bluuebunny/crossref_metadata_2025 huggingface dataset:
Containing COVID‐19 in the Emergency Department: The Role of Improved Case Detection and Segregation of Suspect Cases
Authors: Wee Liang E. , Fua Tzay‐Ping , Chua Ying Y. , Ho Andrew F. W. , Sim Xiang Y. J. , Conceicao Edwin P. , Venkatachalam Indumathi , Tan Kenneth B.‐K. , Tan Ban H.
Published: April 2020

Objectives

Patients with COVID‐19 may present with respiratory syndromes indistinguishable from common viruses. This poses a challenge for early detection during triage in the emergency department (ED). Over a 3‐month period, our ED aimed to minimize nosocomial transmission by using broader suspect case criteria for better detection and using appropriate personal protective equipment (PPE) for health care workers (HCWs).

Methods

All ED admissions with respiratory syndromes over a 3‐month period were tested for COVID‐19. The sensitivity and specificity of screening criteria in detecting COVID‐19 were assessed. A risk‐stratified approach was adopted for PPE usage in the ED, based on high‐risk “fever areas” and lower‐risk zones. When a case of COVID‐19 was confirmed, surveillance was conducted for potentially exposed patients and HCWs.

Results

A total of 1,841 cases presenting with respiratory syndromes required admission over the study period. Among these, 70 cases of COVID‐19 were subsequently confirmed. The majority (84.2%, 59/70) were detected at ED triage because they fulfilled suspect case criteria. Of these, 34 met the official screening criteria; an additional 25 were detected by the broader internal screening criteria. Over the 12‐week period, the cumulative sensitivity of internal screening criteria was 84.3% (95% confidence interval [CI] = 73.6% to 91.9%), whereas the sensitivity of the official screening criteria was 48.6% (95% CI = 36.4% to 60.8%). Given the broadened internal criteria, the preexisting ED “fever area” was insufficient and had to be expanded. However, there were no cases of nosocomial transmission from intra‐ED exposure, despite extensive surveillance.

Conclusion

Frontline physicians need to be given leeway to decide on the disposition of cases based on clinical suspicion during an ongoing outbreak of COVID‐19. If a broader criterion is used at ED triage, ED facilities and isolation facilities need to be readied to accommodate a surge of suspect cases. Usage of appropriate PPE is essential in minimizing nosocomial transmission.
The very old in intensive care: Admission characteristics, mortality and supports needed at six months postdischarge
Authors: Tsang Jessica , Bloomfield Katherine , Lawrey Ywain , Wu Zhenqiang , Connolly Martin J.
Published: April 2020

Objective

To describe survival and six‐month outcomes (residence, community supports) in the very old (≥80 years) admitted to intensive care in Waitemata District Health Board, New Zealand.

Methods

Hospital records of patients 80 years and over admitted from August 2015 to June 2017 were reviewed.

Results

One hundred and seventeen patients were admitted (median age: 83). Standard ICU risk scores predicted survival to hospital discharge. Patients admitted electively were more likely to survive to discharge than emergency ICU/HDU admissions (P = .007). Ninety‐two (79%) survived to hospital discharge, and 84 (72%) survived to 6 months. Eighty‐four were discharged home (91% of survivors), and 79 were living at home at 6 months (94% of survivors). Community supports increased from admission (34, 29%) to 6 months later (34, 43% of community dwellers). Forty‐four (47.8% surviving to discharge) were readmitted within 6 months.

Conclusions

Most patients are alive at discharge and 6 months, with a majority requiring no formal supports.
Can Industry‐level Trade Linkage Predict Stock Returns?
Authors: Lim Tae‐Hoon
Published: April 2020

In this paper, I test whether cross‐predictability exists among trade‐linked industries across international borders and explore possible explanations for this. I find strong evidence of cross‐border stock return predictability among trade‐linked industries. A trading strategy of buying industry portfolios for which trade‐linked industry had high returns, and shorting industry portfolios for which trade‐linked industry had low returns, yields an annualized return of 12%. Such returns cannot be explained by known risk factors and are different from industry momentum. I find some evidence that counters the information segmentation explanation for cross‐predictability and find support for illiquidity as a new channel of explanation.
Gender and occupational allergy: Report from the task force of the EAACI Environmental and Occupational Allergy Interest Group
Authors: Moscato Gianna , Apfelbacher Christian , Brockow Knut , Eberle Chiara , Genuneit Jon , Mortz Charlotte G. , Quecchia Cristina , Quirce Santiago , Siracusa Andrea , Tarlo Susan Mary , van Kampen Vera , Walusiak‐Skorupa Jolanta , Raulf Monika
Published: April 2020

Women's work has traditionally been considered less hazardous to health in comparison with men's work. The increased women's participation in the workforce has led to an increased attention to women's working conditions. Women and men are unequally represented in individual professions or sectors (horizontal segregation), with women also under‐represented in leadership positions (vertical segregation). The selection of specific occupations can result in differences between types and levels of occupational exposures among women and men and can affect prevalence of occupational allergy. Gender distribution of work‐related asthma appears to vary across countries without clear global difference. Occupational rhinitis tends to be higher in women, although is not clear if this is related to a sex/gender effect or to differences in work exposure. Women are more likely to have occupational contact dermatitis, mainly due to wet work. No clear effects of gender on rates of hypersensitivity pneumonitis have been shown. Besides variation in exposures, physical and physiological characteristics, different behaviours and health consciousness have an impact on the occupational health hazards of women and men. Occupational allergy health promotion strategies need to consider approaches for women and men adjusted by gender, and legislative actions similarly could be implemented in a more gender‐sensitive way.
Evolution of pediatric ventricular assist devices and their neurologic and renal complications—A 24‐year single‐center experience
Authors: Mantell Benjamin , Addonizio Linda , Jain Namrata , LaPar Damien , Chai Paul , Bacha Emile , Kalfa David , McAllister Jennie , Zuckerman Warren , Lee Teresa , Richmond Marc , Law Sabrina
Published: April 2020

