bluuebunny/crossref_metadata_2025 huggingface dataset:
Digitized
Authors: Bentley Peter J.
Published: November 2020

There's a hidden science that affects every part of your life, a science so powerful that you would be hard-pressed to find a single human being on the planet unaffected by its achievements. It is the science behind computers, the machines which drive the supply and creation of power, food, medicine, money, communication, entertainment, and most goods our stores. It has transformed societies with the Internet, the digitization of information, mobile phone networks, and GPS technologies. Written in friendly and approachable language, Digitized provides a window onto the mysterious field from which all computer technology originates, making the theory and practice of computation understandable to the general reader. This popular science book explains how and why computers were invented, how they work, and what will happen in the future. Written by a leading computer scientist, Peter J. Bentley, it tells this fascinating story using the voices of pioneers and leading experts interviewed for the book, in effect throwing open the doors of the most cutting-edge computer laboratories. Bentley explores how this young discipline grew from the early work by pioneers such as Turing, through its growth spurts in the Internet, its difficult adolescent stage where the promises of AI were never achieved and dot-com bubble burst, to its current stage as a semi-mature field, capable of remarkable achievements. Packed with real-world examples, Digitized is the only book to explain the origins and key advances in all areas of computing: theory, hardware, software, Internet, user interfaces, virtual reality, and artificial intelligence. If you have an interest in computers--whether you work with them, use them for fun, or are being taught about them in school--this book will provide an entertaining introduction to the science that's changing the world.
The Death of Metal: Corrosion
Authors: Atkins Peter
Published: November 2020

As in life, so in redox reactions: some are good and some are bad. Corrosion is one of the evil among redox reactions. It is the unwanted oxidation of a metal that cuts short the lifetimes of steel products such as bridges and vehicles. Replacing corroded metal parts costs industry and society a huge amount each year. Understanding it helps us to find ways to prevent it. Not all corrosion, however, is unwanted: the green patina of copper roofs is often sought and can be beautiful; the induced oxidation of aluminium in the presence of dyes can also be intentional and can bring graceful colour to a building. I shall focus on the corrosion of iron, Fe (from the Latin ferrum), its rusting, as it is so common a way of death for our everyday artefacts. Iron rusts when it is exposed to damp air, with both oxygen and water present. In the process the Fe atoms of the metal are oxidized—lose some electrons—and become Fe3+ ions. These ions pick up some oxide ions, O2–, and are deposited as the red–brown oxide, Fe2O3. The corrosion of iron is very much like its reversion to the ore, which is also typically Fe2O3, from which, with so great an effort and all the expensive and energy-intensive, environmentally invasive fury of a blast furnace, it was originally obtained (Reaction 4). In the process of forming Fe3+, the oxygen of the air, the oxidizing agent, is converted to water. The hydrogen atoms needed for the formation of H2O molecules from O2 molecules are scavenged from the surrounding solution, especially if it is acidic and rich in hydrogen ions. I shall now show you the reaction in more detail and try to lead you into appreciating visually what is going on inside a small droplet of water on the surface of a sheet of rusting iron. Although rusting is rarely thought beautiful, there is a beauty and subtlety in the choreography of the atomic events that underlie its formation. As usual, you should imagine shrinking to the size of a molecule, plunging below the droplet’s surface, and descending diver-like through the densely agitating, bustling, tumbling water molecules.
Introduction Reframing Adult
Nursing Practice
Authors: Bullock Ian , Clark Jill Macleod
Published: November 2020

Healthcare delivery has been transformed over the past decades with a rapid expansion in the demand for care driven by demographic changes, technological innovation, and increasing consumer expectations. This transformation has in turn had a profound impact on the roles of health professionals in general and nurses in particular. The number of patients with multiple pathologies and complex long-term nursing care needs has also escalated, with pressure for rapid throughput in acute hospital care settings resulting in shorter lengths of stay and greater emphasis on care in the community. To meet growing demand, boundaries between the roles of health professional have blurred, with nurses now undertaking activities previously performed by doctors, and unqualified staff undertaking activities previously performed by registered nurses. These changes are all taking place in the context of economic turbulence. The shift of nursing to an all-graduate profession reflects the recognition that the future role of a registered nurse will carry greater responsibility and autonomy than ever before. The expectations of every student and qualified nurse must therefore also change in relation to the knowledge and skills that they need to deliver expert nursing interventions and clinical leadership. The next generation of nurses will increasingly lead and coordinate the care of a range of patients and clients, supervising and supporting unqualified or lay carers and referring patients to other health professionals when appropriate. As one of this new generation of qualified nurses, it is important that you are able to demonstrate expertise in the fundamentals of nursing practice. You must be equipped with the knowledge and skills needed to enable you to:…● understand the common health conditions that can affect adults; ● understand the pathophysiology of these common health conditions, and the physical and psychosocial needs and problems that result from them; ● recognize your key role in managing the problems and challenges that patients face; ● ensure that your nursing interventions are evidence-based; ● demonstrate competent assessment skills, critical thinking, and problem-solving skills to make informed clinical nursing decisions in collaboration with the patient and other team members; ● adopt an enquiring and questioning approach, and be confident in accessing and interpreting evidence to inform your choice of nursing interventions….
Understanding Stroke
Authors: Burton Christopher R , Smith Caroline
Published: November 2020

