bluuebunny/crossref_metadata_2025 huggingface dataset:
Resection margin involvement after endoscopic excision of malignant colorectal polyps: definition of margin involvement and its impact upon tumour recurrence
Authors: Scott Nigel , Cairns Alison , Prasad Padmini , Rotimi Olorunda , West Nicholas P , Sanni Latifu , Rizig Muaaz , Sood Ruchit , Rembacken Bjorn J
Published: March 2023

Aims

Malignant polyps are examined to assess histological features which predict residual tumour in the unresected bowel and guide surgical decision‐making. One of the most important of these features is resection margin involvement, although the best definition of margin involvement is unknown. In this study we aimed to investigate three different definitions and determine their impact on clinical outcomes.

Methods and results

One hundred and sixty‐five malignant polyps removed endoscopically were identified and histological features correlated with either residual tumour in subsequent surgical resections or tumour recurrence following a period of clinical follow‐up. Involvement of the polyp margin by cancer was defined in three different ways and outcomes compared. Tumour recurrence was associated with tumour grade, mucinous histology and resection margin involvement. All three definitions of margin involvement separated polyps into clinically significant categories; however, a margin ≤ 1 mm identified 73% of polyps as ‘high‐risk’ compared with 59.1% when involvement was defined as tumour within the zone of coagulation artefact at the polyp base or 50% when tumour was present at the margin. All three ‘low‐risk’ groups had a locoregional recurrence rate < 6.5%.

Conclusions

Definitions of margin involvement for endoscopically removed malignant polyps in the colon and rectum vary between health‐care systems, but a 1‐mm clearance is widely used in Europe and North America. Our results suggest that a 1‐mm margin is unnecessary and should be replaced by a definition based on tumour at the margin or within coagulation artefact at the polyp base.
Acute respiratory infection emergency access in a tertiary care children hospital in Italy, prior and after the SARS‐CoV‐2 emergence
Authors: Ciofi degli Atti Marta , Rizzo Caterina , D'Amore Carmen , Ravà Lucilla , Reale Antonino , Barbieri Maria Antonietta , Bernaschi Paola , Russo Cristina , Villani Alberto , Perno Carlo Federico , Raponi Massimiliano
Published: March 2023

Background

The COVID‐19 pandemic has changed the epidemiology of acute respiratory infections (ARIs) in children. The aims of the present study were to describe the epidemiological trend of ARI emergency visits and virology results prior and after the SARS‐CoV‐2 emergence and to estimate the association of ARI emergency department (ED) visits with respiratory viruses.

Methods

This study was conducted at the Bambino Gesù Children's Hospital, a tertiary care children's hospital in the Lazio Region, Italy. The demographic and clinical information of children who accessed the ED and were diagnosed with ARI from January 1, 2018 to June 30, 2022 was retrospectively extracted from the electronic health records. The observed temporal trends in viruses diagnosed from respiratory samples were compared with the number of ARI ED visits over the same period through a multivariable linear regression model.

Results

During the study period, there were 72,959 ED admissions for ARIs and 33,355 respiratory samples resulted positive for viruses. Prior to the pandemic, respiratory syncytial virus (RSV) and influenza had a clear seasonal pattern, which was interrupted in 2020. In 2021–2022, RSV reached the highest peak observed during the study period, whereas influenza activity was minimal. The peaks of ARI ED visits corresponded to peaks of influenza, RSV, and rhinovirus in the 2018–2019 and 2019–2020 seasons, to SARS‐CoV‐2 and rhinovirus in 2020, and to RSV and parainfluenza in 2021–2022.

Conclusions

ARI resulting in ED visits should be included in the ARI disease burden measurement for a more accurate measure of the impact of preventive measures.
Longitudinal association between periodontal condition and glycaemic status in middle‐aged adults: A cross‐lagged panel analysis
Authors: Nasution Dewi L. I. , Furuta Michiko , Li Huihua , Zakaria Myrna Nurlatifah , Takeshita Toru , Peres Marco A. , Yamashita Yoshihisa
Published: March 2023

Aim

To investigate the existence of a bidirectional temporal relationship between periodontal condition and glycaemic status.

Materials and Methods

This longitudinal study included 2198 participants with mean age 43.4 ± 7.7 years, who underwent dental examinations in Yokohama, Japan, at two time points, 2003–2004 and 2008–2009, at an interval of 5 years. Periodontal condition was assessed by the mean value of probing pocket depth (PPD) and clinical attachment level (CAL). Glycaemic status was assessed by fasting glucose and glycated haemoglobin (HbA1c).

Results

The cross‐lagged panel models showed the effect of HbA1c at baseline on mean PPD at follow‐up (β = 0.044, p = .039). There was a marginal effect of fasting glucose on the mean PPD (β = 0.037, p = .059). It was similar to the effect of fasting glucose or HbAlc on mean CAL. However, in the opposite direction, no effect of mean PPD or CAL at baseline on fasting glucose or HbAlc at follow‐up was identified.

