bluuebunny/crossref_metadata_2025 huggingface dataset:
How should we approach parental refusals of opioids on behalf of children in the perioperative setting? A practical approach based on ethical theory
Authors: Moreno‐Galvan Anna , Marron Jonathan Michael , Marsiglio Angela Maree
Published: June 2020

In the midst of the current opioid epidemic, we have encountered more parents who are concerned about the use of opioids in the perioperative setting. Some parents have completely refused the use of opioids on behalf of their children. How should we approach this treatment refusal? This article describes ethical theory related to the refusal of treatment by parents on behalf of their children, and when it is justified to override parental decisions. We propose a decision‐making framework that focuses on improving communication and considering alternatives. Assessment of harm to the child from avoiding opioids, as well as potential harms from overriding parental autonomy must be undertaken prior to considering overriding parents.
Lessons from One Arm Dove Hunt
Authors: Moss Jacob
Published: June 2020

Artist, Jacob Moss's documentary photography project, One Arm Dove Hunt, explores the experiences of individuals with ectodermal dysplasia, a condition he also has. Lessons from One Arm Dove Hunt examines Jacob's own experience growing up with ectodermal dysplasia and what it's like collaborating with others with various forms of ectodermal dysplasia.
Designing to Debias: Measuring and Reducing Public Managers’ Anchoring Bias
Authors: Nagtegaal Rosanna , Tummers Lars , Noordegraaf Mirko , Bekkers Victor
Published: June 2020

Public managers’ decisions are affected by cognitive biases. For instance, employees’ previous year's performance ratings influence new ratings irrespective of actual performance. Nevertheless, experimental knowledge of public managers’ cognitive biases is limited, and debiasing techniques have rarely been studied. Using a survey experiment on 1,221 public managers and employees in the United Kingdom, this research (1) replicates two experiments on anchoring to establish empirical generalization across institutional contexts and (2) tests a consider‐the‐opposite debiasing technique. The results indicate that anchoring bias replicates in a different institutional context, although effect sizes differ. Furthermore, a low‐cost, low‐intensity consider‐the‐opposite technique mitigates anchoring bias in this survey experiment. An exploratory subgroup analysis indicates that the effect of the intervention depends on context. The next step is to test this strategy in real‐world settings.
Coastal wetland restoration improves habitat for juvenile sportfish in Tampa Bay, Florida, U.S.A.
Authors: Schulz Kailee , Stevens Philip W. , Hill Jeffrey E. , Trotter Alexis A. , Ritch Jared L. , Williams Kyle L. , Patterson Joshua T. , Tuckett Quenton M.
Published: June 2020

Increasing human populations and urban development have led to losses of estuarine habitats for fish and wildlife. Where resource managers are restoring coastal wetlands, in addition to meeting goals related to hydrologic connectivity, biodiversity, and recreational opportunities, efforts are being made to provide habitat that is suitable for juvenile sportfish. An 18‐month study was conducted to compare juvenile sportfish use of natural, restored, and impacted sites along Tampa Bay, Florida, shorelines. Juvenile sportfish densities at restored sites were broadly comparable to natural sites and greater than at impacted sites. However, site‐specific differences in sportfish use did occur within site types. For example, one restored site had significantly higher densities of red drum Sciaenops ocellatus than any other site, while black drum Pogonias cromis were found exclusively at another restored site. To evaluate whether the restored sites are providing suitable habitat for juvenile fish, we assessed growth (estimated from counts of daily rings on otoliths) and condition (determined by lipid analyses) of juvenile common snook Centropomus undecimalis, an archetypal coastal wetland‐dependent species. Growth (0.43–0.56 mm SL/day) and condition (4.6–6.1% lipid of dry weight) exhibited only site‐specific differences and did not vary among natural, restored, and impacted site types. Although mortality rates of juvenile sportfish were not determined, use of a 40‐m seine found that densities of potential piscine predators in these coastal wetlands were relatively low compared to published studies of open estuarine shorelines. The restoration and creation of coastal wetlands in Tampa Bay provides improved habitat for juvenile sportfish.
Flood Risk Assessment and Regionalization from Past and Future Perspectives at Basin Scale
Authors: Lai Chengguang , Chen Xiaohong , Wang Zhaoli , Yu Haijun , Bai Xiaoyan
Published: June 2020

Flooding is a major natural disaster that has brought tremendous losses to mankind throughout the ages. Even so, floods can be controlled by appropriate measures to minimize loss and damage. Flood risk assessment is an essential analytic step in preventing floods and reducing losses. Identifying previous flood risk and predicting future features are conducive to understanding the changing patterns and laws of flood risk. Taking the Dongjiang River basin as a study case, we assessed and regionalized flood risk in 1990, 2000, and 2010 from the past perspective and explored dynamic expansion during 1990–2010. Then, we projected land‐use type, population, and gross domestic product in 2030 and 2050 and finally assessed and regionalized the risk from a future perspective. Results show that areas with very high risk accounted for 14.98–18.08% during 1990–2010; approximately 13.90% areas of the basin transformed from lower‐level risk to higher‐level risk whereas 9.07% fell from a higher level to a lower level during the period. For the future scenario, areas with very high and high risk in 2030 and 2050 are expected to account for 21.55% and 24.84%, respectively. Generally, our study can better identify changes in flood risk at a spatial scale and reveal the dynamic evolution rule, which provides a synthetical means of flood prevention and reduction, flood insurance, urban planning, and water resource management in the future under global climate change, especially for developing or high‐speed urbanization regions.
Symbolism in Early Russian Cinema and the Ghostwriter Aleksandr Kursinskii
Authors: KOVALOVA ANNA , RANNEVA ARINA
Published: June 2020

