bluuebunny/crossref_metadata_2025 huggingface dataset:
Element sensor based on microplasma generators
Authors: Matusiak Tomasz , Swiderski Krzysztof , Macioszczyk Jan , Jamroz Piotr , Pohl Pawel , Golonka Leszek
Published: May 2020

Purpose

The purpose of this paper is to present a study on miniaturized instruments for analytical chemistry with a microplasma as the excitation source.

Design/methodology/approach

The atmospheric pressure glow microdischarge could be ignited inside a ceramic structure between a solid anode and a liquid cathode. As a result of the cathode sputtering of the solution, it was possible to determine its chemical composition by analyzing the emission spectra of the discharge. Cathodes with microfluidic channels and two types of anodes were constructed. Both types were tested through experimentation. Impact of the electrodes geometry on the discharge was established. A cathode aperture of various sizes and anodes made from different materials were used.

Findings

The spectroscopic properties of the discharge and its usefulness in the analysis depended on the ceramic structure. The surface area of the cathode aperture and the flow rate of the solution influence on the detection limits (DLs) of Zn and Cd.

Originality/value

Constructed ceramic structures were able to excite elements and their laboratory-size systems. During the experiments, Zn and Cd were detected with DLs 0.024 and 0.053 mg/L, respectively.
COVID-19: potential effects on Chinese citizens’ lifestyle and travel
Authors: Wen Jun , Kozak Metin , Yang Shaohua , Liu Fang
Published: May 2020

Purpose

The 2019 novel coronavirus (COVID-19) outbreak is projected to have adverse consequences on the global tourism and hospitality industry. This paper aims to examine how the outbreak may alter Chinese tourists’ lifestyle choices, travel behaviour and tourism preferences in the short and long term.

Design/methodology/approach

This paper is based on the synthesis of news broadcasted by several media outlets to be supported by an overview of the related literature on tourism marketing, tourism management and tourist behaviour. The authors’ experiences investigating trends in tourism and hospitality at the local and international level have also contributed to the study.

Findings

This paper predicts that COVID-19 will likely affect Chinese travellers’ consumption patterns, such as the growing popularity of free and independent travel, luxury trips and health and wellness tourism. New forms of tourism including slow tourism and smart tourism may also drive future tourism activities. Such changes are likely to force businesses to reconsider their service designs and distribution channels.

Research limitations/implications

While Chinese and other potential visitors rethink how they travel, professionals, too, should reflect upon how to bring positive or negative changes to the tourism industry following this pandemic. Subsequent research should also consider how to mitigate the effects of similar public health crises in the future.

Practical implications

Recommendations for industry practitioners and policymakers focus on tailoring travel arrangements to tourists’ backgrounds. The suggestions may help to alleviate outbreak-related stress, offer travellers newly enriching experiences and partially mitigate the effects of COVID-19 on the tourism and hospitality industry. These recommendations can also apply more broadly to global tourist markets.

Social implications

The COVID-19 outbreak has already brought significant impacts to nearly every society and industry. Tourism scholars and practitioners should carefully consider this tragedy and how it may inform industry and social practices. This and other public health crises represent sterling opportunities to view the industry holistically in terms of its effects on the environment, climate and travellers themselves.

Originality/value

This paper presumably represents a frontier study, critically examining the possible impacts of COVID-19 on Chinese travellers’ consumption patterns and how the tourism and hospitality industry may respond to such changes in the future.
Simultaneous optimization of output parameters in HPC drilling using multi response optimization technique with desirability function approach
Authors: Shete Hanmant Virbhadra , Sohani Madhav S.
Published: May 2020

Purpose

This paper aims to examine an investigation of high-pressure coolant (HPC) drilling process with regard to experimental models of output parameters, effect of input parameters on output parameters and simultaneous optimization of the output parameters.

Design/methodology/approach

Experimental plan was designed using response surface method and experiments were conducted on HPC drilling set up. Measurements for output parameters were carried out and mathematical models were obtained. Multi response optimization using a composite desirability function approach was used to obtain optimum values of input parameters for simultaneous optimization of output parameters.

Findings

Optimal value of input parameters for optimization of HPC drilling process were obtained as; coolant pressure: 21 bar, spindle speed: 3,970 rpm, feed rate: 0.084 mm/rev and peck depth: 5.50 mm. The composite desirability obtained is 0.9412, which indicates that the performance of HPC drilling process was significantly optimized. Developed mathematical models of the output parameters accurately represent the entire design space under investigation.