Conclusions

This study demonstrated a unidirectional relationship between glycaemic status and periodontal condition. The study population, however, had mostly mild periodontitis. Future studies are needed to investigate the effect of periodontal condition on glycaemic status in patients with severe periodontitis.
Effects of monochromatic lights on the melanophores arrangement in the spotted snakehead fish Channa punctata (Bloch, 1793)
Authors: Ali Bulbul , Mishra Abha
Published: March 2023

Some freshwater teleost fish have pigment cells whose arrangement and shape are affected by the environment. Natural light has a wide range of light intensity. Fish are sensitive to the background and exposed light colour. Fish body colour is a significant criterion in fixing its market value, whether it is ornamental or edible. By favourable light exposure, a culturist may get a good market value of fish on most ethical grounds. In this study, we recorded the changes in melanophore response with the changes in light colour on Channa punctata. Adult fish were treated with monochromatic lights (darkness, white, blue and red light) for 5 and 28 days. After treatment, their body colour and melanophore size, number, length and the number of dendrites were studied. The results showed a significant influence of monochromatic light on melanophore arrangement in fish skin. The data showed that blue light is appropriate for the overall species colour of photic C. punctata. Continuous black or white light caused severe damage to the fish's appearance.
Scaffold protein RACK1A positively regulates leaf senescence by coordinating the EIN3‐miR164‐ORE1 transcriptional cascade in Arabidopsis
Authors: Masood Jan , Zhu Wei , Fu Yajuan , Li Zhiyong , Zhou Yeling , Zhang Dong , Han Huihui , Yan Yan , Wen Xing , Guo Hongwei , Liang Jiansheng
Published: March 2023

Plants have adopted versatile scaffold proteins to facilitate the crosstalk between multiple signaling pathways. Leaf senescence is a well‐programmed developmental stage that is coordinated by various external and internal signals. However, the functions of plant scaffold proteins in response to senescence signals are not well understood. Here, we report that the scaffold protein RACK1A (RECEPTOR FOR ACTIVATED C KINASE 1A) participates in leaf senescence mediated by ethylene signaling via the coordination of the EIN3‐miR164‐ORE1 transcriptional regulatory cascade. RACK1A is a novel positive regulator of ethylene‐mediated leaf senescence. The rack1a mutant exhibits delayed leaf senescence, while transgenic lines overexpressing RACK1A display early leaf senescence. Moreover, RACK1A promotes EIN3 (ETHYLENE INSENSITIVE 3) protein accumulation, and directly interacts with EIN3 to enhance its DNA‐binding activity. Together, they then associate with the miR164 promoter to inhibit its transcription, leading to the release of the inhibition on downstream ORE1 (ORESARA 1) transcription and the promotion of leaf senescence. This study reveals a mechanistic framework by which RACK1A promotes leaf senescence via the EIN3‐miR164‐ORE1 transcriptional cascade, and provides a paradigm for how scaffold proteins finely tune phytohormone signaling to control plant development.
Explaining consumers' progress through life insurance decision states: The role of personal values and consumer characteristics
Authors: Bateman Hazel , Gerrans Paul , Thorp Susan , Zeng Yunbo
Published: March 2023

Many people have unsuitable life insurance cover or no cover at all. In this study, we survey consumers about their readiness to purchase life insurance. Consumers rate their own “decision state” from “pre‐aware” of life insurance to “aware,” “interested” or “capable” of deciding to purchase. We also collect data on factors associated with progress along the path to purchase. We find that personal values partly determine life insurance decision states. Values matter in addition to the needs of dependents, bequest intentions, and financial literacy. Consumers who place more value on benevolence and self‐direction are more likely to be aware of life insurance. Our results suggest strategies to promote suitable life insurance cover by targeting factors that help progress through each decision state. Insurance providers could thus prime benevolence and self‐direction in advertising and product information.
Open‐hearted: Preferences for openness in the agreeableness domain
Authors: Robinson Michael D. , Lindquist Jade A. , Irvin Roberta L.
Published: March 2023

Objective

Open objects encourage interactivity and closed objects discourage it. Repeated experiences with open and closed objects are thought to give rise to spatial concepts that can be used to represent a variety of entities such as societies, others, and the self. The present investigation pursues the idea that preferring that which is open to that which is closed is more compatible with an agreeable mode of interacting with others.

Method

Three studies (total N = 901) asked participants whether they preferred “open” or “closed” as spatial concepts. Such preferences were linked to variations in agreeableness, peer perceptions, and daily measures of pro‐social functioning.

Results

Open‐preferring, relative to closed‐preferring, individuals scored higher in agreeableness (Study 1) and were rated by peers as interpersonally warmer (Study 2). Open preferences varied within and across persons in a daily diary protocol and, in both cases, higher levels of open preference were linked to higher levels of pro‐social feeling (Study 3).

Conclusion

The findings point to a fundamental component of spatial orientation that plays a significant role in encouraging (open) or discouraging (closed) warm, interactive relations with others.
Testing the equivalence of the aversive core of personality and a blend of agreeableness(‐related) items
Authors: Horsten Luisa K. , Thielmann Isabel , Moshagen Morten , Zettler Ingo , Scholz David , Hilbig Benjamin E.
Published: March 2023

Objective

There is an ongoing debate in personality research whether the common core of aversive (“dark”) traits can be approximated by or even considered equivalent to one of the constructs that have been labeled “Agreeableness”. In particular, it has been suggested that the low pole of (what we term) AG+, a broad blend of Big Five Agreeableness and the HEXACO factors Honesty‐Humility, Agreeableness, and Altruism, is essentially equivalent to the Dark Factor of Personality (D). Based on theoretical differences, we herein test empirically whether D and AG+ are isomorphic.