This article examines the influence on early Russian cinema of Symbolism and the cinematographic activities of the poet Aleksandr A. Kursinskii. Thus far, the assumption has been that Symbolists worked only sporadically in cinema, and that Kursinskii had written only one screenplay for a film that was actually produced, Beautiful Like Death (1914). But documents that previously had escaped the attention of film studies specialists reveal that there were in fact many films influenced by Symbolists—among them the canonical 1914 releases Anna Karenina and Nest of the Gentry. Kursinskii, moreover, worked for one of the most influential film studios of prerevolutionary Russia, Timan and Reingardt, which in the 1910s produced the outstanding “Russian Golden Series” of films. The cinematography of the Symbolist Kursinskii hugely influenced Russian cinema of the mid‐to‐late 1910s.
Politics and the UK's monetary policy
Authors: Chang Fang‐Shuo , Chen Shiu‐Sheng , Wang Po‐Yuan
Published: June 2020

This paper examines whether politics causes regime shifts in deviations from the optimal monetary policy in the United Kingdom. After using a dynamic stochastic general equilibrium model to construct the welfare‐maximizing policy rule and deviations from the optimal Taylor rule, we show that politics does indeed play an important role in explaining these deviations. In addition to politics, unemployment rates account for regime shifts in the Taylor rule deviations.
Clinical management of tendinopathy: A systematic review of systematic reviews evaluating the effectiveness of tendinopathy treatments
Authors: Irby Alyssa , Gutierrez Jacqueline , Chamberlin Claressa , Thomas Stephen J. , Rosen Adam B.
Published: June 2020

While the pathoetiology is disputed, a wide array of treatments is available to treat tendinopathy. The most common treatments found in the literature include therapeutic modalities, exercise protocols, and surgical interventions; however, their effectiveness remains ambiguous. The purpose of this study was to perform a systematic review of systematic reviews to determine the ability of therapeutic interventions to improve pain and dysfunction in patients with tendinopathy regardless of type or location. Five databases were searched for systematic reviews containing only randomized control trials to determine the effectiveness of treatments for tendinopathies based on pain and patient‐reported outcomes. Systematic reviews were assessed via the Assessment of Multiple Systematic Reviews (AMSTAR) for methodological quality. From the database search, 3,295 articles were found, 107 passed the initial inclusion criteria. After further review, 25 systematic reviews were included in the final qualitative analysis. The AMSTAR scores were relatively high (8.8 ± 1.0) across the 25 systematic reviews. Eccentric exercises were the most common and consistently effective treatment for tendinopathy across systematic reviews. Low‐level laser therapy and extracorporeal shockwave therapy demonstrated moderate effectiveness, while platelet‐rich plasma injections demonstrated inconclusive evidence on their ability to decrease tendinopathy‐related pain and improve function. Corticosteroids also showed some effectiveness for short‐term pain, but for the long‐term use deemed ineffective and at times contraindicated. Regarding surgical options, minimally invasive procedures were more effective compared to open surgical interventions. When treating tendinopathy regardless of location, eccentric exercises were the best treatment option to improve tendinopathy‐related pain and improve self‐reported function.
Biomechanics of graded running: Part II—Joint kinematics and kinetics
Authors: Khassetarash Arash , Vernillo Gianluca , Martinez Aaron , Baggaley Michael , Giandolini Marlene , Horvais Nicolas , Millet Guillaume Y. , Edwards William Brent
Published: June 2020

Compared to level running (LR), different strategies might be implemented by runners to cope with specific challenges of graded running at different speeds. The changes in joint kinetics and kinematics associated with graded running have been investigated, but their interactions with speed are unknown. Nineteen participants ran on an instrumented treadmill at five grades (0°, ±5° and ± 10°) and three speeds (2.50, 3.33 and 4.17 m/s), while 3D motion and forces were recorded. Three speed × five‐grade repeated‐measures ANOVA was used to analyze kinetic and kinematic variables. A speed × grade interaction was observed for hip range of motion (ROM). Downhill running (DR) at fastest speed did not reduce ROM at the hip, compared to LR. Compared to LR, it was observed that the hip joint was responsible for a greater contribution of energy generation while running at the fastest speed at +10°. Speed × grade interactions were also observed for the energy absorption, peak moment, and peak power at the knee. Contrary to LR, running faster during UR did not require higher peak power at the knee. Finally, DR at the fastest speed did not increase peak negative power at the knee compared to LR. This study demonstrates that ankle, knee, and hip joint kinetics depend on speed and grade of running, while the effect of grade on joint kinematics was not substantially modulated by speed.
New World Heterotermes (Isoptera, Rhinotermitidae): molecular phylogeny, biogeography and description of a new species
Authors: Carrijo Tiago F. , Pontes‐Nogueira Matheus , Santos Rafaella G. , Morales Adriana C. , Cancello Eliana M. , Scheffrahn Rudolf H.
Published: June 2020