Originality/value

This is the first study that involves variation of higher coolant pressure and investigation of HPC drilling process using response surface methodology and multi response optimization technique with desirability function.
Idea Paper: Tracking the distribution of accretive reef communities across the Kuroshio region
Authors: Denis Vianney , Fan Tung‐Yung , Hsiao Wanchien Victoria , Hwang Sung‐Jin , Lin Yuting Vicky , Nozawa Yoko
Published: May 2020

In line with contemporary changes in oceanic conditions, reef communities could be declining at the equator and expanding polewards, having previously happened in the past. Yet, some tropical organisms are now decimated at their distributional cores and observed beyond their inferred range limits. However, it remains unclear if this is happening at the community scale, especially due to the challenges of collecting quantitative and comparable data across latitudes. Here, we propose that monitoring sentinel plots via photogrammetry could help to assess abiding changes in benthic communities and trajectories of reef‐building populations across the Kuroshio region. We think that as oceans are becoming warmer, accretive reef communities may shift their distribution northwards which may be primarily due to a change in the relative biomass‐abundance of resident taxa. Consistent trends among latitudes will resolve the possibility of contraction or expansion of accretive reef communities, providing further insight into the variety of responses and dynamics observed across latitudes in the context of the Anthropocene.
Significant Differences in PostMortem Heart Weight Before and After Dissection Using the Short‐Axis Dissecting Method
Authors: Loper Nicole , Garland Jack , Ondruschka Benjamin , Glenn Charley , Kesha Kilak , Stables Simon , Tse Rexson
Published: May 2020

Correctly assessing heart weight can be critical at postmortem examination. The current international guidelines advocate using the short‐axis method in dissecting the heart and the heart weighed when the blood is emptied. However, it did not specify at what point the heart should be weighed or how the blood should be emptied. This study compared heart weights at three different time points during the heart examination (immediately after dissecting out of the pericardial sac with blood still in chambers, blood washed/removed from heart chambers without the heart opened, and the heart completely opened, blood emptied, and pad dried). This was to illustrate the variation in measurement and potential errors when the heart is weighed at different time of dissection. The results show that there were statistical and clinical significant differences between the heart weights at each weighing points. We recommend the heart to be completely dissected with any blood and residual washing/rinsing water emptied before being weighed. Although performed in this study, the effect of pad drying the heart on heart weight was not explored and was a limitation in this study.
Diversity of fungal isolates from fungus‐growing termite Macrotermes barneyi and characterization of bioactive compound from Xylaria escharoidea
Authors: Nagam Venkateswarulu , Aluru Rammohan , Shoaib Muhammad , Dong Guang‐Rui , Li Zhi , Pallaval Veera Bramhachari , Ni Jin‐Feng
Published: May 2020

Owing to their potential applications, as well as their structural diversity, the discovery of novel secondary metabolites from insect‐associated fungi has been of interest to researchers in recent years. The aim of this study was therefore to estimate the diversity of fungi associated with fungus‐growing termites and bioprospecting these for potential secondary metabolites. In total, 18 fungal species were isolated and described from the gut and comb of Macrotermes barneyi based on 18S ribosomal DNA gene sequence analysis. Antimicrobial activity assays were carried out on all the known fungi, and nine isolates were recorded as active against pathogenic fungi. Xylaria escharoidea, the best performing isolate, was grown at laboratory scale and 4,8‐dihydroxy‐3,4‐dihydronaphthalen‐1(2H) was isolated and characterized. The minimum inhibitory concentration of this isolated compound against tested pathogenic organisms was found to be 6.25 μg. In addition, molecular docking studies have revealed that 4,8‐dihydroxy‐3,4‐dihydronaphthalen‐1(2H) is a prominent antibacterial agent with a marked interaction with key residues on protein A (agrAC) that regulates the accessory gene. The findings of this study support the drug discovery of antimicrobial properties in insect‐associated fungi, which may lead to novel secondary metabolites.
Application of TOPSIS to evaluate the effects of different conditions of sonication on eggless cake properties, structure, and mass transfer
Authors: Movahhed Mohammad Khalilian , Mohebbi Mohebbat , Koocheki Arash , Milani Elnaz , Ansarifar Elham
Published: May 2020

The technique for order performance by similarity to ideal solution (TOPSIS) method was used to select the optimum point of power and time of ultrasound and baking temperature of eggless cake production. The effect of ultrasound power and baking time on the mass‐transfer parameters such as moisture diffusion and the activation energy was assessed. The sonication treatment increased the viscosity of the eggless cake batter (25% in consistency coefficient and 24% in apparent viscosity). The minimum batter density was observed at 60% intensity for 30 or 60 s of sonication (1.0253 and 1.027 g/cm3). This condition also increased the eggless cake volume and springiness. In contrast, the crumb fractal dimension, hardness, gumminess, cohesiveness, and chewiness of the eggless cake decreased (1.65, 29, 39, 39, and 33%, respectively). The moisture diffusion during baking at 160, 180, and 200 °C and different ultrasound intensities were studied. The baking temperature of 200 °C and the intensity of 60% had the maximum effect on increasing the moisture diffusivity. Arrhenius equation showed the activation energy varied from 21.38 to 22.95 kJ/mol. The optimum quality of the eggless cake resulted from a combination of 60% intensity and 60 s of sonication and the baking temperature of 180 °C.

Practical Application

Some vegetarians do not consume eggs and egg‐based products; therefore it is important to produce egg‐free food options. Also, considering that eggs are one of the most expensive raw materials in the production of various types of cakes and have a low shelf‐life, in this study, the effects of sonication on the quality characteristics of an eggless cake has been studied.
Using patient‐reported outcomes (PROs) and patient‐reported outcome measures (PROMs) in routine head and neck cancer care: What do health professionals perceive as barriers and facilitators?
Authors: Nguyen Hanh , Butow Phyllis , Dhillon Haryana , Morris Lucinda , Brown Alison , West Katrina , Sundaresan Puma
Published: May 2020

Introduction

Patient‐reported outcomes (PROs) are direct reports from patients about their health status. Patient‐reported outcome measures (PROMs) are validated tools assessing PROs and completed by patients. Though commonly used in research, implementing PROMs into routine clinical care has been challenging. We aimed to examine health professionals’ (HPs’) perceptions of barriers and facilitators to PRO and PROM use in the routine care of head and neck cancer (HNC) patients.