Methods

Self‐report data on D, AG+, and eight criterion measures reflecting justifying beliefs, inflicting disutility on others, and affiliative tendencies were collected in a pre‐registered study (N = 1156) and analyzed via confirmatory factor modeling.

Results

Results speak against unity of D and AG+ (35% shared variance) and support the notion that D subsumes a broader range of aversive content (i.e., justifying beliefs and inflicting disutility on others) than AG+, which, in turn, subsumes a slightly broader range of non‐aversive, affiliative tendencies.

Conclusion

We conclude that AG+ is non‐equivalent to the common core of aversive traits, D.
Using machine learning to identify early predictors of adolescent emotion regulation development
Authors: Van Lissa Caspar J. , Beinhauer Lukas , Branje Susan , Meeus Wim H. J.
Published: March 2023

As 20% of adolescents develop emotion regulation difficulties, it is important to identify important early predictors thereof. Using the machine learning algorithm SEM‐forests, we ranked the importance of (87) candidate variables assessed at age 13 in predicting quadratic latent trajectory models of emotion regulation development from age 14 to 18. Participants were 497 Dutch families. Results indicated that the most important predictors were individual differences (e.g., in personality), aspects of relationship quality and conflict behaviors with parents and peers, and internalizing and externalizing problems. Relatively less important were demographics, bullying, delinquency, substance use, and specific parenting practices—although negative parenting practices ranked higher than positive ones. We discuss implications for theory and interventions, and present an open source risk assessment tool, ERRATA.
Biallelic known and novel DCDC2 variants in cholestatic liver disease: Phenotype–genotype observations in four children
Authors: Azabdaftari Aline , Sczakiel Henrike L. , Danyel Magdalena , Kohlmaier Benno , Mache Christoph J. , Stalke Amelie , Pfister Eva‐Doreen , Thumfart Julia , Henning Stephan , Knisely A. S. , Bufler Philip
Published: March 2023

Neonatal sclerosing cholangitis (NSC) is associated with progressing biliary fibrosis that often requires liver transplantation in childhood. Several recent studies have identified variants in DCDC2, encoding doublecortin domain‐containing protein 2 (DCDC2), expressed in primary cilia, that accompany syndromic disease and NSC. We report four patients with hepatobiliary disease associated with two novel homozygous or compound heterozygous variants in DCDC2. Three patients with protein‐truncating variants in DCDC2, expressing no DCDC2, presented with the originally described severe hepatic phenotype in infancy. One patient with a novel homozygous DCDC2 missense variant shows a markedly milder phenotype only manifest in childhood and with retained DCDC2 expression. Concomitant nephronophthisis is present in three patients and learning disability in two. This report widens the phenotypic spectrum of DCDC2‐associated hepatobiliary disease. Testing for DCDC2 expression and DCDC2 variants should be included in the evaluation of cholangiopathy of unknown aetiology in childhood as well as in infancy.
Associations of serum uric acid levels with liver disease‐related morbidity and mortality: A prospective cohort study of the UK Biobank
Authors: Liu Zhening , Huang Hangkai , Xie Jiarong , Xu Chengfu
Published: March 2023

Background and Aims

The association of serum uric acid (SUA) levels with liver‐related morbidity and mortality remains undetermined. Therefore, we aimed to explore the association of SUA levels with liver‐related morbidity and mortality.

Methods

The present cohort study included 459 619 adults from the UK Biobank. Multivariable Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of SUA levels with morbidity and mortality of overall liver disease. Mendelian randomization (MR) analyses were conducted to explore the underlying causality. A polygenic risk score was generated to assess whether there was a gene‐exposure interaction.

Results

During a median follow‐up of 12.6 years, 14 302 nonfatal and 609 fatal cases of overall liver disease were identified. Compared to individuals in the lowest quartile, the HRs (95% CI) of incident overall liver disease were 1.08 (1.02–1.14), 1.13 (1.07–1.20) and 1.44 (1.36–1.53) for individuals with SUA levels in quartiles 2, 3 and 4 respectively. Similarly, the HRs (95% CI) of liver disease‐associated mortality were 1.09 (0.78–1.52), 1.55 (1.14–2.13) and 1.96 (1.42–2.69) for individuals with SUA levels in quartiles 2, 3 and 4 respectively. The MR results did not support the causal association of SUA levels with liver disease. In addition, there was a significant modification effect of the polygenic risk score on the association of SUA levels with incident overall liver disease (pinteraction = .003).

Conclusions

Higher SUA levels were significantly associated with an increased risk of overall liver disease morbidity and mortality.
A call for total nursing role reformation: Perceptions of Ghanaian nurses
Authors: Laari Luke , Duma Sinegugu Evidence
Published: March 2023

Nurses in Ghana believe that training, practise, practitioner and policy reforms are required for total nursing profession reform to be effective. Their views for role reformation in the nursing profession, which is currently needed, are not only academic but also clinically relevant in the pursuit of health equity and quality nursing care. We explored and described nurses’ views on their roles in the profession using data collected from 24 professional nurses in three regional hospitals in Ghana. Using an inductive descriptive qualitative design, data were gathered and analysed using a qualitative content analysis to describe the views of the nurses. Four major themes, namely practise reforms, practitioner reforms, training reforms and policy reforms have emerged in relation to role reformation in the nursing profession. Three strategic areas, practitioner attitudes, new training modalities and policy realignment, must be reviewed and remodelled for better positioning of the nursing profession before its entire role reformation.
Fungi in ant–plant interactions: a key to enhancing plant nutrient‐acquisition strategies
Authors: Leroy Céline
Published: March 2023

