bluuebunny/crossref_metadata_2025 huggingface dataset:
P58 Managing access to ‘Out Of Hours‘ medications in a tertiary paediatric hospital
Authors: Worrall Mary , Devlin Elizabeth , Howlett Moninne
Published: August 2020

Aims

Many UK and Irish hospitals provide a Monday to Friday pharmacy service; automated dispensing cabinets and hospital-wide information systems remain uncommon. Locating and accessing out of hours (OOH) medications can be a significant workload for nursing staff. In an Irish 230-bed tertiary paediatric hospital processes involve: nursing staff contacting other wards by telephone to source items; completion of an ‘Out of Hours Requisition’; and either transferring stock between wards or contacting nursing administration staff (NAS) to access stock from the Pharmacy Department. A quality improvement project was undertaken to: measure current levels of OOH medications; identify areas for improvement; implement and assess impact of new processes.

Methods

‘Out of Hours Requisition’ data were entered into a custom-built database and analysed for the period January - December 2018. The findings were discussed with nursing staff and NAS. Improving processes for locating medications was identified as a key area for improvement. The ‘Out of Hours Requisition’ form was amended to provide clearer instructions for completion. Using data from clinical area stock lists, a searchable Medicines Locator Database was developed and made accessible to all staff in the pharmacy department, clinical areas and the NAS office in December 2018 enabling staff to remotely identify the location of all medications stocked in the hospital. Data for ‘Out of Hours Requisitions’ for the period January - May 2019 were collated, analysed and compared with data from the same time period in 2018 (January - May). Microsoft Excel® was used for data collection, analyses and development of the Medicines Locator Database.

Results

A total of 1747 OOH medications were accessed by NAS from pharmacy in 2018, 746 during the period January - May 2018. Anti-microbial agents (36%) were most common, with requests originating from 16 clinical areas. Request from the paediatric intensive care units (36%) and the surgical/orthopaedic ward (36%) were most frequent. 515 medications were accessed in the first 5 months after the introduction of the Medicines Locator Database (January - May 2019). This represents a 35% reduction in the number of medications dispensed in the same time period in 2018. No changes to the types of medications were identified, but some differences in clinical areas were found.

Conclusion

This significant reduction (35%) in numbers of medications accessed out of hours, and the corresponding reduction in workload for NAS, demonstrates the benefits of reviewing medication management processes. Further substantial time savings for nursing staff locating stock at ward level are likely. Readily-available technology can be successfully employed to improve processes in the absence of more sophisticated technological solutions. A staff survey is planned to evaluate awareness and usability of the database and identify further areas for improvement.
P65 Advanced neonatal nurse practitioner (ANNP) review of neonatal antibiotics in 36hours to improve antibiotics stewardship
Authors: Bilkhoo Charon , Gray Jim , Patel Mitul , Holder Gemma , Perry Michelle
Published: August 2020

Aim

To ensure neonates in transitional care and postnatal wards are receiving antibiotics appropriately. NICE CG1491 advises to consider stopping antibiotics at 36 hours in babies given antibiotics because of risk factors for infection or clinical indicators of possible infection where:

the blood culture is negative,

the levels and trends of C-reactive protein (crp) concentration are reassuring and

no clinical indicators of possible infection

Neonatal unit was excluded from this study; since daily clinician led ward rounds to review antibiotics already occur. Antibiotics not reviewed in the 36 hour time frame were due to delays in receiving the second crp level. Daily ward rounds to review antibiotics in neonates were not happening on transitional care and postnatal wards, thus to ensure regular care, advanced neonatal nurse practitioner led reviews were implemented.

Method

A crp sample should be taken after delivery and in babies given antibiotics because of possible infection, the crp concentration is measured again 18–24 hours after presentation. The role of the ANNP is to ensure both crp levels are checked and the blood culture is negative, with the aim of stopping antibiotics at 36 hours before the second dose of gentamicin is due. In summary neonates that do not need antibiotics should have only had approximately 3 doses of benzylpenicillin and 1 dose of gentamicin. Audits were carried out on neonates in transitional care and postnatal wards who were receiving antibiotics. The initial base line audit was done over 3 months to assess if antibiotics were reviewed in 36 hours. This was deduced by a signature from the ANNP either stating on the drug chart that antibiotics would continue for 5 days until crp has decreased or the antibiotic would be discontinued if the crp was low. This audit was repeated a year later.

Results

During the first 3 months audit the proportion of babies having their antibiotics reviewed within 36 hour time frame rose from 3% in month 1 to 25% and 50% in months 2 and 3 consecutively. During the second 3 month audit, the proportion of babies having their antibiotics reviewed was 78% in month 1 and 80% in the following two months. The first audit showed a rapid improvement, whereas the second audit showed an significant improvement compared to the end of the first audit, which was sustained throughout the full three months.

Conclusion

The ANNP was a simple and no cost solution in ensuring antibiotic stewardship was consistent throughout neonates, reducing the length of stay of neonates and their mothers. The 20% of babies who are still not having a 36 hour review may be because of delays in blood cultures reaching the laboratories to commence incubation.

