bluuebunny/crossref_metadata_2025 huggingface dataset:
Goal Clarity, Trust in Management and Intention to Stay: The Mediating Role of Work Engagement
Authors: Bellamkonda Neha , Santhanam Nivethitha , Pattusamy Murugan
Published: November 2020

Drawing from the Job Demands-Resources (JD-R) theory, the study explores the relationship between goal clarity, trust in management, work–family conflict and intention to stay among managers in the IT and Information Technology Enabled Service sectors. It also analyses the mediating role of employee engagement in the relationship between job resources (i.e., goal clarity and trust in management), job demands (i.e., work–family conflict) and intention to stay. Data were collected through a structured questionnaire from 200 managerial level employees in India. The model was tested using structural equation modelling techniques. Results indicate that employee engagement fully mediates the relationship between goal clarity, trust in management and intention to stay. This study makes significant theoretical contributions by exploring and establishing the relationship between goal clarity and intention to stay. It also contributes to relevant literature by demonstrating the mediating effects of employee engagement with goal clarity, trust in management and intention to stay of managerial level employees. In addition, this article describes the practical implications of work engagement and intention to stay.
Audience Costs and China’s South China Sea Policy
Authors: Moore Gregory J. , Primiano Christopher B.
Published: November 2020

China’s island building in the South China Sea has received considerable attention from scholars, the media and policy-related officials in recent years. In this article, we conduct a survey to assess the opinions of Chinese university students as it regards their views of any moves by the Chinese government to retreat from its island building and the South China Sea claims due to international pressure. Since China has laid claim to much of the South China Sea via its ‘nine-dash line’, if it were to reverse course and retreat from its man-made islands or remove military installations, how would that play out domestically? Would the Chinese government incur audience costs for doing so? We hypothesise that it would. More specifically, we find it likely that Chinese university students would seek to hold their government accountable for claims to the South China Sea that it has made recently, making it more difficult for the government to retreat from or otherwise adopt a more flexible policy on the South China Sea if it chose to do so. The findings are significant for the audience costs literature, Chinese foreign policy, and South China Sea territoriality studies, in addition to having important policy implications.
Patients’ Experiences About Exercise Prescription and Education in the Physiotherapy Management of Nonspecific Low-Back Pain
Authors: Ogwumike Omoyemi O , Bashir-Bello Fatima , Kaka Bashir
Published: November 2020

Low-back pain (LBP) is highly prevalent in the society, and its socioeconomic consequences are quite evident. Physiotherapists play a prominent role in the management of individuals with this condition, and it is, therefore, of utmost importance that physiotherapists engage in the most efficient and effective management practices available. For perceptions of good performance and quality health care, patient experience is an important indicator of effective care and management. A mixed-methods research design—a cross-sectional survey (quantitative research) and a focus group discussion (FGD; qualitative research)—was employed in this study, investigating patients’ experience in physiotherapy management of nonspecific LBP. An adapted questionnaire was used for data collection from purposively selected participants recruited from 3 hospitals in Kubwa, Abuja, from April to August 2018. The FGD involved 6 patients recruited by simple random sampling using the fishbowl technique. Descriptive and thematic analyses were done on data collected. A total of 126 patients (male = 41, female = 85) were included, with a mean age of 51.0 ± 14.6 years, while the modal age-group was 60 to 69 years. Of these, 41 (32.5%) had nonspecific LBP for less than a year, and the 2 most applied interventions were exercise and heat therapy, followed by education/advice. In all, 110 (87.3%) reported positive experience about education, while 119 (94.4%) reported positive experience about exercise prescription. The result from the qualitative research is in conformity with that of the quantitative analysis. Patients with nonspecific LBP received adequate education regarding their condition and had good experience in the course of their physiotherapy management.
African Christianity and the Intersection of Faith, Traditional, and Biomedical Healing
Authors: Boyo Bernard , Bowen Michael , Kariuki-Githinji Scholastica , Kombo James
Published: November 2020

Africa has witnessed an increase of clergy who favor faith healing but have little appreciation for modern medicine. The intersection between African traditional healing and faith healing remains unclear, with most curricula in theological and Bible schools failing to address these fundamental issues. Research was conducted to establish the intersection between faith, traditional, and biomedical healing. The findings show that faith healing is practiced by nearly three-fourths of the respondents and that African Instituted Churches give relatively more attention to practices of faith healing than do other denominations.
Developing Educational Escape Rooms for Experiential Entrepreneurship Education
Authors: Martina Richard A. , Göksen Sultan
Published: November 2020

Educational escape rooms (EERs) are increasingly used in education as learning innovations for non-digital and game-based learning (GBL) since EERs positively influence student motivation. They are common in educational fields where skills developments are vital such as STEM subjects and healthcare. However, EERs are marginally implemented in entrepreneurship education (EE) because there is a lack of evaluated design elements to guide the creation of EER in this context, which hampers their wider adoption. Therefore, in this study, we evaluated design elements for EERs in EE. We are particularly concerned with experiential EE since EERs are well suited for experiential learning. We used a research-through-design approach and created an EER based on 11 design elements derived from the literature on social cognitive theory, entrepreneurship competence, and gamification. We created and evaluated the EER in two cycles with two diverse groups of students at a university of applied sciences in the Netherlands. We contribute to the literature and practice of experiential EE by presenting evaluated design elements for EERs. We show which design elements work well and which do not. We also present a comprehensively designed EER that educational professionals can implement in their experiential EE programs.
Post-impact damage tolerance of natural fibre-reinforced sheet moulding compound
Authors: Patel Harish K , Peijs Ton
Published: November 2020