This article is a Commentary on Gegenbauer et al. (2023), 238: 2210–2223.
A quality improvement intervention to decrease the decline in renal function in pediatric liver transplant recipients
Authors: Batsis Irini , Elisofon Scott , Ferguson Michael , Jonas Maureen , Kimball Brendan , Lee Christine , Mitchell Paul , Fawaz Rima
Published: March 2023

Background

Chronic kidney disease (CKD) impacts long‐term morbidity in pediatric liver transplant (LT) recipients. The prevalence of estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 (eGFR < 90) at our institution was 25% at 1 year post‐LT; thus, quality improvement (QI) project was initiated, aiming to decrease the prevalence of eGFR < 90 by at least 20% at 1 year‐post LT.

Methods

Children post‐LT under 19 years from 2010 to 2018 were included. Three QI interventions were implemented starting 1/2016: documentation of blood pressure percentile (BP%) and eGFR, documentation of a kidney management plan if either was abnormal, and amlodipine initiation prior to hospital discharge after LT. We compared the prevalence of eGFR < 90 at 3, 12, and 24 months after LT in the pre‐ and post‐intervention period.

Results

68 patients in pre‐ and 42 in post‐intervention periods met inclusion criteria. Pre‐intervention BP%, eGFR, and kidney management plan were documented at 25%, 10%, and 22%, compared to 71%, 83%, and 71% post‐intervention, respectively. 22% of patients were started on amlodipine prior to discharge from LT in the pre‐ versus 74% in the post‐intervention period. Prevalence of eGFR < 90 at 3 m post‐LT was 19% in pre‐ versus 14% in the post‐intervention period (p = .31); at 12 months 24% versus 7% (p = .01) and at 24 months 16% versus 6% (p = .13), respectively. Significant non‐modifiable risk factors for eGFR < 90 were malignancy (RR = 4.5, p < .0001), metabolic disorder (RR = 2.6, p = .02), and age at transplant (7% increased risk per year of age, p = .007).

Conclusion

By improving documentation of BP%, eGFR, and kidney management plan, the prevalence of eGFR < 90 was decreased by a relative 74% and 60% at 12 and 24 months post‐LT, respectively.
Survey of pediatric transplant center practices regarding COVID‐19 vaccine mandates for transplant candidates and living donors and use of COVID‐19‐positive deceased organs
Authors: Feldman Amy G. , Beaty Brenda , Everitt Melanie , Goebel Jens , Kempe Allison , Pratscher Lauren , Danziger‐Isakov Lara A.
Published: March 2023

Background

COVID‐19 vaccine is recommended for individuals ages ≥6 months; however, whether vaccination should be mandated for transplant candidates and living donors remains controversial. This study assessed COVID‐19 policies at US pediatric solid organ transplant centers.

Methods

A 79‐item survey was emailed between March and April 2022 to 200 UNOS Medical Directors detailing center COVID‐19 vaccine policies for transplant candidates and living donors and use of grafts from COVID‐19‐positive deceased donors.

Results

The response rate was 77% (154/200). For children aged 5–15 years, 23% (35/154 centers) have a COVID‐19 vaccine mandate, 27% (42/154) anticipate implementing a future mandate, and 47% (72/154) have not considered or do not anticipate implementing a mandate. For children ≥16 years, 32% (50/154 centers) have a COVID‐19 vaccine mandate, 25% (39/154) anticipate implementing a future mandate, and 40% (62/154) have not considered or do not anticipate implementing a mandate. The top two reasons for not implementing a COVID‐19 vaccine mandate were concerns about penalizing a child for their parent's decision and worsening inequities in transplant. Of 85 kidney and liver living donor centers, 32% (27/85) require vaccination of donors. Twenty percent (31/154) of centers accept organs from COVID‐19‐positive deceased donors.

Conclusions

There is great variation among pediatric SOT centers in both the implementation and details of COVID‐19 vaccine mandates for candidates and living donors. To guide more uniform policies, further data are needed on COVID‐19 disease, vaccine efficacy, and use of grafts from donors positive for COVID‐19 in the pediatric transplant population.
Reconciling the Protection of Nature and Monuments – A Large-scale Nature Conservation Project Between the Siebengebirge and the Sieg
Authors:   LVR-State Service for Archaeological Heritage in the Rhineland, Wohlfarth Christine
Published: March 2023

Funded by the Federal Office for Nature Conservation in close cooperation with Nature Conservation (Rhine-Sieg District) and Cultural Heritage Protection (LVR-State Service for Archaeological Heritage in the Rhineland) , the aim of this project was to conduct a major conservation project according to environmental communication protocols, and the first to be carried out in Germany. The occasion was the establishment of a maintenance and development plan in a major conservation project, scanning more than 10,000 hectares, and their subsequent realisation. The project helped create communication, coordination, and working structures, which were not only expandable but coulf also be applied to other nature conservation projects. In many cases, for their protection, the monument sites are transferred into a sustainable nature and heritage-compatible use during the implementation period using the measures suggested in the care and development plan of the conservation project 'chance 7' in the Rhine-Sieg District. Monuments suitable for presentation are preserved and made accessible to the general public.
Preservation of Archaeological and Natural Values. A Case Study of the North-Western part of Latvia
Authors:   National Heritage Board of Latvia, Zirne Sandra , Lūsēna Egita
Published: March 2023