Utilization of ventricular assist devices (VADs) in adult populations with severe heart failure as a bridge to transplant has become the standard of care over the past two decades. Analogously, the use of VADs in pediatric populations has become more commonplace as pediatric heart transplantation has become more prevalent. We still have much to learn, however, about the complications after VAD placement in pediatric patients, their impact on transplantation and, in particular, how outcomes have changed over time. The objectives of this study were to (a) review the experience of a single pediatric VAD center, (b) identify risk factors that could lead to poor outcomes in patients on the transplant waitlist after VAD implantation and (c) demonstrate changes in outcomes over time. A retrospective cohort analysis was performed comparing death as a primary outcome and stroke and acute kidney injury (AKI) as secondary outcomes, across the study period divided into three timed eras. We analyzed 88 patients supported by a VAD over a 24‐year timeframe. The duration, age at implant and indication for VAD support did not change significantly across the eras. We found that the incidence of stroke decreased over the study period and, while the rates of AKI did not change over the study period, those who developed AKI, while supported on VAD, had an increased risk of death.
Erythrocyte morphometry in teleost fish—Species‐specific, inter‐individual and environmental‐related differences
Authors: Lahnsteiner Franz
Published: April 2020

The present study investigated erythrocyte morphometry of 10 teleost species, Clarias gariepinus, Coregonus marena, Cyprinus carpio, Onchorynchus mykiss, Perca fluviatilis, Thymallus thymallus, Tinca tinca, Salmo trutta f. lacustris, Salvelinus fontinalis and Salvelinus umbla. Significant inter‐individual differences in erythrocyte morphometric parameters were found in all investigated species. Also significant species‐specific differences were observed, which were not related to their systematic position. The genetically fixed temperature optimum of the species correlated significantly and negatively with erythrocyte cell volume, cytoplasm volume, and cell surface and positively with erythrocyte surface to volume ratio indicating that erythrocyte morphometry is influenced by environmental parameters. In all investigated species, erythrocyte morphometry changed with the age of the fish as their size (cell volume and surface, cytoplasm volume) increased significantly in older ones. Changes in the surface to volume ratios were less evident as a significant decrease was only found in S. umbla and T. tinca.
Bayesian analysis of survival data with missing censoring indicators
Authors: Brownstein Naomi C. , Bunn Veronica , Castro Luis M. , Sinha Debajyoti
Published: April 2020

In some large clinical studies, it may be impractical to perform the physical examination to every subject at his/her last monitoring time in order to diagnose the occurrence of the event of interest. This gives rise to survival data with missing censoring indicators where the probability of missing may depend on time of last monitoring and some covariates. We present a fully Bayesian semi‐parametric method for such survival data to estimate regression parameters of the proportional hazards model of Cox. Theoretical investigation and simulation studies show that our method performs better than competing methods. We apply the proposed method to analyze the survival data with missing censoring indicators from the Orofacial Pain: Prospective Evaluation and Risk Assessment study.
The effect of economic inequality on young children's prosocial decision‐making
Authors: Kirkland Kelly , Jetten Jolanda , Nielsen Mark
Published: April 2020

An emerging body of literature has documented the negative implications high economic inequality can have on children's social and cognitive development. However, little experimental research has directly addressed how wealth discrepancies impact the way children treat others. The current study thus aimed to address the implications of economic inequality on prosocial decision‐making in children prior to commencing formal schooling. Using a novel experimental paradigm, we immersed 4‐year‐old children (N = 58) in a series of games where they played against puppets for rewards. During this process, children were exposed to resource allocations featuring either high inequality or low inequality. We subsequently measured children's donation behaviour, resource division behaviour, and fairness perceptions. As predicted, children were less altruistic when exposed to high inequality compared to low inequality. Contrary to predictions, there was no difference in resource division behaviour or fairness perceptions. This study documents for the first time that exposure to environmental inequality, even if brief and in a controlled experimental setting, can influence young children's prosocial decision‐making.

Statement of contribution

What is already known on the subject?

Adults tend to be less prosocial towards others after experiencing high economic inequality.

Young children understand when outcomes are unequal.

Young children also have a rudimentary understanding of what is fair.

What does this study adds?

A novel experimental design was utilized to immerse children in a safe experimental economy.

Pre‐schoolers are less altruistic after experiencing high inequality compared to low inequality.