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with stroke in an evidence-based and person-centred way. The chapter will provide a comprehensive overview of the seven stages of stroke, exploring best practice to deliver care, as well as to prevent or minimize further ill-health. Nursing assessments and priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with stroke can be found in Chapters 23, 24, and 27, respectively. Stroke is defined as the rapid onset of focal neurological deficit lasting more than 24 hours (in which the patient survives the initial event), with no apparent cause other than disruption of blood supply to the brain (World Health Organization, 1978). As well as being the third commonest cause of death only in middle- and high-income countries (WHO, 1978) (along with cancer and heart disease), stroke is the largest cause of adult physical disability in the world (Bath and Lees, 2000). However, owing to advances in research and evidence synthesis, stroke is now a preventable and treatable disease (National Collaborating Centre for Chronic Conditions (NCCC), 2008). Despite its relative small weight (approximately 2% of body weight), the brain requires 750 ml of bloodflow every minute, and consumes nearly 45% of arterial oxygen (Alexandrov, 2003). Bloodflow to the brain is assured through two circulatory systems (anterior and posterior), which are connected by the circle of Willis, and supplied by the internal carotid and vertebral arteries. Disruption of this bloodflow can be either in the form of a bleed (haemorrhagic stroke) or clot (ischaemic stroke), and the clinical presentation will vary depending on the location of the disruption in the brain. Ischaemic strokes are more common and account for almost 70% of all events (Wolfe et al., 2002). Whilst thorough clinical examination is essential, the only clear tool to identify the type of stroke is to perform a brain scan using either magnetic resonance imaging (MRI) or computed tomography (CT) technology. It is important to note that, often, when a CT brain scan is performed within the first few hours of an event, the scan may not show any significant tissue damage because the changes that occur may take several days to be clearly visible.
Managing Breathlessness
Authors: Prigmore Samantha , Knowles, Vikki
Published: November 2020

This chapter addresses the fundamental nursing in managing breathlessness. Every nurse should possess the knowledge and skills to assess patients holistically, to select and implement evidence-based strategies, to manage breathlessness, and to review the effectiveness of these to inform any necessary changes in care. The nurse has a key role in managing this often frightening symptom, which may be caused by many disorders, including certain heart and respiratory conditions, strenuous exercise, or anxiety. Breathlessness is described as a distressing subjective sensation of uncomfortable breathing (Mosby, 2009) and can be expressed as an unpleasant or uncomfortable awareness of breathing, or of the need to breathe (Gift, 1990). The term dyspnoea, also meaning breathlessness, is derived from the Greek word for difficulty in breathing. Whilst it is difficult to estimate the prevalence of dyspnoea, it is apparent when we exercise beyond our normal tolerance levels; pathologically, dyspnoea occurs with little or no exertion and is a symptom response to different aetiologies (causes of illness). Breathlessness is a common symptom in patients with both cardiac (McCarthy et al., 1996) and respiratory disease (Dean, 2008), and also in people with neuromuscular diseases approaching the end of life; this can prove difficult and distressing to manage (see Chapter 18 Managing End-of-Life Care). There is a peak incidence of chronic dyspnoea in the 55舑69 age group (Karnani, 2005), and the prevalence and severity of dyspnoea increases with age. This is associated with an increase in mortality and reduction in quality of life (Huijnen et al., 2006). It is estimated that 70% of all terminal cancer patients experience breathlessness in their last 6 weeks of life (Davis, 1997). Both physiological and psychological responses (including pain, emotion, and anxiety) can lead to an increase in respiratory rate. Breathing is controlled by the respiratory centre in the medulla of the brain. Higher centres in the cerebral hemispheres can voluntarily control respiratory rate so that breathing can be temporarily stopped, slowed, or increased. The respiratory centre generates the basic rhythm of breathing, with the depth and rate being altered in response to the body’s requirements, mainly by nervous and chemical control (Ward and Linden, 2008).
Managing Delirium and Confusion
Authors: Ouldred Emma , Bryant Catherine
Published: November 2020