The article is a review of specially designated nature protected areas and Stone Age settlements in north-western Latvia, called North Kurzeme. This area was chosen because it has a special environment. It is a culturally and historically important coastal region with diverse protected natural areas, a unique coastal landscape, and important archaeological sites. The article provides information about Moricsala Nature Reserve and Slītere National Park, their management, and about the Stone Age settlements discovered there.
Butrint National Park 'Integrated Management Plan' - Combining Natural Park with Cultural Heritage
Authors:   Archaeological Service Directorate, National Institute of Cultural Heritage, Albania, Miziri Ela , Meshini Mariglen , Zoto Rudina
Published: March 2023

Inhabited since prehistoric times, Butrint (ancient Buthrotum), has been the site of a Greek colony, a Roman city and a bishopric. Following a period of prosperity under Byzantine administration, then a brief occupation by the Venetians, the city was abandoned in the late Middle Ages after marshes formed in the area. The present archaeological site has remains representing each period in the city's development. Today, Butrint is an Archaeological Park under the patronage of both UNESCO and Natural Park. The ancient city of Butrint is the best example of combining cultural heritage with the elements of the Natural Park. Owing to the changes in climate that have occurred in the last two decades, the archaeological site of Butrint, especially the area of the ancient theatre and Roman forum, are covered by water at times. The implementation of intervention projects for monuments has been inefficient however due to prolonged procedures and the jurisdiction overlap between specialised institutions. Because of this, a new reasonable approach on conservation interventions and archaeological excavations will be taken on some of the monuments at the Archaeological Park of Butrint . These interventions will be regulated by an Integrated Management Plan implemented in 2021, and will include the management of cultural and natural assets. The Management Plan conditions will determine, control and ensure a sustainable and long-term administration of the monuments and the site.
Cultural Landscape Change from Late Neolithic to Late Middle Ages in Northern Westphalia. Interplay between the Natural Environment and the Anthropogenic Archaeological Remains
Authors:   LVR-State Service for Archaeological Heritage in the Rhineland, Germany, Klinke Leo
Published: March 2023

In a methodologically exemplary study area in northern Westphalia, it has been possible to identify a cultural landscape that has existed since the Late Neolithic. In this diachronic synopsis, it is evident that the cultural landscape was constituted around a geological phenomenon into a sacred landscape from the Late Neolithic onwards, then persisted for at least three millennia and then became more secular in the Middle Ages. New absolute dating has made it possible to synchronise the changes in the natural environment with changes in the anthropogenic material-cultural traces in the study area. Changes in biodiversity are no longer documented exclusively in the pollen data, but can now also be read from the anthropogenic archaeological relics.
Technology roadmap for cold-atoms based quantum inertial sensor in space
Authors: Abend Sven , Allard Baptiste , Arnold Aidan S. , Ban Ticijana , Barry Liam , Battelier Baptiste , Bawamia Ahmad , Beaufils Quentin , Bernon Simon , Bertoldi Andrea , Bonnin Alexis , Bouyer Philippe , Bresson Alexandre , Burrow Oliver S. , Canuel Benjamin , Desruelle Bruno , Drougakis Giannis , Forsberg René , Gaaloul Naceur , Gauguet Alexandre , Gersemann Matthias , Griffin Paul F. , Heine Hendrik , Henderson Victoria A. , Herr Waldemar , Kanthak Simon , Krutzik Markus , Lachmann Maike D. , Lammegger Roland , Magnes Werner , Mileti Gaetano , Mitchell Morgan W. , Mottini Sergio , Papazoglou Dimitris , Pereira dos Santos Franck , Peters Achim , Rasel Ernst , Riis Erling , Schubert Christian , Seidel Stephan Tobias , Tino Guglielmo M. , Van Den Bossche Mathias , von Klitzing Wolf , Wicht Andreas , Witkowski Marcin , Zahzam Nassim , Zawada Michał
Published: March 2023

Recent developments in quantum technology have resulted in a new generation of sensors for measuring inertial quantities, such as acceleration and rotation. These sensors can exhibit unprecedented sensitivity and accuracy when operated in space, where the free-fall interrogation time can be extended at will and where the environment noise is minimal. European laboratories have played a leading role in this field by developing concepts and tools to operate these quantum sensors in relevant environment, such as parabolic flights, free-fall towers, or sounding rockets. With the recent achievement of Bose–Einstein condensation on the International Space Station, the challenge is now to reach a technology readiness level sufficiently high at both component and system levels to provide “off the shelf” payload for future generations of space missions in geodesy or fundamental physics. In this roadmap, we provide an extensive review on the status of all common parts, needs, and subsystems for the application of atom-based interferometers in space, in order to push for the development of generic technology components.
Seismo-acoustic coupling in the deep atmosphere of Venus
Authors: Averbuch Gil , Houston Reyna , Petculescu Andi
Published: March 2023