Heterotermes Froggatt is a subterranean termite genus consisting of 30 living described species worldwide, with nine occurring in the New World. Herein we provide a molecular phylogeny, using both mitochondrial and nuclear markers, of all New World species of Heterotermes, including biogeographical analysis, and describe a new species from Paraguay and Bolivia, based on morphological and molecular evidence. Our analysis recovered the New World species as paraphyletic to a monophyletic Australian clade. Within this New World + Australian clade, two monophyletic major groups were formed c. 28 Ma: the aureus‐ and tenuis‐groups. The aureus‐group has a disjunct and broad distribution consisting of two clades. The first clade extends into the Nearctic region and a second is composed of a branch in the Caatinga and Cerrado biomes (H. sulcatus Mathews) and a branch in the Chacoan biome (a new species, Heterotermes lauralinearum Carrijo sp.n.). The tenuis‐group is composed of four broadly distributed Neotropical species and the Australian clade. A single dispersion event from South America to Australia probably occurred between 13 and 24 Ma. Heterotermes crinitus Emerson was the first to diverge, being sister group of all other species in the tenuis‐group, followed by Heterotermes assu Constantino. An analysis of the historical biogeography of Heterotermes suggests that jump dispersal was the most important cladogenetic process for the genus. This study is the most comprehensive phylogeny of Heterotermes and contributes to the understanding of termite evolution and geographic distribution in the New World, complementing recent studies focused on worldwide patterns.

This published work has been registered on Zoobank, http://zoobank.org/urn:lsid:zoobank.org:pub:8951A29B‐8B69‐4CD5‐B9DF‐2C70D4628D97.
Characterization of the novel HLA‐DRB1*04:275 allele by sequencing‐based typing
Authors: Elsermans Vincent , Visentin Jonathan , Top Isabelle , Varlet Pauline , Labalette Myriam
Published: June 2020

HLA‐DRB1*04:275 differs from HLA‐DRB1*04:04:01 by one nucleotide substitution in codon 41 in exon 2.
Open‐source tools for the measurement of socio‐spatial segregation in activity spaces
Authors: Hong Seong‐Yun
Published: June 2020

Over the last decade, socio‐spatial segregation of different population groups in activity spaces has attracted considerable attention from geographers and sociologists. A careful examination of such activity‐space segregation can provide a more comprehensive description of dynamic intergroup relations in society than conventional residential segregation, as its measurement is not limited to a particular place. However, the evaluation of activity‐space segregation is a challenging task because it requires the manipulation of large spatiotemporal data sets. The lack of software tools that can assist researchers in exploring and analyzing individuals’ travel trajectories is one of the significant impediments to empirical studies. To address this practical limitation, this article proposes a combined use of two R packages, namely,sliceandseg: the former provides tools for storing and manipulating activity‐space data, and the latter implements several existing measures of segregation that can be applied to various social places. The proposed approach is applied to the measurement of activity‐space segregation between high‐ and low‐income groups in Seoul to illustrate the key features of the packages. The results demonstrate that the use of these packages would make it more convenient to conduct activity‐space segregation research and enhance our understanding of the complex socio‐spatial phenomenon.
Retrospective cohort studies of repeat donors reveal donor‐dependent variability in the recovery of transfused platelets
Authors: Stefely Jonathan A. , Gailey Michael , Knudson Michael , Dumont Larry J. , Raife Thomas J. , Samia Noelle I.
Published: June 2020

BACKGROUND

The in vivo recovery of transfused platelets is variable and often unpredictable. Although many recipient‐dependent factors are well described, donor‐dependent variables remain poorly understood.

STUDY DESIGN AND METHODS

To explore donor‐dependent variables we conducted 2 retrospective studies of platelet transfusion outcomes in repeat donors. One study analyzed multiple autologous, radiolabeled platelet transfusions, and a second study analyzed multiple clinical platelet transfusions from a small cohort of repeat donors.

RESULTS

In 36 subjects, multiple within‐subject determinations of recovery and survival of radiolabeled autologous platelets revealed a relative consistency in platelet recoveries within donors compared to the range of recoveries among donors. Intraclass correlation coefficients for platelet recovery were 43% to 93%. In 524 ABO‐compatible clinical platelet transfusions derived from seven donors, a linear mixed‐effects model revealed significant donor‐dependent differences in corrected count increments for units stored for 4 or 5 days.

CONCLUSIONS

These two studies indicate reproducible donor‐dependent differences in transfused platelet recovery, suggesting a possible heritable influence on the quality of transfused platelets.
Testing the asymmetric effects of exchange rate pass‐through in BRICS countries: Does the state of the economy matter?
Authors: Balcilar Mehmet , Roubaud David , Usman Ojonugwa , Wohar Mark E.
Published: June 2020

This paper investigates not only the question of whether there is exchange rate pass‐through (ERPT) but also the extent to which the pass‐through is asymmetric or state‐dependent in the BRICS countries. Using monthly data from 1999:M1 to 2019:M12 and non‐linear smooth transition vector autoregressive (STVAR) model, our results provide evidence of period‐specific ERPT between the upper and lower regime periods, governed by the selected transition variables. The results further suggest that the pass‐through of exchange rate is higher when the economy is experiencing large appreciations and expansions as well as large depreciations and recessions. Theimplication for these findings is that ERPT is strongly affected by the state of the economy.
A new species of Trhypochthoniellus (Acari: Oribatida: Trhypochthoniidae) from Cuatro Ciénegas, Coahuila, Mexico, and a key to the world species