Reference

Neonatal infection (early onset): antibiotics for prevention and treatment. NICE CCG149 2012.
Harlequin syndrome following microwave ablation in a child with a symptomatic paraspinal mass
Authors: Schultz Lauren , Mackarey Amelia , Oh Caleb , Kent Paul
Published: August 2020

Our goal is to describe a case of Harlequin syndrome associated with microwave ablation in the treatment of a symptomatic paraspinal mass in a child, along with a summary of the literature. Our patient is the only known case of persistent Harlequin syndrome associated with microwave ablation treatment of a symptomatic paraspinal mass. Harlequin syndrome is a rare neurological condition characterised by unilateral sweating and flushing of the face, neck and/or upper chest. The specific mechanism is unclear, but the majority of cases are believed to be a result of contralateral lesions along the sympathetic chain. CT-guided microwave ablation therapy is a minimally invasive technique used as an alternative to surgery in this case due to the risk and morbidity associated with excision of the mass. There is limited literature assessing the use and inherent risk of developing complications following microwave ablation to the paraspinal region in the paediatric population.
Juvenile psammomatoid ossifying fibroma of the calcaneus
Authors: Semus Rachel L , Zielinski Elizabeth , Foster William C
Published: August 2020

Juvenile ossifying fibromas (JOFs) are a rare group of fibro-osseous lesions, typically of odontogenic origin. Juvenile psammomatoid ossifying fibroma (JPOF) is one variant, that is, histopathologically distinguished by spherical ossicles resembling psammoma bodies. JPOF tumours are most commonly found in craniofacial skeletal structures and can be locally aggressive. Thus, early management by complete surgical excision is crucial for good outcomes, although recurrence is still possible. Secondary aneurysmal bone cyst (ABC) formation has been reported with JOF lesions, but less commonly with the JPOF variant. We describe an unusual case of JPOF that presented in the calcaneus with secondary ABC formation.
Traumatic costovertebral joint dislocation
Authors: Mennen Anna H M , de Ruiter Kristian J , van Embden Daphne
Published: August 2020

Rib fractures due to blunt trauma are a common chest injury seen at the emergency department; however, injuries to the costovertebral joints are very rare. We present a case of a 24-year-old man who was admitted after a high-speed car collision and was assessed in a level 1 trauma centre in Amsterdam. He had multiple injuries, including dislocation of the costovertebral joint of ribs 7–10. After performing a literature search we concluded that patients with traumatic costovertebral joint dislocations have a high incidence of vertebral fractures, neurological deficits and additional fractures. We believe that isolated dislocation of one or multiple costovertebral joint(s) can safely be treated conservatively. Close monitoring of the patients is advisable as these injuries are caused by high impact and are associated with other injuries.
Massive bilateral stroke in a COVID-19 patient
Authors: Mohamed Iskandar Zulqarnain Bin , Balson Laura , Madathil Shyam
Published: August 2020

Coronavirus disease 2019 (COVID-19) is a novel infection of which we still have much to learn. Microvascular and macrovascular complications are increasingly recognised as being among the drivers of morbidity and mortality in patients with this condition. Here we present a case of a woman with COVID-19 who suffered massive and bilateral middle cerebral artery strokes, which presented as reduced consciousness several days into admission. Clinicians need to be aware of possible causes of reduced consciousness in COVID-19 patients, particularly as delirium appears to be a common complication, and revisit working diagnoses if the clinical picture does not fully fit. Studies into both anticoagulation and the management of stroke in the context of COVID-19 are urgently needed to help inform future practice.
Optimising outcomes of exercise and corticosteroid injection in patients with subacromial pain (impingement) syndrome: a factorial randomised trial
Authors: Roddy Edward , Ogollah Reuben O , Oppong Raymond , Zwierska Irena , Datta Praveen , Hall Alison , Hay Elaine , Jackson Sue , Jowett Sue , Lewis Martyn , Shufflebotham Julie , Stevenson Kay , van der Windt Danielle A , Young Julie , Foster Nadine E
Published: August 2020

Objectives

To compare the clinical effectiveness of (1) physiotherapist-led exercise versus an exercise leaflet, and (2) ultrasound-guided subacromial corticosteroid injection versus unguided injection for pain and function in subacromial pain (formerly impingement) syndrome (SAPS).

Methods

This was a single-blind 2×2 factorial randomised trial. Adults with SAPS were randomised equally to one of four treatment groups: (1) ultrasound-guided corticosteroid injection and physiotherapist-led exercise, (2) ultrasound-guided corticosteroid injection and an exercise leaflet, (3) unguided corticosteroid injection and physiotherapist-led exercise and (4) unguided corticosteroid injection and an exercise leaflet. The primary outcome was the Shoulder Pain and Disability Index (SPADI), collected at 6 weeks, 6 and 12 months and compared at 6 weeks for the injection interventions and 6 months for the exercise interventions by intention to treat.

Results

We recruited 256 participants (64 treatment per group). Response rates for the primary outcome were 94% at 6 weeks, 88% at 6 months and 80% at 12 months. Greater improvement in total SPADI score was seen with physiotherapist-led exercise than with the exercise leaflet at 6 months (adjusted mean difference −8.23; 95% CI −14.14 to -2.32). There were no significant differences between the injection groups at 6 weeks (−2.04; −7.29 to 3.22), 6 months (−2.36; −8.16 to 3.44) or 12 months (1.59; −5.54 to 8.72).

Conclusions

In patients with SAPS, physiotherapist-led exercise leads to greater improvements in pain and function than an exercise leaflet. Ultrasound guidance confers no additional benefit over unguided corticosteroid injection.