Children did not attempt to adjust prior inequalities in their resource division behaviour.
Management of large renal stones with super‐mini percutaneous nephrolithotomy: an international multicentre comparative study
Authors: Liu Yang , Cai Chao , Aquino Albert , Al‐Mousawi Shabir , Zhang Xuepei , Choong Simon K.S. , He Xiang , Fan Xianming , Chen Bin , Feng Jianhua , Zhu Xuhui , Al‐Naimi Abdulla , Mao Houping , Tang Huilong , Jin Dayong , Li Xiancheng , Cao Fenghong , Jiang Hua , Long Yongfu , Zhang Wei , Wang Gang , Xu Zihao , Zhang Xin , Yin Shanfeng , Zeng Guohua
Published: April 2020

Objectives

To comparatively evaluate the clinical outcomes of super‐mini percutaneous nephrolithotomy (SMP) and mini‐percutaneous nephrolithotomy (Miniperc) for treating urinary tract calculi of >2 cm.

Patients and Methods

An international multicentre, retrospective cohort study was conducted at 20 tertiary care hospitals across five countries (China, the Philippines, Qatar, UK, and Kuwait) between April 2016 and May 2019. SMP and Miniperc were performed in 3525 patients with renal calculi with diameters of >2 cm. The primary endpoint was the stone‐free rate (SFR). The secondary outcomes included: blood loss, operating time, postoperative pain scores, auxiliary procedures, complications, tubeless rate, and hospital stay. Propensity score matching analysis was used to balance the selection bias between the two groups.

Results

In all, 2012 and 1513 patients underwent SMP and Miniperc, respectively. After matching, 1380 patients from each group were included for further analysis. Overall, there was no significant difference in the mean operating time or SFR between the two groups. However, the hospital stay and postoperative pain score were significantly in favour of SMP (both P < 0.001). The tubeless rate was significantly higher in the SMP group (72.6% vs 57.8%, P < 0.001). Postoperative fever was much more common in the Miniperc group (12.0% vs 8.4%, P = 0.002). When the patients were further classified into three subgroups based on stones diameters (2–3, 3–4, and >4 cm). The advantages of SMP were most obvious in the 2–3 cm stone group and diminished as the size of the stone increased, with longer operating time in the latter two subgroups. Compared with Miniperc, the SFR of SMP was comparable for 3–4 cm stones, but lower for >4 cm stones. There was no statistical difference in blood transfusions and renal embolisations between the two groups.

Conclusions

Our data showed that SMP is an ideal treatment option for stones of <4 cm and is more efficacious for stones of 2–3 cm, with lesser postoperative fever, blood loss, and pain compared to Miniperc. SMP was less effective for stones of >4 cm, with a prolonged operating time.
Ant–scale mutualism increases scale infestation, decreases folivory, and disrupts biological control in restored tropical forests
Authors: Kulikowski Andy J.
Published: April 2020

Ant–hemipteran mutualisms can have positive and negative effects on host plants depending on the level of hemipteran infestation and plant protection conferred by ants against folivory. Differential effects of such mutualisms on plant survival are well documented in undisturbed and ant‐invaded systems, but few have explored how anthropogenic disturbance affects interactions between hemipterans and native ant species and what the consequences may be for recovering ecosystems. Within a fragmented landscape in Costa Rica, restored tropical forests harbor a mutualism between the native ant Wasmannia auropunctata and the scale insect Alecanochiton marquesi on the abundant, early‐successional tree Conostegia xalapensis. I added A. marquesi scales to C. xalapensis seedlings and either allowed or excluded W. auropunctata to investigate if this mutualism leads to increased scale infestation, decreased scale mortality, and decreased folivory. I also examined whether these effects are mediated by the percentage of remnant forest cover in the landscape. I found that seedlings with ants excluded had fewer scale insects and higher herbivory than plants with ants present. I also found evidence that scale mortality due to fungal attack and parasitism was higher on ant‐excluded versus ant‐allowed seedlings but only at sites with high surrounding landscape forest cover. Together, these results suggest that mutualisms between scale insects and native ants can promote scale infestation, reduce folivory on native plant species, and potentially disrupt biological control of scale insects in recovering tropical forests. Further, my experiment underscores the importance of remnant tropical forests as sources of biological control in anthropogenically disturbed landscapes.

Abstract in Spanish is available with online material.
High expression of Krüppel‐like factor 5 is associated with poor prognosis in patients with colorectal cancer
Authors: Takagi Yutaka , Sakai Nozomu , Yoshitomi Hideyuki , Furukawa Katsunori , Takayashiki Tsukasa , Kuboki Satoshi , Takano Shigetsugu , Suzuki Daisuke , Kagawa Shingo , Mishima Takashi , Nakadai Eri , Miyauchi Hideaki , Matsubara Hisahiro , Ohtsuka Masayuki
Published: April 2020