Methods

A custom survey was created, pilot‐tested and disseminated to all HPs involved in the care of HNC patients in Western Sydney Local Health District, Australia. Participants were asked to rate the degree to which they believed the survey items were barriers or facilitators to routine PRO use by answering ‘not at all’, ‘very little’, ‘quite a bit’ and ‘very much’.

Results

Of 129 HPs, 86% had never routinely used PROs. Key barriers perceived were low workplace awareness of PROs (73%), HPs’ lack of knowledge on PRO use (63%) and lack of PROMs in patient preferred languages (63%). Insufficient time, staff and infrastructure to support routine PRO collection and non‐integrated PROMs in patient electronic medical records were also highlighted. Top facilitators were time for PRO administration and interpretation (86%), clear definition of staff roles (84%) and automatic scoring and interpretation of PROMs (81%).

Conclusions

This study highlighted key barriers and facilitators to PRO use in routine HNC patient care as perceived by HPs. The findings will be useful in guiding the successful and sustainable implementation of routine PRO collection in clinical settings.
Symptom Criteria for COVID‐19 Testing of Heath Care Workers
Authors: Clemency Brian M. , Varughese Renoj , Scheafer Danielle K. , Ludwig Brian , Welch Jacob V. , McCormack Robert F. , Ma Changxing , Nan Nan , Giambra Theresa , Raab Thomas
Published: May 2020

Background

Symptom criteria for COVID‐19 testing of heath care workers (HCWs) limitations on testing availability have been challenging during the COVID‐19 pandemic. An evidence‐based symptom criteria for identifying HCWs for testing, based on the probability of positive COVID‐19 test results, would allow for a more appropriate use of testing resources.

Methods

This was an observational study of outpatient COVID‐19 testing of HCWs. Prior to testing, HCWs were asked about the presence of 10 symptoms. Their responses were then compared to their subsequent pharyngeal swab COVID‐19 polymerase chain reaction test results. These data were used to derive and evaluate a symptom‐based testing criteria.

Results

A total of 961 HCWs were included in the analysis, of whom 225 (23%) had positive test results. Loss of taste or smell was the symptom with the largest positive likelihood ratio (3.33). Dry cough, regardless of the presence or absence of other symptoms, was the most sensitive (74%) and the least specific (32%) symptom. The existing testing criteria consisting of any combination of one or more of three symptoms (fever, shortness of breath, dry cough) was 93% sensitive and 9% specific (area unce the curve [AUC] = 0.63, 95% confidence interval [CI] = 0.59 to 0.67). The derived testing criteria consisting of any combination of one or more of two symptoms (fever, loss of taste or smell) was 89% sensitive and 48% specific (AUC = 0.75, 95% CI = 0.71 to 0.78). The hybrid testing criteria consisting of any combination of one or more of four symptoms (fever, shortness of breath, dry cough, loss of taste or smell) was 98% sensitive and 8% specific (AUC = 0.77, 95% CI = 0.73 to 0.80).

Conclusion

An evidence‐based approach to COVID‐19 testing that at least includes fever and loss of taste or smell should be utilized when determining which HCWs should be tested.
Habitat requirements of Tetanocera elata (Diptera: Sciomyzidae): case study of a dry meadow in western Ireland
Authors: Bistline‐East Allison , Burke Daniel , Williams Christopher D. , Gormally Michael J.
Published: May 2020

Terrestrial slugs are pervasive pests of agriculture throughout temperate regions and have the potential to disrupt the germination of seedlings, cause damage to fruiting bodies of crops, and vector plant pathogens.

Tetanocera elata Fabricius (Diptera: Sciomyzidae), a widely distributed Palaearctic species, is an obligate mesoparasitoid and predator of pestiferous slugs including Deroceras reticulatum Müller (Stylommatophora: Agriolimacidae). It has the potential to be developed as a native natural enemy in a conservation biological control programme as an alternative to chemical molluscicides.

To better understand the ecological requirements of this species, a detailed observational study was conducted at a site in the west of Ireland possessing naturally occurring T. elata populations.

Comparison of local patches where T. elata were recovered revealed no association with plant community composition.