This chapter focuses on the assessment, management, and diagnosis of delirium, one form of confusion that commonly presents in healthcare settings. It will equip you with the skills required to differentiate between dementia, delirium, and depression through comprehensive assessment, and will improve the confidence of practising nurses in the management of this debilitating condition. This chapter will help you to select and implement evidence-based strategies to manage patients presenting with confusion regardless of the cause of confusion, such as dementia (see Chapter 7 Understanding Dementia). Confusion is derived from the Latin verb confundere, meaning ‘to mingle’. It is a descriptive term that has a variety of different definitions. It has been defined as a disturbance of consciousness characterized by impaired capacity to think clearly and with customary rapidity, and to perceive, respond, to, and remember current stimuli, and some degree of disorientation (Faber and Faber, 1953). Disorders causing confusion can be categorized into three groups:…● acute disorders usually associated with acute illness, drugs, and environmental factors; ● more slowly progressive impairment of cognitive function, such as that seen in dementia syndromes; ● impaired cognitive function associated with affective disorders and psychoses such as depression….Regardless of aetiology, confusion can be very distressing for the person exhibiting these symptoms, his or her relatives and carers, and for health and social care practitioners. It is important to differentiate between different causes of confusion for appropriate treatment plans to be developed. The word delirium is derived from Latin, meaning ‘off the track’, and is often referred to as acute confusional state. Delirium is a common and distressing disorder associated with increases in physical morbidity, length of hospital stay, and entry to long-term care, and therefore increases in cost to health services. However, it can be prevented and treated if dealt with urgently (National Institute for Health and Clinical Excellence (NICE), 2010a). The Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV TR), is used by clinicians and psychiatrists to diagnose psychiatric illnesses.
Managing Mobility
Authors: Hayes Nicky , Whitney Julie
Published: November 2020

This chapter addresses the fundamental nursing role in the management of mobility. Every nurse should possess the knowledge and skills to assess mobility needs, to select and implement evidence-based strategies to maintain mobility or assist mobility, and to review the effectiveness of these to inform any necessary changes in care. Mobility is the ability to move around independently. The most readily recognizable component of mobility is locomotion—the ability to walk. It includes transition from one position to another, which is necessary to allow walking to be incorporated into functional activities. Examples of transitions are moving from sitting to standing and from standing to lying down. Virtually all bodily systems are required for safe and effective mobility. Maintaining higher levels of physical activity has been associated with reduced mortality and morbidity from many common diseases (Gregg et al., 2003). People with higher levels of physical activity are less likely to suffer or die from cardiovascular disease (Kesaniemi et al., 2001), have reduced risk of all types of stroke (Wendel-Vos et al., 2004a; 2004b), gain less weight, are less likely to develop type 2 diabetes, breast or colon cancer, osteoarthritis, osteoporosis, falls, and depression (Kesaniemi et al., 2001; Thune and Furberg, 2001). Beneficial effects on cognition have also been documented, the most physically active having 20% lower risk of cognitive decline (Weuve et al., 2004; Yaffe et al., 2001). Maintaining good physical activity levels is associated with generalized well-being, and improved physical function, ability to perform activities of daily living, and walking distance. An active person is less likely to be disabled and is more likely to be independent. There is a lower incidence of depression in people who remain active, and physical activity is known to reduce the symptoms of clinical depression (Kesaniemi et al., 2001). For these reasons, it is important for nurses to promote the benefits of appropriate physical activity as part of their health promotion role. The American College of Sports Medicine and the American Heart Association recommends levels of physical activity required to maintain good health (Box 23.1).
Evidence-Based Guidelines in Management of Glaucoma
Authors: Salim Sarwat
Published: November 2020

Early detection and treatment of primary open-angle glaucoma (POAG) are important to reduce the burden of blindness and its economic impact on society. This chapter will address the evidence-based guidelines for treating POAG.
POAG is defined as an optic neuropathy with associated visual field loss for which elevated IOP is a major risk factor. To date, most of our treatment strategies are directed at reducing IOP, either with medical therapy, laser surgery, or incisional surgery, with medical therapy being the most common initial course of treatment. Three important questions often confront a glaucoma specialist when initiating therapy: Who needs to be treated?, how should a patient be treated, and to what extent? The Ocular Hypertension Study (OHTS) has provided insightful information to guide us in treatment of ocular hypertensives who may present with some risk factors and clinical findings but not others. OHTS demonstrated that reducing IOP by 20% with medical therapy in patients with ocular hypertension reduced the risk of developing glaucoma to 4.4% in the treated group versus 9.5% in the observation group at 5–year follow-up. •This clinical trial not only established the efficacy of lowering IOP with medical therapy but also identified the risk factors for developing glaucoma in these patients. •Older age, higher IOP, larger cup-disc diameter, higher pattern standard deviation, and thin central corneal thickness were determined to be significant risk factors by multivariate analysis. •Although family history and race were not found to be independent risk factors in OHTS, their association with glaucoma has been well established with other large population-based studies, such as the Baltimore Eye Survey. • Of note, a majority of untreated patients (nearly 90%) in the first phase of OHTS did not show any evidence of progression, a finding that emphasized the need to individualize therapy based on assessing risk factors and clinical findings in a given patient.
Management of Surgical Complications
Authors: Patrianakos Thomas
Published: November 2020