Trial registration number

ISRCTN42399123
.
Expression of clock geneDbpin omental and mesenteric adipose tissue in patients with type 2 diabetes
Authors: Ushijima Kentaro , Suzuki Chisato , Kitamura Hiroko , Shimada Ken , Kawata Hirotoshi , Tanaka Akira , Horie Hisanaga , Hosoya Yoshinori , Imai Yasushi , Yamashita Chikamasa , Fujimura Akio
Published: August 2020

Introduction

We previously reported in ob/ob mice, one of animal models of human type 2 diabetes mellitus (DM2), that (i) acetylation of histone H3 lysine 9 (H3K9) at the promoter region of clock geneDbpand DBP mRNA expression are reduced in epididymal adipose tissue, (ii) binding of DBP to the promoter region of peroxisome proliferator-activated receptor (Ppar)-γand mRNA expression of PPAR-γ1sv were decreased in preadipocytes and (iii) adiponectin secretion was decreased, leading to the impaired insulin sensitivity.

Research design and methods

The present study was undertaken to evaluate whether such the changes in visceral adipose tissue were detected in patients with DM2. We obtained omental and mesenteric adipose tissue during surgery of lymph node dissection for gastric and colorectal cancers, and investigated these variables in adipose tissue (omental from gastric cancer; 13 non-DM, 12 DM2: mesenteric from colorectal cancer; 12 non-DM, 11 DM2).

Results

Acetylation of histone H3K9 at the promoter region ofDbpand DBP mRNA expression in omental, but not in mesenteric adipose tissue were significantly lower in DM2 than in patients without DM. PPAR-γ mRNA expression in omental adipose tissue was also lower in patients with DM2, but not in mesenteric adipose tissue.

Conclusions

The changes in DBP-PPAR-γ axis observed in mice with diabetes were also detected in patients with DM2. Because adiponectin secretion is reported to be enhanced through the PPAR-γ-related mechanism, this study supports the hypothesis that omental adipose tissue is involved in the mechanism of DM2.
Endoscopic full-thickness resection and its treatment alternatives in difficult-to-treat lesions of the lower gastrointestinal tract: a cost-effectiveness analysis
Authors: Kuellmer Armin , Behn Juliane , Beyna Torsten , Schumacher Brigitte , Meining Alexander , Messmann Helmut , Neuhaus Horst , Albers David , Birk Michael , Probst Andreas , Faehndrich Martin , Frieling Thomas , Goetz Martin , Thimme Robert , Caca Karel , Schmidt Arthur
Published: August 2020

Objective

Endoscopic full-thickness resection (EFTR) has shown efficacy and safety in the colorectum. The aim of this analysis was to investigate whether EFTR is cost-effective in comparison with surgical and endoscopic treatment alternatives.

Design

Real data from the study cohort of the prospective, single-arm WALL RESECT study were used. A simulated comparison arm was created based on a survey that included suggested treatment alternatives to EFTR of the respective lesions. Treatment costs and reimbursement were calculated in euro according to the coding rules of 2017 and 2019 (EFTR). R0 resection rate was used as a measure of effectiveness. To assess cost-effectiveness, the average cost-effectiveness ratio (ACER) and the incremental cost-effectiveness ratio (ICER) were determined. Calculations were made both from the perspective of the care provider as well as of the payer.

Results

The cost per case was €2852.20 for the EFTR group, €1712 for the standard endoscopic resection (SER) group, €8895 for the surgical resection group and €5828 for the pooled alternative treatment to EFTR. From the perspective of the care provider, the ACER (mean cost per R0 resection) was €3708.98 for EFTR, €3115.10 for SER, €8924.05 for surgical treatment and €7169.30 for all pooled and weighted alternatives to EFTR. The ICER (additional cost per R0 resection compared with EFTR) was €5196.47 for SER, €26 533.13 for surgical resection and €67 768.62 for the pooled rate of alternatives. Results from the perspective of the payer were similar.

Conclusion

EFTR is cost-effective in comparison with surgical and endoscopic treatment alternatives in the colorectum.
Profiling of gastric cancer cell-surface markers to achieve tumour–normal discrimination
Authors: Toh Judith , Hoppe Michal Marek , Thakur Teena , Yang Henry , Tan Kar Tong , Pang Brendan , Ho Sharmaine , Roy Rony , Ho Khek Yu , Yeoh Khay Guan , Tan Patrick , Sundar Raghav , Jeyasekharan Anand
Published: August 2020

Background

Differentiating between malignant and normal cells within tissue samples is vital for molecular profiling of cancer using advances in genomics and transcriptomics. Cell-surface markers of tumour–normal discrimination have additional value in terms of translatability to diagnostic and therapeutic strategies. In gastric cancer (GC), previous studies have identified individual genes or proteins that are upregulated in cancer. However, a systematic analysis of cell-surface markers and development of a composite panel involving multiple candidates to differentiate tumour from normal has not been previously reported.

Methods

Whole transcriptome sequencing (WTS) of GC and matched normal samples from the Singapore Gastric Cancer Consortium (SGCC) was used as a discovery cohort to identify upregulated putative cell-surface proteins. Matched WTS data from the The Cancer Genome Atlas (TCGA) was used as a validation cohort. Promising candidates from this analysis were validated orthogonally using multispectral immunohistochemistry (mIHC) with automated quantitative analysis using the Vectra platform. mIHC was performed on a tissue microarray containing matched normal, marginal and tumour tissues. The receiver-operating characteristic (ROC) curves were analysed to identify markers with the highest diagnostic validity independently and in combination.