Taller dead vegetation was associated with T. elata presence throughout the site. Within the area of greatest T. elata aggregation, there was a significantly greater percentage cover of dead vegetation where T. elata occurred. Abundance of T. elata was also significantly correlated to hedgerow proximity. Results of this study are directly applicable for the design of a conservation biological control programme, which effectively satisfies the principal habitat requirements of T. elata populations.
Identification and functional characterization of CYP4V2 genetic variants exhibiting decreased activity of lauric acid metabolism
Authors: Jarrar Yazun Bashir , Shin Jae‐Gook , Lee Su‐Jun
Published: May 2020

The objectives of the present study were to identify CYP4V2 genetic variants and characterize their functional consequences. A total of 26CYP4V2 genetic variants were identified, including seven novel variants in 60 randomly selected healthy subjects. Six protein‐coding variants were studied, including three novel variants (L22V, R287T, and G410C) and three previously reported variants (R36S, Q259K, and H331P). The cDNA sequences encoding each amino acid variant and the wild‐type CYP4V2 protein were cloned into the pcDNA/PDEST40 expression vector and transfected into eukaryotic 293T cells for overexpression of the CYP4V2 coding variants. CYP4V2 H331P and CYP4V2 G410C exhibited significant decreases in activity for lauric acid oxidation (20–30% of wild‐type activity), when compared to the wildtype, which was correlated with low expression of CYP4V2 H331P and G410C substituted proteins. The other four CYP4V2 amino variants were comparable to wild‐type CYP4V2 for lauric acid metabolism. The CYP4V2 H331P and G410C substitutions were predicted to cause a structural change through in silico analysis. In conclusion, the present study provides functional information about CYP4V2 genetic variants. These findings will be valuable for interpreting individual variations in phenotypes associated with CYP4V2 function in the clinical setting.
Controlling chronic low‐grade inflammation to improve follicle development and survival
Authors: Yang Ziwei , Tang Zijuan , Cao Xiuping , Xie Qi , Hu Chuan , Zhong Zhisheng , Tan Jun , Zheng Yuehui
Published: May 2020

Chronic low‐grade inflammation is one cause of follicle development disturbance. Chronic inflammation exists in pathological conditions such as premature ovarian failure, physiological aging of the ovaries, and polycystic ovary syndrome. Inflammation of the whole body can affect oocytes via the follicle microenvironment, oxidative stress, and GM‐CSF. Many substances without toxic side‐effects extracted from natural organisms have gradually gained researchers’ attention. Recently, chitosan oligosaccharide, resveratrol, anthocyanin, and melatonin have been found to contribute to an improvement in inflammation. This review discusses the interrelationships between chronic low‐grade inflammation and follicle development, the underlying mechanisms, and methods that may improve follicle development by controlling the level of chronic low‐grade inflammation.
Immune response to SARS‐CoV‐2 and mechanisms of immunopathological changes in COVID‐19
Authors: Azkur Ahmet Kursat , Akdis Mübeccel , Azkur Dilek , Sokolowska Milena , van de Veen Willem , Brüggen Marie‐Charlotte , O’Mahony Liam , Gao Yadong , Nadeau Kari , Akdis Cezmi A.
Published: May 2020

As a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of coronavirus disease 2019 (COVID‐19) appears practically impossible. There is a pressing need to improve our understanding of the immunology of this disease to contain the pandemic by developing vaccines and medicines for the prevention and treatment of patients. In this review, we aim to improve our understanding on the immune response and immunopathological changes in patients linked to deteriorating clinical conditions such as cytokine storm, acute respiratory distress syndrome, autopsy findings and changes in acute‐phase reactants, and serum biochemistry in COVID‐19. Similar to many other viral infections, asymptomatic disease is present in a significant but currently unknown fraction of the affected individuals. In the majority of the patients, a 1‐week, self‐limiting viral respiratory disease typically occurs, which ends with the development of neutralizing antiviral T cell and antibody immunity. The IgM‐, IgA‐, and IgG‐type virus‐specific antibodies levels are important measurements to predict population immunity against this disease and whether cross‐reactivity with other coronaviruses is taking place. High viral load during the first infection and repeated exposure to virus especially in healthcare workers can be an important factor for severity of disease. It should be noted that many aspects of severe patients are unique to COVID‐19 and are rarely observed in other respiratory viral infections, such as severe lymphopenia and eosinopenia, extensive pneumonia and lung tissue damage, a cytokine storm leading to acute respiratory distress syndrome, and multiorgan failure. Lymphopenia causes a defect in antiviral and immune regulatory immunity. At the same time, a cytokine storm starts with extensive activation of cytokine‐secreting cells with innate and adaptive immune mechanisms both of which contribute to a poor prognosis. Elevated levels of acute‐phase reactants and lymphopenia are early predictors of high disease severity. Prevention of development to severe disease, cytokine storm, acute respiratory distress syndrome, and novel approaches to prevent their development will be main routes for future research areas. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients.
Sustaining better care for patients undergoing emergency laparotomy
Authors: Jordan L. C. , Cook T. M. , Cook S.‐C. , Dalton S. J. , Collins K. , Scott J. , Peden C. J.
Published: May 2020

Emergency laparotomy is associated with high mortality. Implementation of an evidence‐based care bundle has been shown to improve patient outcomes. A quality improvement project to implement a six‐component care bundle was undertaken between July 2015 and May 2018. As part of this project, we worked with 27 hospitals in the Emergency Laparotomy Collaborative. Previous pilot implementation of the same bundle in our hospital between December 2012 and July 2013 had shown marked improvement, maintained until April 2014, but then deterioration. Understanding the reasons for this deterioration informed our work to re‐implement the bundle and sustain improvement. A cohort of 930 consecutive patients requiring emergency laparotomy between October 2014 and April 2019 were included. Baseline data were collected between October 2014 and June 2015, and the bundle was re‐implemented in July 2015. Thirty‐day mortality decreased from 11% in the baseline group to 7.3% after bundle implementation. Hospital length of stay decreased from 19.5 to 17.9 days. Full bundle compliance improved from < 60% to > 80% for all patients, with improvement in application of all individual bundle components. This study provides further evidence that outcomes for high‐risk surgical patients can be improved with an evidence‐based care bundle, but attention must be paid to maintaining bundle compliance. Issues around sustaining improvement must be considered from project initiation.
Changes in oxygen saturation and the retinal nerve fibre layer in patients with optic neuritis associated with multiple sclerosis in a 6‐month follow‐up
Authors: Svrčinová Tereza , Hok Pavel , Šínová Irena , Dorňák Tomáš , Král Michal , Hübnerová Petra , Mareš Jan , Kaňovský Petr , Šín Martin
Published: May 2020

