels, or even inadvertently over-dosed for more complex children who are underweight for age. We would therefore recommend dosing of enteral paracetamol by weight, when available, in hospital. Substantial improvement in paracetamol safety can be achieved through implementation of prescribing and administration aides to reduce likelihood of human error.

References

Eyers S, Fingleton J, Perrin K, Beasley R. Proposed MHRA changes to UK children’s paracetamol dosing recommendations: modelling study. J R Soc Med 2012;105:263–9.

Kaufmann J, Laschat M, Wappler F. Medication Errors in Paediatric Emergencies: A Systematic Analysis. Dtsch Arztebl Int 2012;109:609–616.
P37 A model for reducing paediatric prescribing errors in secondary care
Authors: Morgan Kate
Published: August 2020

Background

A prescribing error is a preventable error that may lead to inappropriate medication use and patient harm(1). Prescribing errors are particularly important in paediatrics where dose calculations are complicated and small errors can result in significant morbidity and mortality.1 In 2017 pharmacy data showed that paediatric prescribing errors were an issue at our Hospital regarding the severity and high numbers of errors, especially for antibiotics and analgesia.

Objectives

To achieve a zero prescribing error rate for paediatric within the hospital.

Method

Form the Paediatric Medication Errors Prevention (PMEP) group consisting of the Paediatric Consultant, Paediatric Pharmacist, Children’s Assessment Unit Sister and Practice Education Senior Nurse.

Paediatric Pharmacist to record and feedback all paediatric prescribing errors weekly at Doctors’ handover.

Paediatric Pharmacist/Nurses to DATIX report all significant medication prescribing errors

Paediatric Pharmacist to produce and communicate monthly pharmacy prescribing newsletter.

Paediatric Pharmacist to produce quick reference charts for the drugs with the most common prescribing errors e.g. antibiotics and analgesia

Paediatric Doctors to request a second check from another Doctor or Ward Sister when prescribing any medication on the drug chart of take home prescription.

Paediatric Pharmacist to target Doctors’ induction to improve prescribing and implement a prescribing test.

Doctors to complete reflections for errors with their educationsal supervisors.

This study did not require ethics approval.

Results

Following implementation of the above strategies, there was a 33% reduction in the number of prescribing errors recorded by the Paediatric Pharmacist daily intervention log from 2017/2018 to 2018/2019. There were 163 prescribing errors for 2017/2018 compared to 110 for 2018/2019.

Conclusion

The formation of the PMEP group and implementation of strategies to reduce paediatric prescribing errors has positively impacted on reducing the error rate at the hospital. It has also raised awareness of the necessity to report all errors and actively find ways to prevent these from re-occurring. Further work is required to reduce these errors to zero including targeting non paediatric teams prescribing on paediatrics and implementing Pharmacists prescribing on consultant ward rounds. Future work would also include replicating this model in other specialities e.g. neonatal intensive care to achieve the same success rate in reducing medication errors.

Reference

Davis T. Paediatric prescribing errors. Arch Dis Child. 2011;96:489–91. Accessed via http://adc.bmj.com on 2/4/19.
P40 A qualitative study on the supply of specialist medication in children at the interface of care
Authors: Camie Ng Ka Mei , Thoong Hong
Published: August 2020

Aim

To explore the views and experiences of healthcare professionals in primary care around the supply of specialist medication after a child is discharged from a specialist paediatric centre and suggest ways to improve it.

Method

A qualitative study conducted with semi-structured interview via telephone was carried out to explore the views of primary pharmaceutical advisors on the supply of specialist medicine in children. Participants were identified by reviewing outpatient prescriptions from 19 November 2018 to 30 November 2018. Telephone interviews were recorded on interview forms, as the form of data. Framework analysis was used to analyse the data.

Results

A total of 109 outpatient prescriptions with 56 Clinical Commissioning Groups (CCGs) were identified. 8 CCG pharmaceutical advisors were recruited. Four key themes were identified.