Krüppel‐like factor 5 (KLF5) plays an oncogenic role and has diverse functions in cancer cells. However, correlation between KLF5 and clinical outcome has not been determined in patients with colorectal cancer and colorectal liver metastasis. Herein, we analyzed 65 patients with colorectal cancer who developed colorectal liver metastasis. Clinical effects were assessed through immunohistochemical analysis of primary colorectal cancer lesions and metastatic liver lesions. High expression of KLF5 in these tissues correlated with the presence of vascular invasion, elevated serum carbohydrate antigen 19‐9 levels, large diameters of metastatic liver tumors, and poor prognosis following surgery. Multivariate analyses revealed that high expression of KLF5 was an independent prognostic factor. Increased expression of KLF5 in both colorectal cancer primaries and colorectal liver metastasis was significantly associated with shorter overall survival time and time to surgical failure. Krüppel‐like factor 5 expression positively correlated with Ki‐67 and c‐Myc expression in colorectal cancer tissues. In vitro experiments with colon cancer cell lines showed that siRNA knockdown of KLF5 inhibited cell proliferation. Western blot analyses revealed that knockdown of KLF5 expression reduced cyclin D1 and c‐Myc expression. It also impaired the stem cell‐like properties of cancer cells in tumorsphere formation assays. Furthermore, anoikis assay indicated that KLF5 contributed to anoikis resistance. High KLF5 expression is associated with poor prognosis in patients with colorectal cancer and liver metastasis by promoting cell proliferation and cancer stem cell‐like properties.
Activator of thyroid and retinoid receptor increases sorafenib resistance in hepatocellular carcinoma by facilitating the Warburg effect
Authors: Ma Luyuan , Liu Wenpeng , Xu An , Ji Quanbo , Ma Yongfu , Tai Yanhong , Wang Yadong , Shen Chuan , Liu Ying , Wang Tao , Han Juqiang , Zhao Caiyan
Published: April 2020

Sorafenib resistance is a major challenge in the therapy for advanced hepatocellular carcinoma (HCC). However, the underlying molecular mechanisms of HCC resistance to sorafenib remain unclear. Activator of thyroid and retinoid receptor (ACTR, also known as SRC‐3), overexpressed in HCC patients, plays an important oncogenic role in HCC; however, the link between ACTR and sorafenib resistance in HCC is unknown. Our study demonstrated that ACTR was one of the most upregulated genes in sorafenib‐resistant HCC xenografts. ACTR increases sorafenib resistance through regulation of the Warburg effect. ACTR promotes glycolysis through upregulation of glucose uptake, ATP and lactate production, and reduction of the extracellular acidification and the oxygen consumption rates. Glycolysis regulated by ACTR is vital for the susceptibility of HCC to sorafenib in vitro and in vivo. Mechanistically, ACTR knockout or knockdown decreases the expression of glycolytic enzymes. In HCC patients, ACTR expression is positively correlated with glycolytic gene expression and is associated with poorer outcome. Furthermore, ACTR interacts with the central regulator of the Warburg effect, c‐Myc, and promotes its recruitment to glycolytic gene promoters. Our findings provide new clues regarding the role of ACTR as a prospective sensitizing target for sorafenib therapy in HCC.
ASH2L is involved in promotion of endometrial cancer progression via upregulation of PAX2 transcription
Authors: Zeng Kai , Wu Yi , Wang Chunyu , Wang Shengli , Sun Hongmiao , Zou Renlong , Sun Ge , Song Huijuan , Liu Wei , Sun Ning , Wei Shan , Liu Wensu , Su Yingjie , Zhou Tingting , Zhang Yi , Zhao Yue
Published: April 2020

Absent, small or homeotic 2‐like protein (ASH2L) is a core component of a multimeric histone methyltransferase complex that is involved in the maintenance of active transcription, participating in several cancers, however the biological function and molecular mechanism of ASH2L in endometrial cancer (ECa) are largely unknown. Endometrial cancer is a common malignant tumor in women and the incidence of this cancer is on the rise. Estrogen‐ERα signaling, as an oncogenic pathway, plays a crucial role in endometrial carcinogenesis. Therefore, further exploration of the molecular mechanisms around ERα‐mediated gene transcription in ECa would be helpful to the understanding of tumor development and to finding a new therapeutic target for ECa. Here, our study demonstrated that ASH2L was highly expressed in ECa samples, and higher expression of ASH2L was positively correlated with a poor prognosis. Moreover, we identified that ASH2L associated with ERα and that knockdown of ASH2L resulted in decreased expression of a subset of the estrogen‐induced target genes, including paired box 2 (PAX2), an oncogenic gene in ECa. ASH2L was recruited to cis‐regulatory elements in PAX2, thereby altering histone H3K4me3 and H3K27me3 levels, to enhance ERα‐mediated transactivation. Finally, depletion of ASH2L suppressed endometrial cancer cell proliferation and migration. Our findings suggest that ASH2L participates in the promotion of ECa progression, if not totally at least partially, via upregulation of PAX2 transcription.
Epidemiology of episcleritis and scleritis in urban Australia
Authors: Thong Louisa P. , Rogers Sophie L. , Hart Colby T. , Hall Anthony J. , Lim Lyndell L.
Published: April 2020

Importance

The epidemiology of episcleritis and scleritis in Australia is largely unknown.

Background

To determine the incidence, prevalence and clinical characteristics of episcleritis and scleritis in Melbourne.

Design

Retrospective longitudinal study.

Participants

Patients aged ≥18 years with episcleritis or scleritis seen at the Royal Victorian Eye and Ear Hospital from November 2014 to October 2015.

Methods

Medical record review confirmed clinical diagnosis and characteristics. Incidence and prevalence were calculated using estimates of the adult population in areas of Melbourne with ≥30 ocular presentations/year to the emergency department.

Main Outcome Measures

Diagnosis of active episcleritis or scleritis, aetiology, ocular complications and treatments.