Results

Analysis of putative membrane protein transcripts from the SGCC discovery cohort WTS data (n=15 matched tumour and normal pairs) identified several differentially and highly expressed candidates in tumour compared with normal tissues. After validation with TCGA data (n=29 matched tumour and normal pairs), the following proteins were selected for mIHC analysis: CEACAM5, CEACAM6, CLDN4, CLDN7, and EpCAM. These were compared with established glycoprotein markers in GC, namely CA19-9 and CA72-4. Individual ROC curves yielded the best performance for CEACAM5 (area under the ROC curve (AUC)=0.80), CEACAM6 (AUC=0.82), EpCAM (AUC=0.83), and CA72-4 (AUC=0.76). Combined multiplexed imaging of these four markers revealed improved specificity and sensitivity for detection of tumour from normal tissue (AUC of 4-plex=0.91).

Conclusion

CEAMCAM5, CEACAM6, EpCAM, and CA72-4 form a versatile set of markers for robust discrimination of GC from adjacent normal tissue. As cell-surface markers, they are compatible with both IHC and live imaging approaches. These candidates may be exploited to improve automated identification of tumour tissue in GC.
Mobile health in cardiac patients: an overview on experiences and challenges of stakeholders involved in daily use and development
Authors: Kauw Dirkjan , Huisma Piter R , Medlock Stephanie K , Koole Maarten A C , Wierda Eric , Abu-Hanna Ameen , Schijven Marlies P , Mulder Barbara J M , Bouma Berto J , Winter Michiel M , Schuuring Mark J
Published: August 2020

Background

Mobile health (mHealth) can improve quality of care and empower cardiac patients. However, large-scale adoption is still lacking, as several challenges continue to be encountered in daily practice. We aimed to explore the mHealth experiences and challenges in cardiac patients, healthcare professionals, healthcare managers and information and communications technology (ICT) developers.

Methods

A qualitative research was employed where semistructured interviews were conducted in patients, healthcare professionals, managers and ICT developers. We aimed to enrol participants of every stakeholder group, with diversity in sex, age group and occupation. Thematic analysis was used to identify themes reflecting experiences and challenges in mHealth in cardiac patients.

Results

In total, 24 interviews were conducted in six patients, eight healthcare professionals, five managers and five ICT developers. Monitoring/care at home was reported as important advantage of mHealth (n=20, 83%). Patients valued increase of self-care (n=6, 100%) and remote reassurance (n=6, 100%), but reported medicalisation as important concern (n=4, 67%). Healthcare professionals warned for increased data burden (n=4, 50%). Managers agreed on the importance of device reliability (n=5, 100%) and ICT developers emphasised that the goal of mHealth is to replace care, rather than being supplementary (n=4, 80%). The majority of all participants (n=22, 92%) considered future use of mHealth as promising.

Conclusions

All stakeholders foresee benefit of mHealth in cardiac patients, especially for remote care and reassurance. Frequently mentioned challenges included the need to replace care with mHealth, rather than adding more workload, and employing reliable devices and applications. If collaboration can be improved and group-specific challenges overcome, success of mHealth in cardiac patients can improve significantly.
Short-course radiotherapy promotes pro-inflammatory macrophages via extracellular vesicles in human rectal cancer
Authors: Stary Victoria , Wolf Brigitte , Unterleuthner Daniela , List Julia , Talic Merjem , Längle Johannes , Beer Andrea , Strobl Johanna , Stary Georg , Dolznig Helmut , Bergmann, MD Michael
Published: August 2020

Background

Tumor-associated macrophages (TAM) constitute the most abundant immune cells in the tumor stroma initiating pro-inflammatory (M1) or immunosuppressive (M2) responses depending on their polarization status. Advances in tumor immunotherapy call for a detailed understanding of potential immunogenic mechanisms of irradiation routinely applied in rectal cancer patients.

Methods

To test the effects of radiotherapy on TAM, we ex vivo irradiated tissue samples of human rectal cancer and assessed the phenotype by flow cytometry. We furthermore evaluated the distribution of leucocyte subsets in tissue sections of patients after short-course radiotherapy and compared findings to non-pretreated rectal cancer using an immunostaining approach. Organotypic assays (OTA) consisting of macrophages, cancer-associated fibroblast and cancer cell lines were used to dissect the immunological consequences of irradiation in macrophages.

Results

We demonstrate that short-course neoadjuvant radiotherapy in rectal cancer patients is associated with a shift in the polarization of TAM towards an M1-like pro-inflammatory phenotype. In addition, ex vivo irradiation caused an increase in the phagocytic activity and enhanced expression of markers associated with stimulatory signals necessary for T-cell activation. In OTA we observed that this alteration in macrophage polarization could be mediated by extracellular vesicles (EV) derived from irradiated tumor cells. We identified high mobility group box 1 in EV from irradiated tumor cells as a potential effector signal in that crosstalk.