•Glaucoma filtration surgery (GFS) has been associated with higher long-term failure rates and a substantially higher risk profile than most other ophthalmic surgeries. •Identifying and properly managing complications associated with GFS is essential in ensuring the best possible outcome. •Infection is a devastating complication of GFS that must be considered in a separate category (please see Chapter 7 for blebitis and bleb-related endophthalmitis). •Complications unique to glaucoma drainage devices (GDD; see Chapter 12) will be discussed at the end of the chapter. •One simple way to diagnose a complication resulting from GFS is to subcategorize possibilities according to the IOP and anterior chamber (AC) depth. •Table 13.1 shows the four potential outcomes after GFS, and the text below provides additional details about each potential complication. •Usually occurs in the first few months after surgery. •The most common complication of trabeculectomy. •Due to progressive episcleral fibrosis and blockage under the scleral flap. •Incidence has decreased due to intraoperative use of antifibrotics. •Bleb appears constricted, shallow, or flat with increased vascularity and loss of microcysts. •Negative Seidel test. •Gonioscopy reveals an open sclerostomy site, which is essential to differentiate from an inadequate fistula or fistula blockage from iris, blood, fibrin, or vitreous. •Anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) may reveal adherence of Tenon’s capsule and conjunctiva to underlying sclera. •Approached in a stepwise fashion. • Decreases rate of episcleral fibrosis in hopes of rescuing the function of the bleb.•Prednisolone acetate 1% every 2 hours for first 1 to 2 weeks, then taper slowly over 2 to 3 months. •Administered if early signs of bleb failure/episcleral fibrosis are present. •Technique •Instill topical anesthesia followed by direct application of a cottontipped pledget approximately 90 to 180 degrees away from the bleb. •Use a 30-gauge needle on a tuberculin syringe to inject 5 mg (0.1 cc) of undiluted 5-fluorouracil (5-FU; available in a concentration of 50 ug/mL) under the conjunctiva at the anesthetized site. •Avoid areas of bleb elevation and areas that show increased conjunctival vascularity.
Significant reduction of humoral response to SARS-CoV-2 4 months after the diagnosis of COVID-19
Authors: Zhang Kang , Ma Zhen-Guo , Yang Lei , Kang Wei , Yin Yun , Lau Johnson Yiu-Nam
Published: November 2020

Editor's note

A commentary on “Humoral immune response to SARS-CoV-2 in Iceland”.
Predicting the effects of climate change on freshwater cyanobacterial blooms requires consideration of the complete cyanobacterial life cycle
Authors: Cottingham Kathryn L , Weathers Kathleen C , Ewing Holly A , Greer Meredith L , Carey Cayelan C
Published: November 2020

To date, most research on cyanobacterial blooms in freshwater lakes has focused on the pelagic life stage. However, examining the complete cyanobacterial life cycle—including benthic life stages—may be needed to accurately predict future bloom dynamics. The current expectation, derived from the pelagic life stage, is that blooms will continue to increase due to the warmer temperatures and stronger stratification associated with climate change. However, stratification and mixing have contrasting effects on different life stages: while pelagic cyanobacteria benefit from strong stratification and are adversely affected by mixing, benthic stages can benefit from increased mixing. The net effects of these potentially counteracting processes are not yet known, since most aquatic ecosystem models do not incorporate benthic stages and few empirical studies have tracked the complete life cycle over multiple years. Moreover, for many regions, climate models project both stronger stratification and increased storm-induced mixing in the coming decades; the net effects of those physical processes, even on the pelagic life stage, are not yet understood. We therefore recommend an integrated research agenda to study the dual effects of stratification and mixing on the complete cyanobacterial life cycle—both benthic and pelagic stages—using models, field observations and experiments.
Evaluation of PR3- and MPO-ANCA line and dot immunoassays in ANCA-associated vasculitis
Authors: Kempiners Nina , Mahrhold Juliane , Hellmich Bernhard , Csernok Elena
Published: November 2020

Objective

This study was performed to evaluate the diagnostic accuracy of novel line and dot immunoassays for detection of MPO and PR3 ANCA.

Methods

Sera from 50 patients with ANCA-associated vasculitis (AAV), including granulomatosis with polyangiitis and microscopic polyangiitis, and from 45 disease controls were tested by IIF and for the presence of PR3-ANCA and MPO-ANCA by four different line or dot immunoassays, as well as by a chemiluminescence immunoassay.

Results

The area under the curve of the receiver operating characteristic curve to discriminate AAV from controls was 0.858 (95% CI 0.785–0.931) for the IIF method. For the antigen-specific immunoassays, the area under the curve varied between 0.869 (95% CI 0.797–0.941) and 0.936 (95% 0.886–0.985).