Results

From a general population of 3 408 068, we confirmed 149 new and 23 pre‐existing cases of active episcleritis, and 35 new and 23 pre‐existing cases of active scleritis. Incidence per 100 000 person‐years was 4.4 (95% confidence interval [CI] 3.7‐5.1) for episcleritis and 1.0 (95% CI 0.7‐1.4) for scleritis, while 12‐month prevalence was 5.1 (95% CI 4.3‐5.9) and 1.7 (1.3‐2.2) per 100 000 persons, respectively. Systemic disease was associated with 10% of episcleritis compared with 34% of scleritis (P < .001). Ocular complications were seen in 3% (6/184) of episcleritis eyes and 44% (32/72) of scleritis eyes, with the commonest being anterior uveitis (12/72) and ocular hypertension (14/72). At presentation, scleritis patients were commonly treated with oral non‐steroidal anti‐inflammatory drugs (60%) and prednisolone (19%). By 12 months, 24% of scleritis patients required immunosuppressants.

Conclusions and Relevance

Rates of episcleritis and scleritis in our single‐centre Australian study were low. Episcleritis was usually benign, whereas scleritis had increased ocular complications and systemic disease.
Engraftment syndrome following hematopoietic stem cell transplant: A review of the literature
Authors: Grant Andrew , Chapman Laura R.M. , Mitchell Richard , O’Brien Tracey A.
Published: April 2020

Engraftment syndrome (ES) is a poorly understood condition which continues to present a significant cause of morbidity following haematopoietic stem cell transplantation (HSCT). Yet a standard approach to diagnosis and treatment of ES remains elusive and has the potential to impact patient outcomes. A literature search was performed using the databases ProQuest Health, PubMed, Medline and Embase. Included studies were published in English from 2001‐2019 that reported on engraftment syndrome following HSCT. Articles were organized by study design, ES diagnostic criteria, symptom classification and treatment. The review consolidated an array of literature relating to all types of HSCT. Timing of ES onset, risk factors and outcomes were compared within the literature. Signs and symptoms of reported ES were collated to establish a concise set of diagnostic criteria that can provide rapid recognition. The use of a standard approach to ES diagnosis has the potential to improve patient outcomes and provide a uniform approach to future research.
To kidney or not to kidney: Applying lessons learned from the simultaneous liver‐kidney transplant policy to simultaneous heart‐kidney transplantation
Authors: Cheng Xingxing S. , Khush Kiran K. , Wiseman Alexander , Teuteberg Jeffrey , Tan Jane C.
Published: April 2020

As the medical community is increasingly offering transplantation to patients with increasing comorbidity burdens, the number of simultaneous heart‐kidney (SHK) transplants is rising in the United States. How to determine eligibility for SHK transplant versus heart transplant alone is unknown. In this review, we situate this problem in the broader picture of organ shortage. We critically appraise available literature on outcomes in SHK versus heart transplant alone. We posit staged kidney‐after‐heart transplantation as a plausible alternative to SHK transplantation and review the pros and cons. Drawing lessons from the field of simultaneous liver‐kidney transplant, we argue for an analogous policy for SHK transplant with standardized minimal eligibility criteria and a modified Safety Net provision. The new policy will serve as a starting point for comparing simultaneous versus staged approaches and refining the medical eligibility criteria for SHK.
Patch‐type granuloma annulare: An institution‐based study of 23 cases
Authors: Khanna Urmi , North Jeffrey P.
Published: April 2020

Background

Granuloma annulare (GA) is a skin disorder of uncertain etiology. Patch (type) GA is an uncommon variant of GA with a paucity of data characterizing it. We describe the features of 23 cases of patch GA.

Methods

The archives of dermatopathology were searched for cases of patch GA. The clinical history and morphology for each patient were reviewed. Only cases with patch clinical morphology were included. The clinical and histopathologic features were assessed including the pattern of granulomatous inflammation and presence of other inflammatory cell types.

Results

Most patients were female (19/23) with erythematous patches on the trunk and proximal extremities. The most common clinical differential diagnosis included mycosis fungoides (MF), morphea and contact dermatitis. Dyslipidemia was the most common comorbidity (30%), followed by diabetes (15%) and hypertension (15%). Histopathologic features included interstitial lymphocytes and histiocytes with dermal mucin. Two cases showed focal palisaded granulomas. Eosinophils and plasma cells were present in 1/3 of cases.

Conclusion

Patch GA is an uncommon GA variant with an interstitial granulomatous histopathologic pattern that predominantly affects women over 50. It can mimic interstitial MF and early morphea both clinically and histopathologically. Awareness of this GA variant can help prevent misdiagnosis and inappropriate treatment for these patients.
Latin American healthcare systems in times of pandemic
Authors: Litewka Sergio G. , Heitman Elizabeth
Published: April 2020

The COVID‐ 19 pandemic is a critical test for the already overburdened and mostly underfunded public healthcare systems of Latin America. In a region that suffers from severe inequalities, public healthcare systems are the only source of medical care for a large sector of the population who work in the informal economy or are unemployed. State‐run hospitals and clinics are already overstressed by continuous demand for treatment of vector‐borne diseases and community‐acquired infections as well as high rates of non‐communicable diseases. Ideological misconceptions and denial among Latin America’s political leaders prevented timely preparations for the pandemic and added to chronic governance problems. As ethical expertise in Latin America focuses on research ethics, few hospitals in the region have functioning clinical ethics committees or clinical ethics policy, forcing healthcare personnel to make excruciating treatment decisions in an environment dominated by material scarcity and public distrust. This essay examines the emergence of COVID‐19 in Latin America and the serious challenge that it poses for Latin America's public healthcare systems.
Diabetes at the front door. A guideline for dealing with glucose related emergencies at the time of acute hospital admission from the Joint British Diabetes Society (JBDS) for Inpatient Care Group*
Authors: Dhatariya K. , James J. , Kong M.‐F. , Berrington R. ,   the Joint British Diabetes Society (JBDS) for Inpatient Care Group and guidelines writing group
Published: April 2020