Conclusions

Our findings highlight macrophages as potential effector cells upon irradiation in rectal cancer by diminishing their immunosuppressive phenotype and activate pro-inflammation. Our data indicate that clinically applied short-term radiotherapy for rectal cancer may be exploited to stimulate immunogenic macrophages and suggest to target the polarization status of macrophages to enhance future immunotherapeutic strategies.
Characterisation of aortic stenosis severity: a retrospective analysis of echocardiography reports in a clinical laboratory
Authors: Raddatz Michael A , Gonzales Holly M , Farber-Eger Eric , Wells Quinn S , Lindman Brian R , Merryman W David
Published: August 2020

Objective

To evaluate how common echocardiographic metrics of aortic stenosis (AS) influence the proportion of patients who may be categorised as having severe stenosis and therefore considered for valve replacement.

Methods

Retrospective analysis was performed of all echocardiograms with aortic valve area (AVA) ≤1.2 cm2and peak jet velocity (Vmax) ≥3 m/s from 1 December 2014 through 30 October 2017 at a single academic medical centre. Echocardiographic indices collected include AVA, Vmax, left ventricular ejection fraction, stroke volume and annotated aortic stenosis severity.

Results

Among 807 patients with AVA ≤1.2 cm2and Vmax≥3 m/s (44.0% female, median age 74 years (IQR: 66–81)), 45.6% had Vmax≥4 m/s, while 75.8% had AVA ≤1 cm2. 40.0% of patients had concordant indices (Vmax≥4 m/s and AVA ≤1 cm2), and 35.8% had discordant indices (Vmax<4 m/s and AVA ≤1 cm2) of severe AS. Compared with those with concordant indices, patients with discordant indices were more commonly female (54.0% vs 44.3%, p<0.05) and less commonly characterised as severe (42.6% vs 93.8%, p<0.001). Patients with paradoxical low-flow, low-gradient severe AS by echocardiography were disproportionately female (61.5% vs 41.8%, p<0.001), and their disease was characterised as severe only 49.5% of the time.

Conclusions

Patients with discordant indices, who are disproportionately female, are commonly described in clinical echocardiography reports as having less than severe AS. Given the potential benefit of AVR in patients with AVA ≤1 cm2regardless of Vmax, this could have important clinical implications.
Reactions to, and trial intentions for, three dissuasive cigarette designs: a cross-sectional survey of adolescents in Scotland
Authors: Mitchell Danielle , Critchlow Nathan , Moodie Crawford , Bauld Linda
Published: August 2020

Objectives

There has been growing academic and policy interest in opportunities to decrease the appeal of cigarette sticks, such as making them an unattractive colour or requiring them to display a health warning. We therefore explored reactions to, and trial intentions for, three ‘dissuasive’ cigarette designs among adolescents in Scotland.

Methods

A cross-sectional survey with 12–17 year olds in Scotland (n=594) was conducted between November 2017 and November 2018. Participants were shown one ‘standard’ cigarette (imitation cork filter with white paper casing) and three dissuasive cigarettes: (1) a cigarette with the warning ‘smoking kills’; (2) a cigarette with the warning ‘toxic’ and a skull and cross-bones image and (3) a dark green cigarette. Participants rated each cigarette on nine five-point reaction measures (eg, appealing/unappealing or attractive/unattractive). A composite reaction score was computed for each cigarette, which was binary coded (overall negative reactions vs neutral/positive reactions). Participants also indicated whether they would try each cigarette (coded: Yes/No). Demographics, smoking status and smoking susceptibility were also measured.

Results

More participants had negative reactions to the dark green (93% of adolescents), ‘smoking kills’ (94%) and ‘toxic’ (96%) cigarettes, compared with the standard cigarette (85%). For all three dissuasive designs, Chi-square tests found that negative reactions were more likely among younger adolescents (vs older adolescents), never-smokers (vs ever smokers) and non-susceptible never-smokers (vs susceptible never-smokers). Most participants indicated that they would not try any of the cigarettes (range: 84%–91%).

Conclusion

Dissuasive cigarettes present an opportunity to further reduce the appeal of smoking among adolescents.
Aerobic exercise training attenuates detrimental effects of cigarette smoke exposure on peripheral muscle through stimulation of the Nrf2 pathway and cytokines: a time-course study in mice
Authors: Toledo-Arruda Alessandra C. , Sousa Neto Ivo Vieira de , Vieira Rodolfo P. , Guarnier Flávia A. , Caleman-Neto Agostinho , Suehiro Camila L. , Olivo Clarice R. , Cecchini Rubens , Prado Carla M. , Lin Chin J. , Durigan João Luiz Quaglioti , Martins Milton A.
Published: August 2020

Cigarette smoke (CS) exposure reduces skeletal muscle function; however, the mechanisms involved have been poorly investigated. The current study evaluated the temporal effects of aerobic exercise training on oxidant and antioxidant systems as well as inflammatory markers in skeletal muscle of mice exposed to CS. Mice were randomly allocated to control, exercise, smoke, and smoke+exercise groups and 3 time points (4, 8, and 12 weeks; n = 12 per group). Exercise training and CS exposure were performed for 30 min/day, twice a day, 5 days/week for 4, 8, and 12 weeks. Aerobic exercise improved functional capacity and attenuated the increase in the cachexia index induced by CS exposure after 12 weeks. Concomitantly, exercise training downregulated tumor necrosis factor α concentration, glutathione oxidation, and messenger RNA (mRNA) expression of Keap1 (P < 0.01) and upregulated interleukin 10 concentration, total antioxidant capacity, and mRNA expression of Nrf2, Gsr, and Txn1 (P < 0.01) in muscle. Exercise increased mRNA expression of Hmox1 compared with the control after 12 weeks (P < 0.05). There were no significant differences between smoke groups for superoxide dismutase activity and Hmox1 mRNA expression. Exercise training improved the ability of skeletal muscle to adequately upregulate key antioxidant and anti-inflammatory defenses to detoxify electrophilic compounds induced by CS exposure, and these effects were more pronounced after 12 weeks.