Authors: M. Ojeda , Velez P. , Espinosa-asuar L. , Eguiarte L. E. , Souza V.
Published: June 2020

Trhypochthoniellus comprises nine species, being mostly associated to aquatic vegetation; T. chilensis Ermilov & Weigmann as the only known species from North and South America. This genus is recorded for the first time in Mexico. Herein we present the description, illustrations and SEM photographs of Trhypochthoniellus churincensis sp. nov., which was found in association to lignocellulolytic microfungal taxa in the oligotrophic freshwater oasis of Cuatro Ciénegas Basin, Coahuila, México. T. churincensis sp. nov. is morphologically similar to T. longisetus (Berlese) and T. brevisetus Kuriki; however, it differs from both taxa by the presence of nine genital setae (11 to 13 setae), setae h3 subequal to other posterior notogastral setae; subcapitular setae h very short, and notogastral c1 larger. Additionally, we discuss information on food preferences and reproductive mode obtained through the observation of one cultured population maintained under laboratory conditions. A key to the species of Trhypochthoniellus is provided.
Two new species of Tarsonemus (Acari: Tarsonemidae) from Bahia, Brazil

Authors: Sousa André Silva Guimarães , Rezende José Marcos , Lofego Antonio Carlos , Ochoa Ronald , Bauchan Gary , Gulbronson Connor , Oliveira Anibal Ramadan
Published: June 2020

The Tarsonemidae (Acari: Prostigmata) exhibit a high diversity of feeding habits and morphological structures, which allow them to live in a diversity of habitats. Tarsonemus is the largest genus, with more than 280 described species belonging to three subgenera: Tarsonemus sensu stricto, Chaetotarsonemus and Schaarschmidtia. Eight species of the genus have been reported from Brazil. In addition, there are two new species, Tarsonemus cacao sp. nov. from Theobroma cacao L. (Malvaceae) branches, and Tarsonemus bahiensis sp. nov. from Passiflora foetida L. (Passifloraceae) and Etlingera elatior Jack (Zingiberaceae) leaves. Both new species were collected in a cabruca agroforest, a traditional cacao cultivation system in the southern coast region of Bahia state. The new Tarsonemidae are described and illustrated here. Pharyngeal and gnathosomal structures of the new species are compared to other Tarsonemus species.
Assessment of atomic layer deposited TiO2 photocatalytic self-cleaning by quartz crystal microbalance
Authors: Henry Théo , Martins Paolo , Eustache Etienne , Servet Bernard , Divay Laurent , Jouanne Pierre , Grasset Philippe , Dudon Jean-Paul , Hugonnot Patrick , Fleury-Frenette Karl
Published: June 2020

The self-cleaning properties emerging from photocatalytic effects consist in the elimination of an organic contamination layer by light-induced redox reactions. Quartz crystal microbalances (QCMs), monitoring the contaminant mass loss under UV illumination, were used to investigate this effect and its efficiency. A new setup dedicated to such purpose is introduced along with the results of a self-cleaning experiment performed with a 20-nm TiO2 thin film coated on a QCM by atomic layer deposition. In particular, a 10-nm paraffin oil thin film deposited under vacuum is shown to be degraded down to its complete removal according to a zeroth order photocatalytic reaction. Finally, the experimental opportunities offered by the new setup, such as a controlled environment composition, are presented.
A landmark-cue-based approach to analyzing the acoustic realizations of American English intervocalic flaps
Authors: Yun Suyeon , Choi Jeung-Yoon , Shattuck-Hufnagel Stefanie
Published: June 2020

This study examines the acoustic realizations of American English intervocalic flaps in the TIMIT corpus, using the landmark-critical feature-cue-based framework. Three different acoustic patterns of flaps are described: (i) both closure and release landmarks present, (ii) only the closure landmark present, and (iii) both landmarks deleted. The patterns occur consistently across several phonological and morphological conditions but vary with sociolinguistic factors, including speaker dialect and gender. This method of analysing speech at the level of acoustic landmarks and other individual cues to distinctive features contributes to a deeper understanding of how speakers and listeners employ systematic variation in phonetic detail in speech processing.
The Prevalence and Perceived Health Factors of Healthy Eating and Active Living: An International Older Population-Based Study
Authors: Yen Hsin-Yen , Hsu Hsuan
Published: June 2020

Engaging in healthy eating and active living is an effective strategy for preventing noncommunicable diseases in older populations. The purposes were to compare the prevalence rates across countries and explore health factors associated with healthy eating and active living. The data were retrieved from a cross-sectional study conducted by the International Social Survey Program (2011 Health and Healthcare), with structured questionnaire surveys in 32 countries. The results showed that 38.42% reported active living and 39.11% reported healthy eating among 11,250 total respondents. Older adults with a long-standing illness or obesity who felt that they were not overcoming problems and had lost confidence were less likely to engage in healthy behavior. Perceived general health had a positive association with the odds of engaging in healthy eating and active living. The international comparisons provide a reference for local governments to decrease health disparities. Inspiring self-awareness about health might encourage older adults to pursue healthy lifestyles.
Genetic Control of Oxidative Mutagenesis in Sulfolobus acidocaldarius
Authors: Jain Rupal , Dhiman Samuel , Grogan Dennis W.
Published: June 2020