The extreme conditions at the surface of Venus pose a challenge for monitoring the planet's seismic activity using long-duration landed probes. One alternative is using balloon-based sensors to detect venusquakes from the atmosphere. This study aims to assess the efficiency with which seismic motion is coupled as atmospheric acoustic waves across Venus's surface. It is, therefore, restricted to the immediate neighborhood of the crust-atmosphere interface. In order to account for supercritical conditions near the surface, the Peng-Robinson equation of state is used to obtain the acoustic sound speed and attenuation coefficient in the lower atmosphere. The energy transported across the surface from deep and shallow sources is shown to be a few orders of magnitude larger than on Earth, pointing to a better seismo-acoustic coupling. For a more realistic scenario, simulations were made of the acoustic field generated in the lower atmosphere by the ground motion arising from a vertical array of subsurface point-force sources. The resulting transmission loss maps show a strong epicentral cone accompanied by contributions from leaky surface waves. Results at 0.1 Hz and 1 Hz confirm that the width of the epicentral cone is larger at lower frequencies.
Inflow turbulence distortion for airfoil leading-edge noise prediction for large turbulence length scales for zero-mean loading
Authors: dos Santos Fernanda L. , Botero-Bolívar Laura , Venner Cornelis H. , de Santana Leandro D.
Published: March 2023

Turbulence distortion due to airfoil finite thickness is an important but not fully understood phenomenon that affects the airfoil radiated noise, resulting in inaccurate noise predictions. This study discusses the turbulence distortion in the leading edge (LE) region of an airfoil aiming to obtain more accurate LE noise predictions. Wind tunnel experiments were performed for National Advisory Committee for Aeronautics (NACA) 0008 and NACA 0012 airfoils at zero angle of attack subjected to large turbulence length scales (between 10 and 43 times the airfoil LE radius) generated by a grid and a rod. Hot-wire and surface pressure measurements were performed in the LE region. Results show that the root mean square of the velocity fluctuations urms and the turbulence integral length scale Λf at the stagnation line decrease considerably as the LE is approached. Rod–airfoil radiated noise was measured and compared with Amiet's model. The predicted noise overestimates the LE noise for high frequencies. However, the prediction agrees well with measurements when the turbulence spectrum based on the rapid distortion theory is used in Amiet's model, with as inputs the urms and Λf values measured close to the LE. This work's main contribution is to demonstrate that more accurate noise predictions are obtained when the inputs to the model consider the turbulence distortion effects.
A Widefield Light Microscopy-Based Approach Provides Further Insights into the Colonization of the Flea Proventriculus by Yersinia pestis
Authors: Dewitte Amélie , Werkmeister Elisabeth , Pierre François , Sebbane Florent , Bontemps-Gallo Sébastien
Published: March 2023

Yersinia pestis
(the causative agent of plague) is one of the deadliest bacterial pathogens. It circulates primarily among rodent populations and their fleas.
Harnessing the Noncanonical Keap1-Nrf2 Pathway for Human Cytomegalovirus Control
Authors: Ghosh Ayan K. , Su Yu-Pin , Forman Michael , Keyes Robert F. , Smith Brian C. , Hu Xin , Ferrer Marc , Arav-Boger Ravit
Published: March 2023

Antiviral treatment for human cytomegalovirus (HCMV) is limited and suffers from the selection of drug-resistant viruses. Several cellular pathways have been shown to modulate HCMV replication.
Sodium Fluoride Exposure Leads to ATP Depletion and Altered RNA Decay in Escherichia coli under Anaerobic Conditions
Authors: Murashko Oleg N. , Yeh Kun-Hai , Yu Chen-Hsin Albert , Kaberdin Vladimir R. , Lin-Chao Sue
Published: March 2023

Gram-negative
Escherichia coli
is a rod-shaped facultative anaerobic bacterium commonly found in microaerobic/anaerobic environments, including the dental plaques of warm-blooded organisms. These latter can be treated efficiently with fluoride-rich compounds that act as anticaries agents to prevent tooth decay.
Effects of Spatial Expression of Activating Transcription Factor 4 on the Pathogenicity of Two Phenotypes of Bovine Viral Diarrhea Virus by Regulating the Endoplasmic Reticulum-Mediated Autophagy Process
Authors: Wang Jing , Chen Ke-Yuan , Wang Sheng-Hua , Liu Yi , Zhao Yi-Qing , Yang Lan , Yang Guang-Hui , Wang Xiao-Jia , Zhu Yao-Hong , Yin Jin-hua , Wang Jiu-Feng
Published: March 2023

The ER-tropic viruses hijack the host cellular ER as the replication platform of the life cycle, which can lead to strong ER stress. The UPR and related transcriptional cascades triggered by ER stress play a crucial role in viral replication and pathogenesis, but little is known about these underlying mechanisms.
Supplemental Material: To sink or not to sink: The thermal and density structure of the modern northern Andean arc constrained by xenolith petrology
Authors: Zieman Lisa , al. et
Published: March 2023

Analytical methods, thermobarometry and geochronology results, summary of microprobe analyses, and description of instability time scale calculations.
Rare cause of pericardial effusion: ‘Erdheim-Chester disease’
Authors: Imtiaz Haider , Hussein Mohsin , Chan Daniel , Garg Mamta
Published: March 2023

This report details the case of a woman in her 50s who presented with symptoms of congestive heart failure and raised inflammatory biochemical markers. Her investigations included an echocardiogram, which revealed a large pericardial effusion and a subsequent CT-thorax/abdomen/pelvis showing extensive retroperitoneal, pericardial and periaortic inflammation and soft-tissue infiltration. Genetic analysis of histopathological samples detected a V600E or V600Ec missense variant within codon 600 of the BRAF genewith BRAF variants, confirming the diagnosis of Erdheim-Chester disease (ECD).