Novelty Exercise attenuates oxidative stress in skeletal muscle from animals exposed to CS via Nrf2 and glutathione pathways. Exercise is a helpful tool to control the inflammatory balance in skeletal muscle from animals exposed to CS. These beneficial effects were evident after 12 weeks.
Using discrete element method (DEM) to create a cone penetration test (CPT)-based method to estimate the installation requirements of rotary-installed piles in sand
Authors: Sharif Yaseen Umar , Brown Michael John , Ciantia Matteo Oryem , Cerfontaine Benjamin , Davidson Craig , Knappett Jonathan , Meijer Gerrit Johannes , Ball Jonathan
Published: August 2020

Deep foundations may be used in a range of soil types where significant foundation resistance is required, but their installation is often associated with disturbance due to noise and vibration. Greater restrictions on use in urban and offshore environments is now commonplace. Screw piles and rotary-jacked straight-shafted piles are two potential methods of silent piling that could be used as alternative foundation solutions, but the effects of certain geometric and installation properties such as installation pitch, i.e., the ratio between vertical displacement and rotation, on the required installation torque and force in sand are not well understood. In this paper, the effects of installation pitch and base geometry on the installation requirements of a straight-shafted pile are simulated in three dimensions using the discrete element method (DEM). The installation requirements of straight-shafted piles into sand have been validated against centrifuge testing in three different relative densities. The DEM shows reductions in installation force can be achieved by increasing the installation pitch or including a conical tip. An existing cone penetration test (CPT)-based prediction method for installation requirements has been improved to include the effects of installation pitch and base geometry for rotary-installed piles in sand.
Lake water level response to drought in a lake-rich region explained by lake and landscape characteristics
Authors: Perales K. Martin , Hein Catherine L. , Lottig Noah R. , Vander Zanden M. Jake
Published: August 2020

Climate change is altering hydrologic regimes, with implications for lake water levels. While lakes within lake districts experience the same climate, lakes may exhibit differential climate vulnerability regarding water level response to drought. We took advantage of a recent drought (∼2005–2010) and estimated changes in lake area, water level, and shoreline position on 47 lakes in northern Wisconsin using high-resolution orthoimagery and hypsographic curves. We developed a model predicting water level response to drought to identify characteristics of the most vulnerable lakes in the region, which indicated that low-conductivity seepage lakes found high in the landscape, with little surrounding wetland and highly permeable soils, showed the greatest water level declines. To explore potential changes in the littoral zone, we estimated coarse woody habitat (CWH) loss during the drought and found that drainage lakes lost 0.8% CWH while seepage lakes were disproportionately impacted, with a mean loss of 40% CWH. Characterizing how lakes and lake districts respond to drought will further our understanding of how climate change may alter lake ecology via water level fluctuations.
A spatial–temporal approach to modeling somatic growth across inland recreational fisheries landscapes
Authors: Cahill Christopher L. , Anderson Sean C. , Paul Andrew J. , MacPherson Laura , Sullivan Michael G. , van Poorten Brett , Walters Carl J. , Post John R.
Published: August 2020

We develop a mechanistically motivated von Bertalanffy growth model to estimate growth rate and its predictors from spatial–temporal data and compare this model’s performance with a suite of commonly used mixed-effects growth models. We test these models with simulated data and then apply them to test whether concerns that high density is causing growth suppression of walleye (Sander vitreus) in Alberta, Canada, are supported using data collected during 2000–2017. Simulation experiments demonstrated that models that failed to account for complex dependency structures often resulted in growth rate estimates that were less accurate and biased low as judged by median absolute relative error and median relative error, respectively. The magnitude of this bias depended on the parameter values used for simulation. For the case study, a spatial–temporal model was more parsimonious and had higher predictive performance relative to simpler models and did not support the slow-growing walleye hypothesis in Alberta. These findings demonstrate the importance of considering spatial–temporal correlation in analyses that rely on surveillance-style monitoring datasets, particularly when examining relationships between life-history traits and environmental characteristics.
Direct comparison of sterile neutrino constraints from cosmological data, $$\nu _{e}$$ disappearance data and $$\nu _{\mu } \rightarrow \nu _{e} $$ appearance data in a $$3+1$$ model
Authors: Adams Matthew , Bezrukov Fedor , Elvin-Poole Jack , Evans Justin J. , Guzowski Pawel , Fearraigh Brían Ó , Söldner-Rembold Stefan
Published: August 2020