Theme 1: In order to overcome issues around the supply of specialist medicines, it is important to understand different supplying considerations in primary care. Factors including patient clinical status, GP’s expertise and confidence in prescribing and shared care agreement.

Theme 2: Actions that are untaken by primary care to solve supplying issues include drug alternatives, direct communication between clinicians and the clinical input of pharmacists.

Theme 3: Views on current shared care arrangements were generally negative. For example, participant 2 expressed: ‘Good principle… but they are too wordy, they are 10 pages long’.

Theme 4: Views on improvement in continual medicines supply included participants explaining the lack of understanding between GP and Specialist. Participant 1 commented, ‘Specialist has to understand we lack the expertise to prescribe the drug. It is not just about money…’.

Conclusion

Currently there is a lack of an integrated system in medicines supply at the tertiary to secondary/primary care interface. In order to deliver continuity of patient care, there is a need for different healthcare professionals to break down preconceptions and understand the pathway and policy involved in different care setting. A shared care should involve patient and carers, GP and the hospital consultant when making decision on the child’s health. Moreover, pharmacists in different settings have an active role in medicine optimisation and it is important to value their opinions to improve the continuation of specialist medicines supply.
Tuberculosis as a differential diagnosis of salivary gland malignancy
Authors: Medeiros Nuno , Oliveira Pedro , Larangeiro João , Condé Artur
Published: August 2020

Mycobacterial infection of the salivary glands is extremely rare, even in endemic countries. Differential diagnosis with benign or malignant neoplasms is challenging, and treatment is often delayed. We describe the case of a 62-year-old female patient who presented with a 2-month-old complaint of a right preauricular painless swelling. An ultrasound-guided fine-needle aspiration biopsy was performed, with a resulting lymphocytic infiltrate, without clear atypia. MRI demonstrated a lesion with ill-defined contours, described as probably malignant. Because of this mismatch in results, a core biopsy of the main lesion was performed, demonstrating granulomas with central necrosis, with no mycobacteria detected in PCR or culture. As the lesion continued to enlarge, a new biopsy was ordered, and this timeMycobacterium tuberculosiswas detected. Treatment with extrapulmonary tuberculosis therapy was initiated. The sensitivity of PCR and culture combined is only 73% in extrapulmonary tuberculosis. A systematic approach may prevent unnecessary surgical interventions.
Stomach in a parastomal hernia: a rare complication of stomas
Authors: Ekowo Onyekachi Ezekiel , Al Midani Ammar , Abdulaal Yasser , Boshnaq Mohamed
Published: August 2020

Parastomal hernia (PSH) is one of the most known complications to end colostomies. However, PSH containing the stomach is rare: not many case reports were found in literature search. This case is a 92-year-old woman who was brought in by ambulance to the accident and emergency department with vomiting, abdominal distension, palpable mass on the left side of her abdomen and with reduced stoma effluent. Her abdominal CT scan showed a PSH containing a partially incarcerated gastric hernia. Although there are only few similar cases of PSH containing the stomach reported in the literature, an almost similar pattern in presentation of this unique case can be deduced following a thorough comparison of cases in the literature, which can be quite helpful both academically and clinically: they are often advanced in age and are usually women with end colostomies.
Refractory thoracic endometriosis
Authors: Sharma Nishant , Todhe Pandi , Ochieng Pius , Ramakrishna Srinivasarao
Published: August 2020

Thoracic endometriosis syndrome (TES) is a rare entity caused by thoracic implantation of endometrial tissue, manifesting as catamenial pneumothorax, pleural effusion and haemoptysis in young female individuals. Its management and long-term prevention of recurrences, can be challenging. We present the case of a young woman who presented with recurrent pneumothorax, haemopneumothorax and pleural effusion. The diagnosis of TES was confirmed based on cytological findings of pleural fluid. She underwent treatment with mechanical pleurodesis twice but continued to have recurrences. Hormonal treatment failed to produce a satisfactory resolution. She underwent chemical pleurodesis, which successfully induced remission of her TES. A review of the literature suggests that chemical pleurodesis produces better results compared with mechanical pleurodesis and that hormonal treatment with gonadotropin-releasing hormone agonists is effective at preventing recurrences.
Acute pericarditis as a primary presentation of COVID-19
Authors: Kumar Rajesh , Kumar Jathinder , Daly Caroline , Edroos Sadat Ali
Published: August 2020