Natural fibre composites are of interest for a wide range of semi-structural applications in the building, construction and automotive sector. For a number of these applications, the evaluation of performance degradation after impact is of some relevance. The present work focused on the influence of fibre volume fraction and fibre surface treatment on the residual load-bearing capability of hemp fibre-reinforced sheet moulding compound (H-SMC) after non-penetrating impacts. Post-impact flexural strength and stiffness of H-SMC decreased linearly with increasing impact energy. At higher impact energy levels, the residual flexural strength of H-SMC improved with increasing fibre volume fraction. However, for the same amount of absorbed energy, the residual strength or damage tolerance capability of glass fibre-reinforced sheet moulding compound was about twice that of H-SMC. Composites based on surface treated hemp fibres showed a slight improvement in residual flexural strength, particularly for systems based on hemp fibres treated with a combined alkaline and silane surface treatment. Surface treated systems showed improved levels of adhesion and increased levels of energy absorption through potential mechanisms such as debonding, pull-out or fibre fibrillation.
Clinical experience with antifibrotics in fibrotic hypersensitivity pneumonitis: a 3-year real-life observational study
Authors: Tzilas Vasilios , Tzouvelekis Argyris , Bouros Evangelos , Karampitsakos Theodoros , Ntassiou Maria , Avdoula Eleni , Trachalaki Athena , Antoniou Katerina , Raghu Ganesh , Bouros Demosthenes
Published: November 2020

Background

Fibrotic hypersensitivity pneumonitis (f-HP) can exhibit a progressive course similar to idiopathic pulmonary fibrosis (IPF). The lack of diagnostic guidelines and randomised controlled trials in this population represent a significant unmet need.

Objectives

To describe our clinical experience with antifibrotics in patients with f-HP.

Material and methods

Retrospective study of 30 patients diagnosed with f-HP upon re-evaluation within a multidisciplinary team discussion of 295 consecutive patients (January 2012 to December 2017) who had been diagnosed initially with IPF at outside facilities and were referred to our centres.

Results

Pirfenidone was initially administered to 14 (46.7%) patients and nintedanib to 16 (53.3%) patients. There were 26 (86.7%) males, with mean±sdage 70.2±8.4 years. The annual rate of decline in forced vital capacity (FVC) % predicted over the 3-year treatment period adjusted for baseline FVC % pred measurement was 4.2% (95% CI 1.9–6.6%, p=0.001) and 7.5% (95% CI 3.3–11.7%; p=0.001) in imputation analysis. The annual rate of decline in diffusing capacity of the lung for carbon monoxide (DLCO) % predicted throughout the 3-year treatment period adjusted for baselineDLCO% pred was 5.7% (95% CI 3.1–8.4%, p<0.001) and 5.8% (95% CI 3.4–8.1%, p<0.001) in imputation analysis. The nature of adverse events was related to the type of antifibrotic agent administered.

Conclusion

In patients with f-HP receiving antifibrotics there is a statistically significant annual decline in FVC % pred andDLCO% pred over a period of 3 years. Prospective randomised trials exceeding 1 year are warranted to determine the long-term efficacy of antifibrotics.
Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging: a pooled analysis of individual patient data
Authors: García Castillo Elena , Alonso Pérez Tamara , Ancochea Julio , Pastor Sanz Maria Teresa , Almagro Pere , Martínez-Camblor Pablo , Miravitlles Marc , Rodríguez-Carballeira Mónica , Navarro Annie , Lamprecht Bernd , Ramírez-García Luna Ana S. , Kaiser Bernhard , Alfageme Inmaculada , Casanova Ciro , Esteban Cristóbal , Soler-Cataluña Juan J. , de-Torres Juan P. , Celli Bartolomé R. , Marín Jose M. , ter Riet Gerben , Sobradillo Patricia , Lange Peter , Garcia-Aymerich Judith , Anto Josep M. , Turner Alice M. , Han MeiLan K. , Langhammer Arnulf , Vikjord Sigrid Anna Aalberg , Sternberg Alice , Leivseth Linda , Bakke Per , Johannessen Ane , Oga Toru , Cosío Borja G. , Echazarreta Andrés , Roche Nicolás , Burgel Pierre-Régis , Sin Don D. , Puhan Milo A. , López-Campos Jose Luis , Carrasco Laura , Soriano Joan B.
Published: November 2020

In 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A–4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems.

We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications.

In total, 17 139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean±sdage was 63.9±9.8 years and 62.9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0.67 (95% CI 0.66–0.68) for GOLD 2015 and 0.65 (95% CI 0.63–0.66) for GOLD 2019.