We present a quantitative, direct comparison of constraints on sterile neutrinos derived from neutrino oscillation experiments and from Planck data, interpreted assuming standard cosmological evolution. We extend a$$1+1$$1+1model, which is used to compare exclusion contours at the 95% Cl derived from Planck data to those from$$\nu _{e}$$νe-disappearance measurements, to a$$3+1$$3+1model. This allows us to compare the Planck constraints with those obtained through$$\nu _{\mu }\rightarrow \nu _{e}$$νμ→νeappearance searches, which are sensitive to more than one active-sterile mixing angle. We find that the cosmological data fully exclude the allowed regions published by the LSND, MiniBooNE and Neutrino-4 collaborations, and those from the gallium and rector anomalies, at the 95% Cl. Compared to the exclusion region from the Daya Bay$$\nu _{e}$$νe-disappearance search, the Planck data are more strongly excluding above$$|\Delta m^{2}_{41}|\approx 0.1\,\mathrm {eV}^{2}$$|Δm412|≈0.1eV2and$$m_\mathrm {eff}^\mathrm {sterile}\approx 0.2\,\mathrm {eV}$$meffsterile≈0.2eV, with the Daya Bay exclusion being stronger below these values. Compared to the combined Daya Bay/Bugey/MINOS exclusion region on$$\nu _{\mu }\rightarrow \nu _{e}$$νμ→νeappearance, the Planck data is more strongly excluding above$$\Delta m^{2}_{41}\approx 5\times 10^{-2}\,\mathrm {eV}^{2}$$Δm412≈5×10-2eV2, with the exclusion strengths of the Planck data and the Daya Bay/Bugey/MINOS combination becoming comparable below this value.
Recent results and challenges in behavioral systems
Authors: Bellomo N. , Brezzi F. , Soler J.
Published: August 2020

This editorial paper is devoted to present the papers published in a special issue focused on modeling, qualitative analysis and simulation of the collective dynamics of living, self-propelled particles. A critical analysis of the overall contents of the issue is proposed, thus leading to a forward look to research perspectives.
Study on the Spatial Coupling between Expressway Networks and Tourist Attractions: A Case Study of Guizhou Province
Authors: CHEN Sihong , XI Jianchao , LIU Menghao
Published: August 2020

Transportation is the most basic element in the development of tourism, with expressways being the main channel for tourism transportation in the era of driving tours. The relationship between transportation and tourism development has always been one of the hot topics in tourism geography study. Since the expressway service area is the main node of tourist service facilities in the expressway transportation network, we conducted a field research on 125 service areas and 177 tourist attractions in Guizhou Province, and obtained relevant data. By using the centrality measures for social network analysis, and combining the kernel density analysis with bivariate spatial autocorrelation analysis, this paper explores the centrality characteristics of expressway transportation network, the spatial distribution regularity of tourist attractions, and the spatial coupling between them. The main study conclusions are as follows: (1) The expressway service areas in Guizhou Province gradually decrease from a single core to the periphery. (2) The spatial distribution of tourist attractions presents a weak circular structure with multiple cores in a scattered manner, and the regional differences are apparent. (3) There is positive spatial correlation between the expressway networks and tourist attractions. The spatial coupling between the expressway transportation network and tourist attractions can be divided into four types of clusters: high–high cluster, high–low cluster, low–high cluster, and low–low cluster, with high–high and low–low clusters as the main types. The high–high cluster is the area with the best coupling effect and the most mature tourism. The high–low and low–high clusters have a mismatch between transportation and tourism resources. For such clusters, the spatial coupling can be realized by changing the functions of the service area or improving the quality of the tourist attraction. They have great development potential. The low–low cluster is far away from tourist attractions and markets, thus it has a small value of tourism development, and it is the critical area for future improvement. The conclusion of this study can provide a theoretical basis and scientific suggestions for promoting integrated and coordinated sustainable development of transportation and tourism.
Timing of Industrialization, Domestic Politics and Strategic Choices: A Theoretical Evaluation of American Grand Strategy in Managing the Rise of China
Authors: Wang Hao
Published: August 2020

The rise and fall of the major powers have been the most fundamental driving force in shaping international systems since the Industrial Revolution. During this recurrent process, the rise of new major powers and their impacts on the established international systems have been the core concern of dominant states. Therefore, American scholars of international politics have been dedicating themselves to the study of how to appropriately manage the rising-versus-dominant-power dyads to maintain the stability of systems and the dominant states’ leading position. On the other hand, from the Chinese perspective, this question is of equal importance and deserves some more attention, because China, as a rising power, needs to be aware of grand strategies that dominant states may adopt in managing potential challengers, both in theory and history. Only in this way could China finally achieve its goal of a peaceful rise. However, after literature review, we found that, partly attributable to the mainstream Realist paradigm, the existing researches have three main deficiencies: ambiguity of analytical levels, lack of case studies and incomplete theoretical construction. Therefore, this paper first summarizes, layers and combines strategies of dominant states in managing the rising powers. Then, it goes beyond the mainstream Realist paradigm, taking into consideration the factors of timing of industrialization, domestic politics and strategic choices, demonstrating that different rising powers, as well as the same rising power in different periods of history, have exerted varying degrees of impacts on the established international systems. Thus, the dominant states should apply targeted grand strategies to manage them. Finally, based on the theoretical and historical research findings, this paper specifically analyzes the US–China relations today, pointing out the problems within American grand strategy in managing the rise of China since 2010, and the theoretically appropriate choice in the future.
Interpreting the Other: Intellectual History and Cultural Difference
Authors: MURALI MALINI
Published: August 2020