Purpose

Optic neuritis (ON) is an inflammatory demyelinating disorder of the optic nerve, which can be the first manifestation of multiple sclerosis (MS). The main goal was to assess changes in the retinal nerve fibre layer (RNFL) and in retinal oxygen saturation [arterial (AS), venous (VS) and arterio‐venous (A‐V) difference] in the affected and unaffected eye.

Methods

Fifty patients with ON due to MS within 3 months of onset of symptoms were enrolled (17 males, mean age 35.3). All patients were examined at baseline (V1) and after 6 months (V2) using optical coherence tomography (OCT) to get RNFL values; automatic retinal oximetry to obtain saturation values; and ultrasound to exclude arterial stenosis, and orbital colour Doppler imaging was performed in the ophthalmic artery.

Results

At V1, AS was significantly increased in affected eye compared to unaffected eye (99.5% versus 98.0%, p = 0.03). Significant decrease in A‐V difference from baseline was detected in both eyes for ON eye: 32.0% versus 29.0%, p = 0.004; for fellow eye: 31.4% versus 30.0%, p = 0.04. We did not observe any changes in retinal vessel diameter. There were no changes observed in blood flow in ophthalmic artery. At V1, there were no significant differences in RNFL, and significant loss of RNFL was confirmed in the affected eye at V2 (95 μm versus 86 μm, p = 0.0002) and in comparison with the fellow eye (86 μm versus 94 μm, p = 0.0002). There were no correlations between RNFL and saturation values at V1, although at V2, there was a negative correlation between the RNFL and AS (Spearman's rho = −0.480, p = 0.003) and between the RNFL and VS (rho = −0.620, p = 0.00007).

Conclusion

Retinal oximetry is altered in both eyes in MS patients with unilateral ON. During the course of the disease, the retinal oxygen consumption decreases to a different degree in each eye and this change is not completely followed by changes in the RNFL thickness, suggesting either sub‐clinical ON or systemic effects in the clinically unaffected eye. Since this is the first and initial longitudinal evaluation of the saturation changes in MS patients, the clinical value of these findings needs to be deeper evaluated in the future studies.
Learning analytics initiatives in Latin America: Implications for educational researchers, practitioners and decision makers
Authors: Salas‐Pilco Sdenka Zobeida , Yang Yuqin
Published: May 2020

This study presents several Latin American research initiatives in the field of learning analytics (LA). The study’s purpose is to enhance awareness and understanding of LA among researchers, practitioners and decision makers, and to highlight the importance of supporting research on LA. We analyzed case studies of LA research conducted at four levels of the educational system (the national, institutional, classroom and student levels), which were implemented in four countries (Brazil, Ecuador, Mexico and Uruguay). Diversified cases were selected to demonstrate the use of LA in primary, secondary and higher education, and to allow the inclusion of different types of datasets. These cases also showed the development of legal frameworks for handling ethical issues, and they met the requirements for data privacy protection in Latin America. The study concludes with a discussion of the findings and their implications for further research and practice in the field of LA for teaching and learning.
Mean platelet counts are relatively decreased with malaria but relatively increased with endemic Burkitt Lymphoma in Uganda, Tanzania, and Kenya
Authors: Peprah Sally , Ogwang Martin D. , Kerchan Patrick , Reynolds Steven J. , Tenge Constance N. , Were Pamela A. , Kuremu Robert T. , Wekesa Walter N , Masalu Nestory , Kawira Esther , Kinyera Tobias , Otim Isaac , Legason Ismail D. , Nabalende Hadijah , Dhudha Herry , Mumia Mediatrix , Ayers Leona W. , Biggar Robert J. , Bhatia Kishor , Goedert James J. , Mbulaiteye Sam M.
Published: May 2020