Conclusions

Our comparison of various ANCA detection methods showed a high degree of diagnostic precision for all of the PR3- and MPO-ANCA line and dot immunoassays investigated. The performance was equal to or better than the performance of IIF. These results indicate that novel line and dot immunoassays can serve as a first-line test method in patients with the suspected diagnosis of AAV.
COMPARISON OF SPECTRA AND MEAN GLANDULAR DOSE WITH TUBE VOLTAGES USED IN DIGITAL BREAST TOMOSYNTHESIS FROM SIMULATED, METROLOGICAL AND CLINICAL CASES
Authors: da Silveira Gatto Leandro Barbosa , Braz Delson , Pacifico Leonardo , Travassos Paulo , Magalhaes Luis Alexandre Goncalves
Published: November 2020

Digital breast tomosynthesis (DBT) is a screening and diagnostic modality that acquires images of a breast at multiple angles during a short scan. The Selenia Dimensions (Hologic, Bedford, Mass) DBT system can perform both full-field digital mammography and DBT. The system acquires 25 projections over a 15° angular range (from −7.5° to +7.5°). X-ray spectroscopy is generally linked with a high-resolution semiconductor detector through a correction to its energy response function. The energy spectrum describes the radiation field, in which several quality parameters can be extracted, such as the effective energy, half-value layer and exposure. X-ray spectroscopy is usually performed with solid-state semiconductor detectors. Radiation dose is a concern in mammography, as the current protocols recommend that medical physicians evaluate mean glandular dose (MGD) as a part of service quality control. Studies are needed for radiation dose optimization from tomosynthesis patients. The COMET metrological X-ray tube, considered as with a constant potential and cooled, has proved to be a crucial tool in order to obtain the high energy resolution for low-energy radiographs in mammography. The Monte Carlo method, through Monte Carlo N-Particle eXtended (MCNPX), was proven to be an essential tool for image formation and posterior analysis of the deposited dose from breast simulators and radiographic contrast evaluation, for several anode/filter combinations. The purpose of this work was to assess the MGD and spectra in slabs of polymethyl methacrylate (PMMA) and breast equivalent thicknesses using four experiments with a Hologic Selenia Dimensions mammography X-ray tube with multimeter, a spectrometer (only for spectra, in this case), a metrological X-ray tube with a multimeter, and the MCNPX code. References indicate that the real conditions for a mammography X-ray tube that conducts tomosynthesis include tube voltages of 26, 29, 30 and 33 kVp. Taking into account several thicknesses of PMMA, both the MGD and spectral results were in accordance with the references. Most of the spectra were in accordance with the references, showing that the resources used in the experiments can evaluate the energy level received by a patient. The MGD values were lower than those in the references from 30 to 50 mm PMMA, and the data can be used for improvements in the detectors used in the Laboratory of Metrology in the State of Rio de Janeiro University, Brazil. Additionally, in the future, optimization of image quality can be performed for both semiconductors and mammography X-ray equipment.
Morphology and phylogeny of scalopine moles (Eulipotyphla: Talpidae: Scalopini) from the eastern Himalayas, with descriptions of a new genus and species
Authors: Chen Zhong-Zheng , He Shui-Wang , Hu Wen-Hao , Song Wen-Yu , Onditi Kenneth O , Li Xue-You , Jiang Xue-Long
Published: November 2020

All scalopine moles are found in North America, except the Gansu mole (Scapanulus oweni), which is endemic to central-west China. In 2019, we collected two specimens of Scalopini on Mt Namjagbarwa in the eastern Himalayas, Tibet, China. We sequenced two mitochondrial (CYT B and 12S) and three nuclear (APOB, BRCA1 and RAG2) genes to estimate the phylogenetic relationships of the two moles, and also compared their morphology with other genera and species within the Scalopini. Both morphological and molecular analyses strongly suggest that the specimens represent a new monotypic genus and species, which are formally described here as Alpiscaptulus medogensis gen. et sp. nov. The dental formula of the new mole (44 teeth) is distinct from the Chinese Scapanulus oweni (36 teeth) and its hairy and pale brown tail is unique among species of the Scalopini. The Kimura-2-parameter (K2P) distances of CYT B between A. medogensis and the four recognized Scalopini genera range from 14.5% to 18.9%. A sister relationship between A. medogensis and Scapanulus oweni was strongly supported in the phylogenetic trees. The divergence between A. medogensis and Scapanulus oweni occurred in the mid-Miocene (c. 11.56 Mya), which corresponds with the rapid uplift of the Himalayan-Tibetan Plateau.
Detection of Airborne Sporangia of Pseudoperonospora cubensis and P. humuli in Michigan Using Burkard Spore Traps Coupled to Quantitative PCR
Authors: Bello Julian C. , Sakalidis Monique L. , Perla David E. , Hausbeck Mary K.
Published: November 2020