The COVID-19 pandemic is a highly contagious viral illness which conventionally manifests primarily with respiratory symptoms. We report a case whose first manifestation of COVID-19 was pericarditis, in the absence of respiratory symptoms, without any serious complications. Cardiac involvement in various forms is possible in COVID-19. We present a case where pericarditis, in the absence of the classic COVID-19 signs or symptoms, is the only evident manifestation of the disease. This case highlights an atypical presentation of COVID-19 and the need for a high index of suspicion to allow early diagnosis and limit spread by isolation.
Effects of food policy actions on Indigenous Peoples’ nutrition-related outcomes: a systematic review
Authors: Browne Jennifer , Lock Mark , Walker Troy , Egan Mikaela , Backholer Kathryn
Published: August 2020

Introduction

Indigenous Peoples worldwide endure unacceptable health disparities with undernutrition and food insecurity often coexisting with obesity and chronic diseases. Policy-level actions are required to eliminate malnutrition in all its forms. However, there has been no systematic synthesis of the evidence of effectiveness of food and nutrition policies for Indigenous Peoples around the world. This review fills that gap.

Methods

Eight databases were searched for peer-reviewed literature, published between 2000 and 2019. Relevant websites were searched for grey literature. Articles were included if they were original studies, published in English and included data from Indigenous Peoples from Western colonised countries, evaluated a food or nutrition policy (or intervention), and provided quantitative impact/outcome data. Study screening, data extraction and quality assessment were undertaken independently by two authors, at least one of whom was Indigenous. A narrative synthesis was undertaken with studies grouped according to the NOURISHING food policy framework.

Results

We identified 78 studies from Canada, Australia, Aotearoa/New Zealand and the USA. Most studies evaluated targeted interventions, focused on rural or remote Indigenous communities. The most effective interventions combined educational strategies with policies targeting food price, composition and/or availability, particularly in retail and school environments. Interventions to reduce exposure to unhealthy food advertising was the only area of the NOURISHING framework not represented in the literature. Few studies examined the impact of universal food policies on Indigenous Peoples’ diets, health or well-being.

Conclusion

Both targeted and universal policy action can be effective for Indigenous Peoples. Actions that modify the structures and systems governing food supply through improved availability, access and affordability of healthy foods should be prioritised. More high-quality evidence on the impact of universal food and nutrition policy actions for Indigenous Peoples is required, particularly in urban areas and in the area of food marketing.
Mixed-method estimation of population-level HIV viral suppression rate in the Western Cape, South Africa
Authors: Mukonda Elton , Hsiao Nei-Yuan , Vojnov Lara , Myer Landon , Lesosky Maia
Published: August 2020

Introduction

There are few population-wide data on viral suppression (VS) that can be used to monitor programmatic targets in sub-Saharan Africa. We describe how routinely collected viral load (VL) data from antiretroviral therapy (ART) programmes can be extrapolated to estimate population VS and validate this using a combination of empiric and model-based estimates.

Methods

VL test results from were matched using a record linkage algorithm to obtain linked results for individuals. Test-level and individual-level VS rates were based on test VL values <1000 cps/mL, and individual VL <1000 cps/mL in a calendar year, respectively. We calculated population VS among people living with HIV (PLWH) in the province by combining census-derived midyear population estimates, HIV prevalence estimates and individual level VS estimates from routine VL data.