Platelet counts are decreased in Plasmodium falciparum malaria, which is aetiologically linked with endemic Burkitt lymphoma (eBL). However, the pattern of platelet counts in eBL cases is unknown. We studied platelet counts in 582 eBL cases and 2 248 controls enrolled in a case‐control study in Uganda, Tanzania and Kenya (2010–2016). Mean platelet counts in controls or eBL cases with or without malaria‐infection in controls versus eBLcases were compared using Student’s t‐test. Odds ratios (ORs) and two‐sided 95% confidence intervals (95% CIs) were estimated using multiple logistic regression, controlling for age, sex, haemoglobin and white blood cell counts. Platelets were decreased with malaria infection in the controls [263 vs. 339 × 109 platelets/l, P < 0·0001; adjusted OR (aOR) = 3·42, 95% CI: 2·79–4·18] and eBL cases (314 vs. 367 × 109 platelets/l, P‐value = 0·002; aOR = 2·36, 95% CI: 1·49–3·73). Unexpectedly, platelets were elevated in eBL cases versus  controls in overall analyses (mean: 353 vs. 307 × 109 platelets/l, P < 0·0001; aOR = 1·41; 95% CI: 1·12–1·77), and when restricted to malaria‐positive (mean 314 vs. 263 × 109 platelets/l, P < 0·0001; OR = 2·26; 95% CI: 1·56–3·27) or malaria‐negative (mean 367 vs. 339 × 109 platelets/l, P < 0·001; OR = 1·46; 95% CI: 1·17–1·83) subjects. Platelets were decreased with malaria infection in controls and eBL cases but elevated with eBL.
Acute illness in patients with concomitant Addison's disease and type 1 diabetes mellitus: Increased incidence of hypoglycaemia and adrenal crises
Authors: Mortimer Brienna , Naganur Vaidehi Dhirendra , Satouris Paul , Greenfield Jerry R. , Torpy David J. , Rushworth Rosemary Louise
Published: May 2020

Background

Patients with Addison's disease (AD) and comorbid type 1 diabetes mellitus (T1DM) are at increased risk of certain acute metabolic disorders relative to patients with one of these conditions only. The reasons for this are unknown.

Methods

All attendances for acute illness by AD patients at the emergency department of a Sydney hospital between 2000 and 2017 were reviewed. Physiological parameters and illness management strategies were compared between AD patients, those with T1DM and AD combined, and a control group of patients with T1DM.

Results

There were 39 presentations for an acute medical illness by 20 nondiabetic AD (28 attendances) and 5 diabetic AD patients (11 presentations) and 40 attendances by 10 T1DM controls. In AD patients, 17 (43.6%) attendances were medically diagnosed adrenal crises (AC) (63.6% [n = 7] in diabetic AD and 35.7% [n = 10] in nondiabetic AD). This corresponded to an estimated incidence of 12.5 AC/100 patient‐years (PY) for diabetic AD patients compared to 4.7 AC/100PY for nondiabetic AD patients (P < .05). Glucocorticoid stress doses preceded 61.5% (n = 24) of all attendances. Patients who used stress doses had more presentations than those who did not (2.0 ± 1.3 vs 1.2 ± 0.5, P = .01). Diabetic AD patients had a lower mean blood glucose level on presentation (5.6 ± 3.9 mmol/L) than the T1DM control sample (11.6 ± 6.2 mmol/L) P < .001. No T1DM patients had hypoglycaemia in the 3.0‐3.9 mmol/L range but 2 (18.2%) of the diabetic AD patients had presenting blood glucose levels in this category (P < .05). Hyperglycaemia was more common among T1DM control patients (62.5%, n = 26) than diabetic AD patients (18.2%, n = 2), P < .01.

Conclusion

Addison's disease patients with T1DM have a higher incidence of adrenal crisis (AC) and hypoglycaemia than nondiabetic AD patients and a lower incidence of hyperglycaemia than those with T1DM alone. This information may be of value in counselling patients with T1DM and AD about AC and hypoglycaemia prevention.
Hypertrophic lichenoid dermatitis immune‐related adverse event during combined immune checkpoint and exportin inhibitor therapy: A diagnostic pitfall for superficially invasive squamous cell carcinoma
Authors: Marques‐Piubelli Mario L. , Tetzlaff Michael T. , Nagarajan Priyadharsini , Duke Taylor C. , Glitza Oliva Isabella C. , Ledesma Debora A. , Aung Phyu P. , Torres‐Cabala Carlos A. , Wistuba Ignacio I. , Prieto Victor G. , Nelson Kelly C. , Curry Jonathan L.
Published: May 2020

Immune checkpoint inhibitors (ICIs) for cancer treatment have revolutionized the field of medicine. However, an unintended but frequent consequence of ICI therapy is the development of cutaneous immune‐related adverse events (irAEs), such as lichenoid dermatitis irAEs (LD‐irAEs). The hypertrophic variant of LD‐irAE may be a diagnostic challenge since it can mimic superficially invasive squamous cell carcinoma (SCC). A 79‐year‐old woman with metastatic melanoma who began treatment with an ICI—pembrolizumab—plus exportin‐1 (XPO1) inhibitor presented after 1 month of therapy with symmetrical violaceous papules coalescing into plaques and with two nodules of the bilateral dorsal hands. Biopsy of the nodules revealed an actinic keratosis and atypical epidermal proliferation concerning for SCC. However, in the ensuing 3 weeks, the patient developed multiple new erythematous, violaceous, and scaly macules and papules, some coalescing into plaques on the extremities. Biopsies of these lesions revealed exuberant irregular epidermal hyperplasia with hypermaturation and lichenoid infiltrate concentrated at the base of the elongated, broadened rete ridges, consistent with hypertrophic LD‐irAE. Treatment included topical fluocinonide ointment, intralesional triamcinolone injections and oral acitretin. Distinguishing hypertrophic LD‐irAE and SCC can be challenging since both entities share histopathologic features; thus, correlation with clinical presentation is essential for diagnosis and optimal patient management.
CYCLICAL TAX ENFORCEMENT
Authors: Durán‐Cabré José M , Esteller‐Moré Alejandro , Salvadori Luca
Published: May 2020