The new GOLD 2019 classification does not predict mortality better than the previous GOLD 2015 system.
The effect of bronchial thermoplasty on airway volume measured 12 months post-procedure
Authors: Langton David , Banks Ceri , Noble Peter B. , Plummer Virginia , Thien Francis , Donovan Graham M.
Published: November 2020

Bronchial thermoplasty induces atrophy of the airway smooth muscle layer, but the mechanism whereby this improves patient health is unclear. In this study, we use computed tomography (CT) to evaluate the effects of bronchial thermoplasty on airway volume 12 months post-procedure.

10 consecutive patients with severe asthma were evaluated at baseline by the Asthma Control Questionnaire (ACQ), and high-resolution CT at total lung capacity (TLC) and functional residual capacity (FRC). The CT protocol was repeated 4 weeks after the left lung had been treated by bronchial thermoplasty, but prior to right lung treatment, and then again 12 months after both lungs were treated. The CT data were also used to model the implications of including the right middle lobe (RML) in the treatment field.

The mean patient age was 62.7±7.7 years and forced expiratory volume in 1 s (FEV1) 42.9±11.5% predicted. 12 months post-bronchial-thermoplasty, the ACQ improved, from 3.4±1.0 to 1.5±0.9 (p=0.001), as did the frequency of oral steroid-requiring exacerbations (p=0.008).

The total airway volume increased 12 months after bronchial thermoplasty in both the TLC (p=0.03) and the FRC scans (p=0.02). No change in airway volume was observed in the untreated central airways. In the bronchial thermoplasty-treated distal airways, increases in airway volume of 38.4±31.8% at TLC (p=0.03) and 30.0±24.8% at FRC (p=0.01) were observed. The change in distal airway volume was correlated with the improvement in ACQ (r=−0.71, p=0.02). Modelling outputs demonstrated that treating the RML conferred no additional benefit.

Bronchial thermoplasty induces long-term increases in airway volume, which correlate with symptomatic improvement.
Emergency department visits and hospitalisations for asthma, COPD and respiratory tract infections: what is the role of respiratory viruses, and return to school in September, January and March?
Authors: Satia Imran , Adatia Adil , Yaqoob Sarah , Greene Justina M. , O'Byrne Paul M. , Killian Kieran J. , Johnston Neil
Published: November 2020

Background

Asthma exacerbations increase in September coinciding with children returning to school. The aim of this study was to investigate whether this occurs 1) for COPD and respiratory tract infections (RTIs); 2) after school resumes in January and March; and 3) identify which viruses may be responsible.

Methods

Emergency department (ED) visits and admissions for asthma, COPD and RTIs and the prevalence of viruses in Ontario, Canada were analysed daily between 2003 and 2013. ED visits and admissions were provided by the Canadian Institute for Health Information. Viral prevalence was obtained from the Centre for Immunisation and Respiratory Infectious Diseases.

Results

ED visits and admissions rates demonstrated a biphasic pattern. Lowest rates occurred in July and August and the highest rates in September for asthma, and after December for COPD and RTI. The increase in rates for 30 days before and after school return in September was greatest for children with asthma <15 years (2.4–2.6×). Event rates fell after school return in January for all three conditions ranging from 10–25%, and no change followed March break for asthma and COPD. Human rhinovirus was prevalent in summer with a modest relationship to asthma rates in September. The prevalence of respiratory syncytial virus, influenza A and coronavirus was associated with sustained event rates for COPD and RTIs.

Conclusions

Asthma, COPD and RTIs increase in September but do not occur after return to school in January and March. Human rhinovirus is associated with ED visits and admissions only in September.
A phylogenomic study of Steganinae fruit flies (Diptera: Drosophilidae): strong gene tree heterogeneity and evidence for monophyly
Authors: Dias Guilherme Rezende , Dupim Eduardo Guimarães , Vanderlinde Thyago , Mello Beatriz , Carvalho Antonio Bernardo
Published: November 2020

Background

The Drosophilidae family is traditionally divided into two subfamilies: Drosophilinae and Steganinae. This division is based on morphological characters, and the two subfamilies have been treated as monophyletic in most of the literature, but some molecular phylogenies have suggested Steganinae to be paraphyletic. To test the paraphyletic-Steganinae hypothesis, here, we used genomic sequences of eight Drosophilidae (three Steganinae and five Drosophilinae) and two Ephydridae (outgroup) species and inferred the phylogeny for the group based on a dataset of 1,028 orthologous genes present in all species (> 1,000,000 bp). This dataset includes three genera that broke the monophyly of the subfamilies in previous works. To investigate possible biases introduced by small sample sizes and automatic gene annotation, we used the same methods to infer species trees from a set of 10 manually annotated genes that are commonly used in phylogenetics.

Results

Most of the 1,028 gene trees depicted Steganinae as paraphyletic with distinct topologies, but the most common topology depicted it as monophyletic (43.7% of the gene trees). Despite the high levels of gene tree heterogeneity observed, species tree inference in ASTRAL, in PhyloNet, and with the concatenation approach strongly supported the monophyly of both subfamilies for the 1,028-gene dataset. However, when using the concatenation approach to infer a species tree from the smaller set of 10 genes, we recovered Steganinae as a paraphyletic group. The pattern of gene tree heterogeneity was asymmetrical and thus could not be explained solely by incomplete lineage sorting (ILS).