People with diabetes account for nearly one‐fifth of all inpatients in English and Welsh hospitals; of these, up to 90% are admitted as an emergency. Most are admitted for a reason other than diabetes with only 8% requiring admission for a diabetes‐specific cause. Healthcare professionals working in emergency departments experience numerous clinical challenges, notwithstanding the need to know whether each individual with diabetes requires urgent admission. This document has been developed and written by experts in the field, and reviewed by the parent organizations of the Joint British Diabetes Societies for Inpatient Care—Diabetes UK, the Diabetes Inpatient Specialist Nurse Group and the Association of British Clinical Diabetologists. The document aims to support staff working in emergency departments and elsewhere by offering practical advice and tools for effective, appropriate and safe triage. Each section relates to the commonest diabetic specific emergencies and algorithms can be printed off to enable ease of access and use.
Feeding patterns revealed host partitioning in a community of frog‐biting mosquitoes
Authors: de Silva W.A. Priyanka P. , Bernal X. E. , Chathuranga W.G. D. , Herath B. P. , Ekanayake C. , Abeysundara H. T. K. , Karunaratne S. H. P. P.
Published: April 2020

1. Resource partitioning is a critical component in competing species that coexist in a community. The biting behaviour of coexisting frog‐biting mosquito species associated with a tropical anuran community is investigated.

2. Monthly samplings were taken for 2 years at two study sites in central Sri Lanka to collect frog‐biting mosquitoes, anuran abundance, environmental data, and interactions between mosquitoes and anuran hosts. Mosquitoes were collected using mouth‐operated aspirators and sound traps broadcasting anuran calls. Mosquitoes were identified using taxonomic keys and DNA barcodes.

3. A total of 1079 frog‐biting mosquitoes from four species belonging to two genera were collected [Uranotaenia rutherfordi (5%), Ur. morphotype 1 (67%), Ur. morphotype 2 (21%), and Mansonia uniformis (7%)]. Species‐specific interactions between Uranotaenia mosquitoes and their anuran host were found. Uranotaenia morphotype 1, the most common species, was mainly attracted (99%) to Duttaphrynus melanostictus. Uranotaenia rutherfordi was mainly attracted (95%) to Pseudophilautus rus, while Ur. morphotype 2 was attracted (97%) to Polypedates cruciger. These Uranotaenia species are active at different hours at night that correspond to the peak calling activity of their anuran host. Each Uranotaenia species was active at heights that coincide with the calling sites of their host. In contrast, Ma. uniformis was non‐specific in host choice and was equally distributed in space and time with respect to host feeding.

4. Here, previously unknown feeding patterns of co‐occurring frog‐biting mosquito species and their interactions with anurans present in their community are reported, highlighting the existence of complex behavioural patterns of these mosquito communities.
Learning of the mental nerve block technique with dental anaesthesia simulation models builds motor skills and confidence in dental students
Authors: Reyes‐Acuca María J. , Sánchez‐Lezama Zayra S. , Capistrán‐Sarmiento Berenice , Teodoro‐Isneros Ana , Suárez‐Franco José L. , Cerda‐Cristerna Bernardino I.
Published: April 2020

Introduction

We compared the motor learning, self‐confidence whilst performing an anaesthesia technique and the perception of confidence between a group of students trained (G1) with two distinct dental anaesthesia simulation models (DASM) and a group of students (G2) not trained with DASM.

Materials and methods

The G1 students (n = 22) were trained with a learning protocol including a DASM for simulating a puncture and a DASM for simulating an injection of dental anaesthesia. The G2 students (n = 22) received no such training. Both groups performed the mental nerve block (MNB) in a clinical setting, after which the average working time (motor learning), number of times help was requested for performing the MNB (self‐confidence) and the scores of a Likert Scale questionnaire (perception of confidence) between the groups were compared with a t test.

Results

Compared with G2, the G1 students showed a shorter average working time (G1, 7:30 ± 0:54 min; G2, 9:06 ± 2:27 min; P = .017). Hence, G1 students had better motor skills. They also requested help when performing the MNB fewer times than the G2 students (G1, 2.2 ± 0.5 times; G2, 4.6 ± 1.95 times; P < .001). On the other hand, the G1 students demonstrated better perception of confidence (Likert Scale questionnaire) when performing the MNB compared with the G2 students (P = .007).