We wonder whether tax enforcement varies along the economic cycle and aim at answering that question from a positive perspective by means of survey data for the Spanish case (1994–2015). According to a fiscal capacity argument, tax enforcement might be stronger in times of crisis (counter‐cyclical), but if the tax administration prioritizes taxpayers' welfare over public revenue, enforcement might be slacker (procyclical). We find tax enforcement is not immune to the state of the economy. In particular, it presents a prevailing counter‐cyclical trend, but in presence of a severe economic crisis it turns out to be procyclical. (JEL D78, H12, H26, H83)
Microbes in Helicoverpa armigera oral secretions contribute to increased senescence around plant wounds
Authors: Waterman Jamie M. , Mann Timothy J. , Cazzonelli Christopher I. , Hartley Susan E. , Johnson Scott N.
Published: May 2020

1. Plants have long been exposed to insect herbivore attack. Crucial to the plant's ability to defend itself is its ability to identify specific signals associated with attacking insects. Distinctive chemical cues, such as those associated with chewing insect oral secretions (OS), activate targeted defence responses to chewing insect herbivores.

2. Herbivore‐associated cues can be complicated by the fact that many herbivores form associations with microbes that produce their own specific signals, which may induce alternative defence processes.

3. Here we report that OS of the global pest, the cotton bollworm (Helicoverpa armigera), induce senescence around wounds in Brachypodium distachyon leaves. Crude OS activate greater levels of senescence than OS with reduced microbial abundance or mechanical wounding alone. Nonetheless, plants closed mechanical wounds more rapidly when treated with H. armigera OS regardless of the microbial component.

4. This study concludes that H. armigera OS can activate senescence and wound closure in plant tissues and that microbes within OS have an important role in shaping plant‐herbivore interactions through additional increases in senescence.
COVID‐19: The immediate response of european academic dental institutions and future implications for dental education
Authors: Quinn Barry , Field James , Gorter Ronald , Akota Ilze , Manzanares Maria‐Cristina , Paganelli Corrado , Davies Julia , Dixon Jonathan , Gabor Gerber , Amaral Mendes Rui , Hahn Petra , Vital Sibylle , O’Brien Judith , Murphy Denis , Tubert‐Jeannin Stéphanie
Published: May 2020

The COVID‐19 pandemic has had an immediate and dramatic impact on dental education. The Association of Dental Education in Europe decided to carry out an investigation to assess the immediate response of European Academic Dental Institutions. An online survey was sent to both member and non‐member dental schools to investigate the impact on non‐clinical and clinical education, assessment and the well‐being/pastoral care measures implemented. The preliminary findings and discussion are presented in this paper, for the responses collected between the 25 March and 5 April 2020. The survey at this time of publication is ongoing, and detailed results can be accessed https://adee.org/covid‐19‐european‐dental‐education%E2%80%99s‐immediate‐response.
Assessing clinical simulation as a learning tool when training motivation skills in Periodontology—Students' perceptions
Authors: Codeço Andreia , Dias Coutinho Verónica Rita , Pereira‐Lopes Otília , Faria‐Almeida Ricardo , Santos Resende Marta
Published: May 2020

Introduction

The prevention and long‐term success of the treatment of periodontal diseases depend on patient compliance with oral health; thus, there is a need to alert and motivate them to control the disease. Clinical simulation emerges as a useful teaching strategy in the development of these clinical skills since it allows the replication of real situations interactively using a simulator or role‐play.

Aim

This study aimed to evaluate clinical simulation as a learning methodology in Periodontology, through students' perceptions.

Materials and Methods

A quantitative and descriptive study was developed with 51 students of an undergraduate dentistry degree. Data collection was done through a voluntary, anonymous and confidential survey. Students were asked to express their level of agreement with 27 items using a Likert scale ranging from 1 to 5. Statistical analysis included measures of central tendency, measures of dispersion, variability and frequency distribution.

Results

Students believe that clinical simulation contributes to an active participation of learners in their learning process, promoting the development of skills such as communication, priority management and decision‐making. They also mention that debriefing is an essential moment of this process, in which the consolidation of knowledge and the structuring of thought are promoted.

Conclusion

Students make a positive evaluation of clinical simulation, perceiving it as an effective learning methodology.
Shedding light on dyskinesias
Authors: Castela Ivan , Hernandez Ledia F.
Published: May 2020

Dopamine replacement therapy with L‐DOPA remains the most widely prescribed treatment for Parkinson disease. However, prolonged treatment due to disease progression frequently causes unwanted motor movements known as levodopa‐induced dyskinesias. Previous studies have established that alterations to the efferent circuitry of the striatum, a principal component of the basal ganglia, are in part responsible for the pathological motor consequences of prolonged levodopa treatment. While the role of the striatal direct pathway is widely accepted, the engagement of the striatal indirect pathway in dyskinetic pathophysiology is still under consideration. However, recent investigations have finally shown that the activity of both striatal pathways changes as a consequence of dopamine depletion and dyskinetic behavioural conditions. In addition, it has been reported that drug‐induced structural alterations to indirect pathway medium spiny neurons, together with associated changes in synaptic plasticity and firing patterns, could contribute importantly to the development of dyskinesia. These findings, together with recent opto‐ and chemogenetic studies, suggest that a critical imbalance in the activity between both striatal pathways is sufficient to cause dyskinesia in both rodent and primate models of Parkinson disease. In animal models, and in human patients, dyskinetic behaviours elicited by this efferent pathway imbalance can be achieved even in the absence of dopamine denervation. In this review, we summarize recent and past findings to better understand this complex pathology with the aim of pursuing specific cell‐type therapies to re‐balance efferent striatal activity.
An Overview of 25 Years of European Scientific Collaboration in the Field of Strategic Management: A Bibliometric Analysis
Authors: Kosch Oskar , Szarucki Marek
Published: May 2020