Conclusions

Steganinae was clearly a monophyletic group in the dataset that we analyzed. In addition to ILS, gene tree discordance was possibly the result of introgression, suggesting complex branching processes during the early evolution of Drosophilidae with short speciation intervals and gene flow. Our study highlights the importance of genomic data in elucidating contentious phylogenetic relationships and suggests that phylogenetic inference for drosophilids based on small molecular datasets should be performed cautiously. Finally, we suggest an approach for the correction and cleaning of BUSCO-derived genomic datasets that will be useful to other researchers planning to use this tool for phylogenomic studies.
A holistic view of mouse enhancer architectures reveals analogous pleiotropic effects and correlation with human disease
Authors: Sethi Siddharth , Vorontsov Ilya E. , Kulakovskiy Ivan V. , Greenaway Simon , Williams John , Makeev Vsevolod J. , Brown Steve D. M. , Simon Michelle M. , Mallon Ann-Marie
Published: November 2020

Background

Efforts to elucidate the function of enhancers in vivo are underway but their vast numbers alongside differing enhancer architectures make it difficult to determine their impact on gene activity. By systematically annotating multiple mouse tissues with super- and typical-enhancers, we have explored their relationship with gene function and phenotype.

Results

Though super-enhancers drive high total- and tissue-specific expression of their associated genes, we find that typical-enhancers also contribute heavily to the tissue-specific expression landscape on account of their large numbers in the genome. Unexpectedly, we demonstrate that both enhancer types are preferentially associated with relevant ‘tissue-type’ phenotypes and exhibit no difference in phenotype effect size or pleiotropy. Modelling regulatory data alongside molecular data, we built a predictive model to infer gene-phenotype associations and use this model to predict potentially novel disease-associated genes.

Conclusion

Overall our findings reveal that differing enhancer architectures have a similar impact on mammalian phenotypes whilst harbouring differing cellular and expression effects. Together, our results systematically characterise enhancers with predicted phenotypic traits endorsing the role for both types of enhancers in human disease and disorders.
Uncovering fungal community composition in natural habitat of Ophiocordyceps sinensis using high-throughput sequencing and culture-dependent approaches
Authors: Zhang Chuan-Bo , Ren Chao-Hui , Wang Yan-Li , Wang Qi-Qi , Wang Yun-Sheng , Weng Qing-Bei
Published: November 2020

Background

The fungal communities inhabiting natural Ophiocordyceps sinensis play critical ecological roles in alpine meadow ecosystem, contribute to infect host insect, influence the occurrence of O. sinensis, and are repertoire of potential novel metabolites discovery. However, a comprehensive understanding of fungal communities of O. sinensis remain elusive. Therefore, the present study aimed to unravel fungal communities of natural O. sinensis using combination of high-throughput sequencing and culture-dependent approaches.

Results

A total of 280,519 high-quality sequences, belonging to 5 fungal phyla, 15 classes, 41 orders, 79 families, 112 genera, and 352 putative operational taxonomic units (OTUs) were obtained from natural O. sinensis using high-throughput sequencing. Among of which, 43 genera were identified in external mycelial cortices, Ophiocordyceps, Sebacinia and Archaeorhizomyces were predominant genera with the abundance of 95.86, 1.14, 0.85%, respectively. A total of 66 genera were identified from soil microhabitat, Inocybe, Archaeorhizomyces, unclassified Thelephoraceae, Tomentella, Thelephora, Sebacina, unclassified Ascomycota and unclassified fungi were predominant genera with an average abundance of 53.32, 8.69, 8.12, 8.12, 7.21, 4.6, 3.08 and 3.05%, respectively. The fungal communities in external mycelial cortices were significantly distinct from soil microhabitat. Meanwhile, seven types of culture media were used to isolate culturable fungi at 16 °C, resulted in 77 fungal strains identified by rDNA ITS sequence analysis, belonging to 33 genera, including Ophiocordyceps, Trichoderma, Cytospora, Truncatella, Dactylonectria, Isaria, Cephalosporium, Fusarium, Cosmospora and Paecilomyces, etc.. Among all culturable fungi, Mortierella and Trichoderma were predominant genera.

Conclusions

The significantly differences and overlap in fungal community structure between two approaches highlight that the integration of high-throughput sequencing and culture-dependent approaches would generate more information. Our result reveal a comprehensive understanding of fungal community structure of natural O. sinensis, provide new insight into O. sinensis associated fungi, and support that microbiota of natural O. sinensis is an untapped source for novel bioactive metabolites discovery.
The biological effects of microencapsulated organic acids and botanicals induces tissue-specific and dose-dependent changes to the Gallus gallus microbiota
Authors: Feye Kristina M. , Swaggerty Christina L. , Kogut Michael H. , Ricke Steven C. , Piva Andrea , Grilli Ester
Published: November 2020

Background

Microencapsulated organic acids and botanicals have the potential to develop into important tools for the poultry industry. A blend of organic acids and botanicals (AviPlus®P) has previously shown to reduce Salmonella and Campylobacter in chickens; however, changes to the microbiota of the jejunum and ileum have not been evaluated. Microbiota diversity is linked to, but not correlated with, the efficacy of natural products; therefore, understanding the effects on the microbiota is necessary for evaluating their potential as an antibiotic alternative.