Results

Approximately 1.9 million VL test results between 2008 and 2018 were analysed. Among individuals in care, VS increased from 85.5% in 2008 to 90% in 2018. Population VS among all PLWH in the province increased from 12.2% in 2008 to 51.0% in 2017. The estimates derived from this method are comparable to those from other published studies. Sensitivity analyses showed that the results are robust to variations in linkage method, but sensitive to the extreme combinations of assumed VL testing coverage and population HIV prevalence.

Conclusion

While validation of this method in other settings is required, this approach provides a simple, robust method for estimating population VS using routine data from ART services that can be employed by national programmes in high-burden settings.
Effect of exposure to PM10on child health: evidence based on a large-scale survey from 184 cities in India
Authors: Mahapatra Bidhubhusan , Walia Monika , Avis Wiliam Robert , Saggurti Niranjan
Published: August 2020

Introduction

Air pollution is increasingly becoming a serious global public health concern. Prior studies examining the effect of air pollution on health have ignored the role of households’ hygienic practices and socioeconomic condition, which are key determinants of the health status of a country like India. This study examines the effects of air pollution, measured in levels of particulate matters of size below 10 µg/m3(PM10), on child-health outcomes after adjusting for hygiene practices.

Methods

Health data from the National Family Health Survey-4 (NFHS-4) and PM10levels provided by the Central Pollution Control Board were matched for 184 Indian towns/cities. Child health outcomes included neonatal mortality, post-neonatal mortality, premature births, children with symptoms of acute respiratory infections (ARI) and low birth weight. Multilevel mixed-effects models were used to estimate the risk associated with exposure to PM10.

Result

Analyses based on 23 954 births found that every 10-unit increase in PM10level, increased the risk of neonatal mortality by 6% (adjusted RR (95% CI): 1.02 (1.02 to 1.09)), and the odds of symptoms of ARI among children by 7% (adjusted OR (95% CI): 1.07 (1.03 to 1.12)), and premature births by 8% (adjusted OR (95% CI): 1.08 (1.03 to 1.12)). There was no statistically significant difference in the effect of PM10on child health regardless of household’s hygienic practices. Effects of PM10on child health outcomes remained similar for cities whether or not they were part of the National Clean Air Program (NCAP).

Conclusion

Exposure to PM10, regardless of hygienic practices, increases the risk of adverse child health outcomes. Study findings suggest that the focus of mitigating the effects of air pollution should be beyond the towns/cities identified under NCAP. Given the increasing industrialisation and urbanisation, a systemic, coherent approach is required to address the issue of air pollution in India.
Identifying and prioritising technical procedures for simulation-based curriculum in paediatrics: a Delphi-based general needs assessment
Authors: Thim Signe , Nayahangan Leizl Joy , Paltved Charlotte , Jensen Rune Dall , Konge Lars , Hertel Niels Thomas , Balslev Thomas
Published: August 2020

Objectives

To identify and prioritise technical procedures that should be integrated in a curriculum of simulation-based procedural training in paediatrics using the Delphi method.

Study design

National general needs assessment using a Delphi process was completed among 93 key opinion leaders in paediatrics in Denmark. Delphi round 1 identified technical procedures. Round 2 explored frequency of procedures, number of paediatricians performing the procedures, risks and/or discomfort for patients and feasibility for simulation-based training. Round 3 included final elimination and reprioritisation.

Results

Response rates in the Delphi rounds were 73%, 71% and 72%. We identified 37 procedures in Delphi round 1, preprioritised in round 2, resulting in a final list of 19 procedures in round 3. Strong correlation between the prioritisation from the second and third Delphi rounds was identified, Spearman’s r of 0.94 (p<0.0001). Top five on the final list were acute neonatal airway management, acute non-neonatal airway management, non-neonatal peripheral intravenous and intraosseous access, neonatal vascular access and advanced heart lung resuscitation.