The main objective of the paper is to identify and explore specifics and trends of international scientific collaboration in the field of strategic management in Europe over the last quarter‐century. Specifically, the study analyses those scholarly connections between countries and cities on the basis of co‐authorship to determine the flow of knowledge from the geographical aspect, as well as the state of collaboration among different authors (co‐authorship and citations' networks), that is, the depth of such network (collaboration intensity) and whether such a scientific community is consistent, i.e. number of connected elements or related networks. This is the first time international scientific collaboration between researchers in the field of strategic management has been studied to such an extent. We employed all sources of relevant data and analyzed 5,237 results from the Scopus and Web of Science databases. Through the application of bibliometric analysis, our study offers a comprehensive and up‐to‐date identification and assessment of trends in international scientific collaboration in the strategic management field in Europe.
Statins, diabetes mellitus and prognosis of amyotrophic lateral sclerosis: data from 501 patients of a population‐based registry in southwest Germany
Authors: Schumacher J. , Peter R. S. , Nagel G. , Rothenbacher D. , Rosenbohm A. , Ludolph A. C. , Dorst J. ,   ALS Registry Swabia Study Group
Published: May 2020

Background and purpose

A wide variety of metabolic changes, including an increased incidence of diabetes mellitus (DM) and dyslipidaemia, has been described in amyotrophic lateral sclerosis (ALS). The aim of this study was to investigate the associations of statin use and history of DM with onset of disease and survival in patients with ALS.

Methods

In all, 501 patients (mean age 65.2 ± 10.9 years; 58.5% male) from the ALS Registry Swabia recruited between October 2010 and April 2016 were included in this prospective cohort study. Data were collected using a standardized questionnaire.

Results

Statin use (n = 65) was not associated with overall survival (P = 0.62). Age of ALS onset in patients with DM was 4.2 years later (95% confidence interval 1.3–7.2 years) than in patients without DM (P < 0.01). The overall survival of patients with high body mass index at study entry (>27.0 kg/m2, upper quartile, n = 127) was prolonged by more than 5 months compared to patients with low body mass index (<22.0 kg/m2, lower quartile, n = 123; P = 0.04).

Conclusions

This study supports the view that statin use is not associated with overall survival of ALS patients, suggesting that statins are not harmful and should not be discontinued in ALS. Furthermore, the delayed onset of ALS in patients with DM may mirror the potentially protective metabolic profile associated with type 2 DM. Consistently, this study provides further evidence that high body mass index is a positive prognostic factor in ALS.
Interhemispheric distribution of amyloid and small vessel disease burden in cerebral amyloid angiopathy‐related intracerebral hemorrhage
Authors: Planton M. , Pariente J. , Nemmi F. , Albucher J‐F. , Calviere L. , Viguier A. , Olivot J‐M. , Salabert A‐S. , Payoux P. , Peran P. , Raposo N.
Published: May 2020

Background and purpose

Intracerebral hemorrhage (ICH) is a devastating presentation of cerebral amyloid angiopathy (CAA), but the mechanisms leading from vascular amyloid deposition to ICH are not well known. Whether amyloid burden and magnetic resonance imaging (MRI) markers of small vessel disease (SVD) are increased in the ICH‐affected hemisphere compared to the ICH‐free hemisphere in patients with a symptomatic CAA‐related ICH was investigated.

Methods

Eighteen patients with CAA‐related ICH and 18 controls with deep ICH who underwent brain MRI and amyloid positron emission tomography using 18F‐florbetapir were prospectively enrolled. In each hemisphere amyloid uptake using the standardized uptake value ratio and the burden of MRI markers of SVD including cerebral microbleeds, chronic ICH, cortical superficial siderosis, white matter hyperintensities and lacunes were evaluated. Interhemispheric comparisons were assessed by non‐parametric matched‐pair tests within each patient group.

Results

Amyloid burden was similarly distributed across the brain hemispheres in patients with CAA‐related ICH (standardized uptake value ratio 1.11 vs. 1.12; P = 0.74). Cortical superficial siderosis tended to be more common in the ICH‐affected hemisphere compared to the ICH‐free hemisphere (61% vs. 33%; P = 0.063). Other MRI markers of SVD did not differ across brain hemispheres. In controls with deep ICH, no interhemispheric difference was observed either for amyloid burden or for MRI markers of SVD.

Conclusions

Brain hemorrhage does not appear to be directly linked to amyloid burden in patients with CAA‐related ICH. These findings provide new insights into the mechanisms leading to hemorrhage in CAA.