Results

Ileal and jejunal segments from control and supplement-fed chickens (300 and 500 g/metric ton [MT]) were subjected to alpha diversity analysis including Shannon’s diversity and Pielou’s Evenness. In both analytics, the diversity in the ileum was significantly decreased compared to the jejunum irrespective of treatment. Similarly, beta diversity metrics including Bray-Curtis dissimilarity index and Weighted Unifrac Distance Matrix, were significant (Q < 0.05) for both tissue and treatments comparisons. Alpha and beta diversity analytics indicated compartmentalization effects between the ileum and jejunum. Additionally, analysis of communities in the microbiota (ANCOM) analysis showed Lactobacilliaceae predominated the total operational taxonomic units (OTU), with a stepwise increase from 53% in the no treatment control (NTC) to 56% in the 300 g/MT and 67% in the 500 g/MT group. Staphylococcaceae were 2% in NTC and 2 and 0% in 300 and 500 g/MT groups. Enterobacteriaceae decreased in the 500 g/MT (31%) and increased in the 300 g/MT (37%) compared to the NTC (35%). Aerococcaceae was 0% for both doses and 7% in NTC. Ruminococcaceae were 0% in NTC and 2 and 1% in the 300 and 500 g/MT. These changes in the microbial consortia were statistically (Q < 0.05) associated with treatment groups in the jejunum that were not observed in the ileum. Least discriminant analysis effect size (LEfSE) indicated different changes directly corresponding to treatment. Enterobacteriaceae demonstrated a stepwise decrease (from NTC onward) while Clostridiaceae, were significantly increased in the 500 g/MT compared to NTC and 300 g/MT (P < 0.05).

Conclusion

The bioactive site for the microencapsulated blend of organic acids and botanicals was the jejunum, and dietary inclusion enhanced the GIT microbiota and may be a viable antibiotic alternative for the poultry industry.
Comparison of three neutralizing broths for environmental sampling of low levels of Listeria monocytogenes desiccated on stainless steel surfaces and exposed to quaternary ammonium compounds
Authors: Li Fengmin , Xian Zhihan , Kwon Hee Jin , Yoo Jiyoon , Burall Laurel , Chirtel Stuart J. , Hammack Thomas S. , Chen Yi
Published: November 2020

Background

An effective environmental sampling method involves the use of a transport/neutralizing broth with the ability to neutralize sanitizer residues that are collected during sampling and to maintain viability of stressed Listeria monocytogenes (Lm) cells.

Results

We applied Lm onto stainless steel surfaces and then subjected Lm to desiccation stress for 16–18 h at room temperature (RT, 21–24 °C). This was followed by the subsequent application of Whisper™ V, a quaternary ammonium compound (QAC)-based sanitizer, diluted to 400 ppm and 8000 ppm of active quat, for 6 h. We then sampled Lm with sponges pre-moistened in three transport broths, Dey/Engley (D/E) broth, Letheen broth and HiCap™ broth, to generate environmental samples that contained sanitizer residues and low levels of stressed Lm, which were subsequently analyzed by an enrichment-based method. This scheme conformed with validation guidelines of AOAC International by using 20 environmental test portions per broth that contained low levels of Lm such that not all test portions were positive (i.e., fractional positive). We showed that D/E broth, Letheen broth and HiCap™ broth performed similarly when no quat or 400 ppm of quat was applied to the Lm contaminating stainless steel surfaces. However, when 8000 ppm of quat was applied, Letheen broth did not effectively neutralize the QAC in the samples. These comparisons were performed on samples stored under three conditions after collection to replicate scenarios of sample transport, RT for 2 h, 4 °C for 24 h and 4 °C for 72 h. Comparisons under the three different scenarios generally reached the same conclusions. In addition, we further demonstrated that storing Letheen and HiCap™ broths at RT for two months before sampling did not reduce their capacity to neutralize sanitizers.

Conclusions

We developed a scheme to evaluate the ability of transport broths to neutralize QAC sanitizers. The three transport broths performed similarly with a commonly used concentration of quat, but Letheen broth could not effectively neutralize a very high concentration of QAC. The performance of transport broths was not significantly affected under the assessed pre-sampling and post-sampling storage conditions.
Helicopter emergency medical service (HEMS) activity after increased distance to out-of-hours services: an observational study from Norway
Authors: Nystøyl Dag Ståle , Røislien Jo , Østerås Øyvind , Hunskaar Steinar , Breidablik Hans Johan , Zakariassen Erik
Published: November 2020

Background

Organizational changes in out-of-hour (OOH) services may have unintended consequences for other prehospital services. Reports indicate an increased use of helicopter emergency medical services (HEMS) after changes in OOH services in Norway due to greater geographical distances for the on-call doctors. We investigated whether HEMS dispatches increased when nine municipalities in Sogn og Fjordane County merged into one large inter-municipal OOH district.