Conclusion

The learning protocol with two different DASMs had a positive effect on the motor skills and the confidence of dental students performing the mental nerve block.
Effect of pH and prior treatment with phosphate on the rate and amount of reaction of soils with phosphate
Authors: Barrow N. J. , Debnath Abhijit , Sen Arup
Published: April 2020

The rate at which phosphate continues to react with soil is an important determinant of its effectiveness as a fertiliser. Yet it has seldom been measured and we do not know which soil properties affect its value. Here, the effects of electric charge are investigated. The charge of a low phosphorus status soil was changed both by changing the soil pH by incubation with acid or alkali for 2 days at 60°C, and also by adding phosphate and incubating for 30 days at 80°C. The amount and rate of reaction of further additions of phosphate were then measured after periods of 1, 3, 10 and 30 days of incubation at 25°C. Prior reaction with phosphate greatly decreased both the amount and the rate of sorption of subsequent additions. We think this is one factor causing differences between soils in the rate of reaction. Changing the pH had smaller effects on the amount and rate of reaction. We think the effects on rate of reaction were caused by changing the pH rather than the pH itself. The effects of changed pH and of phosphate treatment were closely described by a mechanistic model, with the effects on amount of sorption described by varying the electric potential and the effects on rate of reaction described by varying the rate of diffusion. The two methods of changing the charge have differing effects on both the amount and rate of reaction and we discuss the reasons for these differences.

Highlights

The rate at which phosphate continues to react with soil is an important determinant of its effectiveness as a fertiliser.

Loading with phosphate greatly decreased both the amount and the rate of sorption of subsequent additions.

Changing the pH had smaller effects. Results were closely described by a mechanistic model.

Phosphate status is an important cause of differences between soils in the rate of reaction.
On glyphosate–kaolinite surface interactions. A molecular dynamic study
Authors: Galicia‐Andrés Edgar , Tunega Daniel , Gerzabek Martin H. , Oostenbrink Chris
Published: April 2020

Glyphosate is an important and widely used herbicide, its environmental behaviour being of scientific and public interest. Computational models of clay minerals and their interactions with small organic molecules are valuable in studying adsorption processes at an atomistic resolution. We analysed the adsorption process of glyphosate on kaolinite, a clay mineral with a high abundance in several types of soils (e.g., of subtropical or tropical origin), in terms of the adsorption strength. The molecular interactions are characterized by monitoring the occurrence of hydrogen bonds, the orientation of the molecular dipole relative to the interface and the interaction energy. Two different ionic forms of glyphosate were considered: neutral and anionic (−1). It was shown that the main mechanism of the binding of both glyphosate forms to the aluminol surface of kaolinite is through multiple hydrogen bonds. The standard free energy of adsorption of neutral glyphosate from water solution to the basal octahedral surface of kaolinite was computed at −5 kJ mol−1, whereas for the anionic form this quantity amounted to −14 kJ mol−1. Our finding showed that kaolinite has an important contribution to overall adsorption capacity of soils for glyphosate, specifically in its anionic form.

Highlights

The adsorption free energy of glyphosate on a kaolinite surface is quantified

Interactions are computed by quantum mechanics and by classical force field

Molecular interactions are characterized in terms of hydrogen bonds and orientations

The effect of polarization of the medium on the calculations is analysed
Neurofilament‐light in former athletes: a potential biomarker of neurodegeneration and progression
Authors: Taghdiri F. , Multani N. , Ozzoude M. , Tarazi A. , Khodadadi M. , Wennberg R. , Mikulis D. , Green R. , Colella B. , Davis K.D. , Blennow K. , Zetterberg H. , Tator C. , Tartaglia M.C.
Published: April 2020

Background/Objective

This study aimed to evaluate serum neurofilament light chain (NF‐L) levels in former professional contact sports athletes with multiple concussions (ExPro) as a potential biomarker of neurodegeneration and predictor of white‐matter (WM) abnormality progression.

Methods

Concentrations of NF‐L in the serum of fifty‐two cognitively normal ExPro and twenty‐one healthy controls (HC) with no history of concussions were measured using single molecule array (Simoa) technology. Both groups underwent neuroimaging at the time of serum collection. Eighteen of the participants in the ExPro underwent follow‐up imaging after 2 years.

Results

Levels of serum NF‐L were not significantly different between the ExPro and HC. However, in the ExPro group, NF‐L levels were positively correlated with the mean diffusivity (MD) of corpus callosum (CC) and fornix, and total ventricular volume. Moreover, NF‐L levels in the ExPro group at the first visit were positively correlated with the amount of increase in CC MD at the 2‐year follow‐up.

Conclusions

NF‐L levels reflect neuronal changes in the ExPro group and predict the extent of decrease in white matter integrity over time. Serum NF‐L might be a biomarker of neurodegeneration and WM abnormality progression in ExPro.
Auditor and auditee engagement with public sector performance audit: An institutional logics perspective
Authors: Parker Lee D. , Schmitz Jana , Jacobs Kerry
Published: April 2020

In the context of contemporary public sector performance audit practice in Australia, this study provides significant insights into performance auditors’ and auditees’ apparent logics and attitudes to performance audits. Employing a documentary analysis and in‐depth semistructured interviews with senior audit leaders from all Australian Auditor‐General jurisdictions, performance auditors’ and auditees’ attitudes toward performance audits and their intentions, strategies, and responses were explored through the lens of institutional logics. Empirical evidence reveals that performance auditors’ logics have gradually moved toward greater stakeholder engagement with auditees, parliamentarians, and the media, while preserving their performance audit prerogatives. Auditees appear to become more receptive to performance auditors’ engagement strategies and consultation attempts if auditors maintain a collaborative attitude. Both parties occasionally apply bridging and buffering strategies in situations where their logics are not aligned with those of the other stakeholder group. This study discovered that competing logics held by performance auditors and auditees are in some respects drawn closer together, while differences nonetheless co‐exist, although often in an uneasy partnership.
Avoiding inheritance taxes in family firms
Authors: Shin Hojong
Published: April 2020