Conclusion

We identified and prioritised 19 technical procedures in paediatrics that are suitable for simulation and may be used as a guide for the development of simulation-based curriculum in paediatrics.
Improving safety and reducing error in endoscopy (ISREE): a survey of UK services
Authors: Ravindran Srivathsan , Bassett Paul , Shaw Tim , Dron Michael , Broughton Raphael , Griffiths Helen , Keen Dimple , Wood Eleanor , Healey Chris J , Green John , Ashrafian Hutan , Darzi Ara , Coleman Mark , Thomas-Gibson Siwan
Published: August 2020

Background

The Joint Advisory Group on Gastrointestinal Endoscopy (JAG) ‘Improving Safety and Reducing Error in Endoscopy’ (ISREE) strategy was developed in 2018. In line with the strategy, a survey was conducted within the JAG census in 2019 to gain further insights and understanding of key safety-related areas within UK endoscopy.

Methods

Questions were developed using the ISREE strategy as a guide and adapted by key JAG stakeholders. They were incorporated into the 2019 JAG census of UK endoscopy services. Quantitative and qualitative statistical methods were employed to analyse the results.

Results

There was a 68% response rate. There was regional variability in the provision of out-of-hours GIB services (p<0.001). Across 1 month, 1535 incidents were reported across all services. There was a significantly higher proportion of reported incidents in acute services compared with others (p<0.001). Technical and training incidents were likely to be reported significantly differently to all other incident types. 74% of services have an endoscopy-specific sedation policy and 42% have a named sedation or anaesthetic lead for endoscopy. Services highlighted a desire for more anaesthetic-supported lists. Only 66% of services stated they have an effective strategy for supporting upskilling of endoscopists. Across acute services, 56% have access to human factors and endoscopic non-technical skills (ENTS) training. Patient feedback is used in several ways to improve services, develop training and promote shared learning among endoscopy users.

Conclusions

The census provides a benchmark for key safety-related characteristics of endoscopy services. These results have highlighted key areas to develop, guided by the ISREE strategy.
Could ketamine be the answer to treating treatment-resistant major depressive disorder?
Authors: Ramadan Abdullah Mohammed , Mansour Islam Ahmed
Published: August 2020

Major depressive disorder (MDD) is a common, serious, debilitating condition affecting 350 million people worldwide, which remains to be unsatisfactorily treated with 53% of patients still complaining of symptoms after completing their courses with the correct dosage. Ketamine, which was approved by the Food and Drug Administration in 2019, is a potential treatment option for those recalcitrant cases. The mechanism of ketamine is not fully understood, but as type it is classified as an N-methyl-D-aspartate (NMDA) glutamate receptor antagonist, and can be given intravenously, intranasally and orally. It is used to treat treatment-resistant depression, depression associated with suicidal ideation, mood and anxiety disorders and depressions associated with either type of bipolar disorder. Although ketamine is considered relatively safe, several side effects have been reported with the major ones being psychiatric in the form of worsening mood, anxiety and agitation; psychotomimetic in the form of dissociation, perceptual disturbance and abnormal sensations; cardiovascular in the form of increased blood pressure and increased heart rate; and neurological in the form of headache and dizziness. Ketamine is still not approved worldwide for usage in patients with treatment-resistant MDD, but if it is approved sometime in the future with relatively fewer side effects, it is expected to significantly save millions of dollars spent yearly on patients with treatment-resistant depression and that will lift this major burden off the shoulders of healthcare professionals. This study was designed to measure the effects of ketamine, an NMDA receptor antagonist, on patients with treatment-resistant MDD and to analyse the concept that makes it different and relatively safer than other major antidepressants like selective serotonin reuptake inhibitors, monoamine oxidase inhibitors and TCAs (tricyclic antidepressants).
Novel platform leveraging electronic medical record (EMR) to triage patients admitted with high-grade immune-related adverse events (irAEs) to the immune-toxicity (ITOX) service
Authors: Abu-Shawer Osama , Singh Prabhsimranjot , Yenulevich Eric , Brito Amanda , Ni Jian , Abdulnour Raja-Elie E , Grover Shilpa , Manos Michael , Bowling Peter , LeBoeuf Nicole R , Ott Patrick , Stephen Hodi F , Jacobson Joseph , Rahma Osama
Published: August 2020

Background

The incidence of high-grade immune-related adverse events (irAEs) due to immune checkpoint inhibitors (ICIs) is increasing due to the rapid expansion of indications for their use. There is an urgent need for a feasible approach of identifying patients with high-grade irAEs to ensure early detection and proper management of this unique set of toxicities.