Hyperthermophilic archaea are expected to have effective (and perhaps atypical) mechanisms to limit the genetic consequences of DNA damage, but few gene products have been demonstrated to have genome-preserving functions
in vivo
. This study confirmed by genetic criteria that the
S. acidocaldarius
Ogg protein avoids the characteristic mutagenesis of G oxidation. This enzyme and the bypass polymerase Dbh have similar impacts on genome stability but work independently and may comprise most of the DNA oxidation defense of
S. acidocaldarius
. The critical dependence of accurate oxoG bypass on the accessory DNA polymerase Dbh further argues that some form of polymerase exchange is important for accurate genome replication in
Sulfolobus
, and perhaps in related hyperthermophilic archaea.
A Temperature-Dependent Translation Defect Caused by Internal Ribosome Entry Site Mutation Attenuates Foot-and-Mouth Disease Virus: Implications for Rational Vaccine Design
Authors: Yang Decheng , Sun Chao , Gao Rongyuan , Wang Haiwei , Liu Wenming , Yu Kewei , Zhou Guohui , Zhao Bo , Yu Li
Published: June 2020

The World Organization for Animal Health has called for global control and eradication of foot-and-mouth disease (FMD), the most economically and socially devastating disease affecting animal husbandry worldwide. Live-attenuated vaccines are considered the most effective strategy for prevention, control, and eradication of infectious diseases due to their capacity to induce potent and long-lasting protective immunity. However, efforts to develop FMD virus (FMDV) live-attenuated vaccines have achieved only limited success. Here, by structure-function study of the FMDV internal ribosome entry site (IRES), we find that the C351 mutation of the IRES confers FMDV with an ideal temperature-sensitive attenuation phenotype by decreasing its interaction with cellular pyrimidine tract-binding protein (PTB) to cause IRES-mediated temperature-dependent translation defects. The temperature-sensitive attenuated strains generated by manipulation of the IRES address the challenges of FMDV attenuation differences among various livestock species and immunogenicity maintenance encountered previously, and this strategy can be applied to other viruses with an IRES to rationally design and develop live-attenuated vaccines.
Knee arthrodesis for a congenital luxation with Larsen syndrome
Authors: Kaynak Mustafa , Meuffels Duncan E
Published: June 2020

A 31-year-old woman with known Larsen syndrome presented with congenital chronic luxation of her right knee with increasing instability symptoms, which limited her daily activities. We refrained from a constrained knee arthroplasty due to her relatively young age and decided to perform a knee arthrodesis. Knee arthrodesis is a viable lifelong-lasting operative treatment alternative for specific instability-related knee disease. The knee arthrodesis was performed by double plating with an additional fixation of the patella. At 1-yearfollow-up, she was able to walk without limitations and did not experience any pain with complete consolidation of the arthrodesis. At 2-year follow-up, she performed all her daily activities without limitations. Both the Knee injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee subjective knee form (IKDC) improved at 2-year follow-up (KOOS: 61.3; IKDC: 56.3) compared with 1-year follow-up (KOOS: 52; IKDC: 40.2).
Health-related quality Of Life In patients with advanced Soft TIssue sarcomas treated with Chemotherapy (The HOLISTIC study): protocol for an international observational cohort study
Authors: Younger Eugenie , Jones Robin L , Desar Ingrid M E , Peckitt Clare , van der Graaf Winette T A , Husson Olga
Published: June 2020

Introduction

Chemotherapy is the mainstay of treatment for patients with advanced soft tissue sarcomas (STS). Treatment intent is usually palliative, aiming to improve symptoms, stabilise or reduce tumour burden and extend life. Clinical trials have traditionally used radiological response, time to progression and survival as measures of treatment efficacy. Health-related quality of life (HRQoL) is at least equally important or more important than survival for many patients with advanced cancer. Systematically collecting HRQoL data during chemotherapy can provide greater insight into treatment efficacy from the patient perspective.

The primary aims of this study are to evaluate HRQoL in patients with advanced STS treated with chemotherapy over time, explore the decision-making process and patient reflection post-treatment.

Methods and analysis

This is an observational, international cohort study for 132 patients aged ≥18 years with advanced STS treated at eight centres (three in the UK, five in the Netherlands). Patients will be recruited prior to starting first-line or third-line chemotherapy and invited to complete questionnaires using the Patient-Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship registry (PROFILES); an established international registry for collection of cancer patient-reported outcomes. Online (or paper) questionnaires will be completed at baseline, each cycle of chemotherapy and 2–3 monthly during follow-up. The questionnaire package includes the Decisional Conflict Scale, Control Preferences Scale, Quality–Quantity Questionnaire, treatment expectations, European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30), EORTC financial toxicity items, Work Ability Index, Functional Assessment of Cancer Therapy-General (FACT-G) items and Decisional Regret Scale. Clinical data will be extracted from patient records and linked with questionnaire responses. The primary outcome measure is the change in global HRQoL from baseline to after cycle 4 of first-line chemotherapy (based on published data showing that patients with advanced STS complete a median number of four cycles of first-line chemotherapy).