This paper argues that higher education in India, especially in the field of humanities and area studies, continues to be a Euro-American inheritance. Even when area studies attempt to offer a critique of the post-Enlightenment construction of universal human nature by locating the human in diverse cultural specificities, the discipline is still unable to configure the ‘context’ outside conceptual boundaries of the West. For instance, studies of culture seem to take historical narrativity as a cultural universal. That is to say, even when cultures do not privilege clear-cut notions of history or philosophy, the assumption is that it should be possible to unravel the historical or philosophical impulses of these cultures by studying the kind of narratives that the cultures have produced. The primacy of the narrative as the life-giving and meaning-making source in an essentially chaotic world is grounded, it seems to me, in Western onto-theology. This narrative model is incapable of studying mnemocultures (cultures of memory) like India (and Asia), for even when the culture produces diverse and heterogenous narrative weaves like itihasa, purana and kavya, the narrative does not enjoy a privileged status in these cultural forms. These compositions have a performative significance whose meaning is not found or guided by presence of the narrative or its potential for truth and identity. This paper will show that positivist historiographic assumptions regarding cultural forms in the non-West, especially in the Indian context, are ill-equipped to engage with traditions that lie outside the heritage of the West. Such attempts to situate an ancient past as embodied in cultural forms extraneous to the Western metaphysic are really accounts of self-understanding of the latter. The receptions of Keralamahatmyam purana in modern intellectual discourses set against the existence of the purana in living traditions of performance outside the confines of the university will be used as a case in point to elucidate the incapability of existing conceptual categories in the humanities discourse to configure cultural difference.
ICER 2020 virtual conference
Authors: Ko Amy J.
Published: August 2020

While many conferences this spring had to rapidly pivot to online, giving them little time to innovate, the ACM International Computing Education Research (ICER) conference announced 6 months before our conference. This was a blessing, in that we had the time to try to design an outstanding conference experience. But it was also a curse. Is an outstanding conference experience even possible? By August, will anyone want to be online at all? We set out to try to design a great experience, learning from every past online conference organizer we could find, and from our community.
SIGCSE Technical Symposium 2021 call for papers
Authors: Sherriff Mark , Merkle Larry , Cutter Pam , Monge Alvaro , Sheard Judy
Published: August 2020

The SIGCSE 2021 leadership team wants to express support for the movement in the United States and around the world decrying racial inequality. The protests and conversations calling for reform reinforce the need for dramatic change in society.
Member spotlight
Authors: Davis Karen
Published: August 2020

In this feature of the Bulletin, we highlight members of the SIGCSE community. In this issue, Bulletin co-editor Karen Davis interviewed Dr. Manuel A. Pérez-Quiñones.
An Efficient Nodes Failure Recovery Management Algorithm for Mobile Sensor Networks
Authors: Jadoon Rab Nawaz , Awan Adnan Anwar , Khan Muhammad Amir , Zhou WuYang , Shahzad Aamir
Published: August 2020

Wireless sensor networks are not prone to harsh environments and may fail due to various reasons. Failure of sensor nodes causes partitioning of network into various small segments and restricts the communication of nodes. Due to the significant importance of restoration mechanisms, many approaches have been proposed in the literature so far. However, these approaches do not focus on uniform distribution of sensor nodes before the occurrence of failure. This paper fulfills the shortcoming in the literature by proposing a Uniform Distribution and Recovery Algorithm (UDRA) in two parts. The first part (prefailure algorithm) focuses on preparing the mobile sensor nodes to be ready for the failure beforehand by maintaining half of their communication distance between them. Also, it uses a novel method of directional matrix based on one-hop information. By using this method, each mobile node declares itself as cut-vertex (CV), intermediate node, or leaf node. The second part of the algorithm (postfailure algorithm) gives complete recovery procedure in the network by its recovery nodes. The extensive simulations prove that the proposed algorithm supersedes the existing approaches.
Epidemiological Characteristics of Meningococcal Meningitis (2016 to 2018) Four Years after the Introduction of Serogroup A Meningococcal Conjugate Vaccine in Benin
Authors: Godjedo Togbemabou Primous Martial , Agbankpe Alidehou Jerrold , Paraiso Moussiliou Noël , Dougnon Tamegnon Victorien , Hidjo Marie , Baba-Moussa Lamine , Bankole Honore
Published: August 2020

Objectives. This study aims to study the epidemiological and geographic characteristics of the meningococcal serogroups four years after the introduction of serogroup A meningococcal conjugate vaccine. Methods. This is a prospective, descriptive, analytical study, and it took place from 2016 to 2018. Cerebrospinal fluid (CSF) samples were taken after the identification of meningitis cases. The samples, thus, taken were sent to the laboratory for culture and identification of Neisseria meningitidis in accordance with WHO standards. Results. Eight hundred and ninety-nine bacterial strains were identified, of which 219 were strains of Neisseria meningitidis. The majority of N. meningitidis-positive samples were from male patients (59.8%) with a median age of 4 (IQR: 1–13). Four of N. meningitidis serogroups were identified, namely, serogroups C (6.8%), W (19.6%), X (1.8%), and A (0.5%). Geographically, 92.7% of the identified N. meningitidis serogroups came from patients who lived in the northern region of the country. The departments most concerned were Alibori (N. meningitidis C (66.7%) and N. meningitidis W (20.9%)); Atacora (N. meningitidis W (41.9%), N. meningitidis X (75.0%), and N. meningitidis C (13.3%)); and Borgou (N. meningitidis W (23.3%)). Conclusion. The results of this study showed that there is an emergence of cases of meningococcal of serogroup C four years after the introduction of MenAfricVac in Benin. These results demonstrated the effectiveness of case-by-case surveillance in detecting small changes in the distribution of serogroups that could have important implications for public health strategies in the coming seasons.