Methods

We established one of the first inpatient services that are specifically devoted to mitigating irAEs. The service uses a multidisciplinary approach with consulting service from experts in managing irAEs. We are leveraging the electronic medical record (EMR) to triage patients who are admitted to the hospital and have received or are currently receiving ICIs. A list of patients with ICI exposure is generated daily by EMR and then curated manually to identify patients with potential irAEs.

Results

A total of 129 patients with high-grade irAEs were admitted between June 2018 and June 2019. The most common irAEs were colitis (32%), pneumonitis (30%), and hepatitis (14%). Eighty five per cent of the patients had grade 3 irAEs and 15% had grade 4–5. About half of the patients had received ICI monotherapy; 30% had received combination of ICIs and non-ICIs; and 19% had received a combination of ICIs. Only 9% of patients had steroid-refractory irAEs requiring other immunosuppressive agents. The average length of stay for irAE-related admission was 11 days with a readmission rate due to recurrent irAEs of 26% within a year.

Conclusion

We demonstrated the feasibility of using the EMR to accurately triage patients with suspected irAEs to a dedicated immune-toxicity service. Our model is adaptable in major academic centers and could have a major impact on quality of care and future clinical research addressing irAEs.
A history of smoking does not reduce long-term benefits of cardiac rehabilitation on cardiorespiratory fitness in men and women with cardiovascular disease
Authors: Noguchi Kenneth Shinkichi , Pryzbek Mike , Moncion Kevin , McQuarrie Angelica , MacDonald Maureen Jane , Tang Ada
Published: August 2020

Smoking is an important risk factor for cardiovascular disease and all-cause mortality. Cardiac rehabilitation (CR) is effective for reducing the risk of recurrent cardiac events through improving cardiorespiratory fitness (CRF). Little is known about the influence of smoking on CRF throughout long-term CR. The purpose of this analysis was to compare CRF trajectories among individuals with positive and negative smoking history enrolled in long-term CR. Participants had a positive smoking history if they currently or formerly smoked (Smoke+, n = 55, mean age = 64.9 ± 9.0 years) and had a negative history if they never smoked (Smoke–, n = 34, mean age = 61.4 ± 9.0 years). CRF (peak oxygen uptake) was measured at baseline and annually thereafter for 6 years. The Smoke+ group had lower CRF compared with the Smoke– group over enrollment (β = −3.29 (SE = 1.40), 95% confidence interval (CI) −6.04 to −0.54, p = 0.02), but there was no interaction of smoking history and enrollment (β = 0.35 (SE = 0.21), 95% CI: −0.06 to 0.77, p = 0.10). Moreover, trajectories were not influenced by pack-years (β = 0.01 (SE = 0.01), 95% CI: −0.01 to 0.04, p = 0.23) or time smoke-free (β = −0.002 (SE = 0.01), 95% CI: −0.02 to 0.02, p = 0.80). Although the trajectories of CRF do not appear to be affected by smoking behaviour, individuals without a history of smoking maintained higher CRF throughout enrollment.

Novelty:

The benefits of long-term exercise-based cardiac rehabilitation on cardiorespiratory fitness are similar between those who have smoked and those who have never smoked. Neither the number of pack-years nor the length of time spent smoke-free influence cardiorespiratory fitness trajectories following long-term cardiac rehabilitation.
First limits on double beta decays in $$^\mathbf{232}$$Th
Authors: Laubenstein M. , Lehnert B. , Nagorny S. S.
Published: August 2020

As one of the primordial radioactive isotopes, $$^{232}\mathrm{Th}$$232Th mainly undergoes $$\alpha $$α-decay with a half-life of $$1.402\cdot 10^{10}$$1.402·1010 years. However, it is also one of 35 double beta decay candidates in which the single $$\beta $$β-decay is forbidden or strongly suppressed. 181 mg of thorium contained in a gas mantle were measured in a HPGe well-detector at the Gran Sasso Underground Laboratory with a total exposure of 3.25 g$$\times $$×d.