Ethics and dissemination

Heath Research Authority and Research Ethics Committee (REC 17/NI/0197). Results from the Health-related quality Of Life In patients with advanced Soft TIssue sarcomas treated with Chemotherapy (HOLISTIC) study will be published in peer-reviewed journals and disseminated at local, national and international conferences. We will also present our findings at any appropriate patient meetings and involve patients in study-related publications.

Trial registration number

NCT03621332.
Gender differences in the accuracy of dietary assessment methods to measure energy intake in adults: protocol for a systematic review and meta-analysis
Authors: McKenzie Briar L , Coyle Daisy H , Burrows Tracy , Rosewarne Emalie , Peters Sanne A E , Carcel Cheryl , Collins Clare E , Norton Robyn , Woodward Mark , Jaacks Lindsay M , Webster Jacqui
Published: June 2020

Introduction

Diet is an important modifiable risk factor for many chronic diseases. Measurement of dietary intake usually relies on self-report, subject to multiple biases. There is a need to understand gender differences in the self-report of dietary intake and the implications of any differences in targeting nutrition interventions. Literature in this area is limited and it is currently unknown whether self-report dietary assessment methods are equally accurate for women and men. The aim of this systematic review is to determine whether there are differences by gender in reporting energy intake compared with a reference measure of total energy expenditure.

Methods and analysis

A comprehensive search of published original research studies will be performed in MEDLINE, Scopus, Web of Science, EMBASE, CINAHL and Cochrane library. Original research studies will be included if they were conducted in free-living/unhospitalised adults and included a measure for both women and men of (a) self-reported energy intake and (b) total energy expenditure by doubly labelled water. One author will conduct the electronic database searches, two authors will independently screen studies, conduct a quality appraisal of the included studies using standardised tools and extract data. If further information is needed, then study authors will be contacted. If appropriate, a random-effects meta-analysis will be conducted, with inverse probability weighting, to quantify differences in the mean difference in agreement between reported energy intake and measured energy expenditure between women and men, by self-report assessment method. Subgroup analyses will be conducted by participant factors, geographical factors and study quality.

Ethics and dissemination

All data used will be from published primary research studies or deidentified results provided at the discretion of any study authors that we contact. We will submit our findings to a peer-reviewed scientific journal and will disseminate results through presentations at international scientific conferences.

PROSPERO registration number

CRD42019131715.
Epidemiology and risk factors of pesticide poisoning in Malaysia: a retrospective analysis by the National Poison Centre (NPC) from 2006 to 2015
Authors: Kamaruzaman Nur Azzalia , Leong Yin-Hui , Jaafar Mohd Hafiidz , Mohamed Khan Halilol Rahman , Abdul Rani Noor Afiza , Razali Mohd Fadhli , Abdul Majid Mohamed Isa
Published: June 2020

Objective

Pesticide poisoning is a global health problem, and its progressive deterioration is a major cause of concern. The objective of this study is to assess epidemiological characteristics and identify risk factors of pesticide poisoning in Malaysia.

Setting

Pesticide poisoning database of Malaysia National Poison Centre (NPC) from 2006 to 2015.

Participants

Telephone enquiries regarding pesticide poisoning were made by healthcare professionals. Information received by the NPC was entered into a retrievable database of standardised Poison Case Report Form, as adapted from the World Health Organization (WHO).

Outcomes

The outcome of the study is to provide an overview of national epidemiological profile of pesticide poisoning. High-risk groups of people and their circumstances were also identified to ensure that appropriate measures are strategised.

Results

Within the study period, a total of 11 087 pesticide poisoning cases were recorded. Sixty per cent of these cases were intentional in nature and most were found among male individuals (57%) of the Indian race (36.4%) aged between 20 and 29 years (25.5%), which occurred at home (90%) through the route of ingestion (94%). The highest number of poisoning was due to herbicides (44%) followed by agricultural insecticides (34%), rodenticides (9.9%), household insecticides (9.5%) and fungicides (0.5%). In addition, 93.6% of intentional pesticide poisoning cases were caused by suicide attempts. The results of this study show that there was an increasing trend in pesticide poisoning incidents over the 10-year duration. This indicates that pesticide poisoning is a prevalent public health problem in Malaysia, resulting in an average incidence rate of 3.8 per 100 000 population.

Conclusions

Deliberate pesticide ingestion as a method of suicide has become a disturbing trend among Malaysians. Therefore, regulation of highly hazardous pesticides must be enforced to ensure controlled and limited access to these chemicals by the public.
Variations in antibiotic prescribing among village doctors in a rural region of Shandong province, China: a cross-sectional analysis of prescriptions
Authors: Dyar Oliver James , Yang Ding , Yin Jia , Sun Qiang , Stålsby Lundborg Cecilia
Published: June 2020

Objectives

To assess variation in antibiotic prescribing practices among village doctors in a rural region of Shandong province, China.

Design, setting and participants

Almost all outpatient encounters at village clinics result in a prescription being issued. Prescriptions were collected over a 2.5-year period from 8 primary care village clinics staffed by 24 doctors located around a town in rural Shandong province. A target of 60 prescriptions per clinic per month was sampled from an average total of around 300. Prescriptions were analysed at both aggregate and individual-prescriber levels, with a focus on diagnoses of likely viral acute upper respiratory tract infections (AURIs), defined as International Classification of Diseases, 10th Revision codes J00 and J06.9.