The patient’s clinical management involved several treatments and interventions with input from a variety of clinical specialties. This included the cardiology team for pericardiocentesis, the cardiac surgical team for pericardiectomy due to recurrent pericardial effusions and finally the haematology team for further specialist treatment with pegylated interferon and consideration of BRAF inhibitor therapy. The patient became stable following treatment with significant improvement in her heart failure symptoms. She remains under regular joint cardiology and haematology team follow-up. The case highlighted the importance of using a multidisciplinary approach to best manage the multisystem involvement of ECD.
A comprehensive and healthcare equity promoting response by a civil society–public partnership to COVID-19 in Chiapas, Mexico
Authors: Rodríguez Ana Laura , Aranda Zeus , Brun Elvire , DiChiara Samuel , Esquinca Alondra , González Erick , González Sebastián , Jiménez Ariwame , Molina-Orozco César Uberto , Martínez Laura , Mullen Jaren , Vargas Bruno , Vázquez Sandra , Chacón-Hernández Selene
Published: March 2023

Following the first COVID-19 case in Chiapas, Mexico in March 2020, the non-governmental organisation Compañeros En Salud (CES) and the state’s Ministry of Health (MOH) decided to join forces to respond to the global pandemic. The collaboration was built over 8 years of partnership to bring healthcare to underserved populations in the Sierra Madre region. The response consisted of a comprehensive SARS-CoV-2 infection prevention and control programme, which included prevention through communication campaigns to combat misinformation and stigma related to COVID-19, contact tracing of suspected and confirmed COVID-19 cases and their contacts, outpatient and inpatient care for patients with respiratory symptoms, and CES–MOH collaboration on anti-COVID-19 immunisation campaigns. In this article, we describe these interventions and their principal outcomes, as well as reflect on notable pitfalls identified during the collaboration, and we suggest a series of recommendations to prevent and mitigate their occurrence. As with many cities and towns across the globe, the poor preparedness of the local health system for a pandemic and pandemic response led to the collapse of the medical supply chain, the saturation of public medical facilities and the exhaustion of healthcare personnel, which had to be overcome through adaptation, collaboration and innovation. For our programme in particular, the lack of a formal definition of roles and clear lines of communication between CES and the MOH; thoughtful planning, monitoring and evaluation and active engagement of the communities served in the design and implementation of health interventions affected the outcomes of our efforts.
Correlations between care users’ and the healthcare inspectorate’s ratings of the quality of care in long-term care homes
Authors: Palimetaki Flora , Woutersen Karlijn , Pot Anne Margriet
Published: March 2023

Objectives

Increasing emphasis is being placed on person-centredness as a quality requirement for long-term care (LTC). Although healthcare inspectorates value the importance of care users’ experiences, they struggle to address these experiences in regulatory practice. The aim of this study is to explore the correlations between care users’ and the healthcare inspectorate’s ratings of the quality of LTC in The Netherlands.

Design

The correlations between care users’ ratings from a public Dutch online patient rating site and the Dutch Health and Youth Care Inspectorate’s ratings of the quality of care were examined using Spearman rank correlations. The inspectorate’s ratings cover three themes: ‘attention to person-centred care’, ‘working towards sufficient and competent care staff’ and ‘focusing on quality and safety’.

Setting

Ratings of the quality of care were obtained for 200 LTC homes in The Netherlands between January 2017 and March 2019. These LTC homes had 6 to 350 residents (M=89; SD=57) and belonged to organisations with 1–40 LTC homes in total (M=6; SD=6).

Participants

Publicly available anonymous ratings of the perceived quality of care by care users were extracted from the Dutch patient rating website ‘www.zorgkaartnederland.nl’. Care users’ ratings were available for the 2 years prior to an assessment by the inspectorate for 200 LTC homes.

Results

We found a weak, significant correlation between the mean care users’ ratings and the inspectorate’s aggregated scores for the theme ‘person-centred care’ (r=0.26, N=200, padj<0.01); no other correlations were significant.

Conclusions

This study showed only a weak correlation between care users’ ratings and ratings of the Dutch Inspectorate of the quality of ‘person-centred care’ in LTC homes. Therefore, it may be fruitful to intensify or innovate approaches to involve care users’ experiences in regulation to do them justice.
Process improvement using telemedicine consultation to prevent unnecessary interfacility transfers for low-severity blunt head trauma
Authors: Miles Gayla , Shank Christopher , Quinlan Ann , Cavender Jennifer
Published: March 2023

Objective

Mild traumatic brain injuries (MTBI) associated with intracranial haemorrhage are commonly transferred to tertiary care centres. Recent studies have shown that transfers for low-severity traumatic brain injuries may be unnecessary. Trauma systems can be overwhelmed by low acuity patients justifying standardisation of MTBI transfers. We sought to evaluate the impact of telemedicine services on mitigating unnecessary transfers for those presenting with low-severity blunt head trauma after sustaining a ground level fall (GLF).

Method

A process improvement plan was developed by a task force of transfer centre (TC) administrators, emergency department physicians (EDP), trauma surgeons and neurosurgeons (NS) to facilitate the requesting EDP and the NS on-call to converse directly to mitigate unnecessary transfers. Consecutive retrospective chart review was performed on neurosurgical transfer requests between 1 January 2021 and 31 January 2022. A comparison of transfers preintervention and postintervention (1 January 2021 to 12 September 2021)/(13 September 2021 to 31 January 2022) was performed.