We obtain half-life limits on all double beta decay modes of $$^{232}\mathrm{Th}$$232Th to excited states of $$^{232}\mathrm{U}$$232U on the order of $$10^{11-15}$$1011-15 years. For the most likely transition into the 0$$^+_1$$1+ state we find a lower half-life limit of $$6.7\cdot 10^{14}$$6.7·1014 years (90% C.I.). These are the first constraints on double beta decay excited state transition in $$^{232}\mathrm{Th}$$232Th.
Upper bounds on the compactness at the innermost light ring of anisotropic horizonless spheres
Authors: Peng Yan
Published: August 2020

In the background of isotropic horizonless spheres, Hod recently provided an analytical proof of a bound on the compactness at the innermost light ring with the dominant energy condition. In this work, we extend the discussion of isotropic spheres to anisotropic spheres. With the dominant energy and non-negative trace conditions, we prove that Hod’s bound also holds in the case of anisotropic horizonless spheres.
Vehicle speed estimation using two roadside passive infrared sensors
Authors: Vu Van Quang , Ngo Van Linh , Vu Toan Thang , Doan Van Phuc
Published: August 2020

This paper presents a method for estimating vehicle speed using two roadside passive infrared (PIR) sensors whose optical axes are parallel to each other and perpendicular to the moving direction of vehicles. The vehicle speed was calculated based on the time lag between the two signals received by the PIR sensors, which was evaluated by using cross-correlation analysis. The experiments show that the method has an error of less than 5 km/h over a speed range of 20–60 km/h.
Oil pressure and viscosity influence on stiffness of the hydrostatic spindle bearing of a medium-sized circular grinding machine
Authors: Pham Van-Hung , Nguyen Manh-Toan , Bui Tuan-Anh
Published: August 2020

In surface finishing of a grinding machine, the dimension accuracy of the workpiece is most affected by the stiffness of the spindle. For the hydrostatic spindle of a medium-sized circular grinding machine, the primary factors affecting the oil film stiffness are bearing structure parameters, lubrication characteristics, and working conditions. In this study, the effects of lubricant pressure and oil viscosity on the stiffness of the hydrostatic spindle based on the working conditions were investigated. The oil viscosity affects the spindle by increasing the stiffness that corresponds to the increase in viscosity in the range of 0.001–0.002 Pa[Formula: see text]S, while the stiffness proportionally increases with pump pressure changing in the range of 3–5 MPa. Experimental results also indicate that based on the stiffness of the bearing, a viscosity of 0.002 Pa[Formula: see text]S, pump pressure of 5 MPa, and load range of 500–1000 N are the most feasible working conditions for hydrostatic spindle associated with the fine-machining process on a medium-sized external grinding machine.
Modeling and Optimization of Refracting-Facet Spin-Photodiodes Based on Ferromagnetic Metal-Insulator-Semiconductor Tunnel Junctions
Authors: Roca Ronel Christian , Nishizawa Nozomi , Munekata Hiro
Published: August 2020

A model for lateral-type refracting-facet spin-photodiodes based on ferromagnetic metal-insulator-semiconductor (FM-I-S) junctions is described. The model utilizes spin and charge drift-diffusion equations and spin-dependent tunneling equations which are simultaneously solved numerically in order to obtain a self-consistent solution. The model is used to analyze and optimize the refracting-facet spin-photodiode structure. The relation between the active layer thickness and the effective lifetime of photo-generated electrons is investigated. Results show that the optimum active layer thickness depends on both effective lifetimes of photo-generated electrons and spins. The influence of empty density-of-state of ferromangetic metals is also explored.