Main outcome measures

Proportions of prescriptions for AURIs containing (1) at least one antibiotic, (2) multiple antibiotics, (3) at least one parenteral antibiotic; classes and agents of antibiotics prescribed.

Results

In total, 14 471 prescriptions from 23 prescribers were ultimately included, of which 5833 (40.3%) contained at least 1 antibiotic. Nearly two-thirds 62.5% (3237/5177) of likely viral AURI prescriptions contained an antibiotic, accounting for 55.5% (3237/5833) of all antibiotic-containing prescriptions. For AURIs, there was wide variation at the individual level in antibiotic prescribing rates (33.1%–88.0%), as well multiple antibiotic prescribing rates (1.3%–60.2%) and parenteral antibiotic prescribing rates (3.2%–62.1%). Each village doctor prescribed between 11 and 21 unique agents for AURIs, including many broad-spectrum antibiotics. Doctors in the highest quartile for antibiotic prescribing rates for AURI also had higher antibiotic prescribing rates than doctors in the lowest quartile for potentially bacterial upper respiratory tract infections (pharyngitis, tonsillitis, laryngopharyngitis; 89.1% vs 72.4%, p=0.002).

Conclusions

All village doctors overused antibiotics for respiratory tract infections. Variations in individual prescriber practices are significant even in a small homogenous setting and should be accounted for when developing targets and interventions to improve antibiotic use.
Attitudes of rural communities towards the use of technology for health purposes in New Zealand: a focus group study
Authors: Babbage Duncan R , van Kessel Kirsten , Terraschke Agnes , Drown Juliet , Elder Hinemoa
Published: June 2020

Objectives

Examine attitudes to using online health and wellness services, and determine what barriers may exist to this in two rural communities in New Zealand.

Design

A thematic analysis informed by a social constructivist paradigm explored the attitudes of youth and adults to give voice to these communities. Eighteen focus groups—nine in each region—were held for an hour each, with between three and nine participants in each group.

Setting

Two rural areas at the Northern and Southern ends of New Zealand were chosen. In each area, we partnered with a local health centre providing primary care services. Three localities were identified within each region where we conducted the data collection.

Participants

Participants were youth aged 12–15 years, aged 16–20 years and adults over 21 years. Overall, 74 females and 40 males were recruited. Recruitment occurred through schools, community organisations or personal contacts of the facilitators, who were youth workers in their respective communities. Ethnicity of the participants was representative of each area, with a higher percentage of Māori participants in Northland.

Results

Eight themes were identified which described participants’ attitudes to technology use in healthcare. Themes covered accessibility, cost, independence, anonymity and awareness issues: technology makes health information easily accessible; access to technology can be limited in rural communities; technology can reduce the cost of healthcare but it is too expensive for some; technology increases independence and autonomy of people’s own health; independent healthcare decisions come with risks; anonymity encourages people to seek help online; technology can help raise awareness and provide peer-support for people with health issues; technology impacts on social relationships.

Conclusions

Participants—particularly youth—were generally positive about the role of technology in healthcare delivery, and interested in ways technology could improve autonomy and access to health and wellness services.
Protocol for a mixed-method analysis of implementation of case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs
Authors: Danish Alya , Chouinard Maud-Christine , Aubrey-Bassler Kris , Burge Fred , Doucet Shelley , Ramsden Vivian R , Bisson Mathieu , Cassidy Monique , Condran Brian , Lambert Mireille , Penney Carla , Sabourin Véronique , Warren Mike , Hudon Catherine
Published: June 2020

Introduction

Case management (CM) in a primary care setting is a promising approach to integrating and improving healthcare services and outcomes for patients with chronic conditions and complex care needs who frequently use healthcare services. Despite evidence supporting CM and interest in implementing it in Canada, little is known about how to do this. This research aims to identify the barriers and facilitators to the implementation of a CM intervention in different primary care contexts (objective 1) and to explain the influence of the clinical context on the degree of implementation (objective 2) and on the outcomes of the intervention (objective 3).

Methods and analysis

A multiple-case embedded mixed-methods study will be conducted on CM implemented in ten primary care clinics across five Canadian provinces. Each clinic will represent a subunit of analysis, detailed through a case history. Cases will be compared and contrasted using multiple analytical approaches. Qualitative data (objectives 1 and 2) from individual semistructured interviews (n=130), focus group discussions (n=20) and participant observation of each clinic (36 hours) will be compared and integrated with quantitative (objective 3) clinical data on services use (n=300) and patient questionnaires (n=300). An evaluation of intervention fidelity will be integrated into the data analysis.