Methods

All primary dispatches of the HEMS in the county between 2004 and 2013 were included. We applied interrupted time series regression to monthly aggregated data to evaluate the impact of the organizational change 1 April 2009. The nine target municipalities were compared to the rest of the municipalities in the county, which served as a control group. A quasipoisson model adjusted for seasonality was found to be most applicable.

Results

We included 8,751 dispatches, 5,009 (57.2%) of which were completed with a patient encounter. Overall, we found no alteration in requests for HEMS after 2009 (p = 0.251). Separate analyses of the target municipalities and control group revealed no significant increase after 2009 (p = 0.400 andp = 0.056, respectively). When categorizing the municipalities into urban or rural, we found a general increase in HEMS dispatches for the rural group over the 10-year span (p = 0.045) but no added increase after 2009 (p = 0.502). The urban subgroup showed no change. Distance from the OOH service in regards to travel increased within the nine municipalities after 2009, median [quartiles] (5.0[3.0, 6.2] km vs 26.5[5.0, 62.2] km,p < 0.001).

Conclusion

After relocating nine local OOH services into one large inter-municipal OOH district, we found no increase in requests for HEMS.
Heterogeneity of Baló’s concentric sclerosis: a study of eight cases with different therapeutic concepts
Authors: Tzanetakos D. , Vakrakou A. G. , Tzartos J. S. , Velonakis G. , Evangelopoulos M. E. , Anagnostouli M. , Koutsis G. , Dardiotis E. , Karavasilis E. , Toulas P. , Stefanis L. , Kilidireas C.
Published: November 2020

Background

Baló’s Concentric Sclerosis (BCS) is a rare heterogeneous demyelinating disease with a variety of phenotypes on Magnetic Resonance Imaging (MRI). Existing literature lacks data especially on the therapeutic approach of the disease which we intended to elucidate by means of suggesting a new possible BCS classification and introducing different therapeutic concepts based on each BCS-subgroup characteristics.

Methods

We present a retrospective study of eight treated patients with BCS-type lesions, emphasizing on MRI characteristics and differences on therapeutic maneuvers.

Results

Data analysis showed: at disease onset the BCS-type lesion was tumefactive (size ≥2 cm) in 6 patients, with a mean size of 2.7 cm (± 0.80 SD); a coexistence of MS-like plaques on brain MRI was identified in 7 patients of our cohort. The mean age was 26.3 years (±7.3 SD) at disease onset and the mean follow-up period was 56.8 months (range 9–132 months). According to radiological characteristics and response to therapies, we further categorized them into 3 subgroups: a) Group-1; BCS with or without coexisting nonspecific white matter lesions; poor response to intravenous methylprednisolone (IVMP); treated with high doses of immunosuppressive agents (4 patients), b) Group-2; BCS with typical MS lesions; good response to IVMP; treated with MS-disease modifying therapies (2 patients), c) Group-3; BCS with typical MS lesions; poor response to IVMP; treated with rituximab (2 patients).

Conclusions

Our study introduces a new insight regarding the categorization of BCS into three subgroups depending on radiological features at onset and during the course of the disease, in combination with the response to different immunotherapies. Immunosuppressive agents such as cyclophosphamide are usually effective in BCS. However, therapeutic alternatives like anti-CD20 monoclonal antibodies or more classical disease-modifying MS therapies can be considered when BCS has also mixed lesions similar to MS. Future studies with a larger sample size are necessary to further establish these findings, thus leading to better treatment algorithms and improved clinical outcomes.
Type of facility influences lengths of stay of children presenting to high volume emergency departments
Authors: Rosychuk Rhonda J. , Rowe Brian H.
Published: November 2020

Background

Emergency department crowding may impact patient and provider outcomes. We describe emergency department crowding metrics based on presentations by children to different categories of high volume emergency departments in Alberta, Canada.

Methods

This population-based retrospective study extracted all presentations made by children (age < 18 years) during April 2010 to March 2015 to 15 high volume emergency departments: five regional, eight urban, and two academic/teaching. Time to physician initial assessment, and length of stay for discharges and admissions were calculated based on the start of presentation and emergency department facility. Multiple metrics, including the medians for hourly, facility-specific time to physician initial assessment and length of stay were obtained.

Results

About half (51.2%) of the 1,124,119 presentations were made to the two academic/teaching emergency departments. Males presented more than females (53.6% vs 46.4%) and the median age was 5 years. Pediatric presentations to the three categories of emergency departments had mostly similar characteristics; however, urban and academic/teaching emergency departments had more severe triage scores and academic/teaching emergency departments had higher admissions. Across all emergency departments, the medians of the metrics for time to physician initial assessment, length of stay for discharges and for admission were 1h11min, 2h21min, and 6h29min, respectively. Generally, regional hospitals had shorter times than urban and academic/teaching hospitals.