Cucurbit downy mildew (CDM), caused by the oomycete pathogen Pseudoperonospora cubensis, is a devastating foliar disease on cucumber resulting in reduced yields. In 2004, the pathogen re-emerged in the United States, infecting historically resistant cucumber cultivars and requiring the adoption of an intensive fungicide program. The pathogen cannot overwinter in Michigan fields but because of an influx of airborne sporangia CDM occurs annually. In Michigan, spore traps are used to monitor the presence of airborne P. cubensis sporangia in cucumber growing regions to guide the initiation of a fungicide program. However, Pseudoperonospora humuli sporangia, the causal agent of downy mildew on hop, are morphologically indistinguishable from P. cubensis sporangia. This morphological similarity reduces the ability to accurately detect P. cubensis from spore trap samples when examined with the aid of light microscopy. To improve P. cubensis detection, we adapted a qPCR-based assay to allow the differentiation between P. cubensis and P. humuli on Burkard spore trap samples collected in the field. Specifically, we evaluated the specificity and sensitivity of P. cubensis detection on Burkard spore trap tapes using a morphological-based and quantitative-PCR (qPCR)-based identification assay and determined whether sporangia of P. cubensis and P. humuli on Burkard samples could be distinguished using qPCR. We found that the qPCR assay was able to detect a single sporangium of each species on spore trap samples collected in the field with Cq values <35.5. The qPCR assay also allowed the detection of P. cubensis and P. humuli in samples containing sporangia from both species. However, the number of sporangia quantified using light microscopy explained only 54 and 10% of the variation in the Cq values of P. cubensis and P. humuli, respectively, suggesting a limited capacity of the qPCR assay for the absolute quantification of sporangia in field samples. After 2 years of monitoring using Burkard spore traps coupled with the qPCR in cucumber fields, P. humuli sporangia were detected more frequently than P. cubensis early in the growing season (May and June). P. cubensis sporangia were detected ∼5 to 10 days before CDM symptoms were first observed in cucumber fields during both years. This research describes an improved sporangial detection system that is key for the monitoring and management of P. cubensis in Michigan.
Growth, Sporulation, and Pathogenicity of the Raspberry Pathogen Phytophthora rubi Under Different Temperature and Moisture Regimes
Authors: Graham Kim A. , Beck Bryan R. , Zasada Inga A. , Scagel Carolyn F. , Weiland Jerry E.
Published: November 2020

Phytophthora root rot of raspberry, which is mostly caused by Phytophthora rubi, is a significant issue for the Washington State red raspberry industry. Considered a cool weather pathogen, it is often assumed that it is most active and infective during the cool, wet winters of the region when soil temperatures range from 5 to 10°C; however, there are little data to support this view. More recent research has found that symptoms of root disease during late summer were strongly associated with P. rubi. Therefore, experiments were conducted at four temperatures from 5 to 20°C to evaluate the effects of temperature on P. rubi mycelial growth and sporulation and the effects of both temperature and soil moisture on the pathogenicity of P. rubi on red raspberry. At 20°C, P. rubi grew fastest and sporulated the most heavily. However, disease was most severe at both 15 and 20°C. The soil moisture parameters tested did not affect the pathogenicity results. These results show that P. rubi is more likely to infect during the spring and summer months (from May through September), when soil temperatures are consistently in the range of 15 to 20°C.
On-Farm Evaluations of Anaerobic Soil Disinfestation and Grafting for Management of a Widespread Soilborne Disease Complex in Protected Culture Tomato Production
Authors: Testen Anna L. , Martínez Marlia Bosques , Madrid Alejandra Jiménez , Deblais Loïc , Taylor Christopher G. , Paul Pierce A. , Miller Sally A.
Published: November 2020

Tomato production in Ohio protected culture systems is hindered by a soilborne disease complex consisting of corky root rot (Pyrenochaeta lycopersici), black dot root rot (Colletotrichum coccodes), Verticillium wilt (Verticillium dahliae), and root-knot (Meloidogyne hapla and M. incognita). In a survey of 71 high tunnels, C. coccodes was detected in 90% of high tunnels, and P. lycopersici (46%), V. dahliae (48%), and Meloidogyne spp. (45%) were found in nearly half of high tunnels. Anaerobic soil disinfestation (ASD) with wheat bran (20.2 Mg/ha) plus molasses (10.1 Mg/ha) and grafting onto ‘Maxifort’ or ‘Estamino’ rootstocks were evaluated in high tunnels on five farms. In post-ASD bioassays of trial soils, root and taproot rot severity were significantly reduced after ASD, and root-knot galling was also reduced by ASD. Soilborne pathogenic fungi were isolated less frequently from bioassay plants grown in ASD-treated soils than control soils. Similar results were observed in tomato plants grown in high tunnels. Root rot was significantly reduced by ASD in nearly all trials. Corky root rot severity was highest in nongrafted plants grown in nontreated soils, and the lowest levels of corky root rot were observed in ‘Maxifort’-grafted plants. Black dot root rot severity was higher or equivalent in grafted plants compared with nongrafted plants. Root-knot severity was lower in plants grown in ASD-treated soils in high tunnels compared with plants grown in control soils, but grafting did not significantly decrease root-knot severity. However, soil treatment did not significantly affect yield, and grafting led to inconsistent impacts on yield.
Potato Virus A Isolates from Three Continents: Their Biological Properties, Phylogenetics, and Prehistory
Authors: Fuentes Segundo , Gibbs Adrian J. , Adams Ian P. , Wilson Calum , Botermans Marleen , Fox Adrian , Kreuze Jan , Boonham Neil , Kehoe Monica A. , Jones Roger A. C.
Published: November 2020