Ethics and dissemination

This project received approval from the CIUSSS de l'Estrie – CHUS Research Ethic Board (project number MP-31-2019-2830). Results will provide the opportunity to refine the CM intervention and to facilitate effective evaluation, replication and scale-up. This research provides knowledge on how to resp ond to the needs of individuals with chronic conditions and complex care needs in a cost-effective way that improves patient-reported outcomes and healthcare use, while ensuring care team well-being. Dissemination of results is planned and executed based on the needs of various stakeholders involved in the research.
Onsite telemedicine strategy for coronavirus (COVID-19) screening to limit exposure in ED
Authors: Chou Eric , Hsieh Yu-Lin , Wolfshohl Jon , Green Fonda , Bhakta Toral
Published: June 2020

Coronavirus (severe acute respiratory syndrome coronavirus 2) outbreak is a public health emergency and a global pandemic. During the present coronavirus disease (COVID-19) crisis, telemedicine has been recommended to screen suspected patients to limit risk of exposure and maximise medical staff protection. We constructed the protective physical barrier with telemedicine technology to limit COVID-19 exposure in ED. Our hospital is an urban community hospital with annual ED volume of approximately 50 000 patients. We equipped our patient exam room with intercom and iPad for telecommunication. Based on our telemedicine screening protocol, physician can conduct a visual physical examination on stable patients via intercom or videoconference. Telemedicine was initially used to overcome the physical barrier between patients and physicians. However, our protocol is designed tocreatea protective physical barrier to protect healthcare workers and enhance efficiency in ED. The implementation can be a promising protocol in making ED care more cost-effective and efficient during the COVID-19 pandemic and beyond.
TMEM16A deficiency: a potentially fatal neonatal disease resulting from impaired chloride currents
Authors: Park Julien H , Ousingsawat Jiraporn , Cabrita Inês , Bettels Ruth E , Große-Onnebrink Jörg , Schmalstieg Christian , Biskup Saskia , Reunert Janine , Rust Stephan , Schreiber Rainer , Kunzelmann Karl , Marquardt Thorsten
Published: June 2020

Introduction

TMEM16A is a calcium-activated chloride channel expressed in various secretory epithelia. Two siblings presented in early infancy with reduced intestinal peristalsis and recurrent episodes of haemorrhagic diarrhoea. In one of them, the episodes were characterised by hepatic pneumatosis with gas bubbles in the portal vein similar to necrotising enterocolitis of the newborn.

Methods

Exome sequencing identified a homozygous truncating pathogenic variant in ANO1. Expression analysis was performed using reverse transcription PCR, western blot and immunohistochemistry. Electrophysiological and cell biological studies were employed to characterise the effects on ion transport both in patient respiratory epithelial cells and in transfected HEK293 cells.

Results

The identified variant led to TMEM16A dysfunction, which resulted in abolished calcium-activated Cl− currents. Secondarily, CFTR function is affected due to the close interplay between both channels without inducing cystic fibrosis (CF).

Conclusion

TMEM16A deficiency is a potentially fatal disorder caused by abolished calcium-activated Cl− currents in secretory epithelia. Secondary impairment of CFTR function did not cause a CF phenotyp, which may have implications for CF treatment.
Field monitoring of the ground vibrations adjacent to an onshore wind turbine foundation
Authors: He Pengpeng , González-Hurtado Jesús , Newson Tim , Hong Hanping , Postman Melanie , Molnar Sheri
Published: June 2020

Investigations of the soil–foundation interaction behaviour of wind turbine foundations and transfer of energy from the wind to the ground have not been reported in Canada. Indeed, very few vibration monitoring studies have been conducted globally around wind farms. It has been found that turbines predominantly produce vibrations related to structural resonances and blade-passing frequencies. Energy is found to be modified with distance and is dominated by surface waves. This paper describes a study of the effect of wind–structure interaction on the behaviour of a turbine foundation and the generation of ground-based vibrations around a working commercial wind turbine in Ontario. The field monitoring system and meteorological instrumentation are described in this paper and the responses of the structure and surrounding ground due to the fluctuating wind-field are discussed. The spectral analysis shows that the higher frequency vibrations attenuate more rapidly than the lower frequency vibrations. The tilted elliptical particle motions are found to be non-Gaussian because of the non-Gaussian wind conditions. The response attenuation with distance indicates that both geometric and material attenuation may dominate the vibration attenuation in the near field and only geometric attenuation occurs in the far field.
Experimental investigation of the internal tube flow effect on the vibration response of tubes in a shell and tube heat exchanger
Authors: Ali Nouman , Khushnood Shahab , Nizam Luqman Ahmad , Bashir Shahid , Hafeez Akmal
Published: June 2020

In shell and tube heat exchangers, tube bundles often fail due to flow-induced vibrations. In the current study, the vibration response of tubes, placed in the first and third rows of the tube bundle, has been examined having a normal triangular arrangement with a pitch-to-diameter (P/D) ratio of 1.44. Each tube was tested at three different internal flow velocities of 0.85, 0.9, and 1 m/s and five shell-side velocities ranging from 0.9 to 1.3 m/s with an increment of 0.1 m/s. This is the first experiment of its kind that offers insight into the vibration behavior of the glass tubes of a shell and tube heat exchanger. Experimental analysis shows that tubes with internal flow vibrate with higher amplitudes than tubes without internal flow. Furthermore, the vibration amplitude of the tube tends to rise with increasing internal tube velocity, even for the same shell-side velocity. For the current range of shell- and tube-side velocities, with the internal flow from the tube, the hydrodynamic mass of the tube increases significantly with enhanced damping and contributes toward the stability of the tubes in cross-flow, the stability threshold is delayed and higher shell-side velocities are allowed to enhance the heat transfer rate.