Conclusions

Pediatric presentations to high volume emergency departments in this province suggest similar delays to see providers; however, length of stay for discharges and admissions were shorter in regional emergency departments. Crowding is more common in urban and especially academic emergency departments and the impact of crowding on patient outcomes requires further study.
Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study
Authors: Felde Gunhild , Engeland Anders , Hunskaar Steinar
Published: November 2020

Background

Anxiety and depression are in both cross-sectional and longitudinal studies associated with urinary incontinence (UI) in women, strongest for the urgency component of UI. The role of psychotropic drugs in this association, especially antidepressants, has been questioned, but not clarified. The present study aimed to explore the associations between UI and anxiety/depression and the possible impact of psychotropic drugs on these associations.

Methods

We conducted a cross-sectional, population-based study with questionnaire data from 21,803 women ≥20 years in the Norwegian Nord-Trøndelag Health Study merged with the Norwegian Prescription Database, which contains information on all dispensed prescriptions. We used multivariate logistic regression to investigate the association between UI (any UI, and by type and severity) and anxiety/depression (by different score on Hospital anxiety and depression scale), and the influence of psychotropic drugs on this association (by different volume of drug use).

Results

Compared with normal anxiety- and depression score, having moderate/severe anxiety or depression (HADS≥11) increased the prevalence of UI from 27.6 to 37.8% (OR 1.59 (1.40–1.81), p < 0.001) for anxiety and from 28.0 to 43.7% (OR 1.79 (1.46–2.21), p < 0.001) for depression. According to type of UI, mixed UI was most strongly associated with a high HADS-score with an odds ratio 1.84 (1.65–2.05) for anxiety and 1.85 (1.61–2.13) for depression. Compared to no UI, severe UI was associated with depression with odds ratios of 2.04 (1.74–2.40), compared with no UI. Psychotropic drug use did not influence the associations between UI and anxiety/depression. We found high prevalence of UI among users of various psychotropic drugs. After adjustments, only antidepressants were associated with UI, with OR 1.36 (1.08–1.71) for high defined daily dose of the drug. Anxiolytics were associated with less UI with OR 0.64 (0.45–0.91) after adjustments for anxiety.

Conclusion

This study showed that anxiety, depression and use of antidepressants are associated factors with UI, strongest for urgency and mixed type of UI, with increasing ORs by increasing severity of the conditions and increased daily dose of the medication. Use of antidepressants did not influence the associations between UI and anxiety/depression.
The burden and predisposing factors of non-communicable diseases in Mashhad University of Medical Sciences personnel: a prospective 15-year organizational cohort study protocol and baseline assessment
Authors: Tohidinezhad Fariba , Khorsand Ali , Zakavi Seyed Rasoul , Rezvani Reza , Zarei-Ghanavati Siamak , Abrishami Majid , Moradi Ali , Tavakoli Mahmoud , Farrokh Donya , Rad Masoud Pezeshki , Abbasi Bita , Ahadi Mitra , Saleh Lahya Afshari , Tayebi Mohammad , Amini Mahnaz , Poustchi Hossein , Abu-Hanna Ameen , Eslami Saeid
Published: November 2020

Background

The rising burden of premature mortality for Non-Communicable Diseases (NCDs) in developing countries necessitates the institutionalization of a comprehensive surveillance framework to track trends and provide evidence to design, implement, and evaluate preventive strategies. This study aims to conduct an organization-based prospective cohort study on the NCDs and NCD-related secondary outcomes in adult personnel of the Mashhad University of Medical Sciences (MUMS) as main target population.

Methods

This study was designed to recruit 12,000 adults aged between 30 and 70 years for 15 years. Baseline assessment includes a wide range of established NCD risk factors obtaining by face-to-face interview or examination. The questionnaires consist of demographic and socioeconomic characteristics, lifestyle pattern, fuel consumption and pesticide exposures, occupational history and hazards, personal and familial medical history, medication profile, oral hygiene, reproduction history, dietary intake, and psychological conditions. Examinations include body size and composition test, abdominopelvic and thyroid ultrasonography, orthopedic evaluation, pulse wave velocity test, electrocardiography, blood pressure measurement, smell-taste evaluation, spirometry, mammography, and preferred tea temperature assessment. Routine biochemical, cell count, and fecal occult blood tests are also performed, and the biological samples (i.e., blood, urine, hair, and nail) are stored in preserving temperature. Annual telephone interviews and repeated examinations at 5-year intervals are planned to update information on health status and its determinants.

Results

A total of 5287 individuals (mean age of 43.9 ± 7.6 and 45.9% male) were included in the study thus far. About 18.5% were nurses and midwives and 44.2% had at least bachelor’s degree. Fatty liver (15.4%), thyroid disorders (11.2%), hypertension (8.8%), and diabetes (4.9%) were the most prevalent NCDs. A large proportion of the population had some degree of anxiety (64.2%). Low physical activity (13 ± 22.4 min per day), high calorie intake (3079 ± 1252), and poor pulse-wave velocity (7.2 ± 1.6 m/s) highlight the need for strategies to improve lifestyle behaviors.