Results

The TC received 1091 neurological-based transfer requests during the study period (preintervention group: 406 neurosurgical requests; postintervention group: 353 neurosurgical requests). After consultation with the NS on-call, the number of MTBI patients remaining at their respective ED’s with no neurological degradation more than doubled from 15 in the preintervention group to 37 in the postintervention group.

Conclusion

TC-mediated telemedicine conversations between the NS and the referring EDP can prevent unnecessary transfers for stable MTBI patients sustaining a GLF if needed. Outlying EDPs should be educated on this process to increase efficacy.
Quality improvement project to reduce unplanned extubations in a paediatric intensive care unit
Authors: Ferreira Joyce Caroline Dinelli , Nascimento Milena Siciliano , Brandi Simone , do Prado Cristiane , Cintra Cintia de Cassia , Almeida João Fernando , Malheiro Daniel Tavares , Capone Antonio
Published: March 2023

Background

Unplanned extubations are recurrent adverse events in mechanically ventilated children and have been the focus of quality and safety improvement in paediatric intensive care units (ICUs).

Local problem

To reduce the rate of unplanned extubation in the paediatric ICU by 66% (from 2.02 to 0.7).

Methods

This is a quality improvement project that was conducted in a paediatric ICU of a private hospital at the quaternary level. All hospitalised patients who used invasive mechanical ventilation between October 2018 and August 2019 were included.

Interventions

The project was based on the Improvement Model methodology of the Institute for Healthcare Improvement to implement change strategies. The main ideas of change were innovation in the endotracheal tube fixation model, evaluation of the endotracheal tube positioning, good practices of physical restraint, sedation monitoring, family education and engagement and checklist for prevention of unplanned extubation, with Plan–Do–Study–Act, the tool chosen to test and implement ideas for change.

Results

The actions reduced the unplanned extubation rate to zero in our institution and sustained this result for a period of 2 years, totalling 743 days without any event. An estimate was made comparing cases with unplanned extubation and controls without the occurrence of this adverse event, which resulted in savings of R$955 096.65 (US$179 540.41) during the 2 years after the implementation of the improvement actions.

Conclusion

The improvement project conducted in the 11-month period reduced the unplanned extubation rate to zero in our institution and sustained this result for a period of 743 days. Adherence to the new fixation model and the creation of a new restrictor model, which enabled the implementation of good practices of physical restraint were the ideas of change that had the greatest impact in achieving this result.
Implementation of total laparoscopic hysterectomy as day case surgery
Authors: Ward Alistair , Roberts Samantha , Harvey Naomi , Dana Emily , Goumalatsou Charlotte , Tipples Melanie
Published: March 2023

Elective surgeries within the National Health Service are frequently cancelled due to shortages of inpatient beds due to acute emergency admissions, and more recently, the COVID-19 pandemic. The aim of this quality improvement project was to initiate a day case hysterectomy pathway, prospectively collecting data on a group of selected motivated patients to assess its feasibility and safety. Interventions to maximise the chance of same day discharge included preoperative education and hydration, alterations in anaesthetic and surgical techniques and collaborative working between surgeons and recovery nurses to safely discharge patients. In change cycle 1, 93% of patients were discharged on the same day as surgery. In change cycle 2, 100% of patients were discharged on the same day as surgery. In a patient questionnaire, 90% of patients would recommend a day case hysterectomy to their friends or family. Day case hysterectomy was safely introduced to our unit, through leaders actively encouraging contributions and feedback throughout the initiation of the pathway from different components of the multidisciplinary team, from conception to roll out of the guideline for use by other gynaecological surgical teams within the trust.
POSTOPED: improving surveillance of postoperative delirium in a Scottish tertiary hospital
Authors: Brown Keiran Anthony , McCulloch Alison
Published: March 2023

Delirium is the most common postoperative complication among patients over the age of 65 years. It is associated with increased morbidity and is a significant financial cost to healthcare systems.

We aimed to improve the detection of delirium on the surgical wards of a tertiary surgical centre. This would take the form of completion of 4AT assessments (the 4 AT test for delirium, on admission and 1 day postoperatively). Prior to this project, the 4AT was in use in the surgical admission clerking paperwork for over 65 s, however, 4AT assessments were not routinely performed as part of day 1 postoperative assessment. By introducing routine postoperative assessment and reinforcing the importance of admission assessment, we hoped to allow for objective comparisons to be made about patients cognitive state and thereafter improve delirium identification.

After a baseline snapshot data collection period, we conducted five (Plan, Do, Study, Act) cycles following which repeat snapshot data were collected. Improvement strategies included ‘tea-trolley’ teaching sessions, adhesive 4AT pro-forma, targeted accompaniment of specialty ward rounds with reminders to complete 4AT assessments and working with nursing staff to promote awareness of delirium among permanent non-rotating healthcare professionals.

For the admission 4ATs, completion improved from a baseline of 74.1%–90.5% in cycle 5. Completion of postoperative 4AT assessments rose from 14.8% at baseline to 47.6% in cycle 5.

We were able to improve the use of a delirium screening tool, (the 4AT) among the postoperative elderly population in this centre via the use of regular teaching sessions, targeted interventions on ward rounds as well working with non-rotating staff. Further improvements could be made by widening access to delirium champion programmes and including delirium as an outcome measure of national surgical audits such as the National Emergency Laparotomy Audit.