This article documents a novel way to transfer control in family firms while avoiding inheritance taxes: intragroup mergers. I provide evidence that avoiding inheritance taxes is the motivation behind intragroup mergers in Korea. In 1999, Korea initiated a tax reform that bumped up personal inheritance taxes by 25 percentage points. In the posttax‐reform period, I find that family firms increase stock‐for‐stock intragroup mergers involving targets owned by heirs. Specifically, firms with heavy inheritance taxes acquire affiliates owned by heirs, who then convert private target shares into acquirer shares while avoiding inheritance taxes.
Influence of larval transport and temperature on recruitment dynamics of North Sea cod (Gadus morhua) across spatial scales of observation
Authors: Romagnoni Giovanni , Kvile Kristina Øie , Dagestad Knut‐Frode , Eikeset Anne Maria , Kristiansen Trond , Stenseth Nils Chr. , Langangen Øystein
Published: April 2020

The survival of fish eggs and larvae, and therefore recruitment success, can be critically affected by transport in ocean currents. Combining a model of early‐life stage dispersal with statistical stock–recruitment models, we investigated the role of larval transport for recruitment variability across spatial scales for the population complex of North Sea cod (Gadus morhua). By using a coupled physical–biological model, we estimated the egg and larval transport over a 44‐year period. The oceanographic component of the model, capable of capturing the interannual variability of temperature and ocean current patterns, was coupled to the biological component, an individual‐based model (IBM) that simulated the cod eggs and larvae development and mortality. This study proposes a novel method to account for larval transport and success in stock–recruitment models: weighting the spawning stock biomass by retention rate and, in the case of multiple populations, their connectivity. Our method provides an estimate of the stock biomass contributing to recruitment and the effect of larval transport on recruitment variability. Our results indicate an effect, albeit small, in some populations at the local level. Including transport anomaly as an environmental covariate in traditional stock–recruitment models in turn captures recruitment variability at larger scales. Our study aims to quantify the role of larval transport for recruitment across spatial scales, and disentangle the roles of temperature and larval transport on effective connectivity between populations, thus informing about the potential impacts of climate change on the cod population structure in the North Sea.
Community‐level responses to climate change in forests of the eastern United States
Authors: Knott Jonathan A. , Jenkins Michael A. , Oswalt Christopher M. , Fei Songlin
Published: April 2020

Aim

Climate change has impacted forest ecosystems, leading to species‐level tree migration. However, the impacts of climate change on forest communities are mostly unknown. Here, we assess changes to forest communities at three scales: within‐community changes in species composition, individual community spatial shifts and changes across all communities.

Location

Eastern USA.

Major taxa studied

Forest tree species.

Methods

Using a region‐wide forest inventory dataset from the United States Department of Agriculture Forest Service's Forest Inventory and Analysis Program with > 70,000 plots, we identified forest communities using the latent Dirichlet allocation method. We analysed changes in species composition within communities and assessed community‐level spatial shifts over the last three decades to quantify the responses of individual communities to climate change. We used the distribution of forest communities across climate conditions to predict where communities could migrate to during the study period and compared climate‐predicted shifts with observed community shifts. Changes across all communities were modelled as a function of climatic and non‐climatic variables using generalized linear mixed‐effects models.

Results

We identified 12 regional forest communities of the eastern USA, which varied in their stability of species composition over the study period. All communities experienced relatively short yet significant shifts in their spatial distribution (median = 8.0 km/decade). Historical climate and changes in seasonal temperature variability were the best predictors of change across all communities. However, the distance and direction of individual community migration were poorly predicted by climate change, and the observed direction was often the opposite of the predicted direction.

Main conclusions

Forest communities shifted their distributions over the last three decades, but climate change outpaced the rate of community migration. Continued lags between climate change and forest community responses and the lack of migration in the direction predicted by climate change might lead to the inability of forests to keep up with changing climate.
A critical evaluation of the Oscillayers methods and datasets
Authors: Brown Jason L. , Hill Daniel J. , Haywood Alan M.
Published: April 2020

Here we evaluate Oscillayers, a new method that aims to estimate palaeoclimates for the past 5.4 Myr, and discuss the associated theoretical and methodological issues. We show that the theoretical foundation of Oscillayers is inherently limited, because the method cannot incorporate spatio‐temporal variation and different forcing mechanisms into climate reconstructions. In addition, several methodological weaknesses are clarified that entrench the palaeoclimatic reconstruction of Oscillayers to patterns of climate change observed between the Last Glacial Maximum and current climates. We test the utility of the Oscillayers method to produce palaeoclimatic reconstructions that are similar to general circulation model (GCM)‐based estimates. On average, only 55.6% of values in the mean annual temperature datasets across the Pliocene and Pleistocene were within ±3°C when compared with corresponding GCM‐based datasets. Furthermore, on average only 75.3% of values in the mean annual precipitation datasets across the Pliocene and Pleistocene were within ±200 mm of rainfall of the GCM‐based estimates. Our results demonstrate that the Oscillayers approach does not provide a robust approximation of palaeoclimatic conditions throughout the Plio‐Pleistocene. Thus, when these datasets are used for scientific analyses, the results should be interpreted with a full appreciation of their limitations, particularly for periods outside the last glacial cycle.