Forty-seven potato virus A (PVA) isolates from Europe, Australia, and South America’s Andean region were subjected to high-throughput sequencing, and 46 complete genomes from Europe (n = 9), Australia (n = 2), and the Andes (n = 35) obtained. These and 17 other genomes gave alignments of 63 open reading frames 9,180 nucleotides long; 9 were recombinants. The nonrecombinants formed three tightly clustered, almost equidistant phylogroups; A comprised 14 Peruvian potato isolates; W comprised 37 from potato in Peru, Argentina, and elsewhere in the world; and T contained three from tamarillo in New Zealand. When five isolates were inoculated to a potato cultivar differential, three strain groups (= pathotypes) unrelated to phylogenetic groupings were recognized. No temporal signal was detected among the dated nonrecombinant sequences, but PVA and potato virus Y (PVY) are from related lineages and ecologically similar; therefore, “relative dating” was obtained using a single maximum-likelihood phylogeny of PVA and PVY sequences and PVY’s well-supported 157 CE “time to most common recent ancestor”. The PVA datings obtained were supported by several independent historical coincidences. The PVA and PVY populations apparently arose in the Andes approximately 18 centuries ago, and were taken to Europe during the Columbian Exchange, radiating there after the mid-19th century potato late blight pandemic. PVA’s phylogroup A population diverged more recently in the Andean region, probably after new cultivars were bred locally using newly introduced Solanum tuberosum subsp. tuberosum as a parent. Such cultivars became widely grown, and apparently generated the A × W phylogroup recombinants. Phylogroup A, and its interphylogroup recombinants, might pose a biosecurity risk.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Interactions Between Delia platura and Erwinia amylovora Associated with Insect-Mediated Transmission of Shoot Blight
Authors: Boucher Matthew , Collins Rowan , Harling Kayli , Brind’Amour Gabrielle , Cox Kerik , Loeb Greg
Published: November 2020

Erwinia amylovora is a bacterial pathogen of rosaceous plants that can be devastating to commercial apple and pear production worldwide. Exopolysaccharide (EPS) production is essential for pathogenicity, aiding in biofilm production, and plant defense protection. EPS also plays an epidemiological role in the form of bacterial ooze, which is generated when E. amylovora builds to such high levels within the parenchyma that it ruptures the plant epidermis and a mixture of bacteria encased in EPS exudes from the injury. Insects such as Delia platura feed on the ooze and become potential vectors in the process. The goal of this study was to investigate interactions between D. platura and E. amylovora to better understand how insects facilitate shoot blight. We demonstrate for the first time that D. platura can successfully transmit pathogen cells that initiate new infections in mechanically damaged apple shoots and that EPS aids in adherence of E. amylovora to the insect surface. We show that flies can carry the bacteria externally for at least 5 days and that they shed a constant daily rate. We also show that E. amylovora strains differing in virulence do not behave differently when associated with D. platura and that consumption of E. amylovora has no effect on insect survival. Our data demonstrate that flies can be efficient facilitators of new shoot blight infections, but the field conditions that make this type of transmission possible require further investigation.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Learner Handover: Who Is It Really For?
Authors: Humphrey-Murto Susan , Lingard Lorelei , Varpio Lara , Watling Christopher John , Ginsburg Shiphra , Rauscher Scott , LaDonna Kori
Published: November 2020

Purpose

Learner handover is the sharing of information about learners between faculty supervisors. Learner handover can support longitudinal assessment in rotation-based systems, but there are concerns that the practice could bias future assessments or stigmatize struggling learners. Because successful implementation relies on an understanding of existing practices and beliefs, the purpose of this study was to explore how faculty perceive and enact learner handover in the workplace.

Method

Using constructivist grounded theory, 23 semistructured interviews were conducted with faculty from 2 Canadian universities between August and December 2018. Participants were asked to describe their learner handover practices, including learner handover delivered or received about resident and student trainees either within or between clinical rotations. The authors probed to understand why faculty used learner handover and their perceptions of its benefits and risks.

Results

Learner handover occurs both formally and informally and serves multiple purposes for learners and faculty. While participants reported that learner handover was motivated by both learner benefit and patient safety, they primarily described motivations focused on their own needs. Learner handover was used to improve faculty efficiency by focusing teaching and feedback and was perceived as a “self-defense mechanism” when faculty were uncertain about a learner’s competence and trustworthiness. Informal learner handover also served social or therapeutic purposes when faculty used these conversations to gossip, vent, or manage insecurities about their assessment of learner performance. Because of its multiple, sometimes unsanctioned purposes, participants recommended being reflective about motivations behind learner handover conversations.