Conclusion

The PERSIAN Organizational Cohort study in Mashhad University of Medical Sciences is the first organizational cohort study in a metropolitan city of Iran aiming to provide a large data repository on the prevalence and risk factors of the NCDs in a developing country for future national and international research cooperation.
Sex differences in the trajectories of and factors related to extracurricular sport participation and exercise: a cohort study spanning 13 years
Authors: Wu Wen-Chi , Chang Ling-Yin , Luh Dih-Ling , Wu Chi-Chen , Stanaway Fiona , Yen Lee-Lan , Chang Hsing-Yi
Published: November 2020

Background

Extracurricular sport participation and exercise (ESPE) refers to regular exercise/sport participation in addition to the physical education in school among a school-aged population. Rather than general physical activity, ESPE is typically deliberately initiated and presents an efficient target for interventions. However, compared to physical activity, relatively few studies have investigated sex differences in the development of and factors associated with ESPE using a person-centered approach. This study aimed to examine the latent trajectories of ESPE from childhood to emerging adulthood across sexes, and to identify the associated sex-specific individual (i.e., body mass index, body dissatisfaction, stress, and screen behavior) and parental (i.e., parental exercise and parental screen behavior) factors.

Methods

This study used data from part of the Child and Adolescent Behavior in Long-term Evolution (CABLE) project, which comprised 2072 fourth graders (aged 9 years) in Northern Taiwan followed annually from 2001 to 2013 (13 waves). Repeated-measures latent class analysis was used to identify the trajectories of ESPE for males and females, respectively. Multinomial logistic regression was further used to identify sex-specific factors related to ESPE.

Results

Four trajectories of ESPE were identified for males and females. For males, these trajectories were Rarely-to-Never (20%), Often-to-Rarely (32%), Always-to-Never (21%), and Always (27%). For females, these trajectories were Rarely-to-Never (34%), Rarely (23%), Always-to-Rarely (33%), and Always (10%). We observed that the developmental patterns of ESPE varied by sex such that there was an earlier decline in the trajectories of ESPE in females than in males and that, compared with males, fewer females maintained exercise habits in young adulthood. Furthermore, we found several sex-specific factors related to ESPE, namely, stress, BMI, and parental exercise. Body dissatisfaction and individual screen behavior were associated with trajectories of ESPE for both sexes.

Conclusions

We found distinct trajectories of ESPE from childhood to emerging adulthood for both sexes. The trajectories of ESPE for males and females, however, differ in terms of patterns and associated factors. Our findings suggest that efforts to increase ESPE should be initiated early, and may be made more effective by considering sex differences.
Retrograde ureteric stent insertion from percutaneous suprapubic access to the bladder in renal transplant recipients with ureteric stenosis: a novel minimally invasive technique
Authors: Wu Jian-Hui , Mo Chun-Bai , Dong-Zhai Li , Luo Fei , Ma Qing-Tong , Yang Shi-Qiang
Published: November 2020

Background

Ureteric stricture is a common and salvaging complications after renal transplantation. Two treatment methods are usually used, retrograde ureteral stent placement and percutaneous nephrostomy. The former has a higher failure rate, the latter has a great risk. Therefore, a safe and reliable treatment is needed.

Case presentation

A technique of retrograde insertion of ureteral stent was established, which was applicable in three transplant recipients with post-transplant ureteral stenosis, and the data was retrospectively recorded. The patients are 2 men and 1 woman, ages 44, 27 and 32 years. These patients underwent a total of five times of retrograde insertion of ureteral stent between 2018 and 2019. None of these patients had any postoperative complication, but all patients had complete recovery from oliguric status within two weeks.

Conclusions

The retrograde ureteric stent insertion by percutaneous suprapubic access to the bladder (RUS-PSAB) was demonstrated feasibility and safety in a case series with short-term follow-up. However, larger prospective studies are needed.
Knowledge of dental academics about the COVID-19 pandemic: a multi-country online survey
Authors: Ammar Nour , Aly Nourhan M. , Folayan Morenike O. , Mohebbi Simin Z. , Attia Sameh , Howaldt Hans-Peter , Boettger Sebastian , Khader Yousef , Maharani Diah A. , Rahardjo Anton , Khan Imran , Madi Marwa , Shamala Anas , Al-Batayneh Ola B. , Rashwan Maher , Pavlic Verica , Cicmil Smiljka , Galluccio Gabriella , Polimeni Antonella , Mancino Davide , Arheiam Arheiam , Dama Mai A. , Nyan Myat , Phantumvanit Prathip , Kim Jin-Bom , Choi Youn-Hee , Castillo Jorge L. , Joury Easter , Abdelsalam Maha M. , Alkeshan Mohammad M. , Hussein Iyad , Vukovic Ana P. , Iandolo Alfredo , Kemoli Arthur M. , El Tantawi Maha
Published: November 2020

Background

COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries.

Methods

We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants’ background variables. Multilevel linear models were used to assess the association between dental academics’ knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries.

Results

Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007).

Conclusions

Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need.
Correction to: InsP3R-SEC5 interaction on phagosomes modulates innate immunity to Candida albicans by promoting cytosolic Ca 2+ elevation and TBK1 activity
Authors: Yang Long , Gu Wenwen , Cheung King-Ho , Yan Lan , Tong Benjamin Chun-Kit , Jiang Yuanying , Yang Jun
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.