Conclusions

Learners are not the only potential beneficiaries of learner handover; faculty use learner handover to lessen insecurities surrounding entrustment and assessment of learners and to openly share their frustrations. The latter created tensions for faculty needing to share stresses but wanting to act professionally. Formal education policies regarding learner handover should consider faculty perspectives.
Influences on and Characteristics of the Professional Identity Formation of Clinician Educators: A Qualitative Analysis
Authors: Triemstra Justin D. , Iyer Maya S. , Hurtubise Larry , Poeppelman Rachel Stork , Turner Teri Lee , Dewey Charlene , Karani Reena , Fromme H. Barrett
Published: November 2020

Purpose

Professional identity formation is the process of internalizing the ideals, values, and beliefs of a profession. In recent years, research on clinician–educator (CE) identity formation has expanded, yet gaps exist in understanding initial influences on an educator identity, sustainment throughout a career, and development of successful pathways for early CEs. This study explored the initial influences on and characteristics of the professional identity formation of CEs in an age-diverse, multispecialty population in the United States.

Method

This was a cross-sectional qualitative study of a purposive sample of medical educators at 6 institutions across the United States between 2018 and 2019. Focus groups were conducted to obtain participants’ perspectives on their career choice and subsequent formation of their professional identity as CEs. The authors used a thematic analysis of focus group data to identify themes and domains through an iterative process.

Results

Twelve focus groups were conducted with a total of 93 participants. Responses were categorized into 5 domains: community supportive of medical education, culture of institution and training, personal characteristics, facilitators, and professionalization of medical education. Themes highlighted the importance of role models and mentors, an affinity and aptitude for teaching and education, specific facilitators for entry into a career in medical education, the evolution from a layperson, importance of formalized training programs, and a supportive academic community.

Conclusions

Clinicians experienced a variety of factors that influenced their initial career choice in medical education and subsequent professional identity formation as a CE. This study confirms and expands the current understanding of this process in an age-diverse, multispecialty population of CEs. Educators and administrators designing career development programs across the continuum of medical education should consider these aspects as they mentor and support their learners and faculty.
Participants’ Treatment Perspectives on a Clinical Trial on the Use of Extended-Release Naltrexone for Substance Use Disorders: Considerations for Future Clinical Research
Authors: Bardwell Geoff , Jaffe Kaitlyn , Korthuis P. Todd , Richardson Lindsey
Published: November 2020

Objectives:

We undertook this study to understand participants’ perceptions of their assigned treatment in a randomized control trial examining the use of extended-release naltrexone versus treatment as usual for substance use disorders.

Methods:

Semi-structured qualitative interviews among 22 prospective and actual participants in a larger clinical trial examining the feasibility of extended-release naltrexone for both opioid and alcohol use disorders among people living with HIV. Interviews were transcribed, coded, and analyzed thematically.

Results:

Participants described their study experience as mostly positive, but also concurrently held or developed study medication apprehensions and misperceptions. First, some participants described apprehension, lack of control, and uneasiness regarding their assigned treatment. Second, some participants perceived their treatment as “placebos” and/or were convinced that their treatment was ineffective, shaping perceptions of impact on their substance use. Third, some participants perceived study treatments as cure-alls for substance use disorders.

Conclusions:

Participant perceptions of trial interventions may frame their experience and participation in clinical studies. These findings demonstrate the need for researchers and clinicians to consider how apprehension and a lack of medication receptivity may impact enrollment and participant autonomy. They also identify opportunities for greater community engagement in trial design and implementation in order to improve participant education about the nature of interventions and the potential of ongoing consent processes integrated throughout studies to promote participant understandings of study purposes and objectives.
Substance-Related Found-Down Compartment Syndrome: A Systematic Review
Authors: Mortensen Sharri J. , Smith Richard D. J. , von Keudell Gottfried R. , Smith Malcolm R. , Weaver Michael J. , Nazarian Ara , von Keudell Arvind G.
Published: November 2020

Objective:

To characterize the patient population with substance-related found-down extremity compartment syndrome (FDECS) and report on their treatment and outcome.

Data Source:

This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Articles in English language were identified by searching 3 online databases, EMBASE, PubMed Publisher, and Cochrane Central, in September 2019.

Study Selection:

Studies involving substance-related FDECS were included. Exclusion criteria were as follows: patient age <18 years, not original studies, no full text available, technical reports, traumatic acute extremity compartment syndrome, chronic exertional compartment syndrome, and vascular acute extremity compartment syndrome.

Data Extraction:

There were 61 studies included with 166 cases of FDECS. Two investigators screened and extracted data independently according to a standardized template. Disagreements were addressed by an attempt to reach a consensus, and involvement of a third reviewer. Studies were quality assessed with “Quality Assessment tool for Case Series Studies.”

Data Synthesis:

Descriptive statistics were reported using Excel.

Conclusion:

Substance-related FDECS is often occurring in young adults. Data from this review found that most of the patients were already diagnosed with substance use disorders and/or psychiatric disorders. There should be a high index of suspicion of FDECS in patients presenting after prolonged immobilization.

Level of Evidence:

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.